Browsing by Subject "Health and race"
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Item Health disparities between blacks and whites with HIV/AIDS : an analysis of U.S. national health care surveys from 1996-2008(2011-05) Oramasionwu, Christine Uzonna, 1982-; Frei, Christopher R.Blacks are more affected by Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) than any other race or ethnicity in the United States. The purpose of this dissertation was to investigate potential race-based differences in cardiovascular disease (CVD)-related hospitalizations and use of opportunistic infection (OI) prophylaxis between Blacks and Whites with HIV/AIDS. This dissertation includes two systematic literature reviews that identified knowledge gaps in the areas of CVD diagnosis and OI prophylaxis use between Blacks and Whites with HIV/AIDS, as well as two independent studies that addressed some of the gaps identified in the literature. The first study evaluated the association between race and CVD-related hospitalization in Blacks and Whites with HIV/AIDS. Data were retrieved from the 1996-2008 National Hospital Discharge Surveys (NHDS). Approximately 1.5 million hospital discharges were identified. After controlling for confounders, the odds of CVD-related hospitalization were 45% higher for Blacks than Whites (OR=1.45, 95% CI, 1.39-1.51). There was a statistically significant difference in the proportions of CVD-related hospitalization type and race (x2=479.77; df=3; p<0.001). Compared to Whites with HIV/AIDS, Blacks with HIV/AIDS had greater proportions of heart failure and hypertension, but lower proportions of stroke and coronary heart disease. These results suggest that there is an influence of race on both the occurrence and type of CVD-related hospitalizations in patients with HIV/AIDS. The second study assessed if race was associated with the use of OI prophylaxis (Pneumocystis jiroveci pneumonia [PCP] and Mycobacterium avium complex [MAC]). Data for this study were retrieved from the 1996-2008 National Hospital Ambulatory Medical Care Surveys (NHAMCS). Approximately 9.1 million hospital ambulatory visits were identified. After controlling for confounders, the odds of PCP prophylaxis use were 16% higher for Blacks than for Whites (OR=1.16, 95% CI, 1.15-1.17). In a separate regression analysis, the odds of MAC prophylaxis use were 12% higher for Blacks than for Whites (OR=1.12, 95% CI, 1.10-1.13). These findings suggest that Blacks with HIV/AIDS may have increased odds for OI prophylaxis. Based on this work, there is a need for further research to confirm these findings and to identify the causes of these race-based disparities.Item Invisible stronghold : the role of religion in the psychological well-being of Black Americans(2012-05) Henderson-Platt, Andrea K., 1981-; Musick, Marc A.; Ellison, Christopher G.; Hummer, Robert A.; Sakamoto, Art; Butler, John S.; Cokley, KevinFor decades now researchers and clinicians have exhibited mounting interest in understanding the mental health status of Black Americans and the socio-cultural resources that influence it. Due to its historic and continued importance in the lives of African Americans, evidence suggests that the patterns of religious expression among Black Americans have a measurable impact on a variety of physical and mental health outcomes. Nevertheless, this work is not without its limitations, including its limited focus on just the additive effects of religion on health as well as ignoring the issue of ethnic heterogeneity among Blacks in the U.S. Specifically, this work consists of three discrete chapters examining the multifaceted influence of religious involvement and stress on three dimensions of psychological well-being among Black Americans. Using two conceptual models from the life stress paradigm, this work addresses two research questions: (a) Does religion involvement offset, either partly or entirely, the effect of stress on the psychological well-being of Black Americans?, and (b) Does religious involvement buffer (or mitigate) the deleterious effects of stress on the psychological well-being of Black Americans? The questions are assessed using multiple methodologies and data from two large-scale surveys with nationally representative samples of Black Americans. The results reveal that religion plays a unique role in fostering the psychological well-being of Black Americans and may be particularly salient in the face of stress. Specifically, in the first study, religious attendance and religious support are positively associated with the life satisfaction of African Americans, while subjective religiosity was found to buffer the harmful effects of family-work conflict on life satisfaction. The second study examines the interplay of religious involvement, childhood adversity, and self-perception. The results reveal that religious attendance and subjective religiousness do indeed protect against deleterious effects childhood adversity on psychological well-being. However, other aspects of religious involvement, specifically religious upbringing, exude the opposite effect. The final chapter, on religion, racial discrimination and substance abuse, finds religious involvement deters substance abuse among Black Americans, however little support was found for religion in mitigating the effects of discrimination on substance abuse. Study implications and future directions are discussed.Item Relation of acculturation, perceived benefits and barriers, self-efficacy, social support, and beliefs about physical activity to physical activity levels of college-aged Hispanic and non-Hispanic women(2011-05) Velasquez, Katherine Elizabeth Serna, 1961-; Holahan, Carole K.; Bartholomew, John; Loukas, Alexandra; Beretvas, Susan N.; Harrison, Tracie C.Two overall national health goals are to increase the quality and years of healthy life and to eliminate health disparities. Physical inactivity is a leading cause of disability and death due to its relationship with overweight and chronic disease. Hispanic women are less physically active than Hispanic men and Anglo women in leisure time physical activity and recommended levels of physical activity (PA). From a developmental perspective, understanding prevalence and correlates of PA in emerging adulthood may make a significant contribution to increasing PA as women move into full adulthood. The Health Promotion Model (HPM) advanced by Pender provided the framework for examining beliefs about PA and other correlates of PA. This study also developed and tested a scale measuring beliefs about PA (BPA) that tried to access cultural differences between non-Hispanic and Hispanic women. The study was carried out by electronic solicitation to randomly selected non-Hispanic and Hispanic students from 3 southwestern universities and yielded 237 complete online surveys. Instruments comprising the survey included the Short-version of the International PA Questionnaire (IPAQ), Exercise Benefits and Barriers Scale (EBBS), Self-Efficacy for Exercise (SEE), Social Support for Exercise Survey for Family and Friends (SSFA, SSFR), BPA, the Acculturation Rating Scale for Mexican Americans (ARSMA II), and questions about SES. Statistical procedures included factor analysis, t-tests, and multi-sample path analysis. Respondents included 80 non-Hispanic and 157 Hispanic women, aged 18-27. Factor analysis of the BPA produced 7 subscales accounting for 68% of the explained variance (spirituality, role enhancement, socialization preferences, personal benefits, cultural beliefs, exercise difficulty, and women’s roles). Independent sample t-tests indicated group means for spirituality and cultural beliefs significantly differed, as did total BPA, acculturation, & SES. Path analysis provided evidence for a model with good fit for both groups. Significant path coefficients to vigorous PA included benefits, SE, and SSFA. Total indirect effects for SES to vigorous PA through SE and SSFA were significant. Acculturation, SES, SSFR, and BPA were not significant predictors of vigorous PA.