The Effect Of Structural Racism On Racial And Geographic Disparities In Deceased Organ Donation
结构性种族主义对死者器官捐赠种族和地理差异的影响
基本信息
- 批准号:10537133
- 负责人:
- 金额:$ 8.58万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-07-14 至 2025-07-13
- 项目状态:未结题
- 来源:
- 关键词:Accident and Emergency departmentAddressAffectBenchmarkingBig DataBlack PopulationsCause of DeathCenters for Disease Control and Prevention (U.S.)Cessation of lifeCharacteristicsClinicalCountyDataData LinkagesData SetDatabasesDisadvantaged minorityDoctor of PhilosophyEducational StatusEnrollmentFaceFacultyFrequenciesGeographyGoalsHealthHealth Disparities ResearchHealth PolicyHealth care facilityHealthcareHomeHospitalizationHospitalsIndividualInpatientsInstructionInternationalInterventionKnowledgeLegalLocationLong-Term CareMediatingMediator of activation proteinMedicalMentorsMentorshipMethodsMidwestern United StatesMinorityMinority GroupsNational Health and Nutrition Examination SurveyNeighborhoodsOperative Surgical ProceduresOrganOrgan DonationsOrgan DonorOrgan TransplantationOutcomeOutpatientsPoliciesPopulationProxyPublic HealthPublic Health SchoolsRaceRecoveryRegistriesResearchResearch Project GrantsResourcesRisk FactorsScientistSourceStatistical ComputingStatistical ModelsStructural RacismSurgeonTimeTrainingTransplant RecipientsTransplantationWait TimeWaiting ListsWorkcertificate programclinical investigationdata managementdensitydeprivationgeographic differencegeographic disparityhealth care availabilityhealth care service utilizationhealth disparityhealth inequalitiesmortalitymultilevel analysisnovelorgan allocationprogramsracial determinantracial differenceracial disparityracial health disparityracial minorityracismresidential segregationruralitysegregationsocial determinantssocial epidemiologystatistical learningtransplant registry
项目摘要
PROJECT SUMMARY/ABSTRACT
Among the 12,000 deceased organ donors yearly in the US, there are racial disparities that have persisted
over decades, with the Black population most recently donating at 69% of the White population. Relatively
lower organ donation rates among racial minorities not only contribute to the organ shortage but also contribute
to racial disparities in waitlisted candidate’s access to transplantation, with some racial minorities having longer
wait times owing to difficult matching.
Historically, efforts to address racial disparities in deceased organ donation have examined inpatient medical
facility deaths, using inpatient death counts to estimate the potential organ donor pool, to benchmark
successful organ recovery, and to target interventions. While only individuals who die in an inpatient medical
facility can have their organs recovered for transplantation, the focus on this highly selected population is
limiting. Structural racism, a determinant of racial disparities in health, affects healthcare resource availability,
with Black individuals being 40% less likely than White individuals to have a usual source of healthcare in
racially segregated neighborhoods. To date, healthcare resource availability has not been examined as a
potential mediator of racial and geographic disparities in deceased organ donation.
To better understand the impact of structural racism on deceased donor rates, we will perform novel linkages
with three nationally representative datasets (Scientific Registry of Transplant Recipients, CDC WONDER, and
National Health and Nutrition Examination Survey) to study the following aims: (1) To examine county-level risk
factors for inpatient and outpatient death under medical conditions consistent with organ donation; (2) To
examine the relationship between structural racism and the potential organ donor rate; and (3) To examine
whether healthcare access mediates the relationship between structural racism and the potential organ donor
rate.
We hypothesize that structural racism affects inpatient facility death distribution, and subsequent organ
donation rates, through its differential effects on healthcare access according to race and across geographies.
If the proposed aims are achieved, we will directly inform national healthcare access and organ allocation
policy, and population-level structural interventions to eliminate racial disparities in transplantation.
项目摘要/摘要
在美国每年12000名已故器官捐赠者中,种族差异一直存在
几十年来,黑人人口的捐赠率达到了白人人口的69%。相对的
少数族裔中较低的器官捐赠率不仅是造成器官短缺的原因之一,也是
在等待名单的候选人获得移植方面的种族差异,一些少数族裔的时间更长
由于匹配困难,等待时间。
从历史上看,解决已故器官捐赠方面的种族差异的努力曾审查过住院患者的医疗
设施死亡,使用住院死亡计数来估计潜在的器官捐赠者池,以作为基准
成功地恢复器官,并有针对性地进行干预。而只有在住院医疗中死亡的人
可以将他们的器官回收用于移植,重点是这一高度挑选的人群
限制。结构性种族主义是健康方面种族差异的决定因素,影响医疗资源的可获得性,
黑人比白人拥有普通医疗保健来源的可能性低40%
种族隔离的社区。到目前为止,医疗保健资源的可用性还没有作为
死亡器官捐赠中种族和地理差异的潜在调解人。
为了更好地了解结构性种族主义对已故捐赠率的影响,我们将进行新的联系
拥有三个具有全国代表性的数据集(移植受者科学登记、CDC WONDER和
全国健康和营养检查调查),以研究以下目的:(1)检查县级风险
在符合器官捐献的医疗条件下住院和门诊死亡的因素;
审查结构性种族主义与潜在器官捐赠率之间的关系;以及(3)审查
医疗服务的可获得性是否会调节结构性种族主义和潜在器官捐赠者之间的关系
费率。
我们假设结构性种族主义影响住院设施的死亡分布,以及随后的器官
捐赠率,通过其对不同种族和不同地理位置的医疗保健服务的不同影响。
如果建议的目标实现,我们将直接通知国家医疗保健获取和器官分配
政策,以及人口层面的结构性干预措施,以消除移植方面的种族差异。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Lawrence Brown其他文献
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{{ truncateString('Lawrence Brown', 18)}}的其他基金
The Effect Of Structural Racism On Racial And Geographic Disparities In Deceased Organ Donation
结构性种族主义对死者器官捐献中种族和地理差异的影响
- 批准号:
10685986 - 财政年份:2022
- 资助金额:
$ 8.58万 - 项目类别:
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