A person's racial or ethnic self-identification can change over time and across contexts, which is a component of population change not usually considered in studies that use race and ethnicity as ...variables. To facilitate incorporation of this aspect of population change, we show patterns and directions of individual-level race and Hispanic response change throughout the United States and among all federally recognized race/ethnic groups. We use internal U.S. Census Bureau data from the 2000 and 2010 censuses in which responses have been linked at the individual level (N = 162 million). Approximately 9.8 million people (6.1 %) in our data have a different race and/or Hispanic-origin response in 2010 than they did in 2000. Race response change was especially common among those reported as American Indian, Alaska Native, Native Hawaiian, Other Pacific Islander, in a multiple-race response group, or Hispanic. People reported as non-Hispanic white, black, or Asian in 2000 usually had the same response in 2010 (3 %, 6 %, and 9 % of responses changed, respectively). Hispanic/non-Hispanic ethnicity responses were also usually consistent (13 % and 1 %, respectively, changed). We found a variety of response change patterns, which we detail. In many race/Hispanic response groups, we see population churn in the form of large countervailing flows of response changes that are hidden in cross-sectional data. We find that response changes happen across ages, sexes, regions, and response modes, with interesting variation across racial/ethnic categories. Researchers should address the implications of race and Hispanic-origin response change when designing analyses and interpreting results.
The U.S. Census Bureau is researching uses of administrative records and third party data in survey and decennial census operations. One potential use of administrative records is to utilize these ...data when race and Hispanic origin responses are missing. When federal and third party administrative records are compiled, race and Hispanic origin responses are not always the same for an individual across sources. We explore different methods to assign one race and one Hispanic response when these responses are discrepant. We also describe the characteristics of individuals with matching, non-matching, and missing race and Hispanic origin data by demographic, household, and contextual variables. We find that minorities, especially Hispanics, are more likely to have non-matching Hispanic origin and race responses in administrative records and third party data compared to the 2010 Census. Minority groups and individuals ages 0-17 are more likely to have missing race or Hispanic origin data in administrative records and third party data. Larger households tend to have more missing race data in administrative records and third party data than smaller households.
Monitoring and addressing racial and ethnic disparities in health and health care require the collection and analysis of reliable demographic information. With the intention of improving the ...measurement and monitoring of disparities, certain provisions of the Patient Protection and Affordable Care Act (ACA) of 2010 require states to collect, report, and analyze data on demographic characteristics of applicants and participants in Medicaid and other federally supported programs. In this large-scale study we link Medicaid records to the Census 2000, the 2010 Census, and the American Community Survey for years 2001–2009 to explore the extent to which pre-ACA Medicaid administrative records matched self-reported race and Hispanic origin in Census Bureau data. Record linkage allows comparison of demographic, socioeconomic and neighborhood characteristics between Medicaid participants with matching and non-matching race and Hispanic origin in census. Identification of the groups most likely to have non-matching and missing race and Hispanic origin data in Medicaid relative to census can inform strategies to improve the quality of demographic data collected from the Medicaid population.
Race and ethnicity responses can change over time and across contexts – a component of population change not usually considered in studies that use race and ethnicity as variables. To facilitate ...incorporation of this aspect of population change, we show patterns and directions of individual-level race and Hispanic response change throughout the U.S. and among all federally recognized race/ethnic groups. We use internal Census Bureau data from the 2000 and 2010 censuses in which responses have been linked at the individual level (N = 162 million). About 9.8 million people (6.1 percent) in our data have a different race and/or Hispanic origin response in 2010 than they did in 2000. Race response change was especially common among those reported as American Indian, Alaska Native, Native Hawaiian, Other Pacific Islander, in a multiple-race response group, or Hispanic. People reported as non-Hispanic white, black, or Asian in 2000 usually had the same response in 2010 (3%, 6% and 9% of responses changed, respectively). Hispanic/non-Hispanic ethnicity responses were also usually consistent (13% and 1% changed). There were a variety of response change patterns, which we detail. In many race/Hispanic response groups, there is population churn in the form of large countervailing flows of response changes that are hidden in cross-sectional data. We find that response changes happen across ages, sexes, regions, and response modes, with interesting variation across race/ethnic categories. Researchers should think through and discuss the implications of race and Hispanic origin response change when designing analyses and interpreting results.
This study explores patterns of ethnic boundary crossing as evidenced by changes in Hispanic origin responses across decennial census and survey data. We identify socioeconomic, cultural, and ...demographic factors associated with Hispanic response change. In addition, we assess whether changes in the Hispanic origin question between the 2000 and 2010 censuses influenced changes in Hispanic reporting. We use a unique large dataset that links a person’s unedited responses to the Hispanic origin question across Census 2000, the 2010 Census and the 2006-2010 American Community Survey five-year file. We find that most of the individuals in the sample identified consistently as Hispanic regardless of changes in the wording of the Hispanic origin question. Individuals who changed in or out of a Hispanic identification, as well as those who consistently identified as non-Hispanic (of Hispanic ancestry), differed in socioeconomic and cultural characteristics from individuals who consistently reported as Hispanic. The likelihood of changing their Hispanic origin response is higher among U.S.-born individuals, those reporting mixed Hispanic and non-Hispanic ancestries, those who speak only English at home, and those who live in tracts that are predominantly non-Hispanic. Racial identification and detailed Hispanic background also influence changes in Hispanic origin responses. Finally, changes in mode and relationship to the reference person in the household are associated with changes in Hispanic origin responses, suggesting that data collection elements also can influence Hispanic origin response change.
Age-related macular degeneration (AMD) is a leading cause of visual loss in Western populations. Susceptibility is influenced by age, environmental and genetic factors. Known genetic risk loci do not ...account for all the heritability. We therefore carried out a genome-wide association study of AMD in the UK population with 893 cases of advanced AMD and 2199 controls. This showed an association with the well-established AMD risk loci ARMS2 (age-related maculopathy susceptibility 2)-HTRA1 (HtrA serine peptidase 1) (P =2.7 × 10(-72)), CFH (complement factor H) (P =2.3 × 10(-47)), C2 (complement component 2)-CFB (complement factor B) (P =5.2 × 10(-9)), C3 (complement component 3) (P =2.2 × 10(-3)) and CFI (P =3.6 × 10(-3)) and with more recently reported risk loci at VEGFA (P =1.2 × 10(-3)) and LIPC (hepatic lipase) (P =0.04). Using a replication sample of 1411 advanced AMD cases and 1431 examined controls, we confirmed a novel association between AMD and single-nucleotide polymorphisms on chromosome 6p21.3 at TNXB (tenascin XB)-FKBPL (FK506 binding protein like) rs12153855/rs9391734; discovery P =4.3 × 10(-7), replication P =3.0 × 10(-4), combined P =1.3 × 10(-9), odds ratio (OR) = 1.4, 95% confidence interval (CI) = 1.3-1.6 and the neighbouring gene NOTCH4 (Notch 4) (rs2071277; discovery P =3.2 × 10(-8), replication P =3.8 × 10(-5), combined P =2.0 × 10(-11), OR = 1.3, 95% CI = 1.2-1.4). These associations remained significant in conditional analyses which included the adjacent C2-CFB locus. TNXB, FKBPL and NOTCH4 are all plausible AMD susceptibility genes, but further research will be needed to identify the causal variants and determine whether any of these genes are involved in the pathogenesis of AMD.
Calcium channel blocker (CCB) use has been associated with an increased risk of glaucoma in exploratory studies.
To examine the association of systemic CCB use with glaucoma and related traits among ...UK Biobank participants.
This population-based cross-sectional study included UK Biobank participants with complete data (2006-2010) for analysis of glaucoma status, intraocular pressure (IOP), and optical coherence tomography (OCT)-derived inner retinal layer thicknesses. Data analysis was conducted in January 2023.
Calcium channel blocker use was assessed in a baseline touchscreen questionnaire and confirmed during an interview led by a trained nurse.
The primary outcome measures included glaucoma status, corneal-compensated IOP, and 2 OCT-derived inner retinal thickness parameters (macular retinal nerve fiber layer mRNFL and macular ganglion cell-inner plexiform layer mGCIPL thicknesses). We performed logistic regression and linear regression analyses to test for associations with glaucoma status and IOP and OCT-derived inner retinal thickness parameters, respectively.
This study included 427 480 adults. Their median age was 58 (IQR, 50-63) years, and more than half (54.1%) were women. There were 33 175 CCB users (7.8%). Participants who had complete data for glaucoma status (n = 427 480), IOP (n = 97 100), and OCT-derived inner retinal layer thicknesses (n = 41 023) were eligible for respective analyses. After adjustment for key sociodemographic, medical, anthropometric, and lifestyle factors, use of CCBs (but not other antihypertensive agents) was associated with greater odds of glaucoma (odds ratio OR, 1.39 95% CI, 1.14 to 1.69; P = .001). Calcium channel blocker use was also associated with thinner mGCIPL (-0.34 μm 95% CI, -0.54 to -0.15 μm; P = .001) and mRNFL (-0.16 μm 95% CI, -0.30 to -0.02 μm; P = .03) thicknesses but not IOP (-0.01 mm Hg 95% CI, -0.09 to 0.07 mm Hg; P = .84).
In this study, an adverse association between CCB use and glaucoma was observed, with CCB users having, on average, 39% higher odds of glaucoma. Calcium channel blocker use was also associated with thinner mGCIPL and mRNFL thicknesses, providing a structural basis that supports the association with glaucoma. The lack of association of CCB use with IOP suggests that an IOP-independent mechanism of glaucomatous neurodegeneration may be involved. Although a causal relationship has not been established, CCB replacement or withdrawal may be considered should glaucoma progress despite optimal care.
Background. Postexposure vaccination strategies rely on a rapid induction of poxvirus-specific immune responses. Postvaccination cell-mediated immune (CMI) responses have not been compared by use of ...controlled trials in previously vaccinated (vaccinia-nonnaive) and nonvaccinated (vaccinia-naive) individuals. Methods. To assess the time course of vaccinia-specific CMI responses, 20 previously vaccinated and 10 vaccinia-naive individuals were vaccinated with Dryvax, and serial blood samples were drawn. Results. Both groups developed peak levels of vaccinia-specific interferon (IFN)-γ-producing T cells by day 14 after vaccination. In vaccinia-nonnaive individuals, vaccinia-specific CMI responses were detected by day 7 after vaccination and preceded the increase in antibody titers. IFN-g enzyme-linked immunospot responses were significantly different between the 2 groups on days 7 (greater in vaccinia-nonnaive than in vaccinia-naive individuals) and 14 (greater in vaccinia-naive than in vaccinia-nonnaive individuals). Lymphoproliferation responses in vaccinia-nonnaive individuals were significantly higher on days 3 and 7, but cytotoxic T cell lysis activity was not statistically different at any time point. Antibody responses conformed to expected primary and secondary patterns of induction. Conclusions. This study demonstrates that the kinetics of CMI responses are different after primary vaccination versus after revaccination and indicates that memory can exist in individuals vaccinated ⩾30 years ago. These data support the epidemiological observation in smallpox outbreaks that successful revaccination within 4 days of exposure is partially protective. In vaccinia-nonnaive individuals, protection against smallpox during the postexposure revaccination period may require T cell memory as an essential component for the rapid induction of protective cellular and humoral responses.
IMPORTANCE: Identifying the factors that are associated with the magnitude of treatment benefits from anti–vascular endothelial growth factor (anti-VEGF) therapy for diabetic macular edema (DME) may ...help refine treatment expectations. OBJECTIVE: To identify the baseline factors that are associated with vision and anatomic outcomes when managing DME with anti-VEGF and determine if there are interactions between factors and the agent administered. DESIGN, SETTING, AND PARTICIPANTS: This post hoc analysis of data from the Diabetic Retinopathy Clinical Research Network multicenter randomized clinical trial , Protocol T, was conducted between December 2016 and December 2017. Between August 22, 2012, and August 28, 2013, 660 participants were enrolled with central-involved DME and vision impairment (approximate Snellen equivalent, 20/32-20/320). INTERVENTIONS: Repeated 0.05-mL intravitreous injections of 2.0-mg aflibercept (201 eyes), 1.25-mg bevacizumab (185 eyes), or 0.3-mg ranibizumab (192 eyes) per protocol. MAIN OUTCOMES AND MEASURES: Change in visual acuity (VA) and optical coherence tomography (OCT) central subfield thickness at 2 years and change in VA over 2 years (area under the curve AUC). RESULTS: Among 578 participants, the median age (interquartile range) was 61 (54-67) years. Across anti-VEGF treatment groups, each baseline factor was associated with mean improvement in VA and a reduction in central DME compared with the baseline. For every decade of participant age, the mean VA improvement was reduced by 2.1 letters (95% CI, −3.0 to −1.2; P < .001) in the VA and 1.9 letters (95% CI, −2.4 to −1.3; P < .001) in the VA AUC analyses. For each 1% increase in hemoglobin A1c levels, VA improvement was reduced by 1 letter in the VA (95% CI, −1.5 to −0.5; P < .001) and 0.5 letters (95% CI, −0.9 to −0.2; P < .001) in the VA AUC analyses. Eyes with no prior panretinal photocoagulation (PRP) and less than severe nonproliferative diabetic retinopathy had an approximately 3-letter improvement in the VA (95% CI, 0.9-5.4; P = .007) and VA AUC (95% CI, 1.3-4.2; P < .001) analyses compared with eyes with prior PRP. On average, African American participants had greater reductions in central subfield thickness compared with eyes of white participants (−27.3 μm, P = .01), as did eyes with central subretinal fluid compared with eyes without this OCT feature (−22.9 μm, P = .01). There were no interactions between the predictive factors and the specific anti-VEGF agent that was administered for any VA or OCT outcome. CONCLUSIONS AND RELEVANCE: Lower hemoglobin A1c levels were associated with the magnitude of vision improvement following anti-VEGF therapy, providing further evidence to encourage glycemic control among persons with diabetes. Younger patients and those without prior PRP might expect greater improvement in VA than older patients or those with prior PRP.
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