Association of Exposure to Interpersonal Racism and Racial Disparities in Inadequate Sleep Risk.

OBJECTIVE: To examine the association between caregiver-report of their child's inadequate sleep and exposure to interpersonal racism within racially minoritized subpopulations. STUDY DESIGN: We conducted cross-sectional analysis among racially minoritized 21 924 school-aged children and 27 142 adolescents using a National Survey of Children's Health sample from 2016 through 2021. Multivariable logistic regression models were fit to estimate predicted probabilities for the adjusted associations between caregiver-report of their child's inadequate sleep and prior exposure to interpersonal racism. RESULTS: In bivariate models, caregiver report of child exposure to interpersonal racism was significantly associated with a higher probability of inadequate sleep within non-Hispanic Asian American/Pacific Islander school-aged children, Hispanic adolescents, and non-Hispanic multiracial adolescents. After adjusting for covariates, only the association within Hispanic youth remained significant though attenuated. Unexpectedly, non-Hispanic Black school-age children exposed to racism had a lower probability of inadequate sleep than non-Hispanic Black children without exposure to racism after adjusting for covariates. CONCLUSIONS: Nationally representative pooled data that showed caregiver-report of Hispanic adolescents' inadequate sleep was associated with their exposure to interpersonal racism, although an association with inadequate sleep was not found in other racially minoritized subpopulations. Examining within-race associations helps to assess more accurately risk and target efforts that seek to address racism-related stress among racially minoritized subpopulations.

[Racial inequality in the production of fresh vegetables and cut flowers in Argentina: an analysis in Greater La Plata]. / La desigualdad racial de la producción de hortalizas en fresco y flores de corte en Argentina: análisis en el Gran La Plata.

This study aims to analyze the configuration of inequalities in one of Argentina's most significant production zones for fresh vegetables and cut flowers, located in Greater La Plata, Buenos Aires Province. This ongoing anthropological research, initiated in 2021, employs methods such as participant observation, interviews, food mapping, and digital ethnography. Among the main findings, we highlight that this production zone exhibits, in both its origins and daily operations, certain racist dynamics that are not solely generated by the host society toward migrants but are disseminated throughout the social fabric, including by migrant producers themselves. Positive valuations of ultra-processed foods by those living and working in the area reflect the importance of belonging to the host society, running parallel to strategies for preserving food preparations from before migration. These include the recreation of a "food identity" and the proliferation of "legumbrerías" (legume shops) and "paisano eateries" (restaurants serving traditional food). These transformations are intertwined with the productive changes migrants have experienced, shifting from peasant economies in their places of origin to intensive production in Greater La Plata.

Este trabajo propone analizar la configuración de las desigualdades en uno de los cordones de producción de hortalizas en fresco y flores de corte más importantes de Argentina, localizado en el Gran La Plata, provincia de Buenos Aires. Se trata de una investigación en curso con enfoque antropológico, realizada desde el año 2021, en la que se emplearon técnicas como la observación participante, entrevistas, mapeos alimentarios y etnografía digital. Entre los principales hallazgos destacamos que este cordón productivo posee en su génesis y cotidiano, ciertas dinámicas racistas, que no son únicamente generadas desde la sociedad receptora a la migrante, sino que se propagan por todo el tejido social, incluso ejercidas por los productores migrantes. Las valoraciones positivas de quienes habitan y trabajan allí en torno a los alimentos ultraprocesados están cargadas de la importancia de pertenecer a la sociedad receptora, en paralelo a estrategias de resguardo de preparaciones previas a migrar: la recreación de un "nosotros alimentario" y la proliferación de "legumbrerías" y "comedores paisanos". Estas transformaciones se enlazan con los cambios productivos que atravesaron las personas migrantes desde economías campesinas en su lugar de origen, a la producción intensiva en el Gran La Plata.

Decoding acculturative stress and psychological distress in Mexican immigrant women: insights from a path mediation analysis.

BACKGROUND: This study investigates acculturative stress and its impact on psychological distress among Mexican immigrant women in the United States, with a particular focus on contextual factors shaping these acculturative stress experiences. It also seeks to provide actionable insights to address Mexican immigrant women's mental health needs. METHODS: Using the data from a total of 257 Mexican immigrant women in the National Latino Asian American Survey (NLAAS), path analysis was conducted to examine the relationships between acculturative stress, psychological distress, and various contextual factors. RESULTS: Acculturative stress was found to significantly contribute to psychological distress among Mexican immigrant women. Key factors affecting acculturative stress include contentment with the decision to move to the United States, English language proficiency, experiences of racial discrimination, difficulties associated with visiting family abroad, religiosity, and age at immigration. Critical determinants of psychological distress in the studied cohort, according to the results, are familismo values and racial discrimination. CONCLUSION: The results of this study underscore the need to consider contextual factors in understanding and addressing acculturative stress and psychological distress among Mexican immigrant women. Practical and policy implications include the necessity to develop culturally sensitive interventions, enhance educational opportunities, improve access to mental health services, and implement anti-discrimination policies. By adopting these strategies, mental health professionals and policymakers can foster resilience, wellbeing, and successful integration of Mexican immigrant women in the U.S. society.

[Racism and mental health in indigenous youth living in the Metropolitan Area of Oaxaca, Mexico]. / Racismos y salud mental en jóvenes indígenas residentes en la Zona Metropolitana de Oaxaca, México.

Indigenous populations show high prevalence rates of mental disorders and limited access to mental health services. The aim of this study was to analyze the mental health care trajectories of indigenous youth living in the Metropolitan Area of Oaxaca, Mexico. Between May and August 2023, we conducted a qualitative study involving non-participant observation, in-depth interviews with seven indigenous youth, and semi-structured interviews with nine health professionals, healers, or leaders of mutual support groups. We identified processes, not exempt of tensions, in how these young people perceive themselves as both young and indigenous, in the development of their mental disorders, and in the ways they seek treatment. Their care involved the use of psychological and psychiatric services, mutual support groups, and, to a limited extent, traditional medicine. This study concludes that these dynamics are interwoven and amplified by interpersonal, institutional and epistemic racism, which must be dismantled to improve the mental health of indigenous youth.

Las poblaciones indígenas presentan altas prevalencias de trastornos mentales y limitado acceso a servicios de salud mental. El objetivo del estudio fue analizar las trayectorias de atención a trastornos mentales de jóvenes indígenas residentes en la Zona Metropolitana de Oaxaca, México. Entre mayo y agosto de 2023, se llevó a cabo un estudio cualitativo basado en observación no participante, entrevistas en profundidad a siete personas jóvenes indígenas y entrevistas semiestructuradas a nueve personas profesionales de la salud, curanderas o responsables de grupos de ayuda mutua. Se identificaron procesos de occidentalización, no exentos de tensiones, en la forma de concebirse como jóvenes e indígenas, en el desarrollo de sus trastornos mentales y en la atención de estos, para lo cual utilizaron servicios psicológicos, psiquiátricos, grupos de ayuda mutua y, de manera limitada, medicina tradicional. Se concluye que en estos procesos se articulan y potencian racismos interpersonales, institucionales y epistémicos, que será necesario desarticular para mejorar la salud mental de personas jóvenes indígenas.

[Permanent health education for managers as a tool to combat institutional racism in a Northeastern Brazilian municipality]. / Educación permanente en salud para directivos como herramienta para combatir el racismo institucional en un municipio del noreste de Brasil.

This article discusses the experience of a permanent health education initiative focused on institutional racism with health professionals from the Brazilian Unified Health System (SUS) holding management positions in a municipality in the interior of Bahia, in Northeastern Brazil. A workshop was held in September 2022, based on a problematizing methodology called the Maguerez Arc, conducted by residents of the Multiprofessional Family Health Program. Ten managers participated in the workshop, most of whom were women. Despite acknowledging the presence and impact of racism in health services, managers find it challenging to recognize and address racism in its institutional dimension. A recurring discourse aligned with the myth of racial democracy was notable, and a higher level of commitment among Black women was observed throughout the workshop. Permanent health education emerges as an essential strategy to combat racism, necessary to expand such discussions within health services.

El artículo relata la experiencia de una acción de educación permanente en salud sobre racismo institucional con profesionales de la salud del Sistema Único de Salud (SUS), que ocupan cargos de gestión en un municipio del interior de Bahía, región nordeste de Brasil. Se realizó un taller en septiembre de 2022, basado en una metodología problematizadora denominada Arco de Maguerez, llevada a cabo por residentes del Programa Multiprofesional en Salud Familiar. El taller contó con la participación de diez gestores, siendo la mayoría mujeres. Los gestores, a pesar de reconocer la presencia y el impacto del racismo en los servicios de salud, encuentran dificultades para visibilizar y combatir el racismo en su dimensión institucional. Fue notable el discurso recurrente alineado con el mito de la democracia racial, y se observó un mayor compromiso de las mujeres negras a lo largo del taller. La educación permanente en salud se muestra como una importante estrategia de combate al racismo, necesaria para ampliar los debates de este tipo dentro de los servicios de salud.

The community food environment as an effect modifier of the relationship between racial discrimination and food insecurity among adults in Southern Brazil.

BACKGROUND: Racial discrimination is linked to unhealthy food environments and a higher prevalence of food insecurity. However, no study has explored their interrelated effects. We analyzed the relationship between racial discrimination, community food environment, and food insecurity in adults of different socioeconomic status. We also investigated the potential modifying effect of the food environment on the relationship between racism and food insecurity. METHODS: This was a cross-sectional study of 400 adults aged 20-70 years residing in the central area of ​​Porto Alegre, the capital of Rio Grande do Sul state. Race and racial discrimination were assessed by self-reported race/skin color using the Experiences of Discrimination scale (EOD), respectively. The food environment was assessed using the Nutrition Environment Measures Survey in Stores (NEMS-S) tool. Food insecurity was assessed using the short version of the Brazilian Food Insecurity Scale (EBIA for short, in Portuguese). Poisson regression with robust variance was employed for the multivariate analysis. RESULTS: The prevalence of food insecurity was higher in areas with a poorer food environment (areas 1 and 3; 56.6% and 58.8%, respectively). Racial discrimination was associated with food insecurity, where every 1-point increase in the racial discrimination score increased the likelihood of food insecurity by 7% (prevalence ratio [PR] 1.07; 95% CI, 1.03-1.20). When stratifying the analyses by food environment, racial discrimination was associated with food insecurity only in areas with a poorer food environment (PR 1.06; 95% CI, 1.01-1.10). CONCLUSIONS: Experiences of racial discrimination were associated with a higher prevalence of food insecurity in the study population. The community food environment was an effect modifier of this relationship, highlighting the relevance of interventions in the food environment focused on areas with a greater presence of Black people as a way of combating racism and food insecurity.

The journey of a living statue: Structural violence and a Honduran migrant woman's pathway toward asylum and wellbeing.

Approximately half of the world's displaced migrant population are women, yet gender-specific analyses are often lacking. Such analyses are crucial for understanding migrant women's unique experiences and informing policies that address their health and broader needs. This paper integrates the concept of structural violence with person-centered ethnography to examine women's physical and mental health in contexts of displacement and migration. Using the triple trauma framework, we offer a holistic, temporal-spatial analysis of the health experiences and exposures faced by asylum-seeking women across three stages: places of origin, travel, and destination. Through the representative case of Anahi, a Honduran woman who fled to the US with her family in 2019, we identify four key themes: the persistence of structural violence and its constraints on health decisions and outcomes, the losses and suffering associated with women's triple roles, the harms of racism and xenophobia, and the health implications of inadequate information on asylum and immigration procedures. We conclude with policy recommendations to reduce health inequities among migrant women. This study advances understanding by providing a comprehensive, gendered analysis of the structural forces shaping health outcomes for migrant women, offering insights that extend beyond a narrow focus on reproductive issues to address their physical, mental, and social well-being.

Camouflaged prejudice and the affirmation of skin colour differences: assessment of racism among Brazilian undergraduate dental students.

The negative oral health outcomes of disadvantaged racial groups have been well-documented, as racial disparity in oral health persists over time and in different locations1. However, it is important to note that skin colour has no biological meaning, and the observed differences can be physiological expressions of social injustice such as racism. Aim: The aim of this study was to analyse the association between levels of modern racism (camouflaged prejudice and affirmation of differences) and sociodemographic characteristics of Brazilian dental students. Material and Method: An epidemiological cross-sectional online survey was conducted on 441 Brazilian undergraduate dental students using Google Forms. Participants were recruited via emails and social media, using the snowball technique. The Checklist for Reporting of Survey Studies (CROSS) was followed. The survey used sociodemographic variables, and the Brazilian version of the Modern Racism Scale (B-MRS), which measures the cognitive component of subtle racial attitudes. The scale assesses the central notion of disguised prejudice and has two domains: 'denial of prejudice' and 'affirmation of differences'. Participants' self-declared skin colour was categorized as "white" and "non-white" (black, brown, indigenous, yellow). Univariate analysis and Poisson regression with robust variance were applied. Results: Participants' mean age was 24.1 years (±5.4). Most participants were self-declared as white (54%) and 46% as non-white skin colour. Higher B-MRS overall-scores were observed in male (p=0.008) and non-white (p=0.002) students. B-MRS scores for the domain 'affirmation of differences' (representation of those who believe that whites and non-whites are truly different) were higher among male dental students (PR=1.138; CI 95%: 1.019-1.271) and those from low-income families (PR=1.306; CI 95%: 1.089-1.565). Scores for the domain 'denial of prejudice' (the idea that non-whites use their race to receive legal benefits) were higher among male dental students (PR=1.328; CI 95%: 1.129-1.562). Conclusions: In general, male non-white students had higher modern racism indicators. Male students from low-income families believed that whites and non-whites are truly different, accounting for the affirmation of difference in this sample.

Os impactos negativos da saúde oral dos grupos raciais desfavorecidos têm sido bem documentados, uma vez que a disparidade racial na saúde oral persiste ao longo do tempo e em diferentes locais. No entanto, é importante notar que a cor da pele não tem significado biológico e as diferenças observadas podem ser expressões fisiológicas de injustiça social, como o racismo. Objetivo: A teoria do racismo moderno afirma que as atitudes se expressam em formas preconceituosamente camufladas. Associou-se níveis de racismo moderno (afirmação de diferenças) com características sociodemográficas de universitários brasileiros. Material e Método: Uma pesquisa epidemiológica transversal on-line foi realizada com 441 estudantes brasileiros de graduação em odontologia por meio do Google Forms. Os participantes foram recrutados via e-mail e redes sociais, utilizando a técnica bola de neve. Seguiu-se a Lista de Verificação para Relatórios de Estudos de Pesquisa (CROSS). Variáveis sociodemográficas, bem como a versão brasileira da Escala de Racismo Moderno (B-MRS) que mede o componente cognitivo de atitudes raciais sutis foram utilizadas. A escala acessa o preconceito disfarçado, possuindo dois domínios: 'negação do preconceito' e 'afirmação das diferenças'. A cor da pele autodeclarada dos participantes foi categorizada em "branca" e "não-branca" (preta, parda, indígena, amarela). Foram realizadas análises univariada e regressão de Poisson. Resultados: A média de idade foi de 24,1 anos (±5,4). Muitos participantes se autodeclararam brancos (54%) e 46% não-brancos. Maiores escores da B-MRS foram observados em estudantes do sexo masculino (p=0,008) e não-brancos (p=0,002). Os escores da B-MRS para o domínio 'afirmação de diferenças' (representação daqueles que acreditam que brancos e não-brancos são diferentes) foram maiores entre estudantes de odontologia do sexo masculino (RP=1,138; IC 95%: 1,019­1,271) e aqueles de famílias de baixa renda (RP=1,306; IC 95%: 1,089­1,565). Os escores do domínio 'negação do preconceito' (ideia de que os não-brancos usam sua raça para receber benefícios legais) foram maiores entre os participantes do sexo masculino (RP=1,328; IC 95%: 1,129­1,562). Conclusão: Os estudantes homens, não-brancos, apresentavam indicadores de racismo mais elevados. Homens, provenientes de famílias de baixa renda, acreditavam que brancos e não-brancos são verdadeiramente diferentes, o que representa a afirmação da diferença entre o grupo desta amostra.

Exceptional racism at the dawn of scientific psychiatry in Brazil: the curious case of Juliano Moreira.

Twenty years ago, the British Journal of Psychiatry published an editorial regarding racism and psychiatry. Three decades ago, the journal published a lecture by Professor Michael Sheperd about Kraepelin's contributions to racist degeneration theories. A century ago, Albert Einstein visited the Brazilian Academy of Sciences, where he was hosted by Juliano Moreira [1872-1933], one of the most distinguished Brazilian scientists of that time. The only son of a former enslaved woman, he is regarded as one of the founding fathers of scientific psychiatry in Brazil. Moreira may have been a case of 'exceptional racism', the strategy of praising outstanding people from oppressed groups as a way of denying or covering up processes of structural racism.

[Geographies of (dis)protection: Sketches in anti-racist mental health]. / Geografías del (des)amparo: Bosquejos en salud mental antirracista.

This essay explores the affective maps or emotional archives of racialized communities in Spain, specifically focusing on the Caribbean Afro-diaspora in Madrid. It questions how migratory grief is prescribed by the government without taking into account the colonial wound, racial trauma, and the geopolitics of emotions, while delving into everyday structural racism. Drawing from decolonial theory and Black feminism, as well as narrative healing practices created by migrant collectives, qualitative research was conducted during the period 2023-2024, involving 25 in-depth interviews and two group workshops with the participation of 15 anti-racist activists. After an introduction framed by an autobiographical narrative within the anti-racist conversation, key aspects of the notion of migratory grief are highlighted, associating it with the colonial wound. Subsequently, some characteristics of memory as geographies of abandonment are emphasized. Finally, I turn to the notion of imagination, in the form of collective daydreams or fantasies that activate the hope of transcending the borders of European racism. The article builds bridges between community health, an intercultural perspective, and anti-racism.

El presente ensayo explora los mapas afectivos o archivos emocionales de comunidades racializadas en España, en concreto, de la afrodiáspora caribeña en Madrid. Cuestiona cómo se prescribe gubernamentalmente el duelo migrante sin contar con la herida colonial, el trauma racial y las geopolíticas de las emociones, y ahonda en el racismo estructural cotidiano. Partiendo de la teoría decolonial y el feminismo negro, así como de las prácticas narrativas en sanación creadas por colectivos migrantes, se realizó una investigación cualitativa, en el período 2023-2024, en la que se realizaron 25 entrevistas en profundidad y dos talleres grupales con la participación de 15 personas activistas antirracistas. Tras una introducción desde una narrativa autobiográfica en la conversación antirracista, se señalan aspectos claves de la noción duelo migrante, asociándola con la herida colonial. Posteriormente, se enfatizan algunas características de la memoria como geografías del desamparo. Por último, apelo a la noción de imaginación, en modo de ensoñaciones o fantasías colectivas que activan la esperanza de traspasar las fronteras del racismo europeo. El artículo crea puentes entre la salud comunitaria, la perspectiva intercultural y el antirracismo.

Obstetric racism, a debate under construction in Brazil: perceptions of black women on obstetric violence. / Racismo obstétrico, um debate em construção no Brasil: percepções de mulheres negras sobre a violência obstétrica.

This article aims to know the perception of women on obstetric violence from a racial perspective. This was a qualitative study carried out in a public maternity hospital with 25 women in the city of Salvador, Bahia, Brazil. Data were collected through semi-structured interviews and participant observation from November 2021 to February 2022. Content analysis was used to organize the data obtained through the interviews. The results were analyzed through the theoretical contributions of intersectionality, focusing on the interaction between obstetric violence and obstetric racism. The narratives discuss issues of obstetric violence, institutional racism, and how these experiences are permeated by issues of race, gender, and class. Questions related to the feelings of these women regarding the experience of violence at the time of childbirth care were also highlighted. Obstetric racism denies reproductive rights and hinders access to respectful and equitable care for black women.

O objetivo deste artigo é conhecer a percepção de mulheres sobre a violência obstétrica em uma perspectiva racial. Trata-se de uma pesquisa qualitativa realizada em uma maternidade pública, com 25 mulheres, no município de Salvador, Bahia, Brasil. Os dados foram coletados por meio de entrevistas semiestruturadas e observação participante, no período de novembro de 2021 a fevereiro de 2022. Utilizou-se, para organização dos dados obtidos através das entrevistas, a análise de conteúdo. Os resultados foram analisados através das contribuições teóricas da interseccionalidade, tendo como foco a interação entre violência obstétrica e racismo obstétrico. As narrativas discorrem sobre questões da violência obstétrica, racismo institucional, e como essas vivências são permeadas pelas questões de raça, gênero e classe. Foram apontadas também questões relacionadas aos sentimentos dessas mulheres frente a vivência da violência no momento da assistência ao parto. O racismo obstétrico nega os direitos reprodutivos e dificulta o acesso a uma assistência respeitosa e equânime as mulheres negras.

Iniquidades interseccionais no atendimento obstétrico às mulheres negras de comunidade quilombola / Intersectional inequities in obstetric care for black women in quilombola community / Inequidades interseccionales en el servicio obstétrico a las mujeres negras de comunidad quilombola

Introdução:A conjuntura socioeconômica e cultural da mulher negra a coloca em tripla vulnerabilidade, que se explica pelo fato de que ela é vítima do racismo, do preconceito de classe e da discriminação de gênero, e essa interação de diferentes tipos de opressão é explicada pela teoria da interseccionalidade. Esse negligenciamento precariza-se ainda mais quando se reporta para a atenção àsaúde. Objetivo:Compreender como o contexto social da interseccionalidade de raça, classe e gênero refletem no atendimento obstétrico em Saúde Pública de mulheres negras residentes em comunidade quilombola. Metodologia:Trata-se de pesquisa qualitativa de caráter descritivo-exploratório, realizada com duas mulheres negras residentes em comunidade quilombola, localizada em município no interior do estado do Ceará. Como instrumento para coleta de dados, utilizou-se a entrevista semiestruturada, sendo os dados submetidos à análise do discurso. Resultados:Os sujeitos desta investigação conseguem, a partir de situações do quotidiano vivenciadas nos serviços de saúde públicos, identificar exemplos de racismo e/ou preconceito relacionados ao fato de serem mulheres negras e pobres. Assim, a vulnerabilidade interseccional (raça ­gênero ­classe social) implica em desigualdades no acesso aos serviços de saúde, o que se materializa em violência obstétrica, negligência em relação ao direito da mulher negra sobre o próprio corpo, além de negação da sua subjetividade, o que viola os pressupostos do Sistema Único de Saúde (SUS), particularmente os princípios da universalidade, equidade e integralidade da assistência. Conclusões:Constata-se, portanto, que as iniquidades quanto ao atendimento obstétrico, que afetam majoritariamente as mulheres negras e pobres, apresentam-se como problemática de gestão, denotando o déficit na efetivação de políticas públicas de saúde, ou a sua ausência. Há também a necessidade de que os profissionais de saúde, a partir de educação continuada, tenham um olhar mais holístico, a fim de produzir um atendimento equânime e integral (AU).

Introduction:Black women's socioeconomic and cultural conjuncture puts them into a three-fold vulnerability, which is explained by the fact that they are victims of racism, class prejudice and gender discrimination, and this interaction of different types of oppression is explained by the theory of intersectionality. Such negligence is even more precarious when it comes to healthcare. Objective:To understand how the social context of the intersectionality of race, class and gender reflects on the obstetric care in public healthcare provided to black women residing in quilombola communities. Methodology:This is a qualitative research work of a descriptive-exploratory nature, carried out with two black women residing in a quilombola community located in the a rural areain the state of Ceará. As a data collection instrument, we used semi-structured interviews, and the data was submitted to discourse analysis. Results:The subjects of this investigation can, from daily situations experienced in public healthcare services,identify examples of racism and/or prejudice related to the fact that they are poor black women. Therefore, intersectional vulnerability (race ­gender ­social class) leads to inequalities in the access to healthcare services, which materializes as obstetric violence, negligence to black women's right to their own bodies, as well as denial of their subjectivity, which violates the presuppositions of the Brazilian Unified Health System (SUS), especially the principles of universality, equity, and integrality of care. Conclusions:It is therefore verified that the inequities of obstetric care, which mostly affect poor black women, present themselves as a management problem, denoting the deficit in the application of public healthcare policies, or their absence. There is also a need for healthcare providers, through continued education, to have a more holistic view in order to provide more equanimous and integral healthcare (AU).

Introducción:La coyuntura socioeconómica y cultural de la mujer negra la coloca en una triple vulnerabilidad, que se explica por el hecho de que es víctima del racismo, del prejuicio de clase y de la discriminación de género, y esa interacción de diferentes tipos de opresión es explicada por la teoría dela interseccionalidad. Esta negligencia se precariza mucho más cuando se trata de la atención médica. Objetivo:Comprender cómo el contexto social de la interseccionalidad de raza, clase y género se refleja en la atención obstétrica en la Salud Pública de mujeres negras que viven en una comunidad quilombola. Metodología:Investigación cualitativa de carácter descriptivo-exploratorio, realizada con dos mujeres negras residentes en comunidad quilombola, Ceará, Brazil. Para la recolección de datos, se utilizaron entrevistas semiestructuradas y los datos fueron sometidos a análisis del discurso. Resultados:Los sujetos son capaces, a partir de situaciones vividas en los servicios públicos de salud, de identificar ejemplos de racismo y/o prejuicios por el hecho de ser mujeres negras y pobres. Así, la vulnerabilidad interseccional (raza ­género ­clase social) implica en desigualdades en el acceso a los servicios de salud, que se materializan en violencia obstétrica, negligencia en relación a los derechos de las mujeres negras sobre sus propios cuerpos, además de la negación de su subjetividad, que viola los supuestos del Sistema Único de Salud, en particular los principios de universalidad, equidad e integralidad de la atención. Conclusiones: Se puede observar que las inequidades en la atención obstétrica, que afectanmayormente a mujeres negras y pobres, se presentan como un problema de gestión, denotando el déficit en la implementación de políticas públicas de salud, o su ausencia. También es necesario que los profesionales de la salud, basados en la educación continua, tengan una visión más holística, para producir una atención equitativa e integral (AU).

Mexican-origin women's individual and collective strategies to access and share health-promoting resources in the context of exclusionary immigration and immigrant policies.

BACKGROUND: A growing literature has documented the social, economic, and health impacts of exclusionary immigration and immigrant policies in the early 21st century for Latiné communities in the US, pointing to immigration and immigrant policies as forms of structural racism that affect individual, family, and community health and well-being. Furthermore, the past decade has seen an increase in bi-partisan exclusionary immigration and immigrant policies. Immigration enforcement has been a major topic during the 2024 Presidential election cycle, portending an augmentation of exclusionary policies towards immigrants. Within this context, scholars have called for research that highlights the ways in which Latiné communities navigate exclusionary immigration and immigrant policies, and implications for health. This study examines ways in which Mexican-origin women in a midwestern northern border community navigate restrictive immigration and immigrant policies to access health-promoting resources and care for their well-being. METHODS: We conducted a grounded theory analysis drawing on interviews with 48 Mexican-origin women in Detroit, Michigan, who identified as being in the first, 1.5, or second immigrant generation. Interviews were conducted in English or Spanish, depending on participants' preferences, and were conducted at community-based organizations or other locations convenient to participants in 2013-2014. RESULTS: Women reported encountering an interconnected web of institutional processes that used racializing markers to infer legal status and eligibility to access health-promoting resources. Our findings highlight women's use of both individual and collective action to navigate exclusionary policies and processes, working to: (1) maintain access to health-promoting resources; (2) limit labeling and stigmatization; and (3) mitigate adverse impacts of immigrant policing on health and well-being. The strategies women engaged were shaped by both the immigration processes and structures they confronted, and the resources to which they had access to within their social network. CONCLUSIONS: Our findings suggest a complex interplay of immigration-related policies and processes, social networks, and health-relevant resources. They highlight the importance of inclusive policies to promote health for immigrant communities. These findings illuminate women's agency in the context of structural violence facing immigrant women and are particularly salient in the face of anti-immigrant rhetoric and exclusionary immigration and immigrant policies.

Narcanazo: Community Activation of Antiracist Epidemiology.

The Latinx (Hispanic) social construct obscures differences in the overdose risk levels of groups within this category. When national data are disaggregated, stateside Puerto Rican mortality increases exponentially, so much that this community has the highest rates of overdose deaths across years. Developed by Bronx-based Puerto Ricans, Narcanazo is an empowered upstander campaign that uses local overdose data to mobilize community members as trained naloxone dispensers. This health promotion campaign was grounded in antiracist epidemiological analysis. (Am J Public Health. 2024;114(S6):S463-S466. https://doi.org/10.2105/AJPH.2024.307605) [Formula: see text].

Health of the black population in health training: perspectives towards racial equity. / Saúde da população negra na formação em saúde: perspectivas rumo à equidade racial.

This article aims to understand the view of racial equity and the motivations for approaching the health of the black population in Collective Health, Nursing, and Medicine courses at a Brazilian public university, guided by the black perspective of decoloniality. Considering Institutional Racism, it is necessary to invest in the interfaces between the education and health sectors in the training of professionals for the Unified Health System. This is a qualitative study with an intervention-research approach, affirming a social and political commitment to transforming reality. Workshops were held with representatives of the Structuring Teaching Centers of the selected courses. The theme of the health of the black population has been elaborated in a prompt and decontextualized manner, with no reflection based on structural racism, power relations, and Brazilian socio-historical formation. This creates a distance from the guidelines proposed by the National Policy for Comprehensive Health of the Black Population. At the end of this article, perspectives are identified for the reorientation of health training, aimed at increasing democratic density and racial equity.

Este artigo objetiva compreender a visão de equidade racial e as motivações para a abordagem da saúde da população negra na formação dos cursos de Saúde Coletiva, Enfermagem e Medicina de uma universidade pública brasileira, orientado na perspectiva negra da decolonialidade. Considerando o Racismo Institucional, é preciso investir nas interfaces entre os setores educação e saúde na formação de profissionais para o Sistema Único de Saúde. Trata-se de estudo de natureza qualitativa com abordagem do tipo pesquisa-intervenção, afirmando um compromisso social e político de transformação da realidade. Para tanto, foram realizadas oficinas com representantes dos Núcleos Docentes Estruturantes dos cursos selecionados. A temática da saúde da população negra tem sido trabalhada de forma pontual e descontextualizada, sem uma reflexão do racismo estrutural, das relações de poder e da formação socio-histórica brasileira, o que se distancia das diretrizes propostas pela Política Nacional de Saúde Integral da População Negra. Ao final, são sinalizadas perspectivas para a reorientação da formação em saúde, visando ao aumento da densidade democrática e da equidade racial.

Development and validation of the Ethnic-Racial Discrimination Stress Inventory (ERDSI) for Mexican-origin U.S. adults and Turkish-origin German adults.

OBJECTIVES: We developed the 26-item Ethnic-Racial Discrimination Stress Inventory (ERDSI) to assess ethnic-racial discrimination stress in Mexican-origin adults in the United States and Turkish-origin adults in Germany, two groups with similar sociocultural characteristics and immigration experiences. METHOD: We developed 73 items measuring firsthand, intragroup, and vicarious discrimination, and internalization and expectations of discrimination experiences. If participants reported experiencing a given situation, they were asked to rate its stressfulness. U.S.-based Mexican-origin adults (N = 222) and German-based Turkish-origin adults (N = 105) completed an online survey of these items, measures of related constructs, and sociodemographic measures. RESULTS: Study 1: We eliminated items based on interitem correlations and exploratory factor analyses in the U.S.-based Mexican sample. The exploratory factor analyses yielded four reliable and valid factors (F1: Vicarious Discrimination Stress, seven items; F2: Internalization of Discrimination Stress, seven items; F3: Intragroup Discrimination Stress, seven items; and F4: Firsthand Discrimination Stress, five items). The ERDSI factors predicted well-being measures, even after adjusting for control variables. Study 2: The three ERDSI factors (F1, F2, F4, not F3) that applied to the German-based Turkish sample demonstrated reliability and validity. Confirmatory factor analyses demonstrated metric invariance for F2 and partial scalar invariance for F1, F3, and F4. CONCLUSIONS: The ERDSI can be used to assess ethnic-racial discrimination stress in future studies with U.S.-based Mexican-origin adults and German-based Turkish-origin adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

'Humility, Concern, Respect': A Qualitative Study Exploring Parent Perspectives on a Pediatrician's Role in Addressing Racism.

OBJECTIVE: To explore racially minoritized families' perceptions on how, and if, physicians should address children's racial identity and concepts of racism within clinical settings. STUDY DESIGN: Parents of racially minoritized children, ages 5 through 18, were interviewed to explore experiences with racial identity formation, discrimination, and the extent to which they wanted pediatricians to address these topics. Children were included at the discretion of their parents. Interviews were transcribed, coded, and analyzed through a critical race theory lens based in constructivist grounded theory. RESULTS: Parents encouraged their children to embrace their racial identities but also wanted to shield them from negative experiences of racism to preserve identity safety. Parents felt pediatricians should address racial issues in a manner specific to their child's situation. Thoughtful inclusion of race-related questions, whether in discussion or on questionnaires, is essential to prevent tension in a therapeutic relationship. There was no consensus on the use of preclinical screening. Instead, families highlighted the importance of embracing humility, trust, and respect. CONCLUSIONS: Participant families have preferences for approaches to address the effects of racism on their children's health. Pediatricians should understand the importance of identity safety and approach their discussions with cultural humility, which includes self-reflection, empathy, active listening, and flexible negotiation. Above all, pediatricians need to create a safe environment for appropriate discussion of these issues.

Decolonising global health: why the new Pandemic Agreement should have included the principle of subsidiarity.

The negotiations for the WHO Pandemic Agreement have brought attention to issues of racism and colonialism in global health. Although the agreement aims to promote global solidarity, it fails to address these deeply embedded problems. This Viewpoint argues that not including the principle of subsidiarity into Article 4 of the agreement as a pragmatic strategy was a missed opportunity to decolonise global health governance and promote global solidarity. Subsidiarity, as a structural principle, empowers local units to make decisions and address issues at their level, fostering collaboration, coordination, and cooperation. By integrating subsidiarity, the agreement could have ensured contextually appropriate responses, empowered local communities, and achieved justice in global health. This paper discusses the elements of subsidiarity-namely, agency and non-abandonment-and highlights the need to strike a balance between them. It also maps the principle of subsidiarity within the Pandemic Agreement, emphasising the importance of creating a practical framework for its implementation. By integrating subsidiarity into the agreement, a just and decolonialised approach to pandemic prevention and response could have been closer to being realised, promoting global solidarity and addressing health inequities.

A daily diary study of discrimination and distress in Mexican-origin adolescents: Testing mediating mechanisms.

The present 21-day daily diary study (conducted 2021-2022) tested anger and racism-related vigilance as potential transdiagnostic mediators linking exposure to racial and ethnic discrimination (RED) to distress (negative affect and stress, respectively). The data analytic sample included N = 317 Mexican-origin adolescents (Mage = 13.5 years; 50.8% male, 46.7% female; 2.5% non-binary) from the Midwestern United States. Results from longitudinal mediation models revealed significant mediation effects through anger and racism-related vigilance, respectively, in the association between daily RED and daily distress, both within and across adolescents. Implications for theory, research, and practice are discussed so that future work can leverage these novel findings toward promoting the well-being of Mexican-origin adolescents, especially those who live in contexts of ethnoracial adversity.

Is It Possible to Decolonize the Field of Physical Activity and Health?

Is it possible to decolonize the field of physical activity and health? Decoloniality presupposes a body-geopolitical location, such as in the Brazilian and Latin American context, where it is crucial to use social identity lenses related to race, gender, sexuality, and other social markers that affect the body. Understanding health and physical activity from a decolonial perspective would bring the oppressions that connect capitalism, patriarchy, and racism to the center of the discussion. For a "physical activity other," we challenged the general recommendation of physical activity in the 4 domains. Physical activity should be understood as an end in itself, as a right, and as human development. Approaches that advocate physical activity at work, at home, and while commuting use other human activities to relate these domains to health without considering the inequalities and oppressions that constitute them in most parts of the world. Is it fair to apply "global recommendations" for physical activity to scenarios such as Brazil and Latin America, using models that are inappropriate to the context and history of these places, people, and cultures? Perhaps it is time to socially reorient and reposition physical activity from a decolonial perspective. We need Black, Indigenous, Latino, African, and other people from the Global South to move the research agenda, recommendations, and policies on physical activity from "any" health to a fair health.