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Author(s): Cini Bhanu 1,*, Dipesh P. Gopal 2, Kate Walters 1, Umar A. R. Chaudhry 3 Introduction Individuals from minority ethnic backgrounds are at increased risk of contracting coronavirus disease [...], Background Older adults from minority ethnic backgrounds are at increased risk of contracting COVID-19 and developing severe infection and have increased risk of mortality. Whilst an age-based vaccination approach prioritising older groups is being implemented worldwide, vaccine hesitancy is high amongst minority ethnic groups. Methods and findings We conducted a systematic review and convergent synthesis to systematically examine perceptions of vaccinations amongst older adults from minority ethnic backgrounds. We included studies that reported on perceptions, beliefs, and attitudes towards vaccinations in older adults aged [greater than or equal to]65 years from a minority ethnic background. We excluded studies of vaccinations in investigation or development, studies focused on specific medical conditions, studies where ethnic background or age group was unidentifiable, systematic reviews, editorials, and conference abstracts. We searched MEDLINE, Embase, Virtual Health Library, Web of Science, Cochrane Library, medRxiv, and PROSPERO databases from inception to 15 July 2021. Risk of bias for studies was assessed using the Mixed Methods Appraisal Tool. The quality of evidence of collective outcomes was estimated using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) framework. A total of 28 eligible studies conducted between 1997 and 2020 were included in the final analysis (17 quantitative surveys, 8 focus group or interview studies, 2 mixed methods studies, and 1 case-control study). The majority were US studies in English or Spanish, except for 6 studies set in Hong Kong, 2 studies in Japan, 1 study in Brazil, and 1 multi-centre study (including China, Indonesia, Turkey, South Korea, Greece, UK, Brazil, and Nigeria). In total, 28,262 individuals with an estimated mean age of 69.8 years were included, 63.2% of whom were female. We summarised the common concepts and themes across studies and populations using a convergent synthesis analysis. Thirteen themes categorised as barriers or facilitators were identified and grouped into structural factors-healthcare provider and system related, patient related, and policy and operational-and were analysed by minority ethnic group. The main limitation of the study was the predominance of studies from the US and East Asia. Conclusions In this systematic review, we found that factors influencing vaccination uptake involve healthcare provider and system, patient-related, and governance-level factors that are specific to the older ethnic minority community being served. The evidence included in this review is supported by high or moderate certainty and can be translated to practice and policy. A tailored, multi-level approach combining increased education, access, and culturally competent discussions with trusted healthcare professionals to address health beliefs can maximise the potential impact of widespread vaccination policies.

Physical inactivity represents a well-established risk factor for many chronic health problems, including cardiovascular disease, type 2 diabetes, obesity, and some cancers, and it is a major public health problem [...], This study examined the relationship of race and rural/urban setting to physical, behavioral, psychosocial, and environmental factors associated with physical activity. Subjects included 1,668 eighth-grade girls from 31 middle schools: 933 from urban settings, and 735 from rural settings. Forty-six percent of urban girls and 59% of rural girls were Black. One-way and two-way ANOVAs with school as a covariate were used to analyze the data. Results indicated that most differences were associated with race rather than setting. Black girls were less active than White girls, reporting significantly fewer 30-minute blocks of both vigorous and moderate-to-vigorous physical activity. Black girls also spent more time watching television, and had higher BMIs and greater prevalence of overweight than White girls. However, enjoyment of physical education and family involvement in physical activity were greater among Black girls than White girls. Rural White girls and urban Black girls had more favorable attitudes toward physical activity. Access to sports equipment, perceived safety of neighborhood, and physical activity self-efficacy were higher in White girls than Black girls.

This article examines ethnic differences in total and cause-specific mortality. We employ the linked National Health Interview Survey-National Death Index (NHIS-NDI) to examine ethnic differences in mortality from a combination of demographic, socioeconomic, and health characteristic perspectives. We find that Asian American mortality is low in part because of healthy behaviors and socioeconomic advantages; that Caucasian American mortality is higher partly because of high prevalence and quantity of cigarette smoking; and that Mexican, Native, and African American mortality is higher partly from socioeconomic disadvantages. These results give us added insight into the demographic, social, and health mechanisms that lead us to persevere or to perish., Most mortality research has focused on how demographic characteristics - age, sex, and ethnicity - affect total and cause-specific mortality. But to properly conceptualize the multiple and interacting proximate determinants [...]

The overall purpose of this article is to examine population differences in the risk of infant mortality by race/ethnicity, with special attention given to the influence of nativity. Data are taken from the National Center for Health Statistics (NCHS) linked birth/infant death files for 1989-91. These files cover virtually the entire nation, provide highly reliable data for relatively small racial/ethnic subpopulations, and have recently been updated to include new variables of interest. Results show that there is wide variation in the risk of infant death across racial/ethnic groups, with infants born to black women suffering the highest risks and infants of Japanese women experiencing the lowest risks. It is also clear that nativity has a crucial impact on racial/ethnic differentials in infant mortality. In fact; the favorable infant survival rates of many racial/ethnic groups are largely attributable to a high percentage of births to immigrant women, who are characterized by overall lower infant mortality than native-born women. Both the racial/ethnic differentials in mortality and the effect of nativity, in turn, are due to several sets of factors, the importance of which varies by race/ethnicity. Models of infant mortality estimated separately, by race/ethnicity also revealed that the direction of effects for mortality risk factors tends to be the same across groups, although the magnitudes vary. Thus, it is reasonable to assume that general efforts to lower infant mortality will have a beneficial impact for all groups., Recent years have witnessed increased interest in the health of U.S. minority groups and the foreign-born, in large part due to changing population composition. Currently, about one-fourth of U.S. residents [...]

ABBREVIATIONS. PROS, Pediatric Research in Office Settings; BMI, body mass index; BMI-ZS, body mass index z score. In 1997, Herman-Giddens et al[1] reported evidence that young girls in the United [...], Objective. A recent study conducted by the Pediatric Research in Office Settings network provided evidence that girls in the United States, especially black girls, are starting puberty at a younger age than earlier studies had found, but the reasons for this are not known. Because nutritional status is known to affect timing of puberty and there is a clear trend for increasing obesity in US children during the past 25 years, it was hypothesized that the earlier onset of puberty could be attributable to the increasing prevalence of obesity in young girls. Therefore, the objective of this study was to reexamine the Pediatric Research in Office Settings puberty data by comparing the age-normalized body mass index (BMI-ZS; a crude estimate of fatness) of girls who had breast or pubic hair development versus those who were still prepubertal, looking at the effects of age and race. Results. For white girls, the BMI-ZS were markedly higher in pubertal versus prepubertal 6- to 9-year-olds; for black girls, a smaller difference was seen, which was significant only for 9-year-olds. Higher BMI-ZS also were found in girls who had pubic hair but no breast development versus girls who had neither pubic hair nor breast development. A multivariate analysis confirms that obesity (as measured by BMI) is significantly associated with early puberty in white girls and is associated with early puberty in black girls as well, but to a lesser extent. Conclusions. The results are consistent with obesity's being an important contributing factor to the earlier onset of puberty in girls. Factors other than obesity, however, perhaps genetic and/or environmental ones, are needed to explain the higher prevalence of early puberty in black versus white girls. Pediatrics 2001;108:347-353; puberty, obesity, BMI, breast, pubic hair.

Findings from Europe's largest research project on the health, housing and social care needs of minority ethnic elders across ten countries are published this month, with results from the UK [...]

NASHVILLE, TENN. A $22 million grant announced last month for researchers at Meharry Medical College and Vanderbilt-Ingram Cancer Institute will fund a multistate study to explain why Blacks die of [...]

When Bernadine Healy took over as director of the National Institutes of Health (NIH) a year ago, she promised to increase finding for programs aimed at two groups she said [...]