So many Nigerians: why is Nigeria overrepresented as the ancestral genetic homeland of Legacy African North Americans?

The genetics of African North Americans are complex amalgamations of various West and Central African peoples with modest gene flow from specific European and Amerindian peoples. A comprehensive understanding of African North American biohistory is a prerequisite for accurate interpretations of the ancestral genetics of this population. Too often, genetic interpretations falter with ahistorical reconstructions. The recently reported overrepresentation of Nigerian lineages in African North Americans reflects pronounced limitations in the African genomic database, the artificiality of the colonial maps of Africa, the contributions of multiple African empires and kingdoms into the transatlantic trade in enslaved Africans, and the overrepresentation of Yoruba peoples in the existing limited representation of West Africans in public genomic databases. This Matters Arising paper is in response to Micheletti et al. (2020), published in The American Journal of Human Genetics. See also the response by Micheletti et al. (2020), published in this issue.

Associations between Individual- and Structural-Level Racism and Gestational Age at Birth in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be.

The purpose of this study was to investigate the associations between multilevel racism and gestational age at birth among nulliparous women. We conducted a secondary analysis of data of the nuMoM2b Study (2010-2013) to examine the associations between individual- and structural-level experiences of racism and discrimination and gestational age at birth among nulliparous women (n = 9148) at eight sites across the U.S. Measures included the individual Experiences of Discrimination (EOD) scale and the Index of Concentration at the Extremes (ICE) to measure structural racism. After adjustment, we observed a significant individual and structural racism interaction on gestational length (p = 0.012). In subgroup analyses, we found that among those with high EOD scores, women who were from households concentrated in the more privileged group had significantly longer gestations (ß = 1.27, 95% CI: 0.48, 2.06). Women who reported higher EOD scores and more economic privilege had longer gestations, demonstrating the moderating effect of ICE as a measure of structural racism. In conclusion, ICE may represent a modifiable factor in the prevention of adverse birth outcomes in nulliparas.

Firearm Violence Exposure and Functional Disability among Black Men and Women in the United States.

This study investigates the relationship between firearm violence exposure and functional health among Black adults in the United States (US). We examined associations between different forms of firearm violence exposure (direct, indirect, and community) and functional health with particular attention to differences across sex groups. We used survey data from a nationally representative sample of 3015 Black adult Americans to analyze associations between types of firearm violence exposure and four aspects of functional disability including: the ability to concentrate, walk/use stairs, dress/bathe, and run errands among males and females. The findings indicate notable disparities in exposure and health outcomes based on the exposure type and cumulative exposure to violence. Among males, functional disability was associated most closely with community violence exposure, while direct threats of firearm violence were most consequential for functional health among females. High cumulative exposure to firearm violence was linked to significant risks to functional health, particularly among females. The results shed light on sex differences in the repercussions of firearm violence exposure and emphasize its implications for daily functioning and health. This study contributes to the understanding of the multifaceted impacts of firearm violence on functional well-being and highlights the need for inclusive and culturally sensitive healing approaches based in community settings. There is a critical need for heightened awareness and strategies to enhance the well-being of those disproportionately affected by firearm violence in the US.

Status foe: a psychobiographical investigation of Ida B. Wells.

Ida B. Wells (1862-1931) led an extraordinary life as a journalist, educator, and activist while navigating the intersecting social realities of race, gender, and class. She embodied courage, advocating for the civil rights of Black Americans in an uncompromising fashion.Building on decades of research in social psychology, sociologist Cecilia L. Ridgeway presents (2019) a cultural schema theory of status. She contends that issues of status in interpersonal contexts are an unavoidable aspect of the human condition. Despite the ubiquity of status as a sociocultural force, Ridgeway believes that status hierarchies may be undermined.The present study is a psychobiographical exploration of Wells through the lens of Ridgeway's status theory. It explores: the development of Wells' cultural schemas; how Wells navigated her own status; the inter-relationship between Wells and her sociocultural context; and how Wells undermined and overcame status hierarchies.

Post-traumatic stress disorder symptoms and PrEP intentions among Black American young adults at high-risk for HIV.

OBJECTIVES: Black Americans bear the greatest burden of HIV, accounting for 43% of new diagnoses. Yet Black Americans also evidence the lowest utilization rates of Pre-Exposure Prophylaxis (PrEP), a highly effective biomedical strategy for preventing HIV infection. Predictors of PrEP acceptance vary; however, little is known about psychological distress, such as post-traumatic stress disorder (PTSD) symptoms, as a predictor. DESIGN: In this cross-sectional study, n = 195 Black Americans, evidencing behaviors found in the research literature to heighten risk for contracting HIV (e.g. sex work, injection drug use) ages 18-29, 55% cisgender women, 39.5% cisgender men, 3% transgender/non-binary, completed audio-computer-assisted self-interviews. RESULTS: Bivariate analyses indicated significant positive associations between PTSD symptoms and PrEP acceptance and self-confidence. In multinomial logistic regression analyses, after controlling for Perceived HIV Risk, participants had a higher likelihood of responding they 'probably would' take PrEP (as opposed to 'definitely would not' take PrEP) if they reported higher levels of PTSD symptoms. Post-hoc analyses revealed a curvilinear relationship between PTSD symptoms and PrEP acceptance with those reporting the highest level of PTSD in the sample having slightly lower PrEP acceptance than those reporting moderately high levels of PTSD. CONCLUSION: Findings are discussed in the context of the negative impacts of high levels of PTSD and potential positive adaptations subsequent to moderate levels of PTSD that could be relevant to advances in HIV prevention efforts.

Retinal perfusion is linked to cognition and brain MRI biomarkers in Black Americans.

INTRODUCTION: We investigated whether retinal capillary perfusion is a biomarker of cerebral small vessel disease and impaired cognition among Black Americans, an understudied group at higher risk for dementia. METHODS: We enrolled 96 Black Americans without known cognitive impairment. Four retinal perfusion measures were derived using optical coherence tomography angiography. Neurocognitive assessment and brain magnetic resonance imaging (MRI) were performed. Multiple linear regression analyses were performed. RESULTS: Lower retinal capillary perfusion was correlated with worse Oral Symbol Digit Test (P < = 0.005) and Fluid Cognition Composite scores (P < = 0.02), but not with the Crystallized Cognition Composite score (P > = 0.41). Lower retinal perfusion was also correlated with higher free water and peak width of skeletonized mean diffusivity, and lower fractional anisotropy (all P < 0.05) on MRI (N = 35). DISCUSSION: Lower retinal capillary perfusion is associated with worse information processing, fluid cognition, and MRI biomarkers of cerebral small vessel disease, but is not related to crystallized cognition.

Racial discrimination during middle age predicts higher serum phosphorylated tau and neurofilament light chain levels a decade later: A study of aging black Americans.

INTRODUCTION: Recent evidence suggests that exposure to the stress of racism may increase the risk of dementia for Black Americans. METHODS: The present study used 17 years of data from a sample of 255 Black Americans to investigate the extent to which exposure to racial discrimination predicts subsequent changes in serum Alzheimer's Disease Research Center (ADRC) biomarkers: serum phosphorylated tau181(p-tau181), neurofilament light (NfL), and glial fibrillary acidic protein (GFAP). We hypothesized that racial discrimination assessed during middle age would predict increases in these serum biomarkers as the participants aged into their 60s. RESULTS: Our findings indicate that exposure to various forms of racial discrimination during a person's 40s and early 50s predicts an 11-year increase in both serum p-tau181 and NfL. Racial discrimination was not associated with subsequent levels of GFAP. DISCUSSION: These findings suggest that racial discrimination in midlife may contribute to increased AD pathology and neurodegeneration later in life. HIGHLIGHTS: A 17-year longitudinal study of Black Americans. Assessments of change in serum p-tau181, neurofilament light, and glial fibrillary acidic protein. Exposure to racial discrimination during middle age predicted increases in p-tau181 and neurofilament light. Education was positively related to both p-tau181 and exposure to racial discrimination.

At the intersection of race and immigration: a comprehensive review of depression and related symptoms within the US Black population.

Although the literature on the differences between Black people and White people in terms of differences in major depressive disorder and related self-reported symptoms is robust, less robust is the literature on how these outcomes are patterned within the US Black population and why differences exist. Given increased ethnic diversity of Black Americans due to increases in immigration, continued aggregation may mask differences between Black ethnic-immigrant groups and Black Americans with more distant ancestral ties to Africa (African Americans). The purpose of this narrative review was to comprehensively synthesize the literature on depression and related symptoms within the US Black population across immigration- and ethnicity-related domains and provide a summary of mechanisms proposed to explain variation. Findings revealed substantial variation in the presence of these outcomes within the US Black population by nativity, region of birth, age at immigration, and Caribbean ethnic origin. Racial context and racial socialization were identified as important, promising mechanisms for better understanding variations by region of birth and among those born or socialized in the United States, respectively. Findings warrant data collection efforts and measurement innovation to better account for within-racial differences in outcomes under study. A greater appreciation of the growing ethnic-immigrant diversity within the US Black population may improve understanding of how racism differentially functions as a cause of depression and related symptoms within this group.

Plasma metabolomics profiles in Black and White participants of the Adventist Health Study-2 cohort.

BACKGROUND: Black Americans suffer disparities in risk for cardiometabolic and other chronic diseases. Findings from the Adventist Health Study-2 (AHS-2) cohort have shown associations of plant-based dietary patterns and healthy lifestyle factors with prevention of such diseases. Hence, it is likely that racial differences in metabolic profiles correlating with disparities in chronic diseases are explained largely by diet and lifestyle, besides social determinants of health. METHODS: Untargeted plasma metabolomics screening was performed on plasma samples from 350 participants of the AHS-2, including 171 Black and 179 White participants, using ultrahigh-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) and a global platform of 892 metabolites. Differences in metabolites or biochemical subclasses by race were analyzed using linear regression, considering various models adjusted for known confounders, dietary and/or other lifestyle behaviors, social vulnerability, and psychosocial stress. The Storey permutation approach was used to adjust for false discovery at FDR < 0.05. RESULTS: Linear regression revealed differential abundance of over 40% of individual metabolites or biochemical subclasses when comparing Black with White participants after adjustment for false discovery (FDR < 0.05), with the vast majority showing lower abundance in Blacks. Associations were not appreciably altered with adjustment for dietary patterns and socioeconomic or psychosocial stress. Metabolite subclasses showing consistently lower abundance in Black participants included various lipids, such as lysophospholipids, phosphatidylethanolamines, monoacylglycerols, diacylglycerols, and long-chain monounsaturated fatty acids, among other subclasses or lipid categories. Among all biochemical subclasses, creatine metabolism exclusively showed higher abundance in Black participants, although among metabolites within this subclass, only creatine showed differential abundance after adjustment for glomerular filtration rate. Notable metabolites in higher abundance in Black participants included methyl and propyl paraben sulfates, piperine metabolites, and a considerable proportion of acetylated amino acids, including many previously found associated with glomerular filtration rate. CONCLUSIONS: Differences in metabolic profiles were evident when comparing Black and White participants of the AHS-2 cohort. These differences are likely attributed in part to dietary behaviors not adequately explained by dietary pattern covariates, besides other environmental or genetic factors. Alterations in these metabolites and associated subclasses may have implications for the prevention of chronic diseases in Black Americans.

Vitamin D Levels in Black Americans and the Association With Left Ventricular Remodeling and Incident Heart Failure With Preserved Ejectin Fraction: The Jackson Heart Study.

BACKGROUND: In observational studies, a lower serum vitamin D3 concentration has been associated with an increased risk of cardiovascular disease. However, the associations between serum vitamin D3 levels and left ventricular (LV) structure and heart failure with preserved ejection fraction (HFpEF) have not been well-characterized among Black Americans. The prevalence of vitamin D3 deficiency is higher among Black Americans than in other race/ethnicity groups. We hypothesized that serum vitamin D3 levels are associated with LV concentric remodeling and incident HFpEF in Black Americans. METHODS AND RESULTS: Among 5306 Black Americans in the Jackson Heart Study cohort, we investigated the relationships between serum vitamin D3 levels and LV structure and function, evaluated with echocardiography, and incident HF hospitalization, categorized as either HF with reduced EF (HFrEF; an EF of <50%) or HFpEF (an EF of ≥50%). After adjustment for possible confounding factors, lower vitamin D3 levels were associated with greater relative wall thickness (ß for 1 standard deviation [SD] increase -0.003, 95% confidence interval -0.005 to -0.000). Over a median follow-up period of 11 years (range 10.2-11.0 years), 340 participants developed incident HF (7.88 cases per 1000 person-years), including 146 (43%) HFrEF and 194 (57%) HFpEF cases. After adjustment, higher serum vitamin D3 levels were associated with decreased hazard for HF overall (hazard ratio for 1 SD increase 0.88, 95% confidence interval 0.78-0.99) driven by a significant association with HFpEF (hazard ratio for 1 SD increase 0.84, 95% confidence interval 0.71-0.99). CONCLUSIONS: In this community-based Black American cohort, lower serum vitamin D3 levels were associated with LV concentric remodeling and an increased hazard for HF, mainly HFpEF. Further investigation is required to examine whether supplementation with vitamin D3 can prevent LV concentric remodeling and incident HFpEF in Black Americans.

Police Bias and Low Relatability and Diet Quality: Examining the Importance of Psychosocial Factors in Predominantly Black Communities.

How police bias and low relatability may contribute to poor dietary quality is poorly understood. In this cross-sectional study, we analyzed data from 2021 from a cohort of n = 724 adults living in predominantly Black communities in Pittsburgh, Pennsylvania; these adults were mostly Black (90.6%), low-income (median household income $17,500), and women (79.3%). We estimated direct and indirect paths between police mistrust and dietary quality (measured by Healthy Eating Index (HEI)-2015) through perceived stress, community connectedness, and subjective social status. Dietary quality was poor (mean HEI-2015 score was 50) and mistrust of police was high: 78% of participants either agreed or strongly agreed that something they say might be interpreted as criminal by the police due to their race/ethnicity. Police bias and low relatability was associated with lower perceived social status [Formula: see text]= - 0.03 (95% confidence interval [CI]: - 0.05, - 0.01). Police bias and low relatability was marginally associated with low dietary quality ß = - 0.14 (95% CI: - 0.29, 0.02). Nineteen percent of the total association between police bias and low relatability and lower dietary quality ß = - 0.16 (- 0.01, - 0.31) was explained by an indirect association through lower community connectedness, or how close respondents felt with their community [Formula: see text] Police bias and low relatability may play a role in community connection, social status, and ultimately dietary disparities for Black Americans. Addressing police bias and low relatability is a continuing and pressing public health issue.

Dismantling the monolith: ethnic origin, racial identity, and major depression among US-born Black Americans.

PURPOSE: Numerous investigations have sought to understand why Black Americans have a lower prevalence of major depressive disorder (MDD) than white Americans, yet fewer have explored within-racial group variation or its causes. Limited extant evidence indicates that US-born Caribbeans have higher levels of MDD relative to African Americans. Among African Americans, racial identity is considered protective against depression, yet it is unclear how it functions among Black Americans with recent immigrant origins. We examined the extent to which differential effects of racial identity on MDD by ethnic origin explain the elevated prevalence among US-born Caribbeans relative to all other US-born Black Americans. METHODS: With data from the largest nationally representative study of Black mental health, log-binomial models assessed effect modification of ethnic origin (Caribbean, non-Caribbean) on the relationship between racial identity and MDD. Separate models evaluated four indicators of racial identity-"closeness to Black people," "importance of race to one's identity," "belief that one's fate is shared with other Black people," and "Black group evaluation." RESULTS: Belief in "shared fate" was positively associated with MDD for US-born Caribbeans alone (PR = 3.43, 95% CI 1.87, 6.27). Models suggested that "importance of race" and "Black group evaluation" were detrimental for Caribbeans, yet protective for non-Caribbeans. "Closeness" appeared protective for both groups. CONCLUSION: Findings suggest that the protective effect of racial identity against MDD among US-born Black Americans may depend on both ethnic origin and the operationalization of racial identity. Results provide new insight into the role of racial identity on depression and suggest promising directions for future research.

Black dreams matter: Exploring the polyphonic realms of the Black Radical Imaginary.

OBJECTIVE: Charles Cobb Jr. and Alex Davis are two Black American men who have never experienced the full capacity of freedom. The routine denial of their full humanity, or social equity, has counterintuitively sparked an impetus inside of them both to commit their lives to seek to dismantle oppressive systems. METHOD: Through a series of oral histories with both organizers, I learned that they have been engaged with radical dreaming and imagination as a survivalist movement strategy. RESULTS: Despite the dehumanizing violence of slavery, the political humiliation of Reconstruction, the brutal segregation and state terrorism of Jim Crow, and the many Civil Rights successes and Neoliberal disappointments that have followed, Cobb and Davis have embodied a steadfast commitment to freedom, unwavering trust in their people, in some contexts, a just daring that defies current dominant reason. CONCLUSION: I argue that by drawing through lines between the meaning-making experiences of Charles Cobb Jr. 's and Alex Davis' incredible lives we can better understand their critical consciousness and sociopolitical development have influenced their dreams of freedom, cultivated their radical imaginations, and sustained their collectivism.

Integrating HPV Vaccination Within PrEP care Delivery for Underserved Populations: A Mixed Methods Feasibility Study.

Human Papillomavirus (HPV) vaccination is effective at preventing anal cancer, which disproportionally impacts gay/bisexual men (GBM) and transgender women (TGW). Vaccine coverage among GBM/TGW is insufficient to reduce anal cancer disparities. Federally qualified health centers (FQHCs) can increase reach and uptake of HPV vaccination by integrating and promoting HPV vaccination in ongoing HIV preventive care (e.g., Pre-exposure Prophylaxis [PrEP]). The purpose of the current study was to assess the feasibility and potential impact of integrating HPV vaccination with PrEP care. We conducted a mixed methods study of PrEP providers and staff (qualitative interviews, N = 9) and PrEP patients (quantitative survey, N = 88) at an FQHC in Philadelphia, Pennsylvania. Qualitative thematic analysis of PrEP provider/staff interviews was informed by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to identify and describe barriers and facilitators to HPV vaccination implementation. Quantitative analysis of PrEP patient survey was informed by the Information-Motivation-Behavioral Skills Model. Quantitative interviews resulted in 16 themes related to characteristics of the inner and outer clinic context. Barriers among providers included lack of focus on HPV in PrEP management guidelines, in metrics mandated by funding agencies, and in electronic medical record templates. Lack of anal cancer specific knowledge and motivation was identified in both PrEP patients and providers/staff. Providing HPV vaccination during routine PrEP visits was highly acceptable to both patients and providers. Based on these findings, we recommend several multi-level strategies to increase HPV vaccine uptake among PrEP patients.

Trajectories of depressive symptoms among older African Americans: the influence of neighborhood characteristics and gender.

OBJECTIVES: Focusing on older African Americans, this study aims to (1) identify 9-year trajectories of depressive symptoms, (2) examine the association between baseline neighborhood characteristics (i.e., social cohesion and physical disadvantage) and trajectories of depressive symptoms, and (3) test whether the effects of neighborhood characteristics on depressive symptoms trajectories differ by gender. METHODS: Data came from the National Health and Aging Trend Study. Older African Americans at baseline were selected (N = 1662) and followed up for eight rounds. Depressive symptom trajectories were estimated using group-based trajectory modeling. Weighted multinomial logistic regressions were conducted. RESULTS: Three trajectories of depressive symptoms were identified: "persistently low," "moderate and increasing," and "high and decreasing" (Objective 1). Objective 2 and 3 were partially supported. Specifically, high perceived neighborhood social cohesion was associated with a lower relative risk of being on the "moderate and increasing" versus the "persistently low" trajectory (RRR = 0.64, p < 0.01). The association between neighborhood physical disadvantage and depressive symptom trajectories was stronger among older African American men compared to women. CONCLUSIONS: High levels of neighborhood social cohesion may protect against increasing depressive symptoms in older African Americans. Compared to women, older African American men may be more vulnerable to negative mental health effects of neighborhood physical disadvantage.

Lifetime vicarious experiences of major discrimination and depressive symptoms among middle-aged and older black adults.

OBJECTIVES: Racial disparities in later-life depression among Americans are well-documented. Perceived discrimination has been linked to depressive symptoms among aging Black adults, but little research has considered how vicarious exposure to discrimination shapes the mental health of middle-aged and older Black adults. METHODS: A subsample of Black adults aged 50-69 years (N = 273) were drawn from the Nashville Stress and Health Study. Lifetime vicarious exposures to major discrimination were assessed. Additionally, multivariate linear regression was employed to examine the association between vicarious experiences of major discrimination and depressive symptoms. RESULTS: Once the Black adults in the sample had reached ages 50 and older, the most common discriminatory events that they had vicariously experienced in their lifetime occurred as a result of their loved ones' unfair interactions with law enforcement and the job market, respectively. Furthermore, our findings revealed that vicarious experiences of major discrimination were associated with higher levels of depressive symptoms among middle-aged and older Black adults. CONCLUSION: Vicarious, as well as personal, exposures to discrimination shape the mental health of Black Americans over the lifespan. The secondhand effects of discrimination must be considered for interventions aimed at reducing the mental health consequences of racism-related adversity as Black adults age.

Identifying drivers of increasing opioid overdose deaths among black individuals: a qualitative model drawing on experience of peers and community health workers.

BACKGROUND: Black individuals in the USA face disproportionate increases in rates of fatal opioid overdose despite federal efforts to mitigate the opioid crisis. The aim of this study was to examine what drives increases in opioid overdose death among Black Americans based on the experience of key stakeholders. METHODS: Focus groups were conducted with stakeholders providing substance use prevention services in Black communities in St. Louis, MO (n = 14). One focus group included peer advocates and volunteers conducting outreach-based services and one included active community health workers. Focus groups were held at community partner organizations familiar to participants. Data collection was facilitated by an interview guide with open-ended prompts. Focus groups were audio recorded and professionally transcribed. Transcripts were analyzed using grounded theory to abstract line-by-line codes into higher order themes and interpret their associations. RESULTS: A core theme was identified from participants' narratives suggesting that opioid overdose death among Black individuals is driven by unmet needs for safety, security, stability, and survival (The 4Ss). A lack of The 4Ss was reflective of structural disinvestment and healthcare and social service barriers perpetuated by systemic racism. Participants unmet 4S needs are associated with health and social consequences that perpetuate overdose and detrimentally impact recovery efforts. Participants identified cultural and relationship-based strategies that may address The 4Ss and mitigate overdose in Black communities. CONCLUSIONS: Key stakeholders working in local communities to address racial inequities in opioid overdose highlighted the importance of upstream interventions that promote basic socioeconomic needs. Local outreach efforts utilizing peer services can provide culturally congruent interventions and promote harm reduction in Black communities traditionally underserved by US health and social systems.

Indirect effect of race-related stress on traumatic stress and depression symptoms via subjective social status in a Black community sample.

Experiencing racism is linked to lower subjective social status (SSS), defined as one's perception of their position in society. SSS is influenced by power, prestige, and objective socioeconomic status (SES). Previous findings suggest that race-related stress may be related to adverse mental health outcomes through SSS in Black Americans, a population that has been deeply affected by continuing legacies of oppression. The current study examines the indirect association between race-related stress and posttraumatic stress disorder (PTSD) and depression symptoms through SSS in a community sample of largely trauma-exposed Black Americans (N = 173). Hierarchical regression analyses indicated that overall race-related stress significantly predicted lower SSS, higher PTSD symptoms, and higher depression symptoms. Analyses also revealed indirect effects of cultural race-related stress on PTSD and depression symptoms through SSS after controlling for SES. Results suggest that the experience of race-related stress, particularly cultural race-related stress, which involves the degradation and disparagement of one's culture and worldview, is associated with more severe PTSD and depression symptoms potentially due to these experiences decreasing Black Americans' SSS. Findings support the need for systemic intervention strategies to disrupt the cultural oppression of Black Americans and improve the societal value and mental health of this population.

Inoculating Black/African American and LGBTQ Communities Against the Tobacco Industry: The Role of Community Connectedness and Tobacco Denormalization Beliefs.

The purpose of this study was to explore how connectedness to Black/African American or lesbian, gay, bisexual, transgender and queer (LGBTQ) communities can promote anti-tobacco industry beliefs and to examine the role of targeted anti-tobacco industry messaging (i.e., tobacco industry denormalization [TID] messages).We hypothesized that community connectedness would predict anti-tobacco industry motivation (H1) and that this effect would be mediated by community-specific anti-industry beliefs (H2). We also hypothesized that these effects would be greater (i.e., moderated) for individuals exposed to targeted TID messages (H3). This study was a secondary analysis of data from a web-based experiment focused on the effects of counter-industry messages (data collected in 2020). The sample consisted of 430 Black/African Americans and 458 LGBTQ young adults. Hypotheses were tested using structural equation modeling. In support of hypothesis 1, community connectedness was associated with anti-tobacco industry motivation for both the LGBTQ and Black/African American subsamples. Hypothesis 2 was also supported. The associations between community connectedness and anti-industry motivations were partially mediated by anti-industry beliefs. Hypothesis 3 was not supported. Exposure to counter-industry messages did not modify the structural model; however, counter-industry messages increased anti-industry beliefs in both subsamples. Fostering community connectedness may help to mobilize community-based tobacco control efforts. Furthermore, interventions targeting anti-tobacco industry beliefs may be effective at reducing tobacco-related disparities. Anti-tobacco industry beliefs can be increased using brief targeted TID messages. Collectively, these findings suggest that community-based approaches rooted in consciousness-raising action may provide a useful model for future tobacco control interventions.

A historical review of pain disparities research: Advancing toward health equity and empowerment.

BACKGROUND AND PURPOSE: This theory-guided review draws on 30 years of published data to examine and interrogate the current and future state of pain disparities research. METHODS: Using the Hierarchy of Health Disparity Research framework, we synthesize and present an overview of "three generations" of pain disparities scholarship, while proposing directions for adopting a "fourth generation" that redefines, explains, and theorizes future pain disparities research in a diverse society. DISCUSSION: Prior research has focused on describing the scope of disparities, and throughout the historical context of human existence, racialized groups have been subjected to inadequate pain care. It is imperative that research not only illuminates existing problems but also provides solutions that can be implemented and sustained across varying social milieus. CONCLUSION: We must invest in new theoretical models that expand on current perspectives and ideals that position all individuals at the forefront of justice and equity in their health.