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Racial disparities in obesity are larger between Black and White college graduates compared to disparities among those who did not complete high school. A possible explanation is that Black adults with higher socioeconomic status (SES) experience unique obesogenic determinants. Black adults who have completed a 4-year college degree can report "uplift stress" from providing financial assistance to family members. The aim of this study is to determine whether the association between familial financial assistance and body mass index (BMI) varies among college-educated Black women and men. This study utilized data from an online survey of Qualtrics standing panels including 451 non-Hispanic Black college graduates. Respondents were asked if they had provided or received any monetary gift or financial help from a family member in the past 12 months as well as their height and weight. Using linear regression and multiplicative interaction terms, the association between familial financial assistance and BMI was assessed by sex. Those who reported both giving and receiving familial financial assistance had higher BMI than those who neither gave nor received assistance (β = 2.80, standard error (s.e.) = 1.16). There was a significant interaction such that this association was observed among women only (β = 6.67, s.e. = 2.32). Future studies should seek to understand the gendered impact of familial financial assistance on BMI in college-educated Black women., (© 2021. W. Montague Cobb-NMA Health Institute.)

The objective of this study was to examine the association between discrimination and obesity among a U.S. nationally representative sample of African-American men. Data from the 2001-2003 National Survey of American Life (NSAL) were used to collect measures of everyday and major discrimination, and body mass index (BMI) taken from self-reports. Poisson regression with robust standard errors was applied to estimate the prevalence ratios of everyday and major discrimination as it relates to obesity (BMI ≥ 30 kg/m 2 ), controlling for potential confounders. In the model that included both everyday and major discrimination, men who experienced any major discrimination had a higher likelihood of obesity (prevalence ratio [PR] = 1.33, 95% confidence interval [CI], 1.06, 1.66) than those who did not experience any major discrimination, controlling for age, marital status, income, education, major stressors, two or more chronic conditions, and physical activity. Exposure to any major discrimination was found to be associated with obesity in African-American men. Future studies among this population are needed to examine whether the observed changes in self-reports of major discrimination are associated with obesity, measured by BMI, over time. The health of African-American men must be a priority in reducing excess disparities in disease, disability, and death.

Disparities in men's health research may inaccurately attribute differences in chronic conditions to race rather than the different health risk exposures in which men live. This study sought to determine whether living in the same social environment attenuates race disparities in chronic conditions among men. This study compared survey data collected in 2003 from black and white men with similar incomes living in a racially integrated neighborhood of Baltimore to data from the 2003 National Health Interview Survey. Multivariable logistic regression models estimated to determine whether race disparities in chronic conditions were attenuated among men living in the same social environment. In the national sample, black men exhibited greater odds of having hypertension (odds ratio [OR] = 1.58, 95% confidence interval [CI] 1.34, 1.86) and diabetes (OR = 1.62, 95% CI 1.27-2.08) than white men. In the sample of men living in the same social context, black and white respondents had similar odds of having hypertension (OR = 1.05, 95% CI 0.70, 1.59) and diabetes (OR = 1.12, 95% CI 0.57-2.22). There are no race disparities in chronic conditions among low-income, urban men living in the same social environment. Policies and interventions aiming to reduce disparities in chronic conditions should focus on modifying social aspects of the environment.

Background: Disparities in health among blacks and Hispanics compared to whites individuals exist for a number of health measures; however, the health profile of individuals who are both black and Hispanic is not well known. We sought to determine whether race and ethnicity have synchronous or independent effects on health-related outcomes., Methods: We combined the National Health Interview Survey for 2000-2007 to identify 896 black Hispanics. We selected health-related outcomes where white Hispanics and non-Hispanic blacks significantly differed. We computed adjusted prevalence estimates for black Hispanics and compared them to determine whether their health-related outcomes more closely resemble white Hispanics or non-Hispanic blacks. All prevalence estimates were adjusted for age, sex, education, marital status, income and survey year., Results: Black Hispanics' health behaviours resembled white Hispanics or were similar to both white Hispanics and non-Hispanic blacks. For health services outcomes, they resembled non-Hispanic blacks. However, their health status was influenced by both race and ethnicity, with black Hispanics resembling both white Hispanic and non-Hispanic black people., Conclusion: We conclude that health behaviour interventions incorporating knowledge of Hispanic cultures may be sufficient to reach black Hispanics. However, health services or health status, interventions targeted broadly to Hispanic people may not be sufficient. In some respects black Hispanic people comprise a distinct subgroup that may require targeted attention in public health interventions.

Background: National data do not account for race differences in health risks resulting from racial segregation or the correlation between race and socioeconomic status. Therefore, these data may inaccurately attribute differences in obesity to race rather than differing social context. The goal of this study was to investigate whether race disparities in obesity among women persist in a community of black people and white people living in the same social context with similar income., Methods: Race disparities in obesity were examined among black women and white women living in the same social context with similar income, using the data from the Exploring Health Disparities in Integrated Communities-SWB (EHDIC-SWB) study, and these estimates were compared to national data (National Health Interview Survey) to determine if race disparities in obesity were attenuated among women in EHDIC-SWB. Obesity was based on participants' self-reported height and weight. Logistic regression was used to examine the association between race and obesity., Results: In the national sample, black women exhibited greater odds of being obese (OR 1.99, 95% CI 1.71 to 2.32) than white women after controlling for covariates. In the EHDIC-SWB sample, black women had similar odds of being obese (OR 1.25, 95% CI 0.90 to 1.75) as compared to white women, after adjusting for covariates., Conclusions: There are no race disparities in obesity among poor, urban women sharing the same social context. Developing policies that focus on modifying social aspects of the environment may reduce disparities in obesity among low-income women living in urban communities.

Background: Social support is an important determinant of health, yet understanding of its contribution to racial disparities in hypertension is limited. Many studies have focused on the relationship between hypertension and social support, or race/ethnicity and social support, but few have examined the inter-relationship between race/ethnicity, social support, and hypertension. The objective of this study was to determine whether the relationship between race/ethnicity and hypertension varied by level of social support., Methods: Data from the National Health and Nutrition Examination Survey (NHANES) 2001-2006 were used to calculate the odds ratios (ORs) for the association between hypertension and race/ethnicity by levels of social support. Hypertension was defined as systolic blood pressure (BP) >or=140 mm Hg and/or diastolic BP >or=90 mm Hg or having been prescribed antihypertensive medication. Social support was defined by emotional and financial support, and marital status., Results: Black/white ORs of hypertension increased as social support decreased; that is, the race difference among those without social support was larger compared to those with social support. Contrarily, Mexican American/white ethnic differences were only observed among those with social support; Mexican Americans with social support had lower odds of hypertension than their white counterparts., Conclusions: This study observed that the relationship between race (but not ethnicity) and hypertension varies by social support level. Results suggest there may be beneficial effects of social support on hypertension among blacks, however, the possible impact of social support on ethnic differences in hypertension remains unclear.

Background: We deployed a study design that attempts to account for racial differences in socioeconomic and environmental risk exposures to determine if the diabetes race disparity reported in national data is similar when black and white Americans live under similar social conditions., Design & Methods: We compared data from the 2003 National Health Interview Survey (NHIS) with the Exploring Health Disparities in Integrated Communities-Southwest Baltimore (EHDIC-SWB) Study, which was conducted in a racially-integrated urban community without race differences in socioeconomic status., Results: In the NHIS, African Americans had greater adjusted odds of having diabetes compared to whites (OR: 1.61, 95% CI: 1.26-2.04); whereas, in EHDIC-SWB white and African Americans had similar odds of having diabetes (OR: 1.07, 95% CI: 0.71-1.58). Diabetes prevalence for African Americans was similar in NHIS and EHDIC-SWB (10.4%, 95%CI: 9.5-11.4 and 10.5%, 95%CI: 8.5-12.5, respectively). Diabetes prevalence among whites differed for NHIS (6.6%, 95%CI: 6.2-6.9%) and EHDIC-SWB (10.1%, 95%CI: 7.6-12.5%)., Conclusions: Race disparities in diabetes may stem from differences in the health risk environments that African Americans and whites live. When African Americans and whites live in similar risk environments, their health outcomes are more similar.

Background: The health pessimism hypothesis suggests that Black elders are more pessimistic about health than Whites and therefore tend to report lower self-rated health (SRH) at comparable health status. The current analysis examined the factors associated with SRH and tested the health pessimism hypothesis among older adults at similar levels of physical functioning., Methods: The study example included 2,729 Health, Aging, and Body Composition study participants aged 70-79 years. We used hierarchical logistic regression to examine the association between race and SRH while adjusting for demographic, physical health, and psychosocial factors. The analyses were repeated for participants at similar levels of objective functioning to test the health pessimism hypothesis., Results: The association between race and SRH remained independent of physical and psychosocial health variables, with Whites being 3.7 times more likely than Black elders to report favorable SRH. This association was significant at each level of physical functioning and greater at the higher (odds ratio [OR] = 5.5) versus lower (OR = 2.2) levels of functioning., Conclusions: The results suggest greater health pessimism among Black elders and expand previous work by including objective functioning in multidimensional models to deconstruct race variations in the SRH of older adults.

Objectives: The purpose of this study was to investigate the cumulative effects of poverty and family stressors to the later life functional status of African American women., Methods: We used longitudinal data covering a 30-year period for a cohort of 553 African American women with common life experiences. Interviews were conducted with these women as young mothers, as mothers of adolescents, and in early old age (two thirds aged 60+). We classified women as high, usual, or low functioning by using physical and mental health indicators. We examined both timing and duration of poverty and family stressors., Results: Initially these women were largely healthy, but health declines were steeper and occurred earlier for those who were low functioning in later life. Persistent poverty was detrimental to functioning at older ages, as was persistent family stress. Women who left poverty early did not differ in later life functioning from women who were never poor., Discussion: Despite similar earlier life circumstances and health, there was substantial heterogeneity in functioning in early old age. Long-term poverty and family stress were strongly associated with being low functioning. Early poverty and transient family problems did not have lasting health effects, underscoring the plasticity of human development and the importance of interventions that can alter life course trajectories.

Objectives Substantial evidence documents gender and racial disparities in C-reactive protein (CRP), a measure of systemic inflammation, among older adults. Yet, the comparative approaches of these studies may obscure distinct risk and protective factors associated with elevated CRP among older Black Americans. To pinpoint opportunities for intervention, this study utilizes a "within-group approach" to identify the sociodemographic, psychosocial, behavioral, and health-related correlates of elevated CRP among older Black women and men. Method The sample consisted of 2,420 Black respondents aged 51 and older in the Health and Retirement Study (2006–2016). Gender-stratified, random effects logistic regression models were used to examine correlates of elevated CRP (>3.0 mg/L). Results More than 50% of Black women had elevated CRP, and younger age, Medicaid, lower mastery, religiosity, overweight/obesity, physical inactivity, and activities of daily living (ADLs) contributed to elevated CRP among this group. In contrast, elevated CRP was reported among only 37.25% of Black men, for whom financial distress was associated with lower odds of elevated CRP; religiosity, less neighborhood cohesion, current smoking, overweight/obesity, ADLs, and more chronic conditions were associated with greater odds of elevated CRP among this group. Discussion Sociodemographic factors had a limited association with elevated CRP among older Black Americans. Rather, a range of psychosocial, behavioral, and health-related factors were more influential determinants of elevated CRP among older Black Americans. Most notably, findings demonstrate distinct correlates of CRP among Black women and men, underscoring the critical need to further evaluate the risk and protective mechanisms undergirding disparities among this aging population. [ABSTRACT FROM AUTHOR]

Objectives The theory of selective survival suggests that possibly around 70–75 years of age, Blacks may display substantive changes in their pattern of cognitive decline. This study examined the age-graded pattern of cognitive decline within older Blacks by describing a trend that characterizes differences in the change of cognitive decline from ages 51.5 to 95.5, and hypothesized that this age-graded pattern is nonlinear. Method Utilizing 2 waves of longitudinal data from the Baltimore Study of Black Aging, this study used multilevel modeling to test whether the interaction between age and the 3-year study period (time between waves) had a positive effect on changes in inductive reasoning, declarative memory, working memory, and perceptual speed. Results A significant positive interaction between age and wave was found for inductive reasoning, demonstrating an age-grade pattern of change/decline in cognitive pattern for Blacks aged 51.5–95.4. Simple slope probing via the Johnson–Neyman Technique suggested that Black adults ~64 years and younger experienced significant decline in inductive reasoning across study time, whereas for those older than 63.71, the decline was nonsignificant. No significant age–wave interactions were found for declarative memory, working memory, or perceptual speed. Discussion Findings suggest a selective survival effect for inductive reasoning ability among Blacks. With decline evident so early, common cognitive intervention programs targeting adults 65+ may come too late for Blacks, signifying the importance and urgency for early health interventions and public policy designed to promote cognitive reserve. [ABSTRACT FROM AUTHOR]

Objective: To compare predominantly-Black and predominantly-White Maryland areas with similar socioeconomic status to examine the role of both race and socioeconomic status on tobacco outlet availability and tobacco outlet access. Design: Maryland tobacco outlet addresses were geocoded with 2011–2015 American Community Survey sociodemographic data. Two-sample t-tests were conducted comparing the mean values of sociodemographic variables and tobacco outlet density per Census Tract, and spatial lag based regression models were conducted to analyze the direct association between covariables and tobacco outlet density while accounting for spatial dependence between and within jurisdictions. Results: Predominantly-White jurisdictions had lower tobacco outlet availability and access than predominantly-Black jurisdictions, despite similar socioeconomic status. Spatial lag model results showed that median household income and vacant houses had consistent associations with tobacco outlet density across most of the jurisdictions analyzed, and place-based spatial lag models showed direct associations between predominantly-Black jurisdictions and tobacco outlet availability and access. Conclusion: Predominantly-White areas have lower levels of tobacco outlet density than predominantly-Black areas, despite both areas having similar socioeconomic statuses. [ABSTRACT FROM AUTHOR]

Recent studies suggest that religion and spirituality can yield health benefits for young African-Americans. We examined the relationship between religious practices, spirituality, and excess weight among African-American adolescents (N = 212) residing in the Deep South. Results from modified Poisson regression analysis indicate that adolescents who prayed daily had a lower prevalence of excess weight (PR 0.77 [95% CI 0.62–0.96]) than those who did not. This relationship was only significant for 12–15 year-old participants in age-stratified analysis. These findings suggest that preventive interventions offered to children and younger adolescents can have implications for weight status across the lifespan. [ABSTRACT FROM AUTHOR]

Race disparities in self-rated health in the USA are well-documented, such that African Americans rate their health more poorly than whites. However, after adjusting for health status, socioeconomic status (SES), and health behaviors, residual race differences are observed. This suggests the importance of unmeasured variables. Because African Americans and whites tend to live in differing social contexts, it is possible that accounting for social and environmental conditions may reduce racial disparities in self-rated health. Differences in self-rated health among whites and African Americans were assessed in a low-income, urban integrated community (Exploring Health Disparities in Integrated Communities (EHDIC)) and compared with a national sample (National Health Interview Survey (NHIS)). Controlling for demographics, SES, health insurance, status, and behaviors, African Americans in NHIS had higher odds of reporting fair or poor health (odds ratio [OR] = 1.40, 95% confidence interval [CI] = 1.18-1.66) than whites. In EHDIC, there was no race difference in self-rated health (OR = 0.83, 95% CI = 0.63-1.11). These results demonstrate the importance of social context in understanding race disparities in self-rated health. [ABSTRACT FROM AUTHOR]

This study examined whether parental and adolescent stress act as mediators between socio-economic status (SES) and adolescent executive functioning (EF) in urban youth. Two hundred and sixty-seven 6th–11th grade students (ages 11–16, 55.4% female; 49.1% Black/African American) attending racially and socioeconomically diverse schools in Chicago, Illinois, completed self-report measures on urban stress and EF. Parents of adolescents completed measures on parental chronic stress and demographic information on the family's socioeconomic status. Results indicated that parent stress was directly related to adolescent stress, while adolescent stress was directly related to behavior components of EF (i.e., emotion control, set shifting, and inhibition). Although parental stress was related to adolescent's ability to shift from one task to another, no relationship was found with adolescent's ability to modulate mood or delay impulsive behaviors. Implications for socio-ecological mental health interventions for youth residing in urban environments are discussed. [ABSTRACT FROM AUTHOR]

Objective: To assess domains of social determinants of health (SDoH) and their associations with cognition and quality of life. Method: This investigation uses baseline data from individuals participating in the ACTIVE trial (n = 2505) to reproduce the SDoH domains described in Healthy People 2030 (economic stability, health care, education, neighborhood and built environment, and social and community context). Results: Results support using data from the ACTIVE trial to assess all five SDoH domains, and the ability of the composites to predict baseline performance on measures of cognition and self-reported quality of life within a sample of older adults. Additionally, higher SDoH domain scores were associated with better functioning on composite measures of cognition and higher scores for mental and general health-related quality of life with Access to Healthcare associated with all outcomes. Discussion: These findings can inform investigators interested in assessing multiple domains of SDoH and highlight the importance of access to health care within older Black/African American and White older adults. [ABSTRACT FROM AUTHOR]

Objectives: Slow afternoon cortisol decline may be a marker of aging. We hypothesize that lower socioeconomic status (SES) and African American race are associated with lower waking cortisol and slower afternoon decline. Method: Six salivary cortisol samples, collected within a 24-hr period from 566 cohort participants aged 56-78 years, were examined in random-effects models. SES measures included socioeconomic vulnerability (household income and assets <500% of poverty) and education (>college, some college, and

This study aimed to examine whether hypertension prevalence varies by race/ethnicity and within age groups in a nationally representative sample of men in the United States. Hypertension was defined as blood pressure (BP) readings of 140 mm Hg and higher for systolic BP, 90 mm Hg and higher for diastolic BP, or self-reports of taking medication for hypertension. Modified Poisson models estimated prevalence ratios (PRs) and 95% confidence intervals (CI) for race and age group associations with hypertension. The prevalence of hypertension was 38% overall and 46% of the men were aged 50 and older. Analyses that focused on older men (50 years of age or older) found that non-Hispanic Black men had a higher prevalence of hypertension (PR = 1.28, 95% CI: 1.19 − 1.37) compared to non-Hispanic White men. We suggest future research utilize life course perspectives to better identify which cumulative experiences impact hypertension disparities. [ABSTRACT FROM AUTHOR]

African-American males ages 13 through 24 are disproportionately affected by sexually transmitted infections (STIs) and human immunodeficiency virus (HIV), accounting for over half of all HIV infections in this age group in the United States. Clear communication between African-American parents and their youth about sexual health is associated with higher rates of sexual abstinence, condom use, and intent to delay initiation of sexual intercourse. However, little is known about African-American fathers' perceptions of what facilitates and inhibits sexual health communication with their preadolescent and adolescent sons. We conducted focus groups with 29 African-American fathers of sons ages 10-15 to explore perceived facilitators and barriers for father-son communication about sexual health. Participants were recruited from barbershops in metropolitan and rural North Carolina communities highly affected by STIs and HIV, and data were analyzed using content analysis. Three factors facilitated father-son communication: (a) fathers' acceptance of their roles and responsibilities; (b) a positive father-son relationship; and (c) fathers' ability to speak directly to their sons about sex. We also identified three barriers: (a) fathers' difficulty in initiating sexual health discussions with their sons; (b) sons' developmental readiness for sexual health information; and (c) fathers' lack of experience in talking with their own fathers about sex. These findings have implications for father-focused prevention interventions aimed at reducing risky sexual behaviors in adolescent African-American males. © 2017 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Black men are less likely to seek routine health care examinations or preventative care compared with their racial/ethnic and gender counterparts. Because of Black men’s limited engagement with the health system, Black men’s preference to receive health information is unclear. Guided by a revised version of the Andersen Healthcare Utilization Model, the aim of the study is to examine factors associated with Black men’s preference for informal or formal health information. Findings from the study demonstrate that financial barriers to care (odds ratio [OR] = 0.65, 95% confidence interval [CI] = 0.43-0.98) and higher income (OR = 2.44, 95% CI = 1.49-4.00) were most predictive of using a formal source for health information. Furthermore, age (OR = 1.02, 95% CI = 1.01-1.03) and having a college education (OR = 0.44, 95% CI = 0.26-0.76) were associated with using a formal place for health information. Interestingly, health care discrimination was not associated with preferred source or place for health information. Results from the study suggest that predisposing and enabling factors are most salient to the use of formal sources of health information among Black men. [ABSTRACT FROM AUTHOR]

Spirituality and religion have been identified as important determinants of health for adults; however, the impact of faith-oriented factors on health behaviors and outcomes among African American adolescent males has not been well studied. The purpose of this study is to examine the relationship between religiosity and spirituality and obesity-related behaviors among 12–19 year old African American males (N = 105) in the Jackson Heart KIDS Pilot Study. Key variables of interest are church attendance, prayer, daily spirituality, weight status, attempts to lose weight, nutrition, physical activity, and stress. Daily spirituality is associated with whether an individual attempts to lose weight. The results from logistic regression models suggest that daily spirituality increases the odds that African American male adolescents attempt to lose weight (OR = 1.22, CI: 1.07–1.41) and have a history of diet-focused weight management (OR = 1.13, CI: 1.02–1.26). Future studies are needed to further explore the association between religion, spirituality, and obesity-related behaviors. [ABSTRACT FROM AUTHOR]

Objective: Hearing impairment is highly prevalent, but little is known about hearing health care among older minority adults. Method: We analyzed nationally representative, cross-sectional data from 1,544 older adults ≥70 years with audiometry and hearing care data from the 2005-2006 and 2009-2010 National Health and Nutritional Examination Surveys. Results: After adjusting for age and speech frequency pure tone average, Blacks (odds ratio [OR] = 1.68, vs. Whites) and those with greater education (OR = 1.63, ≥college vs.

Objective: Maintaining functional status and reducing/eliminating health disparities in late life are key priorities. Older African Americans have been found to have worse lower extremity functioning than Whites, but little is known about potential differences in correlates between African American and White men. The goal of this investigation was to examine measures that could explain this racial difference and to identify race-specific correlates of lower extremity function.Methods: Data were analyzed for a sample of community-dwelling men. Linear regression models examined demographics, medical conditions, health behaviors, and perceived discrimination and mental health as correlates of an objective measure of lower extremity function, the Short Physical Performance Battery (SPPB). Scores on the SPPB have a potential range of 0 to 12 with higher scores corresponding to better functioning.Results: The mean age of all men was 74.9 years (SD=6.5), and the sample was 50% African American and 53% rural. African American men had scores on the SPPB that were significantly lower than White men after adjusting for age, rural residence, marital status, education, and income difficulty (P<.01). Racial differences in cognitive functioning accounted for approximately 41% of the race effect on physical function. Additional models stratified by race revealed a pattern of similar correlates of the SPPB among African American and White men.Conclusions: The results of this investigation can be helpful for researchers and clinicians to aid in identifying older men who are at-risk for poor lower extremity function and in planning targeted interventions to help reduce disparities. [ABSTRACT FROM AUTHOR]

Background: Obesity had not been considered a significant factor contributing to high levels of hypertension among African American males until recently. Epidemiologic research on heart disease among males has primarily focused on adults; however, the significant rise in obesity and hypertension prevalence among African American boys indicates that studies examining the relationship between excess body weight and elevated blood pressure among this high-risk population are critically needed. The purpose of our study was to examine the degree to which weight status has implications for elevated blood pressure among young African American males.Methods: The data for this cross-sectional study were drawn from adolescent males (N=105), aged 12-19 years and who participated in the Jackson Heart KIDS Pilot Study - an offspring cohort study examining cardiovascular disease risks among adolescent descendants of Jackson Heart Study participants. Blood pressure was the primary outcome of interest and weight status was a key independent variable. Other covariates were fruit and vegetable consumption, physical activity, sleep, and stress.Results: Approximately 49% of adolescent males in the study were overweight or obese. Bivariate and multiple variable analyses suggest that obesity may be correlated with elevated diastolic blood pressure (DBP) levels among African American boys. Results from ordinary least squared regression analysis indicate that the DBP for boys carrying excess weight was 4.2 mm Hg (P<.01) higher than the corresponding DBP for their normal weight counterparts, after controlling for age, fruit and vegetable consumption, physical activity, and sleep.Conclusions: Additional studies are needed to specify the manner through which excess weight and weight gain can accelerate the development and progression of CVD-related diseases among African American males over the life course, thereby providing evidenced-based information for tailored interventions that can reduce risks for premature morbidity, disability, and mortality among this group. [ABSTRACT FROM AUTHOR]

Objectives To determine effect size and acceptability of a multicomponent behavior and home repair intervention for low-income disabled older adults. Design Prospective randomized controlled pilot trial. Setting Participants' homes. Participants Forty low-income older adults with difficulties in one or more activities of daily living ( ADLs) or two or more instrumental activities of daily living ( IADLs). Intervention The Community Aging in Place, Advancing Better Living for Elders ( CAPABLE), coordinated occupational therapy, nursing, and handyman visits, was compared with attention-control visits. The intervention consisted of up to six visits with an occupational therapist, up to four visits with a nurse, and an average of $1,300 in handyman repairs and modifications. Each intervention participant received all components of the intervention clinically individualized to risk profile and goals. Each attention-control participant received the same number of visits as the intervention participants, involving sedentary activities of their choice. Measurement Primary outcome: difficulty in performing ADLs and IADLs. Secondary outcomes: health-related quality of life and falls efficacy. Results Thirty-five of 40 adults (87%) completed the 6-month trial, and 93% and 100% of the control and intervention group, respectively, stated that the study benefited them. The intervention group improved on all outcomes. When comparing mean change in the intervention group with mean change in the control group from baseline to follow-up, the CAPABLE intervention had effect sizes of 0.63 for reducing difficulty in ADLs, 0.62 for reducing difficulty in IADLs, 0.89 for quality of life, and 0.55 for falls efficacy. Conclusion The CAPABLE intervention was acceptable to participants and feasible to provide and showed promising results, suggesting that this multicomponent intervention to reduce disability should be evaluated in a larger trial. [ABSTRACT FROM AUTHOR]

Background: We deployed a study design that attempts to account for racial differences in socioeconomic and environmental risk exposures to determine if the diabetes race disparity reported in national data is similar when black and white Americans live under similar social conditions.Design& Methods: We compared data from the 2003 National Health Interview Survey (NHIS) with the Exploring Health Disparities in Integrated Communities-Southwest Baltimore (EHDIC-SWB) Study, which was conducted in a racially-integrated urban community without race differences in socioeconomic status.Results: In the NHIS, African Americans had greater adjusted odds of having diabetes compared to whites (OR: 1.61, 95% CI: 1.26-2.04); whereas, in EHDIC-SWB white and African Americans had similar odds of having diabetes (OR: 1.07, 95% CI: 0.71-1.58). Diabetes prevalence for African Americans was similar in NHIS and EHDIC-SWB (10.4%, 95%CI: 9.5-11.4 and 10.5%, 95%CI: 8.5-12.5, respectively). Diabetes prevalence among whites differed for NHIS (6.6%, 95%CI: 6.2-6.9%) and EHDIC-SWB (10.1%, 95%CI: 7.6-12.5%).Conclusions: Race disparities in diabetes may stem from differences in the health risk environments that African Americans and whites live. When African Americans and whites live in similar risk environments, their health outcomes are more similar. [ABSTRACT FROM AUTHOR]

Place and race are two important predictors of fatal police shootings. We used Mapping Police Violence Data and the Washington Post Fatal Force Data to determine whether a county's deprivation status within communities influences the association between the number of fatal police shootings, and how the number of fatal police shootings differs by race and ethnicity. We categorized counties based on the Social Vulnerability Index (SVI) to three categories: low-, medium-, and high-SVI. The analytical sample included 3136 US counties between 2015 and 2020; during this time, 5525 individuals were fatally shot by police. Our findings show that place strongly impacts the number of fatal police shootings. Among all fatal shootings, 713 occurred in low-SVI counties, 1660 in middle-SVI, and 3152 in high-SVI counties. Race played a significant role; fatal shooting deaths increased by 2.3 times among White individuals, 9.6 times among Black individuals, and 15 times among Hispanic individuals between low- and high-SVI counties. The results of negative binomial regressions show a strong association between fatal police shootings and the counties' characteristics. In comparison with low-SVI counties, residents in counties with moderate and high-SVI are more likely to be fatally shot by police by 4.9 and 5.8 percentage points. In addressing violence and fatal police shootings, the vulnerability of counties and the population's racial composition play significant roles and need specific attention in addressing systemic racial disparities in the criminal justice system. • Neighborhood strongly impacts the number of fatal police shootings. • Race and place play a significant role in fatal police shootings. • Compared to low-socially vulnerable, Whites fatally shot 2.3 times more in high-SVI areas by police. • Compared to low-socially vulnerable, Blacks fatally shot 9.6 times more in high-SVI areas by police. • Compared to low-socially vulnerable, Hispanics fatally shot 15 times more in high-SVI areas by police. [ABSTRACT FROM AUTHOR]