These publications show evidence of our work:
Social Determinants of Health: An Approach to Health Disparities Research
Fouad, M.N., Oates, G. R., Scarinci, I.C., Demark-Wahnefried, W, Hamby, B.W., Bateman, L.B., Estrada, J.J., Payton, M., Sims, M., Miele, L., Partridge, E.E. (2016). Supplement to American Journal of Preventive Medicine.
The Mid-South TCC pubished its findings to date, using a conceptual framework that considers the social context in which people live in order to understand the pathways and mechanisms that generate different health outcomes in obesity and related chronic diseases for vulnerable populations.
Pre-school Obesity is Inversely Associated with Vegetable Intake, Grocery Stores and Outdoor Play
Kepper M, Tseng TS, Volaufova J, Scribner R, Nuss H, Sothern M. Pediatric Obesity, 2015.
BACKGROUND:
Kepper M, Tseng TS, Volaufova J, Scribner R, Nuss H, Sothern M. Pediatric Obesity, 2015.
The study determined the association between body mass index (BMI) z score and fruit and vegetable intake, frequency and ratio of fast food outlets and grocery stores in concentric areas around the child’s residence, outdoor play and total crime index.
METHODS:
Data from 78 Louisiana pre-school children were analyzed using Pearson’s correlation and multiple regression analysis. Parental-reported fruit intake was linearly associated with increased number of grocery store counts in concentric areas around the child’s residence (P = 0.0406, P = 0.0281).
RESULTS:
Vegetable intake was inversely (P = 0.04) and the ratio of fast food outlets to grocery stores in a 2-mile concentric area around the child’s residence was positively (P = 0.05) associated to BMI z score after applying Best Model regression analysis (F = 3.06, P = 0.0346).
CONCLUSIONS:
Children residing in neighbourhoods with greater access to fast foods and lower access to fruits and vegetables may be at higher risk for developing obesity during pre-school years.
A Participatory Evaluation Framework in the Establishment and Implementation of Transdisciplinary Collaborative Centers for Health Disparities Research
Scarinci IC, Moore A, Benjamin R, Vickers S, Shikany J, Fouad M
OBJECTIVE:
Scarinci IC, Moore A, Benjamin R, Vickers S, Shikany J, Fouad M
We describe the formulation and implementation of a participatory evaluation plan for three Transdisciplinary Collaborative Centers for Health Disparities Research funded by the National Institute of Minority Health and Health Disparities.
METHODS:
Although different in scope of work, all three centers share a common goal of establishing sustainable centers in health disparities science in three priority areas - social determinants of health, men's health research, and health policy research.
RESULTS:
The logic model guides the process, impact, and outcome evaluation. Emphasis is placed on process evaluation in order to establish a "blue print" that can guide other efforts as well as assure that activities are being implemented as planned.
CONCLUSIONS:
We have learned three major lessons in this process: (1) Significant engagement, participation, and commitment of all involved is critical for the evaluation process; (2) Having a "roadmap" (logic model) and "directions" (evaluation worksheets) are instrumental in getting members from different backgrounds to follow the same path; and (3) Participation of the evaluator in the leadership and core meetings facilitates continuous feedback.
Assessing Nutrition Environment in the Southern Quadrant Area in Jackson, Mississippi.
Leggett S, Wesley J, Betson N, Manogin, MG. Journal of Rural and Urban Research, 2015
BACKGROUND:
Leggett S, Wesley J, Betson N, Manogin, MG. Journal of Rural and Urban Research, 2015
The research assessed the availability, quality, and price of healthy and less healthy foods in grocery stores and convenience stores in a low wealth urban area in south Jackson.
METHODS:
Using the Nutrition Environment Measurement Survey (NEMS), seven grocery stores and two corner stores were selected for evaluation of the area’s nutrition environment. The sample was selected from a larger number of stores located in Hinds County, Jackson Metropolitan Area.
RESULTS:
Findings from the study showed that most stores sold healthier alternatives in beverages, such as low fat milk, fruit juice, and diet sodas. However, the healthier alternatives were generally costly. Less healthy options in meats with higher percentages of fat, frozen dinners, and whole milk were popular foods and available in a majority of stores.
CONCLUSION:
The study concludes that the need exists for improving the availability of healthier foods in low wealth communities.
Disparities in Cervical Cancer Mortality Rates as Determined by the Longitudinal Hyperbolastic Mixed-Effects Type II Model
Tabatabai MA, Kengwoung-Keumo JJ, Eby WM, Bae S, Guemmegne JT, Manne U, Fouad M, Partridge EE, Singh KP. PLUS ONE, 2014.
BACKGROUND:
Tabatabai MA, Kengwoung-Keumo JJ, Eby WM, Bae S, Guemmegne JT, Manne U, Fouad M, Partridge EE, Singh KP. PLUS ONE, 2014.
The main purpose of this study was to model and analyze the dynamics of cervical cancer mortality rates for African-American (Black) and White women residing in 13 states located in the eastern half of the United States of American from 1975-2010.
METHODS:
The cervical cancer mortality rates of the surveillance, epidemiology, and end results (SEER) were used to model and analyze the dynamics of cervical cancer mortality, a longitudinal yperboloastic mixed-effects type II model was used to model the cervical cancer mortality data and SAS PROC NLMixed and Mathematica were utilzed to perform the computations.
RESULTS:
Despite decreasing trends in cervical cancer mortality rates for both races, racial disparities in mortality rates still exist. In all 13 states, Black women had higher mortality rates at all times. The degree of disparities and pace of decline in mortality rates over time differed among these states. Determining the paces of decline over 36 years showed that Tennessee had the most rapid decline in cervical cancer mortality for Black women, and Mississippi had the most rapid decline for White Women. In contrast, slow declines in cervical cancer mortality were noted for Black women in Florida and for White women in Maryland.
CONCLUSIONS:
In all 13 states, cervical cancer mortality rates for both racial groups have fallen. Disparities in the pace of decline in mortality rates in these states may be due to differences in the rates of screening for cervical cancers. Of note, the gap in cervical cancer mortality rates between Black women and White women is narrowing.
A New Robust Method for Nonlinear Regression
Tabatabai MA, Kengwoung-Keumo JJ, Eby WM, Bae S, Manne U, Fouad M, Singh KP. (2014). A New Robust Method for Nonlinear Regression. Journal of Biometrics and Biostatistics, 2014.
BACKGROUND:
Tabatabai MA, Kengwoung-Keumo JJ, Eby WM, Bae S, Manne U, Fouad M, Singh KP. (2014). A New Robust Method for Nonlinear Regression. Journal of Biometrics and Biostatistics, 2014.
When outliers are present, the least squares method of nonlinear regression performs poorly. The main purpose of this paper is to provide a robust alternative technique to the Ordinary Least Squares nonlinear regression method. This new robust nonlinear regression method can provide accurate parameter estimates when outliers and/or influential observations are present.
METHOD:
Real and simulated data for drug concentration and tumor size-metastasis are used to assess the performance of this new estimator. Monte Carlo simulations are performed to evaluate the robustness of our new method in comparison with the Ordinary Least Squares method.
RESULTS:
In simulated data with outliers, this new estimator of regression parameters seems to outperform the Ordinary Least Squares with respect to bias, mean squared errors, and mean estimated parameters. Two algorithms have been proposed. Additionally and for the sake of computational ease and illustration, a Mathematica program has been provided in the Appendix.
CONCLUSION:
The accuracy of our robust technique is superior to that of the Ordinary Least Squares. The robustness and simplicity of computations make this new technique more appropriate and useful tool for the analysis of nonlinear regressions.
Racial Differences in Neighborhood Disadvantage, Inflammation and Metabolic Control in Black and White Pediatric Type 1 Diabetes Patients
Coulon SJ, Belasco-Gonzalez C, Scribner R, Park CL, Gomez R, Vargas A, Stender S, Zabaleta, J, Clesi, P, Chalew SA, Hempe JM. Pediatric Diabetes, 2016.
BACKGROUND:
Coulon SJ, Belasco-Gonzalez C, Scribner R, Park CL, Gomez R, Vargas A, Stender S, Zabaleta, J, Clesi, P, Chalew SA, Hempe JM. Pediatric Diabetes, 2016.
Racial variation in the relationship between blood glucose and hemoglobin A1c (HbA1c) complicates diabetes diagnosis and management in racially mixed populations. Understanding why HbA1c is persistently higher in blacks than whites could help reduce racial disparity in diabetes outcomes.
OBJECTIVE:
Test the hypothesis that neighborhood disadvantage is associated with inflammation and poor metabolic control in a racially mixed population of pediatric type 1 diabetes patients.
METHODS:
Patients (n = 86, 53 white, 33 black) were recruited from diabetes clinics. Self-monitored mean blood glucose (MBG) was downloaded from patient glucose meters. Blood was collected for analysis of HbA1c and C-reactive protein (CRP). Patient addresses and census data were used to calculate a concentrated disadvantage index (CDI). High CDI reflects characteristics of disadvantaged neighborhoods.
RESULTS:
HbA1c and MBG were higher (p < 0.0001) in blacks [10.4% (90.3 mmol/mol), 255 mg/dL] than whites [8.9% (73.9 mmol/mol), 198 mg/dL). CDI was higher in blacks (p < 0.0001) and positively correlated with HbA1c (r = 0.40, p = 0.0002) and MBG (r = 0.35, p = 0.0011) unless controlled for race. CDI was positively associated with CRP by linear regression within racial groups. CRP was not different between racial groups, and was not correlated with MBG, but was positively correlated with HbA1c when controlled for race (p = 0.04).
CONCLUSIONS:
Neighborhood disadvantage was associated with inflammation and poor metabolic control in pediatric type 1 diabetes patients. Marked racial differences in potential confounding factors precluded differentiation between genetic and environmental effects. Future studies should recruit patients matched for neighborhood characteristics and treatment regimen to more comprehensively assess racial variation in HbA1c.
Psychosocial Factors Are Associated With Blood Pressure Progression Among African Americans in the Jackson Heart Study
Ford CD, Sims M, Higginbotham JC, Crowther MR, Wyatt SB, Musani SK, Payne TJ, Fox ER, Parton JM. American Journal of Hypertension, 2016.
BACKGROUND:
Ford CD, Sims M, Higginbotham JC, Crowther MR, Wyatt SB, Musani SK, Payne TJ, Fox ER, Parton JM. American Journal of Hypertension, 2016.
Research that examines the associations of psychosocial factors with incident hypertension among African Americans (AA) is limited. Using Jackson Heart Study (JHS) data, we examined associations of negative affect and stress with incident hypertension and blood pressure (BP) progression among AA.
METHODS:
Our sample consisted of 1,656 normotensive participants at baseline (2000-2004) (mean age 47±12; 61% women). We investigated associations of negative affect (cynical distrust, anger-in, anger-out, and depressive symptoms) and stress (perceived stress, weekly stress inventory (WSI)-event, WSI-impact, and major life events) with BP progression (an increase by one BP stage as defined by JNC VII) and incident hypertension by examination 2 (2005-2008). Poisson regression analysis was utilized to examine the prevalence ratios (PRs; 95% confidence interval (CI)) of BP tracking and incident hypertension with psychosocial factors, adjusting for baseline age, sex, socioeconomic status (SES), and hypertension risk factors.
RESULTS:
Fifty-six percentage of the sample (922 cases) had BP progression from 2005 to 2008. After adjustment for age, sex, and SES, a high anger-out score was associated with a 20% increased risk of BP progression compared to a low anger-out score (PR 1.20; 95% CI 1.05-1.36). High depressive symptoms score was associated with BP progression in the age, sex, and SES-adjusted model (PR 1.14; 95% CI 1.00-1.30). High WSI-event scores were associated with BP progression in the fully adjusted model (PR 1.21; 95% CI 1.04-1.40). We did not observe significant associations with any of the psychosocial measures and incident hypertension.
CONCLUSIONS:
Psychosocial factors were associated with BP progression, with the strongest evidence for number of stressful events that occurred.
Perceived Discrimination is Associated with Health Behaviours Among African-Americans in the Jackson Heart Study
Sims M, Diez-Roux AV, Gebreab SY, Brenner A, Dubbert P, Wyatt S, Bruce M, Hickson D, Payne T, Taylor H. Journal of Epidemiology & Community Health, 2016.
BACKGROUND:
Sims M, Diez-Roux AV, Gebreab SY, Brenner A, Dubbert P, Wyatt S, Bruce M, Hickson D, Payne T, Taylor H. Journal of Epidemiology & Community Health, 2016.
Using Jackson Heart Study data, we examined associations of multiple measures of perceived discrimination with health behaviours among African-Americans (AA).
METHODS: The cross-sectional associations of everyday, lifetime and burden of discrimination with odds of smoking and mean differences in physical activity, dietary fat and sleep were examined among 4925 participants aged 35-84 years after adjustment for age and socioeconomic status (SES).
RESULTS:
Men reported slightly higher levels of everyday and lifetime discrimination than women and similar levels of burden of discrimination as women. After adjustment for age and SES, everyday discrimination was associated with more smoking and a greater percentage of dietary fat in men and women (OR for smoking: 1.13, 95% CI 1.00 to 1.28 and 1.19, 95% CI 1.05 to 1.34; mean difference in dietary fat: 0.37, p<0.05 and 0.43, p<0.01, in men and women, respectively). Everyday and lifetime discrimination were associated with fewer hours of sleep in men and women (mean difference for everyday discrimination: -0.08, p<0.05 and -0.18, p<0.001, respectively; and mean difference for lifetime discrimination: -0.08, p<0.05 and -0.24, p<0.001, respectively). Burden of discrimination was associated with more smoking and fewer hours of sleep in women only.
CONCLUSIONS:
Higher levels of perceived discrimination were associated with select health behaviours among men and women. Health behaviours offer a potential mechanism through which perceived discrimination affects health in AA.
Depressive Symptoms are Associated with Incident Coronary Heart Disease Orrevascularization among Blacks but not Among Whites in the Reasons for Geographical and Racial Differences in Stroke Study
Sims M, Redmond N, Khodeva Y, Durant RW, Halanych J, Safford MM. Annals of Epidemiology, 2015.
PURPOSE:Sims M, Redmond N, Khodeva Y, Durant RW, Halanych J, Safford MM. Annals of Epidemiology, 2015.
To examine the association of depressive symptoms with coronary heart disease (CHD) endpoints by race and income.
METHODS:
Study participants were Blacks and Whites (n=24,443) without CHD at baseline from the national REasons for Geographical and Racial Differences in Stroke (REGARDS) cohort. Outcomes included acute CHD and CHD or revascularization. We estimated race-stratified multivariable Cox proportional hazards models of incident CHD and incident CHD or revascularization with the 4-item Center for Epidemiological Studies-Depression scale, adjusting for risk factors.
RESULTS:
Mean follow-up was 4.2+1.5 years, CHD incidence was 8.3 events per 1000 person years (n=366) among Blacks and 8.8 events per 1000 person years (n=613) among Whites. After adjustment for age, sex, marital status, region, and socioeconomic status, depressive symptoms were significantly associated with incident CHD among Blacks [HR 1.39 (95%CI 1.00-1.91)], but not among Whites [HR 1.10 (95%CI 0.74-1.64)]. In the fully-adjusted model, compared to Blacks who reported no depressive symptoms, those reporting depressive symptoms had greater risk for the composite endpoint of CHD or revascularization [HR 1.36 (95%CI 1.01-1.81)]. Depressive symptoms were not associated with incident CHD endpoints among Whites.
CONCLUSIONS:
High depressive symptoms were associated with higher risk of CHD or revascularization for Blacks but not Whites.
