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Affiliation(s)
- Joelle M Abi-Rached
- From the Department of the History of Science (J.M.A.-R., A.M.B.) and the Radcliffe Institute for Advanced Study (J.M.A.-R.), Harvard University, Cambridge, MA; and the Department of Global Health and Social Medicine, Harvard Medical School, Boston (A.M.B.)
| | - Allan M Brandt
- From the Department of the History of Science (J.M.A.-R., A.M.B.) and the Radcliffe Institute for Advanced Study (J.M.A.-R.), Harvard University, Cambridge, MA; and the Department of Global Health and Social Medicine, Harvard Medical School, Boston (A.M.B.)
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Sacks DA, Incerpi MH. Of Aspirin, Preeclampsia, and Racism. N Engl J Med 2024; 390:968-969. [PMID: 38466616 DOI: 10.1056/nejmp2311019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Affiliation(s)
- David A Sacks
- From the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles
| | - Marc H Incerpi
- From the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles
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Woodard N, Butler J, Ghosh D, Green KM, Knott CL. The Association between State-Level Structural Racism and Alcohol and Tobacco Use Behaviors among a National Probability Sample of Black Americans. Cancer Epidemiol Biomarkers Prev 2024; 33:261-269. [PMID: 38032218 PMCID: PMC10872984 DOI: 10.1158/1055-9965.epi-23-0873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/24/2023] [Accepted: 11/28/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Structural racism is how society maintains and promotes racial hierarchy and discrimination through established and interconnected systems. Structural racism is theorized to promote alcohol and tobacco use, which are risk factors for adverse health and cancer-health outcomes. The current study assesses the association between measures of state-level structural racism and alcohol and tobacco use among a national sample of 1,946 Black Americans. METHODS An existing composite index of state-level structural racism including five dimensions (subscales; i.e., residential segregation and employment, economic, incarceration, and educational inequities) was merged with individual-level data from a national sample dataset. Hierarchical linear and logistic regression models, accounting for participant clustering at the state level, assessed associations between structural racism and frequency of alcohol use, frequency of binge drinking, smoking status, and smoking frequency. Two models were estimated for each behavioral outcome, one using the composite structural racism index and one modeling dimensions of structural racism in lieu of the composite measure, each controlling for individual-level covariates. RESULTS Results indicated positive associations between the incarceration dimension of the structural racism index and binge drinking frequency, smoking status, and smoking frequency. An inverse association was detected between the education dimension and smoking status. CONCLUSIONS Results suggest that state-level structural racism expressed in incarceration disparities, is positively associated with alcohol and tobacco use among Black Americans. IMPACT Addressing structural racism, particularly in incarceration practices, through multilevel policy and intervention may help to reduce population-wide alcohol and tobacco use behaviors and improve the health outcomes of Black populations.
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Affiliation(s)
- Nathaniel Woodard
- Cancer Care Quality Training Program, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - James Butler
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, College Park, MD, USA
| | - Debarchana Ghosh
- Department of Geography, University of Connecticut, University of Connecticut, Storrs, CT, USA
| | - Kerry M. Green
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, College Park, MD, USA
| | - Cheryl L. Knott
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, College Park, MD, USA
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4
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Miller-Kleinhenz JM, Barber LE, Maliniak ML, Moubadder L, Bliss M, Streiff MJ, Switchenko JM, Ward KC, McCullough LE. Historical Redlining, Persistent Mortgage Discrimination, and Race in Breast Cancer Outcomes. JAMA Netw Open 2024; 7:e2356879. [PMID: 38376843 PMCID: PMC10879950 DOI: 10.1001/jamanetworkopen.2023.56879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/28/2023] [Indexed: 02/21/2024] Open
Abstract
Importance Inequities created by historical and contemporary mortgage discriminatory policies have implications for health disparities. The role of persistent mortgage discrimination (PMD) in breast cancer (BC) outcomes has not been studied. Objective To estimate the race-specific association of historical redlining (HRL) with the development of BC subtypes and late-stage disease and a novel measure of PMD in BC mortality. Design, Setting, and Participants This population-based cohort study used Georgia Cancer Registry data. A total of 1764 non-Hispanic Black and White women with a BC diagnosis and residing in an area graded by the Home Owners' Loan Corporation (HOLC) in Georgia were included. Patients were excluded if they did not have a known subtype or a derived American Joint Committee on Cancer stage or if diagnosed solely by death certificate or autopsy. Participants were diagnosed with a first primary BC between January 1, 2010, to December 31, 2017, and were followed through December 31, 2019. Data were analyzed between May 1, 2022, and August 31, 2023. Exposures Scores for HRL were examined dichotomously as less than 2.5 (ie, nonredlined) vs 2.5 or greater (ie, redlined). Contemporary mortgage discrimination (CMD) scores were calculated, and PMD index was created using the combination of HRL and CMD scores. Main Outcomes and Measures Estrogen receptor (ER) status, late stage at diagnosis, and BC-specific death. Results This study included 1764 women diagnosed with BC within census tracts that were HOLC graded in Georgia. Of these, 856 women (48.5%) were non-Hispanic Black and 908 (51.5%) were non-Hispanic White; 1148 (65.1%) were diagnosed at 55 years or older; 538 (30.5%) resided in tracts with HRL scores less than 2.5; and 1226 (69.5%) resided in tracts with HRL scores 2.5 or greater. Living in HRL areas with HRL scores 2.5 or greater was associated with a 62% increased odds of ER-negative BC among non-Hispanic Black women (odds ratio [OR], 1.62 [95% CI, 1.01-2.60]), a 97% increased odds of late-stage diagnosis among non-Hispanic White women (OR, 1.97 [95% CI, 1.15-3.36]), and a 60% increase in BC mortality overall (hazard ratio, 1.60 [95% CI, 1.17-2.18]). Similarly, PMD was associated with BC mortality among non-Hispanic White women but not among non-Hispanic Black women. Conclusions and Relevance The findings of this cohort study suggest that historical racist policies and persistent discrimination have modern-day implications for BC outcomes that differ by race. These findings emphasize the need for a more nuanced investigation of the social and structural drivers of disparate BC outcomes.
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Affiliation(s)
| | - Lauren E. Barber
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Maret L. Maliniak
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Leah Moubadder
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Maya Bliss
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Micah J. Streiff
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jeffrey M. Switchenko
- Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Kevin C. Ward
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Lauren E. McCullough
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
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5
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Sajja A, Tundealao S. Commentary: Disparities and Racial Barriers Among African American Women Despite Breastfeeding Workplace Policies. Fam Community Health 2024; 47:59-61. [PMID: 37830515 DOI: 10.1097/fch.0000000000000389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Affiliation(s)
- Anusha Sajja
- The University of Texas Health Science Center at Houston
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6
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Krishnamurthy S, Rollin FG. We must be clear that the root cause of racial disparities in Alzheimer's disease is racism. Alzheimers Dement 2023; 19:5305-5306. [PMID: 37436001 DOI: 10.1002/alz.13389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 07/13/2023]
Affiliation(s)
- Sudarshan Krishnamurthy
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Francois G Rollin
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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Rutman SP, Borgen N, Spellen S, King DD, Decker MJ, Rand L, Cobbins A, Brindis CD. Addressing anti-black racism in an academic preterm birth initiative: perspectives from a mixed methods case study. BMC Public Health 2023; 23:2039. [PMID: 37853363 PMCID: PMC10585806 DOI: 10.1186/s12889-023-16812-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/21/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Growing recognition of racism perpetuated within academic institutions has given rise to anti-racism efforts in these settings. In June 2020, the university-based California Preterm Birth Initiative (PTBi) committed to an Anti-Racism Action Plan outlining an approach to address anti-Blackness. This case study assessed perspectives on PTBi's anti-racism efforts to support continued growth toward racial equity within the initiative. METHODS This mixed methods case study included an online survey with multiple choice and open-ended survey items (n = 27) and key informant interviews (n = 8) of leadership, faculty, staff, and trainees working within the initiative. Survey and interview questions focused on perspectives about individual and organizational anti-racism competencies, perceived areas of initiative success, and opportunities for improvement. Qualitative interview and survey data were coded and organized into common themes within assessment domains. RESULTS Most survey respondents reported they felt competent in all the assessed anti-racism skills, including foundational knowledge and responding to workplace racism. They also felt confident in PTBi's commitment to address anti-Blackness. Fewer respondents were clear on strategic plans, resources allocated, and how the anti-racism agenda was being implemented. Suggestions from both data sources included further operationalizing and communicating commitments, integrating an anti-racism lens across all activities, ensuring accountability including staffing and funding consistent with anti-racist approaches, persistence in hiring Black faculty, providing professional development and support for Black staff, and addressing unintentional interpersonal harms to Black individuals. CONCLUSIONS This case study contributes key lessons which move beyond individual-level and theoretical approaches towards transparency and accountability in academic institutions aiming to address anti-Black racism. Even with PTBi's strong commitment and efforts towards racial equity, these case study findings illustrate that actions must have sustained support by the broader institution and include leadership commitment, capacity-building via ongoing coaching and training, broad incorporation of anti-racism practices and procedures, continuous learning, and ongoing accountability for both short- and longer-term sustainable impact.
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Affiliation(s)
- Shira P Rutman
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA.
| | - Natasha Borgen
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
| | - Solaire Spellen
- Department of Obstetrics, Gynecology and Reproductive Sciences, California Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA, USA
| | - Dante D King
- Department of Obstetrics, Gynecology and Reproductive Sciences, California Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA, USA
| | - Martha J Decker
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Larry Rand
- Department of Obstetrics, Gynecology and Reproductive Sciences, California Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA, USA
| | - Alexis Cobbins
- Department of Obstetrics, Gynecology and Reproductive Sciences, California Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA, USA
| | - Claire D Brindis
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
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Affiliation(s)
- Joshua Ellis
- From Beth Israel Deaconess Medical Center (J.E., Alden Landry) and Brigham and Women's Hospital (O.O., Adaira Landry) - both in Boston
| | - Onyeka Otugo
- From Beth Israel Deaconess Medical Center (J.E., Alden Landry) and Brigham and Women's Hospital (O.O., Adaira Landry) - both in Boston
| | - Adaira Landry
- From Beth Israel Deaconess Medical Center (J.E., Alden Landry) and Brigham and Women's Hospital (O.O., Adaira Landry) - both in Boston
| | - Alden Landry
- From Beth Israel Deaconess Medical Center (J.E., Alden Landry) and Brigham and Women's Hospital (O.O., Adaira Landry) - both in Boston
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Yalavarthi B, Summerville J, Farahani N, Xiao LZ, Yu C, Aboul-Hassan D, Rajgarhia S, Clauw DJ, Kahlenberg JM, DeJonckheere M, Bergmans RS. Recommendations for Improving Systemic Lupus Erythematosus Care From Black Adults: A Qualitative Study. JAMA Netw Open 2023; 6:e2340688. [PMID: 37906190 PMCID: PMC10618846 DOI: 10.1001/jamanetworkopen.2023.40688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/19/2023] [Indexed: 11/02/2023] Open
Abstract
Importance Racial inequities in incidence, morbidity, and mortality are a defining feature of systemic lupus erythematosus (SLE). Health care systems are integral to addressing these inequities. However, qualitative evidence that highlights Black SLE care experiences is limited. Objective To identify opportunities for improving SLE care based on the experiences and perspectives of Black adults with SLE. Design, Setting, and Participants In this qualitative study, an interpretive description approach was used and data were analyzed using inductive thematic analysis. Semistructured interviews with Black adults in Michigan who were diagnosed with SLE were conducted. Interviews occurred from November 2, 2021, to July 19, 2022, and data analysis occurred from May 6, 2022, to April 12, 2023. Main Outcomes and Measures Deidentified transcripts from the interviews were analyzed to develop themes that focused on opportunities to improve quality of care and symptom management. Results The participants included 30 Black adults with SLE (97% women; mean age, 41 years; range, 18-65 years). Four main themes were identified: (1) awareness of SLE signs and symptoms before diagnosis (participants emphasized delays in diagnosis and how knowledge concerning SLE could be limited in their families and communities); (2) patient-clinician interactions (participants faced discrimination in health care settings and talked about the value of coordinated and supportive health care teams); (3) medication adherence and health effects (participants experienced a range of adverse effects from medications that treat SLE and described how monitoring medication use and efficacy could inform tailored care approaches); and (4) comprehensive care plans after diagnosis (participants reported persistent pain and other symptoms despite treatment). In the context of disease management, participants emphasized the importance of behavioral change and the negative impact of social risk factors. Conclusions and Relevance The findings of this qualitative study suggest how limited information about SLE, experiences of racism, treatment regimens, and social risk factors may affect Black people with SLE. Future research should further engage and include Black communities within the context of treatment and intervention development to reduce racial inequities.
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Affiliation(s)
- Bhaavna Yalavarthi
- Medical School, Department of Anesthesiology, University of Michigan, Ann Arbor
| | - Johari Summerville
- Medical School, Department of Anesthesiology, University of Michigan, Ann Arbor
| | - Nikki Farahani
- Medical School, Department of Anesthesiology, University of Michigan, Ann Arbor
| | - Lillian Z. Xiao
- Medical School, Department of Anesthesiology, University of Michigan, Ann Arbor
| | - Christine Yu
- Medical School, Department of Anesthesiology, University of Michigan, Ann Arbor
| | - Deena Aboul-Hassan
- Medical School, Department of Anesthesiology, University of Michigan, Ann Arbor
| | - Sia Rajgarhia
- Medical School, Department of Anesthesiology, University of Michigan, Ann Arbor
| | - Daniel J. Clauw
- Medical School, Department of Anesthesiology, University of Michigan, Ann Arbor
| | | | - Melissa DeJonckheere
- Medical School, Department of Family Medicine, University of Michigan, Ann Arbor
| | - Rachel S. Bergmans
- Medical School, Department of Anesthesiology, University of Michigan, Ann Arbor
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Motley RO, Joe S, McQueen A, Clifton M, Carlton-Brown D. Development, construct validity, and measurement invariance of the Modified Classes of Racism Frequency of Racial Experiences Measure (M-CRFRE) to capture direct and indirect exposure to perceived racism-based police use of force for Black emerging adults. Cultur Divers Ethnic Minor Psychol 2023; 29:575-589. [PMID: 35113606 PMCID: PMC9546726 DOI: 10.1037/cdp0000525] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To utilize focus groups, cognitive interviews, content expert panel, and computer-assisted surveys to develop and pilot survey items assessing exposure to perceived racism-based police violence to enhance the Classes of Racism Frequency of Racial Experiences (CRFRE). METHOD Focus groups and cognitive interviews were conducted with Black emerging adults (n = 44) in St. Louis, Missouri. Utilizing a grounded theory approach, a thematic analysis of the focus group and cognitive interview transcripts was conducted to identify key items to be added to the CRFRE. Three content experts assessed the face and content validity of survey items. Computer-assisted surveys were conducted to pilot the modified CRFRE with a sample of Black emerging adults (n = 300). Confirmatory factor analyses and structural paths were used to examine the construct validity of the modified CRFRE. RESULTS Participant's qualitative data and suggestions from content experts resulted in the development of 16 additional survey items regarding exposure to perceived racism-based police violence across three domains (victim, witness in person, and seen in media). The modified CRFRE measure showed construct validity, internal reliability, and measurement invariance between men and women. CONCLUSIONS This study advances our epidemiological methodology for quantifying exposure to perceived racism-based police violence. Future research is necessary to assess the prevalence of exposure to perceived racism-based police violence and associated mental and behavioral outcomes for Black emerging adults in the U.S. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Sean Joe
- George Warren Brown School of Social Work Washington University in St. Louis
| | - Amy McQueen
- Washington University in St. Louis School of Medicine
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Nnoli A. Historical Primer on Obstetrics and Gynecology Health Inequities in America: A Narrative Review of Four Events. Obstet Gynecol 2023; 142:779-786. [PMID: 37734087 PMCID: PMC10510831 DOI: 10.1097/aog.0000000000005331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/17/2023] [Accepted: 05/04/2023] [Indexed: 09/23/2023]
Abstract
Four historical events provide context for racial injustices and inequities in medicine in the United States today: the invention of race as a social construct, enslavement in the Americas, the legal doctrine of Partus sequitur ventrem, and the American eugenics movement. This narrative review demonstrates how these race-based systems resulted in stereotypes, myths, and biases against Black individuals that contribute to health inequities today. Education on the effect of slavery in current health care outcomes may prevent false explanations for inequities based on stereotypes and biases. These historical events validate the need for medicine to move away from practicing race-based medicine and instead aim to understand the intersectionality of sex, race, and other social constructs in affecting the health of patients today.
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Affiliation(s)
- Aisha Nnoli
- MultiCare Obstetrics and Gynecology Associates, MultiCare Health Systems, and the Tacoma Family Medicine Residency Program and Rural Family Medicine With Obstetrics, Tacoma, and the Department of Family Medicine, University of Washington, Seattle, Washington
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Schmidt H, Gostin LO, Williams MA. The Supreme Court's Rulings on Race Neutrality Threaten Progress in Medicine and Health. JAMA 2023; 330:1033-1034. [PMID: 37429018 DOI: 10.1001/jama.2023.13749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
This Viewpoint examines the recent Supreme Court rulings on race neutrality, striking down affirmative action programs in higher education, which will affect efforts to eliminate health inequities in the US.
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Affiliation(s)
- Harald Schmidt
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Lawrence O Gostin
- O'Neill Institute for National and Global Health Law, Georgetown University, Washington, DC
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Epple M, Framke M, Franco E, Junginger H, Roy B. Introduction: Indology and Aryanism: Knowledge of India in Nazi Germany-An Invitation for New Research. NTM 2023; 31:219-231. [PMID: 37695375 PMCID: PMC10556168 DOI: 10.1007/s00048-023-00367-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/05/2023] [Indexed: 09/12/2023]
Abstract
The introduction to our special issue offers a brief survey of the historical literature on knowledge about India in Nazi Germany and distinguishes three different, but interrelated layers of such knowledge: disciplinary knowledge of Indology as an academic field, knowledge fulfilling the needs of state agencies, and popular knowledge (and beliefs) about India.
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Affiliation(s)
- Moritz Epple
- Historisches Seminar, Goethe-Universität Frankfurt, Norbert-Wollheim-Platz 1, 60629 Frankfurt am Main, Germany
| | - Maria Framke
- Historisches Seminar, Universität Erfurt, Nordhäuser Str. 63, 99089 Erfurt, Germany
| | - Eli Franco
- Institut für Indologie und Zentralasienwissenschaften, Universität Leipzig, Schillerstraße 6, 04109 Leipzig, Germany
| | - Horst Junginger
- Religionswissenschaftliches Institut, Universität Leipzig, Schillerstraße 6, 04109 Leipzig, Germany
| | - Baijayanti Roy
- Historisches Seminar, Goethe-Universität Frankfurt, Norbert-Wollheim-Platz 1, 60629 Frankfurt am Main, Germany
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Franco E. "There is No Reliable Evidence to Pass Moral Judgment on Frauwallner." : Erich Frauwallner, Jakob Stuchlik, Walter Slaje, and the Whitewashing of Austrian Indology During the Time of National Socialism. NTM 2023; 31:245-274. [PMID: 37672066 PMCID: PMC10556107 DOI: 10.1007/s00048-023-00366-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/05/2023] [Indexed: 09/07/2023]
Abstract
This paper engages with a little-known controversy between Jakob Stuchlik and Walter Slaje on the involvement of Erich Frauwallner, the renowned scholar of Indian philosophy (1898-1974), with NS institutions. It sheds new light on this controversy and highlights the Aryan-supremacist ideology that is reflected in Frauwallner's division of the history of Indian philosophy into an Aryan and non-Aryan period. On the whole, the paper sides with Stuchlik and exposes Slaje's attempt to whitewash Frauwallner and certain aspects of his work, despite his adoption of NS ideology and involvement with NS institutions such as the Gestapo and SA. Moreover, the paper dwells on Frauwallner's adherence to antisemitism and Aryan-supremacist ideology even after the WWII and as late as the 1960s.
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Liebenberg L, Reich J, Denny JF, Gould MR, Hutt-MacLeod D. Two-eyed Seeing for youth wellness: Promoting positive outcomes with interwoven resilience resources. Transcult Psychiatry 2023; 60:613-625. [PMID: 35818776 DOI: 10.1177/13634615221111025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Despite the challenges facing Indigenous youth and their communities due to historical and contemporary institutionalised racism in Canada, communities are drawing on the richness of their own histories to reassert their cultural heritage. Doing so supports mental health outcomes of young people in particular, as highlighted in a compelling body of research. The question facing many communities, however, is how they can facilitate such child and youth engagement in order to support related positive mental health outcomes. This article reports on findings from a Participatory Action Research (PAR) study conducted in a First Nations community in Unama'ki (Cape Breton), Atlantic Canada. The study, Spaces & Places, was a partnership between the community-based mental health service provider (Eskasoni Mental Health Services, EMHS), eight community youth (14-18 years old), and a team of academics. Situated within a resilience framework, the team explored the ways in which the community facilitated, or restricted, youth civic and cultural engagement. Foregrounded against a strong legacy of cultural reassertion within the community, findings highlight the core resilience-promoting resources that support positive youth development. Additionally, findings demonstrate how these resources provide meaningful support for youth because of the way in which they are intertwined with one another. Furthermore, cultural engagement is underpinned by the Two-eyed Seeing model, supporting youth to integrate their own culture with settler culture in ways that work best for them. Findings support community-based service structures, and underscore the importance of community resilience in the effective support of Indigenous children and youth.
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Affiliation(s)
- Linda Liebenberg
- Faculty of Graduate Studies, Dalhousie University, Halifax, NS, Canada
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Munir MM, Woldesenbet S, Endo Y, Moazzam Z, Lima HA, Azap L, Katayama E, Alaimo L, Shaikh C, Dillhoff M, Cloyd J, Ejaz A, Pawlik TM. Disparities in Socioeconomic Factors Mediate the Impact of Racial Segregation Among Patients With Hepatopancreaticobiliary Cancer. Ann Surg Oncol 2023; 30:4826-4835. [PMID: 37095390 DOI: 10.1245/s10434-023-13449-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/21/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND Structural racism within the U.S. health care system contributes to disparities in oncologic care. This study sought to examine the socioeconomic factors that underlie the impact of racial segregation on hepatopancreaticobiliary (HPB) cancer inequities. METHODS Both Black and White patients who presented with HPB cancer were identified from the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database (2005-2015) and 2010 Census data. The Index of Dissimilarity (IoD), a validated measure of segregation, was examined relative to cancer stage at diagnosis, surgical resection, and overall mortality. Principal component analysis and structural equation modeling were used to determine the mediating effect of socioeconomic factors. RESULTS Among 39,063 patients, 86.4 % (n = 33,749) were White and 13.6 % (n = 5314) were Black. Black patients were more likely to reside in segregated areas than White patients (IoD, 0.62 vs. 0.52; p < 0.05). Black patients in highly segregated areas were less likely to present with early-stage disease (relative risk [RR], 0.89; 95 % confidence interval [CI] 0.82-0.95) or undergo surgery for localized disease (RR, 0.81; 95% CI 0.70-0.91), and had greater mortality hazards (hazard ratio 1.12, 95% CI 1.06-1.17) than White patients in low segregation areas (all p < 0.05). Mediation analysis identified poverty, lack of insurance, education level, crowded living conditions, commute time, and supportive income as contributing to 25 % of the disparities in early-stage presentation. Average income, house price, and income mobility explained 17 % of the disparities in surgical resection. Notably, average income, house price, and income mobility mediated 59 % of the effect that racial segregation had on long-term survival. CONCLUSION Racial segregation, mediated through underlying socioeconomic factors, accounted for marked disparities in access to surgical care and outcomes for patients with HPB cancer.
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Affiliation(s)
- Muhammad Musaab Munir
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Selamawit Woldesenbet
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Yutaka Endo
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Zorays Moazzam
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Henrique A Lima
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Lovette Azap
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Erryk Katayama
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Laura Alaimo
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Chanza Shaikh
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Mary Dillhoff
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Jordan Cloyd
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Aslam Ejaz
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
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Conrick KM, Adhia A, Ellyson A, Haviland MJ, Lyons VH, Mills B, Rowhani-Rahbar A. Race, structural racism and racial disparities in firearm homicide victimisation. Inj Prev 2023; 29:290-295. [PMID: 36564165 DOI: 10.1136/ip-2022-044788] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/06/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To identify an approach in measuring the association between structural racism and racial disparities in firearm homicide victimisation focusing on racism, rather than race. METHODS We examined associations of six measures of structural racism (Black/white disparity ratios in poverty, education, labour force participation, rental housing, single-parent households and index crime arrests) with state-level Black-white disparities in US age-adjusted firearm homicide victimisation rates 2010-2019. We regressed firearm homicide victimisation disparities on four specifications of independent variables: (1) absolute measure only; (2) absolute measure and per cent Black; (3) absolute measure and Black-white disparity ratio and (4) absolute measure, per cent Black and disparity ratio. RESULTS For all six measures of structural racism the optimal specification included the absolute measure and Black-white disparity ratio and did not include per cent Black. Coefficients for the Black-white disparity were statistically significant, while per cent Black was not. CONCLUSIONS In the presence of structural racism measures, the inclusion of per cent Black did not contribute to the explanation of firearm homicide disparities in this study. Findings provide empiric evidence for the preferred use of structural racism measures instead of race.
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Affiliation(s)
- Kelsey M Conrick
- School of Social Work, University of Washington, Seattle, Washington, USA
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
| | - Avanti Adhia
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Alice Ellyson
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Miriam Joan Haviland
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
| | - Vivian H Lyons
- Social Development Research Group, School of Social Work, Department of Psychiatry, University of Washington Allies in Healthier Systems for Health & Abundance in Youth, Seattle, Washington, USA
| | - Brianna Mills
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Ali Rowhani-Rahbar
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
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Kaniecki M, Novak NL, Gao S, Harlow S, Stern AM. Operationalizing racialized exposures in historical research on anti-Asian racism and health: a comparison of two methods. Front Public Health 2023; 11:983434. [PMID: 37483944 PMCID: PMC10359498 DOI: 10.3389/fpubh.2023.983434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 06/16/2023] [Indexed: 07/25/2023] Open
Abstract
Background Addressing contemporary anti-Asian racism and its impacts on health requires understanding its historical roots, including discriminatory restrictions on immigration, citizenship, and land ownership. Archival secondary data such as historical census records provide opportunities to quantitatively analyze structural dynamics that affect the health of Asian immigrants and Asian Americans. Census data overcome weaknesses of other data sources, such as small sample size and aggregation of Asian subgroups. This article explores the strengths and limitations of early twentieth-century census data for understanding Asian Americans and structural racism. Methods We used California census data from three decennial census spanning 1920-1940 to compare two criteria for identifying Asian Americans: census racial categories and Asian surname lists (Chinese, Indian, Japanese, Korean, and Filipino) that have been validated in contemporary population data. This paper examines the sensitivity and specificity of surname classification compared to census-designated "color or race" at the population level. Results Surname criteria were found to be highly specific, with each of the five surname lists having a specificity of over 99% for all three census years. The Chinese surname list had the highest sensitivity (ranging from 0.60-0.67 across census years), followed by the Indian (0.54-0.61) and Japanese (0.51-0.62) surname lists. Sensitivity was much lower for Korean (0.40-0.45) and Filipino (0.10-0.21) surnames. With the exception of Indian surnames, the sensitivity values of surname criteria were lower for the 1920-1940 census data than those reported for the 1990 census. The extent of the difference in sensitivity and trends across census years vary by subgroup. Discussion Surname criteria may have lower sensitivity in detecting Asian subgroups in historical data as opposed to contemporary data as enumeration procedures for Asians have changed across time. We examine how the conflation of race, ethnicity, and nationality in the census could contribute to low sensitivity of surname classification compared to census-designated "color or race." These results can guide decisions when operationalizing race in the context of specific research questions, thus promoting historical quantitative study of Asian American experiences. Furthermore, these results stress the need to situate measures of race and racism in their specific historical context.
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Affiliation(s)
- Marie Kaniecki
- University of Michigan, Ann Arbor, MI, United States
- University of California, Los Angeles, Los Angeles, CA, United States
| | - Nicole Louise Novak
- College of Public Health, The University of Iowa, Iowa City, IA, United States
- Public Policy Center, The University of Iowa, Iowa City, IA, United States
| | - Sarah Gao
- University of Michigan, Ann Arbor, MI, United States
- Harvard Center for Population and Development Studies, School of Public Health, Harvard University, Cambridge, MA, United States
| | - Sioban Harlow
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Alexandra Minna Stern
- University of Michigan, Ann Arbor, MI, United States
- University of California, Los Angeles, Los Angeles, CA, United States
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Gao X, Snowden JM, Tucker CM, Allen A, Morello-Frosch R, Abrams B, Carmichael SL, Mujahid MS. Remapping racial and ethnic inequities in severe maternal morbidity: The legacy of redlining in California. Paediatr Perinat Epidemiol 2023; 37:379-389. [PMID: 36420897 PMCID: PMC10373920 DOI: 10.1111/ppe.12935] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/20/2022] [Accepted: 10/22/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Historical mortgage redlining, a racially discriminatory policy designed to uphold structural racism, may have played a role in producing the persistently elevated rate of severe maternal morbidity (SMM) among racialised birthing people. OBJECTIVE This study examined associations between Home-Owner Loan Corporation (HOLC) redlining grades and SMM in a racially and ethnically diverse birth cohort in California. METHODS We leveraged a population-based cohort of all live hospital births at ≥20 weeks of gestation between 1997 and 2017 in California. SMM was defined as having one of 21 procedures and diagnoses, per an index developed by Centers for Disease Control and Prevention. We characterised census tract-level redlining using HOLC's security maps for eight California cities. We assessed bivariate associations between HOLC grades and participant characteristics. Race and ethnicity-stratified mixed effects logistic regression models assessed the risk of SMM associated with HOLC grades within non-Hispanic Black, Asian/Pacific Islander, American Indian/Alaskan Native and Hispanic groups, adjusting for sociodemographic information, pregnancy-related factors, co-morbidities and neighbourhood deprivation index. RESULTS The study sample included 2,020,194 births, with 24,579 cases of SMM (1.2%). Living in a census tract that was graded as "Hazardous," compared to census tracts graded "Best" and "Still Desirable," was associated with 1.15 (95% confidence interval [CI] 1.03, 1.29) and 1.17 (95% CI 1.09, 1.25) times the risk of SMM among Black and Hispanic birthing people, respectively, independent of sociodemographic factors. These associations persisted after adjusting for pregnancy-related factors and neighbourhood deprivation index. CONCLUSIONS Historical redlining, a tool of structural racism that influenced the trajectory of neighbourhood social and material conditions, is associated with increased risk of experiencing SMM among Black and Hispanic birthing people in California. These findings demonstrate that addressing the enduring impact of macro-level and systemic mechanisms that uphold structural racism is a vital step in achieving racial and ethnic equity in birthing people's health.
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Affiliation(s)
- Xing Gao
- Division of Epidemiology, School of Public Health, University of California Berkeley, California, Berkeley, USA
| | - Jonathan M. Snowden
- Division of Epidemiology, School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon, USA
| | - Curisa M. Tucker
- Division of Neonatal & Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, California, USA
| | - Amani Allen
- Division of Epidemiology, School of Public Health, University of California Berkeley, California, Berkeley, USA
- Division of Community Health Sciences, School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Rachel Morello-Frosch
- Division of Community Health Sciences, School of Public Health, University of California Berkeley, Berkeley, California, USA
- Division of Environmental Health Sciences, University of California Berkeley, Berkeley, California, USA
- Department of Environmental Science, Policy and Management, University of California Berkeley, Berkeley, California, USA
| | - Barbara Abrams
- Division of Epidemiology, School of Public Health, University of California Berkeley, California, Berkeley, USA
- Division of Maternal Child and Adolescent Health, School of Public Health, University of California Berkeley, Berkeley, California, USA
- Division of Public Health Nutrition, School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Suzan L. Carmichael
- Division of Neonatal & Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, California, USA
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Stanford University, Stanford, California, USA
| | - Mahasin S. Mujahid
- Division of Epidemiology, School of Public Health, University of California Berkeley, California, Berkeley, USA
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20
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Polanco-Roman L, Williams SZ, Ortin-Peralta A. Study Preregistration: Does State-level Structural Racism Impact Risk for Suicidal Thoughts and Behaviors Among US Adolescents Across Race and Ethnicity? J Am Acad Child Adolesc Psychiatry 2023; 62:829-830. [PMID: 37385715 DOI: 10.1016/j.jaac.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/29/2023] [Accepted: 03/08/2023] [Indexed: 07/01/2023]
Abstract
In the United States, suicide deaths have disproportionately increased among Black and Hispanic youth over the past 2 decades.1 Despite the critical need for more culturally responsive suicide prevention strategies, there has been only sparse research into unique risk factors commonly experienced among ethnoracially minoritized youth, such as racism-related experiences. Experiences of racial and ethnic discrimination (ie, a behavioral manifestation of racism via unfair treatment predicated on an individual's racial and/or ethnic group affiliation) have been associated with higher rates of suicidal thoughts and behaviors (STBs) in Black and Hispanic adolescents.2,3 This research has largely focused on individual-level racism (ie, interpersonal exchanges) assessed via subjective self-report surveys. Thus, less is known about the impact of structural racism, which is enacted at the system level.
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21
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Najdowski CJ. How the "Black criminal" stereotype shapes Black people's psychological experience of policing: Evidence of stereotype threat and remaining questions. Am Psychol 2023; 78:695-713. [PMID: 37079816 DOI: 10.1037/amp0001159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Cultural stereotypes that link Black race to crime in the United States originated with and are perpetuated by policies that result in the disproportionate criminalization and punishment of Black people. The scientific record is replete with evidence that these stereotypes impact perceivers' perceptions, information processing, and decision-making in ways that produce more negative criminal legal outcomes for Black people than White people. However, relatively scant attention has been paid to understanding how situations that present a risk of being evaluated through the lens of crime-related stereotypes also directly affect Black people. In this article, I consider one situation in particular: encounters with police. I draw on social psychological research on stereotype threat generally as well as the few existing studies of crime-related stereotype threat specifically to illuminate how the cultural context creates psychologically distinct experiences of police encounters for Black people as compared to White people. I further consider the potential ramifications of stereotype threat effects on police officers' judgments and treatment of Black people as well as for Black people's safety and well-being in other criminal legal contexts and throughout their lives. Finally, I conclude with a call for increased scholarly attention to crime-related stereotype threat and the role it plays in contributing to racial disparities in policing outcomes, particularly with regard to diverse racial, ethnic, and intersectional identities and personal vulnerability factors, and the systemic changes that might mitigate its deleterious effects. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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22
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Kilpatrick SK, Bauer KW, Heard-Garris N, Malone AM, Abdou CM, Weeks HM, Clayson M, Allgood KL, Dokshina D, Needham BL. Experiences of the Flint Water Crisis Among Reproductive-Age Michigan Women in Communities Outside of Flint: Differences by Race and Ethnicity. J Racial Ethn Health Disparities 2023; 10:993-1005. [PMID: 35320509 PMCID: PMC8941828 DOI: 10.1007/s40615-022-01287-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 02/17/2022] [Accepted: 02/19/2022] [Indexed: 11/02/2022]
Abstract
We sought to understand how women in Michigan communities outside of Flint experienced the Flint water crisis, an avoidable public health disaster widely attributed to structural racism. Using survey data from 950 Michigan women aged 18-45 from communities outside of Flint, we examined racial and ethnic differences in personal connections to Flint, perceived knowledge about the water crisis, and beliefs about the role of anti-Black racism in the water crisis factors that could contribute to poor health via increased psychological stress. We found that White (OR = 0.32; 95% CI: 0.22, 0.46) and Hispanic (OR = 0.21; 95% CI: 0.09, 0.49) women had lower odds than Black women of having family or friends who lived in Flint during the water crisis. Compared to Black women, White women were less likely to be moderately or very knowledgeable about the water crisis (OR = 0.58; 95% CI: 0.41, 0.80). White women (OR = 0.26; 95% CI: 0.18, 0.37), Hispanic women (OR = 0.38; 95% CI: 0.21, 0.68), and women of other races (OR = 0.28; 95% CI: 0.15, 0.54) were less likely than Black women to agree that the water crisis happened because government officials wanted to hurt Flint residents. Among those who agreed, White women (OR = 0.47; 95% CI: 0.30, 0.74) and women of other races (OR = 0.33; 95% CI: 0.12, 0.90) were less likely than Black women to agree that government officials wanted to hurt people in Flint because most residents are Black. We conclude that the Flint water crisis was a racialized stressor, with potential implications for the health of reproductive-age Black women.
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Affiliation(s)
- Sidonie K. Kilpatrick
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104 USA
| | - Katherine W. Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104 USA
| | - Nia Heard-Garris
- Division of Advanced General Pediatrics and Primary Care, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine, and Mary Ann & J. Milburn Smith Child Health Outreach, Research, and Evaluation Center, Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E Chicago Ave, Chicago, IL 60611 USA
| | - Anita M. Malone
- Division of Women’s Health, Department of Obstetrics and Gynecology, University of Michigan Medical School, Michigan Medicine Health, 1500 E. Medical Center Dr., Ann Arbor, MI 48109 USA
| | - Cleopatra M. Abdou
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W 34th St, Los Angeles, CA 90089 USA
| | - Heidi M. Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104 USA
| | - Michelle Clayson
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104 USA
| | - Kristi L. Allgood
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104 USA
| | - Darya Dokshina
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104 USA
| | - Belinda L. Needham
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104 USA
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Ogunbajo A, Siconolfi D, Storholm E, Vincent W, Pollack L, Rebchook G, Tan J, Huebner D, Kegeles S. History of Incarceration is Associated with Unmet Socioeconomic Needs and Structural Discrimination among Young Black Sexual Minority Men (SMM) in the United States. J Urban Health 2023; 100:447-458. [PMID: 37204646 PMCID: PMC10323066 DOI: 10.1007/s11524-023-00737-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/01/2023] [Indexed: 05/20/2023]
Abstract
There is a dearth of research on incarceration among young Black sexual minority men (SMM). The current study aimed to assess the prevalence and association between unmet socioeconomic and structural needs and history of incarceration among young Black SMM. Between 2009 and 2015, young Black SMM (N = 1,774) in Dallas and Houston Texas were recruited to participate in an annual, venue-based, cross-sectional survey. We found that 26% of the sample reported any lifetime history of incarceration. Additionally, participants with unmet socioeconomic and structural needs (unemployment, homelessness, financial insecurity and limited educational attainment) were more likely to have a history of incarceration. It is imperative that interventions are developed to address the basic, social, and economic needs of young Black SMM with a history of incarceration or who are at risk for incarceration.
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Affiliation(s)
| | | | - Erik Storholm
- San Diego State University, School of Public Health, San Diego, CA, USA
| | - Wilson Vincent
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Lance Pollack
- University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - Greg Rebchook
- University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - Judy Tan
- University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - David Huebner
- George Washington University, Milken School of Public Health, Washington, DC, USA
| | - Susan Kegeles
- University of California, San Francisco, School of Medicine, San Francisco, CA, USA
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24
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Pollack CE, Roberts LC, Peng RD, Cimbolic P, Judy D, Balcer-Whaley S, Grant T, Rule A, Deluca S, Davis MF, Wright RJ, Keet CA, Matsui EC. Association of a Housing Mobility Program With Childhood Asthma Symptoms and Exacerbations. JAMA 2023; 329:1671-1681. [PMID: 37191703 PMCID: PMC10189571 DOI: 10.1001/jama.2023.6488] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/01/2023] [Indexed: 05/17/2023]
Abstract
Importance Structural racism has been implicated in the disproportionally high asthma morbidity experienced by children living in disadvantaged, urban neighborhoods. Current approaches designed to reduce asthma triggers have modest impact. Objective To examine whether participation in a housing mobility program that provided housing vouchers and assistance moving to low-poverty neighborhoods was associated with reduced asthma morbidity among children and to explore potential mediating factors. Design, Setting, and Participants Cohort study of 123 children aged 5 to 17 years with persistent asthma whose families participated in the Baltimore Regional Housing Partnership housing mobility program from 2016 to 2020. Children were matched to 115 children enrolled in the Urban Environment and Childhood Asthma (URECA) birth cohort using propensity scores. Exposure Moving to a low-poverty neighborhood. Main Outcomes Caregiver-reported asthma exacerbations and symptoms. Results Among 123 children enrolled in the program, median age was 8.4 years, 58 (47.2%) were female, and 120 (97.6%) were Black. Prior to moving, 89 of 110 children (81%) lived in a high-poverty census tract (>20% of families below the poverty line); after moving, only 1 of 106 children with after-move data (0.9%) lived in a high-poverty tract. Among this cohort, 15.1% (SD, 35.8) had at least 1 exacerbation per 3-month period prior to moving vs 8.5% (SD, 28.0) after moving, an adjusted difference of -6.8 percentage points (95% CI, -11.9% to -1.7%; P = .009). Maximum symptom days in the past 2 weeks were 5.1 (SD, 5.0) before moving and 2.7 (SD, 3.8) after moving, an adjusted difference of -2.37 days (95% CI, -3.14 to -1.59; P < .001). Results remained significant in propensity score-matched analyses with URECA data. Measures of stress, including social cohesion, neighborhood safety, and urban stress, all improved with moving and were estimated to mediate between 29% and 35% of the association between moving and asthma exacerbations. Conclusions and Relevance Children with asthma whose families participated in a program that helped them move into low-poverty neighborhoods experienced significant improvements in asthma symptom days and exacerbations. This study adds to the limited evidence suggesting that programs to counter housing discrimination can reduce childhood asthma morbidity.
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Affiliation(s)
- Craig Evan Pollack
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- School of Nursing, Johns Hopkins School of Nursing, Baltimore, Maryland
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Laken C Roberts
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Roger D Peng
- Department of Statistics and Data Sciences, University of Texas at Austin
| | - Pete Cimbolic
- Baltimore Regional Housing Partnership, Baltimore, Maryland
| | - David Judy
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Susan Balcer-Whaley
- Department of Population Health, Dell Medical School, University of Texas at Austin
| | - Torie Grant
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Ana Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Stefanie Deluca
- Department of Sociology, Johns Hopkins University, Baltimore, Maryland
| | - Meghan F Davis
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Rosalind J Wright
- Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Corinne A Keet
- Department of Pediatrics, University of North Carolina at Chapel Hill
| | - Elizabeth C Matsui
- Department of Population Health, Dell Medical School, University of Texas at Austin
- Department of Pediatrics, Dell Medical School, University of Texas at Austin
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Brooks ES, Mavroudis CL, Tong J, Wirtalla CJ, Friedman A, Kelz RR. Health System Structure: An Opportunity to Address Structural Racism and Discrimination. Ann Surg 2023; 277:854-858. [PMID: 36538633 DOI: 10.1097/sla.0000000000005740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To examine the role of hub-and-spoke systems as a factor in structural racism and discrimination. BACKGROUND Health systems are often organized in a "hub-and-spoke" manner to centralize complex surgical care to 1 high-volume hospital. Although the surgical health care disparities are well described across health care systems, it is not known how they seem across a single system's hospitals. METHODS Adult patients who underwent 1 of 10 general surgery operations in 12 geographically diverse states (2016-2018) were identified using the Healthcare Cost and Utilization Project's State Inpatient Databases. System status was assigned using the American Hospital Association dataset. Hub designation was assigned in 2 ways: (1) the hospital performing the most complex operations (general hub) or (2) the hospital performing the most of each specific operation (procedure-specific hub). Independent multivariable logistic regression was used to evaluate the risk-adjusted odds of treatment at hubs by race and ethnicity. RESULTS We identified 122,236 patients across 133 hospitals in 43 systems. Most patients were White (73.4%), 14.2% were Black, and 12.4% Hispanic. A smaller proportion of Black and Hispanic patient underwent operations at general hubs compared with White patients (B: 59.6% H: 52.0% W: 62.0%, P <0.001). After adjustment, Black and Hispanic patients were less likely to receive care at hub hospitals relative to White patients for common and complex operations (general hub B: odds ratio: 0.88 CI, 0.85, 0.91 H: OR: 0.82 CI, 0.79, 0.85). CONCLUSIONS When White, Black, and Hispanic patients seek care at hospital systems, Black and Hispanic patients are less likely to receive treatment at hub hospitals. Given the published advantages of high-volume care, this new finding may highlight an opportunity in the pursuit of health equity.
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Affiliation(s)
- Ezra S Brooks
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Catherine L Mavroudis
- Department of Surgery, Center for Surgery and Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Jason Tong
- Department of Surgery, Center for Surgery and Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Christopher J Wirtalla
- Department of Surgery, Center for Surgery and Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Ari Friedman
- Department of Emergency Medicine, Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia, PA
| | - Rachel R Kelz
- Department of Surgery, Center for Surgery and Health Economics, University of Pennsylvania, Philadelphia, PA
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Muruthi JR, Muruthi BA, Thompson Cañas RE, Romero L, Taiwo A, Ehlinger PP. Daily discrimination, church support, personal mastery, and psychological distress in black people in the United States. Ethn Health 2023; 28:503-521. [PMID: 35733281 DOI: 10.1080/13557858.2022.2078481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE This study used the stress process model to test the mediating effects of personal mastery and moderating effects of church-based social support on the relationship between daily discrimination and psychological distress across three age groups of African American and Afro-Caribbean adults. METHODS Using a national sample of 5008 African Americans and Afro-Caribbean adults from the National Survey of American Life Study, this study employs structural equation modeling to investigate the relationships between daily discrimination, personal mastery, church-based social support, and psychological distress. RESULTS Daily discrimination was an independent predictor of psychological distress across all groups. Group- and age-specific comparisons revealed significant differences in the experience of daily discrimination and psychological distress. Mastery was a partial mediator of the relationship between discrimination and psychological distress among Afro-Caribbeans while church support was a significant moderator only among the young and older African Americans. IMPLICATIONS Together, our study findings provide useful first steps towards developing interventions to reduce the adverse psychological impacts of daily discrimination on African Americans and Afro-Caribbeans. Intervention efforts such as individual psychotherapy aimed to improve Afro-Caribbean individuals' sense of mastery would be a partial solution to alleviating the adverse effects of discrimination on their psychological health.
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Affiliation(s)
- James R Muruthi
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, USA
| | - Bertranna A Muruthi
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, USA
| | - Reid E Thompson Cañas
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, USA
| | - Lindsey Romero
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, USA
| | - Abiola Taiwo
- Department of School Psychology, University of Oregon, Eugene, USA
| | - Peter P Ehlinger
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, USA
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Lundberg DJ, Wrigley-Field E, Cho A, Raquib R, Nsoesie EO, Paglino E, Chen R, Kiang MV, Riley AR, Chen YH, Charpignon ML, Hempstead K, Preston SH, Elo IT, Glymour MM, Stokes AC. COVID-19 Mortality by Race and Ethnicity in US Metropolitan and Nonmetropolitan Areas, March 2020 to February 2022. JAMA Netw Open 2023; 6:e2311098. [PMID: 37129894 PMCID: PMC10155069 DOI: 10.1001/jamanetworkopen.2023.11098] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/10/2023] [Indexed: 05/03/2023] Open
Abstract
Importance Prior research has established that Hispanic and non-Hispanic Black residents in the US experienced substantially higher COVID-19 mortality rates in 2020 than non-Hispanic White residents owing to structural racism. In 2021, these disparities decreased. Objective To assess to what extent national decreases in racial and ethnic disparities in COVID-19 mortality between the initial pandemic wave and subsequent Omicron wave reflect reductions in mortality vs other factors, such as the pandemic's changing geography. Design, Setting, and Participants This cross-sectional study was conducted using data from the US Centers for Disease Control and Prevention for COVID-19 deaths from March 1, 2020, through February 28, 2022, among adults aged 25 years and older residing in the US. Deaths were examined by race and ethnicity across metropolitan and nonmetropolitan areas, and the national decrease in racial and ethnic disparities between initial and Omicron waves was decomposed. Data were analyzed from June 2021 through March 2023. Exposures Metropolitan vs nonmetropolitan areas and race and ethnicity. Main Outcomes and Measures Age-standardized death rates. Results There were death certificates for 977 018 US adults aged 25 years and older (mean [SD] age, 73.6 [14.6] years; 435 943 female [44.6%]; 156 948 Hispanic [16.1%], 140 513 non-Hispanic Black [14.4%], and 629 578 non-Hispanic White [64.4%]) that included a mention of COVID-19. The proportion of COVID-19 deaths among adults residing in nonmetropolitan areas increased from 5944 of 110 526 deaths (5.4%) during the initial wave to a peak of 40 360 of 172 515 deaths (23.4%) during the Delta wave; the proportion was 45 183 of 210 554 deaths (21.5%) during the Omicron wave. The national disparity in age-standardized COVID-19 death rates per 100 000 person-years for non-Hispanic Black compared with non-Hispanic White adults decreased from 339 to 45 deaths from the initial to Omicron wave, or by 293 deaths. After standardizing for age and racial and ethnic differences by metropolitan vs nonmetropolitan residence, increases in death rates among non-Hispanic White adults explained 120 deaths/100 000 person-years of the decrease (40.7%); 58 deaths/100 000 person-years in the decrease (19.6%) were explained by shifts in mortality to nonmetropolitan areas, where a disproportionate share of non-Hispanic White adults reside. The remaining 116 deaths/100 000 person-years in the decrease (39.6%) were explained by decreases in death rates in non-Hispanic Black adults. Conclusions and Relevance This study found that most of the national decrease in racial and ethnic disparities in COVID-19 mortality between the initial and Omicron waves was explained by increased mortality among non-Hispanic White adults and changes in the geographic spread of the pandemic. These findings suggest that despite media reports of a decline in disparities, there is a continued need to prioritize racial health equity in the pandemic response.
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Affiliation(s)
- Dielle J. Lundberg
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle
| | - Elizabeth Wrigley-Field
- Department of Sociology, University of Minnesota, Minneapolis
- Minnesota Population Center, University of Minnesota, Minneapolis
| | - Ahyoung Cho
- Center for Antiracist Research, Boston University, Boston, Massachusetts
- Department of Political Science, Boston University, Boston, Massachusetts
| | - Rafeya Raquib
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
| | - Elaine O. Nsoesie
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
- Center for Antiracist Research, Boston University, Boston, Massachusetts
| | - Eugenio Paglino
- Department of Sociology, University of Pennsylvania, Philadelphia
- Population Studies Center, University of Pennsylvania, Philadelphia
| | - Ruijia Chen
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Mathew V. Kiang
- Department of Epidemiology and Population Health, Stanford University, Stanford, California
| | - Alicia R. Riley
- Department of Sociology, University of California, Santa Cruz
| | - Yea-Hung Chen
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Marie-Laure Charpignon
- Institute for Data, Systems, and Society, Massachusetts Institute of Technology, Cambridge
| | | | - Samuel H. Preston
- Department of Sociology, University of Pennsylvania, Philadelphia
- Population Studies Center, University of Pennsylvania, Philadelphia
| | - Irma T. Elo
- Department of Sociology, University of Pennsylvania, Philadelphia
- Population Studies Center, University of Pennsylvania, Philadelphia
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Andrew C. Stokes
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
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Awosogba OOR, Jackson SM, Onwong'a JR, Cokley KO, Holman A, McClain SE. Contributions of African-centered (Africentric) psychology: A call for inclusion in APA-accredited graduate psychology program curriculum. Am Psychol 2023; 78:457-468. [PMID: 37384500 DOI: 10.1037/amp0001164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Over the past few years, there has been increased visibility of, and attention paid to, enduring issues such as racial discrimination toward Black Americans. Black psychologists have been called upon to explain various race-related mental health issues to the public, as well as their colleagues and students. Discussions about how to heal from persistent, intergenerational, oppressive attacks on the African psyche are important, but the theories and treatments in which most practitioners are trained and considered "best practices" are Eurocentric in nature. African-centered (or Africentric) psychology is a well-established school of thought, predating the philosophies often discussed in Western/American psychology's History and Systems curriculum, that provides an authentic understanding of the psychology of people of African descent from an African perspective. In this article, we present the historical contention about the lack of inclusion of an African perspective in conceptualizing and addressing the psychological needs of people of African descent, provide an overview of African-centered psychology including its underlying worldview and philosophy, development, and key contributors, and advocate for the inclusion of Africentric psychology in APA-accredited psychology graduate programs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | - J Robina Onwong'a
- Department of Educational, School, and Counseling Psychology, University of Missouri
| | - Kevin O Cokley
- Department of Psychology, University of Michigan-Ann Arbor
| | - Andrea Holman
- Department of Social and Behavioral Sciences, Huston-Tillotson University
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De Trinidad Young ME, Tafolla S, Saadi A, Sudhinaraset M, Chen L, Pourat N. Beyond "Chilling Effects": Latinx and Asian Immigrants' Experiences With Enforcement and Barriers to Health Care. Med Care 2023; 61:306-313. [PMID: 36939228 PMCID: PMC10079615 DOI: 10.1097/mlr.0000000000001839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
OBJECTIVES Immigration enforcement policies are associated with immigrants' barriers to health care. Current evidence suggests that enforcement creates a "chilling effect" in which immigrants avoid care due to fear of encountering enforcement. Yet, there has been little examination of the impact of immigrants' direct encounters with enforcement on health care access. We examined some of the first population-level data on Asian and Latinx immigrants' encounters with law and immigration enforcement and assessed associations with health care access. METHODS We analyzed the 2018 and 2019 Research on Immigrant Health and State Policy survey in which Asian and Latinx immigrants in California (n=1681) reported on 7 enforcement experiences (eg, racial profiling and deportation). We examined the associations between measures of individual and cumulative enforcement experiences and the usual sources of care and delay in care. RESULTS Latinx, compared with Asian respondents, reported the highest levels of enforcement experiences. Almost all individual enforcement experiences were associated with delaying care for both groups. Each additional cumulative experience was associated with a delay in care for both groups (OR=1.30, 95% CI 1.10-1.50). There were no associations with the usual source of care. CONCLUSION Findings confirm that Latinx immigrants experience high levels of encounters with the enforcement system and highlight new data on Asian immigrants' enforcement encounters. Direct experiences with enforcement have a negative relationship with health care access. Findings have implications for health systems to address the needs of immigrants affected by enforcement and for changes to health and immigration policy to ensure immigrants' access to care.
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Affiliation(s)
- Maria-Elena De Trinidad Young
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, CA, 5200 N Lake Road, Merced, CA 95343, USA
| | - Sharon Tafolla
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, CA, 5200 N Lake Road, Merced, CA 95343, USA
| | - Altaf Saadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School; 100 Cambridge St, Suite 2000, Boston, MA 02114, USA
| | - May Sudhinaraset
- Fielding School of Public Health, University of California Los Angeles, 650 Charles E Young Dr S, Los Angeles, CA 90095, USA
| | - Lei Chen
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, 337 Charles E Young Dr E, Los Angeles, CA 90095
| | - Nadereh Pourat
- Fielding School of Public Health, University of California Los Angeles, 650 Charles E Young Dr S, Los Angeles, CA 90095, USA
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30
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Baeker Bispo JA, Douyon A, Ashad-Bishop K, Balise R, Kobetz EK. How Trust in Cancer Information Has Changed in the Era of COVID-19: Patterns by Race and Ethnicity. J Health Commun 2023; 28:131-143. [PMID: 36927415 PMCID: PMC10132996 DOI: 10.1080/10810730.2022.2117439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
COVID-19 emerged during an era of heightened attention to systemic racism and the spread of misinformation. This context may have impacted public trust in health information about chronic diseases like cancer. Here, we examine data from the 2018 and 2020 Health Information National Trends Survey (N = 7,369) to describe how trust in cancer information from government health agencies, doctors, family and friends, charitable organizations, and religious organizations changed after COVID-19 became a pandemic, and whether that change varied by race/ethnicity. Statistical methods included chi-square tests and multiple logistic regression modeling. Overall, the proportion of respondents who reported a high degree of trust in cancer information from doctors increased (73.65% vs. 77.34%, p = .04). Trends for trust in information from government health agencies and family and friends varied significantly by race/ethnicity, with substantial declines observed among non-Hispanic Blacks (NHB) only. The odds of reporting a high degree of trust in cancer information from government health agencies and friends and family decreased by 53% (OR = 0.47, 95% CI = 0.24-0.93) and 73% (OR = 0.27, 95% CI = 0.09-0.82), respectively, among NHB, but were stable for other groups. Future studies should monitor whether recent declines in trust among NHB persist and unfavorably impact participation in preventive care.
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Affiliation(s)
- JA Baeker Bispo
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - A Douyon
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - K Ashad-Bishop
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - R Balise
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - EK Kobetz
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
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Stern JA, Dunbar AS, Cassidy J. Pathways to emotion regulation in young Black children: An attachment perspective. Adv Child Dev Behav 2022; 64:163-188. [PMID: 37080668 PMCID: PMC10763371 DOI: 10.1016/bs.acdb.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Attachment theory proposes that a central function of caregivers is to provide protection and co-regulation of children's distress in the context of threat, and that children's secure attachment (confidence in a secure base/safe haven when needed) precipitates positive developmental cascades in part by supporting children's emotion regulation. Yet the field of attachment has rarely considered the unique experiences of African American families, including the context of systemic racism in which caregivers must provide physical and emotional protection for their children, and in which children must learn to regulate emotion across different sociocultural contexts (emotional flexibility and "code-switching"; Dunbar et al., 2022a; Lozada et al., 2022; Stern et al., 2022b). This chapter brings attachment theory into conversation with the field of positive Black youth development to explore pathways to emotion regulation in African American children during early childhood. In doing so, we (a) highlight the strengths of African American caregivers in providing unique and specific forms of protection via racial and emotional socialization; (b) review research on predictors and consequences of secure caregiver-child relationships in Black families, with a focus on the outcome of child emotion regulation; (c) present a theoretical framework for understanding cascades of positive Black youth development via healthy relationships and emotion regulation; and (d) outline promising new directions for more inclusive and just attachment research.
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Affiliation(s)
- Jessica A Stern
- Department of Psychology, University of Virginia, Charlottesville, VA, United States.
| | - Angel S Dunbar
- Department of African American Studies, University of Maryland, College Park, MD, United States
| | - Jude Cassidy
- Department of Psychology, University of Maryland, College Park, MD, United States
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32
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Torres VN, Williams EC, Ceballos RM, Donovan DM, Ornelas IJ. Discrimination, acculturative stress, alcohol use and their associations with alcohol-related consequences among Latino immigrant men. J Ethn Subst Abuse 2022; 23:150-165. [PMID: 35634786 DOI: 10.1080/15332640.2022.2077273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Latino immigrant men are at increased risk for unhealthy alcohol use and related consequences due to social stressors associated with immigration. We assessed the associations of, and examined whether social stressors moderated associations between, alcohol use and alcohol-related consequences in a community-based sample of Latino immigrant men in Washington (N = 187). The mean Alcohol Use Disorders Identification Test Consumption (AUDIT-C) score was 6.3 (scores ≥ 4 indicate unhealthy alcohol use). More than half of the men (61.5%) reported experiencing discrimination in at least one setting and mean acculturative stress score was 18.3 indicating moderate levels of acculturative stress. Linear regression models were fit to assess main effects (associations between both alcohol use and social stressors and alcohol-related consequences) and moderation (whether the association between alcohol use and consequences varied based on experience of social stressors using multiplicative interaction) after adjustment for potential confounders. Alcohol use (β = 0.47, 95% CI = 0.20-0.73; p = .001), discrimination (β = 0.85, 95% CI = 0.27-1.43; p = .004), and acculturative stress (β = 0.13, 95% CI = 0.02-0.24; p = .025) were all associated with increased experience of alcohol-related consequences. The association between alcohol use and alcohol-related consequences was stronger for those with high levels of acculturative stress (p = .025) but not experience of discrimination (p = .587). Findings underscore the importance of social and cultural context in alcohol use and related consequences. Efforts to reduce negative consequences of drinking may include focus on reducing exposure to discrimination and acculturative stress.
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Affiliation(s)
- Vanessa N Torres
- University of California, Los Angeles, CA, USA
- RAND Corporation, Santa Monica, CA, USA
| | - Emily C Williams
- University of Washington, Seattle, WA, USA
- Puget Sound Health Care System, Seattle, WA, USA
| | - Rachel M Ceballos
- University of Washington, Seattle, WA, USA
- Fred Hutchison Cancer Research Center, Seattle, WA, USA
| | - Dennis M Donovan
- University of Washington, Seattle, WA, USA
- Alcohol and Drug Abuse Institute (ADAI), Seattle, WA, USA
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Smith BD, Lewis Q, Offiong A, Willis K, Prioleau M, Powell TW. "It's on every corner": assessing risk environments in Baltimore, MD using a racialized risk environment model. J Ethn Subst Abuse 2022; 23:95-109. [PMID: 35499103 PMCID: PMC9622427 DOI: 10.1080/15332640.2022.2068719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Physical, social, economic, and political environments can increase harm and risk among people who use drugs. These factors may be exacerbated in urban environments with a history of systemic inequality toward African Americans. However, racialized risk environment models have rarely been used within substance use research. To fill this gap, the current qualitative study sought to describe the racialized risk environment of an African American sample of 21 adults with a history of illicit drug use living in Baltimore, MD. Semi-structured interviews were conducted. Data were analyzed using qualitative content analysis to identify themes related to illicit drug use, neighborhood context, violence, social interactions, and income generation. Themes related to the physical (e.g., the increased visibility of drug markets), social (e.g., normalization of drug use within social networks), and economic (e.g., financial hardships) risk environments emerged from this sample. These perceptions and themes can aid in developing and refining substance use programming within racialized settings.
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Abstract
The Half-Century long problem of addiction treatment disparities. We cannot imagine addressing disparities in addiction treatment without first acknowledging and deconstructing the etiology of this inequity. This article examines the history of addiction treatment disparities beginning with early twentieth-century drug policies. We begin by discussing structural racism, its contribution to treatment disparities, using opioid use disorder as a case study to highlight the importance of a structural competency framework in obtaining care. We conclude by discussing diversity in the workforce as an additional tool to minimizing disparities. Addiction treatment should be aimed at addressing care delivery in the context of the social, economic, and political determinants of health, which require appreciation of their historical origins to move toward equitable treatment.
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Affiliation(s)
- Danielle S Jackson
- Department of Psychiatry, Rutgers- Robert Wood Johnson Medical School, 671 Hoes Lane West, 2nd Floor, Piscataway, NJ 08854, USA.
| | - Max Jordan Nguemeni Tiako
- Department of Internal Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA. https://twitter.com/MaxJordan_N
| | - Ayana Jordan
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY. https://twitter.com/DrAyanaJordan
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