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Weiler AM, Caxaj CS. Housing, health equity, and global capitalist power: Migrant farmworkers in Canada. Soc Sci Med 2024; 354:117067. [PMID: 38972093 DOI: 10.1016/j.socscimed.2024.117067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 05/27/2024] [Accepted: 06/20/2024] [Indexed: 07/09/2024]
Abstract
Health scholars are becoming increasingly attuned to the intimate ties between a person's housing and their access to mental and physical health. However, existing models for understanding the link between housing and health equity do not adequately theorize why inequities arise and persist, who benefits from these social arrangements, and how they operate transnationally. How do domestic and global dynamics of political economy shape housing and health equity for migrant farmworkers? How can conceptual models of housing and health equity better account for political economy? To answer these conceptual questions, our study examines the empirical case of migrant agricultural workers in Canada. Migrant worker housing provides a pertinent case for better conceptualizing capitalist power dynamics in housing and health equity on a global scale. Specifically, we draw on in-depth interviews conducted between 2021 and 2022 with 151 migrant workers Ontario and British Columbia. Participants' housing and health concerns aligned with existing literature, including issues such as overcrowding and barriers to health care due to a remote rural location. Our analysis identified three empirical themes: Precarity, Paternalism, and a lack of Political Participation. Drawing from these insights, we recommend a refined model of housing and health equity that keeps an analytical lens trained on global racial capitalism.
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Affiliation(s)
- Anelyse M Weiler
- University of Victoria, Department of Sociology, PO Box 3050 STN CSC, Victoria, BC, V8W 3P5, Canada.
| | - C Susana Caxaj
- Room 3306, FIMS & Nursing Building, Western University, London, Ontario, N6A 5B9, Canada
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2
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DeAngelis RT. Racial Capitalism and Black-White Health Inequities in the United States: The Case of the 2008 Financial Crisis. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2024:221465241260103. [PMID: 39077803 DOI: 10.1177/00221465241260103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
Scholars cite racist political-economic systems as drivers of health inequities in the United States (i.e., racial capitalism). But how does racial capitalism generate health inequities? I address this open question within the historical context of predatory lending during the 2008 financial crisis. Relevant hypotheses are tested with multiple waves of data from Black and White participants of the National Longitudinal Study of Adolescent to Adult Health (N = 8,877). Across socioeconomic strata, I find that Black participants report higher rates of foreclosure, eviction, repossession, delinquent bills, lost income, and new debts in the wake of the financial crisis. Using structural equation and quasi-experimental models, I then show that Black participants also self-report rapid health declines and increases in prescription drug abuse throughout this period, much of which is explained by chronic financial stress. I conclude that racial capitalism can generate health inequities by ensnaring Black Americans in a toxic web of financial exploitation and stress proliferation.
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Sharif MZ, Maghbouleh N, Baback Boozary AS. COVID-19 Disparities Among Arab, Middle Eastern, and West Asian Populations in Toronto: Implications for Improving Health Equity Among Middle Eastern and North African Communities in the United States. Health Promot Pract 2024; 25:531-536. [PMID: 36624978 PMCID: PMC9834619 DOI: 10.1177/15248399221142898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Equity-oriented efforts to mitigate and prevent COVID-related disparities are hindered due to methodological limitations of the categorization of racial and ethnic groups, including Arabs and Middle Eastern and North African (MENA) communities, which remain invisible in national data collection efforts. This study highlights the disparities in COVID-related outcomes in Toronto, Canada and supports ongoing calls to collect public health data among MENA communities in the United States. METHODS Data on racial/ethnic identity and hospitalizations were collected by the Toronto Public Health (TPH) of the Ontario Ministry of Public Health Case between May 20, 2020, and September 30, 2021 from people with a confirmed or probable case of COVID-19. RESULTS The reported COVID-19 infection rate for Arab, Middle Eastern, West Asians (i.e., categories used to self-identify as MENA in Canada) relative to Whites in Toronto was 3.51. The age-standardized hospitalization rate ratio between Arab, Middle Eastern, West Asians and Whites was 4.59. DISCUSSION Data from Toronto highlight that Arab, Middle Eastern, and West Asians have higher rates of COVID-19 infections and hospitalizations than their White counterparts. Comparable studies are currently not possible in the United States due to lack of data that can disaggregate MENA individuals. This study underscores the critical need to collect data among MENA communities in the United States to advance our field's goal of promoting and advancing equity.
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Affiliation(s)
- Mienah Z. Sharif
- University of Washington, Seattle, WA,
USA
- University of California, Los Angeles,
CA, USA
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4
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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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Watkins NK, Dubar RT. Socio-demographic factors and COVID-19 experiences predict perceived social support and social media engagement among college students in the U.S. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1516-1526. [PMID: 35728017 DOI: 10.1080/07448481.2022.2082843] [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: 08/11/2021] [Revised: 05/06/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study examined socio-demographic characteristics and COVID-19 experiences as concurrent predictors of perceived familial and friend social support, social media use, and socio-emotional motives for electronic communication during the COVID-19 pandemic among college students. PARTICIPANTS Participants were 619 emerging adults (18-29-year-olds) currently enrolled at, or recently graduated from, a U.S.-based college or university (Mean age = 21.8, SD = 2.2; 64% female; 60% Non-Hispanic White). METHODS Online surveys were administered between May and June 2020. A path analysis model was conducted to examine the concurrent associations between socio-demographic factors, COVID-19-related experiences, social media/electronic engagement, and perceived social support. RESULTS Findings indicated significant differences in perceived social support, social media use, and socio-emotional motives for electronic communication as a function of gender, race, sexual orientation, first-generation status, and relationship status. CONCLUSIONS Our findings highlight the role of both individual and situational differences in interpersonal functioning and demonstrate how college students differently engaged with social media for socio-emotional purposes during the COVID-19 pandemic.
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Affiliation(s)
- Nicole K Watkins
- Department of Psychology, Wesleyan University, Middletown, Connecticut, USA
| | - Royette T Dubar
- Department of Psychology, Wesleyan University, Middletown, Connecticut, USA
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Zelner J, Stone D, Eisenberg M, Brouwer A, Sakrejda K. Capturing the implications of residential segregation for the dynamics of infectious disease transmission. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.26.24309541. [PMID: 38978674 PMCID: PMC11230299 DOI: 10.1101/2024.06.26.24309541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Occupational and residential segregation and other manifestations of social and economic inequity drive of racial and socioeconomic inequities in infection, severe disease, and death from a wide variety of infections including SARS-CoV-2, influenza, HIV, tuberculosis, and many others. Despite a deep and long-standing quantitative and qualitative literature on infectious disease inequity, mathematical models that give equally serious attention to the social and biological dynamics underlying infection inequity remain rare. In this paper, we develop a simple transmission model that accounts for the mechanistic relationship between residential segregation on inequity in infection outcomes. We conceptualize segregation as a high-level, fundamental social cause of infection inequity that impacts both who-contacts-whom (separation or preferential mixing) as well as the risk of infection upon exposure (vulnerability). We show that the basic reproduction number, ℛ 0 , and epidemic dynamics are sensitive to the interaction between these factors. Specifically, our analytical and simulation results and that separation alone is insufficient to explain segregation-associated differences in infection risks, and that increasing separation only results in the concentration of risk in segregated populations when it is accompanied by increasing vulnerability. Overall, this work shows why it is important to carefully consider the causal linkages and correlations between high-level social determinants - like segregation - and more-proximal transmission mechanisms when either crafting or evaluating public health policies. While the framework applied in this analysis is deliberately simple, it lays the groundwork for future, data-driven explorations of the mechanistic impact of residential segregation on infection inequities.
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Zadeh H, Curran M, Del Castillo N, Morales C, Dukes K, Martinez D, Salinas JL, Bryant R, Bojang M, Carvour ML. Epidemiological approaches to multivariable models of health inequity: A study of race, rurality, and occupation during the COVID-19 pandemic. Ann Epidemiol 2024; 94:42-48. [PMID: 38642626 PMCID: PMC11326713 DOI: 10.1016/j.annepidem.2024.04.008] [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: 10/07/2023] [Revised: 04/03/2024] [Accepted: 04/16/2024] [Indexed: 04/22/2024]
Abstract
PURPOSE Methods for assessing the structural mechanisms of health inequity are not well established. This study applies a phased approach to modeling racial, occupational, and rural disparities on the county level. METHODS Rural counties with disparately high rates of COVID-19 incidence or mortality were randomly paired with in-state control counties with the same rural-urban continuum code. Analysis was restricted to the first six months of the pandemic to represent the baseline structural reserves for each county and reduce biases related to the disruption of these reserves over time. Conditional logistic regression was applied in two phases-first, to examine the demographic distribution of disparities and then, to examine the relationships between these disparities and county-level social and structural reserves. RESULTS In over 200 rural county pairs (205 for incidence, 209 for mortality), disparities were associated with structural variables representing economic factors, healthcare infrastructure, and local industry. Modeling results were sensitive to assumptions about the relationships between race and other social and structural variables measured at the county level, particularly in models intended to reflect effect modification or mediation. CONCLUSIONS Multivariable modeling of health disparities should reflect the social and structural mechanisms of inequity and anticipate interventions that can advance equity.
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Affiliation(s)
- Hannah Zadeh
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States; Department of Sociology and Criminology, College of Liberal Arts and Sciences, University of Iowa, 401 North Hall, Iowa City, IA 52242, United States
| | - Michaela Curran
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 North Riverside Drive, Iowa City, IA 52242, United States
| | - Nicole Del Castillo
- Department of Psychiatry, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States
| | - Carol Morales
- Department of Internal Medicine, University of New Mexico School of Medicine, MSC10-5550, 1 University of New Mexico, Albuquerque, NM 87131, United States
| | - Kimberly Dukes
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States
| | - Denise Martinez
- Department of Family Medicine, Carver College of Medicine, 200 Hawkins Drive, University of Iowa, Iowa City, IA 52242, United States
| | - Jorge L Salinas
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States; Department of Medicine, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, United States
| | - Rachel Bryant
- Department of Epidemiology, College of Public Health, University of Iowa, 145 North Riverside Drive, Iowa City, IA 52242, United States
| | - Matida Bojang
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States; Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, United States
| | - Martha L Carvour
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States; Department of Epidemiology, College of Public Health, University of Iowa, 145 North Riverside Drive, Iowa City, IA 52242, United States.
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Jason K, Wilson M, Catoe J, Brown C, Gonzalez M. The Impact of the COVID-19 Pandemic on Black and Hispanic Americans' Work Outcomes: a Scoping Review. J Racial Ethn Health Disparities 2024; 11:1157-1172. [PMID: 37117935 PMCID: PMC10147367 DOI: 10.1007/s40615-023-01594-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/25/2023] [Accepted: 03/31/2023] [Indexed: 04/30/2023]
Abstract
In early 2020, it was hypothesized that COVID-19 would lead to disproportionately negative health and work outcomes for Black and Hispanic adults, but sufficient data had yet been collected to fully support this claim. Now, we have empirical evidence, but little has been done to aggregate this information to fully understand its impact on these communities. Utilizing 44 articles from a scoping review of three databases (PubMed, Web of Science, and Business Source Complete), this study seeks to identify the primary work-related risks that help explain Black and Hispanic adults' disparate COVID-19-related work outcomes (e.g., loss of hours, job disruption, stress). Findings illuminate four primary risks faced by Black and Hispanic workers: (1) being an essential worker, (2) type of work performed, (3) workplace factors; and (4) community and geographic factors. We conclude with policy recommendations that will help inform policy and practice for economic recovery from the pandemic for other marginalized populations.
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Affiliation(s)
- Kendra Jason
- University of North Carolina at Charlotte, Charlotte, North Carolina, USA.
| | - Miguel Wilson
- University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Jamel Catoe
- University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Courtney Brown
- University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Mayleen Gonzalez
- University of North Carolina at Charlotte, Charlotte, North Carolina, USA
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Riley AR, Hawkley LC, Piedra LM. Unequal loss: Disparities in relational closeness to a COVID-19 death among U.S. older adults. J Am Geriatr Soc 2024; 72:1483-1490. [PMID: 38217358 PMCID: PMC11090743 DOI: 10.1111/jgs.18755] [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: 07/28/2023] [Revised: 12/02/2023] [Accepted: 12/16/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND COVID-19 mortality occurred unevenly across U.S. demographic subgroups, leaving some communities harder hit than others. Black and Hispanic/Latino older adults are among those disproportionately affected by COVID-19 mortality, and in turn, COVID-19 bereavement. Because disparities in COVID-19 mortality may extend to COVID-19 bereavement, it is important to understand the incidence of COVID-19 bereavement among older adults at various degrees of relational closeness (e.g., spouse vs. household member vs. friend). METHODS We used the National Social Health and Aging Project (NSHAP) COVID Study to evaluate disparities in loss of a social network member to COVID-19 among U.S. older adults by race/ethnicity, language, and relational closeness. Multiple logistic regression was used to estimate the likelihood of experiencing a COVID-19 death in one's social network. RESULTS None of the English-speaking, non-Hispanic White respondents reported the loss of a household member or spouse to COVID-19. English-speaking, non-Hispanic Black and English-speaking, Hispanic older adults were overrepresented in reporting a death at every degree of relational closeness. However, close COVID-19 bereavement was most prevalent among Spanish-speaking older adults of any race. Although Spanish speakers comprised only 4.8% of the sample, half of the respondents who lost a spouse to COVID-19 were Spanish speakers. Language and ethnoracial group disparities persisted after controlling for age, sex, marital status, and education. CONCLUSIONS Known ethnoracial disparities in COVID-19 mortality extend to COVID-19 bereavement among older adults. Because bereavement impacts health, Black, Latino, and Spanish-speaking communities need greater protection and investment to prevent disparities in bereavement from exacerbating disparities in later-life mental and physical health.
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Affiliation(s)
- Alicia R. Riley
- Department of Sociology, University of California, Santa Cruz
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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: 0] [Impact Index Per Article: 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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Esposito F, Rebelo D, Olanrewaju M, Vine M, Fernandes-Jesus M, Bodden D, Kalokoh A, Olson B. A community psychology for migrant justice: Critically examining border violence and resistance during the COVID-19 syndemic. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 73:27-43. [PMID: 37126214 DOI: 10.1002/ajcp.12669] [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: 06/30/2021] [Revised: 01/10/2023] [Accepted: 03/27/2023] [Indexed: 06/19/2023]
Abstract
This article explores the magnifying lenses of the COVID-19 syndemic to highlight how people racialized as migrants and refugees have been-and continue to be-disproportionally harmed. We use empirical evidence collected in our scholarly/activist work in Europe, Africa, South Asia, and the United States to examine migrant injustice as being produced by a combination of power structures and relations working to maintain colonial global orders and inequalities. This is what has been defined as "border imperialism." Our data, complemented by evidence from transnational solidarity groups, show that border imperialism has further intersected with the hygienic-sanitary logics of social control at play during the COVID-19 period. This intersection has resulted in increasingly coercive methods of restraining people on the move, as well as in increased-and new-forms of degradation of their lives, that is, an overall multiplication of border violences. At the same time, however, COVID-19 has provided a unique opportunity for grassroot solidarity initiatives and resistance led by people on the move to be amplified and extended. We conclude by emphasizing the need for community psychologists to take a more vigorous stance against oppressive border imperialist regimes and the related forms of violence they re/enact.
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Affiliation(s)
- Francesca Esposito
- School of Social Sciences, University of Westminster, London, United Kingdom
- Instituto de Ciências Sociais da Universidade de Lisboa, Lisbon, Portugal
| | - Dora Rebelo
- CIS-Iscte, University Institute of Lisbon, Lisbon, Portugal
| | - Moshood Olanrewaju
- School of Psychology and Behavioral Sciences, National Louis University, Chicago, Illinois, United States
| | - Megan Vine
- Department of Psychology, University of Limerick, Ireland
| | - Maria Fernandes-Jesus
- School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Debi Bodden
- School of Social Work, University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada
| | - Aminata Kalokoh
- Association of Visitors to Immigration Detainees (AVID), Nottingham, UK
| | - Bradley Olson
- School of Psychology and Behavioral Sciences, National Louis University, Chicago, Illinois, United States
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Fernández JS. Threading a decolonial feminist response to COVID-19: One community psychologist's reflection on the assemblages of violence. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 73:191-205. [PMID: 37042808 DOI: 10.1002/ajcp.12662] [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: 10/01/2021] [Revised: 07/01/2022] [Accepted: 01/21/2023] [Indexed: 06/19/2023]
Abstract
To challenge and interrogate the assemblages of violence produced by racial capitalism, and exacerbated by the COVID-19 pandemic, community psychologists must engage in a transdisciplinary critical ethically reflexive practice. In this reflexive essay, or first-person account, I offer a decolonial feminist response to COVID-19 that draws strength from the writings of three women of Color decolonial and postcolonial feminist thinkers: Gloria E. Anzaldúa, Sylvia Wynter, and Arundhati Roy. Through their writings I share my reflections on the sociopolitical moment associated with COVID-19. Of importance, I argue in support of engaging a decolonial feminist standpoint to understand the inequitable and dehumanizing conditions under COVID-19, and the possibilities for transformative justice. I offer this reflexive essay with the intention of summoning community psychology and community psychologists to look toward transdisciplinarity, such as that which characterizes a decolonial standpoint and feminist epistemologies. Writings oriented toward imagination, relationality, and borderland ways of thinking that are outside, in-between or within, the self and the collective "we" can offer valuable guidance. The invitation toward a transdisciplinary critical ethically reflexive practice calls us to bear witness to movements for social justice; to leverage our personal, professional and institutional resources to support communities in struggle. A decolonial feminist standpoint guided by the words of Anzaldúa, Wynter, and Roy can cultivate liberatory conditions that can materialize as racial freedom, community wellbeing, and societal thriving.
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Thomeer MB, Brantley M, Reczek R. Cumulative Disadvantage or Strained Advantage? Remote Schooling, Paid Work Status, and Parental Mental Health during the COVID-19 Pandemic. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2024:221465241230505. [PMID: 38409752 DOI: 10.1177/00221465241230505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
During the COVID-19 pandemic, parents experienced difficulties around employment and children's schooling, likely with detrimental mental health implications. We analyze National Longitudinal Survey of Youth 1997 data (N = 2,829) to estimate depressive symptom changes from 2019 to 2021 by paid work status and children's schooling modality, considering partnership status, gender, and race-ethnicity differences. We draw on cumulative disadvantage theory alongside strained advantage theory to test whether mental health declines were steeper for parents with more disadvantaged statuses or for parents with more advantaged statuses. Parents with work disruptions, without paid work, or with children in remote school experienced the greatest increases in depressive symptoms, with steepest increases among single parents without paid work and single parents with children in remote school (cumulative disadvantage), fathers without paid work (strained advantage), and White parents with remote school (strained advantage). We discuss the uneven impacts of the pandemic on mental health and implications for long-term health disparities.
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Affiliation(s)
| | - Mia Brantley
- North Carolina State University, Raleigh, NC, USA
| | - Rin Reczek
- The Ohio State University, Columbus, OH, USA
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Graetz N, Hepburn P, Gershenson C, Porter SR, Sandler DH, Lemmerman E, Desmond M. Examining Excess Mortality Associated With the COVID-19 Pandemic for Renters Threatened With Eviction. JAMA 2024; 331:592-600. [PMID: 38497697 PMCID: PMC10879945 DOI: 10.1001/jama.2023.27005] [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: 05/10/2023] [Accepted: 12/11/2023] [Indexed: 03/19/2024]
Abstract
Importance Residential evictions may have increased excess mortality associated with the COVID-19 pandemic. Objective To estimate excess mortality associated with the COVID-19 pandemic for renters who received eviction filings (threatened renters). Design, Setting, and Participants This retrospective cohort study used an excess mortality framework. Mortality based on linked eviction and death records from 2020 through 2021 was compared with projected mortality estimated from similar records from 2010 through 2016. Data from court records between January 1, 2020, and August 31, 2021, were collected via the Eviction Lab's Eviction Tracking System. Similar data from court records between January 1, 2010, and December 31, 2016, also collected by the Eviction Lab, were used to estimate projected mortality during the pandemic. We also constructed 2 comparison groups: all individuals living in the study area and a subsample of those individuals living in high-poverty, high-filing tracts. Exposures Eviction filing. Main Outcomes and Measures All-cause mortality in a given month. The difference between observed mortality and projected mortality was used as a measure of excess mortality associated with the pandemic. Results The cohort of threatened renters during the pandemic period consisted of 282 000 individuals (median age, 36 years [IQR, 28-47]). Eviction filings were 44.7% lower than expected during the study period. The composition of threatened renters by race, ethnicity, sex, and socioeconomic characteristics during the pandemic was comparable with the prepandemic composition. Expected cumulative age-standardized mortality among threatened renters during this 20-month period of the pandemic was 116.5 (95% CI, 104.0-130.3) per 100 000 person-months, and observed mortality was 238.6 (95% CI, 230.8-246.3) per 100 000 person-months or 106% higher than expected. In contrast, expected mortality for the population living in similar neighborhoods was 114.6 (95% CI, 112.1-116.8) per 100 000 person-months, and observed mortality was 142.8 (95% CI, 140.2-145.3) per 100 000 person-months or 25% higher than expected. In the general population across the study area, expected mortality was 83.5 (95% CI, 83.3-83.8) per 100 000 person-months, and observed mortality was 91.6 (95% CI, 91.4-91.8) per 100 000 person-months or 9% higher than expected. The pandemic produced positive excess mortality ratios across all age groups among threatened renters. Conclusions and Relevance Renters who received eviction filings experienced substantial excess mortality associated with the COVID-19 pandemic.
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Berghs M, Horne F, Yates S, Kemp R, Webster A. The indignities of shielding during the COVID-19 pandemic for people with sickle cell disorders: an interpretative phenomenological analysis. FRONTIERS IN SOCIOLOGY 2024; 9:1334633. [PMID: 38414508 PMCID: PMC10897051 DOI: 10.3389/fsoc.2024.1334633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/15/2024] [Indexed: 02/29/2024]
Abstract
This article seeks to understand the first-hand experiences of people with sickle cell, a recessively inherited blood disorder, who were identified as clinically extremely vulnerable during the COVID-19 pandemic. Part of a larger sequential mixed-methods study, this article uses a selective sample of eight qualitative semi-structured interviews, which were analysed using interpretative phenomenological analysis (IPA). The first stage of IPA focused on practical concerns participants had correlated to understanding shielding and their feelings about being identified as clinically extremely vulnerable. In a secondary stage of analysis, we examined the emotions that it brought forth and the foundations of those based on discriminations. This article adds to our theoretical understanding of embodiment and temporality with respect to chronicity and early ageing. It explains how people with sickle cell disorders have an embodied ethics of crisis and expertise. It also elucidates how people's experiences during the pandemic cannot be seen in void but illustrates ableism, racism, and ageism in society writ large.
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Affiliation(s)
- Maria Berghs
- Allied Health Sciences, De Montfort University, Leicester, United Kingdom
| | | | - Scott Yates
- Applied Social Sciences, De Montfort University, Leicester, United Kingdom
| | | | - Amy Webster
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
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16
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Woodard N, Butler J, Ghosh D, Green KM, Knott CL. The Association between State-Level Structural Racism and Alcohol and Tobacco Use Behaviors among a National Probability Sample of Black Americans. Cancer Epidemiol Biomarkers Prev 2024; 33:261-269. [PMID: 38032218 PMCID: PMC10872984 DOI: 10.1158/1055-9965.epi-23-0873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/24/2023] [Accepted: 11/28/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Structural racism is how society maintains and promotes racial hierarchy and discrimination through established and interconnected systems. Structural racism is theorized to promote alcohol and tobacco use, which are risk factors for adverse health and cancer-health outcomes. The current study assesses the association between measures of state-level structural racism and alcohol and tobacco use among a national sample of 1,946 Black Americans. METHODS An existing composite index of state-level structural racism including five dimensions (subscales; i.e., residential segregation and employment, economic, incarceration, and educational inequities) was merged with individual-level data from a national sample dataset. Hierarchical linear and logistic regression models, accounting for participant clustering at the state level, assessed associations between structural racism and frequency of alcohol use, frequency of binge drinking, smoking status, and smoking frequency. Two models were estimated for each behavioral outcome, one using the composite structural racism index and one modeling dimensions of structural racism in lieu of the composite measure, each controlling for individual-level covariates. RESULTS Results indicated positive associations between the incarceration dimension of the structural racism index and binge drinking frequency, smoking status, and smoking frequency. An inverse association was detected between the education dimension and smoking status. CONCLUSIONS Results suggest that state-level structural racism expressed in incarceration disparities, is positively associated with alcohol and tobacco use among Black Americans. IMPACT Addressing structural racism, particularly in incarceration practices, through multilevel policy and intervention may help to reduce population-wide alcohol and tobacco use behaviors and improve the health outcomes of Black populations.
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Affiliation(s)
- Nathaniel Woodard
- Cancer Care Quality Training Program, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - James Butler
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, College Park, MD, USA
| | - Debarchana Ghosh
- Department of Geography, University of Connecticut, University of Connecticut, Storrs, CT, USA
| | - Kerry M. Green
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, College Park, MD, USA
| | - Cheryl L. Knott
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, College Park, MD, USA
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17
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Riley T, Schleimer JP, Jahn JL. Organized abandonment under racial capitalism: Measuring accountable actors of structural racism for public health research and action. Soc Sci Med 2024; 343:116576. [PMID: 38237286 DOI: 10.1016/j.socscimed.2024.116576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/14/2023] [Accepted: 01/05/2024] [Indexed: 02/10/2024]
Abstract
Understanding the shifting nature of structural racism historically and across institutions is vital for effective action towards racial health equity. While public health research on structural racism is rapidly increasing, most studies are missing the interdependence of policies and institutional practices over time that shape power imbalances and lead to entrenched health inequities. Here, we discuss Ruth Wilson Gilmore's concept of organized abandonment - the intentional disinvestment in communities which, in turn, creates opportunities for extraction, revenue generation, and carceral enforcement to fill the cracks of a compromised social infrastructure - to encourage action-oriented public health research that is grounded in history and an understanding of racial capitalism. We present a case example using publicly-available data on redlining, gentrification and policing in Seattle, Washington. We mapped the intersections of redlining and gentrification and estimated their neighborhood-level association with police activity using Bayesian spatial Poisson regression models. We found that histories of racist housing policies like redlining and processes of gentrification are interdependent and shape contemporary neighborhood racial and economic segregation and police activity. Compared to structurally advantaged neighborhoods, police stops were higher in neighborhoods that were 1) historically disinvested (i.e. redlined) and remain low-income and structurally disadvantaged and 2) formerly industrial and business districts that were not redlined and are now gentrified. Notably, we found that policing practices were significantly more intensive in neighborhoods that were both high redlined and gentrified. Together, these findings illustrate how the place-based racialized processes of dispossession, displacement and policing are deeply intertwined to maintain racial capitalism. Our findings also highlight the importance of examining multiple racialized processes simultaneously to fill critical gaps in the existing literature that are necessary for sustainable solutions to address structural racism.
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Affiliation(s)
- Taylor Riley
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA.
| | - Julia P Schleimer
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | - Jaquelyn L Jahn
- Ubuntu Center on Racism, Global Movements, and Population Health Equity, Department of Epidemiology & Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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18
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Pinedo A, Frisby M, Kubi G, Vezaldenos V, Diemer MA, McAlister S, Harris E. Charting the longitudinal trajectories and interplay of critical consciousness among youth activists. Child Dev 2024; 95:296-312. [PMID: 37501628 DOI: 10.1111/cdev.13977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 06/08/2023] [Accepted: 06/19/2023] [Indexed: 07/29/2023]
Abstract
Critical consciousness (CC) is associated with beneficial developmental outcomes among youth contending with oppression, yet we know little about how CC develops and how the three dimensions of CC (i.e., critical action, critical motivation, and critical reflection) interrelate over time. Therefore, this study employed second-order latent growth modeling to illuminate the longitudinal interplay between the three dimensions of CC among 518 youth activists (Mage = 16; girls = 53%; 11% Asian, 20% Black, 39% Latinx, 8% Multiracial, and 6% White). Youth demonstrated significant growth in critical reflection and action over time, but not in critical motivation. Participation in community-based activism was positively associated with CC development. Altogether, these findings illuminate channels for fostering youth CC and increase our understanding of CC's dynamic development.
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19
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Gee GC, Chien J, Sharif MZ, Penaia C, Tran E. East is east … or is it? Racialization of Asian, Middle Eastern, and Pacific Islander persons. Epidemiol Rev 2023; 45:93-104. [PMID: 37312559 DOI: 10.1093/epirev/mxad007] [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: 09/30/2022] [Revised: 04/28/2023] [Accepted: 06/05/2023] [Indexed: 06/15/2023] Open
Abstract
The conventional use of racial categories in health research naturalizes "race" in problematic ways that ignore how racial categories function in service of a White-dominated racial hierarchy. In many respects, racial labels are based on geographic designations. For instance, "Asians" are from Asia. Yet, this is not always a tenable proposition. For example, Afghanistan resides in South Asia, and shares a border with China and Pakistan. Yet, people from Afghanistan are not considered Asian, but Middle Eastern, by the US Census. Furthermore, people on the west side of the Island of New Guinea are considered Asian, whereas those on the eastern side are considered Pacific Islander. In this article, we discuss the complexity of the racial labels related to people originating from Oceania and Asia, and, more specifically, those groups commonly referred to as Pacific Islander, Middle Eastern, and Asian. We begin with considerations of the aggregation fallacy. Just as the ecological fallacy refers to erroneous inferences about individuals from group data, the aggregation fallacy refers to erroneous inferences about subgroups (eg, Hmong) from group data (ie, all Asian Americans), and how these inferences can contribute to stereotypes such as the "model minority." We also examine how group averages can be influenced merely by the composition of the subgroups, and how these, in turn, can be influenced by social policies. We provide a historical overview of some of the issues facing Pacific Islander, Middle Eastern, and Asian communities, and conclude with directions for future research.
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Affiliation(s)
- Gilbert C Gee
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA 90025, United States
| | - Jessie Chien
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA 90025, United States
| | - Mienah Z Sharif
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA 98195, United States
- Center for the Study of Racism, Social Justice and Health, University of California at Los Angeles, Los Angeles, CA 90025, United States
| | - Corina Penaia
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA 90025, United States
| | - Emma Tran
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA 90025, United States
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20
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Donnelly R, Remani B, Erving CL. Dual pandemics? Assessing associations between area racism, COVID-19 case rates, and mental health among U.S. adults. SSM - MENTAL HEALTH 2023; 4:100248. [PMID: 38125912 PMCID: PMC10732532 DOI: 10.1016/j.ssmmh.2023.100248] [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: 12/23/2023] Open
Abstract
Mental health worsened during the COVID-19 pandemic, especially among racially minoritized adults. Population-level racial attitudes, or area racism, may be associated with mental health, particularly during this historical moment, but this possibility has not been tested in prior research. In the present study, we use nationally representative data from the Household Pulse Survey (April-October 2020) to document associations between area racism and depression/anxiety in the United States among non-Hispanic Black, non-Hispanic Asian, Hispanic, non-Hispanic White, and other racial/ethnic minority adults. We further consider the national COVID-19 case rate to examine an additional macro-level stressor. Findings indicate that area racism was positively associated with depression and/or anxiety for Black, Hispanic, White, and other racial/ethnic minority adults. Moreover, COVID-19 cases posed an additional, independent mental health threat for most groups. This study points to area racism as a macro-level stressor and an antecedent of mental health for racially diverse groups of Americans.
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21
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Alang SM, Carter CR, Blackstock O. Past Is Prologue: Dismantling Colonial Legacies to Advance Black Health Equity in the United States. Health Equity 2023; 7:831-834. [PMID: 38156053 PMCID: PMC10754480 DOI: 10.1089/heq.2023.0226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 12/30/2023] Open
Abstract
Colonialism underlies the commodification of health care in the United States and continues to harm well-being among Black Americans. We present four recommendations for addressing its health consequences: (1) Investments in epigenetic research to improve our understanding of how systemic oppression becomes biology. (2) Centering Black experiences and knowledge traditions in education, practice, and policy. (3) Support for Black scholars, trainees, and practitioners when they critic disciplinary tenets and practices. (4) Expansion of preventive care. Our health care system is a for-profit industry that exploits workers and harms the most marginalized, much like colonialism. Advancing health equity requires dismantling colonial legacies.
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Affiliation(s)
- Sirry M. Alang
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Chelsey R. Carter
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
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22
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Richard MK. Race matters in addressing homelessness: A scoping review and call for critical research. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 72:464-485. [PMID: 37649444 DOI: 10.1002/ajcp.12700] [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: 12/31/2022] [Revised: 07/18/2023] [Accepted: 08/01/2023] [Indexed: 09/01/2023]
Abstract
Structural racism contributes to homelessness in the United States, as evidenced by the stark racial disparities in who experiences it. This paper reviews research at the intersections of race and homelessness to advance efforts to understand and address racial inequities. Part 1 offers a synthesis of homelessness research from the 1980s to 2015, where several scholars examined the role of race and racism despite mainstream efforts to present the issue as race-neutral. Part 2 presents the results of a systematic scoping review of research at the intersections of race and homelessness from 2016 to 2021. The 90 articles included demonstrate a growing, multidisciplinary body of literature that documents how needs and trajectories of people experiencing homelessness differ by race, examines how the racialized structuring of society contributes to homelessness risk, and explores how programs, policies, and grassroots action can address inequities. In addition to charting findings and implications, included studies are appraised against research principles developed by Critical Race Theory scholars, mapping the potential of existing research on race and homelessness to challenge racism.
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Affiliation(s)
- Molly K Richard
- Department of Human and Organizational Development, Peabody College, Vanderbilt University, Nashville, Tennessee, USA
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23
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Gilbert KL, Shaw M, Siddiqi A, Goodman MS. Achieving the Health Equity Agenda Through Transformative Community-Engaged Strategies. Prev Chronic Dis 2023; 20:E99. [PMID: 37943729 PMCID: PMC10684278 DOI: 10.5888/pcd20.230077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Affiliation(s)
- Keon L Gilbert
- Department of Behavioral Science and Health Education, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Ave, St. Louis, MO 63104
- Brookings Institution, Washington, DC
| | - Mary Shaw
- Jackson State University, Department of Behavioral & Environmental Health, College of Health Sciences, Jackson, Mississippi
| | - Arjumand Siddiqi
- University of Toronto, Dalla Lana School of Public Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Melody S Goodman
- New York University, School of Global Public Health, New York, New York
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24
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He C, Igwe N, Damian C, Feder A, Feingold J, Ripp J, Pietrzak R, Peccoralo L, Hurtado A, Chan C. Racial & ethnic differences in mental health outcomes and risk factors among frontline healthcare workers during the COVID-19 pandemic. Gen Hosp Psychiatry 2023; 85:1-7. [PMID: 37716020 DOI: 10.1016/j.genhosppsych.2023.09.003] [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: 03/15/2023] [Revised: 08/06/2023] [Accepted: 09/07/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVE To examine racial/ethnic differences in mental health outcomes and risk factors during the COVID-19 pandemic among frontline healthcare workers (FHCWs). METHODS A survey was conducted on FHCWs at a large metropolitan hospital during winter 2021. Depression, anxiety, and post-traumatic stress symptoms, demographic characteristics, and COVID-19-related occupational factors were assessed. Multivariable logistic regression examined factors associated with screening positive for psychiatric symptoms and their interactions with race/ethnicity. RESULTS Of 1437 FHCWs, 762 (53.0%) self-identified as white, 451 (31.4%) as Asian, 118 (8.2%) as Black, and 106 (7.4%) as Latinx. Black FHCWs had a higher prevalence of screening positive for depression (18.6%) than other groups (6.6%-11.7%, p < .05). Significant risk factors by race/ethnicity interactions indicated that having cared for patients who died from COVID-19 increased risk of psychiatric symptoms among white and Black individuals, having to make difficult decisions prioritizing patients increased risk most significantly among white and Asian individuals, and working more hours increased risk most significantly among Latinx individuals. CONCLUSION Results suggest that occupational stressors may have differential impacts on mental health among racial/ethnic groups of FHCWs. Findings provide insight on subgroups with increased vulnerability to certain risk factors and inform interventions to improve mental health in diverse FHCWs.
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Affiliation(s)
- Celestine He
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, NY, NY 10029, USA.
| | - Nnamdi Igwe
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, NY, NY 10029, USA
| | - Candida Damian
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, NY, NY 10029, USA
| | - Adriana Feder
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1230, NY, NY 10029, USA
| | - Jordyn Feingold
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1230, NY, NY 10029, USA
| | - Jonathan Ripp
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, NY, NY 10029, USA; Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1087, NY, NY 10029, USA
| | - Robert Pietrzak
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1230, NY, NY 10029, USA
| | - Lauren Peccoralo
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, NY, NY 10029, USA; Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1087, NY, NY 10029, USA
| | - Alicia Hurtado
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, NY, NY 10029, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1230, NY, NY 10029, USA
| | - Chi Chan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1230, NY, NY 10029, USA
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25
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Guan A, Cruz T, Sowell J, Mathias B, Hassberg AH, Shariff-Marco S, Akom A, DeRouen MC. Dignified Resources and Coping Strategies During the COVID-19 Pandemic: a Qualitative Study of Racially and Economically Marginalized Communities. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01824-x. [PMID: 37843779 DOI: 10.1007/s40615-023-01824-x] [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: 01/19/2023] [Revised: 09/27/2023] [Accepted: 09/27/2023] [Indexed: 10/17/2023]
Abstract
INTRODUCTION Amid the spread of the novel coronavirus (COVID-19), racially and economically marginalized communities experienced a disproportionate burden of disease and social consequences (e.g., unemployment, increased exposure). This study seeks to understand strategies that these communities employed to cope with unequal burdens of the pandemic. METHODS We utilized qualitative data collected between 2020 and 2021 from a mobile mapping platform designed to facilitate real-time, geocoded data collection on individual's experiences and perceptions of their neighborhoods. Reports were iteratively coded by an academic researcher and community partner. We employed an inductive approach to analysis, which allowed findings to emerge organically without constraint of researcher hypotheses. RESULTS A total of 19 respondents (14 under the age of 45, 16 non-White, 15 with less than half a year of emergency savings) provided 236 qualitative reports. Participants described innovative strategies for exchanging resources as a means of informally networking and building community, the importance of tailored programming (e.g., for specific racial/ethnic groups) in fostering belonging and comfort, and the importance of two specific dimensions of services-interactions with service providers and the quality of goods or services-in providing dignified care. DISCUSSION Amidst exacerbated racial and economic disparities emerging from the COVID-19 pandemic, our study highlights the need for investment in mutual aid, the importance of tailored services and support, and promoting dignity in social services. As other macro-level social stressors become more prevalent as the pandemic continues, these findings can inform how we examine and address them.
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Affiliation(s)
- Alice Guan
- Department of Epidemiology and Biostatistics | University of California, San Francisco, USA
| | - Tessa Cruz
- The Social Innovation and Urban Opportunity Lab, Streetwyze | UCSF & San Francisco State University, San Francisco, Oakland, CA, USA
| | | | - Brenda Mathias
- The Social Innovation and Urban Opportunity Lab, Streetwyze | UCSF & San Francisco State University, San Francisco, Oakland, CA, USA
| | | | - Salma Shariff-Marco
- Department of Epidemiology and Biostatistics | University of California, San Francisco, USA
| | - Antwi Akom
- The Social Innovation and Urban Opportunity Lab, Streetwyze | UCSF & San Francisco State University, San Francisco, Oakland, CA, USA
- Department of Africana Studies | San Francisco State University, San Francisco, USA
| | - Mindy C DeRouen
- Department of Epidemiology and Biostatistics | University of California, San Francisco, USA.
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26
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Gao X, Berkowitz RL, Michaels EK, Mujahid MS. Traveling Together: A Road Map for Researching Neighborhood Effects on Population Health and Health Inequities. Am J Epidemiol 2023; 192:1731-1742. [PMID: 37246316 DOI: 10.1093/aje/kwad129] [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: 10/01/2022] [Revised: 04/12/2023] [Accepted: 05/24/2023] [Indexed: 05/30/2023] Open
Abstract
As evidence of the relationship between place and health mounts, more epidemiologists and clinical science researchers are becoming interested in incorporating place-based measures and analyses into their examination of population health and health inequities. Given the extensive literature on place and health, it can be challenging for researchers new to this area to develop neighborhood-effects research questions and apply the appropriate measures and methods. This paper provides a road map for guiding health researchers through the conceptual and methodological stages of incorporating various dimensions of place into their quantitative health research. Synthesizing across reviews, commentaries, and empirical investigations, the road map consists of 4 broad stages for considering place and health: 1) why?: articulating the motivation for assessing place and health and grounding the motivation in theory; 2) what?: identifying the relevant place-based characteristics and specifying their link to health to build a conceptual framework; 3) how?: determining how to operationalize the conceptual framework by defining, measuring, and assessing place-based characteristics and quantifying their effect on health; and 4) now what?: discussing the implications of neighborhood research findings for future research, policy, and practice. This road map supports efforts to develop conceptually and analytically rigorous neighborhood research projects.
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27
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Lorusso L, Bacchini F. The indispensability of race in medicine. THEORETICAL MEDICINE AND BIOETHICS 2023; 44:421-434. [PMID: 37040059 PMCID: PMC10088754 DOI: 10.1007/s11017-023-09622-6] [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] [Accepted: 03/18/2023] [Indexed: 06/19/2023]
Abstract
A movement asking to take race out of medicine is growing in the US. While we agree with the necessity to get rid of flawed assumptions about biological race that pervade automatic race correction in medical algorithms, we urge caution about insisting on a blanket eliminativism about race in medicine. If we look at racism as a fundamental cause, in the sense that this notion has been introduced in epidemiological studies by Bruce Link and Jo Phelan, we must conclude that race is indispensable to consider, investigate, and denounce the health effects of multilevel racism, and cannot be eliminated by addressing more specific risk factors in socially responsible epidemiology and clinical medicine. This does not mean that realism about human races is vindicated. While maintaining that there are no human races, we show how it is that a non-referring concept can nonetheless turn out indispensable for explaining real phenomena.
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Affiliation(s)
- Ludovica Lorusso
- Department of Social Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fabio Bacchini
- Laboratory of Applied Epistemology, DADU, University of Sassari, Alghero, Italy
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28
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Oh H. Racial Capitalism and Neighborhood Health Disparities: the COVID-19 in California Counties. J Racial Ethn Health Disparities 2023; 10:2338-2343. [PMID: 36097313 PMCID: PMC9466309 DOI: 10.1007/s40615-022-01413-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/01/2022] [Accepted: 09/04/2022] [Indexed: 12/04/2022]
Abstract
PURPOSE This article explores the association between racial capitalism and neighborhood-level health disparities, with a particular focus on COVID-19 in California. METHODS This article investigates COVID-19 incidence in 58 California counties. To account for racial capitalism, the study looks at the per capita incomes ratios (1) between whites and Blacks and (2) between whites and Hispanics. Other county-level neighborhood characteristics were controlled. RESULTS Findings from spatial autoregressive models indicate that increases in white-Black and white-Hispanic income disadvantages lead to an increase in COVID-19 incidence in 58 California counties. Findings also reveal that the disadvantage that results from the white-Black income ratio in COVID-19 spread decreases in counties that report high levels of income inequality between whites and Hispanics. DISCUSSION Findings indicate that a greater income disadvantage for racial minorities is connected to a more COVID-19 incidence. With regard to racial demographics in California, the interaction effect between measures for racial income disadvantages is discussed.
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Affiliation(s)
- Hyunsu Oh
- Department of Sociology, McDaniel College, 2 College Hill, Westminster, MD, 21157, USA.
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29
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Beogo I, Ramdé J, Anne A, Gagnon MP, Sia D, Nguemeleu Tchouaket E. e-Mental Health Program to Prevent Psychological Distress Among French-Speaking International Students in a Linguistic-Cultural Minority Context (Ottawa, Alberta, and Quebec): Protocol for the Implementation and Evaluation of Psy-Web. JMIR Res Protoc 2023; 12:e47059. [PMID: 37725428 PMCID: PMC10548325 DOI: 10.2196/47059] [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: 03/07/2023] [Revised: 07/06/2023] [Accepted: 07/25/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Based on experiences with the COVID-19 pandemic, postsecondary institutions were most affected by the restrictions. Students, especially international students, have borne the brunt associated with in-person learning restrictions imposed by public health recommendations. Canada is among the top 3 countries hosting international students (ISs), including Francophone students in provinces such as Quebec and other anglophone regions. Academic restrictions were accompanied by other measures such as quarantine, self-isolation, social distancing, and travel ban, to cite some. This has had a wide-ranging impact on these ISs. The resulting psychological distress and burden may have a much greater impact on Francophone ISs in anglophone settings, many of whom had ordinarily limited access to active offers of care in French in addition to cultural barriers and low literacy of the health care system. In order to take advantage of the effectiveness of eHealth as a pertinent and promising avenue, our project intends to build a web-based application that is cost-effective, user-friendly, anonymous, and capable to prompt interactive interventions as a first-line resource for psychological distress. In fact, internet applications have been increasingly used for the management of psychological distresses, and internet-based cognitive behavioral therapy is one of the preferred methods to prevent or control them. OBJECTIVE The aims of this study are to (1) design, implement, and maintain Psy-Web for the psychological support of ISs and (2) analyze the results of the implementation of the Psy-Web platform, the additional resources solicited, and the results obtained. METHODS This interventional project will use a sequential mixed design in the exploratory phase (phase 1) including the construction of the Psy-Web platform. A quantitative prospective component (phase 2) will include the intervention content of the Psy-Web platform. In total, 105 ISs participants (study group) and 52 ISs (control group), based on a ratio of 1:2, will be considered. The control group participants include those who did not use the web platform. RESULTS The project is at the data collection stage (phase 1). Psy-Web will be built in accordance with the DMAIC (Define, Measure, Analyze, Improve and Control) model with the perspective of boosting its robustness. As a first-line resource to prevent psychological distress and ultimately improve their academic performance, Psy-Web is an innovative opportunity for high education managers. The project involves a multisectoral and a multidisciplinary partnership. CONCLUSIONS The project will develop a promising web-based solution to prevent psychological distress. Ultimately, Psy-Web will be operable in multiple languages including French. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/47059.
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Affiliation(s)
- Idrissa Beogo
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON, Canada
- Institut du Savoir Montfort, Ottawa, ON, Canada
| | - Jean Ramdé
- Département des fondements et pratiques en éducation, Université Laval, Québec, QC, Canada
| | - Abdoulaye Anne
- Département des fondements et pratiques en éducation, Université Laval, Québec, QC, Canada
| | | | - Drissa Sia
- Département des sciences infirmières, Université du Québec en Outaouais, Saint-Jérôme, QC, Canada
- Département de médecine sociale et préventive, École de santé publique, Université de Montréal, Montréal, QC, Canada
| | - Eric Nguemeleu Tchouaket
- Département des sciences infirmières, Université du Québec en Outaouais, Saint-Jérôme, QC, Canada
- Département de gestion, d'évaluation et de politique de santé, Université de Montréal, Montréal, QC, Canada
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Campbell J, Kaur A, Gamino D, Benoit E, Amos B, Windsor L. Individual and structural determinants of COVID-19 vaccine uptake in a marginalized community in the United States. Vaccine 2023; 41:5706-5714. [PMID: 37550145 PMCID: PMC10560547 DOI: 10.1016/j.vaccine.2023.07.077] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/29/2023] [Accepted: 07/30/2023] [Indexed: 08/09/2023]
Abstract
Socially and medically vulnerable groups (e.g., people 65 years or older, minoritized racial groups, non-telework essential workers, and people with comorbid conditions) experience barriers to COVID-19 prevention and treatment, increased burden of disease, and increased risk of death from COVID-19. Researchers are paying increased attention to social determinants of health (SDH) in explaining inequities in COVID-19-related health outcomes and rates of vaccine uptake. The purpose of the present manuscript is to identify clinically significant predictors of COVID-19 vaccine uptake among people who were socially and medically vulnerable to SARs-CoV-2 infection. Analysis was informed by the SDH framework and included a sample of 641 baseline surveys from participants in a clinical trial designed to increase COVID-19 testing. All participants were at high risk of developing COVID-19-related complications or dying from COVID-19. Following community-based participatory research principles, a well-established community collaborative board conducted every aspect of the study. Multiple logistic regressions were conducted to examine the relationships between individual and structural factors and COVID-19 vaccine uptake. In the final time adjusted model, we found that vaccine uptake was only predicted by specific individual-level factors: being 65 years and older, living with HIV/AIDS, and having previously received a flu vaccine or a COVID-19 test. Those reporting to believe in COVID-19-conspiracy theories were less likely to get the COVID-19 vaccine. More research is needed to identify predictors of vaccine uptake among people with comorbidities that make them more vulnerable to COVID-19 complications or death.
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Affiliation(s)
- Jeanna Campbell
- School of Social Work, University of Illinois Urbana-Champaign, 1010 W Nevada St, Urbana, IL 61801, United States.
| | - Amandeep Kaur
- Interdisciplinary Health Sciences Institute, University of Illinois Urbana-Champaign, 901 W University Ave Ste 201 C-261, Urbana, IL 61801, United States
| | - Danilo Gamino
- North Jersey Community Research Initiative, 393 Central Ave, Newark, NJ 07103, United States
| | - Ellen Benoit
- North Jersey Community Research Initiative, 393 Central Ave, Newark, NJ 07103, United States
| | - Brianna Amos
- Silver School of Social Work, New York University, 1 Washington Square N, New York, NY 10003, United States
| | - Liliane Windsor
- School of Social Work, University of Illinois Urbana-Champaign, 1010 W Nevada St, Urbana, IL 61801, United States; North Jersey Community Research Initiative, 393 Central Ave, Newark, NJ 07103, United States
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Dubey P, Hoover CM, Lu P, Blumberg S, Porco TC, Parsons TL, Worden L. Rates of SARS-CoV-2 transmission between and into California state prisons. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.24.23294583. [PMID: 37662306 PMCID: PMC10473789 DOI: 10.1101/2023.08.24.23294583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Correctional institutions are a crucial hotspot amplifying SARS-CoV-2 spread and disease disparity in the U.S. In the California state prison system, multiple massive outbreaks have been caused by transmission between prisons. Correctional staff are a likely vector for transmission into the prison system from surrounding communities. We used publicly available data to estimate the magnitude of flows to and between California state prisons, estimating rates of transmission from communities to prison staff and residents, among and between residents and staff within facilities, and between staff and residents of distinct facilities in the state's 34 prisons through March 22, 2021. We use a mechanistic model, the Hawkes process, reflecting the dynamics of SARS-CoV-2 transmission, for joint estimation of transmission rates. Using nested models for hypothesis testing, we compared the results to simplified models (i) without transmission between prisons, and (ii) with no distinction between prison staff and residents. We estimated that transmission between different facilities' staff is a significant cause of disease spread, and that staff are a vector of transmission between resident populations and outside communities. While increased screening and vaccination of correctional staff may help reduce introductions, large-scale decarceration remains crucially needed as more limited measures are not likely to prevent large-scale disease spread.
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Affiliation(s)
- Preeti Dubey
- Francis I. Proctor Foundation, University of California, San Francisco, Calif., USA
| | | | - Phoebe Lu
- Francis I. Proctor Foundation, University of California, San Francisco, Calif., USA
| | - Seth Blumberg
- Francis I. Proctor Foundation, University of California, San Francisco, Calif., USA
- Department of Medicine, Division of Hospital Medicine, University of California, San Francisco, Calif., USA
| | - Travis C. Porco
- Francis I. Proctor Foundation, University of California, San Francisco, Calif., USA
| | - Todd L. Parsons
- CNRS & Laboratoire de Probabilités, Statistique et Modélisation, Campus Pierre et Marie Curie, Sorbonne Université, Paris, France
| | - Lee Worden
- Francis I. Proctor Foundation, University of California, San Francisco, Calif., USA
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Zovic HL, Riley T, Perez-Bill ES, Dsouza N, Mitchell C. A Call for a Transformative Public Health Training: The Necessity of Abolition. HEALTH EDUCATION & BEHAVIOR 2023; 50:465-472. [PMID: 37525984 PMCID: PMC11075666 DOI: 10.1177/10901981231177085] [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: 08/02/2023]
Abstract
The societal distrust of public health alongside the complex, intersecting, and large public health crises of today and our future requires a transformation of the education of the next generation of public health leaders. The field of public health's goals of health equity for all cannot be advanced until our field interrogates and resists the prison industrial complex (PIC), which maintains White supremacy and (re)produces health inequities. As current and former public health students, we propose incorporating abolition of the PIC as a political vision, structural and power analysis, and organizing strategy into the public health curriculum. We highlight gaps in the public health curriculum and the existing similarities between stated goals of abolition and public health. We propose calls to action for individuals, faculty, and schools of public health to interrogate the carceral nature of public health and work toward contributing to the positive project of an abolitionist future.
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Affiliation(s)
- Haley Lipo Zovic
- University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Taylor Riley
- University of Washington School of Public Health, Seattle, WA, USA
| | | | - Nishita Dsouza
- Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
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Walters SM, Kerr J, Cano M, Earnshaw V, Link B. Intersectional Stigma as a Fundamental Cause of Health Disparities: A case study of how drug use stigma intersecting with racism and xenophobia creates health inequities for Black and Hispanic persons who use drugs over time. STIGMA AND HEALTH 2023; 8:325-343. [PMID: 37744082 PMCID: PMC10516303 DOI: 10.1037/sah0000426] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Recent evidence points to racial and ethnic disparities in drug-related deaths and health conditions. Informed by stigma, intersectionality, intersectional stigma, and fundamental cause theories, we aimed to explore whether intersectional stigma was a fundamental cause of health. We document key events and policies over time and find that when progress is made new mechanisms emerge that negatively affect health outcomes for Black and Hispanic persons. We then focus on intersectional stigma targeting Black and Hispanic persons who use drugs. We document that when a person, or group of people, occupy multiple stigmatized identities the processes of stigmatization and scapegoating are particularly persistent and pernicious since people and groups can be stigmatized and scapegoated on varying intersections. We propose that an intersectional stigma framework allows for a better understanding of observed patterns over time, thereby providing a better guide for policies and interventions designed to reduce disparities. As a framework, intersectional stigma aims to recognize that when different sources of stigma collide, a new set of circumstances is created for those who reside in the intersection. We conclude that intersectional stigma is a fundamental cause of health inequities and provide policy recommendations aimed at dismantling intersectional stigma processes and mitigating the effects of intersectional stigmas to ultimately promote better health outcomes for Black and Hispanic persons who use drugs.
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Affiliation(s)
- Suzan M Walters
- School of Global Public Health, New York University, New York, NY
- Center for Drug Use and HIV/HCV Research, New York, NY
| | - Jelani Kerr
- Department of Health Promotion and Behavioral Sciences, University of Louisville, Louisville, KY
| | - Manuel Cano
- Department of Social Work, University of Texas at San Antonio, San Antonio, TX
| | - Valerie Earnshaw
- Department of Human Development and Family Sciences, University of Delaware, Newark, DE
| | - Bruce Link
- Department of Sociology, University of California Riverside, Riverside, CA
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Brown JL. Addressing Racial Capitalism's Impact on Black Essential Workers During the COVID-19 Pandemic: Policy Recommendations. J Racial Ethn Health Disparities 2023; 10:1597-1604. [PMID: 35689156 PMCID: PMC9187152 DOI: 10.1007/s40615-022-01346-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 11/09/2022]
Abstract
Black Americans are more likely to be essential workers due to racial capitalism. Because of the COVID-19 pandemic, essential workers are less able to adhere to social distancing and stay-at-home guidelines due to the nature of their work, because they are more likely to occupy crowded households, and are more likely to possess pre-existing health conditions. To assist Black essential workers in preventing infection or reducing the intensity of symptoms if contracted, vaccination against the virus is essential. Unfortunately, Black essential workers face considerable barriers to accessing vaccinations and are hesitant to receive the vaccine due to widespread misinformation and justified historical mistrust of the American medical system. The purpose of this work is to (1) describe the disproportionate impact of COVID-19 on Black essential workers due to racial capitalism, (2) outline the socioeconomic and racial barriers related to vaccination within this population, and (3) to suggest policy-related approaches to facilitate vaccination such as access to on-site vaccination opportunities, the funding of community outreach efforts, and the mandating of increased employee benefits.
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Affiliation(s)
- Jocelyn L Brown
- School of Medicine, University of Maryland Baltimore, Baltimore, MD, USA.
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Haro‐Ramos AY, Brown TT, Deardorff J, Aguilera A, Pollack Porter KM, Rodriguez HP. Frontline work and racial disparities in social and economic pandemic stressors during the first COVID-19 surge. Health Serv Res 2023; 58 Suppl 2:186-197. [PMID: 36718961 PMCID: PMC10339174 DOI: 10.1111/1475-6773.14136] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To assess the magnitude of racial-ethnic disparities in pandemic-related social stressors and examine frontline work's moderating relationship on these stressors. DATA SOURCES Employed Californians' responses to the Institute for Governmental Studies (IGS) poll from April 16-20, 2020, were analyzed. The Pandemic Stressor Scale (PSS) assessed the extent to which respondents experienced or anticipated problems resulting from the inability to pay for basic necessities, job instability, lacking paid sick leave, unavailability of childcare, and reduced wages or work hours due to COVID-19. STUDY DESIGN Mixed-effects generalized linear models estimated (1) racial-ethnic disparities in pandemic stressors among workers during the first COVID-19 surge, adjusting for covariates, and (2) tested the interaction between race-ethnicity and frontline worker status, which includes a subset of essential workers who must perform their job on-site, to assess differential associations of frontline work by race-ethnicity. DATA COLLECTION The IGS poll data from employed workers (n = 4795) were linked to the 2018 Centers for Disease Control and Prevention Social Vulnerability Index at the zip code level (N = 1068). PRINCIPAL FINDINGS The average PSS score was 37.34 (SD = 30.49). Whites had the lowest PSS score (29.88, SD = 26.52), and Latinxs had the highest (50.74, SD = 32.61). In adjusted analyses, Black frontline workers reported more pandemic-related stressors than White frontline workers (PSS = 47.73 vs. 36.96, p < 0.001). Latinxs reported more pandemic stressors irrespective of frontline worker status. However, the 5.09-point difference between Latinx frontline and non-frontline workers was not statistically different from the 4.6-point disparity between White frontline and non-frontline workers. CONCLUSION Latinx workers and Black frontline workers disproportionately reported pandemic-related stressors. To reduce stress on frontline workers during crises, worker protections like paid sick leave, universal access to childcare, and improved job security are needed, particularly for those disproportionately affected by structural inequities, such as racially minoritized populations.
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Affiliation(s)
- Alein Y. Haro‐Ramos
- Health Policy and ManagementUniversity of California Berkeley School of Public HealthBerkeleyCaliforniaUSA
| | - Timothy T. Brown
- Health Policy and ManagementUniversity of California Berkeley School of Public HealthBerkeleyCaliforniaUSA
| | - Julianna Deardorff
- Health Policy and ManagementUniversity of California Berkeley School of Public HealthBerkeleyCaliforniaUSA
- Community Health SciencesUniversity of California Berkeley School of Public HealthBerkeleyCaliforniaUSA
| | - Adrian Aguilera
- Health Policy and ManagementUniversity of California Berkeley School of Public HealthBerkeleyCaliforniaUSA
- School of Social Welfare BerkeleyUniversity of California BerkeleyBerkeleyCaliforniaUSA
| | - Keshia M. Pollack Porter
- Department of Health Policy and ManagementJohns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Hector P. Rodriguez
- Health Policy and ManagementUniversity of California Berkeley School of Public HealthBerkeleyCaliforniaUSA
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Zelner J, Naraharisetti R, Zelner S. Invited Commentary: To Make Long-Term Gains Against Infection Inequity, Infectious Disease Epidemiology Needs to Develop a More Sociological Imagination. Am J Epidemiol 2023; 192:1047-1051. [PMID: 36843044 PMCID: PMC10505408 DOI: 10.1093/aje/kwad044] [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: 09/23/2022] [Revised: 12/16/2022] [Accepted: 02/22/2023] [Indexed: 02/28/2023] Open
Abstract
In a recent article in the Journal, Noppert et al. (Am J Epidemiol. 2023;192(3):475-482) articulated in detail the mechanisms connecting high-level "fundamental social causes" of health inequity to inequitable infectious disease outcomes, including infection, severe disease, and death. In this commentary, we argue that while intensive focus on intervening mechanisms is welcome and necessary, it cannot occur in isolation from examination of the way that fundamental social causes-including racism, socioeconomic inequity, and social stigma-sustain infection inequities even when intervening mechanisms are addressed. We build on the taxonomy of intervening mechanisms laid out by Noppert et al. to create a road map for strengthening the connection between fundamental cause theory and infectious disease epidemiology and discuss its implications for future research and intervention.
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Affiliation(s)
- Jon Zelner
- Correspondence to Dr. Jon Zelner, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109 (e-mail: )
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Yoo W, Hong Y, Oh SH. Communication inequalities in the COVID-19 pandemic: socioeconomic differences and preventive behaviors in the United States and South Korea. BMC Public Health 2023; 23:1290. [PMID: 37407976 DOI: 10.1186/s12889-023-16211-8] [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: 01/19/2023] [Accepted: 06/28/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Communication inequalities are important mechanisms linking socioeconomic backgrounds to health outcomes. Guided by the structural influence model of communication, this study examined the intermediate role of health communication in the relationship between education, income, and preventive behavioral intentions during the COVID-19 pandemic in the United States and South Korea. METHODS The data were collected through two online surveys conducted by two professional research firms in the US (April 1-3, 2020) and South Korea (April 9-16, 2020). To test the mediating role of health communication, as well as the hypothesized relationships in the proposed model, we performed a path analysis using Mplus 6.1. RESULTS In analyzing survey data from 1050 American and 1175 Korean adults, we found that one's socioeconomic positions were associated with their intentions to engage in COVID-19 preventive behaviors through affecting their health communication experiences and then efficacious beliefs. Differences in education and income were associated with willingness to engage in preventive behaviors by constraining health communication among people with low levels of education and income. The findings showed notable differences and some similarities between the US and South Korea. For example, while income was positively associated with health communication in both US and South Korea, education was only significantly related to health communication in US but not in South Korea. CONCLUSIONS This study suggests health communication strategies such as choice of communication channels and messages to promote intention for COVID-19 prevention behaviors in particular consideration of individual differences in socioeconomic positions in countries with different cultural features. Pubic policies and health campaigns can utilize the suggestions to promote efficacy and preventive behavioral intention during early pandemics.
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Affiliation(s)
- Woohyun Yoo
- Department of Media and Communication & Institute of Social Sciences, Incheon National University, Incheon, South Korea
| | - Yangsun Hong
- Department of Communication and Journalism, University of New Mexico, Albuquerque, NM, USA.
| | - Sang-Hwa Oh
- Charles H. Sandage Department of Advertising, College of Media, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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Follis S, Breathett K, Garcia L, Jimenez M, Cené CW, Whitsel E, Hedlin H, Paskett ED, Zhang S, Thomson CA, Stefanick ML. Quantifying structural racism in cohort studies to advance prospective evidence. SSM Popul Health 2023; 22:101417. [PMID: 37207111 PMCID: PMC10189286 DOI: 10.1016/j.ssmph.2023.101417] [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: 11/16/2022] [Revised: 04/21/2023] [Accepted: 04/27/2023] [Indexed: 05/21/2023] Open
Abstract
Calls-to-action in health research have described a need to improve research on race, ethnicity, and structural racism. Well-established cohort studies typically lack access to novel structural and social determinants of health (SSDOH) or precise race and ethnicity categorization, contributing to a loss of rigor to conduct informative analyses and a gap in prospective evidence on the role of structural racism in health outcomes. We propose and implement methods that prospective cohort studies can use to begin to rectify this, using the Women's Health Initiative (WHI) cohort as a case study. To do so, we evaluated the quality, precision, and representativeness of race, ethnicity, and SSDOH data compared with the target US population and operationalized methods to quantify structural determinants in cohort studies. Harmonizing racial and ethnic categorization to the current standards set by the Office of Management and Budget improved measurement precision, aligned with published recommendations, disaggregated groups, decreased missing data, and decreased participants reporting "some other race". Disaggregation revealed sub-group disparities in SSDOH, including a greater proportion of Black-Latina (35.2%) and AIAN-Latina (33.3%) WHI participants with income below the US median compared with White-Latina (42.5%) participants. We found similarities in the racial and ethnic patterning of SSDOH disparities between WHI and US women but less disparity overall in WHI. Despite higher individual-level advantage in WHI, racial disparities in neighborhood resources were similar to the US, reflecting structural racism. Median neighborhood income was comparable between Black WHI ($39,000) and US ($34,700) women. WHI SSDOH-associated outcomes may be generalizable on the basis of comparing across race and ethnicity but may quantitatively (but not qualitatively) underestimate US effect sizes. This paper takes steps towards data justice by implementing methods to make visible hidden health disparity groups and operationalizing structural-level determinants in prospective cohort studies, a first step to establishing causality in health disparities research.
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Affiliation(s)
- Shawna Follis
- Stanford Prevention Research Center, Department of Medicine, Stanford University, 3180 Porter Drive, Mail Code 5702, Palo Alto, CA, 94304, USA
- Corresponding author.
| | - Khadijah Breathett
- Division of Cardiovascular Medicine, Indiana University, Indianapolis, IN, USA
| | - Lorena Garcia
- UC Davis School of Medicine, Department of Public Health Sciences, Davis, CA, USA
| | - Monik Jimenez
- Division of Women's Health and Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Crystal W. Cené
- University of California, San Diego Department of Medicine, San Diego, CA, USA
| | - Eric Whitsel
- Department of Epidemiology, Gillings School of Global Public Health and Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Haley Hedlin
- Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, CA, USA
| | | | - Shiqi Zhang
- Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, CA, USA
| | - Cynthia A. Thomson
- Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Marcia L. Stefanick
- Stanford Prevention Research Center, Department of Medicine, Stanford University, 3180 Porter Drive, Mail Code 5702, Palo Alto, CA, 94304, USA
- Department of Obstetrics & Gynecology and Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA
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Eisenberg-Guyot J, Finsaas MC, Prins SJ. Dead Labor: Mortality Inequities by Class, Gender, and Race/Ethnicity in the United States, 1986-2019. Am J Public Health 2023; 113:637-646. [PMID: 36926964 PMCID: PMC10186820 DOI: 10.2105/ajph.2023.307227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 03/17/2023]
Abstract
Objectives. To estimate social class inequities in US mortality using a relational measure based on power over productive property and workers' labor. Methods. We used nationally representative 1986-2018 National Health Interview Survey data with mortality follow-up through December 31, 2019 (n = 911 850). First, using business-ownership, occupational, and employment-status data, we classified respondents as incorporated business owners (IBOs), unincorporated business owners (UBOs), managers, workers, or not in the labor force (NLFs). Next, using inverse-probability-weighted survival curves, we estimated class mortality inequities overall, after subdividing workers by employment status and occupation, and by period, gender, race/ethnicity, and education. Results. UBOs, workers, and NLFs had, respectively, 6.3 (95% confidence interval [CI] = -8.1, -4.6), 6.6 (95% CI = -8.1, -5.0), and 19.4 (95% CI = -21.0, -17.7) per 100 lower 34-year survival rates than IBOs. Mortality risk was especially high for unemployed, blue-collar, and service workers. Inequities increased over time and were greater among male, racially minoritized, and less-educated respondents. Conclusions. We estimated considerable mortality inequities by class, gender, and race/ethnicity. We also estimated that class mortality inequities are increasing, threatening population health. Public Health Implications. Addressing class inequities likely requires structural, worker-empowering interventions. (Am J Public Health. 2023;113(6):637-646. https://doi.org/10.2105/AJPH.2023.307227).
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Affiliation(s)
- Jerzy Eisenberg-Guyot
- Jerzy Eisenberg-Guyot and Megan C. Finsaas are with the Department of Epidemiology and Seth J. Prins is with the Departments of Epidemiology and Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Megan C Finsaas
- Jerzy Eisenberg-Guyot and Megan C. Finsaas are with the Department of Epidemiology and Seth J. Prins is with the Departments of Epidemiology and Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Seth J Prins
- Jerzy Eisenberg-Guyot and Megan C. Finsaas are with the Department of Epidemiology and Seth J. Prins is with the Departments of Epidemiology and Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
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Quinn KG, Harris M, Sherrod D, Hunt BR, Jacobs J, Valencia J, Walsh JL. The COVID-19, racism, and violence syndemic: Evidence from a qualitative study with Black residents of Chicago. SSM. QUALITATIVE RESEARCH IN HEALTH 2023; 3:100218. [PMID: 36628065 PMCID: PMC9817424 DOI: 10.1016/j.ssmqr.2023.100218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/09/2023]
Abstract
The COVID-19 pandemic emerged in the United States in the shadows of a vast history of structural racism and community and police violence that disproportionately affect Black communities. Collectively, they have created a syndemic, wherein COVID-19, racism, and violence are mutually reinforcing to produce adverse health outcomes. The purpose of this study was to understand the COVID-19, racism, and violence syndemic and examine how structural racism and violence contributed to the disproportionate impact of COVID-19 on Black communities. In early 2021, we conducted phenomenological qualitative interviews with 50 Black residents of Chicago. Interview transcripts were coded and analyzed using thematic analysis. We identified four primary themes in our analyses: 1) the intersection of racism and violence in Chicago; 2) longstanding inequities were laid bare by COVID-19; 3) the pervasiveness of racism and violence contributes to poor mental health; 4) and COVID-19, racism and violence emerged as a syndemic. Our findings underscore the importance of addressing social and structural factors in remediating the health and social consequences brought about by COVID-19.
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Affiliation(s)
- Katherine G Quinn
- Medical College of Wisconsin, Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research (CAIR), Milwaukee, WI, USA
| | - Melissa Harris
- Medical College of Wisconsin, Institute of Health and Equity, Milwaukee, WI, USA
| | - Darielle Sherrod
- Sinai Health System, Sinai Urban Health Institute, Chicago, IL, USA
| | - Bijou R Hunt
- Sinai Health System, Sinai Infectious Disease Center, Chicago, IL, USA
| | - Jacquelyn Jacobs
- Sinai Health System, Sinai Urban Health Institute, Chicago, IL, USA
| | - Jesus Valencia
- Sinai Health System, Sinai Urban Health Institute, Chicago, IL, USA
| | - Jennifer L Walsh
- Medical College of Wisconsin, Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research (CAIR), Milwaukee, WI, USA
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Anneser E, Stopka TJ, Naumova EN, Spangler KR, Lane KJ, Acevedo A, Griffiths JK, Lin Y, Levine P, Corlin L. Environmental equity and COVID-19 experiences in the United States: Results from three survey waves of a nationally representative study conducted between 2020-2022. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.16.23290050. [PMID: 37293071 PMCID: PMC10246057 DOI: 10.1101/2023.05.16.23290050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Certain environmental exposures, such as air pollution, are associated with COVID-19 incidence and mortality. To determine whether environmental context is associated with other COVID-19 experiences, we used data from the nationally representative Tufts Equity in Health, Wealth, and Civic Engagement Study data (n=1785; three survey waves 2020-2022). Environmental context was assessed using self-reported climate stress and county-level air pollution, greenness, toxic release inventory site, and heatwave data. Self-reported COVID-19 experiences included willingness to vaccinate against COVID-19, health impacts from COVID-19, receiving assistance for COVID-19, and provisioning assistance for COVID-19. Self-reported climate stress in 2020 or 2021 was associated with increased COVID-19 vaccination willingness by 2022 (odds ratio [OR] = 2.35; 95% confidence interval [CI] = 1.47, 3.76), even after adjusting for political affiliation (OR = 1.79; 95% CI = 1.09, 2.93). Self-reported climate stress in 2020 was also associated with increased likelihood of receiving COVID-19 assistance by 2021 (OR = 1.89; 95% CI = 1.29, 2.78). County-level exposures (i.e., less greenness, more toxic release inventory sites, more heatwaves) were associated with increased vaccination willingness. Air pollution exposure in 2020 was positively associated with likelihood of provisioning COVID-19 assistance in 2020 (OR = 1.16 per μg/m3; 95% CI = 1.02, 1.32). Associations between certain environmental exposures and certain COVID-19 outcomes were stronger among those who identify as a race/ethnicity other than non-Hispanic White and among those who reported experiencing discrimination; however, these trends were not consistent. A latent variable representing a summary construct for environmental context was associated with COVID-19 vaccination willingness. Our results add to the growing body of literature suggesting that intersectional equity issues affecting likelihood of exposure to adverse environmental conditions are also associated with health-related outcomes.
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Affiliation(s)
- Elyssa Anneser
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Thomas J. Stopka
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
- Tufts Clinical and Translational Sciences Institute, Boston, MA, USA
| | - Elena N. Naumova
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA, USA
- Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Keith R. Spangler
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Kevin J. Lane
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Andrea Acevedo
- Department of Community Health, Tufts University School of Arts and Sciences, Medford, MA, USA
| | - Jeffrey K. Griffiths
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA, USA
- Department of Infectious Disease and Global Health, Tufts University Cummings School of Veterinary Medicine, Grafton, MA, USA
- Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston, MA
| | - Yan Lin
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Peter Levine
- Jonathan Tisch College of Civic Life, Tufts University, Medford, MA, USA
| | - Laura Corlin
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA, USA
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Sprague Martinez L, Scott JC, Rocco M, Rajabiun S, Flores Rodriguez C, Cummings R, McKinney-Prupis E, Minott M, Walker-Jones J, Downes A, Wangari Walter A. Policies enacted during COVID-19 came with unintended health benefits: why go back? BMC Health Serv Res 2023; 23:496. [PMID: 37194099 DOI: 10.1186/s12913-023-09448-x] [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: 10/03/2022] [Accepted: 04/25/2023] [Indexed: 05/18/2023] Open
Abstract
OBJECTIVES To explore the impact of COVID-19 on the implementation of bundled interventions to improve the engagement and retention of Black women in HIV care. METHODS Pre-implementation interviews conducted between January and April 202 L with 12 demonstration sites implementing bundled interventions for Black women with HIV. Directed content analysis was employed to examine the site interview transcripts. RESULTS The pandemic intensified barriers to care and harmful social conditions. However, COVID-19 also forced pivots in health care and social service delivery and some of these changes benefited Black women living with HIV. CONCLUSIONS The continuation of policies that support the material needs of Black women with HIV and ease access to care is critical. Racial capitalism impedes the enactment of these policies and thus threatens public health.
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Affiliation(s)
| | | | - Melanie Rocco
- Boston University School of Social Work, Boston, MA, US
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Hailey CA, Murray B, Boggs R, Broussard J, Flores M. Unmasking racial avoidance: Experimental evidence on parental school choice and public health policies during the Covid-19 pandemic. Soc Sci Med 2023; 327:115915. [PMID: 37163785 PMCID: PMC10108560 DOI: 10.1016/j.socscimed.2023.115915] [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: 10/31/2022] [Revised: 03/18/2023] [Accepted: 04/15/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND COVID-19 drastically changed the school choice landscape as families considered schools with varying public health protocols as well as academic and demographic characteristics. Our understanding of families' preferences during the pandemic is limited, however, because it primarily derives from surveys asking parents about a single school characteristic. OBJECTIVE We aimed to understand how families' preferences for schools' racial composition and public health policies may interdepend. METHODS We conducted an original school choice survey experiment with U.S. White parents in August 2021. Parents indicated their willingness to enroll their student in hypothetical schools with experimentally randomized school quality ratings, racial and socioeconomic demographics, and COVID mitigation strategies (i.e. instructional modalities, mask and vaccination mandates). RESULTS We find novel causal evidence that White parents' preferences for schools' racial demographics and public health policies are interdependent. Among otherwise similar schools, parents expressed stronger preferences to avoid Black, Latinx, and Asian schools when there were fewer COVID mitigation policies. Relatedly, parents required more stringent COVID protocols for their children to attend predominantly Black, Latinx, and Asian schools while showing no preferences for COVID policies among predominantly White schools. The interdependence of preferred racial demographics and public health polices was amplified among White parents who held stigmatizing beliefs about Asian populations carrying the COVID virus and pro-White sentiments. Although Democrats expressed stronger preferences for schools with more COVID mitigation strategies than Republicans, for White parents across the political spectrum school racial composition and COVID mitigation preferences interdepended. CONCLUSIONS This study suggests families may leverage flexible student assignment policies and schools of choice to enroll in or avoid schools based on both preferred public health policies and racial demographics. Districts should consider how adopting strong public health policies during infectious disease outbreaks may help mitigate hardened racial avoidance and school racial segregation.
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Affiliation(s)
- Chantal A Hailey
- Department of Sociology the University of Texas at Austin, 305 E 23rd St, A1700, RLP 3.306, Austin, TX, 78712, USA.
| | - Brittany Murray
- Department of Education Studies and Political Science, Davidson College, Box 7124, Davidson, NC, 28035, USA.
| | - Rachel Boggs
- Department of Education Leadership and Policy, The University of Texas at Austin, 1912 Speedway, Stop D5000, Austin, TX, 78712, USA.
| | - Jalisa Broussard
- Department of Sociology the University of Texas at Austin, 305 E 23rd St, A1700, RLP 3.306, Austin, TX, 78712, USA.
| | - Milani Flores
- Department of Sociology the University of Texas at Austin, 305 E 23rd St, A1700, RLP 3.306, Austin, TX, 78712, USA.
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Trounstine J, Goldman-Mellor S. County-Level Segregation and Racial Disparities in COVID-19 Outcomes. JOURNAL OF HEALTH POLITICS, POLICY AND LAW 2023; 48:187-214. [PMID: 36174248 DOI: 10.1215/03616878-10234170] [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: 06/16/2023]
Abstract
CONTEXT Segregation has been linked to unequal life chances. Individuals from marginalized communities experience more crime, higher levels of poverty, poorer health, and less civic engagement. In addition, segregated metropolitan regions have been found to display inequality in access to basic services. This article builds on these findings by linking segregation to infection and deaths from COVID-19. METHODS Using census data matched to COVID infection and death statistics at the county level, this article offers a theoretical basis for the researchers' choice of segregation measures and predictions for different racial groups. It analyzes the relationship between two dimensions of segregation-racial isolation and racial unevenness-and COVID outcomes for different racial and ethnic groups. FINDINGS In counties where Black and Latino residents lived in more racially isolated neighborhoods, they were much more likely to contract COVID-19. This pattern was exacerbated in counties with a high proportion of frontline workers. In addition, racial segregation increased COVID-19 death rates for Black, Latino, and white residents. CONCLUSIONS These findings suggest that devastating outcomes of the coronavirus pandemic were linked to a long history of racial marginalization and entrenched discrimination produced by structural inequalities embedded in our geographies. This knowledge should be used to inform public health planning.
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Racial and Ethnic Disparities in Mental Health and Mental Health Care During The COVID-19 Pandemic. J Racial Ethn Health Disparities 2023; 10:961-976. [PMID: 35318615 PMCID: PMC8939391 DOI: 10.1007/s40615-022-01284-9] [Citation(s) in RCA: 89] [Impact Index Per Article: 89.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 12/28/2022]
Abstract
During the pandemic, the overall mental health of the US population declined. Given higher rates of COVID-19 infections and deaths experienced by communities of color along with greater exposure to pandemic-related stressors (e.g., unemployment, food insecurity), we expect that the decline in mental health during the pandemic was more pronounced among Black, Hispanic, and Asian adults, with these groups also having less access to mental health services. We examine two nationally representative US surveys: the 2019 National Household Interview Survey (NHIS; N = 30,368) and the 2020-2021 Household Pulse Survey (HPS; N = 1,677,238). We find mental health of Black, Hispanic, and Asian respondents worsened relative to White respondents during the pandemic, with significant increases in depression and anxiety among racialized minorities compared to Whites. There is also evidence of especially high mental health burden for Black adults around the murder of George Floyd by police and for Asian adults around the murder of six Asian women in Atlanta. White respondents are most likely to receive professional mental health care before and during the pandemic, and Black, Hispanic, and Asian respondents demonstrate higher levels of unmet mental health care needs during the pandemic than White respondents. Our results indicate that within the current environment, White adults are at a large and systemic advantage buffering them from unexpected crises-like the COVID-19 pandemic. Without targeted interventions, the long-term social consequences of the pandemic and other co-occurring events (e.g., death of Black and Hispanic people by police) will likely include widening mental health disparities between racial/ethnic groups.
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PONCE NINEZA, SHIMKHADA RITI, ADKINS‐JACKSON PARISB. Making Communities More Visible: Equity-Centered Data to Achieve Health Equity. Milbank Q 2023; 101:302-332. [PMID: 37096622 PMCID: PMC10126976 DOI: 10.1111/1468-0009.12605] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 11/18/2022] [Accepted: 01/06/2023] [Indexed: 04/26/2023] Open
Abstract
Policy Points Despite decades of research exposing health disparities between populations and communities in the US, health equity goals remain largely unfulfilled. We argue these failures call for applying an equity lens in the way we approach data systems, from collection and analysis to interpretation and distribution. Hence, health equity requires data equity. There is notable federal interest in policy changes and federal investments to improve health equity. With this, we outline the opportunities to align these health equity goals with data equity by improving the way communities are engaged and how population data are collected, analyzed, interpreted, made accessible, and distributed. Policy priority areas for data equity include increasing the use of disaggregated data, increasing the use of currently underused federal data, building capacity for equity assessments, developing partnerships between government and community, and increasing data accountability to the public.
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Affiliation(s)
- NINEZ A. PONCE
- Center for Health Policy ResearchUniversity of CaliforniaLos Angeles
- Los Angeles Fielding School of Public HealthUniversity of California
| | - RITI SHIMKHADA
- Center for Health Policy ResearchUniversity of CaliforniaLos Angeles
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47
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Olds PK, Musinguzi N, Geisler BP, Haberer JE. Evaluating disparities by social determinants in hospital admission decisions for patients with COVID-19 quaternary hospital early in the pandemic. Medicine (Baltimore) 2023; 102:e33178. [PMID: 36897732 PMCID: PMC9997198 DOI: 10.1097/md.0000000000033178] [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: 12/15/2022] [Accepted: 02/13/2023] [Indexed: 03/11/2023] Open
Abstract
The COVID-19 pandemic has highlighted significant disparities in hospital outcomes when focusing on social determinants of health. Better understanding the drivers of these disparities is not only critical for COVID-19 care but also to ensure equitable treatment more generally. In this paper, we look at how hospital admission patterns, both to the medical ward and the intensive care unit (ICU), may have differed by race, ethnicity, and social determinants of health. We conducted a retrospective chart review of all patients who presented to the Emergency Department of a large quaternary hospital between March 8 and June 3, 2020. We built logistic regression models to analyze how race, ethnicity, area deprivation index, English as a primary language, homelessness, and illicit substance use impacted the likelihood of admission while controlling for disease severity and timing of admission in relation to the start of data collection. We had 1302 recorded Emergency Department visits of patients diagnosed with SARS-CoV-2. White, Hispanic, and African American patients made up 39.2%, 37.5%, and 10.4% of the population respectively. Primary language was recorded as English for 41.2% and non-English for 30% of patients. Among the social determinants of health assessed, we found that illicit drug use significantly increased the likelihood for admission to the medical ward (odds ratio 4.4, confidence interval 1.1-17.1, P = .04), and that having a language other than English as a primary language significantly increased the likelihood of ICU admission (odds ratio 2.6, confidence interval 1.2-5.7, P = .02). Illicit drug use was associated with an increased likelihood of medical ward admission, potentially due to clinician concerns for complicated withdrawal or blood-stream infections from intravenous drug use. The increased likelihood of ICU admission associated with a primary language other than English may have been driven by communication difficulties or differences in disease severity that our model did not detect. Further work is required to better understand drivers of disparities in hospital COVID-19 care.
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Affiliation(s)
- Peter K. Olds
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - Benjamin P. Geisler
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Ludwig Maximilian University Munich, Munich, Germany
| | - Jessica E. Haberer
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Mbarara University of Science and Technology, Mbarara, Uganda
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48
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Anglin DM, Lui F. Racial microaggressions and major discriminatory events explain ethnoracial differences in psychotic experiences. Schizophr Res 2023; 253:5-13. [PMID: 34750038 PMCID: PMC11056996 DOI: 10.1016/j.schres.2021.10.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 11/27/2022]
Abstract
Few empirical studies have examined whether exposure to major racial discrimination explains ethnoracial disparities in psychosis outcomes and none to our knowledge have done so in the U.S. or have examined the role of other forms of racism such as racial microaggressions. The present study examined ethnoracial differences in self-reported psychotic experiences (PE) among 955 college students in an urban environment in the Northeastern U.S., and the degree to which major experiences of racial discrimination and racial microaggressions explains ethnoracial differences in PE. Mean scores on self-report inventories of PE and distressing PE (i.e., Prodromal Questionnaire (PQ)), major experiences of racial discrimination (EOD), and racial and ethnic microaggressions (REMS) were compared across 4 ethnoracial groups (White, Black, Asian, and Latina/o). Results from parallel mediation linear regression models adjusted for immigrant status, age, gender, and family poverty using the Hayes PROCESS application indicated ethnoracial differences in PE were explained independently by both forms of racism. Specifically, Black young people reported higher mean levels of PE, and distressing PE than both White and Latina/o people and the difference in PE between Black and White and Black and Latino/a young people was significantly explained by both greater exposure to racial microaggressions and major racial discriminatory experiences among Black people. This study re-emphasizes the explanatory role of racism, in its multiple forms, for psychosis risk among Black young populations in the US. Anti-racism interventions at both structural and interpersonal levels are necessary components of public health efforts to improve mental health in Black populations.
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Affiliation(s)
- Deidre M Anglin
- Department of Psychology, The City College of New York, City University of New York, 160 Convent Avenue, North Academic Center, New York, NY 10031, United States of America; The Graduate Center, City University of New York, 365 5th Avenue, New York, NY, 10016, United States of America.
| | - Florence Lui
- Memorial Sloan-Kettering Cancer Center, 641 Lexington Ave., New York, NY 10022, United States of America
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49
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Wilson RF, Kota KK, Sheats KJ, Luna-Pinto C, Owens C, Harrison DD, Razi S. Call out racism and inequity in reports on vaccine intentions. Nat Hum Behav 2023; 7:300-302. [PMID: 36755132 DOI: 10.1038/s41562-023-01532-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
- Rebecca F Wilson
- Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA, USA.
| | - Krishna Kiran Kota
- Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, Oak Ridge, TN, USA
| | - Kameron J Sheats
- CDC, National Center for Injury Prevention and Control, Division of Violence Prevention, Atlanta, GA, USA
| | - Carolina Luna-Pinto
- Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA, USA
| | - Chantelle Owens
- Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA, USA
| | - Dominique D Harrison
- Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, Oak Ridge, TN, USA
- CDC, National Center for Injury Prevention and Control, Division of Violence Prevention, Atlanta, GA, USA
| | - Sima Razi
- Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA, USA
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50
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Saqib K, Qureshi AS, Butt ZA. COVID-19, Mental Health, and Chronic Illnesses: A Syndemic Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3262. [PMID: 36833955 PMCID: PMC9962717 DOI: 10.3390/ijerph20043262] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The COVID-19 pandemic is an epidemiological and psychological crisis; what it does to the body is quite well known by now, and more research is underway, but the syndemic impact of COVID-19 and mental health on underlying chronic illnesses among the general population is not completely understood. METHODS We carried out a literature review to identify the potential impact of COVID-19 and related mental health issues on underlying comorbidities that could affect the overall health of the population. RESULTS Many available studies have highlighted the impact of COVID-19 on mental health only, but how complex their interaction is in patients with comorbidities and COVID-19, the absolute risks, and how they connect with the interrelated risks in the general population, remain unknown. The COVID-19 pandemic can be recognized as a syndemic due to; synergistic interactions among different diseases and other health conditions, increasing overall illness burden, emergence, spread, and interactions between infectious zoonotic diseases leading to new infectious zoonotic diseases; this is together with social and health interactions leading to increased risks in vulnerable populations and exacerbating clustering of multiple diseases. CONCLUSION There is a need to develop evidence to support appropriate and effective interventions for the overall improvement of health and psychosocial wellbeing of at-risk populations during this pandemic. The syndemic framework is an important framework that can be used to investigate and examine the potential benefits and impact of codesigning COVID-19/non-communicable diseases (NCDs)/mental health programming services which can tackle these epidemics concurrently.
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Affiliation(s)
- Kiran Saqib
- School of Public health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Afaf Saqib Qureshi
- Whiting School of Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Zahid Ahmad Butt
- School of Public health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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