Whitney Robinson

PURPOSE: The impact of incarceration on health is well known. Yet, most studies measure incarceration alone and miss additional exposure to the criminal legal system over time. We evaluated adult criminal legal sanctions - inclusive of arrests, charges, probation, incarceration - from ages 18-35 and inequities by juvenile sanctions and race. METHODS: Using the National Longitudinal Survey on Youth 1997, a nationally representative data set of adolescents followed into their mid-thirties (1997-2017), we calculated the mean cumulative count, or the average number of criminal legal events per person per study visit, stratified by juvenile sanctions and race. RESULTS: Of 7024 participants, 1679 experienced 3,075 encounters. There were seven arrests, 30 charges, nine probation encounters, and 13 incarceration events /100 participants by age 35. Juvenile sanctions were most common for Black individuals. Among those experiencing juvenile sanctions, Black and White individuals had similar numbers of encounters, but Black individuals had more arrests and incarceration stays. For those without juvenile encounters, Black individuals had more encounters than White individuals. CONCLUSIONS: Research on health effects of criminal legal sanctions must consider encounters beyond incarceration and focus on life course trajectories and racial inequities.

<jats:title>Abstract</jats:title> <jats:p>Background: African American (AA) women have lower incidence, but higher mortality rates when they are diagnosed with breast cancer. Biological differences in tumor subtypes, with greater prevalence of aggressive basal-like breast cancers in AA women, explain some disparities; however, even when AA women are diagnosed with ‘good prognosis’ Luminal A breast cancers, they fare worse than Caucasian (Cau) women with the same subtype. Our goal was to identify disparity-associated gene expression in breast tumors overall, and in Luminal A breast cancers specifically.</jats:p> <jats:p>Methods: Disparity-associated gene expression was defined as gene expression that was both strongly associated with patient race and with substantial differential in disease-free survival in Cau, defined as the hazard ratio (HR) &amp;gt; 1.25 or &amp;lt; 0.8 comparing patients with &amp;gt;= median expression to those with &amp;lt; median expression. We used microarray data from 165 breast tumor samples (108 Cau and 57 AA women). This dataset included 68 Luminal A tumors and 39 Basal-like tumors. We identified race-associated gene expression using linear models with a false discovery rate (FDR) less than 5%. Genes that were differentially expressed by race in breast cancers overall or among luminal A tumors were tested for associations with survival. Genes that were both race- and survival-associated were further evaluated for race-related patterns of expression in normal reduction mammoplasty samples (N=100) and cancer-adjacent histologically normal (N=92) tissue.</jats:p> <jats:p>Results: At an FDR = 5%, 10 genes were differentially expressed by race in Luminal A tumors. Six of these showed associations with survival [CRYBB2 (HR = 1.36), PSPH (HR = 1.65), ACOX2 (HR = 0.65), MUC1 (HR = 0.65), TYMS (HR = 2.67), SQLE (HR = 1.98)] in NKI295. Two distinct patterns emerged for the expression of these genes in normal tissue: CRYBB2 and PSPH were differentially expressed in tumor and normal tissue of AA compared to Cau women; ACOX2, MUC1, TYMS, SQLE were only differentially expressed in tumors. A composite expression score based on expression of all six genes, or including only CRYBB2/PSPH, was associated with tumor characteristics. Furthermore, composite expression was associated with survival across all tumors and Luminal A tumors in an independent dataset.</jats:p> <jats:p>Discussion: These analyses replicated previously reported associations between CRYBB2 and PSPH expression in breast tumors and race, and extended the analysis to address normal tissue differences and survival among Luminal A tumors. These patterns in normal tissue suggest that CRYBB2 and PSPH expression could represent race-specific differences in susceptibility to aggressive tumors. Although disparities in luminal A breast cancer mortality may be related to treatment or access to care, these data suggest that biological differences between at-risk AA and Cau women may also be operating.</jats:p> <jats:p>Citation Format: Monica E. D’Arcy, Whitney R. Robinson, Erin Kirk, Keith D. Amos, Charles M. Perou, Jodie M. Fleming, Melissa A. Troester. Race-associated gene expression in tumors and breast cancer mortality disparities. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr LB-292. doi:10.1158/1538-7445.AM2014-LB-292</jats:p>

INTRODUCTION: Pathways to diagnosis for women with endometriosis are frequently characterised with delays. Internationally, women face significant barriers and times to diagnosis. The prolonged time without a diagnosis may result in treatment delay, with clinical implications of chronic pain and an unknown effect on fertility outcomes. As delays in diagnosis extend, those suffering from endometriosis incur more cost and frequently experience a reduction in quality of life. The scoping review described in this protocol will (1) map current international scientific peer-reviewed and grey literature investigating pathways, timing, and delay of diagnosis of endometriosis, (2) define common concepts used in the literature, and (3) identify gaps for future examination and intervention development. METHODS AND ANALYSIS: This protocol outlines a scoping review to investigate the current research focused on pathways, timing, and delays in endometriosis diagnosis. The scoping review uses the Joanna Briggs Institute Methodology. The researchers applied the Population, Concept, Context approach to form the research questions. A search string of key terms and Medical Subject Headings will be used to systematically search the PubMed, CINAHL, EMBASE, Web of Science, and Cochrane databases. We will also search ClinicalTrials.gov and grey literature sources. The original search was performed in July 2020, and it will be rerun prior to the manuscript submission. Finally, the reference lists of included works will be reviewed for additional studies. The search results will be screened and reviewed according to predetermined inclusion and exclusion criteria. Data will be extracted from the studies identified for final inclusion using a predetermined tool. The resulting data will be analysed to report the state of the science. ETHICS AND DISSEMINATION: The proposed scoping review does not require review or approval by an ethical board. The researchers will disseminate the study results via conference presentations and publication in a peer-reviewed journal.

OBJECTIVE: To examine patterns of taxed and untaxed food and beverage shopping across store types after Mexico's sugary drink and non-essential food taxes, the nutritional quality of these patterns and the socio-economic characteristics associated with them. DESIGN: We performed k-means cluster analyses using households' percentage of food and beverage purchases from each store type (i.e. convenience stores, traditional shops (e.g. bodegas, tiendas, mom-and-pop shops), supermarkets, wholesalers and others). We calculated adjusted mean proportions of taxed and untaxed products (ml or g/capita per d) purchased in each pattern. We studied the associations between households' SES and shopping patterns using multinomial logistic regressions. Within shopping patterns, we obtained mean volumes and proportions of taxed and untaxed food and beverage subgroups and calculated the proportion of products purchased at each store type. SETTING: Mexico. PARTICIPANTS: Urban Mexican households (n 5493) from the Nielsen Mexico Consumer Panel Survey 2015. RESULTS: We found four beverage shopping patterns and three food shopping patterns, driven by the store type where most purchases were made. For beverages, 48 % of households were clustered in the Traditional pattern and purchased the highest proportion of taxed beverages. Low-SES households had the highest probability of clustering in the Traditional beverage shopping pattern. For foods, 35 % of households were clustered into the Supermarket pattern. High-SES households had the highest probability of clustering in the Supermarket food shopping pattern. CONCLUSIONS: The combination of store types where Mexican households purchase packaged foods and beverages varies. However, households in all shopping patterns and SES purchase taxed beverages mainly at traditional stores. Store-level strategies should be developed to intervene on traditional stores to improve the healthfulness of purchases.

Purpose: Black women in the United States face poor outcomes across reproductive health measures - from pregnancy outcomes to gynecologic cancers. Racial health inequities are attributable to systemic racism, but few population studies of reproductive health outcomes integrate upstream measures of systemic racism, and those who do are limited to maternal and infant health outcomes. Advances in understanding and intervening on the pathway from racism to reproductive health outcomes are limited by a paucity of methodological guidance toward this end. We aim to fill this gap by identifying quantitative measures of systemic racism that are salient across reproductive health outcomes. Methods: We conducted a review of literature from 2000 to 2019 to identify studies that use quantitative measures of exposure to systemic racism in population reproductive health studies. We analyzed the catalog of literature to identify cohesive domains and measures that integrate data across domains. For each domain, we contextualize its use within population health research, describe metrics currently in use, and present opportunities for their application to reproductive health research. Results: We identified four domains of systemic racism that may affect reproductive health outcomes: (1) civil rights laws and legal racial discrimination, (2) residential segregation and housing discrimination, (3) police violence, and (4) mass incarceration. Multiple quantitative measures are available for each domain. In addition, a multidimensional measure exists and additional domains of systemic racism are salient for future development into distinct measures. Conclusion: There are quantitative measures of systemic racism available for incorporation into population studies of reproductive health that investigate hypotheses, including and beyond those related to maternal and infant health. There are also promising areas for future measure development, such as the child welfare system and intersectionality. Incorporating such measures is critical for appropriate assessment of and intervention in racial inequities in reproductive health outcomes.