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1.
Curr Opin Pediatr ; 33(1): 159-169, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33394742

RESUMO

PURPOSE OF REVIEW: The novel coronavirus (COVID-19) pandemic has highlighted healthcare and racial inequities. This article discusses recent literature documenting the impact of racism on early childhood development, disparities in access to developmental services and ways healthcare providers and health systems can promote physician well being during these difficult times. RECENT FINDINGS: Exposure to racism begins prenatally, and early childhood experiences with racism are intimately tied to adverse physical and mental health outcomes. Early intervention is key to treating children with developmental delay, but disparities exist in accessing eligibility screening and in the provision of services. Paediatric providers are at risk of developing secondary traumatic stress and burnout, which may affect the care that they provide. SUMMARY: New research has led to the development of resources that help paediatric providers address racism, access developmental resources in a novel manner and protect the paediatric workforce from trauma and burnout.


Assuntos
Desenvolvimento Infantil , Pandemias , Médicos , Racismo , Esgotamento Profissional , Criança , Pré-Escolar , Humanos
2.
N C Med J ; 82(1): 43-45, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33397754

RESUMO

The COVID-19 pandemic has illuminated many painful truths in our state. This commentary addresses some of them, including racism, lack of universal health care access, and defunded public health infrastructure, from the perspective of a local county health department medical director. We have an opportunity to fundamentally improve North Carolinians' collective health, but only if we are willing to reckon with past and current failings.


Assuntos
Racismo , Humanos , Pandemias , Saúde Pública
3.
N C Med J ; 82(1): 62-67, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33397760

RESUMO

The COVID-19 pandemic has exposed socioeconomic, geographic, and medical vulnerabilities in our country. In North Carolina, inequalities resulting from centuries of structural racism exacerbate disparate impacts of infection and death. We propose three opportunities that leaders in our state can embrace to move toward equity as we weather, and emerge from, this pandemic.


Assuntos
Racismo , Humanos , North Carolina/epidemiologia , Pandemias/prevenção & controle
5.
Cultur Divers Ethnic Minor Psychol ; 27(1): 123-134, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32437199

RESUMO

OBJECTIVES: Experiences of racial discrimination are common for Black Americans and have been associated with depression and sleep disturbance, factors likely involved in the insidious development of health disparities. The current study replicates these associations and examines longitudinal linkages. METHOD: Black American couples (men: N = 248, Mage = 40, SD = 9; women: N = 277, Mage = 37, SD = 7) and their children, aged 9 to 14 (N = 276, Mage = 11, SD = 1), completed measures of experiences of racial discrimination, depressive symptoms, and sleep problems at baseline and 8-month follow-up. In separate analyses for men, women, and youth, we examined concurrent and prospective associations of racial discrimination with depressive symptoms and sleep problems, then used longitudinal indirect effect models to examine whether depressive symptoms in response to racial discrimination led to increased sleep problems, or vice versa. RESULTS: Racial discrimination was associated concurrently with depressive symptoms and sleep problems for all family members. Prospective associations were also found with depressive symptoms and sleep problems in fathers and youth, and sleep problems in mothers. Longitudinal models showed significant indirect effects of racial discrimination on change in sleep problems through depressive symptoms for fathers and mothers, and a similar, but nonsignificant, pattern in youth. There were no indirect effects on change in depressive symptoms through sleep problems. CONCLUSIONS: Persistent associations of racial discrimination with depressive symptoms and sleep problems reflect a lasting impact of racial discrimination. Because discrimination's effects on depression may contribute to increased sleep problems over time, interventions that buffer the effects of discrimination on depressive symptoms may also reduce sleep problems. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Racismo , Transtornos do Sono-Vigília , Adolescente , Afro-Americanos , Criança , Depressão , Feminino , Humanos , Masculino , Estudos Prospectivos
7.
Cultur Divers Ethnic Minor Psychol ; 27(1): 145-155, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32658504

RESUMO

OBJECTIVES: The present study examined the daily relation between racial discrimination experiences and diurnal cortisol patterns among a sample of Black American adults. The daily diary approach afforded the chance to examine how within-person fluctuations in racial discrimination experiences related to same- and next-day changes in cortisol patterns. The use of a lagged approach examines whether exposure to racial discrimination results in diminished outcomes. It was expected that healthy levels of ethnic-racial identity would moderate the relation between racial discrimination and cortisol parameters. METHOD: The participants included 93 Black adults (e.g., 20 males and 73 females) who ranged in age from 17 to 56 years old. Participants completed measures of racial discrimination and ethnic-racial identity, and provided 9 saliva samples. RESULTS: The results indicate that on days when individuals reported increased racial discrimination experiences, they exhibited higher cortisol levels at bedtime and greater overall cortisol output that same day. Lagged analyses revealed that on days when participants reported increased racial discrimination experiences, they exhibited less pronounced cortisol awakening responses and steeper diurnal cortisol slopes the next day. These associations were moderated by high racial centrality levels, high private regard levels, and low public regard levels. CONCLUSIONS: Same-day racial discrimination experiences related to compromised diurnal cortisol patterns. The effects of racial discrimination experiences on next-day physiological functioning largely depended on ethnic-racial identity dimensions, and afforded individuals the ability to recover. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Hidrocortisona , Racismo , Adolescente , Adulto , Afro-Americanos , Ritmo Circadiano , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Psicológico , Adulto Jovem
8.
Cultur Divers Ethnic Minor Psychol ; 27(1): 47-59, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32804521

RESUMO

OBJECTIVE: The Brief Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CVB) is a widely used, multidimensional measure of exposure to ethnic/racial discrimination. The PEDQ-CVB has not been previously validated for use with American Indians, who have endured a unique history of colonization, cultural oppression, and ongoing discrimination. This study examined the measurement invariance of the PEDQ-CVB in American Indians (AIs) and 4 other groups. Additional analyses assessed the scale's convergent and discriminant validity and provided initial evidence of associations with mental and physical health in AIs. METHOD: Primary data were collected from a community sample of urban-dwelling AIs (n = 222), which included measures of ethnic/racial identity, other life stressors, and mental and physical health, along with the PEDQ-CVB. These were supplemented by secondary analysis of PEDQ-CVB data from African Americans (n = 1176), Latinos (n = 564), East Asian Americans (n = 274), and South Asian Americans (n = 242). RESULTS: The PEDQ-CVB demonstrated measurement invariance across the 5 ethnic/racial groups and convergent and discriminant validity in AIs. The PEDQ-CVB was significantly associated with depressive symptoms and physical limitations in AIs, after controlling for relevant demographics. CONCLUSION: This study provides strong evidence that the PEDQ-CVB behaves consistently for AIs and other underrepresented ethnic/racial groups. As such, the PEDQ-CVB allows for documentation of the experiences of different ethnic/racial groups and provides a means to test theoretical models of the antecedents and consequences of perceived discrimination within and across groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Racismo , Afro-Americanos , Grupos Étnicos , Hispano-Americanos , Humanos , Inquéritos e Questionários , Estados Unidos
9.
Cultur Divers Ethnic Minor Psychol ; 27(1): 107-117, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32309971

RESUMO

OBJECTIVES: Studies of discrimination and sleep have largely focused on between-person differences in discrimination as a correlate of sleep outcomes. A common criticism of this research is that standard questionnaire measures of discrimination may be confounded by personality and identity and are subject to recall bias. Partially addressing these limitations, the current study examined within-person, day-to-day fluctuations in perceived discrimination as a predictor of day-to-day fluctuations in sleep. The role of internalized racism as a moderator of the within-person association between discrimination and sleep was also considered. METHOD: Participants were African American college students attending a predominantly White institution (N = 124, 26% male, Mage = 20.1, SD = 1.6). Each student was asked to complete a baseline questionnaire and a 9-day diary. Experiences of discrimination were assessed in the questionnaire and daily diary format. Sleep problems were measured each day using self-report measures focusing on sleep quality. Internalized racism was assessed with the miseducation scale, which captures the degree to which individuals associate negative characteristics such as laziness and criminality with their racial/ethnic group. Established measures of racial identity were considered as covariates. RESULTS: Multilevel analyses indicated that on days when participants experienced more discrimination, subsequent sleep problems increased (B = .037, SE = .017, p = .034). Furthermore, this within-person association was moderated by internalized racism such that the effects of daily discrimination on sleep were stronger among those who scored higher on miseducation (B = .046, SE = .021, p = .033). CONCLUSIONS: Overall, results suggest that ongoing efforts to reduce discrimination, support the adjustment of racial/ethnic minority students, and address internalized racism are warranted. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Racismo , Afro-Americanos , Grupos Étnicos , Feminino , Humanos , Masculino , Grupos Minoritários , Sono , Estudantes
13.
Int Perspect Sex Reprod Health ; 46(Suppl 1): 83-89, 2020 12 14.
Artigo em Inglês | MEDLINE | ID: mdl-33326403

RESUMO

COVID-19 has compromised and disrupted sexual and reproductive health (SRH) across multiple dimensions: individual-level access, health systems functioning, and at the policy and governance levels. Disruptions to supply chains, lockdown measures and travel restrictions, and overburdened health systems have particularly affected abortion access and service provision. The pandemic, rather than causing new issues, has heightened and exposed existing fractures and fissures within abortion access and provision. In this viewpoint, we draw on the concept of "structural violence" to make visible the contributing causes of these ruptures and their inequitable impact among different groups.


Assuntos
Aborto Induzido/psicologia , Acesso aos Serviços de Saúde , Disparidades em Assistência à Saúde , Racismo/psicologia , Serviços de Saúde Reprodutiva , Feminino , Humanos , Pandemias , Política , Gravidez , Determinantes Sociais da Saúde , Violência
18.
Am J Clin Nutr ; 112(6): 1409-1414, 2020 12 10.
Artigo em Inglês | MEDLINE | ID: mdl-33274358

RESUMO

Social disparities in the US and elsewhere have been terribly highlighted by the current COVID-19 pandemic but also an outbreak of state-sponsored violence. The field of nutrition, like other areas of science, has commonly used 'race' to describe research participants and populations, without the recognition that race is a social, not a biologic, construct. We review the limitations of classifying participants by race, and recommend a series of steps for authors, researchers and policymakers to consider when producing and reading the nutrition literature. We recommend that biomedical researchers, especially those in the field of nutrition, abandon the use of racial categories to explain biologic phenomena but instead rely on a more comprehensive framework of ethnicity; that authors consider not just race and ethnicity but many social determinants of health, including experienced racism; that race and ethnicity not be conflated; that dietary pattern descriptions inform ethnicity descriptions; and that depersonalizating language be avoided.


Assuntos
/etnologia , Fenômenos Fisiológicos da Nutrição/etnologia , Publicações Periódicas como Assunto/ética , Publicações Periódicas como Assunto/normas , /mortalidade , Grupos de Populações Continentais/classificação , Dieta/etnologia , Grupos Étnicos/classificação , Variação Genética , Humanos , Publicações Periódicas como Assunto/tendências , Fenótipo , Racismo/etnologia , Classe Social , Estados Unidos
19.
Mol Cell ; 80(5): 745-746, 2020 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-33275881
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