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- All Subjects: Health Disparities
- Creators: Dillon, Frank
- Creators: Bussey, Kimberly
Description
Every year an alarming number of deaths for the Black community are a result of disparities and inequalities in health outcomes. While literature has largely focused on social determinants of heath (e.g., economic, environmental, biological, and behavioral structures) as contributing factors to disparate health outcomes for Black people, literature on medical mistrust has been on the rise. Medical mistrust is defined as the belief that health care entities and providers act against a patient's best interest and well-being, and is associated with lower rates of service utilization, inadequate management of health conditions, lower levels of involvement in research, and treatment nonadherence. Only recently has patient-centered care been examined as a construct that may reduce the negative effects of medical mistrust. This study examined Black identifying patients (N = 174) across gender and their reported levels of medical mistrust, and if the perception of a patient-centered health care environment would moderate the association. The findings indicated that Black females, compared to Black males, endorsed higher levels of medical mistrust that may be indicative of intersectional influences. While there were significant effects of gender and perceived patient-centered care on medical mistrust, perceived patient-centered care was not found to significantly moderate the relationship between gender identity and medical mistrust. This may be indicative of the varying degrees of medical maladies that may be stronger determinants of perceived patient-centered care, despite gender or other demographic characteristics. Implications for practice and future research on the intersectional influences on medical mistrust and perceived patient-centered care in the Black communities are discussed.
ContributorsMatthews, Tianna (Author) / Warner, Cheryl (Thesis advisor) / Randall, Ashley K (Committee member) / Dillon, Frank (Committee member) / Arizona State University (Publisher)
Created2021
Description
Research examining the psychosocial correlates of mental and behavioral health among Latinx populations during the COVID-19 pandemic is limited. This is problematic given that Latinx communities in the U.S. find themselves at the intersection of worse COVID-19-related mortality, mental health distress, and health outcomes. These COVID-19 related disparities came at a time when U.S. Latinxs were already experiencing a disproportionate burden of mental health and substance use disease. Health disparities research has largely focused on Latinxs as a monolithic group, yet in doing so, the intersectionality of race, ethnicity, and socioeconomic status on health are overlooked. It is critical to understand the mental health needs of Latinxs in light of the current COVID-19 pandemic as well as the challenges and potential barriers to services experienced by these communities to better meet their unique needs. Therefore, Study 1 aimed to investigate differences on pandemic-related stressors along economic, emotional, and physical domains, psychological distress, and substance use, based on Latinx ethnicity. The second aim of Study 1 was to identify the most significant pandemic-related stressors and challenges faced by specific Latinx subgroups. Study 2 built off of the results from Study 1. Specifically, Study 2 investigated the association between pandemic-related economic, emotional, and physical stressors examined in Study 1 to various health and mental health outcomes including, psychological distress, alcohol use, and drug use, reported during the pandemic by different Latinx ethnic groups.
ContributorsFlorez, Jennifer Elizabeth (Author) / Capielo-Rosario, Cristalís (Thesis advisor) / Dillon, Frank (Committee member) / Truong, Nancy (Committee member) / Arizona State University (Publisher)
Created2024
Description
Among Latinxs living in the United States (U.S.), AfroLatinx individuals are more susceptible to dying from COVID-19 because of pre-existing health conditions such as diabetes, heart disease, and hypertension (Chapman, 2020). These health disparities, in turn, have been associated with economic inequalities AfroLatinx communities face in the U.S. due to discrimination and racism (Weinstein et al., 2017). Scholars have called attention to the need to focus on AfroLatinx populations, given the systematic denial of AfroLatinx experiences in the psychological literature (Sanchez, 2021) and the systemic and institutional barriers AfroLatinx face when seeking physical and mental health support (Borrell, 2005). Using Borrell's (2005) framework for studying the determinants of health disparities affecting AfroLatinxs, in Study 1, I examined the association between individual characteristics (e.g., socioeconomic indicators), psychosocial factors (e.g., economic distress), and contextual factors (e.g., discrimination) reported by AfroLatinx adults and emotional and physical health problems during the COVID-19 pandemic. As an expansion of Borrell's model, I also examined whether having a pre-existing condition can help explain mental health distress above and beyond other determinants of health disparity. Study 2 built on the first study by helping identify the specific areas of stress and needs identified by AfroLatinxs during the COVID-19 pandemic. The second aim of Study 2 was to determine the more frequent and effective strategies AfroLatinxs with pre-existing conditions used to cope with COVID-19-related stressors and needs.
ContributorsFaison, Alexis Duckett (Author) / Capielo Rosario, Cristalís (Thesis advisor) / Dillon, Frank (Committee member) / Vasquez, Elisa (Committee member) / Arizona State University (Publisher)
Created2024
Description
In the U.S., breast cancer (BC) incidences among African American (AA) and CA (CA) women are similar, yet AA women have a significantly higher mortality rate. In addition, AA women often present with tumors at a younger age, with a higher tumor grade/stage and are more likely to be diagnosed with the highly aggressive triple-negative breast cancer (TNBC) subtype. Even within the TNBC subtype, AA women have a worse clinical outcome compared to CA. Although multiple socio-economic and lifestyle factors may contribute to these observed health disparities, it is essential that the underlying biological differences between CA and AA TNBC are identified. In this study, gene expression profiling was performed on archived FFPE samples, obtained from CA and AA women diagnosed with early stage TNBC. Initial analysis revealed a pattern of differential expression in the AA cohort compared to CA. Further molecular characterization results showed that the AA cohort segregated into 3-TNBC molecular subtypes; Basal-like (BL2), Immunomodulatory (IM) and Mesenchymal (M). Gene expression analyses resulted in 190 differentially expressed genes between the AA and CA cohorts. Pathway enrichment analysis demonstrated that differentially expressed genes were over-represented in cytoskeletal remodeling, cell adhesion, tight junctions, and immune response in the AA TNBC -cohort. Furthermore, genes in the Wnt/β-catenin pathway were over-expressed. These results were validated using RT-qPCR on an independent cohort of FFPE samples from AA and CA women with early stage TNBC, and identified Caveolin-1 (CAV1) as being significantly expressed in the AA-TNBC cohort. Furthermore, CAV1 was shown to be highly expressed in a cell line panel of TNBC, in particular, those of the mesenchymal and basal-like molecular subtype. Finally, silencing of CAV1 expression by siRNA resulted in a significant decrease in proliferation in each of the TNBC cell lines. These observations suggest that CAV1 expression may contribute to the more aggressive phenotype observed in AA women diagnosed with TNBC.
ContributorsGetz, Julie (Author) / Baumbach-Reardon, Lisa L (Thesis advisor) / Lake, Douglas F (Thesis advisor) / Bussey, Kimberly (Committee member) / Kusumi, Kenro (Committee member) / Arizona State University (Publisher)
Created2015