1
|
Shiba K, Inoue K. Harnessing causal forests for epidemiologic research: key considerations. Am J Epidemiol 2024; 193:813-818. [PMID: 38319713 DOI: 10.1093/aje/kwae003] [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: 04/10/2023] [Revised: 12/12/2023] [Accepted: 02/02/2024] [Indexed: 02/07/2024] Open
Abstract
Assessing heterogeneous treatment effects (HTEs) is an essential task in epidemiology. The recent integration of machine learning into causal inference has provided a new, flexible tool for evaluating complex HTEs: causal forest. In a recent paper, Jawadekar et al (Am J Epidemiol. 2023;192(7):1155-1165) introduced this innovative approach and offered practical guidelines for applied users. Building on their work, this commentary provides additional insights and guidance to promote the understanding and application of causal forest in epidemiologic research. We start with conceptual clarifications, differentiating between honesty and cross-fitting, and exploring the interpretation of estimated conditional average treatment effects. We then delve into practical considerations not addressed by Jawadekar et al, including motivations for estimating HTEs, calibration approaches, and ways to leverage causal forest output with examples from simulated data. We conclude by outlining challenges to consider for future advancements and applications of causal forest in epidemiologic research.
Collapse
Affiliation(s)
- Koichiro Shiba
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA 02118, United States
| | - Kosuke Inoue
- Department of Social Epidemiology, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
- Hakubi Center for Advanced Research, Kyoto University, Kyoto 606-8501, Japan
| |
Collapse
|
2
|
Barr E, Belaunzarán-Zamudio PF, Clayton JA, Gerald MS, Greenwood GL, Highsmith K, Jaworski BK, Karraker A, Kobrin S, Lachowicz-Scroggins M, Maric-Bilkan C, Popkin R, Roodzant E, Sankar CA, Senn TE, Siskind R, Temkin SM. Workshop summary: National Institutes of Health (NIH) 2022 scientific workshop on gender and health. Soc Sci Med 2024; 351 Suppl 1:116435. [PMID: 38825375 DOI: 10.1016/j.socscimed.2023.116435] [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: 05/12/2023] [Revised: 11/06/2023] [Accepted: 11/13/2023] [Indexed: 06/04/2024]
Abstract
In this manuscript, we summarize the goals, content, and impact of the Gender and Health: Impacts of Structural Sexism, Gender Norms, Relational Power Dynamics, and Gender Inequities workshop held by the National Institutes of Health (NIH) Office of Research on Women's Health (ORWH) in collaboration with 10 NIH Institutes, Centers, and Offices. Specifically, we outline the key points emerging from the workshop presentations, which are the focus of the collection of articles in this supplement. The overarching goals of the workshop were to convene NIH staff, the external scientific community, and the public to discuss methods, measurement, modifiable factors, interventions, and best practices in health research on gender as a social and cultural variable and to identify opportunities to advance research and foster collaborations on these key topics. Themes emerging from the workshop include the need for intersectional measures in research on gender and health, the role of multilevel interventions and analyses, and the importance of considering gender as a social and structural determinant of health. Careful, nuanced, and rigorous integration of gender in health research can contribute to knowledge about and interventions to change the social and structural forces that lead to disparate health outcomes and perpetuate inequities.
Collapse
Affiliation(s)
- Elizabeth Barr
- National Institutes of Health, Office of Research on Women's Health, Bethesda, MD, USA.
| | - Pablo F Belaunzarán-Zamudio
- National Institutes of Health, National Institute of Allergy and Infectious Diseases [Contractor], Bethesda, MD, USA
| | - Janine Austin Clayton
- National Institutes of Health, Office of Research on Women's Health, Bethesda, MD, USA
| | - Melissa S Gerald
- National Institutes of Health, National Institute on Aging, Bethesda, MD, USA
| | - Gregory L Greenwood
- National Institutes of Health, National Institute of Mental Health, Bethesda, MD, USA
| | - Keisher Highsmith
- United States Public Health Service, National Institutes of Health, National Institute on Drug Abuse, Bethesda, MD, USA
| | - Beth K Jaworski
- National Institutes of Health, Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | - Amelia Karraker
- National Institutes of Health, National Institute on Aging, Bethesda, MD, USA
| | - Sarah Kobrin
- National Institutes of Health, National Cancer Institute, Bethesda, MD, USA
| | | | - Christine Maric-Bilkan
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Ronna Popkin
- National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Erik Roodzant
- Booz Allen Hamilton, McLean, VA, USA; National Institutes of Health, Office of Research on Women's Health [Contractor], Bethesda, MD, USA
| | - Cheryse A Sankar
- National Institutes of Health, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Theresa E Senn
- National Institutes of Health, National Institute of Mental Health, Bethesda, MD, USA
| | - Rona Siskind
- National Institutes of Health, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - Sarah M Temkin
- National Institutes of Health, Office of Research on Women's Health, Bethesda, MD, USA
| |
Collapse
|
3
|
Raj A, Barr E, Griffith DM. Gender, power, and health: Modifiable factors and opportunities for intervention. Soc Sci Med 2024; 351 Suppl 1:116959. [PMID: 38825370 DOI: 10.1016/j.socscimed.2024.116959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 05/08/2024] [Indexed: 06/04/2024]
Affiliation(s)
- Anita Raj
- Newcomb Institute, Tulane University, New Orleans, LA, USA.
| | - Elizabeth Barr
- National Institutes of Health, Office of Research on Women's Health, Bethesda, MD, USA.
| | - Derek M Griffith
- Georgetown University School of Health Department of Health Management and Policy, Washington, DC, USA.
| |
Collapse
|
4
|
Hollands GJ, South E, Shemilt I, Oliver S, Thomas J, Sowden AJ. Methods used to conceptualize dimensions of health equity impacts of public health interventions in systematic reviews. J Clin Epidemiol 2024; 169:111312. [PMID: 38432524 DOI: 10.1016/j.jclinepi.2024.111312] [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: 10/18/2023] [Revised: 02/21/2024] [Accepted: 02/25/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVES Our aims were to, first, identify and summarize the use of methods, frameworks, and tools as a conceptual basis for investigating dimensions of equity impacts of public health interventions in systematic reviews including an equity focus. These include PROGRESS-Plus, which identifies key sociodemographic characteristics that determine health outcomes. Second, we aimed to document challenges and opportunities encountered in the application of such methods, as reported in systematic reviews. STUDY DESIGN AND SETTING We conducted a methodological study, comprising an overview of systematic reviews with a focus on, or that aimed to assess, the equity impacts of public health interventions. We used electronic searches of the Cochrane Database of Systematic Reviews, the Database of Promoting Health Effectiveness Reviews (DoPHER), and the Finding Accessible Inequalities Research in Public Health Database, supplemented with automated searches of the OpenAlex dataset. An active learning algorithm was used to prioritize title-abstract records for manual screening against eligibility criteria. We extracted and analyzed a core dataset from a purposively selected sample of reviews, to summarize key characteristics and approaches to conceptualizing investigations of equity. RESULTS We assessed 322 full-text reports for eligibility, from which we included 120 reports of systematic reviews. PROGRESS-Plus was the only formalized framework used to conceptualize dimensions of equity impacts. Most reviews were able to apply their intended methods to at least some degree. Where intended methods were unable to be applied fully, this was usually because primary research studies did not report the necessary information. A general rationale for focusing on equity impacts was often included, but few reviews explicitly justified their focus on (or exclusion of) specific dimensions. In addition to practical challenges such as data not being available, authors highlighted significant measurement and conceptual issues with applying these methods which may impair the ability to investigate and interpret differential impacts within and between studies. These issues included investigating constructs that lack standardized operationalization and measurement, and the complex nature of differential impacts, with dimensions that may interact with one another, as well as with particular temporal, personal, social or geographic contexts. CONCLUSION PROGRESS-Plus is the predominant framework used in systematic reviews to conceptualize differential impacts of public health interventions by dimensions of equity. It appears sufficiently broad to encompass dimensions of equity examined in most investigations of this kind. However, PROGRESS-Plus does not necessarily ensure or guide critical thinking about more complex pathways, including interactions between dimensions of equity, and with wider contextual factors, and important practical, measurement and conceptual challenges remain. The findings from investigations of equity impacts in systematic reviews could be made more useful through more explicitly rationalized and considered approaches to the design, conduct and reporting of both primary research and the reviews themselves.
Collapse
Affiliation(s)
- Gareth J Hollands
- EPPI Centre, UCL Social Research Institute, University College London, London, UK.
| | - Emily South
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Ian Shemilt
- EPPI Centre, UCL Social Research Institute, University College London, London, UK
| | - Sandy Oliver
- EPPI Centre, UCL Social Research Institute, University College London, London, UK
| | - James Thomas
- EPPI Centre, UCL Social Research Institute, University College London, London, UK
| | - Amanda J Sowden
- Centre for Reviews and Dissemination, University of York, York, UK
| |
Collapse
|
5
|
Ailey SH, Molly B, Tichá R, Abery B, Khuu BK, Angel L. Health professionals' education related to people with intellectual and developmental disabilities: A scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13208. [PMID: 38382496 DOI: 10.1111/jar.13208] [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: 08/09/2023] [Revised: 01/04/2024] [Accepted: 01/16/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND People with intellectual and developmental disabilities are among the most underserved in an inequitable healthcare system. METHODS Using Arksey and O'Malley's methodology and a social determinants of health framework, we conducted a scoping review of literature on the state of practice in education of healthcare professionals in the health and healthcare needs of this population. RESULTS Searches found 4948 articles, with 182 included in the final review. Themes identified included gaps of not being informed by workforce needs, continued use of the medical model of care, not addressing intersectionality with racial/ethnic and other discriminations, and lack of involvement of the population in developing/evaluating programs and promising trends of development of competency-based interprofessional programs with experiential learning. CONCLUSION We provide recommendations for best practices in a concerted effort to educate a healthcare workforce equipped with the knowledge and skills to address the health needs of this population.
Collapse
Affiliation(s)
- Sarah H Ailey
- Department of Community, Systems, and Mental Health Nursing, Rush University College of Nursing, Chicago, Illinois, USA
| | - Bathje Molly
- Occupational Therapy Program, DePaul University, College of Science and Health, Chicago, Illinois, USA
| | - Renáta Tichá
- Institute on Community Integration, University of Minnesota, Minneapolis, Minnesota, USA
| | - Brian Abery
- Institute on Community Integration, University of Minnesota, Minneapolis, Minnesota, USA
| | - Belle K Khuu
- Institute on Community Integration, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lisa Angel
- Department of Community, Systems, and Mental Health Nursing, Rush University College of Nursing, Chicago, Illinois, USA
| |
Collapse
|
6
|
Vandenbroucke JP, Sørensen HT, Rehkopf DH, Gradus JL, Mackenbach JP, Glymour MM, Galea S, Henderson VW. Report on the Joint Workshop on the Relations between Health Inequalities, Ageing and Multimorbidity, Iceland, May 3-4, 2023. Clin Epidemiol 2024; 16:9-22. [PMID: 38259327 PMCID: PMC10801289 DOI: 10.2147/clep.s443152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 12/13/2023] [Indexed: 01/24/2024] Open
Abstract
This paper is a summary of key presentations from a workshop in Iceland on May 3-4, 2023 arranged by Aarhus University and with participation of the below-mentioned scientists. Below you will find the key messages from the presentations made by: Professor Jan Vandenbroucke, Department of Clinical Epidemiology, Aarhus University, Emeritus Professor, Leiden University; Honorary Professor, London School of Hygiene & Tropical Medicine, UKProfessor, Chair Henrik Toft Sørensen, Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, DenmarkProfessor David H. Rehkopf, Director, the Stanford Center for Population Health Sciences, Stanford University, CA., USProfessor Jaimie Gradus, Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USProfessor Johan Mackenbach, Emeritus Professor, Department of Public Health, Erasmus University Rotterdam, HollandProfessor, Chair M Maria Glymour, Department of Epidemiology, Boston University School of Public Health, Boston University, Boston, Massachusetts, USProfessor, Dean Sandro Galea, School of Public Health, Boston University, Boston, Massachusetts, USProfessor Victor W. Henderson, Departments of Epidemiology & Population Health and of Neurology & Neurological Sciences, Stanford University, Stanford, CA, US; Department of Clinical Epidemiology, Aarhus University, Aarhus, DK.
Collapse
Affiliation(s)
- Jan P Vandenbroucke
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
- Leiden University, Leiden, Netherlands
- London School of Hygiene & Tropical Medicine, London, UK
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
- Aarhus University Hospital, Aarhus, Denmark
| | - David H Rehkopf
- Stanford Center for Population Health Sciences, Stanford University, CA, USA
| | - Jaimie L Gradus
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA, USA
| | - Johan P Mackenbach
- Department of Public Health, Erasmus University Rotterdam, Rotterdam, Holland
| | - M Maria Glymour
- Department of Epidemiology, Boston University School of Public Health, Boston University, Boston, MA, USA
| | - Sandro Galea
- School of Public Health, Boston University, Boston, MA, USA
| | - Victor W Henderson
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
- Departments of Epidemiology & Population Health and of Neurology & Neurological Sciences, Stanford University, Stanford, CA, USA
| |
Collapse
|
7
|
Barr E, Popkin R, Roodzant E, Jaworski B, Temkin SM. Gender as a social and structural variable: research perspectives from the National Institutes of Health (NIH). Transl Behav Med 2024; 14:13-22. [PMID: 37074158 DOI: 10.1093/tbm/ibad014] [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] [Indexed: 04/20/2023] Open
Abstract
Gender is a social and structural variable that encompasses multiple domains, each of which influences health: gender identity and expression, gender roles and norms, gendered power relations, and gender equality and equity. As such, gender has far-reaching impacts on health. Additional research is needed to continue delineating and untangling the effects of gender from the effects of sex and other biological variables. The National Institutes of Health (NIH) vision for women's health is a world in which the influence of sex and/or gender are integrated into the health research enterprise. However, much of the NIH-supported research on gender and health has, to date, been limited to a small number of conditions (e.g., HIV, mental health, pregnancy) and locations (e.g., sub-Saharan Africa; India). Opportunities exist to support transdisciplinary knowledge transfer and interdisciplinary knowledge building by advancing health-related social science research that incorporates best practices from disciplines that have well-established methods, theories, and frameworks for examining the health impacts of gender and other social, cultural, and structural variables.
Collapse
Affiliation(s)
- Elizabeth Barr
- Office of Research on Women's Health, National Institutes of Health, Bethesda, MD, USA
| | - Ronna Popkin
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Population Dynamics Branch, National Institutes of Health, Bethesda, MD, USA
| | - Erik Roodzant
- Office of Research on Women's Health, National Institutes of Health, Bethesda, MD, USA
- Booz Allen Hamilton, McLean, VA, USA
| | - Beth Jaworski
- Office of Behavioral and Social Sciences Research, National Institutes of Health, USA
- Booz Allen Hamilton, McLean, VA, USA
| | - Sarah M Temkin
- Office of Research on Women's Health, National Institutes of Health, USA
| |
Collapse
|
8
|
Marshall DC, Carney LM, Hsieh K, Dickstein DR, Downes M, Chaudhari A, McVorran S, Montgomery GH, Schnur JB. Effects of trauma history on cancer-related screening, diagnosis, and treatment. Lancet Oncol 2023; 24:e426-e437. [PMID: 37922933 PMCID: PMC10754479 DOI: 10.1016/s1470-2045(23)00438-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/30/2023] [Accepted: 08/22/2023] [Indexed: 11/07/2023]
Abstract
Trauma has substantial effects on human health and is recognised as a potential barrier to seeking or receiving cancer care. The evidence that exists regarding the effect of trauma on seeking cancer screening, diagnosis, and treatment and the gaps therein can define this emerging research area and guide the development of interventions intended to improve the cancer care continuum for trauma survivors. This Review summarises current literature on the effects of trauma history on screening, diagnosis, and treatment among adult patients at risk for or diagnosed with cancer. We discuss a complex relationship between trauma history and seeking cancer-related services, the nature of which is influenced by the necessity of care, perceived or measured health status, and potential triggers associated with the similarity of cancer care to the original trauma. Collaborative scientific investigations by multidisciplinary teams are needed to generate further clinical evidence and develop mitigation strategies to provide trauma-informed cancer care for this patient population.
Collapse
Affiliation(s)
- Deborah C Marshall
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Lauren M Carney
- Center for Behavioral Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kristin Hsieh
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Daniel R Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Shauna McVorran
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA; Dartmouth Cancer Center, Hanover, NH, USA
| | - Guy H Montgomery
- Center for Behavioral Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julie B Schnur
- Center for Behavioral Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
9
|
Rana K, Poudel P, Chimoriya R. Qualitative Methodology in Translational Health Research: Current Practices and Future Directions. Healthcare (Basel) 2023; 11:2665. [PMID: 37830701 PMCID: PMC10572630 DOI: 10.3390/healthcare11192665] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023] Open
Abstract
Translational health research is an interdisciplinary field aimed at bridging the gap between basic science studies, preventative studies, and clinical practice to improve health-related outcomes. Qualitative research methods provide a unique perspective on the emotional, social, cultural, and contextual factors that influence health and healthcare and thus are recognized as valuable tools for translational health research. This approach can be embedded within a mixed method design which complements the quantitative findings. This methodological paper aims to provide a comprehensive review of the fundamental concepts and methodologies used in qualitative research, emphasizing their utilization and significance in translational health research. Several approaches to qualitative research methodology are discussed in this review, including ethnography, phenomenology, grounded theory, case study, and action research. Theoretical frameworks such as the social-ecological model, intersectionality, and participatory action research are also examined to provide a structure for understanding and interpreting complex health issues. This methodological paper also reviews commonly used sampling techniques such as purposive, snowball, convenience, theoretical, and maximum variation sampling, along with data collection methods such as in-depth interviews, focus groups, observation, document analysis, and participatory methods. Moreover, data analysis techniques such as thematic analysis, grounded theory, content analysis, narrative analysis, and reflexive analysis, are discussed in the context of translational health. Overall, this review highlights the challenges and opportunities of using qualitative methods in current practice, while also discussing future directions and providing valuable guidance and insights to researchers interested in conducting qualitative research in translational health.
Collapse
Affiliation(s)
- Kritika Rana
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia
- Philanthropy Nepal (Paropakari Nepal) Research Collaboration, Auburn, NSW 2144, Australia;
| | - Prakash Poudel
- Office of Research and Education, Canberra Health Services, ACT Government, Garran, ACT 2606, Australia;
| | - Ritesh Chimoriya
- Philanthropy Nepal (Paropakari Nepal) Research Collaboration, Auburn, NSW 2144, Australia;
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
- Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Concord, NSW 2139, Australia
| |
Collapse
|
10
|
Wandji SR, Abshire DA, Davis JE, Tavakoli AS, Pope R. Substance use disorders among African-American men in the rural south: A scoping review. J Ethn Subst Abuse 2023:1-23. [PMID: 37655703 DOI: 10.1080/15332640.2023.2248029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
African American (AA) men in the rural South may be at high risk for experiencing adverse health outcomes from substance use (SU). We conducted a scoping review to explore the research on SU among rural AA men in the rural South of the United States (US). Ten articles addressed the following thematic areas pertaining to SU: factors associated with SU (n = 6), associations between substance use and health outcomes (n = 2), and the influence of impulsivity on SU (n = 2). Additional research on SU among AA men in the rural South is needed, particularly pertaining to treatment-related considerations.
Collapse
Affiliation(s)
| | | | - Jean E Davis
- University of South Carolina, Columbia, South Carolina
| | | | - Robert Pope
- Dominican University of California, San Rafael, California
| |
Collapse
|
11
|
Dorri AA, Loza O, Bond MA, Ciszek E, Elias-Curry Y, Aguilar S, Fliedner P, Norwood A, Stone AL, Cooper MB, Schick V, Wilkerson JM, Wermuth PP, Yockey RA, Schnarrs P. Understanding the Experiences of Latinx LGBTQ Texans at the Beginning of the COVID-19 Pandemic. JOURNAL OF HOMOSEXUALITY 2023:1-25. [PMID: 37552613 DOI: 10.1080/00918369.2023.2241597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
Marginalized communities have been disproportionately affected by COVID-19, including both racial/ethnic minority and sexual minority populations. To date, there has been little research examining the impact of the COVID-19 pandemic at the intersections of marginalized identities. Furthermore, available national data on COVID-19 outcomes may obscure our understanding of region-specific outcomes, particularly in the U.S. South. Using an intersectional approach, we explore differences in worries over COVID-19, preventative behaviors, and COVID-19 outcomes in the early months of the pandemic in a diverse sample of LGBTQ people (N = 1076) living in Texas. Our findings indicated that LGBTQ Latinx people in Texas reported more COVID-19 related worries and adverse outcomes than non-Latinx LGBTQ people. These findings are in line with previous research that found that the increased risk to Latinx and LGBTQ populations in public health crises is often overlooked and can be attributed to many factors such as socioeconomic status, occupational propensity, disparities in physical health, and barriers to healthcare access. Furthermore, our findings suggest the necessity of utilizing an intersectional approach when examining the disproportionate burden marginalized communities face in public health crises.
Collapse
Affiliation(s)
- Armin A Dorri
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Oralia Loza
- Department of Public Health Sciences, University of Texas at El Paso, El Paso, Texas, USA
| | - Mark A Bond
- New Meridian Corporation, Austin, Texas, USA
| | - Erica Ciszek
- Stan Richards School of Advertising & Public Relations, University of Texas at Austin, Texas, USA
| | - Yona Elias-Curry
- Department of Population Health, University of Texas at Austin, Austin, Texas, USA
| | - Sheridan Aguilar
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, USA
| | - Paul Fliedner
- Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Aliza Norwood
- Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Amy L Stone
- Department of Sociology & Anthropology, Trinity University, San Antonio, Texas, USA
| | - M Brett Cooper
- Department of Pediatrics, University of Texas Southwestern, Dallas, Texas, USA
| | - Vanessa Schick
- School of Public Health, University of Texas Health at Houston, Houston, Texas, USA
| | - J Michael Wilkerson
- School of Public Health, University of Texas Health at Houston, Houston, Texas, USA
| | - Paige P Wermuth
- School of Public Health, University of Texas Health at Houston, Houston, Texas, USA
| | - Robert A Yockey
- School of Public Health, The University of North Texas Health Science Center at Fort Worth, Fort Worth, Texas, USA
| | - Phillip Schnarrs
- Department of Population Health, University of Texas at Austin, Austin, Texas, USA
| |
Collapse
|
12
|
Chandler CJ, Liu Q, Brown AL, Matthews DD, Tsai AC, Bukowski LA, Eaton LA, Stall RD, Friedman MR. Associations of past-year stigma and psychosocial syndemic conditions: Considerations for intersectional stigma measures among Black Sexual Minority Men. STIGMA AND HEALTH 2023; 8:372-380. [PMID: 37789829 PMCID: PMC10545331 DOI: 10.1037/sah0000435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
This secondary analysis of a mixed serostatus sample of Black sexual minority men (BSMM) used conditional inference tree methods to explore associations of past-year experienced stigma and psychosocial syndemic conditions. Experienced stigmas were attributed to race, sexuality, socioeconomic status, HIV status or some "other" reason. Psychosocial syndemic conditions studied included physical assault, intimate partner violence, polysubstance use, and depression symptomology. Data are from Promoting Our Worth, Equality and Resilience (POWER), a serial, cross-sectional study conducted between 2014-2017 (N=4430). Experiences of multiple stigmas were reported by n=938 (22.1%) of BSMM. Conditional inference tree results revealed that HIV-related stigma and its intersection with "other" stigma showed the greatest variance in psychosocial condition prevalence. Our findings suggest that when developing intercategorical intersectional analyses with BSMM, there are important stigmas for BSMM beyond those attributed to race, sexuality, and SES, particularly intersecting with HIV-related stigma. Conditional inference tree analysis shows promise in quantitative explorations of intersectional stigma with BSMM, but will benefit from the inclusion of additional forms of stigma, which should be considered by the field moving forward.
Collapse
Affiliation(s)
- Cristian J. Chandler
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University Medical Center, 2525 West End Avenue, Nashville, TN, 37203, USA
- Center for LGBT Health Research, 130 DeSoto Street, Pittsburgh, PA, 15260, USA
| | - Qimin Liu
- Psychological Sciences, Vanderbilt University 2301 Vanderbilt Place · Nashville, TN 37240-7817, USA
| | - Andre L. Brown
- Behavioral and Community Health Science, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA, 15260, USA
- Center for LGBT Health Research, 130 DeSoto Street, Pittsburgh, PA, 15260, USA
| | - Derrick D. Matthews
- Health Behavior, Gillings School of Public Health, University of North Carolina, 361 Rosenau Hall, Chapel Hill, NC 27599, USA
| | - Alexander C. Tsai
- Center for Global Health and Mongan Institute, Massachusetts General Hospital 100 Cambridge St Suite 1600, Boston, MA 02114, USA
| | - Leigh A. Bukowski
- Critical Care Medicine, University of Pittsburgh, 3550 Terrace Street Scaife Hall, Suite 600 Pittsburgh, PA 15213, USA
| | - Lisa A. Eaton
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, 2006 Hillside Rd, Storrs, CT 06269-1248, USA
| | - Ronald D. Stall
- Center for LGBT Health Research, 130 DeSoto Street, Pittsburgh, PA, 15260, USA
| | - M. Reuel Friedman
- Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA, 15260, USA
- Center for LGBT Health Research, 130 DeSoto Street, Pittsburgh, PA, 15260, USA
| |
Collapse
|
13
|
Hall JE, Boulware LE. Combating Racism Through Research, Training, Practice, and Public Health Policies. Prev Chronic Dis 2023; 20:E54. [PMID: 37384830 DOI: 10.5888/pcd20.230167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023] Open
Affiliation(s)
- Jeffrey E Hall
- Office of Health Equity, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS TW-3 Atlanta, Georgia 30341
| | - L Ebony Boulware
- Wake Forest University School of Medicine, Winston-Salem, North Carolina
- Advocate Health, Winston-Salem, North Carolina
| |
Collapse
|
14
|
Moore S, Fox R, Nic Giolla Easpaig B, Deravin L. Family and domestic violence policy discourses and narratives: implications for Emergency Departments and communities in rural Australia. Int J Equity Health 2023; 22:65. [PMID: 37038155 PMCID: PMC10084686 DOI: 10.1186/s12939-023-01873-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/22/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Australian data has indicated that the frequency and severity of family and domestic violence (FDV) tends to increase with remoteness. Rural communities rely on Emergency Departments (ED) within public hospitals for general health and safety needs. Public health departments within Australia are strongly influenced by Government policies which can define 'health problems' and limit institutional responses to patients presenting with FDV. The current study therefore aimed to critically examine FDV Australian Government policies to explore how policy meanings could potentially impact on ED staff and individuals within rural communities. METHODS Foucauldian Discourse Analysis and Policy Narrative Analysis were used to examine 9 policy documents which represented national, state/territory and clinical practice levels. Publication dates ranged from 2006 to 2020. RESULTS A total of 8 discourses were identified, with each one providing a unique construction of the target problem and determining the potential agency of health professionals and subjects of FDV. Discourses combined to produce an overall narrative within each policy document. Narrative constructions of the target problem were compared which produced three narrative themes: 1) Deficit Subject Narratives; 2) Object Oriented Narratives; and 3) Societal Narratives. CONCLUSION The results reflected a transition in the meaning of FDV within Australian society and over the past decade, with policies trending away from Deficit Subject Narratives and towards Object Oriented or Societal Narratives. Institutional systems, sociohistorical context and broader societal movements may have shaped this transition by stagnating policy meanings or introducing new insights that expanded the possibilities of understanding and action. Narratives produced assumptions which significantly altered the relevance and agency of individuals and groups when applied to a rural ED setting. As FDV was moved out of the clinical space and into the public domain, the agency of health professionals was reduced, while the values and strengths of FDV subjects and rural communities were potentially recognised. Later policies provided contextual specificity and meaning fluidity that could benefit diverse groups within rural areas; however, the expectation for ED staff to learn from their communities and challenge institutionalised approaches to FDV requires careful consideration in relation to rural hospital systems and resources.
Collapse
Affiliation(s)
- Sheree Moore
- School of Psychology, Charles Sturt University, Wagga Wagga, NSW, Australia.
| | - Rachael Fox
- School of Psychology, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Bróna Nic Giolla Easpaig
- College of Nursing and Midwifery, Charles Darwin University, Casuarina Campus, Darwin, NT, Australia
| | - Linda Deravin
- School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University, Panorama Avenue, Bathurst, NSW, Australia
| |
Collapse
|
15
|
Udemgba C, Sarkaria SK, Gleeson P, Bryant-Stephens T, Ogbogu PU, Khoury P, Apter AJ. New considerations of health disparities within allergy and immunology. J Allergy Clin Immunol 2023; 151:314-323. [PMID: 36503854 PMCID: PMC9905264 DOI: 10.1016/j.jaci.2022.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 12/13/2022]
Abstract
The pandemic, political upheavals, and social justice efforts in our society have resulted in attention to persistent health disparities and the urgent need to address them. Using a scoping review, we describe published updates to address disparities and targets for interventions to improve gaps in care within allergy and immunology. These disparities-related studies provide a broad view of our current understanding of how social determinants of health threaten patient outcomes and our ability to advance health equity efforts in our field. We outline next steps to improve access to care and advance health equity for patients with allergic/immunologic diseases through actions taken at the individual, community, and policy levels, which could be applied outside of our field. Key among these are efforts to increase the diversity among our trainees, providers, and scientific teams and enhancing efforts to participate in advocacy work and public health interventions. Addressing health disparities requires advancing our understanding of the interplay between social and structural barriers to care and enacting the needed interventions in various key areas to effect change.
Collapse
Affiliation(s)
- Chioma Udemgba
- National Institute of Allergic and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Sandeep K Sarkaria
- Section of Allergy and Immunology, Department of Pulmonary & Critical Care, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Patrick Gleeson
- Section of Allergy & Immunology, Division of Pulmonary, Allergy, & Critical Care Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa
| | - Tyra Bryant-Stephens
- Department of Pediatrics, Division of General Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa
| | - Princess U Ogbogu
- Division of Pediatric Allergy, Immunology, and Rheumatology, University Hospitals Rainbow Babies and Children's Hospital, Cleveland, Ohio; Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Paneez Khoury
- National Institute of Allergic and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Andrea J Apter
- Section of Allergy & Immunology, Division of Pulmonary, Allergy, & Critical Care Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa.
| |
Collapse
|
16
|
Reavis KM, Bisgaard N, Canlon B, Dubno JR, Frisina RD, Hertzano R, Humes LE, Mick P, Phillips NA, Pichora-Fuller MK, Shuster B, Singh G. Sex-Linked Biology and Gender-Related Research Is Essential to Advancing Hearing Health. Ear Hear 2023; 44:10-27. [PMID: 36384870 PMCID: PMC10234332 DOI: 10.1097/aud.0000000000001291] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There is robust evidence that sex (biological) and gender (behavioral/social) differences influence hearing loss risk and outcomes. These differences are noted for animals and humans-in the occurrence of hearing loss, hearing loss progression, and response to interventions. Nevertheless, many studies have not reported or disaggregated data by sex or gender. This article describes the influence of sex-linked biology (specifically sex-linked hormones) and gender on hearing and hearing interventions, including the role of sex-linked biology and gender in modifying the association between risk factors and hearing loss, and the effects of hearing loss on quality of life and functioning. Most prevalence studies indicate that hearing loss begins earlier and is more common and severe among men than women. Intrinsic sex-linked biological differences in the auditory system may account, in part, for the predominance of hearing loss in males. Sex- and gender-related differences in the effects of noise exposure or cardiovascular disease on the auditory system may help explain some of these differences in the prevalence of hearing loss. Further still, differences in hearing aid use and uptake, and the effects of hearing loss on health may also vary by sex and gender. Recognizing that sex-linked biology and gender are key determinants of hearing health, the present review concludes by emphasizing the importance of a well-developed research platform that proactively measures and assesses sex- and gender-related differences in hearing, including in understudied populations. Such research focus is necessary to advance the field of hearing science and benefit all members of society.
Collapse
Affiliation(s)
- Kelly M Reavis
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon, USA.,OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Barbara Canlon
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Judy R Dubno
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Robert D Frisina
- Department of Medical Engineering and Communication Sciences & Disorders, University of South Florida, Tampa, Florida, USA
| | - Ronna Hertzano
- Department of Otorhinolaryngology Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Institute for Genome Science, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Larry E Humes
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, Indiana, USA
| | - Paul Mick
- Department of Surgery, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Natalie A Phillips
- Department of Psychology, Concordia University, Montréal, Québec, Canada
| | | | - Benjamin Shuster
- Department of Otorhinolaryngology Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | | |
Collapse
|
17
|
Nguse S. Intersectionality in South African health care – what is to be done? SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2022. [DOI: 10.1177/00812463221141528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The World Health Organization established a 2005 commission that sought to investigate the Social Determinants of Health and develop mitigating strategies and policies. This marked a shift from the individualized understanding of health and focused on systemic and socioeconomic factors that determine access to health care services and the quality of the available services. This is primarily important in low- and middle-income countries like South Africa, where poverty, unemployment, inequality, and other historical factors play a significant role in health care. Furthermore, the lingering impact of the apartheid system continues to define the social engineering of the South African society, and the availability of resources between the rich and the poor, and between different racial groups, with the Black majority receiving subpar services compared to the White minority. The post-1994 dispensation, which is characterized by corruption, mismanagement of funds, continued health service deficits, and other factors exacerbate the inadequate services that poor Black people receive. Therefore, this article proposes the application of the intersectional theoretical framework in understanding and addressing public health challenges. According to Crenshaw, the theoretical framework may be defined as the prism through which to understand the constellation of factors that affect one's identity in relation to systems of oppression, discrimination, and marginalization.
Collapse
Affiliation(s)
- Siphelele Nguse
- College of Humanities, University of KwaZulu-Natal, South Africa
| |
Collapse
|
18
|
Kelly C, Dansereau L, Sebring J, Aubrecht K, FitzGerald M, Lee Y, Williams A, Hamilton-Hinch B. Intersectionality, health equity, and EDI: What's the difference for health researchers? Int J Equity Health 2022; 21:182. [PMID: 36536361 PMCID: PMC9764702 DOI: 10.1186/s12939-022-01795-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/21/2022] [Indexed: 12/24/2022] Open
Abstract
Many countries adopted comprehensive national initiatives to promote equity in higher education with the goal of transforming the culture of research. Major health research funders are supporting this work through calls for projects that focus on equity, resulting in a proliferation of theoretical frameworks including "intersectionality," "health equity," and variations of equity, diversity and inclusion, or EDI. This commentary is geared at individual principal investigators and health research teams who are developing research proposals and want to consider equity issues in their research, perhaps for the first time. We present histories and definitions of three commonly used frameworks: intersectionality, health equity, and EDI. In the context of health research, intersectionality is a methodology (a combination of epistemology and techniques) that can identify the relationships among individual identities and systems of oppression; however, it should also be used internally by research teams to reflect on the production of knowledge. Health equity is a societal goal that operationalizes the social determinants of health to document and address health disparities at the population level. EDI initiatives measure and track progress within organizations or teams and are best suited to inform the infrastructure and human resourcing "behind the scenes" of a project. We encourage researchers to consider these definitions and strive to tangibly move health research towards equity both in the topics we study and in the ways we do research.
Collapse
Affiliation(s)
- Christine Kelly
- grid.21613.370000 0004 1936 9609Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba Canada
| | - Lisette Dansereau
- grid.21613.370000 0004 1936 9609Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba Canada
| | - Jennifer Sebring
- grid.21613.370000 0004 1936 9609Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba Canada
| | - Katie Aubrecht
- grid.264060.60000 0004 1936 7363Department of Sociology, St. Francis Xavier University, Antigonish, Nova Scotia Canada
| | - Maggie FitzGerald
- grid.25152.310000 0001 2154 235XDepartment of Political Studies, University of Saskatchewan, Saskatoon, Saskatchewan Canada
| | - Yeonjung Lee
- grid.22072.350000 0004 1936 7697Faculty of Social Work, University of Calgary, Calgary, Alberta Canada ,grid.254224.70000 0001 0789 9563Chung-Ang University, Seoul, South Korea
| | - Allison Williams
- grid.25073.330000 0004 1936 8227School of Earth, Environment & Society, McMaster University, Hamilton, Ontario Canada
| | - Barbara Hamilton-Hinch
- grid.55602.340000 0004 1936 8200School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia Canada
| |
Collapse
|
19
|
Mishkin GE, Denicoff AM, Best AF, Little RF. Update on Enrollment of Older Adults Onto National Cancer Institute National Clinical Trials Network Trials. J Natl Cancer Inst Monogr 2022; 2022:111-116. [PMID: 36519819 PMCID: PMC9949562 DOI: 10.1093/jncimonographs/lgac017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/05/2022] [Accepted: 07/27/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Older adults are a large and growing proportion of cancer cases in the United States, but concerns persist about whether older adults are adequately represented in the cancer clinical trials that test new options for treatment and cancer care. METHODS This paper describes adult patient enrollments by age group to the National Cancer Institute's National Clinical Trials Network (NCTN) from 2016 to 2021, compares patient enrollment by age with the estimated incident cancer population across cancer types, and explores possible associations between patient age and patient race, ethnicity, and sex. RESULTS This analysis found that patients aged 18 to 69 years were overrepresented in NCTN trials, whereas patients aged 70 years and older were underrepresented compared with the estimated incident cancer population. Underrepresentation of older patients was seen across cancer types. Older patients who enrolled to NCTN trials were more likely to be non-Hispanic White than the estimated incident cancer population. CONCLUSIONS Compared with earlier analyses, NCTN trials are enrolling greater proportions of older adults, primarily driven by higher enrollment among patients aged 65 to 74 years. There is still significant room for improvement, however, especially among patients aged 75 years and older. Additionally, patient demographics should not be viewed in isolation: older Hispanic patients, for instance, were particularly underrepresented among patients enrolled to NCTN trials. The intersection between trial enrollment and age, race, and ethnicity warrants further study so that more targeted enrollment enhancement efforts can be developed that enhance trial diversity across demographic groups.
Collapse
Affiliation(s)
- Grace E Mishkin
- Correspondence to: Grace E. Mishkin, PhD, MPH, Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, 9609 Medical Center Dr, MSC 9739, Rockville, MD 20850, USA (e-mail: )
| | - Andrea M Denicoff
- Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Rockville, MD, USA
| | - Ana F Best
- Biometric Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Rockville, MD, USA
| | - Richard F Little
- Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Rockville, MD, USA
| |
Collapse
|
20
|
Leybas Nuño V, Mantina NM, Dawodu O, Dykinga M, Carr DL, Pogreba-Brown K, Cordova-Marks F, Jehn M, Peace-Tuskey K, Barraza L, Garcia-Filion P. Consequences of COVID-19 on adolescents in Arizona: A longitudinal study protocol. Front Public Health 2022; 10:945089. [PMID: 36589965 PMCID: PMC9797691 DOI: 10.3389/fpubh.2022.945089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/16/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction The long-term impact of COVID-19 is unknown. We developed a 5-year prospective cohort study designed to generate actionable community-informed research about the consequences of COVID-19 on adolescents ages 12-17 years in Arizona. Methods The study has two primary outcomes: 1) acute and long-term outcomes of COVID-19 illness and 2) symptoms of depression and anxiety. Data is collected using an online survey with plans to integrate qualitative data collection methods. The survey is administered at baseline, 4, and 8 months in year one, and annually in years two through five. This study is informed by Intersectionality Theory, which considers the diverse identities adolescents have that are self and socially defined and the influence they have collectively and simultaneously. To this end, a sample of variables collected is race/ethnicity, language usage, generational status, co-occurring health conditions, and gender. Additional measures capture experiences in social contexts such as home (parent employment, food, and housing security), school (remote learning, type of school), and society (racism). Results Findings are not presented because the manuscript is a protocol designed to describe the procedure instead of report results. Discussion The unique contributions of the study is its focus on COVID-19 the illness and COVID-19 the socially experienced pandemic and the impact of both on adolescents.
Collapse
Affiliation(s)
- Velia Leybas Nuño
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health (MEZCOPH), University of Arizona, Tucson, AZ, United States,*Correspondence: Velia Leybas Nuño
| | - Namoonga M. Mantina
- Department of Health Promotion Sciences, MEZCOPH, University of Arizona, Tucson, AZ, United States
| | - Oriyomi Dawodu
- Department of Health Promotion Sciences, MEZCOPH, University of Arizona, Tucson, AZ, United States
| | - Maureen Dykinga
- Department of Health Promotion Sciences, MEZCOPH, University of Arizona, Tucson, AZ, United States
| | - Dametreea L. Carr
- Department of Epidemiology and Biostatistics, MEZCOPH, University of Arizona, Tucson, AZ, United States
| | - Kristen Pogreba-Brown
- Department of Epidemiology and Biostatistics, MEZCOPH, University of Arizona, Tucson, AZ, United States
| | - Felina Cordova-Marks
- Department of Health Promotion Sciences, MEZCOPH, University of Arizona, Tucson, AZ, United States
| | - Megan Jehn
- School of Human Evolution and Social Change, Arizona States University, Tempe, AZ, United States
| | - Kimberly Peace-Tuskey
- Department of Health Promotion Sciences, MEZCOPH, University of Arizona, Tucson, AZ, United States
| | - Leila Barraza
- Department of Community, Environment and Policy, MEZCOPH, University of Arizona, Tucson, AZ, United States
| | | |
Collapse
|
21
|
Thayer Z, Uwizeye G, McKerracher L. Toolkit article: Approaches to measuring social inequities in health in human biology research. Am J Hum Biol 2022; 34:e23804. [PMID: 36173013 DOI: 10.1002/ajhb.23804] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 08/24/2022] [Accepted: 09/02/2022] [Indexed: 01/25/2023] Open
Abstract
Across populations, human morbidity and mortality risks generally follow clear gradients, with socially-disadvantaged individuals and groups tending to have higher morbidity and mortality at all life stages relative to those more socially advantaged. Anthropologists specialize in understanding the proximate and ultimate factors that shape variation in human biological functioning and health and are therefore well-situated to explore the relationships between social position and health in diverse ecological and cultural contexts. While human biologists have developed sophisticated methods for assessing health using minimally-invasive methods, at a disciplinary level, we have room for conceptual and methodological improvement in how we frame, measure, and analyze the social inequities that might shape health inequities. This toolkit paper elaborates on some steps human biologists should take to enhance the quality of our research on health inequities. Specifically, we address: (1) how to frame unequal health outcomes (i.e., inequalities vs. disparities vs. inequities) and the importance of identifying our conceptual models of how these inequities emerge; (2) how to measure various axes of social inequities across diverse cultural contexts, and (3) approaches to community collaboration and dissemination. We end by discussing (4) future directions in human biology research of health inequities, including understanding the ultimate causes of sensitivity to social inequities and transitioning from research to action.
Collapse
Affiliation(s)
- Zaneta Thayer
- Department of Anthropology, Dartmouth College, Hanover, New Hampshire, USA
| | - Glorieuse Uwizeye
- Arthur Labatt School of Nursing, University of Western Ontario, London, Ontario, Canada
| | | |
Collapse
|
22
|
Kranz AM, Estrada-Darley I. Racial/Ethnic Differences in Receipt of Dental Cleanings During Pregnancy. Womens Health Issues 2022; 32:615-622. [PMID: 35918241 PMCID: PMC9722532 DOI: 10.1016/j.whi.2022.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION We aimed to examine racial/ethnic differences in receipt of dental cleanings during pregnancy, overall and by health insurance type, using 2016-2018 Pregnancy Risk Assessment Monitoring System survey data from 39 states and New York City. METHODS We used a weighted linear probability model to estimate receipt of a dental cleaning during pregnancy. Key explanatory variables included race/ethnicity (Hispanic, White, Black, Asian and Pacific Islander (API), and other racial groups) and health insurance type (Medicaid, private, and other). RESULTS Among a weighted sample of 5,301,753 individuals, 45.9% received a dental cleaning during pregnancy. Regression-adjusted predicted rates of dental cleanings were significantly higher among White than non-White individuals, with the lowest rates observed among Black (43.2%; 95% confidence interval [CI], 40.6%-45.9%) and API individuals (30.6%; 95% CI, 28.5%-32.7%). When comparing rates by health insurance type, adjusted rates were highest among privately insured White individuals (57.4%; 95% CI, 56.1%-58.7%) and lowest among Medicaid-enrolled API individuals (25.4%; 95% CI, 21.5%-29.2%). CONCLUSIONS Fewer than one-half of pregnant individuals received dental cleanings, with the lowest rates observed for non-White individuals and Medicaid-enrolled individuals. Efforts are needed to increase dental visits among publicly insured, Black, Hispanic, and API pregnant individuals.
Collapse
|
23
|
Bennouna C, Gillespie A, Stark L, Seff I. Norms, Repertoires, & Intersections: Towards an integrated theory of culture for health research and practice. Soc Sci Med 2022; 311:115351. [PMID: 36108563 DOI: 10.1016/j.socscimed.2022.115351] [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: 03/07/2022] [Revised: 06/01/2022] [Accepted: 09/01/2022] [Indexed: 10/14/2022]
Abstract
Public health scholars and practitioners have increasingly distanced themselves from the term "culture," which has been used to essentialize and blame marginalized "others." However, leading health theories inevitably entail the study of culture; omitting the term may sever vital connections to useful social theory. Instead, we propose the Intersectional Theory of Cultural Repertoires in Health (RiH), integrating social norms and intersectionality with repertoire theory, which has been highly influential in cultural sociology. We outline an approach to investigating relationships between cultural resources and health behaviors and illustrate the theory's application with two qualitative case studies. The cases demonstrate how RiH theory can elucidate the roles of cultural resources in influencing health outcomes, such as gender-equitable behavior in Nigeria and coping strategies in Haiti. Building on conventional normative explanations of health, we theorize how schemas, narratives, boundaries, and other cultural resources shape behavior and demonstrate how norms constrain the use of repertoires. We detail how this theory can deepen our understanding of health phenomena and identify future research priorities.
Collapse
Affiliation(s)
| | | | - Lindsay Stark
- Brown School at Washington University in St. Louis, USA
| | - Ilana Seff
- Brown School at Washington University in St. Louis, USA.
| |
Collapse
|
24
|
Chandler CJ, Adams BJ, Eaton LA, Meunier É, Andrade E, Bukowski LA, Stall RD, Friedman MR. Intersectional Experienced Stigma and Psychosocial Syndemic Conditions in a Sample of Black Men Who Have Sex with Men Engaged in Sex Work (BMSM-SW) from Six US Cities. JOURNAL OF SEX RESEARCH 2022; 59:920-930. [PMID: 35580257 PMCID: PMC9835797 DOI: 10.1080/00224499.2022.2072799] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Black men who have sex with men (BMSM) in the United States experience a disproportionate burden of violence, substance use, physical and mental health conditions relative to other racial groups. BMSM who engage in sex work (BMSM-SW) experience a high burden of psychosocial conditions, sexually transmitted infections, including HIV, and intersectional stigma. This analysis characterizes remuneration and client typologies for BMSM-SW, documents intersectional stigma experienced by BMSM-SW relative to other BMSM, and explores the impact of experienced intersectional stigma on the relationship between sex work engagement and psychosocial syndemic conditions (violence, polydrug use, and depression symptoms). Results show that a majority of BMSM-SW in the sample had female clients and that sex workers were more likely than other BMSM to hire another sex worker. BMSM-SW were more likely than other BMSM to report stigma attributed to race; sexuality; HIV status; socioeconomic status; and "other" attributes, and were more likely to report experiencing stigma across all settings assessed (schools; healthcare; employment; housing; police/courts; and in public/community). Intersectional stigma mediated the relationship between sex work engagement and psychosocial syndemic conditions, accounting for 49% (95% CI: 47.6-50.0%) of the relationship. Interventions for BMSM-SW should include resilience-building components to counteract the effects of intersectional stigma.
Collapse
Affiliation(s)
- Cristian J. Chandler
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University Medical Center, 2525 West End Avenue, Nashville, TN, USA 37203
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, USA 15261
| | - Brian J. Adams
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, USA 15261
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, USA 15261
| | - Lisa A. Eaton
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT 06269
| | - Étienne Meunier
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032
| | - Elí Andrade
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, USA 15261
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, USA 15261
| | - Leigh A. Bukowski
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, USA 15261
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, USA 15261
| | - Ronald D. Stall
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, USA 15261
| | - M. Reuel Friedman
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, USA 15261
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, USA 15261
| |
Collapse
|
25
|
Roberts LF, Lounsbury O, Awuzudike V, Jennings N, Lawrance EL. Healthy Environments: Understanding Perceptions of Underrepresented Communities in the United Kingdom. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9643. [PMID: 35955008 PMCID: PMC9367862 DOI: 10.3390/ijerph19159643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 07/27/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
A healthy environment has been defined by global health organisations as one that is safe, supportive of healthy lifestyles, and free of hazards. Such definitions disregard the complexity of what it means for an environment to be perceived as 'healthy'-such as the mental, not just physical, health effects on citizens. This study aimed to understand the attributes that underrepresented groups of the United Kingdom (UK) public assign to healthy environments-an important step for directing public policy and actions to create environments that are inclusive of all citizens. This co-created study involved 95 participants from underrepresented communities in 10 separate focus groups, each facilitated by a community member. Thematic analyses highlighted five key attributes of a healthy environment: sounds and sights, accessibility, safety, familiarity and mental health and wellbeing. This study draws a picture of key attributes underrepresented groups of the UK public assign to healthy environments that is richer than that drawn by existing definitions. These findings illustrate the importance of hearing diverse voices when directing research, policy, and actions that attempt to develop healthy environments for all.
Collapse
Affiliation(s)
- Lily F. Roberts
- Institute of Global Health Innovation, Imperial College London, London SW7 2AZ, UK
- School of Public Health, Imperial College London, London SW7 2AZ, UK
| | - Olivia Lounsbury
- Institute of Global Health Innovation, Imperial College London, London SW7 2AZ, UK
| | | | - Neil Jennings
- Grantham Institute, Imperial College London, London SW7 2AZ, UK
| | - Emma L. Lawrance
- Institute of Global Health Innovation, Imperial College London, London SW7 2AZ, UK
- Grantham Institute, Imperial College London, London SW7 2AZ, UK
- Mental Health Innovations, London EC4Y 8JJ, UK
| |
Collapse
|
26
|
Gillespie A, Seff I, Caron C, Maglietti MM, Erskine D, Poulton C, Stark L. "The pandemic made us stop and think about who we are and what we want:" Using intersectionality to understand migrant and refugee women's experiences of gender-based violence during COVID-19. BMC Public Health 2022; 22:1469. [PMID: 35915413 PMCID: PMC9342942 DOI: 10.1186/s12889-022-13866-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Migrant and refugee women have faced a myriad of challenges during COVID-19, which are often exacerbated by the interaction between this population's diverse identities and established systems in the local context. This qualitative study uses the lens of intersectionality to understand migrant and refugee women's experiences of gender-based violence and access to and quality of support services in Italy during the first year of COVID-19. METHODS Data were gathered from 51 key informant interviews and eight focus group discussions of 31 participants. Key informants included service providers across sectors, including gender-based violence and anti-violence organizations, government and law, health, psychology, social work, and anti-trafficking administration. Focus group participants were migrant and refugee women aged 18-65 from the following countries of origin: Bangladesh, Cameroon, Colombia, El Salvador, Gambia, Ghana, Honduras, Libya, Nigeria, Pakistan, Peru, Senegal, and Syria. Interviews were audio-recorded, transcribed and coded using a collaborative process with partners from UNICEF. Transcripts were then evaluated for arising themes using three methods of intersectionality analysis. RESULTS Data analysis revealed how COVID-19 converged with sexism, racism, and xenophobia in Italy, leading to increased public and domestic violence against refugee and migrant women. Another prominent theme was the exacerbated vulnerability for refugee and migrant women in precarious socioeconomic situations, which prompted many service providers to recognize and address gaps in service offerings and coordination around basic needs. However, due to resource constraints and bias, providers did not systematically incorporate inclusive language and cultural mediation into remote and online services, creating a heightened barrier to access for non-Italian women despite their complex needs. As such, refugee and migrant women highlighted community-based solidarity and support as protective factors during lockdown periods. CONCLUSION Findings emphasize how overlapping dominant sociocultural and socioeconomic systems impacted refugee and migrant women's experiences of violence during COVID-19 in Italy, and how some support services were unprepared to respond to the complex needs of diverse, newcomer populations. We discuss how policymakers and practitioners might consider intersectionality in their preparedness and response planning for gender-based violence services during health emergencies moving forward.
Collapse
Affiliation(s)
- Alli Gillespie
- Brown School at Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
| | - Ilana Seff
- Brown School at Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
| | | | | | | | | | - Lindsay Stark
- Brown School at Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA.
| |
Collapse
|
27
|
Crawford TN, Silverstein S, Spaulding T, Cheribin D, Murray T, Rivera J, Wilcher K. Exploring the Impact of Experiences with Everyday and Major Discrimination and HIV-Related Stigma on Engagement in HIV Care Among Older African Americans Living with HIV. J Racial Ethn Health Disparities 2022:10.1007/s40615-022-01373-9. [PMID: 35876984 DOI: 10.1007/s40615-022-01373-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVES The purpose of this pilot study was to explore the effect of HIV-related stigma and everyday major experiences of discrimination on medication and clinic visit adherence among older African Americans living with HIV in Ohio. METHODS We collected data from 53 individuals who were living with HIV in Ohio, ≥ 50 years of age, and who identified as Black or African American. We conducted logistic regression models to examine the impact of HIV-related stigma and experiences of discrimination on medication and visit adherence. Each model controlled for age, time since diagnosis, and sexual orientation. RESULTS The average age was 53.6 ± 2.1 years and 94.3% were men. Almost half (49.1%) of the participants reported poor medication adherence and almost a third (31.4%) reported poor visit adherence. HIV-related stigma (adjusted odds ratio (aOR) = 1.39; 95% confidence interval (CI) = 1.02-1.89) and major experiences of discrimination (aOR = 1.70; 95% CI = 1.11-2.60) were associated with a greater odds of poor medication adherence. Additionally, major experiences of discrimination were associated with a threefold increase in the odds of poor visit adherence (aOR = 3.24; 95% CI = 1.38-7.64). CONCLUSIONS HIV-related stigma and major experiences of discrimination impede optimal medication and HIV clinic visit adherence for older African Americans living with HIV. To reduce the impact of stigma and discrimination on HIV care engagement, our first step must be in understanding how intersecting forms of stigma and discrimination impact engagement among older African Americans living with HIV.
Collapse
Affiliation(s)
- Timothy N Crawford
- Wright State University Boonshoft School of Medicine, Dayton, OH, USA. .,Wright State University Boonshoft School of Medicine, Population and Public Health Sciences, Dayton, OH, USA. .,Family Medicine, Wright State University Boonshoft School of Medicine, Dayton, OH, USA.
| | - Sydney Silverstein
- Wright State University Boonshoft School of Medicine, Dayton, OH, USA.,Wright State University Boonshoft School of Medicine, Population and Public Health Sciences, Dayton, OH, USA
| | - Tiffani Spaulding
- Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - Desby Cheribin
- Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - Tamiel Murray
- Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - Josef Rivera
- Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - Katherine Wilcher
- Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| |
Collapse
|
28
|
Goodenow MM, Rausch DM. Recent Key Efforts to Improve HIV-Related Intersectional Stigma and Discrimination Research. Am J Public Health 2022; 112:S393-S394. [PMID: 35763741 DOI: 10.2105/ajph.2022.306712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Maureen M Goodenow
- Maureen M. Goodenow is with the Office of AIDS Research, National Institutes of Health (NIH), Rockville, MD. Dianne M. Rausch is with the Division of AIDS Research, National Institute of Mental Health, NIH
| | - Dianne M Rausch
- Maureen M. Goodenow is with the Office of AIDS Research, National Institutes of Health (NIH), Rockville, MD. Dianne M. Rausch is with the Division of AIDS Research, National Institute of Mental Health, NIH
| |
Collapse
|
29
|
Williams D, Bartelt E, Thomas B, Guerra-Reyes L, Carspecken L, Rosenstock Gonzalez YR, Klimek S, Dodge B. Beyond the Boundaries: Exploring the Identity-Related Experiences of Biracial/Multiracial and Bisexual Adults. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2241-2259. [PMID: 35622076 PMCID: PMC9137263 DOI: 10.1007/s10508-021-02236-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/10/2021] [Accepted: 11/15/2021] [Indexed: 06/15/2023]
Abstract
Most prior bisexual research takes a monolithic approach to racial identity, and existing racial/ethnic minority research often overlooks bisexuality. Consequently, previous studies have rarely examined the experiences and unique health needs of biracial/multiracial and bisexual individuals. This exploratory qualitative study investigated the identity-related experiences of biracial/multiracial and bisexual adults within the context of health and well-being. Data were collected through 90-min semi-structured telephone interviews. Participants were recruited through online social network sites and included 24 adults between ages 18 and 59 years. We aimed to explore how identity-related experiences shape biracial/multiracial and bisexual individuals' identity development processes; how biracial/multiracial and bisexual individuals negotiate their identities; how the blending of multiple identities may contribute to perceptions of inclusion, exclusion, and social connectedness; and how biracial/multiracial and bisexual individuals may attribute positive and negative experiences to their identities. Interview transcripts were analyzed using an inductive thematic approach. Analysis highlighted four major themes: passing and invisible identities, not measuring up and erasing complexity, cultural binegativity/queerphobia and intersectional oppressions, and navigating beyond boundaries. Our findings imply promoting affirmative visibility and developing intentional support networks may help biracial/multiracial and bisexual individuals cultivate resiliency and navigate sources of identity stress. We encourage future research to explore mental health and chronic stress among this community.
Collapse
Affiliation(s)
- Deana Williams
- Center for Sexual Health Promotion, School of Public Health, Indiana University-Bloomington, 1025 E 7th St., Bloomington, IN, 47405, USA.
| | - Elizabeth Bartelt
- School of Public Health and Health Professions, University at Buffalo-SUNY, Buffalo, NY, USA
| | - Breanna Thomas
- Center for Sexual Health Promotion, School of Public Health, Indiana University-Bloomington, 1025 E 7th St., Bloomington, IN, 47405, USA
| | - Lucia Guerra-Reyes
- Center for Sexual Health Promotion, School of Public Health, Indiana University-Bloomington, 1025 E 7th St., Bloomington, IN, 47405, USA
| | - Lucinda Carspecken
- School of Education, Indiana University-Bloomington, Bloomington, IN, USA
| | - Yael R Rosenstock Gonzalez
- Center for Sexual Health Promotion, School of Public Health, Indiana University-Bloomington, 1025 E 7th St., Bloomington, IN, 47405, USA
| | - Sally Klimek
- Center for Sexual Health Promotion, School of Public Health, Indiana University-Bloomington, 1025 E 7th St., Bloomington, IN, 47405, USA
| | - Brian Dodge
- Center for Sexual Health Promotion, School of Public Health, Indiana University-Bloomington, 1025 E 7th St., Bloomington, IN, 47405, USA
| |
Collapse
|
30
|
Yassine BB, Rojewski JW, Ransom MM. Gender Inequity in the Public Health Workforce. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:E390-E396. [PMID: 34016906 DOI: 10.1097/phh.0000000000001374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
CONTEXT Public health is a gendered field. Although a majority of the public health workforce, women encounter an imbalance of power and experience disparate opportunities within the profession. ANALYSIS This article offers a multidimensional critique of gender inequity within the public health workforce through an examination of the literature. RESULTS There are three existing disparities between men and women in public health: unequal representation in leadership positions; persistence of wage discrimination; and disparities in scholarly publication and citations. Disparities are often more pronounced among women with intersectional identities (eg, race/ethnicity or other identities). DISCUSSION Gender inequity is structural, and solutions must address micro-, interactional, and macro-levels. The changing workforce and practitioners' skills in addressing upstream issues provide the opportunity to address this issue.
Collapse
Affiliation(s)
- Brianne Bostian Yassine
- Department of Career and Information Studies, University of Georgia, Athens, Georgia (Drs Yassine and Rojewski); National Network of Public Health Institutes, Washington, District of Columbia (Dr Ransom); and College of Health and Health Sciences, Walden University, Minneapolis, Minnesota (Dr Ransom)
| | | | | |
Collapse
|
31
|
Abshire DA, Wippold GM, Wilson DK, Pinto BM, Probst JC, Hardin JW. Rurality, Gender, and Obesity: An Intersectionality Perspective on Rural Men's Health. Am J Public Health 2021; 111:1761-1763. [PMID: 34529501 PMCID: PMC8561182 DOI: 10.2105/ajph.2021.306482] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Demetrius A Abshire
- Demetrius A. Abshire and Bernardine M. Pinto are with the College of Nursing, Guillermo M. Wippold and Dawn K. Wilson are with the Department of Psychology, College of Arts and Sciences, Janice C. Probst is with the Department of Health Services Policy and Management, Arnold School of Public Health, and James W. Hardin is with the Department of Health Services Policy and Management and the Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Guillermo M Wippold
- Demetrius A. Abshire and Bernardine M. Pinto are with the College of Nursing, Guillermo M. Wippold and Dawn K. Wilson are with the Department of Psychology, College of Arts and Sciences, Janice C. Probst is with the Department of Health Services Policy and Management, Arnold School of Public Health, and James W. Hardin is with the Department of Health Services Policy and Management and the Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Dawn K Wilson
- Demetrius A. Abshire and Bernardine M. Pinto are with the College of Nursing, Guillermo M. Wippold and Dawn K. Wilson are with the Department of Psychology, College of Arts and Sciences, Janice C. Probst is with the Department of Health Services Policy and Management, Arnold School of Public Health, and James W. Hardin is with the Department of Health Services Policy and Management and the Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Bernardine M Pinto
- Demetrius A. Abshire and Bernardine M. Pinto are with the College of Nursing, Guillermo M. Wippold and Dawn K. Wilson are with the Department of Psychology, College of Arts and Sciences, Janice C. Probst is with the Department of Health Services Policy and Management, Arnold School of Public Health, and James W. Hardin is with the Department of Health Services Policy and Management and the Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Janice C Probst
- Demetrius A. Abshire and Bernardine M. Pinto are with the College of Nursing, Guillermo M. Wippold and Dawn K. Wilson are with the Department of Psychology, College of Arts and Sciences, Janice C. Probst is with the Department of Health Services Policy and Management, Arnold School of Public Health, and James W. Hardin is with the Department of Health Services Policy and Management and the Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - James W Hardin
- Demetrius A. Abshire and Bernardine M. Pinto are with the College of Nursing, Guillermo M. Wippold and Dawn K. Wilson are with the Department of Psychology, College of Arts and Sciences, Janice C. Probst is with the Department of Health Services Policy and Management, Arnold School of Public Health, and James W. Hardin is with the Department of Health Services Policy and Management and the Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| |
Collapse
|