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Harris A, Smith T. Monetary Sanctions as Chronic and Acute Health Stressors: The Emotional Strain of People Who Owe Court Fines and Fees. THE RUSSELL SAGE FOUNDATION JOURNAL OF THE SOCIAL SCIENCES : RSF 2022; 8:36-56. [PMID: 37860787 PMCID: PMC10586471 DOI: 10.7758/rsf.2022.8.2.02] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
In this article, we explore the experiences of people who carry monetary sanction (or penal) debt across eight U.S. states. Using 519 interviews with people sentenced to fines and fees, we analyze the mental and emotional aspects of their experiences. Situating our analysis within research on the social determinants of health and the stress universe, we suggest that monetary sanctions create an overwhelmingly palpable sense of fear, frustration, anxiety, and despair. We theorize the ways in which monetary sanctions function as both acute and chronic health stressors for people who are unable to pay off their debts, highlight the mechanisms linking penal debt with mental and emotional burdens, and generalize our findings using national data from the U.S. Federal Reserve. We find that the system of monetary sanctions generates a great deal of stress and strain that becomes an internalized punishment affecting many realms of people's lives.
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Affiliation(s)
| | - Tyler Smith
- Department of Sociology at the University of Washington, United States
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102
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Pongsavee K, Payakkakom A, Phukao D, Guadamuz TE. Natural recovery from alcohol: a systematic review of the literature 2006–2019. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.2020348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kritpipat Pongsavee
- Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
| | - Anusorn Payakkakom
- Department of Social Sciences, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
| | - Darunee Phukao
- Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
| | - Thomas E. Guadamuz
- Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
- Center of Excellence in Research on Gender, Sexuality and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
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103
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Monk EP, Kaufman J, Montoya Y. Skin Tone and Perceived Discrimination: Health and Aging Beyond the Binary in NSHAP 2015. J Gerontol B Psychol Sci Soc Sci 2021; 76:S313-S321. [PMID: 34918148 PMCID: PMC8678440 DOI: 10.1093/geronb/gbab098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This paper introduces new measures of skin tone (self-reported) and perceived discrimination that are included in the third round of the National Social Life, Health, and Aging Project (NSHAP). We explain the rationale for these new measures, emphasizing, in particular, how they help researchers to conceptualize and measure the significance of race/ethnicity for health and aging beyond binary ethnoracial categories. METHOD We describe new measures of skin tone and perceived discrimination for use in NSHAP 2015. We provide descriptive statistics on the distribution of skin tone (self-reported) by race/ethnicity. As a proof of concept, we use logistic and ordinary least squares regression analyses to examine the relationship between skin tone, perceived discrimination, and perceived stress among ethnoracial minorities. RESULTS We find that there is significant variation in skin tone among non-White respondents in NSHAP 2015 (e.g., non-Hispanic Black and Latinx). We also find that skin tone (self-reported) is a significant predictor of the frequency of perceived discrimination and perceived stress among African American, but not Latinx respondents in NSHAP. DISCUSSION The inclusion of new skin tone and discrimination measures in NSHAP 2015 provides a unique and novel opportunity for researchers to more deeply understand how race/ethnicity is connected to health and aging among ethnoracial minorities. Furthermore, it will enable analyses of how stress and perceived discrimination also affect patterns of health and aging among Whites against the backdrop of steadily increasing socioeconomic inequalities and shifting ethnoracial demographics in the United States.
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Affiliation(s)
- Ellis P Monk
- Department of Sociology, Harvard University, Cambridge, Massachusetts, USA
| | - Jerry Kaufman
- Department of Sociology, University of Chicago, Illinois, USA
- NORC, University of Chicago, Illinois, USA
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Fowler-Davis S, Young R, Maden-Wilkinson T, Hameed W, Dracas E, Hurrell E, Bahl R, Kilcourse E, Robinson R, Copeland R. Assessing the Acceptability of a Co-Produced Long COVID Intervention in an Underserved Community in the UK. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13191. [PMID: 34948798 PMCID: PMC8701839 DOI: 10.3390/ijerph182413191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/23/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The COVID-19 pandemic has disproportionately affected people from more deprived communities. The experience of Long COVID is similarly distributed but very few investigations have concentrated on the needs of this population. The aim of this project was to co-produce an acceptable intervention for people with Long COVID living in communities recognised as more deprived. METHODS The intervention was based on a multi-disciplinary team using approaches from sport and exercise medicine and functional rehabilitation. The co-production process was undertaken with a stakeholder advisory group and patient public involvement representation. This study identified participants by postcode and the indices of multiple deprivation (IMD); recruitment and engagement were supported by an existing health and wellbeing service. A virtual 'clinic' was offered with a team of professional practitioners who met participants three times each; to directly consider their needs and offer structured advice. The acceptability of the intervention was based on the individual's participation and their completion of the intervention. RESULTS Ten participants were recruited with eight completing the intervention. The partnership with an existing community health and wellbeing service was deemed to be an important way of reaching participants. Two men and six women ages ranging from 38 to 73 were involved and their needs were commonly associated with fatigue, anxiety and depression with overall de-conditioning. None reported serious hardship associated with the pandemic although most were in self-employment/part-time employment or were not working due to retirement or ill-health. Two older participants lived alone, and others were single parents and had considerable challenges associated with managing a household alongside their Long COVID difficulties. CONCLUSIONS This paper presents the needs and perspectives of eight individuals involved in the process and discusses the needs and preferences of the group in relation to their support for self- managed recovery from Long COVID.
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Affiliation(s)
- Sally Fowler-Davis
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield S9 3TU, UK; (S.F.-D.); (T.M.-W.); (R.C.)
| | - Rachel Young
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield S9 3TU, UK; (S.F.-D.); (T.M.-W.); (R.C.)
| | - Tom Maden-Wilkinson
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield S9 3TU, UK; (S.F.-D.); (T.M.-W.); (R.C.)
| | - Waqas Hameed
- Community Wellbeing Service (Specific Identity Withheld);
| | - Elizabeth Dracas
- Sheffield Health and Social Care NHS Foundation Trust, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S5 7AU, UK;
| | - Eleanor Hurrell
- Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, S10 2JF, UK;
| | - Romila Bahl
- Faculty of Sport and Exercise Medicine, Virtual Institution, Edinburgh EH8 9DR, UK; (R.B.); (E.K.); (R.R.)
| | - Elisabeth Kilcourse
- Faculty of Sport and Exercise Medicine, Virtual Institution, Edinburgh EH8 9DR, UK; (R.B.); (E.K.); (R.R.)
| | - Rebecca Robinson
- Faculty of Sport and Exercise Medicine, Virtual Institution, Edinburgh EH8 9DR, UK; (R.B.); (E.K.); (R.R.)
| | - Robert Copeland
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield S9 3TU, UK; (S.F.-D.); (T.M.-W.); (R.C.)
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Forde AT, Sims M, Wang X, Barber S, Diez Roux AV. The role of perceived discrimination in predicting changes in health behaviours among African Americans in the Jackson Heart Study. J Epidemiol Community Health 2021; 75:1222-1231. [PMID: 34117112 PMCID: PMC8588298 DOI: 10.1136/jech-2020-215998] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 05/22/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study examined whether perceived discrimination was associated with health behaviours over time and whether associations of discrimination with behaviours varied by attribution of discrimination. METHODS Multinomial logistic regression was used to estimate ORs and CIs for the associations of discrimination (everyday, lifetime, stress from lifetime discrimination) with health behaviours (cigarette smoking, alcohol use) over time among 3050 African Americans in the Jackson Heart Study from visit 1 (2000-2004) to visit 3 (2009-2013). Smoking status was classified as persistent current, persistent former, persistent never, current to former and former/never to current smokers. Alcohol use status was classified as persistent heavy, persistent moderate/none, heavy to moderate/none and moderate/none to heavy alcohol users. RESULTS Higher everyday discrimination was associated with persistent current smoking (OR per SD higher discrimination 1.26, 95% CI 1.11,1.43) and with persistent former smoking (high vs low OR 1.32, 95% CI 1.02,1.70) relative to persistent never smoking. Similar findings were observed for lifetime discrimination and persistent current smoking (high vs low OR 1.85, 95% CI 1.15,2.95) and with persistent former smoking (high vs low OR 1.45, 95% CI 1.06,1.98). Participants reporting lifetime discrimination as very stressful compared with not stressful were more likely to be persistent former smokers (OR 1.44, 95% CI 1.04,1.99). Associations did not vary by discrimination attribution. CONCLUSION Discrimination did not predict changes in smoking status or alcohol use. Discrimination was associated with persistent current smoking status, which may provide a plausible mechanism through which discrimination impacts the health of African Americans.
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Affiliation(s)
- Allana T Forde
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
- The Urban Health Collaborative, and the Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, USA
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Xu Wang
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Sharrelle Barber
- The Urban Health Collaborative, and the Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, USA
| | - Ana V Diez Roux
- The Urban Health Collaborative, and the Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, USA
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Shostak S, Bandini J, Cadge W, Donahue V, Lewis M, Grone K, Trachtenberg S, Kacmarek R, Lux L, Matthews C, McAuley ME, Romain F, Snydeman C, Tehan T, Robinson E. Encountering the social determinants of health on a COVID-19 ICU: Frontline providers' perspectives on inequality in a time of pandemic. SSM. QUALITATIVE RESEARCH IN HEALTH 2021; 1:100001. [PMID: 34870264 PMCID: PMC8459572 DOI: 10.1016/j.ssmqr.2021.100001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 07/27/2021] [Accepted: 08/05/2021] [Indexed: 11/29/2022]
Abstract
Efforts to improve health equity may be advanced by understanding health care providers' perceptions of the causes of health inequalities. Drawing on data from in-depth interviews with nurses and registered respiratory therapists (RRTs) who served on intensive care units (ICUs) during the first surge of the pandemic, this paper examines how frontline providers perceive and attribute the unequal impacts of COVID-19. It shows that nurses and RRTs quickly perceived the pandemic's disproportionate burden on Black and Latinx individuals and families. Providers attribute these inequalities to the social determinants of health, and also raise questions about how barriers to healthcare access may have made some patients more vulnerable to the worst consequences of COVID-19. Providers' perceptions of inequality and its consequences on COVID-19 ICUs were emotionally impactful and distressing, suggesting that this is a critical moment for offering clinicians practical strategies for understanding and addressing the persistent structural inequities that cause racial inequalities in health.
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Affiliation(s)
- Sara Shostak
- Brandeis University, Department of Sociology, MS 071, 415 South Street, Waltham, MA, 02453, USA
| | - Julia Bandini
- RAND Corporation, 20 Park Plaza, Boston, MA, 02116, USA
| | - Wendy Cadge
- Brandeis University, Department of Sociology, MS 071, 415 South Street, Waltham, MA, 02453, USA
| | - Vivian Donahue
- The Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Mariah Lewis
- Brandeis University, Department of Sociology, MS 071, 415 South Street, Waltham, MA, 02453, USA
| | - Katelyn Grone
- The Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Sophie Trachtenberg
- Brandeis University, Department of Sociology, MS 071, 415 South Street, Waltham, MA, 02453, USA
| | - Robert Kacmarek
- The Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Laura Lux
- The Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Cristina Matthews
- The Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | | | - Frederic Romain
- The Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Colleen Snydeman
- The Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Tara Tehan
- The Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Ellen Robinson
- The Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
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107
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Large, open datasets for human connectomics research: Considerations for reproducible and responsible data use. Neuroimage 2021; 244:118579. [PMID: 34536537 DOI: 10.1016/j.neuroimage.2021.118579] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 08/27/2021] [Accepted: 09/14/2021] [Indexed: 12/19/2022] Open
Abstract
Large, open datasets have emerged as important resources in the field of human connectomics. In this review, the evolution of data sharing involving magnetic resonance imaging is described. A summary of the challenges and progress in conducting reproducible data analyses is provided, including description of recent progress made in the development of community guidelines and recommendations, software and data management tools, and initiatives to enhance training and education. Finally, this review concludes with a discussion of ethical conduct relevant to analyses of large, open datasets and a researcher's responsibility to prevent further stigmatization of historically marginalized racial and ethnic groups. Moving forward, future work should include an enhanced emphasis on the social determinants of health, which may further contextualize findings among diverse population-based samples. Leveraging the progress to date and guided by interdisciplinary collaborations, the future of connectomics promises to be an impressive era of innovative research, yielding a more inclusive understanding of brain structure and function.
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108
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Pilla SJ, Kraschnewski JL, Lehman EB, Kong L, Francis E, Poger JM, Bryce CL, Maruthur NM, Yeh HC. Hospital utilization for hypoglycemia among patients with type 2 diabetes using pooled data from six health systems. BMJ Open Diabetes Res Care 2021; 9:9/Suppl_1/e002153. [PMID: 34933872 PMCID: PMC8679092 DOI: 10.1136/bmjdrc-2021-002153] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 07/19/2021] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Hypoglycemia is the most common serious adverse effect of diabetes treatment and a major cause of medication-related hospitalization. This study aimed to identify trends and predictors of hospital utilization for hypoglycemia among patients with type 2 diabetes using electronic health record data pooled from six academic health systems. RESEARCH DESIGN AND METHODS This retrospective open cohort study included 549 041 adults with type 2 diabetes receiving regular care from the included health systems between 2009 and 2019. The primary outcome was the yearly event rate for hypoglycemia hospital utilization: emergency department visits, observation visits, or inpatient admissions for hypoglycemia identified using a validated International Classification of Diseases Ninth Revision (ICD-9) algorithm from 2009 to 2014. After the transition to ICD-10 in 2015, we used two ICD-10 code sets (limited and expanded) for hypoglycemia hospital utilization from prior studies. We identified independent predictors of hypoglycemia hospital utilization using multivariable logistic regression analysis with data from 2014. RESULTS Yearly rates of hypoglycemia hospital utilization decreased from 2.7 to 1.6 events per 1000 patients from 2009 to 2014 (p-trend=0.023). From 2016 to 2019, yearly event rates were stable ranging from 5.6 to 6.6, or 6.3 to 7.3, using the limited and expanded ICD-10 code sets, respectively. In 2014, the strongest independent risk factors for hypoglycemia hospital utilization were chronic kidney disease (OR 2.86, 95% CI 2.33 to 3.57), ages 18-39 years (OR 2.43 vs age 40-64 years, 95% CI 1.78 to 3.31), and insulin use (OR 2.13 vs no diabetes medications, 95% CI 1.67 to 2.73). CONCLUSIONS Rates of hypoglycemia hospital utilization decreased from 2009 to 2014 and varied considerably by clinical risk factors such that younger adults, insulin users, and those with chronic kidney disease were at especially high risk. There is a need to validate hypoglycemia ascertainment using ICD-10 codes, which detect a substantially higher number of events compared with ICD-9.
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Affiliation(s)
- Scott J Pilla
- Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jennifer L Kraschnewski
- Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Erik B Lehman
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Lan Kong
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Erica Francis
- Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Jennifer M Poger
- Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Cindy L Bryce
- Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Nisa M Maruthur
- Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Hsin-Chieh Yeh
- Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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McKenna B, Mekawi Y, Katrinli S, Carter S, Stevens JS, Powers A, Smith AK, Michopoulos V. When Anger Remains Unspoken: Anger and Accelerated Epigenetic Aging Among Stress-Exposed Black Americans. Psychosom Med 2021; 83:949-958. [PMID: 34747582 PMCID: PMC8580214 DOI: 10.1097/psy.0000000000001007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Race-related lifetime stress exposure (LSE) including racial discrimination, trauma, and stressful life events have been shown to contribute to racial health disparities. However, little is known about associations between race-related stressors and premature biological aging that confer the risk of adverse health outcomes. Even less is known about the mechanisms through which race-related stressors may be associated with accelerated aging. Early evidence suggests psychological processes such as anger, and particularly the internalization of anger, may play a role. METHODS In a community sample of predominantly low-income Black adults (n = 219; age = 45.91 [12.33] years; 64% female), the present study examined the association of race-related LSE (as defined by exposure to racial discrimination, trauma, and stressful life events) and epigenetic age acceleration through anger expression. RESULTS Internalized and externalized anger expression were each significantly associated with LSE and age acceleration. Although LSE was not directly associated with age acceleration (ΔR2 = 0.001, p = .64), we found that greater LSE was indirectly associated with age acceleration through increases in internalized, but not externalized, anger (indirect effect: β = 0.03, standard error = 0.02, 95% confidence interval = 0.003 to 0.08; total effect: β = 0.02, 95% confidence interval = -0.25 to 0.31). CONCLUSIONS These results suggest race-related LSE may elicit the internalization of anger, which, along with the externalization of anger, may initiate detrimental epigenetic alterations that confer the risk of adverse health outcomes. These findings lay the groundwork for longitudinal studies of the association between race-related stress and racial health disparities.
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Affiliation(s)
| | - Yara Mekawi
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, GA
| | - Seyma Katrinli
- Department of Gynecology and Obstetrics, Emory University, Atlanta, GA
| | - Sierra Carter
- Department of Psychology, Georgia State University, Atlanta, GA
| | - Jennifer S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, GA
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, GA
| | - Alicia K. Smith
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, GA
- Department of Gynecology and Obstetrics, Emory University, Atlanta, GA
| | - Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, GA
- Yerkes National Primate Research Center, Atlanta, GA
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Austin MK, White II, Kim AW. Parental incarceration and child physical health outcomes from infancy to adulthood: A critical review and multilevel model of potential pathways. Am J Hum Biol 2021; 34:e23691. [PMID: 34665892 PMCID: PMC9016086 DOI: 10.1002/ajhb.23691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND There are currently 2.2 million people incarcerated in U.S. prisons and jails, representing a 500% increase over the past 40 years. An emerging literature suggests the impact of mass incarceration extends beyond the prison, jail, or detention center to the families of incarcerated individuals. Less scholarship has considered consequences of parental incarceration for their children's physical health. METHODS We conduct a critical review of the literature investigating an association between parental incarceration and children's physical health outcomes from infancy to adulthood. RESULTS Studies varied substantially in study design, sample composition, and methodological approach. Most studies suggest an association between parental incarceration and adverse physical health outcomes. Evidence is more consistent for outcomes such as infant and child mortality, lower healthcare access, and negative health behaviors and more mixed for measures such as self-reported/general health. CONCLUSION We propose a multilevel model of mechanistic pathways to stimulate future research on the potential pathways through which parental incarceration could influence children's physical health.
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Affiliation(s)
- Makeda K Austin
- Department of Psychology, Northwestern University, Evanston, Illinois, USA
| | - Inez I White
- Ingalls Memorial Hospital, University of Chicago Medicine, Chicago, Illinois, USA
| | - Andrew Wooyoung Kim
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA.,SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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111
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Medvedyuk S, Govender P, Raphael D. The reemergence of Engels' concept of social murder in response to growing social and health inequalities. Soc Sci Med 2021; 289:114377. [PMID: 34662784 DOI: 10.1016/j.socscimed.2021.114377] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/29/2021] [Accepted: 09/04/2021] [Indexed: 12/18/2022]
Abstract
In 1845, Friedrich Engels identified how the living and working conditions experienced by English workers sent them prematurely to the grave, arguing that those responsible for these conditions -- ruling authorities and the bourgeoisie -- were committing social murder. The concept remained, for the most part, dormant in academic journals through the 1900s. Since 2000, there has been a revival of the social murder concept with its growth especially evident in the UK over the last decade as a result of the Grenfell Tower Fire and the effects of austerity imposed by successive Conservative governments. The purpose of this paper is to document the reemergence of the concept of social murder in academic journal articles. To do so we conducted a scoping review of content applying the social murder concept since 1900 in relation to health and well-being. We identified two primary concepts of social murder: social murder as resulting from capitalist exploitation and social murder as resulting from bad public policy across the domains of working conditions, living conditions, poverty, housing, race, health inequalities, crime and violence, neoliberalism, gender, food, social assistance, deregulation and austerity. We consider reasons for the reemergence of Engels' social murder concept and the role it can play in resisting the forces responsible for the living and working conditions that kill.
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Affiliation(s)
- Stella Medvedyuk
- School of Health Policy and Management, York University, Toronto, Canada
| | - Piara Govender
- School of Health Policy and Management, York University, Toronto, Canada
| | - Dennis Raphael
- School of Health Policy and Management, York University, Toronto, Canada.
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Beach SRH, Ong ML, Lei MK, Carter SE, Simons RL, Gibbons FX, Philibert RA. Methylation of FKBP5 is associated with accelerated DNA methylation ageing and cardiometabolic risk: replication in young-adult and middle-aged Black Americans. Epigenetics 2021; 17:982-1002. [PMID: 34533092 PMCID: PMC9487733 DOI: 10.1080/15592294.2021.1980688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Methylation of FKBP5 is involved in the regulation of the stress response and is influenced by early stress exposure. Two CpG sites, cg20813374 and cg00130530, have been identified as potential reporters of early stress. We examined whether FKBP5 methylation was associated with accelerated DNA methylation ageing and indirectly predicted poorer cardiovascular health among both young adult and middle-aged Black Americans. Four hundred and forty-nine young adults, with a mean age of 28.67 and N = 469 middle-age parents and their current partners with a mean age of 57.21, provided self-reports, biometric assessments, and blood draws. Methylation values were obtained using the Illumina Epic Array. Cardiometabolic risk was calculated by summing the standardized log-transformed scores for the body mass index, mean arterial blood pressure, and HbA1c. We also used a more standard index of risk, the Framingham 10-year cardiometabolic risk index, as an alternative measure of cardiometabolic risk. To measure accelerated ageing, four widely used indices of accelerated, DNA methylation-based ageing were used controlling sex, age, other variation in FKBP5, and cell-type. Exposure to community danger was associated with demethylation of FKBP5. FKBP5 methylation was significantly associated with accelerated ageing for both young-adult and middle-aged samples, with significant indirect effects from FKBP5 methylation to cardiometabolic risk through accelerated ageing for both. Early exposure to danger may influence FKBP5 methylation. In turn, FKBP5 methylation may help explain intrinsic accelerated ageing and elevated cardiometabolic risk in adulthood for Black Americans.
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Affiliation(s)
- Steven R H Beach
- Department of Psychology and the Center for Family Research, University of Georgia, Athens, GA, USA.,Center for Family Research, University of Georgia, Athens, GA, USA
| | - Mei Ling Ong
- Center for Family Research, University of Georgia, Athens, GA, USA
| | - Man-Kit Lei
- Department of Sociology, University of Georgia, Athens, GA, USA
| | - Sierra E Carter
- Department of Psychology, Georgia State University, AtlantaAG, GA, USA
| | - Ronald L Simons
- Department of Sociology, University of Georgia, Athens, GA, USA
| | - Frederick X Gibbons
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Robert A Philibert
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA.,Behavioral Diagnostics, Coralville, IA, USA
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Nalven T, Spillane NS, Schick MR, Weyandt LL. Diversity inclusion in United States opioid pharmacological treatment trials: A systematic review. Exp Clin Psychopharmacol 2021; 29:524-538. [PMID: 34242040 PMCID: PMC8511246 DOI: 10.1037/pha0000510] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Pharmacological treatments for opioid use disorders (OUDs) may have mixed efficacy across diverse groups, i.e., sex/gender, race/ethnicity, and socioeconomic status (SES). The present systematic review aims to examine how diverse groups have been included in U.S. randomized clinical trials examining pharmacological treatments (i.e., methadone, buprenorphine, or naltrexone) for OUDs. PubMed was systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The initial search yielded 567 articles. After exclusion of ineligible articles, 50 remained for the present review. Of the included articles, 14.0% (n = 7) reported both full (i.e., accounting for all participants) sex/gender and race/ethnicity information; only two of those articles also included information about any SES indicators. Moreover, only 22.0% (n = 11) reported full sex/gender information, and 42.0% (n = 21) reported full racial/ethnic information. Furthermore, only 10.0% (n = 5) reported that their lack of subgroup analyses or diverse samples was a limitation to their studies. Particularly underrepresented were American Indian/Alaska Native (AI/AN), Asian, Native Hawaiian/Other Pacific Islander (NH/OPI), and multiracial individuals. These results also varied by medication type; Black individuals were underrepresented in buprenorphine randomized controlled trials (RCTs) but were well represented in RCTs for methadone and/or naltrexone. In conclusion, it is critical that all people receive efficacious pharmacological care for OUDs given the ongoing opioid epidemic. Findings from the present review, however, support that participants from diverse or marginalized backgrounds are underrepresented in treatment trials, despite being at increased risk for disparities related to OUDs. Suggestions for future research are advanced. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Tessa Nalven
- Department of Psychology, University of Rhode Island
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114
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Hall JA, Chen W, Bhayana K, Lee P, Moroni EA, Butler PD, Delacruz C. Quantifying the Pipeline of Ethnically Underrepresented in Medicine Physicians in Academic Plastic Surgery Leadership. Ann Plast Surg 2021; 87:e51-e61. [PMID: 34559716 DOI: 10.1097/sap.0000000000002923] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The lack of underrepresented in medicine (UIM) physicians in academic plastic surgery is emerging as a critical issue. Lack of diversity has a negative effect on patient care and on the culture of our health care system. This study reports the current status of ethnically UIM physicians in the plastic surgery pipeline, starting from the medical student level and progressing to national leadership positions. METHODS The Electronic Residency Applications Service, National Resident Matching Program, Association of American Medical Colleges, and professional Web sites for journals and national societies were accessed for racial demographic information from 2008 to 2019. RESULTS Over the past decade, there has been no change or a slight decrease in representation of Blacks among plastic surgery residency applicants, trainees, and academic faculty, at half or less than expected, compared with US Census data. The first point of drop-off occurs at the resident (3.8% of integrated and 5.6% of independent residents) to faculty level (<2.8%). Two percent of program directors and department heads/division chiefs are Black. The next point of drop-off occurs at the national level: there has never been a Black president of American Society of Plastic Surgeons or Plastic Surgery Foundation, and there are no Black editors-in-chiefs of major plastic surgery journals.Following LatinX American surgeons down the pipeline over the past decade, there has been no change or a decrease in representation among plastic surgery residency applicants, resident physicians, and academic faculty, at one-third or less than expected, compared with US Census data. The first point of drop-off occurs at the faculty (4.8%) to local leadership level (0% of program directors and department heads/division chiefs) where there is no representation of LatinX. Once this drop-off occurs, there is no recovery at the national leadership level. CONCLUSIONS In order for our profession to reflect our nation's demographics, academic plastic surgery is in need of a paradigm shift now. Attrition of UIM physicians in plastic surgery begins at medical school graduation and persists through surgical training, faculty appointments, and attainment of leadership positions. Creative and innovative commitment to diversity and inclusion is necessary.
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Affiliation(s)
- Jennifer A Hall
- From the Geisinger Commonwealth School of Medicine, Scranton, PA
| | | | | | - Phoebe Lee
- University of Pittsburgh School of Medicine
| | - Elizabeth A Moroni
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh
| | - Paris D Butler
- Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA
| | - Carolyn Delacruz
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh
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115
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Rauscher E, Burns A. Unequal Opportunity Spreaders: Higher COVID-19 Deaths with Later School Closure in the United States. SOCIOLOGICAL PERSPECTIVES : SP : OFFICIAL PUBLICATION OF THE PACIFIC SOCIOLOGICAL ASSOCIATION 2021; 64:831-856. [PMID: 37332490 PMCID: PMC10275350 DOI: 10.1177/07311214211005486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Mixed evidence on the relationship between school closure and COVID-19 prevalence could reflect focus on large-scale levels of geography, limited ability to address endogeneity, and demographic variation. Using county-level Centers for Disease Control and Prevention (CDC) COVID-19 data through June 15, 2020, two matching strategies address potential heterogeneity: nearest geographic neighbor and propensity scores. Within nearest neighboring pairs in different states with different school closure timing, each additional day from a county's first case until state-ordered school closure is related to 1.5 to 2.4 percent higher cumulative COVID-19 deaths per capita (1,227-1,972 deaths for a county with median population and deaths/capita). Results are consistent using propensity score matching, COVID-19 data from two alternative sources, and additional sensitivity analyses. School closure is more strongly related to COVID-19 deaths in counties with a high concentration of Black or poor residents, suggesting schools play an unequal role in transmission and earlier school closure is related to fewer lives lost in disadvantaged counties.
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116
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Ciciurkaite G. Race/ethnicity, gender and the SES gradient in BMI: The diminishing returns of SES for racial/ethnic minorities. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:1754-1773. [PMID: 33884635 DOI: 10.1111/1467-9566.13267] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 12/23/2020] [Accepted: 03/01/2021] [Indexed: 06/12/2023]
Abstract
Using the 2013-2016 data from the National Health and Nutrition Examination Survey (NHANES), this study uses the case of obesity to examine whether and to what extent racial and ethnic minorities experience fewer benefits from higher SES relative to their white counterparts. Study results provide support for the diminishing returns in health hypothesis and add an intersectional dimension to this perspective by uncovering stark gendered racial/ethnic disparities in BMI. Specifically, research findings demonstrate that higher income and education is associated with lower BMI among white but not black or Mexican American adults. The most substantial decrease in BMI associated with increase in individual-level SES was observed among white women. Taken together, empirical evidence from this study underscores difficulty in overcoming adverse health effects of lower ascribed status (i.e. gender or race/ethnicity) even with attainment of higher achieved social status (i.e. educational attainment or income) and offers promising avenues for future research on identifying complex hierarchies that shape population health outcomes.
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Affiliation(s)
- Gabriele Ciciurkaite
- Department of Sociology, Social Work and Anthropology, Utah State University, Utah, USA
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117
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Boardman JD, Fletcher JM. Evaluating the Continued Integration of Genetics into Medical Sociology. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2021; 62:404-418. [PMID: 34355610 PMCID: PMC8771926 DOI: 10.1177/00221465211032581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The 2010 special issue of Journal of Health and Social Behavior, titled "Fifty Years of Medical Sociology," defined the contours of the medical sociological perspective. We use this as a backdrop to outline and assess the continued integration of genetics into medical sociology research. We contend that the explosion of genetic and epigenetic data in population health data sources has made the medical sociological perspective increasingly relevant to researchers outside of sociology, including public health, epidemiology, and quantitative genetics. We describe vast, underappreciated, and mostly unsolved challenges that limit the scientifically appropriate interest in incorporating genetics into existing paradigms. It is our hope that medical sociologists continue this integration but redouble efforts to maintain the core insights in social science research, such as the importance of environmental and structural (i.e., nonbiological) factors in determining health processes and outcomes and the use of rich, integrated, and rigorous empirical analyses.
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118
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Cain CL. Valuing Black lives and the 'Good Death' in the United States. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:1840-1844. [PMID: 34224146 DOI: 10.1111/1467-9566.13310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 05/07/2021] [Accepted: 05/14/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Cindy L Cain
- Department of Sociology, University of Alabama at Birmingham, Birmingham, AL, USA
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119
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Clark EM, Ma L, Williams BR, Park CL, Knott CL, Schulz EK, Ghosh D. Social Support as a Mediator of the Personality-Physical Functioning Relationship in a National Sample of African Americans: A Two-Wave Longitudinal Study. JOURNAL OF BLACK PSYCHOLOGY 2021. [DOI: 10.1177/00957984211037970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study investigates whether social support mediates the relationship between personality traits and physical functioning among African Americans over 2.5 years. Data were collected from a national probability sample of African American adults (analytic sample N = 312). Telephone surveys included measures of the five-factor model personality traits, social support, and physical functioning. Personality traits were assessed at Time 1 (T1), and social support and physical functioning were assessed 2.5 years later at Time 2 (T2). Physical functioning was assessed using the SF-12 at T2. Results indicated that T2 social support mediated the relationship between T1 personality traits and T2 physical functioning for the traits of conscientiousness, extraversion, agreeableness, and neuroticism, but not for openness to experience. This information may be useful to healthcare providers and community members in developing strategies targeting personality traits in cultivating social support for health promotion.
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Affiliation(s)
- Eddie M. Clark
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - Lijing Ma
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - Beverly R. Williams
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Crystal L. Park
- Psychological Sciences Department, University of Connecticut, Storrs, CT, USA
| | - Cheryl L. Knott
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
| | | | - Debarchana Ghosh
- Psychological Sciences Department, University of Connecticut, Storrs, CT, USA
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120
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Moore JX, Gilbert KL, Lively KL, Laurent C, Chawla R, Li C, Johnson R, Petcu R, Mehra M, Spooner A, Kolhe R, Ledford CJW. Correlates of COVID-19 Vaccine Hesitancy among a Community Sample of African Americans Living in the Southern United States. Vaccines (Basel) 2021; 9:vaccines9080879. [PMID: 34452004 PMCID: PMC8402307 DOI: 10.3390/vaccines9080879] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 12/23/2022] Open
Abstract
In the United States, African Americans (AAs) have been disproportionately affected by COVID-19 mortality. However, AAs are more likely to be hesitant in receiving COVID-19 vaccinations when compared to non-Hispanic Whites. We examined factors associated with vaccine hesitancy among a predominant AA community sample. We performed a cross-sectional analysis on data collected from a convenience sample of 257 community-dwelling participants in the Central Savannah River Area from 5 December 2020, through 17 April 2021. Vaccine hesitancy was categorized as resistant, hesitant, and acceptant. We estimated relative odds of vaccine resistance and vaccine hesitancy using polytomous logistic regression models. Nearly one-third of the participants were either hesitant (n = 40, 15.6%) or resistant (n = 42, 16.3%) to receiving a COVID-19 vaccination. Vaccine-resistant participants were more likely to be younger and were more likely to have experienced housing insecurity due to COVID-19 when compared to both acceptant and hesitant participants, respectively. Age accounted for nearly 25% of the variation in vaccine resistance, with 21-fold increased odds (OR: 21.93, 95% CI: 8.97-5.26-91.43) of vaccine resistance in participants aged 18 to 29 compared to 50 and older adults. Housing insecurity accounted for 8% of the variation in vaccine resistance and was associated with 7-fold increased odds of vaccine resistance (AOR: 7.35, 95% CI: 1.99-27.10). In this sample, AAs under the age of 30 and those experiencing housing insecurity because of the COVID-19 pandemic were more likely to be resistant to receiving a free COVID-19 vaccination.
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Affiliation(s)
- Justin Xavier Moore
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
- Cancer Prevention, Control, & Population Health Program, Department of Medicine, Augusta University, Augusta, GA 30912, USA
- Institute of Preventive and Public Health, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Correspondence: ; Tel.: +1-706-721-4621
| | - Keon L. Gilbert
- Department of Behavioral Science and Health Education, Saint Louis University, St. Louis, MO 63103, USA;
| | - Katie L. Lively
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Christian Laurent
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Rishab Chawla
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Cynthia Li
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Ryan Johnson
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Robert Petcu
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Mehul Mehra
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Antron Spooner
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Ravindra Kolhe
- Department of Pathology, Section of Anatomic Pathology, Augusta University, Augusta, GA 30912, USA;
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121
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Beach SRH, Ong ML, Lei MK, Klopack E, Carter SE, Simons RL, Gibbons FX, Lavner JA, Philibert RA, Ye K. Childhood adversity is linked to adult health among African Americans via adolescent weight gain and effects are genetically moderated. Dev Psychopathol 2021; 33:803-820. [PMID: 32372728 PMCID: PMC7644595 DOI: 10.1017/s0954579420000061] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Identifying the mechanisms linking early experiences, genetic risk factors, and their interaction with later health consequences is central to the development of preventive interventions and identifying potential boundary conditions for their efficacy. In the current investigation of 412 African American adolescents followed across a 20-year period, we examined change in body mass index (BMI) across adolescence as one possible mechanism linking childhood adversity and adult health. We found associations of childhood adversity with objective indicators of young adult health, including a cardiometabolic risk index, a methylomic aging index, and a count of chronic health conditions. Childhood adversities were associated with objective indicators indirectly through their association with gains in BMI across adolescence and early adulthood. We also found evidence of an association of genetic risk with weight gain across adolescence and young adult health, as well as genetic moderation of childhood adversity's effect on gains in BMI, resulting in moderated mediation. These patterns indicated that genetic risk moderated the indirect pathways from childhood adversity to young adult health outcomes and childhood adversity moderated the indirect pathways from genetic risk to young adult health outcomes through effects on weight gain during adolescence and early adulthood.
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Affiliation(s)
- Steven R. H. Beach
- Department of Psychology, University of Georgia
- Center for Family Research, University of Georgia
| | - Mei Ling Ong
- Center for Family Research, University of Georgia
| | - Man-Kit Lei
- Department of Sociology, University of Georgia
| | | | | | | | | | - Justin A. Lavner
- Department of Psychology, University of Georgia
- Center for Family Research, University of Georgia
| | - Robert A. Philibert
- Department of Psychiatry, University of Iowa
- Behavioral Diagnostics, Coralville, Iowa
| | - Kaixiong Ye
- Department of Genetics and Institute of Bioinformatics, University of Georgia
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122
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Simkin J, Valentino J, Cao W, McCarthy C, Schuon J, Davis J, Marrero L, Dasa V, Leonardi C, Yu Q. Quantifying Mediators of Racial Disparities in Knee Osteoarthritis Outcome Scores: A Cross-Sectional Analysis. JB JS Open Access 2021; 6:JBJSOA-D-21-00004. [PMID: 34337283 PMCID: PMC8318640 DOI: 10.2106/jbjs.oa.21.00004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Studies on symptomatic osteoarthritis suggest that Black patients report worse pain and symptoms compared with White patients with osteoarthritis. In this study, we aimed to quantify the relationship among variables such as overall health and socioeconomic status that may contribute to disparities in patient-reported outcomes.
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Affiliation(s)
- Jennifer Simkin
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - John Valentino
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - Wentao Cao
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - Christina McCarthy
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - Jonathan Schuon
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - Jacob Davis
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - Luis Marrero
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - Vinod Dasa
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - Claudia Leonardi
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - Qingzhao Yu
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
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123
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Emami A, de Castro B. Confronting racism in nursing. Nurs Outlook 2021; 69:714-716. [PMID: 34330527 DOI: 10.1016/j.outlook.2021.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/01/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Azita Emami
- University of Washington School of Nursing, Seattle, WA
| | - Butch de Castro
- Equity, and Inclusion, University of Washington School of Nursing, Seattle, WA
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Paradela RS, Ferreira NV, Nucci MP, Cabella B, Martino LM, Torres LA, Costa DID, Consolim-Colombo FM, Suemoto CK, Irigoyen MC. Relation of a Socioeconomic Index with Cognitive Function and Neuroimaging in Hypertensive Individuals. J Alzheimers Dis 2021; 82:815-826. [PMID: 34092639 DOI: 10.3233/jad-210143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Socioeconomic factors are important contributors to brain health. However, data from developing countries (where social inequalities are the most prominent) are still scarce, particularly about hypertensive individuals. OBJECTIVE To evaluate the relationship between socioeconomic index, cognitive function, and cortical brain volume, as well as determine whether white matter hyperintensities are mediators of the association of the socioeconomic index with cognitive function in hypertensive individuals. METHODS We assessed 92 hypertensive participants (mean age = 58±8.6 years, 65.2%female). Cognitive evaluation and neuroimaging were performed and clinical and sociodemographic data were collected using questionnaires. A socioeconomic index was created using education, income, occupation (manual or non-manual work), and race. The associations of the socioeconomic index with cognitive performance and brain volume were investigated using linear regression models adjusted for age, sex, time of hypertension since diagnosis, and comorbidities. A causal mediation analysis was also conducted. RESULTS Better socioeconomic status was associated with better visuospatial ability, executive function, and global cognition. We found associations between a better socioeconomic index and a higher parietal lobe volume. White matter hyperintensities were also not mediators in the relationship between the socioeconomic index and cognitive performance. CONCLUSION Socioeconomic disadvantages are associated with worse cognitive performance and brain volume in individuals with hypertension.
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Affiliation(s)
- Regina Silva Paradela
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Naomi Vidal Ferreira
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.,Adventist University of São Paulo, Engenheiro Coelho, SP, Brazil
| | - Mariana Penteado Nucci
- Laboratory of Medical Investigations on Magnetic Resonance Imaging (LIM-44), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Brenno Cabella
- Institute of Theoretical Physics, São Paulo State University (IFT-UNESP), São Paulo, SP, Brazil
| | - Luiza Menoni Martino
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Laura Aló Torres
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Danielle Irigoyen da Costa
- Brain Institute (InsCer), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | | | - Claudia Kimie Suemoto
- Division of Geriatrics, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Maria Claudia Irigoyen
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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125
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Massett HA, Mitchell AK, Alley L, Simoneau E, Burke P, Han SH, Gallop-Goodman G, McGowan M. Facilitators, Challenges, and Messaging Strategies for Hispanic/Latino Populations Participating in Alzheimer's Disease and Related Dementias Clinical Research: A Literature Review. J Alzheimers Dis 2021; 82:107-127. [PMID: 33998537 DOI: 10.3233/jad-201463] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD) disproportionally affect Hispanic and Latino populations, yet Hispanics/Latinos are substantially underrepresented in AD/ADRD clinical research. Diverse inclusion in trials is an ethical and scientific imperative, as underrepresentation reduces the ability to generalize study findings and treatments across populations most affected by a disease. This paper presents findings from a narrative literature review (N = 210) of the current landscape of Hispanic/Latino participation in clinical research, including the challenges, facilitators, and communication channels to conduct culturally appropriate outreach efforts to increase awareness and participation of Hispanics/Latinos in AD/ADRD clinical research studies. Many challenges identified were systemic in nature: lack of culturally relevant resources; staffing that does not represent participants' cultures/language; eligibility criteria that disproportionately excludes Hispanics/Latinos; and too few studies available in Hispanic/Latino communities. The paper also details facilitators and messaging strategies to improve engagement and interest among Hispanics/Latinos in AD/ADRD research, starting with approaches that recognize and address the heterogeneity of the Hispanic/Latino ethnicity, and then, tailor outreach activities and programs to address their diverse needs and circumstances. The needs identified in this article represent longstanding failures to improve engagement and interest among Hispanics/Latinos in AD/ADRD research; we discuss how the field can move forward learning from the experiences of the COVID-19 pandemic.
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Affiliation(s)
- Holly A Massett
- Division of Extramural Activities, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | | | - Sae H Han
- Kelly Government, Kelly Services, Inc., Rockville, MD, USA
| | - Gerda Gallop-Goodman
- Office of Communications and Public Liaison, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Melissa McGowan
- Office of Communications and Public Liaison, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
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126
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Gutin I, Hummer RA. Social Inequality and the Future of U.S. Life Expectancy. ANNUAL REVIEW OF SOCIOLOGY 2021; 47:501-520. [PMID: 34366549 PMCID: PMC8340572 DOI: 10.1146/annurev-soc-072320-100249] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Despite decades of progress, the future of life expectancy in the United States is uncertain due to widening socioeconomic disparities in mortality, continued disparities in mortality across racial/ethnic groups, and an increase in extrinsic causes of death. These trends prompt us to scrutinize life expectancy in a high-income but enormously unequal society like the United States, where social factors determine who is most able to maximize their biological lifespan. After reviewing evidence for biodemographic perspectives on life expectancy, the uneven diffusion of health-enhancing innovations throughout the population, and the changing nature of threats to population health, we argue that sociology is optimally positioned to lead discourse on the future of life expectancy. Given recent trends, sociologists should emphasize the importance of the social determinants of life expectancy, redirecting research focus away from extending extreme longevity and towards research on social inequality with the goal of improving population health for all.
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Affiliation(s)
- Iliya Gutin
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27516
- Corresponding author:
| | - Robert A. Hummer
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27516
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Shades of Belonging: The Intersection of Race and Religion in Utah Immigrants’ Social Integration. SOCIAL SCIENCES-BASEL 2021. [DOI: 10.3390/socsci10070246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Utah, USA, a state with a unique history of immigration and a distinctive religious context, provides a useful setting in which to study the intersection of racism and religious participation with immigrant integration. Utah is one of the Whitest states in the United States, with 4 of every 5 residents identifying as non-Hispanic White. It is also home to the headquarters of the Church of Jesus Christ of Latter-day Saints (LDS Church) which, until 1978, explicitly imposed race-based exclusions that prohibited or strictly limited Black members’ participation in church leadership, rituals, and ordinances. The state’s cultural, social, and religious history has contributed to widespread beliefs among modern Utah residents of Whites’ racial supremacy in contexts both mundane and divine. Much of Utah’s population growth since 1960, especially among non-White racial and ethnic groups, can be attributed to immigrants, who today compose nearly 10 percent of the state’s population. Given Utah’s religious, social, and cultural relationship to race, it is an ideal case to study the following question: how do race, religion, and culture shape integration among immigrants? Utilizing interviews with 70 immigrants who have lived in Utah for an average of 13 years, we find that both race and LDS Church membership influence immigrants’ social integration, creating a hierarchy of belonging among immigrants in Utah––with White LDS immigrants reporting the highest levels of integration and non-White, non-LDS immigrants reporting the lowest levels of integration. These findings suggest the power of cultural narratives––beyond explicit institutional policy and practice––in perpetuating racial inequality in society. Thus, efforts to increase integration and belonging among immigrants must not only include work to dismantle legal and structural inequalities but also efforts to actively change the cultural narratives associated with them.
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Sen-Crowe B, Lin IC, Alfaro R, McKenney M, Elkbuli A. COVID-19 fatalities by zip codes and socioeconomic indicators across various U.S. regions. Ann Med Surg (Lond) 2021; 67:102471. [PMID: 34150208 PMCID: PMC8196232 DOI: 10.1016/j.amsu.2021.102471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/30/2021] [Accepted: 06/04/2021] [Indexed: 02/08/2023] Open
Abstract
Background There is a paucity of literature addressing COVID-19 case-fatality ratios (CFR) by zip code (ZC). We aim to analyze trends in COVID-19 CFR, population density, and socioeconomic status (SES) indicators (unemployment, median household income) to identify ZCs heavily burdened by COVID-19. Methods Cross-sectional study to investigate the US prevalence of COVD-19 fatalities by ZC and SES. CFRs were calculated from state/county Departments of Health. Inclusion criteria were counties that reported cases/deaths by ZC and a CFR≥2%. This study was reported in line with the STROCSS criteria. Results 609/1,853 ZCs, spanning 327 counties in 7 states had CFRs ≥2%. A significant positive correlation was found between the CFR and median household income (Pearson correlation:0.107; 95% CI [289.1,1937.9]; p < 0.001). No significant correlations exist between the CFR, and population/mi (Sen-Crowe et al., 2020) [2] or unemployment rate. Significant associations exist between the CFR and young males and elderly females without public insurance. CFR was inversely associated with persons aged <44 and individuals aged ≥65. The percentage of nursing homes (NHs) within cities residing within high CFR ZCs range from 8.7% to 67.6%. Conclusion Significant positive association was found between the CFR and median household income. Population/mi (Sen-Crowe et al., 2020) [2] and unemployment rates, did not correlate to CFR. NHs were heavily distributed in high CFR zip codes. We recommend the targeted vaccination of zip codes with a large proportion of long-term care facilities. Finally, we recommend for improved screening and safety guidelines for vulnerable populations (e.g nursing home residents) and established protocols for when there is evidence of substantial infectious spread. First national sampling of COVID-19 Case Fatality Ratio (CFR) at the zip code level. Population density and unemployment rate did not correlate to COVID-19 CFR. Significant positive correlation was found between CFR and median household income. Nursing homes were concentrated in zip codes with high COVID-19 CFR. States should make COVID-19 data available at the zip code level.
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Affiliation(s)
- Brendon Sen-Crowe
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA
| | - I-Chun Lin
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA
| | - Robert Alfaro
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA
| | - Mark McKenney
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA.,Department of Surgery, University of South Florida, Tampa, FL, USA
| | - Adel Elkbuli
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA
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Firat RB. A Neurosociological Theory of Culturally and Structurally Situated Cognition and Ethno-Racial Stress. FRONTIERS IN SOCIOLOGY 2021; 6:695042. [PMID: 34179183 PMCID: PMC8225953 DOI: 10.3389/fsoc.2021.695042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/02/2021] [Indexed: 06/13/2023]
Abstract
A longstanding body of literature reveals that experiences of discrimination and exclusion lead to health disadvantages by increasing physiological stress responses both in the body and the brain. However, a sociological view that takes into account structurally and culturally shaped biological processes is missing from the literature. Building on recent literature from the sociology of morality and values and the dual process model of culture, this paper proposes and provides preliminary evidence for an applied theory of culturally situated moral cognition as a coping mechanism with ethno-racial stress. I focus on values as they help cope with ethnicity and race related stress such as discrimination. Using functional neuroimaging data, I offer evidence that values operate through both explicit (controlled and conscious) processes recruiting brain regions like the dorsal prefrontal cortex, and implicit (automatic and non-conscious) processes recruiting regions like the ventromedial prefrontal cortex, to help cope with exclusion and discrimination.
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“It’s Not Just about Work and Living Conditions”: The Underestimation of the COVID-19 Pandemic for Black Canadian Women. SOCIAL SCIENCES-BASEL 2021. [DOI: 10.3390/socsci10060210] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic has increasingly been defined as the shecession for its disproportionate debilitating impact on women. Despite this gendered analysis, a number of health activists have called on governments to account for the experiences of Black communities as they are disproportionately suffering the effects of this pandemic. In the media’s address of the impact of the pandemic, we ask, what experiences are represented in news stories and are Black women present in these representations. Performing a content analysis of 108 news articles, a reading of media discourses through a racial lens reveals a homogenization of women’s experiences and an absence of the Black experience. In the small number of news stories that do focus on Black women, we see that the health disparities are not simply the result of precarious work and living conditions, but also the struggle against anti-Black racism on multiple fronts. In critiquing, however, we also bring forth the small number of news stories on the Black experience that speak to the desire and hope that can thrive outside of white supremacist structures.
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131
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Shelton RC, Adsul P, Oh A. Recommendations for Addressing Structural Racism in Implementation Science: A Call to the Field. Ethn Dis 2021; 31:357-364. [PMID: 34045837 DOI: 10.18865/ed.31.s1.357] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Implementation science (IS) has emerged in response to a striking research-to-practice gap, with the goal of accelerating and addressing the development, translation, and widespread uptake of evidence-based interventions (EBIs). Despite the promise of IS, critical gaps and opportunities remain within the field to explicitly facilitate health equity, particularly as they relate to the role of social determinants of health and structural racism. In this commentary, we propose recommendations for the field of IS to include structural racism as a more explicit focus of our work. First, we make the case for including structural racism as a construct and promote its measurement as a determinant within existing IS frameworks/models, laying the foundation for an empirical evidence base on mechanisms through which such factors influence inequitable adoption, implementation, and sustainability of EBIs. Second, we suggest considerations for both EBIs and implementation strategies that directly or indirectly address structural racism and impact health equity. Finally, we call for use of methods and approaches within IS that may be more appropriate for addressing structural racism at multiple ecological levels and clinical and community settings in which we conduct IS, including community-based participatory research and stakeholder engagement. We see these as opportunities to advance the focus on health equity within IS and conclude with a charge to the field to consider making structural racism and the dismantling of racism an explicit part of the IS research agenda.
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Affiliation(s)
- Rachel C Shelton
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY
| | - Prajakta Adsul
- Department of Medicine, University of New Mexico, Albuquerque, NM
| | - April Oh
- National Cancer Institute, Division of Cancer Control and Population Sciences, Rockville, MD
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Mahabir DF, O'Campo P, Lofters A, Shankardass K, Salmon C, Muntaner C. Classism and Everyday Racism as Experienced by Racialized Health Care Users: A Concept Mapping Study. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2021; 51:350-363. [PMID: 33949220 PMCID: PMC8204040 DOI: 10.1177/00207314211014782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
In Toronto, Canada, 51.5 % of the population are members of racialized groups. Systemic
labor market racism has resulted in an overrepresentation of racialized groups in
low-income and precarious jobs, a racialization of poverty, and poor health. Yet, the
health care system is structured around a model of service delivery and policies that fail
to consider unequal power social relations or racism. This study examines how racialized
health care users experience classism and everyday racism in the health care setting and
whether these experiences differ within stratifications such as social class, gender, and
immigration status. A concept mapping design was used to identify mechanisms of classism
and everyday racism. For the rating activity, 41 participants identified as racialized
health care users. The data analysis was completed using concept systems software.
Racialized health care users reported “race”/ethnic-based discrimination as moderate to
high and socioeconomic position-/social class-based discrimination as moderate in
importance for the challenges experienced when receiving health care; differences within
stratifications were also identified. To improve access to services and quality of care,
antiracist policies that focus on unequal power social relations and a broader systems
thinking are needed to address institutional racism within the health care system.
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Affiliation(s)
| | | | | | | | - Christina Salmon
- 518773Knowledge Translation Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Carles Muntaner
- 7938University of Toronto, Toronto, ON, Canada.,Dalla Lana School of Public Health, 7938University of Toronto, ON, Canada
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Thrul J, Garcia-Romeu A. Whitewashing psychedelics: racial equity in the emerging field of psychedelic-assisted mental health research and treatment. DRUGS: EDUCATION, PREVENTION AND POLICY 2021. [DOI: 10.1080/09687637.2021.1897331] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Johannes Thrul
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
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An Assessment of the Role of Parental Incarceration and Substance Misuse in Suicidal Planning of African American Youth and Young Adults. J Racial Ethn Health Disparities 2021; 9:1062-1074. [PMID: 33909282 DOI: 10.1007/s40615-021-01045-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/10/2021] [Accepted: 04/11/2021] [Indexed: 10/21/2022]
Abstract
Suicide rates among youth are increasing, and African American youth are becoming the most likely group to die by suicide in the USA. We utilized ecodevelopmental theory to investigate the relationship between parental incarceration and substance misuse and their association with suicidal planning in a sample of African American youth and young adults. Participants consisted of 190 African American youth and young adults living in public housing in a mid-Atlantic city in the USA who completed a youth health-risk behavior measure, and parental incarceration and substance misuse measures. Findings indicate males were significantly more likely than females to have devised a plan to die by suicide, especially if their mothers were incarcerated or their fathers had an alcohol problem. The findings of this study suggest several implications for health prevention and intervention efforts to reduce suicide-related risks among African American youth and young adults, including strategies that promote family-centered, evidence-based interventions that are culturally tailored to provide further insight into the best practices in suicide prevention.
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135
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"First do no harm": Clinical practice guidelines, mesolevel structural racism, and medicine's epistemological reckoning. Soc Sci Med 2021; 279:113968. [PMID: 34022676 DOI: 10.1016/j.socscimed.2021.113968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/18/2021] [Accepted: 04/22/2021] [Indexed: 11/23/2022]
Abstract
This paper presents a critique of clinical practice guidelines (CPGs) that standardize the use of race as a proxy for biological difference in medical settings. Drawing on the illustrative example of a pediatric UTI testing guideline, we contend that when CPGs necessitate that Black patients meet a higher threshold of illness severity or duration than their non-Black counterparts to receive comparable medical testing or other medical care, they function as mesolevel sites of race-racism reification processes (see Sewell, 2016) that contribute to the reproduction of racial health disparities. We describe broader implications and make recommendations for the conceptualization and implementation of future research in the sociological study of race, health, and medicine.
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136
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Nafiu OO, Mpody C, Michalsky MP, Tobias JD. Unequal rates of postoperative complications in relatively healthy bariatric surgical patients of white and black race. Surg Obes Relat Dis 2021; 17:1249-1255. [PMID: 33985924 DOI: 10.1016/j.soard.2021.04.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 04/01/2021] [Accepted: 04/08/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Racial disparities in postsurgical complications are often presumed to be due to a higher preoperative co-morbidity burden among patients of black race, although being relatively healthy is not a prerequisite for a complication-free postoperative course. OBJECTIVES To examine the association of race with short-term postbariatric surgery complications in seemingly healthy patients. SETTINGS Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database (2015-2018). METHODS We studied a relatively healthy (American Society of Anesthesiologists physical status 1 or 2), propensity score-matched cohort of adult non-Hispanic black and non-Hispanic white bariatric surgery patients. We compared the risk-adjusted incidences of postoperative complications, serious adverse events, and measures of postoperative resource utilization across racial groups. RESULTS We identified 44,090 matched pairs of relatively healthy black and white bariatric surgery patients. Patients of black race were 72% more likely than those of white race to develop 1 or more postoperative complications (.7% versus .4%, respectively; odds ratio [OR], 1.72; 95% confidence interval [CI], 1.32-2.24; P < .01). Measures of postbariatric resource utilization were significantly higher in patients of black race than those of white race, including unplanned reoperations (1.3% versus 1.0%, respectively; OR, 1.28; 95% CI, 1.07-1.52; P = .01), unplanned readmissions (4.5% versus 3.0%, respectively; OR, 1.53; 95% CI, 1.38-1.69; P < .01), unplanned interventions (1.6% versus 1.2%, respectively; OR, 1.36; 95% CI, 1.16-1.60; P < .01), and extended hospital lengths of stay (51.2% versus 42.7%, respectively; OR, 1.41; 95% CI, 1.36-1.46; P < .01). CONCLUSION Even among relatively healthy patients, race appears to be an important determinant of postbariatric surgery complications and resource utilization. Research and interventions aimed at narrowing the racial disparities in bariatric surgery outcomes may need to broaden the focus beyond the racial variation in the preoperative co-morbidity burden.
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Affiliation(s)
- Olubukola O Nafiu
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio.
| | - Christian Mpody
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Marc P Michalsky
- Department of General Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio
| | - Joseph D Tobias
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio
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137
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Mpody C, Willer BL, Minneci PC, Tobias JD, Nafiu OO. Moderating Effects of Race and Preoperative Comorbidity on Surgical Mortality in Infants. J Surg Res 2021; 264:435-443. [PMID: 33848843 DOI: 10.1016/j.jss.2021.02.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/01/2021] [Accepted: 02/27/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND We sought to investigate the risk of pediatric surgical mortality associated with the combined effects of key preoperative comorbidities and race. METHODS We performed a retrospective study that included infants who underwent inpatient surgical procedures between 2012 and 2017 and were entered into the NSQIP-P registry. We assessed additive moderation by estimating the proportion of mortality risk attributable to the combined effects of race and the presence of a preoperative comorbidity (attributable proportion [AP]). RESULTS The study group was comprised of 58466 surgical cases, of whom 15711(26.9%) were neonates and 42755(73.1%) older infants. Among neonates, a history of prematurity carried a poorer prognosis in black babies than their white peers (OR:1.53, 95%CI:1.20,1.95). Additionally, there was evidence of additive moderation by race on the association between prematurity and postoperative mortality (AP: 23.9%; 95%CI: 3.8,43.9, P value = 0.020). In older infants, presence of preoperative sepsis carried almost two times higher risk of mortality for black patients than their white counterparts (OR:1.81; 95%CI:1.21,2.73). This explained 38.4% of mortality cases in black patients with preoperative sepsis (95%CI:14.0,62.7; P = 0.002). A history of prematurity also carried a greater risk of mortality in older infants of black race (OR:1.69; 95%CI: 1.27, 2.24), accounting for 24.2% of mortality cases (AP:24.2%; 95%CI:0.90, 47.5, P = 0.041). CONCLUSIONS We quantified the surgical burden of mortality resulting from the differential impact of key comorbidities on black neonates and infants. Our data suggest that race-specific interventions to mitigate the incidence of the identified comorbidities could narrow the racial disparities in post surgical mortality.
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Affiliation(s)
- Christian Mpody
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Brittany L Willer
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Peter C Minneci
- Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio
| | - Joseph D Tobias
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Olubukola O Nafiu
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio.
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Ho JTK, Tyndale RF, Baker TB, Amos CI, Chiu A, Smock N, Chen J, Bierut LJ, Chen LS. Racial disparities in intensity of smoke exposure and nicotine intake among low-dependence smokers. Drug Alcohol Depend 2021; 221:108641. [PMID: 33652379 PMCID: PMC8335796 DOI: 10.1016/j.drugalcdep.2021.108641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/10/2021] [Accepted: 02/13/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Compared to white smokers, Black smokers are at disproportionately higher risk for smoking-related disease, despite consuming fewer cigarettes per day (CPD). To examine racial disparities in biobehavioral influences on smoking and disease risk, we analyzed the relationship between self-reported tobacco dependence and intensity of tobacco smoke exposure per cigarette, on the one hand, and intensity of nicotine intake per cigarette, on the other. METHODS In 270 Black and 516 white smokers, smoke exposure was measured by expired carbon monoxide (CO), and nicotine intake was measured by plasma cotinine (COT) and cotinine+3'-hydroxycotinine ([COT + 3HC]). Using linear regression analyses, we analyzed how the Fagerström Test for Cigarette Dependence (FTCD) predicted intensity of smoke exposure per cigarette (CO/CPD) and intensity of nicotine intake per cigarette (COT/CPD; [COT + 3HC]/CPD), and how race moderated these relations. RESULTS Overall, Black smokers consumed fewer CPD than white smokers and had higher levels of CO/CPD, COT/CPD, and [COT + 3HC]/CPD. These elevations were most pronounced at lower levels of dependence: amongst Black smokers, FTCD negatively predicted intensity of smoke exposure as measured by CO/CPD (B = -0.12, 95% CI = -0.18, -0.05, p = 0.0003) and intensity of nicotine intake as measured by [COT + 3HC]/CPD (B = -1.31, 95% CI = -2.15, -0.46, p = 0.002). CONCLUSIONS Low-dependence Black smokers had higher intensities of both smoke exposure and nicotine intake per cigarette compared to similarly dependent white smokers, suggesting that measures of dependence, exposure, and intake underestimate incremental risk of each cigarette to Black smokers.
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Affiliation(s)
- Jolie T K Ho
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Rachel F Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Pharmacology & Toxicology, and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Timothy B Baker
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Christopher I Amos
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA; Department of Medicine, Baylor College of Medicine, Institute for Clinical and Translational Research, Houston, TX, USA
| | - Ami Chiu
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Nina Smock
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Jingling Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, USA
| | - Li-Shiun Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, USA.
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Purtle J, Joshi R, LÊ-Scherban FÉ, Henson RM, Diez Roux AV. Linking Data on Constituent Health with Elected Officials' Opinions: Associations Between Urban Health Disparities and Mayoral Officials' Beliefs About Health Disparities in Their Cities. Milbank Q 2021; 99:794-827. [PMID: 33650741 DOI: 10.1111/1468-0009.12501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Policy Points Mayoral officials' opinions about the existence and fairness of health disparities in their city are positively associated with the magnitude of income-based life expectancy disparity in their city. Associations between mayoral officials' opinions about health disparities in their city and the magnitude of life expectancy disparity in their city are not moderated by the social or fiscal ideology of mayoral officials or the ideology of their constituents. Highly visible and publicized information about mortality disparities, such as that related to COVID-19 disparities, has potential to elevate elected officials' perceptions of the severity of health disparities and influence their opinions about the issue. CONTEXT A substantive body of research has explored what factors influence elected officials' opinions about health issues. However, no studies have assessed the potential influence of the health of an elected official's constituents. We assessed whether the magnitude of income-based life expectancy disparity within a city was associated with the opinions of that city's mayoral official (i.e., mayor or deputy mayor) about health disparities in their city. METHODS The independent variable was the magnitude of income-based life expectancy disparity in US cities. The magnitude was determined by linking 2010-2015 estimates of life expectancy and median household income for 8,434 census tracts in 224 cities. The dependent variables were mayoral officials' opinions from a 2016 survey about the existence and fairness of health disparities in their city (n = 224, response rate 30.3%). Multivariable logistic regression was used to adjust for characteristics of mayoral officials (e.g., ideology) and city characteristics. FINDINGS In cities in the highest income-based life expectancy disparity quartile, 50.0% of mayoral officials "strongly agreed" that health disparities existed and 52.7% believed health disparities were "very unfair." In comparison, among mayoral officials in cities in the lowest disparity quartile 33.9% "strongly agreed" that health disparities existed and 22.2% believed the disparities were "very unfair." A 1-year-larger income-based life expectancy disparity in a city was associated with 25% higher odds that the city's mayoral official would "strongly agree" that health disparities existed (odds ratio [OR] = 1.25; P = .04) and twice the odds that the city's mayoral official would believe that such disparities were "very unfair" (OR = 2.24; P <.001). CONCLUSIONS Mayoral officials' opinions about health disparities in their jurisdictions are generally aligned with, and potentially influenced by, information about the magnitude of income-based life expectancy disparities among their constituents.
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Affiliation(s)
- Jonathan Purtle
- Dornsife School of Public Health and Urban Health Collaborative, Drexel University
| | - Rennie Joshi
- Dornsife School of Public Health and Urban Health Collaborative, Drexel University
| | - FÉlice LÊ-Scherban
- Dornsife School of Public Health and Urban Health Collaborative, Drexel University
| | - Rosie Mae Henson
- Dornsife School of Public Health and Urban Health Collaborative, Drexel University
| | - Ana V Diez Roux
- Dornsife School of Public Health and Urban Health Collaborative, Drexel University
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Morrison R, Jesdale B, Dube C, Forrester S, Nunes A, Bova C, Lapane KL. Racial/Ethnic Differences in Staff-Assessed Pain Behaviors Among Newly Admitted Nursing Home Residents. J Pain Symptom Manage 2021; 61:438-448.e3. [PMID: 32882357 PMCID: PMC8094375 DOI: 10.1016/j.jpainsymman.2020.08.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 08/01/2020] [Accepted: 08/26/2020] [Indexed: 11/16/2022]
Abstract
CONTEXT Nonverbal pain behaviors are effective indicators of pain among persons who have difficulty communicating. In nursing homes, racial/ethnic differences in self-reported pain and pain management have been documented. OBJECTIVES We sought to examine racial/ethnic differences in nonverbal pain behaviors and pain management among residents with staff-assessed pain. METHODS We used the U.S. national Minimum Data Set 3.0 and identified 994,510 newly admitted nursing home residents for whom staff evaluated pain behaviors and pain treatments between 2010 and 2016. Adjusted prevalence ratios (aPRs) and 95% CIs estimated using robust Poisson models compared pain behaviors and treatments across racial/ethnic groups. RESULTS Vocal complaints were most commonly recorded (18.3% non-Hispanic black residents, 19.3% of Hispanic residents, and 30.3% of non-Hispanic white residents). Documentation of pain behaviors was less frequent among non-Hispanic black and Hispanic residents than non-Hispanic white residents (e.g., vocal complaints: aPRBlack: 0.76; 95% CI: 0.73-0.78; with similar estimates for other pain behaviors). Non-Hispanic blacks (47.3%) and Hispanics (48.6%) were less likely to receive any type of pharmacologic pain intervention compared with non-Hispanic white residents (59.3%) (aPRBlack: 0.87; 95% CI: 0.86-0.88; aPRHispanics: 0.87; 95% CI: 0.84-0.89). CONCLUSION Among residents requiring staff assessment of pain because they are unable to self-report, nursing home staff documented pain and its treatment less often in Non-Hispanic blacks and Hispanics than in non-Hispanic white residents. Studies to understand the role of differences in expression of pain, explicit bias, and implicit bias are needed to inform interventions to reduce disparities in pain documentation and treatment.
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Affiliation(s)
- Reynolds Morrison
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Bill Jesdale
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Catherine Dube
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Sarah Forrester
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Anthony Nunes
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Carol Bova
- School of Nursing, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Kate L Lapane
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
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141
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Blacksher E, Valles SA. White Privilege, White Poverty: Reckoning with Class and Race in America. Hastings Cent Rep 2021; 51 Suppl 1:S51-S57. [PMID: 33630341 DOI: 10.1002/hast.1230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This essay argues that a failure to think and talk critically and candidly about White privilege and White poverty is a key threat to the United States of America's precarious democracy. Whiteness frames one of America's most pressing collective challenges-the poor state of the nation's health, which lags behind other wealthy nations and is marred by deep and entrenched class- and race-based inequities. The broadscale remedies experts recommend demand what is in short supply: trust in evidence, experts, government, and one another. The authors' prescription is threefold, beginning with a call for intersectional health studies and reports that avoid one-dimensional misrepresentations of widespread health problems as simply Black or White problems. Second, there is the need for a "critical consciousness" about race and class. Lastly, the essay calls for widescale opportunities for Americans to engage in cross-racial and cross-class democratic conversations about their struggles and aspirations in search of common ground.
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142
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Farmer HR, Wray LA, Haas SA. Race, Gender, and Socioeconomic Variations in C-Reactive Protein Using the Health and Retirement Study. J Gerontol B Psychol Sci Soc Sci 2021; 76:583-595. [PMID: 32064519 PMCID: PMC7887729 DOI: 10.1093/geronb/gbaa027] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To clarify the relationships among race, gender, and socioeconomic status (SES) with C-reactive protein (CRP). METHOD The present study analyzed data from 6,521 Black and White respondents aged 51 and older in the Health and Retirement Study, a nationally representative sample of midlife and older adults, to address two aims. We sought to (i) assess the independent associations between race, gender, and SES with CRP concentrations and (ii) test whether race, gender, and SES interacted to produce unequal CRP concentrations cross-sectionally and over a 4-year follow-up. RESULTS The results demonstrated that race, gender, and SES were each independently associated with baseline CRP, but only SES was associated with CRP at follow-up. Furthermore, race, gender, and education interacted to produce differential CRP levels at baseline. There were incremental benefits for each additional level of education for White men and women, but the relationship between education and CRP was more complicated for Black men and women. Compared with other race/gender groups with less than high school, Black women had the highest and Black men had the lowest levels of CRP. There were no apparent benefits to CRP for Black women with college compared with Black women with high school, while Black men with less than high school and college had similar concentrations of CRP. DISCUSSION In clarifying the complexity inherent in CRP disparities, this work contributes to a greater understanding of the biological mechanisms underlying racial disparities in leading causes of morbidity and mortality in the United States.
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Affiliation(s)
- Heather R Farmer
- Department of Population Health Sciences, Duke University Medical Center, Durham, North Carolina
| | - Linda A Wray
- Department of Biobehavioral Health, The Pennsylvania State University, University Park
| | - Steven A Haas
- Department of Sociology and Demography, The Pennsylvania State University, University Park
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143
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Geographic Variation in Reproductive Health Among the Black Population in the US: An Analysis of Nativity, Region of Origin, and Division of Residence. POPULATION RESEARCH AND POLICY REVIEW 2021. [DOI: 10.1007/s11113-020-09629-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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144
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de Valpine MG, Lewis EJ. The "saddest repudiation" redux: Structural racism and the unlearned lesson of 1918. Public Health Nurs 2021; 38:272-278. [PMID: 33538353 DOI: 10.1111/phn.12872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 01/06/2021] [Accepted: 01/10/2021] [Indexed: 01/18/2023]
Abstract
The COVID-19 pandemic reveals how the systems and structures of racism devastate the health and well-being of people of color. The debate is an old one and the lesson we have yet to learn was tragically apparent a century ago during the 1918-1919 influenza pandemic. Any history of structural racism in America must begin with the chronicles of African Americans, Native Alaskans, and Indigenous North Americans as they were the originally enslaved and displaced people, subjected to overt and covert policies of oppression ever since. The experiences of Native Alaskans of Bristol Bay Alaska in 1918-1919 present a parallel, illuminating a wrenching example of structural racism that cost lives and impoverished society, then as now. Proven policy solutions exist to remove the structures that produce inequitable health outcomes, but implementing them will require public health officials and policymakers to take multidisciplinary policy actions, to find policy opportunities for change to be made, and, likely, a change in the political environment. The first exists now, the second is afforded because of the current pandemic and the urgent need for policy solutions, and the third is likely coming soon.
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Affiliation(s)
| | - Erica J Lewis
- School of Nursing, James Madison University, Harrisonburg, VA, USA
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145
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Tan SB, deSouza P, Raifman M. Structural Racism and COVID-19 in the USA: a County-Level Empirical Analysis. J Racial Ethn Health Disparities 2021; 9:236-246. [PMID: 33469868 PMCID: PMC7815192 DOI: 10.1007/s40615-020-00948-8] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/12/2020] [Accepted: 12/14/2020] [Indexed: 01/24/2023]
Abstract
Substantial health disparities exist across race/ethnicity in the USA, with Black Americans often most affected. The current COVID-19 pandemic is no different. While there have been ample studies describing racial disparities in COVID-19 outcomes, relatively few have established an empirical link between these disparities and structural racism. Such empirical analyses are critically important to help defuse “victim-blaming” narratives about why minority communities have been badly hit by COVID-19. In this paper, we explore the empirical link between structural racism and disparities in county-level COVID-19 outcomes by county racial composition. Using negative binomial regression models, we examine how five measures of county-level residential segregation and racial disparities in socioeconomic outcomes as well as incarceration rates are associated with county-level COVID-19 outcomes. We find significant associations between higher levels of measured structural racism and higher rates of COVID-19 cases and deaths, even after adjusting for county-level population sociodemographic characteristics, measures of population health, access to healthcare, population density, and duration of the COVID-19 outbreak. One percentage point more Black residents predicted a 1.1% increase in county case rate. This association decreased to 0.4% when structural racism indicators were included in our model. Similarly, one percentage point more Black residents predicted a 1.8% increase in county death rates, which became non-significant after adjustment for structural racism. Our findings lend empirical support to the hypothesis that structural racism is an important driver of racial disparities in COVID-19 outcomes, and reinforce existing calls for action to address structural racism as a fundamental cause of health disparities.
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Affiliation(s)
- Shin Bin Tan
- Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, MA, USA.
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore.
| | - Priyanka deSouza
- Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Matthew Raifman
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
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146
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Concurrent and Longitudinal Associations of Sex and Race with Inflammatory Biomarkers during Adolescence. J Youth Adolesc 2021; 50:711-723. [PMID: 33449289 DOI: 10.1007/s10964-020-01369-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 12/03/2020] [Indexed: 01/15/2023]
Abstract
Chronic, systemic inflammation is implicated in physical and mental health; little is known about whether sex and racial differences detected in adulthood are observed during adolescence or about normative changes occurring during adolescence. This longitudinal, United States-based study examined four biomarkers of systemic inflammation [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and IL-8) in 315 adolescents (51% female; 58% black; baseline age = 16.49 years (SD = 1.56; range: 12.14-21.28)] at three timepoints. Notable results included: general decline in inflammatory biomarkers in older adolescents, lower levels of TNF-α/IL-8 in black adolescents, elevated CRP/IL-6 in females, and especially higher levels of IL-6 in black, female adolescents. Implications are discussed, particularly the potential health implications of elevated IL-6 in black females.
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147
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Affiliation(s)
- Mohammad S Razai
- Population Health Research Institute, St George's University of London, UK
| | | | - Azeem Majeed
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, UK
| | - Aneez Esmail
- National Institute for Health Research School of Primary Care Research, University of Manchester, UK
| | - David R Williams
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
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148
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Reames TG, Daley DM, Pierce JC. Exploring the Nexus of Energy Burden, Social Capital, and Environmental Quality in Shaping Health in US Counties. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E620. [PMID: 33450890 PMCID: PMC7828329 DOI: 10.3390/ijerph18020620] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 12/04/2022]
Abstract
The United States spends more on health care than any other OECD country, yet the nation's health is declining. Recent research has identified multiple sources for this decline, including one's position in social and economic structures, environmental quality, and individual and collective social capital. This paper assesses the primary hypotheses that the health effects of household energy burden, social capital and environmental quality on aggregated community health levels remain while controlling for other determinants. The analysis moves beyond prior research by integrating multiple secondary data sources to assess those effects across US counties. Three indicators of public health are analyzed (premature mortality, self-reported health, and life expectancy). The county-level energy burden is measured by the percent of household income spent on housing energy bills for low- and moderate-income households. In addition to energy burden, social capital, environmental quality and other determinants are included in the analysis. The results produced by multivariate regression models support the primary hypotheses, even while a number of control variables also have a significant effect on health. The paper concludes that public health is associated with a complex nexus of factors, including environmental quality and social capital, and that energy burden needs to be among the considerations.
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Affiliation(s)
- Tony G. Reames
- School for Environment & Sustainability, University of Michigan, 440 Church St., Ann Arbor, MI 48109, USA
| | - Dorothy M. Daley
- School of Public Affairs & Administration and Environmental Studies Program, University of Kansas, Lawrence, KS 66045, USA;
| | - John C. Pierce
- School of Public Affairs & Administration, University of Kansas, Lawrence, KS 66045, USA;
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149
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Hart AR, Lavner JA, Carter SE, Beach SRH. Racial discrimination, depressive symptoms, and sleep problems among Blacks in the rural South. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2021; 27:123-134. [PMID: 32437199 PMCID: PMC7876626 DOI: 10.1037/cdp0000365] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Experiences of racial discrimination are common for Black Americans and have been associated with depression and sleep disturbance, factors likely involved in the insidious development of health disparities. The current study replicates these associations and examines longitudinal linkages. METHOD Black American couples (men: N = 248, Mage = 40, SD = 9; women: N = 277, Mage = 37, SD = 7) and their children, aged 9 to 14 (N = 276, Mage = 11, SD = 1), completed measures of experiences of racial discrimination, depressive symptoms, and sleep problems at baseline and 8-month follow-up. In separate analyses for men, women, and youth, we examined concurrent and prospective associations of racial discrimination with depressive symptoms and sleep problems, then used longitudinal indirect effect models to examine whether depressive symptoms in response to racial discrimination led to increased sleep problems, or vice versa. RESULTS Racial discrimination was associated concurrently with depressive symptoms and sleep problems for all family members. Prospective associations were also found with depressive symptoms and sleep problems in fathers and youth, and sleep problems in mothers. Longitudinal models showed significant indirect effects of racial discrimination on change in sleep problems through depressive symptoms for fathers and mothers, and a similar, but nonsignificant, pattern in youth. There were no indirect effects on change in depressive symptoms through sleep problems. CONCLUSIONS Persistent associations of racial discrimination with depressive symptoms and sleep problems reflect a lasting impact of racial discrimination. Because discrimination's effects on depression may contribute to increased sleep problems over time, interventions that buffer the effects of discrimination on depressive symptoms may also reduce sleep problems. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Steven R. H. Beach
- Department of Psychology, University of Georgia
- Center for Family Research, University of Georgia
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150
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Ellis KR, Hecht HK, Young TL, Oh S, Thomas S, Hoggard LS, Ali Z, Olawale R, Carthron D, Corbie-Smith G, Eng E. Chronic Disease Among African American Families: A Systematic Scoping Review. Prev Chronic Dis 2020; 17:E167. [PMID: 33416471 PMCID: PMC7784550 DOI: 10.5888/pcd17.190431] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Chronic diseases are common among African Americans, but the extent to which research has focused on addressing chronic diseases across multiple members of African American families is unclear. This systematic scoping review summarizes the characteristics of research addressing coexisting chronic conditions among African American families, including guiding theories, conditions studied, types of relationships, study outcomes, and intervention research. METHODS The literature search was conducted in PsycInfo, PubMed, Social Work Abstracts, Sociological Abstracts, CINAHL, and Family and Society Studies Worldwide to identify relevant articles published from January 2000 through September 2016. We screened the title and abstracts of 9,170 articles, followed by full-text screening of 530 articles, resulting in a final sample of 114 articles. Fifty-seven percent (n = 65) of the articles cited a guiding theory/framework, with psychological theories (eg, social cognitive theory, transtheoretical model) being most prominent. The most common conditions studied in families were depression (70.2%), anxiety (23.7%), and diabetes (22.8%), with most articles focusing on a combination of physical and mental health conditions (47.4%). RESULTS In the 114 studies in this review, adult family members were primarily the index person (71.1%, n = 81). The index condition, when identified (79.8%, n = 91), was more likely to be a physical health condition (46.5%, n = 53) than a mental health condition (29.8%, n = 34). Among 343 family relationships examined, immediate family relationships were overwhelmingly represented (85.4%, n = 293); however, extended family (12.0%, n = 41) and fictive kin (0.6%, n = 2) were included. Most (57.0%, n = 65) studies focused on a single category of outcomes, such as physical health (eg, obesity, glycemic control), mental health (eg, depression, anxiety, distress), psychosocial outcomes (eg, social support, caregiver burden), or health behaviors (eg, medication adherence, disease management, health care utilization); however, 43.0% (n = 49) of studies focused on outcomes across multiple categories. Sixteen intervention articles (14.0%) were identified, with depression the most common condition of interest. CONCLUSION Recognizing the multiple, simultaneous health issues facing families through a lens of family comorbidity and family multimorbidity may more accurately mirror the lived experiences of many African American families and better elucidate intervention opportunities than previous approaches.
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Affiliation(s)
- Katrina R Ellis
- University of Michigan, School of Social Work, Room 3849, Ann Arbor, MI 48109.
| | - Hillary K Hecht
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Health Policy and Management, Chapel Hill, North Carolina
| | - Tiffany L Young
- University of North Carolina at Chapel Hill, North Carolina Translational Research and Clinical Sciences Institute, Chapel Hill, North Carolina
- Lenell and Lillie Consulting, LLC, New Bern, North Carolina
| | - Seyoung Oh
- University of Michigan, School of Social Work, Ann Arbor, Michigan
| | - Shikira Thomas
- University of North Carolina at Chapel Hill, Cecil G. Sheps Center for Health Services Research, Chapel Hill, North Carolina
| | - Lori S Hoggard
- Rutgers University-New Brunswick, Department of Psychology, New Brunswick, New Jersey
| | - Zaire Ali
- Rutgers University-New Brunswick, Department of Psychology, New Brunswick, New Jersey
| | - Ronke Olawale
- University of Michigan, School of Social Work, Ann Arbor, Michigan
| | - Dana Carthron
- North Carolina Central University, College of Behavioral Sciences, Durham, North Carolina
| | - Giselle Corbie-Smith
- University of North Carolina at Chapel Hill, School of Medicine, Department of Social Medicine, Chapel Hill, North Carolina
| | - Eugenia Eng
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Health Behavior, Chapel Hill, North Carolina
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