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Ellen A. Donnelly - One of the best experts on this subject based on the ideXlab platform.
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The Politics of Racial Disparity Reform: Racial Inequality and Criminal Justice Policymaking in the States
American Journal of Criminal Justice, 2017Co-Authors: Ellen A. DonnellyAbstract:Racial inequalities in criminal justice are pressing problems for policymakers. Prior literature suggests elected officials promulgate punitive, Racially disparate criminal justice policies due to partisanship and Racial fears, but scholarship has yet to explain how and why elected officials address Racial problems in criminal processing. This article introduces the framework of Racial Disparity reform policymaking. A Racial Disparity reform is a policy that seeks to reduce distinctions in criminal justice institutions’ treatment of Racial groups. Elected officials pursue these policies due to ideological beliefs in civil rights ideals and political interests in appearing to solve social problems. Using an original database of policy enactments, this article first presents the distribution and types of reform measures adopted by elected officials in all 50 states between 1998 and 2011. It then examines social and political explanations for when state legislatures and executives adopt Racial Disparity reforms. Policy enactment is predicted by worsening problems of Racial disproportion in criminal processing, Democratic control of elected branches, and the absence of judicial efforts to improve Racial fairness within a state’s criminal justice system. Similar dynamics encourage the development of different measures types within policies. Such ideological and problem-solving explanations for Racial Disparity reform show a potential for elected officials to forge more Racially just criminal justice practices.
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Racial Disparity reform: Racial inequality and policy responses in US national politics
Journal of Crime and Justice, 2016Co-Authors: Ellen A. DonnellyAbstract:AbstractPersistent Racial inequality in the US criminal justice system is a significant challenge for policy-makers. Although scholarship has focused on policies that created a punitive criminal justice system and reforms that scale back criminal processing, little is known about policies that elected officials use to address Racial issues in criminal justice. This article introduces the framework of ‘Racial Disparity reform.’ Four types of criminal justice policies that seek to redress politically defined problems of Racial inequality are presented. This framework is then used to explain race-targeted criminal justice reforms in US national politics. A qualitative analysis tests how distinct visions of Racial inequality prompted US presidents and Congress to initiate a study of race in capital punishment, a ban on Racial profiling, and a system-wide corrective to minority overrepresentation in youth confinement. Lessons are drawn concerning the potential of policy-making in forging a more Racially egalit...
Garth H. Rauscher - One of the best experts on this subject based on the ideXlab platform.
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absence of an anticipated Racial Disparity in interval breast cancer within a large health care organization
Annals of Epidemiology, 2017Co-Authors: Garth H. Rauscher, Firas Dabbous, Terry Dolecek, Terry Macarol, Katherine Y Tossasmilligan, Sarah M Friedewald, Thomas W SummerfeltAbstract:Abstract Purpose Compared to non-Latina (nL) white women, nL black women are diagnosed with more aggressive breast cancers, which in turn should be more likely to go undetected on screening mammography and subsequently arise as interval breast cancer (IBC). We sought to estimate the extent of an anticipated Racial Disparity in IBC within a single, large health care organization. Methods The present analysis focuses on 4357 breast cancers diagnosed between 2001 and 2012 and within 18 months of a screening mammogram (N = 714,218). We used logistic regression with model-based standardization (predictive margins) to estimate adjusted prevalence differences corresponding to a Racial Disparity in IBC. Results Overall, prevalence of IBC within 18 months was 20.7%. Contrary to expectation, in patient-adjusted models, there was no IBC Racial Disparity (percentage point Disparity = −2.1, 95% confidence interval: −4.7, 2.6). However, when controlling for facility characteristics, including proportion of nL black patients, the model coefficient for the IBC Disparity reversed sign and changed substantially (P Conclusions The sorting of patients by race across facilities appears to have mitigated an otherwise anticipated Disparity in IBC. Possible explanations are discussed.
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changes in the Racial Disparity in breast cancer mortality in the ten us cities with the largest african american populations from 1999 to 2013 the reduction in breast cancer mortality Disparity in chicago
Cancer Causes & Control, 2017Co-Authors: Dominique Sighoko, Garth H. Rauscher, Anne Marie Murphy, Bethliz Irizarry, Carol Estwing Ferrans, David AnsellAbstract:Assess progress made to reduce Racial Disparity in breast cancer mortality in Chicago compared to nine other cities with largest African American populations and the US. The Non-Hispanic Black (NHB) and Non-Hispanic White (NHW) female breast cancer mortality rates and rate ratios (RR) (Disparity) were compared between 1999 and 2005 and 2006 and 2013. Between the two periods, the NHB breast cancer mortality rate in Chicago decreased by 13.9% (95% CI [−13.81, −13.92] compared to 7.7% (95% CI [−7.52, −7.83]) for NHW. A drop of 20% in the Disparity was observed, from 51% (RR: 1.51, 95% CI [−7.52, −7.83]) to 41% (RR: 1.41, 95% CI [1.30, 1.52]). Whereas from 1999 to 2005 Chicago’s Disparity was above that of the U.S., from 2006 to 2013, it is now slightly lower. For the remaining nine cities and the US, the mortality Disparity either grew or remained the same. Chicago’s improvement in NHB breast cancer mortality and Disparity reduction occurred in the context of city-wide comprehensive public health initiatives and shows promise as a model for other cities with high health outcome disparities.
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abstract pr03 a reverse Racial Disparity with respect to interval breast cancer rates within a large healthcare organization has implications for eliminating disparities more generally
Cancer Epidemiology Biomarkers & Prevention, 2016Co-Authors: Garth H. Rauscher, Firas Dabbous, Terry Dolecek, Terry Macarol, Katherine Y Tossasmilligan, Jenna A Khan, Sarah Friedwald, Wm Thomas SummerfeltAbstract:Background: It is well established that Non Latina (nL) Black patients are more likely than nL white (white) patients to be diagnosed with more aggressive forms of breast cancer. In addition, prior population-based research conducted in Chicago suggests that black women tend to be screened at lower resource facilities, and may also have screening images of lower quality and be more likely to have their breast cancer missed at interpretation. Consistent with all of these observations, black patients were more likely to report symptomatic awareness of their breast cancer despite a recent asymptomatic screening mammogram in the Breast Cancer Care in Chicago study. Therefore, black women may be more likely than their white counterparts to have a breast cancer diagnosis following a negative screen (so-called interval breast cancer). METHODS: The goal of the present study was to examine potential disparities in interval breast cancer (IBC) using data from approximately 30 mammography sites (including 8 hospital-based sites) within a single large health care organization in metropolitan Chicago. Methods: A screening mammogram was defined as a bilateral mammogram with a description of screening in the radiology database, in women without a prior history of breast cancer, mastectomy, or breast implants, and without any imaging in the 9 months prior to the screen. We linked 761,908 screening examinations conducted between 2001-2010 to breast cancer incidence data from the Illinois state cancer registry, using probabilistic methods. After excluding other race/ethnicities for this analysis, we identified 4829 breast cancers diagnosed between 2001 and 2011 and within 12 months of a screen. An interval breast cancer was defined as a breast cancer diagnosed within 12 months of a negative screening mammogram (BIRADS 1,2). IBC was modeled in logistic regression with generalized estimating equations (to account for multiple screens per woman) while adjusting for age, parity, breast density, race, family history, parity and exam year, ER status, tumor grade, and individual screening facility as covariates. Of the 31 facilities with data, 18 smaller screening facilities with less than 20 associated breast cancer diagnoses were collapsed into a single category. Model-based standardization (predictive margins) was used to estimate adjusted prevalence differences (PDs) in IBC from the logistic regression models, and 95% bias-corrected bootstrap confidence intervals were obtained (1000 replications). Results: Before adjusting for mammography site, black patients were, contrary to expectation, less likely to experience an IBC than white patients (1.36 vs. 1.83 per 1000 screens, adjusted Rate Difference or RD = - 0.47 per 1000 screens, p Conclusion: In this large healthcare organization, we observed a reverse Disparity such that white patients were more likely than their black counterparts to experience an IBC, but the association disappeared when we took mammography site into account in the analysis. These results suggest that higher quality mammography screening resources are more widely accessible to black than white patients within this organization. Larger volume facilities within this organization tend to be located in urban areas with higher proportions of black women, whereas smaller standalone facilities tend to be located in the suburbs where there are a higher proportion of white women. These standalone facilities may be less likely to employ breast imaging specialists and less likely provide multimodality breast imaging in a multidisciplinary setting, and these differences may be contributing to differential access to quality screening that benefits black women. The larger implication of these findings is that at a population level, Racial disparities in breast cancer could perhaps be ameliorated or even eliminated if resources were disproportionately made more available to black women. In order to overcome breast cancer disparities and create true equity in care, disproportionate resource allocation solutions may be necessary. This abstract is also presented as Poster C61. Citation Format: Garth H. Rauscher, Firas Dabbous, Terry Dolecek, Terry Macarol, Katherine Tossas-Milligan, Jenna Khan, Sarah Friedwald, Wm. Thomas Summerfelt. A reverse, Racial Disparity with respect to interval breast cancer rates within a large healthcare organization has implications for eliminating disparities more generally. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr PR03.
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The effect of neighborhood disadvantage on the Racial Disparity in ovarian cancer-specific survival in a large hospital-based study in cook county, illinois.
Frontiers in Public Health, 2015Co-Authors: Caryn E. Peterson, Garth H. Rauscher, Carolyn V. Kirschner, Sally Freels, Richard E Barrett, Marian L. Fitzgibbon, Timothy P Johnson, Charlotte E. Joslin, Faith G. DavisAbstract:This paper examines the effect of neighborhood disadvantage on Racial disparities in ovarian cancer-specific survival. Despite treatment advances for ovarian cancer, survival remains shorter for African-American compared to White women. Neighborhood disadvantage is implicated in Racial disparities across a variety of health outcomes and may contribute to Racial disparities in ovarian cancer-specific survival. Data were obtained from 581 women (100 African-American and 481 White) diagnosed with epithelial ovarian cancer between June 1, 1994, and December 31, 1998 in Cook County, Illinois, which includes the city of Chicago. Neighborhood disadvantage score at the time of diagnosis was calculated for each woman based on Browning and Cagney’s index of concentrated disadvantage. Cox proportional hazard models measured the association of self-identified African-American race with ovarian cancer-specific survival after adjusting for age, tumor characteristics, surgical debulking, and neighborhood disadvantage. There was a statistically significant negative association (-0.645) between ovarian cancer-specific survival and neighborhood disadvantage (p = 0.008). After adjusting for age and tumor characteristics, African-American women were more likely than Whites to die of ovarian cancer (HR = 1.59, p = 0.003). After accounting for neighborhood disadvantage, this risk was attenuated (HR = 1.32, p = 0.10). These findings demonstrate that neighborhood disadvantage is associated with ovarian cancer-specific survival and may contribute to the Racial Disparity in survival.
Paul B Tchounwou - One of the best experts on this subject based on the ideXlab platform.
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health and Racial Disparity in breast cancer
Advances in Experimental Medicine and Biology, 2019Co-Authors: Clement G Yedjou, Jennifer N Sims, Lucio Miele, Felicite K Noubissi, Leroy Lowe, Duber D Fonseca, Richard A Alo, Marinelle Payton, Paul B TchounwouAbstract:Breast cancer is the most common noncutaneous malignancy and the second most lethal form of cancer among women in the United States. It currently affects more than one in ten women worldwide. The chance for a female to be diagnosed with breast cancer during her lifetime has significantly increased from 1 in 11 women in 1975 to 1 in 8 women (Altekruse, SEER Cancer Statistics Review, 1975-2007. National Cancer Institute, Bethesda, 2010). This chance for a female of being diagnosed with cancer generally increases with age (Howlader et al, SEER Cancer Statistics Review, 1975-2010. National Cancer Institute, Bethesda, 2013). Fortunately, the mortality rate from breast cancer has decreased in recent years due to increased emphasis on early detection and more effective treatments in the White population. Although the mortality rates have declined in some ethnic populations, the overall cancer incidence among African American and Hispanic population has continued to grow. The goal of the work presented in this book chapter is to highlight similarities and differences in breast cancer morbidity and mortality rates among non-Hispanic white and non-Hispanic black populations. This book chapter also provides an overview of breast cancer, Racial/ethnic disparities in breast cancer, breast cancer incidence and mortality rate linked to hereditary, major risk factors of breast cancer among minority population, breast cancer treatment, and health Disparity. A considerable amount of breast cancer treatment research have been conducted, but with limited success for African Americans compared to other ethnic groups. Therefore, new strategies and approaches are needed to promote breast cancer prevention, improve survival rates, reduce breast cancer mortality, and ultimately improve the health outcomes of Racial/ethnic minorities. In addition, it is vital that leaders and medical professionals from minority population groups be represented in decision-making in research so that Racial Disparity in breast cancer can be well-studied, fully addressed, and ultimately eliminated in breast cancer.
Richard Scribner - One of the best experts on this subject based on the ideXlab platform.
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multiple mediation analysis with survival outcomes with an application to explore Racial Disparity in breast cancer survival
Statistics in Medicine, 2019Co-Authors: Richard ScribnerAbstract:Mediation analysis allows the examination of effects of a third variable in the pathway between an exposure and an outcome. The general multiple mediation analysis method, proposed by Yu et al, improves traditional methods (eg, estimation of natural and controlled direct effects) to enable consideration of multiple mediators/confounders simultaneously and the use of linear and nonlinear predictive models for estimating mediation/confounding effects. In this paper, we extend the method for time-to-event outcomes and apply the method to explore the Racial Disparity in breast cancer survivals. Breast cancer is the most common cancer and the second leading cause of cancer death among women of all races. Despite improvement of survival rates of breast cancer in the US, a significant difference between white and black women remains. Previous studies have found that more advanced and aggressive tumors and less than optimal treatment may explain the lower survival rates for black women as compared to white women. Due to limitations of current analytic methods and the lack of comprehensive data sets, researchers have not been able to differentiate the relative effect each factor contributes to the overall Racial Disparity. We use the CDC-funded Patterns of Care study to examine the determinants of Racial disparities in breast cancer survival using a novel multiple mediation analysis. Using the proposed method, we applied the Cox hazard model and multiple additive regression trees as predictive models and found that all Racial Disparity in survival among Louisiana breast cancer patients were explained by factors included in the study.
Clement G Yedjou - One of the best experts on this subject based on the ideXlab platform.
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health and Racial Disparity in breast cancer
Advances in Experimental Medicine and Biology, 2019Co-Authors: Clement G Yedjou, Jennifer N Sims, Lucio Miele, Felicite K Noubissi, Leroy Lowe, Duber D Fonseca, Richard A Alo, Marinelle Payton, Paul B TchounwouAbstract:Breast cancer is the most common noncutaneous malignancy and the second most lethal form of cancer among women in the United States. It currently affects more than one in ten women worldwide. The chance for a female to be diagnosed with breast cancer during her lifetime has significantly increased from 1 in 11 women in 1975 to 1 in 8 women (Altekruse, SEER Cancer Statistics Review, 1975-2007. National Cancer Institute, Bethesda, 2010). This chance for a female of being diagnosed with cancer generally increases with age (Howlader et al, SEER Cancer Statistics Review, 1975-2010. National Cancer Institute, Bethesda, 2013). Fortunately, the mortality rate from breast cancer has decreased in recent years due to increased emphasis on early detection and more effective treatments in the White population. Although the mortality rates have declined in some ethnic populations, the overall cancer incidence among African American and Hispanic population has continued to grow. The goal of the work presented in this book chapter is to highlight similarities and differences in breast cancer morbidity and mortality rates among non-Hispanic white and non-Hispanic black populations. This book chapter also provides an overview of breast cancer, Racial/ethnic disparities in breast cancer, breast cancer incidence and mortality rate linked to hereditary, major risk factors of breast cancer among minority population, breast cancer treatment, and health Disparity. A considerable amount of breast cancer treatment research have been conducted, but with limited success for African Americans compared to other ethnic groups. Therefore, new strategies and approaches are needed to promote breast cancer prevention, improve survival rates, reduce breast cancer mortality, and ultimately improve the health outcomes of Racial/ethnic minorities. In addition, it is vital that leaders and medical professionals from minority population groups be represented in decision-making in research so that Racial Disparity in breast cancer can be well-studied, fully addressed, and ultimately eliminated in breast cancer.
