On Examining Residential Segregation in Rural Gadag, Karnataka, India: The Case of the Banjara Tandas

Residential segregation of settlements on caste lines is common across Indian villages. Banjara settlements or tandas are an extreme form of residential segregation, rooted in colonial history and India's complex caste system, and an outcome of structural discrimination. This analysis examines the structural discrimination of tandas in the distribution of various infrastructure and compares it with the villages in proximity to it. A cross-sectional comparative study of infrastructure was conducted in Banjara tandas and villages in Gadag district, Karnataka, India. Composite scores were computed for various infrastructure and discriminant analysis done to classify tandas and villages. The villages have better physical infrastructure such as paved roads, multiple water supply sources, and better drains and amenities such as the community water filter, ration shop, veterinary center, milk society, banks, post office, and health facilities compared to tandas. Discriminant analysis indicated that social infrastructural indicators of health and education (Discriminant function coefficient -0.8689), followed by transportation (Discriminant function coefficient -0.3576) and water supply (Discriminant function coefficient -0.2939), are the most significant discriminating factors between tanda and villages. This disadvantage indicates structural discrimination that is a continuation of the stigma and labeling perpetrated upon them historically and the complex caste system in Indian societies.

Structural Origins of Poor Health Outcomes in Documented Temporary Foreign Workers and Refugees in High-Income Countries: A Review

Despite growing evidence of racial and institutional discrimination on minoritized communities and its negative effect on health, there are still gaps in the current literature identifying health disparities among minoritized communities. This review aims to identify health barriers faced by relatively less studied migrant subgroups including documented temporary foreign workers and refugees residing in high-income Organisation for Economic Co-operation and Development (OECD) countries focusing on the structural origins of differential health outcomes. We searched Medline, CINAHL, and Embase databases for papers describing health barriers for these groups published in English between 1 January 2011 and 30 July 2021. Two independent reviewers conducted a title, abstract, and full text screening with any discrepancies resolved by consensus or a third reviewer. Extracted data were analyzed using an inductive thematic analysis. Of the 381 articles that underwent full-text review, 27 articles were included in this review. We identified housing conditions, immigration policies, structural discrimination, and exploitative labour practices as the four major emerging themes that impacted the health and the access to healthcare services of our study populations. Our findings highlight the multidimensional nature of health inequities among migrant populations and a need to examine how the broader context of these factors influence their daily experiences.

Women's Lived Experiences with Temporary Assistance for Needy Families (TANF): How TANF Can Better Support Women's Wellbeing and Reduce Intimate Partner Violence

Women experiencing poverty are more likely to face intimate partner violence (IPV), poor health, and stigma. IPV survivors are overrepresented among those who receive Temporary Assistance for Needy Families (TANF), a conditional cash program serving families experiencing poverty. More generous TANF policies may be protective against IPV, but a greater insight into TANF's effect could be gleaned through a contemporaneous study that examines intersecting determinants of wellbeing and engages community interpretation of findings. Using an adapted Family Stress Model framework and analyzing data through an intersectional and community-based lens, we explore the impact of TANF on women's wellbeing through in-depth, semi-structured interviews during the COVID-19 pandemic with 13 women who had TANF experience in three U.S. states. Data were analyzed using thematic analysis in MAXQDA and researchers facilitated three member-checking events to enhance validity of result interpretation. Four themes emerged: (1) Low cash and conditional benefits provided limited short-term "relief" but contributed to poverty and hard choices; (2) TANF benefit levels and conditions increased women's dependence on others, straining relationships; (3) Women undertook extraordinary measures to access TANF, largely to fulfill their roles as mothers; and (4) TANF stigma creates psychological stress, differentially experienced by African Americans. Increasing TANF cash benefits and other cash transfers for those experiencing poverty, adopting solely state funded TANF programs, increasing funding for TANF administration, addressing TANF stigma and racialized narratives, and allowing optional child support participation or a larger "pass-through" of child support are important steps toward making TANF more protective against IPV.

Living While Black, Gay, and Poor: The Association of Race, Neighborhood Structural Disadvantage, and PrEP Utilization Among a Sample of Black Men Who Have Sex With Men in the Deep South

Utilizing the Andersen Healthcare Utilization Model, we examined the role of neighborhood context on pre-exposure prophylaxis (PrEP) utilization among a sample of Black men who have sex with men (MSM) residing in a medium-sized city in the Deep South. Data were derived from a sample of 142 Black MSM aged 18-64 years who were eligible for PrEP from a community-based study known as "ACCELERATE!" We used multilevel structural equation modeling to assess PrEP use. Social support, sexual risk, and health care access were predictive of PrEP use. Notably, residing in a neighborhood with concentrated poverty was associated with decreased PrEP use. Our findings reveal neighborhood structural disadvantage is associated with decreased PrEP use among Black MSM, after adjusting of individual-level sociodemographic characteristics. There is an urgent need to develop HIV prevention interventions and programs that explicitly address structural-level factors to eliminate racial/ethnic differences in HIV.

Oncology Nursing Research: Moving Toward Equitable and Inclusive Science

One of the challenges for nurse scientists, particularly those of us educated in traditional academic models, is the question of how to make certain that our research addresses critical barriers to achieving health and healthcare equity. Traditional research inculcation taught us to focus on discrete, answerable questions, using an attainable sample given the financial and practical limitations inherent in research implementation. Although these techniques were part of an agreed-upon scientific method, the restrictions can lead to an answer to a circumscribed question but fail to articulate the broader issues inherent in designing and implementing human research that moves from inquiry to impact. Although our strong history in oncology nursing research includes a range of health concerns and responses to cancer, including biologic, socio-cultural, sex and gender, and, more recently, financial, I think that we, as oncology nurse scientists, agree that the focus of our research needs to more explicitly address pernicious aspects of health that lead to health disparities: racism and structural discrimination. Racism and structural barriers cloud all aspects of oncology: early detection, the design and uptake of promising therapeutics, quality of life, and financial well-being during active treatment and survivorship. How do we take the essential steps to not only measure but also address these critical barriers to reduce disparities and bring about more equitable and salubrious outcomes in oncology nursing research?

Structural discrimination from in situ measurement of 1 DCH and 2 DHH residual dipolar coupling constants

A fast residual dipolar coupling constant-assisted strategy involving the simultaneous determination of scalar and total coupling constants from a single ¹ J_CH /² J_HH -resolved NMR spectrum is reported. It is shown that the concerted use of the directly measured ¹ D_CH (for all CH_n multiplicities) and ² D_HH residual dipolar couplings allows an on-the-fly assignment of diastereotopic CH₂ protons, as well as of an efficient discrimination between diastereoisomeric structures of strychnine which contains six stereocenters. Copyright © 2017 John Wiley & Sons, Ltd.

Addiction-Related Stigma and Discrimination: A Qualitative Study in Treatment Centers in Mexico City

Social rejection of drug use is greater than that directed at other psychiatric conditions, like depression and anxiety, which may lead to social exclusion of substance users and prevent them from seeking and receiving treatment.

OBJECTIVE

The objective of this study is to investigate the stigma and discrimination related to addiction in treatment centers in Mexico City.

METHODS

Data are from a broad mixed methods study. The present study is a qualitative analysis of 35 in-depth interviews of drug users, family members, and providers, using guidelines for the exploration of experiences of stigma and discrimination related to substance abuse. A thematic analysis was carried out using specialized software (Atlas.ti 6.2.23).

RESULTS

The common practices of stigma and discrimination (e.g., judging, mockery, inappropriate comments, overprotection, and hostile looks), were identified in participant testimonies. The narratives provide evidence of varied conditions of social and gender inequality, as well as experience of violence and abuse, that refer to a structural context of discrimination surrounding addiction, and that constitute obstacles to treatment.

CONCLUSIONS

The findings allow for a description of the stigmatization process surrounding addiction as a shared problem that requires the implementation of coordinated treatment strategies. They also suggest the need for more comprehensive policies of inclusion, based on human rights, which favor prevention and treatment.

Everyday discrimination and physical health: Exploring mental health processes

Goals of this study were to examine the mental health processes whereby everyday discrimination is associated with physical health outcomes. Data are drawn from a community health survey conducted with 1299 US adults in a low-resource urban area. Frequency of everyday discrimination was associated with overall self-rated health, use of the emergency department, and one or more chronic diseases via stress and depressive symptoms operating in serial mediation. Associations were consistent across members of different racial/ethnic groups and were observed even after controlling for indicators of stressors associated with structural discrimination, including perceived neighborhood unsafety, food insecurity, and financial stress.