There have been unsafe levels of unpaired fructose in the high fructose corn syrup (HFCS) in U.S. beverages, and research/case study evidence shows their intake is associated with greater asthma prevalence/risk/incidence, a debilitating disease, likely due to fructose-malabsorption, gut fructosylation, and gut dysbiosis mechanisms. The “unexplained” asthma epidemic has disproportionately affected children and Black individuals, groups with higher fructose-malabsorption prevalence than others, and research to assess disproportionately higher asthma risk/incidence among Black individuals in association with HFCS sweetened beverage intake is lacking.

Demographic, lifestyle, dietary data collected at enrollment/(1985-86), and incident asthma through exam 5/(1995-96), were used in Cox proportional hazards models to assess HFCS intake associations (hazard-ratios) with asthma risk/incidence.

CARDIA-Study participants from Birmingham, AL, Chicago, IL, Minneapolis, MN, and Oakland, CA.

1998 Black and 2104 White young adults.

HFCS sweetened beverage intake >once/wk was significantly associated with higher asthma risk relative to ≤ once/wk, (P-trend=0.04), among Black participants only; risk was 2.8 times higher among 2-4 times/wk consumers (HR=2.8, 95% CI 1.1-7.3, P=0.04), and 3.5 times higher when consumed multiple times/d, independent of sucrose intake/obesity/dietary quality/smoking/in-home smoke-exposure (HR=3.5, 95% CI 1.3-9.9, P=0.02). Intake of orange juice, with nominal unpaired fructose, was not associated with asthma in either group, nor was intake of sucrose, a disaccharide (paired) of fructose/glucose.

Ubiquitous HFCS in the U.S. food supply, with HFCS that contains high/unsafe unpaired fructose, a.k.a. excess-free-fructose, and the fructose/gut/lung/axis are overlooked risk factors in the “unexplained” U.S. asthma epidemic that disproportionately affects Black individuals.

Seattle Children’s Research Institute is identifying the amount and type of health equity scholarship being conducted institution wide. However, methods for categorizing how scholarship is equity-focused are lacking. We developed and evaluated the reliability of a health equity scholarship coding schema applied to Seattle Children’s affiliated scholarship.

A 2021–2022 Ovid MEDLINE affiliation search yielded 3551 affiliated scholarship records, with 1079 records identified via an existing filter as scholarship addressing social determinants of health. Through reliability testing and examining concordance and discordance across three independent coders of these records, we developed a coding schema to classify health equity scholarship (yes/no). When health equity scholarship proved positive/Yes, the coders assigned a one through five maturity rating of the scholarship towards addressing inequities. Subsequent reliability testing including a new coder was conducted for 992 subsequent affiliated scholarship records (Oct 2022–June 2023), with additional testing of the sensitivity and specificity of the existing filter relative to the new coding schema.

Reliability for identifying health equity scholarship was consistently high (Fleiss kappas ≥ .78) and categorization of health equity scholarship into maturity levels was moderate (Fleiss kappas ≥ .47). The coding schema identified additional health equity scholarship not captured in an existing filter for social determinants of health scholarship. Based on the new schema, 23.3% of Seattle Childrens’ affiliated scholarship published October 2002–June 2023 was health equity focused.

This new coding schema can be used to identify and categorize health equity scholarship to help quantitate the health equity focus of portfolios of human-focused research.

Health technology assessment (HTA) can impact health inequities by informing healthcare priority-setting decisions. This paper presents a novel checklist to guide HTA practitioners looking to include equity considerations in their work: the equity checklist for HTA (ECHTA). The list is pragmatically organized according to the generic HTA phases and can be consulted at each step.

A first set of items was based on the framework for equity in HTA developed by Culyer and Bombard. After rewording and reorganizing according to five HTA phases, they were complemented by elements emerging from a literature search. Consultations with method experts, decision makers, and stakeholders further refined the items. Further feedback was sought during a presentation of the tool at an international HTA conference. Lastly, the checklist was piloted through all five stages of an HTA.

ECHTA proposes elements to be considered at each one of the five HTA phases: Scoping, Evaluation, Recommendations and Conclusions, Knowledge Translation and Implementation, and Reassessment. More than a simple checklist, the tool provides details and examples that guide the evaluators through an analysis in each phase. A pilot test is also presented, which demonstrates the ECHTA's usability and added value.

ECHTA provides guidance for HTA evaluators wishing to ensure that their conclusions do not contribute to inequalities in health. Several points to build upon the current checklist will be addressed by a working group of experts, and further feedback is welcome from evaluators who have used the tool.

Sudden unexpected infant death is the leading cause of infant mortality with black: white infant mortality remaining at 2:1 for the last decade. Smartphone technology provides a convenient and accessible tool for injury prevention anticipatory guidance among at-risk communities.

A convenience sample of pregnant teen mothers who own a smartphone. During a 1-month postnatal home visit, a safe sleep environment survey was administered, infant sleep practices were observed, and mothers trained to take and submit standard infants’ sleep environment photographs. Photographs were independently assessed for inter-rater reliability (IRR) across five sleep safety domains (primary outcome): sleep location, surface, position, presence of soft items, and hazards near the sleep area. Expert and novice coders IRR was measured using Cohen’s kappa coefficient (K). Sleep safety correlation between photographs and observation, and parent report and observation was determined.

Sixteen (57.1%) mothers completed the home visit. Most parents reported infants sleeping supine (78.5) in parents’ bedroom (85.9%). Photographs demonstrated sleep position, soft items without the baby present, and hanging toys had perfect agreement across all three coder pairs. Safe sleep experts’ IRR demonstrated perfect agreement for sleep location, position, and soft items. While 83.8% of parents were observed putting their infants down to sleep on their back, 78.5% of parents reported doing the same and 82.4% of the photographs demonstrated supine infant sleep position.

Using photographs, coders can reliably categorize some key infant sleep safety aspects, and photograph sleep safety is comparable to parent report and direct observation.

The purpose of this article is to describe the process of developing and implementing a transdisciplinary community-based research center, the Center for Health Equity Research (CHER) Chicago, to offer a model for designing and implementing research centers that aim to address structural causes of health inequality.

Scholars from diverse backgrounds and disciplines formed a multidisciplinary team for the Center and adopted the structural violence framework as the organizing conceptual model. All Center activities were based on community partnership. The Center activities were organized within three cores: administrative, investigator development, and community engagement and dissemination cores. The key activities during the first year were to develop a pilot grant program for early-stage investigators (ESIs) and to establish community partnership mechanisms.

CHER provided more than 60 consultations for ESIs, which resulted in 31 pilot applications over the three application cycles. Over 200 academic and community partners attended the community symposium and discussed community priority. Some challenges encountered were to improve communication among investigators, to clarify roles and responsibilities of the three cores, and to build consensus on the definition and operationalization of the concept of structural violence.

There is an increasing need for local hubs to facilitate transdisciplinary collaboration and community engagement to effectively address health inequity. Building consensus around a shared vision among partners is a difficult and yet important step toward achieving equity.

This study examined general and cancer-related stressors of depression that are unique to African-American cancer patients.

The study used cohort design and mixed methods. Seventy-four breast and prostate cancer survivors including 34 depressed and 23 non-depressed African-Americans and 17 depressed whites were interviewed. Qualitative data analysis identified themes. The thematic codes were converted to a SPSS data set numerically. The Fisher's exact test was performed to examine group differences in the experience of stress.

Significantly more depressed African-Americans experienced a dramatic reaction to a cancer diagnosis (p = 0.03) or had concerns about functional decline (p = 0.01), arguments with relatives or friends (p = 0.02), and unemployment status (p = 0.03) than did non-depressed African-Americans, who reacted to the cancer diagnosis as a matter of reality (p = 0.02). Significantly more depressed African-Americans talked about feeling shocked by a cancer diagnosis (p = 0.04) and being unable to do things that they used to do (p = 0.02) than did depressed whites. Qualitative analysis shed light on the extent of such group differences.

Distress from the initial cancer diagnosis and functional decline were likely to have triggered or worsened depression in African-American cancer patients. This study highlighted racial differences in this aspect. It is critical to screen African-American cancer patients for depression at two critical junctures: immediately after the disclosure of a cancer diagnosis and at the onset of functional decline. This will enhance the chance of prompt diagnosis and treatment of depression in this underserved population.