Kasim Ortiz

Factors associated with smoking frequency among current waterpipe smokers in the United States: Findings from the National College Health Assessment II

BACKGROUND Some waterpipe smokers exhibit nicotine dependent behaviors such as increased use over time and inability to quit, placing them at high risk of adverse health outcomes. This study examines the determinants of dependence by measuring frequency of use among current waterpipe smokers using a large national U.S. METHODS Data were drawn from four waves (Spring/Fall 2009 and Spring/Fall 2010) of the American College Health Association-National College Health Assessment datasets. The sample was restricted to students who smoked a waterpipe at least once in the past 30 days (N=19,323). Ordered logistic regression modeled the factors associated with higher frequency of waterpipe smoking. RESULTS Among current waterpipe smokers, 6% used a waterpipe daily or almost daily (20-29 days). Daily cigarette smokers were at higher odds of smoking a waterpipe at higher frequencies compared with non-smokers of cigarettes (OR=1.81; 95% CI=1.61-2.04). There was a strong association between daily cigar smoking and higher frequency of waterpipe smoking (OR=7.77; 95% CI=5.49-11.02). Similarly, students who used marijuana had higher odds of smoking a waterpipe at higher frequencies (OR=1.57; 95% CI=1.37-1.81). CONCLUSIONS Daily consumers of other addictive substances are at a higher risk of intensive waterpipe smoking and thus higher risk of waterpipe dependence. Intervention programs must incorporate methods to reduce waterpipe dependence and subsequently prevent its deleterious health effects.

Smoking Among Sexual Minorities: Are There Racial Differences?

INTRODUCTION Smoking prevalence is higher among sexual minorities compared to their heterosexual peers. However, very little is known about potential racial differences in smoking among sexual minority populations. We examined differences by race in smoking status among a robust sample of sexual minorities. METHODS We used data from the 2010 Social Justice Sexuality project, a large national convenience sample of sexual minority adults that oversampled individuals from racial minority groups. Log-Poisson multivariable regression models were employed to determine the risk of current smoking among sexual minority individuals by race after controlling for socio-demographic characteristics. RESULTS Among smokers, 22.35% identified as White, 26.98% identified as Black, 19.38% identified as Latino/Hispanic, 5.58% identified as Asian American, and 25.67% were other/multiracial. In fully adjusted gender stratified models, Black men (adjusted risk ratio [aRR] = 0.61, 95% confidence interval [CI] = 0.50, 0.75) and Asian American men (aRR = 0.61, 95% CI = 0.50, 0.75) were at lower risk of smoking compared to White men. Black women were the only to remain statistically significant for decreased risk of smoking in fully adjusted gender stratified models (aRR = 0.78, 95 % CI = 0.65, 0.95). CONCLUSIONS Among sexual minorities, Black and Asian American individuals consistently were at decreased risk of current smoking compared to their White peers. Future research should seek to understand the mechanisms that contribute to decreased smoking status among racial sexual minorities.

The systemic lupus erythematosus travel burden survey: baseline data among a South Carolina cohort

BackgroundMany studies on the impact of systemic lupus erythematosus or lupus have identified patient travel costs as being problematic. We administered a survey that examined the impact of self-rated travel burden on lupus patients. The systemic lupus erythematosus travel burden survey included 41 patients enrolled in the systemic lupus erythematosus database project at the Medical University of South Carolina.ResultsMost participants reported that travel caused medications to be discontinued or appointments to be missed. In unadjusted logistic regressions of the relationship between these outcomes and medical travel burden, both distance to rheumatologists and time to lupus medical care were significant.ConclusionsOur findings suggest that more research is needed to examine the influence of travel burden among this population, but data from this report could help to inform physicians, academic researchers, and other health professionals in South Carolina and other areas with significant rural populations on how travel burden may impact patients receiving care for lupus and provide an opportunity for the development of interventions aimed at assisting lupus patients with management of stressors related to travel burden.

Waterpipe tobacco smoking among sexual minorities in the United States: Evidence from the National Adult Tobacco Survey (2012-2014)

OBJECTIVE The current study examined differences in waterpipe smoking (both lifetime and current) comparing sexual minority populations - those identifying with lesbian, gay, or bisexual identity - to their heterosexual counterparts using a nationally representative dataset. METHODS The current study used pooled data from the 2012-2013 & 2013-2014 National Adult Tobacco Survey (NATS). Log-Poisson multivariable regression models were deployed to determine the prevalence of waterpipe smoking behavior among sexual minority individuals controlling for sociodemographic characteristics and stratified by current gender status. RESULTS In fully-adjusted models assessing lifetime WTS, lesbian/gay and bisexual respondents reported higher prevalence of WTS compared to their heterosexual counterparts. This trend held true in gender-stratified models among gay men [gay men: PR 1.25, 95%CI [1.06, 1.47] and women ([lesbians: PR 1.38, 95%CI [1.12, 1.69] and bisexual women: 1.69, 95%CI [1.45, 1.97]). In fully-adjusted models assessing current WTS, lesbian/gay and bisexual respondents reported higher risk of WTS compared to their heterosexual counterparts. This trend held true in gender-stratified models, only for among gay men [gay men: PR 1.56, 95%CI [1.18, 2.05] and bisexual women: 2.38, 95%CI [1.84, 3.09]). CONCLUSIONS Among the US general adult population, sexual minorities exhibited increased prevalence of current waterpipe smoking compared to their heterosexual counterparts. This pattern is also shaped by gender and variation of sexual orientation identification (e.g., lesbian/gay vs. bisexual). This warrants development of tailored interventions aimed at decreasing waterpipe smoking among sexual minority populations.

Systemic lupus erythematosus observations of travel burden: A qualitative inquiry

Explorations of travel impediments among patients suffering from rheumatic diseases have been very limited. Research has consistently indicated a shortage of rheumatologists, resulting in patients potentially having to travel long distances for care. The purpose of our study was to explore how systemic lupus erythematosus (SLE) patients experience travel issues differentially by race and socio‐economic status.

Social Determinants of Health, the Chronic Care Model, and Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is a chronic inflammatory rheumatic disease that disproportionately affects African Americans and other minorities in the USA. Public health attention to SLE has been predominantly epidemiological. To better understand the effects of this cumulative disadvantage and ultimately improve the delivery of care, specifically in the context of SLE, we propose that more research attention to the social determinants of SLE is warranted and more transdisciplinary approaches are necessary to appropriately address identified social determinants of SLE. Further, we suggest drawing from the chronic care model (CCM) for an understanding of how community-level factors may exacerbate disparities explored within social determinant frameworks or facilitate better delivery of care for SLE patients. Grounded in social determinants of health (SDH) frameworks and the CCM, this paper presents issues relative to accessibility to suggest that more transdisciplinary research focused on the role of place could improve care for SLE patients, particularly the most vulnerable patients. It is our hope that this paper will serve as a springboard for future studies to more effectively connect social determinants of health with the chronic care model and thus more comprehensively address adverse health trajectories in SLE and other chronic conditions.

Miles to Go: The Prison Expressway, Health Research, and Health Activism

The contention of these two statements explains largely an ill-directed narrative of individual responsibility, poor policy development in addressing social inequities that shape the health of men of color comprehensively and an unwillingness to recognize the institutionalized realities that prevent men of color from “sticking around.” Such political rhetoric is at minimum thwarting to social progress concerning men’s health and the influence of mass incarceration wherein this rhetoric of “sticking around” is not fully understood through a lens that highlights the systemic epidemic of mass incarceration that challenges full opportunity for many to “stick around.” One major area of concern for the President is the impact mass incarceration has had on the life trajectory of men, particularly men of color. In this commentary, we detail how mass incarceration has compromised the health of all Americans, outline what we describe as a prison expressway, and raise concern for greater public health response to address the needs of those that are incarcerated and/or formerly incarcerated.

Chapter 10 ‘The Last Black Mayor of Atlanta?

Purpose – We examine electoral politics in the City of Atlanta, GA, and shed light on the prospect that in 2009 Atlanta elected its “last Black mayor.” We consider how African American tensions around class and social identity may demobilize key constituents of the Black electoral coalition while an increasing Black out-migration and White in-migration had changed the city’s racial balance of electoral power. Recognizing the margin of victory in the 2009 mayoral election between Kasim Reed (an African American) and Mary Norwood (a White challenger) was small (714 votes), we examine how electoral and demographic characteristics explain this result.Methodology – We utilize (1) the 2009 State of Georgia Board of Elections voter demographic file; (2) 2010 Census data (ACS 5 year estimates), and 2009 Mayoral Election count data. We presented descriptive statistics, comparing community level factors and voter characteristics.Research implications – The limitations of this work is that it is exploratory and thus we do not statistically isolate the effects of class and social identity.Findings – Our findings indicate that Reed and other Black elected officials will have to make concerted efforts if they hope to “retain” the Black poor as well as gay and lesbian citizens within a progressive electoral coalition.

The Buffalo Lupus Project: A Community-Based Participatory Research Investigation of Toxic Waste Exposure and Lupus

Purpose – We designed a community-based participatory research project to investigate a perceived cluster of lupus in a historically contaminated African-American neighborhood. The purpose of the Buffalo Lupus Project was to investigate the high prevalence of lupus in the East Buffalo area and whether cases of disease were linked to chemicals found at a nearby New York State Superfund site. Methods – The projects research activities consisted of a registry to assess the city-wide prevalence of lupus and other autoimmune diseases and a survey to investigate common environmental factors. Lupus prevalence in the area of concern corresponded to seven times greater risk of the disease compared with the general population. The majority of survey participants were African-American women. Almost all survey participants reported some type of potentially harmful residential exposure. Results – The Buffalo Lupus Project identified an excessive number of people with lupus and other autoimmune diseases residing in an area plagued with multiple sources of toxic waste exposure. Social implications – As shown by this project, engaging the community in research and involving the community members in actions to improve their neighborhood can positively impact environmental quality. This study also played a leadership role in advocating for site cleanup and continuing legislation to support lead screening.

Assessing racial differences in lifetime and current smoking status & menthol consumption among Latinos in a nationally representative sample

ABSTRACT Objective: To examine the relationship between race and smoking behaviors among Latinos/Hispanics. Design: Using data from the National Adult Tobacco Survey (NATS), we implemented Log-Poisson regression models for each dependent variable (smoking pattern and menthol cigarette use). Each analysis adjusted for age, gender, marital status, employment status, and socioeconomic status (SES). Final pooled cross-sectional sample included 505 Black-Latinos and 9078 White-Latinos. Results: While no racial differences were found in lifetime smoking status among Latinos, Black-Latinos had a 16.6% (95% CI: 0.274, 0.057) increased risk of menthol smoking compared to White-Latinos. Conclusions: The results indicate that menthol consumption is influenced by race among Hispanics/Latinos. To comprehensively address racial disparities among Latinos/Hispanics, further attention needs to be given to racial differences in smoking-related risks among Latinos/Hispanics.