Dataset Information

Vanishing racial disparities in drowning in Florida.

ABSTRACT: OBJECTIVES:To examine the change in the racial disparity in drowning in Florida from 1970 to 2015 and to analyse the contextual factors associated with white, black and Hispanic drowning rates in Florida from 2007 to 2015. METHODS:Our outcome variable is county-level annual drowning rates by race, ethnicity, sex and age group. We computed county-level contextual data, including emergency weather events, temperature, extreme weather, number of pools, quality of pools, coastline, swimming participation rates and prominent black competitive swim teams. RESULTS:Between 1970 and 1990, the disparity in drowning rates between white and black males in Florida decreased dramatically. By 2005, the overall age-adjusted drowning rates converged. This convergence was most striking for those aged 10-34 and 35-64. While the gap has declined dramatically, there remains a racial disparity in drownings among those aged 10-34. CONCLUSIONS:Overall, racial disparities in drowning have disappeared in Florida. However, some disparities remain. There is a persistent disparity in drownings among those aged 10-34.

SUBMITTER: Gorsuch MM

PROVIDER: S-EPMC6478571 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Vanishing racial disparities in drowning in Florida.

Gorsuch Marina Mileo MM Myers Samuel L SL Lai Yufeng Y Steward Devan D Motachwa Rachel R

Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention 20181023 6

<h4>Objectives</h4>To examine the change in the racial disparity in drowning in Florida from 1970 to 2015 and to analyse the contextual factors associated with white, black and Hispanic drowning rates in Florida from 2007 to 2015.<h4>Methods</h4>Our outcome variable is county-level annual drowning rates by race, ethnicity, sex and age group. We computed county-level contextual data, including emergency weather events, temperature, extreme weather, number of pools, quality of pools, coastline, sw ...[more]

PMID: 30352797

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Project description:Racial-ethnic disparities in acute stroke care can contribute to inequality in stroke outcomes. We examined race-ethnic disparities in acute stroke performance metrics in a voluntary stroke registry among Florida and Puerto Rico Get With the Guidelines-Stroke hospitals.Seventy-five sites in the Florida Puerto Rico Stroke Registry (66 Florida and 9 Puerto Rico) recorded 58 864 ischemic stroke cases (2010-2014). Logistic regression models examined racial-ethnic differences in acute stroke performance measures and defect-free care (intravenous tissue plasminogen activator treatment, in-hospital antithrombotic therapy, deep vein thrombosis prophylaxis, discharge antithrombotic therapy, appropriate anticoagulation therapy, statin use, smoking cessation counseling) and temporal trends. Among ischemic stroke cases, 63% were non-Hispanic white (NHW), 18% were non-Hispanic black (NHB), 14% were Hispanic living in Florida, and 6% were Hispanic living in Puerto Rico. NHW patients were the oldest, followed by Hispanics, and NHBs. Defect-free care was greatest among NHBs (81%), followed by NHWs (79%) and Florida Hispanics (79%), then Puerto Rico Hispanics (57%) (P<0.0001). Puerto Rico Hispanics were less likely than Florida whites to meet any stroke care performance metric other than anticoagulation. Defect-free care improved for all groups during 2010-2014, but the disparity in Puerto Rico persisted (2010: NHWs=63%, NHBs=65%, Florida Hispanics=59%, Puerto Rico Hispanics=31%; 2014: NHWs=93%, NHBs=94%, Florida Hispanics=94%, Puerto Rico Hispanics=63%).Racial-ethnic/geographic disparities were observed for acute stroke care performance metrics. Adoption of a quality improvement program improved stroke care from 2010 to 2014 in Puerto Rico and all Florida racial-ethnic groups. However, stroke care quality delivered in Puerto Rico is lower than in Florida. Sustained support of evidence-based acute stroke quality improvement programs is required to improve stroke care and minimize racial-ethnic disparities, particularly in resource-strained Puerto Rico.

Project description:ObjectiveTo evaluate racial and ethnic differences in women's postpartum pain scores, inpatient opioid administration, and discharge opioid prescriptions.MethodsWe conducted a retrospective cohort study of all deliveries at a single high-volume tertiary care center from December 1, 2015, through November 30, 2016. Women were included if they self-identified as non-Hispanic white, non-Hispanic black, or Hispanic; were at least 18 years of age; and did not have documented allergies to nonsteroidal antiinflammatory drugs or morphine. Medical records were queried for three outcomes: 1) patient-reported postpartum pain score (on a scale of 0-10) at discharge (dichotomized less than 5 or 5 or higher), 2) inpatient opioid dosing during postpartum hospitalization (reported as morphine milligram equivalents [MMEs] per postpartum day), and 3) receipt of an opioid prescription at discharge. The associations between each of these outcomes and maternal race-ethnicity were assessed using multivariable logistic regression models with random effects to account for clustering by discharge physician. A sensitivity analysis was conducted in which women of different race and ethnicity were matched using propensity scores.ResultsA total of 9,900 postpartum women were eligible for analysis. Compared with non-Hispanic white women, Hispanic and non-Hispanic black women had significantly greater odds of reporting a pain score of 5 or higher (adjusted odds ratio [aOR] 1.61, 95% 1.26-2.06 and aOR 2.18, 95% 1.63-2.91, respectively) but received significantly fewer inpatient MMEs/d (adjusted β -5.03, 95% CI -6.91 to -3.15, and adjusted β -3.54, 95% CI -5.88 to -1.20, respectively). Additionally, Hispanic and non-Hispanic black women were significantly less likely to receive an opioid prescription at discharge (aOR 0.80, 95% CI 0.67 to -0.96 and aOR 0.78, 95% CI 0.62-0.98) compared with non-Hispanic white women. Results of the propensity score analysis largely corroborated those of the primary analysis, with the exception that the difference in inpatient MMEs/d between non-Hispanic white and non-Hispanic black women did not reach statistical significance.ConclusionHispanic and non-Hispanic black women experience disparities in pain management in the postpartum setting that cannot be explained by less perceived pain.

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Vanishing racial disparities in drowning in Florida.

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Vanishing racial disparities in drowning in Florida.

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