Racial and Ethnic Discrimination and Medical Students' Identity Formation.

Importance: Investigating racial and ethnic discrimination in medical education is crucial for addressing disparities and fostering an inclusive environment. Objective: To assess how racial and ethnic discrimination in medical school is associated with personal and professional identity formation (PPIF) by race and ethnicity. Design, Setting, and Participants: This retrospective cross-sectional study used deidentified data on 37 610 medical students who matriculated in 2014 or 2015 and took the Association of American Medical Colleges Graduation Questionnaire (GQ) between 2016 and 2020. Statistical analysis was performed from September 1 to November 20, 2023. Exposures: Experiences of racial and ethnic discrimination were assessed through responses to 3 GQ questions about denial of opportunities, offensive remarks or names, and lower evaluations or grades due to race or ethnicity. Main Outcomes and Measures: Personal and professional development were measured as 2 separate outcomes using 2 GQ statements rated on a 5-point Likert scale (where 1 indicated strongly disagree and 5 indicated strongly agree): "My medical school has done a good job fostering and nurturing my development as a person" and "My medical school has done a good job fostering and nurturing my development as a physician." Variables of personal and professional development were both dichotomized. Results: Of 37 610 medical students, 18 200 (48.4%) were female, and 19 410 (51.6%) were male; 2458 (6.5%) were African American or Black, 7801 (20.7%) were Asian, 2430 (6.5%) were Hispanic, 21 380 (56.9%) were White, 2404 (6.4%) were multiracial, and 1137 (3%) were other race or ethnicity. Most respondents attested that their medical school fostered their personal (27 272 [72.5%]) and professional (34 560 [91.9%]) development. African American or Black students reported the lowest rates of personal (1603 of 2458 [65.2%]) and professional (2182 of 2458 [88.8%]) development, and experienced lower likelihoods of personal (adjusted risk ratio [ARR], 0.89 [95% CI, 0.86-0.93]) and professional (ARR, 0.95 [95% CI, 0.94-0.97]) development than White students. Racial discrimination was inversely associated with development, with the highest PPIF rates among those never experiencing discrimination (personal, 25 089 of 33 508 [74.9%]; and professional, 31 257 of 33 508 [93.3%]). Those experiencing isolated discrimination (personal: ARR, 0.83 [95% CI, 0.80-0.87]; professional: ARR, 0.92 [95% CI, 0.91-0.95]) and recurrent discrimination (personal: ARR, 0.63 [95% CI, 0.60-0.66]; professional: ARR, 0.82 [95% CI, 0.80-0.84]) had relatively lower likelihoods of PPIF. African American or Black students experienced the highest rate of recurrent discrimination (543 of 2458 [22.1%]). No significant PPIF risk differences were found for other racial and ethnic groups underrepresented in medicine without discrimination compared with White students without discrimination, but all groups with recurrent discrimination had relatively lower PPIF risk. Conclusions and Relevance: In this cross-sectional study of US medical students, racial and ethnic discrimination was associated with lower PPIF across all racial and ethnic groups compared with White students without such experiences. African American or Black students disproportionately faced this discrimination. Systemic changes in medical education are needed to combat discrimination and ensure equity in holistic student development.

State of the Science on Racial Microaggressions.

Despite racism being widespread and research evidence of racial disparities growing, those who lack the lived experience of racial oppression often find it difficult to acknowledge this specific phenomena due to in-group bias and social learning, among other reasons. The devaluing of this research topic within psychology and greater scientific skepticism around the construct continues to undermine research on racism and microaggressions. The science of microaggressions has advanced significantly in conceptual and theoretical clarity over the last 15 years. Many initial assumptions about the nature of microaggressions have since been found to be incorrect. This state of the science review addresses these concerns by reviewing the concept, validated measures, physical and mental health impacts, critiques and misinformation, recommended strategies and interventions, and clinical implications. We propose future research directions to help advance the scientific study of racial microaggressions.

Experiences of Racism in School and Associations with Mental Health, Suicide Risk, and Substance Use Among High School Students - Youth Risk Behavior Survey, United States, 2023.

Racism is a fundamental determinant of health inequities among racial and ethnic groups and is understudied among adolescents. In 2023, the national Youth Risk Behavior Survey questionnaire included an item assessing experiences of racism in the school setting among students in grades 9-12 in the United States. This report estimates the prevalence of students who reported ever having experienced racism in school and compares prevalence by racial and ethnic groups. For each racial and ethnic group, prevalence differences and prevalence ratios were estimated comparing the prevalence of indicators of poor mental health, suicide risk, and substance use among students who reported that they have ever versus never experienced racism in school. In 2023, approximately one in three high school students (31.5%) said that they had ever experienced racism in school. Reported experiences of racism were most prevalent among Asian (56.9%), multiracial (48.8%), and Black or African American (Black) (45.9%) students and least prevalent among White students (17.3%). Black and Hispanic or Latino (Hispanic) students who reported experiencing racism had a higher prevalence of all health risk behaviors and experiences investigated, including indicators of poor mental health, suicide risk, and substance use compared with students of their racial and ethnic group who reported never experiencing racism. Many of these associations were also found among multiracial and White students. Student reports of racism were associated with indicators of mental health and suicide risk among American Indian or Alaska Native (AI/AN) and Asian students. Among students of color, including AI/AN, Asian, Black, Hispanic, and multiracial students, the prevalence of seriously considering and attempting suicide was more than two times higher among students who ever compared with never experienced racism. These findings demonstrate that racism in the school setting is experienced by high school students attending public and private schools and continues to disproportionately affect students of color. Students who reported experiencing racism had a higher prevalence of indicators of poor mental health, suicide risk, and substance use. Schools can incorporate policies and practices to prevent unfair treatment on the basis of race and ethnicity and offer resources to help students cope with these experiences.

TRANSFORMing theory to practice: Developing and implementing an anti-racist, community-based racial stress and trauma group intervention for BIPOC youth.

Evidence-informed trauma interventions developed specifically by and for Black, Indigenous, and People of Color (BIPOC) that address racial, historical, and intergenerational trauma are sparse, particularly for youth. To meet this need, the current study developed and piloted a new intervention - Trauma and Racism Addressed by Navigating Systemic Forms of Oppression using Resistance Methods (TRANSFORM) - using a and community-engaged research-to-practice approach. Across two phases, we documented the community-participatory development of TRANSFORM and analyzed preliminarily quantitative data collected in a pilot study with N = 19 BIPOC youth. Phase 1 reports on the process and lessons learned from the community centered co-development. The phase 2 pilot study results revealed statistically significant pretest-to-posttest reductions in racial discrimination stress as well as trauma-related symptoms interfering with daily functioning for youth. Implications for community-based approaches to disrupting and healing racial stress and trauma within and across youth-serving systems are discussed.

Apology for the publication of Sheng et al. (2024).

Recently, Cultural Diversity & Ethnic Minority Psychology (CDEMP) published Sheng et al.'s (see record 2024-72017-001) article titled "The Development of Tibetan Children's Racial Bias in Empathy: The Mediating Role of Ethnic Identity and Wrongfulness of Ethnic Intergroup Bias." The article went through the standard peer review process. Subsequent to its publication, one of our readers expressed concerns regarding the biased language (e.g., "backwardness of education") and deficit-oriented interpretation of findings (e.g., "the geographical environment and traditional way of life in Tibet can also impact the development of [racial biases in empathy] in Tibetan children"). The reader rightly pointed out that this language and interpretation reinforce imperialism, particularly given the complex relations between Tibet and China. We sincerely apologize to our readers, and especially to our Tibetan colleagues, for failing to identify these issues prior to the publication of the article.Wetake accountability for the oversight and have followed due process to correct our mistakes in the publication of this article. We will also take action to prevent this from happening again. In this editorial, we describe the study, actions taken by the CDEMP Editorial Team, the authors' response, and future actions to be taken by the CDEMP Editorial Team. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Associations Between Patient/Caregiver Trust in Clinicians and Experiences of Healthcare-Based Discrimination.

BACKGROUND: Higher trust in healthcare providers has been linked to better health outcomes and satisfaction. Lower trust has been associated with healthcare-based discrimination. OBJECTIVE: Examine associations between experiences of healthcare discrimination and patients' and caregivers of pediatric patients' trust in providers, and identify factors associated with high trust, including prior experience of healthcare-based social screening. METHODS: Secondary analysis of cross-sectional study using logistic regression modeling. Sample consisted of adult patients and caregivers of pediatric patients from 11 US primary care/emergency department sites. RESULTS: Of 1,012 participants, low/medium trust was reported by 26% identifying as non-Hispanic Black, 23% Hispanic, 18% non-Hispanic multiple/other race, and 13% non-Hispanic White (P = .001). Experience of any healthcare-based discrimination was reported by 32% identifying as non-Hispanic Black, 23% Hispanic, 39% non-Hispanic multiple/other race, and 26% non-Hispanic White (P = .012). Participants reporting low/medium trust had a mean discrimination score of 1.65/7 versus 0.57/7 for participants reporting high trust (P < .001). In our adjusted model, higher discrimination scores were associated with lower trust in providers (aOR 0.74, 95%CI = 0.64, 0.85). A significant interaction indicated that prior healthcare-based social screening was associated with reduced impact of discrimination on trust: as discrimination score increased, odds of high trust were greater among participants who had been screened (aOR = 1.28, 95%CI = 1.03, 1.58). CONCLUSIONS: Patients and caregivers reporting more healthcare-based discrimination were less likely to report high provider trust. Interventions to strengthen trust need structural antiracist components. Increased rapport with patients may be a potential by-product of social screening. Further research is needed on screening and trust.

COVID-19 vaccine booster willingness among Asian Americans: Influence of racial discrimination and social determinants.

Uptake of COVID-19 vaccine booster doses is an important public health topic of study to prevent morbidity and mortality in underserved U.S. populations. However, limited research exists on COVID-19 vaccine booster use and willingness - including its associated factors - among Asian Americans (AA): the fastest growing racial group in the U.S. This study collected survey data from 447 AA adults from three large AA subgroups: Chinese, Korean, and Filipino. Data were collected as part of a community-driven county-wide needs assessment conducted in collaboration with AA community organizations in Riverside County, California. Data indicated that nearly 24% of AA participants received at least four doses of the COVID-19 vaccine, with 36% expressing definite willingness to receive future booster doses. Participants reported experiencing an average of 1.6 instances of racial discrimination across their lifetime. Ordered logistic regression and marginal effects analysis revealed ethnicity, education, racial discrimination, preexisting health conditions, and the number of prior COVID-19 vaccine doses received significantly predicted willingness to receive future vaccine doses. The study suggests that key social factors such as racial discrimination may play an important role in influencing public health efforts to promote vaccine uptake in diverse Asian American populations.

Asian Pacific Islander Desi American college students and COVID-19-related racial discrimination: Mental health and the moderating role of ethnic identity.

BACKGROUND: In 2020, the Coronavirus disease (COVID-19) triggered the latest wave of anti-Asian discrimination. During the first year of the pandemic, symptoms of depression and anxiety increased seven-fold within Asian Pacific Islander Desi American (APIDA) communities. Among this population, APIDA college students were at particularly high risk for mental health challenges due to COVID-19-related racial discrimination. This study examined the association between COVID-19-related racial discrimination and the mental health of APIDA college students, conceptualizing ethnic identity as a moderator in the association. METHODS: Secondary analysis was conducted on data from 2,559 APIDA college students aged 18 to 29 who participated in the Fall and Winter/Spring Cohorts of the 2020-2021 Healthy Minds Study (HMS), a non-probability web-based survey administered to students in higher education in the United States. Descriptive statistics, comparative analysis (e.g., Chi-square and t-test), and multivariable linear regression were conducted using STATA 17.1 (StataCorp LLC, College Station, TX). Survey weights were applied in all analyses. RESULTS: There were significant positive associations between COVID-19-related racial discrimination and symptoms of depression (b = 2.15, p < 0.001) and anxiety (b = 1.81, p < 0.001) among the overall sample. Furthermore, a greater sense of ethnic identity was associated with lower symptoms of depression (b = -0.15, p< 0.001) among the overall sample. Finally, ethnic identity buffered the association between COVID-19-related racial discrimination and symptoms of anxiety among East Asian students and symptoms of both depression and anxiety among Native Hawaiian and Pacific Islander students. In contrast, ethnic identity intensified the association between COVID-19-related racial discrimination and symptoms of depression among Filipino students. CONCLUSIONS: The research found that COVID-19-related racial discrimination was associated with increased symptoms of depression and anxiety among the full sample of APIDA college students during the first year of the pandemic. Additionally, higher levels of ethnic identity were associated with decreased depression among the entire group. The striking results on the moderating role of ethnic identity among subgroups call for further research on the ethnic identity development of APIDA college students, to help mitigate the effects of racial discrimination within a variety of systemic, complex, and dynamic sociocultural contexts.

An Exploration of the Impact of Racism and Discrimination on the Mental Health of Latinx Youth.

Latinx youth are at high risk of health and health care disparities. They are particularly vulnerable to mental health challenges due to the interplay of racism, health, and health care, which can be overwhelming for Latinx youth and their families to navigate. In this article, we provide an overview of the socio-demographics of Latinx youth living in the United States. Next, drawing on Borrell's framework for the effect of self-racial categorization, we review health disparities commonly experienced by Latinx youth with a more detailed description of mental health. We also explore the impact of racism and colorism on Latinx youth mental health and health care. Finally, we propose multiple strategies across levels to reduce the aforementioned disparities.

[Geographies of (dis)protection: Sketches in anti-racist mental health]. / Geografías del (des)amparo: Bosquejos en salud mental antirracista.

This essay explores the affective maps or emotional archives of racialized communities in Spain, specifically focusing on the Caribbean Afro-diaspora in Madrid. It questions how migratory grief is prescribed by the government without taking into account the colonial wound, racial trauma, and the geopolitics of emotions, while delving into everyday structural racism. Drawing from decolonial theory and Black feminism, as well as narrative healing practices created by migrant collectives, qualitative research was conducted during the period 2023-2024, involving 25 in-depth interviews and two group workshops with the participation of 15 anti-racist activists. After an introduction framed by an autobiographical narrative within the anti-racist conversation, key aspects of the notion of migratory grief are highlighted, associating it with the colonial wound. Subsequently, some characteristics of memory as geographies of abandonment are emphasized. Finally, I turn to the notion of imagination, in the form of collective daydreams or fantasies that activate the hope of transcending the borders of European racism. The article builds bridges between community health, an intercultural perspective, and anti-racism.

El presente ensayo explora los mapas afectivos o archivos emocionales de comunidades racializadas en España, en concreto, de la afrodiáspora caribeña en Madrid. Cuestiona cómo se prescribe gubernamentalmente el duelo migrante sin contar con la herida colonial, el trauma racial y las geopolíticas de las emociones, y ahonda en el racismo estructural cotidiano. Partiendo de la teoría decolonial y el feminismo negro, así como de las prácticas narrativas en sanación creadas por colectivos migrantes, se realizó una investigación cualitativa, en el período 2023-2024, en la que se realizaron 25 entrevistas en profundidad y dos talleres grupales con la participación de 15 personas activistas antirracistas. Tras una introducción desde una narrativa autobiográfica en la conversación antirracista, se señalan aspectos claves de la noción duelo migrante, asociándola con la herida colonial. Posteriormente, se enfatizan algunas características de la memoria como geografías del desamparo. Por último, apelo a la noción de imaginación, en modo de ensoñaciones o fantasías colectivas que activan la esperanza de traspasar las fronteras del racismo europeo. El artículo crea puentes entre la salud comunitaria, la perspectiva intercultural y el antirracismo.

Social mechanisms behind the poor health of marginalized Roma: Novel insights and implications from four ethnographic studies in Slovakia.

Roma represent one of the largest ethnic groups facing marginalization worldwide. However, significant knowledge gaps persist regarding: A) the social mechanisms supporting health-endangering practices among Roma; B) the social mechanisms adversely affecting their use of health services; and C) the social determinants underlying both above pathways. To fill these gaps, we conducted a series of four explorative ethnographic studies spanning over ten years. Beginning in 2004, the series involved 260 participants, including segregated Roma and health services staff in Slovakia. Of the four studies, two addressed gap A, two addressed gap B, and all addressed gap C. Regarding pathway A, we found that Roma in segregated Roma enclaves can be socialized into ethnically framed racialized ideologies that oppose the cultural standards of local non-Roma life, including certain healthy practices. This adherence to counter-cultural ideals of Roma identity increases specific health and care challenges. Regarding pathway B, we discovered that health service frontliners frequently lack any organizational support to better understand and accommodate the current living conditions and practices of segregated Roma, as well as their own and others' racism and professional expectations regarding equity. This lack of support leads many frontliners to become cynical about segregated Roma over their careers, resulting in health services being less effective and exacerbating health problems for both Roma and the frontliners themselves. Concerning pathway C, we found that the societal omnipresence of antigypsyism - racist and racialized anti-Roma ideas and sentiments - serves as a prominent driver of both the above pathways. We conclude that much of the unfavorable health status of Roma can be understood via a systems perspective that embraces structural racism.

Prolonged Boarding and Racial Discrimination and Dissatisfaction Among Emergency Department Patients.

Importance: Emergency department (ED) boarding times have increased rapidly, but their health equity outcomes are unknown. Objective: To investigate whether prolonged ED boarding is associated with increased perceived racial discrimination and dissatisfaction and whether associations vary between patients from marginalized racial and ethnic groups vs non-Hispanic White patients. Design, Setting, and Participants: This is a cross-sectional study of hospitalized adults who boarded in the ED during internal medicine admissions at a large, urban hospital in Boston, Massachusetts, from June 2023 to January 2024. Equal proportions of non-Hispanic White patients and patients from marginalized racial and ethnic groups (American Indian or Alaska Native, Hispanic, non-Hispanic Black and/or African American, and multiracial) were selected randomly. Exposure: The duration of ED boarding was categorized as less than 4 hours (reference), 4 to less than 24 hours, and 24 or more hours. Main Outcomes and Measures: Primary outcomes were odds of reporting (1) discrimination via the Discrimination in Medical Settings scale, and (2) dissatisfaction via the adapted Picker Patient Experience-15 questionnaire. Marginalized race and ethnicity was tested as an effect modifier. Multivariable logistic regression models adjusted for patient age, sex, language, and insurance payer. Results: Of 598 patients approached, 527 were enrolled, and 525 completed the surveys (response rate, 87.8%). The mean age (SD) was 60.6 (18.7) years, 300 patients (57.1%) were female, 246 patients (47.3%) identified as non-Hispanic White, and 274 (52.7%) were from a marginalized racial or ethnic group. In total, 135 (25.7%) boarded less than 4 hours (reference), 202 (38.5%) boarded 4 to less than 24 hours, and 188 (35.8%) boarded 24 hours or longer. Compared with less than 4 hours, boarding 24 hours or longer was associated with increased perceived discrimination (odds ratio [OR], 1.84; 95% CI, 1.14-2.99; P = .01). An increased association was observed in the subgroup of patients from racial and ethnic marginalized groups (OR, 2.36; 95% CI, 1.20-4.65; P = .01); effect modification was not significant (P for interaction, .10). For all patients, boarding 24 hours or longer was associated with increased dissatisfaction with care (OR, 1.77; 95% CI, 1.03-3.06; P = .04); effect modification was not significant (P for interaction, .80). Conclusions and Relevance: In this cross-sectional study, hospitalized patients who boarded in the ED 24 hours or longer reported more discrimination and dissatisfaction with care, which may disproportionately affect patients from marginalized racial and ethnic groups. As ED boarding times increase nationally, it is critical to recognize their potential to exacerbate health inequities and to respond with equity-focused solutions.

Skin tone discrimination and birth control avoidance among women in Harris County, Texas: a cross-sectional study.

INTRODUCTION: Structural racism plays a major role in reproductive health inequities. Colorism, discrimination based on skin color, may profoundly impact reproductive health access and service delivery. However, quantitative research in this area is limited. METHODS: We administered an online survey of women (n = 1,299) aged 18-44 from Harris County, Texas to assess the relationship between skin color discrimination and reproductive health service avoidance. The survey included questions on demographics, self-reported skin tone, and dichotomous measures of previous discrimination experiences and avoidance of care because of perceived discrimination. Binary logistic regression was used to examine whether race/ethnicity, skin tone, and previous discrimination experiences were related to avoidance of contraceptive care because of perceived discrimination. RESULTS: Approximately one-third (31.5%) of the sample classified themselves as non-Hispanic Whites (31.5%), 22.4% as Black, 27.4% as Hispanic and born within the US, and 7.6% as Hispanic born outside of the US. Approximately one-third of women classified themselves in the lightest skin tones, whereas almost one in five women classified themselves in the darkest skin tone palates. Darker skin tones had increasingly greater odds of reporting that they avoided seeking birth control out of a concern for discrimination compared to the lightest skin tone. After adjusting for race/ethnicity and sociodemographic variables (model 3), darker skin tones remained significantly associated with avoiding birth control. DISCUSSION: This study demonstrates the role that skin color discrimination plays in negative reproductive health experiences. While this is not surprising given that those with racist ideologies developed the concept of these racial and ethnic categories, the apparent association with darker skin colors and avoidance of seeking birth control provides evidence that structural and individual racism continues to have far-reaching and insidious consequences. CONCLUSION: Contraception is recognized for reducing maternal mortality, improving child health, increasing female empowerment, and decreasing poverty. However, not all women equally enjoy the benefits of access to contraception. Addressing colorism within reproductive healthcare has become critically important as the nation becomes increasingly diverse. Focusing on skin tone-based discrimination and its roots in anti-blackness expands our understanding beyond a Black-White binary traditionally applied when addressing racism in healthcare delivery.

School belonging mediates the longitudinal effects of racial/ethnic identity on academic achievement and emotional well-being among Black and Latinx adolescents.

Social Identity Theory proposes that a positive in-group social identification fosters students' academic motivation and psychological well-being. The present study, grounded in Social Identity Theory, investigated the roles of racial/ethnicity identity (REI) in the development of school adjustment among Black and Latinx youth as well as the psychological mechanisms underlying these longitudinal associations. We hypothesized that REI would positively predict the development of academic achievement and emotional symptoms. In addition, we hypothesized that the development of school belonging would mediate the predictive effects of REI on the growth of academic achievement and emotional symptoms. Participants were 475 (n = 182 Black, 48.9% female; 293 Latinx, 47.8% female) students in Grades 7-9. Students self-reported their REI, school belonging, and emotional symptoms. Academic achievement was assessed using standardized achievement test scores. The longitudinal mediation models indicated that REI indirectly predicted the development of academic achievement and emotional symptoms through students' sense of school belonging. Specifically, higher REI embedded achievement and lower REI awareness of racism predicted higher school belonging in Grade 7. Higher Grade 7 school belonging in turn predicted faster academic growth in Grade 7 to Grade 9 as well as lower emotional symptoms in Grade 7. In addition, the three dimensions of REI also directly predicted the growth of academic achievement and emotional symptoms in Grades 7-9. The mediated effects were smaller in size than the direct effects. These findings highlight the importance of fostering positive REI and a strong sense of school belonging in promoting school adjustment among racial/ethnic minoritized, academically at-risk youth.

Racial stereotype and Black adolescents' math achievement: Unpacking the socio-cognitive mechanisms.

Racial stereotypes are salient to Black adolescents and to the academic domain of mathematics; however, few studies have examined the socio-cognitive mechanisms through which racial stereotypes impact math achievement. This 2-year longitudinal study (N = 790 Grade 6, 8, and 10 students during Year 1; 50.7% girls and 49.3% boys) investigated (a) the extent to which the endorsement of positively and negatively biased racial stereotypes predicted Black adolescents' math performance through their cognitive engagement and ability mindset and (b) whether gender and ethnic-racial identity moderated these links. Results suggested that endorsement of negatively biased stereotypes was associated with diminished cognitive engagement and lower math scores across 2 years (p < .05). Additionally, adolescents' ethnic-racial identity commitment moderated the negative links between stereotype endorsement and math cognitive engagement in Year 2 (p < .05). When considering the mediating role of math ability mindsets, the endorsement of both positively and negatively biased racial stereotypes operated on math performance via its links to stronger fixed ability mindset beliefs in both years (p < .05). Gender also moderated the effects of racial stereotype endorsement on math mindset beliefs in Year 1 (p < .01). This study's findings advance the field's understanding of the psychosocial mechanisms through which racial stereotypes operate, thus enabling educators to develop tailored practices that facilitate equitable access to math learning opportunities.

Experiences of racism of Black medical students and residents in Montréal: "I wear my stethoscope around my neck at all times".

Background: Black students and residents experience racism in medical school. This qualitative study documents Black students' and residents' experiences of racism using Critical Race Theory (CRT) and explores their coping mechanisms using the theatrical metaphor. Methods: We conducted semi-structured interviews with four Black medical students and residents (two medical students and two residents) studying in Montréal and analyzed their experiences through counter-stories. We identified themes related to their experiences of racism during medical training and their coping mechanisms. Results: Our analysis reveals these experiences of racism occur in academic and clinical settings (classes, internships, social interactions with peers, faculty, and patients, and through the curriculum), in the form of microaggressions. The analysis also indicates that Black students and residents try to cope with racism using a hyper-ritualization strategy to better fit in (e.g., clothing, behaviours). Conclusion: Considering that Black students and residents experience various forms of racism (subtle or explicit) during their medical training, these findings urge us to increase awareness about racism of students, residents, teachers and health care workers in universities and teaching hospitals. Pathways to increase the representation of Black students and residents seem to be part of the solution, but improving the learning environment must be a priority to achieve racial justice in medical training in Québec.

Contexte: Les étudiants et les résidents noirs sont victimes de racisme dans les facultés de médecine. Cette étude qualitative documente les expériences de racisme des étudiants et des résidents noirs à l'aide de la théorie critique de la race (TCR) et explore leurs mécanismes d'adaptation à l'aide de la métaphore théâtrale. Méthodes: Nous avons mené des entrevues semi-structurées avec quatre étudiants et résidents noirs en médecine (deux étudiants en médecine et deux résidents) étudiant à Montréal et analysé leurs expériences par le biais de contre-récits. Nous avons identifié des thèmes liés à leurs expériences du racisme pendant la formation médicale et à leurs mécanismes d'adaptation. Résultats: Notre analyse révèle que ces expériences de racisme se produisent dans les milieux universitaires et cliniques (cours, stages, interactions sociales avec des pairs, des membres du corps professoral et des patients, et dans le cadre du curriculum), sous la forme de microagressions. L'analyse indique également que les étudiants et les résidents noirs tentent de faire face au racisme en utilisant une stratégie d'hyper-ritualisation pour mieux s'intégrer (par exemple, vêtements, comportements). Conclusion: Étant donné que les étudiants et les résidents noirs sont confrontés à diverses formes de racisme (subtil ou explicite) au cours de leur formation médicale, ces résultats nous incitent à sensibiliser davantage les étudiants, les résidents, les enseignants et les travailleurs de la santé au racisme dans les universités et les hôpitaux universitaires. Les parcours visant à accroître la représentation des étudiants et des résidents noirs semblent faire partie de la solution, mais l'amélioration de l'environnement d'apprentissage doit être une priorité pour atteindre la justice raciale dans la formation médicale au Québec.

Lessons Learned About Trauma Related to Racial Discrimination During COVID-19 in the United States.

Race scholars have discussed how the pandemic has disproportionately burdened marginalized communities and exacerbated pre-existing inequities, particularly for Black Indigenous People of Color (BIPOC) in the United States (U.S.). One glaring social determinant during the time of the COVID-19 is racial discrimination. This chapter will discuss lessons learned regarding the negative impact of discrimination on BIPOC, especially as it pertains to their experiences of trauma. Some of these lessons include (1) the need for clinical psychologist to improve access to treatment through increased research on culturally adaptive interventions, (2) increased research on the effects of race-based trauma on mental health symptomatology, (3) policy and institutional changes that reduce disparities in access to care, and (4) increased education for psychologists around billing procedures for individuals with race-based stress.

Racism, not race: Quantitative analysis of the use of race and racism in the addiction literature.

RATIONALE: Prior research has demonstrated that medical journals rarely mention racism, potentially contributing to an incorrect understanding of and inappropriate interventions for health inequities affecting Black and Brown communities in the US. While this infrequency of mentions of racism has been documented in the general medical literature, it is unknown if this pattern extends to the addiction literature, where some have argued that structural racism has played a specific role in shaping policy and treatment. OBJECTIVE: To assess how frequently the addiction literature for the last 30 years has mentioned race and racism and if these rates vary with social movements. METHODS: We created an algorithm to download and process over 30,000 published articles published from 1990 to 2022 in five major addiction journals: Addiction, Addictive Behaviors, Drug and Alcohol Dependence, Journal of Substance Abuse and Treatment, and International Journal of Drug Policy. Using this data, we reported temporal patterns of mentioning both race and racism across journals and article types. Further, we utilized interrupted time series analysis to identify if the social movements against police violence and the murder of George Floyd in 2020 were associated with significant changes in rates of mentioning racism. RESULTS: While over 30% of the articles in addiction medicine journals included the word race, only 1.5% of articles mentioned racism. Based on an interrupted time series model, after the racial reckoning following the murder of George Floyd in 2020, mentions of racism increased in the addiction literature (OR = 3.21, 95% CI: [2.39, 4.32], P<.001). CONCLUSIONS: A large chasm remains between how often authors mention race versus racism in addiction medicine, a field with a unique history intertwined with structural racism. Addressing inequities in addiction outcomes, including burgeoning inequities in overdose deaths, will require acknowledging racism in the scientific literature.

The effect of social factors on eye movements made when judging the aesthetic merit of figurative paintings.

In the present study we explore how social factors (group contact, individuating experience, implicit racial bias) influence the eye movements made during the visual exploration when judging their aesthetic merit of figurative paintings depicting White and Black sitters. An opportunity sample of participants visiting a gallery in Liverpool viewed ten artworks while their eye movements were recorded and completed a set of individual difference measures. The individual difference measures indicated self-report of art interest, social contact and individuating experience with both Black and White communities, and implicitly held racial bias. The results showed that, despite viewing the paintings for less time, the majority of participants reported paintings showing Black sitters as more interesting, emotionally moving, and pleasurable then those depicting White sitters. However, if a participant reported limited social contact with Black community, and a negative implicit racial bias against them, their rating of aesthetic merit of paintings showing Black sitters was reduced, viewing time increased, and fixations became more focused on faces. The influence of social factors on the viewing of paintings showing White sitters was limited to aesthetic rating. The results are discussed in terms of how social factors influence eye movements when viewing paintings in a real-world setting.