Racialised social inequalities were exposed and exacerbated during the COVID-19 pandemic. The methods health researchers employ in designing and conducting research can replicate the same inequalities, with important implications for the creation of new knowledge. In this paper, we retrospectively and critically analyse the thinking and methods we employed during two qualitative studies about the diverse experiences of people and families during the COVID-19 pandemic in the UK. Set within a wider literature on engaging with race and ethnicity in health research, we present an analysis based on reflexive accounts and testimonies from researchers, and close-up examinations of different stages of the research. By illustrating these ideological, practical and interactional components of research, including some uncomfortable reflections, we hope to encourage more open conversations among researchers and research funders. Through this process, we can strengthen efforts that dismantle unhelpful historical research orthodoxies and move towards re-formulating ways of research practice that are more explicitly anti-racist and inclusive.
Background: Numerous prospective studies suggest inverse associations between intake of polyunsaturated fatty acids (PUFA) and cardiovascular outcomes. However, recent randomized studies have failed to demonstrate these benefits. One of the prevailing hypotheses is that the beneficial effects of PUFA may now be masked by the widespread use of statins, which lower lipids and blood pressure and are potent modulators of cardiovascular risk. Hypothesis: We tested the hypothesis that the association between PUFA and hypertension varies by statin use. Methods and Results: We conducted a cross-sectional analysis based on 74,658 black and white men and women in the Southern Community Cohort Study. Intake of PUFA was assessed by a food-frequency questionnaire, while history of diagnosed hypertension and statin use were self-reported. The mean±SD age was 52±9 years, body mass index was 30±8 kg/m 2 , and energy intake from PUFA was 8.0±1.8%. Sixty percent of the participants were women and 68% were African Americans. Hypertension (55%), statin use (16%), smoking (40%) and alcohol use (55%) were common in this cohort. In an adjusted logistic model with hypertension as the dependent variable, there was no interaction between PUFA intake and statin therapy ( P =0.13), whereas a significant inverse association was evident between PUFA intake and hypertension among non-statin users ( P for trend = 0.03) but not among statin users ( P for trend = 0.36) ( Table ). Conclusion: In conclusion, these results support a beneficial effect of PUFA consumption on hypertension, which is only apparent in the absence of statin therapy. These findings underscore the need to stratify by statin therapy when randomizing participants to cardiovascular interventions and support the notion that PUFA may be important in cardiovascular risk reduction in patients where statin therapy is not an option.
Persons with low socioeconomic status and nonwhite persons in the United States have high rates of cardiovascular disease. The use of combination pills (also called "polypills") containing low doses of medications with proven benefits for the prevention of cardiovascular disease may be beneficial in such persons. However, few data are available regarding the use of polypill therapy in underserved communities in the United States, in which adherence to guideline-based care is generally low.
Abstract Objective: We examined total polyphenol intake and intake of polyphenol classes and subclasses with risk of lung cancer in the Southern Community Cohort Study (SCCS). Background: In the US, lung cancer incidence is highest in the south and among underrepresented and underserved populations. Diet is strongly associated with the risk of developing cancer, including lung cancer. Polyphenols, commonly found in plant-based foods, are biologically active compounds with antioxidant and other properties. Several population-based studies have found that higher intakes of some polyphenols were associated with a decreased risk of lung cancer, but this has not been studied in predominantly Black or low-income populations, nor have polyphenol classes and subclasses been studied extensively. Methods: The SCCS is a large, prospective cohort study established in 2002-2009 to study the causes of cancer disparities in 12 southern states. Two-thirds of the cohort are Black and over 50% have an annual household income less than $15,000. Diagnosis of lung cancer was obtained from state cancer registries and death records. Polyphenol intakes derived from a food frequency questionnaire assessing diet in the previous year were adjusted for total energy intake and grouped into quintiles. Cox proportional hazard models adjusted for potential confounders were used to estimate hazard ratios and 95% confidence intervals to determine associations between polyphenol intakes and lung cancer risk. Multiple imputation was performed to account for participants with incomplete information. After exclusions, analyses included 71,569 participants, including 1,484 incident lung cancer cases. Results: Total polyphenols were associated with a statistically significant increased risk of lung cancer (HR, 1.25; 95% CI, 1.04-1.51; P=0.01, comparing the highest to lowest intake quintile). Additionally, three subclasses (phenolic acids, hydroxycinnamic acids, alkylmethoxyphenols) were associated with a similarly statistically significant increased risk of lung cancer. Most associations were similar between Black and White individuals but were largely only statistically significant among Black participants and there was no significant interaction by race. In stratified analysis by smoking status, the associations were primarily present among current and former smokers. Caffeinated or decaffeinated coffee consumption was a major contributor to intake of total polyphenols, phenolic acids, hydroxycinnamic acids, and alkylmethoxyphenols for SCCS participants overall. Conclusions: Total polyphenols and three subclasses of polyphenols were unexpectedly associated with increased lung cancer risk. Further studies should be conducted to evaluate whether some polyphenols may have an adverse effect on lung carcinogenesis, particularly among individuals who smoke. Citation Format: Grace Xu, Heather Munro, Danxia Yu, Qi Dai, Martha Shrubsole. Dietary polyphenols and the risk of lung cancer in the prospective Southern Community Cohort Study [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A019.
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)