RESUMO
BACKGROUND: Discrimination may further impede access to medical care for individuals in socially disadvantaged positions. Sociodemographic information and perceived discrimination intersect and define multiple contexts or strata that condition the risk of refraining from seeking physician's care. By applying analysis of individual heterogeneity and discriminatory accuracy (AIHDA) we aimed to improve the mapping of risk by considering both strata average risk differences and the accuracy of such strata risks for distinguishing between individuals who did or did not refrain from seeking physician's care. METHODS: We analysed nine annual National Public Health Surveys (2004, 2007-2014) in Sweden including 73,815 participants. We investigated the risk of refraining from seeking physician's care across 64 intersectional strata defined by sex, education, age, country of birth, and perceived discrimination. We calculated strata-specific prevalences and prevalence ratios (PR) with 95% confidence intervals (CI), and the area under the receiver operating characteristic curve (AUC) to evaluate the discriminatory accuracy (DA). RESULTS: Discriminated foreign-born women aged 35-49 with a low educational level show a six times higher risk (PR = 6.07, 95% CI 5.05-7.30) than non-discriminated native men with a high educational level aged 35-49. However, the DA of the intersectional strata was small (AUC = 0.64). Overall, discrimination increased the absolute risk of refraining from seeking physician's care, over and above age, sex, and educational level. CONCLUSIONS: AIHDA disclosed complex intersectional inequalities in the average risk of refraining from seeking physician's care. This risk was rather high in some strata, which is relevant from an individual perspective. However, from a population perspective, the low DA of the intersectional strata suggests that potential interventions to reduce such inequalities should be universal but tailored to the specific contextual characteristics of the strata. Discrimination impairs access to healthcare.
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Aceitação pelo Paciente de Cuidados de Saúde , Humanos , Suécia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Idoso , Adolescente , Disparidades em Assistência à Saúde/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/normas , Racismo , Discriminação Social , Médicos/psicologia , Médicos/estatística & dados numéricosRESUMO
This cross-sectional study examined the prevalence of sexual orientation discrimination and its sociodemographic correlates among a large, diverse sample of early adolescents in the US.
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Comportamento Sexual , Humanos , Adolescente , Masculino , Feminino , Comportamento Sexual/psicologia , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Discriminação SocialRESUMO
This narrative review focuses on the impact of bias, prejudice, discrimination, racism (BPDR), social determinants of health, and structural racism on Latino children's health and well-being. The race/ethnicity, country of origin, immigrant/generational status, limited English proficiency (LEP), acculturation level, and social class of Latino children and their parents can heighten or modify the impact of BPDR. These differences have been shown to affect BPDR among Latino adults and presumably for their children. Surveys of Latino adolescents reveal that 60% have experienced discrimination, with first- and second-generation teens having a higher prevalence. These experiences are magnified by adverse social determinants/structural racism. BPDR can impact Latino children prenatally through adolescence. Bias involving neonatal, primary, and inpatient pediatric services has been reported. In 2021, Latino children were 19% less likely to complete preventive care, and 32% of LEP children had no medical home. School-age Latino children experience system inequities associated with chronic physical and mental health conditions. BPDR is also seen in educational performance but can be buffered by a strong racial/ethnic self-identity. To address BPDR/structural racism for Latino children, we suggest pediatricians: 1) increase the Latino child-health workforce to address BPDR internally and externally, 2) advocate for data collection on and monitoring of Latino children's disparities and racism metrics in pediatric services, to improve quality of care for Latino children and their families, and 3) advocate for child health equity. Together, these steps will help eliminate BPDR for Latino children and ensure they obtain their full potential.
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Hispânico ou Latino , Preconceito , Racismo , Determinantes Sociais da Saúde , Humanos , Criança , Adolescente , Hispânico ou Latino/psicologia , Saúde da Criança/etnologia , Disparidades em Assistência à Saúde/etnologia , Proficiência Limitada em Inglês , Aculturação , Discriminação Social/etnologia , Racismo Sistêmico , Pré-Escolar , Viés , Estados UnidosRESUMO
The study of human immunodeficiency virus (HIV)-related stigma and discrimination has been burgeoning with important implications for public health and society, as it negatively impacts people living with HIV. However, data on the experiences of rural women living with HIV/Acquired Immune Deficiency Syndrome (AIDS) in Zimbabwe are lacking. Women represent 50% of the global pandemic, while deaths from AIDS-related illnesses have exceeded 35 million. This study aimed to explore the experiences of rural women living with HIV/AIDS in Zimbabwe. Forty rural women living with HIV were selected from 6 villages (one village per district) of Matabeleland South Province in Zimbabwe. A qualitative descriptive research design using in-depth individual interviews from 22 purposefully selected rural women living with HIV and 3 focus groups, was used to collect the study data. The transcripts of the interviews were analyzed using interpretative phenomenological analysis. Three interconnected themes were identified: social prejudice, social discrimination, and psychosocial dysfunction. A key finding in the themes was that women living with HIV in rural Zimbabwe were psychosocially dysfunctional because of social prejudice and discrimination perpetrated against them by significant others in their communities. The findings provide a valuable understanding of women's experiences of living with HIV and AIDS in Africa's low-income countries. These results can be used by researchers, clinicians, mental health providers, and policymakers to address the unique needs of rural women living with HIV/AIDS.
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Infecções por HIV , Pesquisa Qualitativa , População Rural , Estigma Social , Humanos , Zimbábue/epidemiologia , Feminino , Adulto , Infecções por HIV/psicologia , Pessoa de Meia-Idade , Grupos Focais , Adulto Jovem , Discriminação Social/psicologia , Entrevistas como AssuntoRESUMO
Introduction: Food insecurity is defined as inconsistent access to enough food to meet nutritional needs. Discrimination is associated with food insecurity and poor health, especially among racial and ethnic minoritized and sexual or gender minoritized groups. We examined the demographic associations of perceived everyday discrimination and food pantry discrimination in Massachusetts. Methods: From December 2021 through February 2022, The Greater Boston Food Bank conducted a cross-sectional, statewide survey of Massachusetts adults. Of the 3,085 respondents, 702 were food pantry clients for whom complete data on food security were available; we analyzed data from this subset of respondents. We used the validated 10-item Everyday Discrimination Scale to measure perceived everyday discrimination and a 10-item modified version of the Everyday Discrimination Scale to measure perceived discrimination at food pantries. Logistic regression adjusted for race and ethnicity, age, gender identity, sexual orientation, having children in the household, annual household income, and household size assessed demographic associations of perceived everyday discrimination and discrimination at food pantries. Results: Food pantry clients identifying as LGBTQ+ were more likely than those identifying as non-LGBTQ+ to report perceived everyday discrimination (adjusted odds ratio [AOR] = 2.44; 95% CI, 1.24-4.79). Clients identifying as Hispanic (AOR = 1.83, 95% CI, 1.13-2.96) were more likely than clients identifying as non-Hispanic White to report perceived discrimination at food pantries. Conclusion: To equitably reach and serve households with food insecurity, food banks and pantries need to understand experiences of discrimination and unconscious bias to develop programs, policies, and practices to address discrimination and create more inclusive interventions for food assistance.
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Assistência Alimentar , Insegurança Alimentar , Humanos , Massachusetts , Feminino , Masculino , Estudos Transversais , Adulto , Assistência Alimentar/estatística & dados numéricos , Pessoa de Meia-Idade , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adulto Jovem , Discriminação Social/psicologia , Abastecimento de Alimentos/estatística & dados numéricos , Adolescente , IdosoRESUMO
Background Structural stigma and institutionalised discrimination towards people living with HIV remain pervasive in many settings. However, qualitative explorations of experiences of stigma, health and social service engagement, and quality of life among people living with HIV in Singapore remain under-researched. Methods Semi-structured interviews were conducted with 73 participants in Singapore. These included 56 people living with HIV (30 men who have sex with men, 23 heterosexual men, and 3 women) and 17 stakeholders including healthcare professionals and other allied workers. Interviews focused on participant perspectives or experiences of HIV diagnosis, navigating healthcare, attitudes towards HIV, and impact of HIV on relationships. Data were analysed through inductive thematic analysis. Results Our findings were framed within a minority stress model, highlighting the distal and proximal stressors relating to living with HIV. With regard to distal stressors, participants highlighted that they had experienced or were aware of institutionalised discrimination towards people living with HIV across various aspects of their lives. These included experiences - overt and covert - of discrimination in education, workplace, and healthcare settings. With regard to proximal stressors, participants highlighted the role of anticipated stigma and the stress of concealment. This included participants' fear of potential legal and/or social repercussions resulting from the disclosure of their HIV status, actions that they may not be able to anticipate and articulate. Although employers may not overtly discriminate, the fear of such anticipated discrimination influenced decisions to conceal HIV status in job applications and workplaces. This restricted agency for the people living with HIV in our study by affecting their regular medical follow-ups, socialising behaviours, and overall quality of life. Consequently, many participants felt that concealment of their status, and forgoing potential educational, employment, and even health opportunities, were the only ways of protecting themselves from such forms of stigma and discrimination. Conclusions This study found that anticipated stigma and discrimination diminished the quality of life of people living with HIV in Singapore. Implementing an anti-discrimination framework could address the unpredictability and alleviate the manifold unknowns of anticipated stigma.
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Medo , Infecções por HIV , Qualidade de Vida , Estigma Social , Estresse Psicológico , Humanos , Masculino , Singapura , Infecções por HIV/psicologia , Feminino , Qualidade de Vida/psicologia , Adulto , Estresse Psicológico/psicologia , Medo/psicologia , Pessoa de Meia-Idade , Pesquisa Qualitativa , Discriminação Social/psicologiaRESUMO
This cross-sectional study evaluated the configural and metric structures of the Intersectional Discrimination Index (InDI), an instrument that measures anticipated (InDI-A), dat-to-day (InDI-D), and major (InDI-M) discrimination. Data from a broader study, focused on the impacts of discrimination on the mental health of women living in Brazil, were used. Approximately 1,000 women, selected according to a convenience sampling scheme, answered the InDI and questions about sociodemographic characteristics in an electronic form that was administered in 2021. Exploratory factor analyses and exploratory structural equation modeling were applied to the first half of the sample; for the second, confirmatory factor analysis was conducted. Taken together, the findings suggest that each of the three measures is one-dimensional. However, unlike the study that originally proposed the InDI for use in Canada and the United States, we observed the presence of residual correlations in the three subscales evaluated, all of which were suggestive of content redundancy between specific pairs of items. The three measures showed moderate to strong factor loadings and acceptable fit to the data. InDI exhibited reasonable internal validity, potentially becoming a valuable instrument for investigating the health effects of intersectional discrimination in Brazil. Future studies should evaluate the consistency of these findings, examine the scalar structure of the instrument, and analyze its invariance among different marginalized groups.
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Psicometria , Fatores Socioeconômicos , Humanos , Brasil , Feminino , Estudos Transversais , Adulto , Inquéritos e Questionários/normas , Análise Fatorial , Adulto Jovem , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Adolescente , Discriminação SocialRESUMO
Importance: Governments worldwide have become increasingly cognizant of the spread of genetic discrimination (negative treatment or harm on the basis of actual or presumed genetic characteristics). Despite efforts by a number of governments to establish regulations addressing this phenomenon, public concern about genetic discrimination persists. Objective: To identify key elements of an optimal genetic nondiscrimination policy and inform policymakers as they seek to allay genetic nondiscrimination and related public anxieties. Evidence Review: Sixty multidisciplinary experts from 20 jurisdictions worldwide were consulted to understand their views on effective genetic nondiscrimination policies. Following standard requirements of the Delphi method, 3 rounds of surveys over the course of 1.5 years were conducted. Round 1 focused on assessing participants' understanding of the intricacies of existing genetic nondiscrimination policies, while rounds 2 and 3 invited participants to reflect on specific means of implementing a more effective regime. A total of 60 respondents participated in the first round, 53 participated in round 2, and 43 participated in round 3. Findings: While responses varied across disciplines, there was consensus that binding regulations that reach across various sectors are most useful in preventing genetic discrimination. Overall, experts agreed that human rights-based approaches are well suited to preventing genetic discrimination. Experts also agreed that explicit prohibition of genetic discrimination within nondiscrimination policies can highlight the importance of genetic nondiscrimination as a fundamental right and ensure robust protection at a national level. While most participants believed the international harmonization of genetic nondiscrimination laws would facilitate data sharing worldwide, they also recognized that regulations must reflect the sociocultural differences that exist among regions. Conclusions and Relevance: As the reach of genetic discrimination continues to evolve alongside developments in genomics, strategic policy responses that are harmonious at the international and state levels will be critical to address this phenomenon. In seeking to establish comprehensive frameworks, policymakers will need to be mindful of regional and local circumstances that influence the need for and efficacy of unique genetic nondiscrimination approaches across diverse contexts.
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Consenso , Técnica Delphi , Humanos , Privacidade Genética/legislação & jurisprudência , Política de Saúde/legislação & jurisprudência , Discriminação Social/legislação & jurisprudência , Preconceito/legislação & jurisprudênciaRESUMO
Discrimination in the labor market hinders efficient labor allocation, impeding socio-economic health. With the rapid population aging in China, addressing multifaceted discrimination to enhance labor allocation efficiency emerges as a crucial area of research. To explore the relationship between five types of discrimination (age, gender, hukou, educational background, and occupation) and labor misallocation, this paper based on intersectionality theory, employs the fuzzy-set Qualitative Comparative Analysis (fsQCA) method to conduct a configurational analysis of data from China. The research findings indicate that none of the five forms of discrimination can be deemed a necessary condition for achieving high-level labor misallocation. The study identifies five distinct pathways of multiple discrimination to form high-level labor misallocation, which can be classified into four interaction modes: age-hukou, gender-hukou, gender-occupation, and age-gender-educational background. Meanwhile, there are four configuration paths for the absence of labor misallocation. This study reveals the intricate mechanisms by which multiple forms of discrimination contribute to labor misallocation in China's labor market, and provides valuable insights for addressing employment discrimination and improving the efficiency of labor allocation.
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Emprego , China , Humanos , Feminino , Masculino , Adulto , Ocupações , Fatores Etários , Pessoa de Meia-Idade , Discriminação Social , EscolaridadeAssuntos
Coleta de Dados , Identidade de Gênero , Comportamento Sexual , Humanos , Coleta de Dados/normas , Coleta de Dados/métodos , Estados Unidos , Comportamento Sexual/estatística & dados numéricos , Assistência Centrada no Paciente/normas , Assistência Centrada no Paciente/estatística & dados numéricos , Discriminação Social/prevenção & controle , Disparidades em Assistência à Saúde , Estigma Social , RevelaçãoRESUMO
Academic interest in reducing discrimination has produced substantial research testing interventions to mitigate biased outcomes. However, disparate findings and a scarcity of studies examining work-related behavioral measures make it challenging to determine which interventions are better suited to reduce workplace discrimination. Derived from the tripartite theory of attitudes and the principle of compatibility, I develop a conceptual model mapping the attitude focus of interventions and code studies in this literature from the past two decades for these common properties. Based on a meta-analysis of 70 articles totaling 208 effect sizes, I test this conceptual model, finding that it helps explain why some interventions to reduce discrimination yield superior outcomes relative to others. In particular, results indicate that passive interventions, such as short-term education or reminders of bias processes, are largely ineffective in shifting behavior. Conversely, the class of interventions that targets behavior directly by attempting to inhibit the manifestation of bias (e.g., making individuals accountable for their decisions or changing social norms) emerged as the most helpful category of interventions in this area. Overall, results support a key prediction of the attitude dimension consistency perspective, demonstrating that aligning the attitude dimension primarily targeted by an intervention and the outcome measured could lead to improved results in this area. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Atitude , Emprego , Humanos , Emprego/psicologia , Preconceito/psicologia , Discriminação Social/psicologiaRESUMO
People surviving COVID-19 may experience social stigma related to their condition even after clinical recovery. This study aimed to: (1) investigate COVID-19-related experienced discrimination and internalized stigma, and (2) explore their association with symptoms of anxiety, depression, and insomnia. We conducted an online survey of people who survived COVID-19. Perception of stigma was assessed using the COVID-19 Experienced Discrimination Scale and the COVID-19 Internalized Stigma Scale. Depression, anxiety, and insomnia were assessed using, respectively, the Patient Health Questionnaire-9, the General Anxiety Disorder Scale-7, and the Insomnia Severity Index. Multivariable logistic regression analyses for each psychopathological domain were performed. A total of 579 participants participated in this study. Overall, 25% reported some degree of experienced discrimination, and 23% reported some degree of internalized stigma. Adjusted odds ratio showed that scoring higher on internalized stigma related significantly to higher symptoms of depression (2.14; 95% confidence interval [CI], 1.35-3.39), anxiety (2.30; 95% CI, 1.48-3.59), and insomnia (2.54; 95% CI, 1.64-3.95), whereas experienced discrimination was associated to anxiety (1.55; 95% CI, 1.06-2.28) and insomnia (1.82; 95% CI, 1.24-2.69). Experiences of social stigmatization are frequent among people surviving COVID-19 and seem to be associated with levels of psychological disturbances. Further research is required to elucidate the direction of these relationships to implement effective treatment strategies.
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Ansiedade , COVID-19 , Depressão , SARS-CoV-2 , Distúrbios do Início e da Manutenção do Sono , Estigma Social , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Feminino , Masculino , Distúrbios do Início e da Manutenção do Sono/psicologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Adulto , Pessoa de Meia-Idade , Depressão/psicologia , Ansiedade/psicologia , Inquéritos e Questionários , Idoso , Adulto Jovem , Discriminação Social/psicologiaRESUMO
BACKGROUND: Increasing research examines social determinants of health, including structural oppression and discrimination. Microaggression - subtle/ambiguous slights against one's marginalized identity - is distinct from discrimination, which typically presents as overt and hostile. The current study investigated the comparative effects of each exposure on young adult anxiety, depression, and sleep. Race-stratified analyses investigated patterns across groups. METHODS: Young adults (N = 48,606) completed the Spring 2022 American College Health Association-National College Health Assessment III. Logistic regressions tested odds of anxiety symptoms, depressive symptoms, and sleep disturbance in association with microaggression and discrimination exposure. RESULTS: Microaggression and discrimination equally predicted increased likelihood of anxiety symptoms (ORMicro = 1.42, ORDiscrim = 1.46). Discrimination more strongly predicted depressive symptoms (OR = 1.59) and sleep disturbance (OR = 1.54) than did microaggression (ORDepress = 1.24, ORSleep = 1.27). Race-stratified analyses indicated stronger associations between the each exposure and poor mental health in Whites than Asian American, Black/African American, and Hispanic or Latino/a/x respondents. LIMITATIONS: Microaggression and discrimination exposure were each assessed using a single item. The outcome measures were not assessed using validated measures of anxiety, depression, and sleep (e.g., GAD-7, MOS-SS); thus results should be interpreted with caution. Analyses were cross-sectional hindering our ability to make causal inferences. CONCLUSIONS: The findings provide preliminary evidence that microaggression and discrimination exposure operate on health in distinct ways. Racially marginalized individuals may demonstrate a blunted stress response relative to Whites. Treatment approaches must be tailored to the particular exposures facing affected individuals to maximize benefits.
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Ansiedade , Depressão , Microagressão , Discriminação Social , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Ansiedade/etnologia , Ansiedade/psicologia , Depressão/etnologia , Depressão/psicologia , Hispânico ou Latino/psicologia , Transtornos do Sono-Vigília/etnologia , Transtornos do Sono-Vigília/psicologia , Estudantes/psicologia , Estados Unidos/epidemiologia , Negro ou Afro-Americano/psicologia , Brancos/psicologia , Asiático/psicologia , Discriminação Social/psicologiaRESUMO
This article provides an overview of the High-Level Conference on Ending Financial Discrimination Against Cancer Survivors held on the 15th of February 2024, in Brussels, Belgium. Organised under the auspices of the Belgian Presidency of the European Council and led by the European Initiative on Ending Discrimination Against Cancer Survivors, the focus was the "right to be forgotten" (RTBF), which seeks to prevent financial discrimination against former cancer patients by ensuring their medical history is not considered by insurers and lenders 5 years after the end of treatment and without recurrence of the disease. Through detailed discussions and poignant testimonies, the conference shed light on the profound impact of financial discrimination on cancer survivors' lives and the moral and legal imperatives to address it. The article concludes with recommendations for advancing RTBF legislation at both national and European levels, emphasising the importance of political will, medical research, and strong advocacy from the cancer community.
Assuntos
Sobreviventes de Câncer , União Europeia , Humanos , Neoplasias/economia , Neoplasias/terapia , Europa (Continente) , Discriminação Social/legislação & jurisprudênciaRESUMO
Importance: Discrimination, bullying, and harassment in medicine have been reported internationally, but exposures for Indigenous medical students and physicians, and for racism specifically, remain less examined. Objective: To examine the prevalence of racism, discrimination, bullying, and harassment for Maori medical students and physicians in New Zealand and associations with demographic and clinical characteristics. Design, Setting, and Participants: This cross-sectional study used data from an anonymous national survey of Maori medical students and physicians in New Zealand in late 2021 and early 2022. Data were analyzed from March 2022 to April 2024. Exposures: Age, gender, marginalized status (ie, in addition to being Maori, belonging to other groups traditionally marginalized or underrepresented in medicine), year of medical school, year of graduation, and main work role. Main Outcomes and Measures: Direct and witnessed racism, discrimination, bullying, and harassment were measured as any experience in the last year and ever. Any exposure to negative comments about social groups and witnessing discriminatory treatment toward Maori patients or whanau (extended family). Considering leaving medicine, including because of mistreatment, was measured. Results: Overall, 205 Maori medical students (median [IQR] age, 23.1 [21.6-24.3] years; 137 [67.2%] women) and 200 physicians (median [IQR] age, 36.6 [30.1-45.3] years; 123 [62.8%] women) responded. Direct and witnessed exposure to racism (184 students [91.5%]; 176 physicians [90.7%]) and discrimination (176 students [85.9%]; 179 physicians [89.5%]) ever in medical education, training, or work environments was common. Ever exposure to witnessed and direct bullying (123 students [66.5%]; 150 physicians [89.3%]) and harassment (73 students [39.5%]; 112 physicians [66.7%]) was also common. Most respondents reported witnessing Maori patients or their whanau being treated badly in clinical settings, in direct interactions (67 students [57.8%]; 112 physicians [58.9%]) or behind their backs (87 students [75.0%]; 138 physicians [72.6%]). One-quarter of Maori medical students (45 students), and 37.0% of physicians (61 physicians) had considered leaving or taken a break from medicine because of these experiences. Additional marginalized statuses were significantly associated with any direct experience of mistreatment in the last year for students and physicians. Exposure to some forms of mistreatment were also significantly associated with higher likelihood of thinking about leaving or taking a break from medicine for physicians. Conclusions and Relevance: In this study, Maori medical students and physicians reported high exposure to multiple forms of racism, discrimination, bullying, and harassment in medical education, training, and work environments, requiring an urgent response from medical institutions.
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Bullying , Povo Maori , Médicos , Racismo , Estudantes de Medicina , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Bullying/estatística & dados numéricos , Bullying/psicologia , Estudos Transversais , Nova Zelândia , Médicos/psicologia , Médicos/estatística & dados numéricos , Racismo/estatística & dados numéricos , Racismo/psicologia , Estudantes de Medicina/estatística & dados numéricos , Estudantes de Medicina/psicologia , Inquéritos e Questionários , Discriminação SocialRESUMO
This international cross-sectional survey examined the potential role of organizational psychological support in mitigating the association between experiencing social discrimination against long-term care (LTC) facilities' healthcare professionals (HCPs) and their intention to stay in the current workplace during the COVID-19 pandemic. Participants included a convenience sample of 2,143 HCPs (nurses [21.5 %], nurse aids or residential care workers [40.1 %], social workers [12.1 %], and others [26.4 %]) working at 223 LTC facilities in 13 countries/regions. About 37.5 % of the participants reported experiencing social discrimination, and the percentage ranged from 15.3 % to 77.9 % across countries/regions. Controlling for socio-demographic and work-related variables, experiencing social discrimination was significantly associated with a lower intention to stay, whereas receiving psychological support showed a statistically significant positive association (p-value=0.015 and <0.001, respectively). The interaction term between social discrimination and psychological support showed a statistically significant positive association with the intention to stay, indicating a moderating role of the psychological support.
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COVID-19 , Assistência de Longa Duração , Discriminação Social , Local de Trabalho , Humanos , Estudos Transversais , Masculino , COVID-19/prevenção & controle , COVID-19/psicologia , Feminino , Local de Trabalho/psicologia , Inquéritos e Questionários , Adulto , Pessoal de Saúde/psicologia , Pessoa de Meia-Idade , Casas de Saúde , Sistemas de Apoio PsicossocialRESUMO
Genetic discrimination is an evolving phenomenon that impacts fundamental human rights such as dignity, justice and equity. Although, in the past, various definitions to better conceptualize genetic discrimination have been proposed, these have been unable to capture several key facets of the phenomenon. In this Perspective, we explore definitions of genetic discrimination across disciplines, consider criticisms of such definitions and show how other forms of discrimination and stigmatization can compound genetic discrimination in a way that affects individuals, groups and systems. We propose a nuanced and inclusive definition of genetic discrimination, which reflects its multifaceted impact that should remain relevant in the face of an evolving social context and advancing science. We argue that our definition should be adopted as a guiding academic framework to facilitate scientific and policy discussions about genetic discrimination and support the development of laws and industry policies seeking to address the phenomenon.
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Direitos Humanos , Humanos , Discriminação Social , Privacidade Genética/legislação & jurisprudência , PreconceitoRESUMO
This cross-sectional study investigated the association between experiences of discrimination and oral health self-perception among a probabilistic cluster sample of Brazilian adults who participated in the 2013 National Health Survey. Oral health self-perception was categorized into three groups (very good + good; fair; poor + very poor). Reported experiences of discrimination included attributions based on the respondent's race/skin color, social class, income, occupation, illness, sexual orientation, religion, sex, and age. Covariates included sociodemographic data, oral health conditions, access to healthcare services, health habits, mental health, and participation in social and/or religious activities. Data were analyzed using ordinal logistic regression for non-proportional odds, considering sample weights and complex samples. Among 60,202 adults, 5.84% perceived their oral health as poor + very poor, with a significantly higher proportion among those experiencing discrimination (9.98%). Adults who experienced discrimination were 1.39 times more likely to report a "poor/very poor/fair" oral health self-perception compared to those who did not experience discrimination. Those who suffered discrimination were 1.28 times more likely to have a "very poor/poor" oral health self-perception than their counterparts who were not affected by discrimination. These findings underscore the importance of considering discrimination experiences as part of the social determinants influencing oral health.
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Saúde Bucal , Autoimagem , Humanos , Brasil , Estudos Transversais , Adulto , Masculino , Feminino , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Idoso , Fatores Socioeconômicos , Discriminação Social/psicologiaRESUMO
OBJECTIVES: Workplace stigmatisation and discrimination are significant barriers to accessing employment opportunities, reintegration and promotion in the workforce for people with mental illnesses in comparison to other disabilities. This paper presents qualitative evidence of anticipated and experienced workplace stigma and discrimination among individuals with major depressive disorder (MDD) in 35 countries, and how these experiences differ across countries based on their Human Development Index (HDI) level. DESIGN: Mixed-method cross-sectional survey. PARTICIPANTS, SETTING AND MEASURES: The qualitative data were gathered as part of the combined European Union Anti-Stigma Programme European Network and global International Study of Discrimination and Stigma Outcomes for Depression studies examining stigma and discrimination among individuals with MDD across 35 countries. Anticipated and experienced stigma and discrimination were assessed using the Discrimination and Stigma Scale version 12 (DISC-12). This study used responses to the open-ended DISC-12 questions related to employment. Data were analysed using the framework analysis method. RESULTS: The framework analysis of qualitative data of 141 participants identified 6 key 'frames' exploring (1) participants reported experiences of workplace stigma and discrimination; (2) impact of experienced workplace stigma and discrimination; (3) anticipated workplace stigma and discrimination; (4) ways of coping; (5) positive work experiences and (6) contextualisation of workplace stigma and discrimination. In general, participants from very high HDI countries reported higher levels of anticipated and experienced discrimination than other HDI groups (eg, less understanding and support, being more avoided/shunned, stopping themselves from looking for work because of expectation and fear of discrimination). Furthermore, participants from medium/low HDI countries were more likely to report positive workplace experiences. CONCLUSIONS: This study makes a significant contribution towards workplace stigma and discrimination among individuals with MDD, still an under-researched mental health diagnosis. These findings illuminate important relationships that may exist between countries/contexts and stigma and discrimination, identifying that individuals from very high HDI countries were more likely to report anticipated and experienced workplace discrimination.
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Transtorno Depressivo Maior , Estigma Social , Local de Trabalho , Humanos , Estudos Transversais , Transtorno Depressivo Maior/psicologia , Masculino , Feminino , Adulto , Local de Trabalho/psicologia , Pessoa de Meia-Idade , Emprego/psicologia , Pesquisa Qualitativa , Discriminação Social/psicologia , Adulto Jovem , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Weight stigma, or weight bias, refers to biased beliefs and negative opinions towards people with excess weight. This phenomenon manifests in prejudice and negative attitudes towards people with obesity, including disrespectful treatment, bullying, discrimination and even abuse, and leading to long-term negative consequences on physical and mental health. The purpose of the current review was to examine the relationship between gender and manifestations of weight stigma. Studies listed in this review show that the phenomenon of weight stigma is more common and severe among women, in numerous life areas, which include education, employment, the healthcare system, social media, sports industry, and interpersonal relationships. Possible reasons for such differences include the existing discrimination against women in various areas of life, and the emphasis on external appearance and the ideal of thinness, which relates mainly to women. In light of the serious consequences of weight stigma on public health and individual well-being, efforts must be made to prevent weight stigma, including the education of the general population, changing policies of healthcare, education and media systems, and legislation to prevent weight-based discrimination.