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Although the existence of racial fluidity is generally accepted in both Brazil and the United States, changes in racial classification over the life course are often not incorporated into standard demographic estimates. By taking a multistate perspective on the variability of racial classification, we can use demographic methods to ask new questions about the nature of racial fluidity, such as: How many years can someone classified as White, Brown, or Black at birth expect to live in a different racial category? At what ages are changes in racial classification more likely to occur? We compute multistate life tables using linked data from Brazil's largest household survey (2017-2019 PNAD-C) to estimate transition probabilities between the White, Brown, and Black race categories, which we combine with age- and race-specific mortality probabilities. Transition probabilities reveal that up to age 65, Brazilians are more likely to be reclassified from either White or Black to Brown than they are to die at each age. Conditional life expectancy estimates show that Brazilians who were classified as Black at birth can expect to live almost 15 years of their lives classified as White, while those classified as White at birth can expect to live, on average, three years classified as Black.

The role of smoking in racial disparities in mortality and life expectancy in the United States has been examined previously, but up-to-date estimates are generally unavailable, even though smoking prevalence has declined in recent decades. We estimate the contribution of smoking-attributable mortality to observed differences in mortality and life expectancy for US African-American and white adults from 2000-2019. The indirect Preston-Glei-Wilmoth method was used with national vital statistics and population data and nationally representative never-smoker lung cancer death rates to estimate the smoking-attributable fraction (SAF) of deaths in the United States by sex-race group from 2000-2019. Mortality rates without smoking-attributable mortality were used to estimate life expectancy at age 50 ( ) by group during the period. African-American men had the highest estimated SAF during the period, beginning at 26.4% (95% CI:25.0%-27.8%) in 2000 and ending at 12.1% (95% CI:11.4%-12.8%) in 2019. The proportion of the difference in for white and African-American men that was due to smoking decreased from 27.7% to 14.8%. For African-American and white women, the estimated differences in without smoking-attributable mortality were similar to observed differences. Smoking continues to contribute to racial disparities in mortality and life expectancy among men in the United States. We present updated estimates of the contribution of smoking to mortality differences in the United States using nationally representative data sources.

Age-adjusted COVID-19 mortality estimates have exposed a previously hidden excess mortality burden for the US Hispanic population. Multiple explanations have been put forth, including unequal quality/access to health care, higher proportion of pre-existing health conditions, multigenerational household composition, and disproportionate representation in telecommute-unfriendly occupations. However, these hypotheses have been rarely tested. We examine age-stratified patterns of Hispanic COVID-19 mortality vis-a-vis patterns of exposure to evaluate the multiple posited hypotheses. We use a combination of public and restricted data from the Centers of Disease Control and Prevention and leverage national and subnational race- and age-stratified COVID-19 mortality and case burdens/advantages to evaluate the workplace vulnerability hypothesis. We also use individual-level information on prior health conditions and mortality from the case data to assess whether observed patterns are consistent with the other hypotheses. Our results indicate that the disproportionate burdens for both COVID-19 case and mortality for the Hispanic population are largest among the working-age groups, supporting the hypothesis that workplace exposure plays a critical role in heightening vulnerability to COVID-19 mortality. We find little evidence to support the hypotheses regarding multigenerational household composition, pre-existing health conditions, or unequal quality/access to health care. Our findings point to the key roles played by age structure and differential exposure in contributing to the disproportionately severe impact of COVID-19 on the Hispanic population.

Religion and spirituality (R/S) may be associated with better cognitive health, yet most published studies have been conducted in primarily White populations without investigating association variations by gender and race. A cross-sectional analysis of 1041 community-dwelling diverse older adults from the Philadelphia Healthy Brain Aging (PHBA) cohort study was conducted using multiple regression analysis. We examined associations between facets of R/S and total cognitive scores and performed stratification analysis separately by gender and race to explore potential gender- and race-specific variations. Higher non-organizational R/S was associated with lower cognitive scores, while greater religious and spiritual coping was associated with higher cognitive scores, controlling for age, education, chronic conditions, race, and financial constraints. Across gender and race variations, non-organizational R/S was associated with lower cognitive scores in women alone, with no variations across race. Higher religious and spiritual coping was associated with higher cognitive scores in both Black and White women, but not men, while higher religious and spiritual healing was associated with lower cognitive scores in Black women only. Associations between religious and spiritual facets and cognitive health differ across gender and race; longitudinal studies are needed.

Diversifying counseling psychology programs in the United States is a core value of the profession. For this descriptive study, we reviewed the websites of all currently active American Psychological Association (APA) accredited counseling psychology and counseling psychology combined programs for publicly available information on their core faculty members’ academic rank (i.e., assistant, associate, and full professor), perceived gender, and perceived Black, Indigenous, and People of Color (BIPOC) status. The freely available Publish or Perish software (Harzing, 2007 ) was used to assess the productivity indices (i.e., h-index, h-index norm, papers per author, and authors per paper) of these faculty members. Using multilevel regression analyses, we found that: (1) average h-indexes were highest among full professors, (2) perceived gender identity was a significant predictor of the h-index, h-index norm, and papers per author favoring White faculty, (3) perceived BIPOC status was a significant predictor of h-index, papers per author, and authors per paper favoring White faculty. Limitations, future research directions, and implications are discussed.

Introduction: Increases in industrialization and manufacturing have led to worsening pollution in some components of air quality. In addition, gentrification is occurring in large cities throughout the world. As these socioeconomic and demographic changes occur, there have been no studies examining the association of gentrification with air quality. To investigate this association, we studied the trends of gentrification, changes in racial distribution and changes in air quality in each zip code of a large urban county over a 40-year period. Methods: We conducted a retrospective longitudinal study over 40 years in Wayne County, Michigan using socioeconomic and demographic data from the National Historical Geographic Information System (NHGIS) and air quality data from the United States Environmental Protection Agency (EPA). To assess gentrification, longitudinal analyses were performed to examine median household income, percentage with a college education, median housing value, median gross rent and employment level. The racial distribution was evaluated in each zip code during the time period. Gentrification was studied in relation to air quality using nonparametric 2-sample Wilcon–Mann–Whitney tests and Binomial Generalized Linear Regression models. Results: Although air quality improved overall over the 40-year period, there was a lesser rate of improvement in gentrified areas. Furthermore, gentrification was strongly associated with racial distribution. The most substantial gentrification occurred from 2010 to 2020, in which a specific cluster of adjacent zip codes in downtown Detroit experienced intense gentrification and a drop in the percentage of African-American residents. Conclusions: Gentrified areas seem to have a less pronounced improvement in air quality over time. This reduction in air quality improvement is likely associated with demolitions and the construction of new buildings, such as sporting arenas and accompanying traffic density. Gentrification is also strongly associated with an increase in non-minority residents in an area. Although previous definitions of gentrification in the literature have not included racial distribution, we suggest that future definitions should include this metric given the strong association. Minority residents who are displaced as a result of gentrification do not experience the improvements in housing quality, accessibility to healthy foods and other associations of gentrification.

Background We analyzed the genetic causes of sensorineural hearing loss in racial and ethnic minorities of South Florida by reviewing demographic, phenotypic, and genetic data on 136 patients presenting to the Hereditary Hearing Loss Clinic at the University of Miami. In our retrospective chart review, of these patients, half self-identified as Hispanic, and the self-identified racial distribution was 115 (86%) White, 15 (11%) Black, and 6 (4%) Asian. Our analysis helps to reduce the gap in understanding the prevalence, impact, and genetic factors related to hearing loss among diverse populations. Results The causative gene variant or variants were identified in 54 (40%) patients, with no significant difference in the molecular diagnostic rate between Hispanics and Non-Hispanics. However, the total solve rate based on race was 40%, 47%, and 17% in Whites, Blacks, and Asians, respectively. In Non-Hispanic Whites, 16 different variants were identified in 13 genes, with GJB2 (32%), MYO7A (11%), and SLC26A4 (11%) being the most frequently implicated genes. In White Hispanics, 34 variants were identified in 20 genes, with GJB2 (22%), MYO7A (7%), and STRC-CATSPER2 (7%) being the most common. In the Non-Hispanic Black cohort, the gene distribution was evenly dispersed, with 11 variants occurring in 7 genes, and no variant was identified in 3 Hispanic Black probands. For the Asian cohort, only one gene variant was found out of 6 patients. Conclusion This study demonstrates that the diagnostic rate of genetic studies in hearing loss varies according to race in South Florida, with more heterogeneity in racial and ethnic minorities. Further studies to delineate deafness gene variants in underrepresented populations, such as African Americans/Blacks from Hispanic groups, are much needed to reduce racial and ethnic disparities in genetic diagnoses.

Background: Adjuvant therapies improve disease-free and cancer-specific survival in digestive tract malignancies. Return to intended oncological therapy (RIOT) measures how promptly patients resume these treatments after cancer resection. Because sugammadex has demonstrated superior postoperative outcomes compared to neostigmine, we hypothesize that its use may increase the likelihood and timeliness of RIOT in patients undergoing digestive tract cancer surgery. Methods: Adults (≥18 years) undergoing gastrointestinal, hepatobiliary cancer resection, or liver resection for limited metastases between January 2016 and December 2017 were retrospectively analyzed. Patients were grouped by neuromuscular blockade reversal agent (neostigmine vs. sugammadex). The primary outcome was RIOT within 90 days; secondary outcomes included RIOT within 180 days, time-to-RIOT, hospital length of stay, ICU admission, and readmissions. Results: Of 4358 records screened, 1081 met the inclusion criteria: 273 (25.2%) patients with neostigmine and 808 (74.8%) with sugammadex. Patients in the neostigmine group were slightly younger, and racial distribution differed modestly, but sex, BMI, ASA class, comorbidity, cancer type, and stage were comparable. Median reversal doses were 5 mg and 200 mg, respectively. Anesthesia duration, hospital and ICU length of stay, readmissions, and ICU use showed no significant differences. RIOT frequency was also similar across groups, except for modestly higher radiotherapy resumption with neostigmine at 90 and 180 days. Overall, perioperative and oncological outcomes were largely comparable between groups. Conclusions: Sugammadex and neostigmine showed similar RIOT rates, with only a modest difference in radiotherapy resumption. Larger studies are needed to elucidate the potential benefits of sugammadex, particularly regarding long-term oncological outcomes and treatment continuity.

Wilson (1987) argued that race differences in the frequency of marriage from the 1960s to the 1980s resulted from a shortage of marriageable men in the Black community. A large literature used spatially defined measures of male marriageability to predict marriage rates of women. These studies concluded that the availability of marriageable men can explain only a fraction of race differences in marriage. I argue that this finding may reflect errors in the measurement of the availability of marriageable spouses. My analysis assesses marriage rates from the perspective of men instead of women, allowing direct assessment of men's economic positions without resorting to fuzzy spatial indicators. I develop new measures of first marriage rates for the 1960-1980 censuses and combine them with survey-based measures for 2008-2019. I use classic decomposition methods to assess the changing relationship of economic composition to race differences in male first marriage rates over the 1960-2019 period. The analysis shows that in the mid- to late 20 century, race differences in economic composition were sufficiently large to account for most race differences in first marriage rates, but the size of the economic component declined dramatically over time. With the decline of male-breadwinner families since the late 20 century, the role of male economic circumstances for race differences in marriage rates has diminished, but it remains substantial. Leveraging a new research strategy and a new measure of first marriage, this analysis provides a consistent decomposition of race differences in first marriage rates over six decades.

Background Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are well-established surgical interventions for morbid obesity, offering significant weight loss and improvement or resolution of many obesity-related comorbidities. Some patients who initially undergo SG later elect to convert to RYGB due to inadequate weight loss. Marginal ulcers (MUs), characterized by ulceration at the gastrojejunal anastomosis, are a known and prevalent complication following RYGB. Methods This retrospective study was conducted at a single community hospital. Records were reviewed to identify patients who underwent either primary or conversion RYGB between 2015 and 2023. Data collected included patient demographics, perioperative variables, relevant risk factors, and incidence of gastrojejunal anastomotic ulcers, diagnosed via endoscopy or computed tomography scans. Results A total of 113 patients were included in this study, with 49.6% of them undergoing primary RYGB and 50.4% undergoing conversion RYGB. No significant differences were found between groups in preoperative weight, BMI, ASA status, or other preoperative risk factors. However, there were significant differences in racial distribution between the groups—the primary RYGB group included 69.6% Black or African American patients while the conversion RYGB group consisted of 86% Black or African American patients ( p  = 0.037). Comparatively, the primary RYGB group consisted of 28.6% White patients while only 8.8% of the patients in the conversion RYGB group were White.( p  = 0.007). The incidence of marginal ulceration was not significantly different between the groups (21.4% in the primary group vs. 24.6% in the conversion group; p  = 0.69). Conclusion No differences were observed in the rates of marginal ulceration in patients in the group who underwent primary Roux-en-Y gastric bypass surgery versus those who underwent conversion RYGB from a previous SG. This study’s results contradict the results of some similar studies and challenge the hypothesis that the gastric anatomical changes after SG could possibly result in significantly compromised perfusion, thus increasing the risk of marginal ulceration. The discrepancy between our results and previous reports highlights the need for further research to clarify the underlying mechanisms and risk factors contributing to marginal ulcer development in various surgical contexts.