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1.
Acad Med ; 95(12S Addressing Harmful Bias and Eliminating Discrimination in Health Professions Learning Environments): S163-S168, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33229958

RESUMEN

PURPOSE: Faculty from different racial and ethnic backgrounds developed and piloted an antiracism curriculum initially designed to help medical students work more effectively with patients of color. Learning objectives included developing stronger therapeutic relationships, addressing the effects of structural racism in the lives of patients, and mitigating racism in the medical encounter. METHOD: The antiracism curriculum was delivered and evaluated in 2019 through focus groups and written input before and after each module. The process and outcome evaluation used a grounded theory approach. RESULTS: Three emergent themes reflect how medical students experienced the antiracism curriculum and inform recommendations for integrating an antiracism curriculum into future medical education. The themes are: 1) the differential needs and experiences of persons of color and Whites, 2) the need to address issues of racism within medical education as well as in medical care, and 3) the need for structures of accountability in medical education. CONCLUSIONS: Medical educators must address racism in medical education before seeking to direct students to address it in medical practice.


Asunto(s)
Competencia Cultural/educación , Racismo/prevención & control , Actitud del Personal de Salud , Curriculum/normas , Curriculum/tendencias , Humanos , Racismo/psicología , Racismo/estadística & datos numéricos , Facultades de Medicina/organización & administración , Facultades de Medicina/normas , Facultades de Medicina/estadística & datos numéricos , Determinantes Sociales de la Salud/etnología , Estudiantes de Medicina/psicología , Estudiantes de Medicina/estadística & datos numéricos
2.
J Med Internet Res ; 22(11): e21684, 2020 11 06.
Artículo en Inglés | MEDLINE | ID: mdl-33108307

RESUMEN

BACKGROUND: Media coverage and scholarly research have reported that Asian people who reside in the United States have been the targets of racially motivated incidents during the COVID-19 pandemic. OBJECTIVE: This study aimed to examine the types of discrimination and worries experienced by Asians and Asian Americans living in the United States during the pandemic, as well as factors that were associated with everyday discrimination experience and concerns about future discrimination that the Asian community may face. METHODS: A cross-sectional online survey was conducted. A total of 235 people who identified themselves as Asian or Asian American and resided in the United States completed the questionnaire. RESULTS: Our study suggested that up to a third of Asians surveyed had experienced some type of discrimination. Pooling the responses "very often," "often," and "sometimes," the percentages for each experienced discrimination type ranged between 14%-34%. In total, 49%-58% of respondents expressed concerns about discrimination in the future. The most frequently experienced discrimination types, as indicated by responses "very often" and "often," were "people act as if they think you are dangerous" (25/235, 11%) and "being treated with less courtesy or respect" (24/235, 10%). About 14% (32/235) of individuals reported very often, often, or sometimes being threatened or harassed. In addition, social media use was significantly associated with a higher likelihood of experiencing discrimination (ß=.18, P=.01) and having concerns about future episodes of discrimination the community may face (ß=.20, P=.005). Use of print media was also positively associated with experiencing discrimination (ß=.31, P<.001). CONCLUSIONS: Our study provided important empirical evidence regarding the various types of discrimination Asians residing in the United States experienced or worried about during the COVID-19 pandemic. The relationship between media sources and the perception of racial biases in this group was also identified. We noted the role of social media in reinforcing the perception of discrimination experience and concerns about future discrimination among Asians during this outbreak. Our results indicate several practical implications for public health agencies. To reduce discrimination against Asians during the pandemic, official sources and public health professionals should be cognizant of the possible impacts of stigmatizing cues in media reports on activating racial biases. Furthermore, Asians or Asian Americans could also be informed that using social media to obtain COVID-19 information is associated with an increase in concerns about future discrimination, and thus they may consider approaching this media source with caution.


Asunto(s)
Americanos Asiáticos/psicología , Americanos Asiáticos/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Medios de Comunicación de Masas/estadística & datos numéricos , Neumonía Viral/epidemiología , Racismo/psicología , Racismo/estadística & datos numéricos , Encuestas y Cuestionarios , Adolescente , Adulto , Anciano , Grupos de Población Continentales/estadística & datos numéricos , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Salud Pública , Medios de Comunicación Sociales/estadística & datos numéricos , Estados Unidos/epidemiología , Adulto Joven
5.
BMC Psychol ; 8(1): 111, 2020 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-33097084

RESUMEN

BACKGROUND: Pierce's (The Black seventies: an extending horizon book, 1970) conception of "subtle and stunning" daily racial offenses, or microaggressions, remains salient even 50 years after it was introduced. Microaggressions were defined further by Sue and colleagues (Am Psychol 62:271, 2007), and this construct has found growing utility as the deleterious effects of microaggressions on the health of people of color continues to mount. Microaggressions are common on campuses and contribute to negative social, academic, and mental health outcomes. METHOD: This paper explores how Black college students' experiences correspond to or differ from the microaggression types originally proposed by Sue et al. (Am Psychol 62:271, 2007). Themes were identified from focus group data of students of color (N = 36) from predominately White institutions (PWIs) of higher learning (N = 3) using interpretative phenomenological analysis. RESULTS: We identified 15 categories of racial microaggressions, largely consistent with the original taxonomy of Sue et al. but expanded in several notable ways. New categories in our data and observed by other researchers, included categories termed Connecting via Stereotypes, Exoticization and Eroticization, and Avoidance and Distancing. Lesser studied categories identified included Sue et al.'s Denial of Individual Racism, and new categories termed Reverse Racism Hostility, Connecting via Stereotypes, and Environmental Attacks. DISCUSSION: While previous literature has either embraced the taxonomy developed by Sue and colleagues or proposed a novel taxonomy, this study synthesized the Sue framework in concert with our own focus group findings and the contributions of other researchers. Improving our understanding of microaggressions as they impact people of color may better allow for improved understanding and measurement of this important construct.


Asunto(s)
Afroamericanos/psicología , Agresión , Grupo de Ascendencia Continental Europea/psicología , Investigación Cualitativa , Racismo/estadística & datos numéricos , Universidades , Femenino , Humanos , Masculino , Adulto Joven
6.
Health Educ Behav ; 47(6): 870-879, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32911985

RESUMEN

On March 8, 2020, there was a 650% increase in Twitter retweets using the term "Chinese virus" and related terms. On March 9, there was an 800% increase in the use of these terms in conservative news media articles. Using data from non-Asian respondents of the Project Implicit "Asian Implicit Association Test" from 2007-2020 (n = 339,063), we sought to ascertain if this change in media tone increased bias against Asian Americans. Local polynomial regression and interrupted time-series analyses revealed that Implicit Americanness Bias-or the subconscious belief that European American individuals are more "American" than Asian American individuals-declined steadily from 2007 through early 2020 but reversed trend and began to increase on March 8, following the increase in stigmatizing language in conservative media outlets. The trend reversal in bias was more pronounced among conservative individuals. This research provides evidence that the use of stigmatizing language increased subconscious beliefs that Asian Americans are "perpetual foreigners." Given research that perpetual foreigner bias can beget discriminatory behavior and that experiencing discrimination is associated with adverse mental and physical health outcomes, this research sounds an alarm about the effects of stigmatizing media on the health and welfare of Asian Americans.


Asunto(s)
Americanos Asiáticos , Infecciones por Coronavirus/epidemiología , Medios de Comunicación de Masas/estadística & datos numéricos , Neumonía Viral/epidemiología , Racismo/estadística & datos numéricos , Terminología como Asunto , Betacoronavirus , Humanos , Pandemias , Estereotipo , Estados Unidos
8.
Am J Public Health ; 110(11): 1624-1627, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32941063

RESUMEN

Anti-Asian discrimination and assaults have increased significantly during the Coronavirus disease 2019 (COVID-19) pandemic, contributing to a "secondary contagion" of racism. The United States has a long and well-documented history of both interpersonal and structural anti-Asian discrimination, and the current pandemic reinforces longstanding negative stereotypes of this rapidly growing minority group as the "Yellow Peril."We provide a general overview of the history of anti-Asian discrimination in the United States, review theoretical and empirical associations between discrimination and health, and describe the associated public health implications of the COVID-19 pandemic, citing relevant evidence from previous disasters in US history that became racialized.Although the literature suggests that COVID-19 will likely have significant negative effects on the health of Asian Americans and other vulnerable groups, there are reasons for optimism as well. These include the emergence of mechanisms for reporting and tracking incidents of racial bias, increased awareness of racism's insidious harms and subsequent civic and political engagement by the Asian American community, and further research into resilience-promoting factors that can reduce the negative health effects of racism.


Asunto(s)
Americanos Asiáticos , Infecciones por Coronavirus/etnología , Neumonía Viral/etnología , Racismo/estadística & datos numéricos , Americanos Asiáticos/historia , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Historia del Siglo XIX , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Pandemias , Neumonía Viral/epidemiología , Salud Pública/tendencias , Racismo/historia , Estados Unidos/epidemiología
9.
Pediatrics ; 146(5)2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32873719

RESUMEN

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has fueled xenophobia against Chinese Americans. We examined the rates of 6 types of COVID-19 racism and racial discrimination experienced by Chinese American parents and youth and the associations with their mental health. METHODS: We recruited a population-based sample of Chinese American families to participate in this self-reported survey study conducted from March 14, 2020, to May 31, 2020. Eligible parent participants identified as ethnically/racially Chinese, lived in the United States, and had a 4- to 18-year-old child; their eligible children were 10 to 18 years old. RESULTS: The sample included 543 Chinese American parents (mean [SD] age, 43.44 [6.47] years; 425 mothers [78.3%]), and their children (N = 230; mean [SD] age, 13.83 [2.53] years; 111 girls [48.3%]). Nearly half of parents and youth reported being directly targeted by COVID-19 racial discrimination online (parents: 172 [31.7%]; youth: 105 [45.7%]) and/or in person (parents: 276 [50.9%]; youth: 115 [50.2%]). A total of 417 (76.8%) parents and 176 (76.5%) youth reported at least 1 incident of COVID-19 vicarious racial discrimination online and/or in person (parents: 481 [88.5%]; youth: 211 [91.9%]). A total of 267 (49.1%) parents and 164 (71.1%) youth perceived health-related Sinophobia in America, and 274 (50.4%) parents and 129 (56.0%) youth perceived media-perpetuated Sinophobia. Higher levels of parent- and youth-perceived racism and racial discrimination were associated with their poorer mental health. CONCLUSIONS: Health care professionals must attend to the racism-related experiences and mental health needs of Chinese Americans parents and their children throughout the COVID-19 pandemic via education and making appropriate mental health referrals.


Asunto(s)
Americanos Asiáticos/psicología , Infecciones por Coronavirus/psicología , Neumonía Viral/psicología , Racismo/psicología , Xenofobia/psicología , Adolescente , Adulto , Niño , Preescolar , China/etnología , Estudios Transversales , Femenino , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , Pandemias , Racismo/estadística & datos numéricos , Autoinforme , Percepción Social , Estados Unidos , Xenofobia/estadística & datos numéricos
10.
J Pastoral Care Counsel ; 74(3): 196-202, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32967549

RESUMEN

Profanity, derived from the Latin for "not sacred," has long been seen as antithetical to spirituality. Social norms around organized religion, respectability, race, gender, etc. compound this perception. In this article, I examine how the use of profanity in Clinical Pastoral Education can help students experience personal, social, and physical freedom. Association of Clinical Pastoral Education outcomes, demographic data, and a student experience provide support for this assertion.


Asunto(s)
Lenguaje , Cuidado Pastoral/educación , Afroamericanos/psicología , Afroamericanos/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Homicidio/psicología , Homicidio/estadística & datos numéricos , Humanos , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/psicología , Racismo/psicología , Racismo/estadística & datos numéricos , Desempleo/psicología , Desempleo/estadística & datos numéricos , Estados Unidos/epidemiología
11.
Artículo en Inglés | MEDLINE | ID: mdl-32993005

RESUMEN

Background: Anecdotal reports suggest a rise in anti-Asian racial attitudes and discrimination in response to COVID-19. Racism can have significant social, economic, and health impacts, but there has been little systematic investigation of increases in anti-Asian prejudice. Methods: We utilized Twitter's Streaming Application Programming Interface (API) to collect 3,377,295 U.S. race-related tweets from November 2019-June 2020. Sentiment analysis was performed using support vector machine (SVM), a supervised machine learning model. Accuracy for identifying negative sentiments, comparing the machine learning model to manually labeled tweets was 91%. We investigated changes in racial sentiment before and following the emergence of COVID-19. Results: The proportion of negative tweets referencing Asians increased by 68.4% (from 9.79% in November to 16.49% in March). In contrast, the proportion of negative tweets referencing other racial/ethnic minorities (Blacks and Latinx) remained relatively stable during this time period, declining less than 1% for tweets referencing Blacks and increasing by 2% for tweets referencing Latinx. Common themes that emerged during the content analysis of a random subsample of 3300 tweets included: racism and blame (20%), anti-racism (20%), and daily life impact (27%). Conclusion: Social media data can be used to provide timely information to investigate shifts in area-level racial sentiment.


Asunto(s)
Infecciones por Coronavirus/psicología , Conocimientos, Actitudes y Práctica en Salud , Neumonía Viral/psicología , Racismo/estadística & datos numéricos , Medios de Comunicación Sociales , Grupo de Ascendencia Continental Asiática , Betacoronavirus , Humanos , Pandemias , Aprendizaje Automático Supervisado , Máquina de Vectores de Soporte , Estados Unidos
12.
J Med Internet Res ; 22(9): e22767, 2020 09 25.
Artículo en Inglés | MEDLINE | ID: mdl-32924948

RESUMEN

BACKGROUND: The perceived threat of a contagious virus may lead people to be distrustful of immigrants and out-groups. Since the COVID-19 outbreak, the salient politicized discourses of blaming Chinese people for spreading the virus have fueled over 2000 reports of anti-Asian racial incidents and hate crimes in the United States. OBJECTIVE: The study aims to investigate the relationships between news consumption, trust, intergroup contact, and prejudicial attitudes toward Asians and Asian Americans residing in the United States during the COVID-19 pandemic. We compare how traditional news, social media use, and biased news exposure cultivate racial attitudes, and the moderating role of media use and trust on prejudice against Asians is examined. METHODS: A cross-sectional study was completed in May 2020. A total of 430 US adults (mean age 36.75, SD 11.49 years; n=258, 60% male) participated in an online survey through Amazon's Mechanical Turk platform. Respondents answered questions related to traditional news exposure, social media use, perceived trust, and their top three news channels for staying informed about the novel coronavirus. In addition, intergroup contact and racial attitudes toward Asians were assessed. We performed hierarchical regression analyses to test the associations. Moderation effects were estimated using simple slopes testing with a 95% bootstrap confidence interval approach. RESULTS: Participants who identified as conservatives (ß=.08, P=.02), had a personal infection history (ß=.10, P=.004), and interacted with Asian people frequently in their daily lives (ß=.46, P<.001) reported more negative attitudes toward Asians after controlling for sociodemographic variables. Relying more on traditional news media (ß=.08, P=.04) and higher levels of trust in social media (ß=.13, P=.007) were positively associated with prejudice against Asians. In contrast, consuming news from left-leaning outlets (ß=-.15, P=.001) and neutral outlets (ß=-.13, P=.003) was linked to less prejudicial attitudes toward Asians. Among those who had high trust in social media, exposure had a negative relationship with prejudice. At high levels of trust in digital websites and apps, frequent use was related to less unfavorable attitudes toward Asians. CONCLUSIONS: Experiencing racial prejudice among the Asian population during a challenging pandemic can cause poor psychological outcomes and exacerbate health disparities. The results suggest that conservative ideology, personal infection history, frequency of intergroup contact, traditional news exposure, and trust in social media emerge as positive predictors of prejudice against Asians and Asian Americans, whereas people who get COVID-19 news from left-leaning and balanced outlets show less prejudice. For those who have more trust in social media and digital news, frequent use of these two sources is associated with lower levels of prejudice. Our findings highlight the need to reshape traditional news discourses and use social media and mobile news apps to develop credible messages for combating racial prejudice against Asians.


Asunto(s)
Americanos Asiáticos , Actitud , Infecciones por Coronavirus/psicología , Relaciones Interpersonales , Medios de Comunicación de Masas/estadística & datos numéricos , Neumonía Viral/psicología , Racismo/estadística & datos numéricos , Medios de Comunicación Sociales/estadística & datos numéricos , Confianza , Adulto , Infecciones por Coronavirus/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Pandemias , Neumonía Viral/epidemiología , Racismo/psicología , Estados Unidos/epidemiología
13.
JMIR Public Health Surveill ; 6(4): e19833, 2020 10 15.
Artículo en Inglés | MEDLINE | ID: mdl-32936772

RESUMEN

BACKGROUND: With increasing numbers of patients with COVID-19 globally, China and the World Health Organization have been blamed by some for the spread of this disease. Consequently, instances of racism and hateful acts have been reported around the world. When US President Donald Trump used the term "Chinese Virus," this issue gained momentum, and ethnic Asians are now being targeted. The online situation looks similar, with increases in hateful comments and posts. OBJECTIVE: The aim of this paper is to analyze the increasing instances of cyber racism during the COVID-19 pandemic, by assessing emotions and sentiments associated with tweets on Twitter. METHODS: In total, 16,000 tweets from April 11-16, 2020, were analyzed to determine their associated sentiments and emotions. Statistical analysis was carried out using R. Twitter API and the sentimentr package were used to collect tweets and then evaluate their sentiments, respectively. This research analyzed the emotions and sentiments associated with terms like "Chinese Virus," "Wuhan Virus," and "Chinese Corona Virus." RESULTS: The results suggest that the majority of the analyzed tweets were of negative sentiment and carried emotions of fear, sadness, anger, and disgust. There was a high usage of slurs and profane words. In addition, terms like "China Lied People Died," "Wuhan Health Organization," "Kung Flu," "China Must Pay," and "CCP is Terrorist" were frequently used in these tweets. CONCLUSIONS: This study provides insight into the rise in cyber racism seen on Twitter. Based on the findings, it can be concluded that a substantial number of users are tweeting with mostly negative sentiments toward ethnic Asians, China, and the World Health Organization.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Racismo/estadística & datos numéricos , Medios de Comunicación Sociales/estadística & datos numéricos , Emociones , Humanos
15.
Acad Med ; 95(12S Addressing Harmful Bias and Eliminating Discrimination in Health Professions Learning Environments): S131-S135, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32889929

RESUMEN

In 2018, in response to a news story featuring the Icahn School of Medicine's decision to eliminate its chapter of Alpha Omega Alpha (AOA) due to perceived racial inequities, students at Washington University School of Medicine in St. Louis (WUSM) brought similar concerns to leadership. WUSM leadership evaluated whether students' race, ethnicity, and gender were associated with their receipt of honors in the 6 core clerkships, key determinants of AOA selection. In preliminary analysis of the school's data, statistically significant racial and ethnic disparities were associated with receipt of honors in each clerkship. Leaders shared these findings with the WUSM community along with a clear message that such discrepancies are unacceptable to the school. An effort to further analyze what lay behind the findings as well as to identify steps to resolve the problem was launched. Using a quality improvement framework, data from focus groups and student surveys were analyzed and 2 overarching themes emerged. Students perceived that both assessment and the learning environment impacted racial/ethnic disparities in clerkship grades. In multivariable logistic regression models, shelf exam scores (a part of student assessment) were found to be associated with receipt of honors in each clerkship; in some (but not all) clerkships, shelf exam scores attenuated the effect of race/ethnicity on receipt of honors, so that when the shelf scores were added to the model, the race/ethnicity effect was no longer significant. This case study describes WUSM's process to understand and address bias in clerkship grading and AOA nomination so that other medical schools might benefit from what has been learned.


Asunto(s)
Evaluación Educacional/normas , Racismo/prevención & control , Estudios de Casos y Controles , Prácticas Clínicas/métodos , Prácticas Clínicas/normas , Prácticas Clínicas/estadística & datos numéricos , Competencia Clínica/normas , Competencia Clínica/estadística & datos numéricos , Educación de Postgrado en Medicina/métodos , Educación de Postgrado en Medicina/normas , Evaluación Educacional/métodos , Evaluación Educacional/estadística & datos numéricos , Humanos , Missouri , Racismo/psicología , Racismo/estadística & datos numéricos , Encuestas y Cuestionarios
16.
Acad Med ; 95(12S Addressing Harmful Bias and Eliminating Discrimination in Health Professions Learning Environments): S88-S92, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32889940

RESUMEN

Bias can impact all aspects of human interactions and have major impacts on the education and evaluation of health care professionals. Health care and health professions education, being very dependent on interpersonal interactions and learning as well as on the assessment of interpersonal behaviors and skills, are particularly susceptible to the positive and negative effects of bias. Even trained and experienced evaluators can be affected by biases based on appearance, attractiveness, charm, accent, speech impediment, and other factors that should not play a role in the assessment of a skill. At the Morehouse School of Medicine, elements in the curriculum and the milieu help decrease the burden of bias experienced by learners. In addition, many of the learners develop knowledge, skills, and attitudes that appear to assist them with navigating bias in other learning or practice environments. In this case study, the authors reflect on these elements and how they can be replicated in other settings. According to the authors, modifying the learning environment to enhance and sustain relationships is key in addressing toxic bias.


Asunto(s)
Relaciones Interpersonales , Tutoría/normas , Racismo/psicología , Facultades de Medicina/tendencias , Estudios de Casos y Controles , Georgia , Humanos , Racismo/estadística & datos numéricos , Facultades de Medicina/organización & administración
17.
N Z Med J ; 133(1521): 55-68, 2020 09 04.
Artículo en Inglés | MEDLINE | ID: mdl-32994637

RESUMEN

BACKGROUND: Racism is an underlying cause of ethnic health inequities both in Aotearoa New Zealand and internationally. It is timely to synthesise racism and health research within New Zealand particularly given the current policy environment and shift towards addressing the health effects of racism. AIM: To review quantitative research examining self-reported experiences of racial discrimination and associations with measures of health (health conditions, health risk, health status and healthcare) in New Zealand. METHODS: MEDLINE, PsycINFO, Web of Science and CINAHL databases were searched for studies reporting on associations between experiences of racism and health. RESULTS: The systematic review identified 24 quantitative studies reporting associations between self-reported racial discrimination across a wide range of health measures including mental health, physical health, self-rated health, wellbeing, individual level health risks, and healthcare indicators. CONCLUSIONS: Quantitative racism and health research in New Zealand consistently finds that self-reported racial discrimination is associated with a range of poorer health outcomes and reduced access to and quality of healthcare. This review confirms that experience of racial discrimination is an important determinant of health in New Zealand, as it is internationally. There is a pressing need for effectively designed interventions to address the impacts of racism on health.


Asunto(s)
Disparidades en Atención de Salud/estadística & datos numéricos , Racismo/estadística & datos numéricos , Grupo de Ascendencia Continental Europea , Estado de Salud , Disparidades en el Estado de Salud , Humanos , Nueva Zelanda , Grupo de Ascendencia Oceánica , Autoinforme
18.
PLoS One ; 15(9): e0239482, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32970711

RESUMEN

BACKGROUND: I investigate the association of perceived discrimination based both on race and other attributes such as age, gender, and insurance status on self-reported health access and health outcomes in a diverse and densely populated metropolitan area. METHODS: Restricted data from the 2016 round of the New York City Community Health Survey was used to create prevalence estimates for both racial and non-racial discrimination. Logistic regression models were used to estimate the association of these discrimination measures with health access and health outcome variables. RESULTS: Among residents who perceived discrimination receiving health care during the previous year, 15% reported the reason behind such discrimination to race, while the rest chose other reasons. Among the non-race based categories, 34% reported the reason behind such discrimination to be insurance status, followed by other reasons (26.83%) and income (11.76%). Non-racial discrimination was significantly associated with the adjusted odds of not receiving care when needed (AOR = 6.96; CI: [5.00 9.70]), and seeking informal care (AOR = 2.24; CI: [1.13 4.48] respectively, after adjusting for insurance status, age, gender, marital status, race/ethnicity, nativity, and poverty. It was also associated with higher adjusted odds of reporting poor health (AOR = 2.49; CI: [1.65 3.75]) and being diagnosed with hypertension (AOR = 1.75; CI: [1.21 2.52]), and diabetes (AOR = 1.84; CI: [1.22 2.77]) respectively. CONCLUSIONS: Perceived discrimination in health care exists in multiple forms. Non-racial discrimination was strongly associated with worse health access and outcomes, and such experiences may contribute to health disparities between different socioeconomic groups.


Asunto(s)
Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Disparidades en Atención de Salud/estadística & datos numéricos , Prejuicio/estadística & datos numéricos , Prestación de Atención de Salud/tendencias , Grupos Étnicos/estadística & datos numéricos , Femenino , Encuestas Epidemiológicas , Humanos , Cobertura del Seguro/estadística & datos numéricos , Masculino , Ciudad de Nueva York/epidemiología , Racismo/estadística & datos numéricos , Autoinforme , Factores Socioeconómicos
19.
PLoS One ; 15(9): e0238356, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32991624

RESUMEN

BACKGROUND: A lack of patient-centered communication (PCC) with health providers plays an important role in perpetuating disparities in health care outcomes and experiences for minority men. This study aimed to identify factors associated with any racial differences in the experience of PCC among Black and Latino men in a nationally representative sample. METHODS: We employed a cross-sectional analysis of four indicators of PCC representative of interactions with doctors and nurses from (N = 3082) non-Latino White, Latino, and Black males from the 2010 Health and Retirement Study (HRS) Core and the linked HRS Health Care Mail in Survey (HCMS). Men's mean age was 66.76 years. The primary independent variable was Race/Ethnicity (i.e. Black and Hispanic/Latino compared to white males) and covariates included age, education, marital status, insurance status, place of care, and self-rated health. RESULTS: Bivariate manova analyses revealed racial differences across each of the four facets of PCC experience such that non-Hispanic white men reported PC experiences most frequently followed by black then Hispanic/Latino men. Multivariate linear regressions predictive of PCC by race/ethnicity revealed that for Black men, fewer PCC experiences were predicted by discriminatory experiences, reporting fewer chronic conditions and a lack of insurance coverage. For Hispanic/Latino men, access to a provider proved key where not having a place of usual care solely predicted lower PCC frequency. IMPLICATIONS: Researchers and health practitioners should continue to explore the impact of inadequate health care coverage, time-limited medical visits and implicit racial bias on medical encounters for underrepresented patients, and to advocate for accessible, inclusive and responsive communication between minority male patients and their health providers.


Asunto(s)
Afroamericanos/estadística & datos numéricos , Enfermedad Crónica/terapia , Comunicación , Disparidades en Atención de Salud , Hispanoamericanos/estadística & datos numéricos , Atención Dirigida al Paciente/normas , Relaciones Médico-Paciente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Estudios de Seguimiento , Humanos , Cobertura del Seguro , Masculino , Persona de Mediana Edad , Educación del Paciente como Asunto , Pronóstico , Racismo/estadística & datos numéricos
20.
PLoS One ; 15(8): e0237026, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32760109

RESUMEN

The Occupational Information Network (O*NET) database has been used as a valuable source of occupational exposure information. Although good agreement between O*NET and self-reported measures has been reported, little attention has been paid to O*NET's utility in racially/ethnically diverse samples. Because O*NET offers job-level information, if different racial groups have different experiences under the same job title, O*NET measure would introduce systematic measurement error. Using the General Social Survey data (n = 7,041; 437 occupations), we compared self-report and O*NET-derived measures of job control in their associations with self-rated health (SRH) for non-Hispanic whites and racial/ethnic minorities. The correlation between self-report and O*NET job control measures were moderate for all gender-race groups (Pearson's r = .26 - .40). However, the logistic regression analysis showed that the association between O*NET job control and SRH was markedly weaker for racial/ethnic minorities than for non-Hispanic whites. The self-reported job control was associated with SRH in similar magnitudes for both groups, which precluded the possibility that job control was relevant only for non-Hispanic whites. O*NET may not capture job experience for racial/ethnic minorities, and thus its utility depends on the racial/ethnic composition of the sample.


Asunto(s)
Estado de Salud , Ocupaciones , Racismo/estadística & datos numéricos , Adulto , Bases de Datos Factuales , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Grupos Minoritarios/estadística & datos numéricos , Exposición Profesional , Salud Laboral , Ocupaciones/estadística & datos numéricos , Autoinforme , Factores Socioeconómicos , Estados Unidos
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