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

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

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

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

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

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

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

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

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

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

D'Eichthal and Urbain's "Lettres sur la race noire et la race blanche": race, gender, and reconciliation after slave emancipation.

This article is a close reading of Gustave D'Eichthal and Ishmayl Urbain's Lettres sur la race noire et la race blanche (1839), written during the decade prior to the "second" French emancipation in 1848. The article argues that the hierarchical gendering of race described in the letters is reflective of metropolitan concerns about potential for social disorder accompanying slave emancipation in the French colonies. In arguing for social reconciliation through interracial marriage and its offspring, the symbolically charged figure of the mulatto, the authors deployed gendered and familial language to describe a stable post-emancipation society.

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

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

Being Yoruba in nineteenth-century Rio de Janeiro.

Through the experiences of two West Africans shipped to Bahia as slaves, probably in the 1840s, then sold south to Rio de Janeiro where they met, became lovers, bought their freedom, married, and divorced, I comment on an ongoing debate over the refashioning or transfer of African ethnic identities in American slave societies. The sources in this Brazilian case suggest that previous identities were not suddenly erased, but rather, new layers of understanding and ways of responding were added. Whatever the dynamic of cultural formation, it was memory that crucially bridged the distance between the past they carried with them and the present into which they were thrust; and so it becomes illuminating to reconstruct the plausibly remembered African pasts on which this couple drew to make sense of an unfamiliar Brazilian present.