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Webb EK, Carter SE, Ressler KJ, Fani N, Harnett NG. The neurophysiological consequences of racism-related stressors in Black Americans. Neurosci Biobehav Rev 2024; 161:105638. [PMID: 38522814 PMCID: PMC11081835 DOI: 10.1016/j.neubiorev.2024.105638] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/01/2024] [Accepted: 03/19/2024] [Indexed: 03/26/2024]
Abstract
Racism-related stressors, from experiences of both implicit and explicit racial discrimination to systemic socioeconomic disadvantage, have a cumulative impact on Black Americans' health. The present narrative review synthesizes peripheral (neuroendocrine and inflammation markers), psychophysiological (heart-rate variability, skin conductance), and neuroimaging (structural and functional) findings that demonstrate unique associations with racism-related stress. Emerging evidence reveals how racism-related stressors contribute to differential physiological and neural responses and may have distinct impacts on regions involved with threat and social processing. Ultimately, the neurophysiological effects of racism-related stress may confer biological susceptibility to stress and trauma-related disorders. We note critical gaps in the literature on the neurophysiological impact of racism-related stress and outline additional research that is needed on the multifactorial interactions between racism and mental health. A clearer understanding of the interactions between racism-related stress, neurophysiology, and stress- and trauma-related disorders is critical for preventative efforts, biomarker discovery, and selection of effective clinical treatments for Black Americans.
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Affiliation(s)
- E Kate Webb
- McLean Hospital, Division of Depression and Anxiety, Belmont, MA, USA; Harvard Medical School, Department of Psychiatry, Boston, MA, USA
| | - Sierra E Carter
- Georgia State University, Department of Psychology, Athens, GA, USA
| | - Kerry J Ressler
- McLean Hospital, Division of Depression and Anxiety, Belmont, MA, USA; Harvard Medical School, Department of Psychiatry, Boston, MA, USA
| | - Negar Fani
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Nathaniel G Harnett
- McLean Hospital, Division of Depression and Anxiety, Belmont, MA, USA; Harvard Medical School, Department of Psychiatry, Boston, MA, USA.
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2
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Vincent Jones I, Kim S, Tang H, Liu Z. Black people in Ukraine: A content analysis of TikTok videos documenting discrimination against Black people attempting to flee at the onset of the 2022 Russo-Ukrainian war. Dialogues Health 2024; 4:100161. [PMID: 38516218 PMCID: PMC10953848 DOI: 10.1016/j.dialog.2023.100161] [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] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 09/26/2023] [Accepted: 11/25/2023] [Indexed: 03/23/2024]
Abstract
This cross-sectional, descriptive study conducted on in June 2022 reviewed 100 TikTok videos using the hashtag #africansinukriane that depicted discrimination against Black people attempting to flee Ukraine at the onset of the war in February 2022. Two of the 16 themes were significant and present in over 50% of videos: raising awareness (67%) and racial discrimination (64%). Videos with elements of physical contact (N = 16, 76.2%), violence (N = 12, 75%), and dehumanization (N = 11, 68.8%) had higher shares than overall media shares. Less than 10% of the videos included dark humor (8%), sharing helpful resources (7%), and appreciation of countries that offered support (5%). Results indicate that videos that include raising awareness (p = .02), racial discrimination (p = .001), on-scene clips or war scenes (p = .007), physical contact (p = .006), and denied entry (p = .022). Their estimated differences in locations indicate that all of these themes were related to higher median shares of the videos. This study supports that TikTok is a place where marginalized groups can raise awareness about injustice and create counternarratives. This study exemplifies international anti-blackness with implications for health marketing and communication, human rights efforts, refugee health, and targeted mental health and policy support for those displaced by war.
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Affiliation(s)
- I.I. Vincent Jones
- York College, City University of New York, Department of Health and Human Performance, Health Promotion Center, United States of America
| | - Sungwoo Kim
- Teachers College, Columbia University, Department of Human Development, United States of America
| | - Haoyang Tang
- University of California, Santa Barbara, Department of Sociology, United States of America
| | - Zhiheng Liu
- Columbia University, The Institute for Social and Economic Research and Policy, Graduate School of Arts and Sciences, United States of America
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3
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Grove M, Pickett S, Boone CG, Buckley GL, Anderson P, Hoover FA, Lugo AE, Meléndez-Ackerman E, Muñoz-Erickson TA, Nagendra H, Selles LK. Forging just ecologies: 25 years of urban long-term ecological research collaboration. Ambio 2024; 53:826-844. [PMID: 38643345 PMCID: PMC11058169 DOI: 10.1007/s13280-023-01938-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 04/22/2024]
Abstract
We ask how environmental justice and urban ecology have influenced one another over the past 25 years in the context of the US Long-Term Ecological Research (LTER) program and Baltimore Ecosystem Study (BES) project. BES began after environmental justice emerged through activism and scholarship in the 1980s but spans a period of increasing awareness among ecologists and environmental practitioners. The work in Baltimore provides a detailed example of how ecological research has been affected by a growing understanding of environmental justice. The shift shows how unjust environmental outcomes emerge and are reinforced over time by systemic discrimination and exclusion. We do not comprehensively review the literature on environmental justice in urban ecology but do present four brief cases from the Caribbean, Africa, and Asia, to illustrate the global relevance of the topic. The example cases demonstrate the necessity for continuous engagement with communities in addressing environmental problem solving.
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Affiliation(s)
- Morgan Grove
- USDA Forest Service, 5523 Research Park Drive, Suite 350, Baltimore, MD, 21218, USA.
| | - Steward Pickett
- Cary Institute of Ecosystem Studies, Box AB, Millbrook, NY, 12545, USA
| | - Christopher G Boone
- School of Sustainability, Arizona State University, PO Box 877904, Tempe, AZ, 85287-7904, USA
| | - Geoffrey L Buckley
- Honors Tutorial College, Ohio University, 1 Ohio University Drive, Athens, OH, 45701-2979, USA
| | - Pippin Anderson
- Department of Environmental and Geographical Science, University of Cape Town, Rondebosch, Private Bag x3, Cape Town, 7701, South Africa
| | - Fushcia-Ann Hoover
- University of North Carolina, Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
| | - Ariel E Lugo
- USDA Forest Service International Institute of Tropical Forestry, San Juan, PR, USA
| | - Elvia Meléndez-Ackerman
- Department of Environmental Sciences, The University of Puerto Rico, Rio Piedras, 17 Ave Universidad STE 1701, San Juan, PR, 00925-2537, USA
| | - Tischa A Muñoz-Erickson
- International Institute of Tropical Forestry, USDA Forest Service, 1201 Calle Ceiba, Jardín Botánico Sur, Río Piedras, PR, 00926, USA
| | - Harini Nagendra
- Centre for Climate Change and Sustainability, Azim Premji University, Burugunte Village, Bikkanahalli Main Road, Sarjapura, Bengaluru, 562125, India
| | - L Kidany Selles
- University of Puerto Rico, Rio Piedras, Facundo Bueso Building (FB-003) 17 Ave. Universidad STE 1701, San Juan, PR, 00925-2537, USA
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Alqahtani MH. "Would you take a pay cut? We're looking for Caucasians". How whiteness can affect White, Black and Muslim female 'native-speaker' English language teachers. Heliyon 2024; 10:e29887. [PMID: 38707448 PMCID: PMC11066305 DOI: 10.1016/j.heliyon.2024.e29887] [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: 09/08/2023] [Revised: 03/15/2024] [Accepted: 04/17/2024] [Indexed: 05/07/2024] Open
Abstract
This article sets out investigate the interrelationships between native speakerism, Whiteness, ethnicity and appearance in the TESOL context. It explores whether Whiteness plays a part in TESOL teachers' recruitment and job opportunities when employers are seeking to employ 'native speakers'. It draws its data from focus group interview data with seven female TESOL teachers. Two were White, three were Black and two were White Muslims who wear the hijab. The findings show that when English language teaching job advertisements call for 'native speaker' teachers, recruiters are-consciously or unconsciously-looking for White teachers from ex-colonising countries such as the USA, the UK, Canada, Australia and New Zealand whom they perceive as representing Whiteness. In this sense, Whiteness is inextricably linked to the concepts of the 'native speaker' and 'native speakerism' in English language teaching. The study concludes that native speakerism acts a veiled façade for Whiteness and consequently that White TESOL native speaker teachers are privileged over their Black and Muslim counterparts in a number of areas. These include: pay, objectification, acknowledgement of their professional achievements and visibility in advertising materials aimed at prospective students and their parents. The paper concludes with a call to confront such often-unacknowledged bias in favour of Whiteness by establishing open conversations with recruiters, parents, students and others involved in the TESOL field. It also recommends that countries should follow the European Union's lead and ban any language teaching job criteria that state a 'native speaker' requirement.
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Brown KK, Thomas SP, Brothers RM, Liao Y. "Lord Knows What's Being Done with My Blood!": Black Women's Perceptions of Biospecimen Donation for Clinical Research in the United States. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02015-y. [PMID: 38714639 DOI: 10.1007/s40615-024-02015-y] [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] [Received: 11/05/2023] [Revised: 04/06/2024] [Accepted: 04/28/2024] [Indexed: 05/10/2024]
Abstract
PURPOSE Black women are underrepresented in clinical research and clinical trials. Knowledge gaps lead to biased clinical practice and care. There is a small but growing body of literature on Black women's perceptions about participation when biospecimen donation is sought by researchers. This is the first known study to investigate willingness to participate in clinical research involving biospecimen donation among Black women of reproductive age in the United States. METHODS This cross-sectional study recruited 496 Black women (ages 18-49) from a research crowdsourcing platform. Participants completed a 46-item online survey which asked about their willingness to provide blood samples for clinical health research and reasons for their willingness or for any unwillingness. Descriptive statistics and thematic analysis method were used to analyze the data. RESULTS Less than half (44%) of participants reported willingness to provide blood samples for clinical research. The most common concerns of those expressing unwillingness to provide samples were "fear of blood sample being misused" and "distrust with the health researchers handling the samples." We identified six qualitative themes from the analysis of participants' open-ended responses. The most important factors include a desire for integrity and transparency in research, institutional racism contributing to mistrust, and adequate compensation and clearly defined benefits to participation. CONCLUSIONS The recruitment and engagement of Black women in clinical biospecimen research should involve transparent, trustworthy, and anti-racist practices and informed respect for Black women's autonomy. There is a need to address Black women's concerns about exploitative profits and mistrust of academic and medical institutions.
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Affiliation(s)
- Kyrah K Brown
- Department of Kinesiology, University of Texas at Arlington, 500 W. Nedderman Drive, Arlington, TX, 76019, USA.
| | | | - R Mathew Brothers
- Department of Kinesiology, University of Texas at Arlington, 500 W. Nedderman Drive, Arlington, TX, 76019, USA
| | - Yue Liao
- Department of Kinesiology, University of Texas at Arlington, 500 W. Nedderman Drive, Arlington, TX, 76019, USA
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Carney-Knisely G, Griffin M, Crawford A, Spates K, Singh P. Police killings of unarmed Black persons and suicides among Black youth in the US: A national time-series analysis. Ann Epidemiol 2024; 94:91-99. [PMID: 38710240 DOI: 10.1016/j.annepidem.2024.04.012] [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] [Received: 01/26/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/08/2024]
Abstract
INTRODUCTION Suicide deaths among Black youth in the US have increased rapidly over the past decade. Direct or vicarious racial trauma experienced through exposure to police brutality may underlie these concerning trends. METHODS We obtained nationally aggregated monthly counts of suicides for non-Hispanic Black and White youth (age ≤ 24 years) and adults (age > 24 years) from the National Mortality Vital Statistics restricted-use data files provided by the Centers for Disease Control and Prevention, from 2013 to 2019. Monthly counts of Black youth suicides constituted our main outcome. We defined our exposure as the monthly counts of police killings of unarmed Black persons over 84 months (2013 to 2019), retrieved from the Mapping Police Violence database. We used ARIMA (AutoRegressive Integrated Moving Average) time-series analyses to examine whether Black youth suicides increased within 0 to 3 months following police killings of unarmed Black persons, controlling for autocorrelation and corresponding series of White youth suicides. RESULTS Suicides among Black youth increase by ∼1 count three months following an increase in police killings of unarmed Black persons (exposure lag 0 coefficient = 0.16, p > 0.05; exposure lag 1 coefficient = -0.70, p > 0.05; exposure lag 2 coefficient = -0.54, p > 0.05; exposure lag 3 coefficient = 0.95, p < 0.05). The observed increase in suicides concentrates among Black male youth (exposure lag 3 coefficient = 0.88, p < 0.05).
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Affiliation(s)
| | | | - Alaxandria Crawford
- Division of Epidemiology, College of Public Health, The Ohio State University, USA
| | - Kamesha Spates
- William S. Dietrich II Endowed Chair in Africana Studies, University of Pittsburgh, USA
| | - Parvati Singh
- Division of Epidemiology, College of Public Health, The Ohio State University, USA.
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Merz S, Aksakal T, Hibtay A, Yücesoy H, Fieselmann J, Annaç K, Yılmaz-Aslan Y, Brzoska P, Tezcan-Güntekin H. Racism against healthcare users in inpatient care: a scoping review. Int J Equity Health 2024; 23:89. [PMID: 38698455 PMCID: PMC11067303 DOI: 10.1186/s12939-024-02156-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/19/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Racism in the healthcare system has become a burgeoning focus in health policy-making and research. Existing research has shown both interpersonal and structural forms of racism limiting access to quality healthcare for racialised healthcare users. Nevertheless, little is known about the specifics of racism in the inpatient sector, specifically hospitals and rehabilitation facilities. The aim of this scoping review is therefore to map the evidence on racial discrimination experienced by people receiving treatment in inpatient settings (hospitals and rehabilitation facilities) or their caregivers in high-income countries, focusing specifically on whether intersectional axes of discrimination have been taken into account when describing these experiences. METHODS Based on the conceptual framework developed by Arksey and O'Malley, this scoping review surveyed existing research on racism and racial discrimination in inpatient care in high-income countries published between 2013 and 2023. The software Rayyan was used to support the screening process while MAXQDA was used for thematic coding. RESULTS Forty-seven articles were included in this review. Specifics of the inpatient sector included different hospitalisation, admission and referral rates within and across hospitals; the threat of racial discrimination from other healthcare users; and the spatial segregation of healthcare users according to ethnic, religious or racialised criteria. While most articles described some interactions between race and other social categories in the sample composition, the framework of intersectionality was rarely considered explicitly during analysis. DISCUSSION While the USA continue to predominate in discussions, other high-income countries including Canada, Australia and the UK also examine racism in their own healthcare systems. Absent from the literature are studies from a wider range of European countries as well as of racialised and disadvantaged groups other than refugees or recent immigrants. Research in this area would also benefit from an engagement with approaches to intersectionality in public health to produce a more nuanced understanding of the interactions of racism with other axes of discrimination. As inpatient care exhibits a range of specific structures, future research and policy-making ought to consider these specifics to develop targeted interventions, including training for non-clinical staff and robust, transparent and accessible complaint procedures.
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Affiliation(s)
- Sibille Merz
- Faculty of Health and Education, Alice Salomon University of Applied Sciences, Alice-Salomon-Platz 5, 12627, Berlin, Germany
| | - Tuğba Aksakal
- Faculty of Health, School of Medicine, Witten/Herdecke University, Health Services Research Unit. Alfred-Herrhausen-Straße 50, 58448, Witten, Germany
| | - Ariam Hibtay
- Faculty of Health and Education, Alice Salomon University of Applied Sciences, Alice-Salomon-Platz 5, 12627, Berlin, Germany
| | - Hilâl Yücesoy
- Faculty of Health and Education, Alice Salomon University of Applied Sciences, Alice-Salomon-Platz 5, 12627, Berlin, Germany
| | - Jana Fieselmann
- Faculty of Health, School of Medicine, Witten/Herdecke University, Health Services Research Unit. Alfred-Herrhausen-Straße 50, 58448, Witten, Germany
| | - Kübra Annaç
- Faculty of Health, School of Medicine, Witten/Herdecke University, Health Services Research Unit. Alfred-Herrhausen-Straße 50, 58448, Witten, Germany
| | - Yüce Yılmaz-Aslan
- Faculty of Health, School of Medicine, Witten/Herdecke University, Health Services Research Unit. Alfred-Herrhausen-Straße 50, 58448, Witten, Germany
| | - Patrick Brzoska
- Faculty of Health, School of Medicine, Witten/Herdecke University, Health Services Research Unit. Alfred-Herrhausen-Straße 50, 58448, Witten, Germany.
| | - Hürrem Tezcan-Güntekin
- Faculty of Health and Education, Alice Salomon University of Applied Sciences, Alice-Salomon-Platz 5, 12627, Berlin, Germany
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8
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Faissner M, Brünig L, Gaillard AS, Jieman AT, Gather J, Hempeler C. Intersectionality as a tool for clinical ethics consultation in mental healthcare. Philos Ethics Humanit Med 2024; 19:6. [PMID: 38693533 PMCID: PMC11064353 DOI: 10.1186/s13010-024-00156-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 03/03/2024] [Indexed: 05/03/2024] Open
Abstract
Bioethics increasingly recognizes the impact of discriminatory practices based on social categories such as race, gender, sexual orientation or ability on clinical practice. Accordingly, major bioethics associations have stressed that identifying and countering structural discrimination in clinical ethics consultations is a professional obligation of clinical ethics consultants. Yet, it is still unclear how clinical ethics consultants can fulfill this obligation. More specifically, clinical ethics needs both theoretical tools to analyze and practical strategies to address structural discrimination within clinical ethics consultations. Intersectionality, a concept developed in Black feminist scholarship, is increasingly considered in bioethical theory. It stresses how social structures and practices determine social positions of privilege and disadvantage in multiple, mutually co-constitutive systems of oppression. This article aims to investigate how intersectionality can contribute to addressing structural discrimination in clinical ethics consultations with a particular focus on mental healthcare. To this end, we critically review existing approaches for clinical ethics consultants to address structural racism in clinical ethics consultations and extend them by intersectional considerations. We argue that intersectionality is a suitable tool to address structural discrimination within clinical ethics consultations and show that it can be practically implemented in two complementary ways: 1) as an analytic approach and 2) as a critical practice.
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Affiliation(s)
- Mirjam Faissner
- Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Bochum, Germany.
- Institute of the History of Medicine and Ethics in Medicine, Charité - Universitätsmedizin Berlin, Thielallee 71, 14195, Berlin, Germany.
| | - Lisa Brünig
- Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School, Hannover, Germany
| | - Anne-Sophie Gaillard
- Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Anna-Theresa Jieman
- Department of Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Jakov Gather
- Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
- Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Christin Hempeler
- Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Bochum, Germany
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Lee K, Pellowski JA, Brayboy LM, Thompson KD, Dunsiger S. The Association of Racism and Discrimination in Disparities of Hypertensive Disorders of Pregnancy in the United States: An Analysis of PRAMS Data. Matern Child Health J 2024; 28:969-978. [PMID: 38308757 DOI: 10.1007/s10995-023-03885-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/05/2024]
Abstract
BACKGROUND Hypertensive disorders of pregnancy are a leading cause of maternal mortality. Racial disparities in maternal outcomes such as maternal mortality in the United States (US) are well-documented, but the relationship of racism and/or discrimination with one's risk of developing a hypertension during pregnancy (HDP) is not well-studied. METHODS Data from 17 sites that asked questions regarding experiences with racism and/or discrimination during pregnancy via the Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 8 (2016-2020) was used. Logistic regression models were used compare the potential of stress induced HDP from perceived experiences of racism and/or discrimination versus the effect of systemic racism and/or discrimination (in healthcare settings and generally) on racial disparities in HDP diagnosis. RESULTS Among 9,907 live births, 18% of participants reported they were diagnosed with hypertension during pregnancy, with non-Hispanic Black individuals having the highest rate (21.8%). Regarding experiences of racism and/or discrimination, 76.4% of participants responded "yes", with all races/ethnicities studied here except non-Hispanic White individuals responding "yes" at rates higher than 89%. Perceived experiences of racism and/or discrimination did not statistically significantly affect one's odds of being diagnosed with HDP (OR = 0.94, CI: 0.74, 1.20). The disparity in odds of having hypertension during pregnancy between Non-Hispanic Black individuals and non-Hispanic White individuals was not statistically significant when perceived experiences of racism and/or discrimination were included in the model. CONCLUSIONS Experiences of racism and/or discrimination drive racial disparities in hypertensive disorders in pregnancy. PUBLIC HEALTH IMPLICATIONS It is vital to eliminate racist and discriminatory practices and behaviors to reduce maternal morbidity and mortality.
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Affiliation(s)
- Kiara Lee
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, RI, USA.
| | - Jennifer A Pellowski
- Department of Behavioral and Social Sciences, International Health Institute, Brown University School of Public Health, Providence, RI, USA
| | - Lynae M Brayboy
- Department of Neuropediatrics Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Klinik für Pädiatrie m. S. Neurologie, Charité Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
- Department of Reproductive Biology, Bedford Research Foundation, Bedford, MA, USA
| | - Kathryn D Thompson
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, USA
| | - Shira Dunsiger
- Center for Health Promotion and Health Equity, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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Simela C, Akanbi-Akinlolu T, Okundi M, Abdalla H, McAdams TA, Harris A, Augustine A, Le H, Abdinasir K, Ayorech Z, Ahmadzadeh YI. Intergenerational consequences of racism in the United Kingdom: a qualitative investigation into parents' exposure to racism and offspring mental health and well-being. Child Adolesc Ment Health 2024; 29:181-191. [PMID: 38523495 DOI: 10.1111/camh.12695] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/28/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Experiences of racism are linked to negative physical and mental health outcomes among those exposed. According to quantitative research derived mainly from the United States, these negative outcomes can have cascading effects in families, when parents' experiences of racism indirectly impact offspring. New research is warranted for families in the United Kingdom, informed by a qualitative approach to canvassing community knowledge and perspectives, exploring how existing findings relate to lived experiences. METHOD We conducted four online focus groups with 14 parents of school-aged children and 14 adolescents who had experienced racism in the United Kingdom. Participants were asked what children know of parents' experiences of racism, and how these experiences can impact parent-child interactions, mental health and well-being. Focus group recordings were transcribed, data coded and analysed through iterative categorisation. RESULTS Analyses drew four themes from participants' insights. Together, themes illuminated the pervasive nature of racism experienced by some families in the United Kingdom. Parent and child experiences of racism were connected and co-occurring, with indirect effects impacting mental health and well-being in both generations. These experiences were linked to both positive and negative changes in parenting behaviour and parent-child relationships, which could be moderated by intersecting identities such as the parent's generational status for immigration to the United Kingdom. Social cohesion, safe spaces and education programmes were highlighted for future intervention. CONCLUSIONS Findings corroborate existing literature, while further emphasising a broader bidirectional picture, requiring a family system and intersectional approach to understanding the mental health impact of racism in families. Avenues for future research are discussed to support development of equitable intervention and support strategies to prevent racism and support those affected.
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Affiliation(s)
| | | | | | | | | | - Androulla Harris
- Centre for Mental Health, Registered Charity No. 1091156, London, UK
| | - Alex Augustine
- Centre for Mental Health, Registered Charity No. 1091156, London, UK
| | - Huong Le
- Centre for Mental Health, Registered Charity No. 1091156, London, UK
| | - Kadra Abdinasir
- Centre for Mental Health, Registered Charity No. 1091156, London, UK
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11
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Elbasheir A, Fulton TM, Choucair KC, Lathan EC, Spivey BN, Guelfo A, Carter SE, Powers A, Fani N. Moral injury, race-related stress and post-traumatic stress disorder in a trauma-exposed Black population. J Psychiatr Res 2024; 173:326-332. [PMID: 38574596 DOI: 10.1016/j.jpsychires.2024.03.016] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/17/2024] [Accepted: 03/15/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Race-related stress (RRS) is an unrecognized source of moral injury (MI)-or the emotional and/or spiritual suffering that may emerge after exposure to events that violate deeply held beliefs. Additionally, MI has not been explored as a mechanism of risk for post-traumatic stress disorder (PTSD) in trauma-exposed civilians. We examined relations among exposure to potentially morally injurious events (moral injury exposure, MIE), related distress (moral injury distress, MID), and RRS in Black Americans. Potential indirect associations between RRS and PTSD symptoms via MID were also examined. METHODS Black Americans (n = 228; 90.4% female; Mage = 31.6 years. SDage = 12.8 years) recruited from an ongoing study of trauma completed measures assessing civilian MIE and MID, RRS, and PTSD. Bivariate correlations were conducted with MIE and MID, and mediation analysis with MID, to examine the role of MI in the relationship between RRS and PTSD symptom severity. RESULTS MIE was significantly correlated with cultural (r = 0.27), individual (r = 0.29), and institutional (r = 0.25) RRS; MID also correlated with cultural (r = 0.31), individual (r = 0.31), and institutional (r = 0.26) RRS (ps < 0.001). We found an indirect effect of RRS on PTSD symptoms via MID (β = 0.10, p < 0.005). CONCLUSIONS All types of RRS were associated with facets of MI, which mediated the relationship between RRS and current PTSD symptoms. MI may be a potential mechanism through which RRS increases the risk for PTSD in Black individuals.
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Affiliation(s)
- Aziz Elbasheir
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, USA; Neuroscience PhD Program, Emory University, USA
| | - Travis M Fulton
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, USA; Molecular and Systems Pharmacology PhD Program, Emory University, USA
| | - Khaled C Choucair
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, USA
| | - Emma C Lathan
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, USA
| | | | - Alfonsina Guelfo
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, USA
| | | | - Abigail Powers
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, USA
| | - Negar Fani
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, USA.
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12
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Adams DR, Pérez-Flores NJ, Mabrouk F, Minor C. Assessing Access to Trauma-Informed Outpatient Mental Health Services for Adolescents: A Mystery Shopper Study. Psychiatr Serv 2024; 75:402-409. [PMID: 38018150 PMCID: PMC11062805 DOI: 10.1176/appi.ps.20230198] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
OBJECTIVE The authors aimed to examine how access to trauma-informed mental health services in safety-net health centers varies by insurance type and race-ethnicity of the care seeker. METHODS In this mystery shopper study, three women (White, Latina, and Black voice actresses) called community mental health centers (CMHCs) and federally qualified health centers (FQHCs) (N=229) in Cook County, Illinois, posing as mothers requesting a mental health appointment for their traumatized adolescent child. Each health center was called twice-once in the spring and once in the summer of 2021-with alternating insurance types reported (Medicaid or private insurance). Ability to schedule an appointment, barriers to access, wait times, and availability of trauma-specific treatment were assessed. RESULTS Callers could schedule an appointment in only 17% (N=78 of 451) of contacts. Reasons for appointment denial varied by organization type: the primary reasons for denial were capacity constraints (67%) at CMHCs and administrative requirements to switch to in-network primary care providers (62%) at FQHCs. Insurance and organization type did not predict successful appointment scheduling. Non-White callers were significantly less likely (incidence rate ratio=1.18) to be offered an appointment than the White caller (p=0.019). The average wait time was 12 days; CMHCs had significantly shorter wait times than FQHCs (p=0.019). Only 38% of schedulers reported that their health center offered trauma-informed therapy. CONCLUSIONS Fewer than one in five contacts resulted in a mental health appointment, and an apparent bias against non-White callers raises concern that racial discrimination may occur during scheduling. For equitable access to care, antidiscrimination policies should be implemented.
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Affiliation(s)
- Danielle R Adams
- Center for Mental Health Services Research, Brown School of Social Work, Washington University in St. Louis, St. Louis (Adams, Pérez-Flores); Silver School of Social Work, New York University, New York City (Mabrouk); American Blues Theater, Chicago (Minor)
| | - Nancy Jacquelyn Pérez-Flores
- Center for Mental Health Services Research, Brown School of Social Work, Washington University in St. Louis, St. Louis (Adams, Pérez-Flores); Silver School of Social Work, New York University, New York City (Mabrouk); American Blues Theater, Chicago (Minor)
| | - Fatima Mabrouk
- Center for Mental Health Services Research, Brown School of Social Work, Washington University in St. Louis, St. Louis (Adams, Pérez-Flores); Silver School of Social Work, New York University, New York City (Mabrouk); American Blues Theater, Chicago (Minor)
| | - Carolyn Minor
- Center for Mental Health Services Research, Brown School of Social Work, Washington University in St. Louis, St. Louis (Adams, Pérez-Flores); Silver School of Social Work, New York University, New York City (Mabrouk); American Blues Theater, Chicago (Minor)
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13
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Bhuptani PH, Zhang Y, Danzey L, Bali A, Langdon K, Orchowski LM. Interpersonal trauma, shame, and substance use: A systematic review. Drug Alcohol Depend 2024; 258:111253. [PMID: 38552599 DOI: 10.1016/j.drugalcdep.2024.111253] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/21/2024] [Accepted: 02/24/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Interpersonal trauma is a risk factor for a wide array of adverse mental health outcomes, including substance use. Research has begun investigating the role of shame in the intersection between substance use and interpersonal trauma. The current systematic review summarizes the existing literature documenting the relation among shame, substance use, and interpersonal trauma. METHOD Articles were collected using a Boolean search strategy of terms related to interpersonal trauma, substance use, and shame across six databases. Independent search and screening by three researchers led to a final review of 27 articles, 15 of which were qualitative studies. RESULTS Findings highlight robust associations among shame, interpersonal violence, and substance use across varied samples. Findings emphasize that increased shame is associated with greater substance use among survivors of interpersonal violence and elevated shame and greater interpersonal violence are present among individuals who use substances given the high prevalence rates. Burgeoning research suggests that shame mediates the relationship between interpersonal violence and substance use. CONCLUSION Results from our review suggest that shame may be an important treatment target for individuals presenting with substance use and a history of interpersonal violence. Future studies, with longitudinal designs, are needed to parse out the temporal relation among shame, substance use, and interpersonal violence.
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Affiliation(s)
- Prachi H Bhuptani
- Rhode Island Hospital, Providence, RI, USA; Brown University, Providence, RI, USA.
| | | | - Lauren Danzey
- Rhode Island Hospital, Providence, RI, USA; Brown University, Providence, RI, USA
| | - Aanandita Bali
- Rhode Island Hospital, Providence, RI, USA; Brown University, Providence, RI, USA
| | - Kirsten Langdon
- Rhode Island Hospital, Providence, RI, USA; Brown University, Providence, RI, USA
| | - Lindsay M Orchowski
- Rhode Island Hospital, Providence, RI, USA; Brown University, Providence, RI, USA
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14
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Younas A, Monari EN, Ali P. Applying intersectionality to address inequalities in nursing education. Nurse Educ Pract 2024; 77:103982. [PMID: 38669734 DOI: 10.1016/j.nepr.2024.103982] [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] [Received: 10/19/2023] [Revised: 11/29/2023] [Accepted: 04/18/2024] [Indexed: 04/28/2024]
Abstract
AIM The aim of this paper is to discuss the significance of the intersectionality framework for addressing prejudices, racism and inequalities in nursing education and clinical learning environments. BACKGROUND Discrimination and racism against nursing students and educators based on their gender, ethnicity, race and social identities is well-documented in the nursing literature. Despite documented discrimination and incivility based on intersectional factors, it is reported that often nurse educators show limited interest in the culture, diverse experiences and values of nursing students with culturally and linguistically diverse backgrounds. DESIGN Discussion paper METHODS: The discussion was based on contemporary literature about intersectionality, discrimination and racism in nursing. We completed a cursory search of literature in nursing education journal and selected nursing and health science databases. This was not a formal literature review. Using a fictional example, the application of intersectionality to address inequalities in educational settings is illustrated. RESULTS Intersectionality is an invaluable tool for examining interwoven power relations and power struggles arising from racial, gender, ethnic, religious and sexuality and disability-related differences. Nurse educators, students and leaders should be more cognizant of their preconceived views, sociocultural stereotypes and varied forms of sociocultural oppression affecting their interactions with each other in clinical learning environments. CONCLUSIONS Incorporating intersectionality can address prejudices, racism and inequalities arising due to sociocultural, ethnic, power-related and intergenerational issues among educators, students and other personnel involved in creating clinical learning environments.
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Affiliation(s)
- Ahtisham Younas
- Faculty of Nursing, Memorial University of Newfoundland, Canada.
| | - Esther N Monari
- Faculty of Nursing, Memorial University of Newfoundland, Canada
| | - Parveen Ali
- University of Sheffield & Doncaster and Bassetlaw Teaching Hospitals, UK
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15
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Criss S, Kim M, De La Cruz MM, Thai N, Nguyen QC, Nguyen TT. Experiences of racism in the U.S. - A perspective from Asian & Pacific Islander, Black, Latina, and Middle Eastern women. Heliyon 2024; 10:e28823. [PMID: 38596122 PMCID: PMC11002583 DOI: 10.1016/j.heliyon.2024.e28823] [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: 05/04/2023] [Revised: 02/26/2024] [Accepted: 03/25/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction Racism is a critical social determinant of health because it can have a direct impact on health and well-being, as well as infiltrate systems, policies, and practices. Few studies have explored the similarities and differences of experiences with racism and health between different minoritized groups. The objective of this paper is to examine how racism influences life experiences from the perspectives of Asian & Pacific Islander, Black, Latina, and Middle Eastern women. Methods Eleven online racially/ethnically homogeneous focus groups with a total of 52 participants were conducted in the U.S., with representation from the North, South, and West coast. The online focus groups were recorded, transcribed, and two were translated into English (from Vietnamese and Spanish). The data was coded through NVivo and analyzed through a series of team meetings to establish themes. Results Participants reported experiences of racism and discrimination, including physical and verbal personal attacks. They shared the role of microaggressions in their daily life, along with the ubiquitous anti-Black sentiment discussed in every group. Our participants discussed the complexities of intersectionality in their experience of discrimination, specifically regarding immigration status, language spoken, and gender. Participants also reported the role of direct racism and vicarious racism (e.g., the experiences with racism of friends or family, awareness of racist incidents via the news) in affecting their mental health. Some effects were fear, stress, anxiety, depression, and self-censoring. For participants in the Black and Latina focus groups, mental health stressors often manifested into physical issues. Discussion Understanding the nuances in experiences across racial/ethnic groups is beneficial in identifying potential interventions to prevent and address racism and its negative health impacts.
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Affiliation(s)
- Shaniece Criss
- Department of Health Sciences, Furman University, Greenville, SC, 29613, USA
| | - Melanie Kim
- Department of Anthropology, Brown University, Providence, RI, 02912, USA
| | | | - Nhung Thai
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, 94720, USA
| | - Quynh C. Nguyen
- Department of Epidemiology & Biostatistics, University of Maryland School of Public Health, College Park, MD, 20742, USA
| | - Thu T. Nguyen
- Department of Epidemiology & Biostatistics, University of Maryland School of Public Health, College Park, MD, 20742, USA
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Floyd James K, Chen K, Hindra SS, Gray S, Robinson MN, Tobin CST, Choi K, Saint Arnault D. Racism-related stress and mental health among black women living in Los Angeles County, California: A comparison of postpartum mood and anxiety disorder screening scales. Arch Womens Ment Health 2024:10.1007/s00737-024-01458-w. [PMID: 38561564 DOI: 10.1007/s00737-024-01458-w] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE To assess Black women's exposure to and appraisal of racism-related stress during the postpartum period and to distinguish its impact on three indicators of postpartum mood and anxiety disorders (PMADs) symptoms. METHODS Data from the Black Mothers' Mental Wellness Study (N = 231) and linear regression models estimated the associations between racism-related stress and the PMAD indicators: 3-item Edinburgh Postnatal Depression Scale (EPDS-3), 8-item Patient Health Questionnaire (PHQ-8), and PHQ-15. RESULTS The majority of participants (80.5%, N = 186) experienced racism a few times a year or more, of which 37.1% (N = 69) were bothered somewhat and 19.3% (N = 36) a lot. Racism-related stress, income, level of education, and history of mental health diagnosis explained greater variance in PMAD symptoms as measured by the PHQ-8 score (R2 = 0.58, p = < 0.001) compared to the EPDS-3 (R2 = 0.46, p = < 0.001) or the PHQ-15 (R2 = 0.14, p = 0.035). CONCLUSIONS Racism is a stressor for Black women living in Los Angeles County, California. Racism-related stress and emotional expression of PMAD symptoms were salient to the postpartum mental health of the Black women in this study. Findings from this study suggest that the PHQ-8 should be used to assess how racism impacts Black women's postpartum mental health.
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Affiliation(s)
- Kortney Floyd James
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA.
- RAND Corporation, Santa Monica, CA, USA.
| | - Keren Chen
- David Geffen School of Medicine, Department of Medicine Statistics Core, University of California, Los Angeles, Los Angeles, CA, USA
| | - Sasha S Hindra
- University of California Irvine, Sue & Bill Gross School of Nursing, Irvine, CA, USA
| | | | - Milllicent N Robinson
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Courtney S Thomas Tobin
- Jonathan and Karin Fielding School of Public Health, Department of Community Health Sciences), University of California Los Angeles, Los Angeles, CA, USA
| | - Kristen Choi
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
- Fielding School of Public Health, Department of Health Policy and Management, University of California Los Angeles, Los Angeles, CA, USA
| | - Denise Saint Arnault
- School of Nursing, Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, MI, USA
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Tomko C, Rouhani S, LaSalle L, Sherman SG. Public support for reinvesting resources from enforcing drug possession to health-promoting alternatives: A nationally representative poll of adults in the United States. Int J Drug Policy 2024; 126:104370. [PMID: 38432049 DOI: 10.1016/j.drugpo.2024.104370] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/15/2024] [Accepted: 02/22/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND The legal enforcement of drug possession is associated with a host of negative consequences for people who use drugs (PWUD), has demonstrated little effectiveness at curbing drug use, and has contributed to lasting financial, social, and health-related racial disparities in Black and Brown communities in the United States (U.S.). One policy alternative is reinvesting resources typically used for enforcing drug possession into health-promoting services such as drug treatment or harm reduction that can better serve the needs of PWUD than the criminal legal system. We sought to characterize the prevalence and correlates of national public support for this reinvestment in the U.S. METHODS A nationally representative sample of U.S. adults (N = 1,212) completed the Johns Hopkins COVID-19 Civic Life and Public Health Survey (wave three, fielded November 11-30, 2020). The outcome is support for reinvestment of resources spent on enforcing drug possession into health-promoting alternatives (i.e., drug treatment, harm reduction, housing support, or community-based resources). We measured potential correlates including socio-demographics and social/political attitudes, including political ideology (conservative, moderate, liberal) and racial resentment toward the Black community. Analyses accounted for complex survey weights. RESULTS Weighted prevalence of support for reinvestment of resources was 80 %. Multivariable logistic regression (controlling for confounders) showed that white respondents were more likely than Black (OR = 2.51, 95% CI = 1.08, 5.87) to favor reinvestment. Respondents with moderate (OR = 0.34, 95 % CI = 0.15-0.79) or conservative (OR = 0.21, 95 % CI = 0.09-0.50) political ideology (compared to liberal) and medium (OR = 0.26, 95 % CI = 0.09-0.74) or high (OR = 0.12, 95 % CI = 0.04-0.35) levels of racial resentment (compared to low) were less likely to support reinvestment. CONCLUSION There is substantial national support for reinvesting resources into health-promoting alternatives, though political ideology and racial resentment temper support. Results can inform targeted messaging to increase support for moving drug policy from the criminal legal sphere toward public health.
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Affiliation(s)
- Catherine Tomko
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624N. Broadway, Baltimore, MD 21205, United States.
| | - Saba Rouhani
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624N. Broadway, Baltimore, MD 21205, United States; Department of Epidemiology, New York University School of Global Public Health, 708 Broadway, New York, NY 10003, United States; Center for Anti-racism, Social Justice and Public Health, New York University School of Global Public Health, 708 Broadway, 9th Floor, New York, NY 10003, United States
| | - Lindsay LaSalle
- Drug Policy Alliance, 131 West 33rd St, 15th Floor, New York, NY 10001, United States
| | - Susan G Sherman
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624N. Broadway, Baltimore, MD 21205, United States
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Criss S, Kim M, De La Cruz MM, Thai N, Nguyen QC, Hswen Y, Gee GC, Nguyen TT. Vigilance and Protection: How Asian and Pacific Islander, Black, Latina, and Middle Eastern Women Cope with Racism. J Racial Ethn Health Disparities 2024; 11:773-782. [PMID: 36917397 PMCID: PMC10013280 DOI: 10.1007/s40615-023-01560-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/10/2023] [Accepted: 03/01/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Research is needed to fully investigate the differential mechanisms racial and ethnic groups use to deal with ongoing intersectional racism in women's lives. The aim of this paper was to understand how Asian American and Pacific Islander, Black, Latina, and Middle Eastern women experience racism-from personal perceptions and interactions to coping mechanisms and methods of protection. METHODS A purposive sample of 52 participants participated in 11 online racially/ethnically homogeneous focus groups conducted throughout the USA. A team consensus approach was utilized with codebook development and thematic analysis. RESULTS The findings relate to personal perceptions and interactions related to race and ethnicity, methods of protection against racism, vigilant behavior based on safety concerns, and unity across people of color. A few unique concerns by group included experiences of racism including physical violence among Asian American Pacific Islander groups, police brutality among Black groups, immigration discrimination in Latina groups, and religious discrimination in Middle Eastern groups. Changes in behavior for safety and protection include altering methods of transportation, teaching their children safety measures, and defending their immigration status. They shared strategies to help racial and ethnic minorities against racism including mental health resources and greater political representation. All racial and ethnic groups discussed the need for unity, solidarity, and allyship across various communities of color but for it to be authentic and long-lasting. CONCLUSION Greater understanding of the types of racism specific groups experience can inform policies and cultural change to reduce those factors.
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Affiliation(s)
- Shaniece Criss
- Department of Health Sciences, Furman University, Greenville, SC, 29613, USA.
| | - Melanie Kim
- Department of Anthropology, Brown University, Providence, RI, 02912, USA
| | - Monica M De La Cruz
- School of Social Welfare, University of California, Berkeley, CA, 94720, USA
| | - Nhung Thai
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, 94720, USA
| | - Quynh C Nguyen
- Department of Epidemiology & Biostatistics, School of Public Health, University of Maryland, College Park, MD, 20742, USA
| | - Yulin Hswen
- Department of Epidemiology and Biostatistics, Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, USA
| | - Gilbert C Gee
- Department of Community Health Sciences, University of California, Los Angeles, CA, 90095, USA
| | - Thu T Nguyen
- Department of Epidemiology & Biostatistics, School of Public Health, University of Maryland, College Park, MD, 20742, USA
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Agbonlahor O, DeJarnett N, Hart JL, Bhatnagar A, McLeish AC, Walker KL. Racial/Ethnic Discrimination and Cardiometabolic Diseases: A Systematic Review. J Racial Ethn Health Disparities 2024; 11:783-807. [PMID: 36976513 PMCID: PMC10044132 DOI: 10.1007/s40615-023-01561-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 03/29/2023]
Abstract
INTRODUCTION Racial discrimination has been identified as a risk factor for cardiometabolic diseases, the leading cause of morbidity and mortality among racial/ethnic minority groups; however, there is no synthesis of current knowledge on the association between discrimination and cardiometabolic diseases. The objective of this systematic review was to summarize evidence linking racial/ethnic discrimination and cardiometabolic diseases. METHODS The review was conducted based on studies identified via electronic searches of 5 databases (PubMed, Google Scholar, WorldWideScience.org, ResearchGate and Microsoft Academic) using terms related to discrimination and cardiometabolic disease. RESULTS Of the 123 eligible studies included in the review, 87 were cross-sectional, 25 longitudinal, 8 quasi-experimental, 2 randomized controlled trials and 1 case-control. Cardiometabolic disease outcomes discussed were hypertension (n = 46), cardiovascular disease (n = 40), obesity (n = 12), diabetes (n = 11), metabolic syndrome (n = 9), and chronic kidney disease (n = 5). Although a variety of discrimination measures was employed across the studies, the Everyday Discrimination Scale was used most often (32.5%). African Americans/Blacks were the most frequently studied racial/ethnic group (53.1%), and American Indians the least (0.02%). Significant associations between racial/ethnic discrimination and cardiometabolic disease were found in 73.2% of the studies. DISCUSSION Racial/ethnic discrimination is positively associated with increased risk of cardiometabolic disease and higher levels of cardiometabolic biomarkers. Identifying racial/ethnic discrimination as a potential key contributor to the health inequities associated with cardiometabolic diseases is important for addressing the significant burden borne by racial/ethnic minorities.
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Affiliation(s)
- Osayande Agbonlahor
- Department of Communication, University of Louisville, Louisville, KY USA
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
| | - Natasha DeJarnett
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- Division of Environmental Medicine, School of Medicine, University of Louisville, Louisville, KY USA
| | - Joy L. Hart
- Department of Communication, University of Louisville, Louisville, KY USA
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- Division of Environmental Medicine, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
| | - Alison C. McLeish
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY USA
| | - Kandi L. Walker
- Department of Communication, University of Louisville, Louisville, KY USA
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
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Niemi L, Washington N, Workman C, Arcila-Valenzuela M, De Brigard F. The emotional impact of baseless discrediting of knowledge: An empirical investigation of epistemic injustice. Acta Psychol (Amst) 2024; 244:104157. [PMID: 38354565 DOI: 10.1016/j.actpsy.2024.104157] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/16/2024] Open
Abstract
According to theoretical work on epistemic injustice, baseless discrediting of the knowledge of people with marginalized social identities is a central driver of prejudice and discrimination. Discrediting of knowledge may sometimes be subtle, but it is pernicious, inducing chronic stress and coping strategies such as emotional avoidance. In this research, we sought to deepen the understanding of epistemic injustice's impact by examining emotional responses to being discredited and assessing if marginalized social group membership predicts these responses. We conducted a novel series of three experiments (Total N = 1690) in which participants (1) shared their factual knowledge about how a game worked or their personal feelings about the game; (2) received discrediting feedback (invalidating remarks), validating feedback (affirming remarks), or insulting feedback (general negative social evaluation); and then (3) reported their affect. In all three studies, on average, affective responses to discrediting feedback were less negative than to insulting feedback, and more negative than to validating feedback. Participants who shared their knowledge reported more negative affect after discrediting feedback than participants who shared their feelings. There were consistent individual differences, including a twice-replicated finding of reduced negative affect after receiving discrediting and insulting feedback for Black men compared to White men and women and Black women. Black men's race-based traumatic symptom scores predicted their affective responses to discrediting and insulting feedback, suggesting that experience with discrimination contributed to the emotional processing of a key aspect of epistemic injustice: remarks conveying baseless discrediting of knowledge.
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Affiliation(s)
- Laura Niemi
- Cornell University, Ithaca, NY 14853, United States of America.
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Trinh NHT, Talukder F, Nagendra A, Ali AM, Emmerich A, Chow L, Jenkins JH, Okereke OI. From Diversity, Equity, and Inclusion to an Anti racism Strategic Plan: An Academic Department of Psychiatry's Journey. Psychiatr Serv 2024; 75:391-394. [PMID: 38347815 DOI: 10.1176/appi.ps.20230024] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
The efforts of an academic psychiatry department to embark on an antiracism strategic planning process are outlined, including the establishment of an antiracism task force charged with the development of an antiracism strategic plan. The initial process of the task force is described, recommendations are summarized, and future directions are outlined.
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Affiliation(s)
- Nhi-Ha T Trinh
- Department of Psychiatry, Massachusetts General Hospital (all authors), and Harvard Medical School (Trinh, Nagendra, Emmerich, Chow, Jenkins, Okereke), Boston
| | - Farhabi Talukder
- Department of Psychiatry, Massachusetts General Hospital (all authors), and Harvard Medical School (Trinh, Nagendra, Emmerich, Chow, Jenkins, Okereke), Boston
| | - Arun Nagendra
- Department of Psychiatry, Massachusetts General Hospital (all authors), and Harvard Medical School (Trinh, Nagendra, Emmerich, Chow, Jenkins, Okereke), Boston
| | - Areeba M Ali
- Department of Psychiatry, Massachusetts General Hospital (all authors), and Harvard Medical School (Trinh, Nagendra, Emmerich, Chow, Jenkins, Okereke), Boston
| | - Anne Emmerich
- Department of Psychiatry, Massachusetts General Hospital (all authors), and Harvard Medical School (Trinh, Nagendra, Emmerich, Chow, Jenkins, Okereke), Boston
| | - Louis Chow
- Department of Psychiatry, Massachusetts General Hospital (all authors), and Harvard Medical School (Trinh, Nagendra, Emmerich, Chow, Jenkins, Okereke), Boston
| | - Jonathan H Jenkins
- Department of Psychiatry, Massachusetts General Hospital (all authors), and Harvard Medical School (Trinh, Nagendra, Emmerich, Chow, Jenkins, Okereke), Boston
| | - Olivia I Okereke
- Department of Psychiatry, Massachusetts General Hospital (all authors), and Harvard Medical School (Trinh, Nagendra, Emmerich, Chow, Jenkins, Okereke), Boston
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Nie F. Asian Hate, religion, and perceived changes in physical health: exploring the flip side of minority stress during the COVID-19 pandemic. Ethn Health 2024; 29:279-294. [PMID: 38332734 DOI: 10.1080/13557858.2024.2314593] [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] [Received: 11/19/2023] [Accepted: 01/30/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVES Prior research suggests that racism is associated with adverse mental health outcomes for Asians in the United States. Relatively less research has been conducted to examine the effects of racism on physical health, particularly the changes in physical health among Asians and Asian Americans. This study aims to fill in this gap in prior research. DESIGN Survey was conducted via Qualtrics in March 2023. A panel sample of 356 Asian and Asian American adults from across the US was collected. Ordinary Least Squares Regression was employed to examine the interrelationships among racism, religion, and perceived changes in physical health during the COVID-19 pandemic. RESULTS Contrary to conventional wisdom, more frequent experience with blatant racism was associated with a perceived improvement in physical health after controlling for subtle racism, anxiety, acculturation, and various sociodemographic variables. Interestingly, this robust relationship was more significant among Asians who attended religious services more frequently. Additional three-way interactions revealed that the interaction between blatant racism and religious service attendance on perceived changes in physical health was more significant for US-born Asians and Asians of Indian or Japanese ethnicity. CONCLUSION Racism exerts a significant influence on physical health outcomes among Asians and Asian Americans. However, this relationship was contingent upon the specific aspect of racism and intersected with religiosity, acculturation, and ethnic identity.
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Affiliation(s)
- Fanhao Nie
- Department of Sociology, University of Massachusetts Lowell, Lowell, USA
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23
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Jecker NS, Ravitsky V, Ghaly M, Bélisle-Pipon JC, Atuire C. Proposed Principles for International Bioethics Conferencing: Anti-Discriminatory, Global, and Inclusive. Am J Bioeth 2024; 24:13-28. [PMID: 37549186 DOI: 10.1080/15265161.2023.2232748] [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: 08/09/2023]
Abstract
This paper opens a critical conversation about the ethics of international bioethics conferencing and proposes principles that commit to being anti-discriminatory, global, and inclusive. We launch this conversation in the Section, Case Study, with a case example involving the International Association of Bioethics' (IAB's) selection of Qatar to host the 2024 World Congress of Bioethics. IAB's choice of Qatar sparked controversy. We believe it also may reveal deeper issues of Islamophobia in bioethics. The Section, Principles for International Bioethics Conferencing, sets forth and defends proposed principles for international bioethics conferencing. The Section, Applying Principles to Site Selection applies the proposed principles to the case example. The Section, Applying Principles Beyond Site Selection addresses other applications of the proposed principles. The Section, Objections responds to objections. We close (in the Section, Conclusion) by calling for a wider discussion of our proposed principles. One-Sentence Capsule Summary: How should bioethicists navigate the ethics of global bioethics conferencing?
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Affiliation(s)
- Nancy S Jecker
- University of Washington School of Medicine, Seattle, WA, USA
- University of Johannesburg, Auckland Park, South Africa
- Chinese University of Hong Kong, Hong Kong, China
| | - Vardit Ravitsky
- University of Montreal, Montreal, Canada
- Harvard Medical School, Boston, MA, USA
| | | | | | - Caesar Atuire
- University of Oxford, Oxford, England
- University of Ghana, Legon, Ghana
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24
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Akinsanya J, Smith JB, Langer-Gould A. Traumatic brain injury, race, ethnicity and cognition in newly diagnosed persons with multiple sclerosis. Mult Scler Relat Disord 2024; 86:105577. [PMID: 38579569 DOI: 10.1016/j.msard.2024.105577] [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] [Received: 10/30/2023] [Revised: 02/08/2024] [Accepted: 03/24/2024] [Indexed: 04/07/2024]
Abstract
We sought to determine whether a history of traumatic brain injury (TBI) could explain the lower symbol digit modalities test (SDMT) scores observed among newly diagnosed multiple sclerosis (MS) and control participants identifying as Black or Hispanic versus white in the MS Sunshine Study (n = 1172). 330 (29.2 %) participants reported a history of ≥1 TBI. Accounting for TBI did not explain the significant independent associations between having MS, being Black or Hispanic and lower SDMT. The pervasive effects of systemic racism in the United States remain the best explanation for the lower SDMT scores observed in Black and Hispanic participants.
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Affiliation(s)
- Jemima Akinsanya
- Department of Neurology, Georgetown University Medical Center, Washington, DC, USA
| | - Jessica B Smith
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, USA
| | - Annette Langer-Gould
- Department of Neurology, Los Angeles Medical Center, Southern California Permanente Medical Group, Los Angeles, CA, USA; Department of Clinical Science, Kaiser Permanente School of Medicine, Pasadena CA, USA.
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25
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França M, Dourado I, Grangeiro A, Greco D, Magno L. Racial HIV Testing Inequalities in Adolescent Men who have Sex with Men and Transgender Women in Three Brazilian Cities. AIDS Behav 2024:10.1007/s10461-024-04297-z. [PMID: 38526640 DOI: 10.1007/s10461-024-04297-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2024] [Indexed: 03/27/2024]
Abstract
Many barriers to human immunodeficiency virus (HIV) testing among Black people exist. This study analysed the association between race/skin colour and lifetime HIV testing among adolescent men who have sex with men (AMSM) and transgender women (ATGW) in three Brazilian cities. This cross-sectional study was nested within the PrEP1519 cohort, a multicentre study of AMSM and ATGW aged 15-19 years in Belo Horizonte, Salvador, and São Paulo, Brazil. The outcome variable was the lifetime HIV testing (no or yes). The main exposure variable was self-reported race/skin colour as White and a unique Black group (composed of Pardo-mixed colour and Black, according to the Brazilian classification). Descriptive statistics and bivariate and multiple logistic regression analyses were conducted to estimate the adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) to determine the association between the main exposure and outcome, adjusted for covariates. White adolescents were tested more frequently than the unique Black group (64.0% vs. 53.7%, respectively; Ρ = 0.001). Multiple logistic regression analysis showed that the unique Black group of AMSM and ATGW had 26% (adjusted OR [aOR], 0.74; 95% CI, 0.55-0.98) and 38% (aOR, 0.62; 95% CI, 0.45-0.87) lower odds of being tested for HIV in a lifetime than Whites in model 1 and 2, respectively. Our findings highlight the role of racism in lifetime HIV testing among AMSM and ATGW. Therefore, an urgent need for advances exists in public policies to combat racism in Brazil.
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Affiliation(s)
- Marcus França
- Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, Bahia, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Inês Dourado
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Alexandre Grangeiro
- Faculdade de Medicina Preventiva, Universidade de São Paulo, São Paulo, Brazil
| | - Dirceu Greco
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Laio Magno
- Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, Bahia, Brazil.
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
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26
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Turpin RE, Camp AD, Mandell CJ, Mhonde RRD, Dyer TV, Mayer KH, Liu H, Coates T, Boekeloo B. Black Sexual Minority Men's Experiences in MPowerment Interventions: Implications for HIV Prevention. Int J Behav Med 2024:10.1007/s12529-024-10275-5. [PMID: 38499962 DOI: 10.1007/s12529-024-10275-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Black sexual minority men (BSMM) are disproportionately vulnerable to HIV acquisition; the MPowerment model is one community-based framework for preventing HIV in this population. It focuses on developing a supportive network of peers to promote health messaging, reduce stigma, and improve resilience. While these interventions have demonstrated general success, there are important challenges related to race, sexuality, and internalized stigma. Our study aimed to explore these experiences among BSMM in MPowerment models focused on HIV prevention. METHOD We conducted 24 qualitative interviews of BSMM attending HIV prevention-related MPowerment events in the greater D.C. Metropolitan area. In-depth interviews were conducted via phone, and interviews were analyzed using thematic analysis. RESULTS We identified four themes from the transcript analysis process: Black queer intersectional social support and community, HIV-related information and destigmatization, social status, and sexuality. Within each of these themes, we identified relationships with overall HIV prevention messaging, including barriers to PrEP use. Barriers related to social status were especially prevalent and described as unique to the D.C. metropolitan area. CONCLUSION Overall, MPowerment event spaces provide a forum for BSMM to feel safe and supported while gaining important HIV-related knowledge and prevention access. Challenges related to social status and destigmatization of sexuality are important considerations in designing and implementing this model, especially related to PrEP promotion.
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Affiliation(s)
- Rodman E Turpin
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA.
| | - Aaron D Camp
- Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
- INOVA Health System, Fairfax, VA, USA
| | - C J Mandell
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Rochelle R Davidson Mhonde
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Typhanye V Dyer
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Hongjie Liu
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | - Thomas Coates
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Bradley Boekeloo
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
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27
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Matthew DB, Benfer EA. A Clarion Call for Change: The MLP Imperative to Center Racial Discrimination and Structural Health Inequities. J Law Med Ethics 2024; 51:735-747. [PMID: 38477284 PMCID: PMC10951182 DOI: 10.1017/jme.2023.153] [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: 03/14/2024]
Abstract
Across the country, legal and health care professionals who understand that health outcomes are most influenced by social and environmental conditions have improved patient health by adopting the interdisciplinary MLP health care delivery model. However, the MLP field cannot advance population health, let alone long-term health equity, until it addresses the structural determinants of health inequity that are rooted in discrimination, segregation, and other forms of racial and ethnic subordination.
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Affiliation(s)
| | - Emily A Benfer
- GEORGE WASHINGTON UNIVERSITY LAW SCHOOL, WASHINGTON, DC, USA
- PRINCETON UNIVERSITY EVICTION LAB, PRINCETON, NJ, USA
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28
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Bhambra N, Waicus S, Persaud N. Gender and Racialization Status of Medical Eponym Namesakes: Cross-sectional Study. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01961-x. [PMID: 38436887 DOI: 10.1007/s40615-024-01961-x] [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] [Received: 12/21/2023] [Revised: 02/15/2024] [Accepted: 02/21/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Many medical eponyms were established when women and racialized individuals were excluded from medicine. The objective of this study was to determine the gender and racialization status of individuals whose names are incorporated in medical eponyms. METHODS This study is a cross-sectional analysis of gender and racialization of medical eponym namesakes. The main outcome measures were the study of gender and racialization of medical eponym namesakes found in Whonamedit, Mosby's Medical Dictionary, and the International Classification of Diseases (version 10). The gender and whether the individual was a racialized person were determined using pictures and other available information. RESULTS We identified 3484 unique eponyms. White men represented the majority of medical eponym namesakes (2190 of 2327, 94.1%) followed by white women (85 of 2327, 3.7%), racialized men (49 of 2327, 2.1%), and racialized women (3 of 2327, 0.1%). In the ICD-10 sub-analysis, white men represented the majority of medical eponym namesakes (476 of 514, 92.6%) followed by white women (22 of 514, 4.3%), racialized men (14 of 514, 2.7%), and racialized women (2 of 514, 0.4%). CONCLUSION Most medical eponyms represent men and white individuals, highlighting the underrepresentation of women and racialized individuals. This indicates a need to re-examine the ongoing use of medical eponyms which may entrench sexism and racism in medicine and contribute to an environment that makes some feel unwelcome or undervalued.
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Affiliation(s)
| | - Sarah Waicus
- Department of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Navindra Persaud
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada.
- MAP Centre for Urban Health Solutions, St Michael's Hospital, Toronto, Canada.
- Department of Family and Community Medicine, St Michael's Hospital, Unity Health Toronto, Toronto, Canada.
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29
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Stevens F, Shriver E. The shame of implicit racial bias. J Soc Psychol 2024; 164:258-272. [PMID: 35240949 DOI: 10.1080/00224545.2022.2046538] [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] [Received: 08/22/2021] [Accepted: 02/21/2022] [Indexed: 10/18/2022]
Abstract
This study provides support for the theory that individual shame prevents individuals from recognizing their implicit racial biases. Participants across two studies in multiple conditions took the Race IAT, received feedback about their implicit racial bias, and then completed the Shame IAT. We created various conditions either to attribute their implicit racial bias to the self or to create an alternative explanation. The results demonstrated that when individuals attributed their implicit racial bias to themselves vs. an alternative attribution, they subsequently expressed higher levels of interpersonal shame, through increased associations between self-referential and shameful words. The need for positive self-esteem or the avoidance of a negative emotion such as shame may lead participants to avoid examining their own implicit racial biases.
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30
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Bak H, Jurcevic I, Trawalter S. What black people value when white people confront prejudice. J Soc Psychol 2024; 164:187-198. [PMID: 36864744 DOI: 10.1080/00224545.2023.2178875] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 01/04/2022] [Indexed: 03/04/2023]
Abstract
Previous research in psychology has focused on how confronting racial prejudice affects White people - White perpetrators and bystanders - and reduces their prejudice. We shift the focus to Black people - Black people targeted by prejudice and Black observers - and examine how Black people perceive White people's confrontations. Two hundred forty-two Black participants evaluated White participants' responses to anti-Black comments (i.e., confrontations), which were text-analyzed and content-coded to identify the characteristics that Black participants valued the most. Analyses revealed that Black participants valued confrontations that were coded as direct, targeting the action, labeling the prejudiced action as such, and connecting individual acts of prejudice to systemic racism. Notably, this style of confrontation is not what research suggests is best for White people, for reducing Whites' prejudice. Accordingly, the present work contributes to our understanding of confronting prejudice and the value of centering Black experiences and perspectives rather than White comfort and prejudice.
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Affiliation(s)
| | - Ines Jurcevic
- Daniel J. Evans School of Public Policy & Governance, University of Washington
| | - Sophie Trawalter
- Frank Batten School of Leadership and Public Policy, University of Virginia c
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31
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Boge CLK, Hayes McDonough M, Newman AM, Blumenstock J, Elgarten CW, Freedman JL, Olson TS, Li Y, Fisher BT. Disparities in Cytomegalovirus Infection Rates by Race and Ethnicity among Pediatric Allogeneic Hematopoietic Cell Transplantation Recipients at a Single Center. Transplant Cell Ther 2024; 30:328.e1-328.e12. [PMID: 38191029 DOI: 10.1016/j.jtct.2024.01.055] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/01/2023] [Accepted: 01/02/2024] [Indexed: 01/10/2024]
Abstract
Previous literature has reported cytomegalovirus (CMV) infection rate disparities among racial/ethnic groups of hematopoietic cell transplantation (HCT) recipients. Because race and ethnicity categorizations are social constructs unlikely to affect biological systems, it is likely there are covariates on the pathway to CMV detection, known as mediators, that can explain the observed disparity. Recent developments in mediation analysis methods enable the analysis of time-to-event outcomes, allowing an investigation of these disparities to also consider the timing of CMV infection detection relative to HCT. This study aimed to explore whether racial and ethnic CMV infection disparities existed within a population of HCT recipients at our center, and whether clinical covariates explained any observed association. The study cohort included all recipients of allogeneic HCT performed at the Children's Hospital of Philadelphia between January 2004 and April 2017 who were CMV PCR-negative pretransplantation, had known donor/recipient CMV serology, and were under blood CMV PCR surveillance. Subjects were followed for 100 days post-HCT. Accelerated failure time models using subject's reported race/ethnicity, dichotomized into non-Hispanic White (NHW) and non-NHW, and exposure and time to CMV detection as outcomes examined whether selected clinical factors-donor/recipient CMV serostatus, recipient age, indication for HCT, hematopoietic cell source, match quality-mediated any identified exposure-outcome association. The analysis included 348 HCTs performed in 335 subjects, with 86 episodes (24.7%) in which CMV was detected via PCR analysis. The accelerated failure time model without mediators estimated that non-NHW subjects had fewer CMV-free survival days (time ratio, .21; 95% confidence interval, .10 to .44). Any hypothesized mediator mediated at most 5% of the total association between race/ethnicity and time to CMV detection. Non-NHW HCT recipients had fewer CMV-free survival days than NHW recipients; none of the clinical factors hypothesized to mediate this association accounted for a significant component of total association. Further research should focus on nonclinical factors influenced by systemic racism to better understand their effect on CMV infection among HCT recipients.
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Affiliation(s)
- Craig L K Boge
- Pediatric IDEAS Research Group of Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Molly Hayes McDonough
- Center for Healthcare Quality & Analytics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Alexander M Newman
- Division of Infectious Diseases, University of California San Francisco Benioff Children's Hospitals, San Francisco and Oakland, California
| | - Jesse Blumenstock
- Pediatric IDEAS Research Group of Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Caitlin W Elgarten
- Cell Therapy and Transplant Section, Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jason L Freedman
- Cell Therapy and Transplant Section, Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Timothy S Olson
- Cell Therapy and Transplant Section, Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Yun Li
- Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Brian T Fisher
- Pediatric IDEAS Research Group of Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania; Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
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32
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Johnson JD. Black Pregnancy-Related Mortality in the United States. Obstet Gynecol Clin North Am 2024; 51:1-16. [PMID: 38267121 DOI: 10.1016/j.ogc.2023.11.005] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
The maternal mortality rate for non-Hispanic Black birthing people is 69.9 deaths per 100,000 live births compared with 26.6 deaths per 100,000 live births for non-Hispanic White birthing people. Black pregnancy-related mortality has been underrepresented in research and the media; however, there is growing literature on the role of racism in health disparities. Those who provide care to Black patients should increase their understanding of racism's impact and take steps to center the experiences and needs of Black birthing people.
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Affiliation(s)
- Jasmine D Johnson
- Division of Maternal-Fetal Medicine, Indiana University School of Medicine, 550 North University Bloulevard, Suite 2440, Indianapolis, IN 46202, USA.
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33
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Jones E, Palmer L, Bhui K. Mental health, ethnicity and the UK armed forces: Historical lessons for research and policy. Asian J Psychiatr 2024; 93:103957. [PMID: 38340530 DOI: 10.1016/j.ajp.2024.103957] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/20/2023] [Accepted: 02/02/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND UK armed forces have recruited from other races and ethnicities at times of crisis. To meet diversity targets, they have also recruited indigenous groups of non-White British heritage. Considered at greater risk of mental health problems generally, these populations are likely to suffer more in combat and in transition to civilian life. Yet, there is little data on how they fare. METHODS A scoping review was conducted of peer-reviewed studies of psychological illnesses suffered by racial and ethnic minority soldiers from World War One to the present, together with research at the National Archives, Wellcome Trust Archives and the Imperial War Museum for unpublished studies. RESULTS British commanders and psychiatrists argued that 'martial races' were protected against post-traumatic illnesses because of an innate resilience related to a rural heritage. Consequently, low morale and breakdown were interpreted as malingering to avoid combat. Indian troops received lower levels of psychiatric care than provided for British soldiers delivered with limited cultural understanding. Inferior terms and conditions were offered to Indian soldiers with lesser opportunities for promotion. These practices, established in both World Wars, continued for Gurkha and Commonwealth soldiers recruited to meet manpower and diversity targets. Disproportionate complaints of discrimination may explain why ethnic minority status is a risk factor for mental illness. CONCLUSION Management patterns laid down during the Imperial era continue to influence current practice for ethnic minority service personnel. Yet, armed forces can play a positive role in fostering diversity and integration to provide protective factors against mental illness.
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Affiliation(s)
- Edgar Jones
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
| | - Laura Palmer
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Kamaldeep Bhui
- Department of Psychiatry and Nuffield Dept of Primary Care Health Sciences, and Wadham College, Oxford University, UK; World Psychiatric Association Collaborating Centre, Oxford, UK; Global Policy Institute, QMUL; Oxford Health and East London NHS Foundation Trusts, UK
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34
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Lawton RI, Stanford FC. The Role of Racism in Childhood Obesity. Curr Obes Rep 2024; 13:98-106. [PMID: 38172479 PMCID: PMC10939728 DOI: 10.1007/s13679-023-00538-9] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE OF REVIEW Obesity rates continue to rise among children and have shown persistent racial disparities. Racism plays a potentially essential and actionable role in these disparities. This report reviews some mechanisms through which racism may shape childhood obesity. RECENT FINDINGS From the youngest ages, disparities in childhood obesity prevalence are already present. Racism may shape intergenerational and prenatal factors that affect obesity and various stressors and environments where children grow up. The relationships between clinicians and patients may also be shaped by everyday racism and legacies of past racism, which may affect obesity prevalence and treatment efficacy. Comprehensive data on the extent to which racism shapes childhood obesity is limited. However, compelling evidence suggests many ways through which racism ultimately does affect childhood obesity. Interventions to address racism at multiple points where it shapes childhood obesity, including intergenerational and prenatal mechanisms, may help to close disparities.
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Affiliation(s)
| | - Fatima Cody Stanford
- Harvard Medical School, Boston, MA, USA.
- MGH Weight Center, Department of Medicine-Division of Endocrinology-Neuroendocrine, Massachusetts General Hospital, Weight Center, 50 Staniford Street, 4th Floor, Boston, MA, 02114, USA.
- Department of Pediatrics-Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Weight Center, 50 Staniford Street, 4th Floor, Boston, MA, USA.
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35
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Landor AM, Ramseyer Winter VL, Thurston IB, Chan J, Craddock N, Ladd BA, Tylka TL, Swami V, Watson LB, Choukas-Bradley S. The Sociostructural-Intersectional Body Image (SIBI) framework: Understanding the impact of white supremacy in body image research and practice. Body Image 2024; 48:101674. [PMID: 38154289 DOI: 10.1016/j.bodyim.2023.101674] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 12/01/2023] [Accepted: 12/12/2023] [Indexed: 12/30/2023]
Abstract
White supremacy and racial inequities have long pervaded psychological research, including body image scholarship and practice. The experiences of white, heterosexual, able-bodied, cisgender (predominantly college) women from wealthy, Westernized nations have been centered throughout body image research and practice, thereby perpetuating myths of invulnerability among racialized groups and casting white ideals and experiences as the standard by which marginalized bodies are compared. Body image is shaped by multiple axes of oppression that exist within systemic and structural systems, ultimately privileging certain bodies above others. In this position paper, we highlight how white supremacy has shaped body image research and practice. In doing so, we first review the history of body image research and explain how participant sampling, measurement, interpretive frameworks, and dissemination of research have upheld and reinforced white supremacy. Next, grounded in inclusivity and intersectionality, we advance the Sociostructural-Intersectional Body Image (SIBI) framework to more fully understand the body image experiences of those with racialized and minoritized bodies, while challenging and seeking to upend white supremacy in body image research and practice. We encourage other scholars to utilize the SIBI framework to better understand body inequities and the body image experiences of all people, in all bodies.
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Affiliation(s)
- Antoinette M Landor
- Human Development and Family Science, University of Missouri, Columbia, MO, United States; Center for Body Image Research & Policy, University of Missouri, Columbia, MO, United States
| | - Virginia L Ramseyer Winter
- Center for Body Image Research & Policy, University of Missouri, Columbia, MO, United States; School of Social Work, University of Missouri, Columbia, MO, United States.
| | - Idia Binitie Thurston
- Department of Psychological and Brain Sciences, Northeastern University, Boston, MA, United States; Department of Health Behavior, Northeastern University, Boston, MA, United States
| | - Jamie Chan
- School of Psychology, University of Sussex, Falmer, United Kingdom
| | - Nadia Craddock
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - Brianna A Ladd
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park, MD, United States
| | - Tracy L Tylka
- Department of Psychology, Ohio State University, Marion and Columbus, OH, United States
| | - Viren Swami
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia
| | - Laurel B Watson
- Department of Psychology & Counseling, University of Missouri-Kansas City, Kansas City, MO, United States
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Lala R. A Critical Understanding of Inclusion in Oral Microbiome Research through the Lens of Racial Capitalism. Community Dent Health 2024; 41:70-74. [PMID: 38533922 DOI: 10.1922/cdh_iadr24lala06] [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] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
There are important calls for greater inclusion of Indigenous and racialised communities in oral microbiome research. This paper uses the concept of racial capitalism (the extractive continuity of colonialism) to critically examine this inclusion agenda. Racial capitalism explicitly links capitalist exploitations with wider social oppressions e.g., racisms, sexism, ableism. It is not confined to the commercial sector but pervades white institutions, including universities. By using the lens of racial capitalism, we find inclusion agendas allow white institutions to extract social and economic value from relations of race. Racially inclusive research is perceived as a social good, therefore, it attracts funding. Knowledge and treatments developed from research create immense value for universities and pharmaceutical companies with limited benefits for the communities themselves. Moreover, microbiome research tends to drift from conceptualisations that recognise it as something that is shaped by the social, including racisms, to one that is determined genetically and biologically. This location of problems within racialised bodies reinforces racial oppressions and allows companies to further profit from raciality. Inclusion in oral microbiome research must consider ways to mitigate racial capitalism. Researchers can be less extractive by using an anti-racism praxis framework. This includes working with communities to co-design studies, create safer spaces, giving marginalised communities the power to set and frame agendas, sharing research knowledges and treatments through accessible knowledge distributions, open publications, and open health technologies. Most importantly, inclusion agendas must not displace ambitions of the deeper anti-oppression social reforms needed to tackle health inequalities and create meaningful inclusion.
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Affiliation(s)
- R Lala
- Population Health, School of Medicine and Population Health, University of Sheffield, UK
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Sonder GJB, Grey C, Ryan D, Cumming J, Sporle A, Hill PC. Selective under-representation of Pacific peoples in population estimates for health indicator measurements in Aotearoa New Zealand misinforms policy making. BMC Public Health 2024; 24:564. [PMID: 38388865 PMCID: PMC10882897 DOI: 10.1186/s12889-024-17984-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 02/04/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The Census of Populations and Dwellings' is the five yearly population count of Aotearoa New Zealand. Best available populations (BAP) are subnational projections based on census data and demographic assumptions developed for healthcare planning and funding allocation but are also used as the denominator for health indicator monitoring. Pacific people are systematically undercounted, but the impact on health statistics is not well studied. For COVID-19 vaccination coverage, health service user (HSU) data were considered a more reliable denominator than BAP but introduced new biases. We aimed to understand how the choice of denominator population impacts estimates of population size and health system performance for Pacific people at a local level. METHODS We described how declining census response rates affected population data quality. We compared BAP and HSU data at district level. For the indicators 'access to primary care' and 'cervical cancer screening uptake' we replaced currently used BAP denominators with HSU and examined the impact for different ethnic groups in different geographic districts. RESULTS Overall Census 2018 response declined by 10%, but for Māori and Pacific people by 21% and 23%, respectively. This inequitably affected BAP accuracy. Census undercount was highest in the district with the largest Pacific populations, where HSU exceeded BAP most. Notably, 'access to primary care' for Pacific people in this district consistently exceeds 100%. Using BAP, both health indicators are currently estimated as highest for Pacific people compared to other ethnic groups, but when based on HSU, they dropped to lowest. Similar, but less pronounced trends occurred in other districts. Changes in trends over time for both indicators coincided mostly with adjustments in BAP, rather than changes in the numerators. CONCLUSIONS The current use of BAP denominators for health statistics does not enable reliable monitoring of key health indicators for Pacific people. HSU denominators are also unsuitable for monitoring health. Exploring the feasibility of a real-time population register is strongly recommended as a new, transparent, way of obtaining more reliable, timely population data to guide policymaking and underpin a more equitable health system under the health reforms. Meanwhile, reporting of ethnic specific outcomes need to include a clear assessment of the potential for bias due to inaccurate population estimates.
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Affiliation(s)
- Gerard J B Sonder
- Pacific Perspectives Ltd, PO Box 8010, Wellington, New Zealand.
- Department of Internal Medicine, Amsterdam Infection & Immunity Institute (AIII), Amsterdam UMC, location Academic Medical Center, Amsterdam, the Netherlands.
| | - Corina Grey
- Pacific Perspectives Ltd, PO Box 8010, Wellington, New Zealand
- Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Debbie Ryan
- Pacific Perspectives Ltd, PO Box 8010, Wellington, New Zealand
| | | | - Andrew Sporle
- iNZight Analytics Ltd, Auckland, New Zealand
- Department of Statistics, The University of Auckland, Auckland, New Zealand
| | - Philip C Hill
- Centre for International Health, Division of Health Sciences, University of Otago, Dunedin, New Zealand
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Thomas P, Bishop-Royse J, Lomahan S, Silva A, Murphy AM, Martin MA. Community-Based Organizations Leading Research Efforts: Preliminary Findings from the Chicagoland CEAL Program's COVID-19 Vaccine Uptake and Intention Survey. J Racial Ethn Health Disparities 2024:10.1007/s40615-023-01846-5. [PMID: 38383838 DOI: 10.1007/s40615-023-01846-5] [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] [Received: 05/19/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 02/23/2024]
Abstract
BACKGROUND To foster community engaged research in the communities most impacted by COVID-19, the National Institutes of Health (NIH) formed 21 teams of Community Engagement Alliance Against COVID-19 Disparities (CEAL). The national CEAL initiative developed a Common Survey to investigate attitudes and behaviors to the COVID-19 vaccine and clinical trials. This article describes survey implementation at the Chicagoland CEAL Program (CCP). METHODS This community-based participatory research project was the result of a strong collaboration between academic institutions, and a community-based non-profit health equity-focused partner organization. The survey implementation was developed and refined with strong input from CHWs, participants, and staff in the partner organizations and institutions. Survey data were collected with Qualtrics, a web-based survey tool. RESULTS Survey implementation resulted in data collection for 852 participants during the period 12/18/2021-02/18/2023. Excluding participants on the basis of missing data resulted in a sample of 690, 601 of which (87.10%) indicated that they had received at least one dose or intended to get vaccinated. Overall, 54 (7.83%) respondents reported that they had not received the vaccine and were not planning to. CONCLUSION Hard to reach populations present two unique challenges in emerging infectious disease events. Reaching populations vulnerable to poor outcomes with vaccines was essential to addressing the COVID-19 pandemic. Additionally, learning about barriers and hesitancy toward vaccine uptake is difficult in these communities. CCP's partnership of five academic institutions, a community research center, and a community-based non-profit health equity-focused organization shows what is possible when traditional models of research and inquiry are reconsidered for community-based participatory research. Results shown here are drawn from a collaboratively designed and implemented survey, collected in person, with over 90% completion.
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Affiliation(s)
| | - Jessica Bishop-Royse
- Dept. of Adult Health and Gerontological Nursing, College of Nursing, Rush University, Chicago, IL, USA.
| | | | - Abigail Silva
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Chicago, IL, USA
| | - Anne Marie Murphy
- School of Public Health, Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, USA
| | - Molly A Martin
- Department of Pediatrics, University of Illinois Chicago, Chicago, IL, USA
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Arya S, Mahar A, Callum J, Haspel RL. Examining Injustices: Transfusion Medicine and Race. Transfus Med Rev 2024:150822. [PMID: 38519336 DOI: 10.1016/j.tmrv.2024.150822] [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] [Received: 12/09/2023] [Revised: 02/01/2024] [Accepted: 02/12/2024] [Indexed: 03/24/2024]
Abstract
Race and ethnicity are sociopolitical and not biological constructs, and assertions that these population descriptors have scientific meaning has caused significant harm. A critical assessment of the transfusion medicine literature is an important aspect of promoting race-conscious as opposed to race-based medicine. Utilizing current definitions and health equity frameworks, this review will provide a critical appraisal of transfusion medicine studies at the intersection of race and healthcare disparities, with a focus on larger methodological challenges facing the transfusion medicine community. Moving forward, risk modelling accounting for upstream factors, patient input, as well as an expert consensus on how to critically conduct and evaluate this type of literature are needed. Further, when using race and ethnicity in research contexts, investigators must be aware of existing guidelines for such reporting.
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Affiliation(s)
- Sumedha Arya
- Canadian Blood Services, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada; Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Alyson Mahar
- School of Nursing and Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Jeannie Callum
- University of Toronto, Toronto, Ontario, Canada; Kingston Health Sciences Centre and Queen's University, Kingston, Ontario, Canada
| | - Richard L Haspel
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
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Benes Matos da Silva H, Ribeiro-Silva RDC, Freitas de Mello E Silva J, Chis Ster I, Rebouças P, Goes E, Ichihara MY, Ferreira A, M Pescarini J, Leovigildo Fiaccone R, S Paixão E, L Barreto M. Ethnoracial disparities in childhood growth trajectories in Brazil: a longitudinal nationwide study of four million children. BMC Pediatr 2024; 24:103. [PMID: 38341551 PMCID: PMC10858530 DOI: 10.1186/s12887-024-04550-3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/10/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND The literature contains scarce data on inequalities in growth trajectories among children born to mothers of diverse ethnoracial background in the first 5 years of life. OBJECTIVE We aimed to investigate child growth according to maternal ethnoracial group using a nationwide Brazilian database. METHODS A population-based retrospective cohort study employed linked data from the CIDACS Birth Cohort and the Brazilian Food and Nutrition Surveillance System (SISVAN). Children born at term, aged 5 years or younger who presented two or more measurements of length/height (cm) and weight (kg) were followed up between 2008 and 2017. Prevalence of stunting, underweight, wasting, and thinness were estimated. Nonlinear mixed effect models were used to estimate childhood growth trajectories, among different maternal ethnoracial groups (White, Asian descent, Black, Pardo, and Indigenous), using the raw measures of weight (kg) and height (cm) and the length/height-for-age (L/HAZ) and weight-for-age z-scores (WAZ). The analyses were also adjusted for mother's age, educational level, and marital status. RESULTS A total of 4,090,271 children were included in the study. Children of Indigenous mothers exhibited higher rates of stunting (26.74%) and underweight (5.90%). Wasting and thinness were more prevalent among children of Pardo, Asian, Black, and Indigenous mothers than those of White mothers. Regarding children's weight (kg) and length/height (cm), those of Indigenous, Pardo, Black, and Asian descent mothers were on average shorter and weighted less than White ones. Regarding WAZ and L/HAZ growth trajectories, a sharp decline in average z-scores was evidenced in the first weeks of life, followed by a period of recovery. Over time, z-scores for most of the subgroups analyzed trended below zero. Children of mother in greater social vulnerability showed less favorable growth. CONCLUSION We observed racial disparities in nutritional status and childhood growth trajectories, with children of Indigenous mothers presenting less favorable outcomes compared to their White counterparts. The strengthening of policies aimed at protecting Indigenous children should be urgently undertaken to address systematic ethnoracial health inequalities.
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Affiliation(s)
- Helena Benes Matos da Silva
- School of Nutrition, Federal University of Bahia, Salvador, BA, Brazil.
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil.
| | - Rita de Cássia Ribeiro-Silva
- School of Nutrition, Federal University of Bahia, Salvador, BA, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
| | - Juliana Freitas de Mello E Silva
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
| | - Irina Chis Ster
- Infection and Immunity Research Institute, St George's University of London, London, UK
| | - Poliana Rebouças
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
| | - Emanuelle Goes
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
| | - Maria Yury Ichihara
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
| | - Andrêa Ferreira
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
- The Ubuntu Center on Racism, Global Movements, and Population Health Equity, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Julia M Pescarini
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Enny S Paixão
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Maurício L Barreto
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
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Ruiz-Narváez EA, Cozier Y, Zirpoli G, Rosenberg L, Palmer JR. Perceived Experiences of racism in Relation to Genome-Wide DNA Methylation and Epigenetic Aging in the Black Women's Health Study. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01915-3. [PMID: 38324238 DOI: 10.1007/s40615-024-01915-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND African American women have a disproportionate burden of disease compared to US non-Hispanic white women. Exposure to psychosocial stressors may contribute to these health disparities. Racial discrimination, a major stressor for African American women, could affect health through epigenetic mechanisms. METHODS We conducted an epigenome-wide association study (EWAS) to examine the association of interpersonal racism (in daily life and in institutional settings) with DNA methylation in blood in 384 participants of the Black Women's Health Study (BWHS). We also evaluated whether a greater number of perceived experiences of racism was associated with epigenetic aging as measured using different methylation clocks. Models were adjusted for chronological age, body mass index, years of education, neighborhood SES, geographic region of residence, alcohol drinking, smoking, and technical covariates. RESULTS Higher scores of racism in daily life were associated with higher methylation levels at the cg04494873 site in chromosome 5 (β = 0.64%; 95% CI = 0.41%, 0.87%; P = 6.35E-08). We also replicated one CpG site, cg03317714, which was inversely associated with racial discrimination in a previous EWAS among African American women. In the BWHS, higher scores of racism in daily life were associated with lower methylation levels at that CpG site (β = -0.94%; 95% CI = -1.37%, -0.51%; P = 2.2E-05). Higher racism scores were associated with accelerated epigenetic aging in more than one methylation clock. CONCLUSIONS Exposure to discriminatory events may affect the epigenome and accelerate biological aging, which may explain in part the earlier onset of disease in African American women.
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Affiliation(s)
- Edward A Ruiz-Narváez
- Department of Nutritional Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, 1860 SPH I, Ann Arbor, MI, 48109, USA.
| | - Yvette Cozier
- Slone Epidemiology Center at, Boston University, Boston, MA, USA
| | - Gary Zirpoli
- Slone Epidemiology Center at, Boston University, Boston, MA, USA
| | - Lynn Rosenberg
- Slone Epidemiology Center at, Boston University, Boston, MA, USA
| | - Julie R Palmer
- Slone Epidemiology Center at, Boston University, Boston, MA, USA
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Edelblute HB, Baba Z, Tinago CB, Fyalkowski S. Exploring acculturative stress and family dynamics in African immigrant students in the US: implications for mental health. Ethn Health 2024; 29:239-253. [PMID: 37946383 DOI: 10.1080/13557858.2023.2279935] [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] [Received: 02/11/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES African immigrants represent a rapidly growing immigrant group in the US, yet relatively little is known about influences on the health of this group. This is a particularly important oversight since adaptation to life in the United States can have deleterious effects on health due to the stress associated with immigrant and minority status as well as separation from family abroad. The present study explores how African immigrants experience acculturative stress - the stress-inducing elements of life as an immigrant - and the mental health implications of these experiences in light of home country values and conceptions of health. DESIGN Semi-structured, in-depth interviews were conducted with a purposive sample of sub-Saharan African immigrant students attending a metropolitan university in the northeastern United States (N = 26). Data were analyzed thematically using NVivo 12. RESULTS African immigrant students first experience acculturative stress through schools and neighborhoods where they encounter othering processes, including discrimination and racism. Family responsibilities to loved ones in the US and Africa also represent a source of stress that contributes to feelings of isolation and depression experienced while managing college responsibilities. Since these emotional and mental states are not within the purview of how health is viewed in their home countries, many suffer and may not get the care they need to effectively manage their mental health. CONCLUSION Findings emphasize shared experiences of navigating cultural dynamics, family pressures, and discrimination that contribute to the stress experienced by African immigrants. Findings also underscore the need for the development of culturally sensitive interventions in university settings so that African immigrant students can be upwardly mobile and healthy in the long-term.
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Affiliation(s)
- Heather B Edelblute
- Department of Public Health Sciences, West Chester University, West Chester, PA USA
| | - Zeinab Baba
- Department of Public Health Sciences, West Chester University, West Chester, PA USA
| | - Chiwoneso B Tinago
- Department of Public Health Sciences, West Chester University, West Chester, PA USA
| | - Shannon Fyalkowski
- Department of Public Health Sciences, West Chester University, West Chester, PA USA
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Tao X, Yip T, Fisher CB. Psychological Well-Being and Substance Use During the COVID-19 Pandemic: Ethnic/Racial Identity, Discrimination, and Vigilance. J Racial Ethn Health Disparities 2024; 11:62-71. [PMID: 36576694 PMCID: PMC9795950 DOI: 10.1007/s40615-022-01497-y] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/30/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Emerging evidence indicates that the COVID-19 pandemic has exacerbated mental health disparities among Black, Indigenous, and People of Color (BIPOC) through increased exposure to racism. Although ethnic/racial identity (ERI) and mental health were associated among BIPOC young adults pre-pandemic, it is unclear how these associations may differ in the exacerbated hostile racial environment of the pandemic. The current study examined the associations between ERI exploration and commitment within the context of ethnic/racial discrimination (ERD) and race-related vigilance with psychological well-being and substance use as explained by rumination. METHODS Data from a cross-sectional online survey of 450 AIAN, Asian, Black, and Latinx young adults (18-25 years) collected in April 2020 included demographic variables, standardized measures of ERI, ERD, race-related vigilance, rumination brooding and reflection, substance use, and psychological well-being. RESULTS Black respondents reported more exposure to ERD than AIAN and Asian young adults. ERI exploration and commitment were positively associated with well-being. ERI exploration, ERD, and rumination were associated with higher levels of substance use. An association between ERI exploration and more substance use and lower well-being was partially accounted for by higher levels of rumination. An association between ERI commitment and more substance use was fully accounted for by higher levels of rumination. CONCLUSIONS Although ERI exploration and commitment were associated with better psychological well-being among BIPOC young adults, a significant association was found between ERI commitment and more substance use as explained by rumination. Public health efforts should cultivate culturally sensitive mental health services to decrease rumination and its negative association with substance use and well-being.
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Affiliation(s)
- Xiangyu Tao
- Department of Psychology, Fordham University, Dealy Hall, 441 East Fordham Road, Bronx, NY, 10458, USA.
| | - Tiffany Yip
- Department of Psychology, Fordham University, Dealy Hall, 441 East Fordham Road, Bronx, NY, 10458, USA
| | - Celia B Fisher
- Department of Psychology, Fordham University, Dealy Hall, 441 East Fordham Road, Bronx, NY, 10458, USA
- Center for Ethics Education, Fordham University, Bronx, USA
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Fanton M, Rodrigues YE, Schuch I, de Lima Cunha CM, Pattussi MP, Canuto R. Direct and indirect associations of experience of racial discrimination, dietary patterns and obesity in adults from southern Brazil. Public Health Nutr 2024; 27:e60. [PMID: 38297464 PMCID: PMC10897576 DOI: 10.1017/s1368980024000338] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
OBJECTIVE To analyse the direct and indirect associations of experience of racial discrimination on dietary patterns (DP), obesity and abdominal obesity. DESIGN This is a cross-sectional population-based study. The main exposure was self-reported experiences of racial discrimination (Experiences of Discrimination scale). The mediator variables were the DP: healthy, Brazilian traditional, sugar and carbohydrates, and fast food. The outcomes were obesity (BMI ≥ 30 kg/m2) and abdominal obesity (waist circumference ≥ 88 cm for women; ≥ 102 cm for men). Structural equation modelling was applied. SETTING Porto Alegre, Brazil. PARTICIPANTS Totally, 400 adults aged between 20 and 70 years were participated. RESULTS The mean age of participants was 47·2 years (sd = 13·9), and 75 % were women. Experiencing racial discrimination had a positive direct effect on obesity (healthy DP: β = 0·153, P < 0·05; Brazilian DP: β = 0·156, P < 0·05; sugar and carbohydrates DP: β = 0·156, P < 0·05; and fast-food DP: β = 0·153, P < 0·05) and abdominal obesity (healthy DP: β = 0·206, P < 0·01; Brazilian DP: β = 0·210, P < 0·01; sugar and carbohydrates DP: β = 0·204, P < 0·01; and fast-food DP: β = 0·204, P < 0·01). The experience of racial discrimination did not have a direct effect on DP, nor did it exert an indirect effect on obesity and abdominal obesity through any DP. CONCLUSIONS A higher experience of racial discrimination is associated with obesity and abdominal obesity, independent of diet.
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Affiliation(s)
- Marcos Fanton
- Postgraduate Program in Philosophy. Universidade Federal de Santa Maria. Santa Maria, RS, Brazil
| | - Ylana Elias Rodrigues
- Postgraduate Program in Nutrition Sciences. Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Ilaine Schuch
- Postgraduate Program in Food, Nutrition and Health, Faculty of Medicine, Universidade Federal do Rio Grande do Sul. Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Caroline Marques de Lima Cunha
- Postgraduate Program in Food, Nutrition and Health, Faculty of Medicine, Universidade Federal do Rio Grande do Sul. Porto Alegre, RS, Brazil
| | - Marcos Pascoal Pattussi
- Postgraduate Program in Collective Health, Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brazil
| | - Raquel Canuto
- Postgraduate Program in Food, Nutrition and Health, Faculty of Medicine, Universidade Federal do Rio Grande do Sul. Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
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Worku F, Bennett F, Wheeler S, Siddiqi A, Papadakos J. Exploring the COVID-19 Knowledge, Attitudes, and Practices (KAPs) in the Black Community: a Scoping Review. J Racial Ethn Health Disparities 2024; 11:273-299. [PMID: 36757610 PMCID: PMC9910259 DOI: 10.1007/s40615-023-01518-4] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 01/06/2023] [Accepted: 01/16/2023] [Indexed: 02/10/2023]
Abstract
INTRODUCTION AND BACKGROUND Racial minorities have been the focal point of media coverage, attributing the disproportionate impact of COVID-19 to their individual actions; however, the ability to engage in preventative practices can also depend on one's social determinants of health. Individual actions can include knowledge, attitudes, and practices (KAPs). Since Black communities are among those disproportionately affected by COVID-19, this scoping review explores what is known about COVID-19 KAPs among Black populations. METHODS A comprehensive literature search was conducted in 2020 for articles written in English from the Medline, Embase, and PsycInfo databases. Reviews, experimental research, and observational studies were included if they investigated at least one of COVID-19 KAP in relation to the pandemic and Black communities in OECD peer countries including Canada, the United States, and the United Kingdom. RESULTS AND ANALYSIS Thirty-one articles were included for analysis, and all employed observational designs were from the United States. The following KAPs were examined: 6 (18.8%) knowledge, 21 (65.6%) attitudes, and 22 (68.8%) practices. Black communities demonstrated high levels of adherence to preventative measures (e.g., lockdowns) and practices (e.g., mask wearing), despite a strong proportion of participants believing they were less likely to become infected with the virus, and having lower levels of COVID-19 knowledge, than other racial groups. CONCLUSIONS AND IMPLICATIONS The findings from this review support that Black communities highly engage in COVID-19 preventative practices within their realm of control such as mask-wearing and hand washing and suggest that low knowledge does not predict low practice scores among this population.
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Affiliation(s)
- Fiqir Worku
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Avenue, Toronto, ON, M5T 3M7, Canada.
| | - Falan Bennett
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sarah Wheeler
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Avenue, Toronto, ON, M5T 3M7, Canada
| | - Arjumand Siddiqi
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Janet Papadakos
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Avenue, Toronto, ON, M5T 3M7, Canada
- Cancer Health Literacy Research Centre, Princess Margaret Cancer Centre, Toronto, Canada
- The Institute for Education Research (TIER), University Health Network, Toronto, Canada
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46
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McGarity-Palmer R, Saw A, Horse AJY, Yi SS, Tsoh J, Takeuchi D. Profiles of a COVID-19 Syndemic: Anti-Asian Racism, Economic Challenges, and Mental and Physical Health. J Racial Ethn Health Disparities 2024; 11:300-312. [PMID: 36692660 PMCID: PMC9872729 DOI: 10.1007/s40615-023-01519-3] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, Asians/Asian Americans have experienced co-occurring threats of anti-Asian racism, economic challenges, and negative mental and physical health symptoms. OBJECTIVES We examined the co-occurrence of COVID-19-related anti-Asian discrimination and collective racism, economic stressors, and mental and physical health challenges for Asians/Asian Americans during the COVID-19 pandemic. We also examined Asian/Asian American subgroups associated with these threats. METHODS Nationally representative data from the 2021 Asian American and Native Hawaiian/Pacific Islander COVID-19 Needs Assessment Project (unweighted N = 3,508) were used to conduct a latent profile analysis to identify unique typologies of the co-occurrence of these threats. We also conducted chi-square analyses to investigate subgroup differences by latent profile. RESULTS We identified five distinct latent profiles: multi-threat impact, low impact, collective racism, health challenges, and economic/health challenges. Forty percent of Asians/Asian Americans were in the multi-threat impact profile, indicating high levels across COVID-19-related threats. Subgroup analyses revealed significant differences in profile membership. East Asians, US-born Asians/Asian Americans, and those aged 25-44 seemed to be particularly affected by the proposed syndemic; results also differed by income. CONCLUSION Asians/Asian Americans have experienced co-occurring and interrelated threats during COVID-19 that suggest the presence of a syndemic. Results from our study point to vulnerable Asian/Asian American subgroups and the need for targeted public health efforts to address racism, health challenges, and economic challenges in the context of COVID-19.
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Affiliation(s)
- Rebecca McGarity-Palmer
- Department of Psychology, DePaul University, 2219 N. Kenmore Ave., Byrne Hall 560, Chicago, IL, 60614, USA
- Analyst Institute, Washington, DC, USA
| | - Anne Saw
- Department of Psychology, DePaul University, 2219 N. Kenmore Ave., Byrne Hall 560, Chicago, IL, 60614, USA.
| | | | - Stella S Yi
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Janice Tsoh
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - David Takeuchi
- School of Social Work, University of Washington, Seattle, WA, USA
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47
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Price JH, Khubchandani J. Firearm Mortality of Non-Hispanic Black Americans by Law Enforcement, 2011-2020. J Community Health 2024; 49:86-90. [PMID: 37505361 DOI: 10.1007/s10900-023-01263-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2023] [Indexed: 07/29/2023]
Abstract
Law enforcement officers in the U.S. are more likely to use lethal force against non-Hispanic Black citizens than on their non-Hispanic White counterparts. The purpose of this study was to assess estimates of the national prevalence of fatal firearm violence by law enforcement officers (LEOs) against non-Hispanic Black Americans. The Web-Based Injury Statistics Query and Reporting System (WISQARS) from the Centers for Disease Control and Prevention (CDC) were analyzed using descriptive statistics and joinpoint regression from 2011 to 2020. During the decade (2011-2020) LEOs fatally shot 5,073 citizens and 1,170 were non-Hispanic Black (23%). The vast majority (96%) were males and two-thirds (66%) of those killed were ages 20-39 years. The region with the highest number of LEO fatal shootings was the Western U.S. Firearm deaths of non-Hispanic Blacks were the dominant (82%) method of LEO-induced deaths. Non-Hispanic Black Americans experience LEO firearm-related injuries and deaths at a much higher rate than their non-Hispanic White counterparts. In the context of the racial disparities among people who die following LEO-related gunshot wounds, changes to police training systems and an examination of implicit biases among LEOs should be investigated as the next step in reducing the use of lethal force practices.
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Affiliation(s)
- James H Price
- College of Health & Human Services, University of Toledo, Toledo, OH, 43606, USA.
| | - Jagdish Khubchandani
- College of Health, Education, & Social Transformation, New Mexico State University, Las Cruces, NM-88003, USA
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48
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Quinn KG, Walsh JL, DiFranceisco W, Edwards T, Takahashi L, Johnson A, Dakin A, Bouacha N, Voisin DR. The Inherent Violence of Anti-Black Racism and its Effects on HIV Care for Black Sexually Minoritized Men. J Urban Health 2024; 101:23-30. [PMID: 38158546 PMCID: PMC10897081 DOI: 10.1007/s11524-023-00823-x] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
The goal of this study was to examine the effects of racial discrimination, depression, and Black LGBTQ community support on HIV care outcomes among a sample of Black sexually minoritized men living with HIV. We conducted a cross-sectional survey with 107 Black sexually minoritized men living with HIV in Chicago. A path model was used to test associations between racial discrimination, Black LGBTQ community support, depressive symptoms, and missed antiretroviral medication doses and HIV care appointments. Results of the path model showed that men who had experienced more racism had more depressive symptoms and subsequently, missed more doses of HIV antiretroviral medication and had missed more HIV care appointments. Greater Black LGBTQ community support was associated with fewer missed HIV care appointments in the past year. This research shows that anti-Black racism may be a pervasive and harmful determinant of HIV inequities and a critical driver of racial disparities in ART adherence and HIV care engagement experienced by Black SMM. Black LGBTQ community support may buffer against the effects of racial discrimination on HIV care outcomes by providing safe, inclusive, supportive spaces for Black SMM.
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Affiliation(s)
- Katherine G Quinn
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Jennifer L Walsh
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Wayne DiFranceisco
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Travonne Edwards
- School of Child and Youth Care, Toronto Metropolitan University, Toronto, Canada
| | - Lois Takahashi
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA
| | - Anthony Johnson
- School of Social Work, Loyola University Chicago, Chicago, IL, USA
| | | | | | - Dexter R Voisin
- School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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49
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Conteh E, Alorda A, Lebowitz D, MacIntosh T. Disparities in the Use of Chemical and Physical Restraints in the Emergency Department by Race/Ethnicity. J Racial Ethn Health Disparities 2024; 11:132-136. [PMID: 36622570 DOI: 10.1007/s40615-022-01504-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Restraints are often utilized in the emergency department (ED) to prevent patients from injuring themselves or others while managing their agitation in order to deliver appropriate medical care. Chemical and physical restraints are ordered at the discretion of the medical provider and typically employed after reasonable verbal de-escalation has been attempted. While health inequities and racial bias in medicine and healthcare have been well-established, information on the differences in the selection and use of restraints by race and ethnicity are scarce. METHODS This retrospective cohort study utilized national data from HCA Healthcare ED and inpatient database with patient visits from 2016 to 2019 to evaluate the relationships between race and ethnicity and the utilization of restraints in the ED. Associations are reported using linear and logistic regression analyses. RESULTS The study population included 12,229 unique ED admissions for patients 16 and older with diagnoses of aggression or agitation who had either chemical or physical restraints used. There was no statistically significant difference when comparing Black or other race to White patients and the type of restraint used. Hispanic patients received 0.206 fewer doses of chemical restraints compared to White patients (p = 0.008, 95% C.I. [-0.359, -0.053]) and were slightly less likely to receive physical restraints compared with White patients (p = 0.044, 95% C.I. [0.467, 0.989]), but there was no difference between use of physical restraint and Black or other patients compared to White patients. CONCLUSIONS In this national sample of agitated and/or aggressive ED patients who were restrained, Hispanic patients were slightly less likely to receive physical restraints and received fewer doses of chemical restraints than White patients. There were no differences between Black or other patients compared to White patients in restraint type, number of doses of chemical restraint or time to application of either restraint type. This suggests that physicians apply the use of chemical restraints to agitated and aggressive ED patients based on factors that are not associated with race and ethnicity.
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Affiliation(s)
- Etta Conteh
- University of Central Florida College of Medicine, 6850 Lake Nona Blvd, Orlando, FL, 32827, USA
| | - Abigail Alorda
- University of Central Florida College of Medicine, 6850 Lake Nona Blvd, Orlando, FL, 32827, USA
- University of Central Florida/HCA Healthcare GME (Greater Orlando), HCA Florida Osceola Hospital, Orlando, USA
| | - David Lebowitz
- University of Central Florida College of Medicine, 6850 Lake Nona Blvd, Orlando, FL, 32827, USA
- University of Central Florida/HCA Healthcare GME (Greater Orlando), HCA Florida Osceola Hospital, Orlando, USA
| | - Tracy MacIntosh
- University of Central Florida College of Medicine, 6850 Lake Nona Blvd, Orlando, FL, 32827, USA.
- University of Central Florida/HCA Healthcare GME (Greater Orlando), HCA Florida Osceola Hospital, Orlando, USA.
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50
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Houston K, Arellano F, Imany-Shakibai H, Jackson A, Saleeby E, Dudovitz R, Schickedanz A. "MAMA's is like a second mom:" Client and Staff Experiences in a Comprehensive Social Risk Care Management Program Within a Perinatal Medical Home. Matern Child Health J 2024:10.1007/s10995-024-03896-5. [PMID: 38294604 DOI: 10.1007/s10995-024-03896-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/01/2024]
Abstract
INTRODUCTION Addressing persistent racial inequities in preterm birth requires innovative health care approaches. The Los Angeles County Maternity Assessment and Management Access Service Synergy Neighborhood program (MAMA's) is a perinatal medical home program designed to alleviate the impacts of chronic stress by addressing social determinants of health. It reduced odds of preterm birth rates in Black participants, yet it is unclear which program components most contributed to this reduction. This study seeks to understand the experiences of staff and clients within the MAMA's program to identify what factors decrease stress, how the program addresses racism and the challenges and opportunities of optimizing health during the COVID-19 pandemic. METHODS 21 staff and 34 clients completed semi-structured interviews from November 2020-December 2021. Separate interview guides for staff and clients explored experiences within the program, experiences during the COVID-19 pandemic, and how racism affects clients. Interviews were recorded and transcribed. Analysis used a phenomenologic framework. Coding was performed using grounded theory to identify themes. RESULTS Analysis revealed six key themes: Stressors clients face, barriers for undocumented, Latina, and Spanish-speaking clients, exceptional care, emotional support, naming and responding to racism and discrimination, and impacts of COVID-19 pandemic. DISCUSSION Staff and clients work together to address social needs in order to address chronic stress and racism in their lives, especially during the COVID-19 pandemic. Interviews revealed relationship building is a cornerstone of the program's success and plays a significant role in alleviating chronic stress in this population.
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Affiliation(s)
- Kasee Houston
- Southern California Permanente Medical Group, Department of Neonatal-Perinatal Medicine, Kaiser Permanente Riverside Medical Center, 10800 Magnolia Ave, Riverside, CA, 92505, USA.
| | - Flor Arellano
- Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - Helia Imany-Shakibai
- Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - Ashaki Jackson
- Los Angeles County Department of Health Services, 313 N Figueroa St., Los Angeles, CA, 90012, USA
| | - Erin Saleeby
- Los Angeles County Department of Health Services, 313 N Figueroa St., Los Angeles, CA, 90012, USA
- Harbor UCLA Medical Center, 1000 W Carson St., Torrance, CA, 90502, USA
| | - Rebecca Dudovitz
- Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - Adam Schickedanz
- Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
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