Search

Background: Whether and how much past slavery affects contemporary social and economic conditions in the United States is an area of active debate. Newly available data on which members of the United States Congress are descendants of slaveholders provides an opportunity to examine this topic. This study sought to determine the relationship between slaveholder ancestry and net worth among members of Congress. Methods: Total assets and liabilities were collected from financial declarations of all members of Congress as of April 15, 2021. Net worth was estimated as the difference between total assets and liabilities. Information on slaveholder ancestry was obtained from a Reuters investigative series based on an extensive review of historical documents and verification by board-certified genealogists. Quantile regression was used to determine the association between net worth and slaveholder ancestry after adjustment for demographic factors. Results: The median net worth of the 535 members of Congress was $1.28 million (interquartile range $0.11–5.87 million). On univariate analysis, net worth was associated with increased age, White race, increased education, and number of individuals enslaved by ancestors. On multivariate analysis, net worth was independently associated with age, White race, and number enslaved. Legislators whose ancestors enslaved 16 or more individuals had a $3.93 million (95% confidence interval 2.39–5.46) higher net worth compared to legislators whose ancestors were not slave owners after adjustment for age, sex, race, ethnicity, and education. Conclusions: Past slaveholding practices are independently associated with current wealth among members of Congress. Because members of Congress are a highly selected group, further work is needed to understand how slaveholder ancestry affects current wealth in the general population to inform efforts to reduce social and economic disparities. [ABSTRACT FROM AUTHOR]

Many low-income adults who smoke also have unmet social needs, such as food insecurity, which can serve as a barrier to smoking cessation. We developed a novel intervention to jointly address smoking cessation and food insecurity and assessed its feasibility, acceptability, and preliminary outcomes. We enrolled participants who screened for food insecurity, reported smoking daily, and were ready to quit. All participants received 3 months of resources navigation from a community health worker through monthly telephone calls for referrals and check-ins for smoking cessation and food access resources. Participants randomized to the intervention group received an economic intervention equivalent to the cost of 1 week of groceries/month for 3 months. We randomized 55 participants who were smoking on average 13 cigarettes/day. The trial was feasible and acceptable based on 3-month retention rates (80%) and end-of-study qualitative feedback (91% would recommend the study to others). At 3 months, participants in the intervention versus control group reported a longer length of abstinence from smoking and had a higher proportion of serious quit attempts. Results from this pilot study suggest the importance of attending to social needs, particularly food insecurity, as a strategy to promote smoking cessation among low-income adults who smoke. [ABSTRACT FROM AUTHOR]

We examined the influence of racial and ethnic identity of residents and housing market economic conditions on redlining. Data were extracted from archival area description forms from the Home Owners' Loan Corporation for 568 Ohio neighborhoods from 1934–1940. Logistic regression analysis was used to analyze the relationships between neighborhood characteristics and redlining. Bivariate results indicated a strong association between the presence of African American residents and neighborhood redlining (OR = 40.9, 95% CI 22.9-72.8). Multivariable analysis demonstrated that some neighborhood characteristics were contributors to the decision to redline, including homes in poor condition (OR = 4.3, 95% CI 1.2-15.1), home vacancy (OR = 1.4, 95% CI 1.1-1.6), and housing prices (per thousand dollars) (OR = 0.7, 95% CI 0.4-1.2). Adjusting for these and other factors, the presence of African American residents remained a powerful predictor of redlining (OR = 13.8, 95% CI 4.4-42.8). Racial discrimination was the overriding factor in decisions to redline neighborhoods. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: Many health systems screen patients for social determinants of health and refer patients with social needs to community service organizations for assistance. We developed a framework based on sequential steps to evaluate this process. Methods: We reviewed efforts by The MetroHealth System in Cleveland, Ohio and identified 6 sequential steps: patient screened, has social needs, consents to referral to a service organization, referral placed, referral accepted, and referral outcome. Referral outcomes were categorized as resolved (organization provided requested service or patient self-resolved problem), or unresolved (patient unable to be contacted or declined assistance). We then determined the numbers of patients with food insecurity who completed each step, how completion differed by patient characteristics and service organization, and reasons for failure to complete specific steps. Results: We used the framework to evaluate screening and assistance steps among 5741 patients who attended a COVID-19 vaccine clinic from February 15-March 31, 2021 and were followed through April 30, 2021. The percentage of patients who completed each step ranged from 17-98%. Step completion differed by patient age, patient race, and clinic. Of 360 referrals accepted by community organizations, 98 (27%) were resolved. The most common reasons for unresolved referrals were inability of service organization to contact patients (151), no reason stated (71), and patients declined service (30). Conclusions: A framework based on sequential steps may be used to evaluate social determinants of health screening and assistance programs. Further work is needed to address reasons for failure to complete steps, to include patient perspectives, and to determine long-term outcomes. [ABSTRACT FROM AUTHOR]

Background: Hyperparathyroid crisis (HPTC) is a potentially lethal condition characterized by severe symptomatic hypercalcemia with calcium levels ≥14 mg/dl. We sought to determine the rate of HPTC and how it differs from hyperparathyroidism (HPT) without crisis (HPTWC)., Methods: A retrospective review of patients with surgically treated HPT from 1990 to 2022 was completed., Results: HPTC occurred in 18 (2.4%) of 783 with primary HPT. Patients with HPTC had higher preoperative calcium and parathyroid hormone levels, lower postoperative calcium levels, larger gland weights and higher rates of ectopic glands, carcinoma, recurrence and mortality compared to patients with HPTWC (all p < 0.05)., Conclusions: HPTC is a rare condition manifested by severe HPT that is associated with a higher rate of recurrence and mortality compared to HPTWC. HPTC is associated with larger parathyroid glands that are more often ectopic and malignant., (Copyright © 2022 Elsevier Inc. All rights reserved.)