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  • JAMA August 8, 2017

    Figure: Annual Percent Change (APC) in Colorectal Cancer Mortality Rates Among Adults Aged 20 to 54 Years in the United States by Race, 1970-2014

    Lines were fitted according to the Joinpoint Regression Program (National Cancer Institute), version 4.4.0.0, which uses permutation analysis to fit a series of straight lines on a logarithmic scale to observed rates, indicated by circles; up to 4 joinpoints (5 line segments) were allowed.aThe APC is statistically significantly different from 0 (2-sided P < .05), based on the permutation method.bAge-adjusted to the 2000 US standard population.
  • Walking Study: Women Outpace Men

    Abstract Full Text
    JAMA. 2017; 318(6):511-511. doi: 10.1001/jama.2017.9722
  • JAMA April 11, 2017

    Figure 1: Race- and Ethnicity-Adjusted Life Expectancy for 40-Year-Olds by Household Income Percentile, 2001-2014

    Higher income is associated with longer life expectancy across the income distribution. The vertical height of each bar depicts the 95% confidence interval. The difference between expected age at death in the top and bottom income percentiles is 10.1 years (95% CI, 9.9-10.3 years) for women and 14.6 years (95% CI, 14.4-14.8 years) for men. To control for differences in life expectancies across racial and ethnic groups, race and ethnicity adjustments were calculated using data from the National Longitudinal Mortality Survey and estimates were reweighted so that each income percentile bin has the same fraction of black, Hispanic, and Asian adults. Reprinted from JAMA.aAveraged across years and ages. The data are in thousands unless otherwise indicated.
  • Population Health Equity: Rate and Burden, Race and Class

    Abstract Full Text
    JAMA. 2017; 317(5):467-468. doi: 10.1001/jama.2016.19435

    Although US racial and ethnic minorities have higher rates of poor health because of health care inequities, more low-income white individuals are affected because of greater population numbers. This Viewpoint explains that efforts to improve poor outcomes would be more effective if strategies were not based on proportions of race.

  • JAMA January 10, 2017

    Figure: Year-to-Year Prevalencea of Past-Month Marijuana Useb Among Pregnant and Nonpregnant Women, Overall and by Age, 2002-2014c

    aYear-to-year–adjusted and linear predicted–adjusted prevalence estimates were from log-Poisson regressions. Models controlled for race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, and other non-Hispanic minorities), family income ($0-$19 999, $20 000-$49 999, $50 000-$74 999, ≥$75 000), age (18-25 years, 26-34 years, 35-44 years), education (
  • JAMA April 12, 2016

    Figure 2: Predicted Change in Bronchitic Symptom Prevalence at Age 10 Years vs the Change in Mean Air Pollutants Over the Study Period by Communitya

    aPlots depict the predicted changes from the longitudinal model in prevalence of bronchitic symptoms at age 10 years (across the 1993-2001 and 2003-2012 cohorts) as functions of the changes in mean exposures levels, comparing high to low mean pollution levels for the 1992-2000, 1995-2003, and the 2002-2011 averaging periods. The estimates used in the plots are based on longitudinal models with adjustments for sex, race/ethnicity, and a spline function of age with knots (break points) at 10 and 15 years of age.
  • JAMA September 8, 2015

    Figure 3: Infant Survival to Discharge By Birth Year and Gestational Age

    Circles show the percent of infants born each year who survived to discharge, a smoothed curve shows the trend, and shading indicates a 95% CI for the curve. Shading is not visible where CIs are close to values on the curve. Percentages are among all infants, including those who died at 12 hours of age or less. Relative risks (RRs) for the change per year were adjusted for study center, maternal race/ethnicity, infant gestational age, small size for gestational age, and sex. Survival trends did not vary significantly by gestational age from 1993-2008 (year-gestational age interaction, P = .46), with no significant change in survival (P = .90), but varied by gestational age from 2009-2012 (year-gestational age interaction, P < .001). Therefore, RRs are shown for 2009 through 2012 only. Total number of infants (mean [range] per year): 1550 (77 [48-96]) for 22 weeks; 3133 (156 [122-189]) for 23 weeks; 4762 (238 [151-334]) for 24 weeks; 5361 (268 [170-339]) for 25 weeks; 5829 (291 [182-361]) for 26 weeks; 6627 (331 [204-399]) for 27 weeks; and 7374 (368 [275-430]) for 28 weeks.
  • JAMA September 8, 2015

    Figure 1: Care Practices for Infants Born at Gestational Ages 22 through 28 Weeks

    Circles indicate the percent of infants born each year who received the practice, the smoothed curve shows the trend, and shading indicates the 95% CI for the curve. Shading is not visible where CIs are close to values on the curve. Percentages are among all infants except those for postnatal steroids (which include only infants who survived >12 hours; this outcome was not collected for infants who died ≤12 hours of age). Adjusted relative risks (RRs) are based on infants of all gestational ages and are shown for outcomes for which the year-gestational age interaction was not significant. When the year-gestational age interaction was significant, graphs and RRs are shown for each gestational age in eFigures 1-4 in the Supplement. RRs for the change per year were adjusted for study center, maternal race/ethnicity, infant gestational age, small size for gestational age, and sex. Total number of infants (mean [range] per year): 34 576 (1728 [1214-2022]) for antenatal steroids; 34 531 (1726 [1210-2020]) for antenatal antibiotics; 34 611 (1730 [1213-2024]) for cesarean delivery; 34 611 (1730 [1214-2024]) for intubation; 34 599 (1729 [1214-2023]) for surfactant; and 30 645 (1532 [1036-1802]) for postnatal steroids.
  • JAMA September 8, 2015

    Figure 2: Neonatal Morbidities for Infants Born at Gestational Ages 22 Through 28 Weeks

    Circles show the percent of infants born each year diagnosed with the morbidity and the smoothed curve shows the trend. Shading to indicate the 95% CI for each curve is not visible where CIs are close to values on the curve. Percentages shown in graphs are among infants of all gestational ages who survived more than 12 hours with additional restrictions as noted in the text and eTable 3 in the Supplement. Relative risks (RRs) are based on infants of all gestational ages and are shown for outcomes for which the year-gestational age interaction was not significant. When the year-gestational age interaction was significant, graphs and RRs are shown for each gestational age for late-onset sepsis, severe intracranial hemorrhage, periventricular leukomalacia, and bronchopulmonary dysplasia in eFigures 5-8 in the Supplement. RRs for the change per year were adjusted for study center, maternal race/ethnicity, infant gestational age, small size for gestational age, and sex. Total number of infants (mean [range] per year): 30 790 (1539 [1035-1809]) for necrotizing enterocolitis; 29 252 (1462 [980-1702]) for late-onset sepsis; 29 883 (1494 [1016-1741]) for severe intracranial hemorrhage (ICH); 28 498 (1424 [769-1744]) for periventricular leukomalacia (PVL); 24 951 (1247 [808-1509]) for retinopathy of prematurity (ROP) of stage 3 or greater; and 25 000 (1250 [746-1534]) for bronchopulmonary dysplasia (BPD).
  • JAMA September 8, 2015

    Figure 4: Infant Survival to Discharge Without Major Morbidity by Birth Year and Gestational Age

    Major morbidity was defined as one or more of necrotizing enterocolitis, infections (early-onset sepsis, late-onset sepsis, or meningitis), bronchopulmonary dysplasia (BPD), severe intracranial hemorrhage (ICH), periventricular leukomalacia (PVL), and retinopathy of prematurity (ROP) of stage 3 or greater. Circles show the percent of infants who survived without major morbidity each year, the smoothed curve shows the trend, and shading indicates a 95% CI for the curve. Percentages are among infants who survived to discharge, excluding those not adequately evaluated for major morbidity. Infants born at gestational age 22 weeks are not shown because only 99 of 1550 survived to discharge and only 5 survived without major morbidity. Relative risks (RRs) for the change per year were adjusted for study center, maternal race/ethnicity, infant gestational age, small size for gestational age, and sex. Trends varied by gestational age (year-gestational age interaction, P = .01). Total number of infants [mean (range) per year]: 877 (43 [33-69]) for 23 weeks; 2706 (135 [75-183]) for 24 weeks; 4007 (200 [119-249]) for 25 weeks; 4900 (245 [155-313]) for 26 weeks; 5902 (295 [184-350]) for 27 weeks; and 6808 (340 [256-405]) for 28 weeks.
  • Racial Bias in Health Care and Health: Challenges and Opportunities

    Abstract Full Text
    JAMA. 2015; 314(6):555-556. doi: 10.1001/jama.2015.9260

    This Viewpoint describes the contribution of racial bias to disparities in health care and discusses the need to increase awareness of disparities and work toward eliminating discrimination and its adverse effects.

  • JAMA June 9, 2015

    Figure: Monthly Acute Gastroenteritis and Rotavirus-Coded Hospitalization Rates Among Children Younger Than 5 Years in 24 States During January 2000 Through December 2012

    The following states had consistent reporting of admission month data: Arizona, California, Colorado, Connecticut, Georgia, Hawaii, Iowa, Illinois, Kansas, Kentucky, Massachusetts, Michigan, Montana, North Carolina, New Jersey, New York, Oregon, South Carolina, Tennessee, Texas, Utah, Washington, Wisconsin, and West Virginia. Rates were calculated by dividing the annual number of hospitalizations by the number of children younger than 5 years residing in the participating states during that year and analyzed by admission month, sex, age group, and race.
  • JAMA May 19, 2015

    Figure: Age-Specific Prevalence of the Metabolic Syndrome by Sex and Race/Ethnicity, 2003-2012

    Error bars indicate 95% confidence intervals. Comparisons of prevalence estimates were performed using χ2 tests; patients aged 20-39 years in each group were used as the reference. All comparisons yielded P < .001.
  • Race, Poverty, and Medicine in the United States

    Abstract Full Text
    JAMA. 2015; 313(14):1423-1423. doi: 10.1001/jama.2015.2262
  • Achieving Health Equity by Design

    Abstract Full Text
    JAMA. 2015; 313(14):1417-1418. doi: 10.1001/jama.2015.2434

    This Viewpoint discusses motivating health care organizations to consider a new set of tools and approaches to disparities in health outcomes by race/ethnicity and income status such as payment systems that reward better outcomes and building equity into program design.

  • JAMA March 24, 2015

    Figure 2: Adjusted Male and Female Salary Differences by Work Setting, Clinical Specialty, and Job Position From NSSRN 1988-2008

    Data are from the National Sample Survey of Registered Nurses (NSSRN). Ordinary least-squares regression was used for the model, which included gender (male, female), age, race (white, nonwhite), marital status (married, divorced or widowed, never married), children at home (yes, no), foreign education (yes, no), education (diploma, associate’s degree, bachelor’s degree, master’s or doctorate degree), hours worked per week, years since graduation, polynomial of second degree and years since graduation, Metropolitan Statistical Area (MSA) (in MSA, not in MSA), state (51 categories), survey year (1988, 1992, 1996, 2000, 2004, 2008), work setting (hospital, ambulatory, other), clinical specialty (orthopedics, medical or surgical, neurology, newborn or pediatrics, chronic care, psychiatry, cardiology, other), job position (staff nurse, advanced clinical nurse, nurse anesthetist, education/research, senior academic, middle management, senior administration, other), and interaction terms of gender with work setting, clinical specialty, job position, and survey year. All continuous variables were mean centered. This model accounted for about half of the variance in salaries (R2 = 0.46). The estimated average salary gap was $5148. Orthopedics was the only nonsignificant clinical specialty. Senior academic was the only nonsignificant job position. Survey weights were applied to make results nationally representative. Salary amounts reflect 2013 dollars and were normalized using the consumer price index. Error bars indicate 95% confidence intervals.
  • Differences in Breast Cancer Stage at Diagnosis and Cancer-Specific Survival by Race and Ethnicity in the United States

    Abstract Full Text
    free access has multimedia
    JAMA. 2015; 313(2):165-173. doi: 10.1001/jama.2014.17322

    This observational database study using the Surveillance, Epidemiology, and End Results 18 registries reports that among US women diagnosed with invasive breast cancer, the likelihood of diagnosis at an early stage, and survival after stage I diagnosis, varied by race and ethnicity.

  • Race, Ethnicity, and the Diagnosis of Breast Cancer

    Abstract Full Text
    JAMA. 2015; 313(2):141-142. doi: 10.1001/jama.2014.17323
  • JAMA January 13, 2015

    Figure: Hospital-Level Variation in Episiotomy Use From 2006-2012

    Hospitals are arranged from lowest to highest rates of episiotomy along the x-axis. Each vertical line parallel to the y-axis represents an individual hospital with 95% CI in the adjusted model after accounting for hospital factors, medical and demographic variables, and labor diagnoses. There were 510 hospitals included in the analysis. The following variables were adjusted for in the model: type of insurance, race, maternal age, year of delivery, primiparity, obstetric comorbidity index score, marital status, rural vs urban location, hospital teaching status, hospital bed size, geographic region, precipitous labor, prolonged second stage, other labor abnormalities, induction of labor, fetopelvic disproportion, suspected macrosomia, postdates pregnancy, placental abruption, pregestational diabetes, gestational diabetes, maternal congenital cardiac disease, other maternal cardiovascular disease, human immunodeficiency virus, obesity, gestational hypertension, mild or unspecified preeclampsia, and severe preeclampsia or eclampsia.
  • Lawmakers Call for Details on Trial Participants’ Sex and Race

    Abstract Full Text
    JAMA. 2014; 312(6):589-589. doi: 10.1001/jama.2014.10022