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1.
Med Anthropol Q ; 38(3): 328-341, 2024 09.
Artigo em Inglês | MEDLINE | ID: mdl-38773774

RESUMO

Recent research has unveiled the pervasiveness with which Indigenous patients are subjected to racialized stereotypes within the Canadian health system. Because discrimination in health care is associated with poor health outcomes and undertreated illness, there is a need to better understand how racism is perpetuated systemically in order to rectify the policies, practices, and attitudes that enable it. This article outlines a moral economy of care in emergency departments in western Canada by exploring the discourses that medical professionals employ when discussing cases of medical racism. While these discourses respond to the everyday realities of working in hospitals, they are also rooted in the colonial genealogy of health care in Canada and perpetuated by neoliberal shifts in health care services. By exploring the moral economy of care, this article sheds light on the way pervasive discourses contribute to reproducing and circulating Indigenous-specific racism and its role in decision-making.


Assuntos
Antropologia Médica , Serviço Hospitalar de Emergência , Racismo , Humanos , Racismo/etnologia , Canadá/etnologia , Princípios Morais
2.
Mult Scler Relat Disord ; 86: 105577, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38579569

RESUMO

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


Assuntos
Negro ou Afro-Americano , Lesões Encefálicas Traumáticas , Hispânico ou Latino , Esclerose Múltipla , População Branca , Humanos , Esclerose Múltipla/etnologia , Esclerose Múltipla/diagnóstico , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Lesões Encefálicas Traumáticas/etnologia , Lesões Encefálicas Traumáticas/diagnóstico , Lesões Encefálicas Traumáticas/complicações , Hispânico ou Latino/estatística & dados numéricos , Negro ou Afro-Americano/etnologia , População Branca/etnologia , Estados Unidos/etnologia , Disfunção Cognitiva/etnologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/diagnóstico , Testes Neuropsicológicos , Racismo/etnologia
3.
J Natl Med Assoc ; 116(1): 6-12, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38052698

RESUMO

INTRODUCTION: Part of the difficulty in recruiting and retaining a diverse physician workforce, as well as within medical leadership, is due to racial disparities in medical education. We investigated whether self-identified race-ethnicity is associated with the likelihood of selection as chief resident (CR). MATERIALS AND METHODS: We performed a cross sectional analysis using de-identified person-level data from the GME Track, a national resident database and tracking system, from 2015 through 2018. The exposure variable, self-identified race-ethnicity, was categorized as African American or Black, American Indian or Alaskan Native, Asian, Hispanic, Latino or of Spanish Origin, Native Hawaiian or Pacific Islander, White, and Multi-racial. The primary study outcome was CR selection among respondents in their final program year. Logistic regression was used to estimate the adjusted odds ratios (aOR) and 95% confidence intervals (CI) of CR selection for each racial group, as compared to the White referent group. RESULTS: Among the study population (N=121,247), Black, Asian and Hispanic race-ethnicity was associated with a significantly decreased odds of being selected as CR in unadjusted and adjusted analyses. Black, Asian and Hispanic residents had a 26% (aOR=0.74, 95% CI 0.66-0.83), 29% (aOR=0.71, 95% CI 0.66-0.76) and 28% (aOR=0.72, 95% CI 0.66-0.94) decreased likelihood of becoming CR, respectively. Multi-racial residents also had a decreased likelihood, but to a lesser degree (aOR=0.92, 95% CI 0.89-0.95). CONCLUSIONS: In as much as CR is an honor that sets one up for future opportunity, our findings suggest that residents of color are disproportionately disadvantaged compared to their White peers.


Assuntos
Etnicidade , Internato e Residência , Grupos Raciais , Racismo , Humanos , Estudos Transversais , Etnicidade/estatística & dados numéricos , Hispânico ou Latino/estatística & dados numéricos , Grupos Raciais/estatística & dados numéricos , Estados Unidos/epidemiologia , Brancos , Racismo/etnologia , Racismo/estatística & dados numéricos , Internato e Residência/estatística & dados numéricos , Asiático/estatística & dados numéricos , Indígena Americano ou Nativo do Alasca/estatística & dados numéricos , Negro ou Afro-Americano/estatística & dados numéricos
4.
J Appl Psychol ; 109(2): 238-256, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37796557

RESUMO

The "Bamboo Ceiling" refers to the perplexing phenomenon that, despite the educational and economic achievements of East Asians (e.g., ethnic Chinese, Koreans) in the United States, they are disproportionately underrepresented in leadership positions. To help elucidate this phenomenon, we propose a novel theoretical perspective: East Asians are underselected for leadership positions partially because they are stereotyped as lacking creativity, a prized leadership attribute in U.S. culture. We first tested our proposition in two field studies in a natural setting: Across 33 full class sections of 2,304 Master of Business Administration (MBA) students in a U.S. business program, East Asians were perceived by their classmates as less creative than other ethnicities (e.g., South Asian, White) at the beginning of the MBA program-when the students had limited interactions and thus were likely influenced by creativity stereotypes. Lower perceived creativity mediated why East Asians were less likely than other ethnicities to be nominated (Study 1) and elected (Study 2) as class-section leaders by their classmates. These patterns were robust after accounting for variables such as assertiveness (parallel mediator), leadership motivation, English proficiency, and demographics. These findings were conceptually replicated in two preregistered vignette experiments of non-Asian Americans with managerial experience (Studies 3 and 4, N = 1,775): Compared to candidates of other ethnicities, East Asian American candidates with a substantively identical profile were viewed as less leader-like as a function of lower perceived creativity. Overall, although East Asians are commonly stereotyped as competent, they are also stereotyped as lacking creativity, which can hinder their leadership emergence in U.S. organizations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Criatividade , População do Leste Asiático , Liderança , Racismo , Estereotipagem , Humanos , População do Leste Asiático/psicologia , Escolaridade , Estudantes , Estados Unidos , Racismo/etnologia , Racismo/psicologia
5.
Psychiatry Res ; 330: 115560, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37956588

RESUMO

Racism is a social determinant of mental health which has a disproportionally negative impact on the experiences of psychiatric inpatients of color. Distinct differences in the physical space and clinical settings of two inpatient buildings at a hospital system in the tristate (New York, New Jersey, Connecticut) area of the United States led to the present investigation of racial inequities in the assignment of patients to specific buildings and units. Archival electronic medical record data were analyzed from over 18,000 unique patients over a period of six years. Hierarchical logistic regression analyses were conducted with assigned building (old vs. new building) as the binary outcome variable. Non-Hispanic White patients were set as the reference group. Black, Hispanic/Latinx, and Asian patients were significantly less likely to be assigned to better resourced units in the new building. When limiting the analysis to only general adult units, Black and Hispanic/Latinx patients were significantly less likely to be assigned to units in the new building. These results suggest ethnoracial inequities in patient assignment to buildings which differed in clinical and physical conditions. The findings serve as a call to action for hospital systems to examine the ways in which structural racism impact clinical care.


Assuntos
Disparidades em Assistência à Saúde , Hospitais Psiquiátricos , Racismo , Determinantes Sociais da Saúde , Adulto , Humanos , População Negra , Hispânico ou Latino , Pacientes Internados/psicologia , Pacientes Internados/estatística & dados numéricos , Grupos Raciais/etnologia , Grupos Raciais/psicologia , Grupos Raciais/estatística & dados numéricos , Racismo/etnologia , Racismo/estatística & dados numéricos , Estados Unidos , Hospitais Psiquiátricos/estatística & dados numéricos , Determinantes Sociais da Saúde/etnologia , Determinantes Sociais da Saúde/estatística & dados numéricos , Brancos , Asiático , Disparidades em Assistência à Saúde/etnologia , Disparidades em Assistência à Saúde/estatística & dados numéricos
6.
BMC Public Health ; 23(1): 2039, 2023 10 18.
Artigo em Inglês | MEDLINE | ID: mdl-37853363

RESUMO

BACKGROUND: Growing recognition of racism perpetuated within academic institutions has given rise to anti-racism efforts in these settings. In June 2020, the university-based California Preterm Birth Initiative (PTBi) committed to an Anti-Racism Action Plan outlining an approach to address anti-Blackness. This case study assessed perspectives on PTBi's anti-racism efforts to support continued growth toward racial equity within the initiative. METHODS: This mixed methods case study included an online survey with multiple choice and open-ended survey items (n = 27) and key informant interviews (n = 8) of leadership, faculty, staff, and trainees working within the initiative. Survey and interview questions focused on perspectives about individual and organizational anti-racism competencies, perceived areas of initiative success, and opportunities for improvement. Qualitative interview and survey data were coded and organized into common themes within assessment domains. RESULTS: Most survey respondents reported they felt competent in all the assessed anti-racism skills, including foundational knowledge and responding to workplace racism. They also felt confident in PTBi's commitment to address anti-Blackness. Fewer respondents were clear on strategic plans, resources allocated, and how the anti-racism agenda was being implemented. Suggestions from both data sources included further operationalizing and communicating commitments, integrating an anti-racism lens across all activities, ensuring accountability including staffing and funding consistent with anti-racist approaches, persistence in hiring Black faculty, providing professional development and support for Black staff, and addressing unintentional interpersonal harms to Black individuals. CONCLUSIONS: This case study contributes key lessons which move beyond individual-level and theoretical approaches towards transparency and accountability in academic institutions aiming to address anti-Black racism. Even with PTBi's strong commitment and efforts towards racial equity, these case study findings illustrate that actions must have sustained support by the broader institution and include leadership commitment, capacity-building via ongoing coaching and training, broad incorporation of anti-racism practices and procedures, continuous learning, and ongoing accountability for both short- and longer-term sustainable impact.


Assuntos
Centros Médicos Acadêmicos , Antirracismo , Negro ou Afro-Americano , Equidade em Saúde , Nascimento Prematuro , Racismo Sistêmico , Feminino , Humanos , Recém-Nascido , Nascimento Prematuro/etnologia , Nascimento Prematuro/prevenção & controle , Racismo/etnologia , Racismo/prevenção & controle , Gravidez , Racismo Sistêmico/etnologia , Racismo Sistêmico/prevenção & controle , Centros Médicos Acadêmicos/organização & administração , Centros Médicos Acadêmicos/normas , Internet , Pesquisas sobre Atenção à Saúde , Liderança , Responsabilidade Social , Fortalecimento Institucional
7.
BMJ Open ; 13(10): e073886, 2023 10 29.
Artigo em Inglês | MEDLINE | ID: mdl-37899158

RESUMO

OBJECTIVE: This study has two objectives: first, to explore the diagnostic experiences of black/African American (BAA) patients with lung cancer to pinpoint pitfalls, suboptimal experiences and instances of discrimination leading to disparities in outcomes compared with patients of other ethnic backgrounds, especially white patients. The second objective is to identify the underlying causes contributing to health disparities in the diagnosis of lung cancer among BAA patients. METHODS: We employed a phenomenological research approach, guiding in-depth interviews with patients self-identifying as BAA diagnosed with lung cancer, as well as caregivers, healthcare professionals and community advocates knowledgeable about BAA experiences with lung cancer. We performed thematic analysis to identify experiences at patient, primary care and specialist levels. Contributing factors were identified using the National Institute of Minority Health and Health Disparities (NIMHD) health disparity model. RESULTS: From March to November 2021, we conducted individual interviews with 19 participants, including 9 patients/caregivers and 10 providers/advocates. Participants reported recurring and increased pain before seeking treatment, treatment for non-cancer illnesses, delays in diagnostic tests and referrals, poor communication and bias when dealing with specialists and primary care providers. Factors contributing to suboptimal experiences included reluctance by insurers to cover costs, provider unwillingness to conduct comprehensive testing, provider bias in recommending treatment, high healthcare costs, and lack of healthcare facilities and qualified staff to provide necessary support. However, some participants reported positive experiences due to their insurance, availability of services and having an empowered support structure. CONCLUSIONS: BAA patients and caregivers encountered suboptimal experiences during their care. The NIMHD model is a useful framework to organise factors contributing to these experiences that may be leading to health disparities. Additional research is needed to fully capture the extent of these experiences and identify ways to improve BAA patient experiences in the lung cancer diagnosis pathway.


Assuntos
Negro ou Afro-Americano , Disparidades em Assistência à Saúde , Neoplasias Pulmonares , Racismo , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/etnologia , Recidiva Local de Neoplasia , Pesquisa Qualitativa , Estados Unidos/epidemiologia , Brancos , Disparidades nos Níveis de Saúde , Racismo/etnologia , Racismo/estatística & dados numéricos
8.
Soc Sci Med ; 336: 116245, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37793270

RESUMO

RATIONALE: Known as the "Black-White mental health paradox," Black Americans typically report better mental health than White Americans, despite chronic exposure to the psychologically harmful effects of racism and discrimination. Yet, researchers rarely examine how mental health is experienced across racial groups in economically distressed rural regions where all residents have disproportionately less access to mental healthcare resources. OBJECTIVE: The purpose of this study was to explore how the racialized social system potentially contributes to the mental health beliefs and attitudes of racially majoritized and minoritized rural residents. METHODS: We conducted a secondary analysis of 29 health-focused oral history interviews from Black American (n = 16) and White American (n = 13) adults in rural North Carolina. Through critical discourse analysis, we found nuanced discourses linked to three mental-health-related topics: mental illness, stressors, and coping. RESULTS: White rural residents' condemning discourses illustrated how their beliefs about mental illnesses were rooted in meritocratic notions of individual choice and personal responsibility. Conversely, Black rural residents offered compassionate discourses toward those who experience mental illness, and they described how macro-level mechanisms can affect individual well-being. Stressors also differed along racial lines, such that White residents were primarily concerned about perceived social changes, and Black residents referenced experiences of interpersonal and structural racism. Related to coping, Black and White rural residents characterized the mental health benefits of social support from involvement in their respective religious organizations. Only Black residents signified that a personal relationship with a higher power was an essential positive coping mechanism. CONCLUSIONS: Our findings suggest that belief (or disbelief) in meritocratic ideology and specific religious components could be important factors to probe with Black-White patterning in mental health outcomes. This research also suggests that sociocultural factors can disparately contribute to mental health beliefs and attitudes among diverse rural populations.


Assuntos
Saúde Mental , Racismo , Adulto , Humanos , População Negra/psicologia , Saúde Mental/etnologia , Racismo/etnologia , Racismo/psicologia , População Rural , Brancos , População Branca/psicologia , North Carolina/epidemiologia , Adaptação Psicológica , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia
9.
Int J Soc Psychiatry ; 69(8): 2121-2127, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37665228

RESUMO

BACKGROUND: There is evidence of Indigenous and ethnic minority inequities in the incidence and outcomes of early psychosis. Racism has been implicated as having an important role. AIM: To use Indigenous experiences to develop a more detailed understanding of how racism operates to impact early psychosis outcomes. METHODS: Critical Race Theory informed the methodology used. Twenty-three Indigenous participants participated in four family focus group interviews and thirteen individual interviews, comprising of 9 Maori youth with early psychosis, 10 family members and 4 Maori mental health professionals. An analysis of the data was undertaken using deductive structural coding to identify descriptions of racism, followed by inductive descriptive and pattern coding. RESULTS: Participant experiences revealed how racism operates as a socio-cultural phenomenon that interacts with institutional policy and culture across systems pertaining to social responsiveness, risk discourse, and mental health service structures. This is described across three major themes: 1) selective responses based on racial stereotypes, 2) race related risk assessment bias and 3) institutional racism in the mental health workforce. The impacts of racism were reported as inaction in the face of social need, increased use of coercive practices and an under resourced Indigenous mental health workforce. CONCLUSION: The study illustrated the inter-related nature of interpersonal, institutional and structural racism with examples of interpersonal racism in the form of negative stereotypes interacting with organizational, socio-cultural and political priorities. These findings indicate that organizational cultures may differentially impact Indigenous and minority people and that social responsiveness, risk discourse and the distribution of workforce expenditure are important targets for anti-racism efforts.


Assuntos
Disparidades em Assistência à Saúde , Povo Maori , Transtornos Psicóticos , Racismo , Adolescente , Humanos , Etnicidade , Povo Maori/psicologia , Grupos Minoritários/psicologia , Transtornos Psicóticos/economia , Transtornos Psicóticos/etnologia , Transtornos Psicóticos/psicologia , Transtornos Psicóticos/terapia , Racismo/economia , Racismo/etnologia , Racismo/psicologia , Racismo/estatística & dados numéricos , Disparidades em Assistência à Saúde/economia , Disparidades em Assistência à Saúde/ética , Disparidades em Assistência à Saúde/etnologia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Serviços de Saúde Mental/economia , Serviços de Saúde Mental/ética , Serviços de Saúde Mental/provisão & distribuição , Serviços de Saúde do Indígena/economia , Serviços de Saúde do Indígena/ética , Serviços de Saúde do Indígena/provisão & distribuição , Necessidades e Demandas de Serviços de Saúde/economia , Mão de Obra em Saúde/economia , Ética Institucional , Responsabilidade Social
10.
Dev Psychol ; 59(10): 1892-1905, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37768621

RESUMO

This study investigated 8- to 14-year-old U.S. children's (N = 202, 47% girls, and 49% White) evaluations of statements reflecting individual and structural attributions for the causes of racial inequality between Black and White people in the United States, the epistemic characteristics they used to seek out more information on this topic, and who they believed reflected these characteristics. With age, participants increasingly endorsed statements reflecting structural attributions for racial inequality (i.e., educational and occupational exclusion), and increasingly reasoned about privilege and racism. In contrast, participants did not endorse statements reflecting individual attributions at any age (i.e., group differences in intelligence and effort), instead reasoning about equality between racial groups. Overall, participants sought expertise (i.e., content knowledge) and interpersonal trust (i.e., closeness and support) in a scenario where they could choose a discussion partner to learn more about racial inequality, and were most likely to seek out their family members, though some also sought out their friends, teachers, and the internet or social media. This study provides insights into who children see as relevant sources for learning about racial inequality and their reasons for trusting them. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Negro ou Afro-Americano , Comportamento de Busca de Informação , Aprendizagem , Racismo , Confiança , Brancos , Adolescente , Criança , Feminino , Humanos , Masculino , População Negra , Grupos Raciais , Racismo/etnologia , Racismo/psicologia , Confiança/psicologia , Estados Unidos , Brancos/psicologia , Negro ou Afro-Americano/psicologia
11.
Ann Behav Med ; 57(8): 630-639, 2023 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-37335887

RESUMO

BACKGROUND: Negative interpersonal interactions are associated with acute increases in ambulatory blood pressure (ABP). Yet, the mechanisms underlying this relationship are unclear. PURPOSE: This study tested whether negative interpersonal interactions predict higher ABP both in the moment and during subsequent observations, and whether increases in negative mood mediate these relations. These associations were tested among Black and Hispanic urban adults who may be at higher risk for negative interpersonal interactions as a function of discrimination. Race/ethnicity and lifetime discrimination were tested as moderators. METHODS: Using a 24-hr ecological momentary assessment (EMA) design, 565 Black and Hispanic participants (aged 23-65, M = 39.06, SD = 9.35; 51.68% men) had their ABP assessed every 20 min during daytime accompanied by an assessment of negative interpersonal interactions and mood. This produced 12,171 paired assessments of ABP and self-reports of participants' interpersonal interactions, including how much the interaction made them feel left out, harassed, and treated unfairly, as well as how angry, nervous, and sad they felt. RESULTS: Multilevel models revealed that more intense negative interpersonal interactions predicted higher momentary ABP. Mediation analyses revealed that increased negative mood explained the relationship between negative interpersonal interactions and ABP in concurrent and lagged analyses. Discrimination was associated with more negative interpersonal interactions, but neither race/ethnicity nor lifetime discrimination moderated findings. CONCLUSIONS: Results provide a clearer understanding of the psychobiological mechanisms through which interpersonal interactions influence cardiovascular health and may contribute to health disparities. Implications include the potential for just-in-time interventions to provide mood restoring resources after negative interactions.


Being mistreated by others has been shown to have negative impacts on cardiovascular health, including higher blood pressure (BP) levels. Yet, it is not clear why this mistreatment leads to increased and sustained influences on BP. In this paper, among a sample of Black and Hispanic urban adults, we studied whether changes in negative mood after being treated unfairly, excluded, or harassed explained the reason for higher BP levels. Participants completed reports of how they were treated in recent social interactions, and their levels of negative mood they were feeling at the current moment, every 20 min for 1 day. A BP measurement also occurred at each measurement. We found that negative mood was higher when a person reported being treated unfairly, excluded, and/or harassed, and that the negative mood that followed these negative interpersonal interactions accounted for increases in BP. These results have implications for how mistreatment can lead to chronic illness over time, and provides the potential for providing resources to restore mood and improve BP after mistreatment.


Assuntos
Afeto , Negro ou Afro-Americano , Hispânico ou Latino , Relações Interpessoais , Adulto , Feminino , Humanos , Masculino , Pressão Sanguínea/fisiologia , Monitorização Ambulatorial da Pressão Arterial , Hispânico ou Latino/psicologia , Negro ou Afro-Americano/psicologia , População Urbana , Racismo/etnologia , Racismo/psicologia , Avaliação Momentânea Ecológica , Adulto Jovem , Pessoa de Meia-Idade
12.
Am Psychol ; 78(4): 428-440, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37384498

RESUMO

A. Wade Boykin's scholarship has provided key insights into the psychological realities of racially minoritized people and catalyzed revolutionary changes in psychology and education. Combining insights from personal and research experiences, Boykin authored the foundational triple quandary (TQ), a framework describing how Black Americans must navigate the often conflicting values and priorities of dominant mainstream society, the heritage culture of Black communities, and dynamics associated with being racially minoritized. TQ describes the unique developmental challenges faced by Black children, for whom misalignment between home cultural socialization and U.S. schooling often leads to pathologizing mischaracterizations of their attitudes and behaviors, resulting in chronic academic opportunity gaps. Boykin used his training as an experimental psychologist to empirically test the validity and explanatory utility of the TQ framework and to determine whether Black cultural values could be leveraged to improve student learning. Focusing on cultural values such as expressive movement, verve, and communalism, studies with his collaborators consistently supported Boykin's framework and predictions for improving Black student achievement-related outcomes. Beginning in the early 2000s, Boykin and his colleagues began to scale the lessons of decades of empirical work into the talent quest model for school reform. The TQ and talent quest continue to evolve in their application, as scholars and practitioners have found them relevant to a diverse range of minoritized populations in American society and beyond. Boykin's work continues to bear on the scholarship, career outcomes, and day-to-day lives of many scholars, administrators, practitioners and students across disciplines and institutions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Negro ou Afro-Americano , Cultura , Minorias Étnicas e Raciais , Modelos Psicológicos , Psicologia , Racismo , Criança , Humanos , Sucesso Acadêmico , População Negra/educação , População Negra/história , População Negra/psicologia , Educação/história , Escolaridade , Minorias Étnicas e Raciais/educação , Minorias Étnicas e Raciais/história , Minorias Étnicas e Raciais/psicologia , História do Século XXI , Psicologia/educação , Psicologia/história , Racismo/etnologia , Racismo/psicologia , Instituições Acadêmicas , Comportamento Social/história , Estudantes/psicologia , Estados Unidos , Negro ou Afro-Americano/educação , Negro ou Afro-Americano/história , Negro ou Afro-Americano/psicologia
13.
Child Dev ; 94(6): 1762-1778, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37381797

RESUMO

Racial disparities in school discipline may have collateral consequences on the larger non-suspended student population. The present study leveraged two longitudinal datasets with 1201 non-suspended adolescents (48% Black, 52% White; 55% females, 45% males; Mage : 12-13) enrolled in 84 classrooms in an urban mid-Atlantic city of the United States during the 2016-2017 and 2017-2018 academic years. Classmates' minor infraction suspensions predicted greater next year's defiant infractions among non-suspended Black adolescents, and this longitudinal relation was worse for Black youth enrolled in predominantly Black classrooms. For White youth, classmates' minor infraction suspensions predicted greater defiant infractions specifically when they were enrolled in predominantly non-White classrooms. Racial inequities in school discipline may have repercussions that disadvantage all adolescents regardless of race.


Assuntos
Negro ou Afro-Americano , Punição , Racismo , Instituições Acadêmicas , Estudantes , Brancos , Adolescente , Feminino , Humanos , Masculino , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Instituições Acadêmicas/estatística & dados numéricos , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Estados Unidos/epidemiologia , Brancos/psicologia , Brancos/estatística & dados numéricos , Punição/psicologia , Fatores Raciais/estatística & dados numéricos , Criança , Mid-Atlantic Region/epidemiologia , População Urbana/estatística & dados numéricos , Racismo/etnologia , Racismo/psicologia , Racismo/estatística & dados numéricos
15.
J Youth Adolesc ; 52(6): 1141-1156, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37041426

RESUMO

Ethnic-racial socialization has primarily been examined as a unidirectional, caregiver-directed process. Instead, applying the Theory of Racial Socialization in Action (Smith-Bynum, 2023), the current study observed caregiver-youth conversations about a hypothetical discriminatory experience at school for patterns of dyadic ethnic-racial socialization. Participants were 353 Black (39.7%), Latinx (47.3%), and multiracial/ethnic (13%) pre-adolescents (Mage = 11.19, SD = 0.43; 45.3% female) and their caregivers (94% mothers) with low income from Dallas, Texas. Five subgroups of dyads were identified (High Dyadic Engagement, Parent-Led, Justice Salient Advocates, Child-Dominant and Low Dyadic Engagement) that differed by demographic characteristics of the dyads (e.g., race/ethnicity, caregiver education). Observing ethnic-racial socialization in action with dyads could improve the delivery of interventions to better meet the needs of families.


Assuntos
Negro ou Afro-Americano , Hispânico ou Latino , Relações Mãe-Filho , Racismo , Instituições Acadêmicas , Socialização , Criança , Feminino , Humanos , Masculino , Negro ou Afro-Americano/psicologia , Hispânico ou Latino/psicologia , Mães/psicologia , Identificação Social , Racismo/etnologia , Racismo/psicologia , Texas , Pobreza/etnologia , Pobreza/psicologia , Relações Mãe-Filho/etnologia , Relações Mãe-Filho/psicologia
16.
Am Psychol ; 78(7): 842-855, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-36913280

RESUMO

The significance of youth suicide as a public health concern is underscored by the fact that it is the second-leading cause of death for youth globally. While suicide rates for White groups have declined, there has been a precipitous rise in suicide deaths and suicide-related phenomena in Black youth; rates remain high among Native American/Indigenous youth. Despite these alarming trends, there are very few culturally tailored suicide risk assessment measures or procedures for youth from communities of color. This article attempts to address this gap in the literature by examining the cultural relevancy of currently widely used suicide risk assessment instruments, research on suicide risk factors, and approaches to risk assessment for youth from communities of color. It also notes that researchers and clinicians should consider other, nontraditional but important factors in suicide risk assessment, including stigma, acculturation, and racial socialization, as well as environmental factors like health care infrastructure and exposure to racism and community violence. The article concludes with recommendations for factors that should be considered in suicide risk assessment for youth from communities of color. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Grupos Raciais , Determinantes Sociais da Saúde , Suicídio , Adolescente , Humanos , Indígenas Norte-Americanos/psicologia , Indígenas Norte-Americanos/estatística & dados numéricos , Grupos Raciais/etnologia , Grupos Raciais/psicologia , Grupos Raciais/estatística & dados numéricos , Ideação Suicida , Suicídio/etnologia , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Violência/etnologia , Violência/psicologia , Medição de Risco , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Determinantes Sociais da Saúde/etnologia , Determinantes Sociais da Saúde/estatística & dados numéricos , Racismo/etnologia , Racismo/psicologia , Competência Cultural , Minorias Desiguais em Saúde e Populações Vulneráveis/psicologia
17.
Alzheimers Dement ; 19(7): 3138-3147, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-36724372

RESUMO

INTRODUCTION: Education is correlated with positive health outcomes, but associations are sometimes weaker among African Americans. The extent to which exposure to discrimination and depressive symptoms attenuates the education-cognition link has not been investigated. METHODS: Study of Healthy Aging in African Americans (STAR) participants (n = 764; average age 69 years) completed the Spanish and English Neuropsychological Assessment Scales. We assessed everyday and major lifetime discrimination and depressive symptoms as mediators of education effects on cognition using G-estimation with measurement error corrections. RESULTS: Education was correlated with greater major lifetime and everyday discrimination but lower depressive symptoms. Accounting for discrimination and depressive symptoms slightly reduced the estimated effect of education on cognition. The estimated total effect of graduate education (vs 

Assuntos
Depressão , Envelhecimento Saudável , Idoso , Humanos , Negro ou Afro-Americano , Cognição , Depressão/psicologia , Escolaridade , Racismo/etnologia , Racismo/psicologia
18.
J Natl Med Assoc ; 115(2): 207-222, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36801076

RESUMO

AIMS: While several studies have examined the impact of individual indicators of structural racism on single health outcomes, few have explicitly modeled racial disparities in a wide range of health outcomes using a multidimensional, composite structural racism index. This paper builds on the previous research by examining the relationship between state-level structural racism and a wider array of health outcomes, focusing on racial disparities in mortality from firearm homicide, infant mortality, stroke, diabetes, hypertension, asthma, HIV, obesity, and kidney disease. METHODS: We used a previously developed state structural racism index that consists of a composite score derived by averaging eight indicators across five domains: (1) residential segregation; (2) incarceration; (3) employment; (4) economic status/wealth; and (5) education. Indicators were obtained for each of the 50 states using Census data from 2020. We estimated the Black-White disparity in each health outcome in each state by dividing the age-adjusted mortality rate for the non-Hispanic Black population by the age-adjusted mortality rate for the non-Hispanic White population. These rates were obtained from the CDC WONDER Multiple Cause of Death database for the combined years 1999-2020. We conducted linear regression analyses to examine the relationship between the state structural racism index and the Black-White disparity in each health outcome across the states. In multiple regression analyses, we controlled for a wide range of potential confounding variables. RESULTS: Our calculations revealed striking geographic differences in the magnitude of structural racism, with the highest values generally being observed in the Midwest and Northeast. Higher levels of structural racism were significantly associated with greater racial disparities in mortality for all but two of the health outcomes. CONCLUSIONS: There is a robust relationship between structural racism and Black-White disparities in multiple health outcomes across states. Programs and policies to reduce racial heath disparities must include strategies to help dismantle structural racism and its consequences.


Assuntos
Negro ou Afro-Americano , Disparidades nos Níveis de Saúde , Avaliação de Resultados em Cuidados de Saúde , Racismo Sistêmico , Brancos , Humanos , Lactente , Negro ou Afro-Americano/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Racismo/etnologia , Racismo/estatística & dados numéricos , Racismo Sistêmico/etnologia , Racismo Sistêmico/estatística & dados numéricos , Estados Unidos/epidemiologia , Brancos/estatística & dados numéricos , New England/epidemiologia , Meio-Oeste dos Estados Unidos/epidemiologia
19.
BMC Public Health ; 23(1): 223, 2023 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-36732714

RESUMO

BACKGROUND: Adverse Childhood Experiences (ACEs) are a measure of childhood toxic stress that have a dose-dependent relationship with many adult health outcomes. While ACEs have been validated across diverse populations to measure neglect, abuse, and family dysfunction, they do not specifically assess trauma related to racism/xenophobia and immigration. 54% of Latinx youth in the United States are immigrants or children of immigrants and a large group with potentially unmeasured trauma. This study looks beyond ACEs to identify adverse and protective factors for healthy development among Latinx youth in an agricultural community through the perspectives of their mothers. METHODS: Twenty mothers of adolescent participants in A Crecer: the Salinas Teen Health Study (a prospective cohort study of 599 adolescents) completed semi-structured interviews in Spanish. Interviews focused on mothers' perspectives on community resources, parenting strategies, parenting support systems, and their future aspirations for their children. Four coders completed iterative rounds of thematic coding drawing from published ACEs frameworks (original ACEs, community ACEs) and immigrant specific adverse events arising from the data. RESULTS: Mothers in this study reported adverse experiences captured within community-level ACEs but also distinct experiences related to intergenerational trauma and immigrant-related adversities. The most cited community-level ACEs were housing instability and community violence. Immigrant related adversities included experiences of systemic racism with loss of resources, political instability limiting structural resources, and language-limited accessibility. These were exacerbated by the loss of family supports due to immigration related family-child separation including deportations and staggered parent-child migration. Having experienced intergenerational trauma and systemic oppression, mothers discussed their strategies for building family unity, instilling resilience in their children, and improving socioeconomic opportunities for their family. CONCLUSIONS: Latina mothers shared the impacts of immigrant-related experiences on systemic inequities in the United States which are currently missing from the ACEs framework. Immigrant specific adverse events include language-limited accessibility, or family-child separations, and policies impacting structural resources for immigrant families. Mothers highlighted their capacity to build resilience in their children and buffer impacts of systemic racism. Community-tailored interventions can build on this foundation to reduce health disparities and promote health equity in this population.


Assuntos
Experiências Adversas da Infância , Promoção da Saúde , Racismo , Adolescente , Adulto , Criança , Feminino , Humanos , Hispânico ou Latino , Mães , Estudos Prospectivos , Estados Unidos , Experiências Adversas da Infância/etnologia , Racismo/etnologia , Emigrantes e Imigrantes/psicologia , Resiliência Psicológica , Equidade em Saúde
20.
Clin Child Psychol Psychiatry ; 28(4): 1305-1320, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36210796

RESUMO

INTRODUCTION AND AIMS: Despite growing evidence demonstrating the negative mental health effects of racism-related experiences, racial/ethnic discrimination is seldom examined in youth suicide risk. The present study tested the association between racial/ethnic discrimination and well-supported correlates of suicide-related risk including emotion reactivity and dysregulation, and severity of psychiatric symptoms in a sample of ethnoracially minoritized adolescents receiving outpatient psychiatric services. METHODS: Participants were adolescents (N = 46; 80.4% female; 65.2% Latinx) who ranged in age from 13-20 years old (M=15.42; SD=1.83) recruited from a child outpatient psychiatry clinic in a low-resourced community in Northeast US. Youth completed a clinical interview and a battery of surveys. RESULTS: Findings from separate linear regression models show that increases in frequency of racial/ethnic discrimination were associated with increases in severity of suicidal ideation (SI), independent of emotion reactivity and dysregulation, and symptoms of PTSD and depression. Discriminatory experiences involving personal insults, witnessing family being discriminated, and school-based contexts were uniquely associated with SI. DISCUSSION AND CONCLUSION: Preliminary findings support the association between racial/ethnic discrimination and increased severity of suicide-related risk in ethnoracially minoritized adolescents. Accounting for racial/ethnic discrimination may improve the cultural responsiveness of youth suicide prevention strategies within outpatient psychiatric care.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde , Racismo , Suicídio , Adolescente , Feminino , Humanos , Masculino , Adulto Jovem , Etnicidade/psicologia , Etnicidade/estatística & dados numéricos , Hispânico ou Latino/psicologia , Racismo/etnologia , Racismo/prevenção & controle , Racismo/psicologia , Racismo/estatística & dados numéricos , Ideação Suicida , Suicídio/etnologia , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Grupos Minoritários/psicologia , Grupos Minoritários/estatística & dados numéricos , New England/epidemiologia , Pobreza/etnologia , Pobreza/psicologia , Pobreza/estatística & dados numéricos
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