28 Jan
During the 18-month period under study, 833 African-American (with 1342 medication records) and 4436 white (with 7452 medication records) veterans were eligible for inclusion in the study. Split by drug class, 392 African-American and 1985 white veterans were included in the ACEI analyses, 241 African-American and 1418 white veterans were included in the BB analyses, 409 African-American and 1739 white veterans were included in the CCB analyses, and 222 African-American and 1778 white veterans were included in the statin analyses.
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26 Jan
Adherence to medications is an important predictor of positive clinical outcomes. Poor adherence to medications not only results in poor outcomes, but is associated with greater health care costs. Indeed, inadequate adherence to medications has been cited as a major reason for poor control of hypertension. Adherence to medications has been linked to socio-economic factors, such as race, age, marital status, and ability to pay. Hypertension is reported to be both more common and more severe among African Americans than among their white counterparts. Moreover, African Americans suffer disproportionately from the sequelae of hypertension, including congestive heart failure, end-stage renal disease, and stroke. Although the rates of acute ischemic heart disease are similar among African-American and white men, the rates among women are substantially higher in African Americans. Not surprisingly, cardiovascular diseases overall are more common among African Americans than whites and cause a greater burden of mortality in the African-American community. The reasons for these racial differences in the prevalence and control of hypertension are not clear. Theories include the impact of chronic stress related to direct and indirect effects of racism, cultural differences in diet, and differences in access to care.
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25 Jan
Results from the study suggest that in this population of African-American adults, older participants, women, those with higher socioeconomic status and those who were physically active tended to report better dietary patterns. These findings were not explained by age and sex differences.
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24 Jan
Characteristics of the Study Sample
The 2,172 African-American participants in Project DIRECT were predominately female (62%) and had a mean age of 46 years (see Table 1). About 38% of participants were currently married, and the majority were employed (61%). Most participants had completed high school (>70%) and about one-third had yearly incomes >$25,000.
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23 Jan
Data Source and Study Population
We analyzed data from the baseline assessment of Project DIRECT (Diabetes Interventions Reaching and Educating Communities Together); methods are described in detail elsewhere. Briefly, a baseline assessment was conducted in 1997 using a multistage, population-based probability sample from U.S. census files in predominately African-American neighborhoods in Raleigh and Greensboro, NC. Trained field interviewers visited each household and selected eligible persons according to a specified protocol. Individuals who were eligible were invited to complete a personal interview; the overall response rate was 87%. The total study sample included 2,310 people (2,210 African Americans, 65 whites and 35 members of other races). In this cross-sectional analysis, we evaluated only those individuals who self-identified race as African-American. Individuals who had missing data on sociodemographic (not including income) or dietary variables were excluded, yielding a final study population of 2,172 African Americans.
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22 Jan
African Americans are disproportionately affected by obesity and obesity-related diseases, which are related, in part, to dietary factors. Nonetheless, studies evaluating dietary patterns among this population have been limited.
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21 Jan
The current status of the remaining training programs at Harlem Hospital, Meharry, Morehouse, Howard, and King-Drew is outlined in Tables 2-7. These tables also highlight programs that have been lost over the past 15 years. This is a trend that bears close watching and due diligence, particularly those involved in leadership positions in American medicine. Very little that has been proposed to make our plight better in American medicine has met with success to date, including the 3,000 by 2,000 program, which had the backing of the Association of American Medical Colleges as well as the NMA. If we do not take drastic measures, we will be limited to a few primary care and internal medicine programs, and our students will have limited access to subspecialty training. It has been clearly demonstrated that people of color provide care for people of color and that even affluent black patients have less access to high-quality care than their white counterparts. Therefore, if there are no black interventional cardiologists, ophthalmologists, urologists, surgical oncologists, endocrinologists, cardiac surgeons, orthopedic surgeons OB/GYN surgeons, then blacks and other minorities will have even less access to the healthcare system than they presently experience. This will only accentuate the growing disparities in healthcare among minorities outlined by the Institute of Medicine in its 2002 report.
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