Confronting the consequences of racism, xenophobia, and discrimination on health and health-care systems.

Racism, xenophobia, and discrimination are key determinants of health and equity and must be addressed for improved health outcomes. We conclude that far broader, deeper, transformative action is needed compared with current measures to tackle adverse effects of racism on health. To challenge the structural drivers of racism and xenophobia, anti-racist action and other wider measures that target determinants should implement an intersectional approach to effectively address the causes and consequences of racism within a population. Structurally, legal instruments and human rights law provide a robust framework to challenge the pervasive drivers of disadvantage linked to caste, ethnicity, Indigeneity, migratory status, race, religion, and skin colour. Actions need to consider the historical, economic, and political contexts in which the effects of racism, xenophobia, and discrimination affect health. We propose several specific actions: a commission that explores how we action the approaches laid out in this paper; building a conversation and a series of events with international multilateral agency stakeholders to raise the issue and profile of racism, xenophobia, and discrimination within health; and using our multiple platforms to build coalitions, expand knowledge, highlight inequities, and advocate for change across the world.

Migrações sul-sul: a recente onda de imigrantes zimbabweanos em Tete - Moçambique (2007-2016) / South-south migration: the recent wave of Zimbabwean immigration in Tete − Moçambique (2007-2016) / Migraciones sur-sur: la reciente ola de inmigrantes zimbabuense en Tete − Mozambique (2007-2016)

O objetivo deste artigo é analisar a dinâmica das migrações internacionais sul-sul a partir do estudo de caso da recente imigração de zimbabweanos para a província de Tete, Moçambique, historicamente uma região de emigração. Nesse sentido, examinamos as características sociodemográficas desses novos imigrantes, assim como as condições e motivações individuais, familiares e estruturais subjacentes ao fluxo migratório. Para tanto, combinamos dados quantitativos provenientes do Censo moçambicano de 2007 e dos registros de trabalhadores imigrantes da Direção Provincial de Trabalho, Emprego e Segurança Social, com entrevistas semiestruturadas junto aos imigrantes zimbabweanos em Tete. Os resultados indicam uma multiplicidade de fatores que contribuíram para a recente onda de imigração em Tete, com destaque, além das motivações econômicas e de subsistência familiares, para aspectos sociais e culturais relacionados à longa tradição da mobilidade intrarregional na África Austral, facilitada por fronteiras relativamente porosas e fortes laços culturais, linguísticos e de parentesco. Discutimos, também, como a instalação de megaprojetos de mineração com capital brasileiro, em Tete, contribuiu para torná-la atrativa como destino migratório, num contexto em que se assistiam violentas ondas de xenofobia contra imigrantes na África do Sul, principal destino das migrações na região.

This article analyses the dynamics of international South-South migration through the case study of the recent immigration of Zimbabweans to the province of Tete, Mozambique, historically a region of emigration. We examine immigrants' socio-demographic characteristics, as well as the individual, family and structural conditions and motivations underlying this new migration flow. The analysis combines quantitative data from the 2007 Mozambican Census and administrative records for immigrant workers from the Provincial Directorate of Labour, Employment and Social Security, with semi-structured interviews with Zimbabwean immigrants in Tete. The results indicate a multiplicity of factors that contributed to the recent wave of immigration in Tete. In addition to economic and subsistence motivations, social and cultural aspects related to the long tradition of intra-regional mobility in Southern Africa, facilitated by relatively porous borders and strong cultural, linguistic and kinship ties, seem to be important. We also discussed how the installation of mining megaprojects with Brazilian capital in Tete, contributed to its appeal as a migrant destination, in a context in which violent waves of xenophobia against immigrants were occurring in South Africa, the main destination for migrants in the region.

El objetivo de este artículo es analizar la dinámica de la migración internacional sur-sur a partir del estudio de caso de la reciente inmigración de zimbabuenses a la provincia de Tete, Mozambique, históricamente una región de emigración. En este sentido, examinamos las características sociodemográficas de estos nuevos inmigrantes, así como las condiciones y motivaciones individuales, familiares y estructurales inherentes a este flujo migratorio. Para este fin, combinamos datos cuantitativos del censo de Mozambique de 2007 y registros de trabajadores inmigrantes de la Dirección Provincial de Trabajo, Empleo y Seguridad Social, con entrevistas semiestructuradas con inmigrantes zimbabuenses en Tete. Los resultados indican una multiplicidad de factores que contribuyeron a la reciente ola de inmigración en Tete, entre los que se destacan, además de las motivaciones económicas y de subsistencia familiar, aspectos sociales y culturales relacionados con la larga tradición de movilidad intrarregional en el sur de África, facilitada por fronteras relativamente porosas y por fuertes lazos culturales, lingüísticos y de parentesco. También discutimos cómo la instalación de megaproyectos mineros con capital brasileño en Tete contribuyó con su atractivo como destino migratorio, en un contexto en el que se asistía a violentas oleadas de xenofobia contra inmigrantes en Sudáfrica, el principal destino de las migraciones en la región.

From margin to center: An Asian Americanist psychology.

In the midst of a global pandemic and movements for racial justice, there is an opportunity to (re)imagine an Asian Americanist psychology that can bring about a more just society. The authors describe the contours of an Asian Americanist psychology that is grounded in historical context, an intersectional analysis, and representational ethics while focusing on community strengths and structural change. The article concludes with calls to action for Asian American psychologists, other psychologists of color, and White psychologists to envision a new era that centers Asian Americans in the multiracial pursuit of social justice. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Need for a population health approach to understand and address psychosocial consequences of COVID-19.

This commentary article provides observations on the psychosocial consequences of the coronavirus disease 2019 (COVID-19) among people in China and articulates a population health perspective to understand and address identified issues. We highlight key psychosocial effects of COVID-19, such as anxiety, insomnia, and trauma response, in the context of salient factors that shape Chinese people's psychological experiences, including the availability of Internet and technology, large-scale quarantine, economic impact, and the rise of xenophobia globally. Further, from a population health perspective, we make recommendations in COVID-19-related research and interventions that aim to promote the psychosocial health of Chinese people. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Local economic benefits increase positivity toward foreigners.

Can exposure to discernible economic benefits associated with the presence of a high-socioeconomic status immigrant group reduce xenophobic and antiforeigner attitudes? We explore this question using the case of Chinese internationals in the United States and an exogenous influx of foreign capital associated with their presence. Using a difference-in-differences design with panel data, along with analyses of pooled cross-sectional data, we find that immigration attitudes, as well as views towards China, became more positive over time among Americans residing in locales whose economies were stimulated by Chinese foreign investments. Our findings have implications for research on public attitudes towards immigration in an era of growing flows of high-socioeconomic status immigrants to the United States and other immigrant-receiving nations.

Xenophobic attitudes, behaviors and coping strategies among Lebanese people toward immigrants and refugees.

PURPOSE: To assess the relationship between xenophobia and the coping strategies and evaluate factors associated with xenophobia in Lebanon. DESIGN/METHODS: This cross-sectional study, conducted between March and July 2017, enrolled 433 participants. RESULTS: Severe xenophobia (ß = 1.46) and female sex (ß = 1.45) were associated with higher problem-focused engagement scores. Participants with a low income had lower problem-focused disengagement score compared to those without income. Moderate (ß = 0.80) and intense xenophobia (ß = 1.38) were significantly associated with higher emotion-focused engagement, whereas female sex was significantly associated with lower emotion-focused engagement (ß = -0.71) and disengagement (ß = -0.83). Being divorced compared to single (ß = 2.32) and female sex (ß = 2.04) were associated with higher xenophobia. PRACTICE IMPLICATIONS: Our study supports the prevalence of xenophobia amongst Lebanese but requires a broader assessment of that trend.

Austerity or Xenophobia? The Causes and Costs of the "Hostile Environment" in the NHS.

During the "age of austerity" the UK government has progressively limited free health services for "overseas visitors" on the grounds of fairness and frugality. This is despite the fact that the cost of the additional bureaucracy required by the new system and the public health consequences are expected to exceed the sums saved. In this article I explore the interaction between the discourses of austerity and xenophobia as they relate to migrants' access to healthcare. By examining the available data and adjudicating various moral arguments, I cast doubt on the claim that the current charging regulations are cost-effective and fair. I instead contend that if the UK is concerned with running a health service that is economically-sustainable and morally-defensible, it is critical that migrants are welcomed, both as staff and as patients. I conclude by arguing that xenophobia has precipitated changes to the health service which do not qualify as "austerity" in the way that is claimed, but rather deliberately produce a "hostile environment" for migrants, despite this very likely generating economic losses.

Why it is unethical to charge migrant women for pregnancy care in the National Health Service.

Pregnancy care is chargeable for migrants who do not have indefinite leave to remain in the UK. Women who are not 'ordinarily resident', including prospective asylum applicants, some refused asylum-seekers, unidentified victims of trafficking and undocumented people are required to pay substantial charges in order to access antenatal, intrapartum and postnatal services as well as abortion care within the National Health Service. In this paper, we consider the ethical issues generated by the exclusion of pregnancy care from the raft of services which are free to all. We argue that charging for pregnancy care amounts to sex discrimination, since without pregnancy care, sex may pose a barrier to good health. We also argue that charging for pregnancy care violates bodily autonomy, entrenches the sex asymmetry of sexual responsibility, centres the male body and produces health risks for women and neonates. We explore some of the ideological motivations for making maternity care chargeable, and suggest that its exclusion responds to xenophobic populism. We recommend that pregnancy care always be free regardless of citizenship or residence status, and briefly explore how these arguments bear on the broader moral case against chargeable healthcare for migrants.

Exercícios ambulatórios para uma reflexão acerca das psicologias sociais e da cidade* / Ambulatory exercises for a reflection upon social psychologies and the city / Ejercicios ambulatorios para una reflexión acerca de las psicologías sociales y urbanas

Penso a relação entre diferentes psicologias sociais e as cidades. Para tanto, caracterizo tais psicologias como manifestantes que foram às ruas em 2013 nas chamadas "jornadas de junho". Faço, a partir desse experimento ficcional, uma reflexão acerca do compromisso ético e dos desafios práticos e epistêmicos que as psicologias sociais enfrentam em diferentes campos empíricos, tais como: a luta por direitos humanos; as políticas públicas; a prática científica e acadêmica; e os movimentos sociais. Neste processo, destaca-se a cidade em sua radical heterogênese como potência de desacomodação das formações estereotipadas que assombram as práticas e as pesquisas em Psicologia Social. Por fim, este texto relaciona estas reflexões com a temática do Encontro Regional Sul da ABRAPSO de 2014, em Londrina, que foi "O clamor das ruas", problematizando a dialética rua x interioridade que é constituinte da subjetividade contemporânea, com vistas à problematização de uma dimensão comum que tem na cidade seu modo de expressão por excelência.(AU)

I think on the relation between different social psychologies and the cities. In order to do that, I figure those social psychologies as demonstrators who took the streets in the so -called June Journeys in 2013. From this fictional experiment I make a reflection about the ethical engagement and the practical and epistemic challenges faced by social psychologies in different empirical fields: human rights struggle; public policies; scientific and academy practices; and social movements. By doing so, the city in its radical hetero engenderment is highlighted as a potential inconvenience to the stereotyped formations that haunts Social Psychology in praxis and research. By the end, this text relates those reflections with the theme from de Regional South Encounter of ABRAPSO in 2014, at Londrina, "The claim from the streets", questioning the dialectics street x interior which is constitutive of the contemporary subjectivity, in order to analyse a common dimension which has in the city its expression par excellence.(AU)

Pienso acerca de la relación de las distintas psicologías sociales y las ciudades. En este objetivo caracterizo estas distintas psicologías sociales como manifestantes que salieron a las calles en las llamadas "días de junio" en 2013. Pienso en la relación entre diferentes psicologías sociales y ciudades. Con este fin, caracterizo tales psicologías como manifestantes que salieron a las calles en 2013 en los llamados "viajes de junio". A partir de este experimento ficticio, reflexiono sobre el compromiso ético y los desafíos prácticos y epistémicos que enfrentan las psicologías sociales en diferentes campos empíricos, tales como: la lucha por los derechos humanos; políticas públicas; práctica científica y académica; y movimientos sociales. En este proceso, la ciudad se destaca en su heterogénesis radical como un poder desencadenante de formaciones estereotipadas que persiguen las prácticas e investigaciones de la Psicología Social. Finalmente, este texto relaciona estas reflexiones con el tema de la Reunión Regional del Sur ABRAPSO 2014 en Londrina, que fue "El clamor de las calles", problematizando la dialéctica calle x interioridad que es un componente de la subjetividad contemporánea, con miras a problematizar una dimensión común que tiene en la ciudad su modo de expresión por excelencia.(AU)

Medical mistrust in the context of Ebola: Implications for intended care-seeking and quarantine policy support in the United States.

This investigation explores Ebola conspiracy beliefs, a form of medical mistrust, and their potential impact on health behavior. Results of an online survey in the United States in December 2014 demonstrated that 16 percent of 202 participants held conspiracy beliefs. Participants who were less knowledgeable about Ebola, more mistrustful of medical organizations, and more xenophobic more strongly endorsed conspiracy beliefs. Participants who more strongly endorsed conspiracy beliefs reported that they would be less likely to seek care for Ebola and were less supportive of quarantining people returning from West Africa. Results suggest that medical mistrust may influence health behaviors during infectious disease outbreaks.

Using differential item functioning to evaluate potential bias in a high stakes postgraduate knowledge based assessment.

BACKGROUND: Fairness is a critical component of defensible assessment. Candidates should perform according to ability without influence from background characteristics such as ethnicity or sex. However, performance differs by candidate background in many assessment environments. Many potential causes of such differences exist, and examinations must be routinely analysed to ensure they do not present inappropriate progression barriers for any candidate group. By analysing the individual questions of an examination through techniques such as Differential Item Functioning (DIF), we can test whether a subset of unfair questions explains group-level differences. Such items can then be revised or removed. METHODS: We used DIF to investigate fairness for 13,694 candidates sitting a major international summative postgraduate examination in internal medicine. We compared (a) ethnically white UK graduates against ethnically non-white UK graduates and (b) male UK graduates against female UK graduates. DIF was used to test 2773 questions across 14 sittings. RESULTS: Across 2773 questions eight (0.29%) showed notable DIF after correcting for multiple comparisons: seven medium effects and one large effect. Blinded analysis of these questions by a panel of clinician assessors identified no plausible explanations for the differences. These questions were removed from the question bank and we present them here to share knowledge of questions with DIF. These questions did not significantly impact the overall performance of the cohort. Group-level differences in performance between the groups we studied in this examination cannot be explained by a subset of unfair questions. CONCLUSIONS: DIF helps explore fairness in assessment at the question level. This is especially important in high-stakes assessment where a small number of unfair questions may adversely impact the passing rates of some groups. However, very few questions exhibited notable DIF so differences in passing rates for the groups we studied cannot be explained by unfairness at the question level.

Organisational perspectives on addressing differential attainment in postgraduate medical education: a qualitative study in the UK.

OBJECTIVES: To explore how representatives from organisations with responsibility for doctors in training perceive risks to the educational progression of UK medical graduates from black and minority ethnic groups (BME UKGs), and graduates of non-UK medical schools (international medical graduates (IMGs)). To identify the barriers to and facilitators of change. DESIGN: Qualitative semistructured individual and group interview study. SETTING: Postgraduate medical education in the UK. PARTICIPANTS: Individuals with roles in examinations and/or curriculum design from UK medical Royal Colleges. Employees of NHS Employers. RESULTS: Representatives from 11 medical Royal Colleges (n=29) and NHS Employers (n=2) took part (55% medically qualified, 61% male, 71% white British/Irish, 23% Asian/Asian British, 6% missing ethnicity). Risks were perceived as significant, although more so for IMGs than for BME UKGs. Participants based significance ratings on evidence obtained largely through personal experience. A lack of evidence led to downgrading of significance. Participants were pessimistic about effecting change, two main barriers being sensitivities around race and the isolation of interventions. Participants felt that organisations should acknowledge problems, but felt concerned about being transparent without a solution; and talking about race with trainees was felt to be difficult. Participants mentioned 63 schemes aiming to address differential attainment, but these were typically local or specialty-specific, were not aimed at BME UKGs and were largely unevaluated. Participants felt that national change was needed, but only felt empowered to effect change locally or within their specialty. CONCLUSIONS: Representatives from organisations responsible for training doctors perceived the risks faced by BME UKGs and IMGs as significant but difficult to change. Strategies to help organisations address these risks include: increased openness to discussing race (including ethnic differences in attainment among UKGs); better sharing of information and resources nationally to empower organisations to effect change locally and within specialties; and evaluation of evidence-based interventions.

Haitianos em São Paulo: exclusão e invisibilidade social no contexto da mobilidade urbana / Not available

A partir de 2004, quando o Exército Brasileiro foi para o Haiti, atendendo aos apelos da ONU e aos interesses diplomáticos e políticos internos, aquele país passou a ser um meio para o Brasil se posicionar no contexto das Relações Internacionais, atuando como pacificador em situações de conflito. Desde a chegada das tropas brasileiras ao Haiti, surgiu uma 'ponte' entre os dois países, abrindo um caminho para os haitianos que não contemplavam nenhuma possibilidade de construção de uma vida digna em seu país migrarem para outro. O Brasil, para eles, tornava-se um destino, no movimento migratório, cheio de idealizadas afinidades culturais, com grande número de negros, festivo, receptivo e àquela época, aparentemente próspero. Apesar da ´ponte´ entre os dois países, os imigrantes, ao chegarem ao Brasil, não encontram nada que idealizaram previamente à sua saída. A cidade de São Paulo, a maior cidade da América Latina poderia ser, em tese, o destino perfeito, com grandes oportunidades de trabalho e uma vida digna Há inúmeras barreiras que esses imigrantes transpõem até chegar à metrópole. Na própria legislação brasileira, que normatiza a condição de imigrante, se verifica resquícios que impedem de atender aos princípios básicos dos Direitos Humanos. No cenário, o objetivo geral desta pesquisa é o registro do fato de como os imigrantes haitianos se relacionam com as características da Capital paulista e da cultura nacional, enfrentando toda ordem de dificuldades e sofrimento social que uma trajetória sem planejamento ou estudo pode oferecer a seus protagonistas. Para consolidar estes objetivos adota-se uma metodologia lastreada no método qualitativo de pesquisa, bem como a etnografia, que humaniza o presente trabalho científico, com relatos reais dos personagens que compõem este cenário. Por fim, em concatenação ao registrado, descreve-se o cenário atual deste fenômeno sociológico

From 2004, when the Brazilian Army went to Haiti, in response to the appeals of the UN and to the internal diplomatic and political interests, that country became a means for Brazil to position itself in the context of International Relations, acting as a peacemaker in situations of conflict. Since the arrival of Brazilian troops in Haiti, a "bridge" has emerged between the two countries, opening a way for Haitians who did not contemplate any possibility of building a decent life in their country to migrate to another. Brazil, for them, became a destination in the migratory movement, full of idealized cultural affinities, with large numbers of blacks, festive, receptive and at that time, apparently prosperous. In spite of the 'point' between the two countries, immigrants, when arriving in Brazil, find nothing they had idealized prior to their departure. The city of São Paulo, the largest city in Latin America could be, in theory, the perfect destination, with great work opportunities and a dignified life There are numerous barriers that these immigrants transpose until reaching the metropolis. In the Brazilian legislation itself, which regulates the status of immigrant, there are remnants that prevent compliance with the basic principles of Human Rights. In the scenario, the general objective of this research is to record the fact that Haitian immigrants are related to the characteristics of the capital of São Paulo and of the national culture, facing any order of difficulties and social suffering that a trajectory without planning or study can offer its protagonists. To consolidate these objectives, a methodology based on the qualitative method of research is adopted, as well as the ethnography, which humanizes the present scientific work, with real reports of the characters that make up this scenario. Finally, in concatenation to the registered, the current scenario of this sociological phenomenon is described