Ethno-racial disparities in psychosis-like experiences among students in higher education: Findings from the Healthy Minds Study 2020-2021.

BACKGROUND: Ethno-racial variations of psychosis-like experiences exist in the general population; however, it is unknown whether this variation exists among emerging adults in higher education, and whether there are differences across ethnic groups within racial categories. METHODS: Using the Health Minds Study data from 2020 to 2021, we used multivariable logistic regression models to examine race/ethnicity and psychosis-like experiences, adjusting for socio-demographic characteristics (age, gender, international student status). We then adjusted for food insecurity, parental education, and social belonging. RESULTS: Black, Hispanic/Latinx, multiracial, and American Indian/Alaska Native students had greater odds of 12-month psychosis-like experiences when compared with White students. These associations attenuated and were no longer statistically significant for Black and Hispanic/Latinx students after adjusting for food insecurity and parental education. Multiracial and American Indian/Alaska Native students still had greater odds of psychosis-like experiences after further adjusting for sense of belonging. When looking at ethnic subgroups, Filipinx and multi-ethnic Asian students had significantly greater odds than East Asian students, and multi-ethnic Black students had greater odds than African Americans. CONCLUSION: Odds of psychosis-like experiences vary across and within ethno-racial categories among emerging adults in higher education. Future research may explore psychosis as a disparity impacting Native American/Alaska Native and multiracial/multi-ethnic populations.

Traumatic brain injury, race, ethnicity and cognition in newly diagnosed persons with multiple sclerosis.

We sought to determine whether a history of traumatic brain injury (TBI) could explain the lower symbol digit modalities test (SDMT) scores observed among newly diagnosed multiple sclerosis (MS) and control participants identifying as Black or Hispanic versus white in the MS Sunshine Study (n = 1172). 330 (29.2 %) participants reported a history of ≥1 TBI. Accounting for TBI did not explain the significant independent associations between having MS, being Black or Hispanic and lower SDMT. The pervasive effects of systemic racism in the United States remain the best explanation for the lower SDMT scores observed in Black and Hispanic participants.

We got this: Evaluating racial socialization competency among diverse ethnic-racial groups.

Historically, research on racial socialization (RS) has centered on frequency, beliefs, and content of parent-child communications, with varied applications and implications across racial and ethnic subgroups. The Racial Socialization Competency Scale (RaSCS; Anderson et al., 2020) was developed to assess three dimensions of a novel construct, RS competency (confidence, skills, stress), among Black caregivers. In this article, we investigated the psychometric properties of the RaSCS across diverse ethnic-racial groups. Participants were 778 caregivers (Mage = 44.4 years) of youth between the ages of 10 and 18 recruited from across the United States. The sample was intentionally racially and ethnically diverse, with 26.1% identifying as Black, 24.2% identifying as Latinx, 24.9% identifying as Asian American, and 24.8% identifying as White. Confirmatory factor analyses replicated the previously identified structure of the RaSCS subscales, and scores were reliable. Multigroup measurement invariance analyses supported full scalar invariance across the four racial/ethnic subgroups for the Confidence, Skills, and General RS Stress subscales and partial scalar invariance for the Call to Action RS Stress subscale. These findings suggest that the RaSCS is an appropriate tool for assessing RS competency across racial and ethnic groups and that RS competency as a universal construct is relevant across groups. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Disordered eating and emotional eating in Arab, middle eastern, and north African American women.

Arab, Middle Eastern, and North African (A-MENA) American women are often subject to intersectional discrimination, and they have also not been traditionally recognized as a distinct racial group in disordered eating literature. No study to date has provided descriptive information on disordered and emotional eating A-MENA American women, nor has examined perceptions of widely used measurements of eating pathology in this population. The current study generated descriptive information among A-MENA women on two widely used measures of eating pathology, the Eating Disorder Examination Questionnaire (EDE-Q) and the Emotional Eating Scale (EES). Participants (N = 244) were A-MENA adult women were recruited via social media and snowball sampling. Qualitative findings provide potential sociocultural predictors of disordered eating that should be further explored, such as bicultural identity and family pressures/comments toward appearance. Secondly, themes from the EES-R indicate adding emotion of shame and considering identity-related stress. The current study provides prevalence data and future directions of research on widely used eating pathology and appearance attitude measurements for A-MENA American women.

Associations between gendered racism, racial identity, and nicotine use among Asian American men.

OBJECTIVES: The present study utilized an intersectional framework to examine if two forms of gendered racism, psychological emasculation and messages about Asian American men being undesirable partners, were associated with Asian American men's nicotine use. We also examined the potential mediating roles of two racial identity statuses, racial conformity and racial immersion. METHODS: A sample of 356 Asian American men living in the United States of America (USA) completed a cross-sectional survey via Qualtrics containing measures assessing the aforementioned constructs of interest. The primary analysis examined separate parallel mediation models, situating psychological emasculation and undesirable partner as separate independent variables, racial conformity and racial immersion as parallel mediators, nicotine use as the outcome, and age and employment as covariates. RESULTS: In separate parallel mediation models, the links between psychological emasculation and undesirable partner on one hand, and nicotine use on the other, were completely mediated only by racial conformity, and not significantly mediated by racial immersion. Specifically, greater endorsement of gendered racism was associated with greater conformity with (and internalization of) these gendered racist beliefs, which in turn were associated with greater nicotine use. CONCLUSION: Researchers and practitioners may consider racial conformity as an interventional target to ameliorate Asian American men's nicotine use. Future studies should continue to examine other culturally relevant and/or potentially protective constructs (e.g., on the basis of gender, race, and its intersection) that may mitigate Asian American men's nicotine use.

The Lived Experience of Postpartum Intergenerational Conflict of Vietnamese American Women with their Vietnamese Immigrant Parents: It's A Generational Thing!

PURPOSE: US-born Vietnamese women who are in their childbearing years are more likely to identify with "western" perspectives when compared to their immigrant mothers who were born in Vietnam. Still, a gap in knowledge exists of their intergenerational differences. The purpose of this study was to explore and better understand Vietnamese American women's experiences of postpartum intergenerational conflict. STUDY DESIGN AND METHODS: van Manen's methodological approach (1997) was used. The purposive sample included 11 US-born Vietnamese women who experienced postpartum intergenerational conflict with their parents. Data were transcribed verbatim and analyzed using thematic analysis. The researcher transcended the themes through music. Songs and lyrics were arranged for guitar to bring the phenomenon to life. RESULTS: Four themes were identified: (1) "It's a Generational Thing!" (Mot dieu the he): Leaning both ways; (2) "To rebel or not" (Noi loan hay không): Weighing the evidence of postpartum cultural practices; (3) "Stand My Ground" (Giu vung lap trÆ°ong cua tôi): Keeping my newborn safe and healthy; and (4) "See Me" (Nhìn con): My mental health overshadowed by my mother's thoughts. This study revealed that the intergenerational conflict was influenced by the family's understanding over the division of infant care tasks, disagreements over cultural practices, and generational differences such as age, consistent with previous research. CLINICAL IMPLICATIONS: Tailored interventions for Vietnamese American women should consider the family as a whole. Nurses can assess proactively in prenatal care if there are cultural issues such as family hierarchy, gender, and history influencing one's choices or maternal autonomy.

Disparities in ambient nitrogen dioxide pollution in the United States.

Average ambient concentrations of nitrogen dioxide (NO2), an important air pollutant, have declined in the United States since the enactment of the Clean Air Act. Despite evidence that NO2 disproportionately affects racial/ethnic minority groups, it remains unclear what drives the exposure disparities and how they have changed over time. Here, we provide evidence by integrating high-resolution (1 km × 1 km) ground-level NO2 estimates, sociodemographic information, and source-specific emission intensity and location for 217,740 block groups across the contiguous United States from 2000 to 2016. We show that racial/ethnic minorities are disproportionately exposed to higher levels of NO2 pollution compared with Whites across the United States and within major metropolitan areas. These inequities persisted over time and have worsened in many cases, despite a significant decrease in the national average NO2 concentration over the 17-y study period. Overall, traffic contributes the largest fraction of NO2 disparity. Contributions of other emission sources to exposure disparities vary by location. Our analyses offer insights into policies aimed at reducing air pollution exposure disparities among races/ethnicities and locations.

Latent class analysis of medical mistrust and COVID-19 vaccine hesitancy among adults in the United States just prior to FDA emergency use authorization.

Using a nationally representative household sample, we sought to better understand types of medical mistrust as a driver of COVID-19 vaccine hesitancy. We used survey responses to conduct a latent class analysis to classify respondents into categories and explained this classification as a function of sociodemographic and attitudinal variables using multinomial logistic regression models. We then estimated the probability of respondents agreeing to receive a COVID-19 vaccine conditional on their medical mistrust category. We extracted a five-class solution to represent trust. The high trust group (53.0 %) is characterized by people who trust both their doctors and medical research. The trust in own doctor group (19.0 %) trust their own doctors but is ambiguous when it comes to trusting medical research. The high distrust group (6.3 %) neither trust their own doctor nor medical research. The undecided group (15.2 %) is characterized by people who agree on some dimensions and disagree on others. The no opinion group (6.2 %) did not agree nor disagree with any of the dimensions. Relative to the high trust group, those who trust their own doctors are almost 20 percentage points less likely to plan to get vaccinated (average marginal effect (AME) = 0.21, p <.001), and those who have high distrust are 24 percentage points less likely (AME = -0.24, p <.001) to report planning to get the vaccine. Results indicate that beyond sociodemographic characteristics and political attitudes, people's trust archetypes on parts of the medical field significantly predict their probability of wanting to get vaccinated. Our findings suggest that efforts to combat vaccine hesitancy should focus on building capacity of trusted providers to speak with their patients and parents of their patients, to recommend COVID-19 vaccination and build a trusting relationship; and increase trust and confidence in medical research.

Obstetric violence as immigration injustice: A view from the United States and Colombia.

In September 2020, Project South, along with numerous other organizations, released a report detailing abuses in a Georgia Detention Center - including forced hysterectomies. Whatever other factors are at play, one of them is an intrinsic connection between obstetric violence against pregnant migrants and immigration injustice. It is not incidental that these acts - in US detention centers, along the US-Mexico border, in Colombian hospitals and clinics - are being perpetrated on immigrant bodies. And it is not accidental or random which immigrant bodies are vulnerable to these violations. Understanding and confronting obstetric violence directed at pregnant migrants, though, requires reconceptualizing the nature of obstetric violence itself. In particular, we must recognize that obstetric violence against pregnant Latin American migrants in the United States and Colombia is a type of immigration injustice, a means to perpetrate immigration injustice, and a product of immigration injustice. As such, bioethicists need to collaborate with immigration scholars to resist it. After providing some background on the nature of obstetric violence and some ways it is perpetuated against pregnant migrants in the United States and Colombia, I will give a brief overview of how I conceptualize immigration justice. From there, I explain how this type of obstetric violence constitutes a type of immigration injustice, a means to perpetrate immigration injustice, and a product of immigration injustice. My hope is that this analysis motivates bioethicists throughout the Americas to engage with immigration scholars and activists to confront the issue more forcefully.

Comparing associations between personality and loneliness at midlife across three cultural groups.

OBJECTIVE: Loneliness represents a public health threat given its central role in predicting adverse mental and physical health outcomes. Prior research has established four of the Big Five personality traits as consistent cross-sectional predictors of loneliness in largely western, White samples. However, it is not clear if the personality predictors of loneliness vary across cultures. METHOD: The present study estimates associations between the Big Five traits and loneliness across distinct samples of White American, Black American, and Japanese adults (n = 6051 at T1). Confirmatory factor analysis and exploratory structural equation modeling were used to examine measurement invariance properties of the Big Five and loneliness across these groups. The factor structures were then carried forward to estimate associations between personality and loneliness across two assessments waves using structural equation modeling. RESULTS: While Neuroticism was a strong predictor across groups, low Extraversion was more predictive of loneliness in Japan than in the U.S., and low Conscientiousness was only a significant predictor in the U.S. CONCLUSIONS: Previous literature offers a framework for interpreting these findings in that loneliness may be shaped comparatively more through interconnectedness in Japanese culture, while, in the U.S., individual goals and personal romantic expectations are more salient.

Student trainee and paid internship programs have positive results but do little to influence long-term employee diversity in the USDA forest service.

Women and Black, Indigenous, and People of Color (BIPOC) employees are underrepresented in science and natural resource management institutions. Student and recent graduate trainee and internship programs have been used to try to address this in United States federal agencies over the last few decades. Our study evaluates how effective such programs are at improving U.S. federal workforce diversity. We used a comprehensive employee dataset from the United States Department of Agriculture (USDA) Forest Service-which has the largest natural resource management workforce in the country-to analyze the demographic characteristics and career paths of paid interns from 1996-2017. We found that a majority of employees who started as interns later converted to permanent employment with the USDA Forest Service. In addition, Black and Hispanic interns were, respectively, 5 and 3 times more likely than White interns to work for the agency in permanent positions after their internships. However, people who started as interns had significantly shorter USDA Forest Service careers than those who started in permanent positions. White women entering directly into permanent positions typically advanced to higher pay grades through promotion faster than White women who entered as interns. Finally, male BIPOC interns involuntarily separated (i.e., were fired) at significantly higher rates than all other employees. Our study suggests that while internship employment programs can be an effective tool for hiring a diverse workforce, they are not sufficient to close the overall workforce diversity gap. In addition, only a small percentage of new hires every year are interns. To achieve a level of representation that mirrors the civilian labor force, our study suggests that internship programs need to focus on long-term employee retention and be of significantly larger scale.

C-reactive Protein and Racial Differences in Type 2 Diabetes Incidence: The REGARDS Study.

CONTEXT: Black adults experience more type 2 diabetes mellitus and higher inflammatory markers, including C-reactive protein (CRP), than White adults. Inflammatory markers are associated with risk of incident diabetes but the impact of inflammation on racial differences in incident diabetes is unknown. OBJECTIVE: We assessed whether CRP mediated the Black-White incident diabetes disparity. METHODS: The REasons for Geographic And Racial Differences in Stroke (REGARDS) study enrolled 30 239 US Black and White adults aged ≥45 years in 2003-2007 with a second visit approximately 10 years later. Among participants without baseline diabetes, adjusted sex- and race-stratified risk ratios for incident diabetes at the second visit by CRP level were calculated using modified Poisson regression. Inverse odds weighting estimated the percent mediation of the racial disparity by CRP. RESULTS: Of 11 073 participants without baseline diabetes (33% Black, 67% White), 1389 (12.5%) developed diabetes. Black participants had higher CRP at baseline and greater incident diabetes than White participants. Relative to CRP < 3 mg/L, CRP ≥ 3 mg/L was associated with greater risk of diabetes in all race-sex strata. Black participants had higher risk of diabetes at CRP < 3 mg/L, but not at CRP ≥ 3 mg/L. In women, CRP mediated 10.0% of the racial difference in incident diabetes. This mediation was not seen in men. CONCLUSION: Higher CRP is a risk factor for incident diabetes, but the excess burden of diabetes in Black adults was only seen in those with lower CRP, suggesting that inflammation is unlikely to be the main driver of this racial disparity.

Association Between Social Vulnerability and Rates of HIV Diagnoses Among Black Adults, by Selected Characteristics and Region of Residence - United States, 2018.

During 2018, Black or African American (Black) persons accounted for 43% of all new diagnoses of HIV infection in the United States (1). The annual diagnosis rate (39.2 per 100,000 persons) among Black persons was four times the rate among all other racial/ethnic groups combined, indicating a profound disparity in HIV diagnoses (1,2). Community-level social and structural factors, such as social vulnerability, might help explain the higher rate of HIV diagnoses among Black persons. Social vulnerability refers to the potential negative health effects on communities caused by external stresses (3). CDC used National HIV Surveillance System (NHSS)* and Social Vulnerability Index (SVI)† data to examine the association between diagnosed HIV infections and social vulnerability among Black adults aged ≥18 years. Black adults in communities in the highest quartile of SVI were 1.5 times (rate ratio [RR] = 1.5; 95% CI = 1.4-1.6) as likely to receive a diagnosis of HIV infection as were those in communities in the lowest quartile. Because of a history of racial discrimination and residential segregation, some Black persons in the United States reside in communities with the highest social vulnerability (4,5), and this finding is associated with experiencing increased risk for HIV infection. The development and prioritization of interventions that address social determinants of health (i.e., the conditions in which persons are born, grow, live, work, and age), are critical to address the higher risk for HIV infection among Black adults living in communities with high levels of social vulnerability. Such interventions might help prevent HIV transmission and reduce disparities among Black adults.

Representation of American Indian and Alaska Native Individuals in Academic Medical Training.

Importance: Identifying gaps in inclusivity of Indigenous individuals is key to diversifying academic medical programs, increasing American Indian and Alaska Native representation, and improving disparate morbidity and mortality outcomes in American Indian and Alaska Native populations. Objective: To examine representation of American Indian and Alaska Native individuals at different stages in the 2018-2019 academic medical training continuum and trends (2011-2020) of American Indian and Alaska Native representation in residency specialties. Design, Setting, and Participants: A cross-sectional, population-based analysis was conducted using self-reported race and ethnicity data on trainees from the Association of American Medical Colleges (2018), the Accreditation Council for Graduate Medical Education (2011-2018), and the US Census (2018). Data were analyzed between February 18, 2020, and March 4, 2021. Exposures: Enrolled trainees at specific stages of medical training. Main Outcomes and Measures: The primary outcome was the odds of representation of American Indian and Alaska Native individuals at successive academic medical stages in 2018-2019 compared with White individuals. Secondary outcomes comprised specialty-specific proportions of American Indian and Alaska Native residents from 2011 to 2020 and medical specialty-specific proportions of American Indian and Alaska Native physicians in 2018. Fisher exact tests were performed to calculate the odds of American Indian and Alaska Native representation at successive stages of medical training. Simple linear regressions were performed to assess trends across residency specialties. Results: The study data contained a total of 238 974 607 White and American Indian and Alaska Native US citizens, 24 795 US medical school applicants, 11 242 US medical school acceptees, 10 822 US medical school matriculants, 10 917 US medical school graduates, 59 635 residents, 518 874 active physicians, and 113 168 US medical school faculty. American Indian and Alaska Native individuals had a 63% lower odds of applying to medical school (odds ratio [OR], 0.37; 95% CI, 0.31-0.45) and 48% lower odds of holding a full-time faculty position (OR, 0.52; 95% CI, 0.44-0.62) compared with their White counterparts, yet had 54% higher odds of working in a residency specialty deemed as a priority by the Indian Health Service (OR, 1.54; 95% CI, 1.09-2.16). Of the 33 physician specialties analyzed, family medicine (0.55%) and pain medicine (0.46%) had more than an average proportion (0.41%) of American Indian and Alaska Native physicians compared with their representation across all specialties. Conclusions and Relevance: This cross-sectional study noted 2 distinct stages in medical training with significantly lower representation of American Indian and Alaska Native compared with White individuals. An actionable framework to guide academic medical institutions on their Indigenous diversification and inclusivity efforts is proposed.

Drug overdose mortality by race/ethnicity across US-born and immigrant populations.

BACKGROUND: The present study examined racial/ethnic differences in US drug overdose mortality among US-born and foreign-born men and women. METHODS: In this cross-sectional analysis of 2010-2019 data from the National Center for Health Statistics, Bayesian hierarchical models predicted drug overdose mortality based on the interaction of race/ethnicity, nativity, and sex, adjusting for age, for 518,553 drug overdose deaths among individuals ages 15-74 identified as Non-Hispanic (NH) White, NH Black, Hispanic, or NH Asian/Pacific Islander (PI). Rate ratios with 95% Highest Posterior Density Intervals (HPDIs) were examined by race/ethnicity and nativity. RESULTS: In the US-born population, 2017-2019 estimated overdose mortality rates were higher for NH Black than NH White men (ratio 1.48 [95% HPDI 1.28-1.72]), similar between NH Black and NH White women (ratio 1.03 [95% HPDI 0.89-1.20]), similar between Hispanic and NH White men (ratio 0.96 [95% HPDI 0.82-1.10]), and lower for NH Asian/PI than NH White men and women. In the foreign-born population, both for men and women, estimated overdose mortality rates were lower in every racial/ethnic group relative to the NH White group. For men and women of all racial/ethnic groups examined, estimated overdose mortality rates were higher in US-born than foreign-born subpopulations, yet the extent of this nativity differential was least pronounced in the NH White group. CONCLUSIONS: In the US-born population, NH Black men experienced the highest recent rates of overdose mortality; in the foreign-born population, the highest rates of overdose mortality were observed among NH White men and women.

Life Course Stressors and Functional Limitations in Later Life Among White, Black, and Hispanic Adults: Deleterious, Hardening, or Benign?

OBJECTIVES: Although striking racial and ethnic disparities in health are manifest during later life, they may be rooted in early-life exposures. Drawing from cumulative inequality theory, we investigate whether life course stressors are associated with the risk of later-life functional limitations and whether this relationship differs by race and ethnicity. METHODS: We utilize longitudinal data from the Health and Retirement Study to test whether child and adult stressors predict trajectories of the occurrence and severity of functional limitations among a diverse sample of older adults. RESULTS: Child and adult stressors are associated with greater occurrence and severity of functional limitations during later life. Mediation analyses reveal the indirect influence of child stressors via adult stressors on occurrence and severity of functional limitations; however, the indirect effects are slightly stronger for Black and Hispanic adults than their White counterparts. DISCUSSION: Child stressors, in and of themselves, do not increase functional limitations among Black and Hispanic people but are associated with greater adult stress exposure, predisposing them to more functional limitations. Results suggest that childhood stressors are associated with distinct social pathways to functional limitations among White, Black, and Hispanic older adults.

Religious Involvement and Cognitive Functioning at the Intersection of Race-Ethnicity and Gender Among Midlife and Older Adults.

OBJECTIVES: To investigate the association between religious involvement and cognitive functioning at the intersections of race-ethnicity and gender among midlife and older adults, and to determine if psychosocial factors help explain this relationship. METHOD: The sample included 14,037 adults aged 50+ from the Health and Retirement Study (HRS). We utilized measures from the HRS 2010 and 2012 Core interviews and Leave-Behind questionnaires and estimated our models using linear regression. RESULTS: Compared to individuals who frequently attended religious services, infrequent religious service attendance was related to poorer cognitive functioning. Religiosity was inversely associated with cognitive functioning at baseline, but the relationship varied by race/gender subgroup. Greater religiosity was associated with better cognitive functioning among Black women, but lower cognitive functioning among White men and women. Psychosocial factors did little to explain the inverse association between religiosity and cognitive functioning. DISCUSSION: Results suggest the association between religious involvement and cognitive functioning is varied and complex, and largely dependent on important social identities. The findings have important implications for investigating health-protective factors, like religious involvement, using an intersectional perspective.