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Schinasi LH, Lawrence JA. Everyday discrimination and satisfaction with nature experiences. FRONTIERS IN EPIDEMIOLOGY 2024; 4:1212114. [PMID: 38872717 PMCID: PMC11169619 DOI: 10.3389/fepid.2024.1212114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/07/2024] [Indexed: 06/15/2024]
Abstract
Introduction There is growing interest in creating public green spaces to promote health. Yet, discussions about these efforts often overlook how experiences of chronic discrimination-which may manifest as racism, sexism, or homophobia, and more-could undermine satisfaction with nature experiences. Methods Using data from the 2018 wave of the National Opinion Research Center (NORC) General Social Survey (GSS), we quantified associations of frequency of everyday discrimination, operationalized using the Everyday Discrimination Scale (EDS, the primary independent variable), with respondents' perceptions of nature experiences and with their reported time spent in nature. Specifically, we quantified associations with the following three variables: (1) dissatisfaction with day-to-day experiences of nature, (2) not spending as much time as they would like in natural environments, and (3) usually spending at least one day per week in nature. We used survey-weighted robust Poisson models to estimate overall associations, and also stratified analyses by racial/ethnic and gender identity categories. Results Of 768 GSS respondents, 14% reported dissatisfaction with nature experiences, 36% reported not spending as much time as they would like in nature, and 33% reported that they did not spend at least one day per week in nature. The median non-standardized EDS, coded such that a higher value indicates greater frequency of discrimination, was 11 (interquartile range: 8, 15). Prevalence of reporting dissatisfaction with day-to-day experiences in nature was 7% higher in association with every one unit increase in EDS score above the median (PR: 1.07, 95% CI: 1.02-1.11). The prevalence of reporting not spending as much time as one would like in nature was 2% higher for every unit increase in higher than median everyday discrimination frequency (PR: 1.02, 95% CI: 1.00-1.05). Higher than median frequency in everyday discrimination was not associated with spending less than one day per week in nature. Race/ethnicity and gender identity did not modify associations. Conclusion Greater frequency of everyday discrimination is associated with less satisfaction with experiences in nature. This relationship could undermine efforts to promote health equity through green interventions.
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Affiliation(s)
- Leah H. Schinasi
- Department of Environmental and Occupational Health, Drexel University, Philadelphia, PA, United States
- Urban Health Collaborative, Drexel University, Philadelphia, PA, United States
| | - Jourdyn A. Lawrence
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA, United States
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Doherty EA, Cartmell K, Griffin S, Heo M, Chen L, Britt JL, Crockett AH. Discrimination and Adverse Perinatal Health Outcomes: A Latent Class Analysis. Prev Chronic Dis 2023; 20:E96. [PMID: 37917614 PMCID: PMC10625434 DOI: 10.5888/pcd20.230094] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023] Open
Abstract
INTRODUCTION An intersectionality framework recognizes individuals as simultaneously inhabiting multiple intersecting social identities embedded within systems of disadvantage and privilege. Previous research links perceived discrimination with worsened health outcomes yet is limited by a focus on racial discrimination in isolation. We applied an intersectional approach to the study of discrimination to examine the association with adverse perinatal health outcomes. METHODS We analyzed data from a cohort of 2,286 pregnant participants (Black, n = 933; Hispanic, n = 471; White, n = 853; and Other, n = 29) from the Centering and Racial Disparities trial. Perceived discrimination was assessed via the Everyday Discrimination Scale (EDS) and perinatal health outcomes collected via electronic medical record review. Latent class analysis was used to identify subgroups of discrimination based on EDS item response and the rate of adverse perinatal health outcomes compared between subgroups using a Bolck, Croon and Hagenaars 3-step approach. RESULTS Four discrimination subgroups were identified: no discrimination, general discrimination, discrimination attributed to one or several social identities, and discrimination attributed to most or all social identities. Experiencing general discrimination was associated with postpartum depression symptoms when compared with experiencing no discrimination among Black (9% vs 5%, P = .04) and White participants (18% vs 9%, P = .01). White participants experiencing general discrimination gave birth to low birthweight infants at a higher rate than those experiencing no discrimination (11% vs 6%, P = .04). No significant subgroup differences were observed among Hispanic participants. CONCLUSION Perceived discrimination may play an influential role in shaping perinatal health. More research applying an intersectional lens to the study of discrimination and perinatal health outcomes is needed.
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Affiliation(s)
- Emily A Doherty
- Department of Public Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina
- Center of Rural Health, Oklahoma State University Center for Health Sciences, Department of Public Health Sciences, 1111 W 17th St, Tulsa, OK 74107
| | - Kathleen Cartmell
- Department of Public Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina
| | - Sarah Griffin
- Department of Public Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina
| | - Moonseong Heo
- Department of Public Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina
| | - Liwei Chen
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles
| | - Jessica L Britt
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Prisma Health, Greenville, South Carolina
| | - Amy H Crockett
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Prisma Health, Greenville, South Carolina
- University of South Carolina School of Medicine, Greenville, South Carolina
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Erving CL, Zajdel R, McKinnon II, Van Dyke ME, Murden RJ, Johnson DA, Moore RH, Lewis TT. Gendered Racial Microaggressions and Black Women's Sleep Health. SOCIAL PSYCHOLOGY QUARTERLY 2023; 86:107-129. [PMID: 38371316 PMCID: PMC10869115 DOI: 10.1177/01902725221136139] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Gendered racial microaggressions reflect historical and contemporary gendered racism that Black women encounter. Although gendered racial microaggressions are related to psychological outcomes, it is unclear if such experiences are related to sleep health. Moreover, the health effects of gendered racial microaggressions dimensions are rarely investigated. Using a cohort of Black women (N = 400), this study employs an intracategorical intersectional approach to (1) investigate the association between gendered racial microaggressions and sleep health, (2) assess whether gendered racial microaggressions dimensions are related to sleep health, and (3) examine whether the gendered racial microaggressions-sleep health association persists after accounting for depressive symptoms and worry. Gendered racial microaggressions were associated with poor sleep quality overall and four specific domains: subjective sleep quality, latency, disturbance, and daytime sleepiness. Two gendered racial microaggressions dimensions were especially detrimental for sleep: assumptions of beauty/sexual objectification and feeling silenced and marginalized. After accounting for mental health, the effect of gendered racial microaggressions on sleep was reduced by 47 percent. Future research implications are discussed.
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Affiliation(s)
| | - Rachel Zajdel
- National Heart, Lung, and Blood Institute, Bethesda, MD, USA
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Sacco A, Pössel P, Roane SJ. Perceived discrimination and depressive symptoms: What role does the cognitive triad play? J Clin Psychol 2023; 79:985-1001. [PMID: 36256909 DOI: 10.1002/jclp.23452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 08/25/2022] [Accepted: 09/30/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The present study was designed to integrate perceived everyday discrimination (PED) as stressor in Beck's cognitive theory of depression. We focused on the relationships between PED, the individual components of the cognitive triad, and depressive symptoms and the role of gender and race in these relationships. METHOD Participants included 243 technical and community college students (women: 59%; men: 41%; Black: 30%; White: 51%). They completed measures examined PED, the cognitive triad, and depressive symptoms. RESULTS Conducting mediation analyses using PROCESS 4.1.1, we found significant indirect effects from PED on depressive symptoms through negative views of the self and world. The indirect effect through negative views of the future was not significant. The indirect effects of negative views of the world and future were significantly stronger in women participants than men participants and the indirect effect of negative views of the world was significantly stronger in White students than Black students. CONCLUSIONS Our findings generally support the integration of PED as stressor into Beck's cognitive theory independent of gender and race. This highlights the responsibility of therapists to assist clients in coping with PED and to advocate for equality within organizations, communities, and society in general.
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Affiliation(s)
- Abbi Sacco
- Department of Counseling and Human Development, University of Louisville, Louisville, Kentucky, USA
| | - Patrick Pössel
- Department of Counseling and Human Development, University of Louisville, Louisville, Kentucky, USA
| | - Sarah J Roane
- Department of Counseling and Human Development, University of Louisville, Louisville, Kentucky, USA
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Roach P, Ruzycki SM, Hernandez S, Carbert A, Holroyd-Leduc J, Ahmed S, Barnabe C. Prevalence and characteristics of anti-Indigenous bias among Albertan physicians: a cross-sectional survey and framework analysis. BMJ Open 2023; 13:e063178. [PMID: 36813494 PMCID: PMC9950908 DOI: 10.1136/bmjopen-2022-063178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE Recent deaths of Indigenous patients in the Canadian healthcare system have been attributed to structural and interpersonal racism. Experiences of interpersonal racism by Indigenous physicians and patients have been well characterised, but the source of this interpersonal bias has not been as well studied. The aim of this study was to describe the prevalence of explicit and implicit interpersonal anti-Indigenous biases among Albertan physicians. DESIGN AND SETTING This cross-sectional survey measuring demographic information and explicit and implicit anti-Indigenous biases was distributed in September 2020 to all practising physicians in Alberta, Canada. PARTICIPANTS 375 practising physicians with an active medical licence. OUTCOMES Explicit anti-Indigenous bias, measured by two feeling thermometer methods: participants slid an indicator on a thermometer to indicate their preference for white people (full preference is scored 100) or Indigenous people (full preference, 0), and then participants indicated how favourably they felt toward Indigenous people (100, maximally favourable; 0, maximally unfavourable). Implicit bias was measured using an Indigenous-European implicit association test (negative scores suggest preference for European (white) faces). Kruskal-Wallis and Wilcoxon rank-sum tests were used to compare bias across physician demographics, including intersectional identities of race and gender identity. MAIN RESULTS Most of the 375 participants were white cisgender women (40.3%; n=151). The median age of participants was 46-50 years. 8.3% of participants felt unfavourably toward Indigenous people (n=32 of 375) and 25.0% preferred white people to Indigenous people (n=32 of 128). Median scores did not differ by gender identity, race or intersectional identities. White cisgender men physicians had the greatest implicit preferences compared with other groups (-0.59 (IQR -0.86 to -0.25); n=53; p<0.001). Free-text responses discussed 'reverse racism' and expressed discomfort with survey questions addressing bias and racism. CONCLUSIONS Explicit anti-Indigenous bias was present among Albertan physicians. Concerns about 'reverse racism' targeting white people and discomfort discussing racism may act as barriers to addressing these biases. About two-thirds of respondents had implicit anti-Indigenous bias. These results corroborate the validity of patient reports of anti-Indigenous bias in healthcare and emphasise the need for effective intervention.
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Affiliation(s)
- Pamela Roach
- Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Shannon M Ruzycki
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Santanna Hernandez
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Amanda Carbert
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Sofia Ahmed
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Cheryl Barnabe
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
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