Ethnicity & Health最新文献

Objectives: South Asian individuals (SAs) may have heightened levels of inflammatory markers, such as C reactive protein (CRP), Tumor Necrosis Factor-α (TNF-α), leptin, and resistin, and decreased levels of anti-inflammatory adiponectin, contributing to higher cardiovascular disease (CVD) incidence. Social determinants of health, like discrimination, are also associated with risks for CVD in SAs. This study examined the associations between discrimination and inflammation and whether coping styles moderated the association between discrimination and self-rated health (SRH) among SAs in the United States.

Design: Secondary analysis of data obtained from 1164 SAs (mean age = 57 years, SD = 9.4, 48% women) enrolled in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study was conducted. Discrimination was measured using the Everyday Discrimination Scale (EDS). Inflammatory markers (CRP, TNF-α, leptin, resistin) and anti-inflammatory adiponectin were measured from blood samples. SRH was self-reported by participants. Coping styles were defined as problem-focused or emotion-focused. Multiple regression with bootstrapping was used to examine associations between discrimination and inflammatory markers and adiponectin. Moderation analysis assessed whether coping styles moderated the association between discrimination and SRH.

Results: No significant associations were found between discrimination and inflammation. Discrimination was inversely associated with SRH (OR = 0.969, p = 0.005). Emotion-focused coping moderated the association between discrimination and SRH (OR = 0.969, 95% CI = 0.940-0.999, p = 0.044). Among participants who used emotion-focused coping strategies, an increase in self-reported discriminatory experiences was associated with lower odds of having good or excellent SRH. Problem-focused coping did not moderate the association between discrimination and SRH.

Conclusion: The unknown magnitude and duration, and the lack of variability in discrimination among participants could explain the null findings between discrimination and inflammation. Gaining a better understanding of the ways in which SAs appraise and cope with discriminatory experiences may help to develop future interventions targeted to reduce the adverse health consequences of discrimination among SAs.

Background: Factors that influence health service utilization among Black immigrant women with experiences of trauma are not well understood. An improved understanding of the impact of cumulative trauma on Black immigrant women's health care utilization is critical to increase access to health services for this population.

Methods: Using baseline data of 147 Black immigrant women from an existing NICHD-funded study, hierarchical multiple linear regression was used to assess the impact of length of stay in the US, education, cumulative trauma frequency, everyday discrimination, and the interaction of discrimination and cumulative trauma on health service utilization. A model-building approach was used to determine covariates to include in the final model.

Results: Cumulative trauma frequency was positively associated with health service usage (b = 0.02; p = 0.026). Compared to Black immigrant women who had lived in the US for longer than 10 years, those who had lived in the US between 1 and 4 years were less likely to use health services (b = -0.89; CI: -1.67, -0.11). Black immigrant women with bachelor's degrees were less likely to use health services compared to Black immigrant women with post-graduate degrees (b = -0.85; CI: -1.61, -0.09). The interaction of cumulative trauma and discrimination was also significantly associated with the behavior of utilizing health services (b = 0.002; CI: 0.0003, 0.004). Those who experienced higher perceived levels of discrimination and high cumulative trauma levels were more likely to use health services compared to those with lower levels of discrimination and high levels of cumulative trauma.

Conclusion: Cumulative trauma experiences were positively correlated with health service utilization, and discrimination strengthened this relationship. Future work must examine long-term data for patterns of seeking health services over time, explore specific types of health services associated with cumulative trauma experiences, and study associations between health service usage and health outcomes.

Background: The American Indian and Alaska Native (AI/AN) population is increasing and AI/AN people are living longer than ever before. Although aging-related health issues such as cognitive impairment, dementia, and Alzheimer's disease (AD) are becoming more visible among this population, reliable data on AD prevalence and risk factors among AI/AN people are nearly nonexistent. Concurrently, precision medicine (PM) has demonstrated significant potential for detecting and treating diseases such as AD. For PM to promote health equity for underserved populations, it must not exacerbate existing health disparities and bias in research. There is also little information about preferences among AI/AN people for communicating information regarding AD, PM, or recruitment into clinical trials. Communication barriers and few known facilitators contribute to low rates of AI/AN research participation. This study seeks to address the gaps in AD and PM research among AI/AN communities and promote knowledge of, attitudes towards, and interest and participation in AD-related PM research efforts.

Methods: We designed a three-armed RCT to determine the effect of a culturally tailored brochure and video compared to non-tailored recruitment materials. Participants were recruited in Rapid City, South Dakota and were required to meet the following eligibility criteria: 1) identify as AI/AN; 2) be able to speak, read, and understand English; 3) be aged 40 or older; and 4) have the cognitive and decisional capacity to consent and sign and date the informed consent document.

Results: We enrolled 914 in the RCT and 812 have been randomized to a study condition. The mean age is 54 years (standard deviation = 10.3 years); 62% are female. Overall, 22% reported a parent, grandparent or sibling have been diagnosed with AD, and 22% reported a family member with an other type of dementia. One quarter (25%) of participants reported having an undiagnosed memory problem themselves, and 22% reported having a family member with undiagnosed memory problems. Of randomized participants, 743 (72%) enrolled in the research registry.

Conclusions: This study will inform future recruitment efforts for ADRD-focused clinical trials. Enrollment of AI/AN participants in an Alzheimer's Disease-Precision Medicine (AD-PM) Registry will provide opportunity for future research on this topic in partnership with this population.

Objective: There is increased ethnic diversity of Black Americans as a result of increasing migration. However, it is unclear whether the diverse sociocultural contexts and experiences of U.S.- and foreign-born Black young adults (YA) are similarly associated with substance use behaviors. With a rise in psychosocial stressors among YA in the U.S., this study examined whether there are nativity differences in the association of societal concern, experience of racist events, and discrimination with nicotine/tobacco, cannabis, and binge-drinking among U.S.- and foreign-born Black YA.

Methods: This pilot study used data collected in 2023 from a nationwide, non-probability sample of 484 young adults (182 foreign-born and 302 U.S.-born) aged 18-25 years. Nativity differences in demographic characteristics, study predictors, and substance use were assessed using two sample t-tests and chi-squared tests. Multivariable logistic regression analyses were used to examine the association of societal concern, racism, and discrimination with nicotine/tobacco use, cannabis use, and binge drinking overall and stratified by nativity.

Results: While foreign-born and U.S.-born Black YA had similar mean societal concern and racist experience scores, everyday discrimination was significantly higher among U.S.-born YA (p = 0.002). Societal concern was associated with reduced odds of nicotine/tobacco use in the overall sample (AOR = 0.90, 95% CI 0.83, 0.97) and among foreign-born Black YA (AOR = 0.79, 95% CI 0.66-0.94). Experience of racist events was consistently associated with increased odds of all substances assessed in the overall sample and among the sub-groups, with the exception of binge drinking among U.S.-born YA and cannabis and nicotine/tobacco use among foreign-born YA.

Conclusions: Despite similarities among foreign- and U.S.-born Black YA, exposure to these psychosocial stressors is associated with some distinct substance use patterns. These findings highlight the nuanced relationships between societal and discriminatory stressors and substance use, varying by nativity among Black YA.

Background: Latinx adults experience disparately high rates of chronic diseases and cognitive dysfunction. Participating in cognitive-stimulating activities, such as reading, is thought to improve and preserve cognitive function. However, little is known about cognitively stimulating activities preferred by Latinx adults. In addition, surveys to measure participation in cognitively stimulating activities are not culturally sensitive to Latinx preferences and tend to feature activities that require financial resources and leisure time and may not include cognitively stimulating activities that are more accessible or preferable.

Methods: We conducted an instrumentation study in three phases to adapt the Florida Cognitive Activities Scale (FCAS): Phase (1) revision and translation of the FCAS for Latinx adults with chronic diseases; Phase (2) feasibility testing; and Phase (3) reliability and validity testing.

Results: Five experts provided input on existing items, with suggestions for changes or items to remove and for new items. The resulting 17 item FCAS-Latinx (FCAS-L) was translated into Spanish and back-translated and determined to be readable at the 6th grade level. The FACS-L was administered to 70 participants (mean age 62.17 years; 57% female; 51% Mexican American) with other surveys that measured cognitive functioning and chronic disease management. To select the final items, we analyzed the item discrimination index, item-to-total correlations, and participants' feedback. The final 20-item Spanish - and English versions of the FCAS-L are internally consistent (Cronbach alpha = 0.74 and 0.81, respectively), showed good construct validity (higher scores on cognitive functioning tests correlated with engaging in more frequent cognitively stimulating activities, r = 0.63, P < .01), and temporal reliability (the interclass correlation coefficient between test and retest times was 0.81).

Conclusion: The FCAS-L is a valid and reliable updated measure of cognitively stimulating activities for Spanish- and English-speaking Latinx adults with chronic conditions.

Objectives: Anti-Asian American racism has negatively impacted Asian Americans' mental health. This study investigated how colorblind racial ideology moderates the relationship between COVID-19 racial discrimination and depressive symptoms among Asian Americans.

Design: Data come from an online survey conducted among 794 Asian Americans. Multivariable logistic regression analyses were conducted to test the effects of racial discrimination and colorblind racial attitude on depressive symptoms among Asian Americans, stratified by nativity (451 US-born, 343 foreign-born).

Results: We found that US-born Asian Americans than foreign-born Asian Americans had higher odds of depressive symptoms, whereas the foreign-born displayed higher levels of colorblind racial attitude. The results of multivariable logistic regression tests indicate that colorblind racial attitude moderates the relationship between racial discrimination and depressive symptoms among the US-born, but not among the foreign-born.

Conclusion: Instead of claiming that race no longer matters, more racially conscious socialization and education that promote the awareness of race and racism are warranted to promote mental health of Asian Americans.

Rationale and objectives: Perinatal mental illnesses (PMIs), such as depression and anxiety, affect 25% of mothers in England and occur during pregnancy or within the first year postpartum. PMIs have serious consequences for mothers, children, and families, additionally impacting minoritised ethnic women who experience higher mental health risks and diminished quality of life, stemming from systemic inequalities, socio-economic disadvantages, and limited access to quality care. Social support influences women's help-seeking intentions and behaviours for PMIs, yet its role remains unclear. The present study aimed to investigate minoritised ethnic women's experiences of PMIs to understand the role of social support in help-seeking intentions or behaviour for formal or informal support.

Design: Semi-structured interviews were conducted with minoritised ethnic women (n = 6) in England. The interviews explored their experiences of PMIs, mental health, and views on social support during the perinatal period. The data was analysed using Interpretative Phenomenological Analysis.

Results: Minoritised ethnic women held varied perspectives on what constituted social support, ranging from immediate social circles to broader professional networks. Social support was not the sole determinant of help-seeking behaviours; self-perceptions, cultural background, and prior experiences with maternity care were also crucial. Additionally, a need for non-intrusive, empathetic, and culturally sensitive perinatal mental health support for minoritised ethnic women was expressed. The women emphasised the importance of creating safe spaces for open discussions, expressing a desire for peer support to foster a sense of belonging amongst minoritised ethnic women.

Conclusion: The role of social support in help-seeking for minoritised ethnic women is complex; functioning as both a facilitator and a barrier to help-seeking, contingent upon individual circumstances and subjective perceptions. The dissatisfaction expressed by women around the current perinatal care highlights the need for services in England to prioritise cultural humility and empathetic support to enhance outcomes for minoritised ethnic women.

Objective: Lung cancer screening can reduce lung cancer-specific mortality, but it is widely underutilized, especially among minoritized populations that bear a disproportionate burden of lung cancer, such as Black Americans. Racism, discrimination, medical mistrust, and stigma contribute to lower uptake of preventive screenings in general, but the role these factors play in lung cancer screening is unclear. We therefore conducted a scoping review to synthesize the literature regarding how racism, discrimination, medical mistrust, and stigma relate to lung cancer screening.

Design: Informed by PRISMA-ScR guidelines, we searched five databases for relevant literature, and two trained researchers independently reviewed articles for relevance. We conducted a narrative, descriptive analysis of included articles.

Results: A total of 45 studies met our inclusion criteria. Most articles reported on medical mistrust or one of its cognates (e.g. trust and distrust, n = 37) and/or stigma (n = 25), with several articles focusing on multiple constructs. Few articles reported on racism (n = 3), and n = 1 article reported on discrimination. Results from empirical studies suggest that medical mistrust, distrust, and stigma may be barriers to lung cancer screening, whereas trust in health care providers may facilitate screening. The articles reporting on racism were commentaries calling attention to the impact of racism on lung cancer screening in Black populations.

Conclusions: Overall, novel interventions are needed to promote trust and reduce mistrust, distrust, and stigma in lung cancer screening initiatives. Dedicated efforts are especially needed to understand and address the roles that racism and discrimination may play in lung cancer screening.

Objective: To explore the role of Black-led community organisations in supporting Black mental health and wellbeing in the UK.

Design: A qualitative, Black Emancipatory Action Research Framework was adopted. Framework application involved adequately compensating community organisations for their consultancy role; having 'research conversations' rather than interviewing participants; and focusing outputs on community benefit. Eight individual and group research conversations took place with nine Black directors, employees and volunteers working with Black-led community organisations, aged between 19 and 62, living in the UK. Reflexive thematic analysis was used to analyse conversations.

Results: Three themes were developed in relation to what Black-led community organisations do for Black mental health. These are: identify and respond to mental health needs; selectively build relationships with mainstream services; and drive social and systemic improvements. Findings revealed that Black-led community organisations uniquely identify and address mental wellbeing by offering respite from racism, hosting activities, and meeting urgent needs. They navigate and facilitate access to health and social systems, protect communities from harmful services, and advocate for social and systemic change. Drawing on the study design, findings, and the broader literature, we propose three key changes to current funding, community, and research practices. These are a reconsideration of how Black-led organisations' work is valued and measured, a forging of greater collaboration between these organisations, and bolder consideration of how research practice can benefit Black communities.

Conclusions: Black-led organisations play multiple roles in supporting individual and collective mental health, crucial for mediating the effects of racism and mitigating ethnic inequalities. To our knowledge, this is the first study to both illuminate the critical role of community organisations in promoting Black mental health in the UK and to prioritise participant, and community, benefit throughout the research process.

Objectives: Racism and ethnic discrimination are global health issues, but the extent and effects on Indigenous Peoples in the Arctic region are still poorly understood. By investigating the methods, data sources, and definitions used in articles examining racism and ethnic discrimination among Indigenous peoples in the Arctic between 2008 and 2021 this review aims to create a solid foundation for future research.

Design: We conducted a search across multiple databases, including PubMed, PsycInfo, Web of Science, Scopus, and the Cochrane Review. Our search criteria included: Indigenous groups, racism or ethnic discrimination, and Arctic regions. After removing off-topic articles, two researchers reviewed the remaining articles against predefined eligibility criteria.

Results: The research field is expanding, but a significant portion of Arctic Indigenous peoples remains underrepresented. Predominant research methods include questionnaires, interviews, and case studies, often derived from large cross-sectional studies. Self-reported responses to questions about ethnic discrimination and racism are the primary research method, while some articles involve researchers subjectively evaluating data to determine what qualifies as racism or ethnic discrimination. Reaching a consensus on the definitions of ethnic discrimination and racism is challenging, with definitions ranging from negative, unfair, or differential treatment to broader, structural perspectives. Approximately half of the articles lack clear definitions.

Conclusion: There is a notable difference in terminology, where racism as a term is more used in Canada/US while, ethnic discrimination is more predominant in the Nordic countries. Despite these differences, the scales used to measure racism or ethnic discrimination show significant similarities. A large part of the investigated articles emphasize interpersonal discrimination. An emerging perspective after 2016 views racism/ethnic discrimination as something that produces inequalities between racial or ethnic groups and upholds or creates systems of privilege and oppression. Research consistently highlights the importance of considering local contexts of racism, ethnic discrimination and oppression.