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1.
Proc Natl Acad Sci U S A ; 121(15): e2320299121, 2024 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-38557172

RESUMEN

Racism is associated with negative intergenerational (infant) outcomes. That is, racism, both perceived and structural, is linked to critical, immediate, and long-term health factors such as low birth weight and infant mortality. Antiracism-resistance to racism such as support for the Black Lives Matter (BLM) movement-has been linked to positive emotional, subjective, and mental health outcomes among adults and adolescents. To theoretically build on and integrate such past findings, the present research asked whether such advantageous health correlations might extend intergenerationally to infant outcomes? It examined a theoretical/correlational process model in which mental and physical health indicators might be indirectly related to associations between antiracism and infant health outcomes. Analyses assessed county-level data that measured BLM support (indexed as volume of BLM marches) and infant outcomes from 2014 to 2020. As predicted, in the tested model, BLM support was negatively correlated with 1) low birth weight (Ncounties = 1,445) and 2) mortalities (Ncounties = 409) among African American infants. Given salient, intergroup, policy debates tied to antiracism, the present research also examined associations among White Americans. In the tested model, BLM marches were not meaningfully related to rates of low birth weight among White American infants (Ncounties = 2,930). However, BLM support was negatively related to mortalities among White American infants (Ncounties = 862). Analyses controlled for structural indicators of income inequality, implicit/explicit bias, voting behavior, prior low birth weight/infant mortality rates, and demographic characteristics. Theory/applied implications of antiracism being linked to nonnegative and positive infant health associations tied to both marginalized and dominant social groups are discussed.


Asunto(s)
Antiracismo , Racismo , Recién Nacido , Lactante , Adulto , Adolescente , Humanos , Recién Nacido de Bajo Peso , Mortalidad Infantil , Negro o Afroamericano , Población Negra , Peso al Nacer
2.
BMC Med Ethics ; 25(1): 45, 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38616267

RESUMEN

BACKGROUND: Despite decades of anti-racism and equity, diversity, and inclusion (EDI) interventions in academic medicine, medical racism continues to harm patients and healthcare providers. We sought to deeply explore experiences and beliefs about medical racism among academic clinicians to understand the drivers of persistent medical racism and to inform intervention design. METHODS: We interviewed academically-affiliated clinicians with any racial identity from the Departments of Family Medicine, Cardiac Sciences, Emergency Medicine, and Medicine to understand their experiences and perceptions of medical racism. We performed thematic content analysis of semi-structured interview data to understand the barriers and facilitators of ongoing medical racism. Based on participant narratives, we developed a logic framework that demonstrates the necessary steps in the process of addressing racism using if/then logic. This framework was then applied to all narratives and the barriers to addressing medical racism were aligned with each step in the logic framework. Proposed interventions, as suggested by participants or study team members and/or identified in the literature, were matched to these identified barriers to addressing racism. RESULTS: Participant narratives of their experiences of medical racism demonstrated multiple barriers to addressing racism, such as a perceived lack of empathy from white colleagues. Few potential facilitators to addressing racism were also identified, including shared language to understand racism. The logic framework suggested that addressing racism requires individuals to understand, recognize, name, and confront medical racism. CONCLUSIONS: Organizations can use this logic framework to understand their local context and select targeted anti-racism or EDI interventions. Theory-informed approaches to medical racism may be more effective than interventions that do not address local barriers or facilitators for persistent medical racism.


Asunto(s)
Racismo , Humanos , Exactitud de los Datos , Empatía , Medicina Familiar y Comunitaria , Personal de Salud
3.
Politics Life Sci ; 43(1): 99-131, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38567783

RESUMEN

Recent research suggests that contemporary American society is marked by heightened hostile racial rhetoric, alongside increasing salience of White nationalists who justify an ideology of racial hierarchy with claims of biological superiority. Media coverage of such genetics research has often emphasized a deterministic (or causal) narrative by suggesting that specific genes directly increase negative outcomes and highlighting reported genetic differences between racial groups. Across two experimental studies, we examine the effect of the media's portrayal of scientific findings linking genes with negative health and behavioral outcomes on measures of racism. We find that deterministic genetic attributions for health and behavioral outcomes can lead to more negative racial out-group attitudes. Importantly, we also investigate potential interventions in the presentation of genetic science research. Our research has implications for understanding racial attitudes and racialized ideology in contemporary American politics, as well as for framing scientific communication in intergroup contexts.


Asunto(s)
Racismo , Humanos , Estados Unidos , Actitud , Grupos Raciales , Narración , Blanco
4.
Int Rev Psychiatry ; 36(1-2): 80-90, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38557339

RESUMEN

Siyamthanda (Siya) Kolisi OIG (1992-) is the first black captain of the South African rugby team (Springboks) in its 128 years of existence. The Springboks have long been associated with Afrikaner people and a history of racism. Siya had to navigate a tumultuous upbringing in an environment characterised by various issues such as socioeconomic inequalities, high unemployment among Black people, and lack of resources. Siya was purposively selected for this study as he has become one of the most influential individuals in South Africa. Publicly available biographical data was gathered, analysed, and interpreted using the Phenomenological Variant of Ecological Systems Theory (PVEST; Spencer, 2006). I used the theoretical lens to understand the role of social and cultural context, meaning-making processes in human development, and the transition between different worlds. The findings indicated a need to consider the role of context as a source of consonance or dissonance in human development. The study also sheds light on the importance of viewing marginalised individuals holistically to facilitate smooth boundary transitions. Furthermore, it underscores the importance of recognising that maladaptive and adaptive coping strategies exist on a continuum. The study contributes towards non-WEIRD psychobiographical studies and understanding culture's role on human development.


Asunto(s)
Racismo , Pueblo del Sur de África , Masculino , Humanos , Sudáfrica
6.
Cult. cuid ; 28(68): 179-188, Abr 10, 2024. ilus
Artículo en Español | IBECS | ID: ibc-232321

RESUMEN

Introducción: Maria José Bezerra, Maria Soldado, mujernegra nacida en la ciudad de Limeira, São Paulo, heroína ysímbolo de la Revolución Constitucionalista de 1932, fueuna enfermera de guerra reconocida por su fuerza, valor,patriotismo y abnegación.Objetivo: historiar la trayectoria vital personal y profesionalde Maria José Bezerra. Metodología: Investigación biográficarealizada a partir de registros bibliográficos y documentales.Resultados: Maria José Bezerra sirvió como enfermeramiembro de la Legión Negra en la Guerra Civil de la RevoluciónConstitucionalista de 1932, destacando por sus logros, con unacontribución activa a la construcción de la historia del país.Conclusión: La invisibilidad negra traduce la injusticia, laincoherencia de los derechos y también los actos que tratande deshonrar al individuo en sus aspectos individuales ycolectivos. El estudio de la trayectoria de esta mujer luchadorase constituye como una estrategia para dar voz, fuerza ysentido a hacer pública la historia de una representantede la población negra, y también debería incluirse en loscurrículos académicos.(AU)


Introduction: Maria José Bezerra, a black woman born inthe city of Limeira, São Paulo, hero and symbol of the 1932Constitutionalist Revolution, was a war nurse recognized forher strength, courage, patriotism and abnegation.Objective: To historicize Maria José Bezerra's personal andprofessional life trajectory. Methodology: Biographical research based on bibliographicand documentary records.Results: Maria José Bezerra acted as a nurse member ofthe Black Legion in the Civil War of the ConstitutionalistRevolution of 1932, stood out for her achievements, withactive contribution in the construction of the country's history.Conclusion: Black invisibility translates as injustice, inconsistencyof rights, and even acts that try to discredit the individualin their individual and collective aspects. The study of thetrajectory of this woman fighter constitutes a strategy togive voice, strength and meaning to make public the historyof a representative of the black population, and the themeshould also be included in academic curricula.(AU)


Introdução: Maria José Bezerra, a Maria Soldado, uma mulhernegra nascida na cidade de Limeira, São Paulo, heroína esímbolo da Revolução Constitucionalista de 1932, foi umaenfermeira de guerra reconhecida pela força, coragem,patriotismo e abnegação.Objetivo: Historicizar a trajetória de vida pessoal e profissionalde Maria José Bezerra.Metodologia: Pesquisa biográfica realizada a partir de registrosbibliográficos e documentais.Resultados: Maria José Bezerra atuou como enfermeiramembro da Legião Negra na Guerra Civil da RevoluçãoConstitucionalista de 1932, destacou-se pelos seus feitos,com contribuição ativa na construção da história do país.Conclusão: A invisibilidade negra traduz a injustiça, incoerênciade direitos e, ainda, atos que tentam desabonar o indivíduoem seus aspectos individuais e coletivos. O estudo da trajetóriadessa mulher lutadora constitui-se como estratégia de darvoz, força e sentido de tornar público a história de umarepresentante da população negra, devendo ainda ser inclusaa temática nos currículos acadêmicos.(AU)


Asunto(s)
Humanos , Femenino , Historia de la Enfermería , Rol de la Enfermera , Personal Militar , Racismo , Brasil , Enfermería
7.
Public Health ; 230: 207-215, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38574426

RESUMEN

OBJECTIVES: To examine the prevalence of major racial discrimination (MRD) in healthcare services and its association with COVID-19 vaccine mistrust and uptake, conspiracy theories, COVID-19-related stressors, community resilience, anxiety, depression, and stress symptoms. STUDY DESIGN: The study used a population-based cross-sectional design. METHODS: Data from the BlackVax dataset on COVID-19 vaccination in Black individuals in Canada was analyzed (n = 2002, 51.66% women). Logistic regression analyses were performed to examine the association between MRD and independent variables. RESULTS: 32.55% of participants declared having experienced MRD in healthcare services. Participants with MRD were less vaccinated against COVID-19, presented higher scores of vaccine mistrust, conspiracy beliefs, COVID-19 related stressors, depression, anxiety, and stress, and had lower scores of community resilience. They were more likely to experience depression (AOR = 2.13, P < 0.001), anxiety (AOR = 2.00, P < 0.001), and stress symptoms (AOR = 2.15, P < 0.001). Participants who experienced MRD were more likely to be unvaccinated (AOR = 1.35, P = 0.009). CONCLUSIONS: Racial discrimination experienced by Black individuals in health services is a major public health concern and threat to population health in Canada. Federal, provincial, and municipal public health agencies should adapt their programs, strategies, tools, and campaigns to address the mistrust created by racial discrimination.


Asunto(s)
COVID-19 , Racismo , Resiliencia Psicológica , Femenino , Humanos , Masculino , Vacunas contra la COVID-19 , Estudios Transversales , Depresión/epidemiología , Salud Pública , COVID-19/epidemiología , COVID-19/prevención & control , Ansiedad/epidemiología , Canadá/epidemiología , Atención a la Salud
8.
Environ Health Perspect ; 132(4): 44002, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38602832

RESUMEN

Participants in an NIEHS workshop call on researchers, clinicians, publishers, and funders to address racism, environmental disparities, and other factors affecting women's health.


Asunto(s)
Racismo , Salud de la Mujer , Femenino , Humanos , Inequidades en Salud
9.
JAMA Netw Open ; 7(4): e245288, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38635273

RESUMEN

Importance: Metabolic syndrome (MetS) is a common health condition that predisposes individuals to cardiovascular disease (CVD) and disproportionately affects Black and other racially and ethnically minoritized people. Concurrently, Black individuals also report more exposure to racial discrimination compared with White individuals; however, the role of discrimination in the development of MetS over time and associated mediators in these pathways remain underexplored. Objective: To evaluate the association between racial discrimination and MetS in rural Black individuals transitioning from late adolescence into early adulthood and to identify potential mediating pathways. Design, Setting, and Participants: This longitudinal cohort study included Black adolescents enrolled in the Strong African American Families Healthy Adults (SHAPE) Project between June 2009 and May 2021. Families resided in rural counties of Georgia, where poverty rates are among the highest in the nation. Analyses included 322 of the 500 participants who originally enrolled in SHAPE and who were eligible to participate. Guardians provided information about socioeconomic disadvantage. Analyses were conducted in April 2023. Exposures: Youths reported exposure to racial discrimination annually from ages 19 to 21 years. Main Outcomes and Measures: MetS was the main health outcome and was measured at ages 25 and 31 years. MetS was diagnosed according to the International Diabetes Federation guidelines, which requires central adiposity (ie, waist circumference ≥94 cm for males and ≥80 cm for females) and at least 2 of the 4 additional components: signs of early hypertension (ie, systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥85 mm Hg); elevated triglyceride levels (ie, >150 mg/dL); elevated fasting glucose level (ie, ≥100 mg/dL); or lowered high-density lipoprotein levels (ie, <40 mg/dL in men and <50 mg/dL in women). At age 25 years, markers of inflammatory activity (ie, soluble urokinase plasminogen activator receptor [suPAR]) and sleep problems were collected to consider as potential mediators. Results: In 322 participants (210 [65.2%] female) ages 19 to 21 years, more frequent exposure to racial discrimination was associated with higher suPAR levels (b = 0.006; 95% CI, 0.001-0.011; P = .01) and more sleep problems at age 25 years (b = 0.062; 95% CI, 0.028-0.097; P < .001) as well as a 9.5% higher risk of MetS diagnosis at age 31 years (odds ratio [OR], 1.10; 95% CI, 1.01-1.20; P = .03). Both suPAR (b = 0.015; 95% CI, 0.002-0.037) and sleep problems (b = 0.020; 95% CI, 0.002-0.047) at age 25 years were significant indirect pathways. No significant interactions between sex and discrimination emerged. Conclusions and Relevance: This study suggests that racial discrimination in late adolescence is associated with MetS among Black young adults through biobehavioral pathways. Thus, health interventions for MetS in Black adults will need to contend with sleep behaviors and inflammatory intermediaries as well as address and reduce exposure to racial discrimination to narrow disparities and promote health equity.


Asunto(s)
Ácido Ascórbico/análogos & derivados , Síndrome Metabólico , Racismo , Trastornos del Sueño-Vigilia , Adolescente , Masculino , Adulto Joven , Femenino , Humanos , Adulto , Promoción de la Salud , Estudios Longitudinales , Receptores del Activador de Plasminógeno Tipo Uroquinasa
11.
BMC Public Health ; 24(1): 883, 2024 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-38519967

RESUMEN

BACKGROUND: Students of color disproportionately experience racial discrimination and food insecurity, which both lead to poor academic and health outcomes. This study explores the extent to which the location of racial discrimination experienced is associated with food insecurity, stress, physical health and grade point average among college students METHODS: A cross sectional study design was implemented to survey 143 students from a racially diverse public university. Logistic regression models assessed if discrimination at various locations was associated with food insecurity and linear models assessed how racial discrimination was associated with physical health, stress and grade point average RESULTS: Student's experiencing food security had an average discrimination score of 2.3 (1.23, 3.37), while those experiencing food insecurity had a statistically significant (P < 0.001) higher average discrimination score 7.3 (5.4, 9.21). Experiencing any racial discrimination was associated with increased odds of experiencing food insecurity when experienced from the police (OR 11.76, 95% CI: 1.41, 97.86), in the housing process (OR 7.9, 95% CI: 1.93, 32.34) and in the hiring process (OR 6.81, 95% CI: 1.98, 23.48) compared to those experiencing no racial discrimination after adjusting for race, gender, age and income. CONCLUSION: The location in which a student experienced racial discrimination impacted the extent to which the racial discrimination was associated with food security status. Further research is needed to explore potential mechanisms for how racial discrimination may lead to food insecurity.


Asunto(s)
Racismo , Humanos , Factores Socioeconómicos , Estudios Transversales , Abastecimiento de Alimentos , Estudiantes , Universidades , Inseguridad Alimentaria
12.
Public Health Nurs ; 41(3): 581-588, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38523557

RESUMEN

One way in which professional nursing organizations have chosen to address the social determinants of health (SDoH) is through policy work focused on diversity, health equity and anti-racism activities. The recent report, Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity (FON 2020-2030), calls on professional nursing organizations and/or nursing coalitions to focus on addressing the SDoH to mitigate health inequities, including a focus on addressing racism and promoting practices to ensure the diversity of the nursing workforce. While these recommendations highlight issues of high importance to nursing and the broader society, they assume that professional nursing organizations or coalitions have not been sufficiently engaged in this work to date. Our goal was to better understand the current and/or ongoing activities of professional nursing organizations around their anti-racism work of diversity, health equity, and inclusion (DEI) activities recommended in the FON 2020-2030 report. To address this goal, we conducted a needs assessment of professional nursing organizations to document their DEI activities and the timing of these activities relevant to the recommendations in the report. The 26 responding organizations indicated they had been engaged in work addressing DEI issues for periods ranging from 4 months to 51 years. Minimal funding was the major barrier to advancing this work. Creating a vigorous shared DEI agenda across the profession, as suggested in the FON 2020-2030 report, will require input from nurses across the profession, as well as identification of resources to support this critical endeavor.


Asunto(s)
Personal de Enfermería , Racismo , Humanos , Evaluación de Necesidades , Políticas , Racismo/prevención & control , Determinantes Sociales de la Salud
13.
J Med Internet Res ; 26: e45864, 2024 Mar 29.
Artículo en Inglés | MEDLINE | ID: mdl-38551624

RESUMEN

BACKGROUND: A silver lining to the COVID-19 pandemic is that it cast a spotlight on a long-underserved group. The barrage of attacks against older Asian Americans during the crisis galvanized society into assisting them in various ways. On Twitter, now known as X, support for them coalesced around the hashtag #ProtectOurElders. To date, discourse surrounding older Asian Americans has escaped the attention of gerontologists-a gap we seek to fill. Our study serves as a reflection of the level of support that has been extended to older Asian Americans, even as it provides timely insights that will ultimately advance equity for them. OBJECTIVE: This study explores the kinds of discourse surrounding older Asian Americans during the COVID-19 crisis, specifically in relation to the surge in anti-Asian sentiments. The following questions guide this study: What types of discourse have emerged in relation to older adults in the Asian American community and the need to support them? How do age and race interact to shape these discourses? What are the implications of these discourses for older Asian Americans? METHODS: We retrieved tweets (N=6099) through 2 search queries. For the first query, we collated tweets with the hashtag #ProtectOurElders. For the second query, we collected tweets with an age-based term, for example, "elderly" or "old(er) adults(s)" and either the hashtag #StopAAPIHate or #StopAsianHate. Tweets were posted from January 1, 2020, to August 1, 2023. After applying the exclusion criteria, the final data set contained 994 tweets. Inductive and deductive approaches informed our qualitative content analysis. RESULTS: A total of 4 themes emerged, with 50.1% (498/994) of posts framing older Asian Americans as "vulnerable and in need of protection" (theme 1). Tweets in this theme either singled them out as a group in need of protection because of their vulnerable status or discussed initiatives aimed at safeguarding their well-being. Posts in theme 2 (309/994, 31%) positioned them as "heroic and resilient." Relevant tweets celebrated older Asian Americans for displaying tremendous strength in the face of attack or described them as individuals not to be trifled with. Tweets in theme 3 (102/994, 10.2%) depicted them as "immigrants who have made selfless contributions and sacrifices." Posts in this section referenced the immense sacrifices made by older Asian Americans as they migrated to the United States, as well as the systemic barriers they had to overcome. Posts in theme 4 (85/994, 8.5%) venerated older Asian Americans as "worthy of honor." CONCLUSIONS: The COVID-19 crisis had the unintended effect of garnering greater support for older Asian Americans. It is consequential that support be extended to this group not so much by virtue of their perceived vulnerability but more so in view of their boundless contributions and sacrifices.


Asunto(s)
COVID-19 , Racismo , Medios de Comunicación Sociales , Anciano , Humanos , Asiático , Actitud , Pandemias , Estados Unidos
14.
Ann Behav Med ; 58(5): 305-313, 2024 Apr 11.
Artículo en Inglés | MEDLINE | ID: mdl-38546737

RESUMEN

BACKGROUND: Black young adult women (ages 18-35) are at disproportionate risk for obesity and emotional eating. Emotional eating interventions target psychological flexibility, such as reducing experiential avoidance and increasing acceptance of food-related thoughts. Yet Black women face gendered racism, and some endorse roles that reduce psychological flexibility, such as the superwoman schema role. Culturally centered stress and coping has often been overlooked, leading to an incomplete understanding of processes that engender emotional eating and the implications for appropriate and effective interventions for Black young adult women. PURPOSE: We investigated direct and indirect pathways of associations between stress from gendered racial microaggressions to emotional eating through the endorsement of superwoman schema and two aspects of psychological flexibility. METHODS: Black young adult women (N = 504; Mage = 24.72; 75.2% African American; 98.4% cisgender) participated in an online survey wherein they reported demographics, stress from gendered racial microaggressions, superwoman schema, experiential avoidance, acceptance of food-related thoughts, and emotional eating. Path analysis was conducted to examine direct and indirect effects. RESULTS: Results provided evidence for indirect associations between more stress from gendered racial microaggressions and more emotional eating. More stress was associated with greater endorsement of the superwoman schema which was associated with more experiential avoidance and less acceptance of food-related thoughts, which were each associated with more emotional eating. CONCLUSIONS: Endorsement of superwoman schema and concomitant avoidance and less acceptance may be one way that gendered racial stress propels emotional eating. Future research could test intervention components that disrupt this path.


Emotional eating is eating in order to alleviate negative emotions, like those from stress. Black young adult women face particular forms of stress from being mistreated at the intersection of their race and gender. This research was needed to better understand processes that engender emotional eating for Black young adult women so that appropriate and effective interventions can be developed for this group. In this correlational study, Black young adult women (ages 18­35) completed an online survey wherein they answered questions about their experiences, thoughts, and behaviors. The study results indicated that stress from mistreatment due to being a Black woman was associated with endorsing a need to be strong. This need to be strong was associated with avoiding experiences that may lead to negative emotional states and being less accepting of distressing thoughts about food. More avoidance and less acceptance were each associated with more emotional eating. Therefore, if emotional eating or obesity-related interventions already target acceptance and avoidance, but do not reference or contextualize them for Black young adult women­particularly in terms of stress from mistreatment as a Black woman and the need to be strong­such interventions may be less effective.


Asunto(s)
Microagresión , Racismo , Femenino , Humanos , Adulto Joven , Emociones , Identidad de Género , Negro o Afroamericano , 60670 , Racismo/psicología
15.
PLoS One ; 19(3): e0299870, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38478487

RESUMEN

Bias and discrimination in appointment processes such as hiring decisions (and analogous selection procedures for performance evaluations, promotions, scholarships, and awards), are quantified statistically via the binomial distribution. These statistical measures are described and an easily used webapp for calculating them is provided. The measures considered include the likelihood that a given number of appointments arose from a fair process and the likelihood that an existing process would give rise to a fair outcome if it were repeated. These methods are illustrated by applying them to sex (including gender) discrimination and racial discrimination in senior appointments in the Australian university sector; both conscious and unconscious biases are included. Significant sex discrimination is found to have existed in the appointments of university chief executives (Vice Chancellors) who were in office in 2018, but with a moderate chance that current processes will yield fair outcomes in the future. However, there is no evidence of strong sex discrimination in the country's eight main research universities for senior appointments (i.e., Faculty Deans and members of their governing Boards or Senates) for those in office as of 2021. However, at the same dates, extreme racial discrimination was implicit in the selection procedures for both Vice Chancellors and senior appointments in all these universities. The University of Sydney's senior appointments were found to have had the most racially biased outcomes among the country's eight main research universities. Significantly, there is negligible statistical likelihood of achieving racially unbiased outcomes in the future in any of the contexts considered, unless the selection procedures are significantly modified.


Asunto(s)
Docentes , Racismo , Humanos , Australia , Citas y Horarios , Universidades
17.
Science ; 383(6688): eado7084, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38484061

RESUMEN

Statements based on the best current scientific data and analyses that bear directly on societal issues, especially ones that are critical to societal justice, equity, and health, are practical responsibilities of professional scientific organizations. And they often have impact.


Asunto(s)
Evolución Biológica , Biología , Justicia Social , Humanos , Biología/educación , Genética Humana , Racismo , Estados Unidos
19.
JAMA Netw Open ; 7(3): e242181, 2024 Mar 04.
Artículo en Inglés | MEDLINE | ID: mdl-38506811

RESUMEN

Importance: Racial implicit bias can contribute to health disparities through its negative influence on physician communication with Black patients. Interventions for physicians to address racial implicit bias in their clinical encounters are limited by a lack of high-fidelity (realistic) simulations to provide opportunities for skill development and practice. Objective: To describe the development and initial evaluation of a high-fidelity simulation of conditions under which physicians might be influenced by implicit racial bias. Design, Setting, and Participants: This cross-sectional study, performed on an online platform from March 1 to September 30, 2022, recruited a convenience sample of physician volunteers to pilot an educational simulation. Exposures: In the simulation exercise, physicians saw a 52-year-old male standardized patient (SP) (presenting as Black or White) seeking urgent care for epigastric pain, nausea, and vomiting. The case included cognitive stressors common to clinical environments, including clinical ambiguity, stress, time constraints, and interruptions. Physicians explained their diagnosis and treatment plan to the SP, wrote an assessment and management plan, completed surveys, and took the Race Implicit Association Test (IAT) and Race Medical Cooperativeness IAT. The SPs, blinded to the purpose of the study, assessed each physician's communication using skills checklists and global rating scales. Main Outcomes and Measures: Association between physicians' IAT scores and SP race with SP ratings of communication skills. Results: In 60 physicians (23 [38.3%] Asian, 4 [6.7%] Black, 23 [38.3%] White, and 10 [16.7%] other, including Latina/o/x, Middle Eastern, and multiracial; 31 [51.7%] female, 27 [45.0%] male, and 2 [3.3%] other), the interaction of physicians' Race IAT score and SP race was significant for overall communication (mean [SD] ß = -1.29 [0.41]), all subdomains of communication (mean [SD] ß = -1.17 [0.52] to -1.43 [0.59]), and overall global ratings (mean [SD] ß = -1.09 [0.39]). Black SPs rated physicians lower on communication skills for a given pro-White Race IAT score than White SPs; White SP ratings increased as physicians' pro-White bias increased. Conclusions and Relevance: In this cross-sectional study, a high-fidelity simulation calibrated with cognitive stressors common to clinical environments elicited the expected influence of racial implicit bias on physicians' communication skills. The outlined process and preliminary results can inform the development and evaluation of interventions that seek to address racial implicit bias in clinical encounters and improve physician communication with Black patients.


Asunto(s)
Sesgo Implícito , Racismo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor Abdominal , Comunicación , Estudios Transversales
20.
Community Dent Health ; 41(1): 70-74, 2024 Feb 29.
Artículo en Inglés | MEDLINE | ID: mdl-38533922

RESUMEN

There are important calls for greater inclusion of Indigenous and racialised communities in oral microbiome research. This paper uses the concept of racial capitalism (the extractive continuity of colonialism) to critically examine this inclusion agenda. Racial capitalism explicitly links capitalist exploitations with wider social oppressions e.g., racisms, sexism, ableism. It is not confined to the commercial sector but pervades white institutions, including universities. By using the lens of racial capitalism, we find inclusion agendas allow white institutions to extract social and economic value from relations of race. Racially inclusive research is perceived as a social good, therefore, it attracts funding. Knowledge and treatments developed from research create immense value for universities and pharmaceutical companies with limited benefits for the communities themselves. Moreover, microbiome research tends to drift from conceptualisations that recognise it as something that is shaped by the social, including racisms, to one that is determined genetically and biologically. This location of problems within racialised bodies reinforces racial oppressions and allows companies to further profit from raciality. Inclusion in oral microbiome research must consider ways to mitigate racial capitalism. Researchers can be less extractive by using an anti-racism praxis framework. This includes working with communities to co-design studies, create safer spaces, giving marginalised communities the power to set and frame agendas, sharing research knowledges and treatments through accessible knowledge distributions, open publications, and open health technologies. Most importantly, inclusion agendas must not displace ambitions of the deeper anti-oppression social reforms needed to tackle health inequalities and create meaningful inclusion.


Asunto(s)
Capitalismo , Racismo , Humanos
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