Yearly and Daily Discrimination-Related Stressors and Mexican Youth's Mental Health and Sleep: Insights From the First Wave of a Three-Wave Family Study.

OBJECTIVE: Research is needed to examine discrimination-related stressors and their social and psychological shaping of mental health and sleep outcomes of Latinx youth. The background, design, and methodology of a longitudinal study of Mexican families in Indiana and the initial findings of associations between discrimination-related stressors and youth mental health and sleep outcomes are presented. METHOD: Initiating wave 1 of a 3-wave (yearly) longitudinal study, investigators surveyed an ethnically homogeneous sample of 344 Mexican-origin adolescents (ages 12-15) and their primary caregivers, assessing risks and protective factors for mental health and sleep outcomes. Youth also completed a one-time 21-day daily diary after wave 1. Self-reported measures of youth mental health, sleep, and discrimination across wave 1 and the daily diary were evaluated to compare the cross-sectional (wave 1) and daily associations between discrimination and youth mental health and sleep outcomes. RESULTS: Of youth, 88.1% reported at least one incident of lifetime discrimination. Almost one-third had elevated depressive symptoms, 44.5% had probable generalized anxiety disorder, and 50.9% had poor sleep quality. Between-youth correlations at wave 1 and in the daily diary were consistent in that perceived racial discrimination was positively correlated with worse mental health and poorer sleep quality. Smaller within-youth correlations were observed in the daily diary, but there was striking variability in the effect of discrimination across youth. CONCLUSION: The present results illustrate the powerful methods of combining yearly and daily time data to investigate how and for whom discrimination-related stressors lead to adverse outcomes. PLAIN LANGUAGE SUMMARY: Latinx youth are the largest and fastest growing minoritized youth group in the United States. This study surveyed 344 Mexican-origin adolescents and their primary caregivers to assess risk and protective factors for mental health and sleep outcomes. The authors found that 88.1% of youth reported at least one incident of lifetime discrimination, 29.7% reported elevated depressive symptoms, 44.5% reported elevated anxiety symptoms, and 50.9% reported poor sleep quality. Youth who experienced racial discrimination were more likely to have worse mental health and lower sleep quality than those who did not experience racial discrimination. DIVERSITY & INCLUSION STATEMENT: We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. CLINICAL TRIAL REGISTRATION INFORMATION: Seguimos Avanzando - Latino Youth Coping With Discrimination; https://clinicaltrials.gov/; NCT04875208.

Longitudinal links between maternal cultural socialization, peer ethnic-racial discrimination, and ethnic-racial pride in Mexican American youth.

This paper used cross-lagged panel models to test the longitudinal interplay between maternal cultural socialization, peer ethnic-racial discrimination, and ethnic-racial pride across 5th to 11th grade among Mexican American youth (N = 674, Mage  = 10.86; 72% born in the United States; 50% girls; Wave 1 collected 2006-2008). Maternal cultural socialization predicted increases in subsequent youth ethnic-racial pride, and youth ethnic-racial pride prompted greater maternal cultural socialization. However, peer ethnic-racial discrimination was associated with subsequent decreases in ethnic-racial pride. The magnitude of these associations was consistent across 5th to 11th grades suggesting that maternal cultural socialization messages are necessary to maintain ethnic-racial pride across adolescence, thus families must continually support the development of ethnic-racial pride in their youth to counter the effects of discrimination.

The iatrogenesis of obstetric racism in Brazil: beyond the body, beyond the clinic.

In Brazil, Black women are disproportionately denied access to timely care and are made vulnerable to death by avoidable obstetric causes. However, they have not been at the center of recent initiatives to improve maternal health. This paper contends that the effectiveness of Brazilian maternal and infant health policy is limited by failures to robustly address racial health inequities. Multi-sited ethnographic research on the implementation of the Rede Cegonha program in Bahia, Brazil between 2012 and 2017 reveals how anti-Blackness structures iatrogenic harms for Black women as well as their kin in maternal healthcare. Building on the work of Black Brazilian feminists, the paper shows how Afro-Brazilian women experience anti-Black racism in obstetric care, which the paper argues can be better understood through Dána-Ain Davis' concept of obstetric racism. The paper suggests that such forms of violence reveal the necropolitical facets of reproductive governance and that the framing of obstetric violence broadens the scales and temporalities of iatrogenesis.

Racism against Totonaco women in Veracruz: Intercultural competences for health professionals are necessary.

Racism is a neglected but relevant cause of health disparities within multi-ethnic societies. Different types of racism and other expressions of discrimination must be recognized, critically analyzed, and actively reverted. This paper is based on anthropological fieldwork conducted in three medical facilities in the indigenous region Sierra de Totonacapan in the highlands of Veracruz in Mexico and analyzes maternal health and identifies levels of racism as perceived by female indigenous patients. Applying a theoretical framework that defines racism at three levels, namely, institutionalized, personally mediated, and internalized racism. We empirically distinguish and acknowledge human rights omissions and violations and then analyze the sources of racism in close relation to an intersectional view on gender-, class-, and race-based forms of discrimination. Finally, in addition to investment in health goods and skilled birth attendants, we propose an intercultural competence approach to manage racism, among other ideologies. This approach targets health professionals as conscious, reflexive, and transformative actors of intercultural interactions with culturally diverse patients.

Perceptions and experiences regarding the impact of race on the quality of healthcare in Southeast Brazil: a qualitative study.

Objective: To explore the impact of race on the quality of healthcare received by patients attending a primary care centre in Brazil.Design: This was a qualitative study consisting of 19 semi-structured interviews conducted on patients from six racial groups (as defined in Brazil as white, yellow, brown, black and indigenous and one self-identified 'other' group). The interviews were analysed using thematic analysis.Results: Four main themes were identified during analysis; factors affecting the access to healthcare, experiences regarding quality of healthcare, discrimination in healthcare and deep-rooted societal discrimination, which were categorised into a number of sub-themes. Within these themes, interviewees reported (1) experiences of racism in society towards the black racial group, (2) one personal perception and two observations of racial discrimination in healthcare, (3) perceived racial discrimination due to healthcare professional behaviour and (4) other factors, such as delays in appointments and long waiting times in health facilities were felt to impact access to care.Conclusion: The findings suggest that racial discrimination exists in Brazilian society but its direct impact on healthcare access was felt to be less obvious. Instead, organisational level factors were felt to contribute to difficulty accessing care. Interviewees perceived that racial discrimination may affect the quality of care, particularly for those designated as 'black'. Socio-economic factors were felt to influence discrimination in healthcare. The findings can help inform further studies and educational initiatives to help address discrimination and access to healthcare in Brazil.

Indigenous Identification by Health Professionals in a Mexican Hospital Setting.

In this article, we describe and analyze the identification of people as Indigenous by health-care professionals in a hospital in Mexico City. This socially constructed identification is based on a "contrasting identity" of essentialist and stereotyped categories (language, place of origin, cultural practices, and poverty) that promote the normalization of inequity, marginality, and racism. The ambivalence of the invisibility of the indigenous in the health-care context also marginalizes and generates inequity when it comes to the access to healthcare.

Black people are convicted more for being black than for being poor: The role of social norms and cultural prejudice on biased racial judgments.

Black and poor people are more frequently convicted of committing crimes. However, the specific role played by skin color and social class in convicting a person has yet to be clarified. This article aims to elucidate this issue by proposing that belonging to a lower social class facilitates the conviction of black targets and that this phenomenon is because information about social class dissimulates racial bias. Study 1 (N = 160) demonstrated that information about belonging to the lower classes increases agreement with a criminal suspect being sentenced to prison only when described as being black. Furthermore, Studies 2 (N = 170) and 3 (N = 174) show that the anti-prejudice norm inhibits discrimination against the black target when participants were asked to express individual racial prejudice, but not when they expressed cultural racial prejudice. Finally, Study 4 (N = 134) demonstrated that lower-class black targets were discriminated against to a greater degree when participants expressed either individual or cultural prejudice and showed that this occurs when racial and class anti-prejudice norms are salient. The results suggest that social class negatively affects judgments of black targets because judgment based on lower class mitigates the racist motivation of discrimination.

Prospective Relationships Between Ethnic Discrimination and Substance Use by Mexican-American Adolescents.

Guided by the integrative model (García Coll et al., 1996), this study examines prospective associations between perceived ethnic discrimination by peers, parental support, and substance use from 7th to 11th grades (Mage  = 12.3-16.3 years) in a community sample of 674 Mexican-American adolescents. Results from a cross-lagged panel model indicate that discrimination predicts relative increases in adolescent substance use. Results also revealed a transactional relation between substance use and supportive parenting over time. Supportive parenting was associated with reductions in substance use, but adolescent substance use also predicted lower levels of later parental support. The findings suggest reducing discrimination by peers and supportive parenting as potential targets for intervention in the prevention of substance use.

Entre o particular e o geral: a constituição de uma "loucura negra" no Hospício de Juquery em São Paulo, Brasil - 1898-1920 / Between the particular and the general: constitution of "black madness" in the Hospice of Juquery, São Paulo, Brazil - 1898-1920 / Entre lo particular y lo general: la constitución de una "locura negra" en el Manicomio de Juquery en São Paulo, Brasil - 1898-1920

Em uma perspectiva sócio-histórica, o artigo discute a problematização da questão racial realizada pelo saber psiquiátrico pela análise da produção científica do Hospício do Juquery, e de sua forma de operação cotidiana pelo registro de suas práticas asilares. O período estudado, de 1898 a 1920, compreende a criação da instituição e gestão de Franco da Rocha, seu fundador, momento em que ganha corpo o debate sobre o homem livre e sua significação na formação nacional. As fontes do texto são os prontuários médicos da população internada, os registros e a produção científica da instituição no período enfocado.(AU)

Based on a socio-historical perspective, the present article discusses the problematization of the race issue in psychiatric knowledge by analyzing the scientific production developed by the Hospice of Juquery and its daily operations, through access to records of its asylum practices. The studied period, 1898 to 1920, includes the creation of the institution and its management under Franco da Rocha, its founder, a time when the debate about the free man and its significance to the nation's formation began to take shape. The source text was extracted from the clinical medical histories of inpatients, as well as the records and scientific production developed by the institution during the studied period.(AU)

En una perspectiva sociohistórica, el artículo discute la problematización de la cuestión racial realizada por el saber psiquiátrico por el análisis de la producción científica del manicomio de Juquery y de su forma de operación cotidiana por el registro de sus prácticas de asilo. El período estudiado, de 1898 a 1920, incluye la creación de la institución y gestión de Franco da Rocha, su fundador, momento en el que adquiere cuerpo el debate sobre el hombre libre y su significación en la formación nacional. Las fuentes de texto son las fichas médicas de la población internada, los registros y la producción científica de la institución en el período de estudio.(AU)

Localizing Global Medicine: Challenges and Opportunities in Cervical Screening in an Indigenous Community in Ecuador.

This participatory research study examines the tensions and opportunities in accessing allopathic medicine, or biomedicine, in the context of a cervical cancer screening program in a rural indigenous community of Northern Ecuador. Focusing on the influence of social networks, the article extends research on "re-appropriation" of biomedicine. It does so by recognizing two competing tensions expressed through social interactions: suspicion of allopathic medicine and the desire to maximize one's health. Semistructured individual interviews and focus groups were conducted with 28 women who had previously participated in a government-sponsored cervical screening program. From inductive thematic analysis, the article traces these women's active agency in navigating coherent paths of health. Despite drawing on social networks to overcome formidable challenges, the participants faced enduring system obstacles-the organizational effects of the networks of allopathic medicine. Such obstacles need to be understood to reconcile competing knowledge systems and improve health care access in underresourced communities.

Aproximación crítica a las políticas públicas en salud indígena, medicina tradicional e interculturalidad en México (1990-2016) / A critical examination of public policies related to indigenous health, traditional medicine, and interculturality in Mexico (1990-2016)

RESUMEN En los últimos 26 años, el gobierno mexicano desarrolló múltiples discursos y actividades sobre la denominada "salud intercultural" dirigidos, en especial, a los pueblos originarios de México (alrededor de 62, de acuerdo al criterio lingüístico), y construyó establecimientos de salud (puestos de salud, clínicas y hospitales) en los que propuso la aplicación de indicadores de pertinencia cultural en algunos estados como Puebla, Nayarit, Oaxaca, Chiapas, Querétaro y Jalisco (mínimos e insuficientes). Sin embargo, la salud indígena y la atención médica institucional siguen siendo precarias en cuanto a recursos humanos y materiales (personal sanitario, medicamentos, etc.), y discriminatorios con relación a la forma y al contenido de la atención que se brinda. En este artículo, detallamos algunas de las intervenciones del gobierno que suponen un avance institucional sobre el tema de interculturalidad en salud pero que, en el fondo, significan la continuidad de políticas arbitrarias y excluyentes.

ABSTRACT Over the last 26 years, the Mexican government has developed a number of activities and discourses around what has been called "intercultural health," directed especially at indigenous peoples in Mexico (some 62, according to linguistic criteria). In this way, the government has built health care institutions (rural centers, clinics, and hospitals) in states like Puebla, Nayarit, Oaxaca, Chiapas, Queretaro, and Jalisco, proposing the implementation of cultural pertinence indicators (which are minimal and inadequate). Nevertheless, the health conditions among indigenous populations and the quality of health care provided by public institutions continue to be precarious in terms of human and material resources (health personnel, drugs, etc.) and discriminatory with respect to the form and content of the provided services. This paper describes some of the governmental interventions that purport to be institutional improvements in the field of interculturality, but that actually represent the continuity of arbitrary and exclusive policies.

[A critical examination of public policies related to indigenous health, traditional medicine, and interculturality in Mexico (1990-2016)]. / Aproximación crítica a las políticas públicas en salud indígena, medicina tradicional e interculturalidad en México (1990-2016).

Over the last 26 years, the Mexican government has developed a number of activities and discourses around what has been called "intercultural health," directed especially at indigenous peoples in Mexico (some 62, according to linguistic criteria). In this way, the government has built health care institutions (rural centers, clinics, and hospitals) in states like Puebla, Nayarit, Oaxaca, Chiapas, Queretaro, and Jalisco, proposing the implementation of cultural pertinence indicators (which are minimal and inadequate). Nevertheless, the health conditions among indigenous populations and the quality of health care provided by public institutions continue to be precarious in terms of human and material resources (health personnel, drugs, etc.) and discriminatory with respect to the form and content of the provided services. This paper describes some of the governmental interventions that purport to be institutional improvements in the field of interculturality, but that actually represent the continuity of arbitrary and exclusive policies.

En los últimos 26 años, el gobierno mexicano desarrolló múltiples discursos y actividades sobre la denominada "salud intercultural" dirigidos, en especial, a los pueblos originarios de México (alrededor de 62, de acuerdo al criterio lingüístico), y construyó establecimientos de salud (puestos de salud, clínicas y hospitales) en los que propuso la aplicación de indicadores de pertinencia cultural en algunos estados como Puebla, Nayarit, Oaxaca, Chiapas, Querétaro y Jalisco (mínimos e insuficientes). Sin embargo, la salud indígena y la atención médica institucional siguen siendo precarias en cuanto a recursos humanos y materiales (personal sanitario, medicamentos, etc.), y discriminatorios con relación a la forma y al contenido de la atención que se brinda. En este artículo, detallamos algunas de las intervenciones del gobierno que suponen un avance institucional sobre el tema de interculturalidad en salud pero que, en el fondo, significan la continuidad de políticas arbitrarias y excluyentes.

Perceived Ethnic Discrimination and the Metabolic Syndrome in Ethnic Minority Groups: The Healthy Life in an Urban Setting Study.

OBJECTIVE: Ethnic differences in the metabolic syndrome could be explained by perceived ethnic discrimination (PED). It is unclear whether PED is associated with the metabolic syndrome. We assessed this association and quantified the contribution of PED to the metabolic syndrome. METHODS: Baseline data were used from the Healthy Life in an Urban Setting study collected in the Netherlands from 2011 to 2014. The population-based sample included South-Asian Surinamese, African Surinamese, Ghanaian, Turkish, and Moroccan participants (aged 18 to 70 years). PED was measured using the Everyday Discrimination Scale. The metabolic syndrome was determined according to the harmonized definition of the International Diabetes Federation, American Heart Association, and others. Logistic regression was used for analysis. population-attributable fraction was used to calculate the contribution of PED. RESULTS: PED was positively associated with the metabolic syndrome in South-Asian Surinamese, African Surinamese, and Moroccan participants (odds ratio [95% confidence interval] = 1.13 [0.99-1.30], 1.15 [1.00-1.32], and 1.19 [1.03-1.38], respectively) after adjusting for potential confounders and mediators. No significant association was observed among Ghanaian and Turkish participants. For the individual components, the associations were statistically significant for blood pressure, fasting glucose, and waist circumference among Surinamese participants. PED was associated with dyslipidemia in Moroccan participants. The population-attributable fractions were 5% for South-Asian Surinamese and Moroccan participants, and 7% for African Surinamese participants. CONCLUSIONS: We found a positive association of PED with the metabolic syndrome in some ethnic groups, with PED contributing around 5% to 7% to the metabolic syndrome among Surinamese and Moroccans. This suggests that PED might contribute to ethnic differences in the metabolic syndrome.

Haitianos em Cascavel, Paraná: história, trabalho e saúde

O escopo do estudo é a relação entre saúde e imigração, do ponto de vista da saúde do trabalhador e da determinação social do processo saúde doença. Utiliza-se, também, o aporte do materialismo histórico dialético. O objetivo é analisar a relação entre saúde, trabalho e organização coletiva dos haitianos residentes em Cascavel, Paraná, Brasil. Optou-se por tratara relação trabalho saúde a partir da experiência dos haitianos em um dos frigoríficos de aves da cidade. Trata-se de pesquisa qualitativa na interface das ciências sociais e humanas em saúde, com quatro fontes de dados: entrevistas semi estruturadas; acordos coletivos de trabalho; notícias de portais online e jornais digitais; e revisão bibliográfica. Os resultados estão agrupados em quatro seções: história da presença dos haitianos em Cascavel;aproximação à relação trabalho saúde dos haitianos a partir do trabalho em um frigorífico de aves; formas de resistência e organização coletiva; e imigração, racismo, violência e saúde.Discute-se que os haitianos começaram a chegar a Cascavel em 2010, após o terremoto que atingiu a parte central do Haiti, atraídos por empresários locais. Iniciaram sua inserção em setores produtivos como a construção civil, comércio e, finalmente, a agroindústria avícola,onde grande parte deles estava empregada. Neste setor produtivo, são relatados pela literatura casos graves de lesões por esforço repetitivo e doenças psíquicas. Na amostra de indivíduos entrevistados (11) foram descritas diversas situações envolvidas na saúde do trabalhador,classificadas pelos autores como sofrimento difuso, com base na literatura. Além disso, foram expostas condições de vida e saúde desfavoráveis, acompanhadas por casos de violência e racismo...

The scope of this research is the relationship between health and immigration by thestandpoint of worker’s health, social determination of health and historical-dialecticalmaterialism. The aim is to analyze the relationship between health, work and collectiveorganization of Haitians residing in Cascavel, Paraná, Brazil. The relation work-health isapproached starting from the background of a local poultry slaughterhouse. It is a qualitativeresearch on the connection of social sciences and health, with four data sources: interviews,news from online web portals, collective work agreements and cientific literature review. Theresults are grouped in four sections: history of the Haitian presence in Cascavel; aproximationto the relation work-health starting form the work on a poultry slaughterhouse; forms ofresistance and collective organization; and immigration, racism, violence and health. TheHaitians have been started to arrive at Cascavel in 2010 – after a earthquake that reached Haiti– attracted by local business people. Formerly, they were integrated in productive sectors suchas construction industry, trading and, finally, the pultry slaughterhouses, where a huge part ofthem was employed. Scientific literature reports serious cases of repetitive strain injury andpsychic diseases in this productive sector. The individuals interviewed reported varioussituations envolved with worker’s health, classified by authors as difuse distress. Besides, lifeand health unfavorable conditions has been exposed, followed by violence and racism...

Crime and Punishment: the Impact of Skin Color and Socioeconomic Status of Defendants and Victims in Jury Trials in Brazil.

Social judgments are often influenced by racism. Voluntary crimes against life, and in particular the crime of homicide, may be the most critical situations of the impact of racism in social judgments. We analyzed 114 homicide trials conducted by the 1st Jury Court, in a Brazilian judicial capital, concluded between 2003 and 2007, for the purpose of investigating the effects of skin color and the socioeconomic status of the defendant and the victim of homicides in the jury trial court's decision. The results indicate that the social and economic profile of defendants and victims of homicide is identical. They are almost all poor (more than 70%), with low education (more than 73%) and frequently non-Whites (more than 88%). We found that judges assign longer sentences to black (ß = .34, p = .01) and poor defendants (ß = .23, p < .05). We even verified that the poorer the defendant, the higher was the corresponding conviction rate (Wald's Test = 5.90, p < .05). The results are discussed based on theories of social psychology and criminological sociology, which consider the relationship between skin color and socioeconomic status in social judgments and in discrimination.

Race and Resting-State Heart Rate Variability in Brazilian Civil Servants and the Mediating Effects of Discrimination: An ELSA-Brasil Cohort Study.

OBJECTIVES: African Americans are characterized by higher heart rate variability (HRV), a finding ostensibly associated with beneficial health outcomes. However, these findings are at odds with other evidence that blacks have worse cardiovascular outcomes. Here, we examine associations in a large cohort from the ELSA-Brasil study and determined whether these effects are mediated by discrimination. METHODS: Three groups were compared on the basis of self-declared race: "black" (n = 2,020), "brown" (n = 3,502), and "white" (n = 6,467). Perceived discrimination was measured using a modified version of the Everyday Discrimination Scale. Resting-state HRV was extracted from 10-minute resting-state electrocardiograms. Racial differences in HRV were determined by regression analyses weighted by propensity scores, which controlled for potentially confounding variables including age, sex, education, and other health-related information. Nonlinear mediation analysis quantified the average total effect, comprising direct (race-HRV) and indirect (race-discrimination-HRV) pathways. RESULTS: Black participants displayed higher HRV relative to brown (Cohen's d = 0.20) and white participants (Cohen's d = 0.31). Brown relative to white participants also displayed a small but significantly higher HRV (Cohen's d = 0.14). Discrimination indirectly contributed to the effects of race on HRV. CONCLUSIONS: This large cohort from the Brazilian population shows that HRV is greatest in black, followed by brown, relative to white participants. The presence of higher HRV in these groups may reflect a sustained compensatory psychophysiological response to the adverse effects of discrimination. Additional research is needed to determine the health consequences of these differences in HRV across racial and ethnic groups.