Health Disparities & Geospatial Transdisciplinary Research Lab

National Institute On Minority Health And Health Disparities

Investigators

Linked publications & trials

Abstract

Cancer remains the second most common cause of death in men and women in the United States (U.S.). While breast cancer (BC) remains the most common cancer in women, the burden does not fall equally across all group. Racial/ethnic disparities exist in diagnosis, treatment, mortality, and survivorship particularly among Blacks, Hispanics, immigrants, and rural dwellers. To address this, we have utilized various research approaches including geographic information system (GIS) and examined spatial access to health care services on BC diagnosis considering access and distance traveled to the nearest mammography facility and/or hospital. Also, we have applied community-based system method to understand the dynamic complexity underlying the widening cancer disparities between White and other minority populations in addition to latent class analysis, a person-centered measure to identify risk profiles in cancer treatment and survivorship outcomes. The U.S. is currently home to almost 48 million immigrants. The number of immigrants in the U.S. is expected to reach 78.2 million by 2065. Overall, immigrants and their offspring are projected to account for 88% of the total population around the same time. The processes of immigration and acculturation can be highly disruptive and translate to higher risk for stress-related disease and suboptimal lifestyles due to structural inequities. Nevertheless, studying acculturation and social determinants influencing immigrants health is particularly challenging due to the complex interactions of factors and their fluid nature. These factors, which are sociocultural, environmental, economic, biological, and genetic in nature, are often interconnected, requiring interdisciplinary and novel approaches to disentangle effects. Subsequently, building on our previous research, we aspire to use novel transdisciplinary methods including system science, GIS, and quantitative to understand the complex, dynamic acculturative factors influencing psychosocial, and cancer health disparities. Please see below the specifics. New Research Projects Since the Last Report 1. Social Distancing and Social Isolation Factors. We aim to conduct a nationally representative study to examine the effects of social and physical distancing policies and recommendations due to coronavirus SARS-CoV-2the virus responsible for COVID-19 on physical and psychosocial health disparities among U.S.-born and foreign-born adults. a. We are using survey to identify psychosocial factors that potentially influence disparities and how resiliency and coping strategies differ between and within U.S.-born and foreign-born populations, taking into account national origin for those not born in the U.S. b. We aim to apply qualitative methods using focus groups to gain a deeper understanding of the perceived susceptibility to and severity of COVID-19 and its psychological impacts, and factors that support optimal psychosocial well-being during stressful events or pandemics. 2. Nationally Representative Datasets including the National Health Interview Survey (NHIS), National Health and Nutrition Examination Survey (NHANES), Medical Expenditure Panel Survey (MEPS), National Survey of Childrens Health (NSCH) to assess several aspects of mental health (i.e. depression, anxiety) among immigrant populations in the U.S. Overall Aims/Objectives are: (1) Estimate the prevalence of the problem; (2) the association between the outcome(s) of interest and predictor(s); and (3) examine the variance by foreign-born status. Major topics under are: 1. Cluster analysis of analysis of depression and self-reported health status among U.S.-born citizens, foreign-born and non-citizen adults aged 18 year - NHIS 2. Decision tree assessment of chronic diseases on psychological distress among foreign-born adults aged 18 year - NHIS 3. Understanding the association between occupation, depression, and anxiety among U.S.-born and foreign-born pregnant population: Mediation analysis - NHIS 4. Impact of depression on health and medical care utilization and expenses in U.S. adults with hypertension - MEPS 5. Impact of depression on health and medical care utilization and expenses in U.S. foreign-born adults with diabetes - MEPS 6. Association between childrens health and neighborhood characteristics in the U.S. by parent-child nativity/generation - NSCH 7. Parent-child nativity, adverse childhood experiences and mental health among U.S. children: A mediation analysis - NSCH 8. Association between hypertension and depression by citizenship status using the NHIS Data, 2015-2019. 9. Understanding the impact of hypercholesterolemia cost of care for connective tissue disorders and psychological distress among U.S. population - MEPS 3. United Kingdom (UK) Biobank. This is a large-scale biomedical database and research resource, containing in-depth genetic and health information from over half a million UK participants. We aim to investigate diverse aspects of physical and psychosocial health and risk factors among immigrants including (1) to assess and compare different mental health measures available in the UK biobank; (2) the relationships of neuroticism and intelligence as a major depressive disorder (MDD) and psychological distress; (3) how multiple lifestyle factors relate to depressed mood, and how these relations may differ in individuals with major MDD and those without a depressive disorder; among others. 4. National Human Genome Research Institute (NHDRI) Social and Behavioral Research Branch/Social Network Methods Section. The central objective of the proposed project is to investigate how family network structure influences cardiometabolic and rheumatoid arthritis (RA) risks as well as mental health in individuals of Hispanic heritage, particularly Salvadorans, Dominicans and Puerto Ricans in the Washington DC, Maryland, and Virginia area. Specific aims are to determine (1) how shared epitope and tumor necrosis factor (TNF) are related to RA severity in Hispanic populations; (2) how interpersonal ties affect RA-related health communication and use of health care service in families of Hispanic heritage; and (3) to identify family network-level predictors of functional limitations and depressive/anxiety symptoms in Hispanics affected by RA Continuing Research Projects. We are wrapping up on non-Immigrant Mental Health projects 1. Nativity and health behaviors: Using the Sister Study Cohort, we aimed to investigate the associations between: (i) nativity and race/ethnicity; and (ii) extent of breast cancer family history and its influence on timing of most recent screening. Manuscript submitted 2. Nativity and occupational exposure. We aim to use the National Agricultural Workers Survey, an employment-based, random-sample survey of U.S. crop workers to assess occupational health hazards among foreign-born respondents. Manuscript in preparation 3. Neighborhood factors and their effects on sleep and chronic diseases. Using a nationally NHIS, we examined sleep duration and neighborhood cohesion among different U.S. foreign-born subpopulations. Manuscript submitted 4. Hispanic/Latino acculturation subgroups and telomere length, NHIS. Manuscript submitted 5. Using the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study data. We aimed to identify cardiometabolic risk profiles by acculturation and mental health indicators. Manuscript in preparation 6. Using the New York City Health and Nutrition Examination Survey (NYC HANES) 2013/14. We aimed to compare type 2 diabetes risk profiles and disease burden among foreign-born Afro-Caribbean and U.S.-born African American New Yorkers by estimating. Manuscript in preparation 7. MASALA grocery stores and cardiometabolic risk. Manuscript in preparation