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Suglia SF, Hidalgo B, Baccarelli AA, Cardenas A, Damrauer S, Johnson A, Key K, Liang M, Magnani JW, Pate B, Sims M, Tajeu GS. Improving Cardiovascular Health Through the Consideration of Social Factors in Genetics and Genomics Research: A Scientific Statement From the American Heart Association. Circ Cardiovasc Qual Outcomes 2025; 18:e000138. [PMID: 40123498 DOI: 10.1161/hcq.0000000000000138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/25/2025]
Abstract
Cardiovascular health (CVH) is affected by genetic, social, and genomic factors across the life course, yet little research has focused on the interrelationships among them. An extensive body of work has documented the impact of social determinants of health at both the structural and individual levels on CVH, highlighting pathways in which racism, housing, violence, and neighborhood environments adversely affect CVH and contribute to disparities in cardiovascular disease. Genetic factors have also been identified as contributors to risk for cardiovascular disease. Emerging evidence suggests that social factors can interact with genetic susceptibility to affect disease risk. Increasingly, social factors have been shown to affect epigenetic markers such as DNA methylation, which can regulate gene and protein expression. This is a potential biological mechanism through which exposure to poor social determinants of health becomes physically embodied at the molecular level, potentially contributing to the development of suboptimal CVH and chronic disease, thus reinforcing and propagating health disparities. The objective of this statement is to highlight and summarize key literature that has examined the joint associations between social, genetic, and genomic factors and CVH and cardiovascular disease.
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Fuentes A, Espinoza UJ, Cobbs V. Follow the citations: Tracing pathways of "race as biology" assumptions in medical algorithms in eGFR and spirometry. Soc Sci Med 2024; 346:116737. [PMID: 38447335 DOI: 10.1016/j.socscimed.2024.116737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 03/08/2024]
Abstract
Despite overwhelming evidence to the contrary, the concept of 'race' as a biological unit continues to persist in various scientific disciplines, notably in the field of medicine. This paper explores the persistence of 'race as biology' in medical research via examining select citational practices that have perpetuated this problematic concept. Citations serve as a cornerstone in scientific literature, signifying reliability and expert affirmation. By analyzing citation threads and historical patterns, we aim to shed light on the creation and perpetuation of false scientific truths and their impact on medical research, training, and practice. We focus on two prominent examples, eGFR and Spirometry, and trace key articles' citational histories, highlighting the flawed evidence in support of racial corrections in medical assessments. The eGFR equation incorporates 'race' as a factor based on the erroneous belief that Black individuals have higher muscle mass than white individuals. Our analysis reveals that key cited sources for this belief lack robust and well-developed datasets. Similarly, Spirometry measurements incorporate racial correction factors, relying on questionable evidence dating back to the Civil War era. Citations serve as a cornerstone in scientific literature, signifying reliability and expert affirmation. They play a crucial role in shaping theoretical positions and validating data and assumed knowledge. Evaluating citation threads and key articles consistently referenced over time can reveal how falsehoods and erroneous assertions are constructed and maintained in scientific fields. This study underscores the need for critical examination of citational practices in medical research and urges a shift toward a more cautious approach when citing sources that support 'race as biology.' The paper calls for a reevaluation of pedagogical approaches and assigned readings in medical education to prioritize an anti-racist perspective in future research endeavors.
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Quinn EB, Ross JD, Boston PQ, Committee HS, Mulligan CJ, Gravlee CC. The social patterning of vicarious discrimination: Implications for health equity. Soc Sci Med 2023; 332:116104. [PMID: 37517313 DOI: 10.1016/j.socscimed.2023.116104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/26/2023] [Accepted: 07/18/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Most research on discrimination and health operationalizes discrimination as direct individual experiences. Here, we examine the social patterning of vicarious discrimination, an important but largely overlooked dimension of discrimination. METHODS Drawing on community-based participatory research with a multi-stage probability sample (n = 178) of African Americans in Tallahassee, Florida, we measured vicarious discrimination, or exposure to discrimination through one's family and friends. We used chi-square tests to examine gender differences in the social domains and relational sources of vicarious discrimination. Negative binomial regression models were fit to identify predictors of exposure to vicarious discrimination. RESULTS Vicarious discrimination is more prevalent than direct experiences of discrimination (73 versus 61%) and more than 20% of participants report vicarious discrimination in the absence of direct discrimination. For women, vicarious discrimination most often involved the workplace; for men, police. However, gender differences are smaller for vicarious versus direct discrimination. Close friends and children were top relational sources of vicarious discrimination for men and women, respectively. Middle-aged participants reported the most vicarious discrimination. CONCLUSIONS Overall, our data show that vicarious discrimination is more common than widely understood and associated with individual-level sociodemographic characteristics that index one's position in broader social systems. The prevalence of vicarious discrimination in the absence of direct discrimination suggests that standard approaches, which measure individual exposures in isolation, are subject to misclassification bias. Our results imply that existing research on discrimination and health, which already demonstrates substantial harm, underestimates African Americans' true exposures to salient aspects of discrimination.
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Affiliation(s)
- Edward B Quinn
- Department of Anthropology, University of Florida, Gainesville, FL 32611, USA; Genetics Institute, University of Florida, Gainesville, FL 32608, USA.
| | - Jessica D Ross
- Department of Biology, University of Florida, Gainesville, FL 32611, USA
| | - P Qasimah Boston
- Tallahassee Food Network, Institute of Public Health, Florida A&M University, Tallahassee, FL 32307, USA
| | | | - Connie J Mulligan
- Department of Anthropology, University of Florida, Gainesville, FL 32611, USA; Genetics Institute, University of Florida, Gainesville, FL 32608, USA
| | - Clarence C Gravlee
- Department of Anthropology, University of Florida, Gainesville, FL 32611, USA; Genetics Institute, University of Florida, Gainesville, FL 32608, USA
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Moody MD, Lewis JCJ. Lifetime vicarious experiences of major discrimination and depressive symptoms among middle-aged and older black adults. Aging Ment Health 2023; 27:1103-1110. [PMID: 36038955 PMCID: PMC9971339 DOI: 10.1080/13607863.2022.2117792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 08/07/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Racial disparities in later-life depression among Americans are well-documented. Perceived discrimination has been linked to depressive symptoms among aging Black adults, but little research has considered how vicarious exposure to discrimination shapes the mental health of middle-aged and older Black adults. METHODS A subsample of Black adults aged 50-69 years (N = 273) were drawn from the Nashville Stress and Health Study. Lifetime vicarious exposures to major discrimination were assessed. Additionally, multivariate linear regression was employed to examine the association between vicarious experiences of major discrimination and depressive symptoms. RESULTS Once the Black adults in the sample had reached ages 50 and older, the most common discriminatory events that they had vicariously experienced in their lifetime occurred as a result of their loved ones' unfair interactions with law enforcement and the job market, respectively. Furthermore, our findings revealed that vicarious experiences of major discrimination were associated with higher levels of depressive symptoms among middle-aged and older Black adults. CONCLUSION Vicarious, as well as personal, exposures to discrimination shape the mental health of Black Americans over the lifespan. The secondhand effects of discrimination must be considered for interventions aimed at reducing the mental health consequences of racism-related adversity as Black adults age.
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Affiliation(s)
- Myles D. Moody
- Department of Sociology, University of Alabama-Birmingham, Heritage Hall, Rm. 460, 1401 University Blvd., Birmingham, Alabama 35233
| | - Joshua C. J. Lewis
- Department of Sociology, University of Alabama-Birmingham, Heritage Hall, Rm. 460, 1401 University Blvd., Birmingham, Alabama 35233
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Moody MD, Browning WR, Hossain M, Clay OJ. Vicarious experiences of major discrimination, anxiety symptoms, and mental health care utilization among Black Adults. Soc Sci Med 2023; 316:114997. [PMID: 35534345 DOI: 10.1016/j.socscimed.2022.114997] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND The adverse mental health consequences of discrimination among Black adults, such as anxiety symptoms, are well documented. Prior research establishes anxiety as a risk factor for suboptimal health outcomes among Black adults. Most discrimination and mental health studies, however, have focused on the effects of personal experiences of discrimination. Moreover, of the studies that examine the mental health effects of vicarious exposure to discrimination, few investigate this relationship from a stress and coping perspective beyond the life stages of childhood and adolescence. Thus, the purpose of this study was to assess the effects of vicarious and personal experiences of discrimination on the subjective well-being of Black adults, while observing the potentially moderating effects of utilizing mental health care. METHODS A subsample of Black adults (N = 627) between the ages of 22-69 years old were drawn from the Nashville Stress and Health Study and analyzed to assess within-group variation. Multivariate linear regression was employed to examine the association between vicarious experiences of major discrimination and self-reported anxiety symptoms. Additionally, we evaluated the moderating effects of lifetime utilization of mental health services on the relationship between discrimination and symptoms of anxiety. RESULTS Findings revealed that vicarious experiences of major discrimination and personal experiences of everyday discrimination were both associated with higher levels of anxiety symptoms among the participants. Additionally, lifetime utilization of mental health care moderated the effects of vicarious and personal experiences of discrimination. CONCLUSIONS The secondhand consequences of discrimination must be considered while assessing the racism-related stress experience. Results from this investigation suggest that mental health treatment should be included in programs targeted to reduce the negative effects of discrimination among Black adults. Additionally, culturally-specific strategies should be considered for addressing racism-related adversity.
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Affiliation(s)
- Myles D Moody
- Department of Sociology, University of Alabama-Birmingham, Heritage Hall, Rm. 460, 1401 University Blvd, Birmingham, AL, 35233, USA.
| | - Wesley R Browning
- Department of Psychology, University of Alabama-Birmingham, Campbell Hall, Rm. 415, 1300 University Blvd, Birmingham, AL, 35233, USA
| | - Monir Hossain
- Department of Sociology, University of Alabama-Birmingham, Heritage Hall, Rm. 460, 1401 University Blvd, Birmingham, AL, 35233, USA
| | - Olivio J Clay
- Department of Psychology, University of Alabama-Birmingham, Campbell Hall, Rm. 415, 1300 University Blvd, Birmingham, AL, 35233, USA
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Hsiao CJ, Dumeny L, Bress AP, Johnson DA, Shimbo D, Cavallari LH, Mulligan CJ. Identification of a SGCD × Discrimination Interaction Effect on Systolic Blood Pressure in African American Adults in the Jackson Heart Study. Am J Hypertens 2022; 35:938-947. [PMID: 35999027 PMCID: PMC9629434 DOI: 10.1093/ajh/hpac098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/12/2022] [Accepted: 08/18/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND In the United States, hypertension disproportionately afflicts over half of African American adults, many of whom also experience racial discrimination. Understanding gene × discrimination effects may help explain racial disparities in hypertension. METHODS We tested for the main effects and interactive effects of 5 candidate single nucleotide polymorphisms (SNPs: rs2116737, rs11190458, rs2445762, rs2597955, and rs2416545) and experiences of discrimination on blood pressure (BP) in African Americans not taking antihypertensive medications in the Jackson Heart Study from Mississippi (n = 2,933). Multiple linear regression models assumed an additive genetic model and adjusted for ancestry, age, sex, body mass index, education, and relatedness. We additionally tested recessive and dominant genetic models. RESULTS Discrimination was significantly associated with higher diastolic BP (P = 0.003). In contrast, there were no main effects of any SNP on BP. When analyzing SNPs and discrimination together, SGCD (Sarcoglycan Delta; rs2116737) demonstrated a gene × environment interaction. Specifically, an SGCD × Discrimination interaction was associated with systolic BP (β =1.95, P = 0.00028) in a recessive model. Participants carrying a T allele, regardless of discrimination experiences, and participants with a GG genotype and high experiences of discrimination had higher systolic BP than participants with a GG genotype and low experiences of discrimination. This finding suggests the SGCD GG genotype may have a protective effect on systolic BP, but only in a setting of low discrimination. CONCLUSIONS The inclusion of culturally relevant stressors, like discrimination, may be important to understand the gene-environment interplay likely underlying complex diseases with racial health inequities.
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Affiliation(s)
- Chu J Hsiao
- Department of Anthropology, University of Florida, Gainesville, Florida, USA
- Genetics Institute, University of Florida, Gainesville, Florida, USA
| | - Leanne Dumeny
- Genetics Institute, University of Florida, Gainesville, Florida, USA
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, University of Florida, Gainesville, Florida, USA
| | - Adam P Bress
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Daichi Shimbo
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Larisa H Cavallari
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, University of Florida, Gainesville, Florida, USA
| | - Connie J Mulligan
- Department of Anthropology, University of Florida, Gainesville, Florida, USA
- Genetics Institute, University of Florida, Gainesville, Florida, USA
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Moody MD, Tobin CST, Erving CL. Vicarious Experiences of Major Discrimination and Psychological Distress among Black Men and Women. SOCIETY AND MENTAL HEALTH 2022; 12:175-194. [PMID: 36277676 PMCID: PMC9581462 DOI: 10.1177/21568693221116631] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Racism-related stress frameworks posit that the discriminatory experiences of one's loved ones may threaten one's well-being, but relatively few studies have examined how they may impact mental health beyond childhood and adolescence. Using data from the Nashville Stress and Health Study (N = 1,252), the present study assessed the prevalence of vicarious experiences of discrimination among subsamples of Black men (n = 297) and women (n = 330), examined the association between vicarious experiences of discrimination and psychological distress among Black men and women, and evaluated the impact of vicarious discrimination on psychological distress in the context of other stressors. Results suggest that Black women report more vicarious exposure to specific types of discrimination. Furthermore, vicariously experienced discrimination was associated with higher levels of psychological distress among Black women, but not among Black men. Our findings extend the literature on racism-related stress and offer new insights for interventions aimed at reducing racial disparities in mental health.
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Affiliation(s)
- Myles D. Moody
- The University of Alabama at Birmingham, Birmingham, AL, USA
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Scott J, Cousin L, Woo J, Gonzalez-Guarda R, Simmons LA. Equity in Genomics: A Brief Report on Cardiovascular Health Disparities in African American Adults. J Cardiovasc Nurs 2022; 37:58-63. [PMID: 32649378 PMCID: PMC7775264 DOI: 10.1097/jcn.0000000000000725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND African Americans are more likely to die from cardiovascular disease (CVD) than all other populations in the United States. Although technological advances have supported rapid growth in applying genetics/genomics to address CVD, most research has been conducted among European Americans. The lack of African American representation in genomic samples has limited progress in equitably applying precision medicine tools, which will widen CVD disparities if not remedied. PURPOSE This report summarizes the genetic/genomic advances that inform precision health and the implications for cardiovascular disparities in African American adults. We provide nurse scientists recommendations for becoming leaders in developing precision health tools that promote population health equity. CONCLUSIONS Genomics will continue to drive advances in CVD prevention and management, and equitable progress is imperative. Nursing should leverage the public's trust and its widespread presence in clinical and community settings to prevent the worsening of CVD disparities among African Americans.
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Biruk C. The Politics of Global Health. POLAR-POLITICAL AND LEGAL ANTHROPOLOGY REVIEW 2021. [DOI: 10.1111/plar.12431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Coughlin SS, Ayyala DN, Moore JX, Majeed BA, Vernon MM, Dergaga H, Luque JS. A Health Survey of African American Men Seen at an Academic Medical Center in the Southern United States. JOURNAL OF COMMUNITY MEDICINE (RENO, NEV.) 2021; 4:1036. [PMID: 34589710 PMCID: PMC8478342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND African Americans have poorer cardiovascular health and higher chronic disease mortality than non-Hispanic whites. The high burden of chronic diseases among African Americans is a primary cause of disparities in life expectancy between African Americans and whites. METHODS We conducted a cross-sectional study via a postal survey among a sample of 65 male, African American patients aged ≥ 40 years. The overall objective was to examine the frequency of high blood pressure, high cholesterol, diabetes, myocardial infarction, congestive heart failure, stroke, asthma, emphysema, and cancer among patients treated at Augusta University Health. RESULTS A high percentage of study participants (81.5 %) reported a history of high blood pressure; 50.8% had high cholesterol; 44.3% were overweight, 44.3% were obese, and 13.9% were current cigarette smokers. About 36.9% of the men had a reported history of diabetes; 10.8% of the men had a history of heart attack, 13.9% had a history of congestive heart failure, 9.2% had a history of stroke, and 15.4% had a history of prostate cancer. Men who reported a personal history of prostate cancer were significantly more likely to have a history of heart attack and stroke and to be overweight (p < 0.05 in each instance). DISCUSSION Additional studies are needed of cardiovascular risk factors and adverse cardiovascular events among African American men, and interventional research aimed at controlling hypertension. Of particular concern is prostate cancer, and whether patients with hypertension, hypercholesterolemia, and diabetes are receiving appropriate therapy to reduce their cardiovascular risk and prevent morbidity and mortality from adverse cardiovascular events.
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Affiliation(s)
- Steven S Coughlin
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA
- Institute of Public and Preventive Health, Augusta University, Augusta, GA
| | - Deepak Nag Ayyala
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA
| | - Justin Xavier Moore
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA
- Institute of Public and Preventive Health, Augusta University, Augusta, GA
| | - Ban A Majeed
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA
- Institute of Public and Preventive Health, Augusta University, Augusta, GA
| | - Marlo M Vernon
- Department of Medicine, Augusta University, Augusta, GA
- Georgia Cancer Center, Augusta University, Augusta, GA
| | - Hayat Dergaga
- Department of Psychology, Augusta University, Augusta, GA
| | - John S Luque
- Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, FL
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11
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Brown RL, Ciciurkaite G. The "Own" and the "Wise" Revisited: Physical Disability, Stigma, and Mental Health among Couples. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2021; 62:170-182. [PMID: 33719633 DOI: 10.1177/0022146521998343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Utilizing data from a cross-sectional community survey of 455 heterosexual couples in which at least one partner has a physical disability, we examine the associations between stigma and psychological distress for both partners. We also assess whether these associations are moderated by gender. Findings from an actor-partner interdependence model analysis reveal that personally experienced stigma and vicarious stigma experiences have additive effects on psychological distress, but only among women. We discuss how these findings extend a relational understanding of stigma and its effects and implications for research and practice.
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Scott J, Johnson R, Ibemere S. Addressing health inequities re-illuminated by the COVID-19 pandemic: How can nursing respond? Nurs Forum 2021; 56:217-221. [PMID: 32959411 PMCID: PMC7537307 DOI: 10.1111/nuf.12509] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/11/2020] [Accepted: 09/07/2020] [Indexed: 04/21/2023]
Abstract
The coronavirus disease 2019 mortality rate among Black adults in the U.S. is double that of other racial and ethnic groups. The current pandemic is re-illuminating health inequities that are pervasive in our society and reflected in our health system. This creative controversy describes critical conversations needed within nursing to acknowledge the contribution of structural racism to health equity. We recommend implementing structural competency into nursing education and prioritizing nursing research and policies focused on health equity and community-based interventions.
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Affiliation(s)
- Jewel Scott
- Cardiovascular Behavioral Medicine ResearchUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Ragan Johnson
- Healthcare in Adult PopulationsDuke University School of NursingDurhamNorth CarolinaUSA
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Cardel MI, Chi X, Min YI, Sims M, Musani SK, Dulin A, Gravlee CC, Smith SM, DeBoer MD, Gurka MJ. Experiences of Discrimination Are Associated With Worse Metabolic Syndrome Severity Among African Americans in the Jackson Heart Study. Ann Behav Med 2020; 55:266-279. [PMID: 32686818 DOI: 10.1093/abm/kaaa050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a risk factor for the development of cardiovascular disease and type 2 diabetes. Although the development of MetS is attributed to known lifestyle factors, perceived discrimination may also contribute to MetS development and severity. PURPOSE We examined the associations of perceived discrimination with MetS severity among African American adults at baseline and 8-year follow-up. METHODS Three thousand eight hundred and seventy participants (mean age 53.8 ± 13.0; 63.1% female) without diabetes and no missing MetS severity scores at baseline were included. Each self-reported measure of discrimination at baseline (everyday, lifetime, and burden of lifetime) was classified into tertiles (low, medium, high). After adjustment for demographics and MetS risk factors, associations of discrimination were examined with a sex- and race/ethnicity-specific MetS severity Z-score. We employed a mixed model approach that allowed for the assessment of an overall association between reported discrimination at baseline and MetS severity, and for the possible change over time. RESULTS Sex and age differences were observed in experiences with discrimination, such that men reported higher levels of all aspects of discrimination relative to women. Everyday discrimination decreased with age, whereas lifetime discrimination increased with age (p < .05). Independent of lifestyle and demographic factors, everyday and lifetime discrimination were significantly associated with MetS severity (p = .003 and p = .017, respectively) and the associations remained constant over the 8 years (i.e., no interaction with time). CONCLUSIONS Our results suggest that, in a large community-based sample of African Americans, discrimination is a salient psychosocial risk factor for severity of MetS.
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Affiliation(s)
- Michelle I Cardel
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Xiaofei Chi
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Yuan-I Min
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Solomon K Musani
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Akilah Dulin
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Clarence C Gravlee
- Department of Anthropology, University of Florida, Turlington Hall, Gainesville, FL, USA
| | - Steven M Smith
- Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, FL, USA
| | - Mark D DeBoer
- Department of Pediatrics, University of Virginia Health System, Charlottesville, VA, USA
| | - Matthew J Gurka
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
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14
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Hoke MK, Schell LM. Doing biocultural anthropology: Continuity and change. Am J Hum Biol 2020; 32:e23471. [PMID: 32681558 DOI: 10.1002/ajhb.23471] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 12/27/2022] Open
Abstract
Biocultural anthropology has long represented an important approach in the study of human biology. However, despite demonstrated utility, its somewhat amorphous identity leaves some scholars questioning just what it means to be biocultural. In this article, rather than providing proscriptive doctrine, we contribute to these conversations about the nature of biocultural anthropology by considering what biocultural research does. We begin with a consideration of some of the foundational themes of biocultural work including recognition of the dialectical nature of sociocultural and biological forces, interest in inequality, and incorporation of both evolutionary and political economic perspectives. To emphasize the consistency of biocultural work over time, we also trace these themes from originating work to their appearance in current research. We then identify some of the key actions of the biocultural approach, noting that biocultural work can execute any number though rarely all of these actions simultaneously. We then offer brief introductions to the articles that make up this special issue, highlighting the ways in which each piece undertakes key biocultural actions. Following these introductions, we provide a discussion of some of the types of biocultural work that are not present in this special issue, recognizing the breadth of biocultural research across multiple subfields of anthropology. Finally, we point to some potentially fruitful directions for future biocultural research. In the end, we conclude that while biocultural anthropology may not have a cohesive or set agenda, it does have a clear and recognizable form of content and methodology illuminated by its actions.
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Affiliation(s)
- Morgan K Hoke
- Department of Anthropology & Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lawrence M Schell
- Department of Anthropology, Department of Epidemiology and Statistics, & the Center for the Elimination of Minority Health Disparities, University at Albany, Albany, New York, USA
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15
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Parsons S. Addressing Racial Biases in Medicine: A Review of the Literature, Critique, and Recommendations. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2020; 50:371-386. [DOI: 10.1177/0020731420940961] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This article reviews the literature on racism in medicine in the United States and reflects on the persistent barriers to diminishing racial biases in the U.S. health care system. Espoused strategies for decreasing racial disparities and reducing racial biases among physicians are critiqued, and recommendations are offered. Those recommendations include increasing the number of minority students in medical school, using Xavier University in New Orleans, Louisiana, as the model for medical school preparation; revamping the teaching of cultural competence; ensuring the quality of non-clinical staff; and reducing the risk of burnout among medical providers.
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Affiliation(s)
- Sharon Parsons
- School of Doctoral Studies, Grand Canyon University, West Palm Beach, Florida, USA
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16
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Rej PH, Gravlee CC, Mulligan CJ. Shortened telomere length is associated with unfair treatment attributed to race in African Americans living in Tallahassee, Florida. Am J Hum Biol 2019; 32:e23375. [PMID: 31867825 DOI: 10.1002/ajhb.23375] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 12/03/2019] [Accepted: 12/04/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Experiences of interpersonal discrimination are pervasive stressors in the lives of African Americans. Increased discrimination stress may cause premature aging. Telomere length (TL) is a plastic genetic trait that is an emerging indicator of cellular health and aging. Short TL is a risk factor for the earlier onset of disease. TL shortens with age, a process that may be accelerated by psychosocial stress. Our study explores the relationship between TL and experiences of discrimination in the form of self-reported unfair treatment (UT). METHODS Using a qPCR-based method, we measured TL in DNA from saliva samples provided by 135 African American adults from Tallahassee, FL. We developed discrimination measures using a modified survey that explores nine social domains of self-reported unfair treatment experienced both directly and indirectly. We used multiple regression to examine associations between UT and TL. RESULTS We found that racial discrimination in the form of self-reported unfair treatment attributed to race (UT-Race-Self) is inversely associated with TL. CONCLUSIONS The significant association between increased UT-Race-Self and shorter telomeres supports the hypothesis that psychosocial stress stemming from racial discrimination may affect TL. The potential impact of discrimination on TL may contribute to premature biological aging and racial health inequalities seen in African Americans.
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Affiliation(s)
- Peter H Rej
- Department of Anthropology, University of Washington, Seattle, Washington.,Department of Anthropology, University of Florida, Gainesville, Florida.,Genetics Institute, University of Florida, Gainesville, Florida
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- Health Equity Alliance of Tallahassee Steering Committee, Tallahassee, Florida: James Bellamy, Qasimah Boston, Edward Holifield, Miaisha Mitchell, and Cynthia Seaborn
| | - Clarence C Gravlee
- Department of Anthropology, University of Florida, Gainesville, Florida.,Genetics Institute, University of Florida, Gainesville, Florida
| | - Connie J Mulligan
- Department of Anthropology, University of Florida, Gainesville, Florida.,Genetics Institute, University of Florida, Gainesville, Florida
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Delfín DA, DeAguero JL, McKown EN. The Extracellular Matrix Protein ABI3BP in Cardiovascular Health and Disease. Front Cardiovasc Med 2019; 6:23. [PMID: 30923710 PMCID: PMC6426741 DOI: 10.3389/fcvm.2019.00023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 02/20/2019] [Indexed: 01/31/2023] Open
Abstract
ABI3BP is a relatively newly identified protein whose general biological functions are not yet fully defined. It is implicated in promoting cellular senescence and cell-extracellular matrix interactions, both of which are of vital importance in the cardiovascular system. ABI3BP has been shown in multiple studies to be expressed in the heart and vasculature, and to have a role in normal cardiovascular function and disease. However, its precise role in the cardiovascular system is not known. Because ABI3BP is present in the cardiovascular system and is altered in cardiovascular disease states, further investigation into ABI3BP's biological and biochemical importance in cardiovascular health and disease is warranted.
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Affiliation(s)
- Dawn A. Delfín
- Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico, Albuquerque, NM, United States
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18
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Zilbermint M, Hannah-Shmouni F, Stratakis CA. Genetics of Hypertension in African Americans and Others of African Descent. Int J Mol Sci 2019; 20:ijms20051081. [PMID: 30832344 PMCID: PMC6429313 DOI: 10.3390/ijms20051081] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 02/19/2019] [Accepted: 02/21/2019] [Indexed: 02/07/2023] Open
Abstract
Hypertension is the leading cause of cardiovascular disease in the United States, affecting up to one-third of adults. When compared to other ethnic or racial groups in the United States, African Americans and other people of African descent show a higher incidence of hypertension and its related comorbidities; however, the genetics of hypertension in these populations has not been studied adequately. Several genes have been identified to play a role in the genetics of hypertension. They include genes regulating the renin-aldosterone-angiotensin system (RAAS), such as Sodium Channel Epithelial 1 Beta Subunit (SCNN1B), Armadillo Repeat Containing 5 (ARMC5), G Protein-Coupled Receptor Kinase 4 (GRK4), and Calcium Voltage-Gated Channel Subunit Alpha1 D (CACNA1D). In this review, we focus on recent genetic findings available in the public domain for potential differences between African Americans and other populations. We also cover some recent and relevant discoveries in the field of low-renin hypertension from our laboratory at the National Institutes of Health. Understanding the different genetics of hypertension among various groups is essential for effective precision-guided medical therapy of high blood pressure.
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Affiliation(s)
- Mihail Zilbermint
- Section on Endocrinology and Genetics, The Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, BG 31 RM 2A46, 31 Center Dr, Bethesda, MD 20892, USA.
- Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
- Johns Hopkins Community Physicians at Suburban Hospital, Bethesda, MD 20814, USA.
- Johns Hopkins University Carey Business School, Baltimore, MD 21202, USA.
| | - Fady Hannah-Shmouni
- Section on Endocrinology and Genetics, The Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, BG 31 RM 2A46, 31 Center Dr, Bethesda, MD 20892, USA.
| | - Constantine A Stratakis
- Section on Endocrinology and Genetics, The Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, BG 31 RM 2A46, 31 Center Dr, Bethesda, MD 20892, USA.
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19
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Kissel M, Kim NC. The emergence of human warfare: Current perspectives. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 168 Suppl 67:141-163. [PMID: 30575025 DOI: 10.1002/ajpa.23751] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/08/2018] [Accepted: 10/21/2018] [Indexed: 11/11/2022]
Abstract
The origins of warfare have long been of interest for researchers across disciplines. Did our earliest ancestors engage in forms of organized violence that are appropriately viewed as approximations, forms of, or analogs for more recent forms of warfare? Assessed in this article are contrasting views that see warfare as being either a product of more recent human societies or a phenomenon with a much deeper chronology. The article provides an overview of current debates, theories, and methodological approaches, citing literature and data from archaeological, ethnographic, genetic, primatological, and paleoanthropological studies. Synthetic anthropological treatments are needed, especially in efforts to inform debates among nonacademic audiences, because the discipline's approaches are ideally suited to study the origins of warfare. Emphasized is the need to consider possible forms of violence and intergroup aggression within Pleistocene contexts, despite the methodological challenges associated with fragmentary, equivocal, or scarce data. Finally, the review concludes with an argument about the implications of the currently available data. We propose that socially cooperative violence, or "emergent warfare," became possible with the onset of symbolic thought and complex cognition. Viewing emergent warfare as a byproduct of the human capacity for symbolic thought explains how the same capacities for communication and sociality allowed for elaborate peacemaking, conflict resolution, and avoidance. Cultural institutions around war and peace are both made possible by these changes. Accordingly, we suggest that studies on warfare's origins should be tied to research on the advent of cooperation, sociality, and communication.
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Affiliation(s)
- Marc Kissel
- Department of Anthropology, Appalachian State University College of Arts and Sciences, Boone, North Carolina
| | - Nam C Kim
- Department of Anthropology, University of Wisconsin-Madison, Madison, Wisconsin
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20
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Dengah HF, Snodgrass JG, Else RJ, Polzer ER. The social networks and distinctive experiences of intensively involved online gamers: A novel mixed methods approach. COMPUTERS IN HUMAN BEHAVIOR 2018. [DOI: 10.1016/j.chb.2017.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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21
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Koss CS, Baker TA. A Question of Trust: Does Mistrust or Perceived Discrimination Account for Race Disparities in Advance Directive Completion? Innov Aging 2017; 1:igx017. [PMID: 30480111 PMCID: PMC6218018 DOI: 10.1093/geroni/igx017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Indexed: 11/15/2022] Open
Abstract
Background and Objectives Advance directive completion is associated with end-of-life quality indicators such as dying at home and receiving hospice care. Black older adults are less likely to complete advance directives than their white counterparts. The underlying reasons for these race disparities are not well understood. Research Design and Methods In two related studies, data from the Health and Retirement Study were used to examine whether mistrust in health care providers and/or perceived discrimination accounted for lower rates of advance directive completion by black older adults in the United States. Odds of advance directive completion were modeled using logistic regression and multiple measures of trust in health care providers and both medical and nonmedical perceived discriminatory treatment. Results In Study 1 (n = 699), controlling for medical mistrust did not reduce the gap between black and white participants’ odds of possessing advance directives. In Study 2 (n = 2,736), higher percentages of black participants reported experiencing medical and nonmedical discriminatory treatment. However, none of the measures of discrimination accounted for black participants’ lower odds of possessing advance directives. Discussion and Implications These results call into question the common assertion that mistrust in medical providers or the health care system contributes to lower rates of advance care planning by black older adults. Future research should examine the potential relationships between advance directive completion and other dimensions of discrimination.
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Affiliation(s)
- Catheryn S Koss
- Gerontology Program, California State University, Sacramento
| | - Tamara A Baker
- Department of Psychology, University of Kansas, Lawrence
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