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Misra S, Etkins OS, Yang LH, Williams DR. Structural Racism and Inequities in Incidence, Course of Illness, and Treatment of Psychotic Disorders Among Black Americans. Am J Public Health 2022; 112:624-632. [PMID: 35319958 PMCID: PMC8961835 DOI: 10.2105/ajph.2021.306631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 11/04/2022]
Abstract
Psychotic disorders (e.g., schizophrenia, schizoaffective disorder) are a leading cause of morbidity and premature mortality and an overlooked health inequity in the United States. European data indicate inequities in incidence, severity, and treatment of psychotic disorders, particularly for Black communities, that appear to be primarily attributable to social adversities. The dominant US narrative is that any observed differences are primarily a result of clinician bias and misdiagnosis. We propose that employing the framework of structural racism will prompt European and US research to converge and consider the multifaceted drivers of inequities in psychotic disorders among Black Americans. In particular, we describe how historical and contemporary practices of (1) racialized policing and incarceration, and (2) economic exploitation and disinvestment, which are already linked to other psychiatric disorders, likely contribute to risks and experiences of psychotic disorders among Black Americans. This framework can inform new strategies to (1) document the role of racism in the incidence, severity, and treatment of psychotic disorders; and (2) dismantle how racism operates in the United States, including defunding the police, abolishing carceral systems, and redirecting funds to invest in neighborhoods, housing, and community-based crisis response and mental health care. (Am J Public Health. 2022;112(4):624-632. https://doi.org/10.2105/AJPH.2021.306631).
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Affiliation(s)
- Supriya Misra
- Supriya Misra is with the Department of Public Health, San Francisco State University, San Francisco, CA. Onisha S. Etkins and David R. Williams are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY
| | - Onisha S Etkins
- Supriya Misra is with the Department of Public Health, San Francisco State University, San Francisco, CA. Onisha S. Etkins and David R. Williams are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY
| | - Lawrence H Yang
- Supriya Misra is with the Department of Public Health, San Francisco State University, San Francisco, CA. Onisha S. Etkins and David R. Williams are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY
| | - David R Williams
- Supriya Misra is with the Department of Public Health, San Francisco State University, San Francisco, CA. Onisha S. Etkins and David R. Williams are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY
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Affiliation(s)
- David R. Williams
- Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonMAUSA,Department of African and African American StudiesHarvard UniversityCambridgeMAUSA
| | - Onisha S. Etkins
- Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonMAUSA
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Cowger TL, Davis BA, Etkins OS, Makofane K, Lawrence JA, Bassett MT, Krieger N. Comparison of Weighted and Unweighted Population Data to Assess Inequities in Coronavirus Disease 2019 Deaths by Race/Ethnicity Reported by the US Centers for Disease Control and Prevention. JAMA Netw Open 2020; 3:e2016933. [PMID: 32721026 PMCID: PMC7388022 DOI: 10.1001/jamanetworkopen.2020.16933] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This cross-sectional study compares the use of weighted and unweighted population data to assess inequities in coronavirus disease 2019 (COVID-19) deaths by race/ethnicity as reported by the US Centers for Disease Control and Prevention (CDC).
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Affiliation(s)
- Tori L. Cowger
- FXB Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Population Health Sciences Department, Harvard Graduate School of Arts and Sciences, Cambridge, Massachusetts
| | - Brigette A. Davis
- FXB Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Population Health Sciences Department, Harvard Graduate School of Arts and Sciences, Cambridge, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Onisha S. Etkins
- FXB Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Population Health Sciences Department, Harvard Graduate School of Arts and Sciences, Cambridge, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Keletso Makofane
- FXB Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Population Health Sciences Department, Harvard Graduate School of Arts and Sciences, Cambridge, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jourdyn A. Lawrence
- FXB Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Population Health Sciences Department, Harvard Graduate School of Arts and Sciences, Cambridge, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Mary T. Bassett
- FXB Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Nancy Krieger
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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