Black Lives Matter, and Yes, You are Racist: The Parallelism of the Twentieth and Twenty-First Centuries

Workplace inequities and health outcomes among Black professionals in Canada

BACKGROUND

Anti-Black racism in Canada remains a significant barrier to the career advancement and overall well-being of Black professionals. Despite the existence of policies and legislation aimed at reducing workplace discrimination, Black Canadians continue to face systemic racism, microaggressions, and various forms of discrimination that hinder their professional growth and contribute to a hostile work environment.

OBJECTIVE

This study explores the specific manifestations of anti-Black racism in Canadian workplaces, examines the physical and mental health impacts on Black professionals, and investigates the responses and coping mechanisms employed by these individuals in the face of racism.

METHODS

A qualitative study was conducted involving semi-structured interviews with 24 Black professionals from diverse sectors, including healthcare, information technology, academia, and public service. Participants were selected based on their professional experience and self-identification as Black. Data were collected through in-depth interviews, which were transcribed and analyzed using LeximancerTM software to identify recurring themes and patterns.

RESULTS

The study identified three primary themes: (1) Mechanisms of anti-Black racism, including microaggressions, overt bias, and tokenism; (2) Impacts of anti-Black racism, such as mental health trauma, career stagnation, and exacerbation of chronic health conditions; and (3) Responses of Black professionals, including code-switching, self-preservation behaviors, and early exit from the workplace. The findings reveal that despite high academic achievement and leadership positions, Black professionals face persistent discrimination that affects their career trajectories and personal lives.

CONCLUSION

Anti-Black racism in Canadian workplaces is deeply entrenched and continues to negatively impact the lives and careers of Black professionals. The study highlights the need for more effective diversity and inclusion initiatives that address the root causes of racism. Further research is recommended to explore the economic and psychological impacts of anti-Black racism and to develop strategies to mitigate its effects in the workplace.

'We are in for a culture change': continuing professional development leaders' perspectives on COVID-19, burn-out and structural inequities

INTRODUCTION

The COVID-19 pandemic positioned healthcare systems in North America at the epicentre of the crisis, placing inordinate stress on clinicians. Concurrently, discussions about structural racism, social justice and health inequities permeated the field of medicine, and society more broadly. The confluence of these phenomena required rapid action from continuing professional development (CPD) leaders to respond to emerging needs and challenges.

METHODS

In this qualitative study, researchers conducted 23 virtual semistructured interviews with CPD leaders in Canada and the USA. Interview audiorecordings were transcribed, deidentified and thematically analysed.

RESULTS

This study revealed that the CPD leaders attributed the pandemic as illuminating and exacerbating problems related to clinician wellness; equity, diversity and inclusion; and health inequities already prevalent in the healthcare system and within CPD. Analysis generated two themes: (1) From heroes to humans: the shifting view of clinicians and (2) Melding of crises: an opportunity for systemic change in CPD.

DISCUSSION

The COVID-19 pandemic increased recognition of burn-out and health inequities creating momentum in the field to prioritise and restrategise to address these converging public health crises. There is an urgent need for CPD to move beyond mere discourse on these topics towards holistic and sustainable actionable measures.

Subjective Stress Appraisals Over Time: the Evolving Structure of the COVID-19 Stressor Scale

The COVID-19 Stressors Scale measures individuals' appraisals of stressors related to the pandemic. Measurement of perceptions of stressors is necessary to understand the socioemotional impacts of not only the COVID-19 pandemic, but other disasters. The study examined the factor structure of the scale among adults in the U.S. over six time points. A shortened version was used, and the fit was examined over time. The results of the study show contextual appraisals change over time and offer important implications for the measurement of stressfulness of disasters, a critical step in designing and assessing impacts of social programs aimed to reduce the deleterious effects of disasters.

Space and place for health and care - Nationalist discourses in Swedish daily press during the first year of COVID-19

Sweden's strategy during COVID-19 with restrictions but no firm closure of the society surprised the rest of the world and was questioned, not least by neighbouring countries. This article analyses public discourses on space and place for health and care in the Swedish daily press during the first year of the pandemic, 2020. Critical discourse analysis was conducted on daily press newspaper articles to approach issues of space, place, health and care during the COVID-10 pandemic. The findings suggest three main discourses. First, a powerful discourse on unity against the threat is articulated, urging citizens in Sweden to be loyal in the national space. Secondly, an affirming national reconstructing discourse is manifested, related to constructions of borders of national space but also in relation to places of family life and social contacts to 'flatten the curve' and stay healthy. Thirdly, later in the period the overarching discourse of the nation and its loyal citizens was torn apart and increasing tensions were articulated due to, as it appeared, the uncertain actions from the government. This study adds to the literature on a theoretical and practical level. Raising awareness on nationalist discourses in relation to place, space, health, and care could prove important in combating inequalities in the local society as well as when cooperating on an international level.

Where's the BIPOC Blueprint for Healthy Youth Development? The Role of Scientific Omissions in Our Struggle for Science Translation and Racial Equity in the United States

Prevention Science seeks to advance the prevention research and to translate scientific advances into the promotion of healthy development for all youth. Despite tremendous progress creating a robust evidence-base and set of translational tools, elaborations and expansions for equity are required. Our collective errors of omission as prevention researchers have left prevention practitioners and policy-makers without sufficient information to identify strategies that have been demonstrated to prevent behavioral health problems in young people who identify as Black, Indigenous, or other People of Color (BIPOC). We first describe the current shortcomings of available evidence, and then we call for individual and collective action to conceptualize equity-enhancing prevention, sample more inclusively, and improve analytic approaches such that we can truly promote the healthy development of all youth.

Racial inequities in homicide rates and homicide methods among Black and White women aged 25-44 years in the USA, 1999-2020: a cross-sectional time series study

BACKGROUND

In the USA, Black women aged 25-44 years are disproportionately murdered compared with their White counterparts. Despite ongoing efforts to reduce racial and structural inequities, the result of these efforts remains unclear, particularly in light of the COVID-19 pandemic.

METHODS

This study examined a cross-sectional time series of homicide death rates, by race, from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research system. We included data for women aged 25-44 years between 1999 and 2020 among 30 states in the USA. Homicide death was classified using underlying cause and multiple cause of death codes; mortality rates were calculated per 100 000 based on US Census Bureau population sizes. Homicide methods were classified as firearm, cutting or piercing, and other. Firearm homicides were compared with other homicides with logistic regression including covariates of race, time, and their interaction. We report odds ratios and 95% CIs.

FINDINGS

In 2020, the homicide rate among Black women was 11·6 per 100 000, compared with 3 per 100 000 among White women. This inequity has persisted over time and is virtually unchanged since 1999. Homicide inequities vary across US states; in 11 states, racial inequities have increased since 1999. The racial inequity was greatest in Wisconsin, where in 2019-20, Black women aged 25-44 years were 20 times more likely to die by homicide than White women. Homicide by firearm is increasing in frequency; women in the USA had 2·44 (95% CI 2·14-2·78) times the odds of homicide involving firearms in 2019-20 compared with 1999-2003. Firearm homicide deaths are disproportionately concentrated among Black women in every region in the USA.

INTERPRETATION

Our findings suggest that there is an urgent need to address homicide inequities among Black and White women in the USA. Enacting federal legislation that reduces gun access is a crucial step. Policy makers must address long-standing structural factors that underpin elevated gun violence by implementing sustainable wealth-building opportunities; developing desegregated, mixed income and affordable housing; and increasing green spaces in communities where Black women largely reside.

FUNDING

National Institute of Mental Health of the National Institutes of Health.

Testing a QuantCrit-Informed Approach to the Empirical Study of Race/Ethnicity and Child Maltreatment

The past several years have seen calls from QuantCrit scholars to "disaggregate" samples into same-race groups. To date, however, there has been no attempt to empirically evaluate the benefits of disaggregation within a child welfare sample. Using a child maltreatment dataset derived from the National Child Abuse and Neglect Data System and Census data, we empirically evaluate the utility of employing sample disaggregation (in which separate records are created for White, Black and Latino populations in each county) as well as variable creation disaggregation (in which we avoid using "full county" economic measures, but instead employ "same race/ethnicity" measures). Using model fit and convergence with findings from individual-level studies as evaluation metrics, we find that both kinds of disaggregation are demonstrably beneficial. We recommend that sample and variable disaggregation be considered by any future researchers using national geographically structured child maltreatment data.

State Policies on Child Maltreatment and Racial Disproportionality

Over the past several decades researchers have documented disproportionality for Black families across multiple decision-making points within the child welfare system. Yet, few studies have examined how specific state policies may impact disproportionality across decision points. The racial disproportionality index (RDI) was calculated for Black children in each state and Washington DC (N = 51) based on the proportion of children who were received a referral to CPS, a substantiated investigation, or entered foster care. A series of bivariate analyses (one-way ANOVAs; independent sample t-tests) were used to explore the relationship between the RDI and these decision points. Further analyses were conducted between the RDI and state policies (e.g., child maltreatment definitions, mandated reporting, and alternative response). Our results suggest there is an overrepresentation of Black children in CPS across the three decision points. This overrepresentation continues with specific state policies such as a state using harsh punishment in their definition of child maltreatment. Recommendations are provided for policy and research, including a suggestion for further exploration of state policies and county-level disproportionality indexes.

RE/UN/DIScover Heuristic: Working with Clinical Practice Impingements in Dehumanizing Times

Although clinical social work seeks to center the transformative potential of human relationships, practitioners are experiencing heightened systemic and organizational impingements from the dehumanizing pressures of neoliberalism. Neoliberalism and racism diminish the vitality and transformative potential of human relationships, disproportionately affecting Black, Indigenous and People of Color (BIPOC) communities. Practitioners are also experiencing increased stress and burnout related to increased caseloads and decreased professional autonomy and organizational practitioner support. Holistic, culturally responsive, and anti-oppressive processes seek to counter these oppressive forces but need further development to synthesize antioppressive structural understandings with embodied relational interactions. Practitioners can potentially contribute to efforts that apply critical theories and antioppressive understandings within their practice and workplace. Through an iterative flow of three sets of practices, the RE/UN/DIScover heuristic supports practitioners' efforts to respond in those challenging everyday moments where oppressive forms of power are imposed and embedded within systemic processes. With themselves and other colleagues, practitioners engage in compassionate REcover practices; use curious, critical reflection to UNcover full understandings of power dynamics, impacts, and meanings; and draw on creative courage to DIScover and enact socially just and humanizing responses. This paper describes how practitioners can use the RE/UN/DIScover heuristic in two common challenging moments of clinical practice: systemic practice impingements and implementing a new training or practice model. The heuristic seeks to support practitioners' efforts to preserve and expand socially just, relational spaces for themselves and those with whom they work within the context of systemic dehumanizing neoliberal forces.

Development of the awareness, skills, knowledge: General (ASK-G) scale for measuring cultural competence in the general population

Measuring cultural competence has been difficult for conceptual and practical reasons. Yet, professional guidelines and stated values call for training to improve cultural competence. To develop a strong evidence-base for training and improving cultural competence, professionals need reliable and valid measures to capture meaningful changes in cultural competence training. We developed a measure for cultural competence that could be used in a general population to measure changes in awareness, knowledge, and skills in interacting with culturally diverse others. We built an 81-item scale with items conceptually categorized into awareness, knowledge, and skills and was presented to an expert panel for feedback. For evaluation, a national panel of 204 adults responded to the new scale and other measures associated with cultural competence. Factor analysis revealed four factors with strong reliabilities: Awareness of Self, Awareness of Others, Proactive Skills Development, and Knowledge (as = .87 - .92). The final overall scale, Awareness, Knowledge, Skills—General (ASK-G) had 37 items and strong reliability (a = .94). The ASK-G was then compared to validated scales to provide evidence of concurrent, convergent, and divergent validity. Strong evidence emerged for these. The ASK-G is a promising tool to measure cultural competence in a general population.

Strategies to address structural and institutional barriers to success among students of color in nursing programs

The COVID-19 pandemic and the significant disparities experienced by Black, Indigenous, and people of color (BIPOC) in infections, hospitalizations, and deaths associated with the Coronavirus have underscored the imperative to increase the size and diversity of the healthcare workforce, including nursing. Academically focused pipeline development programs have led to some advances in minority recruitment and retention; however, emerging research highlights the importance of extra-academic factors that reduce the sense of belonging and persistence among underrepresented and minority students. The purpose of this manuscript is to describe the diversity, equity, and inclusion goals and activities of a college of nursing located in a minority-serving institution. Here, we emphasize the description of a range of activities aimed at meeting our diversity goals. Further, we highlight the actions initiated in response to emergent "extra-academic" student needs over the past year related to the COVID-19 pandemic and police brutality. The strategies described have implications for improving diversity, equity, and inclusion among higher education institutions in nursing.

Crime and deviance during the COVID-19 pandemic

The COVID-19 pandemic has fundamentally changed the world and inevitably influenced people's behaviors including the likelihood of crime and deviance. Emerging empirical evidence suggests a decline in certain crimes (e.g., theft, robbery, and assault) but also proliferation of different violent behaviors and cybercriminal activity during the pandemic. To explain those trends, we draw on existent theories and elaborate on how crime and violence have been affected by the changes in people's daily routines and accumulated stressful conditions. However, as recent crime trends appear to be largely inconsistent and vary across social groups and contexts, we argue that social scientists need to pay particular attention to the differential experiences related to crime and violence during this global crisis. Specifically, because of the disproportionate experience of violence by vulnerable groups including minorities and women as well as the unique cross-national variations in deviance, more nuanced approaches to understanding causes of crime are warranted. We also discuss the limitations of present research and provide recommendations for the development of comparative and multi-disciplinary studies on criminal and deviant behaviors that are influenced by human crisis situations.

Racism, COVID-19, and Health Inequity in the USA: a Call to Action

The current national COVID-19 mortality rate for Black Americans is 2.1 times higher than that of Whites. In this commentary, we provide historical context on how structural racism undergirds multi-sector policies which contribute to racial health inequities such as those highlighted by the COVID-19 pandemic. We offer a concrete, actionable path forward to address structural racism and advance health equity for Black Americans through anti-racism, implicit bias, and cultural competency training; capacity building; community-based participatory research (CBPR) initiatives; validated metrics for longitudinal monitoring of efforts to address health disparities and the evaluation of those interventions; and advocacy for and empowerment of vulnerable communities. This necessitates a multi-pronged, coordinated approach led by clinicians; public health professionals; researchers; social scientists; policy-makers at all governmental levels; and local community leaders and stakeholders across the education, legal, social service, and economic sectors to proactively and systematically advance health equity for Black Americans across the USA.

How Should Clinicians Determine a Traumatized Patient's Readiness to Return to Work?

A clinician's standard primary role is to treat and monitor their patients' health and to be their ally. Clinicians with obligations to patients and to organizations, however, must also assess patients for nontherapeutic purposes (eg, readiness to resume work). These 2 obligations can conflict, and, when they do, clinicians must balance their duties to patients and to society. We propose criteria clinicians should consider when determining a patient's readiness to return to work and offer recommendations for interpreting factors that influence this decision.

Pressure injuries and skin tone diversity in undergraduate nurse education: Qualitative perspectives from a mixed methods study

AIMS

To, firstly, explore student and academic nurse perceptions of classroom content about the assessment and identification of pressure injuries across skin tone diversity and, secondly, to describe the impact of classroom content on student nurse understanding of pressure injury in people with dark skin tones.

DESIGN

Qualitative case study employing focus groups and semi-structured interviews.

METHODS

Five higher education institutions in the United Kingdom were purposively chosen. At each of the five-case sites, one focus group with student nurses and one semi-structured interview with a nurse academic were conducted between May 2018 and April 2019. The participants' narratives were transcribed verbatim and analysed via thematic analysis.

RESULTS

Classroom learning was predominately framed through a white lens with white normativity being strongly reinforced through teaching and learning activities. This reinforcement of white normativity was evidenced through two main themes: (i) dominance of whiteness in the teaching and learning of pressure injuries in undergraduate nurse education and (ii) the impact and implications for student nurses of whiteness as the norm in pressure injury teaching.

CONCLUSION

Nurses responsible for the design and delivery of teaching and learning experiences for nursing students need to ensure meaningful teaching and learning experiences. This learning should assist future nurses to interrogate their complicity in a system of white dominance.

IMPACT

Nurse education delivered today influences and shapes nurses of the future. Nurses are the cornerstone of healthcare and play a significant role in the delivery of equitable healthcare. Nurse academics have a duty of care to inform and highlight health inequities in nursing and ultimately to enhance equity in care.

Building bridges and capacity for Black, Indigenous, and scholars of color in the era of COVID-19 and Black Lives Matter

Background

There is a critical need to increase diversity in the nursing workforce to better address racial health disparities.

Purpose

To provide academic institutions with practical recommendations to foster a collaborative environment and essential resources for and in support of Black, Indigenous, and People of Color (BIPOC) scholars.

Methods

We examine the experiences of three Black nurse scholars, at a research-intensive university in an urban area during the COVID-19 pandemic and civil unrest in the United States.

Findings

Findings suggest barriers exist, which negatively impact workplace climate, collaboration and mentoring for BIPOC nursing scholars. Guided by a Black feminist perspective and utilizing existing literature, we recommend strategies to enhance workplace climate, to develop culturally aware collaboration, and to center mentoring as the foundation for BIPOC nurse scholar success.

Discussion

This article acknowledges that a crucial step in addressing health disparities is successful support of and collaboration with BIPOC nurse scholars.

Ethics of research at the intersection of COVID-19 and black lives matter: a call to action

This paper describes how to ethically conduct research with Black populations at the intersection of COVID-19 and the Black Lives Matter movement. We highlight the issues of historical mistrust in the USA and how this may impact Black populations' participation in COVID-19 vaccination trials. We provide recommendations for researchers to ethically engage Black populations in research considering the current context. Our recommendations include understanding the impact of ongoing trauma, acknowledging historical context, ensuring diverse research teams and engaging in open and honest conversations with Black populations to better address their needs. The core of our recommendation is recognising the impact of trauma in our research and health care practices.