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Brown MJ, Adkins-Jackson PB, Sayed L, Wang F, Leggett A, Ryan LH. The Worst of Times: Depressive Symptoms Among Racialized Groups Living With Dementia and Cognitive Impairment During the COVID-19 Pandemic. J Aging Health 2024; 36:535-545. [PMID: 38128585 DOI: 10.1177/08982643231223555] [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] [Indexed: 12/23/2023]
Abstract
Objective: To explore differences in depressive symptoms for older adults (Black, Latinx, and White) by cognitive status during the 2020 COVID-19 pandemic. Methods: Data from the Health and Retirement Study identified older adults as cognitively normal, cognitively impaired without dementia (CIND), and persons living with dementia (PLWD). Multiple linear regression analyses examined associations between cognitive status and depressive symptoms among these racialized groups. Results: Compared to the cognitively normal older adults racialized as Black, those with CIND reported higher depressive symptoms during the pandemic (overall and somatic) and PLWD had higher somatic symptoms (p < .01). Older adults racialized as White with CIND reported higher somatic (p < .01) symptoms compared to cognitively normal older adults racialized as White. Discussion: The COVID-19 pandemic was a challenging event among older adults racialized as Black with CIND and PLWD. Future studies should examine if these depressive symptoms persist over time.
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Affiliation(s)
- Monique J Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Paris B Adkins-Jackson
- Departments of Epidemiology and Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Linda Sayed
- James Madison College and College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Fei Wang
- College of Social Work, University of Tennessee, Knoxville, TN, USA
| | - Amanda Leggett
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Lindsay H Ryan
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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2
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Li Verdugo J, Kong Z, Sembukutti Liyanage DS, Keum BT, Moody MD, Oh HY. Associations between vicarious discrimination and mental health among young adult college students: Findings from the 2020-2021 Healthy Minds Study. J Affect Disord 2024; 361:760-767. [PMID: 38925312 DOI: 10.1016/j.jad.2024.06.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 06/19/2024] [Accepted: 06/22/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Poor mental health among young adults in higher education is a growing concern. In recent years, the visibility of racism has sharply risen. Vicarious discrimination is defined as the secondhand witnessing of racism, and given society's increased accessibility to social media and the Internet, addressing indirect violence is urgently needed to inform anti-racism and mental health efforts. The current study examined associations between vicarious discrimination and mental health across a large sample of young college students in the United States. METHODS We analyzed data from the Healthy Minds Study (HMS; 2020-2021; N=130,566) and used multivariable logistic regression to examine whether past-year vicarious discrimination was associated with various mental health outcomes, adjusting for age, gender, race/ethnicity, and direct discrimination. RESULTS The sample was predominantly white (n=31,438, 63.66%) and female-identifying (n=34,313, 69.49%) with an average age of 21.1 years. Approximately 35.9% of the sample endorsed experiencing vicarious discrimination. Vicarious discrimination was associated with greater depression (OR:1.97; 95% CI: [1.86,2.09], p< 0.001), anxiety (OR:1.82; 95% CI: [1.72,1.92], p<0.001), languishing (OR:1.75; 95% CI: [1.65,1.87], p<0.001), perceived need for treatment (OR:2.24; 95% CI: [2.10,2.40], p<0.001), suicidal ideation (OR:1.86; 95% CI: [1.73,2.01], p<0.001), suicide plan (OR:1.91; 95% CI: [1.71,2.14], p<0.001), suicide attempt (OR:1.89; 95% CI: [1.51,2.36], p<0.001), self-injurious behavior (OR:2.0; 95% CI: [1.88,2.12], p<0.001), and loneliness (OR:1.67; 95% CI: [1.58,1.77], p<0.001). DISCUSSION Consistent with growing literature, vicarious discrimination was associated with poorer mental health among young college students. Additional research should investigate moderators, mediators, and interventions to support those who may be impacted indirectly by discrimination.
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Affiliation(s)
- Juliann Li Verdugo
- University of Washington School of Social Work, United States of America.
| | - Zifang Kong
- Department of Statistics and Data Science, Southern Methodist University, United States of America
| | | | - Brian TaeHyuk Keum
- Department of Counseling, Developmental, and Educational Psychology, Boston College, United States of America
| | - Myles D Moody
- Department of Sociology, The University of Alabama at Birmingham, United States of America
| | - Hans Y Oh
- University of Southern California Dworak Peck School of Social Work, United States of America
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3
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McNamara M, Barondeau J, Brown J. Mental Health, Climate Change, and Bodily Autonomy: An Analysis of Adolescent Health Policy in the Post-Pandemic Climate. Pediatr Clin North Am 2024; 71:729-744. [PMID: 39003013 DOI: 10.1016/j.pcl.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/15/2024]
Abstract
The COVID-19 pandemic exacerbated the vulnerability of adolescents and young adults (AYAs) who face economic disadvantage, depend on social safety net resources, have politically targeted identities, are geopolitically displaced, and/or are racially or ethnically marginalized. A rapid change in social safety net policies has impacts that reverberate throughout interrelated domains of AYA health, especially for vulnerable AYAs. The authors analyze policy-related changes in mental health, climate change, and bodily autonomy to offer a paradigm for an equitable path forward.
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Affiliation(s)
| | - Jesse Barondeau
- University of Nebraska Medical Center, Children's Nebraska, 8200 Dodge Street, Omaha, NE 68114, USA
| | - Joanna Brown
- Boston Children's Hospital, 333 Longwood Avenue, Boston, MA 02115, USA
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4
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Castelin S, Jacquez F, Burlew AK, Cunningham SR. Dual Pandemics: Race-Related COVID Stress and Mental Health Outcomes in Black Individuals. J Racial Ethn Health Disparities 2024; 11:2141-2153. [PMID: 37378805 DOI: 10.1007/s40615-023-01683-6] [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: 01/31/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023]
Abstract
Black individuals have been disproportionately affected by the COVID-19 pandemic, likely due in part to historically rooted stressors that lie at the intersection of the COVID-19 pandemic and racism. We used secondary data from The Association of Black Psychologists' multi-state needs assessment of 2480 Black adults to examine the link between race-related COVID stress (RRCS) and mental health outcomes. We also examined the moderating roles of everyday discrimination, cultural mistrust, Black activism, Black identity, and spirituality/religiosity in these associations. T-tests revealed that several demographic and cultural factors are associated with RRCS endorsement. A series of regression analyses showed that endorsement of RRCS is associated with higher psychological distress and lower well-being, above and beyond several sociodemographic characteristics. While traditional cultural protective factors did not buffer against the effects of RRCS on mental health, cultural mistrust strengthened the positive association between RRCS and psychological distress; nonetheless, the association of cultural mistrusts with psychological distress was only seen in those who endorsed RRCS. We provide recommendations for policymakers, clinicians, and researchers to consider the impact of RRCS when addressing Black mental health and well-being in the age of COVID-19.
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Affiliation(s)
- Stephanie Castelin
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA.
| | - Farrah Jacquez
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | - A Kathleen Burlew
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
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5
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Cruz-Vespa I, Dembling SJ, Han BH, Inagaki TK. Associations between vicarious racism and psychoactive substance use depend on strength of ethnic identity. Sci Rep 2024; 14:17217. [PMID: 39060300 PMCID: PMC11282253 DOI: 10.1038/s41598-024-67202-7] [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: 02/06/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Racism is a pervasive threat to health with differential impact based on race and ethnicity. Considering the continued perpetration and visibility of racism online and in the news, vicarious racism, or "secondhand" racism when hearing about or witnessing racism being committed against members of one's ethnic or racial group, is a particularly urgent threat in the context of such disparities and their subsequent health consequences. The current study examines if frequency of exposure to vicarious racism and the emotional impact of those experiences are linked to psychoactive substance use, and explores the role of ethnic identity in moderating these relationships. In a cross-sectional survey, 504 adult participants aged 18-78 (M age = 30.15, SD = 11.52, 52.6% female) identifying as Black/African American or Latine reported on their experiences with vicarious racism and alcohol, marijuana, and tobacco use over the past 30 days. Logistic regression was utilized to test hypotheses. Primary findings indicate that greater emotional impact of vicarious racism was associated with a 50% increase in odds of alcohol consumption and that ethnic identity moderated the association between vicarious racism and marijuana use. Greater emotional impact of vicarious racism was related to more marijuana use for those lower on ethnic identity, whereas there was no association for those higher on ethnic identity. Vicarious racism was not related to tobacco use. Results suggest that ethnic identity might be protective in the association of vicarious racism on substance use. Further research on this topic is needed as vicarious racism becomes an increasingly common experience among marginalized populations.
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Affiliation(s)
| | - Sarah J Dembling
- Department of Psychology, San Diego State University, San Diego, USA
- SDSU-UC San Diego Joint Doctoral Program, San Diego, USA
| | | | - Tristen K Inagaki
- Department of Psychology, San Diego State University, San Diego, USA
- SDSU-UC San Diego Joint Doctoral Program, San Diego, USA
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6
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Jacobson R, Westberg DW, Chou E, Syed M, Weston SJ. Using structural topic modeling to understand ethnicity-related narratives. J Pers 2024. [PMID: 39041589 DOI: 10.1111/jopy.12966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 07/24/2024]
Abstract
OBJECTIVE Narrative identity is a promising approach for understanding the content of individuals' ethnic identities but can be limited by the time-intensive nature of human coding and the reliance on preestablished coding systems. BACKGROUND The aim of our preregistered study is to elucidate the content of individuals' ethnicity-related experiences using a novel statistical approach. METHOD We applied structural topic modeling (STM), a natural language processing tool, to narratives written by an ethnically diverse sample of 1149 young adults about a moment they felt aware of their ethnicity. RESULTS We identified 14 topics within ethnicity narratives and analyzed how each topic related to both the participant's ethnicity and the human-coded themes of agency and communion. For example, the topic Gained perspective of structural inequality was associated with greater agency, whereas Peer dynamics was associated with greater communion. Ethnic/cultural celebration was associated with both. CONCLUSIONS This study introduces STM as a useful tool for extracting topic content in narrative data and demonstrates how the multi-method assessment of ethnicity narratives provides greater insight into the content of ethnic experiences. These findings contribute to our understanding of contextualized aspects of personality, including the innovative ways we might examine them.
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Affiliation(s)
- Rachel Jacobson
- Department of Psychology, University of Oregon, Eugene, Oregon, USA
| | | | - Edward Chou
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Moin Syed
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sara J Weston
- Department of Psychology, University of Oregon, Eugene, Oregon, USA
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7
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Cénat JM, Moshirian Farahi SMM, Dalexis RD, Caulley L, Xu Y, Beogo I, Pongou R. COVID-19 vaccine mistrust, health literacy, conspiracy theories, and racial discrimination among a representative ethnically diverse sample in Canada: The vulnerability of Arab, Asian, Black, and Indigenous peoples. J Med Virol 2024; 96:e29795. [PMID: 39007429 DOI: 10.1002/jmv.29795] [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: 04/28/2024] [Revised: 06/19/2024] [Accepted: 07/02/2024] [Indexed: 07/16/2024]
Abstract
Despite increased risk of severe acute respiratory syndrome coronavirus 2 infections and higher rates of COVID-19-related complications, racialized and Indigenous communities in Canada have lower immunization uptake compared to White individuals. However, there is woeful lack of data on predictors of COVID-19 vaccine mistrust (VM) that accounts for diverse social and cultural contexts within specific racialized and Indigenous communities. Therefore, we sought to characterize COVID-19 VM among Arab, Asian, Black, and Indigenous communities in Canada. An online survey was administered to a nationally representative, ethnically diverse panel of participants in October 2023. Arabic, Asian, Indigenous, and Black respondents were enriched in the sampling panel. Data were collected on demographics, COVID-19 VM, experience of racial discrimination, health literacy, and conspiracy beliefs. We used descriptive and regression analyses to determine the extent and predictors of COVID-19 VM among racialized and Indigenous individuals. All racialized respondents had higher VM score compared to White participants. Among 4220 respondents, we observed highest VM among Black individuals (12.18; ±4.24), followed by Arabic (12.12; ±4.60), Indigenous (11.84; ±5.18), Asian (10.61; ±4.28), and White (9.58; ±5.00) participants. In the hierarchical linear regression analyses, Black participants, women, everyday racial discrimination, and major experience of discrimination were positively associated with COVID-19 VM. Effects of racial discrimination were mediated by addition of conspiracy beliefs to the model. Racialized and Indigenous communities experience varying levels of COVID-19 VM and carry specific predictors and mediators to development of VM. This underscores the intricate interaction between race, gender, discrimination, and VM that need to be considered in future vaccination campaigns.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ontario, Ottawa, Canada
- Interdisciplinary Centre for Black Health, University of Ottawa, Ontario, Ottawa, Canada
- University of Ottawa Research Chair on Black Health, Ontario, Ottawa, Canada
| | | | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Ontario, Canada
| | - Lisa Caulley
- Interdisciplinary Centre for Black Health, University of Ottawa, Ontario, Ottawa, Canada
- Faculty of Medicine, University of Ottawa, Ontario, Ottawa, Canada
| | - Yan Xu
- Faculty of Medicine, University of Ottawa, Ontario, Ottawa, Canada
| | - Idrissa Beogo
- Interdisciplinary Centre for Black Health, University of Ottawa, Ontario, Ottawa, Canada
- School of Nursing, University of Ottawa, Ontario, Ottawa, Canada
| | - Roland Pongou
- Interdisciplinary Centre for Black Health, University of Ottawa, Ontario, Ottawa, Canada
- Department of Economics, University of Ottawa, Ontario, Ottawa, Canada
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8
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Li L, Kang J, Nguyen B, Ho M, Li AT, Shih JJ, Kotwal A, Yeh J, Karliner L, Jeung R, Smith A. "Hate has chipped away at my sense of security": A survey study of the impacts of anti-Asian hate on the health of older Asians. J Am Geriatr Soc 2024; 72:2174-2183. [PMID: 38801317 PMCID: PMC11226351 DOI: 10.1111/jgs.19016] [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: 02/27/2024] [Revised: 04/18/2024] [Accepted: 05/04/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Since the beginning of the COVID-19 pandemic, older Asians have experienced a rise in racism and discrimination based on their race and ethnicity. This study examines how anti-Asian hate impacts older Asians' mental, social, and physical health. METHODS From March 18, 2022 to January 24, 2023, we conducted a cross-sectional survey study of community-dwelling Asian/Asian American adults aged ≥50 years from the San Francisco Bay Area. Measures included perceptions of anti-Asian hate; direct encounters with hate incidents; indirect experiences with hate incidents (e.g. knowing a friend who was a victim); reports of anxiety, depression, loneliness, and changes in daily activities; ways to address these issues; and discussions with clinicians about hate incidents. RESULTS Of the 293 older Asians, 158 (54%) were Vietnamese and 97 (33%) Chinese. Eighty-five (29%) participants were direct victims of anti-Asian hate, 112 (38%) reported anxiety, 105 (36%) reported depression, 161 (55%) reported loneliness, and 142 (48%) reported decreased daily activities. Compared with those who were "not-at-all" to "moderately" worried about hate incidents, participants who were "very" to "extremely" worried experienced heightened anxiety (42% versus 16%), loneliness (30% versus 14%), and changes in daily activities (66% versus 31%), p < 0.01 for all. Most participants (72%) felt comfortable discussing hate incidents with clinicians; however, only 31 (11%) reported that a clinician had talked with them about these incidents. CONCLUSION Both directly and indirectly, anti-Asian hate negatively impacts older Asians' mental, social, and physical health. Clinicians have a role in addressing the health impacts of anti-Asian hate.
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Affiliation(s)
- Lingsheng Li
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
| | - Jasmine Kang
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
| | - Brian Nguyen
- UC Davis School of Medicine, Sacramento, California, USA
| | - Maxwell Ho
- School of Medicine, University of California, San Francisco, California, USA
| | - Andrew T. Li
- School of Medicine, University of California, San Francisco, California, USA
| | - Jonathan J. Shih
- School of Medicine, University of California, San Francisco, California, USA
| | - Ashwin Kotwal
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Jarmin Yeh
- Institute for Health and Aging, School of Nursing, University of California, San Francisco, California, USA
| | - Leah Karliner
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, California, USA
| | - Russell Jeung
- Asian American Studies, College of Ethnic Studies, San Francisco State University, California, USA
- Stop AAPI Hate Coalition. https://stopaapihate.org/
| | - Alex Smith
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
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9
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Quinn KG, Hunt BR, Jacobs J, Valencia J, Voisin D, Walsh JL. Examining the Relationship between Anti-Black Racism, Community and Police Violence, and COVID-19 Vaccination. Behav Med 2024; 50:250-259. [PMID: 37578320 PMCID: PMC10864675 DOI: 10.1080/08964289.2023.2244626] [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: 01/12/2023] [Revised: 05/12/2023] [Accepted: 05/18/2023] [Indexed: 08/15/2023]
Abstract
In 2020, the COVID-19 pandemic emerged against a backdrop of long-standing racial inequities that contributed to significant disparities in COVID-19 mortality, morbidity, and eventually, vaccination rates. COVID-19 also converged with two social crises: anti-Black racism and community and police violence. The goal of this study was to examine the associations between community violence, police violence, anti-Black racism, and COVID-19 vaccination. Survey data were collected from a sample of 538 Black residents of Chicago between September 2021 and March 2022. Structural equation modeling was used to test associations between neighborhood violence, police violence, racism, medical mistrust, trust in COVID-related information, depressive symptoms, and having received a COVID-19 vaccination. In line with predictions, neighborhood violence had a significant indirect effect on vaccination via trust in COVID-related information from a personal doctor. Additionally, racism had a significant indirect effect on vaccination via trust in COVID-related information from a personal doctor, as well as via medical mistrust and trust in COVID-related information from a personal doctor. These findings add to the growing body of literature demonstrating the importance of medical mistrust when examining COVID-19 vaccination disparities. Furthermore, this study highlights the importance of considering how social and structural factors such as violence and racism can influence medical mistrust.
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Affiliation(s)
- Katherine G Quinn
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin
| | - Bijou R Hunt
- Sinai Health System, Sinai Infectious Disease Center
| | | | | | - Dexter Voisin
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University
| | - Jennifer L Walsh
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin
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10
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Keum BT, Wong MJ, Sanders I. Racial Hate at the Intersection of Online and Offline Worlds: The Joint Impact of Online and Offline Racism on the Mental Health of Racially Minoritized Individuals. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:2487-2506. [PMID: 38149586 DOI: 10.1177/08862605231220015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
With the everyday influence of social media and online platforms, racially minoritized individuals face the risk of experiencing racial discrimination in both offline and online contexts. Yet, there is scant research on how online and offline racism could jointly impact the mental health of racially minoritized individuals. Thus, the study examined online racism as a moderator in the link between offline racism and mental health issues. Using data from 651 racially minoritized emerging adults (Mage = 22.15, SD = 3.39), a moderation analysis was conducted using the PROCESS macro with bias-corrected bootstrapping (10,000 resamples). Experiencing more offline racism was significantly associated with greater mental health issues. Online racism was a significant moderator in the link between offline racism and mental health issues. The link between offline racism and mental health issues was not significant at low levels of online racism. However, the link was significant and strengthened at mean to high levels of online racism. The results suggest complex interactions in understanding the compounding impact of online and offline racism on mental health costs among racially minoritized individuals. Implications for future research on understanding the interplay between online and offline racism are discussed.
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11
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Strassle PD, Wilkerson MJ, Stewart AL, Forde AT, Jackson CL, Singh R, Nápoles AM. Impact of COVID-related Discrimination on Psychological Distress and Sleep Disturbances across Race-Ethnicity. J Racial Ethn Health Disparities 2024; 11:1374-1384. [PMID: 37126156 PMCID: PMC10150686 DOI: 10.1007/s40615-023-01614-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/18/2023] [Accepted: 04/22/2023] [Indexed: 05/02/2023]
Abstract
COVID-related discrimination towards historically marginalized racial-ethnic groups in the United States has been well-documented; however, its impact on psychological distress and sleep (overall and within specific racial-ethnic groups) is largely unknown. We used data from our nationally representative, online survey of 5,500 American Indian/Alaska Native, Asian, Black/African American, Native Hawaiian/Pacific Islander, Latino, White, and multiracial adults, conducted from 12/2020-2/2021. Participants were asked how often they experienced discriminatory behaviors "because they think you might have COVID-19" (modified Everyday Discrimination Scale). Psychological distress was captured as having experienced anxiety-depression symptoms (Patient Health Questionairre-4, PHQ-4), perceived stress (modified Perceived Stress Scale), or loneliness-isolation ("How often have you felt lonely and isolated?"). Sleep disturbances were measured using the Patient-Reported Outcomes Information System Short Form Sleep Disturbance scale (PROMIS-SF 4a). Overall, 22.1% reported COVID-related discriminatory behaviors (sometimes/always: 9.7%; rarely: 12.4%). 48.4% of participants reported anxiety-depression symptoms (moderate/severe: 23.7% mild: 24.8%), 62.4% reported feeling stressed (moderate/severe: 34.3%; mild: 28,1%), 61.0% reported feeling lonely-isolated (fairly often/very often: 21.3%; almost never/sometimes: 39.7%), and 35.4% reported sleep disturbances (moderate/severe:19.8%; mild: 15.6%). Discrimination was only associated with increased psychological distress among racial-ethnic minorities. For example, COVID-related discrimination was strongly associated with anxiety-depression among Black/African American adults (mild: aOR=2.12, 95% CI=1.43-5.17; moderate/severe: aOR=5.19, 95% CI=3.35-8.05), but no association was observed among White or multiracial adults. Mitigating pandemic-related discrimination could help alleviate mental and sleep health disparities occurring among minoritized racial-ethnic groups.
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Affiliation(s)
- Paula D Strassle
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
| | - Miciah J Wilkerson
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Anita L Stewart
- University of California San Francisco, Institute for Health & Aging, Center for Aging in Diverse Communities, San Francisco, CA, USA
| | - Allana T Forde
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Chandra L Jackson
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Rupsha Singh
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Anna María Nápoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
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12
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Chen YT, Zhou Y, Williams S, Cantor J, Taylor BG, Lamuda PA, Pollack HA, Schneider J. Racial discrimination and mental health in the context of anti-Asian xenophobia: An intersecting approach of race, ethnicity, nativity, and socioeconomic status. SSM - MENTAL HEALTH 2024; 5:100292. [PMID: 39036441 PMCID: PMC11259006 DOI: 10.1016/j.ssmmh.2023.100292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024] Open
Abstract
The COVID-19 pandemic, polarized politics, and heightened stigma and discrimination are salient drivers for negative mental health outcomes, particularly among marginalized racial and ethnic minoritized groups. Intersectionality of race, ethnicity, foreign-born status, and educational attainment may distinctively shape an individual's experience of discrimination and mental health during such unprecedented time. The present study examines the differential associations of racial discrimination and mental health based on an individual's race, ethnicity, foreign-born status, and educational attainment during the COVID-19 pandemic. Analyses were based on a nationally representative sample of U.S. adults collected between October and November 2021 (n = 6276). We utilized multivariable linear regressions to identify the multiplicative effects of race, ethnic, foreign-born status and self-reported racial discrimination on mental health, stratified by educational attainment. Among individuals with lower educational attainment, associations between racial discrimination and poor mental health were stronger among Asians (US-born: β = -2.07, p = 0.03; foreign-born: β = -3.18, p = 0.02) and US-born multiracial individuals (β = -1.96, p = 0.02) than their White counterparts. Among individuals with higher educational attainment, foreign-born Hispanics (β = -3.66, p < 0.001) and US-born Asians (β = -2.07, p = 0.01) reported worst mental health when exposed to racial discrimination out of all other racial, ethnic and foreign-born groups. Our results suggest that association of racial discrimination and mental health varies across racial, ethnic, foreign-born, and education subgroups. Using an intersectional approach to address the widening inequities in racial discrimination and mental health during the COVID-19 pandemic contextualizes unique experience of discrimination and provides crucial insight on the patterns of mental health among marginalized groups.
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Affiliation(s)
- Yen-Tyng Chen
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA
| | - Yuqing Zhou
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Sharifa Williams
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA
| | - Joel Cantor
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA
- Center for State Health Policy, Institute for Health, Rutgers University, New Brunswick, NJ, USA
| | - Bruce G. Taylor
- Public Health Department, NORC at the University of Chicago, Chicago, IL, USA
| | - Phoebe A. Lamuda
- Public Health Department, NORC at the University of Chicago, Chicago, IL, USA
| | - Harold A. Pollack
- School of Social Service, Administration Admissions, University of Chicago, Chicago, IL, USA
| | - John Schneider
- School of Social Service, Administration Admissions, University of Chicago, Chicago, IL, USA
- Department of Medicine and Public Health Sciences, University of Chicago, Chicago, IL, USA
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13
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Simela C, Akanbi-Akinlolu T, Okundi M, Abdalla H, McAdams TA, Harris A, Augustine A, Le H, Abdinasir K, Ayorech Z, Ahmadzadeh YI. Intergenerational consequences of racism in the United Kingdom: a qualitative investigation into parents' exposure to racism and offspring mental health and well-being. Child Adolesc Ment Health 2024; 29:181-191. [PMID: 38523495 DOI: 10.1111/camh.12695] [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: 02/28/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Experiences of racism are linked to negative physical and mental health outcomes among those exposed. According to quantitative research derived mainly from the United States, these negative outcomes can have cascading effects in families, when parents' experiences of racism indirectly impact offspring. New research is warranted for families in the United Kingdom, informed by a qualitative approach to canvassing community knowledge and perspectives, exploring how existing findings relate to lived experiences. METHOD We conducted four online focus groups with 14 parents of school-aged children and 14 adolescents who had experienced racism in the United Kingdom. Participants were asked what children know of parents' experiences of racism, and how these experiences can impact parent-child interactions, mental health and well-being. Focus group recordings were transcribed, data coded and analysed through iterative categorisation. RESULTS Analyses drew four themes from participants' insights. Together, themes illuminated the pervasive nature of racism experienced by some families in the United Kingdom. Parent and child experiences of racism were connected and co-occurring, with indirect effects impacting mental health and well-being in both generations. These experiences were linked to both positive and negative changes in parenting behaviour and parent-child relationships, which could be moderated by intersecting identities such as the parent's generational status for immigration to the United Kingdom. Social cohesion, safe spaces and education programmes were highlighted for future intervention. CONCLUSIONS Findings corroborate existing literature, while further emphasising a broader bidirectional picture, requiring a family system and intersectional approach to understanding the mental health impact of racism in families. Avenues for future research are discussed to support development of equitable intervention and support strategies to prevent racism and support those affected.
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Affiliation(s)
| | | | | | | | | | - Androulla Harris
- Centre for Mental Health, Registered Charity No. 1091156, London, UK
| | - Alex Augustine
- Centre for Mental Health, Registered Charity No. 1091156, London, UK
| | - Huong Le
- Centre for Mental Health, Registered Charity No. 1091156, London, UK
| | - Kadra Abdinasir
- Centre for Mental Health, Registered Charity No. 1091156, London, UK
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14
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Ðoàn LN, Chau MM, Ahmed N, Cao J, Chan SWC, Yi SS. Turning the Health Equity Lens to Diversity in Asian American Health Profiles. Annu Rev Public Health 2024; 45:169-193. [PMID: 38134402 DOI: 10.1146/annurev-publhealth-060222-023852] [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] [Indexed: 12/24/2023]
Abstract
The monolithic misrepresentation of Asian American (AsAm) populations has maintained assumptions that AsAm people are not burdened by health disparities and social and economic inequities. However, the story is more nuanced. We critically review AsAm health research to present knowledge of AsAm health profiles from the past two decades and present findings and opportunities across three topical domains: (a) general descriptive knowledge, (b) factors affecting health care uptake, and (c) effective interventions. Much of the literature emphasized underutilization of health care services; low knowledge and awareness among AsAms about health-related risk factors, prevention, diagnosis, and treatment; inadequate efforts by health systems to improve language access, provider-patient communication, and trust; and the critical roles of community- and faith-based organizations and leaders in health promotion initiatives. Future opportunities for AsAm health research will require adoption of and significant investment in community-engaged research infrastructure to increase representation, funding, and research innovation for AsAm communities.
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Affiliation(s)
- Lan N Ðoàn
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA;
| | - Michelle M Chau
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA;
| | - Naheed Ahmed
- Institute for Excellence in Health Equity, NYU Grossman School of Medicine, New York University, New York, NY, USA
| | - Jiepin Cao
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA;
| | - Sze Wan Celine Chan
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA;
| | - Stella S Yi
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA;
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15
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Ryan SC, Sugg MM, Runkle JD, Wertis L, Singh D, Green S. Short-term changes in mental health help-seeking behaviors following exposure to multiple social stressors and a natural disaster. Soc Sci Med 2024; 348:116843. [PMID: 38603916 PMCID: PMC11134597 DOI: 10.1016/j.socscimed.2024.116843] [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: 09/22/2023] [Revised: 02/23/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
In 2020, unprecedented circumstances led to significant mental health consequences. Individuals faced mental health stressors that extended beyond the devastating impact of the COVID-19 pandemic, including widespread social unrest following the murder of George Floyd, an intense hurricane season in the Atlantic, and the politically divisive 2020 election. The objective of this analysis was to consider changes in help-seeking behavior following exposure to multiple social stressors and a natural disaster. Data from Crisis Text Line (CTL), a national text-based mental health crisis counseling service, was used to determine how help-seeking behavior changed in the wake of each event. Wilcoxon rank sum tests assessed changes in help-seeking behavior for each event in 2020 as compared to the same period in 2019. AutoRegressive Integrated Moving Average (ARIMA) models examined if changes in crisis conversation volumes following each event differed. Higher median conversation volumes noted for the COVID-19 pandemic (+1 to +5 conversations), Hurricane Laura (+1 to +7 conversations) and the 2020 Election (+1 to +26 conversations). ARIMA models show substantial increases in help-seeking behavior following the declaration of a national emergency for the COVID-19 pandemic (+4.3 to +38.2%) and following the 2020 election (+3 to +24.44%). Our analysis found that the mental health response following social stressors may be distinct from natural events, especially when natural disasters occur in the context of multiple social stressors. This analysis adds to the growing body of literature considering the mental health impact of exposure to multiple co-occurring societal stressors, like police violence and a global pandemic.
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Affiliation(s)
- Sophia C Ryan
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA.
| | - Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA
| | - Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, Raleigh NC, 27695, USA
| | - Luke Wertis
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA
| | - Devyani Singh
- Data Team, Crisis Text Line, New York City, New York, USA
| | - Shannon Green
- Data Team, Crisis Text Line, New York City, New York, USA
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16
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Ormiston CK, Strassle PD, Boyd E, Williams F. Discrimination is associated with depression, anxiety, and loneliness symptoms among Asian and Pacific Islander adults during COVID-19 Pandemic. Sci Rep 2024; 14:9417. [PMID: 38658790 PMCID: PMC11043456 DOI: 10.1038/s41598-024-59543-0] [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: 03/26/2024] [Accepted: 04/11/2024] [Indexed: 04/26/2024] Open
Abstract
In the United States, Asian and Pacific Islander (A/PI) communities have faced significant discrimination and stigma during the COVID-19 pandemic. We assessed the association between discrimination and depression, anxiety, and loneliness symptoms among Asian or Pacific Islander adults (n = 543) using data from a 116-item nationally distributed online survey of adults (≥ 18 years old) in the United States conducted between 5/2021-1/2022. Discrimination was assessed using the 5-item Everyday Discrimination Scale. Anxiety, depression, and loneliness symptoms were assessed using the 2-item Generalized Anxiety Disorder, 2-item Patient Health Questionnaire, and UCLA Loneliness Scale-Short form, respectively. We used multivariable logistic regression to estimate the association between discrimination and mental health. Overall, 42.7% of participants reported experiencing discrimination once a month or more. Compared with no discrimination, experiencing discrimination once a month was associated with increased odds of anxiety (Adjusted Odds Ratio [aOR] = 2.60, 95% CI = 1.38-4.77), depression (aOR = 2.58, 95% CI = 1.46-4.56), and loneliness (aOR = 2.86, 95% CI = 1.75-4.67). Experiencing discrimination once a week or more was associated with even higher odds of anxiety (aOR = 6.90, 95% CI = 3.71-12.83), depression, (aOR = 6.96, 95% CI = 3.80-12.74), and loneliness (aOR = 6.91, 95% CI = 3.38-13.00). Discrimination is detrimental to mental health, even at relatively low frequencies; however, more frequent discrimination was associated with worse mental health symptoms. Public health interventions and programs targeting anti-A/PI hate and reducing A/PI mental health burden are urgently needed.
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Affiliation(s)
- Cameron K Ormiston
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 11545 Rockville Pike, Rockville, MD, 20852, USA
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paula D Strassle
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 11545 Rockville Pike, Rockville, MD, 20852, USA
| | - Eric Boyd
- Information Management Services, Inc., Calverton, MD, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 11545 Rockville Pike, Rockville, MD, 20852, USA.
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17
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Alvarez D, Adynski H, Harris R, Zou B, Taylor JY, Santos HP. Social Support Is Protective Against the Effects of Discrimination on Parental Mental Health Outcomes. J Am Psychiatr Nurses Assoc 2024:10783903241243092. [PMID: 38600825 DOI: 10.1177/10783903241243092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
BACKGROUND Discrimination, or unfair treatment based on individual characteristics such as gender, race, skin color, and or sexual orientation, is a pervasive social stressor that perpetuates health disparities by limiting social and economic opportunity and is associated with poor mental and physical health outcomes. AIMS The purpose of the present study is to (1) examine the association between maternal experiences of discrimination and paternal experiences of discrimination; (2) explore how discrimination relates to parental (maternal and paternal) stress and depressive symptoms; and (3) examine whether social support exerts protective effects. METHODS The sample was 2,510 mothers and 1,249 fathers from the Child Community Health Network study. Linear regression models were conducted to explore associations between maternal and paternal discrimination. In addition, mediation analyses were conducted to explore if social support functioned as a mediator between discrimination on parental stress and depressive symptoms. RESULTS Most mothers (40.3%) and fathers (50.7%) identified race as the predominant reason for discrimination. Experiencing discrimination was significantly related to stress and depressive symptoms for both parents, and all forms of social support mediated these relationships. Our findings suggest that social support can act as a protective factor against the negative association between discrimination and both stress and depressive symptoms. CONCLUSIONS These findings highlight the need to integrate social support into existing interventions and include fathers in mental health screenings in primary-care settings. Finally, we briefly describe the role of nurses and other allied health professionals in addressing discrimination in health care and health policy implications.
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Affiliation(s)
- Dallis Alvarez
- Dallis Alvarez, BSN, RN, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Harry Adynski
- Harry Adynski, PhD, RN, PMH-BC, University of California San Francisco, San Francisco, CA, USA
| | - Rebeca Harris
- Rebeca Harris BSN, RN, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Baiming Zou
- Baiming Zou, PhD, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jacquelyn Y Taylor
- Jacquelyn Y. Taylor, PhD, RN, FAHA, FAAN, Columbia University, New York, NY, USA
| | - Hudson P Santos
- Hudson P. Santos Jr, PhD, RN, FAAN, University of Miami, Coral Gables, FL, USA
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18
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Criss S, Kim M, De La Cruz MM, Thai N, Nguyen QC, Hswen Y, Gee GC, Nguyen TT. Vigilance and Protection: How Asian and Pacific Islander, Black, Latina, and Middle Eastern Women Cope with Racism. J Racial Ethn Health Disparities 2024; 11:773-782. [PMID: 36917397 PMCID: PMC10013280 DOI: 10.1007/s40615-023-01560-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/10/2023] [Accepted: 03/01/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Research is needed to fully investigate the differential mechanisms racial and ethnic groups use to deal with ongoing intersectional racism in women's lives. The aim of this paper was to understand how Asian American and Pacific Islander, Black, Latina, and Middle Eastern women experience racism-from personal perceptions and interactions to coping mechanisms and methods of protection. METHODS A purposive sample of 52 participants participated in 11 online racially/ethnically homogeneous focus groups conducted throughout the USA. A team consensus approach was utilized with codebook development and thematic analysis. RESULTS The findings relate to personal perceptions and interactions related to race and ethnicity, methods of protection against racism, vigilant behavior based on safety concerns, and unity across people of color. A few unique concerns by group included experiences of racism including physical violence among Asian American Pacific Islander groups, police brutality among Black groups, immigration discrimination in Latina groups, and religious discrimination in Middle Eastern groups. Changes in behavior for safety and protection include altering methods of transportation, teaching their children safety measures, and defending their immigration status. They shared strategies to help racial and ethnic minorities against racism including mental health resources and greater political representation. All racial and ethnic groups discussed the need for unity, solidarity, and allyship across various communities of color but for it to be authentic and long-lasting. CONCLUSION Greater understanding of the types of racism specific groups experience can inform policies and cultural change to reduce those factors.
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Affiliation(s)
- Shaniece Criss
- Department of Health Sciences, Furman University, Greenville, SC, 29613, USA.
| | - Melanie Kim
- Department of Anthropology, Brown University, Providence, RI, 02912, USA
| | - Monica M De La Cruz
- School of Social Welfare, University of California, Berkeley, CA, 94720, USA
| | - Nhung Thai
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, 94720, USA
| | - Quynh C Nguyen
- Department of Epidemiology & Biostatistics, School of Public Health, University of Maryland, College Park, MD, 20742, USA
| | - Yulin Hswen
- Department of Epidemiology and Biostatistics, Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, USA
| | - Gilbert C Gee
- Department of Community Health Sciences, University of California, Los Angeles, CA, 90095, USA
| | - Thu T Nguyen
- Department of Epidemiology & Biostatistics, School of Public Health, University of Maryland, College Park, MD, 20742, USA
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19
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Cheslack-Postava K, Forthal S, Musa GJ, Ryan M, Bresnahan M, Sapigao RG, Lin S, Fan B, Svob C, Geronazzo-Alman L, Hsu YJ, Skokauskas N, Hoven CW. Persistence of anxiety among Asian Americans: racial and ethnic heterogeneity in the longitudinal trends in mental well-being during the COVID-19 pandemic. Soc Psychiatry Psychiatr Epidemiol 2024; 59:599-609. [PMID: 37624465 DOI: 10.1007/s00127-023-02553-6] [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: 01/04/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE To examine within-individual time trends in mental well-being and factors influencing heterogeneity of these trends. METHODS Longitudinal telephone survey of adults over 3 waves from the New York City (NYC) Metropolitan area during the COVID-19 Pandemic. Participants reported depression using the Patient Health Questionnaire (PHQ)-8, anxiety using the Generalized Anxiety Disorder (GAD)-7, and past 30-day increases in tobacco or alcohol use at each wave. Adjusted mixed effects logistic regression models assessed time trends in mental well-being. RESULTS There were 1227 respondents. Over 3 study waves, there were statistically significant decreasing time trends in the odds of each outcome (adjusted OR (95% CI) 0.47 (0.37, 0.60); p < 0.001 for depression; aOR (95% CI) 0.55 (0.45, 0.66); p < 0.001 for anxiety; aOR (95% CI) 0.50 (0.35, 0.71); p < 0.001 for past 30-day increased tobacco use; aOR (95% CI) 0.31 (0.24, 0.40); p < 0.001 for past 30-day increased alcohol use). Time trends for anxiety varied by race and ethnicity (p value for interaction = 0.05, 4 df); anxiety declined over time among white, Black, Hispanic, and Other race and ethnicity but not among Asian participants. CONCLUSIONS In a demographically varied population from the NYC Metropolitan area, depression, anxiety and increased substance use were common during the first months of the pandemic, but decreased over the following year. While this was consistently the case across most demographic groups, the odds of anxiety among Asian participants did not decrease over time.
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Affiliation(s)
- Keely Cheslack-Postava
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA.
| | - Sarah Forthal
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - George J Musa
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Megan Ryan
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
| | - Michaeline Bresnahan
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Rosemarie G Sapigao
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- CUNY Graduate School of Public Health and Health Policy, New York, USA
| | - Susan Lin
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
| | - Bin Fan
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
| | - Connie Svob
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Lupo Geronazzo-Alman
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
| | - Yi-Ju Hsu
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
| | - Norbert Skokauskas
- Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Christina W Hoven
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
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20
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Rodriguez AK, Akram S, Colverson AJ, Hack G, Golden TL, Sonke J. Arts Engagement as a Health Behavior: An Opportunity to Address Mental Health Inequities. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024; 44:315-322. [PMID: 37196338 PMCID: PMC11409561 DOI: 10.1177/2752535x231175072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
The significance of mental health inequities globally is illustrated by higher rates of anxiety and depression amongst racial and ethnic minority populations as well as individuals of lower socioeconomic status. The COVID-19 pandemic has further exacerbated these pre-existing mental health inequities. With rising mental health concerns, arts engagement offers an accessible, equitable opportunity to combat mental health inequities and impact upstream determinants of health. As the field of public health continues to shift its focus toward social ecological strategies, the social ecological model of health offers an approach that prioritizes social and structural determinants of health. To capture the impacts of arts engagement, this paper creates an applied social ecological model of health while aiming to advocate that engaging in the arts is a protective and rehabilitative behavior for mental health.
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Affiliation(s)
- Alexandra K Rodriguez
- University of Florida Center for Arts in Medicine, Gainesville, FL, USA
- University of Florida College of Public Health and Health Professions, Gainesville, FL, USA
| | - Seher Akram
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Aaron J Colverson
- University of Florida Center for Arts in Medicine, Gainesville, FL, USA
- University of Florida Musicology/Ethnomusicology Program, Gainesville, FL, USA
| | - George Hack
- University of Florida College of Public Health and Health Professions, Gainesville, FL, USA
| | - Tasha L Golden
- University of Florida Center for Arts in Medicine, Gainesville, FL, USA
- International Arts + Mind Lab, Brain Science Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jill Sonke
- University of Florida Center for Arts in Medicine, Gainesville, FL, USA
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21
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Williams J, Mayes C, Flint-Peterson E, Degeling C. Vigilance in infectious disease emergencies: Expanding the concept. Soc Sci Med 2024; 344:116648. [PMID: 38330632 DOI: 10.1016/j.socscimed.2024.116648] [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: 09/25/2023] [Revised: 12/21/2023] [Accepted: 02/02/2024] [Indexed: 02/10/2024]
Abstract
In their 2010 book, Lorna Weir and Eric Mykhalovskiy conceptualised the role of vigilance in unknown and emerging infectious disease threats. Theirs is a macro-level account which draws on empirical data to describe vigilance as a set of technical and political arrangements that govern collection, analysis, interpretation and communication of data as it pertains to unknown threats. In this paper we expand their work to detail a conceptual analysis of the role of vigilance at the micro-level during periods of high infectious disease threat. Our data are daily press conferences and associated non-discursive tools in New South Wales (NSW), Australia during times of heightened COVID-19 risk. This paper is a conceptual analysis that draws on theories of vigilance and related concepts to show how a key aspect of vigilance is making previously unseen threats visible or present. Communications formulated and encouraged three types of vigilance as a set of governing relations: institutional or authority-based; individual outward-facing; and individual inward-facing. We also describe the relationship between vigilance and related concepts that are used in response to anticipated public threats. Authority based vigilance involved contact tracing and policing of movement and behaviours. In individual outward facing vigilance people were asked to be alert to, analyse, and react to risk in their immediate environment. Inward facing vigilance required people to gather and react to information about their own behaviours and within their own bodies. There was a relationship between different types of vigilance; as risk increased and authority-based vigilance was less successful in containing the spread of infection, individual vigilance had a stronger role to play. This extension of vigilance at the micro-level sees some of the same unintended consequences as Weir and Mykhalovskiy describe at the global level, particularly in how burdens are inequitably distributed and experienced.
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Affiliation(s)
- Jane Williams
- Australian Centre for Health Engagement, Evidence and Values (ACHEEV), School of Health and Society, University of Wollongong, Australia; Sydney Health Ethics, School of Public Health, University of Sydney, Australia.
| | - Christopher Mayes
- School of Humanities and Social Science, Deakin University, Australia
| | | | - Chris Degeling
- Australian Centre for Health Engagement, Evidence and Values (ACHEEV), School of Health and Society, University of Wollongong, Australia
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22
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Franco K, Patler C, Pirtle WL. COVID-19's Unequal Toll: Differences in Health-Related Quality of Life by Gendered and Racialized Groups. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2024; 65:60-74. [PMID: 37830769 PMCID: PMC10908199 DOI: 10.1177/00221465231199734] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
We examine whether the COVID-19 pandemic was associated with changes to daily activity limitations due to poor physical or mental health and whether those changes were different within and between gendered and racialized groups. We analyze 497,302 observations across the 2019 and 2020 waves of the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System survey. Among White men and women, the COVID-19 pandemic was associated with fewer days of health-related activity limitations and decreased frequent activity limitation (≥14 days in the past month) compared to the prepandemic period. By contrast, Latina and Black women experienced increased days of activity limitation and greater likelihood of frequent activity limitation, and these changes were significantly different than for White women. These findings are robust to the inclusion of structural inequality measures and demonstrate how systemic racism and sexism likely exacerbate a myriad of pandemic-related health problems.
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23
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Ramezani N, Taylor BG, Balawajder EF, MacLean K, Pollack HA, Schneider JA, Taxman FS. Predictors of mental health among U.S. adults during COVID-19 early pandemic, mid- pandemic, and post-vaccine eras. BMC Public Health 2024; 24:643. [PMID: 38424510 PMCID: PMC10902933 DOI: 10.1186/s12889-024-17781-x] [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: 04/18/2023] [Accepted: 01/15/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND A collective trauma like COVID-19 impacts individuals differently due to socio-contextual and individual characteristics. Younger adults, minorities, affiliates of certain political parties, and residents of some regions of the United States reported experiencing poorer mental health during the pandemic. Being diagnosed with COVID-19, or losing a friend/family to it, was related to more adverse mental health symptoms. While the negative impact of COVID-19 on health outcomes has been studied, mental health changes during this pandemic need further exploration. METHODS In a study of 8,612 U.S. households, using three surveys collected from a nationally representative panel between May 2020 and October 2021, using a repeated cross-sectional design, a linear mixed effect regression model was performed to investigate factors associated with the mental health status, based on the Mental Health Inventory-5, of individuals throughout different phases of the COVID-19 pandemic, and whether an improvement over time, especially after vaccines became available, was observed. RESULTS An overall improvement in mental health was observed after vaccines became available. Individuals with no COVID-related death in their household, those not wearing masks, those identifying as members of the Republican Party, race/ethnicities other than Asian, men, older adults, and residents of the South were less likely than others to report mental health challenges. CONCLUSIONS Our results highlight the need for widespread mental health interventions and health promotion to address challenges during the COVID-19 pandemic and beyond. Due to the worse mental health observed among Asians, younger adults, women, low-income families, those with a higher level of concern for COVID-19, people who lost someone to COVID-19, and/or individuals with histories of opioid use disorder and criminal legal involvement, over the period of this study, targeted attention needs to be given to the mental health of these groups.
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Affiliation(s)
- Niloofar Ramezani
- Department of Biostatistics, Virginia Commonwealth University, Box 980032, One Capital Square, 830 East Main St, Richmond, VA, 23219, USA.
| | - Bruce G Taylor
- NORC at the University of Chicago, Public Health Department, 4350 East West Highway, 8th floor, Bethesda, MD, 20814, USA
| | - Elizabeth Flanagan Balawajder
- NORC at the University of Chicago, Public Health Department, 4350 East West Highway, 8th floor, Bethesda, MD, 20814, USA
| | - Kai MacLean
- NORC at the University of Chicago, Public Health Department, 4350 East West Highway, 8th floor, Bethesda, MD, 20814, USA
| | - Harold A Pollack
- Crown Family School of Social Work, Policy, and Practice, Department of Public Health Sciences, Urban Health Lab, University of Chicago, 969 E 60th St, Chicago, IL, 60637, USA
| | - John A Schneider
- Department of Medicine and Public Health Sciences, Crown Family School of Social Work, Policy, and Practice, University of Chicago, 5841 South Maryland Avenue MC 5065, Chicago, IL, 60637, USA
| | - Faye S Taxman
- Schar School of Policy and Government, George Mason University, 3351 Fairfax Drive Van Metre Hall, Arlington, VA, 22201, USA
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Luo Y, Liberman J, Burke SR. Social Statuses, Perceived Everyday Discrimination and Health and Well-being Before and After COVID-19 Pandemic. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01930-4. [PMID: 38409488 DOI: 10.1007/s40615-024-01930-4] [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: 08/25/2023] [Revised: 01/25/2024] [Accepted: 01/31/2024] [Indexed: 02/28/2024]
Abstract
This study investigates the impact of COVID-19 pandemic on perceived everyday discrimination using data from the 2018 and 2021 General Social Survey. The study included representative samples of 1,499 adults in 2018 and 2,361 adults in 2021 in the United States. The study found that the overall level of perceived everyday discrimination had a slight decline from 2018 to 2021. However, frequency of being threatened/harassed increased in all racial/ethnic groups and more substantially among Asian Americans and people in the "other race" category. Most social statuses had a similar association with perceived everyday discrimination in 2018 and 2021 (e.g., higher among younger age, homo/bisexual, non-Hispanic Black, U.S. born, divorced/separated). In 2018, perceived discrimination was also higher among Hispanics, people of multiple races, Jews and people of "other religions." In 2021, it was also higher among "other races" and parents who were never married. Perceived everyday discrimination was associated with all health and well-being outcomes. Also, the negative association between perceived discrimination and health and well-being appears to be stronger in 2021 than in 2018. These findings suggest that the pandemic intensified the relationship between perceived everyday discrimination and health and well-being. They point to an urgent need to develop effective efforts to mitigate the harmful impact of discrimination.
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Affiliation(s)
- Ye Luo
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, USA.
| | - Jessica Liberman
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, USA
| | - Savannah R Burke
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, USA
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Burton WM, Mumba MN. Race as a Structural Determinant of Mental Health. J Psychosoc Nurs Ment Health Serv 2024; 62:3-5. [PMID: 38315974 DOI: 10.3928/02793695-20240109-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Affiliation(s)
| | - Mercy Ngosa Mumba
- Center for Substance Use Research and Related Conditions, Capstone College of Nursing, The University of Alabama, Tuscaloosa, Alabama
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Tao X, Yip T, Fisher CB. Psychological Well-Being and Substance Use During the COVID-19 Pandemic: Ethnic/Racial Identity, Discrimination, and Vigilance. J Racial Ethn Health Disparities 2024; 11:62-71. [PMID: 36576694 PMCID: PMC9795950 DOI: 10.1007/s40615-022-01497-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/30/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Emerging evidence indicates that the COVID-19 pandemic has exacerbated mental health disparities among Black, Indigenous, and People of Color (BIPOC) through increased exposure to racism. Although ethnic/racial identity (ERI) and mental health were associated among BIPOC young adults pre-pandemic, it is unclear how these associations may differ in the exacerbated hostile racial environment of the pandemic. The current study examined the associations between ERI exploration and commitment within the context of ethnic/racial discrimination (ERD) and race-related vigilance with psychological well-being and substance use as explained by rumination. METHODS Data from a cross-sectional online survey of 450 AIAN, Asian, Black, and Latinx young adults (18-25 years) collected in April 2020 included demographic variables, standardized measures of ERI, ERD, race-related vigilance, rumination brooding and reflection, substance use, and psychological well-being. RESULTS Black respondents reported more exposure to ERD than AIAN and Asian young adults. ERI exploration and commitment were positively associated with well-being. ERI exploration, ERD, and rumination were associated with higher levels of substance use. An association between ERI exploration and more substance use and lower well-being was partially accounted for by higher levels of rumination. An association between ERI commitment and more substance use was fully accounted for by higher levels of rumination. CONCLUSIONS Although ERI exploration and commitment were associated with better psychological well-being among BIPOC young adults, a significant association was found between ERI commitment and more substance use as explained by rumination. Public health efforts should cultivate culturally sensitive mental health services to decrease rumination and its negative association with substance use and well-being.
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Affiliation(s)
- Xiangyu Tao
- Department of Psychology, Fordham University, Dealy Hall, 441 East Fordham Road, Bronx, NY, 10458, USA.
| | - Tiffany Yip
- Department of Psychology, Fordham University, Dealy Hall, 441 East Fordham Road, Bronx, NY, 10458, USA
| | - Celia B Fisher
- Department of Psychology, Fordham University, Dealy Hall, 441 East Fordham Road, Bronx, NY, 10458, USA
- Center for Ethics Education, Fordham University, Bronx, USA
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McGarity-Palmer R, Saw A, Tsoh JY, Yellow Horse AJ. Trends in Racial Discrimination Experiences for Asian Americans During the COVID-19 Pandemic. J Racial Ethn Health Disparities 2024; 11:168-183. [PMID: 36602751 PMCID: PMC9815050 DOI: 10.1007/s40615-022-01508-y] [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: 10/20/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Asian Americans (AAs) are experiencing increased rates of anti-Asian racism during COVID-19. Experiences of racism, whether personal or collective, constitute stress and psychosocial trauma that negatively impact mental and physical health. OBJECTIVES Examine subgroup differences in rates of personal experience of discrimination and COVID-related collective racism and how each is associated with mental and physical health for AAs. METHODS Nationally representative data from the 2021 Asian American and Native Hawaiian/Pacific Islander COVID-19 Needs Assessment Project were used to estimate prevalence rates of discrimination and average COVID-related collective racism scores for AAs (unweighted N = 3478). We conducted logistic and linear regression models to examine subgroup differences by sociodemographic factors. We also conducted hierarchical logistic regression models to examine associations between racism and psychological distress and health decline. RESULTS Twenty-four percent of AAs (95% CI: 21.6, 25.6) reported experiencing discrimination during the first year of the COVID-19 pandemic. Subgroup analyses revealed that Chinese, younger adults, and AAs who completed the survey in an Asian language were significantly more likely to experience discrimination compared to their counterparts. For COVID-related collective racism, subgroup analyses revealed that Chinese, women, and adults ages 25-44 were more likely to report experiences of collective racism compared to their counterparts. Both discrimination and collective racism were independently associated with negative mental and physical health. CONCLUSION Discrimination and COVID-related collective racism are associated with negative mental and physical health outcomes for AAs. Results point to vulnerable AA subgroups and the need for targeted public health efforts to address racism in the context of COVID-19.
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Affiliation(s)
- Rebecca McGarity-Palmer
- Department of Psychology, DePaul University, 2219 N. Kenmore Ave., Byrne Hall 560, Chicago, IL, 60614, USA
- Analyst Institute, Washington, DC, USA
| | - Anne Saw
- Department of Psychology, DePaul University, 2219 N. Kenmore Ave., Byrne Hall 560, Chicago, IL, 60614, USA.
- Asian American Research Center On Health (ARCH), San Francisco, USA.
| | - Janice Y Tsoh
- Asian American Research Center On Health (ARCH), San Francisco, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, USA
| | - Aggie J Yellow Horse
- Asian American Research Center On Health (ARCH), San Francisco, USA
- School of Social Transformation, Arizona State University, Tempe, USA
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Tolentino DA, Ajuwon AM. A cross-sectional study on social determinants of mental health during COVID-19 among adults in California. J Adv Nurs 2024; 80:683-691. [PMID: 37550826 DOI: 10.1111/jan.15803] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 06/19/2023] [Accepted: 07/12/2023] [Indexed: 08/09/2023]
Abstract
AIM To explore the impact of structural and intermediary social determinants of health (SDoH) on Californian adults' mental health during the early phase of the COVID-19 pandemic. DESIGN This cross-sectional study used data from the 2020 cycle of the California Health Interview Survey, the largest US state-level population health survey. METHODS Descriptive statistics and logistic regression were used to analyse the data. Using a general social determinant of health framework, we operationalized different survey questions to measure structural and intermediary determinants of mental health. RESULTS Mental health during the early phase of COVID-19 among adults in California was associated with age, gender, health conditions, delayed care, employment status (loss of job or reduced income) and discrimination. People in higher social strata were more likely to have better mental health for many of these factors. CONCLUSION This study supports the assertion that material circumstances (such as employment status) and discrimination are associated with experiencing mental health issues among adults in California during COVID-19. Racism is a public health issue, and as nurses, addressing racism is critical. In addition, much work is needed to address SDoH to improve health outcomes, especially among marginalized populations. IMPACT This study addressed the knowledge gap concerning the social determinants of mental health among Californian adults during the early phase of the COVID-19 pandemic. Those who had reduced income and those who lost their jobs during the COVID-19 pandemic were 46% and 56%, respectively, more likely to report mental health problems. Those who experienced discrimination in healthcare were 304% more likely to report mental health issues. This research will increase the understanding of the social determinants of health, particularly for those with chronic illnesses and mental health issues during the COVID-19 pandemic. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution, as we used an existing US state dataset. However, California Health Interview Survey is the largest state health survey in the United States and interviews more than 20,000 households each year representing the health care needs of Californians.
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Bernard DL, Saleem FT, Moreland AD, Shacklewood C, Danielson CK. A qualitative analysis of black mother preparation for bias messages following incidents of racism-related violence. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2024; 38:38-47. [PMID: 37917492 PMCID: PMC10842490 DOI: 10.1037/fam0001162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Preparation for bias messages (PFB), represent a specific form of racial socialization, used to inform youth about racism and how to cope with racism-related adversity. Although research commonly examines how frequently PFB are delivered to children, few studies have qualitatively explored the heterogeneity in the content of such messages, making it difficult to ascertain how caregivers prepare and coach their children to negotiate incidents of racism-related violence. To address this gap in the literature, the present study qualitatively examined the content of PFB given to Black children from their mothers following high-profile incidents of anti-Black violence. Semistructured interviews were conducted with 12 mothers (Mage = 41.91) of Black children to explore how parental concerns regarding their children's safety inform the content of their PFB. Using thematic analysis, two primary themes emerged. The first theme related to psychosocial factors among caregivers that precipitated PFB (i.e., awareness of anti-Black violence, worry about the child being a victim). The second theme pertained to the different types of PFB that caregivers provided to their children (i.e., awareness of racial biases, strategies to navigate discriminatory encounters). Overall findings support and extend extant racial socialization research and have important implications for how Black youth come to understand the significance of race and racism in the aftermath of racism-related violence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Donte L. Bernard
- Department of Psychological Sciences University of Missouri Columbia
| | | | - Angela D. Moreland
- Department of Psychiatry and Behavioral Sciences, National Crime Victims Research and Treatment Center, Medical University of South Carolina
| | | | - Carla Kmett Danielson
- Department of Psychiatry and Behavioral Sciences, National Crime Victims Research and Treatment Center, Medical University of South Carolina
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30
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ElTohamy A, Hyun S, Rastogi R, Wong GTF, Kim GS, Chae DH, Hahm H“C, Liu CH. Effect of vicarious discrimination on race-based stress symptoms among Asian American young adults during the COVID-19 pandemic. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2024; 16:217-224. [PMID: 37227832 PMCID: PMC10674031 DOI: 10.1037/tra0001480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has led to a rise in anti-Asian hate crimes in the United States. Previous work has established that experiencing racism increases one's dysfunctional anxiety and avoidance actions-key symptoms of race-based stress symptoms. However, the psychological impact of vicarious, or secondhand, discrimination (witnessing racism targeting one's own race group) remains less understood. METHOD We tested the hypothesis that higher reported vicarious discrimination would be associated with higher levels of race-based stress symptoms reported by Asian American young adults (n = 135) during the pandemic using a cross-sectional analysis of the COVID-19 Adult Resilience Experiences Study (CARES). Starting in April 2020, CARES assessed sociodemographic characteristics and key psychometric scales in young adults through three waves of online surveys. RESULTS Our multiple regression analysis showed vicarious discrimination significantly predicted race-based stress symptoms, even after controlling for direct discrimination (p < .01). This association remained significant after controlling for age, gender, subjective childhood family social status, and preexisting psychiatric disorders (p < .01). Our results demonstrate that regardless of the effect that direct discrimination might have on race-based stress symptoms, witnessing discrimination against members of one's own racial group is significantly associated with increased race-based stress symptoms (b = 2.68, p < .01). Social media was the most common source of vicarious discrimination, with one out of three participants in our sample reporting nearly daily exposure. CONCLUSION Providers should intentionally create a space within the therapeutic setting to discuss the effects of vicarious discrimination. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Abdelrahman ElTohamy
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
- Department of Psychiatry, Brigham and Women’s Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
| | - Sunah Hyun
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Ritika Rastogi
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Ga Tin Finneas Wong
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Grace S. Kim
- Wheelock College of Education & Human Development, Boston University, 2 Silber Way, Boston, MA, 02215, USA
| | - David H. Chae
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Hyeouk “Chris” Hahm
- School of Social Work, Boston University, 264 Bay State Rd, Boston, MA, 02215, USA
| | - Cindy H. Liu
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
- Department of Psychiatry, Brigham and Women’s Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
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Liu S, Curenton SM, Sims J, Fisher PA. The promotive and protective effects of parents' perceived changes during the COVID-19 pandemic on emotional well-being among U.S. households with young children: an investigation of family resilience processes. Front Psychol 2024; 14:1270514. [PMID: 38259548 PMCID: PMC10800496 DOI: 10.3389/fpsyg.2023.1270514] [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: 07/31/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction The COVID-19 pandemic may constitute a traumatic event for families with young children due to its acute onset, the unpredictable and ubiquitous nature, and the highly distressing disruptions it caused in family lives. Despite the prevalent challenges such as material hardships, child care disruptions, and social isolation, some families evinced remarkable resilience in the face of this potentially traumatic event. This study examined domains of changes perceived by parents of young children that were consistent with the post-traumatic growth (PTG) model as factors that facilitate family resilience processes. Methods This study drew data from the RAPID project, a large ongoing national study that used frequent online surveys to examine the pandemic impact on U.S. households with young children. A subsample of 669 families was leveraged for the current investigation, including 8.07% Black, 9.57% Latino(a), 74.44% non-Latino(a) White families, and 7.92% households of other racial/ethnic backgrounds. In this subsample, 26.36% were below 200% federal poverty level. Results Approximately half of the parents reported moderate-to-large degrees of changes during the pandemic, and the most prevalent domain of change was appreciation of life, followed by personal strengths, new possibilities, improved relationships, and spiritual growth. Black and Latino(a) parents reported more changes in all five domains than White parents and more spiritual growth than parents of the other racial/ethnic groups. Moreover, parent-reported improved relationships were found to indirectly reduce young children's overall fussiness/defiance and fear/anxiety symptoms through reducing parents' emotional distress. Perceived changes in the new possibilities, personal strengths, and appreciation of life domains were found to serve as protective factors that buffered the indirect impacts of material hardship mean levels on child behavioral symptoms via mitigating parents' emotional distress. Discussion These findings shed light on resilience processes of a family system in a large-scale, disruptive, and stressful socio-historical event such as the COVID-19 pandemic. The five PTG domains could inform therapeutic and intervention practices in the face of future similar events. Importantly, these findings and the evinced family resilience should not negate the urgent needs of policy and program efforts to address material hardships, financial instabilities, and race/ethnicity-based structural inequalities for families of young children.
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Affiliation(s)
- Sihong Liu
- Stanford Center on Early Childhood, Stanford University, Stanford, CA, United States
| | - Stephanie M. Curenton
- Center on Ecology of Early Development, Boston University, Boston, MA, United States
| | - Jacqueline Sims
- Center on Ecology of Early Development, Boston University, Boston, MA, United States
| | - Philip A. Fisher
- Stanford Center on Early Childhood, Stanford University, Stanford, CA, United States
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Kim Y, Beale AM, Rasmussen HF, Kazmierski KFM, Margolin G. Anti-Black violence, discrimination, and sleep difficulties amongst racially diverse Americans: The aftermath of the murder of George Floyd. Soc Sci Med 2024; 340:116410. [PMID: 38016308 DOI: 10.1016/j.socscimed.2023.116410] [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: 02/19/2022] [Revised: 09/06/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Abstract
RATIONALE Following the murders of George Floyd and other Black Americans during the summer of 2020, there was unprecedented exposure to media-disseminated depictions of anti-Black violence. Little is known about the impact of this widespread form of vicarious racism that was pervasive during that historic time. OBJECTIVE The present study applies the concept of vicarious racism to study this secondary exposure to anti-Black violence. We investigated negative impacts of anti-Black violence (NIAV) and personal experiences with discrimination in association with sleep difficulties, a critical intermediary health process. METHODS Racially diverse Americans (N = 487) were recruited to participate in a cross-sectional study using an online survey given between December 11, 2020 and February 11, 2021. RESULTS Black participants endorsed greater NIAV than Asian, Latinx, and White participants. Moreover, Black, Asian, and Latinx participants reported greater direct discrimination than White participants. NIAV and direct discrimination were each associated with more sleep difficulties. Although associations between NIAV and sleep difficulties did not vary by race, race moderated the association between direct discrimination and sleep difficulties. In addition, direct discrimination moderated the association between NIAV and sleep difficulties in an unanticipated direction: the link between NIAV and sleep difficulties was weaker for those experiencing more direct discrimination. CONCLUSION Findings suggest that anti-Black violence and police brutality not only impact direct victims but have widespread vicarious impacts on racially diverse Americans, and highlight that vicarious anti-Black racism and discrimination are important issues of public health.
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Affiliation(s)
- Yehsong Kim
- University of Southern California, 3620 South McClintock Ave, SGM 501, Los Angeles, CA, 90089, USA.
| | - Alexis M Beale
- University of Southern California, 3620 South McClintock Ave, SGM 501, Los Angeles, CA, 90089, USA.
| | - Hannah F Rasmussen
- University of Southern California, 3620 South McClintock Ave, SGM 501, Los Angeles, CA, 90089, USA.
| | - Kelly F M Kazmierski
- University of California, Irvine, 4201 Social & Behavioral Sciences Gateway, University of California Irvine, Irvine, CA, 92697, USA.
| | - Gayla Margolin
- University of Southern California, 3620 South McClintock Ave, SGM 501, Los Angeles, CA, 90089, USA.
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Cooper J, Theivendrampillai S, Lee T(T, Marquez C, Lau MWK, Straus SE, Fahim C. Exploring perceptions and experiences of stigma in Canada during the COVID-19 pandemic: a qualitative study. BMC GLOBAL AND PUBLIC HEALTH 2023; 1:26. [PMID: 38798820 PMCID: PMC11116254 DOI: 10.1186/s44263-023-00020-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/13/2023] [Indexed: 05/29/2024]
Abstract
Background The COVID-19 pandemic fueled stigmatization and discrimination, particularly towards individuals of Chinese or East Asian ethnicity. We conducted interviews with members of the public in Canada in order to describe and understand stigma perceptions and experiences during the COVID-19 pandemic. Methods We used a phenomenological approach to describe stigma experiences of Canadian residents during the COVID-19 pandemic and compared the stigma perceptions and experiences of East Asian and non-East Asian individuals. Participants were invited to take part in a single, semi-structured interview. The interview guide was rooted in the Health Stigma and Discrimination Framework (HSDF). Interviews were conducted in English, Mandarin, and Cantonese. Following participant consent, interviews were audio recorded and transcribed verbatim. Data were double coded and analyzed using qualitative content analysis guided by a framework approach. Results A total of 55 interviews were conducted between May and December 2020. Fifty-five percent of the sample identified as East Asian, 67.3% identified as women, and mean age was 52 years (range 20-76). Fear of infection, fear of social and economic ramifications, and blame for COVID-19 were reported drivers of stigma. Participants described preexisting perceptions on cultural norms and media influence as facilitators of stigma that propagated harmful stereotypes, particularly against Chinese and East Asian individuals. Participants observed or experienced stigmatization towards place of residence, race/ethnicity, culture, language, occupation, and age. Stigma manifestations present in the public and media had direct negative impacts on East Asian, particularly Chinese, participants, regardless of whether or not they personally experienced discrimination. Conclusions We used the HSDF as a rooting framework to describe perceptions and impact of stigma, particularly as they related to race/ethnicity-based stigmatization in Canada. Participants reported a number of drivers and facilitators of stigma that impacted perceptions and experiences. These findings should be used to develop sustained strategies to mitigate stigma during public health emergencies or other major crises. Supplementary Information The online version contains supplementary material available at 10.1186/s44263-023-00020-7.
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Affiliation(s)
- Jeanette Cooper
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 209 Victoria Street, Toronto, M5B 1T8 Canada
| | - Suvabna Theivendrampillai
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 209 Victoria Street, Toronto, M5B 1T8 Canada
| | - Taehoon (Tom) Lee
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 209 Victoria Street, Toronto, M5B 1T8 Canada
| | - Christine Marquez
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 209 Victoria Street, Toronto, M5B 1T8 Canada
| | - Michelle Wai Ki Lau
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 209 Victoria Street, Toronto, M5B 1T8 Canada
| | - Sharon E. Straus
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 209 Victoria Street, Toronto, M5B 1T8 Canada
| | - Christine Fahim
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 209 Victoria Street, Toronto, M5B 1T8 Canada
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Daniels KP, D Thomas M, Chae DH, Allen AM. Black Mothers' Concern for Their Children as a Measure of Vicarious Racism-Related Vigilance and Allostatic Load. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2023; 64:520-536. [PMID: 37332176 DOI: 10.1177/00221465231175942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
This study investigates the relationship between allostatic load and a novel form of altruistic racism-related fear, or concern for how racism might harm another, which we term vicarious racism-related vigilance. Using a subsample of Black mothers from the African American Women's Heart & Health Study (N = 140), which includes detailed health and survey data on a community sample of Black women in the San Francisco Bay Area, this study investigates the relationship between Black mothers' experiences with racism-related vigilance as it relates to their children and allostatic load-a multisystem metric of underlying health across multiple biological systems. Findings indicate that vicarious racism-related vigilance was positively associated with allostatic load (i.e., worse health). Findings highlight the salience of vicarious racism-related vigilance for the health of Black mothers, underscoring how intersections between race, gender, and parenthood result in susceptibility to unique forms of health-harming stress.
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Hennein R, Tiako MJN, Bonumwezi J, Tineo P, Boatright D, Crusto C, Lowe SR. Vicarious Racism, Direct Racism, and Mental Health Among Racialized Minority Healthcare Workers. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01844-7. [PMID: 37935947 DOI: 10.1007/s40615-023-01844-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/03/2023] [Accepted: 10/17/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Racism-related stress is a root cause of racial and ethnic disparities in mental health outcomes. An individual may be exposed to racism directly or vicariously by hearing about or observing people of the same racial and/or ethnic group experience racism. Although the healthcare setting is a venue by which healthcare workers experience both direct and vicarious racism, few studies have assessed the associations between direct and vicarious racism and mental health outcomes among healthcare workers. METHODS In this cross-sectional study, we assessed the relationships between direct and vicarious racism and symptoms of posttraumatic stress, depression, and anxiety among healthcare workers in the USA in 2022. RESULTS Our sample consisted of 259 healthcare workers identifying as a racialized minority, including 68 (26.3%) who identified as mixed-race, 61 (23.6%) East Asian, 36 (13.9%) Black, 33 (12.7%) South Asian, 22 (8.5%) Southeast Asian, 21 (8.1%) Middle Eastern/North African, and 18 (6.9%) another race. The mean age was 37.9 years (SD 10.1). In multivariable linear regression models that adjusted for demographics, work stressors, and social stressors, we found that increased reporting of vicarious racism was associated with greater symptoms of anxiety (B = 0.066, standard error = 0.034, p = .049). We did not identify significant relationships between vicarious and direct racism and symptoms of posttraumatic stress or depression in the fully adjusted models. CONCLUSIONS Our findings should be considered by academic health systems to mitigate the negative impact of racism on healthcare workers' mental health.
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Affiliation(s)
- Rachel Hennein
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College St, New Haven, CT, USA.
- Yale School of Medicine, New Haven, CT, USA.
| | | | - Jessica Bonumwezi
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Petty Tineo
- Department of Psychology, Montclair State University, Montclair, NJ, USA
| | - Dowin Boatright
- Department of Emergency Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Cindy Crusto
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychology, University of Pretoria, Pretoria, South Africa
| | - Sarah R Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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Johnson S, Quick KN, Rieder AD, Rasmussen JD, Sanyal A, Green EP, Duerr E, Nagy GA, Puffer ES. Social Vulnerability, COVID-19, Racial Violence, and Depressive Symptoms: a Cross-sectional Study in the Southern United States. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01831-y. [PMID: 37884856 DOI: 10.1007/s40615-023-01831-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 09/21/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND In March 2020, the novel 2019 coronavirus disease (COVID-19) was declared a pandemic. In May 2020, George Floyd was murdered, catalyzing a national racial reckoning. In the Southern United States, these events occurred in the context of a history of racism and high rates of poverty and discrimination, especially among racially and ethnically minoritized populations. OBJECTIVES In this study, we examine social vulnerabilities, the perceived impacts of COVID-19 and the national racial reckoning, and how these are associated with depression symptoms in the South. METHODS Data were collected from 961 adults between June and November 2020 as part of an online survey study on family well-being during COVID-19. The sample was majority female (87.2%) and consisted of 661 White participants, 143 Black participants, and 157 other racial and ethnic minoritized participants. Existing social vulnerability, perceived impact of COVID-19 and racial violence and protests on families, and depressive symptoms were assessed. Hierarchical regression analysis was used to predict variance in depressive symptoms. RESULTS Half of the sample (52%) reported a negative impact of COVID-19, and 66% reported a negative impact of national racial violence/protests. Depressive symptoms were common with 49.8% meeting the cutoff for significant depressive symptoms; Black participants had lower levels of depressive symptoms. Results from the hierarchical regression analysis indicate social vulnerabilities and the perceived negative impact of COVID-19 and racial violence/protests each contribute to variance in depressive symptoms. Race-specific sensitivity analysis clarified distinct patterns in predictors of depressive symptoms. CONCLUSION People in the South report being negatively impacted by the confluence of the COVID-19 pandemic and the emergence of racial violence/protests in 2020, though patterns differ by racial group. These events, on top of pre-existing social vulnerabilities, help explain depressive symptoms in the South during 2020.
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Affiliation(s)
- Savannah Johnson
- Duke University, Durham, NC, USA.
- Duke Global Health Institute, Durham, NC, USA.
| | - Kaitlin N Quick
- Duke Global Health Institute, Durham, NC, USA
- University of North Carolina at Greensboro, Greensboro, NC, USA
| | | | - Justin D Rasmussen
- Duke University, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | | | | | | | | | - Eve S Puffer
- Duke University, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
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Jones G, Castro-Ramirez F, McGuire T, Al-Suwaidi M, Herrmann F. A Digital Music-Based Mindfulness Intervention ("healing attempt") for Race-Based Anxiety in Black Americans. J Med Internet Res 2023; 25:e51320. [PMID: 37824179 PMCID: PMC10603556 DOI: 10.2196/51320] [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: 07/27/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
This study replicates and extends findings that "healing attempt"-a brief digital music-based mindfulness intervention-represents a feasible and potentially effective intervention for race-based anxiety in the Black community.
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Affiliation(s)
- Grant Jones
- Department of Psychology, Harvard University, Cambridge, MA, United States
| | | | - Taylor McGuire
- Department of Psychology, Harvard University, Cambridge, MA, United States
| | - Maha Al-Suwaidi
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Felipe Herrmann
- Department of Psychology, Harvard University, Cambridge, MA, United States
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Lam CN, Tam B, Kawaguchi ES, Unger JB, Hur K. The Differential Experience of COVID-19 on Asian American Subgroups: The Los Angeles Pandemic Surveillance Cohort Study. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01742-y. [PMID: 37819411 DOI: 10.1007/s40615-023-01742-y] [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: 02/14/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 10/13/2023]
Abstract
Data from Asian Americans (AsA) are commonly aggregated in research studies and reporting, obscuring the significant differences across AsA subgroups. We investigated the differential experience of AsA subgroups in COVID-19 testing, vaccination, engagement in risky and protective behaviors and mental health status against this infectious disease. We surveyed a representative sample of the Los Angeles County population (N = 5500) in April 2021 as part of the Los Angeles Pandemic Surveillance Cohort Study and focused on participants who self-identified as AsA (N = 756). There were significant differences across the AsA subgroups, with Koreans, Asian Indians, and Other Asians living in areas with higher COVID-19 mortality rates, and Asian Indians demonstrating the lowest proportion of COVID-19 vaccination. Vietnamese and Koreans had a higher proportion of becoming unemployed during the pandemic. Although the AsA sample on average demonstrated better outcomes than other racial and ethnic groups, the apparent advantages were heterogenous and due to specific subgroups of AsAs rather than AsAs as a whole. The observed differences in COVID-19 measures across AsA subgroups underscore the need to disaggregate AsA data to identify and reduce existing disparities.
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Affiliation(s)
- Chun Nok Lam
- Department of Emergency Medicine, Keck School of Medicine of USC, 1200 N State Street, Room 1011, Los Angeles, CA, 90033, USA.
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, 1845 N Soto Street, Los Angeles, CA, 90032, USA.
| | - Benjamin Tam
- Caruso Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine of USC, Los Angeles, USA
| | - Eric S Kawaguchi
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, 1845 N Soto Street, Los Angeles, CA, 90032, USA
| | - Jennifer B Unger
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, 1845 N Soto Street, Los Angeles, CA, 90032, USA
| | - Kevin Hur
- Caruso Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine of USC, Los Angeles, USA
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Brannon TN. Racism hurts, can antiracism heal?: Positive mental health correlates of antiracist engagement. PNAS NEXUS 2023; 2:pgad309. [PMID: 37799326 PMCID: PMC10548497 DOI: 10.1093/pnasnexus/pgad309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 09/11/2023] [Indexed: 10/07/2023]
Abstract
Racism can hurt by negatively impacting mental health. For instance, large-scale events tied to racism like the May 2020 police-involved murder of George Floyd have been linked to poor mental health indicators (e.g. depression and anxiety). Notably, racism can spark antiracist engagement-support for addressing systemic racism. For example, Floyd's murder sparked unprecedented antiracist engagement, including heightened Black Lives Matter (BLM) support and protest participation. The present research explored the potential that antiracist engagement can heal: be positively associated with well-being. First, study 1 found that state-level BLM engagement (i.e. protest numbers, antiracism information-seeking on Google/YouTube) during an 8-week period following Floyd's death was associated with positive mental health indicators (i.e. lower depression and anxiety, higher self-rated health). It found these effects among racial/ethnic minorities (e.g. Black/African Americans, Hispanics, N = 161,359) and Whites (N = 516,002). Then, study 2 examined social media data (i.e. tweets) and emotional well-being. It used a measure of happiness indexed across 144,649,285,571 tweets from 2019 through 2021. It found a positive correlation between the volume of tweets with antiracist engagement content (e.g. referenced efforts to address systemic racism) and the happiness measure. Finally, study 3 examined antiracism protest data/information-seeking and a sample of BLM tweets (N = 100,321) posted between April and July 2020. Conceptually replicating studies 1-2, study 3 found that antiracist engagement was associated with greater positive emotion/sentiment (e.g. happiness) relative to negative emotion/sentiment (e.g. anxiety). Relevant to theory and policy, the observed results suggest that antiracist engagement can be associated with benefits for well-being across racial/ethnic groups.
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Affiliation(s)
- Tiffany N Brannon
- Department of Psychology, University of California, Los Angeles (UCLA), 1285 Franz Hall, Los Angeles, CA 90095, USA
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Hennein R, Tiako MJN, Tineo P, Lowe SR. Development and Validation of the Vicarious Racism in Healthcare Workers Scale. J Racial Ethn Health Disparities 2023; 10:2496-2504. [PMID: 36287336 PMCID: PMC9607839 DOI: 10.1007/s40615-022-01430-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 10/31/2022]
Abstract
Vicarious racism occurs when hearing about or observing people of the same racial and/or ethnic group experience racism. Healthcare workers may face unique experiences of vicarious racism through witnessing or hearing about racism that their patients and colleagues face. However, there are no validated measures of vicarious racism for the healthcare worker population. In this study, we developed and conducted an initial evaluation of the Vicarious Racism in Healthcare Workers Scale. We developed the 12-item scale based on a qualitative study exploring the experiences of racism among healthcare workers and existing literature on the topic. We administered the scale to a cohort of 259 healthcare workers identifying as a racialized minority to evaluate its factor structure, internal consistency, and construct validity. Factor analysis yielded two factors: racism in social networks and racism in society at-large. This two-factor solution had good model fit (standardized root mean square residual = 0.061). The internal consistencies of the overall scale, social networks subscale, and society subscale were excellent (α = 0.93, 0.92, and 0.89, respectively). We found evidence in support of convergent validity; scale scores were higher among Black healthcare workers compared with non-Black healthcare workers and those with greater social support needs. Scale scores were positively correlated with directly experienced racism and symptoms of posttraumatic stress, depression, and anxiety. The scale demonstrated discriminant validity; scale scores did not differ based on gender or job. The Vicarious Racism in Healthcare Workers Scale demonstrated favorable psychometric properties and may be used to assess vicarious racism in this population.
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Affiliation(s)
- Rachel Hennein
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College St, New Haven, CT, 06511, USA.
- Yale School of Medicine, 333 Cedar St, New Haven, CT, 06511, USA.
| | | | - Petty Tineo
- Department of Psychology, Montclair State University, 1 Normal Ave, Montclair, NJ, 07043, USA
| | - Sarah R Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College St, New Haven, CT, 06511, USA
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Ho IK, Çabuk K. The impact of racial discrimination on the health of Asian Americans during the COVID-19 pandemic: a scoping review. ETHNICITY & HEALTH 2023; 28:957-982. [PMID: 37160688 DOI: 10.1080/13557858.2023.2208312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 04/24/2023] [Indexed: 05/11/2023]
Abstract
ABSTRACTObjective: Cases of discrimination and hate crimes against Asian Americans have surged ever since the beginning of the COVID-19 pandemic, with deleterious effects. This scoping review synthesizes the literature on how pandemic-related discrimination is associated with the health of Asian Americans.Design: First, application search terms were entered into selected databases. Next, using a set of inclusion criteria, the articles were screened and assessed for eligibility. Data from the selected articles were extracted and summarized to answer the research questions.Results: Thirty-five studies were included. Almost all the studies examined psychological well-being. The remaining studies examined physical and workplace well-being. All the studies found that discrimination was associated with poorer health outcomes.Conclusion: Further research is needed to address the gaps in knowledge about how pandemic-related discrimination is associated with various domains of health among Asian Americans.
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Affiliation(s)
- Ivy K Ho
- Department of Psychology, University of Massachusetts Lowell, Lowell, MA, USA
| | - Kübra Çabuk
- Department of Psychology, University of Massachusetts Lowell, Lowell, MA, USA
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Cook SH, Wood EP, Risner E, Weng CA, Xin Y. A national examination of discrimination, resilience, and depressive symptoms during the COVID-19 pandemic: the All of Us Research Program. Front Psychol 2023; 14:1175452. [PMID: 37823074 PMCID: PMC10562571 DOI: 10.3389/fpsyg.2023.1175452] [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: 02/27/2023] [Accepted: 09/11/2023] [Indexed: 10/13/2023] Open
Abstract
Objective To examine the impact of resilience on the association between discrimination and trajectories of depressive symptoms during the COVID-19 pandemic across racial and ethnic groups. Methods Data were drawn from 5 waves of the All of Us Research Program's survey on the impact of COVID-19 on the lives of American adults. Linear mixed-effects models were fitted to assess the association between discrimination exposure throughout the pandemic and depressive symptoms over time. An interaction term was introduced between resilience and discrimination exposure to assess if resilience buffered the association between discrimination and depressive symptoms over time. Race-stratified linear mixed-effects models examined racial/ethnic differences in the association between resilience, discrimination, and depressive symptoms over time. Results Fifty-one thousand nine hundred fifty-eight participants completed surveys between May and December of 2020. Results indicated that exposure to more discrimination was associated with increasing trajectories of depressive symptoms over time (b = 0.48, p < 0.001). However, resilience moderated the association between discrimination and well-being over time such that higher resilience mitigated the detrimental effect of experiencing discrimination on depressive symptoms across time (b = -0.02, p < 0.001). Conclusion Identifying protective features such as resilience can promote the development of culturally tailored interventions to address mental health in the context of discrimination.
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Affiliation(s)
- Stephanie H. Cook
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, United States
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, United States
| | - Erica P. Wood
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, United States
| | - Emma Risner
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, United States
| | - Chenziheng Allen Weng
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, United States
| | - Yao Xin
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, United States
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Quinn EB, Ross JD, Boston PQ, Committee HS, Mulligan CJ, Gravlee CC. The social patterning of vicarious discrimination: Implications for health equity. Soc Sci Med 2023; 332:116104. [PMID: 37517313 DOI: 10.1016/j.socscimed.2023.116104] [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: 02/13/2023] [Revised: 05/26/2023] [Accepted: 07/18/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Most research on discrimination and health operationalizes discrimination as direct individual experiences. Here, we examine the social patterning of vicarious discrimination, an important but largely overlooked dimension of discrimination. METHODS Drawing on community-based participatory research with a multi-stage probability sample (n = 178) of African Americans in Tallahassee, Florida, we measured vicarious discrimination, or exposure to discrimination through one's family and friends. We used chi-square tests to examine gender differences in the social domains and relational sources of vicarious discrimination. Negative binomial regression models were fit to identify predictors of exposure to vicarious discrimination. RESULTS Vicarious discrimination is more prevalent than direct experiences of discrimination (73 versus 61%) and more than 20% of participants report vicarious discrimination in the absence of direct discrimination. For women, vicarious discrimination most often involved the workplace; for men, police. However, gender differences are smaller for vicarious versus direct discrimination. Close friends and children were top relational sources of vicarious discrimination for men and women, respectively. Middle-aged participants reported the most vicarious discrimination. CONCLUSIONS Overall, our data show that vicarious discrimination is more common than widely understood and associated with individual-level sociodemographic characteristics that index one's position in broader social systems. The prevalence of vicarious discrimination in the absence of direct discrimination suggests that standard approaches, which measure individual exposures in isolation, are subject to misclassification bias. Our results imply that existing research on discrimination and health, which already demonstrates substantial harm, underestimates African Americans' true exposures to salient aspects of discrimination.
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Affiliation(s)
- Edward B Quinn
- Department of Anthropology, University of Florida, Gainesville, FL 32611, USA; Genetics Institute, University of Florida, Gainesville, FL 32608, USA.
| | - Jessica D Ross
- Department of Biology, University of Florida, Gainesville, FL 32611, USA
| | - P Qasimah Boston
- Tallahassee Food Network, Institute of Public Health, Florida A&M University, Tallahassee, FL 32307, USA
| | | | - Connie J Mulligan
- Department of Anthropology, University of Florida, Gainesville, FL 32611, USA; Genetics Institute, University of Florida, Gainesville, FL 32608, USA
| | - Clarence C Gravlee
- Department of Anthropology, University of Florida, Gainesville, FL 32611, USA; Genetics Institute, University of Florida, Gainesville, FL 32608, USA
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Louie-Poon S, Chiu P, Kung JY. Asian Healthcare Workers and Their Experiences of Racism in North America: A Scoping Review. Can J Nurs Res 2023; 55:279-291. [PMID: 36959748 PMCID: PMC10416554 DOI: 10.1177/08445621231166101] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND The rising rates of anti-Asian sentiments has recently been called into question by several community activists and scholars. While this collective work has heightened awareness to address anti-Asian racism, the experiences of Asian healthcare workers in particular remains limited. PURPOSE To map the existing literature on anti-Asian racism experienced by Asian healthcare workers in North American healthcare settings, identify gaps in the current literature base, and inform future areas of anti-Asian racism research. METHODS A scoping review following Arksey and O'Malley's (2005) methodology with updated guidance by Levac et al. (2010) and Peters et al. (2020) was undertaken. FINDINGS A total of 3565 articles from database searches were identified from eight databases, with 64 full text articles screened and 15 articles included in this review. Anti-Asian racism amongst healthcare workers has been conceptualized, studied, and understood in three broad categories: levels of racism, descriptions of anti-Asian racism, and the impact of racism. In 60% of the included articles, interpersonal level of racism was solely studied, while 40% articles simultaneously studied interpersonal and institutional levels of racism. Anti-Asian racism was described through three key perspectives: otherness, inferior professional status, and general racial discrimination. Lastly, the impact of Asian healthcare workers' experiences of anti-Asian racism was studied by exploring the impact on mental health and barriers to career advancement. CONCLUSION Despite the presence of anti-Asian racism, the limited literature examining the complexities of the experiences of anti-Asian racism for Asian healthcare workers is concerning. Future scholarship requires further investigation that comprehensively explores the multiple pathways of anti-Asian racism, the contestation of monolithic stereotypes, and how Asian healthcare workers negotiate both hypervisibility and invisibility within healthcare spaces.
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Affiliation(s)
| | - Patrick Chiu
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Janice Y. Kung
- John W. Scott Health Sciences Library, University of Alberta, Edmonton, AB, Canada
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Duncan MJ, Mitchell J, Riazi NA, Belita E, Vanderloo LM, Carsley S, Carson V, Chaput JP, Faulkner G, Leatherdale ST, Patte KA. Sleep duration change among adolescents in Canada: Examining the impact of COVID-19 in worsening inequity. SSM Popul Health 2023; 23:101477. [PMID: 37593229 PMCID: PMC10428109 DOI: 10.1016/j.ssmph.2023.101477] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/19/2023] Open
Abstract
Purpose The purpose of this study was to assess if adolescent sub-populations in Canada (i.e., based on race/ethnicity, sex/gender, socioeconomic status, and urbanicity groups) experienced a larger change in sleep duration and guideline adherence between 2019 and 2020 (pre-pandemic) and the 2020-2021 (mid-pandemic) school years. Methods Longitudinally linked data from 2019 to 2020 (pre-pandemic) and 2020-2021 (mid-pandemic) of a prospective cohort study of secondary school students (M = 14.2, SD = 1.3 years, N = 8209) in Canada were used for analyses. Regression modelling tested the main effects of race/ethnicity, sex/gender, socioeconomic status, and urbanicity on changes in sleep duration as well as adherence to Canada's 24-h Movement Guidelines for sleep (8-10 h/night). Interactions between identity variables (race/ethnicity or sex/gender) and other main effect variables were subsequently tested. Results Females gained more sleep (4.5 [1.5, 7.5] min/day more) and increased guideline adherence (AOR = 1.16 [1.04, 1.30] than males on average. Asian race/ethnic identity was associated with less sleep gain than White identity -10.1 [-19.4, -0.8], but not guideline adherence. Individuals in large urban areas gained less sleep and adhered less to guidelines than individuals from any other level of urbanicity (-21.4 [-38.5, -4.2] to -15.5 [-30.7, -0.2] min/day). Higher individual SES scores were associated with greater sleep gain (linear trend: 11.16 [1.2-21.1]). The discrepancies in sleep gain and guideline adherence between males and females were significantly modified by race/ethnicity and urbanicity. Discussion Increases in sleep duration may be one of the few benefits to adolescents during the COVID-19 pandemic but were not equally distributed across sub-populations. Efforts to promote better sleep adherence may need to account for sex/gender differences, especially in less urbanized areas and certain racial/ethnic groups.
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Affiliation(s)
- Markus J. Duncan
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, Saint Catharines, ON, L2S 3A1, Canada
| | - Jessica Mitchell
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, Saint Catharines, ON, L2S 3A1, Canada
| | - Negin A. Riazi
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, Saint Catharines, ON, L2S 3A1, Canada
| | - Emily Belita
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Leigh M. Vanderloo
- Child Health Evaluative Sciences, The Hospital for Sick Children, 686 Bay St, Toronto, ON, M5G 0A4, Canada
- Department of Science and Evaluation, ParticiPACTION, 77 Bloor St West, Suite 1205, Toronto, ON, M5S 1M2, Canada
| | - Sarah Carsley
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, M5G 1V2, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Room 500, Toronto, ON, M5T 3M7, Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 8840 114 St., Edmonton, AB, T6G 2H9, Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
- Department of Pediatrics, University of Ottawa, 75 Laurier Ave. East, Ottawa, ON, K1N 6N5, Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Lower Mall Research Station, 2259 Lower Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Scott T. Leatherdale
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| | - Karen A. Patte
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, Saint Catharines, ON, L2S 3A1, Canada
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Hamilton-Moseley KR, Phan L, Hacker KJ, Jewett BJ, Ajith AU, Chen-Sankey J, Choi K. Racial/Ethnic Disparities in Vicarious and Direct COVID-19-Related Discrimination and Vigilance. Am J Prev Med 2023; 65:439-447. [PMID: 36963472 PMCID: PMC10033145 DOI: 10.1016/j.amepre.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 03/17/2023] [Accepted: 03/17/2023] [Indexed: 03/24/2023]
Abstract
INTRODUCTION The high visibility of COVID-19-related discrimination underscores the importance of understanding the psychological harms associated with vicariously and directly experiencing such incidents. In this observational study, both vicariously and directly experienced COVID-19-related discrimination and their association with heightened concerns about discrimination and vigilance were examined in U.S. adults who use commercial tobacco. METHODS Data were from a nationally representative sample of adults who currently or formerly used commercial tobacco products (N=1,700; mean age=43 years) from an online survey panel administered in January-February 2021 (analyzed in 2021-2022). Participants reported vicariously and directly experienced COVID-19-related discrimination, concern about experiencing such discrimination, and heightened vigilance. Weighted multivariable linear and logistic regression models were used to examine the associations among these variables. RESULTS Overall, 69% of individuals reported exposure to vicarious COVID-19-related discrimination, and 22% reported directly experiencing COVID-19-related discrimination. Asian, Hispanic, and Black individuals reported higher levels of concern and vigilance than White individuals (p<0.05). Vicariously and directly experienced COVID-19-related discrimination was independently associated with concern about experiencing COVID-19-related discrimination in the entire sample and within each racial and ethnic group (p<0.05). This concern was associated with increased vigilance (p<0.05) and was stronger in those exposed to vicarious COVID-19-related discrimination than in those who were not (p<0.05). CONCLUSIONS COVID-19-related discrimination may undermine the psychological well-being of those who are exposed to it vicariously as well as those who experience it directly and may also make individuals feel vulnerable and unsafe. Interventions to prevent and reduce the impact of COVID-19-related discrimination may have wide-reaching societal benefits.
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Affiliation(s)
- Kristen R Hamilton-Moseley
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland.
| | - Lilianna Phan
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland
| | - Kiana J Hacker
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland
| | - Bambi J Jewett
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland
| | - Aniruddh U Ajith
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Julia Chen-Sankey
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey; Department of Health Behavior, Society and Policy, School of Public Health, Rutgers University, Piscataway, New Jersey
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland
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Hagiwara N, Shipman-Lacewell J, Smith D, Jones HA, Green TL, Belgrave F, Valrie C. Personal- vs. Group-Level Discrimination and Physical and Mental Health Outcomes Among Black Adolescents. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01758-4. [PMID: 37624537 DOI: 10.1007/s40615-023-01758-4] [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: 04/28/2023] [Revised: 08/07/2023] [Accepted: 08/10/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND The negative health consequences of personal experiences of racial discrimination (personal-level discrimination) has been well-documented across developmental stages, including adolescence, in Black individuals. There is also some evidence suggesting perceiving other Black individuals experiencing racial discrimination (group-level discrimination) can protect one's health in Black adults. METHODS This study examined the role of personal- and group-level discrimination in Black adolescent health. The study was a secondary analysis of survey data collected from 186 Black adolescents that included reports of discrimination, physical function, anxiety, and depression. RESULTS Black adolescents who reported greater, as opposed to lower, personal-level discrimination were more likely to experience poorer physical and mental health outcomes. While group-level discrimination was also associated with physical health outcomes, it was not directly associated with mental health outcomes. Importantly, across all three health outcomes, awareness of group-level discrimination mitigated the negative health consequences of personal-level discrimination. Among adolescents who reported low levels of group-level discrimination, personal-level discrimination was associated negatively with physical function and positively with anxiety and depressive symptoms. Among adolescents who reported high levels of group-level discrimination, there was no association between personal-level discrimination and any of the health outcomes. DISCUSSION Consistent with prior research with Black adults, awareness of high group-level discrimination may protect Black adolescents from the negative health consequences of personal-level discrimination. The pattern of the results is also consistent with the literature of the personal-group discrimination discrepancy (PGDD) and psychological wellbeing. Future research should investigate the psychological mechanisms implicated in PGDD (e.g., external attribution of discrimination and intragroup comparison) as potential coping strategies for Black adolescents against the negative health consequences of personal-level discrimination.
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Affiliation(s)
- Nao Hagiwara
- University of Virginia, Charlottesville, VA, USA.
| | | | - Danyel Smith
- University of Virginia, Charlottesville, VA, USA
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Jones G, Herrmann F, Nock MK. A Digital Music-Based Mindfulness Intervention for Black Americans With Elevated Race-Based Anxiety: A Multiple-Baseline Pilot Study. JMIR Form Res 2023; 7:e49284. [PMID: 37585252 PMCID: PMC10468709 DOI: 10.2196/49284] [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: 05/24/2023] [Revised: 06/26/2023] [Accepted: 07/19/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Race-based anxiety is a substantial health issue for the Black community. Although mindfulness interventions have demonstrated efficacy for alleviating anxiety, three central barriers prevent Black Americans from accessing existing mindfulness treatments: high costs, excessive time commitments, and limited cultural relevance. There is a need for novel mindfulness interventions for the Black community that can overcome these barriers. OBJECTIVE The goal of this web-based study was to examine the preliminary efficacy, feasibility, and acceptability of a novel digital music-based mindfulness intervention for middle-to-low-income Black Americans with elevated race-based anxiety. METHODS This study used a nonconcurrent multiple-baseline design (n=5). The intervention featured contributions from Lama Rod Owens (a world-renowned meditation teacher and LA Times best-selling author) and Terry Edmonds (the former chief speechwriter for President Bill Clinton). We examined the effect of the intervention on state anxiety and assessed its feasibility and acceptability using quantitative and qualitative measures. RESULTS Results revealed that administration of the intervention led to significant decreases in state anxiety (Tau-U range -0.75 to -0.38; P values<.001). Virtually all feasibility and acceptability metrics were high (ie, the average likelihood of recommending the intervention was 98 out of 100). CONCLUSIONS This study offers preliminary evidence that a digital music-based mindfulness intervention can decrease race-based anxiety in Black Americans. Future research is needed to replicate these results, test whether the intervention can elicit lasting changes in anxiety, assess mechanisms of change, and explore the efficacy of the intervention in real-world contexts.
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Affiliation(s)
- Grant Jones
- Harvard University, Cambridge, MA, United States
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Anderson A, Lewis DF, Shafer P, Anderson J, LaVeist TA. Public trust is earned: Historical discrimination, carceral violence, and the COVID-19 pandemic. Health Serv Res 2023; 58 Suppl 2:218-228. [PMID: 37279782 PMCID: PMC10339167 DOI: 10.1111/1475-6773.14187] [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] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVE To assess whether knowledge of Tuskegee, the U.S. Immigration and Customs Enforcement (ICE) agency's detainment of children, and satisfaction with the George Floyd death investigation were associated with trust in actors involved in the development and distribution of coronavirus vaccines. DATA SOURCES AND STUDY SETTING National survey with a convenience sample of Black (n = 1019) and Hispanic (n = 994) adults between July 1 and 26, 2021. STUDY DESIGN Observational study using stratified adjusted logistic regression models to measure the association between ratings of the trustworthiness of actors involved in the development and distribution of coronavirus vaccines. PRINCIPAL FINDINGS Among Black respondents, lower satisfaction with the George Floyd death investigation was associated with lower trustworthiness ratings of pharmaceutical companies (ME: -0.09; CI: -0.15, 0.02), the FDA (ME: -0.07; CI: -0.14, -0.00), the Trump Administration (ME: -0.09; CI: -0.16, -0.02), the Biden Administration (ME: -0.07, CI: -0.10, 0.04), and elected officials (ME: -0.10, CI: -0.18, -0.03). Among Hispanic respondents, lower satisfaction was associated with lower trustworthiness ratings of the Trump Administration (ME: -0.14, CI: -0.22, -0.06) and elected officials (ME: -0.11; CI: -0.19, -0.02). Greater knowledge of ICE's detainment of children and families among Hispanic respondents was associated with lower trustworthiness ratings of state elected officials (ME: -0.09, CI: -0.16, 0.01). Greater knowledge of the US Public Health Service Study of Syphilis in Tuskegee was associated with higher trustworthiness ratings of their usual source of care (ME: 0.09; CI: 0.28, 0.15) among Black respondents (ME: 0.09; CI: 0.01, 0.16). CONCLUSIONS Among Black respondents, lower satisfaction with the George Floyd death investigation was associated with lowered levels of trust in pharmaceutical companies, some government officials, and administrators; it was not associated with the erosion of trust in direct sources of health care delivery, information, or regulation. Among Hispanic respondents, greater knowledge of the ICE detainments was associated with lower trustworthiness ratings of elected state officials. Paradoxically, higher knowledge of the Study of Syphilis in Tuskegee was associated with higher trustworthiness ratings in usual sources of care.
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Affiliation(s)
- Andrew Anderson
- Health Policy & ManagementTulane UniversityNew OrleansLouisianaUSA
| | - Demar F. Lewis
- Department of African American StudiesYale UniversityNew HavenConnecticutUSA
| | - Paul Shafer
- National Center for Chronic Disease Prevention and Health PromotionBoston UniversityBostonMassachusettsUSA
| | - Jordan Anderson
- National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control & PreventionAtlantaGeorgiaUSA
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Cénat JM, Farahi SMMM, Dalexis RD. Prevalence and determinants of depression, anxiety, and stress symptoms among Black individuals in Canada in the context of the COVID-19 pandemic. Psychiatry Res 2023; 326:115341. [PMID: 37482045 DOI: 10.1016/j.psychres.2023.115341] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/25/2023]
Abstract
The COVID-19 pandemic has disproportionately affected Black communities in Canada in terms of infection, hospitalizations, and mortality rates. It exacerbated social, economic, and health disparities that can impact their mental health. We investigated the prevalence and predictors of symptoms of depression, anxiety, and stress in Black individuals in Canada. A community-representative weighted sample of 2002 Black individuals (51.66% women) aged 14 to 94 years old (Mean age 29.34; SD = 10.13). Overall, 40.94%, 44.50%, and 31.36% of participants were classified as having clinically meaningful anxiety, depression, and stress levels, respectively, based on DASS scores. Men (45.92%) reported a higher prevalence of anxiety than women (36.27%), χ2 (1) = 19.24, p<.001, but similar symptoms of depression and stress. The progression of the prevalence of anxiety, depression, and stress symptoms were consistent with the progression of the prevalence of everyday racial discrimination. After controlling for socio-demographic variables, regression models showed that everyday discrimination (B = 0.14, p=.001, B = 0.14, p= .006, B = 0.18, p< .001), major experiences of racial discrimination (B = 0.30, p=.046, B = 0.34, p= .033, B = 0.35, p=.024), and COVID-19 traumatic stressors (B = 0.43, p<.001, B = 0.43, p< .001, B = 0.44, p< .001) were positively associated with anxiety, while community resilience (B= -0.02, p= .039, B= -0.04, p= .001, B= -0.03, p= .014) was negatively associated with anxiety, depression, and stress, respectively. This study demonstrates the need to address racial discrimination in implementing prevention and intervention programs among Black individuals and to consider intersectional factors related to age, birthplace, language spoken, and province of residence.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, ON, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, Ottawa, Ontario, Canada.
| | | | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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