2024
Racial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic
Faust J, Renton B, Bongiovanni T, Chen A, Sheares K, Du C, Essien U, Fuentes-Afflick E, Haywood T, Khera R, King T, Li S, Lin Z, Lu Y, Marshall A, Ndumele C, Opara I, Loarte-Rodriguez T, Sawano M, Taparra K, Taylor H, Watson K, Yancy C, Krumholz H. Racial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic. JAMA Network Open 2024, 7: e2438918. PMID: 39392630, DOI: 10.1001/jamanetworkopen.2024.38918.Peer-Reviewed Original ResearchConceptsCOVID-19 public health emergencyNon-HispanicPublic health emergencyOther Pacific IslanderExcess mortalityAlaska NativesUS populationExcess deathsRates of excess mortalityCross-sectional study analyzed dataYears of potential lifeMortality relative riskNon-Hispanic whitesCross-sectional studyPacific IslandersStudy analyzed dataAll-cause mortalityEthnic groupsMortality disparitiesMortality ratioTotal populationDeath certificatesEthnic disparitiesMain OutcomesDecedent age
2023
Race and Ethnicity and Emergency Department Discharge Against Medical Advice
Tsai J, Janke A, Krumholz H, Khidir H, Venkatesh A. Race and Ethnicity and Emergency Department Discharge Against Medical Advice. JAMA Network Open 2023, 6: e2345437. PMID: 38015503, PMCID: PMC10685883, DOI: 10.1001/jamanetworkopen.2023.45437.Peer-Reviewed Original ResearchConceptsWhite patientsHispanic patientsEmergency departmentCross-sectional studyED visitsBlack patientsDAMA rateMedical adviceMAIN OUTCOMEEthnic disparitiesNationwide Emergency Department SampleNational cross-sectional studyHospital ED visitsEmergency department dischargeHospital-level variationEmergency Department SampleMetropolitan teaching hospitalHealth care resourcesMedian ageGreater morbidityHospital variationUnadjusted analysesTeaching hospitalAdditional adjustmentLower oddsRacial/ethnic disparities in PM2.5-attributable cardiovascular mortality burden in the United States
Ma Y, Zang E, Opara I, Lu Y, Krumholz H, Chen K. Racial/ethnic disparities in PM2.5-attributable cardiovascular mortality burden in the United States. Nature Human Behaviour 2023, 7: 2074-2083. PMID: 37653149, PMCID: PMC10901568, DOI: 10.1038/s41562-023-01694-7.Peer-Reviewed Original ResearchConceptsNon-Hispanic White peopleCVD deathMortality burdenNon-Hispanic black peopleCardiovascular disease mortality ratesDisease mortality ratesNon-Hispanic blacksRace/ethnicityMortality rateLong-term exposureWhite peopleEthnic disparitiesHealth benefitsHispanic peopleSignificant differencesBurdenDeathUS countiesEthnic groupsAbsolute disparityAssociationExposureEthnic minoritiesDisparitiesAmbient fine particulate matter (PM2.5) concentrationsExcess Mortality and Years of Potential Life Lost Among the Black Population in the US, 1999-2020
Caraballo C, Massey D, Ndumele C, Haywood T, Kaleem S, King T, Liu Y, Lu Y, Nunez-Smith M, Taylor H, Watson K, Herrin J, Yancy C, Faust J, Krumholz H. Excess Mortality and Years of Potential Life Lost Among the Black Population in the US, 1999-2020. JAMA 2023, 329: 1662-1670. PMID: 37191702, PMCID: PMC10189563, DOI: 10.1001/jama.2023.7022.Peer-Reviewed Original ResearchConceptsExcess mortality ratesExcess deathsMortality ratePotential lifeWhite populationExcess mortalitySerial cross-sectional studyHighest excess mortality ratesBlack populationCause-specific mortalityCross-sectional studyHigh mortality rateNon-Hispanic whitesYears of lifeUS national dataMiddle-aged adultsCause mortalityHeart diseaseDeath certificatesNon-Hispanic black populationMAIN OUTCOMEAge groupsDisease controlMortalityBlack malesTrends in the likelihood of receiving percutaneous coronary intervention in a low-volume hospital and disparities by sociodemographic communities
Wang C, Lindquist K, Krumholz H, Hsia R. Trends in the likelihood of receiving percutaneous coronary intervention in a low-volume hospital and disparities by sociodemographic communities. PLOS ONE 2023, 18: e0279905. PMID: 36652416, PMCID: PMC9847957, DOI: 10.1371/journal.pone.0279905.Peer-Reviewed Original ResearchConceptsLow-volume hospitalsNon-Latinx WhitesRelative riskSociodemographic groupsLow-income zip codesHospital PCI volumeRetrospective cohort studyPercutaneous coronary interventionCoronary artery diseaseLow-volume centersFavorable patient outcomesLow-volume facilitiesZip code median incomeLow incomeRace/ethnicityCohort studyCoronary interventionLatinx patientsSecondary outcomesArtery diseasePCI centerPrimary outcomePCI volumeAsian patientsCertain socioeconomic factors
2022
Trends in Racial and Ethnic Disparities in Barriers to Timely Medical Care Among Adults in the US, 1999 to 2018
Caraballo C, Ndumele CD, Roy B, Lu Y, Riley C, Herrin J, Krumholz HM. Trends in Racial and Ethnic Disparities in Barriers to Timely Medical Care Among Adults in the US, 1999 to 2018. JAMA Health Forum 2022, 3: e223856. PMID: 36306118, PMCID: PMC9617175, DOI: 10.1001/jamahealthforum.2022.3856.Peer-Reviewed Original ResearchConceptsTimely medical careSerial cross-sectional studyNational Health Interview SurveyCross-sectional studyHealth Interview SurveyMedical careLack of transportationEthnic disparitiesHispanics/LatinosWhite individualsEthnicity groupsInterview SurveyCost of careSelf-reported raceStudy cohortClinic hoursMAIN OUTCOMEMedical officesCarePrevalenceLatino individualsBlack individualsSignificant differencesSignificant increasePopulation groupsRacial and Ethnic Disparities in Financial Barriers Among Overweight and Obese Adults Eligible for Semaglutide in the United States
Lu Y, Liu Y, Krumholz HM. Racial and Ethnic Disparities in Financial Barriers Among Overweight and Obese Adults Eligible for Semaglutide in the United States. Journal Of The American Heart Association 2022, 11: e025545. PMID: 36172953, PMCID: PMC9673703, DOI: 10.1161/jaha.121.025545.Peer-Reviewed Original ResearchConceptsLow family incomeEligible populationUsual sourceHispanic adultsFinancial barriersEthnic disparitiesNutrition Examination Survey 2015Drug Administration labelingCross-sectional analysisFamily incomePercentage of adultsObese adultsNational HealthUS adultsSemaglutideEligibility criteriaSocial determinantsBlack adultsLarge proportionFinal analysisWeight lossHispanic individualsWhite individualsAdultsRisk reductionTemporal Trends in Racial and Ethnic Disparities in Multimorbidity Prevalence in the United States, 1999-2018
Caraballo C, Herrin J, Mahajan S, Massey D, Lu Y, Ndumele CD, Drye EE, Krumholz HM. Temporal Trends in Racial and Ethnic Disparities in Multimorbidity Prevalence in the United States, 1999-2018. The American Journal Of Medicine 2022, 135: 1083-1092.e14. PMID: 35472394, DOI: 10.1016/j.amjmed.2022.04.010.Peer-Reviewed Original ResearchConceptsMultimorbidity prevalenceRace/ethnicityWhite individualsChronic conditionsBlack individualsSerial cross-sectional analysisCommon chronic conditionsRisk of morbidityPrevalence of multimorbidityPublic health interventionsCross-sectional analysisSelf-reported presenceSelf-reported raceLatino/HispanicMAIN OUTCOMEHealth interventionsEthnic disparitiesPrevalenceHealth inequalitiesStudy periodEarly lifeHispanic individualsTemporal trendsStudy sampleAsian individualsEvaluation of Temporal Trends in Racial and Ethnic Disparities in Sleep Duration Among US Adults, 2004-2018
Caraballo C, Mahajan S, Valero-Elizondo J, Massey D, Lu Y, Roy B, Riley C, Annapureddy AR, Murugiah K, Elumn J, Nasir K, Nunez-Smith M, Forman HP, Jackson CL, Herrin J, Krumholz HM. Evaluation of Temporal Trends in Racial and Ethnic Disparities in Sleep Duration Among US Adults, 2004-2018. JAMA Network Open 2022, 5: e226385. PMID: 35389500, PMCID: PMC8990329, DOI: 10.1001/jamanetworkopen.2022.6385.Peer-Reviewed Original ResearchConceptsCross-sectional studyLong sleep durationSleep durationWhite individualsBlack individualsLatino individualsEthnic differencesSerial cross-sectional studyNational Health Interview Survey dataHealth Interview Survey dataSelf-reported sleep durationShort sleep durationInterview Survey dataMiddle-aged adultsSelf-reported raceEstimated prevalenceMAIN OUTCOMELong sleepSleep deficiencyHigher household incomeEthnic disparitiesAge groupsHealth disparitiesPrevalenceSleep disparities
2021
National Trends in Racial and Ethnic Disparities in Antihypertensive Medication Use and Blood Pressure Control Among Adults With Hypertension, 2011–2018
Lu Y, Liu Y, Dhingra LS, Massey D, Caraballo C, Mahajan S, Spatz ES, Onuma O, Herrin J, Krumholz HM. National Trends in Racial and Ethnic Disparities in Antihypertensive Medication Use and Blood Pressure Control Among Adults With Hypertension, 2011–2018. Hypertension 2021, 79: 207-217. PMID: 34775785, DOI: 10.1161/hypertensionaha.121.18381.Peer-Reviewed Original ResearchConceptsAntihypertensive medication usePoor hypertension controlOverall treatment rateLow control rateHypertension controlHypertension awarenessMedication useControl rateHispanic individualsEthnic differencesTreatment ratesBlack individualsGuideline-recommended medicationsBlood pressure controlWhite individualsNutrition Examination SurveyLow awareness rateAntihypertensive medicationsHypertensive peopleExamination SurveyIntensive medicationNational HealthAwareness rateEthnic disparitiesPressure controlDisparities in Excess Mortality Associated with COVID-19 — United States, 2020
Rossen LM, Ahmad FB, Anderson RN, Branum AM, Du C, Krumholz HM, Li SX, Lin Z, Marshall A, Sutton PD, Faust JS. Disparities in Excess Mortality Associated with COVID-19 — United States, 2020. MMWR Morbidity And Mortality Weekly Report 2021, 70: 1114-1119. PMID: 34411075, PMCID: PMC8375709, DOI: 10.15585/mmwr.mm7033a2.Peer-Reviewed Original ResearchConceptsMortality incidence ratesIncidence rateExcess mortalityAge groupsHighest excess mortality ratesExcess Mortality AssociatedGreater excess mortalityExcess mortality ratesAI/AN populationsNon-Hispanic American IndianNon-Hispanic blacksNational Vital Statistics SystemCOVID-19 pandemicPublic health messagingNon-Hispanic white populationRace/ethnicityVital Statistics SystemMortality AssociatedLack of adjustmentMortality rateExcess deathsAN populationsEthnic groupsHealth messagingHispanic persons
2020
Seroprevalence of SARS-CoV-2-Specific IgG Antibodies Among Adults Living in Connecticut: Post-Infection Prevalence (PIP) Study
Mahajan S, Srinivasan R, Redlich CA, Huston SK, Anastasio KM, Cashman L, Massey DS, Dugan A, Witters D, Marlar J, Li SX, Lin Z, Hodge D, Chattopadhyay M, Adams MD, Lee C, Rao LV, Stewart C, Kuppusamy K, Ko AI, Krumholz HM. Seroprevalence of SARS-CoV-2-Specific IgG Antibodies Among Adults Living in Connecticut: Post-Infection Prevalence (PIP) Study. The American Journal Of Medicine 2020, 134: 526-534.e11. PMID: 33130124, PMCID: PMC7598362, DOI: 10.1016/j.amjmed.2020.09.024.Peer-Reviewed Original ResearchConceptsSARS-CoV-2-specific IgG antibodiesWeighted seroprevalenceIgG antibodiesSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodiesSARS-CoV-2-specific antibodiesConnecticut residentsSelf-reported adherenceImmunoglobulin G antibodiesSARS-CoV-2Symptomatic illnessSerology testingSeroprevalence studyG antibodiesPrevalence studyGeneral populationPercentage of peopleSeroprevalenceLack antibodiesMajority of respondentsAntibodiesHispanic subpopulationsConvenience sampleHispanic populationCOVID-19Risk mitigation behaviorsAssociation Between Sociodemographic Determinants and Disparities in Stroke Symptom Awareness Among US Young Adults
Mszar R, Mahajan S, Valero-Elizondo J, Yahya T, Sharma R, Grandhi GR, Khera R, Virani SS, Lichtman J, Khan SU, Cainzos-Achirica M, Vahidy FS, Krumholz HM, Nasir K. Association Between Sociodemographic Determinants and Disparities in Stroke Symptom Awareness Among US Young Adults. Stroke 2020, 51: 3552-3561. PMID: 33100188, DOI: 10.1161/strokeaha.120.031137.Peer-Reviewed Original ResearchConceptsNational Health Interview SurveyCommon stroke symptomsStroke symptomsHealth Interview SurveyYoung adultsUS young adultsSymptom awarenessFocused public health interventionsInterview SurveyStroke symptom awarenessHigh-risk characteristicsPublic health interventionsArms/legsCertain sociodemographic subgroupsLow education levelStroke incidenceSevere headacheSingle symptomStudy populationTimely diagnosisHigher oddsStroke rateHispanic ethnicityGeneral populationSociodemographic determinantsTrends in Reoperative Coronary Artery Bypass Graft Surgery for Older Adults in the United States, 1998 to 2017
Mori M, Wang Y, Murugiah K, Khera R, Gupta A, Vallabhajosyula P, Masoudi FA, Geirsson A, Krumholz HM. Trends in Reoperative Coronary Artery Bypass Graft Surgery for Older Adults in the United States, 1998 to 2017. Journal Of The American Heart Association 2020, 9: e016980. PMID: 33045889, PMCID: PMC7763387, DOI: 10.1161/jaha.120.016980.Peer-Reviewed Original ResearchConceptsCoronary artery bypass graft surgeryFirst-time coronary artery bypass graft surgeryArtery bypass graft surgeryBypass graft surgeryGraft surgeryMedicare feeOlder adultsPatient baseline characteristicsData of adultsYear of dischargeProportion of womenService inpatientsIndex surgeryBaseline characteristicsHospital dischargeOlder patientsMedian agePrimary outcomeCox regressionService patientsUnique patientsPatientsSurgeryAnnual declineDemographic subgroupsStroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic
Jasne AS, Chojecka P, Maran I, Mageid R, Eldokmak M, Zhang Q, Nystrom K, Vlieks K, Askenase M, Petersen N, Falcone GJ, Wira CR, Lleva P, Zeevi N, Narula R, Amin H, Navaratnam D, Loomis C, Hwang DY, Schindler J, Hebert R, Matouk C, Krumholz HM, Spudich S, Sheth KN, Sansing LH, Sharma R. Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic. Stroke 2020, 51: 2664-2673. PMID: 32755347, PMCID: PMC7446978, DOI: 10.1161/str.0000000000000347.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBetacoronavirusBrain IschemiaCohort StudiesComorbidityConnecticutCoronary Artery DiseaseCoronavirus InfectionsCOVID-19DyslipidemiasEmergency Medical ServicesEthnicityFemaleHumansHypertensionIncomeInsurance, HealthIntracranial HemorrhagesMaleMedically UninsuredMiddle AgedOutcome and Process Assessment, Health CarePandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2Severity of Illness IndexStrokeSubstance-Related DisordersTelemedicineThrombectomyThrombolytic TherapyTime-to-TreatmentConceptsComprehensive stroke centerStroke codePatient characteristicsStroke severityStroke code patientsHistory of hypertensionStroke-like symptomsCoronary artery diseaseCoronavirus disease 2019 (COVID-19) pandemicPatient-level dataLower median household incomePublic health initiativesDisease 2019 pandemicCOVID-19 pandemicRace/ethnicityCode patientsHospital presentationPublic health insuranceRankin ScaleStroke centersArtery diseaseReperfusion timeStroke symptomsEarly outcomesConnecticut hospitals
2019
Variation and Disparities in Awareness of Myocardial Infarction Symptoms Among Adults in the United States
Mahajan S, Valero-Elizondo J, Khera R, Desai NR, Blankstein R, Blaha MJ, Virani SS, Kash BA, Zoghbi WA, Krumholz HM, Nasir K. Variation and Disparities in Awareness of Myocardial Infarction Symptoms Among Adults in the United States. JAMA Network Open 2019, 2: e1917885. PMID: 31851350, PMCID: PMC6991230, DOI: 10.1001/jamanetworkopen.2019.17885.Peer-Reviewed Original ResearchConceptsMyocardial infarction symptomsShortness of breathMyocardial infarctionInfarction symptomsLow education levelEmergency medical servicesChest painSociodemographic subgroupsNational Health Interview SurveyEmergency cardiac careCross-sectional studyMedical servicesHealth Interview SurveyPublic health initiativesEducation levelLow-income subgroupsPrompt recognitionBack painCommon symptomsMale sexCardiac careHigher oddsHispanic ethnicityMAIN OUTCOMEHigh risk
2018
Sex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014
Angraal S, Khera R, Wang Y, Lu Y, Jean R, Dreyer RP, Geirsson A, Desai NR, Krumholz HM. Sex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014. Journal Of The American Heart Association 2018, 7: e009014. PMID: 30005557, PMCID: PMC6064835, DOI: 10.1161/jaha.118.009014.Peer-Reviewed Original ResearchConceptsCoronary artery bypassCABG utilizationArtery bypassUse of CABGService Medicare beneficiariesCalendar year trendsCABG mortalityUnderwent CABGReadmission ratesCABG proceduresWhite patientsBlack patientsPatient groupMedicare beneficiariesMedicare feeMortality rateCABGAnnual declineWomenRacial subgroupsRacial differencesGreater declineOutcomesPatientsSex
2016
Participation of the elderly, women, and minorities in pivotal trials supporting 2011–2013 U.S. Food and Drug Administration approvals
Downing NS, Shah ND, Neiman JH, Aminawung JA, Krumholz HM, Ross JS. Participation of the elderly, women, and minorities in pivotal trials supporting 2011–2013 U.S. Food and Drug Administration approvals. Trials 2016, 17: 199. PMID: 27079511, PMCID: PMC4832528, DOI: 10.1186/s13063-016-1322-4.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedClinical Trials as TopicCross-Sectional StudiesDatabases, FactualDrug ApprovalEthnicityFemaleHealth Status DisparitiesHealthcare DisparitiesHumansMaleMiddle AgedMinority GroupsPatient SelectionSex FactorsTime FactorsUnited StatesUnited States Food and Drug AdministrationConceptsSubgroup efficacy analysesPivotal trialsEfficacy analysisNovel therapeuticsSubgroup analysisTrial participantsU.S. FoodMean proportionAvailable FDA documentsCross-sectional studyDrug Administration approvalBasis of approvalYears of ageTrial patientsElderly patientsMedian ageBlack patientsAsian patientsAdministration approvalClinical studiesFDA reviewersPatientsHispanic participantsTrialsDemographic characteristicsReply Coronary Artery Calcification Testing: A Platonic Certainty
Nasir K, Krumholz HM. Reply Coronary Artery Calcification Testing: A Platonic Certainty. Journal Of The American College Of Cardiology 2016, 67: 1126-1127. PMID: 26940937, DOI: 10.1016/j.jacc.2015.12.027.Peer-Reviewed Original Research
2015
Implications of Coronary Artery Calcium Testing Among Statin Candidates According to American College of Cardiology/American Heart Association Cholesterol Management Guidelines MESA (Multi-Ethnic Study of Atherosclerosis)
Nasir K, Bittencourt MS, Blaha MJ, Blankstein R, Agatson AS, Rivera JJ, Miedema MD, Sibley CT, Shaw LJ, Blumenthal RS, Budoff MJ, Krumholz HM. Implications of Coronary Artery Calcium Testing Among Statin Candidates According to American College of Cardiology/American Heart Association Cholesterol Management Guidelines MESA (Multi-Ethnic Study of Atherosclerosis). Journal Of The American College Of Cardiology 2015, 66: 1657-1668. PMID: 26449135, DOI: 10.1016/j.jacc.2015.07.066.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAmerican Heart AssociationAtherosclerosisCalciumCoronary AngiographyCoronary Artery DiseaseCoronary VesselsEthnicityFemaleFollow-Up StudiesGuideline AdherenceHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedProspective StudiesRisk AssessmentRisk FactorsUnited StatesConceptsCoronary artery calciumASCVD event ratesYears of ageStatin therapyAmerican CollegeAbsence of CACHard coronary heart disease eventsNew ACC/AHA guidelinesCoronary Artery Calcium TestingACC/AHA guidelinesAtherosclerotic cardiovascular disease riskCoronary heart disease eventsLow-density lipoprotein levelsEvent ratesCholesterol management guidelinesHigh-intensity statinsHeart disease eventsLipid-lowering medicationsModerate-intensity statinsCardiovascular disease riskLow-density lipoproteinStatin candidatesASCVD riskAHA guidelinesArtery calcium