Time and Flesh: Exploring the Embodied Experiences of Black Mothers.

Drawing on Black feminist theories of intersectionality and concepts of temporality and embodiment, this study centers Black girlhood to understand Black girls embodied journeys of "becoming" Black women. Findings revealed that: (a) Black girls often have complicated histories that lead to constrained and liberatory choices in adulthood and motherhood; (b) becoming a Black woman involves continual adaptations to temporal and historical contexts; and (c) Black motherhood is a contested space, deeply shaped by remembering Black girlhood and navigating maternal responses to legacies of harm. This study highlights the challenges and strengths in the transitory states of Black womanhood.

Addressing unique challenges and crafting inclusive policies for Queer living with disabilities.

Background: This article addresses the intersectional challenges faced by Queer people living with disabilities (QPwD). Objectives: The article aims to highlight the nature and extent of their struggles while proposing inclusive policies for societal integration and equality. Amid global efforts to promote Queer rights, discrimination and violence persist, particularly affecting those with disabilities. Method: Drawing upon a comprehensive review of literature and empirical research, this study investigated the experiences of QPwD, identifying key challenges such as limited access to inclusive services, heightened vulnerability to abuse and systemic unemployment. The methodological approach used in this study involves synthesising existing scholarship and empirical evidence to inform the proposed inclusive policies. Results: The findings reveal pervasive barriers encountered by QPwD, including societal stigma, attitudinal biases and physical obstacles. Discrimination in employment, education and healthcare further exacerbates their marginalisation, necessitating proactive measures to address systemic inequalities and promote social inclusion. Conclusion: In conclusion, this article underscores the urgent need for policy reforms and societal interventions to uphold the rights and dignity of QPwD. By advocating for Queer-inclusive workplace policies, enhancing accessibility in public infrastructure and fostering governmental support for equality initiatives, this study contributes to advancing social justice and inclusivity. Contribution: The article calls for concerted efforts to create a more equitable and inclusive society where all individuals, regardless of their sexual orientation or disability status, can thrive and fulfil their potential.

Autoimmune Health Crisis: An Inclusive Approach to Addressing Disparities in Women in the United States.

Autoimmune diseases are identified by the chronic inflammation and tissue damage resulting from unregulated immune responses throughout the body. Systemic lupus erythematosus, type 1 diabetes mellitus, and Hashimoto's thyroiditis are among the 80+ characterized conditions, 80% of which are diagnosed in women. The compounded effects of biological sex and hormones; social identities, such as age, race, and gender; and other determinants on health highlight a pressing need for an inclusive approach to address disparities for women living with autoimmune diseases. Such an approach must recognize and incorporate intersectional experiences of diverse populations of women into biomedical research, clinical practice, and policy solutions. Research must prioritize inclusive designs, data collection, and representation of women in clinical studies. Clinical care must focus on developing guidelines and promoting patient-provider interactions that meet a range of demographic needs. Health care policies must support financial investments in research and equitable access to care. This review provides an overview of the impacts of autoimmune diseases on women's health through an intersectional lens, identifies persistent gaps in addressing the unique needs of women, and proposes recommendations for a comprehensive, equity-focused approach to mitigate disparities and better serve all women at risk for or living with autoimmune diseases.

Lesbian and Gay Population, Work Experience, and Well-Being: A Ten-Year Systematic Review.

Despite an increase in the promotion of equal opportunities at work, there is still persistent discrimination against lesbian and gay (LG) workers. In this vein, this study aimed to systematically review the research investigating the peculiarities of the work experience of LG people, particularly considering the theoretical frameworks in the approach to sexual minorities' work-related issues, as well as individual and contextual variables influencing the work experience and the impact they may have on health and well-being. We explored the PsycArticles, EMBASE, Scopus, and Web of Science electronic databases and the EBSCOHost (PsycInfo, Psychology and Behavioral Sciences Collection) scholarly search engine, between 01/01/2013 to 01/03/2023, with regards to the search terms "lgb*", "gay*", "lesbian*", "homosexual*", and "sexual minorit*", associated with "employee*", "personnel", "worker*", and "staff", and with "workplace", "work", "job", "occupation", "employment", and "career". Data were narratively synthesized and critically discussed. Of the 1584 potentially eligible articles, 140 papers contributed to this systematic review. Five main theoretical frameworks were identified: (a) minority stress, (b) sexual prejudice and stigma, (c) queer and Foucauldian paradigms, (d) social identity theories, and (e) intersectionality. Furthermore, significant individual (e.g., outness, disclosure, and work-family conflict) and contextual (e.g., heterosexist and heteronormative workplace climate and culture) variables influencing LG people's work experience were identified. This review highlights the need to develop a unified theoretical model for the construction of specific measurement tools to assess the work experience of LG people and for the implementation of interventions aimed at minimizing the effects of stigma in work contexts.

Resistance for Disrupting Inequities and Fostering Social Justice in Nursing: A Discussion.

AIMS: The purpose of this paper is to provide a conceptual overview of resistance and argue for the need to embrace resistance as a part of nurses' professional repertoire for disrupting inequities and fostering social justice in both nursing education and practice. DESIGN: Discursive article. DATA SOURCES: Published peer reviewed literature on 'resistance' and 'professional resistance' in nursing, medicine, social work and other allied health care professions. RESULTS: Enhancing critical consciousness and engaging in intersectional collaboration are promising strategies to embrace resistance for collective action towards disrupting inequities and injustices in nursing education and practice. CONCLUSION: Embracing and legitimising resistance in everyday individual and social interactions in educational and practice settings is instrumental to fostering social justice in nursing. Without resistance, nurses may risk jeopardising enactment of moral and ethical responsibilities and suppressing their professional values of caring and compassion. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Nurses can embrace resistance in practice to counteract social injustice and promote diversity, equity, inclusion and belonging and antiracism in clinical and educational settings. IMPACT: Research demonstrated that perceived and real inequities and injustices are common in nursing in the form of individual and structural racism, sex and gender discrimination, power imbalances and incivility. Nurses' engagement in resistance and increased capacity to resist injustices and incivilities can play an instrumental role in disrupting professional inequities in clinical practice and education. PATIENT AND PUBLIC CONTRIBUTION: There was no patient or public involvement in the design or writing of this discursive article.

An intersectional approach on menstrual inequity as lived by women in circumstances of socioeconomic vulnerability in an urban and rural setting in Spain: a qualitative study.

Since menstrual health and menstrual inequity are determined by social power structures, this study proposes to analyse, from an intersectional perspective, the experiences of menstrual inequity of women and people who menstruate (PWM) (≥18 years) under circumstances of socioeconomic vulnerability in an urban and rural setting in Catalonia (Spain), focusing on menstrual poverty, menstrual management and access to health care for menstrual health. An exploratory and interpretative qualitative study was conducted. Venue-based convenience sampling was carried out, recruiting women from a non-governmental organisation and a primary health care centre. Eighteen individual semi-structured interviews were conducted between October 2022 and February 2023. Data were analysed through reflexive thematic analysis. Analysis revealed that menstrual care was generally a distant preoccupation that revolved around circumstances of socioeconomic vulnerability, housing, and productive/reproductive work. Menstrual poverty, menstrual management and menstrual self-care challenges, barriers to accessing health care for menstrual health, and menstrual taboo, stigma and discrimination were commonplace and deepened by socioeconomic vulnerability. In this way, women's menstrual experiences were rooted in intersecting axes of inequity, based on gender, race and class. Intersectional and critical participatory research, policy and practice are imperative to develop counter mechanisms that confront systems of privilege-oppression to modulate menstrual experience, health and equity.

This study investigates menstrual inequity among women living in difficult socioeconomic conditions in urban and rural areas of Catalonia, Spain. The study uses an intersectional approach to understand how forms of discrimination­such as sexism, racism, and classism­affect women's menstrual experiences. Between October 2022 and February 2023, we recruited and interviewed 18 women via an NGO and a primary health care centre. We focused on three areas: (1) What access women had to products like pads or tampons, (2) How women used menstrual products and dealt with symptoms like pain, and (3) How women accessed health care for problems related to menstruation. We found menstrual care is often not a top priority for women who face economic difficulties, are in unstable housing, have demanding work and/or are carers. These women often struggle to access menstrual products, manage their periods effectively, get necessary health care, or overcome menstrual stigma. These challenges are made worse by the combined effects of gender, race, and class, showing how different forms of discrimination can reinforce one another. We conclude that more inclusive research is needed. Changes in policy and practice to address these compounded inequities and improve menstrual health and equity are essential.

Moving towards transformative justice for black women survivors of intimate partner violence: an intersectional qualitative study.

BACKGROUND: Intimate partner violence (IPV) disproportionately affects Black women, yet the current IPV justice response, relying on the criminal legal system, often fails them due to racialized, sexist stereotypes that disrupt Black women's claims to survivorship. Transformative justice, a community-based approach designed to repair harm between the survivor and person who caused harm and transform the social conditions that perpetuate violence, may be a promising alternative approach to facilitate justice and accountability for IPV. However, little is known about the justice preferences of Black women IPV survivors. This qualitative study sought to understand Black women IPV survivors' experiences interacting with police and their justice preferences following IPV. METHODS: Semi-structured interviews with 15 Black women IPV survivors were conducted between April 2020 and April 2022. Inductive analytic techniques derived from grounded theory were used to contextualize Black women IPV survivors' experiences. RESULTS: One theme was identified that aligned with Black women IPV survivors' experiences interacting with the police: 1) fear and distrust. Four themes were identified that aligned with justice preferences: (1) resolution through dialogue, (2) therapy and counseling services, (3) resource support, and (4) protection and prevention for children. Fear and distrust of the police was mainly driven by anticipated discrimination. Survivors' justice preferences encompassed solution-based dialogue between the survivor and person who caused harm mediated by family and trusted individuals in the community, therapy services, housing support, and attention to preventing the intergenerational cycle of IPV for children as part of a community-based, holistic justice response. CONCLUSIONS: Police interactions as part of the current justice response were counterproductive for Black women IPV survivors. Black women IPV survivors deserve alternative forms of justice and accountability for IPV. As an alternative justice response to IPV, transformative justice can encompass their justice preferences and promote equity and center Black women IPV survivors and their communities.

Examining the Emergency Department Care Experiences of Equity-Deserving Groups Using an Intersectional Lens.

INTRODUCTION: Equity-deserving groups (EDGs) face societal barriers, including healthcare barriers within the emergency department (ED), due to discrimination. Most patient-care experience research considers only a single-axis perspective, neglecting multifaceted impacts of discrimination, or intersectionality. METHODS: Detailed is a secondary analysis of a mixed-methods, cross-sectional study conducted at the Kingston Health Sciences Centre (KHSC) between June and August 2021. A quantitative analysis was conducted to identify differences between participants who did not identify as equity-deserving (controls), and those who identified with 1, 2, or 3 EDGs, respectively. The research team conducted thematic analysis on the shared micronarratives to contextualize the quantitative results. The research team also held focus groups with community partners that served EDGs to gain their insights on study findings and add their perspectives to the captured themes. RESULTS: Comparing 1973 individuals belonging to none, 1, 2, or 3 EDGs revealed significant differences in patient-perceived attention to their needs (P < .001), patient-control in health care decision-making (P = .001), and whether quality medical care or experiencing kindness/respect was more important (P = .003). Three themes were identified: stigma and discrimination, lack of patient-centered care, and need for improved patient-provider communication. CONCLUSION: The study's findings contribute to a sparse body of evidence on EDG-care experiences in the ED through an intersectionality lens. Future research efforts should evaluate the complex interactions of specific EDG memberships to improve care experiences.

Black Women in Medical Education Publishing: Bibliometric and Testimonio Accounts Using Intersectionality Methodology.

BACKGROUND: Black women in academic medicine experience racial and gender discrimination, all while being tasked with improving a flawed system. Representation of Black women in medicine remains low, yet they bear the burden of fostering diversity and mentoring trainees, exacerbating their minority tax and emotional labor, and negatively impacting career progression. OBJECTIVE: To complement qualitative accounts of Black women authors in the medical education literature with a quantitative account of their representation. We used statistical modeling to estimate the representation of Black women authors in medical education publishing as compared to other groups. DESIGN: An intersectional methodology employing bibliometric analysis and testimonio reflection. SUBJECTS: US-based authors of journal articles published in medical education journals between 2000 and 2020. MAIN MEASURES: Author race was determined using a probability-based algorithm incorporating US Census data, and author gender was ascribed using Social Security Administration records. We conducted two negative binomial generalized linear models by first and last author publications. Metadata for each article was retrieved from Web of Science and PubMed to include author names, country of institutional affiliation, and Medical Subject Headings (MeSH). Results were contextualized via the "testimonio" account of a Black woman author. KEY RESULTS: Of 21,945 unique authors, Black women (and other racially minoritized groups) published far fewer first and last author papers than white women and men. In addition, major MeSH terms used by Black women authors reveal little overlap with highly ranked medical education topics. The testimonio further narrated struggles with belonging and racial identity. CONCLUSION: This study revealed that Black women are underrepresented in medical education publishing. We believe that dismantling oppressive structures in the publishing ecosystem and the field is imperative for achieving equity. Additionally, further experiential accounts are needed to contextualize this quantitative account and understand underrepresentation in medical education publishing.

An Intersectional Approach to Cervical Cancer Screening Disparities by Race/Ethnicity and Immigrant Status.

Background: Disparities in cervical cancer (CC) screening exist within racial/ethnic minority and immigrant groups. However, few studies have explored the joint influence of race/ethnicity and immigrant status on screening, and the disparities that have been identified by existing studies remain incompletely explained. This study aims to identify the joint influence of race/ethnicity and immigrant status on CC screening and elucidate the barriers contributing to identified disparities. Methods: A cross-sectional analysis of 25,660 U.S. women from the 2005, 2010, and 2015 National Health Interview Surveys was done. The CC screening up-to-date status of cases was analyzed by race/ethnicity and immigrant status using logistic regression models. Conceptualized mediators were added to models to identify their contribution to identified disparities. Results: All immigrants had lower screening odds than U.S.-born non-Hispanic White women with foreign-born non-Hispanic Asians having the lowest odds (adjusted odds ratio [aOR]: 0.36, 95% confidence interval [CI]: 0.26-0.49) followed by foreign-born non-Hispanic White (aOR: 0.52, 95% CI: 0.36-0.76), Hispanic/Latinx (aOR: 0.58, 95% CI: 0.47-0.73), and non-Hispanic Black women (aOR: 0.62, 95% CI: 0.38-0.99). Adjusting for only socioeconomic status or access to care attenuated the aOR: for foreign-born Hispanic/Latinx and non-Hispanic Black women only. Adjusting simultaneously for language and acculturation attenuated the aOR: for all immigrants. Conclusions: Disparities in CC screening were only found in the immigrant populations of various racial/ethnic groups. Targeting insurance and health care access may address disparities in immigrant Hispanic/Latinx and non-Hispanic Black women. Focusing on culturally and linguistically competent care and education may be more crucial for immigrant non-Hispanic Asian and White women.

Reflecting sex, social class and race inequalities in reproduction? Study of the gender representations conveyed by 38 fertility centre websites in 8 European countries.

BACKGROUND: Fertility centre websites are a key sources of information on medically assisted reproduction (MAR) for both infertile people and the general public. As part of a global fertility market, they are also a window to attract potential future patients. They give formal and practical information but in the way the information is displayed, they also convey social representations, and in particular, gender representation in its intersectional dimension. The objective is to analyse the sex, class and race representations regarding reproduction and parenthood that are embedded in the content of fertility centre websites in eight European countries. METHODS: The 5 most visible fertility centres that appeared in the first places on Internet search were selected for each country under study, except for one country which has only three fertility centres. In total, 38 fertility centre websites were considered for a thematic analysis using an iterative approach and a comprehensive perspective. RESULTS: Each centre details its services and techniques according to the legal provisions in force in its country. However, on all the websites studied, the fertility centres demonstrate a strong gendered representation. The logos generally depict women or parts of their bodies, as do the photos, which mainly show white women with light eyes. The description of the causes of infertility and the techniques offered by the centres also highlights gender differences. Sperm donation, where MAR is reserved for heterosexual couples, is included among the techniques for women with the comment that it will enable them to fulfil their dream of becoming mothers. CONCLUSIONS: MAR, and through it the project of having a child and procreative work, is presented as a matter for white, cisgender and heterosexual women, thus fueling stratified reproduction and limiting reproductive justice. The research team formulated guidelines for fertility centres to encourage them to adopt a more inclusive approach in terms of sex, social class and race, so that the diversity of infertile people feel involved and welcome in these centres, to avoid misperceptions about infertility in the general population and to reinforce autonomy and justice in reproductive matters.

Fertility centre websites are a key sources of information on medically assisted reproduction (MAR) for both people undergoing MAR and the general public. As part of a global fertility market, they may also be a window to attract potential future patients. In this context, they convey formal and practical information but also, through their content, narratives and visuals, social representations. The objective is here to analyse the gender representations of reproduction and parenthood that the 38 European fertility centres under study convey through the texts and images they display on their websites. Each centre details its services and techniques according to the social and legal provisions in force in its country. However, on all the websites studied, the fertility centres demonstrate a strong gendered representation, including in terms of social class and race. MAR, and through it the project of having a child and procreative work, is presented as a matter for white, cisgender and heterosexual women, thus fueling stratified reproduction and limiting reproductive justice.

Centering Social Justice and Equity in Research on Accessibility to Public Buildings for Individuals with Mobility Disabilities: A scoping review.

Purpose: To explore how principles of social justice and equity are integrated into research concerning accessibility to public buildings for individuals with mobility disabilities. Methods: Utilising a scoping review methodology to assess literature based on the criteria set by the Joanna Briggs Institute, seven databases were screened. Studies were selected using the framework: "persons with mobility disabilities" AND "accessibility" AND "public buildings". A theoretical framework helped to extract codes and develop themes through an inductive-deductive analysis method. The results are presented descriptively. Results: The examination of 84 studies uncovered a complex interplay between agencies, systemic challenges, discriminatory practices, and societal attitudes perpetuating marginalisation of individuals with mobility disabilities in their access to public buildings. The recommendations emphasize importance of practical measures, research imperatives, and policy developments to promote inclusivity. We present a 'Ten-step approach' to integrate social justice and equity into research on accessibility in public buildings for people with mobility disabilities. Conclusion: Integrating diversity, active participation, and inclusive methodologies are essential to address systemic issues, discriminatory practices, and societal attitudes that hinder accessibility and inclusion. Collaborations with diverse stakeholders are crucial for policy changes, resource allocation, and advancing social justice and equity in accessibility research and practice.

Teaching Family? Care/Work Policy in Selected Family Courses in Canada's Research-Intensive Universities.

To what degree is explicit care/work policy taught in family courses in Canada's leading research-intensive universities? We analyze family courses in sociology departments and in political studies and women's/gender studies programs in Canada's 15 R1 universities to make a contribution to the scholarship of teaching and learning. This national scan marks a methodological innovation from curriculum studies that generally adopt a single-program or single-site focus. From a Canadian universe of 74 family courses, we identify 15 whose formal course calendar description explicitly addresses care/work family policy (measures to reconcile caring for young children with employment, through early learning and childcare, parental leaves, and child benefits). Sociology predominates among courses where family policy is taught, yet care/work policy content is not common. Given growing concerns about the care crisis and the care deficit in Canada, the low profile of care/work family policy content in family courses is significant. This study sheds light on the value of national postsecondary education curricular reviews and suggests that family curriculum renewal is warranted.

Understanding the Intersection of Identity and Cancer Experience Among Racially, Ethnically, Gender and Sexual Minoritized Adolescents and Young Adults With Cancer.

OBJECTIVES: Adolescents and young adults (AYAs, 18-39 years) with cancer identifying as racially/ethnically minoritized or 2SLGBTQIA+ (Two-Spirit, lesbian, gay, bisexual, transgender, queer, intersex, asexual and "+" referring to other queer identities) have been underrepresented in cancer research. This study explores the aspects of identity that hold significance for these minoritized AYAs and how these facets impact their healthcare experiences. METHODS: Eligible participants comprised English-speaking AYAs who self-identified as racially/ethnically minoritized and/or 2SLGBTQIA+, were diagnosed with cancer between the ages of 15-39, currently aged > 18, and had received or were receiving cancer care within Canadian healthcare system. Additionally, four patient partners meeting the same criteria were recruited as research collaborators. Semi-structured one-on-one virtual interviews guided by an interview script were conducted, and qualitative analysis employed a framework approach. RESULTS: We recruited 23 participants from 4 Canadian provinces (mean age: 28, Range: 20-44); 17 identified as racially/ethnically minoritized, one as sexual/gender minoritized, and five as racially/ethnically and sexually/gender minoritized. Participants emphasized that their culture/ethnicity, religion/spirituality, sexuality, gender, family, career, and being an immigrant are important aspects of their identity, with only one participant recognizing their identity as a "person with cancer". A cancer diagnosis altered the aspects of identity deemed most significant by participants. Both visible and invisible aspects of identity shaped participants' experiences and influenced their level of trust in the healthcare system. CONCLUSION: Racially, ethnically, gender, or sexually minoritized AYAs with cancer place considerable importance on aspects of their identity that are shaped by their respective communities. Recognizing and respecting these identities are paramount for healthcare professionals to deliver safe and inclusive care.

You can't be too many things: the experiences of gender-affirming care for trans people of color - a thematic analysis.

Background: Barriers to healthcare and negative healthcare experiences are frequently reported by transgender people, which is known to be compounded by intersectional issues including racism. Aims: The present study aimed to explore the experiences of trans people of color accessing a national Gender Service in the United Kingdom, to better understand the facilitators and barriers to positive healthcare experiences. Methods: Six transgender people of color attended two separate focus groups. Thematic analysis was used to identify themes in the data. Results: Three themes were identified: The Western-biased model of gender-affirming care; the lack of diversity in support provided throughout medical transition; and lack of visibility and community. Participants talked of various ways in which their ethnicity and cultural backgrounds raised apprehensions and negative experiences within their gender-related care, such as assumptions being made about their transition process, and a general lack of visibility such as not seeing examples of the outcomes of surgeries and in community spaces. Conclusions: The findings are discussed in relation to previous research, noting that culturally-inclusive models of transition, increased access to diverse, inclusive community spaces and further research in this field is needed to improve healthcare experiences.

Perceived discrimination and refraining from seeking physician's care in Sweden: an intersectional analysis of individual heterogeneity and discriminatory accuracy (AIHDA).

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.

The Causes and Consequences of Stigma among Individuals Involved in the Criminal Legal System: A Systematic Review.

The purpose of this study was to systematically review the types of stigmatized attributes that have been assessed and the causes and consequences of stigma for individuals involved in the criminal legal system. PubMed, GoogleScholar, and PsycInfo databases were searched to identify studies for inclusion through March 2021. Eligible studies were peer-reviewed, quantitative, and assessed stigma from the perspective of the person involved in the criminal legal system. 59 studies were included (total n=21,738), assessing stigma associated with criminal involvement, HIV, substance use, race/ethnicity, help-seeking, and others. Experiencing criminal involvement stigma was linked to poor well-being, but less so for racial/ethnic minorities. Experiencing racial/ethnic stigma was associated with recidivism risk, and substance use stigma was associated with substance use risk. Several stigmas intersected to impact treatment engagement and well-being. In conclusion, individuals involved in the criminal legal system experience many stigmatized statuses that impact their well-being, treatment adherence, community integration, and criminal behavior. Stigma must be addressed among individuals involved in the criminal legal system and the systems they interact with to reduce health inequity and recidivism risk.

A Novel Time Use Approach on Daily Active Engagement with Life: The Intersectionality of Race and Gender.

BACKGROUND AND OBJECTIVES: Active engagement with life (AE) is an integral aspect of successful aging. Using time diary data, this study explored how U.S. older adults structure their daily lives involving social participation and productive engagement, and the extent to which these patterns differ by race and gender. RESEARCH DESIGN AND METHODS: We used American Time Use Survey (ATUS) data (n = 17,990) and sequence and cluster analyses to identify distinctive daily AE patterns. Multivariable linear regression models were used to evaluate associations between AE patterns and self-rated health, and the moderating roles of race and gender. RESULTS: Five AE clusters were identified: Low Degree of AE (26%), Moderate Unpaid Work & Light Social Participation (39%), Persistent Unpaid Work (20%), Persistent Paid Work (10%), and Persistent Social Participation (4%). White women were the most likely and Black men the least likely to have any AE. Compared to "Low Degree of AE", all other AE clusters were associated with better self-rated health, with these associations varying by gender and race. The strongest positive association was observed for "Persistent Paid Work", especially among women. Racial differences in the association between AE and health were more prominent among women than men. Differences by AE were less pronounced among Black women in comparison to White women. DISCUSSION AND IMPLICATIONS: We found that the association between AE and self-rated health varies by race and gender. Persistent structural barriers may prevent older adults from historically minoritized backgrounds, particularly Black women, from benefiting from AE.