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Trends in Poor Health Indicators Among Black and Hispanic Middle-aged and Older Adults in the United States, 1999-2018

IMPORTANCE: Adults who belong to racial/ethnic minority groups are more likely than White adults to receive a diagnosis of chronic disease in the United States. OBJECTIVE: To evaluate which health indicators have improved or become worse among Black and Hispanic middle-aged and older adults since th...

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Autores principales: Odlum, Michelle, Moise, Nathalie, Kronish, Ian M., Broadwell, Peter, Alcántara, Carmela, Davis, Nicole J., Cheung, Ying Kuen K., Perotte, Adler, Yoon, Sunmoo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7658737/
https://www.ncbi.nlm.nih.gov/pubmed/33175177
http://dx.doi.org/10.1001/jamanetworkopen.2020.25134
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author Odlum, Michelle
Moise, Nathalie
Kronish, Ian M.
Broadwell, Peter
Alcántara, Carmela
Davis, Nicole J.
Cheung, Ying Kuen K.
Perotte, Adler
Yoon, Sunmoo
author_facet Odlum, Michelle
Moise, Nathalie
Kronish, Ian M.
Broadwell, Peter
Alcántara, Carmela
Davis, Nicole J.
Cheung, Ying Kuen K.
Perotte, Adler
Yoon, Sunmoo
author_sort Odlum, Michelle
collection PubMed
description IMPORTANCE: Adults who belong to racial/ethnic minority groups are more likely than White adults to receive a diagnosis of chronic disease in the United States. OBJECTIVE: To evaluate which health indicators have improved or become worse among Black and Hispanic middle-aged and older adults since the Minority Health and Health Disparities Research and Education Act of 2000. DESIGN, SETTING, AND PARTICIPANTS: In this repeated cross-sectional study, a total of 4 856 326 records were extracted from the Behavioral Risk Factor Surveillance System from January 1999 through December 2018 of persons who self-identified as Black (non-Hispanic), Hispanic (non-White), or White and who were 45 years or older. EXPOSURE: The 1999 legislation to reduce racial/ethnic health disparities. MAIN OUTCOMES AND MEASURES: Poor health indicators and disparities including major chronic diseases, physical inactivity, uninsured status, and overall poor health. RESULTS: Among the 4 856 326 participants (2 958 041 [60.9%] women; mean [SD] age, 60.4 [11.8] years), Black adults showed an overall decrease indicating improvement in uninsured status (β = −0.40%; P < .001) and physical inactivity (β = −0.29%; P < .001), while they showed an overall increase indicating deterioration in hypertension (β = 0.88%; P < .001), diabetes (β = 0.52%; P < .001), asthma (β = 0.25%; P < .001), and stroke (β = 0.15%; P < .001) during the last 20 years. The Black-White gap (ie, the change in β between groups) showed improvement (2 trend lines converging) in uninsured status (−0.20%; P < .001) and physical inactivity (−0.29%; P < .001), while the Black-White gap worsened (2 trend lines diverging) in diabetes (0.14%; P < .001), hypertension (0.15%; P < .001), coronary heart disease (0.07%; P < .001), stroke (0.07%; P < .001), and asthma (0.11%; P < .001). Hispanic adults showed improvement in physical inactivity (β = −0.28%; P = .02) and perceived poor health (β = −0.22%; P = .001), while they showed overall deterioration in hypertension (β = 0.79%; P < .001) and diabetes (β = 0.50%; P < .001). The Hispanic-White gap showed improvement in coronary heart disease (−0.15%; P < .001), stroke (−0.04%; P < .001), kidney disease (−0.06%; P < .001), asthma (−0.06%; P = .02), arthritis (−0.26%; P < .001), depression (−0.23%; P < .001), and physical inactivity (−0.10%; P = .001), while the Hispanic-White gap worsened in diabetes (0.15%; P < .001), hypertension (0.05%; P = .03), and uninsured status (0.09%; P < .001). CONCLUSIONS AND RELEVANCE: This study suggests that Black-White disparities increased in diabetes, hypertension, and asthma, while Hispanic-White disparities remained in diabetes, hypertension, and uninsured status.
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spelling pubmed-76587372020-11-12 Trends in Poor Health Indicators Among Black and Hispanic Middle-aged and Older Adults in the United States, 1999-2018 Odlum, Michelle Moise, Nathalie Kronish, Ian M. Broadwell, Peter Alcántara, Carmela Davis, Nicole J. Cheung, Ying Kuen K. Perotte, Adler Yoon, Sunmoo JAMA Netw Open Original Investigation IMPORTANCE: Adults who belong to racial/ethnic minority groups are more likely than White adults to receive a diagnosis of chronic disease in the United States. OBJECTIVE: To evaluate which health indicators have improved or become worse among Black and Hispanic middle-aged and older adults since the Minority Health and Health Disparities Research and Education Act of 2000. DESIGN, SETTING, AND PARTICIPANTS: In this repeated cross-sectional study, a total of 4 856 326 records were extracted from the Behavioral Risk Factor Surveillance System from January 1999 through December 2018 of persons who self-identified as Black (non-Hispanic), Hispanic (non-White), or White and who were 45 years or older. EXPOSURE: The 1999 legislation to reduce racial/ethnic health disparities. MAIN OUTCOMES AND MEASURES: Poor health indicators and disparities including major chronic diseases, physical inactivity, uninsured status, and overall poor health. RESULTS: Among the 4 856 326 participants (2 958 041 [60.9%] women; mean [SD] age, 60.4 [11.8] years), Black adults showed an overall decrease indicating improvement in uninsured status (β = −0.40%; P < .001) and physical inactivity (β = −0.29%; P < .001), while they showed an overall increase indicating deterioration in hypertension (β = 0.88%; P < .001), diabetes (β = 0.52%; P < .001), asthma (β = 0.25%; P < .001), and stroke (β = 0.15%; P < .001) during the last 20 years. The Black-White gap (ie, the change in β between groups) showed improvement (2 trend lines converging) in uninsured status (−0.20%; P < .001) and physical inactivity (−0.29%; P < .001), while the Black-White gap worsened (2 trend lines diverging) in diabetes (0.14%; P < .001), hypertension (0.15%; P < .001), coronary heart disease (0.07%; P < .001), stroke (0.07%; P < .001), and asthma (0.11%; P < .001). Hispanic adults showed improvement in physical inactivity (β = −0.28%; P = .02) and perceived poor health (β = −0.22%; P = .001), while they showed overall deterioration in hypertension (β = 0.79%; P < .001) and diabetes (β = 0.50%; P < .001). The Hispanic-White gap showed improvement in coronary heart disease (−0.15%; P < .001), stroke (−0.04%; P < .001), kidney disease (−0.06%; P < .001), asthma (−0.06%; P = .02), arthritis (−0.26%; P < .001), depression (−0.23%; P < .001), and physical inactivity (−0.10%; P = .001), while the Hispanic-White gap worsened in diabetes (0.15%; P < .001), hypertension (0.05%; P = .03), and uninsured status (0.09%; P < .001). CONCLUSIONS AND RELEVANCE: This study suggests that Black-White disparities increased in diabetes, hypertension, and asthma, while Hispanic-White disparities remained in diabetes, hypertension, and uninsured status. American Medical Association 2020-11-11 /pmc/articles/PMC7658737/ /pubmed/33175177 http://dx.doi.org/10.1001/jamanetworkopen.2020.25134 Text en Copyright 2020 Odlum M et al. JAMA Network Open. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Odlum, Michelle
Moise, Nathalie
Kronish, Ian M.
Broadwell, Peter
Alcántara, Carmela
Davis, Nicole J.
Cheung, Ying Kuen K.
Perotte, Adler
Yoon, Sunmoo
Trends in Poor Health Indicators Among Black and Hispanic Middle-aged and Older Adults in the United States, 1999-2018
title Trends in Poor Health Indicators Among Black and Hispanic Middle-aged and Older Adults in the United States, 1999-2018
title_full Trends in Poor Health Indicators Among Black and Hispanic Middle-aged and Older Adults in the United States, 1999-2018
title_fullStr Trends in Poor Health Indicators Among Black and Hispanic Middle-aged and Older Adults in the United States, 1999-2018
title_full_unstemmed Trends in Poor Health Indicators Among Black and Hispanic Middle-aged and Older Adults in the United States, 1999-2018
title_short Trends in Poor Health Indicators Among Black and Hispanic Middle-aged and Older Adults in the United States, 1999-2018
title_sort trends in poor health indicators among black and hispanic middle-aged and older adults in the united states, 1999-2018
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7658737/
https://www.ncbi.nlm.nih.gov/pubmed/33175177
http://dx.doi.org/10.1001/jamanetworkopen.2020.25134
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