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Background: Stressful large-scale events, such as the COVID-19 pandemic and natural disasters, impact birthing individuals' postpartum experiences and their mental health. Resultant changes in government assistance, housing, and employment may further exacerbate these impacts, with differences experienced by varying income levels and races. This study aimed to examine maternal depression and anxiety in postpartum individuals by income and race during a stressful large-scale event, and the mediating role of government assistance, housing, and employment., Methods: An explanatory sequential mixed methods study was conducted (QUANT + QUAL). For aim 1 (quantitative), birthing individuals who delivered during peak pandemic (June 2020 - September 2021) completed questionnaires related to their perinatal experiences and mental health. Macrosystem factors (government assistance, housing, and employment changes) were assessed using the Psychosocial Recommended Measures. The Edinburgh Postnatal Depression Scale (EPDS) and the Generalized Anxiety Disorder-7 (GAD7) assessed depression and anxiety, respectively. Serial linear regression models assessed the relationship between race and income with mental health and macrosystem factors. For aim 2 (qualitative), 40 individuals from the quantitative study balanced by income (low vs. high income) and race (Black vs. White) completed one-on-one semi-structured interviews which were analyzed using thematic analysis., Results: Amongst 1582 birthing individuals, Black individuals had a significantly higher EPDS score compared to White counterparts. Not receiving government assistance, unstable housing, and experiencing various employment changes were all related to worse mental health during stressful large-scale events. In semi-structured interviews, low-income individuals discussed that government assistance helped alleviate a financial and mental burden. Low- and high-income individuals reported varying job changes that impacted their mental health (low-income: job loss, high-income: increased hours)., Conclusions: This research spotlights the negative impact of large-scale events most affected both Black and low-income individuals' postpartum mental health, and the role of government assistance, stable housing, and secure employment in helping to alleviate these disparities between income levels., Competing Interests: Declarations. Ethics approval and consent to participate: Pennington Biomedical Research Center provided institutional review board and ethics approval. The institutional review board approved the method of collecting consent. Participants provided their consent to the quantitative portion by submitting their response. Prior to the beginning of the survey, participants were given instructions that explained consent, and notified them if they do not consent to this procedure that they should not proceed with the survey. Verbal consent was collected from participants prior to the semi-structured interviews. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Across two studies, we examined intergroup relations between Black-White multiracial and Black monoracial people in the U.S. Study 1 showed that Black-White multiracial participants reported more solidarity with Black than White people, but less solidarity with Black people than Black participants reported. Likewise, their race-relevant political attitudes were somewhat more aligned with Black than White participants, but not completely aligned with Black participants. Reflecting this pattern, Black participants perceived that Black-White multiracial people feel more solidarity with Black than White people, but less solidarity with Black people than they themselves feel. Solidarity perceptions were consequential. Both Study 1 (correlational) and Study 2 (experimental) showed that Black participants' perceptions of Black-White multiracial people's solidarity with Black people were related to their inclusion of multiracial people. Furthermore, contingent on high levels of solidarity with Black people, multiracial people's relationships with White people were less consequential for Black participants' inclusion of them., Competing Interests: Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Youth with disabilities often encounter many challenges in securing employment. Although the common barriers that youth face are well documented, little is known about the experiences of youth who have multiple minoritized identities in finding and maintaining employment. Youth with disabilities who belong to racial minoritized groups may encounter ableism and racism and other forms of discrimination at work. Exploring the experiences of racial minoritized youth with non-apparent disabilities is important given the growing concern about social inequities that are linked to disadvantage and differential access to resources such as employment. We used a qualitative design involving semi-structured interviews with 19 youth (13 women, 3 non-binary, 3 men), aged 17-30 (mean 23.5 years). An inductive thematic analysis was applied to analyze the data. We identified the following themes: (1) challenges finding and maintaining employment; (2) the extent of safety and comfort with disclosing minoritized identities in the workplace (i.e., comfortable disclosing; uncomfortable disclosing; did not need to disclose and/or hiding identities); (3) workplace discrimination based on minoritized identities (i.e., ableism, racism, ableist racism, gendered ableism, racist and gendered ableism); (4) impact of discrimination (i.e., negative affective outcomes, social and work adjustment, impact on professional development) and coping strategies (i.e., advocacy, networking, peer support); and (5) advice for youth and employers. Our study highlights the extent of racism and ableism that racial minoritized youth with non-apparent disabilities experience in the workplace and the importance of rehabilitation clinicians supporting their inclusion., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Lindsay et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Rationale: Prior research has demonstrated that medical journals rarely mention racism, potentially contributing to an incorrect understanding of and inappropriate interventions for health inequities affecting Black and Brown communities in the US. While this infrequency of mentions of racism has been documented in the general medical literature, it is unknown if this pattern extends to the addiction literature, where some have argued that structural racism has played a specific role in shaping policy and treatment., Objective: To assess how frequently the addiction literature for the last 30 years has mentioned race and racism and if these rates vary with social movements., Methods: We created an algorithm to download and process over 30,000 published articles published from 1990 to 2022 in five major addiction journals: Addiction, Addictive Behaviors, Drug and Alcohol Dependence, Journal of Substance Abuse and Treatment, and International Journal of Drug Policy. Using this data, we reported temporal patterns of mentioning both race and racism across journals and article types. Further, we utilized interrupted time series analysis to identify if the social movements against police violence and the murder of George Floyd in 2020 were associated with significant changes in rates of mentioning racism., Results: While over 30% of the articles in addiction medicine journals included the word race, only 1.5% of articles mentioned racism. Based on an interrupted time series model, after the racial reckoning following the murder of George Floyd in 2020, mentions of racism increased in the addiction literature (OR = 3.21, 95% CI: [2.39, 4.32], P<.001)., Conclusions: A large chasm remains between how often authors mention race versus racism in addiction medicine, a field with a unique history intertwined with structural racism. Addressing inequities in addiction outcomes, including burgeoning inequities in overdose deaths, will require acknowledging racism in the scientific literature., Competing Interests: Declaration of competing interest None to report., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Ethnic-racial identity formation has significant consequences for positive youth development. Existing findings support the efficacy of the Identity Project, a school-based ethnic-racial identity intervention, when delivered by researchers; however, effectiveness of the program when delivered by teachers is unknown. This study examined changes in adolescents' (N = 180; 42.2% male, 50.6% female, 6.7% another gender identity; M age  = 14.11, SD = 0.33; 38.3% Latinx, 33.9% White, 15.0% Black, 9.4% Asian American, 3.3% another ethnoracial background) ethnic-racial identity exploration as a function of their teachers' implementation of the Identity Project. Findings indicated that ethnic-racial identity exploration significantly increased from pretest to posttest, and this did not vary based on familial ethnic-racial socialization, student-teacher ethnoracial match/mismatch, gender, immigrant status, or ethnoracial background. This study provides preliminary evidence that U.S. educators can be trained to efficaciously implement the Identity Project with high school students and, furthermore, that this approach to program dissemination may not only facilitate scale-up but also result in greater gains for adolescents relative to research-led implementations., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Ethnic-racial identity (ERI) development is consequential for youth adjustment and includes exploration, resolution, and affect about the meaning of one's ethnic-racial group membership. Little is known about how identity-relevant experiences, such as ethnic-racial socialization and discrimination in peer relationships and school contexts, catalyze adolescent ERI development. The present study examines how identity-relevant experiences in friend and school contexts (i.e., proportion of same-ethnoracial friends, cultural socialization among friends, friends' ERI dimensions, friends' experiences of ethnoracial discrimination, and school promotion of cultural competence and critical consciousness) are associated with ERI development. A multivariate path model with a sample from four southwestern U.S. schools (N = 717; 50.5% girls; M age  = 13.76; 32% Latinx, 31.5% Multiethnic, 25.7% White, 11% other) was used to test these associations. Findings showed that friend and school predictors of ERI did not differ between early and middle adolescents, but significant differences and similarities emerged in some of these associations between ethnoracially minoritized and White youth. Specifically, friend cultural socialization was positively associated with ERI exploration for ethnoracially minoritized youth only, whereas school critical consciousness socialization was positively linked with ERI exploration only for White youth. Friend cultural socialization and friend network's levels of ERI resolution were positively associated with ERI resolution across both ethnoracial groups. These friend and school socialization associations were documented above and beyond significant contributions of personal ethnoracial discrimination to ERI exploration and negative affect for both ethnoracially minoritized and White youth. These findings expand our understanding of how friend and school socialization mechanisms are associated with adolescent ERI development, which is vital to advancing developmental theory and fostering developmental competences for youth to navigate their multicultural yet socially stratified and inequitable world., (© 2024. The Author(s).)

Objective: The current study explored differences in mental health problems, services utilization, and support of graduate students by gender, race/ethnicity, and year in school., Participants: Participants consisted of 734 graduate students from a large, Midwestern university., Methods: Graduate students answered a series of questionnaires in fall 2021 assessing their mental health, services utilization, and perception of services., Results: Women (vs men) and participants in their second year and beyond (vs first year) reported greater mental health problems, negative impact of the pandemic, and more services utilization. White (vs non-White) participants reported greater negative impact of the pandemic, greater services utilization, and less financial strain. Finances, lack of knowledge about resources, and inadequate communication from the university about services were reported as treatment barriers., Conclusion: Graduate students struggle with mental health, and universities may need to improve communication with and tailor their services to graduate students specifically to better support them.

Objective: Trait mindfulness is associated with well-being in college students, yet it is unclear whether these associations are consistent across demographics. Participants: Undergraduate students ( n  = 534; 33% nonwhite; Apr2018-Sep2019). Methods: A cross-sectional online survey was performed. Pearson correlations tested the relationship between specific facets of trait mindfulness and four domains of mind-body health: stress, well-being, cognitive functioning, and health behaviors. Gender, race, and ethnicity were tested as moderators. Results: In general, higher trait mindfulness is consistently associated with better mind-body health across demographics. However, in men, some health behavior variables correlated more strongly with mindfulness. Among Black students, the relationship between Non-Reactivity and some outcome variables was null or counterintuitive. In Asian students, several predicted associations were significantly stronger. Conclusion: Trait mindfulness corresponds to mind-body health in college students, but relationships may not be universal. Future research is needed to replicate these findings and to examine possible demographic differences in response to mindfulness training.

People quickly form consequential impressions of others' social class standing from nonverbal cues, including facial appearance. Extant research shows that perceivers judge faces that appear more positive, attractive, and healthy as higher-class, in line with stereotypes associating high class standing with happiness, attractiveness, and better wellbeing (which bear a kernel of truth). A wealth of research, moreover, demonstrates strong stereotypical associations between social class and both race and gender. The current work bridged these areas of inquiry to explore (1) intersectional biases in social class impressions from faces and (2) how associations between social class and attractiveness/health and affect can be used to shift social class impressions. Our studies found evidence of race and gender stereotypes impacting British perceivers' social class judgements, with Black (vs. White and Asian) and female (vs. male) faces judged as lower in class. Furthermore, manipulating faces' emotion expression shifted judgements of their social class, with variations in magnitude by faces' race, such that emotion expressions shifted judgements of Black faces more than White faces. Finally, manipulating faces' complexion to appear healthier/more attractive shifted social class judgements, with the magnitude of this varying by faces' and perceivers' race, suggesting a role of perceptual expertise. These findings demonstrate that stereotypes bias social class impressions and can be used to manipulate them., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose : This study assessed gender, race, use of complementary and alternative medicine (CAM), attitudes toward CAM, and disclosure of CAM use to health providers using an online survey of 506 students at a regional public university. Methods : Ordinary least squares regression models were used to examine relationships of interest, including use, attitudes, and disclosure of CAM by self-identified gender and race. Results : The most common therapy reported included vitamins and mineral supplements, and participants of all racial and gender identities expressed generally positive attitudes toward CAM. Women reported using CAM significantly more often than men, and Whites more often than non-Whites. Conclusions : White respondents were more likely to disclose the use of CAM to healthcare providers compared to African American respondents, and women reported disclosure more often than men. A significant interaction between gender and race was noted for attitudes toward CAM for Whites and African Americans, with White women most positive toward CAM.

Schools and friendships represent important but distinct contexts for adolescent identity development. However, research has yet to explore the long-term interplay between these factors on ethnic/racial identity (ERI). This study included a sample of 640 adolescents from 9 public high schools in a diverse United States metropolis (M age  = 14.50, SD = 0.67; 44% Asian, 20% Black, 36% Latinx; female = 68%, male = 32%, non-binary = 0%). Latent growth curve modeling was conducted to investigate longitudinal associations in friendship ethnic/racial composition and ERI exploration. From the 9th-11th grades, same-race friends and ERI exploration increased linearly whereas friendship ethnic/racial diversity decreased linearly. Adolescents attending more ethnically/racially diverse schools maintained more ethnically/racially diverse friends over time but did not differ in changes in ERI exploration compared to adolescents in less diverse schools. There was no association between the rates at which adolescents' friendship ethnic/racial composition and ERI changed over time. More ethnically/racially diverse friends in the 9th-grade predicted faster increases in subsequent ERI exploration. The findings highlight important differences in the roles of friendship and school contexts on ERI, suggesting that friendship ethnic/racial diversity, but not school ethnic/racial diversity, facilitated ERI exploration over time. School ethnic/racial diversity did facilitate a slower decline in friendship ethnic/racial diversity, emphasizing the importance of school integration., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Although the term "diversity" is ubiquitous in modern day society, the meaning of the term is not well understood, and it is unclear when people perceive groups to be more or less diverse. Across five experiments, we examined perceptions of racial diversity and preferences for living in diverse contexts related to visual representations of groups. While recent theorizing suggests that a greater number of low-status racial minorities may contribute to perceiving more diversity and determine living preferences, our findings indicate the importance of the race of the perceiver in these processes. Although White and Black participants rated majority Black compared to majority Asian groups as more diverse, followed by majority White targets (cf. Experiment 4), Asian participants did not differ in their diversity ratings across the different racial compositions. Notably, White and Asian participants rated majority White and majority Asian compared to majority Black neighborhoods as more desirable. Black participants, in contrast, consistently rated majority Black compared to majority White and majority Asian neighborhoods as more desirable and did not distinguish between the latter two contexts. Together these findings provide new evidence about how people define diversity and the importance of target-level factors, perceiver-level factors, and the interplay between these factors on perceptions of racial diversity and inclusivity., (© 2024. The Author(s).)

While many frameworks exist for building person-centered and equitable systems of contraceptive care, evidence indicates that the reality of patients' experiences of care is often not in alignment with these ideals. Historical and current contexts of racism in the healthcare system contribute to negative perceptions and experiences of care, as well as reduced care-seeking behavior, for those who identify as Black, Indigenous, and people of color (BIPOC). Our objective in this analysis is to examine whether people's past experiences of contraceptive care are a driver of subsequent barriers to contraceptive access, and whether this relationship differs across racial and ethnic identity. We draw on panel data from five waves of surveys collected between 2018-2023 among patients ages fifteen and older seeking family planning care at sites that receive public funding for these services in Arizona, Iowa, and Wisconsin. Overall and stratified by race/ethnicity, we examine cross-sectional and longitudinal associations between patients' experiences of high-quality, person-centered contraceptive care and three contraceptive access outcomes: use of preferred contraception, satisfaction with contraceptive method, and experience of no barriers to accessing preferred contraception. We find longitudinal associations between patients experiencing higher-quality, more person-centered contraceptive care and subsequent satisfaction with contraceptive methods. Among non-Hispanic white-identifying patients, we find similar associations between shifting to higher-quality contraceptive care and use of preferred contraception, but we find no statistical relationship between experiencing higher-quality care and subsequent contraceptive outcomes for patients who identify as Black, Indigenous, or Person of Color (BIPOC). Highlighting the dissonance between clinical guidance for quality contraceptive care and patient experiences of care, and especially whether similar experiences across racial and ethnic identity lead to differential outcomes, is a crucial step toward bringing contraceptive care systems into alignment with principles of sexual and reproductive health equity., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Kavanaugh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Assisted dying, also commonly known as euthanasia and physician-assisted suicide, is legal in many countries. Interest in assisted dying is growing due to evolving societal understandings of a good death and a desire for choice. Ethico-legal perspectives are well-known, but as societies become more heterogenous, a greater understanding of the perspectives of people from diverse racial, ethnic, and cultural backgrounds is needed., Aim: To explore perspectives of people from diverse racial, ethnic and cultural backgrounds about assisted dying., Design: Scoping review with narrative synthesis. The protocol was registered with Open Science Framework., Data Sources: Medline, CINAHL Complete, PsycINFO and ProQuest Dissertations & Theses Global were searched from inception to May 2023. Citations were independently assessed against inclusion and exclusion criteria., Results: Of the 17 included studies, perspectives of assisted dying were presented according to religion, religiosity, spirituality, race, ethnicity and ancestry. Perspectives were diverse, presenting more as a spectrum, with multiple intersections and interconnections. Support and/or opposition for assisted dying differed according to cultural attributes, but even amongst those with similar cultural attributes, perspectives differed according to life experiences and notions of suffering., Conclusion: Perspectives on assisted dying are dynamic and evolving. Even where assisted dying is legalised, individual's cultural attributes contribute to unique perspectives of assisted dying as an end-of-life option. Thus, understanding a person's culture, beliefs, expectations and choices in illness, treatment goals and care is fundamental, extending beyond what may be already considered as part of clinician-patient care relationships and routine advance care planning., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Labor unions are associated with better wages, improved working conditions, and greater worker empowerment, which may result in better health. However, less is known about the relationship between unionization and health among U.S. healthcare workers, whether the relationship differs among racially diverse workers, and how much control over workplace schedules and location mediates the relationship., Methods: We analyzed a cross-sectional survey of a nationally representative sample of 3000 U.S. healthcare workers collected from March 14 through April 5, 2023. Using ordinal logistic regression, we evaluated whether unionized healthcare workers had better self-rated health (SRH) than their nonunionized counterparts and examined potential differences between White and racially minoritized respondents. We quantified the mediation percentage explained by control over one's schedule and workplace location in the total and stratified samples using Karlson, Holm, and Breen decomposition analysis., Results: Over a third (36.1%) of racially minoritized respondents were unionized, compared to 22.3% of White respondents. Among racially minoritized workers, a greater share of unionized workers reported excellent health (40.6% vs. 21.8%) than their nonunionized counterparts. In confounder-adjusted ordinal logistic regression analyses, labor union membership was associated with better SRH overall, with a stronger association for racially minoritized workers. Among White healthcare workers, control over workplace arrangements explained 68.1% of the union membership and SRH relationship. For racially minoritized workers, control over workplace arrangements partially mediated the relationship, explaining 17.4% of the variation, suggesting that labor unions may impact health through additional pathways for these workers., Conclusions: This study provides empirical evidence of the relationship between labor union membership and health among U.S. healthcare workers. We demonstrate that control over schedules and location is an important mechanism by which unionization may protect healthcare workers' health. Among racially diverse healthcare workers, labor unions may play an important role in health through various pathways beyond workplace control., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Understanding biological pathways that mediate trauma-related psychopathology is a major goal for traumatic stress studies. There is growing interest in studying differences in neural, physiological, and behavioral correlates of traumatic stress across demographic groups (e.g., sex/gender, race/ethnicity). However, challenges remain in how to appropriately conceptualize the source, mechanisms, and practical utility of between-group variation. The present brief conceptual review discusses ethnicity, race, and sex/gender-related variability relevant to understanding the psychobiology of traumatic stress in the context of traumatic stress studies. We discuss recent evidence related to socioenvironmental influences on ethnoracial variability in the brain and behavior relevant to traumatic stress, as well as sex/gender associations in neurophysiology that may contribute to the development of adverse posttraumatic sequelae. We further synthesize these findings by discussing intersectional influences of sex/gender- and race/ethnicity-related factors on trauma-related physical and mental health outcomes. The present review provides an important foundation for future research on disparities and individual differences in traumatic stress to move the field toward more effective assessment and treatment approaches., (© 2024 International Society for Traumatic Stress Studies.)

Objectives: Extant research supports a positive relationship between weight-related abuse (WRA) and disordered eating constructs. Individuals who face marginalization and who are more likely to live in larger bodies, such as Black and Hispanic individuals in the United States (U.S.), may be at a heightened risk of WRA. This study is aimed at understanding whether the relationship between WRA and disordered eating constructs varies by race/ethnicity. We hypothesized that individuals from marginalized backgrounds would have differential levels of dietary restraint, body dissatisfaction, and shape/weight overvaluation with increased experiences of WRA compared to non-Hispanic White individuals., Methods: Two thousand one hundred sixteen undergraduates were recruited from two U.S. universities for a survey-based study assessing psychosocial functioning. Participants completed a demographics questionnaire assessing race/ethnicity, the Weight-Related Abuse Questionnaire assessing WRA experiences, and the Eating Disorders Examination-Questionnaire assessing disordered eating constructs., Results: Results showed positive relationships between verbal (vWRA) and physical (pWRA) WRA and disordered eating behaviors and cognitions. Moreover, at higher levels of vWRA, Asian and multiracial individuals showed greater dietary restraint compared to White individuals. No other tested models were moderated by race/ethnicity., Conclusion: WRA is positively associated with disordered eating behaviors and cognitions across racial/ethnic identities, and vWRA may be differentially related to increased dietary restraint in Asian and multiracial individuals compared to White individuals. Further research utilizing intersectional analyses (e.g., examining how this relationship varies according to the intersection of race/ethnicity, gender, and weight status) would help clarify this relationship., (© 2023. W. Montague Cobb-NMA Health Institute.)

This study employed a Reasoned Action Approach to investigate two communication behaviors that were being built into a statewide behavioral health campaign: initiating a conversation about one's own mental health struggles, and starting a conversation to discuss someone else's mental health difficulties. We examined whether the extent of attitudes, perceived norms, and perceived behavioral control regarding intent to perform these behaviors varied by racial identity. Using original survey data from Texans ( N  = 2,033), we conducted regression analyses for the two communication behaviors and found that intention to seek help was primarily explained by instrumental attitude, injunctive norm, descriptive norm, and perceived capacity; and intention to start a conversation to help someone else was primarily explained by instrumental attitude, injunctive norm, and perceived capacity. Additionally, we identified important common and distinct determinants of the two behaviors across different racial groups. Implications for health communication campaign message development and audience segmentation are discussed.

Objective: College men may be at risk for binge eating (BE) but are underrepresented in research. This study aimed to examine if body weight/shape concerns, perceived stress, and psychological distress significantly contributed to the likelihood of BE over the past 28 days. Participants: A racially/ethnically diverse sample ( N  = 873) of college men. Method: An anonymous online survey was administered. Logistic regression analysis was conducted to examine the hypothesized associations for the entire sample, and exploratory analyses were conducted within each racial/ethnic group. Results: The model explained approximately 25% of the variance in BE, with body weight/shape concerns as the only significant predictor in the overall sample and for the White, Black, and Asian subsamples; none of the variables were significant among Latino men. Conclusions: Body weight/shape concerns predict BE among diverse college men. The findings have implications for future research, as well as for prevention and intervention for college men.

Background: Neighborhood factors of social isolation have been understudied, hindering efforts to reduce social isolation at the neighborhood level. This study aims to investigate the longitudinal effects of neighborhood social cohesion and physical disorder on social isolation in community-dwelling older adults, as well as to examine whether race/ethnicity moderates the neighborhood-isolation relationship., Methods: We used 11-year data from the National Health and Aging Trend Study, a longitudinal national study of Medicare beneficiaries aged 65 and older. Social isolation was measured through a summary score across four domains: marital/partner status, family and friend contact, religious attendance, and club participation. A series of weighted mixed-effects logistic regression models were performed to test the study aims. Sample sizes ranged from 7,303 to 7,291 across individual domains of social isolation., Results: Approximately 20% of participants reported social isolation. Findings indicated a negative association between neighborhood social cohesion and social isolation. Higher levels of neighborhood social cohesion were longitudinally associated with lower odds of social isolation (odds ratio [OR] = 0.52, 95% CI: 0.47-0.58). Yet, the presence of neighborhood physical disorder was associated with an increased risk of overall social isolation ([OR] = 1.2, 95% CI: 1.00, 1.44). Race/ethnicity significantly moderated the effects of neighborhood social cohesion and physical disorder on social isolation. The odds of no in-person visits associated with neighborhood social cohesion are smaller among Black adults compared to White adults. Black adults had constantly lower odds of isolation from religious attendance compared to White adults regardless of the level of neighborhood social cohesion. Hispanic adults had decreased odds of having no friends associated with signs of physical disorder, while no associations were found among older White adults. White adults had higher odds of isolation from in-person visits when living in neighborhoods with signs of physical disorder, whereas no association was observed among older Black and Hispanic adults., Conclusions: This study elucidates the role of neighborhood characteristics in shaping social isolation dynamics among older adults. Furthermore, the observed moderation effects of race/ethnicity suggest the need for culturally sensitive interventions tailored to address social isolation within specific neighborhood and racial contexts., (© 2024. The Author(s).)

Competing Interests: Competing interests: None declared.

Background: This study explored whether opinions about the government's role in addressing the COVID-19 pandemic vary based on demographic characteristics and racial beliefs. We hypothesized that opinions about the United States (U.S.) government's response to COVID-19 would differ based on an individual's characteristics such as age, race, and racial beliefs., Methods: We utilized an Inter-University Consortium for Political and Social Research dataset to examine differences in opinion regarding the government's pandemic response, considering personal characteristics and racial beliefs. Descriptive statistics depicted respondents' characteristics, and a Chi-square test for independence assessed whether differences emerged based on racial attitude, self-reported racial identity, sex, income, education, and age. Logistic regression analyses were conducted to independently determine which characteristics were associated with differences in evaluating the government's pandemic response., Results: The sample consisted of 1028 respondents: 47.5% male and 52.5% female. Overall, the group viewed the government unfavorably, with only 40% reporting that the government responded correctly and 54% believing the government is almost always wasteful and inefficient. Hispanics or Latinos were more likely to view the government as wasteful or inefficient, while more Whites rated the government's pandemic response as appropriate. Individuals who believed that racial discrimination is the main reason why many Black people cannot get ahead generally regarded the government's pandemic response more favorably. Only 5% deemed the government's response excessive. Being Black, younger, and female was associated with the view that racial discrimination is the main reason why many Black people cannot get ahead. Individuals who felt this way viewed the government unfavorably by almost a 2:1 ratio., Conclusions: A majority of U.S. residents do not believe the government responded correctly to the pandemic and more than half viewed the government as wasteful and inefficient. Differences emerged by ethnicity and racial attitudes, with individuals of color holding more negative views of the government's response. Understanding this perspective can help develop messaging and strategies that resonate with communities where racial and minority groups live.

Objective: The demographic homogeneity of the physical therapist workforce and its educational pathway may undermine the profession's potential to improve the health of society. Building academic environments that support the development of all learners is fundamental to building a workforce to meet societal health care needs. The Benchmarking in Physical Therapy Education study uses the Physical Therapy Graduation Questionnaire to comprehensively assess learner perceptions of the physical therapist academic environment. The present report examined whether racial and ethnic minoritized (REM) physical therapist learners perceive their doctor of physical therapy education differently from their non-REM peers., Methods: Five thousand and eighty graduating doctor of physical therapy learners in 89 institutions provided demographic data and perceptions of a range of learning environment domains. Analyses included REM versus non-REM comparisons as well as comparisons among individual race and ethnicity groups., Results: Compared with their non-minoritized peers, REM respondents expressed less satisfaction with their education and lower confidence in their preparedness for entry-level practice. REM respondents observed more faculty professionalism disconnects and demonstrated less agreement that their program had fostered their overall psychological well-being. REM respondents experienced higher rates of mistreatment than their peers and reported higher rates of exhaustion and disengagement, the 2 axes of academic burnout. Black/African American and Hispanic/Latino/a/x (Hispanic, Latino, Latina, and/or Latinx) respondents incurred significantly more educational debt than Asian and White respondents. REM respondents reported greater empathy and greater interest in working in underserved communities., Conclusion: REM respondents perceived the physical therapist learning environment more negatively than their non-minoritized peers but expressed strong interest in serving people from underserved communities. These national benchmarks offer academic institutions the opportunity to self-assess their own environment and to work to improve the quality of the educational experience for all learners., Impact: In a nationwide benchmarking study, learners from minoritized race and ethnicity backgrounds reported more negative experiences and outcomes during physical therapist education than their non-minoritized peers. These same learners demonstrated high empathy and interest in serving people from underserved (under-resourced) communities. Learning environments that permit all individuals to thrive may be an essential avenue to improve the health of a rapidly diversifying society., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

As the United States grows more racially diverse, it is imperative to understand whether being in a racially diverse environment impacts conversations about race. This study examines whether exposure to, and interactions with racially diverse others relate to whether people talk about race, the frequency with which people talk about race, and their comfort with doing so within the racially diverse context of Hawaii. We employed experience sampling to measure whether people had conversations about race, how frequently conversations about race occurred and their comfort in those conversations, and whether their exposure to and interactions with racially diverse others predicted these behaviors. Exposure to and interactions with racially diverse others were not significant predictors of race-related conversations (and their comfort with said conversations). However, interactions with racially diverse friends was related to greater likelihood of discussing race, more frequent discussions of race, and more comfort with race-related conversations. These findings illustrate the importance that interactions with cross-race friends have for improving intergroup relations.

Background: Intersectionality has rarely been considered in research studies of cognitive ageing. We investigated whether life-course financial mobility is differentially associated with later-life memory function and decline across intersectional identities defined by gender, and race and ethnicity., Methods: Data were from two harmonised multiethnic cohorts (the Kaiser Healthy Aging and Diverse Life Experiences cohort and the Study of Healthy Aging in African Americans cohort) in northern California, USA (n=2340). Life-course financial mobility, measured using a combination of self-reported financial capital measures in childhood (from birth to age 16 years) and later adulthood (at the cohort baseline) was defined as consistently high, upwardly mobile, downwardly mobile, or consistently low. We clustered individuals into 32 strata representing intersectional identities defined by life-course financial mobility combined with gender, and race and ethnicity. Verbal episodic memory was assessed using the Spanish and English Neuropsychological Assessment Scales over four waves from 2017 to 2023. Adjusted mixed-effects linear regression models were estimated with and without fixed effects of gender, race and ethnicity, and financial mobility, to evaluate whether the random effects of the intersectional identity strata contributed variance to memory beyond individual fixed effects., Findings: Mean age was 73·6 years (SD 8·1). Of 2340 individuals, 1460 (62·4%) were women, 880 (37·6%) were men, 388 (16·6%) were Asian, 1136 (48·5%) were Black, 334 (14·3%) were Latinx, and 482 (20·6%) were White. Consistently low and downwardly mobile financial capital were strongly negatively associated with later-life memory at baseline (-0·162 SD units [95% CI -0·273 to -0·051] for consistently low and -0·171 [-0·250 to -0·092] for downwardly mobile), but not rate of change over time. Intersectional identities contributed 0·2% of memory variance after accounting for the fixed effects of gender, race and ethnicity, and financial mobility., Interpretation: Consistently low and downward life-course financial mobility are associated with lower later-life memory function. Intersectional identities defined by financial mobility in addition to gender, and race and ethnicity, contribute negligible additional variance to later-life memory in this study setting., Funding: US National Institute on Aging, US National Institutes of Health., Competing Interests: Declaration of interests PG and LCK report funding from the US National Institute on Aging at the US National Institutes of Health. ERM reports funding from the US National Institute on Aging at the US National Institutes of Health and the California Department of Public Health, consulting fees from consulting on grants funded by the US National Institutes of Health, honoraria for research talks at Columbia University and the XVII Symposium on Sleep and Breathing, and serving on the leadership committees for the Methods in Longitudinal Research on Dementia (MELODEM) Initiative and the Advanced Psychometrics Methods in Cognitive Aging Conference. RLP reports funding from the US National Institute on Aging at the US National Institutes of Health, honorarium for a symposium presentation at the University of California Davis Alzheimer’s Disease Research Center, and travel support from the Alzheimer’s Association Interdisciplinary Summer Research Institute. CES reports funding from the US National Institute on Aging at the US National Institutes of Health and serving as chair of the ISTAART PIA to Elevate Early Career Researchers (PEERs) and co-chair of the Sex and Gender Special Interest Group of the Diversity and Disparities PIA in ISTAART. RAW reports funding from the US National Institutes of Health and the Alzheimer’s Association, consulting fees from the University of Colorado and Genentech Pan Neuro, and serving on the Observational Monitoring Board for the Efficacy and Durability of Initial Combination Therapy for Type 2 Diabetes (EDICT) study and the Diabetes Prevention Program Outcomes Study (DPPOS), and the Data Monitoring Committee of the Add Health Study. XY, JA-R, PAA-H, CV-C, and EM declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Due to demographic changes of the U.S. population in the past few decades, more attention has been placed on understanding the sociocultural factors that have an impact on the mental health of racially and ethnically minoritized (REM) groups. One factor that has gained increased attention in recent years is acculturative stress. Acculturative stress is associated with negative mental health outcomes, such as depression, anxiety, psychological distress, and suicide ideation (SI). However, the magnitude of this association remains unclear. A systematic review and meta-analysis were conducted to provide a comprehensive review of the impact of acculturative stress on depression, anxiety, psychological distress, and SI among REM youth. We also aimed to explore whether sociodemographic variables (i.e., race/ethnicity, generational status, sex/gender, and age) moderate the relationships between acculturative stress and mental health outcomes. Forty-six peer-reviewed articles examining the link between acculturative stress and internalizing problems among REM youth in the U.S. (mean age range: 13-29) met inclusion criteria and were included in this systematic review and meta-analysis. A positive relationship of moderate size between acculturative stress and depression, anxiety, psychological distress, and SI was found. Moderation analyses also revealed that the impact of acculturative stress on depression may be greater among those who are older and for first-generation immigrants. Similarly, its impact on anxiety may also be more pronounced for first-generation immigrants. Results also suggested that the impact of acculturative stress on depression and psychological distress may be greater among men compared to women. These findings highlight the importance of making sure clinicians assess for acculturative stress when working with REM youth, as well as factors that may be contributing to an individual's acculturative stress level., Competing Interests: Declaration of competing interest We have no known conflict of interest to disclose., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Eurocentric physical characteristics, including a thin, tall physique, long straight hair, and fair skin, typify Western beauty standards. Past research indicates that for Black women, greater identification with one's racial/ethnic culture may buffer against internalizing Eurocentric beauty standards, specifically the thin ideal. Black/White Biracial women often experience different appearance pressures from each of their racial identity's sociocultural appearance ideals. Unfortunately, body image research is limited among Bi/Multiracial individuals. Participants were recruited online via Prime Panels, a high-quality data recruitment service provided by CloudResearch. Participants, M(SD) Age = 34.64 (12.85), self-reported their racial/ethnic identification, thin and thick/curvy ideal internalization, and hair and skin tone satisfaction. Using linear regression analyses, we assessed whether racial/ethnic identification buffered against monoracial Black (n = 317) and Black/White Biracial (n = 254) women's thin ideal internalization. Additionally, we assessed whether stronger racial/ethnic identity was associated with stronger thick/curvy ideal internalization and hair and skin tone satisfaction. Supporting hypotheses, greater racial/ethnic identification was associated with higher thick/curvy ideal internalization and hair and skin tone satisfaction among both Black and Biracial women. Contrary to hypotheses, greater racial/ethnic identification was not associated with lower thin ideal internalization in either group. Our results stress the need to use racially and culturally sensitive measurements of body image., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Although the relationship between bullying victimization and suicidal behaviors of lesbian, gay, bisexual, transgender, and questioning (i.e., unsure of their sexual orientation) students has been well documented in research, few studies have focused on how bullying victimization might be related to suicidal behaviors among youth with intersectional identities. This study examines associations between bullying victimization and suicidal behaviors across racial/ethnic groups in a sample of lesbian, gay, bisexual, and questioning (LGBQ) students. Data for this cross-sectional study were derived from the Center for Disease Control and Prevention's Youth Risk Behavior Survey combined data set (2003-2019), with a sample of 95,603 students who identified as LGBQ. Analyses included descriptive statistics and logistic regression. We found that homophobic bullying victimization was associated with higher odds of suicidal ideation and plans among the total sample and Black and Hispanic students. School-based bullying victimization was associated with higher odds of suicidal ideation, plans, and attempts among white and Hispanic students and higher suicidal ideation among multiracial-non-Hispanic students. Cyberbullying victimization was not associated with suicidal behavior among Asian students, but it was associated with all forms of suicidal behavior among youth of other racial/ethnic identities. Addressing bullying victimization and suicidality with culturally relevant, evidence-based violence prevention strategies is critical., (© 2024 Society for Community Research and Action.)

Relatively few neighborhood-focused studies explicitly model the relationship between neighborhood change- i.e., racial change within a neighborhood-and individual mental health, instead focusing on the current composition of the neighborhood or on the outcomes of individuals that switch neighborhood contexts via moves. Further, while neighborhoods and schools are interconnected, researchers tend to focus on only one of these contexts in their work. Combining family and student data from the Panel Study of Income Dynamics (PSID) with multiple waves of neighborhood and school administrative data, our study extends current scholarship in this area by explicitly focusing on the relationship between exposure to neighborhood and school racial change-i.e., change occurring within the neighborhood or school in the prior decade-and the behavior problems of current students. We further analyze how associations vary: 1) by student race; 2) between newcomers to the neighborhood and those that lived in the neighborhood as it underwent demographic change; 3) and in neighborhoods with higher proportions of same-race residents. Our findings suggest that the relationship between local neighborhood contexts and the behavioral problems of children is nuanced and depends on the racial trajectories-change or stability-of neighborhoods, schools, and the interaction of both. Compared to longer-term residents, White newcomers tended to have more behavioral problems across racially changing and stable neighborhoods alike, regardless of the racial trajectories observed in the local school. Our results align with past work documenting the protective effect of same-race peers for Black children. Conversely, we find White students exhibit greater behavioral problems in settings with very high proportions of same-race peers, particularly in neighborhoods and schools that are simultaneously becoming increasingly racially isolated., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Research suggests that BIPOC (Black, Indigenous, People of Color) adolescents have the best developmental outcomes when strong, positive ethnic-racial identity (ERI) is acknowledged and embraced. This study investigated whether discrimination, internalizing symptomology, parent socialization, and/or interactions of these variables were associated with adolescent ERI, specifically in exploration, resolution, and affirmation, to illuminate nuanced ways BIPOC youth can achieve positive ERI. Recruited from third-party research panels, surveyed participants were adolescents (M age  = 15.28; 51.6% male) of diverse ethnic/racial groups and socioeconomic backgrounds from all regions of the United States. Overall, results showed that there were four significant main effects on ERI: a negative relation between internalizing symptomology and exploration, a positive relation between parent socialization and exploration, a positive relation between parent socialization and resolution, and a negative relation between internalizing symptomology and affirmation. There were also two significant interactive effects such that (1) discrimination had a stronger negative relation with affirmation under condition of high internalizing, and (2) parent socialization had a stronger positive relation with affirmation under condition of high internalizing. Results show development of ERI in adolescence is subject to multiple, interactive influences. Main and interactive effects highlight the contextual role that mental health implicates for youth of color. Implications for parents and practitioners are discussed., (© 2024 Society for Research on Adolescence.)

Racial and ethnic differences have been observed across patterns of substance use and exposure to adverse childhood experiences (ACEs). The goal of this review was to summarize the current evidence on ACE and health outcomes across racial and ethnic groups in the United States. A scoping review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta- Analysis for Scoping Review (PRISMA-ScR) guideline was performed. Using predetermined search terms and parameters, an electronic database search of peer-reviewed literature between 1997 and 2022 was performed. Forty-five articles met the inclusion and exclusion criteria. Thirteen articles focused on health behavior and education outcomes, fifteen reported on physical health outcomes, and eighteen reported on mental health outcomes. Relatively to mental health outcomes, race/ethnicity appeared to play a less significant role in the relationship between ACE and behavioral outcomes or physical health outcomes. There was stronger evidence that race/ethnicity may moderate relationships between ACE exposure and mental health outcomes. Across health behavior, physical health, and mental health domains, the evidence suggests that the relationship between ACE exposure and health outcomes is not uniform across different racial and ethnic groups. These findings highlight the need for future research to uncover how cultural, societal, and developmental factors interact to shape health in the context following exposure to childhood adversity., Competing Interests: Author’s NotePhillip Yang is now affiliated to University of California, San Francisco, USA. Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: We examined the association between symptoms of anxiety and depression among individuals with long COVID and five social vulnerabilities (expenses, employment, food insufficiency, housing, and insurance)., Methods: Data from the Census Bureau's Household Pulse Survey (HPS) detailing COVID incidence, duration, and symptoms between June 1st and November 14th, 2022 contained versions of the Generalized Anxiety Disorder (GAD-2) and the Patient Health Questionnaire (PHQ-2) questionnaires. Associations between anxiety, depression, and the five social vulnerabilities among respondents from different racial and ethnic groups experiencing long COVID were evaluated using generalized binomial logistic regression. Structural equation models tested whether social vulnerabilities mediated the pathway between race/ethnicity and anxiety/depression., Results: Blacks, Asians/others, and Hispanics with long COVID were significantly more likely to report anxiety and depression and various social vulnerabilities than Whites. Anxiety among Blacks was significantly associated with difficulty with expenses [Odds Ratio (OR) = 1.743, 95 % Confidence Interval (CI) = 1.739, 1.747], employment (OR = 1.519, 95 % CI = 1.516, 1.523), and housing (OR = 1.192, 95 % CI = 1.19, 1.194). Anxiety among Hispanics was significantly associated with food insufficiency (OR = 1.048, 95 % CI = 1.044, 1.052). Depression among Blacks was significantly associated with trouble with expenses (OR = 1.201, 95 % CI = 1.198, 1.205) and employment (OR = 1.129, 95 % CI = 1.127, 1.132). Mediation analysis showed that the number of social vulnerabilities partially mediated the association between race and anxiety., Limitations: This retrospective study utilized secondary, observational, self-reported data from the HPS. Therefore, results may not be generalizable outside of the context in which they were collected., Conclusions: The development of tailored programs for population health should address the differential associations of anxiety and depression with social difficulties among racial and ethnic groups., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: Mental health problems in emerging adulthood are linked to tobacco and cannabis use, but whether race and ethnicity modifies these associations is unclear., Methods: We used data from wave 4 of the Population Assessment of Tobacco and Health Study (youth n = 6898, young adult n = 10,304) to conduct latent class analysis (LCA) of six past 30-day tobacco and cannabis use indicators (i.e., cigarettes, electronic nicotine delivery systems (ENDS), cigars, blunts, cannabis vaping, other cannabis). We estimated associations between past 30-day internalizing and externalizing (i.e., low (referent), moderate, high) problems and latent classes of tobacco/cannabis use (vs. never/former use) using adjusted multinomial logistic regression. We explored whether associations varied by race and ethnicity through stratification., Results: We identified four exclusive use latent classes and two dual/poly use latent classes for both youth and young adult samples. Race/ethnicity-stratified models identified associations between internalizing/externalizing problems and most use classes for Hispanic and non-Hispanic White youth/young adults, with mixed results for non-Hispanic Black youth/young adults. For example, Hispanic (OR: 2.50, 95% CI: 1.09-5.74) and non-Hispanic White (OR: 1.90, 95% CI: 1.18-3.06) youth with high internalizing problems had higher odds of ENDS + cannabis vaping. Externalizing problems were not associated with use among non-Hispanic Black youth while internalizing problems were not associated with use among non-Hispanic Black young adults., Conclusion: We observed racial/ethnic variation in mental health problems and tobacco and cannabis use. Understanding mental health problem and tobacco product and cannabis use comorbidity may better inform culturally relevant interventions aimed to prevent and reduce use., Competing Interests: Declarations Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Competing Interests The authors declare no competing interests., (© 2023. W. Montague Cobb-NMA Health Institute.)

Health disparities and the impact of racism on the mental and physical health of people of color has been well-documented. However, health research has historically approached race as a genetic and biological attribute to explain differences in health outcomes. Although more recent policies and research have begun to move toward conceptualizing race as a socially constructed category that can be thought of as a proxy for racism, the ways in which race and racism are conceptualized in mental health disparities research needs deeper analysis. Using critical race theory (CRT) and content analysis, we investigate how mental health research has examined race, racism, and mental health in PubMed articles published between 2012 and 2022. Findings suggest a need for more complex conceptualizations of race, particularly related to essentialized, monoracial framings that rarely explore how race is defined and employed. Much of the research analyzed did not position racism, discrimination, or oppression as central to contextualizing racial mental health disparities. Additionally, the role of voice was often missing, limiting understandings of racialized experiences. Results of this analysis illuminate areas the need for more racism conscious approaches to understanding racial disparities in mental health and identifying opportunities to promote health equity., Competing Interests: Declarations Competing Interests The authors declare no competing interests., (© 2023. W. Montague Cobb-NMA Health Institute.)

Background: Previous studies showed that comorbidity and demographic factors added to burden on health-related quality of life (HRQoL). Only one study explored the relationship between HRQoL and comorbidity in college students with mental disorders, leaving generalizability of findings uncertain. Less is known about the association of demographics on HRQoL. This study investigated HRQoL based on demographics and comorbidity among college students with mental disorders., Methods: Participants were students (N = 5535) across 26 U.S. colleges and universities who met criteria for depression, generalized anxiety, panic, social anxiety, post-traumatic stress, or eating disorders based on self-report measures. ANOVA and linear regressions were conducted., Results: Overall, female, minoritized (gender, sexual orientation, race, or ethnicity), and lower socioeconomic status students reported lower HRQoL than male, heterosexual, White, non-Hispanic, and higher socioeconomic status peers. After accounting for comorbidity, differences in physical HRQoL based on sex assigned at birth and gender were no longer significant. For mental HRQoL, only gender and sexual orientation remained significant. A greater number of comorbidities was associated with lower HRQoL regardless of demographic group., Limitations: The non-experimental design limits causal inference. The study focused on univariable associations without examining potential interactions between demographic factors. Future research should explore structural factors like discrimination., Conclusion: Results suggested that increased comorbidities placed an additional burden on HRQoL and that certain demographic groups were more vulnerable to HRQoL impairment among students with mental disorders. Findings suggest the need for prevention of disorders and their comorbidity and implementing tailored interventions for specific student subgroups with increased vulnerability., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier B.V.)

Background: Numerous studies have highlighted mental health disparities based on race/ethnicity, nativity, and gender across different life stages. However, few have investigated how the intersectionality of these factors influences mental health trajectories during midlife to late life. This study fills this gap by adopting a life course-intersectional approach, viewing mental health trajectories as dynamic processes shaped by the combined influences of race/ethnicity, nativity, and gender. It explores social, psychological, and physiological pathways contributing to these disparities., Design: Using data from the Health and Retirement Study (2006-2018; N = 38,049 observations) and growth curve models, this study examines how intra-individual trends in depressive symptoms (measured as CES-D scale, 07) are influenced by the intersection of race/ethnicity, nativity, and gender. It also investigates the impact of objective and subjective social isolation and physical health on group disparities in mental health trajectories., Results: The findings reveal that, during mid- to early late-life, most Black and Hispanic Americans experience higher levels of depressive symptoms compared to their White counterparts (disparities ranging from 0.184 to 0.463 for men and 0.117 to 0.439 for women). However, this disadvantage diminishes for US-born Hispanic men and US-born Black women (0.014-0.031 faster decrease rates compared to US-born White), while it intensifies for Hispanic immigrants (0.017-0.018 slower decrease rates compared to US-born White) in advanced ages. Mediation analysis demonstrates that both social isolation and physical health contribute to these disparities, with physical health explaining a larger portion, particularly in differences between immigrant Hispanic women and US-born Whites., Conclusion: This study underscores the importance of a life course-intersectional approach in understanding mental health disparities. It emphasizes the need for improved social welfare systems and community-level interventions targeting the specific challenges faced by older Hispanic immigrants, especially women who encounter multiple forms of oppression., Competing Interests: Declarations Ethics Approval The authors confirm that this research paper is based on the Health and Retirement Study and that all data are fully available without restriction. Competing Interests The authors have no relevant financial or non-financial interests to disclose., (© 2023. W. Montague Cobb-NMA Health Institute.)

Background: This study explores intersectionality in moral distress and turnover intention among healthcare workers (HCWs) in British Columbia, focusing on race and gender dynamics. It addresses gaps in research on how these factors affect healthcare workforce composition and experiences., Methods: Our cross-sectional observational study utilized a structured online survey. Participants included doctors, nurses, and in-home/community care providers. The survey measured moral distress using established scales, assessed coping mechanisms, and evaluated turnover intentions. Statistical analysis examined the relationships between race, gender, moral distress, and turnover intention, focusing on identifying disparities across different healthcare roles. Complex interactions were examined through Classification and Regression Trees., Results: Racialized and gender minority groups faced higher levels of moral distress. Profession played a significant role in these experiences. White women reported a higher intention to leave due to moral distress compared to other groups, especially white men. Nurses and care providers experienced higher moral distress and turnover intentions than physicians. Furthermore, coping strategies varied across different racial and gender identities., Conclusion: Targeted interventions are required to mitigate moral distress and reduce turnover, especially among healthcare workers facing intersectional inequities., (© 2024. The Author(s).)

Background: Studies investigating the impact of racial segregation on health have reported mixed findings and tended to focus on the racial composition of neighborhoods. These studies use varying racial composition measures, such as census data or investigator-adapted questions, which are currently limited to assessing one dimension of neighborhood racial composition., Objective: This study aims to develop and validate a novel racial segregation measure, the Pictorial Racial Composition Measure (PRCM)., Methods: The PRCM is a 10-item questionnaire of pictures representing social environments across adolescence and adulthood: neighborhoods and blocks (adolescent and current), schools and classrooms (junior high and high school), workplace, and place of worship. Cognitive interviews (n=13) and surveys (N=549) were administered to medically underserved patients at a primary care clinic at the Barnes-Jewish Hospital. Development of the PRCM occurred across pilot and main phases. For each social environment and survey phase (pilot and main), we computed positive versus negative pairwise comparisons: mostly Black versus all other categories, half Black versus all other categories, and mostly White versus all other categories. We calculated the following validity metrics for each pairwise comparison: sensitivity, specificity, correct classification rate, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, false positive rate, and false negative rate., Results: For each social environment, the mostly Black and mostly White dichotomizations generated better validity metrics relative to the half Black dichotomization. Across all 10 social environments in the pilot and main phases, mostly Black and mostly White dichotomizations exhibited a moderate-to-high sensitivity, specificity, correct classification rate, positive predictive value, and negative predictive value. The positive likelihood ratio values were >1, and the negative likelihood ratio values were close to 0. The false positive and negative rates were low to moderate., Conclusions: These findings support that using either the mostly Black versus other categories or the mostly White versus other categories dichotomizations may provide accurate and reliable measures of racial composition across the 10 social environments. The PRCM can serve as a uniform measure across disciplines, capture multiple social environments over the life course, and be administered during one study visit. The PRCM also provides an added window into understanding how structural racism has impacted minoritized communities and may inform equitable intervention and prevention efforts to improve lives., (©Jemar R Bather, Kimberly A Kaphingst, Melody S Goodman. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 08.08.2024.)

Objectives: Providing personal demographic information is routine practice in the United States, and yet, little is known about the impacts of this process. This study aims to examine the experiences and perspectives of Multiracial/ethnic adults in the United States when disclosing racial/ethnic identity., Methods: Seventeen semistructured interviews were conducted with adults identifying as Multiracial/ethnic. The Multiracial/ethnic identities of participants included Black or African American and White; Black or African American, American Indian or Alaska Native (AI/AN) and Hispanic or Latino; Black or African American and Hispanic or Latino; Black or African American and AI/AN; AI/AN and White and Asian, Native Hawaiian or Pacific Islander and White. Multiple participants reported identifying with multiple ethnic groups for any single broad category. Three identified as sexual minorities. Nine were Millennials; six were Gen X; one was Gen Z; one was Baby Boomer. Qualitative data were analyzed using staged hybrid inductive-deductive thematic analysis., Results: Disclosure of racial and ethnic identities presents a unique stressor for Multiracial/ethnic populations due to methods used to obtain data, perceived mismatch of identity and phenotype and exposure to prejudice. Social norms, constructs and movements impact the categories that a Multiracial/ethnic person indicates to external parties., Conclusions: The stress and negative feelings that Multiracial/ethnic adults face when identifying their race/ethnicity underscore the broader implications of standard demographic questions on feelings of inclusivity and visibility within a population., Patient or Public Contribution: Gathering data on individuals' racial and ethnic backgrounds is a standard practice, and yet, it can pose challenges for those who identify with multiple groups or do not see their identities reflected in the options provided. Such individuals may feel excluded or experience unfair treatment when disclosing their identity, leading to significant stress. As the frequency of this data collection increases, it is essential that the questions are posed empathetically and equitably, with a strong commitment to enhancing inclusivity throughout the process., (© 2024 The Authors. Health Expectations published by John Wiley & Sons Ltd.)

Objective: Disparities in physical activity (PA) and PA antecedents, such as exercise self-efficacy, based on the intersection of gender and race/ethnicity among college students are poorly understood. This study aimed to examine differences in PA and exercise self-efficacy based on the intersection of gender and race/ethnicity., Methods: An online survey collected data on demographics (age, gender, race/ethnicity), PA, and exercise self-efficacy from students ( n  = 5341) enrolled in general health and wellness at a large Northeastern U.S. University. Differences in PA and exercise self-efficacy based on gender and race/ethnicity were examined using two-way ANOVAs., Results: Analyses revealed significant differences in overall PA and exercise self-efficacy based on gender and race/ethnicity. A significant interaction between gender and race/ethnicity was found in relation to PA, but not exercise self-efficacy., Conclusion: Findings demonstrate the need for universities to tailor PA promotion efforts, and to consider how gender and race/ethnicity may intersect to influence PA participation.

Introduction: While suicides in the United States decreased during the COVID-19 pandemic, statistically significant decreases have been limited to White people throughout a large portion of 2020., Methods: This paper outlines possible explanations for racial/ethnic differences in suicidality in the early pandemic phases., Results: We propose both distal (i.e., tele-mental health usage, internet and technology access, employment protections, and economic security) and proximal (cultural beliefs, coping strategies, clustering, pulling together, and embracing life) factors that may have helped build and foster community and mental wellness. However, this paper argues these factors did not extend, or did not extend as much, to many communities of color., Conclusions: We argue that these disparities are due to the myriad effects of discrimination and systemic racism, encapsulated broadly by the minority stress theory, and provide suggestions for relief and research., (© 2024 American Association of Suicidology.)

Background: Patient and provider race and gender concordance (patient and physician identify as the same race/ethnicity or gender) may impact patient experience and satisfaction., Objective: We sought to examine how patient and physician racial and gender concordance effect patient satisfaction with outpatient clinical encounters. Furthermore, we examined factors that changed satisfaction among concordant and discordant dyads., Design: Consumer Assessment of Healthcare Provider and Systems (CAHPS) Patient Satisfaction Survey Scores were collected from outpatient clinical encounters between January 2017 and January 2019 at the University of California, San Francisco., Participants: Patients who were seen in the eligible time period, who voluntarily provided physician satisfaction scores. Providers with fewer than 30 reviews and encounters with missing data were excluded., Main Measures: Primary outcome was rate of top satisfaction score. The provider score (1-10 scale) was dichotomized as "top score (9-10)" and "low scores (<9).", Key Results: A total of 77,543 evaluations met inclusion criteria. Most patients identified as White (73.5%) and female (55.4%) with a median age of 60 (IQR 45, 70). Compared to White patients, Asian patients were less likely to give a top score even when controlling for racial concordance (OR: 0.67; CI 0.63-0.714). Telehealth was associated with increased odds of a top score relative to in-person visits (OR 1.25; CI 1.07-1.48). The odds of a top score decreased by 11% in racially discordant dyads., Conclusions: Racial concordance, particularly among older, White, male patients, is a nonmodifiable predictor of patient satisfaction. Physicians of color are at a disadvantage, as they receive lower patient satisfaction scores, even in race concordant pairs, with Asian physicians seeing Asian patients receiving the lowest scores. Patient satisfaction data is likely an inappropriate means of determining physician incentives as such may perpetuate racial and gender disadvantages., (© 2023. W. Montague Cobb-NMA Health Institute.)

Integrating diverse perspectives in psychological science can enhance innovation in research and allow research teams to better study diverse populations of individuals through an authentic lens. Despite recent efforts to better address issues of race and ethnicity in research samples, the field of psychology broadly-and the area of mathematics cognition specifically-has largely failed to support scientists from diverse racial and ethnic backgrounds. In this essay, we consider the unique contributions that scholars of color can make to psychological research in mathematics cognition. Next, we reveal common challenges faced by scholars of color and challenges to recruiting and maintaining scholars of color in our community with a focus on Black scholars. Finally, we propose actions for diversifying the "pipeline" of promising scholars., (Copyright © 2024 Elsevier Inc. All rights reserved.)

We used a reverse-correlation image-classification paradigm to visualize facial representations of immigrants and citizens in the United States. Visualizations of immigrants' faces were judged by independent raters as less trustworthy and less competent and were more likely to be categorized as a non-White race/ethnicity than were visualizations of citizens' faces. Additionally, image generators' personal characteristics (e.g., implicit and explicit evaluations of immigrants, nativity status) did not reliably track with independent judges' ratings of image generators' representations of immigrants. These findings suggest that anti-immigrant sentiment and racial/ethnic assumptions characterize facial representations of immigrants in the United States, even among people who harbor positivity toward immigrants., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Hutchings et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Impressions of trustworthiness are formed quickly from faces. To what extent are these impressions shared among observers of the same or different races? Although high consensus of trustworthiness evaluation has been consistently reported, recent studies suggested substantial individual differences. For instance, negative implicit racial bias and low contact experience towards individuals of the other race have been shown to be related to low trustworthiness judgments for other-race faces. This pre-registered study further examined the effects of implicit social bias and experience on trustworthiness judgments of other-race faces. A relatively large sample of White (N = 338) and Black (N = 299) participants completed three tasks: a trustworthiness rating task of faces, a race implicit association test, and a questionnaire of experience. Each participant rated trustworthiness of 100 White faces and 100 Black faces. We found that the overall trustworthiness ratings for other-race faces were influenced by both implicit bias and experience with individuals of the other-race. Nonetheless, when comparing to the own-race baseline ratings, high correlations were observed for the relative differences in trustworthiness ratings of other-race faces for participants with varied levels of implicit bias and experience. These results suggest differential impact of social concepts (e.g., implicit bias, experience) vs. instinct (e.g., decision of approach-vs-avoid) on trustworthiness impressions, as revealed by overall vs. relative ratings on other-race faces., (© 2024. The Author(s).)

Background: Research is needed to understand the impact of social determinants of health on health literacy throughout the life course. This study examined how racial composition of multiple past and current social environments was related to adults' health literacy., Methods: In this study, 546 adult patients at a primary care clinic in St. Louis, Missouri, completed a self-administered written questionnaire that assessed demographic characteristics and a verbally administered component that assessed health literacy with the Rapid Estimate of Adult Literacy in Medicine - Revised (REALM-R) and Newest Vital Sign (NVS), and self-reported racial composition of six past and four current social environments. Multilevel logistic regression models were built to examine the relationships between racial composition of past and current social environments and health literacy., Results: Most participants identified as Black or multiracial (61%), had a high school diploma or less (54%), and household income <$20,000 (72%). About 56% had adequate health literacy based on REALM-R and 38% based on NVS. In regression models, participants with multiple past white environments (e.g., locations/conditions in which most of the people who live, go to school, work, and have leisure time are White) and (vs. 0 or 1) were more likely to have adequate health literacy based on REALM-R (adjusted odds ratio [aOR] = 1.79; 95% confidence interval [CI]: 1.04-3.07). Similarly, participants who had multiple past white social environments were more likely (aO R = 1.94, 95% CI: 1.15-3.27) to have adequate health literacy based on NVS than those who had not. The racial composition of current social environments was not significantly associated with health literacy in either model., Conclusions: Racial composition of past, but not current, educational and residential social environments was significantly associated with adult health literacy. The results highlight the importance of examining the impact of social determinants over the life course on health literacy. The findings suggest that policies ensuring equitable access to educational resources in school and community contexts is critical to improving equitable health literacy. [ HLRP: Health Literacy Research and Practice . 2024;8(3):e130-e139. ].

Background: Ethnically and racially diverse (ERD) nursing students experience unique challenges in the educational environment. Existing research on perspectives of ERD nurse faculty, with emphasis on their perceptions of the factors that support the academic success of ERD nursing students is limited., Purpose: The purpose of this study was to explore factors that contribute to the success of ERD nursing students as perceived by ERD nurse faculty., Methods: This qualitative study was conducted utilizing a focused ethnography design and methodology, with the theoretical underpinning of Critical Race Theory., Results: Twelve themes emerged relating to support, resources, relationships, faculty hiring practices, program structure, instructional content, flexibility, and culture of the educational environment., Conclusions: The perspectives of ERD nurse faculty provide an essential body of information that program administrators, faculty, and staff can utilize to positively impact the academic success of ERD nursing students., Competing Interests: The author declares no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Understanding similarities and differences between groups with intersecting social identities provides key information in research and practice to promote well-being. Building on the intersectionality literature indicating significant gender and racial/ethnic differences in depressive symptoms, the present study used quantile regression to systematically present the diversity in the development of depressive symptoms for individuals with intersecting gender, race/ethnicity, and levels of symptoms., Methods: Information from the National Longitudinal Survey of Youth 79: Child and Young Adult study was employed. A detailed picture of depressive symptom trajectories from low to high quantiles was illustrated by depicting 13 quantile-specific trajectories using follow-up data from ages 15 to 40 in six gender-race/ethnicity groups: both genders of Black, Hispanic, and non-Black, non-Hispanic individuals., Results: From low to high quantiles, Black and non-Black, non-Hispanic individuals showed mostly curved, and Hispanic individuals showed mostly flat trajectories. Across the six gender-race/ethnicity groups, the trajectories below 0.50 quantiles were similar in levels and shapes from mid-adolescence to young adulthood. The differences between the six gender-race/ethnicity groups widened, indicated by outspreading trajectories, especially at quantiles above 0.50. Furthermore, non-Black, non-Hispanic males and females showed especially fast-increasing patterns at quantiles above 0.75. Among those without or with only a high school degree, Black females and non-Black, non-Hispanic females tended to report similar levels of depressive symptoms higher than other groups at high quantiles. These unique longitudinal trajectory profiles cannot be captured by the mean trajectories., Conclusions: The intersectionality of gender, race/ethnicity, and quantile of symptoms on the development of depressive symptoms was identified. Further studying the mechanism explaining this diversity can help reduce mental health disparities., (© 2023. W. Montague Cobb-NMA Health Institute.)

The COVID-19 pandemic has led to economic turndowns, social restrictions, and family life alterations. The stress induced by the public health crisis and its consequences are beginning to be explored. This study examined stress experiences since the pandemic'sonset in work, financial, social, and health domainsamong a large sample of post-9/11, United States military veterans. The sample, who separated from active-duty service or deactivated from active status in a reserve component in 2016, completed an online survey (n = 3180) in 2020. Participants were 70% White non-Hispanic, 81% male, and had an average age of 38 years. Frequencies and descriptive statistics were calculated. Female veterans and veterans of colour reported significantly higher levels of stress across most life domains. The results suggest White, male, post-9/11 veterans may be somewhat protected from COVID-19 stress, but that the pandemic is exacerbatinghealth and social disparities experienced by post-9/11 veterans of colour and female veterans. Supports and comprehensive care, particularly targeted towardsat-risk populations, are likely needed to provide sufficient resources for resiliency during and after the pandemic., (© 2023 The Authors. Stress and Health published by John Wiley & Sons Ltd.)