Explaining the Relationship Between Minority Group Status and Health Disparities: A Review of Selected Concepts

Discrimination experiences and problematic alcohol and cannabis use in young adulthood

BACKGROUND AND OBJECTIVES

Limited research has examined how discrimination in young adulthood relates to substance use. We examined how multiple and specific types (e.g., race-based) of experiences of unfair treatment are related to problematic alcohol and cannabis use.

METHODS

We analyzed cross-sectional data from a diverse cohort of young adults (mean age 24.7) predominantly residing in southern California (n = 2303) to examine associations of multiple (count) and specific experiences (race-, sexual orientation-, gender-based) of perceived everyday discrimination with self-reported alcohol and cannabis use outcomes (consequences, use disorders, and solitary use). We also tested interactions between the three specific discrimination experiences and sociodemographic characteristics (e.g., race-based discrimination × race/ethnicity).

RESULTS

In this diverse sample (e.g., 47% Latinx/o and 22% Asian; 22% sexual/gender diverse; 56% female) of young adults, about 46% reported up to four different discrimination experiences and 27% reported race-, 26% gender-, and 5% sexual orientation-based discrimination. Race- and gender-based discrimination and experiencing more types of discrimination were associated with worse cannabis use outcomes. Race-based discrimination was associated with fewer alcohol consequences and lower Alcohol Use Disorders Identification Test (AUDIT) scores. Associations with sexual orientation-based discrimination and the interactions were not significant.

DISCUSSION AND CONCLUSIONS

Findings build on limited research on associations of discrimination with cannabis use in young adults. More work is needed to understand the mechanisms by which discrimination influences drinking behaviors.

SCIENTIFIC SIGNIFICANCE

This study advances the field by examining the unique contributions of specific and multiple types of discrimination experiences in young adulthood, a critical developmental period in which substance use peaks.

Social Inequalities in Long-Term Health Effects After COVID-19-A Scoping Review

Objectives: We aimed to map and synthesize evidence about social inequalities in long-term health effects after COVID-19 (LTHE), often referred to as "long COVID" or "post-COVID-19 conditions." Methods: We conducted a scoping review of peer-reviewed articles by searching the databases Embase and Scopus. According to predefined inclusion criteria, titles/abstracts and full texts were screened for eligibility. Additionally, reference lists of all included studies were hand-searched for eligible studies. This study followed the PRISMA guidelines for scoping reviews. Results: Nineteen articles were included. LTHE were analysed according to ethnicity, education, income, employment and deprivation indices. The studies varied significantly in their definitions of LTHE. Eighty-two analyses showed no statistically significant associations. At least 12 studies had a high risk of type II errors. Only studies associating deprivation indices and long COVID tended to show a higher prevalence of LTHE in deprived areas. Conclusion: Although some studies indicated social inequalities in LTHE, evidence was generally weak and inconclusive. Further studies with larger sample sizes specifically designed to detect social inequalities regarding LTHE are needed to inform future healthcare planning and public health policies.

An Exploration of Factors that Mediate the Relationship Between Adverse Childhood Experiences and Sexual Assault Victimization Among LGBTQ+ College Students

Despite alarming rates of sexual assault on college campuses, little research has examined risk factors for sexual victimization among LGBTQ+ college students. This exploratory study aims to examine adolescent sexual assault, internalized homonegativity, and problematic alcohol use as mediators linking several types of adverse childhood experiences (ACEs; i.e., childhood sexual abuse, parental abuse, and household disorder) to collegiate sexual assault. Utilizing data from 241 LGBTQ+ college students, path analysis findings demonstrated that these proposed mediators increased risk for sexual assault and that various types of ACEs exerted differential impacts on sexual re-victimization, internalized homonegativity, and problematic alcohol use. Practice-based implications are offered, including the need for affirming programming that includes problem drinking prevention components and considers the role of ACEs and internalized homonegativity in increasing risk for sexual assault during college as well as the need for LGBTQ+ resource centers on campus.

The Rohingya refugees: a conceptual framework of their psychosocial adversities, cultural idioms of distress and social suffering

Rohingya refugees, a group of religious and ethnic minorities, primarily reside in the South Asian nations. With decades of displacement, forced migration, limited freedom of movement, violence and oppression, they have been termed by the United Nations (UN) as the 'most persecuted minority group' in world history. Literature shows an increased prevalence of psychiatric disorders such as depression, anxiety, post-traumatic stress, insomnia, etc., in this population. However, beyond 'medicalisation', the psychosocial challenges of the Rohingyas need to be understood through the lens of 'social suffering', which results from a complex interplay of multiple social, political, environmental and geographical factors. Lack of essential living amenities, poverty, unemployment, overcrowding, compromised social identity, and persistent traumatic stressors lead to inequality, restricted healthcare access, human rights deprivation and social injustice in this group. Even though the United Nations High Commission for Refugees (UNHCR) has taken a renewed interest in Rohingya re-establishment with well-researched standards of care, there are several pragmatic challenges in their implementation and inclusion in policies. This paper reviews these multi-dimensional psychosocial challenges of the Rohingyas by synthesising various intersecting conceptual models including minority stress, health-stigma-discrimination framework, refugee ecological model and capability approach. Furthermore, it highlights multidisciplinary interventions to mitigate these adversities, improve their living situation and eventually foster healing via means which are culturally relevant and contextually appropriate. These interventions need to involve various stakeholders from a human rights and dignity based lens, including the voices of the Rohingyas and supported by more research in this area.

Diabetes Complications in Racial and Ethnic Minority Populations in the USA

PURPOSE OF REVIEW

Racial and ethnic minority populations have a higher burden of diabetes-related complications. There have been many epidemiologic studies to better define these racial/ethnic disparities in diabetes outcomes with additional studies offering interventions to mitigate them. This narrative review highlights the epidemiologic trends in diabetes complications specific to racial and ethnic minorities and underscores differences in microvascular and macrovascular complications of diabetes, health care utilization, and diabetes prevention efforts and also reviews interventions aimed to reduce racial/ethnic disparities and their limitations.

RECENT FINDINGS

While we have seen in general an overall improvement in complication rates for all people with diabetes, the disparities between Black and Hispanic compared to non-Hispanic White people with diabetes seem to persist. There is a continued need to better understand the underlying causes of and strategies to mitigate race/ethnicity disparities in diabetes complications in the USA.