Twitter Fingers and Echo Chambers: Exploring Expressions and Experiences of Online Racism Using Twitter

Racial Diversity of Patient Population Represented on United States Plastic Surgeons' Webpages

ABSTRACT

Current literature demonstrates a lack of racial diversity in plastic surgery media. However, to our knowledge, no study has yet examined the racial diversity of Webpage content as if from a patient-search perspective. The objective of this study is to determine if there is a racial discrepancy between the US Census, American Society of Plastic Surgeons (ASPS) statistics, and the media featuring implied patients on US plastic surgeons' Webpages from a patient-focused approach. A Google search was completed using the term "(state) plastic surgeon." The first 10 relevant Web sites were collected for each state, and homepages were analyzed. In line with previous studies, the implied patients in media were classified into 1 of 6 skin tone categories: I, ivory; II, beige; III, light brown; IV, olive; V, brown; and VI, dark brown. These correlate to Fitzpatrick phototypes; however, the Fitzpatrick scale measures skin's response to UV exposure. Skin tone was used as a guide to measure racial representation in the media, with the caveat that skin tone does not absolutely correlate to racial identity. Categories I-III were further classified as "white" and IV-VI as "nonwhite." These data were compared with the 2020 ASPS demographics report and US Census. Four thousand eighty individuals were analyzed from 504 Webpages, the majority of which were those of private practice physicians. A total of 91.62% of individuals were classified as "white" and 8.38% "nonwhite." The distribution by category was as follows: I = 265, II = 847, III = 2626, IV = 266, V = 71, and VI = 5. Using χ2 analyses, a statistically significant difference was found between the racial representation within this sample and that of the 2020 US Census nationally (P < 0.001), regionally (P < 0.001), and subregionally (P < 0.001); the 2020 ASPS Cosmetic Summary Data (P < 0.001); and the 2020 ASPS Reconstructive Summary Data (P < 0.001). This study highlights the significant difference between racial representation on plastic surgeons' Webpages and the demographics of patients they serve. Further analyses should identify the impact of these representational disparities on patient care and clinical outcomes, as well as examine how best to measure racial diversity and disparities in patient-oriented media.

Racism During Pregnancy and Birthing: Experiences from Asian and Pacific Islander, Black, Latina, and Middle Eastern Women

BACKGROUND

Despite persistent racial disparities in maternal health in the USA, there is limited qualitative research on women's experiences of discrimination during pregnancy and childbirth that focuses on similarities and differences across multiple racial groups.

METHODS

Eleven focus groups with Asian American and Pacific Islander (AAPI), Black, Latina, and Middle Eastern women (N = 52) in the USA were conducted to discuss the extent to which racism and discrimination impact pregnancy and birthing experiences.

RESULTS

Participants across groups talked about the role of unequal power dynamics, discrimination, and vulnerability in patient-provider relationships. Black participants noted the influence of prior mistreatment by providers in their healthcare decisions. Latinas expressed fears of differential care because of immigration status. Middle Eastern women stated that the Muslim ban bolstered stereotypes. Vietnamese participants discussed how the effect of racism on mothers' mental health could impact their children, while Black and Latina participants expressed constant racism-related stress for themselves and their children. Participants recalled better treatment with White partners and suggested a gradient of treatment based on skin complexion. Participants across groups expressed the value of racial diversity in healthcare providers and pregnancy/birthing-related support but warned that racial concordance alone may not prevent racism and emphasized the need to go beyond "band-aid solutions."

CONCLUSION

Women's discussions of pregnancy and birthing revealed common and distinct experiences that varied by race, skin complexion, language, immigration status, and political context. These findings highlight the importance of qualitative research for informing maternal healthcare practices that reduce racial inequities.

Not Just Time on Social Media: Experiences of Online Racial/Ethnic Discrimination and Worse Sleep Quality for Black, Latinx, Asian, and Multi-racial Young Adults

Sleep quality in young adulthood sets the stage for long-term health. Racial/ethnic sleep disparities between White college-attending young adults and college-attending young adults of color exist. The stress of experiencing racial/ethnic discrimination makes it difficult for college-attending young adults of color to get good quality sleep. Yet it remains unclear if experiencing online racial/ethnic discrimination also has consequences for sleep quality, and if this association may vary by frequency of social media use. To investigate the role of racial/ethnic discrimination on sleep quality, we conducted an online survey of 154 college-attending young adults (Mage = 19.51) who identified as Black (42.2%), Latinx (16.9%), Asian (20.8%), or Bi-/multi-racial (20.1%) from a predominantly White university. Results indicated that more exposure to racial/ethnic discrimination was associated with worse sleep quality for young adults of color. Results suggest that online racial/ethnic discrimination has a similar negative impact on sleep quality regardless of the frequency of social media use. Increased attention to negative race-related experiences online as one potential risk factor for poor long-term health for young adults of color is needed, regardless of how many hours they spend on social media. Structural interventions, screening for stress due to exposure to online racial/ethnic discrimination, and facilitating opportunities to prepare for this exposure may be an important priority for sleep health and reduction of racial/ethnic health disparities.

Examining Public Awareness of Ageist Terms on Twitter: Content Analysis

Background

The World Health Organization, the Centers for Disease Control and Prevention, and the Gerontological Society of America have made efforts to raise awareness on ageist language and propose appropriate terms to denote the older adult population. The COVID-19 pandemic and older adults' vulnerability to the disease have perpetuated hostile ageist discourse on social media. This is an opportune time to understand the prevalence and use of ageist language and discuss the ways forward.

Objective

This study aimed to understand the prevalence and situated use of ageist terms on Twitter.

Methods

We collected 60.32 million tweets between March and July 2020 containing terms related to COVID-19. We then conducted a mixed methods study comprising a content analysis and a descriptive quantitative analysis.

Results

A total of 58,930 tweets contained the ageist terms "old people" or "elderly." The more appropriate term "older adult" was found in 11,328 tweets. Twitter users used ageist terms (eg, "old people" and "elderly") to criticize ageist messages (17/60, 28%), showing a lack of understanding of appropriate terms to describe older adults. Highly hostile ageist content against older adults came from tweets that contained the derogatory terms "old people" (22/30, 73%) or "elderly" (13/30, 43%).

Conclusions

The public discourse observed on Twitter shows a continued lack of understanding of appropriate terms to use when referring to older adults. Effort is needed to eliminate the perpetuation of ageist messages that challenge healthy aging. Our study highlights the need to inform the public about appropriate language use and ageism.

Meta-analysis of the effect of racial discrimination on suicidality

Racial discrimination (RD) is unfair treatment of individuals based on race or ethnicity. It is a pervasive and increasing phenomenon in the lives of many individuals with deleterious effects on mental health. Research implicates RD in diminished well-being, lower life satisfaction and self-esteem, and mental health disorders. Furthermore, there have been reports that minorities and marginalized groups exposed to RD are at a higher risk of suicide. Given that RD negatively impacts mental health and that suicide is a major public health concern, we meta-analytically reviewed the literature to investigate whether RD is associated with suicidal ideation (SI) and suicide attempt (SA). We identified 43 eligible articles investigating the association between RD and suicidality through PubMed, Embase, PsycINFO and Scopus, from which we pooled 39 effect sizes for SI (58,629 individuals) and 15 for SA (30,088 individuals). Results demonstrated that RD has a small but significant effect both on SI (r = 0.16, 95% CI: 0.12 to 0.19; p < 0.0001) and on SA (r = 0.13, 95% CI: 0.02 to 0.23; p = 0.018). We found no indication of publication bias, and fail-safe tests confirmed the robustness of the results. Furthermore, we tested the moderating effects of several study characteristics (e.g., age, race, RD and SI time frame assessment, and categorization of RD measures). The only study characteristic to moderate the effect of RD on SI was SI time frame assessment (r = 0.07; 95% CI: 0.015 to 0.12; p = 0.01). Our findings suggest that SI and SA are phenomena that may be influenced by exposure to RD. Thus, individuals that are discriminated based on race may develop more suicidal thoughts and an increased likelihood of attempting suicide. These findings underscore the need for more prevention and intervention efforts to attenuate the effect of RD on suicidality.

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We conducted a meta-analysis of 62,349 individuals.

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We pooled effect sizes from 43 studies from seven countries.

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Racial discrimination has a statistically significant effect on suicidal ideation (r = 0.16, p < 0.0001).

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Racial discrimination has a statistically significant effect on suicide attempt (r = 0.13, p = 0.018).

Types of Racism and Twitter Users' Responses Amid the COVID-19 Outbreak: Content Analysis

BACKGROUND

When the first COVID-19 cases were noticed in China, many racist comments against Chinese individuals spread. As there is a huge need to better comprehend why all of these targeted comments and opinions developed specifically at the start of the outbreak, we sought to carefully examine racism and advocacy efforts on Twitter in the first quarter of 2020 (January 15 to March 3, 2020).

OBJECTIVE

The first research question aimed to understand the main type of racism displayed on Twitter during the first quarter of 2020. The second research question focused on evaluating Twitter users' positive and negative responses regarding racism toward Chinese individuals.

METHODS

Content analysis of tweets was utilized to address the two research questions. Using the NCapture browser link and NVivo software, tweets in English and Spanish were pulled from the Twitter data stream from January 15 to March 3, 2020. A total of 19,150 tweets were captured using the advanced Twitter search engine with the keywords and hashtags #nosoyunvirus, #imNotAVirus, #ChineseDon'tComeToJapan, #racism, "No soy un virus," and "Racismo Coronavirus." After cleaning the data, a total of 402 tweets were codified and analyzed.

RESULTS

The data confirmed clear sentiments of racism against Chinese individuals during the first quarter of 2020. The tweets displayed individual, cultural, and institutional racism. Individual racism was the most commonly reported form of racism, specifically displaying physical and verbal aggression. As a form of resistance, Twitter users created spaces for advocacy and activism. The hashtag "I am not a virus" helped to break stereotypes, prejudice, and discrimination on Twitter.

CONCLUSIONS

Advocacy efforts were enormous both inside and outside the Chinese community; an allyship sentiment was fostered by some white users, and an identification with the oppression experienced by the Chinese population was expressed in the Black and Muslim worldwide communities. Activism through social media manifested through art, food sharing, and community support.

Gender and Racial Identity Moderate the Effects of Online and Offline Discrimination on Mental Health: Dismantling Systems of Racism and Oppression during Adolescence

The present study highlights the growing need to examine Black youths' exposure to racial discrimination in online and offline contexts. Using a sample of 353 Black college students, findings indicate that high public regard moderates the positive association between online and offline racial discrimination and psychological consequences (i.e., depression, anxiety, and psychological well-being) among Black women. Additionally, racial centrality moderated the positive association between online and offline racial discrimination and mental health consequences regardless of gender. The findings highlight the importance of considering context, gender, and racial identity when examining the links between Black emerging adults' experiences of discrimination and mental health.

Three clusters of content-audience associations in expression of racial prejudice while consuming online television news

It is well investigated that the expression of racial prejudice is often induced by news coverage on the internet, and the exposure to media contributes to the cultivation of long-term prejudice. However, there is a lack of information regarding the immediate effects of news delivered through television or television-like media on the expression of racial prejudice. This study provides a framework for understanding such effects by focusing on content-audience associations using the logs of an "online television" service, which provides television-like content and user experiences. With these logs, we found an association between the news-watching and comment-posting behaviors. Consequently, logs relevant to two distinct forms of racism, modern and old-fashioned racism, were extracted. Using mathematical modeling, which considers the different levels of program inducements to racist expression, personal inclinations of audiences to racism, and certainty of prediction of audience behaviors, we found three associative patterns between the news programs and audiences. The relevance of the topics covered to the basic beliefs of each form of racism was characterized into three clusters: expression as a reaction to news that is directly relevant to the basic beliefs of racism with weak inducements by non-bigots, minority abuse by distorting the meanings of news content indirectly relevant to the beliefs but with strong inducements by audiences with a strong bias, and racial toxic opinions independent of the news content by clear bigots. Our findings provide implications for inhibiting the expression of online prejudice based on the characteristics of these patterns.

Vicarious Racism and Vigilance During the COVID-19 Pandemic: Mental Health Implications Among Asian and Black Americans

OBJECTIVES

Experiences of vicarious racism-hearing about racism directed toward one's racial group or racist acts committed against other racial group members-and vigilance about racial discrimination have been salient during the COVID-19 pandemic. This study examined vicarious racism and vigilance in relation to symptoms of depression and anxiety among Asian and Black Americans.

METHODS

We used data from a cross-sectional study of 604 Asian American and 844 Black American adults aged ≥18 in the United States recruited from 5 US cities from May 21 through July 15, 2020. Multivariable linear regression models examined levels of depression and anxiety by self-reported vicarious racism and vigilance.

RESULTS

Controlling for sociodemographic characteristics, among both Asian and Black Americans, greater self-reported vicarious racism was associated with more symptoms of depression (Asian: β = 1.92 [95% CI, 0.97-2.87]; Black: β = 1.72 [95% CI, 0.95-2.49]) and anxiety (Asian: β = 2.40 [95% CI, 1.48-3.32]; Black: β = 1.98 [95% CI, 1.17-2.78]). Vigilance was also positively related to symptoms of depression (Asian: β = 1.54 [95% CI, 0.58-2.50]; Black: β = 0.90 [95% CI, 0.12-1.67]) and anxiety (Asian: β = 1.98 [95% CI, 1.05-2.91]; Black: β = 1.64 [95% CI, 0.82-2.45]).

CONCLUSIONS

Mental health problems are a pressing concern during the COVID-19 pandemic. Results from our study suggest that heightened racist sentiment, harassment, and violence against Asian and Black Americans contribute to increased risk of depression and anxiety via vicarious racism and vigilance. Public health efforts during this period should address endemic racism as well as COVID-19.

Advocacy, Hesitancy, and Equity: Exploring U.S. Race-Related Discussions of the COVID-19 Vaccine on Twitter

BACKGROUND

Our study aimed to describe themes of tweets related to COVID-19 vaccines, race, and ethnicity to explore the context of the intersection of these topics on Twitter.

METHODS

We utilized Twitter's Streaming Application Programming Interface (API) to collect a random 1% sample of publicly available tweets from October 2020 to January 2021. The study team conducted a qualitative content analysis from the full data set of 1110 tweets.

RESULTS

The tweets revealed vaccine support through vaccine affirmation, advocacy through reproach, a need for a vaccine, COVID-19 and racism, vaccine development and efficacy, racist vaccine humor, and news updates. Vaccine opposition was demonstrated through direct opposition, vaccine hesitancy, and adverse reactions. Conspiracy and misinformation included scientific misinformation, political misinformation, beliefs about immunity and protective behaviors, and race extermination conspiracy. Equity and access focused on overcoming history of medical racism, pointing out health disparities, and facilitators to vaccine access. Representation touted pride in development and role models, and politics discussed the role of politics in vaccines and international politics.

CONCLUSION

Our analysis demonstrates that Twitter can provide nuances about multiple viewpoints on the vaccine related to race and ethnicity and can be beneficial in contributing to insights for public health messaging.