RESUMEN
People surviving COVID-19 may experience social stigma related to their condition even after clinical recovery. This study aimed to: (1) investigate COVID-19-related experienced discrimination and internalized stigma, and (2) explore their association with symptoms of anxiety, depression, and insomnia. We conducted an online survey of people who survived COVID-19. Perception of stigma was assessed using the COVID-19 Experienced Discrimination Scale and the COVID-19 Internalized Stigma Scale. Depression, anxiety, and insomnia were assessed using, respectively, the Patient Health Questionnaire-9, the General Anxiety Disorder Scale-7, and the Insomnia Severity Index. Multivariable logistic regression analyses for each psychopathological domain were performed. A total of 579 participants participated in this study. Overall, 25% reported some degree of experienced discrimination, and 23% reported some degree of internalized stigma. Adjusted odds ratio showed that scoring higher on internalized stigma related significantly to higher symptoms of depression (2.14; 95% confidence interval [CI], 1.35-3.39), anxiety (2.30; 95% CI, 1.48-3.59), and insomnia (2.54; 95% CI, 1.64-3.95), whereas experienced discrimination was associated to anxiety (1.55; 95% CI, 1.06-2.28) and insomnia (1.82; 95% CI, 1.24-2.69). Experiences of social stigmatization are frequent among people surviving COVID-19 and seem to be associated with levels of psychological disturbances. Further research is required to elucidate the direction of these relationships to implement effective treatment strategies.
Asunto(s)
Ansiedad , COVID-19 , Depresión , SARS-CoV-2 , Trastornos del Inicio y del Mantenimiento del Sueño , Estigma Social , Humanos , COVID-19/psicología , COVID-19/epidemiología , Femenino , Masculino , Trastornos del Inicio y del Mantenimiento del Sueño/psicología , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Adulto , Persona de Mediana Edad , Depresión/psicología , Ansiedad/psicología , Encuestas y Cuestionarios , Anciano , Adulto Joven , Discriminación Social/psicologíaRESUMEN
PURPOSE: Although discrimination has gained increasing attention in research and practice intervention for family caregivers of children with disabilities, little is known about the social determinants that associate with the perceived discrimination among caregivers, especially in non-Western contexts. This study aims to examine the socio-familial and child-level determinants of perceived discrimination among family caregivers of children with disabilities in China. METHOD: This study drew from a population-based cross-sectional survey in Shenzhen, China. Proportional quota sampling was conducted to get data from 2500 family caregivers of children with disabilities in rehabilitation service centers (response rate = 94.9%, n = 2373), accounting for 25% of the total population of children with disabilities receiving service in Shenzhen. Latent profile analysis was conducted to categorize three perceived discrimination groups among caregivers (i.e., severe perceived discrimination group, moderate perceived discrimination group, and low perceived discrimination group). The multinomial logistic regression models were conducted to test the association between these social determinants and perceived discrimination. RESULTS: Most caregivers (82.9%) reported moderate or severe levels of perceived discrimination. Caregivers of children with moderate and severe impairments and children with mental and multiple disabilities were more vulnerable to perceiving severe social discrimination. Socio-familial characteristics, particularly the intersectionality between gender and employment, influence caregivers' perceived discrimination. CONCLUSION: Caregivers of children with disabilities experience pervasive social discrimination in contemporary urban China. Our study demonstrates that the social construction of disablism and the affiliate discrimination against family caregivers of children with disabilities is complex and multidimensional and depends upon the children's disability and the caregivers' socio-demographic characteristics.
Asunto(s)
Cuidadores , Niños con Discapacidad , Discriminación Social , Humanos , China , Masculino , Femenino , Estudios Transversales , Niños con Discapacidad/psicología , Cuidadores/psicología , Cuidadores/estadística & datos numéricos , Niño , Adulto , Discriminación Social/psicología , Persona de Mediana Edad , Adolescente , Determinantes Sociales de la Salud , Preescolar , Factores Socioeconómicos , Percepción , Encuestas y CuestionariosRESUMEN
BACKGROUND: The criteria-oriented assessment of the population with a migration background that is common in Germany is currently being criticized from a social science and methodological perspective, among others. In particular, its usefulness as an indicator of perceived discrimination against the population with a migration background can be critically questioned based on the current state of research METHOD: Based on a population-representative data set (N=1,989) for the city of Berlin, the subjective perception of a migration background based on self-attribution and anticipated external attribution of a migration background was recorded in addition to the objective assessment of a migration background. Furthermore, socio-demographic and migration-specific characteristics as well as perceived discrimination were assessed. Using descriptive and inferential statistical methods, differences between the objective and subjective assessment of a migration background and their relationship with perceived discrimination were analyzed. RESULTS: Less than half (38%, 154/400) of the respondents identified as having a migrant background using the criterion-oriented approach reported describing themselves as migrants. 36% (144/405) reported that they believed that others in Germany described them as a person with a migrantion background. Respondents with a migration background are significantly more likely to experience discrimination on grounds of skin color, religion or country of origin compared to respondents without a migration background. Furthermore, it was found that both the self-attribution and the anticipated attribution by others as a migrant are positively associated with experiences of discrimination and racism. DISCUSSION: The results suggest that migration-sensitive research should not simply differentiate between people with and without a migration background according to official criteria. Rather, the subjective perceptions of one's own attribution as a migrant seem more suitable as indicators of discrimination and should be taken into account in future research or surveys on experiences of discrimination.
Asunto(s)
Racismo , Humanos , Racismo/psicología , Masculino , Femenino , Adulto , Persona de Mediana Edad , Alemania , Anciano , Adulto Joven , Prejuicio , Adolescente , Migrantes/psicología , Emigrantes e Inmigrantes/psicología , Percepción Social , Factores Socioeconómicos , Discriminación Social/psicología , Encuestas y CuestionariosRESUMEN
INTRODUCTION: Weight stigma, or weight bias, refers to biased beliefs and negative opinions towards people with excess weight. This phenomenon manifests in prejudice and negative attitudes towards people with obesity, including disrespectful treatment, bullying, discrimination and even abuse, and leading to long-term negative consequences on physical and mental health. The purpose of the current review was to examine the relationship between gender and manifestations of weight stigma. Studies listed in this review show that the phenomenon of weight stigma is more common and severe among women, in numerous life areas, which include education, employment, the healthcare system, social media, sports industry, and interpersonal relationships. Possible reasons for such differences include the existing discrimination against women in various areas of life, and the emphasis on external appearance and the ideal of thinness, which relates mainly to women. In light of the serious consequences of weight stigma on public health and individual well-being, efforts must be made to prevent weight stigma, including the education of the general population, changing policies of healthcare, education and media systems, and legislation to prevent weight-based discrimination.
Asunto(s)
Obesidad , Estigma Social , Humanos , Obesidad/psicología , Femenino , Factores Sexuales , Masculino , Prejuicio/psicología , Sexismo/psicología , Peso Corporal , Prejuicio de Peso/psicología , Salud Pública , Discriminación Social/psicología , Relaciones InterpersonalesRESUMEN
OBJECTIVES: Workplace stigmatisation and discrimination are significant barriers to accessing employment opportunities, reintegration and promotion in the workforce for people with mental illnesses in comparison to other disabilities. This paper presents qualitative evidence of anticipated and experienced workplace stigma and discrimination among individuals with major depressive disorder (MDD) in 35 countries, and how these experiences differ across countries based on their Human Development Index (HDI) level. DESIGN: Mixed-method cross-sectional survey. PARTICIPANTS, SETTING AND MEASURES: The qualitative data were gathered as part of the combined European Union Anti-Stigma Programme European Network and global International Study of Discrimination and Stigma Outcomes for Depression studies examining stigma and discrimination among individuals with MDD across 35 countries. Anticipated and experienced stigma and discrimination were assessed using the Discrimination and Stigma Scale version 12 (DISC-12). This study used responses to the open-ended DISC-12 questions related to employment. Data were analysed using the framework analysis method. RESULTS: The framework analysis of qualitative data of 141 participants identified 6 key 'frames' exploring (1) participants reported experiences of workplace stigma and discrimination; (2) impact of experienced workplace stigma and discrimination; (3) anticipated workplace stigma and discrimination; (4) ways of coping; (5) positive work experiences and (6) contextualisation of workplace stigma and discrimination. In general, participants from very high HDI countries reported higher levels of anticipated and experienced discrimination than other HDI groups (eg, less understanding and support, being more avoided/shunned, stopping themselves from looking for work because of expectation and fear of discrimination). Furthermore, participants from medium/low HDI countries were more likely to report positive workplace experiences. CONCLUSIONS: This study makes a significant contribution towards workplace stigma and discrimination among individuals with MDD, still an under-researched mental health diagnosis. These findings illuminate important relationships that may exist between countries/contexts and stigma and discrimination, identifying that individuals from very high HDI countries were more likely to report anticipated and experienced workplace discrimination.
Asunto(s)
Trastorno Depresivo Mayor , Estigma Social , Lugar de Trabajo , Humanos , Estudios Transversales , Trastorno Depresivo Mayor/psicología , Masculino , Femenino , Adulto , Lugar de Trabajo/psicología , Persona de Mediana Edad , Empleo/psicología , Investigación Cualitativa , Discriminación Social/psicología , Adulto Joven , Encuestas y CuestionariosRESUMEN
This cross-sectional study investigated the association between experiences of discrimination and oral health self-perception among a probabilistic cluster sample of Brazilian adults who participated in the 2013 National Health Survey. Oral health self-perception was categorized into three groups (very good + good; fair; poor + very poor). Reported experiences of discrimination included attributions based on the respondent's race/skin color, social class, income, occupation, illness, sexual orientation, religion, sex, and age. Covariates included sociodemographic data, oral health conditions, access to healthcare services, health habits, mental health, and participation in social and/or religious activities. Data were analyzed using ordinal logistic regression for non-proportional odds, considering sample weights and complex samples. Among 60,202 adults, 5.84% perceived their oral health as poor + very poor, with a significantly higher proportion among those experiencing discrimination (9.98%). Adults who experienced discrimination were 1.39 times more likely to report a "poor/very poor/fair" oral health self-perception compared to those who did not experience discrimination. Those who suffered discrimination were 1.28 times more likely to have a "very poor/poor" oral health self-perception than their counterparts who were not affected by discrimination. These findings underscore the importance of considering discrimination experiences as part of the social determinants influencing oral health.
Asunto(s)
Salud Bucal , Autoimagen , Humanos , Brasil , Estudios Transversales , Adulto , Masculino , Femenino , Persona de Mediana Edad , Adulto Joven , Adolescente , Anciano , Factores Socioeconómicos , Discriminación Social/psicologíaRESUMEN
Health care workers have been exposed to COVID-19 more than people in other professions, which may have led to stigmatization, discrimination, and violence toward them, possibly impacting their mental health. We investigated (1) factors associated with stigma, discrimination, and violence, (2) the association of stigma, discrimination, and violence with mental health, (3) everyday experiences of stigmatization, discrimination, and violence. We chose a combination of a quantitative approach and qualitative content analysis to analyze data collected at three time points: in 2020, 2021 and 2022. A higher age was associated with lower odds of experiencing stigma, discrimination, and violence, whereas female gender was related to more negative experiences. The intensity of exposure to COVID-19 was associated with greater experience with stigmatization, discrimination, and violence across all three years (for example in 2022: odds ratio, 95% confidence interval: 1.74, 1.18-2.55 for mild exposure; 2.82, 1.95-4.09 for moderate exposure; and 5.74, 3.55-9.26 for severe exposure, when compared to no exposure). Stigma, discrimination, and violence were most strongly associated with psychological distress in 2020 (odds ratio = 2.97, 95% confidence interval 2.27-3.88) and with depressive symptoms in 2021 (odds ratio = 2.78, 95% confidence interval 2.12-3.64). Attention should be given to the destigmatization of contagious diseases and the prevention of discrimination, violence, and mental health problems, both within workplaces and among the public.
Asunto(s)
COVID-19 , Personal de Salud , Salud Mental , Pandemias , Estigma Social , Humanos , COVID-19/psicología , COVID-19/epidemiología , Femenino , Masculino , Personal de Salud/psicología , Adulto , Persona de Mediana Edad , SARS-CoV-2 , Violencia/psicología , Discriminación Social/psicologíaRESUMEN
INTRODUCTION: Electronic cigarettes (also termed e-cigarette or vapes) often contain nicotine, an addictive psychoactive substance, which can have harmful effects during adolescence. Frequent experiences of discrimination are one risk factor shown to increase susceptibility to tobacco use, especially for individuals that identify as a social minority. Applying Intersectionality Theory, this research examined the relationship between youth experiences of discrimination and vape use at the intersection of race/ethnicity and sexual orientation. METHOD: Cross-sectional survey data from 4747 youth (ages 12-17) that participated in the 2022 Teens, Nicotine, and Tobacco Project (TNT) online survey were used to evaluate the impact of discrimination on vape use for lesbian, gay, bisexual, and/or queer/questioning (LGBQ+) youth of color. RESULTS: Multivariable regression analyses showed that identifying as both a sexual and racial/ethnic minority was a risk factor for experiencing discrimination. Frequent discrimination and reporting discrimination due to sexual orientation was associated with a greater likelihood of ever and current vaping. Path models supported that discrimination mediated the relationship between intersectional identity and vape use. LGBQ+ youth of color reported more frequent discrimination, which was associated with a greater likelihood of ever/current vape use. CONCLUSIONS: Intersectionality Theory aids in understanding how discrimination can exacerbate tobacco-related disparities for youth with multiple minority identities. Findings corroborate the importance of measuring discrimination in public health surveys. Effective tobacco interventions could incorporate strategies to cope with discrimination-related stress.
Asunto(s)
Minorías Sexuales y de Género , Vapeo , Humanos , Adolescente , Masculino , Femenino , Vapeo/psicología , Estudios Transversales , Niño , Minorías Sexuales y de Género/psicología , Discriminación Social/psicología , Etnicidad/psicologíaRESUMEN
OBJECTIVE: This study focused on employees' perceived discrimination due to parenthood; and mental health, occupational stress and turnover intention. Methods: Survey (2016) of an Australian convenience sample of employed parents: women ( n = 2950) and men ( n = 1318). Results: Forty-two percent of all mothers reported missing out on promotion ( n = 1234/2950); one-third reported negative comments from managers ( n = 805/2950, 27%) or colleagues ( n = 832/2950, 28%). One in five fathers reported these forms of discrimination. In adjusted analyses, perceived discrimination was associated with poorer mental health (ß = 0.23, P < 0.001); higher occupational stress (ß = 0.30, P < 0.001); and increased odds of turnover intention (adjusted odds ratio = 1.5, P < 0.001) for mothers; and poorer mental health (ß = 0.34, P < 0.001); stress (ß = 0.35, P < 0.001); and increased odds of turnover intention (adjusted odds ratio = 1.7, P < 0.001) for fathers. Conclusions: Experiences of negativity and hostility at work are common and link to employee health and well-being.
Asunto(s)
Padre , Salud Mental , Madres , Estrés Laboral , Lugar de Trabajo , Humanos , Femenino , Masculino , Australia , Padre/psicología , Padre/estadística & datos numéricos , Adulto , Madres/psicología , Madres/estadística & datos numéricos , Lugar de Trabajo/psicología , Estrés Laboral/psicología , Estrés Laboral/epidemiología , Persona de Mediana Edad , Reorganización del Personal/estadística & datos numéricos , Encuestas y Cuestionarios , Discriminación Social/psicología , Adulto JovenRESUMEN
Stigma-related stressors are central to understanding psychopathology, distress, and coping in stigmatized groups; individuals who experience attractions to children are a highly stigmatized group. Currently, few validated self-report measures exist to assess stigma-related stressors in minor attracted people (MAPs) and the current research describes the development and initial validation of two measures of internalized stigma and experiences of discrimination. A sample of MAPs (n = 289; mean age = 31.8 years, SD = 12.2) was recruited online and completed a set of self-report measures assessing stigma-related stress, negative mental health outcomes, substance use, and coping. Exploratory factor analyses of the two newly developed stigma-related stress measures were conducted and convergent associations with other constructs were examined for validity evidence. Exploratory factor analyses indicated a two-factor solution to both the measure of internalized stigma and experiences of discrimination. The total scale scores and factors scores generally demonstrated the anticipated patterns of correlations with mental health concerns, distress, coping, and substance use. Clinical intervention with MAPs may benefit from an exploration of stigma-related stressors in clients' lives to improve mental health outcomes. The relatively large sample that was recruited from multiple online forums is a strength of the current study. The use of a self-report measurement modality for all measures used in the study weakens that strength of the validation evidence presented here. These results provide initial validity evidence for the measures of stigma-related stress in MAPs and the promise of stigma processes in understanding negative outcomes in this population.
Asunto(s)
Adaptación Psicológica , Estigma Social , Humanos , Masculino , Femenino , Adulto , Autoinforme , Estrés Psicológico/psicología , Persona de Mediana Edad , Adulto Joven , Adolescente , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Psicometría , Discriminación Social/psicologíaRESUMEN
This meta-analysis synthesizes experimental studies on the immediate effects of discrimination on mental health, exploring the effects of different paradigms and discrimination types on diverse facets of mental health. We analyzed data from a systematic literature search (73 studies; 12,097 participants; 245 effect sizes) for randomized controlled trials with manipulation of discrimination as a predictor and mental health as an outcome using a three-level random-effects model. Experimentally manipulated discrimination led to poorer mental health (g = -0.30), also after controlling for publication year, region, education level, and methodological quality. Moderator analyses revealed stronger effects for pervasive (g = -0.55) compared to single-event manipulations (g = -0.25) and a trend toward weaker effects for samples with nonmarginalized (g = -0.16) compared to marginalized identities (g = -0.34). Gender and age did not moderate the effect. Discrimination had the largest effects on externalizing (g = -0.66) and distress-related outcomes (g = -0.41); heterosexism (g = -0.66), racism (g = -0.32), and sexism (g = -0.30) had the largest effects on mental health. Convenience sampling compromised generalizability to subgroups and the general population, downgrading methodological quality for all included studies. When interpreting the findings, selective samples (mostly young female adults with higher education), often limited ecological validity, and ethical restrictions of lab-induced discrimination need to be considered. These constraints likely led to conservative estimates of the mental health effects of discrimination in this meta-analysis. Future research should investigate more diverse samples, further explain the heterogeneity of findings, and explore protective factors of the effects of discrimination on mental health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Asunto(s)
Salud Mental , Humanos , Racismo/psicología , Discriminación Social/psicología , Sexismo/psicología , Prejuicio/psicologíaRESUMEN
BACKGROUND: Despite advances in biomedical HIV prevention modalities such as pre-exposure prophylaxis to prevent the transmission of HIV, racial/ethnic and sexual/gender minority populations are disproportionately impacted by HIV epidemic. Alarming rates of HIV have persisted among Black gay and bisexual men, particularly in Southern states. METHODS: Utilizing data from the ViiV ACCELERATE! initiative, we explored the impact of As Much As I Can, an immersive theatre production, on HIV-related stigma behaviors. A self-administered post-performance survey was conducted with a cohort (n = 322) of randomly selected audience members. RESULTS: Overall, the results showed participants had a highly favorable experience, rating the performance with a mean score of 9.77/10. Respondents indicated they intended to change behaviors to promote HIV prevention education and to reduce stigma and discrimination including: (1) Say something if I hear stigmatizing language against people living with HIV (75.4%), (2) Say something if I hear anti-gay language (69.7%) and (3) Tell others about HIV prevention options (e.g., PrEP, PEP, condoms (64.1%). The findings show there is an association between HIV-related behavior intention and linkage to HIV care. Respondents who reported they were more likely to say something about HIV stigma were almost three times (O.R. 2.77; 95% C.I. 0.98-7.8) more likely to indicate they would follow up with a healthcare professional. CONCLUSIONS: This study suggests that immersive theatre is an effective method for communicating HIV prevention education and reducing HIV-related structural stigma and discrimination that increases HIV vulnerability for Black sexual minority men.
Asunto(s)
Arteterapia , Negro o Afroamericano , Infecciones por VIH , Conductas Relacionadas con la Salud , Promoción de la Salud , Minorías Sexuales y de Género , Humanos , Masculino , Negro o Afroamericano/educación , Negro o Afroamericano/psicología , Población Negra , Promoción de la Salud/métodos , Infecciones por VIH/etnología , Infecciones por VIH/prevención & control , Infecciones por VIH/psicología , Infecciones por VIH/terapia , Homosexualidad Masculina/etnología , Homosexualidad Masculina/psicología , Medicina en las Artes , Minorías Sexuales y de Género/educación , Minorías Sexuales y de Género/psicología , Conducta Sexual/etnología , Conducta Sexual/psicología , Discriminación Social/etnología , Discriminación Social/prevención & control , Discriminación Social/psicología , Estigma Social , Arteterapia/métodos , Conductas Relacionadas con la Salud/etnologíaRESUMEN
Discrimination is associated with antiretroviral therapy non-adherence and reduced well-being among people with HIV. We examined the potential for coping to mediate the associations between intersectional discrimination and non-adherence and coping self-efficacy (confidence in one's ability to cope with discrimination) as a moderator that may buffer the negative effects of discrimination on non-adherence in a cross-sectional convenience sample of 82 Latino sexual minority men with HIV. In bivariate linear regressions, discrimination targeting Latino ethnic origin, undocumented residency status, and sexual orientation were each significantly associated with lower self-reported antiretroviral therapy non-adherence (percentage of prescribed doses taken in the last month) and greater use of disengagement coping (denial, substance use, venting, self-blame, behavioral disengagement). Associations between discrimination targeting Latino ethnicity and non-adherence, and discrimination targeting undocumented residency status and non-adherence, were each mediated by disengagement coping responses. Moderation analyses highlighted significant discrimination by coping self-efficacy interaction effects-both coping self-efficacy for problem solving and stopping unpleasant emotions/thoughts each moderated the associations between Latino discrimination and adherence, between undocumented residency status discrimination and adherence, and between HIV discrimination and adherence. Coping self-efficacy for getting social support moderated the association between undocumented residency status discrimination and adherence. Further, the interaction coefficients across models indicated that the negative effects of discrimination on adherence were attenuated at higher levels of coping self-efficacy. Findings highlight the need for structural interventions that reduce-and ultimately eliminate-discrimination, and interventions that address the harmful effects of discrimination and adherence improvement interventions to enhance coping skills among people faced with intersectional discrimination.
Asunto(s)
Adaptación Psicológica , Infecciones por VIH , Hispánicos o Latinos , Cumplimiento de la Medicación , Autoeficacia , Discriminación Social , Humanos , Masculino , Estudios Transversales , Hispánicos o Latinos/psicología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/etnología , Infecciones por VIH/psicología , Discriminación Social/etnología , Discriminación Social/prevención & control , Discriminación Social/psicología , Cumplimiento de la Medicación/etnología , Cumplimiento de la Medicación/psicología , Fármacos Anti-VIH/uso terapéutico , Bienestar Psicológico/psicología , Minorías Sexuales y de Género/psicología , Estados Unidos/epidemiologíaRESUMEN
Research has consistently linked discrimination and poorer health; however, fewer studies have focused on immigration-related discrimination and mental health outcomes. Drawing on quantitative surveys (N = 1,131) and qualitative interviews (N = 63) with Latino undergraduate students who are undocumented or U.S. citizens with undocumented parents, we examine the association between perceived immigration-related discrimination and mental health outcomes and the process through which they are linked. Regression analyses identify an association between immigration-related discrimination and increased levels of depression and anxiety; this relationship did not vary by self and parental immigration status. Interview data shed light on this result as immigration-related discrimination manifested as individual discrimination as well as vicarious discrimination through family and community members. We contend that immigration-related discrimination is not limited to individual experiences but rather is shared within the family and community, with negative implications for the mental health of undocumented immigrants and mixed-status family members.
Asunto(s)
Emigración e Inmigración , Hispánicos o Latinos , Discriminación Social , Estudiantes , Inmigrantes Indocumentados , Humanos , Hispánicos o Latinos/psicología , Salud Mental , Padres/psicología , Estudiantes/psicología , Inmigrantes Indocumentados/psicología , Discriminación Social/etnología , Discriminación Social/psicología , Familia/psicologíaRESUMEN
In the United States, the coronavirus disease-2019 (COVID-19) pandemic has disproportionally affected Black, Latinx, and Indigenous populations, immigrants, and economically disadvantaged individuals. Such historically marginalized groups are more often employed in low-wage jobs without health insurance and have higher rates of infection, hospitalization, and death from COVID-19 than non-Latinx White individuals. Mistrust in the health care system, language barriers, and limited health literacy have hindered vaccination rates in minorities, further exacerbating health disparities rooted in structural, institutional, and socioeconomic inequities. In this article, we discuss the lessons learned over the last 2 years and how to mitigate health disparities moving forward.
Asunto(s)
COVID-19 , Inequidades en Salud , Accesibilidad a los Servicios de Salud , Determinantes Sociales de la Salud , Discriminación Social , Poblaciones Vulnerables , Humanos , Negro o Afroamericano , COVID-19/epidemiología , COVID-19/etnología , COVID-19/prevención & control , COVID-19/psicología , Emigrantes e Inmigrantes/psicología , Emigrantes e Inmigrantes/estadística & datos numéricos , Etnicidad/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Hispánicos o Latinos/psicología , Hispánicos o Latinos/estadística & datos numéricos , Pueblos Indígenas/psicología , Pueblos Indígenas/estadística & datos numéricos , Pobreza/etnología , Pobreza/psicología , Pobreza/estadística & datos numéricos , Determinantes Sociales de la Salud/economía , Determinantes Sociales de la Salud/etnología , Determinantes Sociales de la Salud/estadística & datos numéricos , Discriminación Social/economía , Discriminación Social/etnología , Discriminación Social/psicología , Discriminación Social/estadística & datos numéricos , Marginación Social/psicología , Confianza/psicología , Estados Unidos/epidemiología , Vacunación/economía , Vacunación/psicología , Vacunación/estadística & datos numéricos , Poblaciones Vulnerables/psicología , Poblaciones Vulnerables/estadística & datos numéricos , Blanco/psicología , Blanco/estadística & datos numéricosRESUMEN
The common sense model of illness is a promising conceptual framework that can promote our understanding of the predictors of schizophrenia-related public stigma. Because stigma is a multidimensional phenomenon, studies on schizophrenia-related stigma need to account for the origins of the various aspects of this phenomenon. This study explored which common sense model of illness components (cognitive and emotional) predicted three distinct indicators of stigma (stereotypes and discrimination on the individual and structural levels). A nonprobability sample of 149 students from one of the largest universities in Israel was drawn. Data were collected via a self-reported questionnaire. We found that five of the nine common sense model of illness variables predicted schizophrenia stereotypes, whereas very few predicted discrimination. Additionally, we found that greater belief in the effectiveness of schizophrenia treatment was associated with lower stereotypes and social-level discrimination. The less the perceived consequences of schizophrenia (the extent to which the illness is perceived to affect one's life), the lower the stereotypes and discrimination (individual and social). The perceived cause of schizophrenia and attribution of personal control over the illness did not predict any stigma dimension. The findings suggest that the common sense model of illness is more suitable for predicting stereotypes than discrimination. More research is needed to understand the unique drivers of different dimensions of stigma. The findings also imply the need to design separate programs to address different aspects of schizophrenia-related stigma.
Asunto(s)
Esquizofrenia , Humanos , Estereotipo , Israel , Estigma Social , Discriminación Social/psicologíaRESUMEN
South Asians face stressors as a growing immigrant group in America. Work is needed to understand how these stressors impact mental health to identify those at risk of depression and design interventions. This study examined associations of three stressors (discrimination, low social support, limited English proficiency) with depressive symptoms in South Asians. Using cross-sectional data from the Mediators of Atherosclerosis in South Asians Living in America study (N = 887), we fit logistic regression models to evaluate independent/joint effects of three stressors on depression. Overall prevalence of depression was 14.8%; 69.2% of those with all three stressors had depression. The combined effect of high discrimination/low social support was significantly greater than the sum of the individual factors. Experiences of discrimination, low social support, or limited English proficiency, as well as a combination of these factors, should be considered when diagnosing/treating South Asian immigrants in a culturally appropriate manner.
Asunto(s)
Depresión , Emigrantes e Inmigrantes , Dominio Limitado del Inglés , Discriminación Social , Apoyo Social , Personas del Sur de Asia , Humanos , Asiático , Estudios Transversales , Depresión/etnología , Depresión/etiología , Depresión/psicología , Emigrantes e Inmigrantes/psicología , Apoyo Social/psicología , Personas del Sur de Asia/psicología , Estados Unidos , Discriminación Social/etnología , Discriminación Social/psicologíaRESUMEN
OBJECTIVE: This study used the stress process model to test the mediating effects of personal mastery and moderating effects of church-based social support on the relationship between daily discrimination and psychological distress across three age groups of African American and Afro-Caribbean adults. METHODS: Using a national sample of 5008 African Americans and Afro-Caribbean adults from the National Survey of American Life Study, this study employs structural equation modeling to investigate the relationships between daily discrimination, personal mastery, church-based social support, and psychological distress. RESULTS: Daily discrimination was an independent predictor of psychological distress across all groups. Group- and age-specific comparisons revealed significant differences in the experience of daily discrimination and psychological distress. Mastery was a partial mediator of the relationship between discrimination and psychological distress among Afro-Caribbeans while church support was a significant moderator only among the young and older African Americans. IMPLICATIONS: Together, our study findings provide useful first steps towards developing interventions to reduce the adverse psychological impacts of daily discrimination on African Americans and Afro-Caribbeans. Intervention efforts such as individual psychotherapy aimed to improve Afro-Caribbean individuals' sense of mastery would be a partial solution to alleviating the adverse effects of discrimination on their psychological health.
Asunto(s)
Población Negra , Distrés Psicológico , Religión y Psicología , Autoeficacia , Apoyo Social , Racismo Sistemático , Adulto , Humanos , Factores de Edad , Negro o Afroamericano/psicología , Población Negra/psicología , Salud Mental/etnología , Racismo/etnología , Racismo/psicología , Discriminación Social/etnología , Discriminación Social/psicología , Apoyo Social/psicología , Estrés Psicológico/etnología , Estrés Psicológico/etiología , Estrés Psicológico/psicología , Racismo Sistemático/etnología , Racismo Sistemático/psicología , Estados Unidos/epidemiología , Adaptación PsicológicaRESUMEN
OBJECTIVES: The purpose of this pilot study was to explore the effect of HIV-related stigma and everyday major experiences of discrimination on medication and clinic visit adherence among older African Americans living with HIV in Ohio. METHODS: We collected data from 53 individuals who were living with HIV in Ohio, ≥ 50 years of age, and who identified as Black or African American. We conducted logistic regression models to examine the impact of HIV-related stigma and experiences of discrimination on medication and visit adherence. Each model controlled for age, time since diagnosis, and sexual orientation. RESULTS: The average age was 53.6 ± 2.1 years and 94.3% were men. Almost half (49.1%) of the participants reported poor medication adherence and almost a third (31.4%) reported poor visit adherence. HIV-related stigma (adjusted odds ratio (aOR) = 1.39; 95% confidence interval (CI) = 1.02-1.89) and major experiences of discrimination (aOR = 1.70; 95% CI = 1.11-2.60) were associated with a greater odds of poor medication adherence. Additionally, major experiences of discrimination were associated with a threefold increase in the odds of poor visit adherence (aOR = 3.24; 95% CI = 1.38-7.64). CONCLUSIONS: HIV-related stigma and major experiences of discrimination impede optimal medication and HIV clinic visit adherence for older African Americans living with HIV. To reduce the impact of stigma and discrimination on HIV care engagement, our first step must be in understanding how intersecting forms of stigma and discrimination impact engagement among older African Americans living with HIV.
Asunto(s)
Atención Ambulatoria , Negro o Afroamericano , Infecciones por VIH , Cooperación del Paciente , Discriminación Social , Estigma Social , Femenino , Humanos , Masculino , Persona de Mediana Edad , Negro o Afroamericano/psicología , Negro o Afroamericano/estadística & datos numéricos , Población Negra/psicología , Población Negra/estadística & datos numéricos , Infecciones por VIH/epidemiología , Infecciones por VIH/etnología , Infecciones por VIH/psicología , Infecciones por VIH/terapia , Cumplimiento de la Medicación/etnología , Cumplimiento de la Medicación/psicología , Cumplimiento de la Medicación/estadística & datos numéricos , Proyectos Piloto , Ohio/epidemiología , Cooperación del Paciente/etnología , Cooperación del Paciente/psicología , Cooperación del Paciente/estadística & datos numéricos , Atención Ambulatoria/psicología , Atención Ambulatoria/estadística & datos numéricos , Racismo/etnología , Racismo/psicología , Racismo/estadística & datos numéricos , Discriminación Social/etnología , Discriminación Social/psicología , Discriminación Social/estadística & datos numéricosRESUMEN
En la actualidad se evidenciado aumento de los desplazamientos provocados por conflictos, persecuciones, falta de oportunidades, seguridad, entre otras razones, inscrementando la población de migrante en países de América Latina. Se destaca los desplazados venezolanos, siendo Perú el segundo país de Latinoamérica con más de esta población de migrantes. Estudios han alertado sobre la desvalorización de los migrantes y especialmente aquellos que vivan con enfermedades infectocontagiosas como es el VIH. Los ciudadanos autóctonos del país receptor, percirbe la presencia del exogrupo como amenazas a sus derechos sociales relacionándose con actitudes negativas, que se ha ido poteciando por los medios de comunicación. Por tanto, es importante realizar estudios que estimen el discernimiento de amenazas exogrupal estrechamente hacia los migrantes. El objetivo evaluar las evidencias psicométricas del instrumento de medición EPAE en una muestra de adultos peruanos frente a los inmigrantes VIH. El análisis de los ítems y de confiabilidad demostró un adecuado funcionamiento a excepción de los ítems 4, 5, 11 y 12. Se propone utilizar el modelo 2, el cual consta de 9 agregados, confirmado por los diferentes índices estadísticos (X2/gl=3.49; WMRM=1.124; NFI=0.993; CFI=0.995; GFI=0.997; RMSEA=0.045; SRMR=0.035). Según los valores del análisis bifactor no existe suficiente evidencia para asumir un factor general, se recomienda trabajar con dimensiones independientes. Es importante la identificación de percepción de amenazas reales, debido a que investigaciones han evidenciado que el estigma asociado con el VIH constituye uno de los mayores obstáculos para la prevención de nuevas infecciones(AU)
Currently, there is evidence of an increase in displacement caused by conflicts, persecution, lack of opportunities, security, among other reasons, increasing the migrant population in Latin American countries. The displaced Venezuelans stand out, with Peru being the second country in Latin America with more than this population of migrants. Studies have warned about the devaluation of migrants and especially those who live with infectious diseases such as HIV. The autochthonous citizens of the receiving country perceive the presence of the outgroup as threats to their social rights, related to negative attitudes, which has been promoted by the media. Therefore, it is important to carry out studies that estimate the discernment of out-group threats closely towards migrants. The objective is to evaluate the psychometric evidence of the EPAE measurement instrument in a sample of Peruvian adults compared to HIV immigrants. The analysis of the items and reliability showed an adequate functioning with the exception of items 4, 5, 11 and 12. It is proposed to use model 2, which consists of 9 aggregates, confirmed by the different statistical indices (X2/df= 3.49; WMRM=1.124; NFI=0.993; CFI=0.995; GFI=0.997; RMSEA=0.045; SRMR=0.035). Given the values of the bifactor analysis, there is not enough evidence to assume a general factor, it is recommended to work with independent dimensions. It is important to identify the perception of real threats, since research has shown that the stigma associated with HIV constitutes one of the greatest obstacles to the prevention of new infections(AU)