Cardiovascular Health Disparities. A Systematic Review of Health Care Interventions. The publisher's final edited version of this article is available at Med Care Res Rev. See other articles in PMC that cite the published article. Abstract. Racial and ethnic disparities in cardiovascular health care are well documented. Promising approaches to disparity reduction are increasingly described in literature published since 1. The authors conducted a systematic review of clinically oriented studies in communities of color that addressed hypertension, hyperlipidemia, physical inactivity, tobacco, and two major cardiovascular conditions, coronary artery disease and heart failure. Virtually no literature specifically addressed disparity reduction. The greatest focus has been African American populations, with relatively little work in Hispanic, Asian, and Native American populations. The authors found 6. Only 1 study specifically addressed postmyocardial infarction care. Data supporting the value of registries, multidisciplinary teams, and community outreach were found across several conditions. Interventions addressing care transitions, using telephonic outreach, and promoting medication access and adherence merit further exploration. Keywords: cardiovascular disease, health disparities, interventions, quality improvement. Communities of color bear a disproportionate burden of ill health in the United States, with little improvement in overall mortality differentials during the past 4. R. Cardiovascular disease accounts for 1. United States (Thom et al. African Americans having two to three times the likelihood of dying from cardiovascular disease compared to whites at any given age (Mensah and Brown 2. These differentials in cardiovascular outcomes are thought to be partially attributable to disparities in cardiovascular disease prevention and treatment. Disparities in treatment are defined by the Institute of Medicine as ethnic/racial differences in treatment that are not justified by the underlying health conditions or treatment preferences of patients (Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care: Institute of Medicine 2. Notable ethnic/racial disparities have been described in the diagnosis, management, and outcomes of many cardiac risk factors and conditions. Considerably less research has evaluated interventions designed to reduce those disparities. Fortunately, there is a growing literature describing interventions designed to improve care in communities of color. This later body of work may not directly address disparities reduction; however, interventions that are found to improve the health of patients of color may still prove valuable given the current situation in which African Americans and Hispanics receive poorer quality of care compared to whites for a broad range of core measures of health care quality (Agency for Healthcare Research and Quality 2. H1). Racial/Ethnic Representation in Studies. In the following section of this review, we briefly describe the disparities landscape for traditional vascular risk factors (hypertension, hyperlipidemia, physical inactivity, tobacco use) and for two cardiovascular conditions (coronary artery disease and heart failure . Monitoring the Invisible Empire, the Worlds Largest Secret Society. Freemasons News and Freemason Enlightenment. TurboBit.net provides unlimited and fast file cloud storage that enables you to securely share and access files online. Search the history of over 505 billion pages on the Internet. Featured texts All Texts latest This Just In Smithsonian Libraries FEDLINK (US) Genealogy Lincoln. Welcome to our website. We deal in all aspects of militaria throughout the twentieth century. With original military items both personal and issued, including uniforms, insignia, headgear, medals, pictures,books and knives. Hypertension in African Americans has earlier onset and greater prevalence, is harder to control, and is associated with far more end- organ damage (Bosworth et al. Gadegbeku, Lea, and Jamerson 2. Fully half of the cardiovascular mortality disparity between whites and African Americans may be due to hypertension (Hicks et al. African Americans having five times as many potentially preventable hospitalizations for hypertension compared to whites (Russo, Andrews, and Coffey 2. Hypertension is also a great public health concern among other communities of color (Glover 2. Ong et al. 2. 00. Prevalence of Classical Vascular Risk Factors by Ethnicity/Race. Disparities in the prevalence and management of lipid abnormalities are also well described (Ma et al. Woodard, Kressin, and Petersen 2. African Americans have lower rates of medication adherence and control relative to whites (Benner et al. Trivedi et al. Mexican Americans are less likely to be aware of or to be treated for dyslipidemia (Hertz, Unger, and Ferrario 2. Patterns of disparities in tobacco dependence differ from that of hypertension and hyperlipidemia. The prevalence of tobacco use in African Americans and whites is similar, with lower prevalence among Hispanic and Asian populations, but with smoking rates approaching 4. Native Americans and Alaskan natives. African Americans and Hispanics are less likely to be offered assistance with cessation (Houston et al. Lopez- Quintero, Crum, and Neumark 2. Physical inactivity is most prevalent in Hispanic and African American populations, especially among females. HOUSE BLESSING: CHRISTLICHER HAUS-SEEGEN - TEMPLATE FOR ISAAC Z. HUNSICKER FRAKTUR $500 CAD; Yarmouth NS Watercolour By Listed Artist Lucy Jarvis $395 CAD; Nova Scotian Watercolour of Petite Riviere by Edith Smith Sold. Racial and ethnic disparities in cardiovascular health care are well documented. Promising approaches to disparity reduction are increasingly described in literature published since 1995, but reports are fragmented by risk. In March and April 1962, archaeologist Clement Meighan accompanied an expedition, funded by mystery writer Erle Stanley Gardner, the creator of Perry Mason, to record 'newly discovered' painted rock shelters in central Baja. On vous propose de venir vous d A large collection of easy lap quilt patterns and easy throw quilt patterns. Differential rates of inactivity begin to manifest in childhood and widen during adolescence (Kimm et al. Genkinger et al. Overviews of correlates of physical inactivity in underserved populations have recently been published (Coble and Rhodes 2. Yancey, Ory, and Davis 2. Differentials in Coronary Disease Procedures and Therapies. Differentials in the prevalence of cardiovascular conditions across racial and ethnic groups (table 2) might be attributed mainly to risk factor variation (Hozawa et al. However, the breadth and degree of racial and ethnic variations in access, management, and outcomes of established cardiovascular disease goes beyond that which can be explained by risk factor variation alone (Kindig and Thompson 2. Mayberry, Mili, and Ofili 2. Procedural differentials have been documented for nearly every area of cardiac diagnosis and care (Allison et al. Mickelson, Blum, and Geraci 1. Peterson et al. 1. Pezzin, Keyl, and Green 2. Schulman et al. Williams and Pokharna 2. Yarzebski et al. Differentials in care persist even when the clinical appropriateness of the cardiac procedure (Epstein et al. Vaccarino et al. 2. As a related issue, communities of color tend to lag behind as new therapies are introduced (NCHS 2. Sonel et al. Patient preference probably explains relatively little of the differentials in cardiac care (Gordon, Paterniti, and Wray 2. Groeneveld et al. Redberg 2. 00. 5; Whittle et al. Prevalence and Incidence of Vascular Conditions by Ethnicity/Race. Differences in residence and access to higher quality specialists (Ayanian et al. Fiscella and Franks 2. Grimshaw et al. 2. Konety, Vaughan Sarrazin, and Rosenthal 2. La. Veist et al. 2. Angelelli, Grabowski, and Mor 2. Bach et al. 2. 00. Kressin 2. 00. 5; Liu et al. Williams and Collins 2. African Americans and Hispanics appear to receive vascular care at health care organizations that perform a lower volume of procedures and have higher risk- adjusted mortality after coronary artery bypass graft surgery (Trivedi, Sequist, and Ayanian 2. MI; Skinner et al. Mortality and morbidity gaps appear to widen further in studies that look at longterm cardiovascular outcomes after hospitalizations or procedures (Bhandari et al. Konety, Vaughan Sarrazin, and Rosenthal 2. Skinner et al. This may be due, in part, to the fact that African Americans and Hispanics are 1. Ajani et al. 2. 00. Brown, Shepard, et al. Schneider, Zaslavsky, and Epstein 2. Virnig et al. Financial barriers are also much more likely in African American and Hispanic cardiac patients and are strongly associated with persistent angina and rehospitalization (Rahimi et al. Disparities in HFHF is the leading cause of medical admission in the Medicare population, and HF admission occurs significantly more in African Americans than whites, though the higher prevalence in African Americans is less clearly attributable to race once hypertension and other risk factors are controlled for (Brown, Haldeman, et al. Mortality after HF admission appears to be equal or lower in African Americans relative to whites (Agoston et al. However, once advanced left ventricular dysfunction develops, mortality in African Americans may be greater (Dries et al. African Americans (Vaccarino et al. Nationally, inpatient quality of HF care appears similar between blacks and whites in some (Lafata et al. Ahmed et al. When considering disparities in HF care, it is important to realize that the current understanding of the optimal treatment for HF for communities of color is evolving (Dries et al. Kahn and Sankar 2. A. 2. 00. 1). New Contribution. The overall impression left by the preceding literature is that disparities in the quality of cardiovascular care exist, and they may partially explain disparities in cardiovascular outcomes. Disparities in cardiovascular care for communities of color have been attributed to factors such as limited access to care, limited health literacy, and education (Daumit et al. Fiscella and Franks 2. Parker, Ratzan, and Lurie 2. Sudore et al. 2. 00. Moser et al. 2. 00. T. Taylor and Lurie 2. Ryn et al. 2. 00. Armstrong et al. 2. Fiscella and Williams 2. Wyatt et al. Such factors are thought to operate synergistically (Mehta et al. Williams 2. 00. 5). While the preceding discussion might temper expectations of success, there is, in fact, a great deal of research that has been devoted to evaluating cardiovascular interventions for communities of color in the past decade, and some of this work has begun to bear fruit. The results of these interventions are often scattered in the cardiology, prevention, public health, and general medicine literature and typically are limited to a single cardiac risk factor or condition. A comprehensive review that brings together these interventions may help to identify flaws in the design of current studies, illustrate what risk factors and conditions have received limited attention, identify interventions that have shown particular promise, and provide direction for future research. We set out to conduct such a review and bring together interventions addressing risk factor control (i. Job Interview Online Practice Tests. Get Prepared For Any Interviewin only 3. Because you may not have a lot of time to prepare, we've designed a focused interview tests to help get you interview- ready in 3. My interview was the next day and I wanted a quick, easy to use guide and this was perfect. 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