<p>It is a time-honored tradition in medicine and public health to recognize and honor individuals and teams for their original discoveries in basic, clinical, and population science research or for a sustained commitment to patient care and teaching. In following that tradition, <em>Ethnicity & Disease</em> pays special tribute to Elijah B. Saunders, MD, FACC, FACP, FAHA, FASH for his life-long commitment to patient care, teaching, community service, and most importantly, for his tireless efforts in taking many first steps to advance health equity for medically underserved communities in the United States and worldwide.<sup>1</sup><sup>, </sup><sup>2</sup> </p>
<p>Patients with chronic kidney disease (CKD) suffer from an increased prevalence of cardiovascular disease (CVD) risk factors, and a high rate of premature CV morbidity and mortality. The confluence of CV risk factors, in the context of cardio-metabolic perturbations that vary as renal function declines, complicates strategies for the care of patients with CKD. Understanding the existing evidence for effective CVD treatment strategies can help providers better care for these patients, navigate the complex treatment guidelines, which often differ across major organizations, and minimize the conflicting recommendations that new studies may pose. A pragmatic approach is to target a BP <140/90 mm Hg, which frequently requires more than two or three antihypertensive agents. Most guidelines recommend a combination of diuretic and angiotensin converting enzyme inhibitor or angiotensin receptor blockers, along with a dihydropyridine calcium channel blocker, beta blocker or other agent based on co-existing medical conditions. Consideration for a lower BP goal and/or other therapeutic interventions should be based on the etiology of CKD, stage of CKD, and/or presence of proteinuria. Finally, most patients with CKD, not on dialysis, would benefit from treatment with statins and non-pharmacologic lifestyle interventions should be promoted for all patients with CKD. <em>Ethn Dis. </em>2015;25(4):515- 520; doi:10.18865/ed.25.4.515</p>
AbstractThe National Institutes of Health (NIH) made a sizeable investment in developing a scientific approach to understanding how to best increase diversity in the NIH‐funded workforce by fostering inclusive excellence at a national scale through the Diversity Program Consortium (DPC). This chapter provides an overview of the context in which the consortium‐wide evaluation study has taken place to provide readers with an understanding of its level of complexity. This evaluation effort is the first large‐scale, national, systemic, longitudinal evaluation of harmonized interventions focused on undergraduate biomedical research training programs in the history of the NIH and the National Institute of General Medical Sciences.
The development of research training opportunities for investigators from the untapped pool of traditionally underrepresented racial/ethnic groups has gained intense interest at the National Institutes of Health (NIH). The significant and persistent disparity in the likelihood of R01 funding between African American and Whites was highlighted in the groundbreaking 2011 report, Race, Ethnicity, and NIH Research Awards. Disparities in funding success were also shown to exist at the institutional level, as 30 institutions receive a disproportionate share of federal research funding. Historically Black Colleges and Universities (HBCUs) have a dual commitment to education and research; however, the teaching loads at HBCUs may present challenges for research-oriented faculty. Few research training and mentoring programs have been specifically designed for this group.During 2015 and 2016, we held three conversation cafés with 77 participants in Jackson, Mississippi and Baltimore, Maryland. The purpose of this article is to describe findings from these conversation cafés regarding barriers and facilitators to building robust research careers at HBCUs, and to illustrate how these data were used to adapt the conceptual framework for the NHLBI-funded Obesity Health Disparities (OHD) PRIDE program. Identified barriers included teaching and advising loads, infrastructures, and lack of research mentors on campus. The benefit of incorporating research into classroom teaching was a noted facilitator. Ethn Dis. 2020;30(1):83-90; doi:10.18865/ed.30.1.83
<p><strong>Objective: </strong>We examined variation in rates of hospitalization, risk factors, and costs by race/ethnicity, gender and age among heart failure (HF) patients. <strong></strong></p><p><strong>Methods: </strong>We analyzed California hospital discharge data for patients in 2007 (n=58,544) and 2010 (n=57,219) with a primary diagnosis of HF (ICD-9 codes: 402, 404, 428). HF cases included African Americans (Blacks; 14%), Hispanic/Latinos (21%), and non-Hispanic Whites (65%). Age-adjusted prevalence rates per 100,000 US population were computed per CDC methodology. <strong></strong></p><p><strong>Results: </strong>Four major trends emerged: 1) Overall HF rates declined by 7.7% from 284.7 in 2007 to 262.8 in 2010; despite the decline, the rates for males and Blacks remained higher compared with others in both years; 2) while rates for Blacks (aged ≤54) were 6 times higher compared with same age Whites, rates for Hispanics were higher than Whites in the middle age category; 3) risk factors for HF included hypertension, chronic heart disease, chronic kidney disease, atrial fibrillation, and chronic obstructive pulmonary disease; and 4) submitted hospitalization costs were higher for males, Blacks, and younger patients compared with other groups. <strong></strong></p><p><strong>Conclusion: </strong>Health inequality in HF persists as hospitalization rates for Blacks remain higher compared with Whites and Hispanics. These findings reinforce the need to determine whether increased access to providers, or implementing proven hypertension and diabetes preventive programs among minorities might reduce subsequent hospitalization for HF in these populations. <em>Ethn Dis. </em>2016;26(3):345-354; doi:10.18865/ed.26.3.345 </p>
Introduction: The current hypercompetitive extramural funding environment in the United States emphasizes the critical need for effective research training programs that focus not only on grantsmanship, but on skill development across the full range of research activities, culminating in writing research results for publication. Using Writing Accountability Groups (WAG), the National Heart, Lung, and Blood Institute (NHLBI) funded Obesity Health Disparities (OHD) PRIDE is one of the few research training and mentoring programs that places an equal focus on scientific writing and grant writing. This article reports on the utility of WAGs for OHD PRIDE mentees.Method: Participants included 14 of 26 individuals who were fellows in the OHD PRIDE research training and mentoring program. A typical WAG has between four and eight members who meet for one hour each week over a 10-week period and commit a priori to attend at least 70% of the sessions. Summary statistics were produced to characterize number of peer-reviewed publications, grants, years in academic rank, and category of current academic rank, barriers to frequency of writing, and duration of writing. Results from pre- and post-WAG surveys were compared to determine the overall impact of the WAG. The study period discussed in this article took place between January and December 2017 and included data from three 10-week cycles beginning in February, May, and September.Results: Fifty-three percent of OHD PRIDE participants successfully completed at least one 10-week WAG cycle. The WAGs did not have a statistically significant impact on either the frequency of writing or the duration of writing. However, the majority of the participants who successfully completed at least one WAG cycle reported that they either maintained or increased their frequency or duration of writing.Conclusion: By providing a structured approach to developing and/or enhancing a practice of consistent writing, time management skills, and collaborative relationships, the WAG has promise for enhancing scientific writing skills for many trainees and early-career faculty. Longer term follow-up is needed to more fully assess the potential impact of WAGs. Ethn Dis. 2020;30(2):295- 304; doi:10.18865/ed.30.2.295
Community-based participatory research/ community-partnered participatory research (CBPR/CPRR) is viewed as a critical approach for improving health and addressing inequities found in under-resourced communities by pairing community partners and academic partners to address health and environmental concerns. This article aims to amplify the potential of the current CBPR/CPPR models through insights learned from the underserved community of Watts in south central Los Angeles. We discuss our framework that shifts the primary academic focus in the community-academia partnership from individual investigators and/or research groups to the academic institution to generate sustainable partnerships. We summarize the Community Action Research Engagement (CARE) Framework as a new set of recommended tenets to expand CBPR/ CPPR. This framework can provide guidance for how universities can catalyze: 1) building trust; 2) facilitating knowledge; 3) advancing solutions; and 4) fostering mentorship in the context of leveraging a university's position to address the root causes of community inequities and thus create more sustained partnerships that achieve greater impact within their surrounding communities.Ethn Dis. 2022;32(4):333-340; doi:10.18865/ed.32.4.333
<p>Mentoring has been consistently identified as an important element for career advancement in many biomedical and health professional disciplines and has been found to be critical for success and promotion in academic settings. Early-career faculty from groups underrepresented in biomedical research, however, are less likely to have mentors, and in general, receive less mentoring than their majority-group peers, particularly among those employed in teaching-intensive institutions. This article describes Obesity Health Disparities (OHD) PRIDE, a theoretically and conceptually based research training and mentoring program designed for early-career faculty who trained or are employed at Historically Black Colleges and Universities (HBCUs). <em></em></p><p><em>Ethn Dis. </em>2018;28(2):115-122; doi:10.18865/ed.28.2.115. </p>
Background: African American children and adolescents make up a disproportionately large segment of those classified as overweight and obese. The purpose of this study was to examine social and behavioral factors associated with accelerated accumulation of weight and adiposity among this group.Methods: The data for this cross-sectional study were drawn from the Jackson Heart KIDS Pilot Study – an offspring cohort study comprising 12- to 19-year-old descendants of Jackson Heart Study participants (N=212). Body mass index (BMI) and waist circumference were the outcomes of interest. Daily hassles, fruit and vegetable consumption, physical activity, television watching, parent/grandparent weight status and participant birth weight, age and sex were the independent variables included in the analyses.Results: Males and females were equally represented in the study and the mean BMI and waist circumference for adolescents in the study was 25.81±7.78 kg/m2 and 83.91 ± 19.81 cm, respectively. Fully adjusted linear regression models for the total sample produced results indicating that age, television viewing, weight control, and parental weight status were positively associated with BMI and waist circumference, respectively. Findings from sex-stratified models for BMI and waist circumference indicated that the significance of coefficients for age, television viewing, and parent/grandparent weight status varied by sex.Conclusions: Knowledge is limited about how sex or gender interact with social and behavioral factors to influence African Americans' health and additional studies are needed to specify how these factors interact to accelerate weight gain and adipose tissue accumulation over the life course.Ethn Dis. 2021;31(3):453-460; doi:10.18865/ed.31.3.453