Search

To assess publishing trends regarding the contribution of societal systems on health disparities within the urology literature.We performed a bibliometric analysis of the top 15 urology journals for titles and abstracts with the term race or ethnicity between 2000-2021. Articles were graded by the presence of (1) race, (2) disparities secondary to race, or (3) racial disparities secondary to structural biases. Frequencies were tabulated and logistic regression was used to determine odds of disparities publishing.Our query returned 934 articles for review. In 484 (52%) articles, race was mentioned as a demographic/covariate. 110 (12%) abstracts noted a racial health disparity and only 2 articles implicated racism. Rates of more direct language varied significantly by journal and year of publication. Discussion of disparities increased over time, ranging from 0% in 2002 to 25% in 2020 (P-trend.001). Logistic regression demonstrated an 11% annual increase in the likelihood of disparity publishing (OR=1.11, 95%CI=1.08-1.14; P.001).While it is widely acknowledged that race is a determinant of health, often "race" itself is ascribed the risk when societal inequities are largely at fault. Despite the frequent use of race as a key covariate within the urologic literature, health-disparities relating to structural racism are rarely explicitly named. In order to address the systemic biases that underpin these inequities, increased awareness through clear language in publishing is needed.

Racism and childhood obesity are both pervasive factors adversely affecting the health and wellbeing of children and adolescents in the United States. The association between racism and obesity has been touched upon in the literature; yet most work has focused on a few dimensions of intersectionality of these two domains at one time. The renewed focus on structural racism as the primary contributor to distress of Black individuals in the United States has highlighted the urgency of identifying the contributions of racism to the childhood obesity epidemic. The current article is not a complete review of the literature, rather, it is meant to take a broad narrative review of the myriad ways in which racism contributes to the obesity epidemic in Black youth to serve as a call to action for more research, prevention, and intervention. The current article illustrates how a number of mechanisms for the etiology and maintenance of obesity are heavily influenced by racism and how addressing racism is critical for ameliorating the childhood obesity epidemic.

Objective To synthesize the growing body of literature on the role of social determinants of health (SDoH) in asthma and asthma disparities. Data Sources A pubmed.gov search was performed to identify published literature on SDoH, asthma, asthma disparities, and race and ethnicity. Current asthma statistics of the Centers for Disease Control and Prevention were reviewed. Study Selections Relevant articles on SDoH, asthma, asthma disparities, and race and ethnicity were reviewed in detail. Results Black and Latinx Americans have a higher asthma prevalence and greater asthma morbidity than White Americans and also bear a disproportionate burden of SDoH. Inequities in SDoH are rooted in structural racism and population-level injustices that affect the socioeconomic status, physical environment, and health care access/quality of Black and Latinx Americans. There is evidence that racial/ethnic inequities in SDoH, such as socioeconomic status, neighborhood environment, housing, environmental exposures, and health care access/quality, contribute to excess burden of asthma prevalence/incidence, morbidity, exacerbations, and abnormal lung function among certain racial/ethnic populations. In addition, Black and Latinx communities experience high levels of long-term stress, which may increase asthma risk through direct effects on the immune system and hypothalamic-pituitary-adrenocortical activation. Long-term stress may also mediate the effects of SDoH on asthma. Conclusion Although there is clear evidence linking SDoH to excess asthma risk and implicating SDoH in asthma disparities, the extent to which asthma disparities are explained by inequities in SDoH and the relative contributions of each of these SDoH to asthma disparities remain unclear. This knowledge is needed to effectively develop and test systems-level interventions targeting SDoH, with the ultimate goal of meaningfully reducing racial/ethnic asthma disparities.

Most studies of racial and ethnic survival disparities in patients with cancer diagnosed and treated in the USA have pertained to patients with solid tumours. However, increasing research on health inequities shows that these differences also extend to patients with haematological malignancies. In particular, Black and Hispanic patients with cancer have had markedly worse survival outcomes for several decades, although the need to critically evaluate and address these disparities has, for several compelling reasons, gained a greater sense of urgency. To effectively implement strategies to counteract barriers that underlie survival disparities and systemic racism, understanding the current state of survival outcomes for patients with haematological cancers who are racially or ethnically minoritised is important. In this Viewpoint, we review the specifics of outcome differences across haematological malignancies and investigate the contributions of race-associated differences in administration of treatment and genetic differences in underlying disease biology. We also provide our perspective on key actions that we feel are crucial for the haematology community to pursue to abrogate systemic racism and ensure fair and equitable care for all.

Introduction The purpose of this study was twofold: (a) explore how Black women perceive their roles as nursing professionals during the COVID-19 pandemic, and (b) how Black women in nursing mobilized themselves to respond to the disproportionate numbers of Black Americans impacted by COVID-19. Method I conducted semistructured interviews with 6 Black women nursing professionals (5 nurse practitioners and 1 registered nurse). Data were analyzed in 3 cycles: eclectic coding, focused coding, and identifying subthemes and major themes in the data. Results I identified 1 major theme, educating as motherwork, from the data with the following subthemes: educating our own and balancing education with advocacy. Discussion Participants provided education to Black patients about controlling underlying health conditions and making lifestyle changes to reduce the impact of COVID-19. They advocated for changes in health care that reflect the needs and sociohistorical experiences of Black Americans to improve the overall quality of health care. This type of Black women's motherwork or reproductive labor reflects a sense of Black consciousness stemming from their identity as Black women and their recognition of the importance of women in Black families and communities. Participants educated and advocated for Black patients while negotiating their own experiences with systemic racism in health care as Black women nursing professionals. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Infant Mental Health Journal is committed to ending systemic racism and promoting diversity, equity, and inclusion in academic publishing. IMHJ unequivocally denounces all forms of racism and white supremacy, including systemic racism in academic publishing. We commit to investigating and working to terminate the ways in which systemic racism has become normalized in academic publishing, including examining our practices and processes at IMHJ. We invite you to join us in intentional, anti-racist work through your scholarship. As part of this effort, IMHJ has updated the author guidelines to include new information regarding how authors can express the ways in which they are engaging with intention in diverse, anti-racist research. These guidelines are available under the author guidelines section on the IMHJ website (https://onlinelibrary.wiley.com/journal/10970355). As a second immediate response relative to promoting diverse, equitable, and inclusive research, IMHJ is releasing the following Call to Action, focusing on centering Blackness in infant and early childhood mental health research. This call is designed as a first step in our efforts, and IMHJ looks forward to coming initiatives aimed at disrupting systemic racism in infant and early childhood mental health research for the many scholars studying and working with diverse populations marginalized by racism and systemic inequities.La Revista de Salud Mental Infantil está comprometida a terminar el racismo sistémico y promover la diversidad, la equidad y la inclusividad en las publicaciones académicas. La Revista IMHJ censura categóricamente toda forma de racismo y supremacía de la raza blanca, incluyendo el racismo sistémico en publicaciones académicas. Estamos comprometidos a investigar y trabajar para erradicar los medios por los cuales el racismo sistémico se ha convertido en la norma en las publicaciones académicas, incluyendo el examinar nuestras prácticas y procesos dentro de la Revista IMHJ. Les invitamos a que se nos unan en nuestro esfuerzo intencional, antirracista, por medio de sus investigaciones profesionales. Como parte de este esfuerzo, la Revista IMHJ ha actualizado los parámetros para los autores para incluir nueva información acerca de cómo los autores pueden expresar de qué maneras están trabajando con intención en investigaciones diversas, antirracistas. Estos parámetros se encuentran disponibles bajo la sección de parámetros de autor en la página electrónica de la Revista IMHJ (https://onlinelibrary.wiley.com/journal/10970355). Como una segunda respuesta inmediata en relación con el fomento de la investigación diversa, igualitaria e incluyente, la Revista IMHJ presenta esta Llamada a la Acción, la cual se enfoca en centralizar la Negritud en la investigación de salud mental en infantes y la temprana niñez. Esta llamada está diseñada como un primer paso en nuestros esfuerzos y la Revista IMHJ anticipa próximas iniciativas dedicadas a poner fin al racismo sistémico en la investigación sobre salud mental en infantes y la temprana niñez para los muchos investigadores profesionales que estudian y trabajan con grupos diversos de población marginalizados por el racismo y las desigualdades sistémicas.Le Infant Mental Health Journal s'engage à mettre fin au racisme endémique et à promouvoir la diversité, l’équité, et l'inclusion dans les publications académiques. L'IMHJ dénonce sans équivoque toutes les formes de racisme et de suprématie de la race blanche, y compris le racisme systémique dans les publications académiques. Nous nous engageons à déterminer comment le racisme systémique s'est normalisé dans les publications académiques et nous nous engageons à travailler à éradiquer cette normalisation ainsi qu’à examiner et à disséquer les pratiques et les processus de l'IMHJ. Nous vous invitons à nous rejoindre dans ce travail intentionnel, délibéré et anti-raciste à travers vos recherches. Dans cette optique l'IMHJ a mis à jour les directives pour les auteurs afin d'inclure plus d'informations sur la manière dont les auteurs peuvent exprimer les façons dont ils s'engagent délibérément dans des recherches diverses et anti-racistes. Ces directives sont disponibles dans la section « directives pour auteurs » dans le site de IMHJ (https://onlinelibrary.wiley.com/journal/10970355). De plus, en tant que deuxième réaction immédiate liée à la promotion de recherches diverses, équitables et inclusives, l'IMHJ rend publique l'Appel à l'Action suivant, mettant l'accent sur la nécessité de centrer la condition noire dans les recherches sur la santé mentale du nourrisson et de la petite enfance. Cet appel est le premier pas de nos efforts et l'IMHJ attend avec intérêt les initiatives à venir se donnant pour but de contrecarrer le racisme systémique dans les recherches sur la santé mentale du nourrisson et de la petite enfance pour les nombreux chercheurs étudiant et travaillant avec des populations diverses marginalisées par le racisme et les inéquités systémiques.Aufruf zum Handeln: Schwarzsein in den Mittelpunkt rücken und den strukturellen Rassismus in der Forschung zur psychischen Gesundheit von Kindern und in der akademischen Publizistik durchbrechen Das Infant Mental Health Journal setzt sich für das Ende von strukturellem Rassismus und für die Förderung von Vielfalt, Gleichberechtigung und Inklusion im akademischen Publikationswesen ein. Das IMHJ prangert unmissverständlich alle Formen von Rassismus und weißer Vorherrschaft an, einschließlich des strukturellen Rassismus im akademischen Verlagswesen. Wir verpflichten uns, die Art und Weise, in der struktureller Rassismus im akademischen Verlagswesen normalisiert wurde, zu untersuchen und daran zu arbeiten, ihn zu beenden. Dies schließt die Überprüfung unserer Praktiken und Prozesse beim IMHJ ein. Wir laden Sie ein, sich uns mit ihrer Forschung bei der bewussten, antirassistischen Arbeit anzuschließen. Als Teil dieser Bemühungen hat das IMHJ die Autor:innenrichtlinien aktualisiert. Es wurden neue Informationen darüber aufgenommen, wie Autor:innen zum Ausdruck bringen können, wie sie sich explizit für eine vielfältige, antirassistische Forschung einsetzen. Diese Richtlinien sind auf der IMHJ-Website unter dem Abschnitt Autor:innenrichtlinien zu finden (https://emea01.safelinks.protection.outlook.com/?url = https%3A%2F%2Fonlinelibrary.wiley. com%2Fjournal%2F10970355data = 04%7C01%7C%7C04fcb2ce91b44348abfe08d9958a88dd%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637705244491301364%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000sdata = kPRKcHYbAwvFHz1JT4QOX4igY7VelpdZoRcynlhJI4w%3Dreserved = 0). Als zweite unmittelbare Reaktion bzgl. der Förderung einer vielfältigen, gerechten und inklusiven Forschung veröffentlicht das IMHJ den folgenden Aufruf zum Handeln, der Schwarzsein in den Mittelpunkt der Forschung zur psychischen Gesundheit von Säuglingen und Kleinkindern rücken will. Dieser Aufruf soll ein erster Schritt in unseren Bemühungen sein. Das IMHJ freut sich auf kommende Initiativen, die darauf abzielen, den strukturellen Rassismus in der Forschung zur psychischen Gesundheit von Säuglingen und Kleinkindern für die vielen Wissenschaftler:innen zu durchbrechen, die mit verschiedenen Bevölkerungsgruppen arbeiten, die durch Rassismus und strukturelle Ungleichheiten marginalisiert werden.行動喚起:乳幼児精神保健研究及び学術出版において、Blacknessを中心に置き、制度的人種差別を止める 乳幼児精神保健ジャーナル(IMHJ)は、学術出版において、制度的人種差別を終わりにし、多様性・公平性・包括性を促進することに全力を注ぐ。IMHJ は明確に、学術出版における制度的人種差別を含めた、あらゆる形態の人種差別と白人至上主義を非難する。我々は、IMHJでの実践と過程を調査することを含め、制度的人種差別が学術出版において常態となることを終結させるために、調査し取り組むことに全力を注ぐ。是非、あなた方も研究を通じて、意図的で反人種差別の取り組みに参加してほしい。この取り組みの一環として、IMHJは著者が意図をもって、多様性と反人種差別の研究に取り組んでいることを表現できる仕方に関する新しい情報を含めるために著者ガイドラインを更新した。これらのガイドラインは、IMHJのホームページ(https://urldefense.com/v3/__https://onlinelibrary.wiley.com/journal/10970355)**f__;44Gu6JGX6ICF44Ks44Kk44OJ44Op44Kk44Oz44Gu44K7!!HXCxUKc!ht5w9WS1VrQQFy9SI4HWUAtrMwPyYhW_DVUgwdRcA6WwVEqIKIONvSQ97ePUYa1R$ クションの下から入手できる。多様性、公平かつ包括的な研究の促進に関連する２番目の即時対応として、IMHJは、乳幼児精神保健の研究においてBlacknessを中心に置くことに焦点を当て、後述の行動喚起を公表している。この喚起は、我々の取り組みの第一歩としてデザインされている。そしてIMHJは、人種差別と制度的不平等によって阻害された多様な人々と共に研究し活動している多くの研究者にとって、乳幼児精神保健研究における制度的人種差別を止めることを目的とした新機軸となることを期待する。.摘 要:《婴儿心理健康杂志》致力于结束系统性种族主义, 促进学术出版的多样性、公平性和包容性。IMHJ明确谴责所有形式的种族主义和白人至上主义, 包括学术出版中的系统性种族主义。我们致力于调查并努力终止学术出版中系统性种族主义的常态化, 包括审查我们在IMHJ的做法和流程。我们邀请您通过学术研究加入我们有意识的反种族主义工作。作为这项工作的一部分, IMHJ更新了作者指南, 纳入了有关作者如何表达他们主动参与各种反种族主义研究的新信息。这些指南可在IMHJ网站的作者指南部分找到 (https://onlinelibrary.wiley.com/journal/10970355 )。作为促进多样性、公平性和包容性研究的第二个直接回应, IMHJ发布以下行动呼吁:重点关注婴幼儿心理健康研究中“以黑人为中心”的问题。这一呼吁是我们努力的第一步, 对于那些与因种族主义和系统性不平等而被边缘化的不同人群学习工作共事的学者来说, IMHJ期待着未来推出更多旨在消除婴幼儿心理健康研究中系统性种族主义的举措。.دعوة للعمل: تسليط الضوء على قضايا السود ووقفالعنصرية المنهجية في أبحاث الصحة النفسية للرضع والنشر الأكاديمي الملخص جريدة الصحة النفسية للأمهات والرضع ملتزمة بإنهاء العنصرية النظامية وتعزيز التنوع والمساواه والشمول في النشر الأكاديمي.وتدين الجريدة بشكل قاطع جميع أشكال العنصرية واستعلاء البيض ، بما في ذلك العنصرية الممنهجة في النشر الأكاديمي. نلتزم بالتحقيق والعمل على إنهاء الطرق التي أصبحت بها العنصرية الممنهجة من الأمور البديهية في النشر الأكاديمي ، بما في ذلك فحص ممارساتنا وعملياتنا في الجريدة. ندعوكم للانضمام إلينا في العمل الذي يستهدف مناهضة العنصرية من خلال أعمالكم البحثية. كجزء من هذا الجهد ، قامت الجريدة بتحديث إرشادات المؤلفين لتشمل معلومات جديدة تتعلق بكيفية تعبير المؤلفين عن الطرق التي يستطيعون بها أن يساهموا في بحث متنوع مناهض للعنصرية. تتوفر هذه الإرشادات ضمن قسم إرشادات المؤلف على موقع الجريدة على الانترنت. (https://urldefense.com/v3/__https://onlinelibrary.wiley.com/journal/10970355__;!!HXCxUKc!hyF7qF-DmF3dFfiOpsPozODIYhPA-gI6zgEstSsNmHtjzYL7TjBEIwLMRX6bxSGA$) وكاستجابة فورية ثانية فيما يتعلق بترويج البحوث المتنوعة والعادلة والشاملة ، تطلق جريدة الصحة النفسية للأطفال والرضع هذه الدعوة للعمل ، مع التوجه لتسليط الضوء على قضايا السود في أبحاث الصحة النفسية للرضع والأطفال في مرحلة الطفولة المبكرة. تم تصميم هذه الدعوة كخطوة أولى في جهودنا ، وتتطلع الجريدة إلى المبادرات القادمة التي تهدف إلى تعطيل العنصرية المنهجية في أبحاث الصحة النفسية للرضع والأطفال في مرحلة الطفولة المبكرة للعديد من الباحثين الذين يدرسون ويعملون مع مجموعات سكانية متنوعة مهمشة بسبب العنصرية وعدم المساواة المنهجية.

Introduction Racial disparities in COVID-19 morbidity and mortality have been well-documented. However, there may also be racial disparities in COVID-19 vaccination rates which, if present, would further exacerbate the existing disparities. No previously published articles have identified and quantified potential racial disparities in vaccination throughout the USA at any geography lower than the national level. Methods Using data compiled from state health departments, we calculated racial disparities in COVID-19 vaccination for the Black and Hispanic populations compared to the White population in each state. We explored the relationship between a state-level index of structural racism and the observed differences in the racial disparities in COVID-19 vaccination across states for both the Black and Hispanic populations by conducting linear regression analyses. Results Racial disparities in COVID-19 vaccination were present for both the Black and Hispanic populations in the overwhelming majority of states. There were vast differences between the states in the magnitude of the racial disparity in race-specific vaccination rates. These differences were largely explained by differences in the level of structural racism in each state. The relationship between structural racism and the racial disparities in vaccination was not entirely explained by racial differences in vaccine hesitancy or political affiliation. Conclusions There are marked racial disparities in COVID-19 vaccination throughout the USA, and structural racism is strongly associated with the magnitude of these disparities. Efforts to reduce these disparities must address not only individual behavior but must also confront the structural barriers that are inhibiting equitable vaccine distribution.

Problem The racial and ethnic makeup of physicians in the United States does not reflect that of the communities they serve. Addressing this disparity may improve patient outcomes and combat structural racism. Approach Starting in 2014, the pediatric residency program at Children's National Hospital deliberately worked to assemble residency classes with racial and ethnic diversity that was similar to that of the Washington, DC community it served. This work consisted of 3 initiatives: the Minority Senior Scholarship Program (MSSP), a pipeline program for rising fourth-year underrepresented in medicine (UIM) medical students to expose them to careers in academic pediatrics; an enhanced applicant recruitment process for UIM applicants; and mechanisms like a diversity dinner series for UIM residents to find the support they need to succeed. Outcomes Since its inception in 2015, 73 participants have completed the MSSP, with 26% (19/73) going on to match at Children's National Hospital. An additional 12 participants are completing the program during the 2022 Match cycle. The MSSP has also increased participants' self-reported interest in pursuing a career in academic pediatrics, from 70% (14/20) prior to participation to 95% (19/20) after participation. In addition, the enhanced recruitment efforts have proven fruitful. The percentage of UIM interns at Children's National Hospital has increased from 5% (2/40) in 2014 to 51% (21/41) in 2021. Next steps The dimensions of diversity included in these initiatives will be expanded to include individuals from other marginalized populations, such as certain individuals of Southeast Asian descent, those who identify as LGBTQ+, and those with disabilities. An antiracism initiative has also been implemented in the residency program in collaboration with the hospital and partner medical schools.

The COVID-19 pandemic’s disproportionate impact on people from some racial and ethnic groups in the U.S. persisted throughout 2021. Black, Latinx, and American Indian persons have been hospitalized and died at a higher rate than White persons consistently from the start of the pandemic. Early data show that hospitalization and mortality rates for Black, Latinx, and American Indian children are higher than White children in a worrying trend. The pandemic has likely worsened the gaps in wealth, employment, housing, and access to health care: the social determinants of health that caused the disparities in the first place. School closures will have a long-lasting impact on the widening achievement gaps between Black and Latinx students and White students. In the earlier vaccination phase, Black and Latinx persons were being vaccinated at a lower rate than their proportion of cases due to vaccine hesitancy, misinformation, and barriers to access. Vaccine hesitancy rates among these groups have since decreased and are now comparable to White persons. Aggregated data make it challenging to paint a picture of the actual impact of COVID-19 on Asian Americans as they are a diverse group with significant disparities. All of this highlights that we have much work to do in dismantling systemic racism, engaging communities we serve, and advancing health equity to prepare us for future pandemics and a more just healthcare system.

For Black American youth and their families, the racial terror that claimed the life of George Floyd in May 2020 is nothing new, as stories of people who look just like them have been part and parcel of their lived experience in the United States. Beyond state-sanctioned murder, Black youth were also witnessing the disproportionate transmission, treatment, and travesty plaguing their community with COVID-19 - all predictable outcomes given the inequitable systems supporting the American pipeline from cradle to grave. Why, then, were so many White Americans just coming into awareness of this deadly disease of individual and systemic racism that has ravaged Black American communities for centuries? In this work, we seek to explain in what ways racism is tantamount to a social virus and how its permeation is endemic to the American body, rather than an emerging threat, like a pandemic. We will also address how better conceptualizing racism as a virus allows for more accurate, precise, and feasible treatments for transmitters and targets of racism with respect to prevention (e.g., inoculation) and intervention (e.g., healing and vaccination). Finally, we will describe clinical therapeutic trials that will help to decipher whether our treatment of this social disease is effective, including family-level interventions and systemic shifts in prevention through clinical training.

Community violence exposure poses a public health risk exacerbated by immigration-related stressors and environmental factors, including systemic racism and interpersonal discrimination, socioeconomic disparities, and anti-immigrant laws and policies, that disproportionately impact Latinx-immigrant and systematically minoritized youth. Using the ecological-transactional model of community violence as a conceptual framework, this systematic review was conducted to examine research on exposure to community violence, risk and protective factors, and associated health and mental health sequelae among Latinx youth. The initial search generated 2,152 articles, 291 of which were reviewed for detailed evaluation; ultimately, 59 articles were included. Mexican-origin youth and adolescent samples were the most represented in research studies. Across several studies, Latinx youth reported high rates of violence exposure and poor health or mental health outcomes. The findings revealed important gaps in socioecological factors, with a dearth of evidence establishing macrosystem factors or culturally salient and immigrant-related factors. Notable risk and protective factors at various ecological levels were identified and discussed as key opportunities for future research and points of intervention or prevention efforts for Latinx-immigrant and systematically minoritized youth.

The Coronavirus 2019 (COVID-19) continues to devastate the world and the United States remains number one of reported COVID-19 cases and deaths. Research demonstrates that Blacks and Hispanics in the United States are disproportionately impacted by COVID-19, especially among highly marginalized people at the intersection of immigration and incarceration. Social distancing is a privilege and contact tracing is a deterrent for historically oppressed populations. Public health professionals have attempted a multicausal approach to prevent the spread of infectious diseases, but they have been unsuccessful in addressing the biological-social impact of highly vulnerable populations. An emphasis is placed on syndemics and social determinants of health to address health inequities associated with COVID-19 due to systemic racism. Implications for social work will reinforce the profession's obligation to address public emergencies through social and political action. Recommendations will be made for social workers to support local, state, and federal level responses of COVID-19.

Previous findings suggest that experiences with systems of oppression that disproportionately affect individuals based on race and neighborhood residency (e.g., systemic racism, neighborhood income disadvantage [NID]) can be associated with higher odds of developing psychological problems following traumatic events. Although race/ethnicity and NID residency are often associated, they are separate concepts that play unique roles in mental health outcomes among youth. Residents of Black, Latinx, and income-disadvantaged communities also have an increased risk of exposure to polyvictimization and the loss of multiple loved ones. Studies have not carefully delineated the potential relations between race/ethnicity and NID residency, polyvictimization, accumulated losses, and trauma and grief outcomes in youth. We examined mediation models to investigate whether polyvictimization, the loss of multiple loved ones, and exposure to violent death were potential mechanisms through which race/ethnicity and NID would predict trauma and grief outcomes in youth. Participants (N = 429) included Black (19.9%), Latinx (36.0%), and White (27.3%) children and adolescents who were assessed through a routine baseline assessment at a trauma and grief outpatient clinic. Black youth reported significantly elevated posttraumatic stress and maladaptive grief symptoms through higher polyvictimization and violent death exposure relative to White youth, βs = .06-.12, ps

Central to attachment theory is the idea that behavior in close relationships can best be understood in context. Although decades of research have illuminated cross-cultural patterns of caregiving and attachment, there remains a critical need to increase research with African American families, examine the specific sociocultural context of systemic anti-Black racism, and integrate the rich theory and research of Black scholars. The goal of this special issue is to bring together attachment researchers and scholars studying Black youth and families to leverage and extend attachment-related work to advance anti-racist perspectives in developmental science. The papers in this special issue, highlighted in the introduction, illuminate pathways of risk and resilience in Black children, adolescents, and families and point to the protective power of relationships (and the limits of such protection) for mental and physical health. We highlight critical questions to guide ongoing dialogue and collaboration on this important topic.

The consequences of racial microaggressions are most often discussed at an interpersonal level. In this article, we contend that microaggressions play an important role in maintaining systems of racial oppression beyond the interpersonal context. Specifically, we illustrate how microaggressions establish White superiority in the United States by othering people of color (e.g., treating people of color as if they are not true citizens) and communicating that they are inferior (e.g., environmental exclusions and attacks, treating people of color as second-class citizens). We also present evidence that microaggressions play a role in protecting and reinforcing systemic racism. By obscuring systemic racism (e.g., false color blindness, denial of individual racism) and promoting ideas that maintain existing systemic inequalities (e.g., the myth of meritocracy, reverse-racism hostility), microaggressions provide cover and support for established systems of oppression. Overall, we find considerable evidence—from both empirical studies and real-world examples—that microaggressions contribute to the maintenance of systems of racial oppression in the United States. We conclude with a discussion of how we might begin to challenge this cycle by increasing awareness of systemic racism and the microaggressions that aid in its perpetuation.

Introduction Although disparities in COVID-19 mortality have been documented at the national and state levels, no previous study has quantified such disparities at the county level by explicitly measuring race-specific COVID-19 death rates. In this paper, we quantify the racial/ethnic disparities in COVID-19 mortality between the non-Hispanic Black and non-Hispanic White populations at the county level by estimating age-adjusted, race-specific death rates. Methods Using COVID-19 case data from the Centers for Disease Control and Prevention, we calculated crude and indirect age-adjusted COVID-19 mortality rates for the non-Hispanic White and non-Hispanic Black populations in each of 353 counties for the period February 2, 2020, through January 30, 2021. Using linear regression analysis, we examined the relationship between several county-level measures of structural racism and the observed differences in racial disparities in COVID-19 mortality across counties. Results Ninety-three percent of the counties in our study experienced higher death rates among the Black compared to the White population, with an average ratio of Black to White death rates of 1.9 and a 17.5-fold difference between the disparity in the lowest and highest counties. Three traditional measures of structural racism were significantly related to the magnitude of the Black-White racial disparity in COVID-19 mortality rates across counties. Conclusions There are large disparities in COVID-19 mortality rates between the Black and White populations at the county level, there are profound differences in the level of these disparities, and those differences are directly related to the level of structural racism in a given county.

In this paper we explore some of the ways systemic racism operates and is maintained within our health and social services. We look at a very specific context, that of Nunavik Quebec, land and home to 13,000 Nunavimmiut, citizens of Quebec and Canada, signatories of the James Bay and Northern Quebec Agreement. We operationalize some of the ways in which policies and practices create and support social hierarchies of knowledges, also called epistemic racism, and how it impacts our ability to offer quality care that Indigenous peoples can trust and use.

PURPOSE: Students of color are disproportionately affected by exposure to adverse childhood experiences (ACEs), racial trauma, and traumatic stress. Trauma-informed interventions in schools can promote healing among ACE-impacted students of color. These interventions require collaboration with family members to decide upon services and referrals; however, educators commonly face challenges with engaging families. The study purpose is to understand barriers and facilitators to engaging families in trauma-informed mental health interventions for ACE-impacted students of color. METHODS: As part of a larger school-based trauma-informed trial (Link for Equity), 6 focus groups were conducted with parents/guardians of color and school staff (n=39) across 3 Midwestern school districts. Participants were asked open-ended questions about trauma, discrimination, school supports, and family engagement. Transcripts were coded by two team members, and thematic analysis was used to identify barriers/facilitators to family involvement. RESULTS: Results indicated that families of ACE-impacted students of color commonly experienced racism including microaggressions and stereotypes from the school community, which deterred engagement and prevented trusting relationships between families and school staff. Parents highlighted feeling excluded from decisions related to their child’s education and that their voices were not heard or understood. Participants discussed the need for schools to consider how family obstacles (such as mental health and trauma) may prevent families from engaging with staff, and they recommended structural changes, such as anti-racism trainings for educators. CONCLUSIONS: Findings highlight the need for anti-racist work that addresses interpersonal and structural racism in schools, in order to promote family engagement in trauma-informed mental health interventions.

Given the rapidly changing Long-Term Services and Supports (LTSS) system in the United States, it is essential for social workers and other health professionals to critically examine how this evolving landscape continues to shape racial inequities in formal LTSS and subsequent health outcomes. This commentary seeks to inform social work education, research, and practice by describing how systemic racism impacts the use and quality of formal LTSS. We present a call to action for social workers to dismantle systemic racism in LTSS that perpetuates ongoing racial inequities.

Significant racial and ethnic disparities in health care and service access exist. In the present article, we reviewed qualitative studies investigating the racism-related experiences of Black caregivers of children with autism spectrum disorder (ASD) in the U.S. health care system. Specifically, we examined institutional racism (i.e., systemic racism) and individual racism directed toward Black families when they seek diagnoses and services for their children with ASD. Additionally, we summarized culturally responsive and context-specific practice guidelines to work collaboratively with Black caregivers of children with ASD for applied behavior analysis practitioners.

NIH has acknowledged and committed to ending structural racism. The framework for NIH's approach, summarized here, includes understanding barriers; developing robust health disparities/equity research; improving its internal culture; being transparent and accountable; and changing the extramural ecosystem so that diversity, equity, and inclusion are reflected in funded research and the biomedical workforce.

Recent events in America in 2020 have stimulated a worldwide movement to dismantle anti-Black racism in all facets of our lives. Anti-Black racism is, as defined by the Movement for Black Lives, a "term used to specifically describe the unique discrimination, violence, and harm imposed on and impacting Black people specifically." In science, technology, engineering, and mathematics (STEM), we have yet to achieve the goal and responsibility to ensure that the field reflects the diversity of our lived experiences. Members of the Women in Molecular Imaging Network (WIMIN) have come together to take a stand on diversity, equity, and inclusion in the field of molecular imaging. We strongly condemn oppression in all its forms and strive to identify and dismantle barriers that lead to inequities in the molecular imaging community and STEM as a whole. In this series coined "Visions" (Antiracism and Allyship in Action), we identify and discuss specific actionable items for improving diversity and representation in molecular imaging and ensuring inclusion of all members of the community, inclusive of race, disability, ethnicity, religion, or LGBTQ+ identity. Although the issues highlighted here extend to other under-recruited and equity-seeking groups, for this first article, we are focusing on one egregious and persistent form of discrimination: anti-Black racism. In this special article, Black women residing in America present their lived experiences in the molecular imaging field and give candid insights into the challenges, frustrations, and hopes of our Black friends and colleagues. While this special article focuses on the experiences of Black women, we would like the readers to reflect on their anti-Blackness toward men, transgender, nonbinary, and gender non-conforming people. From the vulnerability we have asked of all our participants, these stories are meant to inspire and invoke active antiracist work among the readership. We present strategies for dismantling systemic racism that research centers and universities can implement in the recruitment, retention, mentorship, and development of Black trainees and professionals. We would like to specifically acknowledge the Black women who took the time to be interviewed, write perspectives, and share their lived experiences in hopes that it will inspire genuine and lasting change.

When health professions learners’ primary pedagogical experience of Black people and how they become patients is through statistics, it becomes very easy for learners to think of Black people as data points rather than as individuals whose health is often at the mercy of racist institutions. When the human dimension of Black people’s health is ignored, specifically the ways that poor health affects individual wellbeing, one of the barriers to proper health for Black patients is how to be seen and considered as a part of a larger problem of systemic racism and institutional injustices as well as individuals whose personal lives are affected by such larger problems. I propose an approach to health professions pedagogy—the experiential race testimonies (ERT) approach—that can change the way health professions learners understand and treat Black patients, thus changing the future of Black health. The ERT approach pairs population data analysis with analysis of personal testimonies and the experiences they convey.

IntroductionResearch has shown that the likelihood of ex-military personnel developing mental health problems following service is around one in five. Little is known about the barriers to accessing mental health in veterans from diverse ethnic backgrounds. This study aims to explore mental health treatment experiences of veterans from commonwealth countries and therefore diverse ethnic backgrounds.MethodsSemi-structured interviews were conducted over the telephone with veterans from commonwealth countries. Veterans were recruited from a mental health charity and were at various stages of treatment.ResultsWe interviewed six veterans who were from a diverse range of commonwealth countries including St Lucia, Gambia, Ghana, Fiji and South Africa. All had served in the UK army in combat roles. Our findings consisted of key themes: (1) feeling that they are treated differently, (2) they felt as though they were unheard when reaching out for help, (3) systemic pressures such as financial difficulties, missed opportunities and lack of insight about mental health and (4) the importance of involving the wider community in care.ConclusionOur findings highlight some distinct barriers to mental health treatment that commonwealth veterans experience. The themes reported by the participants appear to suggest they had experience signs of institutional racism. Suggesting the importance of highlighting these issues, and to help overcome these potential barriers to accessing services. Given that commonwealth veterans involvement in the UK military is significant and increasing, the findings in this study should be used to support this population by implementing service provision and policy.

The United States has been shaped by clashes between rival “racial orders” or “racial policy alliances” since the nation’s very beginning. For the last half century, those contests have chiefly been between proponents of “color-blind” and “race-conscious” public policies. Today, however, the nation’s dominant racial policy alliances are transforming into ones centered on significantly new themes. The racially conservative “color-blind” policy alliance is, under the leadership of President Donald Trump, becoming an alliance promising “white protectionism.” The “race conscious” policy alliance is, with the mobilizations around the slogan of Black Lives Matter, becoming an alliance focused on “racial reparations” to end “systemic racism”. These new, even more polarized racial policy alliances have counterparts across the globe, and they are likely to shape political life for many years to come.

Multicultural behavior analysts must stand together to address the issues of systemic racism collectively, show solidarity, and support Black lives. This article discusses the role of culturally and linguistically diverse behavior analysts, the mechanisms underlying barriers to showing solidarity, and the mechanisms required for cultural evolution to promote a compassionate and nurturing approach to racial equity. It is critical that non-Black people of color actively participate in antiracist advocacy to express solidarity with the Black Lives Matter movement.

African Americans are bearing a disproportionate burden of morbidity and mortality due to COVID-19 pandemic. To our knowledge, no previous study has delineated inequities potentially incentivized by systemic racism, and whether synergistic effects impose an abnormally high burden of social determinants of mental health on African American families in the era of COVID-19 pandemic. We applied the social ecological model (SEM) to portray inequities induced by systemic racism that impact the mental health of African American families. In our model, we identified systemic racism to be the primary operator of mental health disparity, which disproportionately affects African American families at all levels of the SEM. Programs tailored towards reducing the disproportionate detrimental effects of COVID-19 on the mental health of African Americans need to be culturally appropriate and consider the nuances of systemic racism, discrimination, and other institutionalized biases. Key words: • African American • COVID-19 • Mental health • Systemic racism • Social determinants of mental health Copyright © 2020 Ibrahimi et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

Racism in health and healthcare has long been recognised as a structural issue. While there has been growing research and a number of important initiatives that have come from approaching racism as a structural issue, there are a range of implications that yet have to be explored as they relate to health and healthcare. Conceptualising racism in this way provides a means to consider how it shapes and is shaped by a range of global injustices and serves as a foundation for more egregious harms. It also suggests that if we are to dismantle racism, we need to look both within and beyond the traditional domains of health and healthcare and account for a range of broader forces that sustain and re-enforce racism. We first discuss the issue of responsibility, drawing on Young’s social connection model to argue that we all have a responsibility to take action in addressing structural racism. We will then deal with a question that naturally follows, namely how we discharge our responsibilities, with a focus on the role of disruptive action in challenging power and ignorance in dismantling racism in health and healthcare.

The traumatic stress experienced by our black healthcare colleagues is often overlooked. This work contextualizes workplace racism, identifies some interpersonal barriers limiting anti-racist growth, and calls for solidarity.

Context Structural racism, a fundamental cause of health inequities, must be dismantled to fulfill society's interest in ensuring conditions in which all people have opportunities conducive to health. Correspondingly, the Ten Essential Public Health Services center equity, and Council on Education for Public Health (CEPH) accreditation criteria require public health students to learn about racism. However, little guidance is provided to help faculty empower future generations of public health professionals to challenge it. Program In response to the 2020 murders of George Floyd, Ahmaud Arbery, and Breonna Taylor, faculty at UNC Greensboro denounced racism and recommitted to anti-racist pedagogy and praxis. In this article, we discuss integrated ways a graduate-level public health assessment and planning course empowered students to name structural racism, understand how it operates, and collaborate for action. Implementation Specifically, we highlight (1) our use of the book The Color of Law as means to understand racism as a structural intervention; (2) the Harvard Case Teaching Method as an organizing framework to make the classroom a critically engaged democratic setting; (3) change experts from local health and nonprofit organizations engaged in policy making to address social determinants and disparities resulting from structural racism (eg, housing, health care access, food insecurity); and (4) engagement with a minority-owned nonprofit to allow for practice applying knowledge and skills to address local inequities. Discussion Our 4-pronged pedagogical approach provides an innovative, tangible example for other public health programs as they reflect upon academic institutions' unique power and role in addressing the public health crisis of structural racism.

Buncombe County, North Carolina, was recognized in 2014 as a Robert Wood Johnson Foundation Culture of Health Prize Winner for its work fostering collaboration and partnership to address community health needs. As part of this work, Buncombe County Health and Human Services (HHS) convened a cross-sector Public Health Advisory Council that supported community-based initiatives and ensured that community members were involved in identifying and implementing solutions to issues such as poverty and child well-being. Leveraging existing relationships and past efforts, Buncombe County has continued to build collaborative networks for systems change using a collective impact framework. Bringing together partners across sectors, including the faith community, Black fraternities and sororities, community health workers, consulates, and others, Buncombe County HHS is supporting efforts to train and equip community members to lead health promotion efforts and community conversations on historical trauma and racial healing; engage community members in the policymaking process through town halls; and archive the community's pandemic journey through storytelling. The collective impact framework has shaped an environment that supports community change by centering community aspirations and values. This environment informed recent declarations by Buncombe County HHS and the Board of Commissioners that racism is a public health crisis, as well as a resolution by the city of Asheville supporting community reparations. This article explores how the collective impact framework has been used in Buncombe County to engage and continually invest in communities of color and reviews steps taken to develop and implement an equity action plan to address structural racism.

A growing body of community resilience literature emphasizes the importance of social resources in preparing for and responding to disturbances. In particular, scholars have noted that community based organizations and strong social networks positively contribute to adaptive capacity, or the ability to adjust and respond to change while enhancing the conditions necessary to withstand future events. While it is well established that strong civic engagement and social networks contribute to enhanced adaptive capacity in times of change, there is more to learn about how adaptive capacity at the civic group and network level is impacted temporally by multiple and compounding crises. Research has shown that the ability for communities to adapt and respond to crisis is closely tied to longer term recovery. In the midst of the COVID-19 pandemic, which has overlapped and intersected with multiple additional climate crises as well as a reigniting of the ongoing American reckoning with racial injustice, the ability for communities to adapt and respond to compounding crises seems more crucial than ever. This paper uses qualitative data from semi-structured interviews with 34 civic environmental stewardship groups in New York City to explore their role in building adaptive capacity. In order to better understand how past crises have impacted stewardship groups' response to COVID-19, we focus on how groups have demonstrated flexibility and learning at an organizational scale. We look at two other crises, both acute (Superstorm Sandy, which hit the East Coast in 2012) and chronic (systemic racism) to identify instances of learning that lead to organizational transformation. We further aim to understand how group professionalization, measured by budget and staff size, and network connectivity impact their actions. By comparing the groups' experiences and responses to each event, we uncover strategies learned from past events (e.g., sharing contact lists, holding internal dialogues, leveraging new funding sources) that enable stewardship groups to respond to disaster in a way that builds their organizational adaptive capacity as well as contributes to the long-term resilience of their communities.

Structural racism has received renewed focus over the past year, fueled by the convergence of major political and social events. Psychiatry as a field has been forced to confront a legacy of systemic inequities. Here, we use examples from our clinical and supervisory work to highlight the urgent need to integrate techniques addressing racial identity and racism into psychiatric practice and teaching. This urgency is underlined by extensive evidence of psychiatry's long-standing systemic inequities. We argue that our field suffers not from a lack of available techniques, but rather a lack of sustained commitment to understand and integrate those techniques into our work; indeed, there are multiple published examples of strategies to address racism and racial identity in psychiatric clinical practice. We conclude with recommendations geared toward more firmly institutionalizing a focus on racism and racial identity in psychiatry, and suggest applications of existing techniques to our initial clinical examples.

It is time to acknowledge and overcome conservation's deep-seated systemic racism, which has historically marginalized Black, Indigenous and people of colour (BIPOC) communities and continues to do so. We describe how the mutually reinforcing ‘twin spheres’ of conservation science and conservation practice perpetuate this systemic racism. We trace how institutional structures in conservation science (e.g. degree programmes, support and advancement opportunities, course syllabuses) can systematically produce conservation graduates with partial and problematic conceptions of conservation's history and contemporary purposes. Many of these graduates go on to work in conservation practice, reproducing conservation's colonial history by contributing to programmes based on outmoded conservation models that disproportionately harm rural BIPOC communities and further restrict access and inclusion for BIPOC conservationists. We provide practical, actionable proposals for breaking vicious cycles of racism in the system of conservation we have with virtuous cycles of inclusion, equality, equity and participation in the system of conservation we want.

Background Epistemological biases in environmental epidemiology prevent the full understanding of how racism’s societal impacts directly influence health outcomes. With the ability to focus on “place” and the totality of environmental exposures, environmental epidemiologists have an important opportunity to advance the field by proactively investigating the structural racist forces that drive disparities in health. Objective This commentary illustrates how environmental epidemiology has ignored racism for too long. Some examples from environmental health and male infertility are used to illustrate how failing to address racism neglects the health of entire populations. Discussion While research on environmental justice has attended to the structural sources of environmental racism, this work has not been fully integrated into the mainstream of environmental epidemiology. Epidemiology’s dominant paradigm that reduces race to a mere data point avoids the social dimensions of health and thus fails to improve population health for all. Failing to include populations who are Black, Indigenous, and people of color (BIPOC) in health research means researchers actually know very little about the effect of environmental contaminants on a range of population health outcomes. This commentary offers different practical solutions, such as naming racism in research, including BIPOC in leadership positions, mandating requirements for discussing “race”, conducting far more holistic analyses, increasing community participation in research, and improving racism training, to address the myriad of ways in which structural racism permeates environmental epidemiology questions, methods, results and impacts.

We evaluated the impact of the current COVID-19 pandemic and systemic racism on Underrepresented Minority (URM) students pursuing higher education in the STEM fields. Given the ongoing pandemic and the wave of protests in response to a series of police brutalities and systemic racism, URM students were thrown into uncharted territory. We reached out to a group of Black and Latino students who were already engaged in STEM. We began surveys and interviews by asking participants how they were and how their family and communities were doing. Next, participants answered questions about academic progress, challenges, and what support would be helpful. Our framework was based on a mixed-methods approach that draws on the work of Michael Patton (Qualitative Research & Evaluation Methods: Integrating Theory and Practice, 2014) and Veronica Thomas (American Journal of Evaluation, 2016, 38 (1), 7–28). Qualitative data from interviews were collected to capture perceptions, experiences, and recommendations of the study participants. Survey data were collected to reach as many students as possible and to provide numerical self-assessments of student experience, progression, and obstacles. All qualitative data were coded thematically using Atlas. ti, with the goal of illuminating emerging themes, and quantitative data were reviewed using descriptive statistics. Themes emerging from both data sets were compared, contrasted, and integrated in order to develop consistent findings that would enhance URM student perseverance and persistence in the face of confounding adversities. This study shows that ILSAMP COVID-19 Study participants maintained a commitment to pursuing a career in STEM. The findings of this study also indicate that the participants are stressed by their immediate circumstances and by the ongoing racism of U.S. society. These students ask for additional financial, academic, and networking support during the disruptions caused by the pandemic. More specifically, students request continued advising and connection with STEM professionals who can help them envision and enact a pathway to their own careers in STEM during this tumultuous period. The study validates the importance of key elements of the national LSAMP model as reported by Clewell et al. (Revitalizing the Nation’s Talent Pool in STEM, 2006). These are: academic integration, social integration, and professional integration. In addition, it identifies several other factors that are key to student success, including interventions that directly address racial trauma and economic hardship. © Copyright © 2021 Botanga, Blanc, Jones, Day and Charles.

African American women are at higher risk of poor mental ill health compared with other racial and ethnic groups in the United States. For low-income and homeless African American populations, the risk of poor mental ill health is even higher. The purpose of our study was to learn what programmes at a long-term transitional living centre helped at-risk and homeless African American mothers to succeed on their own, in accordance with self-identified goals. We conducted ten focus group interviews with 39 graduates of a long-term transitional living centre located in a Midwestern city, and an individual interview with the founder of that centre (N = 40). Our study was informed by Black Feminist Thought, Life Course Theory, and an instrumental case study design. Thematic analysis was used to identify patterns in the qualitative data collected. Findings pertaining to mental health included impacts of adverse childhood experiences, lack of social networks, child placement in foster care, and implications on self-esteem and self-worth. Our findings demonstrate the need for healthcare providers to take into account the intersecting factors facing African American women experiencing homelessness undergirded by systemic racism, which impacts their mental health and well-being.

In our target article (Sabatello et al. 2021), we proposed the use of community engagement and the establishment of a Truth and Reconciliation Commission (TRC) as pathways for promoting social just...

Key Points Question Is variation in care management during terminal hospitalization among adults with metastatic cancer associated with sociodemographic status? Findings In this cross-sectional study of 21 335 patients with metastatic cancer who died in the hospital, racial and ethnic minority patients and those with Medicare or Medicaid coverage were more likely to receive low-value, high-cost aggressive medical interventions at the end of life. Meaning This study’s findings suggest that identifying and understanding factors associated with the observed disparities will be helpful to inform communications with patients with metastatic cancer about end-of-life care., Importance Many patients with metastatic cancer receive high-cost, low-value care near the end of life. Identifying patients with a high likelihood of receiving low-value care is an important step to improve appropriate end-of-life care. Objective To analyze patterns of care and interventions during terminal hospitalizations and examine whether care management is associated with sociodemographic status among adult patients with metastatic cancer at the end of life. Design, Setting, and Participants This retrospective, population-based cross-sectional study used data from the Healthcare Cost and Utilization Project to analyze all-payer, encounter-level information from multiple inpatient centers in the US. All utilization and hospital charge records from national inpatient sample data sets between January 1, 2010, and December 31, 2017 (n = 58 761 097), were screened. The final cohort included 21 335 patients 18 years and older at inpatient admission who had a principal diagnosis of metastatic cancer and died during hospitalization. Data for the current study were analyzed from January 1, 2010, to December 31, 2017. Exposures Patient demographic characteristics, patient insurance status, hospital location, and hospital teaching status. Main Outcomes and Measures Receipt of systemic therapy (including chemotherapy and immunotherapy), receipt of invasive mechanical ventilation, emergency department (ED) admission, time from hospital admission to death, and total charges during a terminal hospitalization. Results Among 21 335 patients with metastatic cancer who had terminal hospitalizations between 2010 and 2017, the median age was 65 years (interquartile range, 56-75 years); 54.0% of patients were female; 0.5% were American Indian, 3.3% were Asian or Pacific Islander, 14.1% were Black, 7.5% were Hispanic, 65.9% were White, and 3.1% were identified as other; 58.2% were insured by Medicare or Medicaid, and 33.2% were privately insured. Overall, 63.2% of patients were admitted from the ED, 4.6% received systemic therapy, and 19.2% received invasive mechanical ventilation during hospitalization. Racial and ethnic minority patients had a higher likelihood of being admitted from the ED (Asian or Pacific Islander patients: odds ratio [OR], 1.43 [95% CI, 1.20-1.72]; P, This cross-sectional study uses data from the Healthcare Cost and Utilization Project national inpatient sample between 2010 and 2017 to examine care management patterns during terminal hospitalization among adult patients with metastatic cancer.

Data on the health and social determinants for Native Hawaiians and Pacific Islanders (NHPIs) in the United States are hidden, because data are often not collected or are reported in aggregate with other racial/ethnic groups despite decades of calls to disaggregate NHPI data. As a form of structural racism, data omissions contribute to systemic problems such as inability to advocate, lack of resources, and limitations on political power. The authors conducted a data audit to determine how US federal agencies are collecting and reporting disaggregated NHPI data. Using the COVID-19 pandemic as a case study, they reviewed how states are reporting NHPI cases and deaths. They then used California's neighborhood equity metric—the California Healthy Places Index (HPI)—to calculate the extent of NHPI underrepresentation in communities targeted for COVID-19 resources in that state. Their analysis shows that while collection and reporting of NHPI data nationally has improved, federal data gaps remain. States are vastly underreporting: more than half of states are not reporting NHPI COVID-19 case and death data. The HPI, used to inform political decisions about allocation of resources to combat COVID-19 in at-risk neighborhoods, underrepresents NHPIs. The authors make recommendations for improving NHPI data equity to achieve health equity and social justice.

Racial microaggressions are an insidious form of racism with devastating mental-health outcomes, but the concept has not been embraced by all scholars. This article provides an overview of new scholarship on racial microaggressions from an array of diverse scholars in psychology, education, and philosophy, with a focus on new ways to define, conceptualize, and categorize racial microaggressions. Racism, along with its many forms and manifestations, is defined and clarified, drawing attention to the linkages between racial microaggressions and systemic racism. Importantly, the developmental entry points leading to the inception of racial bias in children are discussed. Theoretical issues are explored, including the measurement of intersectional microaggressions and the power dynamics underpinning arguments designed to discredit the nature of racial microaggressions. Also described are the very real harms caused by racial microaggressions, with new frameworks for measurement and intervention. These articles reorient the field to this pertinent and pervasive problem and pave the way for action-based responses and interventions. The next step in the research must be to develop interventions to remedy the harms caused by microaggressions on victims. Further, psychology must make a fervent effort to root out racism that prevents scholarship on these topics from advancing.

Socially and economically disadvantaged racial and ethnic minorities have experienced comparatively severe clinical outcomes from the coronavirus disease (COVID-19) pandemic in the United States. Disparities in health outcomes arise from a myriad of synergistic biomedical and societal factors. Syndemic theory provides a useful framework for examining COVID-19 and other diseases that disproportionately affect vulnerable populations. Syndemic models ground research inquiries beyond individual clinical data to include non-biological community-based drivers of SARS-CoV-2 infection risk and severity of disease. Given the importance of such economic, environmental, and sociopolitical drivers in COVID-19, our aim in thisPerspectiveis to examine entrenched racial and ethnic health inequalities and the magnitude of associated disease burdens, economic disenfranchisement, healthcare barriers, and hostile sociopolitical contexts—all salient syndemic factors brought into focus by the pandemic. Systemic racism persists within long-term care, health financing, and clinical care environments. We present proximal and distal public policy strategies that may mitigate the impact of this and future pandemics.

This study examines the numbers of scientists who are underrepresented in medicine serving on editorial boards and in leadership positions in peer-reviewed psychiatry/neuroscience journals.