Session
Population Health Efforts within African Americans
APHA 2022 Annual Meeting and Expo
Abstract
Girls, we run this!
APHA 2022 Annual Meeting and Expo
• Issue: African American girls with sickle cell disease may face a myriad of impediments in the management of this genetic condition. Factors including racism, implicit bias from healthcare professionals, access to financial resources, fragmented systems of care and the laissez-faire nature of this disease can play a consequential role in the dynamics of this condition. Yet, despite these factors, African American girls who choose to practice coping mechanisms may find a variety of ways to aid in the self-management of this disease. • Description: A research evaluation was performed utilizing secondary data analysis to identify and analyze coping mechanisms of African American girls with sickle cell disease. • Lessons Learned: A variety of coping mechanisms aligned with the themes found in the Theory of Self-Care Management for Sickle Cell Disease exist including (but not limited to) breathing relaxation, imagery, calming self-statements, and distraction techniques. Yet, contextual factors such as identity and femininity must be examined in order to appreciate the milieu in which these coping mechanisms occur. • Recommendations: Further study is needed to assess the relational interplay between the biological impact of coping mechanisms, their contextual framework and the health outcomes of African American girls with sickle cell disease.
Abstract
Black Alaskan Health Status Report: Examining Racial Differences in Morbidity
APHA 2022 Annual Meeting and Expo
Background: Prevalence of certain illnesses and diseases are disproportionately higher among Black populations. Disparities in mortality rates among Black Alaskans also indicate the potential for higher morbidity among Black Alaskans compared to other races/ethnicities. Morbidity among Black Alaskans is understudied. This study addressed this dearth in state-specific literature by examining illness prevalence and risk factors among Black Alaskans.
Methodology: Secondary data analyses were conducted with the state using the Alaska Behavioral Risk Factor Surveillance System (BRFSS; 2016-2020). Chi-squared and independent t-tests examined dichotomous and continuous variables, respectively. Between-group differences were examined by race (Black and Other), with significance at p < 0.05. Multiple morbidity indicators and health risk factors assessed in the BRFSS were examined.
Results: More Black Alaskans had negative physical and mental health days, a higher risk of HIV exposure, diabetes, cardiovascular disease, hypertension, and at least one disability. There were also disproportionate risk factors affecting Black Alaskans, such as financial barriers to health care, lower COVID-19 vaccination rates, more tobacco and marijuana use, higher BMI, insufficient sleep, exercise, and vegetable intake. Black Alaskans also had positive health indicators with more routine health check-ups, lifetime pap-smears and HIV testing, higher flu vaccination rates, higher fruit intake, and lower e-cigarette and alcohol consumption than other races/ethnicities.
Conclusions: Health disparities negatively affect Black Alaskans. Black Alaskans also excel in important ways. Understanding both can inform strategies to target specific areas of need while simultaneously highlighting opportunities to learn from Black Alaskan communities. Findings also aligned with Black Alaskan mortality data.
Abstract
Life Beyond the Diagnosis: A retrospective phenomenological study of Black mothers and their journeys managing HIV care while parenting dependent children
APHA 2022 Annual Meeting and Expo
Background
Black mothers living with HIV (BMLWH) may experience psychosocial stressors related to the daily hassles of caregiving and managing their HIV care and treatment adherence. Little is known about the barriers and facilitators of ART treatment adherence among BMLWH. This retrospective phenomenological study sought to explore the lived experiences of BMLWH navigating HIV medical care while parenting dependent children.
Methodology
Participants were recruited from a local infectious disease clinic and referred by staff a member. A total of nine semi-structured individual interviews were conducted between April and June 2021, virtually via zoom video conferencing. Interviews were audio-recorded and transcribed verbatim. Transcripts were subsequently coded by a team using constant comparison to ensure reliability. Data were analyzed using deductive thematic analysis and Nvivo software. We explored caregiving, coping, social support, and HIV care themes.
Results
On average, BMLWH were 51.67 years old (SD= 14.77) and averaged 19.78 (SD= 9.21) years living with HIV. BMLWH reported being a caregiver of at least one child with a range of 1-4 children. Barriers included lack of social support, substance use, and HIV-related stigma and discrimination. Supportive HIV healthcare providers, HIV non-disclosure among family and friends, religiosity, and social support from non-kin networks were identified as facilitators of ART treatment adherence and engagement in HIV care.
Discussion
Findings suggest BMLWH social networks are nuanced and should be fully explored. Furthermore, findings can inform ASO’s programming by enhancing service delivery for newly diagnosed Black mothers by increasing opportunities for supportive social services and strong patient-provider relationships.
Abstract
Bearers of the Light: Blackness and the Medical imagination
APHA 2022 Annual Meeting and Expo
White supremacist ideology and anti-blackness have long and deep roots in our nation. These beliefs have influenced the foundations of our oldest institutions, the fields of medicine and public health included. The COVID-19 pandemic exacerbated the many long standing inequities affecting racial/ethnic minorities and other historically and structurally marginalized groups. This pivotal moment of the COVID-19 pandemic requires new perspectives and understandings to expand and elevate our work to meet today’s challenges. Through an investigation of the negative impact of white supremacist thinking and anti-blackness, on medicine and public health, providers can critically evaluate the foundational problems facing healthcare. By examining the contributions of Black Physicians, and their equity minded allies, to public health and healthcare, providers of all backgrounds can better understand how essential their presence, their diverse perspectives and contributions are for advancing health care, bridging the widening gaps between the public and public health and building a more just and equitable future.
Abstract
Building Capacity for African American Breast Cancer Survivors In Cancer Research
APHA 2022 Annual Meeting and Expo
Self-advocacy is a vital component for African American women across the breast cancer continuum. Their voices are critical in informing the education they receive, the types of screening they obtain, the treatment protocols prescribed to them, and for survivors to thrive post-treatment. The absence of the Black voice at the policy level is contributing to their absence in screening, treatment, funding, clinical trials, research, and in all places that matter, and in all conversations that impact change. Community-academic partnerships are a vital component of addressing disparities in communities of color. Building bi-directional capacity of African American breast cancer survivors, as well as physicians and academic researchers, creates opportunities for better health outcomes. Elevated Survivorship partnered with the Community Health Allies Training (C.H.A.T.) lab at the University of Chicago to develop strategies to build capacity for African American breast cancer survivors to engage in research and advocacy. The C.H.A.T. lab is dedicated to researching cancer prevention strategies among underserved populations, using community-engaged methodologies. This presentation will describe the partnership between Elevated Survivorship, the C.H.A.T. lab, a MD/MPH student intern, a population health researcher and the community engagement office at an NCI designated Comprehensive Cancer Center. The presentation will assess the development and impact of this project in shaping the professional learning experience of the MD/MPH student intern in community engaged research and social justice advocacy.
Abstract
Implementing State-wide Education on Medical Cannabis Use among Predominately Minority Communities, as Tasked by a Large, Southern Historically Black College/University
APHA 2022 Annual Meeting and Expo
Issues:
Blacks and whites use cannabis at similar rates; however, a Black person is 3.73 times more likely to be arrested for cannabis possession than a white person. Research details the benefits of using medical cannabis. Given there are a myriad of health issues that impact minority communities at higher rates, these groups should be educated on how to legally obtain medical cannabis. Educating minority communities regarding cannabis for medical use and the impact of unlawful use of cannabis could benefit minority populations, decrease minority groups from being arrested as well as obtaining cannabis prescribed by a physician.
Description:
State programs are dedicating resources to educate minorities on safe and legal ways to obtain medical cannabis. In a southern state’s department of health has collaborated with a large, historically Black university to implement a program of this nature. This university has contracted a minority-owned business to hire competent staff of health educators for state-wide execution. Several steps were taken to ensure success. First, a predominantly minority staff (i.e., Black and/or Hispanic) was recruited to preserve racial concordance between the target population and the health educators. Next, health educators identified minority-focused organizations (i.e., minority serving higher education institutions, faith-based institutions, and minority Greek organizations). Most importantly, communication and educational tools using minority images and voices were created for recruitment of participants to complete the state’s education course.
Lessons learned:
Racial concordance of health educators was critical to participants’ receptiveness and ability to be open in communicating about their needs and understanding of using medical cannabis. Weekly touchpoints were also used to manage the team’s workload and ensure presentation goals were met. Lastly, developing a communications package that included e-mail language, flyers, social media messaging, and a standardized presentation helped everyone deliver the program with consistent language.
Recommendations:
Medical cannabis education programs targeting minority populations should aim to build on their current community connections to reduce concerns that have been created by the historic medical and research mistreatment of minorities. Moreover, partnering with predominate Black and Hispanic institutions and faith-based organizations chance at reaching larger groups for education.
Abstract
COVID-19 in the Black Community: Early Pandemic Focus Groups Findings
APHA 2022 Annual Meeting and Expo
INTRODUCTION
We conducted a qualitative study as part of the National Institute of Health’s Community Engagement Alliance (CEAL) Against COVID-19 Disparities to identify Black adults’ attitudes and perspectives on COVID-19 and COVID-19 clinical trials. This was a collaboration of FL-CEAL teams at the University of Florida (UF), Florida A&M University (FAMU), and Health Choice Network (HCN) in 2020.
METHODOLOGY
Participants were recruited by community advocates. Participants were Florida residents and older than 18. UF and FAMU participants identified as Black, while HCN focus groups consisted of one with 90% Black participants and two with racially diverse provider groups focused on their Black patient populations. Transcripts of the focus group were validated and coded to find themes.
RESULTS
Eight focus groups were held, with 73 participants. Seven themes were identified: 1) Impact of COVID-19 on the Black Community, 2) COVID-19 Knowledge, 3) COVID-19 Misinformation, 4) COVID-19 Prevention, 5) COVID-19 Vaccination, 6) COVID-19 Research Participation, and 7) COVID-19 Community Education. These were found to be informed by the effects of the COVID-19 pandemic, limited understanding of COVID-19, myths surrounding COVID-19, lack of interest in COVID-19 clinical trials, and hesitancy rooted in public health injustice.
CONCLUSION
Participants described a collective trauma from a loss of normalcy, jobs, opportunities, activities, and loved ones. These groups highlighted opportunities for growth in reducing the effects of social determinants of health. The COVID-19 pandemic provides an opportunity to examine the disparities that exist to adequately address factors responsible for the disproportionate burden experienced by Black communities.
Abstract
Association of MyPlate Diet and Exercise with Diabetes in African American Women
APHA 2022 Annual Meeting and Expo
Lifestyle choices such as diet and physical activity have been described as significant predictors of preventable disease, such as Type 2 diabetes mellitus. African American women disproportionately develop Type 2 diabetes and are at greater risk, compared to Caucasian/European Americans. The purpose of this study was to examine the association of physical activity and adherence to the MyPlate diet plan with the occurrence of Type 2 diabetes among African American women. The health belief model was the theoretical foundation for this study. Research questions were designed to examine the extent to which diet and physical activity predict Type 2 diabetes. In this quantitative cross-sectional study, data from the 2015-2016 National Health and Nutrition Examination data sets were analyzed, including a representative sample of African American women, ages 18 and older in the United States. Using SPSS, a series of binary logistic regressions were conducted. After controlling for age, there was no statistically significant association between the MyPlate dietary pattern adherence and diabetes (OR = 0.706, 95% CI [0.292, 1.707], p > 0.005). Similarly, no statistically significant association between exercise and diabetes status was observed among this population (OR = 1.032, 95%CI [0.721, 1.504], p > 0.005). Implications for potential positive social change that could arise from this research include encouraging additional research into other dietary plans that may be better correlated with diabetes prevention. Likewise, researchers, health promotion advocates and public health professionals can build on these findings to expand research and examine lifestyle choices that may bring about improved health outcomes among African American diabetics.
Abstract
Disparities in bullying among minority children in the United States: Evidence from the 2018-2019 national survey of child health
APHA 2022 Annual Meeting and Expo
Background: The public health of bullying is wide-ranging, including emotional and physical health. Over the life-course, these experience will condemn victims to a cascade of disadvantage in higher educational attainment, employment, housing, and disproportionately poor health outcomes and intergenerational gaps wealth status. The purposes of this study was to determine the extent of bullying in schools and understand the perpetrators of bullying as a health construct among children aged 12-17 years old.
Methods: We conducted a cross-sectional analysis of data for 27,427 from the combined 2018-2019 Children Health Survey using Stata 16.0 for Windows. Descriptive, Chi-Square test and multinomial logistic regression were used to determine the risk of experience with bullying at school. Significance level was set at 0.05. Results: The sample comprised of children ages 12-15 (43.1%) and 15-17 (56.9%); 25.8% Hispanic, 50.6% white, Black/African American (13.6%) and 4.75 Asia, and 5.5% Multi-racial. Nearly a third (29.2%) [95% CI: 28.0-30.36] experienced 1-2 episodes of bullying in 12 months prior, 7% [6.05-7.76] every month, and 5.5% [4.97-6.04] weekly. At the bivariate level, bullying was significantly associated with race (p<0.001). African Americans and Hispanic students experienced equal levels of bullying at 11.75% and 11.22% respectively. About 5.5% of Asians experienced bullying in same timeframe. Ages 15-17 were less likely to be bullied (RRR=0.56, p<0.001). Boys were consistently significantly more likely to experience bullying with RRR ranging from 1.22 for weekly [95% CI 1.10 -1.36, p<0.001] to 1.36 [1.291.44; p<0.001) at least 1-2 times in preceding 12 months. Additional results, strategies and recommendations for addressing bullying will be discussed.