COVID-19 amplified racial disparities in the US criminal legal system.

The criminal legal system in the USA drives an incarceration rate that is the highest on the planet, with disparities by class and race among its signature features1-3. During the first year of the coronavirus disease 2019 (COVID-19) pandemic, the number of incarcerated people in the USA decreased by at least 17%-the largest, fastest reduction in prison population in American history4. Here we ask how this reduction influenced the racial composition of US prisons and consider possible mechanisms for these dynamics. Using an original dataset curated from public sources on prison demographics across all 50 states and the District of Columbia, we show that incarcerated white people benefited disproportionately from the decrease in the US prison population and that the fraction of incarcerated Black and Latino people sharply increased. This pattern of increased racial disparity exists across prison systems in nearly every state and reverses a decade-long trend before 2020 and the onset of COVID-19, when the proportion of incarcerated white people was increasing amid declining numbers of incarcerated Black people5. Although a variety of factors underlie these trends, we find that racial inequities in average sentence length are a major contributor. Ultimately, this study reveals how disruptions caused by COVID-19 exacerbated racial inequalities in the criminal legal system, and highlights key forces that sustain mass incarceration. To advance opportunities for data-driven social science, we publicly released the data associated with this study at Zenodo6.

Race and school enrollment among the children of African immigrants in the United States.

This study examines whether previous findings of an immigrant schooling advantage among Blacks in the United States reflect a declining significance of race in the enrollment patterns of immigrants' children. Using data from the 2000 US census, the study finds that, despite their advantage within the Black population, the children of Black Africans are collectively disadvantaged relative to the children of White Africans. Disparate enrollment trajectories are found among children in Black and White African families. Specifically, between the first and second generations, enrollment outcomes improved among the children of White Africans but declined among Black Africans' children. The results also suggest that among immigrants from African multi-racial societies, pre-migration racial schooling disparities do not necessarily disappear after immigration to the United States. Additionally, the children of Black Africans from these contexts have worse outcomes than the children of other Black African immigrants and their relative disadvantage persists even after other factors are controlled.

White on black: can white parents teach black adoptive children how to understand and cope with racism?

In this article, the authors examine White parents' endeavors toward the racial enculturation and inculcation of their transracially adopted Black children. Drawing on in-depth interviews, the authors identify and analyze themes across the specific race socialization strategies and practices White adoptive parents used to help their adopted Black children to develop a positive racial identity and learn how to effectively cope with issues of race and racism. The central aim of this article is to examine how these lessons about race help to connect family members to U.S. society's existing racial hierarchy and how these associations position individuals to help perpetuate or challenge the deeply embedded and historical structures of White supremacy. The authors use the notion of White racial framing to move outside of the traditional arguments for or against transracial adoption to instead explore how a close analysis of the adoptive parents' racial instructions may serve as a learning tool to foster more democratic and inclusive forms of family and community.

"We were all trespassers": George Edward Lemmon, Anglo-American cattle ranching, and the Great Sioux Reservation.

With the opening of the Black Hills to white settlement in the mid-1870s, thousands of fortune-seekers made their way into Dakota Territory. George Edward Lemmon, a man later renowned as one of the world's most accomplished cowboys, was among them. During the 1880s his employer, the Sheidley Cattle Company, grazed thousands of cattle in western Dakota Territory, many of them on Sioux Indian land. Indeed, the company owed a great deal of its success to illegal grazing on the Great Sioux Reservation. Opportunists such as Lemmon supported Indian reservations because they could use those lands to make a profit. The interaction between large-scale white ranchers and the Indians of the Great Sioux Reservation provides insight into the development of the range cattle industry in the northern Great Plains and illuminates the motivations that led many ranchers to support, rather than oppose, the reservation system.

Bad blood: poverty, psychopathy and the politics of transgression in Kenya Colony, 1939-59.

This article examines the inter-relationship between psychiatry and sex, both fertile fields within the recent historiography of colonialism and empire. Using a series of case files pertaining to European patients admitted to the Mathari Mental Hospital in Nairobi during the 1940s and 1950s, this article shows how sexual transgression among colonial Europeans precipitated, and was combined with, mental distress. Considering psychiatric treatment as a form of social control, the article investigates a number of cases in which a European patient had been perceived to have transgressed the normative sexual behaviour codes of settler society in Kenya. What these files suggest is that transgressive sexuality in Kenya was itself framed by indices, as insistent as they were uncertain, of gender, race and class. While psychiatry as social control has some degree of purchase here, more valuable is an attempt to discern the particular ways in which certain forms of sexual behaviour were understood in diagnostic terms. Men who had sex with Africans, we see, tended to be diagnosed as 'depressed' on arrival at the hospital but were judged to be mentally normal consequently. Women, by contrast, were liable to be diagnosed as psychopathic, a diagnosis, I argue, that helped to explain the uniquely transgressive status of impoverished European women living alone in the margins of white society. Unlike white men, moreover, women did not have to have sex with non-Europeans to transgress sexual codes: this is because female poverty was a sexual problem in a way that male poverty decidedly was not. Poor white women were marked by uncertainty over their sexual behaviour­and dubious racial identity in its turn­and the problem of social contamination was described by reference both to the polluted racial ancestry of an individual and to the prospective contamination of healthy racial stocks. This article aims to address current historical debates around sex and empire, 'white subalternity' and the social history of psychiatry and mental health. All names have been changed to protect patient anonymity.

Alcohol use, abuse, and treatment in people of African descent.

The use and abuse of alcohol is prevalent in many nations across the globe, but few studies have examined within-group differences found in people of African descent in the United States, in Africa, and in the Caribbean. A review of current research about alcohol use, abuse, and treatment in people of African descent is presented, including information about risk factors and contributors to alcohol use. Examples of education and prevention interventions are also described. Finally, conclusions based on the review of the research literature as well as recommendations for future research are explained.

Cultural remains in local and regional context on the central Alaska Peninsula: housepits, language, and cultural affinities at Marraatuq after 1000 B.P.

Professor Dumond's research on the Alaska Peninsula provided information that prior to 1,000 years ago people of both sides of the Alaska Peninsula shared material culture and exhibited subsistence interests that persisted into historic times, During the Late Precontact Era (ca. 1100 A.D. to mid-1700s) these Alutiiq societies shared cultural traits including language, house styles, and material culture with their relatives and neighbors on Kodiak Island. Until recently, few data were available regarding potential variability in house construction techniques, or styles and functions of Alutiiq semi-subterranean houses of this era found on the Alaska Peninsula, This paper provides examples of a few known prehistoric and historic Alaska Peninsula and Kodiak Alutiiq houses and presents previously unreported data from archaeological tests at Marraatuq on the Central Alaska Peninsula, Taken together with Dumond's 1998-1999 field work at Leader Creek and archaeological research on Kodiak Island, the work provides further evidence that interregional interaction was strong during the Late Precontact Era. However, large population centers and ranked political hierarchies probably were not hallmarks of central Alaska Peninsula communities during the Late Precontact Era and historic times as they were on the Kodiak and Aleutian islands.

The end of the Kachemak tradition on the Kenai Peninsula, southcentral Alaska.

The Kachemak tradition was established by ca. 3000 B.P. in Kachemak Bay. Probably somewhat later a variant termed Riverine Kachemak, with a population adapted to salmon and terrestrial resources, appeared on the northern Kenai Peninsula. The Kachemak tradition people seem to have abandoned Kachemak Bay by ca. 1400 B.P. Seven of 12 available Kachemak tradition dates predate 1400 B.P. even at two sigma. Scattered younger dates are thus suspect outliers. The end of Riverine Kachemak tradition has been placed at ca. 1000 B.P., at which time the population was supposedly replaced by in-migrating groups ancestral to the Dena'ina Athapaskans. Close examination of the numerous available radiocarbon dates shows that most Riverine Kachemak dates cluster in the early centuries of the First Millennium A.D. and most Dena'ina dates substantially postdate 1000 A.D. Probably the Riverine Kachemak and Dena'ina peoples never met on the Kenai River. However, the correspondence in date ranges between Kachemak Bay and Riverine Kachemak is striking, suggesting their fates were linked. Both traditions collapsed by 1400-1500 B.P. The causes are probably multiple but do not include cultural replacement.

Patenting race.

As genetic databases continue to yield new insights and inventions, the commercial incentive to conflate race and genetics may be hard to resist.

Racial and Ethnic Disparities in Meeting MTM Eligibility Criteria Based on Star Ratings Compared with the Medicare Modernization Act.

BACKGROUND: Previous research found racial and ethnic disparities in meeting medication therapy management (MTM) eligibility criteria implemented by the Centers for Medicare & Medicaid Services (CMS) in accordance with the Medicare Modernization Act (MMA). OBJECTIVE: To examine whether alternative MTM eligibility criteria based on the CMS Part D star ratings quality evaluation system can reduce racial and ethnic disparities. METHODS: This study analyzed the Beneficiary Summary File and claims files for Medicare beneficiaries linked to the Area Health Resource File. Three million Medicare beneficiaries with continuous Parts A, B, and D enrollment in 2012-2013 were included. Proposed star ratings criteria included 9 existing medication safety and adherence measures developed mostly by the Pharmacy Quality Alliance. Logistic regression and the Blinder-Oaxaca approach were used to test disparities in meeting MMA and star ratings eligibility criteria across racial and ethnic groups. Multinomial logistic regression was used to examine whether there was a disparity reduction by comparing individuals who were MTM-eligible under MMA but not under star ratings criteria and those who were MTM-eligible under star ratings criteria but not under the MMA. Concerning MMA-based MTM criteria, main and sensitivity analyses were performed to represent the entire range of the MMA eligibility thresholds reported by plans in 2009, 2013, and proposed by CMS in 2015. Regarding star ratings criteria, meeting any 1 of the 9 measures was examined as the main analysis, and various measure combinations were examined as the sensitivity analyses. RESULTS: In the main analysis, adjusted odds ratios for non-Hispanic blacks (backs) and Hispanics to non-Hispanic whites (whites) were 1.394 (95% CI = 1.375-1.414) and 1.197 (95% CI = 1.176-1.218), respectively, under star ratings. Blacks were 39.4% and Hispanics were 19.7% more likely to be MTM-eligible than whites. Blacks and Hispanics were less likely to be MTM-eligible than whites in some sensitivity analyses. Disparities were not completely explained by differences in patient characteristics based on the Blinder-Oaxaca approach. The multinomial logistic regression of each main analysis found significant adjusted relative risk ratios (RRR) between whites and blacks for 2009 (RRR = 0.459, 95% CI = 0.438-0.481); 2013 (RRR = 0.449, 95% CI = 0.434-0.465); and 2015 (RRR = 0.436, 95% CI = 0.425-0.446) and between whites and Hispanics for 2009 (RRR = 0.559, 95% CI = 0.528-0.593); 2013 (RRR = 0.544, 95% CI = 0.521-0.569); and 2015 (RRR = 0.503, 95% CI = 0.488-0.518). These findings indicate a significant reduction in racial and ethnic disparities when using star ratings eligibility criteria; for example, black-white disparities in the likelihood of meeting MTM eligibility criteria were reduced by 55.1% based on star ratings compared with MMA in 2013. Similar patterns were found in most sensitivity and disease-specific analyses. CONCLUSIONS: This study found that minorities were more likely than whites to be MTM-eligible under the star ratings criteria. In addition, MTM eligibility criteria based on star ratings would reduce racial and ethnic disparities associated with MMA in the general Medicare population and those with specific chronic conditions. DISCLOSURES: Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health under award number R01AG049696. The content of this study is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Cushman reports an Eli Lilly grant and uncompensated consulting for Takeda Pharmaceuticals outside this work. The other authors have no potential conflicts of interest to report. Study concept and design were contributed by Wang and Shih, along with Wan, Kuhle, Spivey, and Cushman. Wang, Qiao, and Wan took the lead in data collection, with assistance from the other authors. Data interpretation was performed by Wang, Kuhle, and Qiao, with assistance from the other authors. The manuscript was written by Spivey and Qiao, along with the other authors, and revised by Cushman, Dagogo-Jack, and Chisholm-Burns, along with the other authors.

Perspectives on affirmative action in academic dental institutions: the U.S. Supreme Court rulings in the University of Michigan cases.

In June 2003 the U.S. Supreme Court upheld the constitutionality of using race as a factor in higher education admissions decisions. This article considers the impact of the Supreme Court decisions on admissions procedures at selected academic dental institutions (ADI) and their parent institutions. We interviewed fifty-eight leaders considered to be individual stakeholders at seven ADI and their related parent institutions, state dental associations, and state legislatures using a common set of questions about the Supreme Court decisions. Educators from the ADI and their parent institutions were consistent in their responses that the rulings upheld affirmative action as necessary to achieve diversity. State organized dentistry officials did not appear to be as aware as others of the rulings, whereas legislators were mixed in their responses. Except for the University of Michigan undergraduate admissions procedures, it remains to be seen what the impact will be for other higher education institutions and for academic dental institutions. Although the rulings have provided guidelines for achieving diversity using race/ ethnicity as one of several factors, the rulings will possibly be challenged, thus requiring vigilance on the part of parent institutions and their ADI to ensure compliance with the spirit of the rulings and to avoid attack from opponents of affirmative action.

Raising the bar on achieving racial diversity in higher education: the United States Supreme Court's decision in Fisher v University of Texas.

In Fisher v University of Texas, the U.S. Supreme Court revisited the constitutionality of race-conscious admissions practices aimed at fostering student diversity in university programs. Although it concluded that student diversity remains the type of compelling state interest that justifies consideration of race in admissions, the court nonetheless raised the bar on the use of such practices by requiring universities to prove that no workable race-neutral methods can produce the same result. Whether this standard of proof is one that can be met-and whether challenges will mount against universities that continue to use the holistic methods sanctioned 10 years ago in Grutter v Bollinger-remains to be seen. In this commentary, the authors review the background and history of the Supreme Court's decisions on race as a factor in university admissions decisions and examine the potential effects of Fisher on medical education specifically.