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Algrim K, Keita M, Herbert C, Moreno F, Boxer P. Perceptions of police as a moderator between negative experiences and mental health symptoms. JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 52:1163-1178. [PMID: 39126676 DOI: 10.1002/jcop.23141] [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: 01/18/2024] [Revised: 06/04/2024] [Accepted: 07/31/2024] [Indexed: 08/12/2024]
Abstract
Negative experiences with police present serious risks for mental health. However, interpretation plays a meaningful and little understood role in the effects of those experiences. This study expands on previous work exploring coping responses to negative police experiences and investigates the relation between negative experiences with police and mental health outcomes. Participants (N = 198) were from a diverse sample of young adults at a minority-serving institution. Black/African American, Hispanic/Latinx, and Middle Eastern/North African participants reported significantly more negative police experiences than White and Asian/Asian American participants. Black/African American and Hispanic/Latinx also showed more negative perceptions of police. Negative police experiences were positively related to depression but not posttraumatic stress symptoms. There were also meaningful interactive effects between negative experiences and perceptions of police on levels of posttraumatic stress and depression, suggesting negative perceptions of police may buffer negative effects of negative police experiences. Our findings point to the importance of addressing negative encounters with police as mental health stressors, as well as effects of crucial differences in perceptions of police by race. This research contributes to a growing understanding of the complex nature and effects of experiences with police on mental health.
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Affiliation(s)
- Kaylise Algrim
- Department of Psychology, Rutgers University, Newark, New Jersey, USA
| | - Mamadee Keita
- Department of Psychology, Rutgers University, Newark, New Jersey, USA
| | - Christian Herbert
- Department of Psychology, Rutgers University, Newark, New Jersey, USA
| | - Franklin Moreno
- Department of Criminal Justice, Temple University, Philadelphia, Pennsylvania, USA
| | - Paul Boxer
- Department of Psychology, Rutgers University, Newark, New Jersey, USA
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2
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Voisin DR, Takahashi L, Walsh JL, DiFranceisco W, Johnson A, Dakin A, Bouacha N, Brown K, Quinn KG. An exploratory study of community violence and HIV care engagement among Black gay and bisexual men. AIDS Care 2024; 36:1111-1118. [PMID: 38648523 DOI: 10.1080/09540121.2024.2331221] [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: 08/14/2023] [Accepted: 03/08/2024] [Indexed: 04/25/2024]
Abstract
This study examined the relationship between exposure to community violence and HIV care engagement among 107 Black gay or bisexual men living with HIV in Chicago. Measures assessed the importance of demographic covariates (age, annual income, health insurance status, and years living with HIV), community violence exposures, mental health, social support, in explaining variations in missed doses of antiretroviral therapy (ART) medication and missed HIV care appointments. Results showed that participants who reported higher rates of exposure to community violence were two times more likely to have missed ART doses and HIV care appointments. Participants who reported depression scores were two times more likely to have greater non-ART adherence. Finally, older participants were more likely to report fewer missed ART doses. More research is needed to clarify the mechanisms between age or depression and ART adherence given community violence exposure. Health care providers should screen for depression when attempting to promote better ART adherence and keeping HIV care appointments for Black gay and bisexual men living with HIV. Younger Black gay and bisexual men living with HIV may be more vulnerable than older men for missed ART doses and may require additional screening and follow-up.
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Affiliation(s)
- Dexter R Voisin
- Jack Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Lois Takahashi
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA
| | | | | | - Anthony Johnson
- School of Social Work, Loyola University Chicago, Chicago, IL, USA
| | | | | | - Khalil Brown
- Jack Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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3
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Quinn KG, Hunt BR, Jacobs J, Valencia J, Voisin D, Walsh JL. Examining the Relationship between Anti-Black Racism, Community and Police Violence, and COVID-19 Vaccination. Behav Med 2024; 50:250-259. [PMID: 37578320 PMCID: PMC10864675 DOI: 10.1080/08964289.2023.2244626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/12/2023] [Accepted: 05/18/2023] [Indexed: 08/15/2023]
Abstract
In 2020, the COVID-19 pandemic emerged against a backdrop of long-standing racial inequities that contributed to significant disparities in COVID-19 mortality, morbidity, and eventually, vaccination rates. COVID-19 also converged with two social crises: anti-Black racism and community and police violence. The goal of this study was to examine the associations between community violence, police violence, anti-Black racism, and COVID-19 vaccination. Survey data were collected from a sample of 538 Black residents of Chicago between September 2021 and March 2022. Structural equation modeling was used to test associations between neighborhood violence, police violence, racism, medical mistrust, trust in COVID-related information, depressive symptoms, and having received a COVID-19 vaccination. In line with predictions, neighborhood violence had a significant indirect effect on vaccination via trust in COVID-related information from a personal doctor. Additionally, racism had a significant indirect effect on vaccination via trust in COVID-related information from a personal doctor, as well as via medical mistrust and trust in COVID-related information from a personal doctor. These findings add to the growing body of literature demonstrating the importance of medical mistrust when examining COVID-19 vaccination disparities. Furthermore, this study highlights the importance of considering how social and structural factors such as violence and racism can influence medical mistrust.
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Affiliation(s)
- Katherine G Quinn
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin
| | - Bijou R Hunt
- Sinai Health System, Sinai Infectious Disease Center
| | | | | | - Dexter Voisin
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University
| | - Jennifer L Walsh
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin
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4
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Roude GD, Wu K, Richardson L, Tucker A, Moss L, Kondo M, Morrison CN, Branas CC, Gustat J, Theall KP. The Impact of Vacant and Abandoned Property on Health and Well-Being: A Qualitative Inquiry. APPLIED RESEARCH IN QUALITY OF LIFE 2024; 19:2125-2145. [PMID: 39211005 PMCID: PMC11349791 DOI: 10.1007/s11482-024-10325-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 05/03/2024] [Indexed: 09/04/2024]
Abstract
This qualitative study explored the role of neglected properties and neighborhood environment characteristics on a sample of New Orleans, Louisiana residents' health and well-being, sense of community, sense of safety, and civic engagement. We hypothesized that residents would identify conditions of their neighborhood's physical environment, including neglected properties, as one factor that impacted their health and other aspects of well-being. Seventy-four (N = 74) participants, including women, men, youth, young adults, and community leaders, took part in 11 focus groups (n = 51) and 23 key informant interviews. Thematic content analysis through inductive and deductive coding cycles of interview transcripts revealed five main categories related to urban neighborhood-built and social environments: 1) health and well-being, 2) sense of community, 3) sense of safety, 4) civic engagement, and 5) youth and family violence. Ten themes were developed and included, for example, the role of neighborhoods in delineating access to health-promoting characteristics and resources; the role of neighborhood social networks as crime prevention strategies; resident-led decision-making in neighborhood improvements; the negative impact of neglected properties; and the role of the local government in improving physical infrastructure. These findings affirm that residents were aware of and impacted by the cyclical nature of built environment neglect on health and well-being, community violence, neighborhood cohesion, civic engagement, and youth violence. Participants recommended improving neighborhood conditions to shift resident mindsets about the health of neighborhoods, reduce violence, and improve quality of life.
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Affiliation(s)
| | - Kimberly Wu
- School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA USA
| | | | - Amber Tucker
- School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA USA
- Tulane Mary Amelia Center for Women’s Health Equity Research, New Orleans, LA USA
| | - Lolita Moss
- School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA USA
- Tulane Mary Amelia Center for Women’s Health Equity Research, New Orleans, LA USA
- Tulane Violence Prevention Institute, New Orleans, LA USA
| | - Michelle Kondo
- USDA Forest Service, Northern Research Station, Philadelphia, PA USA
| | - Christopher N. Morrison
- Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, NY USA
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive, Medicine, Monash University, Melbourne, Australia
| | - Charles C. Branas
- Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, NY USA
| | - Jeanette Gustat
- School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA USA
| | - Katherine P. Theall
- School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA USA
- Tulane Mary Amelia Center for Women’s Health Equity Research, New Orleans, LA USA
- Tulane Violence Prevention Institute, New Orleans, LA USA
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5
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Semenza DC, Baker NS, Vil CS. Firearm Violence Exposure and Functional Disability among Black Men and Women in the United States. J Urban Health 2024; 101:522-534. [PMID: 38753136 PMCID: PMC11189861 DOI: 10.1007/s11524-024-00866-8] [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] [Accepted: 03/27/2024] [Indexed: 06/22/2024]
Abstract
This study investigates the relationship between firearm violence exposure and functional health among Black adults in the United States (US). We examined associations between different forms of firearm violence exposure (direct, indirect, and community) and functional health with particular attention to differences across sex groups. We used survey data from a nationally representative sample of 3015 Black adult Americans to analyze associations between types of firearm violence exposure and four aspects of functional disability including: the ability to concentrate, walk/use stairs, dress/bathe, and run errands among males and females. The findings indicate notable disparities in exposure and health outcomes based on the exposure type and cumulative exposure to violence. Among males, functional disability was associated most closely with community violence exposure, while direct threats of firearm violence were most consequential for functional health among females. High cumulative exposure to firearm violence was linked to significant risks to functional health, particularly among females. The results shed light on sex differences in the repercussions of firearm violence exposure and emphasize its implications for daily functioning and health. This study contributes to the understanding of the multifaceted impacts of firearm violence on functional well-being and highlights the need for inclusive and culturally sensitive healing approaches based in community settings. There is a critical need for heightened awareness and strategies to enhance the well-being of those disproportionately affected by firearm violence in the US.
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Affiliation(s)
- Daniel C Semenza
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers University - Camden, 405-7 Cooper Street, Camden, NJ, 08102, USA.
- Department of Urban-Global Public Health, Rutgers University - New Brunswick, New Brunswick, NJ, USA.
- New Jersey Gun Violence Research Center, Rutgers University, New Brunswick, NJ, USA.
| | - Nazsa S Baker
- New Jersey Gun Violence Research Center, Rutgers University, New Brunswick, NJ, USA
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Khazanchi R, South EC, Cabrera KI, Winkelman TNA, Vasan A. Health Care Access and Use Among U.S. Children Exposed to Neighborhood Violence. Am J Prev Med 2024; 66:936-947. [PMID: 38416088 DOI: 10.1016/j.amepre.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/29/2024]
Abstract
INTRODUCTION Neighborhood violence is an adverse childhood experience which impacts millions of U.S. children and is associated with poor health outcomes across the life course. These effects may be mitigated by access to care. Yet, the ways in which exposure to neighborhood violence shapes children's health care access have been understudied. METHODS This is a cross-sectional analysis of 16,083 children (weighted N=67,214,201) ages 1 to <18 years from the 2019 and 2021 National Health Interview Survey. Guardians were asked about preventive care access, unmet health needs, and health care utilization in the last year. Changes associated with exposure to neighborhood violence were estimated using marginal effects from multivariable logistic regression models adjusted for year, age, sex, race/ethnicity, parental education, family structure, rurality, income, insurance type, insurance discontinuity, and overall reported health. RESULTS Of 16,083 sample children, 863 (weighted 5.3% [95% CI 4.8-5.7]) reported exposure to neighborhood violence, representing a weighted population of ∼3.5 million. In adjusted analyses, exposure to violence was associated with forgone prescriptions (adjusted difference 1.2 percentage-points (pp) [95%CI 0.1-2.3]; weighted national population impact 42,833 children), trouble paying medical bills (7.7pp [4.4-11.0]; 271,735), delayed medical (1.5pp [0.2-2.9]; 54,063) and mental health care (2.8pp [1.1-4.6]; 98,627), and increased urgent care (4.5pp [0.9-8.1]; 158,246) and emergency department utilization (6.4pp [3.1-9.8]; 227,373). CONCLUSIONS In this nationally representative study, neighborhood violence exposure among children was associated with unmet health needs and increased acute care utilization. Evidence-based interventions to improve access to care and reduce economic precarity in communities impacted by violence are needed to mitigate downstream physical and mental health consequences.
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Affiliation(s)
- Rohan Khazanchi
- Harvard Internal Medicine-Pediatrics Residency Program at Brigham and Women's Hospital, Boston Children's Hospital, and Boston Medical Center, Boston, Massachusetts; FXB Center for Health and Human Rights, Harvard University, Boston, Massachusetts; Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, Minneapolis, Minnesota.
| | - Eugenia C South
- Urban Health Lab, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Keven I Cabrera
- Urban Health Lab, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Tyler N A Winkelman
- Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, Minneapolis, Minnesota; Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota
| | - Aditi Vasan
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia; PolicyLab, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Goodman-Williams R, Clark SL, Campbell R, Ullman SE. Longitudinal patterns of posttraumatic stress disorder symptoms among sexual assault survivors: A latent transition analysis. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2024; 16:586-595. [PMID: 36174154 PMCID: PMC10386878 DOI: 10.1037/tra0001376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The aim of this study was to identify latent classes of posttraumatic stress disorder (PTSD) symptoms in a community sample of sexual assault survivors whose assaults occurred varying lengths of time in the past and to explore patterns of transition between those latent classes over time. METHOD Latent class analysis was used to identify naturally occurring subgroups of PTSD symptoms in a sample of sexual assault survivors who completed two mailed surveys 1 year apart (N = 1,271). Latent transition analysis was then used to examine individuals' probabilities of transitioning into each latent class at Time 2 based on their latent class membership at Time 1. RESULTS A four-class model emerged as the best fitting model at both Time 1 and Time 2. Classes demonstrated overall severity and symptom cluster severity differences. Transition into a lower severity class was more common than transition into a higher severity class, though escalation was demonstrated by 6-20% of participants in each latent class. CONCLUSIONS The substantial heterogeneity in sexual assault survivors' PTSD symptoms highlights the variety of ways that posttraumatic stress may be experienced years after a sexual assault. Future research should explore factors that affect long-term symptoms, including cumulative lifetime trauma and social support. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Sarah E Ullman
- Department of Criminology, Law, and Justice, University of Illinois at Chicago
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Quinn KG, Walsh JL, Johnson A, Edwards T, Takahashi L, Dakin A, Bouacha N, Voisin D. Police Violence Experienced by Black Gay and Bisexual Men: The Effects on HIV Care Engagement and Medication Adherence. AIDS Behav 2024; 28:1642-1649. [PMID: 38315300 PMCID: PMC11070282 DOI: 10.1007/s10461-024-04278-2] [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] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
Black men face high rates of police violence, including direct victimization and indirect exposure to or knowledge of harmful policing. This violence can result in death and physical harm, as well as in numerous poor mental health outcomes. There has been little research examining experiences of police violence experienced by Black gay and bisexual men or the effects of police brutality on HIV continuum of care outcomes. To address this important gap, in this exploratory study, we examined the effects of police brutality on engagement in HIV care and adherence to antiretroviral medications. Cross-sectional survey data were collected from 107 Black gay and bisexual men living with HIV. The path analysis showed that men with greater exposure to police violence had increased symptoms of post-traumatic stress disorder and were more likely to have missed HIV care appointments in the past year. Additionally, there was a significant indirect effect of exposure to police violence on missed medication doses via PTSD symptoms.
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Affiliation(s)
- Katherine G Quinn
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin Center for AIDS Intervention Research, 2071 N. Summit Ave, Milwaukee, WI, 53202, USA.
| | - Jennifer L Walsh
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin Center for AIDS Intervention Research, 2071 N. Summit Ave, Milwaukee, WI, 53202, USA
| | - Anthony Johnson
- School of Social Work, Loyola University Chicago, Chicago, IL, USA
| | - Travonne Edwards
- School of Child and Youth Care, Toronto Metropolitan University, Toronto, ON, Canada
| | - Lois Takahashi
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA
| | | | | | - Dexter Voisin
- School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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9
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Semenza DC, Hamilton JL, Testa A, Jackson DB. Individual and cumulative firearm violence exposure: Implications for sleep among Black and American Indian/Alaska Native adults. Ann Epidemiol 2024; 91:18-22. [PMID: 38244953 DOI: 10.1016/j.annepidem.2024.01.006] [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: 10/13/2023] [Revised: 01/11/2024] [Accepted: 01/17/2024] [Indexed: 01/22/2024]
Abstract
PURPOSE We investigated the relationship between various forms of firearm violence exposure and sleep problems among nationally representative samples of Black (N = 3015) and American Indian and Alaska Native (AI/AN) (N = 527) adults, focusing on difficulties falling asleep, staying asleep, and waking too early. Survey data were collected in April and May 2023. METHODS We employed negative binomial regression models to analyze the associations between the different types of firearm violence exposure and sleep problems. We further examined associations between cumulative firearm violence exposure and sleep outcomes. RESULTS A substantial proportion of Black (59%) and AI/AN (56%) adults reported experiencing some form of firearm violence exposure. Being threatened with a firearm emerged as a consistent factor associated with sleep problems for both racial groups. Witnessing or hearing about shootings was linked to sleep problems in the Black sample, while cumulative firearm violence exposure was associated with all sleep problems in both groups. CONCLUSIONS Individual and cumulative firearm violence exposure is associated with increased sleep problems among Black and AI/AN adults.
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Affiliation(s)
- Daniel C Semenza
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers University, Camden, NJ, USA; Department of Urban-Global Public Health, Rutgers University, Piscataway, NJ, USA; New Jersey Gun Violence Research Center, Rutgers University, Piscataway, NJ, USA.
| | | | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Maryland, MD, USA
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Tausen BM, Misgano M, Wilson B. Campus Racial Climate, Psychological Well-being, and Race-Based Traumatic Stress Symptoms Among Monoracial Black and Biracial Black Students Following Heightened Exposure to Police Brutality. J Racial Ethn Health Disparities 2024; 11:121-131. [PMID: 36648621 PMCID: PMC9844182 DOI: 10.1007/s40615-022-01503-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/05/2022] [Accepted: 12/21/2022] [Indexed: 01/18/2023]
Abstract
The spring of 2020 was characterized by highly visible acts of police brutality and a heightened attention to systemic racism that created a macro-stressor for Black-identifying individuals. The current study aimed to capture college students' perceptions of campus racial climate, subjective well-being, and race-based trauma symptoms during this time. Results indicated that racial identity was associated with students' mental well-being, perceptions of campus racial climate, and experiences of traumatic stress symptoms. Monoracial Black and biracial Black students differed from non-Black students in their perceptions of campus racial climate and their traumatic stress symptoms. Monoracial Black and biracial Black students differed from one another on reports of subjective well-being. A unique pattern of correlations among the study variables emerged for each group. Our findings document the race-based trauma symptoms experienced by monoracial Black and biracial Black students in the spring of 2020 and provide a foundation for future research to examine factors that uniquely contribute to the well-being of monoracial Black and biracial Black students.
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Affiliation(s)
- Brittany M Tausen
- Department of Psychology, Seattle Pacific University, 3307 Third Avenue West, Suite 123, Seattle, WA, 98119-1922, USA.
| | - Mintesinot Misgano
- Department of Industrial/Organizational Psychology, Seattle Pacific University, Seattle, USA
| | - Brea Wilson
- Department of Psychology, Seattle Pacific University, 3307 Third Avenue West, Suite 123, Seattle, WA, 98119-1922, USA
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Sabbath EL, McKetchnie SM, Arora KS, Buchbinder M. US Obstetrician-Gynecologists' Perceived Impacts of Post-Dobbs v Jackson State Abortion Bans. JAMA Netw Open 2024; 7:e2352109. [PMID: 38231510 PMCID: PMC10794934 DOI: 10.1001/jamanetworkopen.2023.52109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/29/2023] [Indexed: 01/18/2024] Open
Abstract
Importance Following the Dobbs v Jackson Women's Health Organization decision in June 2022, 17 US states have functionally banned abortion except in narrow circumstances, and physicians found in violation of these laws face felony charges, loss of their medical license, fines, and prison sentences. Patient impacts are being studied closely, but less research has focused on the consequences for obstetrician-gynecologists (OB-GYNs), for whom medically necessary care provision may now carry serious personal and professional consequences. Objective To characterize perceptions of the impact of abortion restrictions on clinical practice, moral distress, mental health, and turnover intention among US OB-GYNs practicing in states with functional bans on abortion. Design, Setting, and Participants This qualitative study included semistructured, remote interviews with OB-GYNs from 13 US states with abortion bans. Volunteer sample of 54 OB-GYNs practicing in states that had banned abortion as of March 2023. Exposure State abortion bans enacted between June 2022 and March 2023. Main Outcomes and Measures OB-GYNs' perceptions of clinical and personal impacts of abortion bans. Results This study included 54 OB-GYNs (mean [SD] age, 42 [7] years; 44 [81%] female participants; 3 [6%] non-Hispanic Black or African American participants; 45 [83%] White participants) who practiced in general obstetrics and gynecology (39 [72%]), maternal-fetal medicine (7 [13%]), and complex family planning (8 [15%]). Two major domains were identified in which the laws affected OB-GYNs: (1) clinical impacts (eg, delays in care until patients became more sick or legal sign-off on a medical exception to the ban was obtained; restrictions on counseling patients on pregnancy options; inability to provide appropriate care oneself or make referrals for such care); and (2) personal impacts (eg, moral distress; fears and perceived consequences of law violation; intention to leave the state; symptoms of depression and anxiety). Conclusions and relevance In this qualitative study of OB-GYNs practicing under abortion bans, participants reported deep and pervasive impacts of state laws, with implications for workforce sustainability, physician health, and patient outcomes. In the context of public policies that restrict physicians' clinical autonomy, organization-level supports for physicians are essential to maintain workforce sustainability, clinician health and well-being, and availability of timely and accessible health care throughout the US.
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Affiliation(s)
- Erika L. Sabbath
- School of Social Work, Boston College, Chestnut Hill, Massachusetts
- Center for Work, Health, and Wellbeing, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | | | - Kavita S. Arora
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Mara Buchbinder
- Center for Bioethics, Department of Social Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
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12
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Quinn KG, Edwards T, Johnson A, Takahashi L, Dakin A, Bouacha N, Voisin D. Understanding the impact of police brutality on Black sexually minoritized men. Soc Sci Med 2023; 334:116191. [PMID: 37666095 PMCID: PMC10565611 DOI: 10.1016/j.socscimed.2023.116191] [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: 02/14/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/06/2023]
Abstract
Young Black gay, bisexual, and other sexually minoritized men (SMM) face high levels of police brutality and other negative, unwarranted encounters with the police. Such interactions have known health consequences. The purpose of this study was to understand the health, mental health, and social consequences of police brutality experienced by young Black SMM. We conducted in-depth interviews with 31 Black, cisgender men, ages of 16-30 and analyzed the data using thematic analysis. Our primary results are summarized in four themes: 1) Police brutality is built into the system and diminishes trust; 2) Videos and social media make visible violence that has long existed; 3) Police brutality contributes to anxiety and other psychosocial effects; and 4) Violence reduces feelings of safety and contributes to avoidance of police. Our results highlight the direct and vicarious police brutality participants are subjected to and sheds light on the effects of such violence on trust, perceived safety, anxiety, and trauma symptoms. Results from this study contribute to the needed public health conversation around police brutality against Black men, specifically shedding light on the experiences of Black SMM.
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Affiliation(s)
- Katherine G Quinn
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Travonne Edwards
- School of Child and Youth Care, Toronto Metropolitan University, Canada
| | - Anthony Johnson
- School of Social Work, Loyola University Chicago, Chicago, IL, USA
| | - Lois Takahashi
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA
| | | | | | - Dexter Voisin
- School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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Das A, Bruckner TA. New York City's Stop, Question, and Frisk Policy and Psychiatric Emergencies among Black Americans. J Urban Health 2023; 100:255-268. [PMID: 36763179 PMCID: PMC10160307 DOI: 10.1007/s11524-022-00710-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 02/11/2023]
Abstract
Under the Stop, Question, and Frisk (SQF) policy, New York City (NYC) police stopped Black Americans at more than twice the rate of non-Hispanic whites, after controlling for arrests and precinct differences. We examined whether police stops of Black Americans during SQF correspond positively with psychiatric emergency department (ED) visits among Black residents in NYC. We utilized as the exposure all police stops, stops including frisking, and stops including use of force among Black Americans in NYC between 2006 and 2015 from the New York City Police Department's New York City-Stop, Question, and Frisk database. We examined 938,356 outpatient psychiatric ED visits among Black Americans in NYC between 2006 and 2015 from the Statewide Emergency Department Database (SEDD). We applied Box-Jenkins time-series methods to control for monthly temporal patterns. Results indicate that all stops, frisking, and use of force of Black residents correspond with increased psychiatric ED visits among Black Americans in NYC (all stops-coef = 0.024, 95%CI = 0.006, 0.043; frisking-coef = 0.048, 95%CI = 0.015, 0.080; use of force-coef = 0.109, 95%CI = 0.028, 0.190). Our findings indicate that a one standard deviation increase in police stops equates to a 2.72% increase in psychiatric ED visits among Black residents in NYC. Use of force may have the greatest mental health consequences due to perceived threats of physical violence or bodily harm to other members of the targeted group. Racially biased and unconstitutional police encounters may have acute mental health implications for the broader Black community not directly involved in the encounter itself.
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Affiliation(s)
- Abhery Das
- Program in Public Health, University of California, 653 East Peltason Drive, Irvine, CA, 92617, USA.
| | - Tim A Bruckner
- Program in Public Health, University of California, 653 East Peltason Drive, Irvine, CA, 92617, USA
- Center for Population, Inequality, and Policy, University of California, Irvine, USA
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14
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Harris LK, Conklin JL, Woods-Giscombe CL, Cortés YI. Mapping definitions, measures and methodologies of assessing police violence in the health literature: a scoping review protocol. BMJ Open 2023; 13:e066946. [PMID: 36921937 PMCID: PMC10030772 DOI: 10.1136/bmjopen-2022-066946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 02/23/2023] [Indexed: 03/17/2023] Open
Abstract
INTRODUCTION Police violence is a growing public health issue in the USA. Emerging evidence suggests that negative police encounters are associated with adverse physical and mental health outcomes. There is a critical need to examine the relationship between police violence and health disparities. However, the lack of consensus on a conceptual and operational definition of police violence is a limitation in scientific investigations on police violence and its health impacts. Here, we present the protocol for a scoping review that maps definitions, measures and methodologies of assessing police violence in the health literature. METHODS AND ANALYSIS We will comprehensively search PubMed, Cumulative Index to Nursing and Allied Health Literature and APA PsycInfo databases. We will use the following string of key terms separated with the Boolean operator 'or': 'police violence', 'police brutality', 'police use of force', 'law enforcement violence', 'law enforcement brutality', 'law enforcement use of force' and 'legal intervention'. An English language limit will be applied. We will include studies published in English or that have an English language abstract available. Eligible studies will include: (1) a definition of police violence and/or (2) a measurement of police violence. ETHICS AND DISSEMINATION This scoping review does not require ethical approval. The findings of this review will be disseminated through publication in a peer-reviewed journal and at conferences.
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Affiliation(s)
- Latesha K Harris
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jamie L Conklin
- Health Science Library, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Cheryl L Woods-Giscombe
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Yamnia I Cortés
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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15
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Nistler CM, James TL, Dugan E, Pino EC. Racial and Ethnic Disparities in Violent Penetrating Injuries and Long-Term Adverse Outcomes. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:2286-2312. [PMID: 35604722 DOI: 10.1177/08862605221101395] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Violent injury is known to be a chronic, recurrent issue, with high rates of recidivism following initial injury. While the burden of violence is disproportionately felt among young Black men and in communities of color, examination of distinct risk factors and long-term outcomes for other racial and ethnic groups could lead to improved violence intervention strategies. In this study, we examined the risk of violent penetrating injury and long-term adverse outcomes by race and ethnicity. This retrospective study was performed using a cohort of patients presenting to the Boston Medical Center emergency department for a violent penetrating injury between 2006 and 2016. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (95%CI) for the risk of all-cause mortality and violent re-injury at one and 3 years after surviving a penetrating injury.Of the 4191 victims of violent injury, 12% were White, 18% were Hispanic, and the remaining 70% self-identified as Black. Within 3 years after initial injury, Black patients were at the greatest risk of all-cause violent re-injury (vs. Hispanic: HR = 1.46, 95%CI[1.15,1.85], p = 0.002; vs. White: HR = 1.89, 95%CI[1.40,2.57], p < 0.0001), particularly by gunshot wound (vs. Hispanic: HR = 2.04, 95%CI[1.29,3.22] p = 0.002; vs. White: HR = 2.34, 95%CI[1.19,4.60], p = 0.01). At 3-years following initial injury, White patients were at 2.03 times the risk for all-cause mortality, likely due to a 4.96 times greater risk of death by drug or alcohol overdose for White patients compared to Black patients (HR = 4.96, 95%CI[2.25,10.96], p < 0.0001). In conclusion, Black survivors of violent injury have a significantly higher risk of violent re-injury, particularly by gun violence, while White patients are at the highest risk for mortality due to the incidence of drug and alcohol overdose. Violence intervention programs with similar patient populations should explore options to collaborate with drug treatment programs to reach this vulnerable population.
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Affiliation(s)
- Conor M Nistler
- 27118Boston University School of Public Health, Boston, MA, USA
| | - Thea L James
- Department of Emergency Medicine, Boston Violence Intervention Advocacy Program (VIAP), 1836Boston Medical Center, Boston, MA, USA
| | - Elizabeth Dugan
- Department of Emergency Medicine, Boston Violence Intervention Advocacy Program (VIAP), 1836Boston Medical Center, Boston, MA, USA
| | - Elizabeth C Pino
- Department of Emergency Medicine, Boston Violence Intervention Advocacy Program (VIAP), 1836Boston Medical Center, Boston, MA, USA
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16
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del Pozo B, Knorre A, Mello MJ, Chalfin A. Comparing Risks of Firearm-Related Death and Injury Among Young Adult Males in Selected US Cities With Wartime Service in Iraq and Afghanistan. JAMA Netw Open 2022; 5:e2248132. [PMID: 36547982 PMCID: PMC9856602 DOI: 10.1001/jamanetworkopen.2022.48132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE In 2020, homicides in the United States saw a record single-year increase, with firearm injuries becoming the leading cause of death for children, adolescents, and young adults. It is critical to understand the magnitude of this crisis to formulate an effective response. OBJECTIVE To evaluate whether young adult males living in parts of 4 major US cities faced a firearm-related death and injury risk comparable with risks encountered during recent wartime service in Iraq and Afghanistan. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study of young adult males aged 18 to 29 years living in the top 10% most violent zip codes in each domestic setting (as measured by fatal shooting rates), fatal and nonfatal shooting data for 2020 and 2021 were aggregated at the zip code level for 4 of the largest US cities (Chicago, Illinois; Los Angeles, California; New York, New York; and Philadelphia, Pennsylvania). Wartime mortality and combat injury rates for the conflicts in Iraq and Afghanistan were used to assess relative risk. MAIN OUTCOMES AND MEASURES The relative risk of firearm-related death and nonfatal shootings in each setting as compared with combat death and injury in the comparator setting. RESULTS Of 129 826 young adult males aged 18 to 29 years living in the top 10% most violent zip codes in the 4 cities studied, 45 725 (35.2%) were Black, 71 005 (54.7%) were Hispanic, and 40 355 (31.1%) were White. Among this population, there were 470 homicides and 1684 firearm-related injuries. Young adult males living in the most violent zip code of Chicago (2585 individuals aged 20-29 y) and Philadelphia (2448 individuals aged 18-29 y) faced a higher risk of firearm-related homicide than US soldiers who were deployed to Afghanistan, with risk ratios of 3.23 (95% CI, 2.47-4.68) and 1.91 (95% CI, 1.32-3.46), respectively. In expanding the analysis to the top 10% of the cities' most violent zip codes, the risks in Chicago likewise exceeded those of combat death faced by military service members, with a risk ratio of 2.10 (95% CI, 1.82-2.46), and the risks in Philadelphia were comparable with those of deployment to war 1.15 (95% CI, 0.98-1.39). Nonfatal shooting risks were comparable with, or exceeded, the injury risk of combat in Iraq, producing a combined annual firearm risk of 5.8% in Chicago and 3.2% in Philadelphia. However, these findings were not observed in the most violent zip codes of Los Angeles and New York City, where young men faced a 70% to 91% lower risk than soldiers in the Afghanistan war across fatal and nonfatal categories (eg, fatal shooting in most violent zip code in Los Angeles: risk ratio, 0.30; 95% CI, 0.26-0.34; nonfatal shooting in top 10% most violent zip codes in New York: risk ratio, 0.09; 95% CI, 0.08-0.10). The risk of violent death and injury observed in the zip codes studied was almost entirely borne by individuals from minoritized racial and ethnic groups: Black and Hispanic males represented 96.2% of those who were fatally shot (452 individuals) and 97.3% of those who experienced nonfatal injury (1636 individuals) across the 4 settings studied. CONCLUSIONS AND RELEVANCE In this cross-sectional study, for young adult men in several of the communities studied, firearm violence carried morbidity and mortality risks that exceeded those of war. Health equity requires prioritizing effective responses.
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Affiliation(s)
- Brandon del Pozo
- Division of General Internal Medicine, Rhode Island Hospital, Providence
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Alex Knorre
- Department of Criminology, University of Pennsylvania, Philadelphia
| | - Michael J. Mello
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Injury Prevention Center at Rhode Island Hospital, Providence
| | - Aaron Chalfin
- Department of Criminology, University of Pennsylvania, Philadelphia
- National Bureau of Economic Research, Cambridge, Massachusetts
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17
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Greene C, Urbanik MM, Samuels-Wortley K. "It Stays with You for Life": The Everyday Nature and Impact of Police Violence in Toronto's Inner-City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10503. [PMID: 36078218 PMCID: PMC9518342 DOI: 10.3390/ijerph191710503] [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: 07/05/2022] [Revised: 08/02/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
In recent years, police violence has amassed notable international attention from the public, practitioners, and academics alike. This paper explores experiences and perceptions of police violence in Canada, documenting the impacts of direct and vicarious experiences of police violence on inner-city residents. The study employed semi-structured interviews with 45 community members across three Toronto inner-city neighbourhoods. Using a general interview prompt guide, participants were asked a range of questions about their experiences with and perceptions of police, and particularly, of police violence in their community. The interviews were audio recorded, transcribed, thematically coded, and analyzed. All participants reported direct and/or vicarious experiences of police violence, and most described experiencing long-standing, and continual fear that police contact would result in harm to them. Further, participants described a variety of serious and negative outcomes associated with experiencing and/or witnessing police violence. Police violence in Canada is a public health issue that requires an integrated public health policy approach to address the negative outcomes associated with direct and vicarious police violence exposure.
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Affiliation(s)
- Carolyn Greene
- Faculty of Humanities and Social Sciences, Athabasca University, Athabasca, AB T9S 3A3, Canada
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18
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Police Stops and the Erosion of Positive Future Orientation Among Urban Adolescents. J Adolesc Health 2022; 71:180-186. [PMID: 35537889 DOI: 10.1016/j.jadohealth.2022.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/27/2022] [Accepted: 02/22/2022] [Indexed: 12/21/2022]
Abstract
PURPOSE The objective is to examine the ramifications of adolescent personal and vicarious police stops for positive future orientation, among all adolescents and by race/ethnicity and sex subgroups, and to assess how features of police stops-including frequency, intrusiveness, resultant stigma, and resultant traumatic stress response-are associated with positive future orientation. METHODS We used data from the Fragile Families and Child Wellbeing Study (N = 3,437), a national sample of at-risk urban-born youth, and a series of ordinary least squares regression models that account for observed nonrandom selection into police stops to examine the relationship between adolescent police stops and positive future orientation. RESULTS Three key findings emerged. First, personal and vicarious police stops, compared to no police stops, are negatively associated with positive future orientation among adolescents. Second, associations are largest among Black and Hispanic girls. Third, any exposure to police stops, regardless of features of the stops (including frequency, intrusiveness, resultant stigma, and resultant traumatic stress response), is negatively associated with positive future orientation. DISCUSSION Given that positive future orientation is linked to mental and physical health throughout the life course, the findings suggest both personal and vicarious police stops among adolescents may increase health inequality in the United States.
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19
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Jones NE, Lewis K, Brown AM. Navigating a hyperracialized space: exploring the intersections of whiteness, social control, and mental health in st. louis county, missouri. ETHNIC AND RACIAL STUDIES 2022; 46:966-986. [PMID: 36919022 PMCID: PMC10010681 DOI: 10.1080/01419870.2022.2085523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 05/26/2022] [Indexed: 06/18/2023]
Abstract
Places marred by a legacy of racial violence have contemporary implications for racial and ethnic minorities. However, there is limited work examining how racial and ethnic minorities perceive and navigate these spaces and how they may affect their health. We examine the daily lives of Black residents of St. Louis County, living in what we refer to as a hyperracialized space, or areas characterized by multiple forms of violence, to understand how navigating a hyperracialized space impacts how Black residents negotiate space and make meaning of their health. Qualitative interviews (n = 20) revealed three themes: (1) Whiteness and the maintenance of a hyperracialized space, (2) unspoken rules of police encounters and the embodiment of self-regulation, (3) and hypervigilance. Narratives reveal how individuals and institutions concretize a hyperracialized space through social control. Moreover, participants discussed how their environment influenced how they interacted with and navigated space, the toll of which elicited hypervigilance.
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Affiliation(s)
- Nicole E. Jones
- Department of Sociology, University of Missouri, Columbia, MO, US
| | - Kaleea Lewis
- Department of Public Health and Department of Women’s and Gender Studies, University of Missouri, Columbia, MO, US
| | - Alaysia M. Brown
- Department of Human Development and Family Science, University of Missouri, Columbia, MO, US
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20
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Tomas CW, Webb EK, Bennett KP, Huggins AA, Fitzgerald JM, Miskovich TA, Krukowki J, deRoon-Cassini TA, Larson CL. Neighborhood Socioeconomic Disadvantage and the Neurobiology of Uncertainty in Traumatically Injured Adults. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022; 2:263-272. [PMID: 35903110 PMCID: PMC9328402 DOI: 10.1016/j.bpsgos.2022.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 02/04/2022] [Accepted: 02/21/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Individuals residing in more socioeconomically disadvantaged neighborhoods experience greater uncertainty through insecurity of basic needs such as food, employment, and housing, compared with more advantaged neighborhoods. Although the neurobiology of uncertainty has been less frequently examined in relation to neighborhood disadvantage, there is evidence that neighborhood disadvantage is associated with widespread neural alterations. METHODS Recently traumatically injured participants (n = 90) completed a picture anticipation task in the magnetic resonance imaging scanner, in which they viewed images presented in a temporally predictable or unpredictable manner. We investigated how neighborhood disadvantage (via area deprivation index [ADI]) was related to neural activation during anticipation and presentation of negative and neutral images after accounting for individual factors (i.e., age, gender, income, acute posttraumatic stress symptoms). RESULTS There was a significant interaction during the anticipation period such that higher ADI rankings were related to greater activation of the right anterior cingulate cortex to predictable versus unpredictable neutral stimuli. Although no other robust interactions emerged related to ADI, we note several novel simple effects of ADI during anticipation and presentation periods in the hippocampus and prefrontal, cingulate, and occipital cortices. CONCLUSIONS Together, these results may represent an adaptive response to predictable and/or negative stimuli, stemming from chronic exposure to socioeconomic-based uncertainties. Although effects were modest, future work should continue to examine pretrauma context on posttrauma outcomes. To better understand trauma outcomes, it is imperative that researchers consider the broader context in which trauma survivors reside.
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Affiliation(s)
- Carissa W. Tomas
- Institute for Health and Equity, Division of Epidemiology and Social Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - E. Kate Webb
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | | | - Ashley A. Huggins
- Brain Imaging and Analysis Center, Duke University, Durham, North Carolina
| | | | | | - Jessica Krukowki
- Department of Psychology, Marquette University, Milwaukee, Wisconsin
| | - Terri A. deRoon-Cassini
- Division of Trauma and Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Christine L. Larson
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
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21
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The racial and cultural ecology of home and community-based services for diverse older adults. J Aging Stud 2022; 61:101023. [DOI: 10.1016/j.jaging.2022.101023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 11/19/2022]
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22
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Jenkins KA, Keddem S, Bekele SB, Augustine KE, Long JA. Perspectives on Racism in Health Care Among Black Veterans With Chronic Kidney Disease. JAMA Netw Open 2022; 5:e2211900. [PMID: 35552724 PMCID: PMC9099421 DOI: 10.1001/jamanetworkopen.2022.11900] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/10/2022] [Indexed: 12/20/2022] Open
Abstract
Importance The burden of chronic kidney disease (CKD) and end-stage kidney disease falls disproportionately on Black individuals in the US, with Black veterans experiencing substantial consequences, and only a portion of the disparities in health conditions and health care can be explained by nonbiological factors. Among Black individuals, racism is likely one of those factors, suggesting the need to examine the consequences of racism and the resulting social structures that establish and perpetuate these racial disparities. Objective To investigate the health care experiences of Black veterans with CKD and identify and explore the racial discrimination encountered by this vulnerable population. Design, Setting, and Participants This qualitative study used semistructured interview guides to investigate the health care experiences of 36 Black veterans with CKD who received care at the Corporal Michael Crescenz Veterans Affairs Medical Center in Philadelphia, Pennsylvania, from October 2018 to September 2019. Interview transcripts were analyzed using applied thematic analysis. Results Among 36 Black veterans with CKD who characterized racism in the context of their care at a Veterans Affairs medical center, the mean (SD) age was 66.0 (7.8) years; 35 participants (97.2%) were male, 1 participant (2.8%) was female, and 19 participants (52.8%) were married. The mean (SD) duration of military service was 8.0 (7.0) years. Overall, 15 participants (41.7%) were not dependent on dialysis, and hypertension was the most common comorbidity (9 participants [25.0%]). Veterans described the ways in which racism produced emotional and physical stress, including psychological symptoms (eg, anger and hurt) and physiological symptoms (eg, headaches). Veterans described a strong sense of distrust in the health care system coupled with a need to be hypervigilant during clinical encounters. When encountering racism, veterans described bottling up their feelings, which sometimes led to maladaptive behavior (eg, substance use). Veterans also described individual and collective positive strategies (eg, faith) for coping with the stress of racism. Conclusions and Relevance In this study, Black veterans with CKD experienced racism in the clinical setting that produced physical and emotional stress and a strong sense of distrust in the health care system. These findings highlight an important opportunity for education and training of health care professionals in the implementation of trauma-informed approaches to care as a means of addressing race-based stress and trauma.
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Affiliation(s)
- Kevin A. Jenkins
- Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania
- Annenberg School of Communications, University of Pennsylvania, Philadelphia
| | - Shimrit Keddem
- Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | | | | | - Judith A. Long
- Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
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23
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Bruce MM, Ulrich CM, Webster J, Richmond TS. Injured black men's perceptions of the recovery environment. Soc Sci Med 2022; 292:114608. [PMID: 34861572 PMCID: PMC8748408 DOI: 10.1016/j.socscimed.2021.114608] [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: 12/19/2020] [Revised: 07/23/2021] [Accepted: 11/24/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Black men are disproportionately impacted by injuries in the United States. This disparity is glaring given that injury is one of the top ten causes of death. Injured Black men from disadvantaged neighborhoods experience higher injury mortality, years of life-expectancy loss, and psychological symptoms that persist after initial wounds have been treated. These injured men are typically transported to a hospital where they are medically stabilized and soon after are returned to the community. Black men are less likely to be discharged to comprehensive rehabilitation facilities, magnifying disparities in recovery from injury. While much research has examined individual characteristics that predict poor recovery from injury, fewer studies have focused on social and physical features of the environment and how they may impact the recovery of injury survivors. PURPOSE The purpose of this study was to describe Black men's perceptions of how characteristics of their environment affect their recovery following serious injury. METHODS This was a secondary analysis of an existing data set consisting of semi-structured, qualitative interviews of 43 injured Black men in a northeastern city. The interviews were conducted three months following discharge from a large urban trauma center, and were audiotaped, transcribed verbatim, and de-identified. Thematic analysis consistent with the qualitative paradigm was used to identify themes. RESULTS Four themes were identified in injured men's narratives: challenges to recovery, feeling unsafe, efforts to increase safety, and resources for recovery. CONCLUSIONS Our findings emphasize the importance of the role of community resources that can support injured men's recovery within their neighborhoods. Additional resources should be directed to survivors who return to disadvantaged communities after injury in order to minimize adverse emotional experiences that detract from recovery.
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Affiliation(s)
- Marta M Bruce
- University of Pennsylvania School of Nursing, Claire Fagin Hall, 418 Curie Blvd, Philadelphia, PA, 19104, USA; Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA; Penn Injury Science Center, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Connie M Ulrich
- University of Pennsylvania School of Nursing, Claire Fagin Hall, 418 Curie Blvd, Philadelphia, PA, 19104, USA; Department of Medical Ethics and Health Policy, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Jessica Webster
- University of Pennsylvania School of Nursing, Claire Fagin Hall, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Therese S Richmond
- University of Pennsylvania School of Nursing, Claire Fagin Hall, 418 Curie Blvd, Philadelphia, PA, 19104, USA; Penn Injury Science Center, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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24
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Glasser NJ, Tung EL, Peek ME. Policing, health care, and institutional racism: Connecting history and heuristics. Health Serv Res 2021; 56:1100-1103. [PMID: 34618369 DOI: 10.1111/1475-6773.13888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 09/30/2021] [Accepted: 09/30/2021] [Indexed: 11/27/2022] Open
Affiliation(s)
- Nathaniel J Glasser
- Section of General Internal Medicine, University of Chicago, Chicago, Illinois, USA
| | - Elizabeth L Tung
- Section of General Internal Medicine, University of Chicago, Chicago, Illinois, USA.,Center for Health and the Social Sciences, University of Chicago, Chicago, Illinois, USA.,Chicago Center for Diabetes Translation Research, University of Chicago, Chicago, Illinois, USA
| | - Monica E Peek
- Section of General Internal Medicine, University of Chicago, Chicago, Illinois, USA.,Chicago Center for Diabetes Translation Research, University of Chicago, Chicago, Illinois, USA.,MacLean Center for Medical Ethics, University of Chicago, Chicago, Illinois, USA.,Center for the Study of Race, Politics and Culture, University of Chicago, Chicago, Illinois, USA
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25
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Grupe DW, Stoller JL, Alonso C, McGehee C, Smith C, Mumford JA, Rosenkranz MA, Davidson RJ. The Impact of Mindfulness Training on Police Officer Stress, Mental Health, and Salivary Cortisol Levels. Front Psychol 2021; 12:720753. [PMID: 34539521 PMCID: PMC8448191 DOI: 10.3389/fpsyg.2021.720753] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/09/2021] [Indexed: 12/25/2022] Open
Abstract
Unaddressed occupational stress and trauma contribute to elevated rates of mental illness and suicide in policing, and to violent and aggressive behavior that disproportionately impacts communities of color. Emerging evidence suggests mindfulness training with police may reduce stress and aggression and improve mental health, but there is limited evidence for changes in biological outcomes or the lasting benefits of mindfulness training. We conducted a randomized controlled trial (RCT) of 114 police officers from three Midwestern U.S. law enforcement agencies. We assessed stress-related physical and mental health symptoms, blood-based inflammatory markers, and hair and salivary cortisol. Participants were then randomized to an 8-week mindfulness intervention or waitlist control (WLC), and the same assessments were repeated post-intervention and at 3-month follow-up. Relative to waitlist control, the mindfulness group had greater improvements in psychological distress, mental health symptoms, and sleep quality post-training, gains that were maintained at 3-month follow-up. Intervention participants also had a significantly lower cortisol awakening response (CAR) at 3-month follow-up relative to waitlist control. Contrary to hypotheses, there were no intervention effects on hair cortisol, diurnal cortisol slope, or inflammatory markers. In summary, an 8-week mindfulness intervention for police officers led to self-reported improvements in distress, mental health, and sleep, and a lower CAR. These benefits persisted (or emerged) at 3-month follow-up, suggesting that this training may buffer against the long-term consequences of chronic stress. Future research should assess the persistence of these benefits over a longer period while expanding the scope of outcomes to consider the broader community of mindfulness training for police. Clinical Trial Registration: ClinicalTrials.gov#NCT03488875.
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Affiliation(s)
- Daniel W Grupe
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, United States
| | - Jonah L Stoller
- Colorado School of Public Health, University of Colorado Denver, Aurora, CO, United States
| | | | - Chad McGehee
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, United States.,Department of Athletics, University of Wisconsin-Madison, Madison, WI, United States
| | - Chris Smith
- Academy for Mindfulness, Glendale, WI, United States
| | - Jeanette A Mumford
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Melissa A Rosenkranz
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, United States.,Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States
| | - Richard J Davidson
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, United States.,Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States.,Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, United States
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26
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Peek ME. Racism and health: A call to action for health services research. Health Serv Res 2021; 56:569-572. [PMID: 34155638 DOI: 10.1111/1475-6773.13693] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Monica E Peek
- Section of General Internal Medicine, Chicago Center for Diabetes Translation Research, Center for the Study of Race, Politics and Culture, The University of Chicago, Chicago, Illinois, USA
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27
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Abstract
Police violence in the United States represents a pressing public health crisis impacting youth, particularly youth of color. This article reviews the recent epidemiology of police executions and conflicts involving children, adolescents, and young adults. The roles of social determinants of health and centuries-long history of white supremacy and racism as root causes of adverse policing are emphasized. The article summarizes the evidence as to how direct and vicarious experiences of police violence impact youth academic, behavioral, and health outcomes. Recommendations are provided for pediatricians to address this public health crisis through clinical practice, education, advocacy, and research.
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Affiliation(s)
- Tiffani J Johnson
- Department of Emergency Medicine, University of California, Davis School of Medicine, 4150 V Street Suite 2100, Sacramento, CA 95817, USA.
| | - Joseph L Wright
- Pediatrics and Health Policy & Management, University of Maryland Schools of Medicine and Public Health, University of Maryland Capital Region Health, 3001 Hospital Drive, Executive Suite, Cheverly, MD 20785, USA
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28
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Quinn KG, Spector A, Takahashi L, Voisin DR. Conceptualizing the Effects of Continuous Traumatic Violence on HIV Continuum of Care Outcomes for Young Black Men Who Have Sex with Men in the United States. AIDS Behav 2021; 25:758-772. [PMID: 32944841 PMCID: PMC7886964 DOI: 10.1007/s10461-020-03040-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 01/06/2023]
Abstract
The United States (US) is on track to achieve the 90-90-90 targets set forth by UNAIDS and the National HIV/AIDS strategy, yet significant racial disparities in HIV care outcomes remain, particularly for young Black men who have sex with men (YBMSM). Research has demonstrated that various types of violence are key aspects of syndemics that contribute to disparities in HIV risk. However, little research has looked collectively at cumulative violent experiences and how those might affect HIV treatment and care outcomes. Drawing on extant literature and theoretical underpinnings of syndemics, we provide a conceptual model that highlights how continuous traumatic violence experienced by YBMSM may affect HIV outcomes and contribute to racial disparities in HIV outcomes. The findings of this focused review suggest a need for research on how continuous exposure to various types of violence influence HIV prevention and treatment outcomes for young Black MSM.
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Affiliation(s)
- Katherine G Quinn
- Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, 2071 N. Summit Ave., Milwaukee, WI, 53202, USA.
| | - Antoinette Spector
- Medical College of Wisconsin, Institute for Health Equity, Milwaukee, USA
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29
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Maguire E. Effect of race on suspect injuries during encounters with police. Inj Prev 2020; 27:456-460. [PMID: 33303558 DOI: 10.1136/injuryprev-2020-044010] [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: 09/23/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To estimate the effects of race and ethnicity on suspect injuries during use of force encounters with police in Tucson, Arizona. METHODS Data on all use of force cases recorded by the Tucson Police Department from January 2018 to March 2020 were analysed. Logistic regression was used to estimate the effects of race and ethnicity on the likelihood of suspect injuries controlling for a variety of other factors. RESULTS Overall, 28.5% of people who had force used against them by Tucson police were injured. Multivariate analyses reveal that among those who had force used against them, African-American suspects were significantly less likely than white suspects to be injured. The risk of injury for other racial and ethnic groups is about the same as the risk for white suspects. Resisting arrest and seeking to escape from police custody do not increase the risk of injury among suspects, but assaulting officers or other individuals does increase the risk of injury. Certain types of force, such as canines, firearms and TASERs, are associated with significantly elevated risks of injury among suspects. CONCLUSIONS Numerous interest groups have raised concerns about the police use of force against minorities. Using publicly available data, this analysis examined the effects of race and ethnicity on risk of injury during the use of force encounters with police in Tucson. The findings reveal that minorities are not injured at elevated rates relative to whites. To the contrary, African-American suspects are less likely to be injured than white suspects are.
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Affiliation(s)
- Edward Maguire
- Watts College of Public Service and Community Solutions, Arizona State University, Phoenix, Arizona, USA
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