Prevalence and features of colorectal lesions among Hispanics: A hospital-based study

AIM: To evaluate the prevalence and characteristics of colorectal adenoma and carcinoma in an inner city Hispanic population.METHODS: We reviewed the reports of 1628 Hispanic patients who underwent colonoscopy at Howard University from 2000 to 2010. Advanced adenoma was defined as adenoma ≥ 1 cm in size,adenomas with villous histology,high grade dysplasia and/or invasive cancer. Statistical analysis was performed using χ2 statistics and t-test.RESULTS: The median age of the patients was 54 years,64.2% were females. Polyps were observed in 489(30.0%) of patients. Adenoma prevalence was 16.8%(n = 273),advanced adenoma 2.4%(n = 39),and colorectal cancer 0.4%(n = 7). Hyperplastic polyps were seen in 6.6% of the cohort(n = 107). Adenomas predominantly exhibited a proximal colonic distribution(53.7%,n = 144); while hyperplastic polyps were mostly located in the distal colon(70%,n = 75). Among 11.7%(n = 191) patients who underwent screening colonoscopy,the prevalence of colorectal lesions was 21.4% adenoma,2.6% advanced adenoma; and 8.3% hyperplastic polyps.CONCLUSION: Our data showed low colorectal cancer prevalence among Hispanics in the Washington DC area. However,the pre-neoplastic pattern of colonic lesions in Hispanics likely points toward a shift in this population that needs to be monitored closely through large epidemiological studies.

Features of hepatocellular carcinoma in Hispanics differ from African Americans and non-Hispanic Whites

AIM To compare features of hepatocellular carcinoma(HCC) in Hispanics to those of African Americans and Whites.METHODS Patients treated for HCC at an urban tertiary medical center from 2005 to 2011 were identified from a tumor registry. Data were collected retrospectively, including demographics, comorbidities, liver disease characteristics, tumor parameters, treatment, and survival(OS) outcomes. OS analyses were performed using Kaplan-Meier method.RESULTS One hundred and ninety-five patients with HCC were identified: 80.5% were male, and 22% were age 65 or older. Mean age at HCC diagnosis was 59.7 ± 9.8 years. Sixty-one point five percent of patients had Medicare or Medicaid; 4.1% were uninsured. Compared to African American(31.2%) and White(46.2%) patients, Hispanic patients(22.6%) were more likely to have diabetes(P = 0.0019), hyperlipidemia(P = 0.0001), nonalcoholic steatohepatitis(NASH)(P = 0.0021), end stage renal disease(P = 0.0057), and less likely to have hepatitis C virus(P < 0.0001) or a smoking history(P < 0.0001). Compared to African Americans, Hispanics were more likely to meet criteria for metabolic syndrome(P = 0.0491), had higher median MELD scores(P = 0.0159), ascites(P = 0.008), and encephalopathy(P = 0.0087). Hispanic patients with HCC had shorter OS than the other racial groups(P = 0.020), despite similarities in HCC parameters and treatment. CONCLUSION In conclusion, Hispanic patients with HCC have higher incidence of modifiable metabolic risk factors including NASH, and shorter OS than African American and White patients.

COVID-19 among African Americans and Hispanics:Does gastrointestinal symptoms impact the outcome?

BACKGROUND The coronavirus disease 2019(COVID-19)disproportionately affected African Americans(AA)and Hispanics(HSP).AIM To analyze the significant effectors of outcome in African American patient population and make special emphasis on gastrointestinal(GI)symptoms,laboratory values and comorbidities METHODS We retrospectively evaluated the medical records of 386 COVID-19 positive patients admitted at Howard University Hospital between March and May 2020.We assessed the symptoms,including the GI manifestations,comorbidities,and mortality,using logistic regression analysis.RESULTS Of these 386 COVID-19 positive patients,257(63.7%)were AAs,102(25.3%)HSP,and 26(6.45%)Whites.There were 257(63.7%)AA,102(25.3%)HSP,26(6.45%)Whites.The mean age was 55.6 years(SD=18.5).However,the mean age of HSP was the lowest(43.7 years vs 61.2 for Whites vs 60 for AAs).The mortality rate was highest among the AAs(20.6%)and lowest among HSP(6.9%).Patients with shortness of breath(SOB)(OR2=3.64,CI=1.73-7.65)and elevated AST(OR2=8.01,CI=3.79-16.9)elevated Procalcitonin(OR2=8.27,CI=3.95-17.3),AST(OR2=8.01,CI=3.79-16.9),ferritin(OR2=2.69,CI=1.24-5.82),and Lymphopenia(OR2=2.77,CI=1.41-5.45)had a high mortality rate.Cough and fever were common but unrelated to the outcome.Hypertension and diabetes mellitus were the most common comorbidities.Glucocorticoid treatment was associated with higher mortality(OR2=5.40,CI=2.72-10.7).Diarrhea was prevalent(18.8%),and GI symptoms did not affect the outcome.CONCLUSION African Americans in our study had the highest mortality as they consisted of an older population and comorbidities.Age is the most important factor along with SOB in determining the mortality rate.Overall,elevated liver enzymes,ferritin,procalcitonin and C-reactive protein were associated with poor prognosis.GI symptoms did not affect the outcome.Glucocorticoids should be used judiciously,considering the poor outcomes associated with it.Attention should also be paid to monitor liver function during COVID-19,especially in AA and HSP patients with higher disease severity.

Assessing Colorectal Cancer Screening Behaviors and Knowledge among At-Risk Hispanics in Southern New Mexico

Purpose: Colorectal cancer (CRC) mortality rates in New Mexico (NM) continue to be higher than national rates. Hispanic CRC mortality rates in NM surpass those of overall Hispanics in the US. This study was designed to characterize and understand factors contributing to low CRC screening rates in this border region. Methods: A CRC Knowledge Assessment Survey (KAS) was administered in either English or Spanish to 247 individuals attending community events throughout southern NM. A subset of these individuals completed an online CRC risk assessment survey managed by the National Cancer Institute (NCI). Data analysis tested for significant differences in knowledge, physician-patient CRC interactions, CRC risk level perception, and screening rates across diverse ethnic and age groups. Results: Both CRC knowledge and physician-patient CRC interactions were positively associated with participant screening history. Significant age and ethnic differences for CRC knowledge, physician-patient CRC interactions, and screening history in the NM border sample were also seen. Age-eligible Hispanics (50+) as well as those less than 50 years of age had lower CRC knowledge and were less likely to engage in physician-patient CRC interactions than non-Hispanic Whites (NHWs). The age-eligible Hispanics also reported lower CRC screening rates than their NHW counterparts. Conclusions: Low CRC knowledge and limited physician-patient CRC interactions appear to contribute to low screening rates in this NM population. Expanding education and outreach efforts for this border population are essential to promote early CRC detection and thereby decrease overall CRC mortality rates.

Sleep Quality among Hispanics of Mexican Descent and Non-Hispanic Whites: Results from the Sleep Health and Knowledge in US Hispanics Study

Objectives: To investigate differences in sleep quality between Hispanics of Mexican descent (HMD) and Non-Hispanic Whites (NHW) and evaluate the effect of acculturation to the US lifestyle in sleep health. We hypothesize that the detrimental effect of acculturation on health outcomes will impact sleep quality among HMD. Design: We performed a population-based random digit dialing telephone survey to determine sleep quality in HMD and NHW. We collected from 3667 subjects, demographics, previous diagnosis of depression or anxiety, past treatment for sleep disorders, the Pittsburgh Sleep Quality Index (PSQI) and the Short Acculturation Scale for Hispanics. Results: The prevalence of poor sleep quality (PSQI > 5) was 64.4% for HMD and 64.3% for NHW (p = 0.93). A prior diagnosis of depression or anxiety was an independent predictor of poor sleep quality in both groups (OR 3.4 and 2.7 for HMD and NHW. Ethnicity was not a predictor of poor sleep quality in HMD or NHW. Acculturation was not a predictor of poor sleep quality in HMD. However, highly acculturated young HMD males had significantly more prevalence of poor sleep quality compared to NHW (64.8% vs. 49.8%, p Conclusion: The absence of sleep quality differences in a large sample of HMD and NHW living in San Diego County is contrary to current data of having poorer sleep quality among Latinos. We found that neither ethnicity nor acculturation were predictors of poor sleep quality in HMD. However, we demonstrated a highly prevalent poor sleep quality among the two ethnic groups. The finding of significantly lower sleep quality in young highly acculturated HMD men may represent the heterogeneity of ethnicity related to sleep. Programs to improve sleep quality in subjects with depression and/or anxiety, and in young highly-acculturated HMD seems warranted.

Disparate outcomes in Hispanic patients with metabolic dysfunctionassociated steatotic liver disease/steatohepatitis and type 2 diabetes: Large cohort study

BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD)and metabolic dysfunction-associated steatohepatitis(MASH)are a growing health burden across a significant portion of the global patient population.However,these conditions seem to have disparate rates and outcomes between different ethnic populations.The combination of MASLD/MASH and type 2 diabetes increases the risk of hepatocellular carcinoma(HCC),and Hispanic patients experience the greatest burden,particularly those in South Texas.AIM To compare outcomes between Hispanic and non-Hispanic patients in the United States,while further focusing on the Hispanic population within Southeast Texas to determine whether the documented disparity in outcomes is a function of geographical circumstance or if there is a more widespread reason that all clinicians must account for in prognostic consideration.METHODS This cohort analysis was conducted with data obtained from TriNetX,LLC(“TriNetX”),a global federated health research network that provides access to deidentified medical records from healthcare organizations worldwide.Two cohort networks were used:University of Texas Medical Branch(UTMB)hospital and the United States national database collective to determine whether disparities were related to geographic regions,like Southeast Texas.RESULTS This study findings revealed Hispanics/Latinos have a statistically significant higher occurrence of HCC,type 2 diabetes mellitus,and liver fibrosis/cirrhosis in both the United States and the UTMB Hispanic/Latino groups.Allcause mortality in Hispanics/Latinos was lower within the United States group and not statistically elevated in the UTMB cohort.CONCLUSION This would appear to support that Hispanic patients in Southeast Texas are not uniquely affected compared to the national Hispanic population.

Burden of nonalcoholic fatty liver disease and advanced fibrosis in a Texas Hispanic community cohort

AIM: To investigate the potential burden of nonalcoholic steatohepatitis(NASH) and advanced fibrosis in a hispanic community.METHODS: Four hundred and forty two participants with available ultrasonography data from the Cameron County Hispanic Cohort were included in this study. Each participant completed a comprehensive questionnaire regarding basic demographic information, medical history, medication use, and social and family history including alcohol use. Values of the nonalcoholic fatty liver disease fibrosis score(NFS), FIB4 index, BARD score, and Aspartate aminotransferase to Platelet Ratio Index(APRI) were computed using the blood samples collected within 6 mo of liver ultrasonography from each participant. Hepatic steatosis was determined by ultrasonography. As part of univariable analysis, for continuous variables, comparisons among groups were performed with student-t test, one way analysis of variance, and Mann-Whitney test. Pearson χ2 and the Fisher exact test are used to assess differences in categorical variables. For multivariable analyses, logistic regression analyses were performed to identify characteristics associated with hepatic steatosis. All reported P values are based two-sided tests, and a P value of less than 0.05 was considered to indicate statistical significance.RESULTS: The mean age and body mass index(BMI) of the study participants were 49.1 years and 31.3 kg/m2, respectively. Among them, 65.6% were females, 52% had hepatic steatosis, 49.5% had metabolic syndrome, and 29% had elevated aminotransferases. Based on established cut-offs for diagnostic panels, between 17%-63% of the entire cohort was predicted to have NASH with indeterminate or advanced fibrosis. Participants with hepatic steatosis had significantly higher BMI(32.9 ± 5.6 kg/m2 vs 29.6 ± 6.1 kg/m2, P < 0.001) and higher prevalence rates of elevation of ALT(42.2% vs 14.6%, P < 0.001), elevation of aspartate aminotransferase(38.7% vs 18.9%, P < 0.001), and metabolic syndrome(64.8% vs 33%, P < 0.001) than those without hepatic steatosis. The NFS scores(P = 0.002) and the APRI scores(P = 0.002) were significantly higher in those with steatosis but the scores of the FIB4 index and BARD were similar between the two groups. After adjusting for age, gender and BMI, elevated transaminases, metabolic syndrome and its components, intermediate NFS and APRI scores were associated hepatic steatosis in multivariable analysis. CONCLUSION: The burden of NASH and advanced fibrosis in the Hispanic community in South Texas may be more substantial than predicted from referral clinic studies.

Effect of the Mediterranean Diet on BMI in Middle-Aged Hispanic Women with Pre-Obesity and Obesity Central Washington State

Background: Conclusive evidence has yet to emerge regarding the effectiveness and applicability of the Mediterranean diet on middle-aged Hispanic women, the largest female minority group in the United States who is at-risk of metabolic disorders. Objective: The aim of this study is to evaluate the effect of the Mediterranean diet (MED) on the BMI in middle-aged Hispanic women with pre-obesity and obesity in Central Washington State. Design: A prospective study was performed to determine the effect of Mediterranean diet on the BMI of 67 Hispanic women with pre-obesity and obesity between 45 to 65 years of age in Central Washington State. The study was carried out for eight weeks. Dietary adherence was monitored to ensure consistent results. Results: The proportion of Hispanic women who reported a reduction in BMI was 94%, with a decrease in mean BMI after eight weeks of 2.8 (95% CI: 2.5 to 3.0) and P = 0.02, with an odds ratio of 2.6. Multiple linear regression analysis was used to adjust for age, education, physical activity, and smoking. Conclusion: The reduction in BMI demonstrates that the Mediterranean diet can be a promising, culturally appropriate therapy to address the obesity epidemic that is prevalent among Hispanic women.

Analysis of Childhood Obesity in Alabama and Delaware: A Cohort Study

Objective: The objective is to evaluate data sets for children aged 24 to 59 months that identified the risk factors of being obese and overweight and compare it between two U.S. states (Alabama and Delaware). Methods: An analysis of survey data sets published between 2013 and 2017, comparing the factors of obesity and its prevalence amongst different races of 50,760 children aged 24 to 59 months in the U.S., was conducted using Microsoft Excel 2016 and IBM SPSS version 1.0.0. Results: Hispanic children have the highest rate of obesity in the U.S compared to all other races. Children aged 2 - 4 years old from Alabama were more at risk for being overweight and obese compared to those from Delaware. Those between the ages of 48 - 59 months of age were more at risk than the other age groups. Conclusions: Childhood obesity is a predisposing factor for adult obesity. There is a need to identify the risk factors of obesity early in a person’s life and address them appropriately.

Comparative study of breast cancer in Mexican and Mexican-American women

Breast cancer is the number one cause of can- cer deaths among Hispanic women in the United States, and in Mexico, it recently became the primary cause of cancer deaths. This malign- nancy represents a poorly understood and un- derstudied disease in Hispanic women. The ELLA Binational Breast Cancer Study was es- tablished in 2006 as a multi-center study to as- sess patterns of breast tumor markers, clinical characteristics, and their risk factors in women of Mexican descent. We describe the design and implementation of the ELLA Study and provide a risk factor comparison between women in the U.S. and those in Mexico based on a sample of 765 patients (364 in the U.S. and 401 in Mexico). Compared to women in Mexico, U.S. women had significantly (p < 0.05) lower parity (3.2 vs. 3.9 mean live births) and breastfeeding rates (57.5% vs. 80.5%), higher use of oral contraceptives (60.7% vs. 50.1%) and hormone replacement therapy (23.3% vs. 7.6%), and higher family history of breast cancer (15.7% vs. 9.0%). Re- sults show that differences in breast cancer risk factor patterns exist between Mexico and U.S. women. We provide lessons learned from the conduct of our study. Binational studies are an important step in understanding disease pat- terns and etiology for women in both countries.

Predictors of colorectal cancer testing using the California Health Inventory Survey

AIM:To identify key variables associated with colon cancer testing using the 2009 California Health Inventory Survey(CHIS).METHODS:The CHIS has been conducted biennially since 2001 using a two-stage,geographically stratified random-digit-dial sample design to produce a representative sample of the entire State.For this study we used survey data from 2001-2009 inclusive.We restricted our analysis to White,Black,and Hispanic/Latinos aged 50-80 years.Weighted data was used to calculate the proportion of participants who underwent some form of colon cancer testing(colonoscopy,flexible sigmoidoscopy or fecal occult blood testing) within the previous 5 years stratified by race/ethnicity.For inferential analysis,boot-strapping with replacement was performed on the weighted sample to attain variance estimates at the 95%CI.For mean differences among categories we used t-tests and for comparisons of categorical data we used Pearson's χ 2.Binary logistic regression was used to identify independent variables associated with undergoing some form of testing.Trend analysis was performed to determine rates of testing over the study period stratified by race.RESULTS:The CHIS database for 2009 had 30 857 unique respondents corresponding to a weighted sample size of 10.6 million Californians.Overall,63.0%(63.0-63.1) underwent a colon cancer test within the previous 5 years;with 70.5%(70.5%-70.6%) of this subset having undergone colonoscopy.That is 44.5%(44.4%-44.5%) of all individuals 50-80 underwent colonoscopy.By multivariable regression,those tested were more likely to be male(OR = 1.06;95%CI:1.06-1.06),Black(OR = 1.30;95%CI:1.30-1.31),have a family member with colon cancer(OR = 1.71;95%CI:1.70-1.72),and have health insurance(OR = 2.71;95%CI:2.70-2.72).Progressive levels above the poverty line were also associated with receiving a test(100%-199%:1.21;1.20-1.21),(200%-299%:1.41;1.40-1.42),(> 300:1.69;1.68-1.70).The strongest variable was physician recommendation(OR = 3.90;95%CI:3.88-3.91).For the Hispanic/Latino group,additional variables associated with testing were success of physician-patient communication(OR = 2.44;95%CI:2.40-2.48) and naturalized citizenship status(OR = 1.91;95%CI:1.89-1.93).Trend analysis demonstrated increased colon cancer testing for all racial/ethnic subgroups from 2001-2009 although the rate remained considerably lower for the Hispanic/Latino subgroup.CONCLUSION:Using CHIS we identified California citizens most likely to undergo colon cancer testing.The strongest variable associated with testing for all groups was physician recommendation.

Clinical features of alcoholic hepatitis in latinos and caucasians: A single center experience

AIM To study differences of presentation, management, and prognosis of alcoholic hepatitis in Latinos compared to Caucasians. METHODS We retrospectively screened 876 charts of Caucasian and Latino patients who were evaluated at University of California Davis Medical Center between 1/1/2002-12/31/2014 with the diagnosis of alcoholic liver disease. We identified and collected data on 137 Caucasians and 64 Latinos who met criteria for alcoholic hepatitis, including chronic history of heavy alcohol use, at least one episode of jaundice with bilirubin ≥ 3.0 orcoagulopathy, new onset of liver decompensation or acute liver decompensation in known cirrhosis within 12 wk of last drink. RESULTS The mean age at presentation of alcoholic hepatitis was not significantly different between Latinos and Caucasians. There was significant lower rate of overall substance abuse in Caucasians compared to Latinos and Latinos had a higher rate of methamphetamine abuse(12.5% vs 0.7%) compared to Caucasians. Latinos had a higher mean number of hospitalizations(5.3 ± 5.6 vs 2.7 ± 2.7, P = 0.001) and mean Emergency Department visits(9.5 ± 10.8 vs 4.5 ± 4.1, P = 0.017) for alcohol related issues and complications compared to Caucasians. There was significantly higher rate of complications of portal hypertension including gastrointestinal bleeding(79.7% vs 45.3%, P < 0.001), spontaneous bacterial peritonitis(26.6% vs 9.5%, P = 0.003), and encephalopathy(81.2% vs 55.5%, P = 0.001) in Latinos compared to Caucasians.CONCLUSION Latinos have significant higher rates of utilization of acute care services for manifestations alcoholic hepatitis and complications suggesting poor access to outpatient care.

Moderate and Severe Blood Pressure Elevation Associated with Stroke in the Mexican Hispanic Population

Background: Stroke is the fourth leading cause of death in US. Amongst other factors such as age, sex, race, genetics, obesity, diabetes etc., hypertension continues to be the leading contributing factor towards stroke. Studies regarding stroke in Hispanics are sparse and inconclusive. Objectives: The objective of the present study is to investigate the potential association between blood pressure elevation and risk of ischemic stroke among the Mexican Hispanic population. Methods: A retrospective data analysis was carried out for a planned case-control study with case-control ratios of 1:2. Mexican Hispanic cases were from the ElPasoStroke database with diagnosed hypertension that had sustained an ischemic stroke (n = 505) and Mexican Hispanics diagnosed with hypertension who were stroke-free as controls from the 2005-2010 NHANES databases (n = 1010). In this analysis, we included subjects who had data on systolic, diastolic or mean arterial blood pressures for cases (327) and controls (772). In cases, blood pressure was determined by the initial admission measurement, and in controls, the first measured blood pressure was used. The unadjusted and adjusted effects of continuous measurements of systolic, diastolic and mean arterial blood pressure on stroke were determined using logistic regression analyses. Subjects were further classified into groups based on prehypertension and hypertension ranges, as established by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7). Unadjusted and adjusted logistic regression models were also used to determine the effect of categorized blood pressures. Results: Our data indicate that per unit increase in systolic, diastolic or mean arterial blood pressure elevates the odds of stroke among the Mexican Hispanic population. Adjusted analysis of categorized blood pressures showed that mild or moderate/severe high blood pressure significantly associated with odds of stroke. Maintaining and controlling blood pressure at more stringent and lower levels, specifically lowering mean arterial pressure may effectively reduce the odds of ischemic stroke among the Mexican Hispanic population. Conclusion: Elevation of blood pressure increases the odds of stroke among the Mexican Hispanic population. Our results provide new strategies to manage the stroke prevention and health disparity issues among the Mexican Hispanic population.

Bone density, microarchitecture and stiffness in Caucasian and Caribbean Hispanic postmenopausal American women

Hispanic Americans of Caribbean origin are a fast-growing subset of the US population, but there are no studies on bone density, microstructure and biomechanical integrity in this minority group. In this study, we aimed to compare Caucasian and Caribbean Hispanic postmenopausal American women with respect to these characteristics. Thirty-three Caribbean Hispanics were age-matched to thirty-three Caucasian postmenopausal women. At the lumbar spine, the Hispanic women had significantly lower areal bone mineral density （aBMD）. At the radius by high-resolution peripheral quantitative computed tomography （HR-pQCT）, there were minimal differences between Hispanic and Caucasian women. At the tibia, Hispanic women had lower trabecular volumetric bone density and trabecular number, and higher trabecular separation. Individual trabecula segmentation （ITS） analyses indicated that at the tibia, Hispanic women not only had significantly lower bone volume fraction, but also had significantly lower rod bone volume fraction, plate trabecular number, rod trabecular number and lower plate-plate, plate-rod and rod-rod junction densities compared to Caucasian women. The differences in bone quantity and quality contributed to lower whole bone stiffness at the radius, and both whole bone and trabecular bone stiffness at the tibia in Hispanic women. In conclusion, Hispanic women had poorer bone mechanical and microarchitectural properties than Caucasian women, especially at the load-bearing distal tibia.

Racial disparities in nonalcoholic fatty liver disease clinical trial enrollment: A systematic review and meta-analysis

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)has a heterogeneous distribution across racial and ethnic groups,with a disproportionate burden among Hispanics.Although there are currently no approved therapies for treatment of NAFLD,several therapies have been investigated in clinical trials.AIM To analyze the inclusion of racial and ethnic minority groups in clinical trials for NAFLD.METHODS We performed a systematic review of North American,English-language,prospective studies for NAFLD therapies published from 2005 to 2019.Racial and ethnic enrollment data were recorded for each eligible study.Meta-analysis was performed to compute pooled prevalence of different racial and ethnic groups,followed by further subgroup analyses.These analyses were based on diagnosis of non-alcoholic steatohepatitis(NASH)and timing of study on enrollment by ethnicity.Descriptive statistics were performed to compare racial and ethnic study enrollment to previously reported NAFLD population prevalence.RESULTS Thirty-eight studies met criteria for inclusion in the systematic review.When reported,median age of enrolled subjects was 49 years(range 41.5-58)with 56%female participants.NAFLD was defined through biopsy findings in 79%(n=30)of the studies.Of the included articles,treatment modalities ranged from medications(n=28,74%),lifestyle interventions(n=5,13%),bariatric surgery(n=4,11%)and phlebotomy(n=1,2%).Twenty-eight studies(73%)included racial and/or ethnic demographic information,while only 17(45%)included information regarding Hispanic participation.Of the 2983 patients enrolled in all eligible trials,a total of only 346(11.6%)Hispanic participants was reported.Meta-analysis revealed a pooled Hispanic prevalence of 24.3%(95%confidence interval 16.6-32.0,I294.6%)among studies documenting Hispanic enrollment.Hispanic enrollment increased over time from 15%from 2005-2014 to 37%from 2015-2019.CONCLUSION In a meta-analysis of NAFLD trials,documentation of racial/ethnic demographic data occurred in less than half of studies.Standardization of reporting of race/ethnicity and targeted interventions toward minority recruitment are needed to improve diversity of enrollment.

Exploring the Differences between Hispanic Men and Women with Type 2 Diabetes Mellitus Using the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Studies have shown Hispanic patients are at an increasing risk of developing type 2 diabetes;however, little is known about whether gender plays a role. Several studies were examined to help answer this question. Results of studies found female Hispanic patients tend to be more sedentary and thus struggle more with obesity, while male Hispanic patients tend to be more at risk due to smoking status and hypercholesterolemia. In addition, psychological distress and chronic stress were more likely to affect the risk for diabetes in men while immigration status was more likely to affect cardiovascular health in women. More studies are needed to fully understand the role of gender on diabetes risk;however, practitioners can utilize known information in order to tailor treatment to male or female Hispanic patients.

A Community Case Study on Geographic, Environmental, and Social Health Disparities in COVID-19 Disease: Yakima, Washington

Yakima County, Washington, a rural county with an urban core suffered disproportionately under the conditions presented by the COVID-19 pandemic and summer wildfires of 2020. With an infection rate of over 700 per 100,000 population at the height of the pandemic, the county concurrently experienced 14 consecutive days of an air quality index in the unhealthy to hazardous range in August 2020. This paper examines the contributing socioeconomic, geographic, and environmental vulnerabilities that make Yakima County particularly susceptible to the continuum of expected COVID-19 disease and related outcomes and suggests comprehensive areas of investigation to mitigate its impact on special populations, including Hispanic-Latino communities, agricultural, food production, and other essential workers.

Parenting style and oral health status

Objective: This study examined the correlation between parenting style and oral health status. Methods: Eighty-seven children aged 2 - 14 years old were examined and their oral health status was measured by the decayed, missing, filled teeth (DMFT/dmft) index, untreated caries and caries experience. Caries experience was defined as untreated and treated teeth, either restored or filled. The parenting style of parents was measured by the Parenting Style Dimension Questionnaire (PSDQ). Demographic information recorded included race/ethnicity, level of education and child’s type of dental insurance. Results: The majority of the parents identified with the authoritative parenting style. There was no correlation between parenting styles and oral health status. Hispanic children and those whose parents had less education and low socioeconomic status (Medicaid) tended to show poorer oral health status. Conclusion: The expected relationship between parenting style and oral health status was not confirmed. Race/ethnicity, level of parents’ education and socioeconomic status may have a greater impact on oral health than parenting approaches.

Increasing BMI Z-Scores 3 Years after Diagnosis among a Multiethnic Cohort of Childhood Cancer Survivors Treated in South Los Angeles

Background: Due to successful treatment modalities, the majority of pediatric cancer patients will survive. Increased body mass index (BMI) is a complication among pediatric cancer survivors. Methods: This retrospective single-center study examined BMI changes among a cohort of predominantly Hispanic patients who were treated in South Los Angeles. Data were collected at diagnosis, 1, 2 and 3 years after. Analyses included z-scores derived from calculated BMIs compared over 3 years per gender, diagnosis, and treatment modality. The unhealthy BMI z-score was defined as >1.04. Results: Thirty-four percent of the predominantly Hispanic sample had unhealthy BMI z-scores of >1.04 correlating to at or greater than the 85th percentile for age and gender. The study cohort’s BMI z-scores significantly increased from 0.15 to 1.29 at year 3 (P < 0.0001), putting 55% of this population in the unhealthy category. Median BMI z-score significantly increased to the unhealthy category at 3 years. Conclusions: Due to the predominance of Hispanic patients in this group, culturally sensitive interventions beginning at diagnosis should be considered.