American Men (american + man)

Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of American Men

  • african american man


  • Selected Abstracts


    Aggressive osteogenic desmoplastic melanoma: a case report

    JOURNAL OF CUTANEOUS PATHOLOGY, Issue 5 2007
    Patrick O. Emanuel
    A case of an osteogenic desmoplastic melanoma occurring on the sole of the foot of a 60-year-old African American man is described. The tumor measured 4.8 cm in greatest dimension, invaded to a thickness of 2.2 cm and metastasized to four of ten inguinal lymph nodes. The majority of the tumor had a classic desmoplastic phenotype with malignant spindle cells set in a sclerotic and myxoid matrix and foci of lymphocyte aggregation. In other areas, there were thick trabeculae of bone rimmed by malignant epithelioid melanocytes. There was a markedly atypical lentiginous hyperplasia in the overlying epidermis. Imaging showed no continuity with the underlying calcaneus. The tumor was characterized immunohistochemically by S100 positivity. Pathologists should be aware of this diagnosis and should differentiate it from osteosarcoma. [source]


    Higher fasting insulin but lower fasting C-peptide levels in African Americans in the US population,

    DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 2 2002
    Maureen I. Harris
    Abstract Background Fasting serum insulin and fasting serum C-peptide are risk factors for developing type 2 diabetes. Because of the higher incidence of type 2 diabetes in African Americans and Hispanic Americans, it is likely that these groups may differ from non-Hispanic whites in their levels of insulin and C-peptide. Methods We analyzed data from a nationally representative sample of adults in the US population for whom sociodemographic, clinical, and laboratory information were obtained. The data were used to describe distributions of fasting insulin and fasting C-peptide in non-Hispanic white, non-Hispanic black, and Mexican American men and women aged ,20 years without a medical history of diabetes. Results Among men, Mexican Americans had higher insulin values than non-Hispanic whites and blacks. Among women, both Mexican Americans and blacks had higher insulin values than whites. For C-peptide, differences by sex and race-ethnicity paralleled those seen for fasting insulin with the exception that black men had significantly lower C-peptide values than whites and Mexican Americans. After adjustment for age, fasting plasma glucose (FPG), body mass index (BMI), and waist-to-hip ratio (WHR), the higher levels for insulin in blacks and Mexican Americans remained; both black men and women had significantly lower C-peptide values than whites and Mexican Americans. The molar ratio of fasting C-peptide to fasting insulin was similar for men and women in each race-ethnic group. However, blacks had substantially lower ratios than whites and Mexican Americans. Conclusions We found wide variations in fasting insulin and fasting C-peptide levels by race and ethnicity in US adults that were not explained by confounding factors, primarily measures of obesity. Most notably, the higher fasting insulin and lower fasting C-peptide levels in blacks implies that there is a derangement in insulin clearance and an impairment in beta-cell function in blacks compared with whites and Mexican Americans. Published in 2002 by John Wiley & Sons, Ltd. [source]


    MALE MARITAL WAGE DIFFERENTIALS: TRAINING, PERSONAL CHARACTERISTICS, AND FIXED EFFECTS

    ECONOMIC INQUIRY, Issue 3 2010
    WILLIAM M. RODGERS III
    Using the National Longitudinal Survey of Youth 1979, we replicate previous estimates of the marital wage differential for white men, extend the analysis to African American men, then explain the within and between race differentials. We first control for formal job training, then for cognitive skills, parental background, and self-esteem with little effect. By contrast, the white differential but not the black differential disappears in fixed-effects estimation. We reconcile the cross-section/panel differentials by focusing on the distinct identification conditions employed by each technique. Men who never change marital status play a significant role in white cross-sectional estimates. (JEL J31, J12) [source]


    Multiple myeloma: A review of the epidemiologic literature

    INTERNATIONAL JOURNAL OF CANCER, Issue S12 2007
    Dominik D. Alexander
    Abstract Multiple myeloma, a neoplasm of plasma cells, accounts for ,,15% of lymphatohematopoietic cancers (LHC) and 2% of all cancers in the US. Incidence rates increase with age, particularly after age 40, and are higher in men, particularly African American men. The etiology is unknown with no established lifestyle, occupational or environmental risk factors. Although several factors have been implicated as potentially etiologic, findings are inconsistent. We reviewed epidemiologic studies that evaluated lifestyle, dietary, occupational and environmental factors; immune function, family history and genetic factors; and the hypothesized precursor, monoclonal gammopathies of undetermined significance (MGUS). Because multiple myeloma is an uncommon disease, etiologic assessments can be difficult because of small numbers of cases in occupational cohort studies, and few subjects reporting exposure to specific agents in case,control studies. Elevated risks have been reported consistently among persons with a positive family history of LHC. A few studies have reported a relationship between obesity and multiple myeloma, and this may be a promising area of research. Factors underlying higher incidence rates of multiple myeloma in African Americans are not understood. The progression from MGUS to multiple myeloma has been reported in several studies; however, there are no established risk factors for MGUS. To improve our understanding of the causes of multiple myeloma, future research efforts should seek the causes of MGUS. More research is also needed on the genetic factors of multiple myeloma, given the strong familial clustering of the disease. © 2007 Wiley-Liss, Inc. [source]


    Handgrip Strength and Mortality in Older Mexican Americans

    JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2002
    Soham Al Snih MD
    OBJECTIVES: To examine the association between handgrip strength and mortality in older Mexican American men and women. DESIGN: A 5-year prospective cohort study. SETTING: Five southwestern states: Texas, New Mexico, Colorado, Arizona, and California. PARTICIPANTS: A population-based sample of 2,488 noninstitutionalized Mexican-American men and women aged 65 and older. MEASUREMENTS: Maximal handgrip strength, timed walk, and body mass index were assessed at baseline during 1993/94. Self-reports of functional disability, various medical conditions, and status at follow-up were obtained. RESULTS: Of the baseline sample with complete data, 507 persons were confirmed deceased 5 years later. Average handgrip strength ± standard deviation was significantly higher in men (28.4 kg ± 9.5) than in women (18.2 kg ± 6.5). Of men who had a handgrip strength less than 22.01 kg and women who had a handgrip strength less than 14 kg, 38.2% and 41.5%, respectively, were dead 5 years later. In men in the lowest handgrip strength quartile, the hazard ratio of death was 2.10 (95% confidence interval (CI) = 1.31,3.38) compared with those in the highest handgrip strength quartile, after controlling for sociodemographic variables, functional disability, timed walk, medical conditions, body mass index, and smoking status at baseline. In women in the lowest handgrip strength quartile, the hazard ratio of death was 1.76 (95% CI = 1.05,2.93) compared with those in the highest handgrip strength quartile. Poorer performance in the timed walk and the presence of diabetes mellitus, hypertension, and cancer were also significant predictors of mortality 5 years later. CONCLUSION: Handgrip strength is a strong predictor of mortality in older Mexican Americans, after controlling for relevant risk factors. [source]


    Perceptions of and Preferences for Skin Color, Black Racial Identity, and Self-Esteem Among African Americans,

    JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 11 2001
    Stephanie Irby Coard
    The purpose of the present study was to examine the role of skin color (i.e., lightness,darkness), as it pertains to racial identity development theory and self-esteem among 113 African American college students of various skin colors. Findings revealed that the sample preferred skin color of a medium tone, rather than exhibiting self-preference for either lighter or darker skin tones. There was also a significant relationship between one's perceptions of and preferences for his or her skin color and the skin tones idealized by others (e.g., opposite gender, family). Lighter skin color was positively related to higher levels of racial identity attitudes (immersion/emersion); the more satisfied darker skinned individuals were with their skin color, the lower their self-esteem, and gender differences existed in perceptions of others' preferences for skin color. Implications of this study for providing therapeutic clinical services and fostering the healthy psychological development of African American men, women, and children are discussed. [source]


    Nuclear matrix proteins as biomarkers in prostate cancer

    JOURNAL OF CELLULAR BIOCHEMISTRY, Issue 2 2002
    Eddy S. Leman
    Abstract The nuclear matrix (NM) is the structural framework of the nucleus that consists of the peripheral lamins and pore complexes, an internal ribonucleic protein network, and residual nucleoli. The NM contains proteins that contribute to the preservation of nuclear shape and its organization. These protein components better known as the NM proteins have been demonstrated to be tissue specific, and are altered in many cancers, including prostate cancer. Alterations in nuclear morphology are hallmarks of cancer and are believed to be associated with changes in NM protein composition. Prostate cancer is the most frequently diagnosed cancer in American men and many investigators have identified unique NM proteins that appear to be specific for this disease. These NM protein changes are associated with the development of prostate cancer, as well as in some cases being indicative of cancer stage. Identification of these NM proteins specific for prostate cancer provides an insight to understanding the molecular changes associated with this disease. This article reviews the role of NM proteins as tumor biomarkers in prostate cancer and the potential application of these proteins as therapeutic targets in the treatment of this disease. J. Cell. Biochem. 86: 213,223, 2002. © 2002 Wiley-Liss, Inc. [source]


    Clinical efficacy of prostate cancer detection using power doppler imaging in American and Japanese men

    JOURNAL OF CLINICAL ULTRASOUND, Issue 4 2002
    Koji Okihara MD
    Abstract Purpose The aim of this study was to compare the detection rates of tumor vascular flow as measured by power Doppler imaging (PDI) in 2 populations and to determine whether PDI can reduce the number of unnecessary prostate biopsies in men with serum prostate-specific antigen (PSA) concentrations less than 10.1 ng/ml. Methods The patient populations were Japanese (group 1) and American (group 2) men with either serum PSA concentrations of 4.1,10.0 ng/ml or abnormal findings on digital rectal examination (DRE) plus PSA concentrations less than 4.1 ng/ml. We compared the overall diagnostic accuracy of DRE, gray-scale transrectal sonography (TRUS), and PDI between the 2 groups. Results In total, 275 men were studied, 154 in group 1 and 121 in group 2. Cancer was identified in 27% of men in group 1 and in 60% of group 2. Men with cancer in both groups differed significantly in age, peripheral zone volume, and mean number of positive biopsy cores. The sensitivity and specificity of PDI in group 2 were significantly inferior to those in group 1. The negative predictive value (NPV) of PDI was significantly higher for group 1 than for group 2. The NPV of PDI in group 1 was equivalent to that for the combination of DRE and TRUS, whereas the NPV for PDI in group 2 was significantly inferior to that of DRE and TRUS. Conclusions Tumor vascularity could be detected by PDI more effectively in Japanese men with cancer than in American men with cancer. We hypothesize that this difference was a result of larger cancer volumes and smaller prostates in the Japanese men. PDI did not provide any performance advantage over DRE and TRUS in avoiding unnecessary biopsies. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 30:213,221, 2002; Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/jcu.10054 [source]


    ORIGINAL ARTICLE: Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US,

    JOURNAL OF DIABETES, Issue 3 2010
    Earl S. FORD
    Abstract Background:, Recently, a Joint Scientific Statement bridged differences between previous definitions of metabolic syndrome. Our objective was to estimate the prevalence of metabolic syndrome in a representative sample of US adults and to examine its correlates. Methods:, We analyzed data for up to 3461 participants aged ,20 years of the 2003,2006 National Health and Nutrition Examination Survey. Results:, Using waist circumference thresholds of ,102 cm for men and ,88 cm for women, the age-adjusted prevalence of metabolic syndrome was 34.3% among all adults, 36.1% among men, and 32.4% among women. Using racial- or ethnic-specific International Diabetes Federation criteria for waist circumference, the age-adjusted prevalence of metabolic syndrome was 38.5% for all participants, 41.9% for men, and 35.0% for women. Prevalence increased with age, peaking among those aged 60,69 years. Prevalence was lower among African American men than White or Mexican American men, and lower among White women than among African American or Mexican American women. In a multivariate regression model, significant independent associations were noted for age (positive), gender (men higher than women), race or ethnicity (African Americans and participants of another race lower than Whites), educational status (inverse), hypercholesterolemia (positive), concentrations of C-reactive protein (positive), leisure time physical activity (inverse), microalbuminuria (positive), and hyperinsulinemia (positive). Additional adjustment for body mass index weakened many of the associations, with educational status and microalbuminuria no longer significant contributors to the model. Conclusion:, Metabolic syndrome continues to be highly prevalent among adults in the US. [source]


    Partner Notification Methods for African American Men Being Treated for Trichomoniasis: A Consideration of Main Men, Second Hitters, and Third Players

    MEDICAL ANTHROPOLOGY QUARTERLY, Issue 4 2005
    Bronwen Lichtenstein
    This pilot study sought information on African American men's preferences for partner notification methods for a common sexually transmitted infection called trichomoniasis. Two focus groups of African American men were convened at a public STI clinic where they were being treated for trichomoniasis. The groups identified a sexual hierarchy in men's preferences for methods of partner notification. The hierarchy consisted of main men (Cake Daddies), second men (Second Hitters), and third or fourth men (Third Players), with placement depending on age, income, and social status. Health department employees affirmed the existence of a sexual hierarchy in a separate focus group. Sexual and economic bartering formed the basis of the hierarchy, and the secrecy involved in such arrangements presented a considerable challenge for STI control. Disease intervention specialists who were responsible for contact tracing spoke of cat-and-mouse methods in contacting the men without understanding fully exactly how the hierarchy influenced men's responses to partner notification. The findings suggest that STI control efforts must take the sexual hierarchy and its privacy implications into account if partner notification methods are to be acceptable to African American men. [source]


    Distress about mating rivals

    PERSONAL RELATIONSHIPS, Issue 3 2000
    DAVID M. BUSS
    This research tested the evolutionary psychological hypothesis that men and women would be most distressed about threats from rivals who surpass them on sex-linked components of mate value. Six predictions were tested in samples from three cultures, the United States (N= 208), the Netherlands (N= 349), and Korea (N= 174). Five predictions were supported in all three cultures. Korean, Dutch, and American men, more than corresponding women, report greater distress when a rival surpasses them on financial prospects, job prospects, and physical strength. Korean, Dutch, and American women, in contrast, report greater distress when a rival surpasses them on facial and bodily attractiveness. The cultures differed on some variables. Korean women and men, for example, differed from Americans and Dutch in reporting more distress over rivals who had better financial prospects, better job prospects, and higher status and prestige. Americans exceeded Koreans in reporting distress when rivals had more attractive faces and bodies, whereas the Dutch exceeded the other cultures in reporting more distress when rivals had a better sense of humor. Discussion focuses on possible proximate psychological mechanisms underlying distress over rivals and the theoretical importance of intrasexual competition. [source]


    A Comparison of Biological Risk Factors in Two Populations: The United States and Japan

    POPULATION AND DEVELOPMENT REVIEW, Issue 3 2008
    Eileen M. Crimmins
    Life expectancy is higher in Japan than in the United States. We compared the prevalence of clinically recognized risk factors in the two countries to explore the possibility that differences in these likely precursors to disease and death are linked to the paths to higher mortality for Americans. We found that American men and women have higher levels of total biological risk than the Japanese, particularly for risk factors included in the metabolic syndrome. A significant difference between the two countries is the higher prevalence of overweight among Americans. On the other hand, measured blood pressure appears more favorable among Americans. A larger proportion of Americans use prescription drugs, which results in lowered levels of measured biological risk. There are large differences in the prevalence of a number of risk factors between American and Japanese women less than age 40; this could mean that Americans develop biological risk earlier in life or that the differences are growing larger in more recent cohorts. [source]


    Racial Differences in the Characteristics of Firearm Suicide Decedents in the United States

    AMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 1 2007
    Sean Joe MSW
    Focusing on the reported growing use of firearms to complete suicide among African Americans, this article analyzes the 1993 National Mortality Followback Survey to examine the association of firearm suicide with race, education, geographic region, access to a firearm, depressive symptoms, and mental health service utilization on decedents aged 15 years and older. After controlling for demographic, socioeconomic, and clinical variables, the analysis indicates that African American men were twice as likely as White men to use a firearm to complete suicide. The findings suggest the importance for clinicians to screen for the presence of firearms in depressed African Americans and to reduce their access to firearms. In addition, clinicians, social workers, and public health professionals should consider racial differences in correlates of firearm suicide when designing prevention and intervention initiatives. [source]


    Quality of Diets Consumed by Older Rural Adults

    THE JOURNAL OF RURAL HEALTH, Issue 1 2002
    Mara Z. Vitolins Dr.P.H.R.D
    Older adults residing in rural communities are at risk for low dietary quality because of a variety of social, physical and environmental circumstances. Minority elders are at additional risk because of poorer health status and lower socioeconomic status. This study evaluated the food group intake of 130 older (>70 years) African American (34%), European American (36%), and Native American (30%) residents of two rural communities in central North Carolina. An interviewer-administered food frequency questionnaire was used to measure dietary intake. Food items were classified into food groups similar to the United States Department of Agriculture (USDA) Food Guide Pyramid and the National Cancer Institutés 5 A Day for Better Health program. None of the survey participants met minimum intake recommendations and most over-consumed fats, oils, sweets and snacks. African Americans and Native Americans consumed fewer servings of meats, fruits and vegetables, and fats, oils, sweets and snacks than European Americans. African American men consumed the fewest servings of fruits and vegetables of all gender/ethnic groups. Consumption of fats, oils and sweets was greatest among those 85 years and older and was more common among denture users. National strategies to educate the public about the importance of consuming a varied diet based on the recommendations presented in national nutrition education campaigns may not be reaching older adults in rural communities, particularly minority group members. [source]


    Prevalence of and risk factors for prostatitis in African American men: The Flint Men's Health Study

    THE PROSTATE, Issue 1 2009
    Lauren P. Wallner
    Abstract INTRODUCTION Prostatitis is a common, yet ill-defined condition without clear diagnostic criteria and treatment strategies. Previous studies examining the prevalence and correlates of prostatitis are limited in their inclusion of primarily white populations. The objective of the current study was to identify prevalence of and risk factors for prostatitis in a population-based sample of African-American men. METHODS In 1996, a probability sample of 703 African-American men, aged 40,79, residing in Genesee County, Michigan without a prior history of prostate cancer/surgery provided responses to a structured interview-administered questionnaire which elicited information regarding sociodemographics, current stress and health ratings, and past medical history, including history of physician diagnosed prostatitis, BPH and sexually transmitted diseases. Logistic regression was used to identify predictors of prostatitis after adjustment for age. RESULTS Forty-seven (6.7%) of the 703 men reported a history of prostatitis. Increased frequency of sexual activity and physical activity were significantly associated with decreased odds of disease. Moderate to severe lower urinary tract symptoms (LUTS) and a history of BPH were significantly associated with prostatitis after adjustment for age. CONCLUSION After adjustment for age, LUTS severity and history of BPH were associated with increased odds of prostatitis. BMI, physical activity and sexual frequency were associated with decreased odds of prostatitis. Finally, poor emotional and physical health, high perceived stress and low social support were associated with an increased risk of prostatitis history. Importantly, these findings suggest that the primary risk factors for this condition are largely modifiable and highlight potential targets for future prevention. Prostate 69: 24,32, 2009. © 2008 Wiley,Liss, Inc. [source]


    Recruiting Black/African American men for research on prostate cancer prevention,,

    CANCER, Issue 5 2004
    V. Diane Woods M.S.N.
    Abstract BACKGROUND Black/African American men die of prostate cancer at a greater rate relative to other males. During the period from 1992 to 1998, prostate cancer incidence rates in the United States were 234.2 per 100,000 persons among non-Hispanic black males and 144.6 per 100,000 persons among white males. The reasons for these increased rates of prostate cancer among black males are largely unknown, but increased mortality is associated with late detection. The authors conducted a longitudinal study of black men that investigated prostate cancer prevention behaviors within this population. The purpose of the current article is to identify successful recruitment strategies that were reported by participants in this study of prevention behaviors. METHODS Qualitative research methods were used to elucidate men's thoughts, attitudes, beliefs, and practices regarding prostate cancer prevention behaviors and to identify strategies for attracting black men to research programs and retaining them in these programs. RESULTS Ethnocentric recruitment strategies that were identified included the development of tailored printed materials; the use of targeted locations; and a personalized, participatory approach for engaging potential participants. We contacted 498 black men and enrolled a cohort of 277 non-Hispanic black males (75% of whom were recruited within a 9-week period) in the current study. CONCLUSIONS Unlike other studies that reported difficulty in recruiting African American men, the current study did not encounter such difficulties. The authors attribute their success to culturally attractive Afrocentric materials; cultural sensitivity; a caring, professional, personalized ethnic approach; respect; and participatory involvement of the target population. Nonetheless, the authors did encounter barriers, such as lack of physician interest and lack of trust in quality medical care. These barriers must be overcome before black males can be engaged and retained in research studies on prostate cancer prevention. Cancer 2004;100:1017,25. © 2004 American Cancer Society. [source]


    Prospective study of cancer detection in black and white men with normal digital rectal examination but prostate specific antigen equal or greater than 4.0 ng/mL ,

    CANCER, Issue 6 2002
    Jackson E. Fowler Jr. M.D.
    Abstract BACKGROUND The serum prostate specific antigen (PSA) concentration with no clinical evidence of prostate carcinoma is higher and more variable in black than in white American men. The influence of this phenomenon on relations between race, PSA, and cancer detection in men with a PSA greater than or equal to 4.0 ng/mL has not been investigated. METHODS Between January 1992 and December 2000, 451 black and 480 white men with a normal digital rectal examination and a PSA greater than or equal to 4.0 ng/mL had an initial prostate biopsy at one medical center. The histology of the biopsy specimens and the Gleason score of malignant specimens was determined by one uropathologist. RESULTS Cancer was detected in 207 (46%) black and 167 (35%) white men (P = 0.0006). When adjusted for PSA, cancer detection was also greater in the black than the white men, but the difference did not achieve statistical significance (relative risk, 1.30; 95% confidence interval [CI], 0.99,1.71; P = 0.06). Gleason score 7,10 cancer was detected in 88 (20%) black and 45 (9%) white men (P = 0.0001), and the difference remained significant when adjusted for PSA (relative risk, 1.73; 95% CI, 1.16,2.61; P = 0.0008). In the intermediate PSA range of 4.0,9.9 ng/mL, cancer detection and Gleason score 7,10 cancer detection was greater in black than in white men younger than 60, 60,69, and 70 years of age or older, but the difference was significant only for Gleason score 7,10 cancer detection among men 60,69 years of age (P = 0.006). CONCLUSIONS There is a direct correlation between Gleason score and cause specific survival with local stage prostate carcinoma. The authors' study indicates that prostate carcinomas with established malignant potential are more likely to be identified in black than in white men with PSA elevation as the only indication of malignancy and raises the possibility that a PSA threshold less than 4.0 ng/mL in black men younger than 70 years of age may reduce racial disparities in prostate carcinoma morbidity and mortality. Cancer 2002;94:1661,7. © 2002 American Cancer Society. DOI 10.1002/cncr.10446 [source]


    The ryanodine receptor type 1 gene variants in African American men with exertional rhabdomyolysis and malignant hyperthermia susceptibility

    CLINICAL GENETICS, Issue 6 2009
    N Sambuughin
    It has been suggested that exertional rhabdomyolysis (ER) and malignant hyperthermia (MH) are related syndromes. We hypothesize that patients with unexplained ER harbor mutations in the ryanodine receptor gene type 1 (RYR1), a primary gene implicated in MH, and therefore ER patients are at increased risk for MH. Although there are reported cases of MH in individuals of African descent, there are no data available on molecular characterization of these patients. We analyzed RYR1 in six, unrelated African American men with unexplained ER, who were subsequently diagnosed as MH susceptible (MHS) by the Caffeine Halothane Contracture Test. Three novel and two variants, previously reported in Caucasian MHS subjects, were found in five studied patients. The novel variants were highly conserved amino acids and were absent among 230 control subjects of various ethnic backgrounds. These results emphasize the importance of performing muscle contracture testing and RYR1 mutation screening in patients with unexplained ER. The MHS-associated variant Ala1352Gly was identified as a polymorphism predominant in individuals of African descent. Our data underscore the need for investigating RYR1 across different ethnic groups and will contribute to interpretation of genetic screening results of individuals at risk for MH. [source]


    Disparities in the Emergency Department Evaluation of Chest Pain Patients

    ACADEMIC EMERGENCY MEDICINE, Issue 2 2007
    Liliana E. Pezzin PhD
    Background The existence of race and gender differences in the provision of cardiovascular health care has been increasingly recognized. However, few studies have examined whether these differences exist in the emergency department (ED) setting. Objectives To evaluate race, gender, and insurance differences in the receipt of early, noninvasive diagnostic tests among persons presenting to an ED with a complaint of chest pain. Methods Data were drawn from the U.S. National Hospital Ambulatory Health Care Survey of EDs. Visits made during 1995,2000 by persons aged 30 years or older with chest pain as a reason for the visit were included. Factors affecting the likelihood of ordering electrocardiography, cardiac monitoring, oxygen saturation measurement using pulse oximetry, and chest radiography were analyzed using multivariate probit analysis. Results A total of 7,068 persons aged 30 years or older presented to an ED with a primary complaint of chest pain during the six-year period, corresponding to more than 32 million such visits nationally. The adjusted probability of ordering a test was highest for non,African American patients for all tests considered. African American men had the lowest probabilities (74.3% and 62% for electrocardiography and chest radiography, respectively), compared with 81.1% and 70.3%, respectively, among non,African American men. Only 37.5% of African American women received cardiac monitoring, compared with 54.5% of non,African American men. Similarly, African American women were significantly less likely than non,African American men to have their oxygen saturation measured. Patients who were uninsured or self-pay, as well as patients with "other" insurance, also had a lower probability than insured persons of having these tests ordered. Conclusions This study documents race, gender, and insurance differences in the provision of electrocardiography and chest radiography testing as well as cardiac rhythm and oxygen saturation monitoring in patients presenting with chest pain. These observed differences should catalyze further study into the underlying causes of disparities in cardiac care at an earlier point of patient contact with the health care system. [source]