American journal of preventive medicine
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Multicenter Study Comparative Study
A Comparison of Black and White Racial Differences in Health Lifestyles and Cardiovascular Disease.
This study examines the health lifestyles of a cohort of blacks and whites in relation to cardiovascular disease (CVD). The link between health lifestyles and CVD is well established, but most of the focus has been on SES and more research is needed on racial differences. ⋯ Health lifestyles differ by race and support the exploratory hypothesis that distinct classes of healthy-unhealthy lifestyles exist within each racial group.
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Comparative Study
Perceived Discrimination and Privilege in Health Care: The Role of Socioeconomic Status and Race.
This study examined how perceived racial privilege and perceived racial discrimination in health care varied with race and socioeconomic status (SES). ⋯ SES is an important social determinant of perceived privilege and perceived discrimination in health care, but its role varies by indicator and racial group. Whites with low education or no health insurance, well-educated blacks, and individuals who face cost-related barriers to care are at increased risk of perceived discrimination. Policies and interventions to reduce these perceptions should target structural and systemic factors, including society-wide inequalities in income, education, and healthcare access, and should be tailored to account for racially specific healthcare experiences.
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Comparative Study
Sociodemographic Patterns of Chronic Disease: How the Mid-South Region Compares to the Rest of the Country.
States in the Mid-South region are among the least healthy in the nation. This descriptive study examines sociodemographic differences in the distribution of chronic diseases and health-related behaviors in the Mid-South versus the rest of the U.S., identifying subgroups at increased risk of chronic disease. ⋯ Future studies should test tailored interventions to address the specific needs of population subgroups in order to improve their health.
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Randomized Controlled Trial
A Cluster Randomized Trial of a Personalized Multi-Condition Risk Assessment in Primary Care.
Personal risk for multiple conditions should be assessed in primary care. This study evaluated whether collection of risk factors to generate electronic health record (EHR)-linked health risk appraisal (HRA) for coronary heart disease, diabetes, breast cancer, and colorectal cancer was associated with improved patient-provider communication, risk assessment, and plans for breast cancer screening. ⋯ Patient-reported risk factors and EHR-linked multi-condition HRAs in primary care can modestly improve communication and promote accuracy of self-perceived risk.
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The relationship between low income and worse health outcomes is evident, yet its association with cognitive outcomes is less explored. Most studies have measured income at one time and none have examined how sustained exposure to low income influences cognition in a relatively young cohort. This study examined the effect of sustained poverty and perceived financial difficulty on cognitive function in midlife. ⋯ Cumulative exposure to low income over 2 decades was strongly associated with worse cognitive function of a relatively young cohort. Poverty and perceived hardship may be important contributors to premature aging among disadvantaged populations.