Browsing by Subject "Race/Ethnicity"
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Item Open Access Racial-ethnic differences in health-related quality of life among adults and children with glomerular disease.(Glomerular diseases, 2021-08) Krissberg, Jill R; Helmuth, Margaret E; Almaani, Salem; Cai, Yi; Cattran, Daniel; Chatterjee, Debanjana; Gbadegesin, Rasheed A; Gibson, Keisha L; Glenn, Dorey A; Greenbaum, Laurence A; Iragorri, Sandra; Jain, Koyal; Khalid, Myda; Kidd, Jason M; Kopp, Jeffrey B; Lafayette, Richard; Nestor, Jordan G; Parekh, Rulan S; Reidy, Kimberly J; David T Selewski; John Sperati, C; Tuttle, Katherine R; Twombley, Katherine; Vasylyeva, Tetyana L; Weaver, Donald Jack; Wenderfer, Scott E; O'Shaughnessy, Michelle MIntroduction
Disparities in health-related quality of life (HRQOL) have been inadequately studied in patients with glomerular disease. The aim of this study was to identify relationships between race/ethnicity, socioeconomic status, disease severity, and HRQOL in an ethnically and racially diverse cohort of patients with glomerular disease.Methods
Cure Glomerulonephropathy (CureGN) is a multinational cohort study of patients with biopsy-proven glomerular disease. Associations between race/ethnicity and HRQOL were determined by the following: 1. Missed school or work due to kidney disease; 2. Responses to Patient Reported Outcomes Measurement Information System (PROMIS) questionnaires. We adjusted for demographics, socioeconomic status, and disease characteristics using multivariable logistic and linear regression.Results
Black and Hispanic participants had worse socioeconomic status and more severe glomerular disease than White or Asian participants. Black adults missed work or school most frequently due to kidney disease (30% versus 16-23% in the other three groups, p=0.04), and had the worst self-reported global physical health (median score 44.1 versus 48.0-48.2, p<0.001) and fatigue (53.8 versus 48.5-51.1, p=0.002), compared to other racial/ethnic groups. However, these findings were not statistically significant with adjustment for socioeconomic status and disease severity, both of which were strongly associated with HRQOL in adults. Among children, disease severity but not race/ethnicity or socioeconomic status were associated with HRQOL.Conclusions
Among patients with glomerular disease enrolled in CureGN, the worse HRQOL reported by Black adults was attributable to lower socioeconomic status and more severe glomerular disease. No racial/ethnic differences in HRQOL were observed in children.Item Open Access Trapped Like Monkeys in a Cage: Structural Racism and Mental Health in the Dominican Republic(2017) Childers, Trenita B.Haitian immigrants and their Dominican-born descendants face sociopolitical exclusion in spite of their contribution to the Dominican economy. This project engages three key theoretical perspectives to explain inequality in the Dominican Republic. First, intersectionality theory informs analyses of gender- and nativity-based social factors that influence mental health. Mental health inequalities based on gender and nativity have been documented independently; however, few studies have examined how the intersection of these social locations influences mental health. Results show that contextual factors shape gender- and nativity-related stressors according to intersectional patterns, revealing the importance of intersectional analyses of mental health that include nativity as a site of structural oppression. Next, I use stress process theory to examine how documentation policy is a key driver of negative mental health outcomes among Haitian immigrants and their descendants. Results reveal two major findings. First, documentation policy can act as a primary stressor that yields additional stressors for affected populations. Second, documentation policy can produce the social locations which contribute to compound disadvantage as ethnic Haitians are excluded from multiple domains of social life at once: education, employment, political and social participation. Finally, I apply assimilation theory to examine how the racial context of reception affects immigrant incorporation. Data show that although anti-immigrant sentiment contributes to Haitians’ context of reception in the D.R., immigration officials use race and racialized characteristics to screen for Haitian ancestry. This points to the need to explore the racial context of reception when theorizing inequality among immigrants’ incorporation trajectories. Collective results from this project underscore the importance of including of nativity in intersectional analyses, examining the social consequences of documentation policies, and measuring immigrants’ social contexts comprehensively.