Journal of racial and ethnic health disparities
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J Racial Ethn Health Disparities · Aug 2019
Socioeconomic, Racial, and Ethnic Disparities in Postpartum Readmissions in Patients with Preeclampsia: a Multi-state Analysis, 2007-2014.
Childbirth is the most common reason for hospitalization for reproductive-aged women, with about 4 million annual deliveries nationally. Hypertension is the leading indication for postpartum readmission and therefore women with preeclampsia are at high risk for readmission. Social determinants of health are associated with increased readmission in postpartum patients; however, no study has specifically investigated readmissions in this higher risk group of patients. We sought to evaluate the effect of social determinants of health on postpartum readmissions in all postpartum patients and in a subgroup analysis of those with a diagnosis of preeclampsia. ⋯ The present study has shown that socioeconomic and racial/ethnic disparities exist in postpartum readmissions. These findings additionally exist among the already highest-risk preeclamptic patients. Future research should further elucidate this relationship and develop amelioration strategies.
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J Racial Ethn Health Disparities · Aug 2019
Spanish-Speaking Caregivers' Experience with an Emergency Department Pediatric Asthma-Care Bundle Quality Initiative.
Most pediatric emergency departments' (ED) quality improvement (QI) initiatives for asthma aim to standardize care based on the priorities of healthcare providers. Perceptions and priorities of the caregiver rarely are addressed, especially in families with limited English-language proficiency. We explored Spanish-speaking caregivers' perceptions, understandings, and barriers with the care they received for asthma, after exposure to an ED asthma-care bundle. ⋯ Three themes emerged regarding the caregivers' perceived barriers: (1) need for improved accessibility to medication, primary care, and insurance; (2) communication barriers, such as timeliness, availability of interpreters, and need for resources in their preferred language; and (3) uncertainty about the child's diagnosis and acuity. Incorporating the caregivers' perspectives into QI projects may yield valuable information when developing new interventions. In the ED, improving accessibility to interpreters and providing discharge materials in their preferred language, as well as addressing misconceptions about asthma, may enhance caregivers' satisfaction.
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J Racial Ethn Health Disparities · Jun 2019
Comparative StudyComparisons of Conditioned Pain Modulation and Physical Activity Between Hispanic and Non-Hispanic White Adults.
It is well-documented that adults of racial/ethnic minorities experience pain more frequently and suffer from more severe pain compared to non-Hispanic White (NHW) adults. These observations are consistent with laboratory findings that adults of racial/ethnic minorities show increased sensitivity to laboratory pain stimuli compared to NHW adults. Research generally shows that central pain inhibitory processing, as quantified using conditioned pain modulation (CPM), serves as a risk factor of clinical pain. ⋯ Results indicated that Hispanic and NHW adults exhibited comparable CPM responses and PA levels, along with similar levels of pain catastrophizing and dispositional optimism (p > 0.05). These results suggest that young, healthy Hispanic and NHW adults may possess a similar risk of clinical pain when they are comparable in PA, pain catastrophizing, and dispositional optimism. More research is needed to explore the role of PA in racial/ethnic disparities in clinical pain and central pain inhibitory processing.
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J Racial Ethn Health Disparities · Apr 2019
Awareness of Racial Disparities in Diabetes Among Primary Care Residents and Preparedness to Discuss Disparities with Patients.
Many healthcare providers lack the awareness of health disparities among their patients that precedes action to improve outcomes. Limited health disparities training is a probable contributor. We assessed primary care residents' awareness of racial and ethnic disparities in diabetes, their perceived preparedness to discuss health disparities with patients, and their preferences for training and resources to improve their preparedness. ⋯ Residents indicated that having information regarding how to discuss and address health disparities would make them feel more prepared. Cultural competency training and experiential learning were the most preferred methods to learn how to identify and address health disparities. Future health disparities training should focus on improving residents' preparedness to address health disparities in their clinical practice using culturally relevant communication tools and experiential learning opportunities.
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J Racial Ethn Health Disparities · Apr 2019
Psychological Therapy in Secondary Mental Health Care: Access and Outcomes by Ethnic Group.
To explore the differences in access to, and outcomes of, psychological therapy for different ethnic groups across a South London Mental Health Trust. ⋯ Across the Trust, there were significant differences in the proportion of ethnic groups in accessing psychological therapy, as well as in outcomes. More research is needed to understand the factors that may underlie these disparities.