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Minority populations, especially Black and Indigenous communities, are likely to experience poorer healthcare and health outcomes in Canada. These disparities in healthcare can lead to differences in the risk of developing many conditions, including Alopecia Areata.

Below are a few articles where you can learn more about the discriminatory challenges that Black and Aboriginal populations face.

 

Race and Alopecia Areata amongst US Women

Jordan M. Thompson1, Min Kyung Park1, Abrar A. Qureshi1,2,3 and Eunyoung Cho1,2,3

Few studies have examined the clinical epidemiology of alopecia areata (AA) in regard to patient race, and therefore, any disparities in incidence or prevalence of disease are largely unexplored. We sought to investigate potential racial disparities amongst two large cohorts of women. We conducted a cross-sectional analysis from the Nurses’ Health Study (NHS) and Nurses’ Health Study II (NHSII), wherein participants self-reported a diagnosis of AA. We determined odds ratios for AA by race in a multivariate analysis. Among 63,960 women from NHS and 88,368 women from NHSII with information on race and diagnosis of AA, we identified 418 and 738 cases of AA, respectively. In NHS, the multivariate-adjusted odds ratio for AA was 2.72 (95% confidence interval 1.61e4.61) amongst black women as compared with white women. In NHSII, the multivariate-adjusted odds ratio was 5.48 (95% confidence interval 4.10e7.32) amongst black as compared with white women. In a secondary analysis designating participants by Hispanic ethnicity, in NHSII the multivariate odds ratio was 1.94 (95% CI 1.24e3.02) in Hispanic compared with non-Hispanic white women. In this study, we found increased odds of AA based on self-reported race in black and Hispanic women as compared with white women. Further studies are needed to explore the mechanism of this racial disparity related to AA.

Journal of Investigative Dermatology Symposium Proceedings (2018) 19, S47eS50; doi:10.1016/j.jisp.2017.10.007

 

Racial characteristics of alopecia areata in the United States

Hemin Lee, MD, MPH,a Sun Jae Jung, MD, PhD,b,c Anisha B. Patel, MD,d,e Jordan M. Thompson, MD,f Abrar Qureshi, MD, MPH,f,g,h and Eunyoung Cho, ScDf,g,h
Boston, Massachusetts; Seoul, Korea; Houston, Texas; and Providence, Rhode Island

Background: Epidemiologic studies on the association between race and alopecia areata (AA) are limited.

Objective: To characterize racial differences of AA in the United States.

Methods: Cross-sectional study of self-registered AA patients and noncases in the National Alopecia Areata Registry (NAAR). We evaluated odds of AA and its subtypes for 5 ethnic/racial groups using logistic regression. A sex-stratified analysis and a sensitivity analysis among dermatologist-confirmed cases were also performed.

Results: We identified 9340 AA patients and 2064 noncases. Compared with whites, African Americans had greater odds of AA (odds ratio, 1.77; 95% confidence interval, 1.37-2.28) and Asians had lower odds (odds ratio, 0.40; 95% confidence interval, 0.32-0.50) of AA. The results were consistent in AA subtypes, dermatologist-confirmed cases, and by sex.

Limitations: Residual confounding due to limited number of covariates. Recall or recruitment bias not representative of the entire disease spectrum. Also, outcome misclassification was possible because not all AA cases in the registry were confirmed by dermatologists.

Conclusion: Our findings suggest higher odds of AA in African Americans and lower odds in Asians compared with whites. Future studies examining racial disparity in AA from clinical and genetic perspectives are warranted for a better understanding of the disease pathogenesis. ( J Am Acad Dermatol https://doi.org/10.1016/j.jaad.2019.06.1300.)

 

The Health Status of Black Canadians: Do Aggregated Racial and Ethnic Variables Hide Health Disparities?

Patricia Rodney, Esker Copeland

Abstract

This paper examines the importance of collecting and reporting data on race and ethnicity in public health and biomedical research in Canada. Literature and available sta- tistics related to social determinants of health were reviewed and analyzed to illustrate that minority populations in Canada, especially Blacks, are likely to experience poorer health outcomes. Statistics Canada in its commitment to multiculturalism uses broad categories such as visible minorities and racialised groups as surrogates for race and ethnicity. These categories, when used in health literature may conceal underlying inequities in health between population groups. Blacks and minority groups in Canada have higher rates of unemployment, lower rates of educational attainment, and lower socioeconomic status. Whenever Canadian data based on race and ethnic categories are reported, disparities are observed. The lack of disaggregated data may hide health disparities.

Journal of Health Care for the Poor and Underserved, Volume 20, Number 3, August 2009, pp. 817-823 (Article)

Published by Johns Hopkins University Press

DOI: https://doi.org/10.1353/hpu.0.0179

 

Black–White Health Inequalities in Canada

Gerry Veenstra • Andrew C. Patterson

Abstract 

Little is known about Black–White health inequalities in Canada or the applicability of competing explanations for them. To address this gap, we used nine cycles of the Canadian Community Health Survey to ana- lyze multiple health outcomes in a sample of 3,127 Black women, 309,720 White women, 2,529 Black men and 250,511 White men. Adjusting for age, marital status, ur- ban/rural residence and immigrant status, Black women and men were more likely than their White counterparts to report diabetes and hypertension, Black women were less likely than White women to report cancer and fair/poor mental health and Black men were less likely than White men to report heart disease. These health inequalities per- sisted after controlling for education, household income, smoking, physical activity and body-mass index. We con- clude that high rates of diabetes and hypertension among Black Canadians may stem from experiences of racism in everyday life, low rates of heart disease and cancer among Black Canadians may reflect survival bias and low rates of fair/poor mental health among Black Canadian women represent a mental health paradox similar to the one that exists for African Americans in the United States.

J Immigrant Minority Health (2016) 18:51–57 DOI 10.1007/s10903-014-0140-6

 

Racial Disparities in Access to Care Under Conditions of Universal Coverage

Arjumand A. Siddiqi, ScD, Susan Wang, MSc, Kelly Quinn, PhD, Quynh C. Nguyen, PhD, Antony Dennis Christy, MSc

Background: Racial disparities in access to regular health care have been reported in the U.S., but little is known about the extent of disparities in societies with universal coverage.

Purpose: To investigate the extent of racial disparities in access to care under conditions of universal coverage by observing the association between race and regular access to a doctor in Canada.

Methods: Racial disparities in access to a regular doctor were calculated using the largest available source of nationally representative data in Canada—the Canadian Community Health Survey. Surveys from 2000 2010 were analyzed in 2014. Multinomial regression analyses predicted odds of having a regular doctor for each racial group compared to whites. Analyses were stratified by immigrant status—Canadian-born versus shorter-term immigrant versus longer-term immigrants —and controlled for sociodemographics and self-rated health.

Results: Racial disparities in Canada, a country with universal coverage, were far more muted than those previously reported in the U.S. Only among longer-term Latin American immigrants (OR1⁄41.90, 95% CI1⁄41.45, 2.08) and Canadian-born Aboriginals (OR1⁄41.34, 95% CI1⁄41.22, 1.47) were significant disparities noted. Among shorter-term immigrants, all Asians were more likely than whites, and among longer-term immigrants, South Asians were more like than whites, to have a regular doctor.

Conclusions: Universal coverage may have a major impact on reducing racial disparities in access to health care, although among some subgroups, other factors may also play a role above and beyond health insurance.
(Am J Prev Med 2016;50(2):220–225) & 2016 American Journal of Preventive Medicine

PMID: 25441235

DOI: 10.1016/j.amepre.2014.08.004

 

Understanding Inequalities in Access to Health Care Services for Aboriginal People A Call for Nursing Action

Brenda L. Cameron, PhD, RN;
Maria del Pilar Carmargo Plazas, PhD, RN;
Anna Santos Salas, PhD, RN; R. Lisa Bourque Bearskin, MN, RN; Krista Hungler, MSc

We present findings from an Access Research Initiative to reduce health disparities and promote equitable access with Aboriginal peoples in Canada. We employed Indigenous, in- terpretive, and participatory research methodologies in partnership with Aboriginal people. Participants reported stories of bullying, fear, intimidation, and lack of cultural understand- ing. This research reveals the urgent need to enhance the delivery of culturally appropriate practices in emergency. As nurses, if we wish to affect equity of access, then attention is required to structural injustices that act as barriers to access such as addressing the stigma, stereotyping, and discrimination experienced by Aboriginal people in this study.

ANS896 August 1, 2014 21:8Advances in Nursing ScienceVol. 37, No. 3, pp. E1–E16

DOI: 10.1097/ANS.0000000000000039