Multiracial Health Study

Self-rated health among multiracial young adults in the United States: findings from the add health study

 ABSTRACT

Objective: The multiracial adult population is one of the fastest growing segments of the U.S. population, yet much remains to be learned about multiracial health. Considerable research finds racial/ethnic disparities in self-rated health, however subgroups within the multiracial population have not been consistently described.

Design: We use data from the National Longitudinal Survey of Adolescent Health (Add Health) and multivariate logistic regression analyses to compare self-rated health of multiracial and monoracial young adults (n = 7880).

Results: Overall, there were no significant differences in poor self-rated health status of multiracial adults as a single group odds ratio 0.84 (95% CI: 0.52–1.36) compared to monoracial White adults. Analyses further revealed important variations in health-status by specific subgroups and show that some multiracial subgroups may not fit existing patterns of health disparities. For instance, Asian-White multiracial adults do not fit documented patterns of health disparities and report better health than monoracial Asian and monoracial White adults.

Conclusion: This study illustrates that the inclusion of specific multiracial categories provides evidence to enhance understanding of the pathways that are linked to health outcomes and the implications for health disparities.

Being Multiracial: A Matter of Life or Death?

Vancouversun.com

VIFF premieres documentary Mixed Match

1004 VIFF 2016 Mixed Match. Documentary by Vancouver director Jeff Chiba Stearns looking at the unique challenges facing children of racially mixed parents who have rare blood diseases. [PNG Merlin Archive]

STUART DERDEYN

A rare disease diagnosis requiring a suitable bone marrow match to keep a child alive is something no parent ever wants to deal with. Yet many do.

In director Jeff Chiba Stearns’ documentary Mixed Match, the challenges that children of multiracial unions sometimes face finding compatible donors to fit their genetic markers and the issue of race in medicine is well explored. The Emmy-nominated and Webby Award-winning Vancouver director (One Big Hapa Family, 2010) is the co-founder of Vancouver’s annual Hapa-palooza Festival, Canada’s first and largest celebration of people with mixed ancestry that keeps growing.

A news report about the passing of a 23-year-old of Eurasian descent who was searching the global donor bank but unable to find a match in time sparked his interest in the Mixed Match subject matter. His film featuring live action and inventive animation took six years to complete.

“When you walk down the street in Vancouver, you see so many mixed-race families and children and the prediction is that will be the majority fairly soon,” said Stearns. “Tons of babies being born right now are born to mixed (parents) and, while rare blood diseases are thankfully rare, I thought we should do something to focus on the people stories. There are people searching now and desperate now.”

In searching out the unique stories, the director came into contact with the American-based Mixed Marrow organization which is trying to build mixed-race donor banks. He also profiles scientists working on the cutting edge of genetic science, aw well as racist trolls and some truly inspirational subjects such as Imani Cornelius. This spectacularly well-spoken, lively young woman in Wisconsin is as good a spokesperson as anyone could hope for to get more people onto a donor registry.

“We wanted a call to action. We wanted to cover all the angles. It’s controversial in so many ways how we talk about the racial language in medicine and beyond,” said Stearns. “But what we didn’t want was a two-hour PSA. We wanted the people like Imani to make the point.”

Mixed Match is more than a movie for Stearns. His own child’s birth becomes part of the awareness-raising in the film. The tagline for the film says it all: “When being mixed race is more than just an identity, it’s a matter of life and death.”

MEDICAL MONDAY: Without Diversity of Blood Donors, Minority Patients Are Left Without Hope

FEB 22 2016
If you’re mixed race or an ethnic minority, your chances of finding a lifesaving bone marrow donor are drastically reduced. That’s because the health system is stacked against minorities.

Lara Casalotti was diagnosed with acute myeloid leukemia in December. Photo courtesy of Anthony Nolan

When 24-year-old Londoner Lara Casalotti was diagnosed with acute myeloid leukemia last December, her family were desperate to find a bone marrow donor who would save her life. But the odds were against her.

The reason? Casalotti is half Italian and half Thai-Chinese, and the global donor register is severely lacking in mixed race donors. Sometimes the chance of finding a lifesaving match can be as low as one in a million—or, as in Lara’s case, one in 25 million.

If you are white and diagnosed with blood cancer, you stand a 60 percent chance of finding a perfect match for a stem cell transplant. If you’re from a black or Asian background, that figure drops to 20 percent. If you’re mixed race, the likelihood of finding someone who can save your life is lower still.

This is because stem cell and bone marrow matching relies on inherited ancestral tissue type, so most matches occur between people of similar heritage. And, as blood charities such as Anthony Nolan and Delete Blood Cancer have been warning for decades, donors of color are vastly underrepresented on the register.

In January, Casalotti’s family launched a global appeal online to encourage new donors to sign up to the register. During the Match4Lara campaign, which saw the likes of Mark Wahlberg, J.K. Rowling, and Stephen Fry expressing their support on Twitter, Anthony Nolan reported an “unprecedented spike” of donors from ethnic minority backgrounds in the UK. At the campaign’s peak, more than 50 percent of those signing up to the register were people of color, the highest proportion ever seen by the charity in a campaign of this nature.

But why are there so few donors from diverse ethnic backgrounds in the first place? The main reason lies in the fact that these groups are minorities in life itself. As Athena Asklipiadis, founder of Mixed Marrow, an American organization committed to finding donors for patients of multi-ethnic descent, told Broadly: “The obvious reason is that minorities and mixed race adults are still minority populations so the numbers of possible donors from those groups will be smaller.”

Another reason, according to Athena, is due to “language and cultural barriers,” which many registries are looking to address by providing information in multiple languages and identifying spokespeople from within minority communities. A YouGov survey commissioned by Anthony Nolan in January 2015 revealed that just over one in three black respondents would be supportive if a young family member (aged 16 to 21) wanted to donate stem cells, compared to nearly two-thirds of the overall sample.

And nearly one in ten of black respondents said their family wouldn’t approve of donating stem cells—compared to just one percent of the total population. The research also showed that people from the black community are more likely to view stem cell donation as a “dangerous activity” than any other ethnicity.

In spite of the manifold misconceptions, donating is relatively painless. For 90 percent of people it is a simple, outpatient procedure, similar to giving blood. For the remaining 10 percent, stem cells are taken from bone marrow in the pelvis during a one-to-two-hour surgical procedure performed under anaesthetic.

Ann O’Leary, head of register development at Anthony Nolan, told Broadly: “It is heartbreaking that people with blood cancer who are from mixed race or ethnic minority backgrounds may struggle to find their lifesaving match, not because a matching donor for them isn’t out there—but because that person never joined the register.”

She added: “The closer the tissue match, the better the chances for the patient, and you’re most likely to find your match from someone in the same ethnic group. Because there are tens of thousands of different tissue types out there, it means the odds are stacked against you if you’re mixed race, as the pool of potential donors is so much smaller.

“We have a vital job to do—we must grow and diversify the bone marrow register. People’s lives depend on it.”

In February, against innumerable odds, a match for Casalotti was found and her operation is planned for the beginning of March. Yet, while Casalotti may have found her one in 25 million, there are around 2,000 people in the UK still waiting for good news.

Although Match4Lara helped publicize the need to diversify the register, the odds of finding a match remain bleak if you are a person of color.

May Brown was diagnosed with acute myeloid leukemia, the same condition as Casalotti, at the end of June last year. The 22-year-old mother of one, who was forced to delay her studies in law and criminology at the University of Liverpool, is desperately awaiting the news that a match has been found.

Brown is Nigerian, and is aware that her ethnicity drastically reduces her chances. “I have been waiting for a donor for months now,” she told Broadly. “My family have a one in four chance of being a match for me but they’re all back in Africa and they don’t have the same charitable organisations there. You have to pay to see if you’re a match and that costs £250 per person. I don’t have that kind of money and neither do they.”

She remains hopeful that her match will be found. “I’m staying positive about a match being found for me. I just need as many people as possible to come forward and get tested.”

Thirteen-year-old Zara Al Shaikh from Winchester is in a similarly stark position. Zara was diagnosed with a blood disorder called myelodysplastic syndrome when she was 11, which has since transitioned into acute myeloid leukemia.

Al Shaikh’s dad, Dr Loua Shaikh, told Broadly, “Zara has been remaining positive and decided to dye her hair blue before she lost it through chemotherapy treatment. We need to find her a matching blood stem cell donor as soon as possible, anyone out there could be that person, they just need to be on the register.”

As Al Shaikh is half English and half Arabic, her chance of finding a match remains slim. Like Casalotti, Al Shaikh’s family have launched a Match4Zara campaign to expand the donor pool, but her outlook remains uncertain.

There is little that anyone can do to prevent someone from getting cancer but so much that can be done to help them beat it. Casalotti found her one in 25 million chance of a match through the power of her inspirational global campaign.

Blood charities urge that the world has to build on the momentum she created until we find a match for everyone—including and especially people of color. The registration process is simple: All you need to do is fill in a short online form for a charity like Anthony Nolan or Delete Blood Cancer, and they will post a DIY cheek swab kit that will add your tissue type to the registry.

As Al Shaikh, who is being treated at Southampton University Hospital, told Broadly: “Please come forward and register. It’s really easy. You never know, you might be my match.”

Project RACE Helps Welcome New U.S. Surgeon General

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PR Kids President, Karson Baldwin (that’s me!) with my new hero, the new U.S. Surgeon General, Dr. Vivek Murthy!

Fort Myer, VA –

Yesterday was a day I will never forget. It was an awesome honor to be invited to the Swearing-In and Change of Command Ceremony for the 19th Surgeon General of the United States, Vice Admiral Vivek Murthy, MD, MBA.

The Surgeon General is considered “America’s Doctor” and his job is improving personal and public health for the USA. Dr. Murthy gave a really inspiring speech about his childhood and what made him decide to become a doctor. In his speech he also talked a lot about health care being a basic civil right for all and not a privilege for some and he talked about racial and economic health disparities.  At Project RACE, one of the main things we care about is equal rights in health care for multiracial people.  I think Dr. Murthy is now one of the most important people in our country, because he has the power to help with that.

But he was not the only big time government person there. Health and Human Service Secretary Burwell introduced Vice President Biden who was there to read the commission and lead Dr. Murthy in the Oath of Office. There were lots of other officials in the ceremony and in the crowd and I got to talk to three pharmacists at the FDA about including multiracial people in medical research!

The ceremony was at Fort Myer in Virginia and included all kinds of military activities because the Surgeon General leads the U.S. Public Health Service Commissioned Corps of 6,700 uniformed health officers “who serve around the world to promote, protect and advance the health and safety of our nation and our world.” There were bells, medals, frocking, marching and more. One of the coolest moments was when the Deputy Surgeon General announced to Dr. Murthy that they were “awaiting his command” and the new Surgeon General declared, “POST MY COLORS!” (like a BOSS!)

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Dr. Murthy went to Harvard for undergrad and Yale for Med School so we had to talk a little Harvard-Yale sports rivalry.

The highlight, of course, was when my mom and I got to talk with Dr. Murthy and his fiance, Dr. Alice Chen, after the ceremony.  All that Dr. Murthy has accomplished is crazy impressive. Being the youngest Surgeon General ever is crazy impressive. Being the first Indian Surgeon General ever is crazy impressive. But welcoming a 13 year old advocate to share in such a special day and taking the time to be so warm and humble is most impressive of all!

 

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Mom, Dr. Murthy, Me and Dr. Chen

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Dr. Murthy started his first non profit when he was 17 years old!

 

 

 

 

 

 

 

 

 

 

 

 

 

Medical Monday

Racial Differences May Necessarily Affect Eye Care

Written by
Jonathan Temte MD, MS, PhD
 We are confronted with diversity on a daily basis in the practice of medicine. Patients present for evaluation of symptoms or for preventive care. The health professional takes in myriad strands of information in routine decision-making. In a broader sense, this is encompassed in the concept of personalized medicine: customized interventions based on one’s genetic makeup and/or lifestyle choices. Personalized medicine has now become sufficiently mainstream to be featured in the recent State of the Union address. Two recent papers highlight this concept for the eye care professional.1-2

Race and Ancestry Important in Medicine

We agree that ancestry and racial information are BOTH important to the personal medical history, especially for the multiracial population.

Ancestry, not just race, is important to personal medical history

Doctors often ask patients to list their race — white, Latino, African American, Asian, Native American — to help them provide better healthcare. They do this because loads of medical research shows that the incidence of certain diseases and treatment success can vary somewhat from race to race.
But the more important question may be: What is your genetic ancestry?

Asthma genetic ancestry race A study released Wednesday in the New England Journal of Medicine examined the accuracy of a lung function test and how race and ancestry played a role in the test’s accuracy. A lung function test measures damage to the lungs caused by asthma or other disease. However, the definition of “normal” lung function is known to vary substantially by race. For example, doctors have long known that vital lung capacity (the maximum amount of air that can be expelled after maximum inhalation) is 6% to 12% lower in blacks compared with whites and Native Americans.

Researchers looked at data from more than 3,000 patients that included their lung function test results, standard information on race and additional information on genetic ancestry that was obtained through genotyping. The study found that standard race categories don’t capture the extent of ancestral diversity and, thus, may limit the amount of information available to a doctor in making a diagnosis or ordering treatment. Instead, many people have a rich and diverse genetic background that does not lend itself to a simple classification, such as “white” or “Asian.”

For example, when using genetic ancestry data, the study showed a strong link between African ancestry and lung function measurement in both men and women. According to the findings, for 6.4% of people in the United States who identify themselves as African American, the actual percentage of African ancestry would be 15% higher or lower than average — a difference that would result in an incorrect estimation of lung function test, and possibly, mistakes about the severity of lung disease. About 2.1 million self-identified African Americans have asthma. But based on the study conclusions, the severity of the asthma would be misclassified in about 4% of those patients.

“When we force patients into an individual box, such as ‘African American’ or ‘Caucasian,’ we’re missing a lot of genetic information,” senior author of the study Dr. Esteban G. Burchard, of UC San Francisco, said in a news release. “This study provides new evidence that genetic ancestry correlates to physiological measures. With it, we’re one step closer to personalized medicine.”

On a more practical level, the study points to the need for improvements in measuring lung function in some people. In an editorial accompanying the paper, authors noted: “Refinements are needed for poorly represented or misrepresented populations and for persons of mixed ancestry, who represent an increasing proportion of the U.S. population.”
— Shari Roan
SOURCE: LA Times July 7, 2010