Minority ethnic

In the United States, tuberculosis disproportionately affects ethnic minorities as compared with whites, reflecting greater ongoing transmission in ethnic minority communities. Additional tuberculosis surveillance and preventive treatment are required within these communities. 

It is widely held that differences exist in the usage and dosage of antipsychotics among ethnic minority groups. A number of factors are felt to account for these differences and include sociocultural variables (racial bias, cultural divide between patient and physician, language), as well as biological variables (pharmacogenetic, pharmacokinetic, and pharmacodynamic). 

Dominguez, R. A., Bravo-Valverde, R. L., Kaplowitz, B. R. Cott, J. M. (2000). Valerian as a hypnotic for Hispanic patients. Cultur. Divers. Ethnic Minor. Psychol., 6, 84-92. 

Roy-Byrne, R P., Philip, P., Pitts, C. Christi, J. (2005). Paroxetine response and tolerability among ethnic minority patients with mood or anxiety disorders a pooled analysis. /. Clin. Psychiatry, 66, 1228-33. 

Identifying inter-ethnic variations in psychotropic response in African Americans and other ethnic minorities... 

The United States is becoming more diverse, ethnically and culturally. This process is happening primarily through immigration and also to some extent from differential birth rates ofvarious ethnic groups. Over a third of today s Americans are considered ethnic minorities. Currently Hispanics and African Americans each make up about 15% of the population. It is anticipated that individuals of European ancestry will become less than a majority in 2050 (US Census, 2000). 

Research in psychopharmacology has shown that ethnicity must be considered in psychiatry as well (Lawson, 1986 Pi 8c Simpson, 2005). Early clinical trials with antipsychotic and antidepressant medications showed that ethnic minorities may respond when given the same doses as Caucasians, and may have more side effects (Lawson, 1986 Lawson, 1990). However, dosing cannot be used as a measure of appropriate pharmacotherapy because an extensive literature has shown that African Americans often receive higher doses of antipsychotics despite evidence of more side effects. 

These findings emphasize the importance of including ethnic minorities in clinical trials in sufficient numbers and to do intra-ethnic analysis. Failure to do so will mean that guidelines for new pharmacological products will be relevant mostly to treating Caucasians only. Ethnic minorities are left at risk for possible idiosyncratic side effects, inappropriate dosing, or lack of efficacy. 

The argument is often made that African Americans and other ethnic minorities do not participate in clinical trials because they do not want to. African Americans in particular were thought to be suspicious of participation because of previous experiences of exploitation and manhandling of vulnerable minority groups (Melfi et al, 2000 Corbie-Smith et al, 1999). The Tusgekee syphilis study is often cited as a reason for mistrust (Shavers et al, 2000 Shavers et al, 2002 Corbie-Smith et al, 1999). This study was a federally funded study of the long-term consequences of syphilis on African American men initially started before antibiotics were available. 

Wendler, D., Kington, R., Madans, J. et al. (2006). Are racial and ethnic minorities less willing to participate in health research PLoS Med., 3, el9. 

Centers for Disease Control. Policy on the Inclusion of Women and Racial and Ethnic Minorities in Externally Awarded Research. 60 Fed. Reg. 47947 (Sep 15, 1995). 

M. tuberculosis is transmitted from person to person by coughing or sneezing. Close contacts of TB patients are most likely to become infected. Fifty-four percent of TB patients in the United States are foreign born, most often from Mexico, the Philippines, Vietnam, India, and China. In the United States, TB disproportionately affects ethnic minorities (African Americans, Hispanics, and Asians). 

Susceptibility factors increase the risk for kidney disease but do not directly cause kidney damage. Susceptibility factors include advanced age, reduced kidney mass and low birth weight, racial or ethnic minority, family history, low income or education, systemic inflammation, and dyslipidemia. 

In the multivariate analysis, African Americans were nearly twice as likely as whites (OR = 1.88, p = 0.013), whereas Asians were 2.6 times (p = 0.001) and Hispanics 3.1 times (p < 0.001) as likely as whites to have such a test. These results suggest that confidentiality of genetic test results and possible discrimination by employers is not a salient concern of racial/ethnic minorities, but it is a concern among whites. 

The final question in this section of the interview inquired into the respondents willingness to have a genetic test if the results were available to their life insurance company. Again, the likelihood of participation decreases with years of education and is significantly higher among racial/ ethnic minorities compared with whites. What is noteworthy here is the finding that respondents who have total family incomes above 50,000 are... 

Lucino, J., "Pharmacogenomics and Ethnic Minorities." Psychiat. Times XVII(ll), 1-6... 

In the U.S., race has been used as a proxy for a variety of physical, mental, and social dimensions. The legacy of racism still pervades society, including disparity in access to health care and in health care outcomes (see chapter by Nsiah-Jefferson, this volume). In attempting to eliminate these health disparities there have been efforts to include racial and ethnic minorities in research studies and to generate better data on racial and ethnic variations in health status. Although most policy makers and commentators believe that racial classifications in data collection and outcomes research are needed to eliminate health disparities, others believe that such policies prolong the use of a flawed concept and reify race as a pseudoscientific measure (Lee et al., 2001). 

Assessment instruments may have cultural biases that overpatholo-gize ethnic-minority clients. True or False ... 

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