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Ethnic/racial disparities in adolescents' home food environments and linkages to dietary intake and weight status.

ABSTRACT: Research is needed to confirm that public health recommendations for home/family food environments are equally relevant for diverse populations. This study examined ethnic/racial differences in the home/family environments of adolescents and associations with dietary intake and weight status. The sample included 2374 ethnically/racially diverse adolescents and their parents enrolled in coordinated studies, EAT 2010 (Eating and Activity in Teens) and Project F-EAT (Families and Eating and Activity in Teens), in the Minneapolis/St. Paul metropolitan area. Adolescents and parents completed surveys and adolescents completed anthropometric measurements in 2009-2010. Nearly all home/family environment variables (n=7 of 8 examined) were found to vary significantly across the ethnic/racial groups. Several of the home/family food environment variables were significantly associated with one or more adolescent outcome in expected directions. For example, parental modeling of healthy food choices was inversely associated with BMI z-score (p=0.03) and positively associated with fruit/vegetable consumption (p<0.001). Most observed associations were applicable across ethnic/racial groups; however; eight relationships were found to differ by ethnicity/race. For example, parental encouragement for healthy eating was associated with lower intake of sugar-sweetened beverages only among youth representing the White, African American, Asian, and mixed/other ethnic/racial groups and was unrelated to intake among East African, Hispanic, and Native American youth. Food and nutrition professionals along with other providers of health programs and services for adolescents should encourage ethnically/racially diverse parents to follow existing recommendations to promote healthy eating such as modeling nutrient-dense food choices, but also recognize the need for cultural sensitivity in providing such guidance.

SUBMITTER: Larson N

PROVIDER: S-EPMC4268119 | biostudies-literature | 2015 Jan

REPOSITORIES: biostudies-literature

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Ethnic/racial disparities in adolescents' home food environments and linkages to dietary intake and weight status.

Larson Nicole N Eisenberg Marla E ME Berge Jerica M JM Arcan Chrisa C Neumark-Sztainer Dianne D

Eating behaviors 20141101

Research is needed to confirm that public health recommendations for home/family food environments are equally relevant for diverse populations. This study examined ethnic/racial differences in the home/family environments of adolescents and associations with dietary intake and weight status. The sample included 2374 ethnically/racially diverse adolescents and their parents enrolled in coordinated studies, EAT 2010 (Eating and Activity in Teens) and Project F-EAT (Families and Eating and Activit ...[more]

PMID: 25464066

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Project description:ObjectiveHealth disparities are pervasive in nursing homes (NHs), but disparities in NH end-of-life (EOL) care (ie, hospital transfers, place of death, hospice use, palliative care, advance care planning) have not been comprehensively synthesized. We aim to identify differences in NH EOL care for racial/ethnic minority residents.DesignA systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and registered in PROSPERO (CRD42020181792).Setting and participantsOlder NH residents who were terminally ill or approaching the EOL, including racial/ethnic minority NH residents.MethodsThree electronic databases were searched from 2010 to May 2020. Quality was assessed using the Newcastle-Ottawa Scale.ResultsEighteen articles were included, most (n = 16) were good quality and most (n = 15) used data through 2010. Studies varied in definitions and grouping of racial/ethnic minority residents. Four outcomes were identified: advance care planning (n = 10), hospice (n = 8), EOL hospitalizations (n = 6), and pain management (n = 1). Differences in EOL care were most apparent among NHs with higher proportions of Black residents. Racial/ethnic minority residents were less likely to complete advance directives. Although hospice use was mixed, Black residents were consistently less likely to use hospice before death. Hispanic and Black residents were more likely to experience an EOL hospitalization compared with non-Hispanic White residents. Racial/ethnic minority residents experienced worse pain and symptom management at the EOL; however, no articles studied specifics of palliative care (eg, spiritual care).Conclusions and implicationsThis review identified NH health disparities in advance care planning, EOL hospitalizations, and pain management for racial/ethnic minority residents. Research is needed that uses recent data, reflective of current NH demographic trends. To help reduce EOL disparities, language services and cultural competency training for staff should be available in NHs with higher proportions of racial/ethnic minorities.

Project description:BackgroundRacial/ethnic disparities in the use of opioids to treat pain disorders have been previously reported in the emergency department (ED). Further research is needed to better evaluate the impact race/ethnicity may have on the use of opioids in adolescents for the management of pain disorders in the ED.MethodsThis was a cross-sectional study using data from the National Hospital Ambulatory Medical Care Survey from 2006 to 2016. Multivariate models were used to evaluate the role of race/ethnicity in the receipt of opioid agonists while in the ED. All ED visits with patients aged 11-21 years old were analyzed. Races/ethnicities were stratified as non-Hispanic Whites, non-Hispanic Blacks, and Hispanics. In addition to race, statistical analysis included the following covariates: pain score, pain diagnosis, age, region, sex, and payment method.ResultsThere was a weighted total of 189,256,419 ED visits. Those visits involved 109,826,315 (58%) non-Hispanic Whites, 46,314,977 (24%) non-Hispanic Blacks, and 33,115,127 (18%) Hispanics, with 21.6% (95% CI, 21.1%-22.1), 15.2% (95% CI, 14.6-15.9%), and 17.4% (95% CI, 16.5-18.2%) of those visits reporting use of opioids, respectively. Regardless of age, sex, and region, non-Hispanic Whites received opioids at a higher rate than non-Hispanic Blacks and Hispanics. Based on diagnosis, non-Hispanic Whites received opioids at a higher rate in multiple pain diagnoses. Additionally, non-Hispanic Blacks and Hispanics were less likely to receive an opioid when reporting moderate pain (aOR = 0.738, 95% CI 0.601-0.906, aOR = 0.739, 95% CI 0.578-0.945, respectively) and severe pain (aOR = 0.580, 95% CI 0.500-0.672, aOR = 0.807, 95% CI 0.685-0.951, respectively) compared to non-Hispanic Whites.ConclusionsDifferences in the receipt of opioid agonists in EDs among the races/ethnicities exist, with more non-Hispanic Whites receiving opioids than their minority counterparts. Non-Hispanic Black women may be an especially marginalized population. Further investigation into sex-based and regional differences are needed.

Project description:OBJECTIVE:The current study aimed to (i) describe racial/ethnic disparities in household food and beverage purchases among participants and non-participants in the Supplemental Nutrition Assistance Program (SNAP) and (ii) examine longitudinal associations between SNAP participation and purchases by race/ethnicity. DESIGN:To describe disparities, we estimated sociodemographic-adjusted mean purchases of seven unhealthy food and beverage groups (e.g. junk food, sugar-sweetened beverages) and four nutrients (e.g. sugar, Na) among white, black and Hispanic SNAP-participating and non-participating households. To examine longitudinal associations, we used multivariable linear regression with household fixed effects. SETTING:USA, 2010-2014. SUBJECTS:Food and beverage purchases among low-income (?250 % federal poverty line) US households (n 30 403) participating in the Nielsen Homescan Panel. RESULTS:Among non-participants, there were significant black-white disparities (i.e. differences favouring white households) in households' adjusted mean purchases of processed meat, sweeteners, sugar-sweetened beverages, energy and Na. These disparities persisted among SNAP participants. In contrast, the only significant Hispanic-white disparity among non-participants was for Na purchases; this disparity was reduced in magnitude and no longer significant among SNAP-participating households. Additionally, Hispanic households purchased less energy from junk foods than white households, regardless of SNAP status. In longitudinal models accounting for household fixed effects, SNAP participation was associated with increased energy purchased among black households. No other significant longitudinal associations between SNAP and purchase outcomes were observed. CONCLUSIONS:SNAP may not be meeting its potential to improve food and beverage purchases or reduce disparities. Research is needed to identify strategies for ensuring nutritious purchases across all racial/ethnic groups.

Dataset Information

Ethnic/racial disparities in adolescents' home food environments and linkages to dietary intake and weight status.

Publications

Ethnic/racial disparities in adolescents' home food environments and linkages to dietary intake and weight status.

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