The chronic load carried by minority status, including anti-Muslim prejudice.
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376 to 400 of 599Zeng XZ, Meng LB, Jia N, Shi J, Zhang C, Li YY, Hu X, Hu JB, Li JY, Wu DS, Li H, Qi X, Wang H, Zhang QX, Li J, Liu DP (2023)MEDLINE-indexed journal, not yet read by usFrontiers in public health1 citations Prevalence of frailty and pre-frailty and related factors in older adults with cardio-cerebral vascular disease in China: a national cross-sectional study.
Objective: Frailty increases adverse clinical outcomes in older patients with cardio-cerebral vascular disease (CCVD). The aim of this study was to investigate the prevalence of frailty and pre-frailty in older adults with CCVD in China and the factors associated with it.
Research design and methods: In this cross-sectional study, we used data from the fourth Sample Survey of Aged Population in Urban and Rural China. We used the frailty index for frailty and pre-frailty assessment, and the diagnosis of CCVD in older adults was self-reported.
Results: A total of 53,668 older patients with CCVD were enrolled in the study. The age-standardized prevalence of frailty and pre-frailty in older patients with CCVD was 22.6% (95% CI 22.3-23.0%) and 60.1% (95% CI 59.7-60.5%). Multinomial logistic regression analyses showed that being female, increasing age, rural residence, illiteracy, widowhood, e…
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Religiosity and Mental Wellbeing Among Members of Majority and Minority Religions: Findings From Understanding Society: the UK Household Longitudinal Study.
It is unclear whether links between religiosity and mental health are found in contexts outside the United States or are causal. We examined differences in mental wellbeing and associations between mental wellbeing and religiosity among the religiously unaffiliated, White and non-White Christians, Muslims of Pakistani, Bangladeshi, and other ethnicities, and other minority ethnoreligious groups. We used 4 waves of Understanding Society: the UK Household Longitudinal Study (2009-2013; n = 50,922). We adjusted for potential confounders (including socioeconomic factors and personality) and for household fixed effects to account for household-level unobserved confounding factors. Compared with those with no religious affiliation, Pakistani and Bangladeshi Muslims and members of other minority religions had worse wellbeing (as measured using the Shortened Warwick-Edinburgh Mental Wellbeing Sc…
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Using Implementation Science to Promote Integration and Sustainability of Community Health Workers in the HIV Workforce.
Background: Community health worker (CHW) interventions are an evidence-based practice adopted by health care settings to increase retention in care and viral suppression for people living with HIV (PLWH) from racial/ethnic minority communities. However, disparate funding, unclear roles vis a vis other care team members, limited training and promotion opportunities, and a lack of standards for wages and tasks limit the ability to effectively use CHWs as part of the health care team. Guided by the Exploration, Preparation, Implementation, and Sustainment and Reach, Effectiveness, Adoption, Implementation, and Maintenance frameworks, this study describes the key determinants for CHW integration and sustainability at 3 agencies in Shelby County, TN, to improve viral suppression and reduce disparities among rural and urban people living with HIV.
Setting: Memphis Transitional Grant Area (TGA…
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Visualizing community networks to recruit South Asian participants for interviews about bowel cancer screening.
Background: South Asians make up the largest ethnic minority group in England and Wales. Yet this group is underrepresented in some programmes to promote health, such as cancer screening. A challenge to addressing such health disparities is the difficulty of recruiting South Asian communities to health research. Effective recruitment requires the development of participants' knowledge about research and their trust. Researchers also need to increase their cultural understanding and to think about how they will communicate information despite language barriers. This article describes the use of an organogram, informed by social network analysis, to identify the community contacts likely to encourage participation of South Asian adults (aged 50-75 years) in interviews to identify the facilitators of home bowel cancer screening.
Methods: We developed an organogram which represented the dire…
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Ethnoracial status, intersectionality with gender, and psychotherapy utilization, retention, and outcomes.
Objective: Psychotherapy access, utilization, retention, and effectiveness require continued improvement, especially for groups for whom availability and outcomes may be currently suboptimal, including ethnoracial minorities. Further, ethnoracial status' intersectionality with other identity variables (e.g., gender) may relate to structural barriers to care and effectiveness of care, an area in need of further research.
Method: The Florida State University Psychology Clinic, a low-cost population-facing treatment center, has routinely collected clinically relevant information on all consenting clients, including severity of clinical presentation at intake and over time, number of therapy sessions attended and of no-shows, premature termination, demographics, etc. A large sample of clients (N = 2,076; 57% women; 67.9% non-Hispanic White) on whom we collected and entered at least some data…
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Association of Social Determinants of Health and Vaccinations With Child Mental Health During the COVID-19 Pandemic in the US.
Importance: The COVID-19 pandemic disproportionately affected mental health in socioeconomically disadvantaged children in the US. However, little is known about the relationship of preexisting and time-varying social determinants of health (SDoH) at individual and structural levels, vaccination eligibility/rates, and the racial and ethnic differences to trajectories of child mental health during the COVID-19 pandemic.
Objective: To estimate the association of trajectories of child mental health to multilevel SDoH and vaccination eligibility/rates.
Design, setting, and participants: This prospective longitudinal cohort study, conducted from May 16, 2020, to March 2, 2021, integrated structural-level, pandemic-related data with the Adolescent Brain Cognitive Development (ABCD) cohort data (release 4.0). The ABCD study recruited 11 878 children (baseline) and conducted 6 COVID-19 rapid res…
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The impact of communal learning contexts on adolescent self-concept and achievement: Similarities and differences across race and gender.
Misalignment between students' communal values and those expressed in classrooms is an obstacle to academic engagement, especially in mathematics, and especially for racial ethnic minority and female students. Using 10 schools across the United States, we conducted a longitudinal field study in 8th grade mathematics classes to investigate: (a) how perceptions of communally oriented classrooms influence student outcomes in early adolescence, (b) what psychological processes mediate these relations, and (c) whether the influence of perceived communal practices in classrooms have similar or different effects on students with varying social identities based on race, ethnicity, and gender. Results showed that middle school classes that emphasize communality (both social relevance of math and peer collaboration) significantly predicted stronger math self-concept, more behavioral engagement, an…
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The impact of military sexual trauma and warfare exposure on women veterans' perinatal outcomes.
Objective: In the general population, history of trauma is associated with a range of adverse perinatal outcomes, which have long-term negative consequences for both mother and child. Research examining the impact of trauma, particularly trauma occurring during military service, on perinatal outcomes among women veterans is still in its nascence. The current study examined if warfare exposure and military sexual trauma (MST) contributed unique variance to the prediction of a broad range of adverse perinatal outcomes (i.e., preterm birth, full-term birth, infant birth weight, postpartum depression and/or anxiety).
Method: Women veterans living across the U.S. (oversampled for veterans living in high crime communities) completed a mail-based survey, and reported information about all pregnancies that occurred since enlistment in the military. They also reported on warfare exposure and MST …
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A qualitative study of minority ethnic women's experiences of access to and engagement with perinatal mental health care.
Background: Approximately one in five women will experience mental health difficulties in the perinatal period. However, for a large group of women, symptoms of adverse perinatal mental health remain undetected and untreated. This is even more so for women of ethnic minority background, who face a variety of barriers which prevents them from accessing appropriate perinatal mental health care.
Aims: To explore minority ethnic women's experiences of access to and engagement with perinatal mental health care.
Methods: Semi-structured interviews were conducted with 18 women who had been diagnosed with perinatal mental health difficulties and who were supported in the community by a specialist perinatal mental health service in South London, United Kingdom. Women who self-identified as being from a minority ethnic group were purposefully selected. Data were transcribed verbatim, uploaded into…
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Improving Recruitment for Mental Health Research in Muslim American Women : Research Recruitment in Muslim American Women.
This study determines the methods for improving recruitment of Muslim American women in mental health research. Studying this minority population in more depth will reduce their suffering from mental illness. A 40-item survey, along with cover letter, was hosted on the Stanford University website and sent via email to organizations known to have large Muslim American women populations. Although approximately 200-300 responses were hoped for, an unexpected total of 1279 women completed the survey within days. The effectiveness of this survey was attributed to multiple factors: ease of an online survey, privacy afforded through an anonymous survey, trust in the PI, the survey being hosted by a reputable university and understanding the importance of mental health research. It is important to continue improving methods to recruit the minority Muslim American women population for studies.
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The roles of resilience, peer relationship, teacher-student relationship on student mental health difficulties during COVID-19.
The present cross-sectional study aimed to (a) expand our understanding of the role of risk and resilience factors for adolescent adjustment during coronavirus disease (COVID-19) and (b) examine personal resilience, peer and teacher-student relationships as protective factors against mental health difficulties. A total of 3,662 students from 4th to 11th grades in Urumchi, China completed a survey in June 2020. Urumchi is an ethnically diverse city, with nearly 40% of the population in this school district being ethnic minority students. The schools of Urumchi closed in February 2020 and reopened in April 2020. The results of latent moderated structural equation modeling suggested that peer victimization was associated with greater mental health difficulties in students. Personal resilience and teacher-student relationships were promotive factors for better mental health and also served a…
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College Students' Sense of Belonging and Mental Health Amidst the COVID-19 Pandemic.
Purpose: Social isolation, anxiety, and depression have significantly increased during the COVID-19 pandemic among college students. We examine a key protective factor-students' sense of belonging with their college-to understand (1) how belongingness varies overall and for key sociodemographic groups (first-generation, underrepresented racial/ethnic minority students, first-year students) amidst COVID-19 and (2) if feelings of belonging buffer students from adverse mental health in college.
Methods: Longitudinal models and regression analysis was assessed using data from a longitudinal study of college students (N = 1,004) spanning (T1; Fall 2019) and amidst COVID-19 (T2; Spring 2020).
Results: Despite reporting high levels of belonging pre- and post-COVID, consistent with past research, underrepresented racial/ethnic minority/first-generation students reported relatively lower sense of…
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Perceived religious discrimination and mental health.
Objectives: Most knowledge on the health consequences of discrimination comes from studies on racial/ethnic minorities, and research on religious discrimination is rare. To address this gap in knowledge, we examine the relationship between religious discrimination and self-rated mental health (SRMH), focusing on the role of religious affiliation as well as religious participation and the importance of religion/spirituality.
Methods: The empirical analysis uses cross-sectional data from Statistics Canada's 2013 General Social Survey (GSS-27) and the target population includes Canadians aged 15 and older (N = 27,104) from all 10 provinces. The outcome variable is SRMH. Using OLS regressions, we compare the consequences of religious discrimination across five major religious groups (Christian, Buddhist, Hindu, Jewish, and Muslim), controlling for racial status and other confounding variable…
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More Than Inconvenienced: The Unique Needs of U.S. College Students During the COVID-19 Pandemic.
U.S. college students are a distinct population facing major challenges due to the COVID-19 pandemic. Before the pandemic, students were already experiencing substantial mental health concerns, putting both their health and academic success in jeopardy. College students now face increasing housing and food insecurity, financial hardships, a lack of social connectedness and sense of belonging, uncertainty about the future, and access issues that impede their academic performance and well-being. There is also reason to believe that COVID-19 is exacerbating inequalities for students of color and low-income students. We provide several recommendations for institutions of higher education to mitigate these obstacles, including engaging in data-driven decision making, delivering clear and informative messaging to students, prioritizing and expanding student support services, and using an equit…
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Disparities in adverse childhood experiences by race/ethnicity, gender, and economic status: Intersectional analysis of a nationally representative sample.
Background: Adverse childhood experiences (ACEs) are disturbingly common and consequential. Priority should be given to identifying populations that bear a disproportionate share of the burden of ACEs, but such disparities have received limited attention to date.
Objective: This study analyzes data from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample in the U.S., to explore variation in ACEs by race/ethnicity, economic status, and gender.
Methods: In addition to using conventional statistical methods to generate unadjusted and adjusted estimates, we conduct an intercategorical intersectional analysis of variation in ACEs using multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA).
Results: Descriptively, we find that ACEs are more prevalent overall among the poor than the non-poor, among most racial/ethnic m…
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How Diversity Approaches Affect Ethnic Minority and Majority Adolescents: Teacher-Student Relationship Trajectories and School Outcomes.
This study aimed to relate school diversity approaches to continuity and change in teacher-student relationships, comparing Belgian-majority (N = 1,875, Mage = 14.56) and Turkish and Moroccan-minority adolescents (N = 1,445, Mage = 15.07). Latent-Growth-Mixture-Models of student-reported teacher support and rejection over 3 years revealed three trajectories per group: normative-positive (high support, low rejection) and decreasing-negative (moderate support, high-decreasing rejection) for both groups, increasing-negative (moderate support, low-increasing rejection) for minority, moderate-positive (moderate support, low rejection) for majority youth. Trajectories differed between age groups. Student and teacher perceptions of equality and multiculturalism afforded, and assimilationism threatened, normative-positive trajectories for minority youth. Diversity approaches had less impact on…
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Majority group belonging without minority group distancing? Minority experiences of intergroup contact and inequality.
As most immigrant-origin minority youth grow up in ethnically diverse social worlds, they develop a sense of belonging to both the national majority and the ethnic minority group. Our study adds to a growing body of research on minority experiences of intergroup contact by (1) including both minority and majority group belonging as outcomes and (2) examining the interplay of majority contact with unequal treatment. We surveyed 1,200 Turkish and Moroccan-Belgian minority youth in 315 classrooms across 65 schools, using multiple measures of intergroup contact, unequal treatment in school, and minority and majority group belonging. Multi-level models showed that minority youth who experienced more intergroup contact, and less unequal treatment, reported more belonging to the majority group. In addition, contact predicted less belonging to the minority group only in the presence of unequal t…
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"As an ethnic minority, you just have to work twice as hard." Experiences and motivation of ethnic minority students in medical education.
Introduction: Adequate representation of ethnic minority groups in the medical workforce is crucial for ensuring equitable healthcare to diverse patient groups. This requires recruiting ethnic minority medical students and taking measures that enable them to complete their medical studies successfully. Grounded in self-determination theory and intersectionality, this paper explores the experiences of ethnic minority medical students across intersections with gender and other categories of difference and how these relate to students' motivation.
Methods: An explorative, qualitative study was designed. Six focus groups were conducted with 26 ethnic minority students between December 2016 and May 2017. Thematic analysis was performed to identify, analyse and report themes within the data.
Results: The findings were categorized into three main themes: the role of autonomy in the formation of…
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Rejecting homosexuality but tolerating homosexuals: The complex relations between religiosity and opposition to homosexuality in 9 Arab countries.
Public debates portray Arab Muslims as universally opposed to homosexuality due to Islam. Those Orientalist claims are mirrored by large-scale studies that argue Muslims oppose homosexuality more than non-Muslims. We argue that assuming religion and opposition to homosexuality are unidimensional concepts obscures how they relate to each other and why; we study both "religiosity" and "opposition to homosexuality" multidimensionally. WVS data on 9000 Arab Muslims show, first, that although most respondents reject both homosexuality and homosexuals, one in five reject homosexuality but do not object to having homosexual neighbors. A substantial minority of Arab Muslims thus "hate the sin but love the sinner". Multilevel analyses show that stronger religious attachment increases opposition to homosexuality and homosexual people. However, all other dimensions of religiosity we study (textuali…
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Explaining the Immigrant Paradox: The Influence of Acculturation, Enculturation, and Acculturative Stress on Problematic Alcohol Consumption.
The present study explored the Immigrant Paradox (IP), generational differences in problematic alcohol use (alcohol consumption and alcohol-related consequences), among immigrants and US born groups from a number of ethnic minority backgrounds. Our approach separates group differences in problematic alcohol consumption in a counterfactual manner for immigrants and the US born to answer the following counterfactual question: "What would problematic alcohol use levels be for the US born had they been exposed to the alcohol use generation (or protective) processes of immigrants and vice versa?" Multidimensional measures of enculturation (involvement with heritage culture), acculturation (involvement with US culture), acculturative stress, and demographic covariates were used to statistically explain these differences. The sample consisted of Asian American (n = 1,153), Black American (n = 8…
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Perinatal Anxiety and Depression in Minority Women.
Depression and anxiety are common during pregnancy and are experienced at higher rates among women who are racial and ethnic minorities. Because depression and anxiety influence maternal and infant outcomes, intervening to improve perinatal mental health should be a priority for all healthcare providers. However, in the United States, a number of barriers including lack of mental health providers, lack of perinatal behavioral health systems, and stigma, limit access to care. Universal screening has been recommended and here we examine how universal screening can help nurses improve the mental health of childbearing women. Interventions that are currently in use to improve perinatal anxiety and depression are reviewed and include: psychopharmacology, cognitive behavioral therapy, interpersonal psychotherapy, and mindfulness. Recommendations for future research and healthcare system change…
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Exploring Grit Among Black Prelicensure Nursing Students.
Unequal representation of black nurses in the workforce continues to plague the nursing profession. Preconceptions and understandings of the discipline are underpinned by the dominant white racial makeup, which may challenge ethnically diverse nursing students' perceptions of their ability for success. The need for a diverse nursing workforce includes the challenge of enticing minority students into and successfully through prelicensure programs. This study of attributes of grit in the lived experiences of black nursing students revealed evidence including consistent efforts and perseverance to reach goals in the participants' stories.
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Moving towards culturally competent health systems for migrants? Applying systems thinking in a qualitative study in Malaysia and Thailand.
Background: Cultural competency describes interventions that aim to improve accessibility and effectiveness of health services for people from ethnic minority backgrounds. Interventions include interpreter services, migrant peer educators and health worker training to provide culturally competent care. Very few studies have focussed on cultural competency for migrant service use in Low- and Middle-Income Countries (LMIC). Migrants and refugees in Thailand and Malaysia report difficulties in accessing health systems and discrimination by service providers. In this paper we describe stakeholder perceptions of migrants' and health workers' language and cultural competency, and how this affects migrant workers' health, especially in Malaysia where an interpreter system has not yet been formalised.
Method: We conducted in-depth interviews with stakeholders in Malaysia (N = 44) and Thailand (N…
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Haggins AN (2020)MEDLINE-indexed journal, not yet read by usAcademic medicine : journal of the Association of American Medical Colleges40 citations To Be Seen, Heard, and Valued: Strategies to Promote a Sense of Belonging for Women and Underrepresented in Medicine Physicians.
Lingering unconscious biases and daily cues continue to permeate and persist in academic medicine environments in the form of the exclusion of physicians who are women or racially/ethnically underrepresented in medicine. Academic medicine environments must change so that women and underrepresented in medicine racial/ethnic groups are seen, heard, and valued. A shared awareness among faculty, administrators, and trainees can inform the development of intentional strategies to alter individual behaviors, academic spaces, and institutional processes to cultivate a sense of belonging. Shifting the norms in medicine and the course of historical exclusion will require professional development in areas of inclusive teaching practices, skills to cultivate mentoring relationships with diverse trainees, and fostering discussions about the relevance of personal identity, as well as attention to the…
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Mental health in the UK during the COVID-19 pandemic: cross-sectional analyses from a community cohort study.
Objectives: Previous pandemics have resulted in significant consequences for mental health. Here, we report the mental health sequelae of the COVID-19 pandemic in a UK cohort and examine modifiable and non-modifiable explanatory factors associated with mental health outcomes. We focus on the first wave of data collection, which examined short-term consequences for mental health, as reported during the first 4-6 weeks of social distancing measures being introduced.
Design: Cross-sectional online survey.
Setting: Community cohort study.
Participants: N=3097 adults aged ≥18 years were recruited through a mainstream and social media campaign between 3 April 2020 and 30 April 2020. The cohort was predominantly female (n=2618); mean age 44 years; 10% (n=296) from minority ethnic groups; 50% (n=1559) described themselves as key workers and 20% (n=649) identified as having clinical risk factors …
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