{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:22:48Z","timestamp":1785424968448,"version":"3.56.0"},"reference-count":44,"publisher":"North Carolina Institute of Medicine","issue":"4","license":[{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec id=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is regional variability in sarcoidosis mortality across the United States. North Carolina ranks highly in sarcoidosis-related mortality, especially among African Americans (AA). We sought to determine any regional variability of sarcoidosis-related mortality and the relationship to sociodemographic determinants of health in North Carolina.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Counties in North Carolina were categorized into three distinct geographic regions: Western, Piedmont, and Eastern. Sarcoidosis deaths were stratified by region, race, and gender. We conducted a mapping and cluster analysis utilizing ArcGIS; Global and Local Moran\u2019s I was used to determine the prevalence, spatial autocorrelation, and clustering of mortality vis-a-vis various sociodemographic variables, occupational\/environmental exposures, and levels of atmospheric particulate matter less than 2.5 microns in size (PM2.5). Multivariate linear regression with exposure limited to the county level was used to determine the relationship between sarcoidosis mortality and the variables of interest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eastern North Carolina (ENC) had the highest age-adjusted sarcoidosis mortality rate (1.16\/100,000 versus 0.49\/100,000 in Piedmont and 0.32\/100,000 in the Western region) with statistically significant high-high mortality clusters (P &lt; .001 for Global Moran\u2019s I). Several sociodemographic and occupational factors (proportion of AA, obese adults, and individuals working in nature) were more prevalent in ENC. Region and proportion of AA were the significant mortality predictors in our multivariate analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"limitations\">\n                    <jats:title>Limitations<\/jats:title>\n                    <jats:p>This was a cross-sectional study with exposure limited to the county level. Associations do not imply causality and risks cannot be extrapolated to the individual level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusion\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is regional variability of sarcoidosis mortality in North Carolina. Eastern North Carolina had the highest mortality with high-high mortality clusters.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.18043\/001c.118578","type":"journal-article","created":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T11:19:08Z","timestamp":1717586348000},"source":"Crossref","is-referenced-by-count":0,"title":["Sarcoidosis Mortality in North Carolina: Role of Region, Race, and Other Sociodemographic Variables"],"prefix":"10.18043","volume":"85","author":[{"given":"David","family":"Wambui","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01vx35703","id-type":"ROR","asserted-by":"publisher"}],"name":"East Carolina University","department":["Brody School of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Kearney","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01vx35703","id-type":"ROR","asserted-by":"publisher"}],"name":"East Carolina University","department":["Brody School of Medicine Department of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"O'Brien","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01vx35703","id-type":"ROR","asserted-by":"publisher"}],"name":"East Carolina University","department":["College of Allied Health Sciences Department of Biostatistics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Iverson","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01vx35703","id-type":"ROR","asserted-by":"publisher"}],"name":"East Carolina University","department":["Environmental Health Sciences Program, Department of Health Education and Promotion"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ogugua Ndili","family":"Obi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01vx35703","id-type":"ROR","asserted-by":"publisher"}],"name":"East Carolina University","department":["Division of Pulmonary, Critical Care and Sleep Medicine, Brody School of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"7507","published-online":{"date-parts":[[2024,6,5]]},"reference":[{"issue":"11","key":"ref1","doi-asserted-by":"publisher","first-page":"2366","DOI":"10.3390\/jcm10112366","article-title":"State-level health disparity is associated with sarcoidosis mortality","volume":"10","author":"Y. C. Lee","year":"2021","journal-title":"J Clin Med"},{"issue":"4","key":"ref2","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1016\/S0002-9343(97)89518-6","article-title":"Sarcoidosis mortality in the United States 1979\u20131991: An analysis of multiple-cause mortality data","volume":"100","author":"N.M. Gideon","year":"1996","journal-title":"Am J Med"},{"issue":"11","key":"ref3","doi-asserted-by":"publisher","first-page":"1524","DOI":"10.1164\/rccm.201010-1679OC","article-title":"Sarcoidosis-related mortality in the United States from 1988 to 2007","volume":"183","author":"J. J. Swigris","year":"2011","journal-title":"Am J Respir Crit Care Med"},{"issue":"8","key":"ref4","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1513\/AnnalsATS.201511-760OC","article-title":"Sarcoidosis in America. Analysis based on health care use","volume":"13","author":"R. P. 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Khan","year":"2017","journal-title":"Respir Med"},{"issue":"11","key":"ref36","doi-asserted-by":"publisher","first-page":"1832","DOI":"10.1513\/AnnalsATS.202011-1467OC","article-title":"Barriers to care among patients with sarcoidosis: A qualitative study","volume":"18","author":"L. J. Harper","year":"2021","journal-title":"Ann Am Thorac Soc"},{"issue":"2","key":"ref37","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1016\/s1047-2797(00)00179-4","article-title":"A current assessment of rurally linked exposures as potential risk factors for sarcoidosis","volume":"11","author":"D. K. 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Judson","year":"2012","journal-title":"Sarcoidosis Vasc Diffuse Lung Dis"},{"issue":"2","key":"ref42","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1378\/chest.14-1120","article-title":"Racial difference in sarcoidosis mortality in the United States","volume":"147","author":"M. Mirsaeidi","year":"2015","journal-title":"Chest"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.rmed.2018.11.010","article-title":"Sarcoidosis deaths in the United States: 1999\u20132016","volume":"149","author":"G. D. Kearney","year":"2019","journal-title":"Respir Med"},{"issue":"9","key":"ref44","doi-asserted-by":"publisher","first-page":"1062","DOI":"10.1016\/j.amjmed.2019.03.048","article-title":"Disparities in sarcoidosis mortality by region, urbanization and race in the United States: A multiple cause of death analysis","volume":"132","author":"F. Ogundipe","year":"2019","journal-title":"Am J Med"}],"container-title":["North Carolina Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ncmedicaljournal.com\/article\/118578-sarcoidosis-mortality-in-north-carolina-role-of-region-race-and-other-sociodemographic-variables","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T20:12:35Z","timestamp":1780603955000},"score":1,"resource":{"primary":{"URL":"https:\/\/ncmedicaljournal.com\/article\/118578-sarcoidosis-mortality-in-north-carolina-role-of-region-race-and-other-sociodemographic-variables"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,5]]},"references-count":44,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.18043\/001c.118578","relation":{},"ISSN":["2379-4313","0029-2559"],"issn-type":[{"value":"2379-4313","type":"electronic"},{"value":"0029-2559","type":"print"}],"subject":[],"published":{"date-parts":[[2024,6,5]]}}}