J Natl Med Assoc
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Ecologic studies have examined the relationship across states between levels of household gun ownership and suicide rates using household gun ownership data from the Behavioral Risk Factor Surveillance System (BFRSS) or proxies. However, no study has examined how race-specific survey-based or proxy measures of gun ownership are related to race-specific suicide rates. ⋯ For White adults, states with higher levels of measured household gun ownership have higher overall suicide rates. This relationship does not hold for Black adults, largely due to a more attenuated correlation between these measures of firearm availability and firearm suicide rates coupled with a more substantial countervailing (inverse) relationship between these measures and non-firearm suicide rates. Future efforts using individual level data might help determine why this puzzling difference exists, especially for young Black adults.
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Pancreatic ductal adenocarcinoma (PDAC) is currently the third leading cause of cancer mortality and the incidence is projected to increase by 2030. Despite recent advances in its treatment, African Americans have a 50-60% higher incidence and 30% higher mortality rate when compared to European Americans possibly resulting from differences in socioeconomic status, access to healthcare, and genetics. Genetics plays a role in cancer predisposition, response to cancer therapeutics (pharmacogenetics), and in tumor behavior, making some genes targets for oncologic therapeutics. ⋯ Our findings suggest that the genetic profiles of African Americans may contribute to disparities related to FDA approved chemotherapeutic response for patients with PDAC. We recommend a strong focus on improving genetic testing and participation in biobank sample donations for African Americans. In this way, we can improve our current understanding of genes that influence drug response for patients with PDAC.
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As healthcare systems become more complex, medical education needs to adapt in many ways. There is a growing need for more formal leadership learning for healthcare providers, including greater attention to health disparities. An important challenge in addressing health disparities is ensuring inclusive excellence in the leadership of healthcare systems and medical education. ⋯ Also consistently noted, through qualitative assessments, are broader healthcare system knowledge and shared tactics for addressing common challenges among Scholars. This case example shows that the promotion of leadership equity may jointly enhance professional development while creating opportunities for systems change within academic medical centers. Such an approach can be a potential model for academic medical institutions and other healthcare schools seeking to promote leadership equity and inclusion.
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Comparative Study
Inpatient outcomes comparing White and Black patients with obesity hospitalized for COVID-19 infection.
Comparisons between Black and White patients with obesity hospitalized with COVID-19 have not been fully studied. We sought to determine outcomes differences between these two groups. ⋯ During the first year of the pandemic, Black patients with obesity and COVID-19 were less likely to die during the incident hospitalization but used greater hospital resources compared to White patients.
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Black Americans have a higher prevalence of diabetes compared to White Americans and have higher rates of complications and death. Exposure to the criminal legal system (CLS) is a social risk factor for chronic disease morbidity and mortality with significant overlap with populations most likely to experience poor diabetes outcomes. However, little is known about the association between CLS exposure and healthcare utilization patterns among U.S. adults with diabetes. ⋯ Among those with diabetes, lifetime CLS exposure is associated with higher ED and inpatient visits in unadjusted analyses. Adjusting for socioeconomic status and clinical confounders attenuated these relationships, thus more research is needed to understand how CLS exposure interacts with poverty, structural racism, addiction and mental illness to influence health care utilization for adults with diabetes.