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Ryus CR, Yang D, Brackett A, Barnett L, Boatright D. Examining trends in emergency medicine journals' publications about racism. Acad Emerg Med 2024; 31:339-345. [PMID: 38097532 DOI: 10.1111/acem.14852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 03/12/2024]
Abstract
OBJECTIVE In recent years, the academic medicine community has produced numerous statements and calls to action condemning racism. Though health equity work examining health disparities has expanded, few studies specifically name racism as an operational construct. As emergency departments serve a high proportion of patients with social and economic disadvantage rooted in structural racism, it is critically important that racism be a focus of our academic discourse. This study examines the frequency at which four prominent emergency medicine journals, Annals of Emergency Medicine, Academic Emergency Medicine, the American Journal of Emergency Medicine, and the Western Journal of Emergency Medicine, publish on health disparities and racism. METHODS This is a descriptive analysis measuring the frequency of publications on health disparities and racism in U.S.-based emergency medicine journals from 2014 to 2021. The search strategies for the concepts of "racism" and "health disparities" used a combination of MeSH and keywords. These search strategies were developed based on prior literature and the MEDLINE/PubMed Health Disparities and Minority Health Search Strategy. Articles identified through the PubMed search were then reviewed by two authors for final inclusion. RESULTS Since 2014, a total of 6248 articles were published by the four emergency medicine journals over the 8-year study period. Of those, 82 research papers that focused on health disparities were identified and only 16 that focused on racism. Most emergency medicine publications on racism and health disparities were in 2021. CONCLUSIONS Our findings suggest that the national discourse on racism and calls to action within emergency medicine were followed by an increase in publications on health disparities and racism. Continued investigation is needed to evaluate these trends moving forward.
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Affiliation(s)
- Caitlin R Ryus
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - David Yang
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Alexandria Brackett
- Harvey Cushing/John Hay Whitney Medical Library, Yale School of Medicine, New Haven, Connecticut, USA
| | - Lindsay Barnett
- Yale University Library, Yale School of Medicine, New Haven, Connecticut, USA
| | - Dowin Boatright
- Ronald O. Perelman Department of Emergency Medicine, New York University, New York, New York, USA
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2
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Pagkas-Bather J, Motley DN, Schneider JA. Health equity for Black sexually minoritised men through status-neutral HIV care. Lancet HIV 2024:S2352-3018(24)00032-8. [PMID: 38430923 DOI: 10.1016/s2352-3018(24)00032-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/25/2024] [Accepted: 02/01/2024] [Indexed: 03/05/2024]
Abstract
Current strategies (both biomedical and barrier methods) for HIV elimination in the USA do not best serve those who are most affected by HIV. Improving healthc are for individuals most affected by HIV requires restructuring of care delivery to improve their HIV outcomes. The transformation of clinical care delivery is crucial to address the needs of one of the most affected populations along the HIV care continuum: Black sexually minoritised men (BSMM). Status-neutral HIV care delivery systems might address social determinants of health of BSMM who are stigmatised and disenfranchised within the context of American society. Addressing the needs of BSMM will bring us closer to health-care equity, which benefits us all.
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Affiliation(s)
- Jade Pagkas-Bather
- Section of Infectious Diseases & Global Health, Department of Medicine, University of Chicago, Chicago, IL, USA; Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA.
| | - Darnell N Motley
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
| | - John A Schneider
- Section of Infectious Diseases & Global Health, Department of Medicine, University of Chicago, Chicago, IL, USA; Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA; Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
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3
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Temple JA, Varshney N. Using Prevention Research to Reduce Racial Disparities in Health Through Innovative Funding Strategies: The Case of Doula Care. Prev Sci 2024; 25:108-118. [PMID: 36757659 DOI: 10.1007/s11121-023-01497-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 02/10/2023]
Abstract
Racial disparities in maternal birth outcomes are substantial even when comparing women with similar levels of education. While racial differences in maternal death at birth or shortly afterward have attracted significant attention from researchers, non-fatal but potentially life-threatening pregnancy complications are 30-40 times more common than maternal deaths. Black women have the worst maternal health outcomes. Only recently have health researchers started to view structural racism rather than race as the critical factor underlying these persistent inequities. We discuss the economic framework that prevention scientists can use to convince policymakers to make sustainable investments in maternal health by expanding funding for doula care. While a few states allow Medicaid to fund doula services, most women at risk of poor maternal health outcomes arising from structural racism lack access to culturally sensitive caregivers during the pre-and post-partum periods as well as during birth. We provide a guide to how research in health services can be more readily translated to policy recommendations by describing two innovative ways that cost-benefit analysis can help direct private and public funding to support doula care for Black women and others at risk of poor birth outcomes.
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Affiliation(s)
- Judy A Temple
- Humphrey School of Public Affairs and Human Capital Research Collaborative, University of Minnesota - Twin Cities, 301-19th Avenue South, MN, 55455, Minneapolis, USA.
| | - Nishank Varshney
- Humphrey School of Public Affairs and Human Capital Research Collaborative, University of Minnesota - Twin Cities, 301-19th Avenue South, MN, 55455, Minneapolis, USA
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4
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Alang SM, Carter CR, Blackstock O. Past Is Prologue: Dismantling Colonial Legacies to Advance Black Health Equity in the United States. Health Equity 2023; 7:831-834. [PMID: 38156053 PMCID: PMC10754480 DOI: 10.1089/heq.2023.0226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 12/30/2023] Open
Abstract
Colonialism underlies the commodification of health care in the United States and continues to harm well-being among Black Americans. We present four recommendations for addressing its health consequences: (1) Investments in epigenetic research to improve our understanding of how systemic oppression becomes biology. (2) Centering Black experiences and knowledge traditions in education, practice, and policy. (3) Support for Black scholars, trainees, and practitioners when they critic disciplinary tenets and practices. (4) Expansion of preventive care. Our health care system is a for-profit industry that exploits workers and harms the most marginalized, much like colonialism. Advancing health equity requires dismantling colonial legacies.
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Affiliation(s)
- Sirry M. Alang
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Chelsey R. Carter
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
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5
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Tobin-Tyler E, Boyd-Caine T, Genn H, Ries NM. Health Justice Partnerships: An International Comparison of Approaches to Employing Law to Promote Prevention and Health Equity. J Law Med Ethics 2023; 51:332-343. [PMID: 37655576 PMCID: PMC10881269 DOI: 10.1017/jme.2023.84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
This article traces the development and growth of health justice partnerships (HJPs) in three countries: the United States, Australia and the United Kingdom.
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Affiliation(s)
- Elizabeth Tobin-Tyler
- BROWN UNIVERSITY SCHOOL OF PUBLIC HEALTH AND ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY, PROVIDENCE, RI, USA
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6
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Kopel J, Sehar U, Choudhury M, Reddy PH. Alzheimer’s Disease and Alzheimer’s Disease-Related Dementias in African Americans: Focus on Caregivers. Healthcare (Basel) 2023; 11:healthcare11060868. [PMID: 36981525 PMCID: PMC10048201 DOI: 10.3390/healthcare11060868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/19/2023] Open
Abstract
Alzheimer’s disease (AD) and Alzheimer’s Disease-Related Dementias (ADRD) are chronic illnesses that are highly prevalent in African Americans (AA). AD and ADRD are caused by multiple factors, such as genetic mutations, modifiable and non-modifiable risk factors, and lifestyle. Histopathological, morphological, and cellular studies revealed how multiple cellular changes are implicated in AD and ADRD, including synaptic damage, inflammatory responses, hormonal imbalance, mitochondrial abnormalities, and neuronal loss, in addition to the accumulation of amyloid beta and phosphorylated tau in the brain. The contributions of race, ethnicity, location and socioeconomic status all have a significant impact on the care and support services available to dementia patients. Furthermore, disparities in health care are entangled with social, economic, and environmental variables that perpetuate disadvantages among different groups, particularly African Americans. As such, it remains important to understand how various racial and ethnic groups perceive, access, and experience health care. Considering that the mounting data shows AA may be more susceptible to AD than white people, the demographic transition creates significant hurdles in providing adequate care from family caregivers. Furthermore, there is growing recognition that AD and ADRD pose a significant stress on AA caregivers compared to white people. In this review, we examine the current literature on racial disparities in AD and ADRD, particularly concerning AA caregivers.
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Affiliation(s)
- Jonathan Kopel
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Moumita Choudhury
- Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - P. Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Department of Public Health, School of Population and Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Neurology, Departments of School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Nutritional Sciences Department, College of Human Sciences, Texas Tech University, Lubbock, TX 79409, USA
- Correspondence: ; Tel.: +1-806-743-3194
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7
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King LM, Barnett TE, Allen AC, Maizel JL, Wilson RE. Tobacco-related health inequalities among Black Americans: A narrative review of structural and historical influences. J Ethn Subst Abuse 2022:1-31. [PMID: 35839212 DOI: 10.1080/15332640.2022.2093812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We conducted a narrative literature review to examine contributing factors of disparities in tobacco usage and outcomes affecting Black Americans. We propose potential solutions that can be used to effectively address these disparities. We identified historical factors; socioeconomic factors; targeted marketing/advertising; the influence of racism/discrimination; neighborhood socioeconomic disadvantage; and mass incarceration. We call for more thorough examinations of these factors as a key element of tobacco-focused research and interventions to eliminate the disproportionate burdens faced by Black Americans. We advocate for greater emphases on the impacts of personal and structural racism on tobacco usage and outcomes affecting Black Americans.
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Affiliation(s)
| | - Tracey E Barnett
- University of North Texas Health Science Center at Fort Worth, Fort Worth, Texas
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8
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Affiliation(s)
- William Ventres
- From the Departments of Family and Preventive Medicine and Psychiatry, University of Arkansas for Medical Sciences, Little Rock
| | - Erick Messias
- From the Departments of Family and Preventive Medicine and Psychiatry, University of Arkansas for Medical Sciences, Little Rock
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9
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Franks NM, Gipson K, Kaltiso SA, Osborne A, Heron SL. The Time Is Now: Racism and the Responsibility of Emergency Medicine to Be Antiracist. Ann Emerg Med 2021; 78:577-586. [PMID: 34175155 PMCID: PMC8487015 DOI: 10.1016/j.annemergmed.2021.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 01/18/2023]
Abstract
The COVID-19 pandemic has shed light on the ongoing pandemic of racial injustice. In the context of these twin pandemics, emergency medicine organizations are declaring that "Racism is a Public Health Crisis." Accordingly, we are challenging emergency clinicians to respond to this emergency and commit to being antiracist. This courageous journey begins with naming racism and continues with actions addressing the intersection of racism and social determinants of health that result in health inequities. Therefore, we present a social-ecological framework that structures the intentional actions that emergency medicine must implement at the individual, organizational, community, and policy levels to actively respond to this emergency and be antiracist.
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Affiliation(s)
- Nicole M Franks
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA.
| | - Katrina Gipson
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA
| | - Sheri-Ann Kaltiso
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA
| | - Anwar Osborne
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA
| | - Sheryl L Heron
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA
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10
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Hudson MF. General orders for the embedded researcher: Moorings for a developing profession. Learn Health Syst 2021; 5:e10254. [PMID: 34667876 PMCID: PMC8512733 DOI: 10.1002/lrh2.10254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/23/2020] [Accepted: 11/28/2020] [Indexed: 11/18/2022] Open
Abstract
Learning health systems increasingly welcome embedded researchers as stakeholders poised to inform evidence-based practice. While care systems are potentially familiar with the embedded researcher tools and techniques, care systems may less frequently consider embedded research as a vocation. This insensitivity potentially reduces embedded researchers merely to instruments, as opposed to professional partners in transdisciplinary research. This discussion outlines "general orders" for embedded researchers. The general orders outline embedded researchers' fundamental identity and guide conduct as a means to encourage a shared identity among embedded researchers and clarify embedded researchers' roles in learning health system teams. Students and embedded researchers newly engaging learning health systems may particularly benefit from this rudimentary order list.
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11
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Moore JX, Gilbert KL, Lively KL, Laurent C, Chawla R, Li C, Johnson R, Petcu R, Mehra M, Spooner A, Kolhe R, Ledford CJW. Correlates of COVID-19 Vaccine Hesitancy among a Community Sample of African Americans Living in the Southern United States. Vaccines (Basel) 2021; 9:vaccines9080879. [PMID: 34452004 PMCID: PMC8402307 DOI: 10.3390/vaccines9080879] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 12/23/2022] Open
Abstract
In the United States, African Americans (AAs) have been disproportionately affected by COVID-19 mortality. However, AAs are more likely to be hesitant in receiving COVID-19 vaccinations when compared to non-Hispanic Whites. We examined factors associated with vaccine hesitancy among a predominant AA community sample. We performed a cross-sectional analysis on data collected from a convenience sample of 257 community-dwelling participants in the Central Savannah River Area from 5 December 2020, through 17 April 2021. Vaccine hesitancy was categorized as resistant, hesitant, and acceptant. We estimated relative odds of vaccine resistance and vaccine hesitancy using polytomous logistic regression models. Nearly one-third of the participants were either hesitant (n = 40, 15.6%) or resistant (n = 42, 16.3%) to receiving a COVID-19 vaccination. Vaccine-resistant participants were more likely to be younger and were more likely to have experienced housing insecurity due to COVID-19 when compared to both acceptant and hesitant participants, respectively. Age accounted for nearly 25% of the variation in vaccine resistance, with 21-fold increased odds (OR: 21.93, 95% CI: 8.97-5.26-91.43) of vaccine resistance in participants aged 18 to 29 compared to 50 and older adults. Housing insecurity accounted for 8% of the variation in vaccine resistance and was associated with 7-fold increased odds of vaccine resistance (AOR: 7.35, 95% CI: 1.99-27.10). In this sample, AAs under the age of 30 and those experiencing housing insecurity because of the COVID-19 pandemic were more likely to be resistant to receiving a free COVID-19 vaccination.
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Affiliation(s)
- Justin Xavier Moore
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
- Cancer Prevention, Control, & Population Health Program, Department of Medicine, Augusta University, Augusta, GA 30912, USA
- Institute of Preventive and Public Health, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Correspondence: ; Tel.: +1-706-721-4621
| | - Keon L. Gilbert
- Department of Behavioral Science and Health Education, Saint Louis University, St. Louis, MO 63103, USA;
| | - Katie L. Lively
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Christian Laurent
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Rishab Chawla
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Cynthia Li
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Ryan Johnson
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Robert Petcu
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Mehul Mehra
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Antron Spooner
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Ravindra Kolhe
- Department of Pathology, Section of Anatomic Pathology, Augusta University, Augusta, GA 30912, USA;
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12
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Lee RE, Joseph RP, Blackman Carr LT, Strayhorn SM, Faro JM, Lane H, Monroe C, Pekmezi D, Szeszulski J. Still striding toward social justice? Redirecting physical activity research in a post-COVID-19 world. Transl Behav Med 2021; 11:1205-1215. [PMID: 33822205 PMCID: PMC8083595 DOI: 10.1093/tbm/ibab026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 crisis and parallel Black Lives Matter movement have amplified longstanding systemic injustices among people of color (POC). POC have been differentially affected by COVID-19, reflecting the disproportionate burden of ongoing chronic health challenges associated with socioeconomic inequalities and unhealthy behaviors, including a lack of physical activity. Clear and well-established benefits link daily physical activity to health and well-being—physical, mental, and existential. Despite these benefits, POC face additional barriers to participation. Thus, increasing physical activity among POC requires additional considerations so that POC can receive the same opportunities to safely participate in physical activity as Americans who are White. Framed within the Ecologic Model of Physical Activity, this commentary briefly describes health disparities in COVID-19, physical activity, and chronic disease experienced by POC; outlines underlying putative mechanisms that connect these disparities; and offers potential solutions to reduce these disparities. As behavioral medicine leaders, we advocate that solutions must redirect the focus of behavioral research toward community-informed and systems solutions.
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Affiliation(s)
- Rebecca E Lee
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Rodney P Joseph
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Loneke T Blackman Carr
- Department of Nutritional Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, CT, USA
| | - Shaila Marie Strayhorn
- Institute of Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Jamie M Faro
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Hannah Lane
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Courtney Monroe
- Department of Health Promotion, Education, and Behavior, Technology Center to Promote Healthy Lifestyles, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Dorothy Pekmezi
- School of Public Health, Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jacob Szeszulski
- The University of Texas Health Science Center at Houston School of Public Health, Center for Health Promotion and Prevention Research, Michael & Susan Dell Center for Healthy Living, Houston, TX, USA
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13
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Evans KR, Gusmano MK. Civic Learning, Science, and Structural Racism. Hastings Cent Rep 2021; 51 Suppl 1:S46-S50. [PMID: 33630337 DOI: 10.1002/hast.1229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Vaccine hesitancy is a major public health challenge, and racial disparities in the acceptance of vaccines is a particular concern. In this essay, we draw on interviews with mothers of Black male adolescents to offer insights into the reasons for the low rate of vaccination against the human papillomavirus among this group of adolescents. Based on these conversations, we argue that increasing the acceptance of HPV and other vaccines cannot be accomplished merely by providing people with more facts. Instead, we must address the pervasive racial discrimination in the United States that undermines trust in social institutions, including the health care system. In the short term, it may be helpful to increase the number of clinicians of color working in the health system, but more fundamental changes are required. The U.S. must adopt and implement policies that dismantle structural racism if it hopes to produce greater trust and community-oriented thinking on behalf of people who have been exploited for centuries.
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