Eradicating Racism: An Endocrine Society Policy Perspective

The Endocrine Society recognizes racism as a root cause of the health disparities that affect racial/ethnic minority communities in the United States and throughout the world. In this policy perspective, we review the sources and impact of racism on endocrine health disparities and propose interventions aimed at promoting an equitable, diverse, and just healthcare system. Racism in the healthcare system perpetuates health disparities through unequal access and quality of health services, inadequate representation of health professionals from racial/ethnic minority groups, and the propagation of the erroneous belief that socially constructed racial/ethnic groups constitute genetically and biologically distinct populations. Unequal care, particularly for common endocrine diseases such as diabetes, obesity, osteoporosis, and thyroid disease, results in high morbidity and mortality for individuals from racial/ethnic minority groups, leading to a high socioeconomic burden on minority communities and all members of our society. As health professionals, researchers, educators, and leaders, we have a responsibility to take action to eradicate racism from the healthcare system. Achieving this goal would result in high-quality health care services that are accessible to all, diverse workforces that are representative of the communities we serve, inclusive and equitable workplaces and educational settings that foster collaborative teamwork, and research systems that ensure that scientific advancements benefit all members of our society. The Endocrine Society will continue to prioritize and invest resources in a multifaceted approach to eradicate racism, focused on educating and engaging current and future health professionals, teachers, researchers, policy makers, and leaders.

Expanding PrEP Services for Men Who Have Sex With Men and Transgender Persons Through Health Department Programs: Key Processes and Outcomes From Project PrIDE, 2015-2019

Objective: Pre-exposure prophylaxis (PrEP) Implementation, Data to Care, and Evaluation (PrIDE) was a demonstration project implemented by 12 state and local health departments during 2015-2019 to expand PrEP services for men who have sex with men (MSM) and transgender persons at risk for HIV infection. We describe findings from the cross-jurisdictional evaluation of the project. Methods: We analyzed work plans, annual progress reports, and aggregate quantitative program data submitted by funded health departments (n = 12) to identify key activities implemented and summarize key project outcomes. Results: PrIDE jurisdictions implemented multiple health equity–focused activities to expand PrEP services to priority populations, including building program capacity, conducting knowledge and awareness campaigns, providing PrEP support services, and addressing barriers to PrEP use. Overall, PrIDE jurisdictions identified 44 813 persons with PrEP indications. Of these, 74.8% (n = 33 500) were referred and 33.1% (n = 14 821) were linked to PrEP providers, and 25.3% (n = 11 356) were prescribed PrEP. Most persons prescribed PrEP were MSM or transgender persons (87.9%) and persons from racial and ethnic minority groups (65.6%). However, among persons with PrEP indications, non-Hispanic Black/African American persons (14.9% of 18 782) were less likely than non-Hispanic White persons (31.0% of 11 633) to be prescribed PrEP ( z = −33.57; P < .001). Conclusions: PrIDE jurisdictions successfully expanded PrEP services for MSM, transgender persons, and racial and ethnic minority groups by implementing health equity–focused activities that addressed barriers to PrEP services. However, PrEP prescription was generally low, with significant disparities by demographic characteristics. Additional targeted interventions are needed to expand PrEP services, achieve equity in PrEP use, and contribute to ending the HIV epidemic in the United States.

‘It’s possibly made us feel a little more alienated’: How people from ethnic minority communities conceptualise COVID-19 and its influence on engagement with testing

Objectives The cultural beliefs, practices and experiences of ethnic minority groups, alongside structural inequalities and the political economy play a critical, but overlooked role in health promotion. This study aimed to understand how ethnic minority groups in the United Kingdom conceptualised COVID-19 and how this influenced engagement in testing. Method Black (African and Caribbean) and South Asian (Indian, Pakistani and Bangladeshi) community members were purposefully recruited from across the UK. Fifty-seven semi-structured interviews were conducted and analysed using principles of grounded theory. Results We found that people of Black and South Asian ethnicity conceptualised COVID-19 as a disease that makes them visible to others outside their community and was seen as having more severe risk and suffering worse consequences, resulting in fear, stigmatisation and alienation. Views about COVID-19 were embedded in cultural beliefs, relating to culturally specific ideas around disease, such as ill-health being God’s will. Challenges brought about by the pandemic were conceptualised as one of many struggles, with the saliency of the virus contextualised against life experiences. These themes and others influenced engagement with COVID-19 testing. Testing was less about accessing timely and effective treatment for themselves and more about acting to protect the family and community. Testing symbolised a loss of income, anxiety and isolation, accentuated by issues of mistrust of the system and not being valued, or being treated unfairly. Conclusion Health communications should focus on counterbalancing the mistrust, alienation and stigmatisation that act as barriers to testing, with trust built using local credible sources.

The Reproduction of “Petro-Nationalism” in Ethnic Media: A Case Study of WeChat Public Accounts’ Coverage of the Trans Mountain Pipeline Controversy

Over the past 2 decades, Alberta’s bitumen industry has emerged as a major point of contention in Canadian politics, with the Trans Mountain pipeline expansion (TMX) project being a recent controversy that has attracted both domestic and international media attention. This brief research report focuses on news coverage of TMX in a rarely studied form of ethnic media: WeChat newsfeeds (known as “public accounts”) targeting Chinese diasporas across Canadian metropolises. A thematic analysis of TMX-related WeChat articles published between January 2016 and May 2021 reveals an overall negative attitude toward the project’s opponents. This stance is mainly due to WeChat public accounts’ heavy reliance on the Canadian mainstream media’s framing of TMX. As a result, the Canadian mainstream media’s downplay of the climate emergency and decarbonization sets the news agendas of the surveyed WeChat public accounts. Accordingly, there is an urgent need to develop non-English alternative media to engage ethnic minority groups in broader public conversations on climate change mitigation.

Effect of the Social and Cultural Control on Young Eastern Ethnic Minority Groups’ Online-Startup Motivation

This study is developed based on particular social and cultural backgrounds and discovers young Eastern ethnic minority groups’ (EMGs) online-startup motivation on live streaming platforms. Drawing on the Hofstede cultural dimensions, this paper explores various influencing factors, including peers’ support, conservative thinking and family support. It analyses young Eastern EMGs’ entrepreneurial motivation and behaviour based on the Stimulus, Organism and Response (S-O-R) model. Compared with traditional research models, the combination of the Hofstede cultural theory and the S-O-R model could be conducive to make the research model reflect influencing factors and present their specific relationships. By analysing 531 valid online questionnaires based on the partial least squares path modelling and variance-based structural equation modelling (PLS-SEM), the paper proves that peers’ support and family support can reduce young EMGs’ conservative thinking and positively affect young people EMGs’ online-startup motivation. Based on the analysis results, some suggestions are provided for related departments, aiming to enhance young EMGs’ online-startup confidence.