Dataset Information

Breastfeeding Trends by Race/Ethnicity Among US Children Born From 2009 to 2015.

ABSTRACT: Importance:Large racial/ethnic disparities in breastfeeding are associated with adverse health outcomes. Objectives:To examine breastfeeding trends by race/ethnicity from 2009 to 2015 and changes in breastfeeding gaps comparing racial/ethnic subgroups with white infants from 2009-2010 to 2014-2015. Design, Setting, and Participants:This study used data from 167?842 infants from the National Immunization Survey-Child (NIS-Child), a random-digit-dialed telephone survey among a complex, stratified, multistage probability sample of US households with children aged 19 to 35 months at the time of the survey. This study analyzed data collected from January 1, 2011, through December 31, 2017, for children born between 2009 and 2015. Exposures:Child's race/ethnicity categorized as Hispanic or non-Hispanic white, black, Asian, or American Indian or Alaskan Native. Main Outcomes and Measures:Breastfeeding rates, including ever breastfeeding, exclusive breastfeeding through 6 months, and continuation of breastfeeding at 12 months. Results:This study included 167?842 infants (mean [SD] age, 2.33 [0.45] years; 86?321 [51.4%] male and 81?521 [48.6%] female). Overall unadjusted breastfeeding rates increased from 2009 to 2015 by 7.1 percentage points for initiation, 9.2 percentage points for exclusivity, and 11.3 percentage points for duration, with considerable variation by race/ethnicity. Most racial/ethnic groups had significant increases in breastfeeding rates. From 2009-2010 to 2014-2015, disparities in adjusted breastfeeding rates became larger between black and white infants. For example, the difference for exclusive breastfeeding through 6 months between black and white infants widened from 0.5 to 4.5 percentage points with a 4.0% difference in difference (P?

SUBMITTER: Li R

PROVIDER: S-EPMC6802058 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Breastfeeding Trends by Race/Ethnicity Among US Children Born From 2009 to 2015.

Li Ruowei R Perrine Cria G CG Anstey Erica H EH Chen Jian J MacGowan Carol A CA Elam-Evans Laurie D LD

JAMA pediatrics 20191202 12

<h4>Importance</h4>Large racial/ethnic disparities in breastfeeding are associated with adverse health outcomes.<h4>Objectives</h4>To examine breastfeeding trends by race/ethnicity from 2009 to 2015 and changes in breastfeeding gaps comparing racial/ethnic subgroups with white infants from 2009-2010 to 2014-2015.<h4>Design, setting, and participants</h4>This study used data from 167 842 infants from the National Immunization Survey-Child (NIS-Child), a random-digit-dialed telephone survey among ...[more]

PMID: 31609438

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Project description:ImportancePredialysis nephrology care is associated with better survival among patients with end-stage kidney disease.ObjectiveTo examine national trends in racial/ethnic disparities in receipt of predialysis nephrology care at least 1 year before dialysis initiation in the United States from 2005 to 2015.Design, setting, and participantsThis national registry study assessed US registry data of 1 000 390 adults in the US Renal Data System who initiated maintenance dialysis treatment from January 1, 2005, to December 31, 2015, in multiple cross-sectional analyses. Multivariable logistic regression models were used to examine national trends in racial/ethnic disparities in receipt of predialysis nephrology care with adjustments for potential confounders. Data were analyzed April 17, 2020.ExposureRace/ethnicity of the patients.Main outcomes and measuresReceipt of at least 12 months of predialysis nephrology care as determined by clinician-based documentation on the End Stage Renal Disease Medical Evidence Report Form CMS 2728.ResultsAmong 1 000 390 adults (57.2% male; 54.6% White, 27.8% Black, 14.0% Hispanic, and 3.6% Asian; mean [SD] age, 62.4 [15.6] years) who initiated maintenance dialysis in the United States from 2005 to 2015, 310 743 (31.1%) received at least 12 months of predialysis nephrology care. In 2005 to 2007, compared with White adults, the adjusted odds ratio for receipt of at least 12 months of predialysis nephrology care was 0.82 (95% CI, 0.80-0.84) among Black adults, 0.67 (95% CI, 0.65-0.69) among Hispanic adults, and 0.84 (95% CI, 0.80-0.89) among Asian adults; in 2014 to 2015, the adjusted odds ratio was 0.76 (95% CI, 0.74-0.78) among Black adults, 0.61 (95% CI, 0.60-0.63) among Hispanic adults, and 0.90 (95% CI: 0.86-0.95) among Asian adults.Conclusions and relevanceIn this cross-sectional study of more than 1 million US adults with end-stage kidney disease, racial and ethnic disparities in predialysis nephrology care did not substantially improve from 2005 to 2015. Study findings suggest that national strategies to address racial/ethnic disparities in predialysis nephrology care are needed.

Project description:IntroductionAlthough there are racial/ethnic differences in cigarette use, little is known about how non-cigarette tobacco use differs among racial/ethnic groups. This study investigated trends in cigar use from 2002 to 2016, by racial/ethnic group, in nationally representative US data.MethodsData were drawn from the 2002-2016 National Survey on Drug Use and Health public use data files (total analytic sample n = 630 547 including 54 060 past-month cigar users). Linear time trends of past-month cigar use were examined by racial/ethnic group (Non-Hispanic [NH] White, NH Black, Hispanic, NH Other/Mixed Race/Ethnicity) using logistic regression models.ResultsIn 2016, the prevalence of past-month cigar use was significantly higher among NH Black respondents than among other racial/ethnic groups (ps < .001). Cigar use was also higher among NH White respondents than among Hispanic and NH Other/Mixed Race/Ethnicity respondents. The year by racial/ethnic group interaction was significant (p < .001). Past-month cigar use decreased significantly from 2002 to 2016 among NH White and Hispanic respondents (ps = .001), whereas no change in prevalence was observed among NH Black (p = .779) and NH Other/Mixed Race/Ethnicity respondents (p = .152). Cigar use decreased for NH White men (p < .001) and did not change for NH White women (p = .884). Conversely, cigar use increased for NH Black women (p < .001) and did not change for NH Black men (p = .546).ConclusionsCigar use remains significantly more common among NH Black individuals in the United States and is not declining among NH Black and NH Other/Mixed Race/Ethnicity individuals over time, in contrast to declines among NH White and Hispanic individuals.ImplicationsThis study identified racial/ethnic differences in trends in past-month cigar use over 15 years among annual cross-sectional samples of US individuals. The highest prevalence of cigar use in 2016 was found among NH Black individuals. In addition, cigar use prevalence did not decline from 2002 to 2016 among NH Black and NH Other/Mixed Race/Ethnicity groups over time, in contrast to NH White and Hispanic groups. Further, cigar use increased over time for NH Black women. Targeted public health and clinical efforts may be needed to decrease the prevalence of cigar use, especially for NH Black individuals.

Project description:Importance:Increasing diversity in the physician workforce is a fulcrum for reducing health disparities. Efforts to increase the diversity in the internal medicine (IM) workforce may improve health equity among an increasingly diverse population with increasing prevalence of chronic disease. Objectives:To assess diversity trends in the academic IM workforce and evaluate how well these trends reflected medical student diversity and the changing demographic composition of the general population. Design, Setting, and Participants:This secondary analysis of a cross-sectional study analyzed data from January 1, 1980, to December 31, 2018, from the Association of American Medical Colleges Faculty Roster and Applicant Matriculant File, which capture full-time US medical school faculty and matriculants, respectively, and population data through 2017 from the US Census Bureau. Main Outcomes and Measures:The study calculated the proportions of women and individuals from racial/ethnic groups that are traditionally underrepresented in medicine (URM) among IM faculty and faculty in all other clinical departments. These data were compared with the proportions of female and URM matriculants in US medical schools and the proportions of women and individuals from underrepresented racial/ethnic groups in the population. The analysis was stratified by sex, race/ethnicity, and intersections of sex and race/ethnicity. Results:From 1980 to 2018, the absolute number of full-time IM faculty increased from 10?964 to 42?547. Although IM was the department classification with the most women faculty, in 2018 it continued to have a lower proportion of women (n?=?17?165 [40.3%]) compared with all other clinical departments (n?=?48?936 [43.2%]). Among IM faculty, the percentage of URM faculty members more than doubled during the study period (from 4.1% to 9.7%) but still made up only a small portion of faculty members. The percentage of female matriculants among medical school matriculants increased steadily (from 28.7% in 1980 to 51.6% in 2018) and was nearly identical to their population representation in 2017 (50.7% compared with 50.8%). Although the percentage of URM matriculants had nearly doubled since 1980 (from 11.3% to 18.1%), it still lagged far behind the proportion of individuals in the US population who are members of underrepresented racial/ethnic groups (18.1% vs 31.5% in 2017). Conclusions and Relevance:This cross-sectional study found that progress has been made in diversifying academic IM faculty; however, it does not yet reflect the diversity of medical students or the US population. Continued efforts to increase the diversity of the academic IM workforce are needed.

Dataset Information

Breastfeeding Trends by Race/Ethnicity Among US Children Born From 2009 to 2015.

Publications

Breastfeeding Trends by Race/Ethnicity Among US Children Born From 2009 to 2015.

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