No abstract

Disparities in hypertension between African Americans and non-Hispanic whites have been well-documented, yet an explanation for this persistent disparity remains elusive. Since African Americans and non-Hispanic white Americans tend to live in very different social environments, it is not known whether race disparities in hypertension would persist if non-Hispanic whites and African Americans were exposed to similar social environments. We compared data from the Exploring Health Disparities in Integrated Communities-SWB (EHDIC-SWB) Study with the National Health and Nutrition Examination Survey (NHANES) 1999–2004 to determine if race disparities in hypertension in the USA were attenuated in EHDIC-SWB, which is based in a raciallyintegrated community without race differences in income. Hypertension was defined as systolic Blood Pressure (BP)>= 140 millimeters of mercury (mmHg) and/or diastolic BP >= 90 mm Hg or respondent’s report of taking antihypertensive medications. Of the 1408 study participants, 835 (59.3%) were African American, 628 (44.6%) were men, and the mean age was 40.6 years. After adjustment for potential confounders, various analytic models from EHDIC-SWB and NHANES 1999–2004 data, we found the race odds ratio was between 29.0% and 34% smaller in the EHDIC-SWB sample. We conclude that social and environmental exposures explained a substantial proportion of the race difference in hypertension.

We compared race disparities in health services use in a national sample of adults from the 2002 Medical Expenditure Panel Survey and data from the Exploring Health Disparities in Integrated Communities Project, a 2003 survey of adult residents from a low-income integrated urban community in Maryland. In the Medical Expenditure Panel Survey data, African Americans were less likely to have a health care visit compared with Whites. However, in the Exploring Health Disparities in Integrated Communities Project, the integrated community, African Americans were more likely to have a health care visit than Whites. The race disparities in the incidence rate of health care use among persons who had at least one visit were similar in both samples. Our findings suggest that disparities in health care utilization may differ across communities and that residential segregation may be a confounding factor.

In twin research, typically both members of a pair must participate. Survivorship of members of intact pairs compared to surviving members of nonintact twin pairs may reflect differences in psychosocial and health factors, and represent a potential selection bias relative to the general population. The purpose of the present study is to examine health, cognition, and well-being among members of African American intact twin pairs compared to individuals from nonintact twin pairs. Data from the Carolina African American Twin Study of Aging (CAATSA) were used for analyses. Subjects ranged in age from 25 to 89 years of age (mean = 59.78 years, SD = 12.84 years). CAATSA implements a 3-h protocol to collect data on demographics, health, cognition, and well-being. Data from one randomly selected member of each twin pair (N = 78) was compared to data from surviving members of nonintact twin pairs (N = 52). The results indicated significant differences on 11 of the 39 measures (i.e., age, education, forced expiratory volume, mean standing and sitting systolic and diastolic blood pressures, cognitive impairment score, alpha span, digit symbol, and logical memory). In each case, members of intact twin pairs performed better than surviving members of nonintact twin pairs. After controlling demographic variables, only blood pressures differed between the groups. It appears that using only pairs in research on older African American twins may represent a selection bias in estimating origins of individual variability in cognitive functioning and health but not psychological well-being.

Results: In men, additive genetic effects accounted for 77% of the variance in WC, 59% in WHR, and 89% in BMI. In women, additive genetic effects accounted for 76% of the variance in WC, 56% in WHR, and 73% in BMI. The remaining variance in both men and women was attributed to unique environmental effects (WC, 21%; WHR, 36%; BMI, 11% in men and WC, 22%; WHR, 38%; BMI, 27% in women) and age (WC, 2%; WHR, 5% in men and WC, 2%; WHR, 6% in women). When BMI was controlled in the analysis of WC and WHR, it accounted for a portion of the genetic and environmental variance in WHR and over onehalf of the genetic and environmental variance in WC. Discussion: There are both genetic and environmental influences on WC, WHR, and BMI, and independent of BMI, there are genetic and environmental effects on WC and WHR among both genders. The results from this AfricanAmerican twin sample are similar to findings among white twin samples.

Depression is typically considered relative to individuals and thought to originate from both biological and environmental factors. However, the environmental constraints and insults that African Americans experience likely influence the concordance by age and gender for depression scores among adult African American twins. Monozygotic (MZ) (n = 102) and Dizygotic (DZ) (n = 110) twins, age 25-88 years in the Carolina African American Twin Study of Aging were examined using an 11-item version of the CES-D measure of depressive symptomatology. Those participants with scores above nine were considered depressed. Overall, the MZ pairs had a higher concordance than the DZ pairs implying genetic influence. Both MZ and DZ males had higher concordances than either female zygosity groups. The difference between the concordance rates for MZ and DZ twin pairs was greater in males than females. By age group, the difference between the concordance rates for younger MZ and DZ twin pairs was much larger than for older pairs. The results suggest that, even though African Americans may be at risk for depression due to contextual/environmental factors, genetic influences remain important.

Objective: African Americans have a particularly high prevalence of excessive body fat and high blood pressure. Genetic and environmental influences may be implicated for both of these risk factors. We investigated the potential for common genetic and environmental influences on body fat (waist circumference (WC), body mass index (BMI)) and blood pressure measures (systolic and diastolic pressure (SBP, DBP)) among African-American male and female subjects. Research methods and procedures: Measurements were taken as part of the Carolina African-American Twin Study of Aging (CAATSA). The CAATSA sample contains 217 same-sex African-American male and female twins with average age of 47 years. This analysis included 39 monozygotic male pairs (MZ), 43 dizygotic male pairs (DZ); 63 MZ female pairs, and 72 DZ female pairs. Maximum likelihood quantitative genetic analyses were used. Results: The total genetic variance for SBP was 22% in male subjects and 40.1% in female subjects. Of this total variance, 3.1% was in common with BMI in male subjects and 6% was in common with BMI in female subjects. After controlling for the effects of BMI, WC had less than 1% of its variance in common with SBP in male and female subjects. For DBP, the total genetic variance was 16.9% in male and 38.7% in female subjects. Of this total variance 6.1% was in common with BMI in male subjects and 3.7% was in common in female subjects. Again, WC had less than 1% of its genetic variance in common with DBP in both male and female subjects. The environmental variance common among these measures was also very small. The remaining variance was primarily accounted for by genetic and environmental effects unique to each measure as well as age. Discussion: Based on the very small common genetic variance for BMI, SBP, and DBP as well as WC and the blood pressure measures, our results suggest that searching for common genes among these measures may be inconclusive.

The American Cancer Society's Cancer Facts & Figures for African Americans 2011–2012 (Atlanta) reports that African American men have the highest incidence of prostate cancer (ACS, 2011) and that African Americans have the highest death rate of any racial or ethnic group in the United States for nearly all cancers. The fact that 40 percent of African American males are being diagnosed with prostate cancer, and 16 percent of African males are estimated to die from the condition, demands research and action. This study examines the effectiveness of theater in comparison to standard workshop/lecture in educating African American males about prostate cancer. Employing a retrospective/pre–post‐test design, the study recruited 127 men to attend theater and standard workshop/lectures. Researchers assessed the effectiveness of theater in increasing participants' knowledge and awareness about prostate cancer in comparison to standard workshop/lecture. Results of the study indicate statistically significant increases in knowledge for playgoers before and after the play. Participants also reported statistically significant increases in the likelihood of engaging in healthy pro‐social prostate‐related behaviors. In addition, results of the study indicate that the increase in knowledge for participants who attended the standard workshop/lecture was greater than the increase in knowledge for participants who attended the play. Thus standard workshop/lecture proved to be more effective in educating African American men about prostate cancer. The findings suggest that further research will be needed to identify more innovative educational tools to increase knowledge and alter health‐related behaviors.