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Robison M, Robertson L, Joiner TE. Why did peri-pandemic suicide death rates decrease among non-Hispanic white people while increasing among most people of color? Suicide Life Threat Behav 2024; 54:762-774. [PMID: 38676429 PMCID: PMC11305907 DOI: 10.1111/sltb.13088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/15/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION While suicides in the United States decreased during the COVID-19 pandemic, statistically significant decreases have been limited to White people throughout a large portion of 2020. METHODS This paper outlines possible explanations for racial/ethnic differences in suicidality in the early pandemic phases. RESULTS We propose both distal (i.e., tele-mental health usage, internet and technology access, employment protections, and economic security) and proximal (cultural beliefs, coping strategies, clustering, pulling together, and embracing life) factors that may have helped build and foster community and mental wellness. However, this paper argues these factors did not extend, or did not extend as much, to many communities of color. CONCLUSIONS We argue that these disparities are due to the myriad effects of discrimination and systemic racism, encapsulated broadly by the minority stress theory, and provide suggestions for relief and research.
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Affiliation(s)
- Morgan Robison
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Lee Robertson
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - T E Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
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2
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Carney-Knisely G, Griffin M, Crawford A, Spates K, Singh P. Police killings of unarmed Black persons and suicides among Black youth in the US: A national time-series analysis. Ann Epidemiol 2024; 94:91-99. [PMID: 38710240 DOI: 10.1016/j.annepidem.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/08/2024]
Abstract
INTRODUCTION Suicide deaths among Black youth in the US have increased rapidly over the past decade. Direct or vicarious racial trauma experienced through exposure to police brutality may underlie these concerning trends. METHODS We obtained nationally aggregated monthly counts of suicides for non-Hispanic Black and White youth (age ≤ 24 years) and adults (age > 24 years) from the National Mortality Vital Statistics restricted-use data files provided by the Centers for Disease Control and Prevention, from 2013 to 2019. Monthly counts of Black youth suicides constituted our main outcome. We defined our exposure as the monthly counts of police killings of unarmed Black persons over 84 months (2013 to 2019), retrieved from the Mapping Police Violence database. We used ARIMA (AutoRegressive Integrated Moving Average) time-series analyses to examine whether Black youth suicides increased within 0 to 3 months following police killings of unarmed Black persons, controlling for autocorrelation and corresponding series of White youth suicides. RESULTS Suicides among Black youth increase by ∼1 count three months following an increase in police killings of unarmed Black persons (exposure lag 0 coefficient = 0.16, p > 0.05; exposure lag 1 coefficient = -0.70, p > 0.05; exposure lag 2 coefficient = -0.54, p > 0.05; exposure lag 3 coefficient = 0.95, p < 0.05). The observed increase in suicides concentrates among Black male youth (exposure lag 3 coefficient = 0.88, p < 0.05).
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Affiliation(s)
| | | | - Alaxandria Crawford
- Division of Epidemiology, College of Public Health, The Ohio State University, USA
| | - Kamesha Spates
- William S. Dietrich II Endowed Chair in Africana Studies, University of Pittsburgh, USA
| | - Parvati Singh
- Division of Epidemiology, College of Public Health, The Ohio State University, USA.
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3
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Duncan DT, Park SH, Dharma C, Torrats-Espinosa G, Contreras J, Scheinmann R, Watson K, Herrera C, Schneider JA, Khan M, Lim S, Trinh-Shevrin C, Radix A. Neighborhood Safety and Neighborhood Police Violence Are Associated with Psychological Distress among English- and Spanish-Speaking Transgender Women of Color in New York City: Finding from the TURNNT Cohort Study. J Urban Health 2024; 101:557-570. [PMID: 38831154 PMCID: PMC11189871 DOI: 10.1007/s11524-024-00879-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 06/05/2024]
Abstract
Transgender women of color (TWOC) experience high rates of police violence and victimization compared to other sexual and gender minority groups, as well as compared to other White transgender and cisgender women. While past studies have demonstrated how frequent police harassment is associated with higher psychological distress, the effect of neighborhood safety and neighborhood police violence on TWOC's mental health is rarely studied. In this study, we examine the association between neighborhood safety and neighborhood police violence with psychological distress among TWOC. Baseline self-reported data are from the TURNNT ("Trying to Understand Relationships, Networks and Neighborhoods among Transgender Woman of Color") Cohort Study (analytic n = 303). Recruitment for the study began September 2020 and ended November 2022. Eligibility criteria included being a TWOC, age 18-55, English- or Spanish-speaking, and planning to reside in the New York City metropolitan area for at least 1 year. In multivariable analyses, neighborhood safety and neighborhood police violence were associated with psychological distress. For example, individuals who reported medium levels of neighborhood police violence had 1.15 [1.03, 1.28] times the odds of experiencing psychological distress compared to those who experienced low levels of neighborhood police violence. Our data suggest that neighborhood safety and neighborhood police violence were associated with increased psychological distress among TWOC. Policies and programs to address neighborhood police violence (such as body cameras and legal consequences for abusive officers) may improve mental health among TWOC.
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Affiliation(s)
- Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168Th Street, Room 715, New York, NY, 10032, USA.
| | - Su Hyun Park
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168Th Street, Room 715, New York, NY, 10032, USA
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, 117549, Singapore
| | - Christoffer Dharma
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168Th Street, Room 715, New York, NY, 10032, USA
- Department of Epidemiology, University of Toronto School of Public Health, Toronto, Canada
| | | | - Jessica Contreras
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168Th Street, Room 715, New York, NY, 10032, USA
| | - Roberta Scheinmann
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168Th Street, Room 715, New York, NY, 10032, USA
| | | | | | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
- Crown School of Social Work, University of Chicago, Chicago, IL, USA
| | - Maria Khan
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Sahnah Lim
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Chau Trinh-Shevrin
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Asa Radix
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168Th Street, Room 715, New York, NY, 10032, USA
- Callen-Lorde Community Health Center, New York, NY, USA
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4
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Goto H, Kawachi I, Vandoros S. The association between economic uncertainty and suicide in Japan by age, sex, employment status, and population density: an observational study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 46:101069. [PMID: 38711964 PMCID: PMC11070334 DOI: 10.1016/j.lanwpc.2024.101069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/16/2024] [Accepted: 04/06/2024] [Indexed: 05/08/2024]
Abstract
Background Suicide is one of the ten leading causes of death globally, and previous research has revealed a link between economic conditions and mental health. However, the literature has focused primarily on recessions and unemployment, i.e. actual economic developments, as opposed to uncertainty, which relates to economic developments that have not (yet) materialised. This study examines the differential association between economic uncertainty and suicide in Japan, depending on age, sex, employment status, and population density, in order to identify the groups that are affected the most. Methods Using monthly prefectural suicide mortality data from the Ministry of Health, Labour and Welfare and a monthly economic uncertainty index for the period 2009 to 2019, we employed a fixed effects panel data approach to examine the association between uncertainty and suicide by population group. Findings We found that a 1% increase in economic uncertainty is associated with a 0.061 increase in the monthly number of suicides per 100,000 people per prefecture, on average (coefficient: 6.08; 95% CI: 5.07-7.08), which constitutes a 3.62% increase. Self-employed people, as well as men in their 50s and unemployed men, experience the highest additional risk of suicide when uncertainty increases. The association was approximately three times stronger for males than for females, and a strong association was observed for self-employed males living in more densely-populated areas. Interpretation Uncertainty appears to relate to suicides for most groups, but self-employed people, males, and those living in more densely populated areas appear to be more at risk of suicide in periods of increased economic uncertainty. Our results provide an indication of which groups mental health services and prevention strategies can focus on in times of economic uncertainty. Funding None.
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Affiliation(s)
- Haruka Goto
- University College London (UCL), London, United Kingdom
| | - Ichiro Kawachi
- Harvard T.H. Chan School of Public Health, Boston, United States
| | - Sotiris Vandoros
- University College London (UCL), London, United Kingdom
- Harvard T.H. Chan School of Public Health, Boston, United States
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Venkataramani AS, Bair EF, Bor J, Jackson CL, Kawachi I, Lee J, Papachristos A, Tsai AC. Officer-Involved Killings of Unarmed Black People and Racial Disparities in Sleep Health. JAMA Intern Med 2024; 184:363-373. [PMID: 38315465 PMCID: PMC10845041 DOI: 10.1001/jamainternmed.2023.8003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 11/27/2023] [Indexed: 02/07/2024]
Abstract
Importance Racial disparities in sleep health may mediate the broader health outcomes of structural racism. Objective To assess changes in sleep duration in the Black population after officer-involved killings of unarmed Black people, a cardinal manifestation of structural racism. Design, Setting, and Participants Two distinct difference-in-differences analyses examined the changes in sleep duration for the US non-Hispanic Black (hereafter, Black) population before vs after exposure to officer-involved killings of unarmed Black people, using data from adult respondents in the US Behavioral Risk Factor Surveillance Survey (BRFSS; 2013, 2014, 2016, and 2018) and the American Time Use Survey (ATUS; 2013-2019) with data on officer-involved killings from the Mapping Police Violence database. Data analyses were conducted between September 24, 2021, and September 12, 2023. Exposures Occurrence of any police killing of an unarmed Black person in the state, county, or commuting zone of the survey respondent's residence in each of the four 90-day periods prior to interview, or occurence of a highly public, nationally prominent police killing of an unarmed Black person anywhere in the US during the 90 days prior to interview. Main Outcomes and Measures Self-reported total sleep duration (hours), short sleep (<7 hours), and very short sleep (<6 hours). Results Data from 181 865 Black and 1 799 757 White respondents in the BRFSS and 9858 Black and 46 532 White respondents in the ATUS were analyzed. In the larger BRFSS, the majority of Black respondents were between the ages of 35 and 64 (99 014 [weighted 51.4%]), women (115 731 [weighted 54.1%]), and college educated (100 434 [weighted 52.3%]). Black respondents in the BRFSS reported short sleep duration at a rate of 45.9%, while White respondents reported it at a rate of 32.6%; for very short sleep, the corresponding values were 18.4% vs 10.4%, respectively. Statistically significant increases in the probability of short sleep and very short sleep were found among Black respondents when officers killed an unarmed Black person in their state of residence during the first two 90-day periods prior to interview. Magnitudes were larger in models using exposure to a nationally prominent police killing occurring anywhere in the US. Estimates were equivalent to 7% to 16% of the sample disparity between Black and White individuals in short sleep and 13% to 30% of the disparity in very short sleep. Conclusions and Relevance Sleep health among Black adults worsened after exposure to officer-involved killings of unarmed Black individuals. These empirical findings underscore the role of structural racism in shaping racial disparities in sleep health outcomes.
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Affiliation(s)
- Atheendar S. Venkataramani
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
| | - Elizabeth F. Bair
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia
| | - Jacob Bor
- Departments of Global Health and Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Chandra L. Jackson
- Epidemiology Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Ichiro Kawachi
- Department of Social Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jooyoung Lee
- Department of Sociology, University of Toronto, Toronto, Ontario, Canada
| | | | - Alexander C. Tsai
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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Kemp CG, Mensa-Kwao A, Concepcion T, Hughsam M, Queen E, Sinha M, Collins PY. COVID-19, the COVID-19 response, and racial injustice: Associations with depressive and anxiety symptoms among US adults from April 2020 to March 2021. SSM - MENTAL HEALTH 2023; 3:100214. [PMID: 37124707 PMCID: PMC10122769 DOI: 10.1016/j.ssmmh.2023.100214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 03/20/2023] [Accepted: 04/21/2023] [Indexed: 05/02/2023] Open
Abstract
Background People in the United States have faced numerous large and intersecting threats to their mental health since the onset of the coronavirus disease pandemic. This study aimed to understand the unique relationships between these co-occurring threats - including the police killings of unarmed Black people and the fight for racial justice - and how they affect mental health symptoms among various demographic groups. Methods Data on population mental health, state-level COVID-19 incidence rates, cases of police-involved killings, and occurrences of racial justice protests were analyzed. The primary outcome was depression or anxiety symptoms. Regression models were used to estimate prospective associations between individual-, household-, and state-level exposures to hypothesized mental health threats and subsequent depression or anxiety symptoms. Results Data from 2,085,041 individual participants were included. Most were women (51.2%), and most were white, non-Hispanic (61.2%), with almost half (47.7%) reporting some loss of household income since March 13, 2020. Neither the killing of unarmed Black people by police, nor the above-average occurrence of Black Lives Matter (BLM) protests, were observed to be associated with anxiety or depressive symptoms in the overall population, though the BLM protests were associated with reduced depressive and anxiety symptoms among younger participants. State-level COVID-19 incidence risk was more strongly associated with depressive and anxiety symptoms among women, Black people, older people, and higher income people, compared to men, white people, younger people, and lower income people. Conclusion Our findings are relevant for anticipating and addressing the mental health consequences of social injustice and protest movements in the context of COVID-19 pandemic, as well as future pandemics. Promoting population mental health requires addressing underlying social and structural inequities and prioritizing the pursuit of social justice and health equity as a primary mental health intervention.
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Affiliation(s)
- Christopher G Kemp
- Johns Hopkins University, Department of International Health, Baltimore, MD, USA
| | | | - Tessa Concepcion
- University of Washington, Department of Global Health, Seattle, WA, USA
| | | | | | | | - Pamela Y Collins
- University of Washington, Department of Global Health, Seattle, WA, USA
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Quinn KG, Edwards T, Johnson A, Takahashi L, Dakin A, Bouacha N, Voisin D. Understanding the impact of police brutality on Black sexually minoritized men. Soc Sci Med 2023; 334:116191. [PMID: 37666095 PMCID: PMC10565611 DOI: 10.1016/j.socscimed.2023.116191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/06/2023]
Abstract
Young Black gay, bisexual, and other sexually minoritized men (SMM) face high levels of police brutality and other negative, unwarranted encounters with the police. Such interactions have known health consequences. The purpose of this study was to understand the health, mental health, and social consequences of police brutality experienced by young Black SMM. We conducted in-depth interviews with 31 Black, cisgender men, ages of 16-30 and analyzed the data using thematic analysis. Our primary results are summarized in four themes: 1) Police brutality is built into the system and diminishes trust; 2) Videos and social media make visible violence that has long existed; 3) Police brutality contributes to anxiety and other psychosocial effects; and 4) Violence reduces feelings of safety and contributes to avoidance of police. Our results highlight the direct and vicarious police brutality participants are subjected to and sheds light on the effects of such violence on trust, perceived safety, anxiety, and trauma symptoms. Results from this study contribute to the needed public health conversation around police brutality against Black men, specifically shedding light on the experiences of Black SMM.
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Affiliation(s)
- Katherine G Quinn
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Travonne Edwards
- School of Child and Youth Care, Toronto Metropolitan University, Canada
| | - Anthony Johnson
- School of Social Work, Loyola University Chicago, Chicago, IL, USA
| | - Lois Takahashi
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA
| | | | | | - Dexter Voisin
- School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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Er ST, Demir E, Sari E. Suicide and economic uncertainty: New findings in a global setting. SSM Popul Health 2023; 22:101387. [PMID: 37026039 PMCID: PMC10070933 DOI: 10.1016/j.ssmph.2023.101387] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/14/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
This study extends the previous literature on the association between country-level economic uncertainty and suicide rate to 141 countries by introducing the World Uncertainty Index. We first examine the role of economic uncertainty on the suicide rates in a global setting for the period 2000-2019 and then analyze if the association varied across different income groups. Our primary findings suggest that a rise in economic uncertainty is related to an increased suicide rate. According to the estimates based on various income levels, higher economic uncertainty is associated with increased suicide risk in high-income countries. For middle- and low-income countries, we find no such impact. Overall, we conclude that contemporaneous and lagged economic uncertainty is a concern for the increased risk of suicide, especially in high-income countries. The results highlight the need for proactive suicide-prevention strategies in uncertain times.
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Affiliation(s)
- S. Tolga Er
- Institute of Law and Economics, University of Hamburg, Johnsallee 35, Hamburg, 20148, Germany
| | - Ender Demir
- Department of Business Administration, School of Social Sciences, Reykjavik University, Menntavegur 1, 102, 101 Reykjavík, Iceland
- Istanbul Medeniyet University, Kadıköy, İstanbul, Turkey
| | - Emre Sari
- School of Business and Economics, UiT the Arctic University of Norway, 9010, Tromsø, Norway
- Division for Health and Social Sciences, NORCE Norwegian Research Centre, Tromsø, Norway
- Corresponding author. School of Business and Economics, UiT the Arctic University of Norway, Postboks 6050 Langnes, 9037, Tromsø, Norway.
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Pamplin JR, Kelsall NC, Keyes KM, Bates LM, Prins SJ. Race, criminalization and urban mental health in the United States. Curr Opin Psychiatry 2023; 36:219-236. [PMID: 36762668 PMCID: PMC10079600 DOI: 10.1097/yco.0000000000000857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
PURPOSE OF REVIEW As efforts to increase policing and roll back criminal legal system reforms in major U.S. cities rise, the collateral consequences of increased criminalization remain critical to document. Although the criminalization of mental illness has been well studied in the U.S., the mental health effects of criminalization are comparatively under-researched. In addition, despite extreme racial disparities in U.S. policing, there is limited understanding of how criminalization may contribute to racial disparities in mental health. RECENT FINDINGS Literature included in this review covers various types of criminalization, including direct and indirect impacts of incarceration, criminalization of immigration, first-hand and witnessed encounters with police, and the effects of widely publicized police brutality incidents. All forms of criminalization were shown to negatively impact mental health (depression, anxiety and suicidality), with evidence suggestive of disproportionate impact on Black people. SUMMARY There is evidence of significant negative impact of criminalization on mental health; however, more robust research is needed to address the limitations of the current literature. These limitations include few analyses stratified by race, a lack of focus on nonincarceration forms of criminalization, few longitudinal studies limiting causal inference, highly selected samples limiting generalizability and few studies with validated mental health measures.
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Affiliation(s)
- John R. Pamplin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Nora Clancy Kelsall
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Lisa M. Bates
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Seth J. Prins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
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Bozorgmehr K, Kühne S, Biddle L. Local political climate and spill-over effects on refugee and migrant health: a conceptual framework and call to advance the evidence. BMJ Glob Health 2023; 8:bmjgh-2022-011472. [PMID: 36898715 PMCID: PMC10008416 DOI: 10.1136/bmjgh-2022-011472] [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: 12/06/2022] [Accepted: 02/21/2023] [Indexed: 03/12/2023] Open
Abstract
The health of refugees and migrants is determined by a wide range of factors. Among these, the local political climate in the postmigration phase is an important determinant which operates at interpersonal and institutional levels. We present a conceptual framework to advance theory, measurement and empirical evidence related to the small-area factors which shape and determine the local political climate, as these may translate into variations in health outcomes among refugees, migrants and other marginalised population groups. Using the example of Germany, we present evidence of small-area variation in factors defining political climates, and present and discuss potential pathways from local political climates to health outcomes. We show that anti-immigrant and antirefugee violence is a Europe-wide phenomenon and elaborate how resilience of individuals, communities, and the health system may function as moderator of the effects of the local political climate on health outcomes. Building on a pragmatic review of international evidence on spill-over effects identified in other racialised groups, we present a conceptual framework which incorporates direct effects as well as 'spill-over' effects on mental health with the aim to spark further academic discussion and guide empirical analysis on the topic. After presenting and discussing methodological challenges, we call for collective efforts to build coalitions between social sciences, conflict and violence studies, political science, data science, social psychologists and epidemiology to advance theory, measurement, and analysis of health effects of local political climates.
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Affiliation(s)
- Kayvan Bozorgmehr
- Department of Population Medicine & Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany .,Section Health Equity Studies & Migration, University Hospital Heidelberg, Heidelberg, Germany.,Institute for Interdisciplinary Research on Conflict and Violence (IKG), Bielefeld University, Bielefeld, Germany
| | - Simon Kühne
- Institute for Interdisciplinary Research on Conflict and Violence (IKG), Bielefeld University, Bielefeld, Germany.,Applied Social Data Science, Faculty of Sociology, Bielefeld University, Bielefeld, Germany
| | - Louise Biddle
- Department of Population Medicine & Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
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