scholarly journals Understanding and Promoting Racial Diversity in Healthcare Settings to Address Disparities in Pandemic Crisis Management

2021 ◽  
Vol 12 ◽  
pp. 215013272110183
Author(s):  
Azza Sarfraz ◽  
Zouina Sarfraz ◽  
Alanna Barrios ◽  
Kuchalambal Agadi ◽  
Sindhu Thevuthasan ◽  
...  
Keyword(s):  
United States ◽  
Health Disparities ◽  
Racial Discrimination ◽  
Clinical Training ◽  
Minority Groups ◽  
Mental Health Problems ◽  
Minority Group ◽  
Healthcare Delivery ◽  
The United States ◽  
Majority Group

Background: Health disparities have become apparent since the beginning of the COVID-19 pandemic. When observing racial discrimination in healthcare, self-reported incidences, and perceptions among minority groups in the United States suggest that, the most socioeconomically underrepresented groups will suffer disproportionately in COVID-19 due to synergistic mechanisms. This study reports racially-stratified data regarding the experiences and impacts of different groups availing the healthcare system to identify disparities in outcomes of minority and majority groups in the United States. Methods: Studies were identified utilizing PubMed, Embase, CINAHL Plus, and PsycINFO search engines without date and language restrictions. The following keywords were used: Healthcare, raci*, ethnic*, discriminant, hosti*, harass*, insur*, education, income, psychiat*, COVID-19, incidence, mortality, mechanical ventilation. Statistical analysis was conducted in Review Manager (RevMan V.5.4). Unadjusted Odds Ratios, P-values, and 95% confidence intervals were presented. Results: Discrimination in the United States is evident among racial groups regarding medical care portraying mental risk behaviors as having serious outcomes in the health of minority groups. The perceived health inequity had a low association to the majority group as compared to the minority group (OR = 0.41; 95% CI = 0.22 to 0.78; P = .007), and the association of mental health problems to the Caucasian-American majority group was low (OR = 0.51; 95% CI = 0.45 to 0.58; P < .001). Conclusion: As the pandemic continues into its next stage, efforts should be taken to address the gaps in clinical training and education, and medical practice to avoid the recurring patterns of racial health disparities that become especially prominent in community health emergencies. A standardized tool to assess racial discrimination and inequity will potentially improve pandemic healthcare delivery.

Perceived Discrimination, Experiential Avoidance, and Mental Health among Hispanic Adults in Primary Care

2022 ◽  
pp. 136346152110381
Author(s):  
Michael J. Zvolensky ◽  
Andrew H. Rogers ◽  
Nubia A. Mayorga ◽  
Justin M. Shepherd ◽  
Jafar Bakhshaie ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Primary Care ◽  
Racial Discrimination ◽  
Experiential Avoidance ◽  
Minority Group ◽  
The United States ◽  
Hispanic Population ◽  
Hispanic Adults ◽  
Perceived Racial Discrimination

The Hispanic population is the largest minority group in the United States and frequently experiences racial discrimination and mental health difficulties. Prior work suggests that perceived racial discrimination is a significant risk factor for poorer mental health among Hispanic in the United States. However, little work has investigated how perceived racial discrimination relates to anxiety and depression among Hispanic adults. Thus, the current study evaluated the explanatory role of experiential avoidance in the relation between perceived racial discrimination and anxiety/depressive symptoms and disorders among Hispanic adults in primary care. Participants included 202 Spanish-speaking adults ( Mage = 38.99, SD = 12.43, 86.1% female) attending a community-based Federally Qualified Health Center. Results were consistent with the hypothesis that perceived racial discrimination had a significant indirect effect on depression, social anxiety, and anxious arousal symptoms as well as the number of mood and anxiety disorders through experiential avoidance. These findings suggest future work should continue to explore experiential avoidance in the association between perceived racial discrimination and other psychiatric and medical problems among the Hispanic population.

School Busing in Britain: Policies and Perceptions

1979 ◽  
Vol 49 (2) ◽  
pp. 185-206 ◽  
Author(s):  
Lewis Killian
Keyword(s):  
United States ◽  
Minority Groups ◽  
Minority Group ◽  
The United States ◽  
Department Of Education ◽  
Neighborhood Schools ◽  
Indian Children ◽  
Political Issue ◽  
School Busing ◽  
Group Members

In 1965 the British Department of Education and Science promulgated a policy encouraging local education authorities to disperse immigrant children, by busing if necessary, from schools in which they constituted more than one third of the enrollment. This legitimized the practice by a few authorities of busing Asian and West Indian children out of neighborhood schools where there was racial imbalance. Although busing never became widely practiced, it was challenged by minority group members as being discriminatory. In 1975 the Race Relations Board issued a ruling that busing did constitute racial discrimination unless it could be shown that the children needed special language training. The major opposition to busing came from minority groups and was expressed in much the same terms as white opposition to busing in the United States. Comparing the origins of school busing in Britain and the United States, Lewis Killian concludes that busing can best be understood as a political issue rather than in terms of educational effects.

Historical Overview of Health Disparities in the United States

2021 ◽  
pp. 18-30
Keyword(s):  
United States ◽  
Health Disparities ◽  
The United States ◽  
Cultural Bias ◽  
Demographic Groups ◽  
Majority Group ◽  
The Us ◽  
The World ◽  
The Status ◽  
History Of

Health disparities in the United States and around the world carry with them a history of cultural bias, fear of the unknown, racism, sexism, ageism, intolerance of religious beliefs, and a desire to retain the status quo. Some people perceive a majority group as superior to demographic groups that are believed to be inferior. However, as the US population becomes increasingly diverse, changes will come. Internationally, globalization and immigration merge the worlds of the poor and rich, as each social class struggles to find their socioeconomic and healthcare footprint in modern-day society. All US citizens will be affected by a failure to unite.

Holding Healthcare Systems Accountable

2021 ◽  
pp. 129-144
Keyword(s):  
United States ◽  
Health Disparities ◽  
Health Status ◽  
Federal Government ◽  
Vulnerable Populations ◽  
Healthcare Delivery ◽  
The United States ◽  
Healthcare Systems ◽  
Quality Improvements ◽  
Show Evidence

Statistically, there are data that support the persistent existence of health disparities in the United States. Should healthcare systems and facilities be held accountable by their state and the federal government to show evidence of improvements in recognizing and resolving disparities experienced by vulnerable populations receiving care within their organizations? The answer to this question is yes. If healthcare systems consistently produce data indicative of poor health outcomes for vulnerable populations, interventions should be identified to improve healthcare delivery and quality. Improvements in the health status of all Americans is contingent upon a united front by all Americans in ending health disparities.

scholarly journals COVID-19-Associated Mortality among Kidney Transplant Recipients and Candidates in the United States

2021 ◽  
pp. CJN.02690221
Author(s):  
Sumit Mohan ◽  
Kristen King ◽  
S. Ali Husain ◽  
Jesse Schold
Keyword(s):  
United States ◽  
Ethnic Minority ◽  
Kidney Transplant ◽  
Minority Groups ◽  
Minority Group ◽  
The United States ◽  
National Registry ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Racial Ethnic

Background and Objectives: The COVID-19 pandemic has had a profound impact on transplantation activity in the United States and globally. Several single center reports suggest higher morbidity and mortality among candidates waitlisted for a kidney transplant as well as recipients of a kidney transplant. We aim to describe 2020 mortality patterns during the COVID-19 pandemic in the United States among kidney transplant candidates and recipients. Design, Setting, Participants, and Measurements: Using national registry data for waitlisted candidates and kidney transplant recipients collected through April 23, 2021, we report demographic and clinical factors associated with COVID-19 related mortality in 2020, other deaths in 2020 and deaths in 2019 among waitlisted candidates and transplant recipients . We quantify excess all-cause deaths among candidate and recipient populations in 2020 as well as deaths directly attributed to COVID-19 in relation to pre-pandemic mortality patterns in 2019 and 2018. Results: Among waitlisted patient deaths in 2020, 11% of deaths were attributed to COVID-19, and these candidates were more likely to be male, obese, and belong to a racial/ethnic minority group. Nearly 1 in 6 deaths (16%) among active transplant recipients in the United States in 2020 was attributed to COVID-19. Recipients who died of COVID-19 were younger, more likely to be obese, had lower educational attainment, and were more likely to belong to racial/ethnic minority groups than those who died of other causes in 2020 or 2019. We found higher overall mortality in 2020 among waitlisted candidates (24%) than among kidney transplant recipients (20%) compared to 2019. Conclusions: Our analysis demonstrates higher rates of mortality associated with COVID-19 among waitlisted candidates and kidney transplant recipients in the United States in 2020.

Early Psychosis: Diagnosis and Treatment

2020 ◽  
Vol 09 ◽  
Author(s):  
Nataly S. Beck ◽  
Melanie L. Lean ◽  
Kate V. Hardy ◽  
Jacob S. Ballon
Keyword(s):  
United States ◽  
Early Identification ◽  
Mental Health Problems ◽  
The United States ◽  
Early Psychosis ◽  
Screening Tools ◽  
Diagnosis And Treatment ◽  
First Episode ◽  
Psychotic Episode ◽  
First Onset

Background: The typical age of onset for psychotic disorders is concurrent with the typical age of enrollment in higher education. College and graduate students often experience new academic and social demands that may leave them vulnerable to substance use and mental health problems, including the initial onset of a psychotic episode. Objective: To provide a current overview of the guidelines and literature for the diagnosis and treatment of first-onset psychosis with special consideration for the college and graduate student population in the United States. To highlight areas of need and provide recommendations for clinicians who work at educational institutions and their health services, along with general psychiatrists and psychologists who work with post-secondary education populations, to help close the treatment gap. Method: A review of interventions and best practice for the treatment of early psychosis in college students was conducted, informed by the authors’ current experience as clinicians with this population at a United States university. Results: Thorough psychiatric interviews and screening tools can help in the early identification of individuals at clinical high risk for and at first onset of psychosis. Coordinated specialty care services are the gold standard for early psychosis services, including psychotherapy (such as cognitive behavioral therapy and individual resiliency training), as well as support for a student to return to school or work. Individuals experiencing a first episode of psychosis in general respond better to lower doses of antipsychotics and may also experience more adverse effects. Conclusion: Return to a high level of functioning is possible in many cases of first onset of psychosis, and early identification and treatment is essential.

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