Prostate cancer screening guidelines emphasize shared decision-making, yet these decisions are shaped by structural contexts. While racial and ethnic disparities in outcomes are well-documented, the socioeconomic and pre-diagnostic health pathways driving these differences in later life remain unclear. This study utilized structural equation modeling (SEM) to evaluate whether socioeconomic status (SES) and pre-diagnostic health profiles mediate the relationship between race/ethnicity and clinical severity at prostate cancer diagnosis. We analyzed 5,438 men aged 55 to 74 years diagnosed with prostate cancer in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. Parallel mediation SEM with weighted least squares estimation examined two pathways linking race/ethnicity to latent clinical severity (prostate-specific antigen (PSA), Gleason score, and stage): SES pathway and a pre-diagnostic health profile pathway (PSA screening history, comorbidity, and family history). The baseline latent severity model demonstrated acceptable fit (CFI = 0.872, TLI = 0.872, RMSEA = 0.034, SRMR = 0.027). Neither SES nor the measured pre-diagnostic health profile meaningfully mediated racial/ethnic differences in clinical severity. Compared with White men, total effects on latent clinical severity were significant only for AsAm men (0.465, 95
Firearm suicides among Asian Americans rose significantly between 2018 and 2023, outpacing the increase in firearm suicides among Whites over the same period. Despite this rising risk, firearm suicide research and prevention efforts have rarely focused on Asian Americans. Our study compares the relationship between suicidal thoughts and personal experiences of racial discrimination between firearm owners and non-owners among Asian American adults. Our study utilizes a nationwide cross-sectional online survey conducted among Asian Americans in July 2023 using a multi-sourced, non-probabilistic panel of U.S. adults. Eligible participants were aged 21 or older and could read English. A logistic regression model assessed the interaction between experiences of racial discrimination and firearm ownership on suicidal ideation, controlling for mental distress, alcohol use, and demographic variables for 729 survey respondents. The interaction between racism and firearm ownership was significant (OR = 2.60, C.I.=1.19–5.66). Simple slope analysis showed a stronger, positive association between experiences of racial discrimination and suicidal ideation among firearm owners (OR = 2.88, C.I.= 1.40–5.90) compared to non-owners (OR = 1.11, C.I.=0.80–1.54). Our findings indicate that the combination of racism-related stress and firearm ownership is linked to an elevated likelihood of suicidal ideation among Asian Americans. Attention to these co-occurring risks is critical for informing culturally responsive strategies for firearm suicide prevention within this population.
Chronic obstructive pulmonary disease (COPD) exacerbations and hospital admission rates remain high in the Top End of Northern Territory (NT), Australia, particularly among Aboriginal people. To examine the clinical characteristics of patients admitted with acute exacerbations of COPD (AECOPD) and evaluate the alignment of care with the Australian COPD-X guidelines in a regional and remote context. Retrospective study included adult Aboriginal and non-Aboriginal patients aged > 18 years admitted to the Royal Darwin Hospital with a primary diagnosis of AECOPD between June 2022 and June 2023. A total of 211 hospital admissions were recorded (Aboriginal 140 (41.4
The study aimed to examine ethnic differences in breastfeeding intentions and six-month breastfeeding among Roma and non-Roma mothers in Hungary, and the underlying factors. We analysed data from the nationally representative Cohort’18 Growing Up in Hungary birth cohort survey (n = 7,674). Weighted logistic regression models estimated ethnic differences in intention to breastfeed beyond one year, measured prenatally, and breastfeeding at six months postpartum, with covariates introduced sequentially by thematic blocks. Fairlie nonlinear decomposition quantified the contribution of compositional differences under pooled and group-specific models. Roma mothers were more likely than non-Roma to intend prolonged breastfeeding (51.4
The limited recognition of Indigenous, Afro-Brazilian, and other traditional food knowledge in Nutrition education may restrict professionals’ ability to provide culturally responsive care and address racial and ethnic health inequities. This study developed and applied a Curricular Thematic Integration Index to assess the incorporation of ancestral food knowledge, Brazilian sociobiodiversity, and traditional food systems into undergraduate Nutrition curricula at Brazilian federal universities. A nationwide documentary study analyzed pedagogical course projects, curricular matrices, syllabi, teaching plans, program content, and bibliographies. Eligible curricular components were examined across three dimensions: traditional peoples and communities; foods from Brazilian sociobiodiversity; and concepts related to ancestral food knowledge. The index combined five standardized indicators: thematic scope, curricular density, compulsory status, eligible-component workload, and thematic specificity. Forty universities were assessed, and 34 included at least one relevant curricular component, totaling 163 eligible curricular components. Most components were compulsory, but curricular integration was uneven and fragmented. The mean index was 0.428, ranging from 0.000 to 0.709. Food and nutrition security and agroecology were frequently addressed, whereas explicit references to Indigenous, quilombola, and other traditional communities, native foods, and traditional culinary practices were less common. Thematic specificity was the weakest index component, and only 12 curricular components integrated all three dimensions. Sensitivity analyses showed moderate-to-high stability of institutional rankings across alternative index specifications. Ancestral food knowledge remains insufficiently integrated and territorially grounded in Brazilian Nutrition education. Strengthening intercultural and decolonial curricula may improve professional preparation for culturally responsive practice and contribute to addressing racial and ethnic inequities in food, nutrition, and health.
