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1.
Proc Natl Acad Sci U S A ; 118(39)2021 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-34544875

RESUMO

On May 25, 2020, George Floyd, an unarmed Black American male, was killed by a White police officer. Footage of the murder was widely shared. We examined the psychological impact of Floyd's death using two population surveys that collected data before and after his death; one from Gallup (117,568 responses from n = 47,355) and one from the US Census (409,652 responses from n = 319,471). According to the Gallup data, in the week following Floyd's death, anger and sadness increased to unprecedented levels in the US population. During this period, more than a third of the US population reported these emotions. These increases were more pronounced for Black Americans, nearly half of whom reported these emotions. According to the US Census Household Pulse data, in the week following Floyd's death, depression and anxiety severity increased among Black Americans at significantly higher rates than that of White Americans. Our estimates suggest that this increase corresponds to an additional 900,000 Black Americans who would have screened positive for depression, associated with a burden of roughly 2.7 million to 6.3 million mentally unhealthy days.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Emoções/fisiologia , Homicídio/psicologia , Saúde Mental/etnologia , Polícia/estatística & dados numéricos , Racismo/psicologia , Adolescente , Adulto , Afro-Americanos/psicologia , Ira/fisiologia , Ansiedade/psicologia , Depressão/psicologia , Grupo com Ancestrais do Continente Europeu/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
2.
Ann Surg ; 274(4): 597-604, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34506314

RESUMO

OBJECTIVE: To evaluate patient satisfaction scores as a function of physician and patient race and sex. BACKGROUND: Patient satisfaction is increasingly used as a surrogate for physician performance. How patient and surgeon race and ethnicity affect perceptions of surgeon communication and care is not widely explored. METHODS: Press Ganey patient satisfaction surveys collected from January 2019 to September 2020 were studied. Multivariate logistic regressions were used to identify factors associated with favorable surgeon performance as a function of patient and surgeon demographics. RESULTS: A total of 4732 unique outpatient satisfaction survey responses were analyzed. The majority of patients were White (60.5%), followed by Asian (8.6%), Black (4.2%), and Hispanic (4.3%). URM accounted for 8.9% of the 79 surgeons evaluated, and 34% were female. Black, Hispanic, and Asian patients were more likely to report unfavorable experiences than their White counterparts (P < 0.01). Spanish-speaking patients were most likely to perceive that surgeon show less respect for patient concerns (13.9% vs 9.3%, P = 0.004) and inadequate time spent explaining health concerns (12.6% vs 9.2%, P < 0.001). Female surgeons were more likely to achieve the highest overall ratings for effective communication, whereas Asian surgeons received lower scores. Asian surgeons were more likely than non-Asian surgeons to receive lower scores in explanation (37.3% vs 44.1%, P = 0.003). After adjusting for confounding factors, Asian surgeons had 26% lower odds of receiving favorable scores for overall communication (odds ratio: 0.736, 95% confidence interval: 0.619-0.877, P = 0.001). CONCLUSIONS: Both patient and surgeon race and sex drive negative perceptions of patient-physician communication. As URM report more negative experiences, further studies should focus on effects of surgeon cultural awareness on underrepresented patient satisfaction.


Assuntos
Grupos Étnicos/psicologia , Grupo com Ancestrais do Continente Europeu/psicologia , Satisfação do Paciente , Adulto , Idoso , Viés , Comunicação , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Relações Médico-Paciente , Inquéritos e Questionários
4.
Law Hum Behav ; 45(3): 243-255, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34351206

RESUMO

OBJECTIVE: Although researchers, policymakers, and practitioners recognize the importance of the public's perceptions of police, few studies have examined developmental trends in adolescents and young adults' views of police. HYPOTHESES: Hypothesis 1: Perceptions of police legitimacy would exhibit a U-shaped curve, declining in adolescence before improving in young adulthood. Hypothesis 2: At all ages, Black youth would report more negative perceptions of police legitimacy than Latino youth, who would report more negative perceptions than White youth. Hypothesis 3: Perceptions of police bias would be consistently associated with worse perceptions of police legitimacy. METHOD: Utilizing longitudinal data from the Crossroads Study, this study examined within-person trends in males' perceptions of police legitimacy from ages 13 to 22, as well as whether perceptions of police bias were associated with perceptions of police legitimacy. RESULTS: Perceptions of police legitimacy followed a U-shaped curve that declined during adolescence, reached its lowest point around age 18, and improved during the transition to young adulthood. Compared with White youth, Latino and Black youth had shallower curves in perceptions of police legitimacy that exhibited less improvement during the transition to adulthood. Further, perceptions of police bias were consistently associated with more negative perceptions of police legitimacy across races and ages. CONCLUSIONS: While perceptions of police legitimacy may decline during adolescence before improving during the transition to adulthood, perceptions of police bias are consistently negatively related to youth and young adults' perceptions of police legitimacy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Atitude/etnologia , Grupo com Ancestrais do Continente Europeu/psicologia , Hispano-Americanos/psicologia , Percepção , Polícia , Racismo/etnologia , Adolescente , Fatores Etários , Humanos , Aplicação da Lei , Estudos Longitudinais , Masculino , Estados Unidos/etnologia , Adulto Jovem
5.
Psychol Aging ; 36(5): 572-583, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34351184

RESUMO

The longitudinal associations between subjective and objective memory functioning in later life remain unclear. This may be due, in part, to sociodemographic differences across studies, given the hypothesis that these associations differ across racial groups. Using data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE; N = 2,694; 26% African American), multiple-group, parallel-process latent growth curve models were used to explore relationships between subjective and objective memory over 10 years and assess racial differences in these associations. Across African Americans and whites, we found bidirectional associations between subjective and objective memory such that greater self-reported forgetting at baseline predicted faster subsequent verbal episodic memory declines, and higher baseline objective memory scores predicted less increase in self-reported forgetting over time. However, rates of change in self-reported frequency of forgetting were correlated with rates of change in verbal episodic memory in whites, but not in African Americans. Subjective memory complaints may be a harbinger of future memory declines across African Americans and whites but may not track with objective memory in the same way across these racial groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Envelhecimento/psicologia , Grupos de Populações Continentais/psicologia , Transtornos da Memória/psicologia , Memória Episódica , Memória , Afro-Americanos/psicologia , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Europeu/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Fatores de Tempo
6.
Psychol Addict Behav ; 35(5): 501-513, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34110841

RESUMO

BACKGROUND: Family history of alcohol use disorder; AUD (FH +) and impulsivity-related traits are known risk factors for problem drinking that have been investigated in predominately White samples. This cross-sectional study examined whether these risk factors vary by sex in the overall, majority White sample and in a Black subsample. METHOD: A model building regression procedure was used to investigate the combined effect of FH + and impulsivity-related traits on alcohol quantity, frequency, and problems by sex (overall sample: N = 757, 50% female, 73% White, agemean = 33.74, SD = 11.60; Black subsample: n = 138, 47% female, agemean = 33.60, SD = 9.87). RESULTS: Overall Sample. No sex differences were found in the compounding effects of FH + and impulsivity-related traits on alcohol outcomes. Males reported more physical, social, and overall alcohol-related problems than females. FH + was positively associated with all alcohol-related consequences. Poor self-regulation was the only trait associated with all alcohol outcomes. Black Subsample: A three-way interaction suggested a negative association between inhibition and frequency of alcohol use among FH + males only. A two-way interaction also suggested impulse control was associated with more interpersonal alcohol-related problems among males only. Main effects were also found in the expected direction such that higher impulsivity and FH + were associated with poorer alcohol outcomes. CONCLUSION: These findings suggest no sex differences in the overall sample in the interactive effects of established risk factors for AUD on alcohol outcomes, and that poor self-regulation may be key for personality-targeted alcohol prevention and intervention programs. Preliminary findings of sex differences in the Black subsample should be replicated. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Transtornos Relacionados ao Uso de Álcool , Alcoolismo , Individualidade , Adulto , Afro-Americanos/psicologia , Afro-Americanos/estatística & dados numéricos , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Transtornos Relacionados ao Uso de Álcool/etnologia , Transtornos Relacionados ao Uso de Álcool/psicologia , Alcoolismo/epidemiologia , Alcoolismo/etnologia , Alcoolismo/psicologia , Estudos Transversais , Grupo com Ancestrais do Continente Europeu/psicologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Comportamento Impulsivo , Masculino , Anamnese/estatística & dados numéricos , Fatores de Risco , Distribuição por Sexo
8.
Asia Pac J Public Health ; 33(5): 587-594, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34078132

RESUMO

Existing research on subjective cognitive decline (SCD) among Native Hawaiians/Other Pacific Islanders (NHOPIs) is limited even though NHOPI adults have the highest prevalence of cardiovascular risk factors. In this study, we investigated SCD disparities among NHOPIs, Asian Americans, and White Americans and its contributing factors utilizing the 2015 and 2017 survey year data from the Behavioral Risk Factor Surveillance System (BRFSS) for Hawai'i State in the United States. The SCD prevalence was 11.9%, 8.97%, and 7.86% among NHOPIs, Whites, and Asians, respectively. Adjusting for sociodemographic and health behavioral variables, the prevalence ratios (PRs) of SCD were 1.37 (95% confidence interval [CI] = 1.05-1.78) for NHOPI versus Asian and 1.15 (95% CI = 0.89-1.50) for NHOPI versus Whites. The associations were weakened after adjusting for health conditions. Depressive disorders, coronary heart disease or myocardial infarction, stroke, and diabetes were associated with cognitive decline in the multivariate-adjusted model. NHOPIs experienced more SCD-related functional difficulties than other races.


Assuntos
Americanos Asiáticos , Disfunção Cognitiva , Grupo com Ancestrais do Continente Europeu , Disparidades nos Níveis de Saúde , Grupo com Ancestrais Oceânicos , Adulto , Americanos Asiáticos/psicologia , Americanos Asiáticos/estatística & dados numéricos , Sistema de Vigilância de Fator de Risco Comportamental , Disfunção Cognitiva/etnologia , Grupo com Ancestrais do Continente Europeu/psicologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Humanos , Grupo com Ancestrais Oceânicos/psicologia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Estados Unidos/epidemiologia
9.
West J Emerg Med ; 22(3): 488-497, 2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-34125018

RESUMO

INTRODUCTION: Firearm-related deaths and injuries are ongoing public health issues in the United States. We reviewed a series of gun violence- and firearm-related injuries treated at a multi-campus community healthcare system in West Michigan to better understand the demographic and clinical characteristics of these injuries. We also studied hospital charges, and payers responsible, in an effort to identify stakeholders and opportunities for community- and hospital-based prevention. METHODS: We performed a retrospective review of firearm injuries treated at Mercy Health Muskegon (MHM) between May 1, 2015 and June 30, 2019. Demographic data, injury type, Injury Severity Score (ISS), anatomic location and organ systems involved, length of stay (LOS), mortality, time of year, and ZIP code in which the injury occurred were reviewed, as were hospital charges and payers responsible. RESULTS: Of those reviewed, 307 firearm-related injuries met inclusion criteria for the study. In 69.4% of cases the injury type was attempted murder or intent to do bodily harm. Accidental and self-inflicted injuries accounted for 25% of cases. There was a statistically significant difference in the mechanism of injury between Black and White patients with a higher proportion of Black men injured due to gun violence (P < 0.001). Median ISS was 8 and the most commonly injured organ system was musculoskeletal. Median LOS was one day. Self-inflicted firearm injuries had the highest rate of mortality (50%) followed by attempted murder (7%) and accidental discharge (3.1%; P < 0.001). Median hospital charge was $8,008. In 68% of cases, Medicaid was the payer. MHM received $4.98 million dollars in reimbursement from Medicaid; however, when direct and indirect costs were taken into account, a loss of $12,648 was observed. CONCLUSION: Findings from this study reveal that young, Black men are the primary victims of gun violence-related injuries in our West Michigan service area. Hospital care of firearm-related injuries at MHM was predominantly paid for by Medicaid. Multiple stakeholders stand to benefit from funding and supporting community- and hospital-based prevention programs designed to reduce gun violence and firearm-related injuries in our service area.


Assuntos
Afro-Americanos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/psicologia , Armas de Fogo/estatística & dados numéricos , Violência com Arma de Fogo/prevenção & controle , Homicídio/estatística & dados numéricos , Ferimentos por Arma de Fogo/epidemiologia , Adolescente , Adulto , Violência com Arma de Fogo/estatística & dados numéricos , Preços Hospitalares , Humanos , Escala de Gravidade do Ferimento , Tempo de Internação/estatística & dados numéricos , Masculino , Medicaid , Michigan/epidemiologia , Pessoa de Meia-Idade , Alta do Paciente , Estudos Retrospectivos , Estados Unidos
10.
Am Soc Clin Oncol Educ Book ; 41: e29-e46, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34161138

RESUMO

Persistent disparities in the burden of breast cancer between African Americans and White Americans have been documented over many decades. Features characterizing breast cancer in the African American community include a 40% higher mortality rate, younger age distribution, greater advanced-stage distribution, increased risk of biologically aggressive disease such as the triple-negative phenotype, and increased incidence of male breast cancer. Public health experts, genetics researchers, clinical trialists, multidisciplinary oncology teams, and advocates must collaborate to comprehensively address the multifactorial etiology of and remedies for breast cancer disparities. Efforts to achieve breast health equity through improved access to affordable, high-quality care are especially imperative in the context of the COVID-19 pandemic and its disproportionately high economic toll on African Americans.


Assuntos
Neoplasias da Mama/epidemiologia , COVID-19/epidemiologia , Disparidades em Assistência à Saúde/tendências , Pandemias , Afro-Americanos/psicologia , Neoplasias da Mama/patologia , COVID-19/patologia , Grupo com Ancestrais do Continente Europeu/psicologia , Feminino , Humanos , SARS-CoV-2/patogenicidade , Fatores Socioeconômicos
11.
J Soc Psychol ; 161(4): 419-434, 2021 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-33960284

RESUMO

This research examined the effects of the onset of the COVID-19 pandemic on perceived Black-White intergroup competition and negative intergroup psychological outcomes. Two datasets (collected before [2018] and after the onset of [April, 2020] COVID-19) were combined (N = 2,131) for this research. The data provided support for the hypothesis that perceptions of Black-White intergroup competition, and subsequently perceptions of discrimination, behavioral avoidance, intergroup anxiety, and interracial mistrust would be higher after the onset of COVID-19. Three additional predictors, a perceived interracial competition manipulation, political orientation, and population density at the ZIP-code level were examined to test for main effects and moderation of COVID-19 effects. All three predictors exhibited main effects on focal outcomes, and political orientation moderated COVID-19 onset effects: effects were stronger for conservatives. Lastly, perceived intergroup competition mediated the effect of COVID-19 onset on the four focal outcomes.


Assuntos
Afro-Americanos/psicologia , COVID-19/psicologia , Grupo com Ancestrais do Continente Europeu/psicologia , Relações Interpessoais , Racismo/psicologia , Adolescente , Adulto , Afro-Americanos/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Política , Racismo/estatística & dados numéricos , SARS-CoV-2 , Adulto Jovem
12.
Am J Public Health ; 111(S2): S107-S115, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33984244

RESUMO

Objectives. To investigate racial/ethnic differences in legal intervention‒related deaths using state-of-the-art topic modeling of law enforcement and coroner text summaries drawn from the 2003-2017 US National Violent Death Reporting System (NVDRS). Methods. Employing advanced topic modeling, we identified 8 topics consistent with dangerousness in death incidents in the NVDRS death narratives written by public health workers (PHWs). Using logistic regression, we then evaluated racial/ethnic differences in PHW-coded variables and narrative topics among 4981 males killed by legal intervention, while adjusting for age, county-level characteristics, and year. Results. Black, as compared with White, decedents were younger and their deaths were less likely to include PHW-coded mental health or substance use histories, weapon use, or positive toxicology for alcohol or psychoactive drugs, but more likely to include "gangs-as-an-incident-precipitant" coding. Topic modeling revealed less frequent thematic representation of "physical aggression" or "escalation" but more of "gangs or criminal networks" among Black versus White decedents. Conclusions. While Black males were more likely to be victims of legal intervention deaths, PHW-coded variables in the NVDRS and death narratives suggest lower threat profiles among Black versus similar White decedents. The source of this greater risk remains undetermined.


Assuntos
Afro-Americanos/estatística & dados numéricos , Agressão/psicologia , Pena de Morte/estatística & dados numéricos , Pena de Morte/tendências , Grupos Étnicos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Racismo/tendências , Violência/estatística & dados numéricos , Adolescente , Adulto , Afro-Americanos/psicologia , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Criança , Comparação Transcultural , Grupos Étnicos/psicologia , Grupo com Ancestrais do Continente Europeu/psicologia , Previsões , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Racismo/psicologia , Racismo/estatística & dados numéricos , Estados Unidos , Violência/psicologia , Adulto Jovem
13.
PLoS One ; 16(5): e0251960, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34038459

RESUMO

Social distancing prescribed by policy makers in response to COVID-19 raises important questions as to how effectively people of color can distance. Due to inequalities from residential segregation, Hispanic and Black populations have challenges in meeting health expectations. However, segregated neighborhoods also support the formation of social bonds that relate to healthy behaviors. We evaluate the question of non-White distancing using social mobility data from Google on three sites: workplaces, grocery stores, and recreational locations. Employing hierarchical linear modeling and geographically weighted regression, we find the relation of race/ethnicity to COVID-19 distancing is varied across the United States. The HLM models show that compared to Black populations, Hispanic populations overall more effectively distance from recreation sites and grocery stores: each point increase in percent Hispanic was related to residents being 0.092 percent less likely (p< 0.05) to visit recreational sites and 0.127 percent less likely (p< 0.01) to visit grocery stores since the onset of COVID-19. However, the GWR models show there are places where the percent Black is locally related to recreation distancing while percent Hispanic is not. Further, these models show the association of percent Black to recreation and grocery distancing can be locally as strong as 1.057 percent (p< 0.05) and 0.989 percent (p< 0.05), respectively. Next, the HLM models identified that Black/White residential isolation was related to less distancing, with each point of isolation residents were 11.476 percent more likely (p< 0.01) to go to recreational sites and 7.493 percent more likely (p< 0.05) to visit grocery stores compared to before COVID-19. These models did not find a measurable advantage/disadvantage for Black populations in these places compared to White populations. COVID-19 policy should not assume disadvantage in achieving social distancing accrue equally to different racial/ethnic minorities.


Assuntos
COVID-19/epidemiologia , Grupos Étnicos/psicologia , Distanciamento Físico , Afro-Americanos/psicologia , Americanos Asiáticos/psicologia , COVID-19/patologia , COVID-19/virologia , Grupo com Ancestrais do Continente Europeu/psicologia , Hispano-Americanos/psicologia , Humanos , Recreação , SARS-CoV-2/isolamento & purificação , Supermercados , Estados Unidos/epidemiologia , Local de Trabalho
14.
JAMA Netw Open ; 4(5): e2111629, 2021 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-34042990

RESUMO

Importance: The impact of COVID-19 in the US has been far-reaching and devastating, especially in Black populations. Vaccination is a critical part of controlling community spread, but vaccine acceptance has varied, with some research reporting that Black individuals in the US are less willing to be vaccinated than other racial/ethnic groups. Medical mistrust informed by experiences of racism may be associated with this lower willingness. Objective: To examine the association between race/ethnicity and rejection of COVID-19 vaccine trial participation and vaccine uptake and to investigate whether racial/ethnic group-based medical mistrust is a potential mediator of this association. Design, Setting, and Participants: This cross-sectional survey study was conducted from June to December 2020 using a convenience sample of 1835 adults aged 18 years or older residing in Michigan. Participants were recruited through community-based organizations and hospital-academic networks. Main Outcomes and Measures: Separate items assessed whether respondents, if asked, would agree to participate in a research study to test a COVID-19 vaccine or to receive a COVID-19 vaccine. Participants also completed the suspicion subscale of the Group-Based Medical Mistrust Scale. Results: Of the 1835 participants, 1455 (79%) were women, 361 (20%) men, and 19 (1%) other gender. The mean (SD) age was 49.4 (17.9) years, and 394 participants (21%) identified as Black individuals. Overall, 1376 participants (75%) reported low willingness to participate in vaccine trials, and 945 (52%) reported low willingness to be vaccinated. Black participants reported the highest medical mistrust scores (mean [SD], 2.35 [0.96]) compared with other racial/ethnic groups (mean [SD] for the total sample, 1.83 [0.91]). Analysis of path models revealed significantly greater vaccine trial and vaccine uptake rejection among Black participants (vaccine trial: B [SE], 0.51 [0.08]; vaccine uptake: B [SE], 0.51 [0.08]; both P < .001) compared with the overall mean rejection. The association was partially mediated by medical mistrust among Black participants (vaccine trial: B [SE], 0.04 [0.01]; P = .003; vaccine uptake: B [SE], 0.07 [0.02]; P < .001) and White participants (vaccine trial: B [SE], -0.06 [0.02]; P = .001; vaccine uptake: B [SE], -0.10 [0.02]; P < .001). Conclusions and Relevance: In this survey study of US adults, racial/ethnic group-based medical mistrust partially mediated the association between individuals identifying as Black and low rates of acceptance of COVID-19 vaccine trial participation and actual vaccination. The findings suggest that partnerships between health care and other sectors to build trust and promote vaccination may benefit from socially and culturally responsive strategies that acknowledge and address racial/ethnic health care disparities and historical and contemporary experiences of racism.


Assuntos
Vacinas contra COVID-19/uso terapêutico , COVID-19/etnologia , Ensaios Clínicos como Assunto/psicologia , Grupos de Populações Continentais/psicologia , Confiança , Recusa de Vacinação/etnologia , Adolescente , Adulto , Afro-Americanos/psicologia , Afro-Americanos/estatística & dados numéricos , Idoso , Americanos Asiáticos/psicologia , Americanos Asiáticos/estatística & dados numéricos , Atitude Frente a Saúde/etnologia , COVID-19/prevenção & controle , Grupos de Populações Continentais/estatística & dados numéricos , Estudos Transversais , Grupo com Ancestrais do Continente Europeu/psicologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Hispano-Americanos/psicologia , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Michigan , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Confiança/psicologia , Recusa de Vacinação/psicologia , Recusa de Vacinação/estatística & dados numéricos , Adulto Jovem
15.
Neuropsychology ; 35(3): 265-275, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33970660

RESUMO

Objective: Racial/ethnic disparities in cognitive aging are only partly attributable to socioeconomic indicators. Psychosocial factors, such as discrimination and perceived control, also differ across racial/ethnic groups, and emerging literature highlights their potential role in contributing to cognitive disparities in addition to socioeconomic status. Method: 1,463 older adults (51% Hispanic, 27% non-Hispanic Black, and 22% non-Hispanic White) in the Washington Heights-Inwood Columbia Aging Project completed cognitive and psychosocial measures, including a comprehensive neuropsychological battery, Everyday and Major Experiences of Lifetime Discrimination scales, and the Perceived Control scale. Mediation models quantified separate indirect effects of Black race and Hispanic ethnicity on global cognitive composite scores through education, income, discrimination, and external perceived control. Results: Educational attainment, income, and perceived control each mediated racial/ethnic disparities in global cognition. Socioeconomic indicators (i.e., lower education and lower income) explained approximately 50% of the Black-White and Hispanic-White disparities in global cognition, and more external perceived control explained an additional 5%-8%. Hispanics reported the lowest levels of discrimination, while non-Hispanic Blacks reported the highest levels. However, neither everyday nor major lifetime discrimination was associated with global cognition. Significant racial/ethnic disparities in global cognition remained after accounting for the included socioeconomic and psychosocial factors. Conclusions: This study suggests that psychosocial factors may explain racial/ethnic disparities in cognitive aging above and beyond socioeconomic indicators. More external perceived control, which could reflect chronic exposure to interpersonal and institutional marginalization, may be a particularly salient psychosocial risk factor for poorer cognitive aging among non-Hispanic Black and Hispanic older adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Afro-Americanos/psicologia , Envelhecimento/etnologia , Envelhecimento/psicologia , Cognição , Envelhecimento Cognitivo , Grupo com Ancestrais do Continente Europeu/psicologia , Hispano-Americanos/psicologia , Fatores Socioeconômicos , Idoso , Idoso de 80 Anos ou mais , Grupos de Populações Continentais/psicologia , Escolaridade , Grupos Étnicos/psicologia , Feminino , Humanos , Renda , Masculino , Fatores de Risco , Classe Social , Estados Unidos
16.
Psychol Addict Behav ; 35(5): 514-522, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33914562

RESUMO

OBJECTIVE: Blunt smoking presents unique public health concerns relative to other methods of marijuana use, including greater exposure to toxins and carcinogens as well as increased risk for cannabis use disorder. This study examines correlates of self-reported daily blunt use among a nationally representative sample of adult blunt users in the United States. METHOD: We pooled and analyzed 5 years of cross-sectional data from n = 10,826 adult blunt smokers in the United States using the National Survey on Drug Use and Health (2014-2018). Multiple logistic regression analysis examined correlates of daily blunt use among non-Hispanic White, non-Hispanic African American, and Hispanic/Latino adult blunt users in the United States. Next, multiple logistic regression analyses stratified by race/ethnicity were conducted. This study examined: (a) socio-demographic (age, sex, and income); (b) behavioral (alcohol, tobacco, and illicit drug use); (c) intrapersonal (depression); and (d) regulatory (marijuana laws) factors. RESULTS: African Americans had the greatest prevalence of daily blunt use (24.2%), relative to Whites (9.1%) and Hispanic/Latinos (13.9%) (p < .001). African Americans aged 26-34 years old (adjusted odds ratio [Adj OR]: 1.37) and living in medical marijuana states (Adj OR: 1.28) were more likely to be daily blunt users; these factors were not associated with daily blunt use in the full sample or in stratified models of Whites or Hispanic/Latinos. Alcohol use was negatively associated with daily blunt use among Whites and Hispanic/Latinos but not African Americans. CONCLUSIONS: Socio-demographic, behavioral, and regulatory factors appear differently associated with daily blunt use across racial/ethnic groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Afro-Americanos , Grupo com Ancestrais do Continente Europeu , Hispano-Americanos , Fumar Maconha , Adolescente , Adulto , Afro-Americanos/psicologia , Afro-Americanos/estatística & dados numéricos , Estudos Transversais , Grupo com Ancestrais do Continente Europeu/psicologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Hispano-Americanos/psicologia , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Fumar Maconha/etnologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estados Unidos/epidemiologia , Adulto Jovem
17.
PLoS One ; 16(4): e0250999, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33914815

RESUMO

OBJECTIVE: Clinicians and healthcare organizations are ethically obligated to treat patients with respect, yet it is not clear what actions best demonstrate respect to patients. This exploratory qualitative study aimed to understand what actions on both an individual and organizational level effectively demonstrate respect for primary care patients. METHODS: We conducted semi-structured telephone interviews with primary care patients in an integrated healthcare delivery system in Oregon and an integrated safety net health system in Colorado who were participating in a genomics implementation research study of a hereditary cancer screening program. We systematically coded interview transcripts using a coding framework developed based on iterative review of the interview guide and transcripts. We further analyzed the data coded with sub-codes relating to patients' experiences with respect in healthcare using a descriptive content analysis approach. RESULTS: We interviewed 40 English-speaking (n = 30, 75%) and Spanish-speaking (n = 10, 25%) patients. Most interviewees identified as female (n = 35, 88%) and either Hispanic/Latino(a) (n = 17, 43%) or White or European American (n = 15, 38%). Interviewees identified two categories of efforts by individual clinicians that demonstrate respect: engaging with patients and being transparent. They identified five efforts by healthcare organizations: promoting safety and inclusivity, protecting patient privacy, communicating about scheduling, navigating financial barriers to care, and ensuring continuity of care. CONCLUSIONS: Our findings suggest that patients' experiences of respect depend on efforts by individual clinicians as well as healthcare organizations. Our findings offer insight into how clinicians can build stronger partnerships with patients and how organizations can seek to promote access to care and patient safety and comfort. They also illustrate areas for future research and quality improvement to more effectively respect patients.


Assuntos
Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Hispano-Americanos/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Relações Médico-Paciente/ética , Adulto , Colorado/etnologia , Prestação Integrada de Cuidados de Saúde , Grupo com Ancestrais do Continente Europeu/psicologia , Feminino , Hispano-Americanos/psicologia , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Oregon/etnologia , Satisfação do Paciente/etnologia , Atenção Primária à Saúde , Pesquisa Qualitativa , Adulto Jovem
18.
J Int AIDS Soc ; 24(4): e25689, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33821554

RESUMO

INTRODUCTION: Due to factors associated with structural racism, Black men who have sex with men (MSM) living with HIV are less likely to be virally suppressed compared to white MSM. Most of these data come from clinical cohorts and modifiable reasons for these racial disparities need to be defined in order to intervene on these inequities. Therefore, we examined factors associated with racial disparities in baseline viral suppression in a community-based cohort of Black and white MSM living with HIV in Atlanta, GA. METHODS: We conducted an observational cohort of Black and white MSM living with HIV infection in Atlanta. Enrolment occurred from June 2016 to June 2017 and men were followed for 24 months; laboratory and behavioural survey data were collected at 12 and 24 months after enrolment. Explanatory factors for racial disparities in viral suppression included sociodemographics and psychosocial variables. Poisson regression models with robust error variance were used to estimate prevalence ratios (PR) for Black/white differences in viral suppression. Factors that diminished the PR for race by ≥5% were considered to meaningfully attenuate the racial disparity and were included in a multivariable model. RESULTS: Overall, 26% (104/398) of participants were not virally suppressed at baseline. Lack of viral suppression was significantly more prevalent among Black MSM (33%; 69/206) than white MSM (19%; 36/192) (crude Prevalence Ratio (PR) = 1.6; 95% CI: 1.1 to 2.5). The age-adjusted Black/white PR was diminished by controlling for: ART coverage (12% decrease), housing stability (7%), higher income (6%) and marijuana use (6%). In a multivariable model, these factors cumulatively mitigated the PR for race by 21% (adjusted PR = 1.1 [95% CI: 0.8 to 1.6]). CONCLUSIONS: Relative to white MSM, Black MSM living with HIV in Atlanta were less likely to be virally suppressed. This disparity was explained by several factors, many of which should be targeted for structural, policy and individual-level interventions to reduce racial disparities.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/psicologia , Infecções por HIV/tratamento farmacológico , Disparidades em Assistência à Saúde/etnologia , Homossexualidade Masculina/estatística & dados numéricos , Adolescente , Adulto , Estudos de Coortes , Georgia/epidemiologia , Infecções por HIV/etnologia , Infecções por HIV/virologia , Disparidades nos Níveis de Saúde , Homossexualidade Masculina/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Características de Residência , Carga Viral , Adulto Jovem
19.
J Med Internet Res ; 23(7): e26296, 2021 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-33819909

RESUMO

BACKGROUND: In the United States, racial and ethnic minorities are disproportionately affected by COVID-19, with persistent social and structural factors contributing to these disparities. At the intersection of race/ethnicity and gender, women of color may be disadvantaged in terms of COVID-19 outcomes due to their role as essential workers, their higher prevalence of pre-existing conditions, their increased stress and anxiety from the loss of wages and caregiving, and domestic violence. OBJECTIVE: The purpose of this study is to examine racial and ethnic differences in the prevalence of COVID-19 outcomes, stressors, fear, and prevention behaviors among adult women residing in the United States. METHODS: Between May and June 2020, women were recruited into the Capturing Women's Experiences in Outbreak and Pandemic Environments (COPE) Study, a web-based cross-sectional study, using advertisements on Facebook; 491 eligible women completed a self-administered internet-based cross-sectional survey. Descriptive statistics were used to examine racial and ethnic differences (White; Asian; Native Hawaiian or other Pacific Islander; Black; Hispanic, Latina, or Spanish Origin; American Indian or Alaskan Native; multiracial or some other race, ethnicity, or origin) on COVID-19 outcomes, stressors, fear, and prevention behaviors. RESULTS: Among our sample of women, 16% (73/470) reported COVID-19 symptoms, 22% (18/82) were concerned about possible exposure from the people they knew who tested positive for COVID-19, and 51.4% (227/442) knew where to get tested; yet, only 5.8% (27/469) had been tested. Racial/ethnic differences were observed, with racial/ethnic minority women being less likely to know where to get tested. Significant differences in race/ethnicity were observed for select stressors (food insecurity, not enough money, homeschooling children, unable to have a doctor or telemedicine appointment) and prevention behaviors (handwashing with soap, self-isolation if sick, public glove use, not leaving home for any activities). Although no racial/ethnic differences emerged from the Fear of COVID-19 Scale, significant racial/ethnic differences were observed for some of the individual scale items (eg, being afraid of getting COVID-19, sleep loss, and heart racing due to worrying about COVID-19). CONCLUSIONS: The low prevalence of COVID-19 testing and knowledge of where to get tested indicate a critical need to expand testing for women in the United States, particularly among racial/ethnic minority women. Although the overall prevalence of engagement in prevention behaviors was high, targeted education and promotion of prevention activities are warranted in communities of color, particularly with consideration for stressors and adverse mental health.


Assuntos
COVID-19/prevenção & controle , COVID-19/psicologia , Grupos de Populações Continentais/psicologia , Grupos Étnicos/psicologia , Medo , Comportamentos Relacionados com a Saúde , Internet , Adulto , Afro-Americanos/psicologia , Afro-Americanos/estatística & dados numéricos , Nativos Estadunidenses/psicologia , Nativos Estadunidenses/estatística & dados numéricos , COVID-19/epidemiologia , Teste para COVID-19 , Grupos de Populações Continentais/estatística & dados numéricos , Estudos Transversais , Grupos Étnicos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/psicologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Educação em Saúde , Hispano-Americanos/psicologia , Hispano-Americanos/estatística & dados numéricos , Humanos , Grupos Minoritários/psicologia , Grupos Minoritários/estatística & dados numéricos , Grupo com Ancestrais Oceânicos/psicologia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Pandemias , Prevalência , SARS-CoV-2 , Estados Unidos/epidemiologia
20.
J Psychosom Res ; 144: 110403, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33730637

RESUMO

Racial and ethnic minorities, including Blacks/African-Americans and Hispanics/Latinos,indicate lower tolerance to psychological distress (DT) and secular hope yet endorse more religious and spiritual hope than their non-Hispanic White (NHW) counterparts. Whether racial-ethnic minorities derive greater benefit from non-secular hope on the tolerance of psychological distress remains unclear. Self-reported endorsement of religious/spiritual (R/S) hope, secular hope, DT, and a number of other psychosocial, R/S and sociodemographic variables were analyzed from a nationwide survey of persons aged over 18 years (N = 2875) identifying as Black (14.2%), Hispanic (15.4%), or NHW (67.3%) using multiple regression. Overall, higher levels of both R/S and secular hope predicted greater DT. In turn, greater DT was associated with lower psychosomatic distress. Compared to NHW, the ethnic-minority groups reported lower overall levels of DT. An interaction for race-ethnicity further revealed that compared to distress intolerant NHW, Blacks/African-Americans at lower levels of DT report higher R/S and secular hope. Hispanics/Latinos were also higher on R/S and secular hope, but endorsed lower hope at higher levels of DT than the reference group. Although hope is considered a more passive form of coping, it is more frequently endorsed in marginalized ethnic-minority groups. However, compared to NHW, differences do exist in the extent to which R/S hope mitigates DT in Blacks/African-Americans compared to Hispanics/Latinos.


Assuntos
Afro-Americanos/psicologia , Disparidades nos Níveis de Saúde , Esperança , Angústia Psicológica , Religião e Psicologia , Adulto , Afro-Americanos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/psicologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Hispano-Americanos/psicologia , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/psicologia , Grupos Minoritários/estatística & dados numéricos , Análise Multivariada , Estados Unidos/epidemiologia
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