Ethnicity & Disease最新文献

Background: The immigration enforcement system has significant effects on the health of immigrants, their families, and society. Exposure to the immigration enforcement system is linked to adverse mental health outcomes, which may have been exacerbated by sustained immigration enforcement activities during the COVID-19 pandemic.

Objectives: This study was conducted to investigate the association between exposure to immigration enforcement and the mental health of undocumented young adults in California during the COVID-19 pandemic.

Methods: Data are from the COVID-19 BRAVE (Building Community Raising All Immigrant Voices for Health Equity) Study, a community-engaged cross-sectional survey of the impacts of the COVID-19 pandemic on undocumented immigrants in California. A total of 366 undocumented immigrants between 18 and 39 years of age completed the online survey, which was conducted between September 2020 and February 2021. Multivariable logistic regression models were fit to examine the association between immigration enforcement exposure and depression.

Results: Almost all participants (91.4%) disclosed exposure to the immigration enforcement system, with most reporting an average of 3.52 (SD=2.06) experiences. Multivariate analyses revealed that an increase in the immigration enforcement exposure score was significantly associated with higher odds of depression (adjusted odds ratio [aOR]=1.24; 95% confidence interval [CI]: 1.10, 1.40), and women were 92% more likely to report depression than were men (aOR=1.92; 95% CI: 1.12, 3.31). Those who reported deportation fears were significantly more likely to be depressed (aOR=1.24; 95% CI: 1.10, 1.40).

Conclusions: Researchers should consider the mental health implications of a punitive immigration enforcement system, and policymakers should examine the impacts of immigration policies on local communities.

Background: Although small, the African immigrant population is one of the fastest growing immigrant populations in the United States. Emerging research indicates a high prevalence of noncommunicable preventable chronic conditions in this population. Like other African Americans, African immigrants are mistrustful of the health care system, hampering efforts for prevention and intervention research.

Purpose: To describe our experiences conducting 2 studies in an African immigrant community, discuss the lessons learned, and provide advice to researchers interested in conducting research in similar populations.

Design: The 2 published studies for which we derive lessons learned for this paper were a cross-sectional study and a qualitative study using focus group interviews. Participants included Zimbabwean immigrants in the Eastern United States recruited at religious festivals and community events. The 2 studies enrolled a total of 135 participants.

Results: Of our recruitment goal of 120 in the first study, we enrolled only 98 despite numerous efforts. However, after strategically partnering with a community advisory board (CAB), in the second study, we met our recruitment goal within 4 months. With the CAB, we recruited a larger proportion of men (38% versus 24%). Without the CAB, 350 individuals agreed to participate, but only 98 (28%) returned the questionnaire, whereas with the CAB, 40 agreed to participate, and 37 (93%) successfully completed the study.

Conclusion: Conducting health-related research in immigrants requires strategic partnerships with the community to build strong relationships between the research team and the target community. By nurturing these relationships, research teams can effectively access this hard-to-reach population and achieve high participation.

Intracranial volume (ICV) reflects maximal brain development and is associated with later-life cognitive abilities. We quantified ICV among first- and second-generation Hispanic and Latino adults from the Study of Latinos-Investigation of Cognitive Aging - MRI (SOL-INCA-MRI), estimated ICV heritability, and tested its associations with previously reported genetic variants, both individually and as a genetic risk score (GRS). We also estimated the association of ICV with early life environmental measures: nativity or age of immigration and parental education. The estimated heritability of ICV was 19% (95% CI, 0.1%-56%) in n=1781 unrelated SOL-INCA-MRI individuals. Four of 10 tested genetic variants were associated with ICV and an increase of 1 SD of the ICV-GRS was associated with an increase of 10.37 cm³ in the ICV (95% CI, 5.29-15.45). Compared to being born in the continental United States, immigrating to the United States at age 11 years or older was associated with 24 cm³ smaller ICV (95% CI, -39.97 to -8.06). Compared to both parents having less than high-school education, at least 1 parent completing high-school education was associated with 15.4 cm³ greater ICV (95% CI, 4.46-26.39). These data confirm the importance of early life health on brain development.

Objective: Entertainment-education interventions remain underutilized in sexual and reproductive health (SRH) despite evidence that they can be effective and place a low burden on staff. This study explores perceived facilitators and barriers for implementing an entertainment-education video intervention for 18- to 19-year-old African American and Latina women in SRH clinics.

Design: Cross-sectional online survey (n=100) and telephone interviews (n=19) were completed May through August 2018.

Setting: SRH clinics were located across 32 US states and 1 Canadian province.

Participants: SRH clinic staff were diverse in type of clinic, role, and geography and were recruited using purposive sampling.

Methods: Bivariate analyses were used for quantitative data, and thematic analysis was used for qualitative data.

Main outcome measures: Intervention acceptability, perceived feasibility, and likely uptake were assessed using agreement statements (survey) and open-ended questions (interviews and survey).

Results: Interviewed clinic staff described the intervention as engaging, educational, and promising for improving client SRH knowledge and behaviors. Nearly all (95%) survey respondents said showing the video would be feasible. Most (56%) indicated likely uptake, which was significantly associated with perceived feasibility (P=.000), acceptability (P≤.001), and working at a public health clinic (P=.023). Implementation barriers included the video's potential relevance to only certain clients and the need for additional information or staff and/or management buy-in.

Conclusions: This is the first study to assess perceived implementation facilitators and barriers of an entertainment-education video intervention among SRH clinic staff. The intervention was well received, with certain barriers potentially alleviated by offering information about entertainment-education and multiple implementation methods. These findings can help improve dissemination efforts for video-based entertainment-education interventions in clinics serving young women of color.

Background: The root causes of coronavirus disease 2019 (COVID-19) disparities include longstanding systemic racial bias in economic advancement and care delivery, discrimination, lack of access, and social determinants of health. To address these causes, research institutions and health care systems must shift their lens from one that focuses solely on changing behaviors among underserved and vulnerable populations to one that is inward facing.

Methods: We worked with a community advisory board and an African American church that has partnered on research for more than a decade to identify community norms, needs, and key resources needed for establishing community-academic partnerships for COVID-19 testing. Participants were purposefully sampled with equal representation from 3 groups: (1) church members and leaders, (2) academic or organization researchers with experience in community-engaged research, and (3) community members with experience participating in community-engaged research. Participants engaged in a hands-on exercise in the church basement as part of a town hall-style meeting.

Results: Active discussion led to the identification of business model components salient to COVID-19 testing in an underserved Baltimore community, predominantly made up of African Americans. Our discussion identified key partners, activities, resources, costs, value propositions, community relationships, community groups, communication channels, and outputs for community buy-in.

Conclusion: Developing the business case for mutual trustworthiness to be better prepared for future pandemics and public health crises may foster more sustainable community-academic partnerships. Using a Business Model Canvas, we delineate the major components, activities, and value propositions that are needed to achieve authentic community-academic partnerships to advance health equity.

Introduction: Coronavirus disease (COVID) dashboards rarely provide insights about the racialized contexts in which vaccination inequities occur.

Objective: The purpose of this study was to use the emerging Project REFOCUS dashboard to contextualize COVID vaccination patterns among 6 diverse communities.

Methods: We queried the dashboard to generate descriptive statistics on vaccination trends and racism-related contextual factors among the 6 Project REFOCUS pilot sites (Albany, Georgia, Bronx, New York, Detroit, Michigan, Helena-West Helena, Arkansas, San Antonio, Texas, and Wake County, North Carolina).

Results: Vaccination rates, demographic indicators, and contextual factors differed across sites. As of October 17, 2022, the proportion of people who had received at least 1 COVID vaccine dose ranged from 58.4% (Wayne County, Michigan) to 95.0% (Wake County, North Carolina). The pilot sites with the greatest percentage of Black residents (Dougherty County, Georgia, Wayne County, Michigan, and Phillips County, Arkansas) had lower proportions of fully vaccinated people. Wayne County, Michigan, had the highest level of residential segregation between Black and White residents (78.5%) and non-White and White residents (68.8%), whereas Phillips County, Arkansas, had the highest overall mortgage denial rates (38.9%). Both counties represent settings where over 75.0% of residents report Black race and over 30.0% of the population live in poverty.

Discussion: The dashboard integrates racism-related factors with COVID vaccination visualizations and provides a fuller picture of the context in which COVID trends are occurring.

Conclusions: Community organizers, researchers, policymakers, and practitioners can track racism-related factors and other social determinants of health as part of the contexts in which COVID-related inequities occur.

Introduction: Despite widespread efforts to promote coronavirus disease 2019 vaccination in the United States, a significant segment of the population is still unvaccinated or incompletely vaccinated.

Objective: The objective of this study was to understand attitudes toward the vaccine in patients presenting to an urban emergency department.

Methods: We used a qualitative analysis and semistructured interviews with a convenience sample of patients presenting to an urban emergency department from January 18, 2021, to March 14, 2021. Our final sample consisted of 32 people.

Results: We found that people trusted their own medical providers rather than popular or political figures. Critiques of the vaccination program highlighted difficulties in navigation and perceptions of inequity.

Conclusions: Equitable distribution strategies and honest messaging may facilitate acceptance of the coronavirus disease 2019 vaccine. Trustworthy sources for vaccine knowledge should be used to target populations in which vaccine hesitancy is a persistent concern.

Objective: Racial disparities in health outcomes are a persistent threat in gentrifying neighborhoods. A contributor to health outcomes is health services utilization, the extent to which people receive care from a medical professional. There are documented racial disparities in health services utilization in the general population. We aim to determine whether racial disparities in health services utilization exist in gentrifying neighborhoods.

Methods: We used data from the American Community Survey to identify gentrifying neighborhoods across the United States from 2006 to 2017. We collected data on three measures of healthcare services utilization (office-based physician visits, office-based nonphysician visits, and having a usual source of care) for 247 Black and 689 White non-Hispanic respondents of the 2014 Medical Expenditure Panel Survey living in gentrifying neighborhoods. We used modified Poisson models to determine whether there is a difference in the prevalence of health services utilization by race among residents of gentrifying neighborhoods.

Results: After adjusting for age, gender, education, income, employment, insurance, marital status, region, and self-rated health, Black residents of gentrifying neighborhoods demonstrated a similar prevalence of having an office-based physician visit, a lower prevalence of having an office-based nonphysician visit (prevalence ratio: 0.74; 95% confidence interval, 0.60 to 0.91), and a lower prevalence of having a usual source of care (prevalence ratio: 0.87; 95% confidence interval, 0.77 to 0.98) than White residents.

Conclusions: The existence of racial disparities in health services utilization in US gentrifying neighborhoods demonstrates a need for policy-relevant solutions to create a more equitable distribution of health resources.

Introduction: Over the past two years, public health practitioners in African countries have worked actively to combat the Coronavirus Disease 2019 (COVID-19) pandemic with relatively low fatality rates. This pandemic has forced healthcare professionals to re-think and redesign the healthcare system within their own country.

Methods: Using the Afrocentric PEN-3 framework and a letter style, the purpose of this commentary was to describe the positive, existential, and negative socio-cultural values associated with African healthcare systems. The commentary also highlights socio-cultural factors affecting public trust in African healthcare systems and their health agencies and how systematically decolonizing them may decrease foreign reliance and empower efficient locally based solutions.

Results: We, as African public health practitioners, make three key points in this commentary. First, African public health practitioners have developed resilience within under-resourced healthcare systems. Secondly, oral tradition in African societies and its byproduct (social media) is the means through which people connect and share what they know about any topics (COVID-19). Thirdly, African leaders have particularly contributed to the high level of distrust in their countries' healthcare systems in favor of the healthcare systems of industrialized countries.

Conclusion: This commentary concludes with implications for encouraging African public health practitioners to cultivate the resilience that has led to contributing to the wellness of millions of Africans during this COVID-19 pandemic.

Historically, the US immigration system (ie, institutions, agencies, and laws) has served the goals and principles of white supremacy through its treatment of globally displaced people and this appears to have continued through the COVID pandemic. Yet, the implications for immigrant health are not routinely addressed in mainstream public health discourse, and especially so in regard to public health disasters. This study conducted a series of focus groups with participants from social justice organizations working with immigrants, migrants, undocumented persons, refugees, persons seeking asylum, and persons detained in immigration jails to collect stories on how the immigration system undermined efforts to control the spread of COVID-19 and exacerbated health inequity within immigrant jails and across related community contexts during the pandemic. Focus groups were conducted to explore issues related to immigrants and immigration detention during the COVID-19 pandemic. There was a total of N=14 participants across the 4 focus groups with a dedicated focus group on perspectives of Black immigrants/from Black immigrant organizations only. Each focus group consisted of 3 to 4 participants. Five key themes emerged: 1) dehumanization of immigrants and migrants and devaluation of their lives; 2) inhumane conditions of confinement that propagate risk of disease; 3) denial of resources for COVID-19 prevention and mitigation; 4) expansion of intersecting oppressive systems; and 5) community-based resistance and mobilization against immigration policies and enforcement. Our findings highlight the harms from policing, criminalization, and exclusion that racialized communities face as a result of the (in)actions within the immigration system during a public health disaster including the COVID context.