09/25/2023
By Hsien-Yuan Hsu
Date: Sept. 27
Time: Noon to 1 p.m.
Location: Coburn Hall 275
Please RSVP to reserve your spot.
Title: Racial Disparity in Mortality From TB in the U.S. Between States With and Without History of Jim Crow Laws: An Analysis of the Global Burden of Disease (GBD) and Risk Factors Study, 1990 to 2019.
Speaker's Short Bio
Phil Gona is a Professor of Biostatistics in the Departments of Urban Public Health, and Department of Exercise Health Sciences at UMass Boston. He earned his Ph.D. in Biostatistics at Boston University. His research interests include statistical methods for epidemiology with applications in cardiovascular disease and HIV/AIDS. Gona is a Fellow of the American Heart Association and a recent Fulbright Scholar in Global Health. Prior to joining UMass, Gona was a senior statistician in the pharma industry where he conducted clinical trials for new drug development including vaccine trials. He was a research scientist at the Harvard School of Public Health’s Department of Biostatistics working for the AIDS Clinical Trials Group, an international research consortium. As an Assistant Professor in the Department of Mathematics & Statistics at Boston University’s Statistical Consulting Unit, he taught statistics courses at all levels and was seconded as senior statistician at the NIH’s Framingham Heart Study where he developed risk prediction models for cardiovascular diseases. As an Associate Professor of Quantitative Health Sciences at UMass Medical School, he instructed courses in the Clinical & Population Health Research Ph.D. program. He is a team scientist with collaborative research funded by the NIH. His current scholarship is focused in part on the effects of structural racism on health outcomes such as COVID-19 and others. He is a longtime Collaborator of the Global Burden of Disease Study, the study which is the basis of his talk today.
Abstract
In 16 US Southern States the effects of health inequities engendered by Jim Crow laws enacted between the late 1800s to the 1960s have not been evaluated for TB-related mortality. While TB-related mortality in the US declined four-fold from 1990 to 2019, country-level estimates of TB burden obscure within-state racial heterogeneity and changes over time. We evaluated whether TB-related mortality varied from 1990 to 2019, between states that have a history of enacting Jim Crow laws vs. states with no such history using estimates from the Global Burden of Diseases Study. TB mortality was modelled using the Cause of Death Ensemble model (CODEm) framework with varying combinations of predictive covariates. Annualized rates of change and uncertainty intervals were calculated. From 1990 to 2019, most former Jim Crow states had higher TB mortality rates than states that did not enact such laws. TB mortality decreased relatively slowly in former Jim Crow states than in non-Jim Crow states. Even though the 1964 Civil Rights Act dismantled Jim Crow statutes, racial inequities in TB burden experienced by past generations may still be felt in subsequent generations (i.e., “intergenerational drag”). Understanding the role of structural racism at the intersection of science and medicine shows the complex ways historical laws, such as Jim Crow laws, continue to negatively impact health outcomes and warn of future dangers, such as COVID-19, to avoid.