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Plasencia G, Kaalund K, Gupta R, Martinez-Bianchi V, Gonzalez-Guarda R, Sperling J, Thoumi A. ¿No Hay Racismo?: application of the levels of racism framework to Latinx perspectives on barriers to health and wellbeing. BMC Public Health 2024; 24:2105. [PMID: 39103864 PMCID: PMC11299397 DOI: 10.1186/s12889-024-19587-3] [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: 12/14/2023] [Accepted: 07/25/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND The purpose of this study is to increase understanding of the forms of systemic racism experienced by Latinx communities in North Carolina during the COVID-19 pandemic as identified by Latinx community health workers (CHWs) and community-based organization (CBO) leaders. METHODS We held three focus groups in July 2022 (N = 16) with CHWs and CBO leaders in Spanish to discuss policy and community interventions that improved access to resources during the COVID-19 pandemic; policy or community interventions needed to improve care of Latinx communities; and lessons learned to improve the health of Latinx communities in the future. We performed directed and summative qualitative content analysis of the data in the original language using the Levels of Racism Framework by Dr. Camara Jones to identify examples of implicitly and explicitly discussed forms of systemic racism. RESULTS Latinx CHWs and CBO leaders implicitly discussed numerous examples of all levels of racism when seeking and receiving health services, such as lack of resources for undocumented individuals and negative interactions with non-Latinx individuals, but did not explicitly name racism. Themes related to institutionalized racism included: differential access to resources due to language barriers; uninsured or undocumented status; exclusionary policies not accounting for cultural or socioeconomic differences; lack of action despite need; and difficulties obtaining sustainable funding. Themes related to personally-mediated racism included: lack of cultural awareness or humility; fear-inciting misinformation targeting Latinx populations; and negative interactions with non-Latinx individuals, organizations, or institutions. Themes related to internalized racism included: fear of seeking information or medical care; resignation or hopelessness; and competition among Latinx CBOs. Similarly, CHWs and CBO leaders discussed several interventions with systems-level impact without explicitly mentioning policy or policy change. CONCLUSION Our research demonstrates community-identified examples of racism and confirms that Latinx populations often do not name racism explicitly. Such language gaps limit the ability of CHWs and CBOs to highlight injustices and limit the ability of communities to advocate for themselves. Although generally COVID-19 focused, themes identified represent long-standing, systemic barriers affecting Latinx communities. It is therefore critical that public and private policymakers consider these language gaps and engage with Latinx communities to develop community-informed anti-racist policies to sustainably reduce forms of racism experienced by this unique population.
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Affiliation(s)
- Gabriela Plasencia
- Duke Department of Family Medicine & Community Health, Durham, NC, 701 W Main Street, 27701, USA.
- Latinx Advocacy Team & Interdisciplinary Network for COVID, -19 (LATIN-19), Durham, NC, USA.
- Duke-Margolis Health Policy Institute, 230 Science Dr, Durham, NC, United States.
- Duke Clinical and Translational Science Institute, Durham, NC, United States.
| | - Kamaria Kaalund
- Duke-Margolis Health Policy Institute, 230 Science Dr, Durham, NC, United States
| | - Rohan Gupta
- Duke-Margolis Health Policy Institute, 230 Science Dr, Durham, NC, United States
| | - Viviana Martinez-Bianchi
- Duke Department of Family Medicine & Community Health, Durham, NC, 701 W Main Street, 27701, USA
- Latinx Advocacy Team & Interdisciplinary Network for COVID, -19 (LATIN-19), Durham, NC, USA
| | - Rosa Gonzalez-Guarda
- Latinx Advocacy Team & Interdisciplinary Network for COVID, -19 (LATIN-19), Durham, NC, USA
- School of Nursing, Duke University, Durham, NC, 27708, United States
- Duke Clinical and Translational Science Institute, Durham, NC, United States
| | - Jessica Sperling
- Duke Social Science Research Institute, Durham, NC, Gross Hall, 140 Science Dr 2nd Floor, 27708, United States
- Duke Clinical and Translational Science Institute, Durham, NC, United States
| | - Andrea Thoumi
- Duke Department of Family Medicine & Community Health, Durham, NC, 701 W Main Street, 27701, USA
- Latinx Advocacy Team & Interdisciplinary Network for COVID, -19 (LATIN-19), Durham, NC, USA
- Duke-Margolis Health Policy Institute, Washington, DC, 1201 Pennsylvania Avenue NW 5th floor, 20004, United States
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Willis DE, Kaholokula JK, Andersen JA, Selig JP, Bogulski CA, Scott AJ, McElfish PA. Racial Misclassification, Discrimination, Consciousness, and Self-Rated Health Among Native Hawaiian and Pacific Islander Adults in the USA. J Racial Ethn Health Disparities 2024; 11:730-738. [PMID: 36892814 PMCID: PMC9997430 DOI: 10.1007/s40615-023-01556-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/10/2023]
Abstract
BACKGROUND Medical researchers have historically utilized the variable of race uncritically, rarely defining race, rarely acknowledging it as a social construct, and often omitting information about how it was measured. In this study, we use the following definition of race: "a system of structuring opportunity and assigning value based on the social interpretation of how one looks." We examine the influence of racial misclassification, racial discrimination, and racial consciousness on the self-rated health of Native Hawaiian and Pacific Islanders (NHPI) living in the United States of America (USA). METHODS Our analysis used online survey data from a subgroup of NHPI adults living in the USA (n = 252) who were oversampled as part of a larger study of US adults (N = 2022). Respondents were recruited between September 7, 2021 and October 3, 2021, from an online opt-in panel of individuals across the USA. Statistical analyses include weighted and unweighted descriptive statistics for the sample, as well as a weighted logistic regression for poor/fair self-rated health. RESULTS Odds of poor/fair self-rated health were greater for women (OR = 2.72; 95% CI [1.19, 6.21]) and those who experienced racial misclassification (OR = 2.90; 95% CI [1.20, 7.05]). No other sociodemographic, healthcare, or race-related variables were significantly associated with self-rated health in the fully adjusted results. CONCLUSIONS Findings suggest that racial misclassification may be an important correlate of self-rated health among NHPI adults in the US context.
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Affiliation(s)
- Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA.
| | - Joseph Keawe'aimoku Kaholokula
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI, USA
| | - Jennifer A Andersen
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Cari A Bogulski
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Aaron J Scott
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
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Andersen JA, Willis DE, Kaholokula JK, Rowland B, Council S, Riklon S, McElfish PA. Experiences of Discrimination Among Native Hawaiians and Pacific Islanders Living in the USA. J Racial Ethn Health Disparities 2024; 11:184-191. [PMID: 36626048 PMCID: PMC9838348 DOI: 10.1007/s40615-022-01509-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/07/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023]
Abstract
Experiences of racism and discrimination are stressors that adversely affect the well-being of marginalized populations, including Native Hawaiians and Pacific Islanders (NHPI). However, commonly used data aggregation methods obscure information on NHPI communities and their lived experiences. The aim of our study is to understand the types and frequency of discrimination experienced by NHPI adults in the USA. The study utilized online survey data collected from 252 NHPI adults living in the USA between September and October 2021. Younger NHPI adults, those who report constantly thinking about their race/ethnicity, and those who are socially assigned a race/ethnicity that does not match their own report experiencing more types of discrimination. NHPI who constantly think about their race/ethnicity and those who are socially assigned a race/ethnicity that does not match their own report a greater frequency of discrimination. Findings indicate the need to understand the experiences of discrimination in this population.
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Affiliation(s)
- Jennifer A. Andersen
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St, Springdale, AR 72762 USA
| | - Don E. Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St, Springdale, AR 72762 USA
| | - Joseph Keawe‘aimoku Kaholokula
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai’i at Manoa, 651 Ilalo St, Honolulu, HI 96813 USA
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St, Springdale, AR 72762 USA
| | - Sarah Council
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St, Springdale, AR 72762 USA
| | - Sheldon Riklon
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St, Springdale, AR 72762 USA
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St, Springdale, AR 72762 USA
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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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Fakolade A, Akbar N, Mehelay S, Phadke S, Tang M, Alqahtani A, Pullattayil AK, Busse M. Mapping two decades of multiple sclerosis rehabilitation trials: A systematic scoping review and call to action to advance the study of race and ethnicity in rehabilitation research. Mult Scler Relat Disord 2023; 72:104606. [PMID: 36917889 DOI: 10.1016/j.msard.2023.104606] [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: 11/21/2022] [Revised: 01/16/2023] [Accepted: 03/04/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Multiple sclerosis (MS), is prevalent across many racial and ethnic groups, and disproportionately impacts racially minoritized populations. Rehabilitation interventions are an important component of comprehensive MS care. Yet, we do not know the extent to which MS rehabilitation trials consider race and ethnicity in defining eligibility criteria, planning recruitment strategies, selecting outcome measures, supporting intervention delivery, and designing approaches to promote adherence and retention. METHODS We conducted a scoping review of five databases (MEDLINE, CINAHL, Cochrane Central, EMBASE, and Web of Science) to locate randomized controlled rehabilitation trials published from January 2002 to March 2022. We extracted data from relevant studies, assessed their methodological quality, and narratively summarized results. Reporting of this review is in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). RESULTS Fifty-six studies of neurorehabilitation (n = 3), cognitive rehabilitation (n = 6), exercise training (n = 9) and self-management (n = 38) interventions were included in this review. The studies were predominantly from North America (n = 44; 73%) or Europe (n = 12; 20%) and included 4280 participants. Most participants (n = 3669; 86%) were Caucasians. Less than 10% of participants were Black (n = 282), Latinx/Hispanic (n = 60), Asian (n = 46), Indigenous (n = 7), or Arab (n = 2). Few studies discussed how race and/or ethnicity were considered in trial planning or execution. CONCLUSIONS Without consistent and systematic attention to race and ethnicity, both in terms of trial design and reporting, it is impossible to know how MS rehabilitation interventions will translate into real-world applications. This call to action - to the MS rehabilitation research community to ensure trial and intervention processes that accommodate the needs of diverse racial and ethnic groups - is an important first step in addressing inequities in rehabilitation care for persons with MS.
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Affiliation(s)
- Afolasade Fakolade
- School of Rehabilitation Therapy, Queen's University, Louise D. Acton Building, 31 George Street, Kingston K7L 3N6, Canada.
| | - Nadine Akbar
- School of Rehabilitation Therapy, Queen's University, Louise D. Acton Building, 31 George Street, Kingston K7L 3N6, Canada; Research Department, Humber River Hospital, Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Sumaya Mehelay
- Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - Siona Phadke
- Department of Psychology, Queen's University, Kingston, Canada; Department of Biology, Queen's University, Kingston, Canada
| | - Matthew Tang
- Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - Ashwaq Alqahtani
- School of Rehabilitation Therapy, Queen's University, Louise D. Acton Building, 31 George Street, Kingston K7L 3N6, Canada; Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Buraydah 52645, Saudi Arabia
| | | | - Monica Busse
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
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Abuelezam NN, Cuevas AG, Galea S, Hawkins SS. Contested racial identity and the health of women and their infants. Prev Med 2022; 155:106965. [PMID: 35065971 DOI: 10.1016/j.ypmed.2022.106965] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 12/22/2021] [Accepted: 01/15/2022] [Indexed: 11/28/2022]
Abstract
Contested racial identity- self-identified race not matching socially-assigned race-may be an indication of experiences with racism. We aimed to understand the relationship between contested racial identity and women's health behaviors, health outcomes, and infant health outcomes. We used 2012-2015 Massachusetts Pregnancy Risk Assessment Monitoring System data on 5735 women linked with infants' birth certificates. We conducted regression analyses to examine associations between contested racial identity with pregnancy and infant health outcomes and further sub-analyses among women who had experienced a contested racial identity. A total of 901 (15.7%) women reported a contested racial identity. When compared to those who did not, women who had a contested racial identity had lower odds of initiating prenatal care in the first trimester (AOR: 0.76, 95% CI: 0.62, 0.95) and higher odds of smoking (AOR: 1.70, 95% CI: 1.32, 2.19). Among women who had experienced a contested racial identity, those who were socially-assigned as White had decreased odds of having a low birth weight baby (AOR: 0.52, 95% CI: 0.28, 0.99) when compared to those socially-assigned as non-White. Contested racial identity is common; it affects the behaviors that women engage in and the outcomes they experience postpartum. Further, we found that there is a potential benefit to a White social ascription. This work adds to growing evidence of the impact of racism on maternal and infant health in the United States.
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Affiliation(s)
- Nadia N Abuelezam
- Boston College William F. Connell School of Nursing, Chestnut Hill, MA, USA.
| | | | - Sandro Galea
- Boston University School of Public Health, Boston, MA, USA
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Garcia L, Follis S, Thomson CA, Breathett K, Cené CW, Jimenez M, Kooperberg C, Masaki K, Paskett ED, Pettinger M, Aragaki A, Dilworth-Anderson P, Stefanick ML. Taking action to advance the study of race and ethnicity: the Women's Health Initiative (WHI). Womens Midlife Health 2022; 8:1. [PMID: 34983682 PMCID: PMC8724230 DOI: 10.1186/s40695-021-00071-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/12/2021] [Indexed: 11/10/2022] Open
Abstract
“Race” and “ethnicity” are socially constructed terms, not based on biology - in contrast to biologic ancestry and genetic admixture - and are flexible, contested, and unstable concepts, often driven by power. Although individuals may self-identify with a given race and ethnic group, as multidimensional beings exposed to differential life influencing factors that contribute to disease risk, additional social determinants of health (SDOH) should be explored to understand the relationship of race or ethnicity to health. Potential health effects of structural racism, defined as “the structures, policies, practices, and norms resulting in differential access to goods, services, and opportunities of society by “race,” have been largely ignored in medical research. The Women’s Health Initiative (WHI) was expected to enroll a racially and ethnically diverse cohort of older women at 40 U.S. clinical centers between 1993 and 1998; yet, key information on the racial and ethnic make-up of the WHI cohort of 161,808 women was limited until a 2020–2021 Task Force was charged by the WHI Steering Committee to better characterize the WHI cohort and develop recommendations for WHI investigators who want to include “race” and/or “ethnicity” in papers and presentations. As the lessons learned are of relevance to most cohorts, the essence of the WHI Race and Ethnicity Language and Data Interpretation Guide is presented in this paper. Recommendations from the WHI Race and Ethnicity Language and Data Interpretation Guide include: Studies should be designed to include all populations and researchers should actively, purposefully and with cultural-relevance, commit to recruiting a diverse sample; Researchers should collect robust data on race, ethnicity and SDOH variables that may intersect with participant identities, such as immigration status, country of origin, acculturation, current residence and neighborhood, religion; Authors should use appropriate terminology, based on a participant’s self-identified “race” and “ethnicity”, and provide clear rationale, including a conceptual framework, for including race and ethnicity in the analytic plan; Researchers should employ appropriate analytical methods, including mixed-methods, to study the relationship of these sociocultural variables to health; Authors should address how representative study participants are of the population to which results might apply, such as by age, race and ethnicity.
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Affiliation(s)
- Lorena Garcia
- UC Davis School of Medicine, Department of Public Health Sciences, Davis, CA, USA.
| | - Shawna Follis
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Cynthia A Thomson
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | - Khadijah Breathett
- Division of Cardiology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | | | - Monik Jimenez
- Division of Women's Health and Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Charles Kooperberg
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Kamal Masaki
- Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Electra D Paskett
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Mary Pettinger
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Aaron Aragaki
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Peggye Dilworth-Anderson
- Department of Health Policy and Management, Gillings School of Global Public Health at UNC, Chapel Hill, NC, USA
| | - Marcia L Stefanick
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA.,Department of Obstetrics & Gynecology, Stanford University, Stanford, CA, USA
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Cano M, Perez Portillo AG, Figuereo V, Rahman A, Reyes-Martínez J, Rosales R, Ángel Cano M, Salas-Wright CP, Takeuchi DT. Experiences of Ethnic Discrimination Among US Hispanics: Intersections of Language, Heritage, and Discrimination Setting. INTERNATIONAL JOURNAL OF INTERCULTURAL RELATIONS : IJIR 2021; 84:233-250. [PMID: 34840361 PMCID: PMC8622792 DOI: 10.1016/j.ijintrel.2021.08.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Informed by Latino Critical Race Theory, the present study examined how intersections between English use/proficiency, Spanish use/proficiency, and heritage group shape the varying experiences of ethnic discrimination reported by US Hispanic adults. METHODS The study utilized data from 7,037 Hispanic adults from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. Multivariable binomial logistic regression modeled language use/proficiency, heritage, and demographic characteristics as predictors of past-year self-reported perceived ethnic discrimination, overall and in six different settings. RESULTS Both English and Spanish use/proficiency were positively associated with increased adjusted odds of reporting ethnic discrimination overall, in public, or with respect to employment/education/ housing/courts/police; however, with respect to being called a racist name or receiving verbal/physical threats/assaults, a positive association was observed for English, yet not Spanish. Results also indicated a significant interaction between English use/proficiency and Spanish use/proficiency when predicting past-year ethnic discrimination overall or for any of the six types/settings examined, although the relationship between language use/proficiency and ethnic discrimination varied by Hispanic heritage group. CONCLUSION Study findings emphasize that experiencing some form of ethnic discrimination is relatively common among US Hispanic adults, yet the prevalence and types or settings of ethnic discrimination vary widely on the basis of demographics, immigrant generation, heritage, and the interplay between English and Spanish use/proficiency.
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Peña JM, Verney SP, Devos T, Venner K, Sanchez GR. Racial/Ethnic Group Differences and Sociocultural Factors Associated With Implicit and Explicit Attitudes Toward Undocumented Latino Immigrants. JOURNAL OF LATINX PSYCHOLOGY 2021; 9:125-139. [PMID: 34109948 DOI: 10.1037/lat0000180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In the context of recent policies aimed at deterring immigration and criminalizing undocumented Latino immigrants, we examined factors predicting implicit and explicit attitudes toward this population. We hypothesized that more positive implicit and explicit attitudes toward undocumented Latino immigrants would be displayed by Latinxs (compared to non-Hispanic Whites) and by individuals having personal connections to undocumented immigrants or a high level of intercultural sensitivity. Latinx (n = 376) and non-Hispanic White (n = 214) college students (70% female, M age = 21) participated in this cross-sectional study and completed two Implicit Association Tests and measures of explicit attitudes, personal connections, and intercultural sensitivity. As predicted, Latinx participants held more positive implicit and explicit attitudes than non-Hispanic White participants. Intercultural sensitivity and personal connections to undocumented immigrants were associated with more positive explicit attitudes. Identifying factors that increase a sense of commonality and cultural sensitivity with undocumented Latino immigrants may be helpful in diminishing the profiling and criminalization of this community.
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Affiliation(s)
- Juan M Peña
- Department of Psychology, The University of New Mexico
| | | | - Thierry Devos
- Department of Psychology, San Diego State University
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10
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Figuereo V, Calvo R. Racialization and Psychological Distress among U.S. Latinxs. J Racial Ethn Health Disparities 2021; 9:865-873. [PMID: 33791996 DOI: 10.1007/s40615-021-01026-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 10/21/2022]
Abstract
This study investigated the relationship between race and psychological distress among Latinxs in the United States. Using data from the National Health Interview Survey (NHIS) 2010-2018, we estimated the relative risk ratios (RRR) of experiencing psychological distress among White, Black and Other Latinxs from Mexico, Cuba, Dominican Republic, and Puerto Rico. Results revealed that Black Latinxs experienced higher levels of psychological distress than their White counterparts. Additional analysis among and within groups showed that Puerto Ricans and Dominicans reported higher psychological distress than Mexicans, and that race was associated with the distress of Cubans and Mexicans, but not with the distress of Puerto Ricans and Dominicans. Future work on the effect of racial self-identification on Latinxs' mental health-related outcomes, such as psychological distress, should include multidimensional measures of racial identity, such as self-reported and ascribed race, racial ideology, as well as measures of skin color and discrimination. Integrating racialization experiences during clinical assessments would help practitioners to gain a more comprehensive picture of how these identities and experiences may shape the stress, distress, and mental health outcomes (e.g., depression, anxiety) of different racial and ethnic Latinx groups in the U.S.
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Affiliation(s)
- Victor Figuereo
- Boston University Center for Innovation in Social Work and Health, Crosstown Center, 3rd Floor 801 Massachusetts Ave, Boston, MA, 02118, USA
| | - Rocío Calvo
- School of Social Work, Boston College, McGuinn Hall 304, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA.
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Abstract
Multiracial individuals represent a growing segment of the population and have been increasingly the focus of empirical study. Much of this research centers on the perception and racial categorization of multiracial individuals. The current paper reviews some of this research and describes the different types of stimuli that have been used in these paradigms. We describe the strengths and weaknesses associated with different operationalizations of multiracialism and highlight the dearth of research using faces of real multiracial individuals, which we posit may be due to the lack of available stimuli. Our research seeks to satisfy this need by providing a free set of high-resolution, standardized images featuring 88 real multiracial individuals along with extensive norming data and objective physical measures of these faces. These data are offered as an extension of the widely used Chicago Face Database and are available for download at www.chicagofaces.org for use in research.
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Laidley T, Domingue B, Sinsub P, Harris KM, Conley D. New Evidence of Skin Color Bias and Health Outcomes Using Sibling Difference Models: A Research Note. Demography 2020; 56:753-762. [PMID: 30627966 PMCID: PMC6449491 DOI: 10.1007/s13524-018-0756-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
In this research note, we use data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to determine whether darker skin tone predicts hypertension among siblings using a family fixed-effects analytic strategy. We find that even after we account for common family background and home environment, body mass index, age, sex, and outdoor activity, darker skin color significantly predicts hypertension incidence among siblings. In a supplementary analysis using newly released genetic data from Add Health, we find no evidence that our results are biased by genetic pleiotropy, whereby differences in alleles among siblings relate to coloration and directly to cardiovascular health simultaneously. These results add to the extant evidence on color biases that are distinct from those based on race alone and that will likely only heighten in importance in an increasingly multiracial environment as categorization becomes more complex.
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Affiliation(s)
- Thomas Laidley
- Department of Sociology, New York University, New York, NY, 10012, USA
| | - Benjamin Domingue
- Graduate School of Education, Stanford University, Stanford, CA, 94305, USA
| | - Piyapat Sinsub
- Department of Sociology, Princeton University, Princeton, NJ, 08544, USA
| | - Kathleen Mullan Harris
- Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27516, USA
| | - Dalton Conley
- Department of Sociology, Princeton University, Princeton, NJ, 08544, USA.
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White K, Lawrence JA, Tchangalova N, Huang SJ, Cummings JL. Socially-assigned race and health: a scoping review with global implications for population health equity. Int J Equity Health 2020; 19:25. [PMID: 32041629 PMCID: PMC7011480 DOI: 10.1186/s12939-020-1137-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 02/04/2020] [Indexed: 11/10/2022] Open
Abstract
Self-identified race/ethnicity is largely used to identify, monitor, and examine racial/ethnic inequalities. A growing body of work underscores the need to consider multiple dimensions of race - the social construction of race as a function of appearance, societal interactions, institutional dynamics, stereotypes, and social norms. One such multidimensional measure is socially-assigned race, the perception of one's race by others, that may serve as the basis for differential or unfair treatment and subsequently lead to deleterious health outcomes. We conducted a scoping review to systematically appraise the socially-assigned race and health literature. A systematic search of the PubMed, Web of Science, 28 EBSCO databases and 24 Proquest databases up to September 2019 was conducted and supplemented by a manual search of reference lists and grey literature. Quantitative and qualitative studies that examined socially-assigned race and health or health-related outcomes were considered for inclusion. Eighteen articles were included in the narrative synthesis. Self-rated health and mental health were among the most frequent outcomes studied. The majority of studies were conducted in the United States, with fewer studies conducted in New Zealand, Canada, and Latin America. While most studies demonstrate a positive association between social assignment as a disadvantaged racial or ethnic group and poorer health, some studies did not document an association. We describe key conceptual and methodological considerations that should be prioritized in future studies examining socially-assigned race and health. Socially-assigned race can provide additional insight into observed differential health outcomes among racial/ethnic groups in racialized societies based upon their lived experiences. Studies incorporating socially-assigned race warrants further investigation and may be leveraged to examine nuanced patterns of racial health advantage and disadvantage.
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Affiliation(s)
- Kellee White
- Department of Health Policy and Management, University of Maryland College Park School of Public Health, 3310B SPH Bldg 255, 4200 Valley Drive, College Park, MD, 20742, USA.
| | - Jourdyn A Lawrence
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Nedelina Tchangalova
- Research and Academic Services, University of Maryland Libraries, College Park, MD, USA
| | - Shuo J Huang
- Department of Health Policy and Management, University of Maryland College Park School of Public Health, 3310B SPH Bldg 255, 4200 Valley Drive, College Park, MD, 20742, USA
| | - Jason L Cummings
- Department of Sociology and African American Studies, University of South Carolina, Columbia, SC, USA
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Vargas ED, Juarez M, Stone LC, Lopez N. Critical ‘street race’ praxis: advancing the measurement of racial discrimination among diverse Latinx communities in the U.S. CRITICAL PUBLIC HEALTH 2019. [DOI: 10.1080/09581596.2019.1695040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Edward D. Vargas
- School of Transborder Studies, Arizona State University, Tempe, AZ, USA
| | - Melina Juarez
- Department of Political Science and Women, Gender, & Sexuality Studies, Western Washington University, Bellingham, WA, USA
| | - Lisa Cacari Stone
- Department of Family & Community Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Nancy Lopez
- Department of Sociology, University of New Mexico, Albuquerque, NM, USA
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Vasquez Guzman CE, Sanchez GR. The Impact of Acculturation and Racialization on Self-Rated Health Status Among U.S. Latinos. J Immigr Minor Health 2019; 21:129-135. [PMID: 29380096 DOI: 10.1007/s10903-018-0696-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We investigate the Hispanic paradox by examining the relationship between acculturation and health status of Latinos to understand nuances among this growing heterogeneous population using a 2011 Latino Decisions survey. We find that acculturation remains an important determinant of Latino health; however, this varies based on whether the sample is restricted to immigrants or includes all Latino adults and on the measures of acculturation employed. We find Latino citizens reported better health than non-citizens; however, other acculturation measures, such as language use and time in the U.S. do not have a marked effect. Furthermore, skin color matters only for U.S.-born Latinos. Racialization is therefore important to consider within the context of the Hispanic paradox. Our findings suggest that some of the disadvantages stemming from minority status in the U.S. are more prominent among Latinos who have greater experience with the racial hierarchy of the U.S. and greater acculturation more broadly.
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Affiliation(s)
- Cirila Estela Vasquez Guzman
- Department of Sociology, The University of New Mexico, Albuquerque, NM, USA. .,Robert Wood Johnson Foundation Center for Health Policy, 1 University of New Mexico, MSC05-2400, 1909 Las Lomas NE, Albuquerque, NM, 87131-0001, USA.
| | - Gabriel R Sanchez
- Department of Political Science, The University of New Mexico, Albuquerque, NM, USA.,Robert Wood Johnson Foundation Center for Health Policy, 1 University of New Mexico, MSC05-2400, 1909 Las Lomas NE, Albuquerque, NM, 87131-0001, USA
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Socially Assigned Race and Diabetes: Findings from the Arizona Behavioral Risk Factor Surveillance System, 2013-2014. J Racial Ethn Health Disparities 2019; 6:926-934. [PMID: 31065999 DOI: 10.1007/s40615-019-00593-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/07/2019] [Accepted: 04/16/2019] [Indexed: 12/15/2022]
Abstract
Socially assigned race, the racial/ethnic categorization of individuals by others, may serve as the basis for differential or unfair treatment. Latinxs are commonly socially assigned to a race/ethnicity with which they do not self-identify. However, it is unclear the degree to which self-identified Latinxs who are socially assigned as white or Latinx may differentially predict health outcomes beyond general health status and healthcare utilization. We examine the association between socially assigned race and type 2 diabetes mellitus (T2DM). Data from the Arizona's Behavioral Risk Factor Surveillance System (2013, 2014) was used in a cross-sectional analysis (restricted to Latinxs and non-Hispanic whites; N = 8370) to examine the association between self-identified (SI) and socially assigned (SA) race/ethnicity agreement and T2DM. Latinxs were categorized according to SI-SA race/ethnicity agreement: discordant (SI-SA, different) and concordant (SI-SA, same). T2DM was based on self-reported physician diagnosis. Data were analyzed using Poisson regression models to estimate prevalence ratios (PR) and 95% confidence intervals (CI). Latinxs comprised 28.5% of our sample, of which, 18.5% was discordant and 81.5% was concordant. In fully adjusted models, concordant Latinxs were more likely to have T2DM than whites (aPR 2.01, 95% CI 1.44, 2.82). There were no significant differences in T2DM between discordant Latinxs and whites. Our results suggest that socially assigned race is an understudied determinant of health and may further understanding of the impact of racial stratification on Latinx health inequities. Additional research examining socially assigned race and other health outcomes are warranted to gain further insight of the biological impact of racialized lived experiences.
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Abstract
In recent decades, there has been remarkable growth in scientific research examining the multiple ways in which racism can adversely affect health. This interest has been driven in part by the striking persistence of racial/ethnic inequities in health and the empirical evidence that indicates that socioeconomic factors alone do not account for racial/ethnic inequities in health. Racism is considered a fundamental cause of adverse health outcomes for racial/ethnic minorities and racial/ethnic inequities in health. This article provides an overview of the evidence linking the primary domains of racism-structural racism, cultural racism, and individual-level discrimination-to mental and physical health outcomes. For each mechanism, we describe key findings and identify priorities for future research. We also discuss evidence for interventions to reduce racism and describe research needed to advance knowledge in this area.
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Affiliation(s)
- David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA;
- Department of African and African American Studies and Department of Sociology, Harvard University, Cambridge, Massachusetts 02138-3654, USA
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Jourdyn A Lawrence
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA;
| | - Brigette A Davis
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA;
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Abstract
In recent decades, there has been remarkable growth in scientific research examining the multiple ways in which racism can adversely affect health. This interest has been driven in part by the striking persistence of racial/ethnic inequities in health and the empirical evidence that indicates that socioeconomic factors alone do not account for racial/ethnic inequities in health. Racism is considered a fundamental cause of adverse health outcomes for racial/ethnic minorities and racial/ethnic inequities in health. This article provides an overview of the evidence linking the primary domains of racism-structural racism, cultural racism, and individual-level discrimination-to mental and physical health outcomes. For each mechanism, we describe key findings and identify priorities for future research. We also discuss evidence for interventions to reduce racism and describe research needed to advance knowledge in this area.
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Affiliation(s)
- David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA;
- Department of African and African American Studies and Department of Sociology, Harvard University, Cambridge, Massachusetts 02138-3654, USA
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Jourdyn A Lawrence
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA;
| | - Brigette A Davis
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA;
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López N, Vargas ED, Juarez M, Cacari-Stone L, Bettez S. What's Your "Street Race"? Leveraging Multidimensional Measures of Race and Intersectionality for Examining Physical and Mental Health Status Among Latinxs. SOCIOLOGY OF RACE AND ETHNICITY (THOUSAND OAKS, CALIF.) 2018; 4:49-66. [PMID: 29423428 PMCID: PMC5800755 DOI: 10.1177/2332649217708798] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Using the 2015 Latino National Health and Immigration Survey (N= 1,197) we examine the relationship between physical and mental health status and three multidimensional measures of race: 1) "street race," or how you believe other "Americans" perceive your race at the level of the street; 2) socially assigned race or what we call "ascribed race," which refers to how you believe others usually classify your race in the U.S.; and 3) "self-perceived race," or how you usually self-classify your race on questionnaires. We engage in intersectional inquiry by combining street race and gender. We find that only self-perceived race correlates with physical health and that street race is associated with mental health. We also find that men reporting their street race as Latinx1 or Arab were associated with higher odds of reporting worse mental health outcomes. One surprising finding was that, for physical health, men reporting their street race as Latinx were associated with higher odds of reporting optimal physical health. Among women, those reporting their street race as Mexican were associated with lower odds of reporting optimal physical health when compared to all other women; for mental health status, however, we found no differences among women. We argue that "street race" is a promising multidimensional measure of race for exploring inequality among Latinxs.
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Affiliation(s)
- Nancy López
- University of New Mexico, Sociology Department, MSCO5 3080, 1 University of New Mexico, Albuquerque, NM 87131, Tel: 505 277-3101
| | - Edward D Vargas
- Center for Women's Health and Health Disparities Research, University of Wisconsin-Madison, 1180 Observatory Drive, IRP 3467, Madison, WI 53705, USA
| | - Melina Juarez
- University of New Mexico, Political Science Department, MSC05 3070, 1 University of New Mexico, Albuquerque, NM 87131, 505 277-5104
| | - Lisa Cacari-Stone
- University of New Mexico, MSCO9 5070, College of Population Health, 1 University of New Mexico, Albuquerque, NM 87131, 505 272-0511
| | - Sonia Bettez
- University of New Mexico, Evaluation Lab, MSC02 1625, 1 University of New Mexico, Albuquerque, NM 87131, 505 277-4257
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The Race Project: Researching Race in the Social Sciences Researchers, Measures, and Scope of Studies. ACTA ACUST UNITED AC 2017. [DOI: 10.1017/rep.2017.15] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
AbstractWhile the concept and measurement of race has been a longstanding focus of social science research, capturing its significance requires a broader notion than utilizing only racial group categories. More recently, race has been treated as both a “characteristic” and a set of experiences that affect a multitude of life conditions and outcomes. This discussion and analysis moves away from treating race as only a categorical and static characteristic to a multi-dimensional concept that is dynamic, relational, and represents the intersection of individual, ecological, and structural components. By exploring the data collection of the Inter-University Consortium for Political and Social Research and studies that include race as a variable, we were able to trace how race has been used by social scientists over the past 60 years. Using an extensive coding protocol, we have attained key characteristics of the principal investigator(s) (PI), funders, scope of the overall study, and the use of different measures of race. As a result, this “meta-analysis” of social science surveys enabled this researcher to examine how these studies use a wide scope of racial “variables,” and the way in which PI characteristics affected the inclusion of race-related items. In addition, bivariate analysis is presented to examine social scientists’ tendencies in investigating race and inclusion of qualitative examples of item wordings and response categories. This overview of social science studies is placed in the context of conceptual and measurement issues surrounding the use and meaning of race. Hopefully this can serve to advance the discussion and strategic approaches in doing research about race and what should be incorporated in studying race as a lived experience.
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