Race Differences in Opioid Misuse and Adolescent Suicidality.

Purpose: The rise of the opioid epidemic coincided with the increased risk of suicide as the leading causes of death among adolescents in the United States. Past research has linked non-medical prescription opioid use (NMPOU) with adolescent suicide. Less focus has been placed on race and ethnic differences among adolescents impacted by the opioid epidemic. This study examined the relationship of adolescent NMPOU and suicidality, stratified by race. Method: The 2016 National Survey on Drug Use and Health (NSDUH) was used for this study. Weighted multivariate logistic regression analyses were conducted on a sample of 11,489 adolescent respondents to examine the effect of past-year NMPOU with the odds for serious thoughts of suicide, having a suicide plan, and making a suicide attempt. Results: Findings indicated a higher prevalence of suicidality among adolescents who engaged in NMPOU compared to non-users. Adolescent opioid misuse was associated with 68% higher odds for having a suicide plan in the past year (OR = 1.68, 95% CI: [1.07, 2.63], p < 0.05). Interaction analysis found that among Asian adolescents, NMPOU was associated with higher odds for having a suicide plan compared to other race groups (OR=1.53, 95% CI: [1.04, 2.23], p < 0.05). Discussion: Results indicated that adolescent opioid misuse is a risk factor for suicide, and Asians compared to other race groups were at greater risk. Social workers can serve as a nexus point in effectively engaging at-risk adolescents in substance use and mental health prevention and recovery services.

Ethnic and Neighborhood Differences in Poverty and Disability among Older Asian Americans in New York City.

Asian Americans are the fastest growing and fastest aging U.S. population, and occupy both extremes of socioeconomic and health indices. Using the 2016 NYCgov dataset, multilevel logistic regression analyses were conducted to examine the relationship of poverty, acculturation and neighborhood-level variables with disability for different ethnic groups of Asian older adults (Chinese, South Asian, Filipino, Japanese, Korean and Vietnamese) in New York City. Findings indicated that South Asian older adults had higher odds for disability compared to other ethnic groups. Living in a neighborhood with higher percentages of persons of the same ethnicity was protective for Chinese older adults only. There is an important opportunity for interprofessional collaborations through education, awareness, screening and intervening to enhance systems of care for Asian older adults. Social workers can play a pivotal role in providing key linkages to form interprofessional solutions and shared efforts to address the needs of this understudied and under-resourced population. Future research is needed to better understand how ethnic enclaves are defined, and how they can benefit different ethnic groups of vulnerable Asian older adults.

Examining social determinants in use of assistive technology for race/ethnic groups of older adults.

OBJECTIVE: Assistive technologies (AT) can compensate for activity limitations and loss of physical functioning. Little is known regarding how minority older adults differ in AT use as they age. This study examined race and ethnic differences in AT use among a nationally representative sample of older adults in the United States. DESIGN: Weighted logistic regression analyses were conducted using the 2012 Behavioural Risk Factor Surveillance System (BRFSS), collected annually by the Centres for Disease Control and Prevention (CDC). The study sample included 282,825 non-Hispanic White, African American, Asian and non-White Hispanic older adults. Activity limitation, health care access, overall health status and sociodemographic characteristics were included as variables in the analysis. Interaction analyses were conducted to examine the moderating effect of race/ethnicity on social determinants with AT use. RESULTS: Results indicated that 13.5% of older adults reported the use of an AT. African American older adults had the highest percentage of AT use (21.0%), and Asian older adults had the lowest (5.1%). Those who were 85 years and older, reported an activity limitation, were unmarried and in poor health were most likely to use an AT. Having health insurance was significantly associated with higher AT use for non-Hispanic Whites (OR = 1.66, p < 0.001) and non-White Hispanics (OR = 1.98, p < 0.01), but not African Americans and Asians. CONCLUSION: Health professionals can promote access and address barriers in AT use, particularly in regard to accessibility and acceptability among minority older adults.Implications for rehabilitationAfrican-Americans older adults were most likely to use ATs, and Asian older adults the leastOlder adults who were 85 years and older, reported an activity limitation, were unmarried and in poor health were most likely to use an ATDifferent social determinants to AT use were found among race/ethnic groups, highlighting the need to promote access and address barriers to health care utilization.

Diabetes and Diabetes Care among Nonobese Japanese-Americans: Findings from a Population-Based Study.

OBJECTIVES: The objectives of this study are as follows: (1) to determine the prevalence of diabetes among nonobese Japanese-Americans and to determine the adjusted odds of diabetes among nonobese Japanese-Americans compared to non-Hispanic Whites (NHWs); (2) to identify the risk factors associated with having diabetes in a large sample of nonobese Japanese-Americans; and (3) to determine the prevalence and adjusted odds of diabetes management behaviors among nonobese Japanese-Americans with diabetes in comparison to NHWs with diabetes. METHODS: The combined 2007-2016 waves of the adult California Health Interview Survey (CHIS) were used to analyze a nonobese (BMI<30) sample of 2,295 Japanese-Americans and 119,651 NHWs. Chi-square and logistic regression analyses were performed using Stata. RESULTS: The findings of this representative community study of nonobese Californians indicate that the prevalence of diabetes among Japanese-American respondents was higher than their NHW counterparts (8.0% versus 4.5%). Prevalence increased markedly with age; one-quarter of nonobese Japanese Americans aged 80 and older had diabetes. CONCLUSIONS: The prevalence of diabetes among nonobese Japanese-Americans is significantly higher than that among NHWs. There is an urgent need to develop appropriate intervention and prevention approaches with lifestyle modification specifically targeted towards nonobese Japanese-Americans.

Diabetes Care of Non-obese Korean Americans: Considerable Room for Improvement.

BACKGROUND: Family doctors are increasingly managing the diabetes care of Korean-Americans. Little is known about the prevalence of diabetes among non-obese Korean-Americans, or the extent to which they receive timely and appropriate diabetes care. The purpose of this investigation is to: (1) identify the prevalence of diabetes and to determine the adjusted odds of diabetes among non-obese Korean-Americans compared to non-Hispanic White (NHW) Americans, (2) examine the factors associated with having diabetes in a large sample of non-obese KoreanAmericans, and (3) determine the prevalence and adjusted odds of optimal frequency of eye care, foot care and A1C blood glucose level monitoring among non-obese Korean-Americans with diabetes in comparison to NHWs with diabetes. METHODS: Secondary analysis of population-based data from the combined 2007, 2009, and 2011 adult California Health Interview Survey. The sample included 74,361 respondents with body mass index (BMI) <30 kg/m2 (referred to as 'non-obese BMI'), of whom 2,289 were Korean-Americans and 72,072 were NHWs, and 4,576 had diabetes. RESULTS: The prevalence and adjusted odds of diabetes among non-obese Korean-Americans are significantly higher than among their NHW peers. More than 90% of Korean-Americans with diabetes were non-obese. NHWs had substantially higher odds of having optimal frequency of eye care, foot care and A1C glucose level monitoring, even after adjusting for insulin dependence, sex, age, education, income, and BMI. CONCLUSION: Non-obese Korean-Americans are at higher risk for diabetes and are much less likely to receive optimal diabetes care in comparison to NHWs. Targeted outreach is necessary.

Diabetes among asian americans with BMI less than or equal to 23.

Lowering the BMI overweight cut point to 23 for Asian Americans (AA) is helpful, but careful monitoring for diabetes across the whole BMI spectrum is still required for AA; One in every 17 AA with a BMI < 23 has diabetes. Twenty one percent of all AA with diabetes has a BMI < 23.

Risk and preventive factors for type 2 diabetes and heart disease among foreign-born older Vietnamese Americans.

The 2009 California Health Interview Survey (CHIS) data was used to examine associations of bodyweight, lifestyles, and demographic variables with type 2 diabetes (T2DM) and heart disease among foreign-born older Vietnamese adults. CHIS consisted of 709 Vietnamese Americans aged 50 to 85. Thirteen percent reported T2DM and 11% had heart disease. Using logistic regression, body mass index ≥ 24, age ≥ 65, and female were significantly associated with T2DM. There was significant interaction effect of alcohol consumption and psychological distress with T2DM. The interaction of vegetable consumption, poverty, and length of living in the U.S. was significantly associated with heart disease.