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Keigan J, De Los Santos B, Gaither SE, Walker DC. The relationship between racial/ethnic identification and body ideal internalization, hair satisfaction, and skin tone satisfaction in black and black/white biracial women. Body Image 2024; 50:101719. [PMID: 38788592 DOI: 10.1016/j.bodyim.2024.101719] [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: 07/03/2023] [Revised: 04/03/2024] [Accepted: 04/25/2024] [Indexed: 05/26/2024]
Abstract
Eurocentric physical characteristics, including a thin, tall physique, long straight hair, and fair skin, typify Western beauty standards. Past research indicates that for Black women, greater identification with one's racial/ethnic culture may buffer against internalizing Eurocentric beauty standards, specifically the thin ideal. Black/White Biracial women often experience different appearance pressures from each of their racial identity's sociocultural appearance ideals. Unfortunately, body image research is limited among Bi/Multiracial individuals. Participants were recruited online via Prime Panels, a high-quality data recruitment service provided by CloudResearch. Participants, M(SD)Age= 34.64 (12.85), self-reported their racial/ethnic identification, thin and thick/curvy ideal internalization, and hair and skin tone satisfaction. Using linear regression analyses, we assessed whether racial/ethnic identification buffered against monoracial Black (n = 317) and Black/White Biracial (n = 254) women's thin ideal internalization. Additionally, we assessed whether stronger racial/ethnic identity was associated with stronger thick/curvy ideal internalization and hair and skin tone satisfaction. Supporting hypotheses, greater racial/ethnic identification was associated with higher thick/curvy ideal internalization and hair and skin tone satisfaction among both Black and Biracial women. Contrary to hypotheses, greater racial/ethnic identification was not associated with lower thin ideal internalization in either group. Our results stress the need to use racially and culturally sensitive measurements of body image.
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Affiliation(s)
- Jessica Keigan
- Union College, Department of Psychology, 807 Union Street, Schenectady, NY 12308, USA
| | - Bonelyn De Los Santos
- Union College, Department of Psychology, 807 Union Street, Schenectady, NY 12308, USA
| | - Sarah E Gaither
- Duke University, Department of Psychology, 417 Chapel Dr, Durham, NC 27708, USA
| | - D Catherine Walker
- Union College, Department of Psychology, 807 Union Street, Schenectady, NY 12308, USA.
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Bell MJ, Neff OT. Exploring the intersection of income and race in an age diverse sample of people with Type 1 diabetes. SOCIOLOGY OF HEALTH & ILLNESS 2024. [PMID: 38965795 DOI: 10.1111/1467-9566.13814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/14/2024] [Indexed: 07/06/2024]
Abstract
Prior literature suggests that the social gradient in health is racialised such that Black individuals receive fewer health benefits from socioeconomic status than White individuals, yet scarce research studies examine whether this relationship persists in the context of Type 1 diabetes (T1D). Further, most research studies on racial health disparities in T1D outcomes focus on health during early life. We used data from the 2017-2018 wave of the T1D Exchange Registry (N = 11,963) and examined the relationship between household income, race and HbA1c in an age diverse sample of people with T1D. Results revealed that the inverse association between income and HbA1c is stronger for Black T1Ds compared to White T1Ds. Despite this, Black T1Ds with an income of $100,000 or more had higher HbA1c values compared to White individuals with an income of less than $25,000. Further, Black adolescents with T1D had particularly high HbA1c values. There is an urgent need for more research on the interpersonal and structural barriers associated with suboptimal glycaemic control among Black individuals.
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Affiliation(s)
- Mallory J Bell
- Department of Sociology, Purdue University, West Lafayette, Indiana, USA
- Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana, USA
| | - Olivia T Neff
- Department of Sociology, Purdue University, West Lafayette, Indiana, USA
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Nordyke K, Kressin A, Holtz ML, Robinson R. The Impact of Racism on Healthcare Experiences and Well-Being: a Qualitative Study Based on Focus Group Discussions with Communities of Color. J Racial Ethn Health Disparities 2024; 11:1246-1253. [PMID: 37615901 DOI: 10.1007/s40615-023-01603-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/31/2023] [Accepted: 04/11/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION Connections between race and health are discussed, and racism has been called out as a root cause of health disparities. The impacts of systemic racism are not fully understood and should be considered in order to advance health equity. The aim of the study is to explore the impact of racism on healthcare experiences and well-being for communities of color. METHODS Individuals from a Northeast region of Wisconsin, who self-identified as Somali, Hmong, Black/African American, Hispanic/Latino/a, and First Nations/Native American/Indigenous, were invited to participate in focus group discussions, and informed consent was obtained from all participants (25 adults, 17 females, and 8 males). Focus groups were planned so participants from the same self-identified communities were together, and five virtual focus group discussions were carried out. A qualitative content analysis approach was used to gain a deeper understanding of the content. RESULTS There was a range of experiences; however, everyone experienced the negative impacts of racism. Three categories, representing areas impacted by racism, and a final theme, describing the overall impact on healthcare experiences and well-being, were created. Dealing with systemic racism means that "backgrounds and values," "resources," and "prejudices" (categories) require constant attention, maneuvering, and "juggling the impacts of racism diminishes access to healthcare and well-being for communities of color" (theme). DISCUSSION Systemic racism negatively impacts access to healthcare and well-being for communities of color perpetuating health disparities. Planning and policy should include a focus on health equity and target systemic racism in order to diminish health disparities.
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Hargrove TW. Mental Health across the Early Life Course at the Intersection of Race, Skin Tone, and School Racial Context. SOCIAL FORCES; A SCIENTIFIC MEDIUM OF SOCIAL STUDY AND INTERPRETATION 2024; 102:1398-1423. [PMID: 38774030 PMCID: PMC11104712 DOI: 10.1093/sf/soad126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
Prior research documents higher levels of depressive symptoms among Black Americans relative to Whites. Yet, we know less about the role of other dimensions of stratification (e.g., skin tone) in shaping mental health inequality between Black and White adults, and whether mental health trajectories by race and skin tone among Black adults are contingent upon social contexts in childhood and adolescence. To address these gaps, this study asks: 1) to what extent do self-identified race and interviewer-rated skin tone among Black respondents shape inequalities in depressive symptoms between Black and White Americans across ages 12-42? 2) Are trajectories of depressive symptoms by race and skin tone among Black respondents contingent on school racial contexts (e.g., school racial composition)? Using five waves of data from the National Longitudinal Study of Adolescent to Adult Health and growth curve models, results suggest trajectories of depressive symptoms across ages 12-42 vary by race, school racial context, and skin tone among Black respondents. Specifically, Black students rated as having very dark, dark, and medium brown skin who attended high proportion Black schools in adolescence experienced lower levels of depressive symptoms than their White and light-skinned Black counterparts, particularly across the teen years and early 20s. Conversely, attending higher proportion White schools led to increases in depressive symptoms across earlier ages for Black students, particularly those who fell within the middle of the skin color continuum. Findings highlight competing advantages and disadvantages of navigating racialized spaces in childhood/adolescence for Black Americans of different skin tones.
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Nguyen AW, Taylor HO, Keith VM, Qin W, Mitchell UA. Discrimination and social isolation among African Americans: The moderating role of skin tone. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2024; 30:374-384. [PMID: 36441993 PMCID: PMC10225012 DOI: 10.1037/cdp0000569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVES Discrimination is an urgent public health problem. A number of major cities and counties across the United States has declared racism a public health crisis. While there is a growing body of research on the discrimination-health connection, less is known regarding the social relational consequences of discrimination. The present study addresses this knowledge gap by investigating the relationship between discrimination, skin tone, and objective and subjective social isolation using a nationally representative sample of African Americans. METHOD This analysis was based upon the African American subsample (N = 3,570) of the National Survey of American Life. Discrimination was assessed with the Everyday Discrimination Scale. Objective and subjective isolation differentiated between respondents who were (a) socially isolated from both family and friends, (b) socially isolated from friends only, (c) socially isolated from family only, and (d) not socially isolated. Skin tone was self-reported. Multinomial logistic regression analyses were used to test the study hypotheses. RESULTS The analyses indicated that more frequent discriminatory experiences were associated with increased risk for subjective and objective social isolation. Skin tone moderated the association between discrimination and subjective isolation; the discrimination-isolation relationship was stronger among participants with darker skin tones. CONCLUSIONS These findings shed light on African Americans' nuanced experiences with discrimination and colorism. Further, the data demonstrate heterogeneity in the vulnerability to the adverse effects of discrimination within the African American population; the relationship between discrimination and subjective isolation was stratified by skin tone. This underscores the well-documented and persistent racialized social stratification system in the United States (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Ann W. Nguyen
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University
| | | | - Verna M. Keith
- Department of Sociology, University of Alabama at Birmingham
| | - Weidi Qin
- Populations Studies Center, University of Michigan
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de Oliveira VH, Carvalho JR. Measuring skin color inequality in women's health in Northeast Brazil: Evidence from the PCSVDF Mulher survey. HEALTH ECONOMICS 2024; 33:3-11. [PMID: 37796738 DOI: 10.1002/hec.4764] [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: 12/08/2022] [Revised: 05/01/2023] [Accepted: 09/10/2023] [Indexed: 10/07/2023]
Abstract
In this paper, we investigate whether skin color is a source of inequality in women's health by exploring the longitudinal framework of the PCSVDFMulher survey in Northeast Brazil. Specifically, we measure the skin color gradient in women's general and mental health, as well as in showing health risk behavior. We find that darker-skinned women show poorer mental health outcomes and a higher likelihood of drinking and smoking more frequently than their lighter-skinned counterparts. The skin color gradient is persistent and systematic, even when modeling different sources of unobserved heterogeneity and accounting for the existing socioeconomic inequalities and racial identity. We also find that racial identity is an important source of heterogeneous responses of women's health to skin tone.
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Daftary K, Poondru S, Patel N, Shramuk M, Muhammad L, Kundu RV. Colorism attitudes and use of skin lightening agents in the United States. Int J Womens Dermatol 2023; 9:e092. [PMID: 37457383 PMCID: PMC10344531 DOI: 10.1097/jw9.0000000000000092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/30/2023] [Indexed: 07/18/2023] Open
Abstract
Skin lightening (SL) is a practice involving the use of chemicals to lighten the skin that is more common among skin of color (SOC) individuals, particularly women, and can lead to adverse health consequences. Objective In this study, we examine SL habits, including both general lightening and lightening for the treatment of a skin condition, among SOC individuals in the United States and the role of colorism in motivating these behaviors. Methods A cross-sectional survey was administered to SOC individuals through ResearchMatch, an online national health registry. Demographics, rates of SL, SL habits, and perceived colorism among SL users and nonusers were collected and analyzed with χ2, Fisher's exact, Analysis of variance (ANOVA), Spearman correlation, and t tests. Results A total of 455 participants completed the survey. Ninety-seven participants (21.3%) reported using SL agents: 73.2% (71/97) used SL agents for the treatment of a skin condition and 26.8% (26/97) used the products for general SL. Only 22.6% (22/97) of SL users consulted a medical provider before using the products. Forty-four participants (45.4%) were unaware of their SL product ingredients, and 35.1% (34/97) reported using hydroquinone-based products. Composite colorism scores were significantly higher in SL users than nonusers (20.03 vs 18.20; P < .001). Limitations This study used self-reported racial/ethnic groups to characterize those with SOC rather than assessing actual skin tones of participants, which could have led to variability. Conclusion SL among SOC individuals is prevalent in the U.S. and poses a health risk, as many SL users are unaware of product ingredients, do not consult a medical provider before use, and have access to potentially unsafe formulations. Dermatologists should address skin tone and pigmentary concerns with their SOC patients.
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Affiliation(s)
- Karishma Daftary
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Sneha Poondru
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Nina Patel
- Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois
| | - Maxwell Shramuk
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lutfiyya Muhammad
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Roopal V. Kundu
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Sissoko DRG, Baker S, Caron EH. Into and Through the School-to-Prison Pipeline: The Impact of Colorism on the Criminalization of Black Girls. JOURNAL OF BLACK PSYCHOLOGY 2023. [DOI: 10.1177/00957984231161900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Colorism is a social construct privileging lighter-skinned people of color with proximity to European features over their darker-skinned counterparts. Despite the significant role in the lives of Black women and girls, colorism is an overlooked and understudied phenomenon, particularly regarding how it shapes their punishment and criminalization in schools. We conceptualize colorism as a social determinant of Black girls’ psychological well-being and outcomes. Darker-skinned Black girls face disproportionately severe school discipline, negative evaluation by teachers and peers, and are inundated with stereotypical messages that influence their sense of self—which increase vulnerability to trauma and psychological distress. Once inside the legal system, colorism plays a role in moving dark-skinned Black girls further into and through the pipeline at every stage of legal processing. The goal of the paper is to (1) highlight the role of colorism in the criminalization of Black girls, (2) identify school, forensic, and counseling/clinical psychology’s role in reducing the impact of colorism on Black girls’ lived experience as it relates to mental health and criminalization, and (3) identify psychological research and policy needs to mitigate the impact of colorism on Black girls’ life outcomes.
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Affiliation(s)
- D. R. Gina Sissoko
- The Graduate Center, City University of New York, New York, NY, USA
- John Jay College of Criminal Justice, New York, NY, USA
| | - Sydney Baker
- The Graduate Center, City University of New York, New York, NY, USA
- John Jay College of Criminal Justice, New York, NY, USA
| | - Emily Haney Caron
- The Graduate Center, City University of New York, New York, NY, USA
- John Jay College of Criminal Justice, New York, NY, USA
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Daftary K, Krishnam NS, Kundu RV. Uncovering the roots of skin bleaching: Colorism and its detrimental effects. J Cosmet Dermatol 2023; 22:337-338. [PMID: 35510787 PMCID: PMC10084095 DOI: 10.1111/jocd.15049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/03/2022] [Accepted: 05/02/2022] [Indexed: 02/02/2023]
Affiliation(s)
- Karishma Daftary
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Neha S Krishnam
- University of Washington School of Public Health, Seattle, Washington, USA
| | - Roopal V Kundu
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Hamler TC, Nguyen AW, Keith V, Qin W, Wang F. How Skin Tone Influences Relationships Between Discrimination, Psychological Distress, and Self-Rated Mental Health Among Older African Americans. J Gerontol B Psychol Sci Soc Sci 2022; 77:2026-2037. [PMID: 35976084 PMCID: PMC9683503 DOI: 10.1093/geronb/gbac115] [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: 07/05/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES As within-group differences have emerged as a key area of inquiry for health disparities among African Americans, skin tone has been identified as an important factor. This study aims to examine: (a) the moderating role of skin tone in the relationship between discrimination, self-rated mental health, and serious psychological distress (SPD) and (b) whether this moderating effect differs across genders in a nationally representative sample of older African Americans. METHODS Analyses were conducted on a subsample of African Americans aged 55+ (N = 837) from the National Survey of American Life. The mental health outcomes were SPD and self-rated mental health. Discrimination was assessed with the Everyday Discrimination Scale. Skin tone was self-reported. Multiple linear regressions tested the study aims. RESULTS Discrimination was associated with worse self-rated mental health and SPD in the total sample and among women. Skin tone moderated the association between discrimination and SPD in the total sample and among men and women. The associations between discrimination and mental health outcomes were stronger among darker-skinned respondents than lighter respondents. Gender-stratified analyses indicated skin tone moderated the association between discrimination and self-rated mental health for men but not women. DISCUSSION This study contributes to the emerging body of literature on skin tone, discrimination, and mental health. Uncovering mechanisms behind the "why" is an important next step in understanding how skin tone influences the relationship between discrimination and mental health. The negative psychological effects associated with darker complexion provide several areas to be examined.
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Affiliation(s)
- Tyrone C Hamler
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Ann W Nguyen
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Verna Keith
- Department of Sociology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Weidi Qin
- Center for Social Epidemiology and Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Fei Wang
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
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Abstract
This study addresses two questions. First, why do Black Americans exhibit worse health outcomes than White Americans even at higher levels of socioeconomic status (SES)? Second, are diminished health returns to higher status concentrated among Black Americans with darker skin color? Novel hypotheses are tested with biosocial panel data from Add Health, a nationally representative cohort of Black and White adolescents who have transitioned to adulthood. We find that White and light-skin Black respondents report improved health after achieving higher SES, on average, while their darker-skin Black peers report declining health. These patterns persist regardless of controls for adolescent health status and unmeasured between-person heterogeneity. Moreover, increased inflammation tied to unfair treatment and perceptions of lower status helps to account for patterns of diminished health returns for dark-skin Black groups. Our study is the first to document skin tone heterogeneity in diminished health returns and one of few studies to identify life course stress processes underlying such disparities. We consider additional processes that could be examined in future studies, as well as the broader health and policy implications of our findings.
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Affiliation(s)
- Reed T. DeAngelis
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill
| | - Taylor W. Hargrove
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill
| | - Robert A. Hummer
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill
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“From All Sides”: Black-Asian Reddit Communities Identify and Expand Experiences of the Multiracial Microaggression Taxonomy. SOCIAL SCIENCES-BASEL 2022. [DOI: 10.3390/socsci11040168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this paper is to examine the identity narratives of online Black-Asian communities concerning their multiracial microaggression experiences. As we are investigating an under-explored population, we utilize a purposive sampling method to narrow forum engagement by Black-Asian users on the popular social media network, Reddit. Our research is guided by multiracial critical theory (MultiCrit) which highlights monoracism as a ubiquitous element of the monoracial paradigm of race. In our research, we employ a content analysis using Black-Asian microaggression narratives to test the existing multiracial microaggression taxonomy. Our findings demonstrate that Black-Asian subreddit communities identified all of the existing multiracial microaggression categories: (1) exclusion or isolation; (2) exotification and objectification; (3) assumption of monoracial or mistaken identity; (4) denial of multiraciality; (5) pathologizing of identity and experiences; and (6) microaggressions based on racial stereotypes. Our analysis also found an emerging microaggression category entitled (7) white-mixed superiority. These multiracial microaggressions drew on monoracist ideologies and the monoracial paradigm of race, which exclude Black-Asian people and aid the maintenance of white supremacy in the United States. As such, we suggest further inquiry and expansion of the multiracial microaggression taxonomy to include how racism, particularly the monoracial paradigm of race, influences non-white multiracial identities.
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Blebu BE, Waters O, Lucas CT, Ro A. Variations in Maternal Factors and Preterm Birth Risk among Non-Hispanic Black, White, and Mixed-Race Black/White Women in the United States, 2017. Womens Health Issues 2022; 32:140-146. [PMID: 34844852 PMCID: PMC8958864 DOI: 10.1016/j.whi.2021.10.010] [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: 03/16/2021] [Revised: 10/19/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study aims to compare preterm birth (PTB) risk and maternal factors associated with PTB among non-Hispanic White, Black, and mixed-race Black/White women in the United States. METHODS In this study, we used U.S. birth certificate data from the 2017 National Vital Statistics System. We included live singleton births to women who self-identified as non-Hispanic White, Black, or mixed-race Black/White. PTB was defined as less than 37 weeks of gestation. We used logistic regression models to estimate the PTB odds ratios for Black and Black/White relative to White women, adjusted for maternal factors. We used logistic regression to estimate associations between PTB and maternal factors in race-stratified models. RESULTS The sample included a total of 2,297,076 births in 2017 to White (n = 1,792,257), Black (n = 476,969), and Black/White (n = 27,850) women. The prevalence of PTB varied for Black (11.2%), Black/White (8.2%), and White (6.8%) women. The odds of PTB compared with White differed for Black (odds ratio, 1.51; 95% confidence interval, 1.49-1.53) and Black/White (odds ratio, 1.13; 95% confidence interval, 1.08-1.18) women after adjusting for maternal factors. The odds of PTB associated with maternal sociodemographic, prepregnancy, and gestational factors differed by maternal race. CONCLUSIONS Evaluation of PTB risk among White, Black, and Black/White women revealed distinct associations between PTB and maternal factors for Black/White women. This study highlights the need for research assessing the relationships between social risk factors such as colorism and racism and the outcome of PTB, and it provides evidence that may inform more targeted PTB prevention among Black/White and Black women.
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Affiliation(s)
- Bridgette E Blebu
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, California; California Preterm Birth Initiative, University of California, San Francisco, San Francisco, California.
| | - Olivia Waters
- Department of Health, Society, and Behavior, Program in Public Health, University of California, Irvine, Irvine, California
| | - Candice Taylor Lucas
- Department of Pediatrics, School of Medicine, University of California, Irvine, Irvine, California; Pediatric Exercise and Genomics Research Center, University of California, Irvine, Irvine, California
| | - Annie Ro
- Department of Health, Society, and Behavior, Program in Public Health, University of California, Irvine, Irvine, California
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Liu MM, Crowe M, Telles EE, Jiménez-Velázquez IZ, Dow WH. Color disparities in cognitive aging among Puerto Ricans on the archipelago. SSM Popul Health 2022; 17:100998. [PMID: 35967472 PMCID: PMC9366965 DOI: 10.1016/j.ssmph.2021.100998] [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] [Received: 08/25/2021] [Revised: 11/24/2021] [Accepted: 12/08/2021] [Indexed: 01/19/2023] Open
Abstract
This research seeks to contribute new understanding of color disparities and gender in cognitive aging among older adults residing in Puerto Rico. We use the island-representative Puerto Rican Elderly Health Conditions (PREHCO) longitudinal study that measures cognitive health at baseline and cognitive decline between waves. In pooled models, we discern little or no color disparities in cognition at baseline. Sex-stratified models of baseline cognition indicate that Trigueño men slightly outperform white men. In contrast, color disparities in cognitive decline are apparent. In just four years between the two waves of PREHCO, on a 20-point cognitive test scale, Black men experienced 0.78 more points of cognitive decline, while Trigueño men experienced 0.44 more points of cognitive decline than white men in Puerto Rico. Mestiza women experience 0.80 less points of cognitive decline relative to white women. Nearly all of the color/race association with cognitive decline appears to be independent from health behaviors and conditions, individual human capital attainment, and family background. While lower-status color groups more frequently report discrimination, discrimination does not mediate the impact of color/skin tone and cognitive performance, suggesting the importance of further research on the role of broader dimensions of life course structural racism.
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Affiliation(s)
- Mao-Mei Liu
- Department of Demography, University of California Berkeley, 2232 Piedmont Avenue, Berkeley, CA, 94720, USA
| | - Michael Crowe
- Department of Psychology, University of Alabama, Birmingham, Campbell Hall, Rm 334, 1300 University Blvd., Birmingham, AL, 35233, USA
| | - Edward E. Telles
- Department of Sociology, University of California Irvine, 4171 Social Science Plaza A, Irvine, CA, 92697-5100, USA
| | - Ivonne Z. Jiménez-Velázquez
- School of Medicine & Department of Medicine, University of Puerto Rico, Medical Sciences Campus PO Box 365067, San Juan, PR, 00936-5067, USA
| | - William H. Dow
- Department of Demography, University of California Berkeley, 2232 Piedmont Avenue, Berkeley, CA, 94720, USA
- School of Public Health, University of California Berkeley, 2121 Berkeley Way #5324, Berkeley, CA, 94720, USA
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Monk EP, Kaufman J, Montoya Y. Skin Tone and Perceived Discrimination: Health and Aging Beyond the Binary in NSHAP 2015. J Gerontol B Psychol Sci Soc Sci 2021; 76:S313-S321. [PMID: 34918148 PMCID: PMC8678440 DOI: 10.1093/geronb/gbab098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This paper introduces new measures of skin tone (self-reported) and perceived discrimination that are included in the third round of the National Social Life, Health, and Aging Project (NSHAP). We explain the rationale for these new measures, emphasizing, in particular, how they help researchers to conceptualize and measure the significance of race/ethnicity for health and aging beyond binary ethnoracial categories. METHOD We describe new measures of skin tone and perceived discrimination for use in NSHAP 2015. We provide descriptive statistics on the distribution of skin tone (self-reported) by race/ethnicity. As a proof of concept, we use logistic and ordinary least squares regression analyses to examine the relationship between skin tone, perceived discrimination, and perceived stress among ethnoracial minorities. RESULTS We find that there is significant variation in skin tone among non-White respondents in NSHAP 2015 (e.g., non-Hispanic Black and Latinx). We also find that skin tone (self-reported) is a significant predictor of the frequency of perceived discrimination and perceived stress among African American, but not Latinx respondents in NSHAP. DISCUSSION The inclusion of new skin tone and discrimination measures in NSHAP 2015 provides a unique and novel opportunity for researchers to more deeply understand how race/ethnicity is connected to health and aging among ethnoracial minorities. Furthermore, it will enable analyses of how stress and perceived discrimination also affect patterns of health and aging among Whites against the backdrop of steadily increasing socioeconomic inequalities and shifting ethnoracial demographics in the United States.
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Affiliation(s)
- Ellis P Monk
- Department of Sociology, Harvard University, Cambridge, Massachusetts, USA
| | - Jerry Kaufman
- Department of Sociology, University of Chicago, Illinois, USA
- NORC, University of Chicago, Illinois, USA
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Cuevas AG, Abuelezam N, Chan SW(C, Carvalho K, Flores C, Wang K, Mattei J, Tucker KL, Falcon LM. Skin Tone, Discrimination, and Allostatic Load in Middle-Aged and Older Puerto Ricans. Psychosom Med 2021; 83:805-812. [PMID: 34297007 PMCID: PMC8419137 DOI: 10.1097/psy.0000000000000969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE A growing body of research suggests that skin tone may be a health risk indicator for Hispanics. Black and darker-skinned Hispanics have worse mental and physical outcomes than White and lighter-skinned Hispanics. Discrimination exposure has been implicated as a risk factor that may explain the association between skin tone and health. However, there is scant research examining the interrelationship between skin tone, discrimination, and health, particularly among Puerto Ricans. We examine the interrelationships between two measures of skin tone, two measures of discrimination, and allostatic load (AL) among Puerto Rican adults. METHODS Using cross-sectional data from wave 3 of the Boston Puerto Rican Health Study (n = 882), we examined the indirect association (IA) of skin tone on physiological dysregulated systems, also known as AL, through major discrimination and everyday discrimination. We tested these associations using two distinct measures of skin tone: interviewer-ascribed skin tone and spectrophotometer-measured skin tone. RESULTS Interviewer-ascribed skin tone was indirectly associated with AL through major discrimination (IA = 0.03, 95% confidence interval = 0.004 to 0.06). However, there was no evidence of an IA of interviewer-ascribed skin tone on AL through everyday discrimination (IA = -0.01, 95% confidence interval = -0.03 to 0.01). In addition, there was no evidence that spectrophotometer-measured skin tone was indirectly associated with AL through major discrimination or everyday discrimination. CONCLUSIONS The sociocultural significance of skin tone may affect how Puerto Ricans are perceived and treated by others, which can, in turn, have physiological health consequences. Future research is needed to replicate these findings and examine the interrelationship between skin tone, discrimination, and other health outcomes.
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Affiliation(s)
- Adolfo G. Cuevas
- Department of Community Health, Tufts University, Medford, MA, USA
| | - Nadia Abuelezam
- Boston College William F. Connell School of Nursing, Chestnut Hill, MA, USA
| | | | - Keri Carvalho
- Department of Community Health, Tufts University, Medford, MA, USA
| | - Cecilia Flores
- Department of Community Health, Tufts University, Medford, MA, USA
| | - Kaipeng Wang
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Katherine L. Tucker
- Department of Biomedical & Nutritional Sciences, University of Massachusetts Lowell, MA, USA
| | - Luis M. Falcon
- College of Fine Arts, Humanities and Social Sciences, University of Massachusetts Lowell, MA, USA
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Perceived skin tone discrimination and suicidal ideation Black Americans: Findings from the National Survey of American Life. J Affect Disord 2021; 284:143-148. [PMID: 33596486 DOI: 10.1016/j.jad.2021.02.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND To examine the association between skin tone discrimination and lifetime suicidal ideation and suicide attempt among Black Americans. METHODS We analyzed the National Survey of American Life (NSAL), which is a national probability sample of Black American adults residing in the general population of the United States. Using multivariable logistic regression, we examined the associations between skin tone discrimination (from Blacks and from whites) and suicidal ideation and suicide attempt, adjusting for sociodemographic characteristics. RESULTS While respondents on average reported higher frequency of inter-group skin tone discrimination, only intra-group skin tone discrimination was significantly associated with greater odds of lifetime suicidal ideation [aOR: 1.21; 95% CI: 1.08-1.36] and suicide attempt [aOR: 1.22; 95% CI: 1.22; 95% CI: 1.04-1.44] adjusting for sociodemographic characteristics. Inter-group skin tone discrimination was not significantly related to suicidal ideation or suicide attempt. When stratifying by ethnicity, the effect of intra-group skin tone discrimination on suicidal ideation and attempt was stronger among Caribbean Black Americans than it was for African Americans. LIMITATIONS All measures in the sample were self-reported and thus vulnerable to recall bias. CONCLUSIONS Intra-group skin tone discrimination is a risk factor for suicidal ideation among Black Americans, and especially among Caribbean Black Americans.
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Harari L, Lee C. Intersectionality in quantitative health disparities research: A systematic review of challenges and limitations in empirical studies. Soc Sci Med 2021; 277:113876. [PMID: 33866085 DOI: 10.1016/j.socscimed.2021.113876] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 01/12/2023]
Abstract
RATIONALE Quantitative health disparities research has increasingly employed intersectionality as a theoretical tool to investigate how social characteristics intersect to generate health inequality. Yet, intersectionality was not designed to quantify, predict, or identify health disparities, and, as a result, multiple criticisms against its misapplication in health disparities research have been made. As such, there is an emerging need to evaluate the growing body of quantitative research that aims to investigate health disparities through an intersectional lens. METHODS We conducted a systematic review from earliest records to January 2020 to (i) describe the scope of limitations when applying intersectionality to quantitative health disparities research, and (ii) identify recommendations to improve the future integration of intersectionality with this scholarship. We identified relevant publications with electronic searches in PubMed and CA Web of Science. Studies eligible for inclusion were English-language publications that used quantitative methodologies to investigate health disparities among adults in the U.S. while explicitly claiming to adopt an intersectional perspective. Out of 1279 articles reviewed, 65 were eligible for inclusion. RESULTS Our review found that, while the value of intersectionality to the study of health disparities is evident, the existing research struggles with meeting intersectionality's fundamental assumptions. In particular, four limitations were found to be widespread: narrowing the measurements of intersectionality, intersectional groups, and health outcomes; placing primacy on the study of certain intersectional groups to the neglect of others; overlooking underlying explanatory mechanisms that contribute to the health disparities experienced by intersectional groups; and, lacking in the use of life-course perspectives to show how health disparities vary across different life stages. CONCLUSION If the goal of health equality is to be achieved among diverse intersectional groups, future research must be assisted by the collection and examination of data that overcomes these limitations.
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Affiliation(s)
- Lexi Harari
- Department of Sociology, University of California-Riverside, Riverside, CA, USA
| | - Chioun Lee
- Department of Sociology, University of California-Riverside, Riverside, CA, USA.
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Monk EP. Colorism and Physical Health: Evidence from a National Survey. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2021; 62:37-52. [PMID: 33426926 DOI: 10.1177/0022146520979645] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study uses nationally representative data to extend a steadily growing body of research on the health consequences of skin color by comparatively examining the consequences of perceived ingroup and outgroup skin color discrimination (perceived colorism) for physical health among African Americans. Using a comprehensive set of measures of physical health, I find that perceived ingroup colorism is significantly associated with worse physical health outcomes among African Americans. Notably, the magnitude of ingroup colorism's associations with most of these outcomes rivals or even exceeds that of major lifetime discrimination, everyday discrimination, and perceived outgroup colorism. These findings compellingly suggest the inclusion of perceived colorism measures in future survey data collection efforts.
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Pollock S, Taylor S, Oyerinde O, Nurmohamed S, Dlova N, Sarkar R, Galadari H, Manela-Azulay M, Chung HS, Handog E, Kourosh AS. The dark side of skin lightening: An international collaboration and review of a public health issue affecting dermatology. Int J Womens Dermatol 2021; 7:158-164. [PMID: 33937483 PMCID: PMC8072511 DOI: 10.1016/j.ijwd.2020.09.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 11/07/2022] Open
Abstract
Skin lightening (SL) for cosmetic reasons is associated with profound negative impacts on well-being and adverse effects on the skin, resulting in immense challenges for dermatologists. Despite current regulations, lightening agents continue to dominate the cosmetic industry. In this review, our international team of dermatologists tackles the topic of SL as a global public health issue, one of great concern for both women's health and racial implications. We have examined SL in Africa, Asia, the Middle East, and the Americas. We aim to inspire a global discourse on how modern dermatologists can utilize scientific evidence and cultural competency to serve and protect patients of diverse skin types and backgrounds. In doing so, we hope to promote healthy skin and inclusive concepts of beauty in our patients and society.
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Affiliation(s)
- Samara Pollock
- Massachusetts General Hospital, Department of Dermatology, Boston, MA, United States
- Boston University School of Medicine, Boston, MA, United States
| | - Susan Taylor
- Perelman School of Medicine Department of Dermatology, Philadelphia, PA
| | - Oyetewa Oyerinde
- Massachusetts General Hospital, Department of Dermatology, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | | | - Ncoza Dlova
- University of KwaZulu Natal, Dermatology Department, South Africa
| | - Rashmi Sarkar
- Lady Hardinge Medical College and Hospital, New Delhi, India
| | - Hassan Galadari
- United Arab Emirates University, Department of Dermatology, Dubai, United Arab Emirates
| | | | - Hae Shin Chung
- Yonsei University College of Medicine, Seoul, South Korea
| | - Evangeline Handog
- Perelman School of Medicine Department of Dermatology, Philadelphia, PA
- Asian Hospital and Medical Center, Department of Dermatology, Philippines
| | - A. Shadi Kourosh
- Massachusetts General Hospital, Department of Dermatology, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
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Slaughter-Acey JC, Brown TN, Keith VM, Dailey R, Misra DP. A tale of two generations: Maternal skin color and adverse birth outcomes in Black/African American women. Soc Sci Med 2020; 265:113552. [PMID: 33277068 PMCID: PMC7781157 DOI: 10.1016/j.socscimed.2020.113552] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/17/2020] [Accepted: 11/23/2020] [Indexed: 01/03/2023]
Abstract
We examined how sociopolitical context (marked by generational cohort) and maternal skin color interacted to influence preterm delivery (PTD) rates in sample of Black women. Data were from 1410 Black women, ages 18-45 years, residing in Metropolitan Detroit, MI enrolled (2009-2011) in the Life-course Influences on Fetal Environments (LIFE) Study. Because we hypothesized that generational differences marked by changes in the sociopolitical context would influence exposure to racism, we categorized women into two cohorts by maternal birth year: a) Generation X, 1964-1983 and b) Millennial, 1984-1993. Descriptive results showed similar PTD rates by generational cohort, Generation X: 16.3% vs. Millennials: 16.1%. Yet, within each generation, PTD rates varied by women's skin tone (categorized: light, medium, and dark brown). Poisson regression models confirmed a significant interaction between generational cohort and maternal skin tone predicting PTD (P = 0.001); suggesting a salubrious association between light brown skin tone (compared to medium and dark) and PTD for Generation X. However, Millennials with medium and dark brown skin experienced lower PTD rates than their light Millennial counterparts. Research should consider sociopolitical context and the salience of skin tone bias when investigating racial health disparities, including those in perinatal health.
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Affiliation(s)
- Jaime C Slaughter-Acey
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
| | - Tony N Brown
- Department of Sociology, Rice University, Houston, TX, USA
| | - Verna M Keith
- Department of Sociology, University of Alabama Birmingham, Birmingham, AL, USA
| | - Rhonda Dailey
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Dawn P Misra
- Department of Epidemiology & Biostatistics, Michigan State University, East Lansing, MI, USA
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Slaughter-Acey JC, Sneed D, Parker L, Keith VM, Lee NL, Misra DP. Skin Tone Matters: Racial Microaggressions and Delayed Prenatal Care. Am J Prev Med 2019; 57:321-329. [PMID: 31353164 PMCID: PMC6702105 DOI: 10.1016/j.amepre.2019.04.014] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 04/16/2019] [Accepted: 04/17/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Literature posits that discrimination can be a barrier to racial and ethnic minorities' healthcare use. This study examines the relationship between perceived discrimination in the form of racial microaggressions and delayed prenatal care in African American women. It also investigates whether this relationship is modified by women's shade of skin color owing to societal attitudes and beliefs tied to colorism (also known as skin-tone bias). METHODS Data were collected from a cohort of 1,410 black, African American women in metropolitan Detroit, Michigan, enrolled in 2009-2011 (analyzed between August 2017 and July 2018). Perceived racial microaggressions were assessed using the 20-item Daily Life Experiences of Racism and Bother scale. Logistic regression modeled the relationship between the Daily Life Experiences of Racism and Bother scale and delayed prenatal care, defined as third trimester or no prenatal care entry. RESULTS Nearly a quarter (24.8%) of women had delayed prenatal care. Logistic regression models showed that a Daily Life Experiences of Racism and Bother score above the median was associated with delayed prenatal care (AOR=1.31, 95% CI=1.00, 1.71). This association was moderated by self-reported maternal skin tone (interaction p=0.03). A higher Daily Life Experiences of Racism and Bother score was associated with delayed prenatal care among African-American women at either end of the color continuum (light brown: AOR=1.64, 95% CI=1.02, 2.65; dark brown: AOR=2.30, 95% CI=1.20, 4.41) but not in the middle (medium brown women). CONCLUSIONS Skin tone-based mistreatment in tandem with racial discrimination in the form of racial microaggressions may influence African American women's use of prenatal care. These findings have implications related to the engagement of women of color, particularly African American women, in healthcare systems and maternal and child health programs.
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Affiliation(s)
- Jaime C Slaughter-Acey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
| | - Devon Sneed
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Lauren Parker
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Verna M Keith
- Department of Sociology, University of Alabama Birmingham, Birmingham, Alabama
| | - Nora L Lee
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Dawn P Misra
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, Michigan
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