scholarly journals Syndemic Framework Evaluation of Severe COVID-19 Outcomes in the United States: Factors Associated With Race and Ethnicity

2021 ◽  
Vol 9 ◽  
Author(s):  
Christopher Williams ◽  
Sten H. Vermund
Keyword(s):  
United States ◽  
Race And Ethnicity ◽  
Clinical Care ◽  
Health Financing ◽  
The United States ◽  
Systemic Racism ◽  
Term Care ◽  
Societal Factors ◽  
Healthcare Barriers ◽  
The Impact

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

Racism: A Public Health Crisis

2020 ◽  
Vol 19 (3) ◽  
pp. 506-515
Author(s):  
Katie L. Acosta
Keyword(s):  
United States ◽  
General Population ◽  
The United States ◽  
Systemic Racism ◽  
Health Crisis ◽  
Infected People ◽  
The Face ◽  
The Impact ◽  
Racial Ethnic ◽  
Bear Witness

The impact of COVID–19 on racially minoritized communities in the United States has forced us all to look square in the face of the systemic racism that is embedded in every fabric of our society. As the number of infected people continues to rise, the racial disparities are glaringly obvious. Black and Latinx communities have been hit considerably harder by this pandemic. Both racial/ethnic groups have seen rates of infection well above their percentage in the general population and African Americans have seen rates of death from COVID–19 as high as twice their percentage in the general population. These numbers bear witness to the high cost of racism in the United States.

scholarly journals Systemic Considerations in Child Development and the Pursuit of Racial Equality in the United States

2021 ◽  
Author(s):  
Sylvia Perry ◽  
Allison Louise Skinner-Dorkenoo ◽  
James Wages ◽  
Jamie L Abaied
Keyword(s):  
United States ◽  
Child Development ◽  
Driving Force ◽  
The United States ◽  
Racial Equality ◽  
Systemic Racism ◽  
Racial Inequalities ◽  
Family Level ◽  
Psychological Inquiry ◽  
The Impact

In this commentary on Lewis’ (2021) article in Psychological Inquiry, we expand on ways that both systemic and interpersonal contexts contribute to and uphold racial inequalities, with a particular focus on research on child development and socialization. We also discuss the potential roadblocks that may undermine the effectiveness of Lewis’ (2021) recommended strategy of relying on experts as a driving force for change. We conclude by proposing additional strategies for pursuing racial equality that may increase the impact of experts, such as starting anti-racist socialization early in development, family-level interventions, and teaching people about racial injustices and their connections to systemic racism.

scholarly journals COVID-19 Misinformation Prophylaxis: Protocol for a Randomized Trial of a Brief Informational Intervention (Preprint)

2020 ◽  
Author(s):  
Jon Agley ◽  
Yunyu Xiao ◽  
Esi E Thompson ◽  
Lilian Golzarri-Arroyo
Keyword(s):  
United States ◽  
Randomized Trial ◽  
Race And Ethnicity ◽  
Face Mask ◽  
The United States ◽  
Placebo Control ◽  
Preventive Behaviors ◽  
Institutional Review ◽  
Superiority Trial ◽  
The Impact

BACKGROUND As the COVID-19 pandemic continues to affect life in the United States, the important role of nonpharmaceutical preventive behaviors (such as wearing a face mask) in reducing the risk of infection has become clear. During the pandemic, researchers have observed the rapid proliferation of misinformed or inconsistent narratives about COVID-19. There is growing evidence that such misinformed narratives are associated with various forms of undesirable behavior (eg, burning down cell towers). Furthermore, individuals’ adherence to recommended COVID-19 preventive guidelines has been inconsistent, and such mandates have engendered opposition and controversy. Recent research suggests the possibility that trust in science and scientists may be an important thread to weave throughout these seemingly disparate components of the modern public health landscape. Thus, this paper describes the protocol for a randomized trial of a brief, digital intervention designed to increase trust in science. OBJECTIVE The objective of this study is to examine whether exposure to a curated infographic can increase trust in science, reduce the believability of misinformed narratives, and increase the likelihood to engage in preventive behaviors. METHODS This is a randomized, placebo-controlled, superiority trial comprising 2 parallel groups. A sample of 1000 adults aged ≥18 years who are representative of the population of the United States by gender, race and ethnicity, and age will be randomly assigned (via a 1:1 allocation) to an intervention or a placebo-control arm. The intervention will be a digital infographic with content based on principles of trust in science, developed by a health communications expert. The intervention will then be both pretested and pilot-tested to determine its viability. Study outcomes will include trust in science, a COVID-19 narrative belief latent profile membership, and the likelihood to engage in preventive behaviors, which will be controlled by 8 theoretically selected covariates. RESULTS This study was funded in August 2020, approved by the Indiana University Institutional Review Board on September 15, 2020, and prospectively registered with ClinicalTrials.gov. CONCLUSIONS COVID-19 misinformation prophylaxis is crucial. This proposed experiment investigates the impact of a brief yet actionable intervention that can be easily disseminated to increase individuals’ trust in science, with the intention of affecting misinformation believability and, consequently, preventive behavioral intentions. CLINICALTRIAL ClinicalTrials.gov NCT04557241; https://clinicaltrials.gov/ct2/show/NCT04557241 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/24383

scholarly journals The Impact of Race and Ethnicity on Receipt of Family Planning Services in the United States

2009 ◽  
Vol 18 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Sonya Borrero ◽  
Eleanor B. Schwarz ◽  
Mitchell Creinin ◽  
Said Ibrahim
Keyword(s):  
United States ◽  
Family Planning ◽  
Race And Ethnicity ◽  
The United States ◽  
Family Planning Services ◽  
The Impact

scholarly journals Registered Nurse Migration to the United States and the Impact on Long-Term Care

2021 ◽  
Author(s):  
Roy A. Thompson ◽  
Kirsten N. Corazzini ◽  
Thomas Konrad ◽  
Michael Cary ◽  
Susan G. Silva ◽  
...  
Keyword(s):  
United States ◽  
Registered Nurse ◽  
Long Term Care ◽  
The United States ◽  
Nurse Migration ◽  
Term Care ◽  
The Impact

Cultural Difference and Adoption Policy in the United States: The Quest for Social Justice for Children

2010 ◽  
Vol 18 (2) ◽  
pp. 291-308 ◽  
Author(s):  
Madeline Engel ◽  
Frances DellaCava ◽  
Norma Kolko Phillips
Keyword(s):  
United States ◽  
Race And Ethnicity ◽  
Cultural Difference ◽  
The United States ◽  
Three Dimensions ◽  
Policy And Practice ◽  
Rights Of The Child ◽  
The Hague ◽  
The Impact ◽  
Historical Periods

AbstractThis article discusses the impact of cultural difference on adoption in the United States (U.S.) during three historical periods and along three dimensions: religion, race and ethnicity. The focus is on the extent to which national and international definitions of the rights of the child as put forth by the United States, the United Nations and The Hague have affected adoption policy and practice. The article questions the extent to which the failure to respond to cultural differences has diminished the rights of the child and resulted in social injustice. Although focused on the U.S., the argument has relevance for many other countries, including Sweden, Romania, Ukraine, Australia, Korea and China.

scholarly journals COVID-19 Misinformation Prophylaxis: Protocol for a Randomized Trial of a Brief Informational Intervention

10.2196/24383 ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. e24383
Author(s):  
Jon Agley ◽  
Yunyu Xiao ◽  
Esi E Thompson ◽  
Lilian Golzarri-Arroyo
Keyword(s):  
United States ◽  
Randomized Trial ◽  
Race And Ethnicity ◽  
Face Mask ◽  
The United States ◽  
Placebo Control ◽  
Preventive Behaviors ◽  
Institutional Review ◽  
Superiority Trial ◽  
The Impact

Background As the COVID-19 pandemic continues to affect life in the United States, the important role of nonpharmaceutical preventive behaviors (such as wearing a face mask) in reducing the risk of infection has become clear. During the pandemic, researchers have observed the rapid proliferation of misinformed or inconsistent narratives about COVID-19. There is growing evidence that such misinformed narratives are associated with various forms of undesirable behavior (eg, burning down cell towers). Furthermore, individuals’ adherence to recommended COVID-19 preventive guidelines has been inconsistent, and such mandates have engendered opposition and controversy. Recent research suggests the possibility that trust in science and scientists may be an important thread to weave throughout these seemingly disparate components of the modern public health landscape. Thus, this paper describes the protocol for a randomized trial of a brief, digital intervention designed to increase trust in science. Objective The objective of this study is to examine whether exposure to a curated infographic can increase trust in science, reduce the believability of misinformed narratives, and increase the likelihood to engage in preventive behaviors. Methods This is a randomized, placebo-controlled, superiority trial comprising 2 parallel groups. A sample of 1000 adults aged ≥18 years who are representative of the population of the United States by gender, race and ethnicity, and age will be randomly assigned (via a 1:1 allocation) to an intervention or a placebo-control arm. The intervention will be a digital infographic with content based on principles of trust in science, developed by a health communications expert. The intervention will then be both pretested and pilot-tested to determine its viability. Study outcomes will include trust in science, a COVID-19 narrative belief latent profile membership, and the likelihood to engage in preventive behaviors, which will be controlled by 8 theoretically selected covariates. Results This study was funded in August 2020, approved by the Indiana University Institutional Review Board on September 15, 2020, and prospectively registered with ClinicalTrials.gov. Conclusions COVID-19 misinformation prophylaxis is crucial. This proposed experiment investigates the impact of a brief yet actionable intervention that can be easily disseminated to increase individuals’ trust in science, with the intention of affecting misinformation believability and, consequently, preventive behavioral intentions. Trial Registration ClinicalTrials.gov NCT04557241; https://clinicaltrials.gov/ct2/show/NCT04557241 International Registered Report Identifier (IRRID) PRR1-10.2196/24383

scholarly journals The impact of race and ethnicity on outcomes in 19,584 adults hospitalized with COVID-19

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254809
Author(s):  
Ann M. Navar ◽  
Stacey N. Purinton ◽  
Qingjiang Hou ◽  
Robert J. Taylor ◽  
Eric D. Peterson
Keyword(s):  
United States ◽  
Race And Ethnicity ◽  
The United States ◽  
Lower Mortality ◽  
Real World Data ◽  
Black Adults ◽  
Increased Risk ◽  
Hispanic Patients ◽  
The Impact ◽  
White Patients

Introduction At the population level, Black and Hispanic adults in the United States have increased risk of dying from COVID-19, yet whether race and ethnicity impact on risk of mortality among those hospitalized for COVID-19 is unclear. Methods Retrospective cohort study using data on adults hospitalized with COVID-19 from the electronic health record from 52 health systems across the United States contributing data to Cerner Real World DataTM. In-hospital mortality was evaluated by race first in unadjusted analysis then sequentially adjusting for demographics and clinical characteristics using logistic regression. Results Through August 2020, 19,584 patients with median age 52 years were hospitalized with COVID-19, including n = 4,215 (21.5%) Black and n = 5,761 (29.4%) Hispanic patients. Relative to white patients, crude mortality was slightly higher in Black adults [22.7% vs 20.8%, unadjusted OR 1.12 (95% CI 1.02–1.22)]. Mortality remained higher among Black adults after adjusting for demographic factors including age, sex, date, region, and insurance status (OR 1.13, 95% CI 1.01–1.27), but not after including comorbidities and body mass index (OR 1.07, 95% CI 0.93–1.23). Compared with non-Hispanic patients, Hispanic patients had lower mortality both in unadjusted and adjusted models [mortality 12.7 vs 25.0%, unadjusted OR 0.44(95% CI 0.40–0.48), fully adjusted OR 0.71 (95% CI 0.59–0.86)]. Discussion In this large, multicenter, EHR-based analysis, Black adults hospitalized with COVID-19 had higher observed mortality than white patients due to a higher burden of comorbidities in Black adults. In contrast, Hispanic ethnicity was associated with lower mortality, even in fully adjusted models.

Latinx Sexual and Gender Minority Mental Health

2020 ◽  
pp. 185-198
Author(s):  
Alison Cerezo ◽  
Juan Camarena ◽  
Amaranta Ramirez
Keyword(s):  
Mental Health ◽  
United States ◽  
Latin America ◽  
Race And Ethnicity ◽  
The United States ◽  
Minority Mental Health ◽  
Gender Diverse ◽  
The Social ◽  
And Gender ◽  
The Impact

Sexual and gender diverse (SGD) Latinxs are a vibrant, heterogenous community that can trace their heritage to various countries in Latin America. This chapter describes how socio-historical trends in the United States and Latin America have shaped the social and health conditions of SGD Latinxs, including the impact of colonialism and recent state-sanctioned discriminatory violence. An intersectionality framework is used in this chapter to consider how race and ethnicity, immigration, language, sexual orientation, and gender identity function interdependently to impact the lives of SGD Latinxs in the United States and around the world. The authors also discuss trends in SGD Latinx research in the United States and Latin America, with a focus on mental health and substance abuse.

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