Special Issue "Racism, Chronic Disease, and Mental Health: Essential Insights and Approaches for Achieving Health and Healthcare Equity"

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 30 June 2021.

Special Issue Editors

Dr. Shelley White-Means
Website
Guest Editor
College of Graduate Health Sciences, The University of Tennessee Health Science Center Memphis, TN 38163, USA
Interests: health disparities; health care disparities; health economics, breast cancer disparities; family caregiving; minority health; implicit bias; long term care for ethnic elderly
Special Issues and Collections in MDPI journals
Dr. Altha J. Stewart
Website
Guest Editor
The University of Tennessee Health Science Center, Memphis, TN 38163, USA
Interests: public sector and minority issues in mental health care; effects of trauma and violence on children

Special Issue Information

Racism directed toward individuals may be experienced in multifaceted environments, including the workplace, community (criminal justice, social, and educational institutions), and healthcare institutions. Despite the place of the experience, racism may consequentially present itself as underlying diagnosed chronic physical conditions, as well as diagnosed or undiagnosed mental conditions. Structural racism, experienced by select populations, is a root factor underlying a culture of discriminatory practices in housing, education, employment opportunities, environmental hazards, and geographical locations of health-enhancing institutions and services. Consequently, we observe racially disparate outcomes in chronic diseases (e.g., COVID-19) and depression.

For this Special Issue on Racism, Chronic Disease, and Mental Health, we are interested in manuscripts that:

  1. Document the various pathways connecting racism, chronic disease, and mental health. Meta-analyses, reviews, and/or data-driven analyses are welcome.; and
  2. Propose structural interventions at the institutional or local/state/federal policy levels. Community-informed interventions are welcome.

Innovative research strategies that have been unmasked by realities laid bare by COVID-19 are encouraged. Manuscripts that integrate interdisciplinary approaches are also encouraged.

Dr. Shelley White-Means
Dr. Altha J. Stewart
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (1 paper)

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Research

Open AccessArticle
Association between Work Environments and Stigma towards People with Schizophrenia among Mental Health Professionals in Japan
Healthcare 2021, 9(2), 107; https://doi.org/10.3390/healthcare9020107 - 21 Jan 2021
Abstract
This study aimed to examine the association between control over practice in work environments and stigma toward people with schizophrenia among mental health professionals. We conducted secondary analyses on data from a self-administered questionnaire survey. The sample in the initial study included mental [...] Read more.
This study aimed to examine the association between control over practice in work environments and stigma toward people with schizophrenia among mental health professionals. We conducted secondary analyses on data from a self-administered questionnaire survey. The sample in the initial study included mental health professionals from two psychiatric hospitals, 56 psychiatric clinics, and community service agencies in Japan. The Ethics Committee of the University of Tokyo, approved this study. Data from 279 participants were used for secondary analyses (valid response rate = 58.7%). The hierarchical multiple regression analysis was used to determine the association between control over practice and stigma. We performed subgroup analyses among nurses (n = 121) and psychiatric social workers (n = 92). Control over practice was negatively associated with stigma among mental health professionals (β = −0.162, p < 0.01). The subgroup analyses among nurses indicated that control over practice, educational history and recovery knowledge were associated with stigma. However, these variables were not associated with stigma among psychiatric social workers. Control over practice might help to reduce stigma among mental health professionals. Factors related to stigma might differ by occupation. Therefore, further comprehensive studies among various professionals would further our understanding of these factors. Full article

Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: Discrimination and Leukocyte Telomere Length by Depressive Symptomology: The Jackson Heart Study
Authors: LáShauntá M. Glover, MSa; Crystal Wiley-Cenѐb; James G. Wilson, MD, PhDc; Alex Reiner PhDd; Samson Gebreab, PhDe; David R. Williams, PhD, MPHf; Mario Sims, PhD, MSg
Affiliation: University of Mississippi Medical Center
Abstract: Background: Leukocyte telomeres are biological markers of the aging immune system that are associated with cardiovascular disease and mortality. Psychosocial stressors, such as perceived discrimination and depressive symptoms, may shorten telomeres and exacerbate aging-related illnesses. African-American adults experience cardiovascular and mortality disparities, which may be partially explained by psychosocial stressors and their effects on telomeres. Objective: To investigate the association between multiple dimensions of and coping responses to discrimination and leukocyte telomere length (LTL) by levels of depressive symptomology and determine the extent to which this association varies by sex. Methods: Participants from the Jackson Heart Study at visit 1 (2000-2004) with LTL data and Center for Epidemiological Studies-Depression (CES-D) scores (n=1526) were utilized. The dimensions of discrimination (everyday, lifetime, burden of lifetime discrimination, and stress from lifetime discrimination) were categorized as low, moderate, and high and coping responses to everyday and lifetime discrimination were categorized as emotion- and problem-focused coping. Multivariable linear regression analyses were performed to estimate the mean difference (standard errors-SEs) in LTL by dimensions of discrimination and coping responses stratified by CES-D scores < 16 (low depressive symptoms) and CES-D ≥ 16 (high depressive symptoms). Covariates were age, sex, education, waist circumference, smoking and CVD status. Results: There was no statistically significant association between mean LTL and high everyday discrimination among those with high depressive symptoms (b=-0.03, SE=0.09). Among those with low depressive symptoms, moderate vs. low lifetime discrimination was marginally associated with shorter LTL (b=-0.08, SE=0.05) after full adjustment. High vs. low stress from lifetime discrimination, though not significant, was inversely associated with LTL among those with high depressive symptoms in the fully adjusted model. Men with low depressive symptoms who used emotion-focused coping for lifetime discrimination had longer LTL after full adjustment (b=0.21, SE=0.09). Men with high depressive symptoms who used problem-focused coping for lifetime discrimination also had longer LTL after full adjustment (b=1.10, SE=0.37). Conclusion: The intersection of perceived discrimination and depressive symptomology may be related to LTL, but the effects may vary by sex. Further research should explore how behavioral responses to discrimination might mitigate the negative effects of discrimination on LTL in longitudinal analyses.

Title: Dementia-Related Research and Clinical Care
Authors: Steven Starks
Affiliation: College of Medicine, University of Houston, Houston, USA
Abstract: Alzheimer’s disease (AD) is a chronic neurodegenerative disorder – most commonly occurring in late life – that affects both an individual’s cognitive processes and daily life functioning. The disease process of AD is suspected to begin two to three decades before any onset of symptoms and has been associated with cardiovascular disease, diabetes, hypertension and hypercholesterolemia. Approximately one in ten seniors age 65 and older are diagnosed with AD; disease incidence increases with age. AD, the sixth leading cause of death (after stroke and ahead of diabetes), carries a tremendous financial burden on the U.S. healthcare spending (more than $300 billion annually) and significant physical and psychological strain on unpaid family caregivers. Research suggests that AD prevalence in Black Americans is twice that of non-Hispanic white Americans. Black Americans likely face harms associated with bias in clinical research, healthcare settings, diagnostic evaluation and treatment planning. In this article, the author considers whether the current framework on race and ethnicity in dementia research perpetuates race supremacy and unsubstantiated genetic differences of Black Americans. This text reviews the sociopolitical factors (i.e. unequal access to education, safe housing, and financial resources) that contributes to health disparities in dementia-related evaluation and treatment. The article describes policy interventions in dementia-related research and clinical care to address disparity gaps and to promote the needs of Black older adults and their caregivers in attaining high quality services and supports.

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