Search Results (85)

Amidst the health and socioeconomic burdens COVID-19 placed on families, communities of color also grappled with heightened xenophobia and racism. Yet, adolescents also found silver linings in the form of spending time with family and engaging in activities promoting relaxation and leisure. The present study examined parent-adolescent relationship quality (RQ) as a moderator of the relations of Latinx youth’s environment (i.e., racial-ethnic discrimination, COVID-19 stress, and COVID-19 silver linings) on their anxiety and depressive symptoms, both concurrently and six months later. Participants included 135 Latinx adolescents (M_age = 16.00, SD = 1.27; 59.3% female; 85.2% U.S.-born). Path analytic models revealed that youth discrimination experiences were positively associated with youth symptomatology, whereas COVID-19 silver linings and positive RQ were negatively associated with youth symptomatology. We also found that at mean and higher levels of negative RQ, discrimination experiences were positively associated with concurrent anxiety symptoms, suggesting that negative relationship features (e.g., conflict, pressure) exacerbated the effects of discrimination on youth anxiety. Therefore, stressors may predict youth symptomatology concurrently, but cultivating a positive parent-adolescent relationship and encouraging finding silver linings may bolster resilience in Latinx youth across time amidst adversity. Full article

We examined the association between perceived discrimination and body mass index (BMI) in Asian American (AA) women before and during the COVID-19 pandemic. The data used were from the Epidemiology/Epigenetics of Asian Women’s Action for Resilience and Empowerment (Epi AWARE) study, which enrolled 157 AA women aged 18 to 59 between December 2019 and September 2022. Two sets of questions measured “everyday” (e.g., “How often do people act as if you are dishonest?”) and “lifetime” (e.g., “unfair treatment due to your race at school”) discrimination. Responses were combined, creating a cumulative score, and dichotomized into “no” versus “any” discrimination. Self-reported height and weight were used to calculate BMI, dichotomized as <25 kg/m² and ≥25 kg/m². Multivariable binomial regression estimated risk ratios (RRs) and 95% confidence intervals (95% CIs). Overall, women reporting any versus no discrimination were more likely to be classified as having a BMI ≥ 25 kg/m² (RR = 2.09; 95% CI: 1.06–4.13). The RR for women who responded during the COVID-19 pandemic (20 March 2020 or later) was 2.65 (95% CI: 0.82–8.58); the RR for pre-pandemic response was 1.93 (95% CI: 0.75–5.01). Our data suggest that experiences of racism may impact BMI among AA women. Further research is needed to identify mechanisms and design appropriate interventions. Full article

Historically, the attribution of biology to race has shaped societies and manifested in innumerable disparities and irreparable harm, especially in communities of color. From the earliest days of the United States to the present day, the dehumanization and “othering” of African Americans have caused deep racial inequities that have been perpetuated and embedded in American culture. The early months of the COVID-19 pandemic underscored the deep racial inequalities in the US, especially in health outcomes for communities of color. Structural racism has played a critical role in exacerbating disparities, with Black, Hispanic, Latinx, and Indigenous populations experiencing higher rates of severe disease and mortality. The interconnectedness of racism with the social determinants of health, concomitant with higher rates of chronic illnesses like diabetes and hypertension, increases vulnerability to severe COVID-19. Health disparities are compounded by implicit biases in the medical field, a lack of diversity among healthcare providers, and historical medical mistrust among marginalized groups. Underrepresentation in the medical field, biomedical sciences, and academia hinders efforts to address health disparities effectively. This essay seeks to raise awareness of how the concepts of race and racism have resulted in racial hierarchies that perpetuate systems of oppression and impede efforts toward racial and health equity. Specifically, this essay covers time periods in American history, including slavery, the Jim Crow Era, the Civil Rights Movement, and the COVID-19 pandemic, and discusses how addressing race and racism and the achievement of racial health equity require targeted efforts to increase diversity in healthcare and biomedical fields, improve cultural competence, and foster trust between medical professionals and communities of color. Full article

The human immunodeficiency virus (HIV) pandemic is a global public health and social justice issue. HIV continues to disproportionately affect marginalized populations, including immigrants and refugees living with HIV (IRLHIV). This study investigated and captured the experiences of IRLHIV using the social determinants of health framework. This study examined the intersecting factors affecting the health and well-being of IRLHIV in Alberta, Canada, prior to and during the COVID-19 pandemic. Concurrent mixed methods were used. Employing an online survey (n = 124) and photovoice methodology (n = 13), the researchers identified five salient themes: experiences of racism and discrimination, challenges accessing nutrition, healthcare, and affordable housing, and precarious employment situations. The findings underscored the amplification of pre-existing inequities during the COVID-19 pandemic, intensifying the discrimination and stigma faced by IRLHIV due to both their health status and immigration background. These findings highlight the urgent need for targeted, evidence-based interventions to address the social determinants of health that adversely affect IRLHIV. The researchers recommend further participatory research action into health disparities for IRLHIV to create responsive and culturally safe services for IRLHIV. Full article

Context: Calls to collect patients’ race/ethnicity (RE) data as a measure to promote equitable health care among vulnerable patient groups are increasing. The COVID-19 pandemic has highlighted how a public health crisis disproportionately affects racialized patient groups. However, less is known about the uptake of RE data collection in the context of mental health care services. Methodology: A qualitative case study used surveys with mental health patients (n = 47) and providers (n = 12), a retrospective chart review, and a focus group to explore healthcare providers’ and patients’ perspectives on collecting RE data in Canada. Results: The patient survey data and focus groups show that patients avoid providing identifying information due to perceived stigma and discrimination and a lack of trust. Providers did not feel comfortable asking patients about RE, leading to chart review data where RE information was not systematically collected. Conclusions: The uptake and implementation of RE data collection in mental health care contexts require increased training and support, systematic implementation, and further evaluation and measurement of how the collection of RE data will be used to mitigate systemic racism and improve mental health outcomes. Full article

The purpose of this study was to understand how the challenges and coping strategies among international students in the United States changed before and during the COVID-19 pandemic. We conducted a qualitative study through one-on-one in-depth interviews during April–June 2021. A total of 34 international students in the San Francisco Bay Area participated in this study. NVivo was used to analyze the qualitative data. Before COVID-19, the challenges were primarily related to a sense of belonging, such as culture shock, language barriers, and loss of identity. However, some positive experiences from school life and new culture were also found before COVID-19. During the pandemic, students faced difficulties with online learning and lockdown protocols that they had never experienced before. The ongoing challenges before and during COVID-19 were identity crisis, racism and discrimination, and financial struggles. Common coping strategies for overcoming these difficulties included engaging in physical activity, social exposure, self-improvement, and mental self-care. The frequency of online engagement and motivation for self-improvement were particularly highlighted during COVID-19. However, international students expressed a preference for improved support systems, including financial aid, paid research opportunities, and more accessible campus resources. Future research could focus on the strategies to support the psychological well-being of international students in coping with unexpected situations, such as disease outbreaks. Full article

Nurses play key roles in dealing with pandemics yet are often conceived solely as “technical” experts without political agency. This study conducts the first global comparative analysis of COVID-19-related protests of nurses and other frontline health workers, with a focus on the first 18 months of the pandemic. We draw on quantitative and qualitative data on nurses’ protests and protest drivers. Results show that such protests were widespread: We identify 3515 events in 90 countries, with several regional hotspots existing. The most common reasons for protests were poor working conditions and insufficient workplace safety, followed by wider social issues like poverty and racism. For most of the time period under consideration, protests demanding access to vaccinations (a rarely explored phenomenon) were more widespread than anti-vaccination events. Protest frequency was highest in countries with high COVID-19-related mortality rates, high levels of human development, and strong social movements at the onset of the pandemic. Recognising the key role of nurses as political actors would help to improve health policies and to maintain a capable healthcare workforce, particularly during acute crises like pandemics. Full article

The current study examines the links between anxiety and depression symptoms and COVID-19-related racism amongst Asian Americans living in western New York, United States. Based on the findings of survey data (n = 333) and in corroboration with minority stress theory, all forms of racism are positively correlated with anxiety and depression levels. There are differences across different forms of racism. Experiences of avoidance and verbal harassment are primarily linked to increased levels of anxiety, while encountering discrimination in business and social settings is more likely to contribute to depression. Indirect discrimination and stigma consciousness tend to heighten anxiety more than depression. Moreover, individuals who are native-born and female tend to report worse mental health outcomes than those who are foreign-born Asians or males. There is a contrasting relationship with income, where higher earnings are linked to reduced depression but can correlate with more significant anxiety. The study findings reveal that COVID-19-related racism may lead to stigma consciousness, race- and racism-based stress, anxiety, and depression. The study contributes to the literature by connecting theories on mental health effects of racism, as well as by distinguishing the links between different forms and intensities of racism and mental well-being, rather than treating all racism as uniform. Considering the detrimental effects on mental health, public policies must confront and address racial prejudice and discrimination that individuals from marginalized communities encounter, particularly during times of crisis. Full article

For people from communities experiencing poverty and oppression, education, particularly higher education, is a means to ensure upward socioeconomic mobility. The access to and attainment of education are issues of social and economic justice, built upon foundational experiences in primary and secondary settings, and impacted by students’ cultural and socio-political environments. 6. The 2020 murder of George Floyd, the Black Lives Matter movement, ongoing discourse around immigration, and COVID-19-related hate targeting people of Asian American descent prompted national calls to dismantle social and systemic racism, spurring diversity, equity, inclusion, and accessibility (DEIA) initiatives, particularly in education. However, these efforts have faced opposition from teachers who have told students that all lives matter, and racism does not exist in many American classrooms Loza. These comments negate students’ experiences, suppress cultural and identity affirmation, and negatively impact student wellness and academic performance. Forged in this polarized environment, two longtime community organizers and educators, an indigenous person living away from her ancestral lands and a multiracial descendant of Japanese Americans interned during WWII, whose identities, experiences, and personal narratives shape the course of their work in and outside of the physical classroom, call on fellow educators to exercise y (2018) component of the archeology of self, a “profound love, a deep, ethical commitment to caring for the communities where one works”, by adopting a framework to encourage this profound love in students, acting not just as a teacher, but as a sensei. The word sensei is commonly understood in reference to a teacher of Japanese martial arts. The honorific sensei, however, in kanji means one who comes before, implying intergenerational connection. Sensei is an umbrella expression used for elders who have attained a level of mastery within their respective crafts—doctors, teachers, politicians, and spiritual leaders may all earn the title of sensei. The sensei preserves funds of knowledge across generations, passing down and building upon knowledge from those who came before. The Student Empowerment through Narrative, Storytelling, Engagement, and Identity (SENSEI) framework provides an asset-based, culturally affirming approach to working with students in and beyond the classroom. The framework builds on tools and perspectives, including Asset-based Community Development (ABCD), the Narrative Theory, Yosso’s cultural community wealth, cultural continuity, thrivance, community organizing tenets, and storytelling SENSEI provides a pedagogy that encourages students to explore, define, and own their identities and experiences and grow funds of knowledge, empowering them to transform their own communities from within. The SENSEI framework begins by redefining a teacher as not simply one who teaches in a classroom but rather one who teaches valuable life lessons that transcend colonial conceptualizations of the teacher. In colonized contexts, teachers function to maintain hegemony and assert dominance over marginalized populations. In the SENSEI framework, teachers are those who disrupt colonial patterns and function to reclaim the strengths and voices of the communities they serve. In the SENSEI framework, students are not relegated to those enrolled in classrooms. As with a sensei, a student exists to counter hegemony by embracing and enacting their cultural wealth Educators must help counter harmful narratives and encourage students to identify the strengths that lie within themselves and their communities. Collective forms of narrative that value identity can ensure the continuity of a community or a people. The stories of students’ histories, traditional practices, and resilience can help disrupt harms, many that have lasted for generations, so they may not just survive, but thrive. Full article

Racism has been a long-standing influential factor that has negatively impacted both past and current health disparities within the United Sates population. Existing problems of racism and its impact on both health disparities and health inequalities were only amplified during the COVID-19 pandemic. The pandemic allowed both clinicians and researchers to recognize a growing list of health concerns at the macro-, meso-, and micro-level among underserved racially minoritized patients with specific chronic illnesses such as cancer. Based on these concerns, this Special Issue was designed to highlight the challenges of cancer screening, cancer treatment, and cancer-centered educational outreach among racially minoritized communities. Full article

Background: The mental health of Black youth during the COVID-19 pandemic is potentially influenced by various systemic factors, including racism, socioeconomic disparities, and access to culturally sensitive mental health support. Understanding these influences is essential for developing effective interventions to mitigate mental health disparities. Methods: Our project used a community-based participatory (CBP) research design with an intersectional theoretical perspective. An advisory committee consisting of fourteen Black youth supported all aspects of our project. The research team consisted of experienced Black researchers who also trained six Black youths as research assistants and co-researchers. The co-researchers conducted individual interviews, contributed to data analysis, and mobilized knowledge. Participants were recruited through the advisory committee members and networks of Black youth co-researchers and sent an email invitation to Black community organizations. Forty-eight Black identified were interviewed between the ages of 16 and 30 in Canada. The data was analyzed thematically. We kept a reflexive note throughout all aspects of the project. Results: Participants reported significant challenges with online schooling, including a lack of support and access to resources. Lockdowns exacerbated stress, particularly for those living in toxic living/home environments. Financial burdens, such as food insecurity and precarious employment, were prevalent and exacerbated mental health challenges. Additionally, experiences of anti-Black racism and police brutality during the pandemic heightened stress and anxiety among participants. Conclusions: The findings underscore the complex interplay of systemic factors in shaping the mental health of Black youth during the COVID-19 pandemic. Addressing these disparities requires targeted interventions that address structural inequities and provide culturally competent support to mitigate the impact on mental well-being. Full article

During the first wave of the COVID-19 pandemic, immigrants were among the most socially vulnerable in Western countries. The Chinese diaspora in Canada were one such group due to the widespread cultural stigma surrounding their purported greater susceptibility to transmit and become infected by COVID-19. This paper aims to understand the social vulnerability of the Chinese diaspora in the Greater Toronto Area, Canada, during the first wave of COVID-19 from an explanation of their risk perception and threat appraisal of risk communication. We conducted secondary data analysis of 36 interviews using critical realism. The participants self-identified as being of Chinese descent. The results were used to develop a model of how social vulnerability occurred. In brief, cognitive dissonance was discovered to generate conflicts of one’s cultural identity, shaped by social structures of (i) stigma of contagion, (ii) ethnic stigma, and (iii) public sentiment, and mediated by participants’ threat appraisal and (iv) self-reliance. We assert that risk communicators need to consider their audiences’ diverse socialization in crafting messages to modify behaviors, create a sense of responsibility, and mitigate public health threats. A lack of awareness of one’s cognitive dissonance driven by cultural vulnerability may heighten their social vulnerability and prevent them from taking action to protect themself from high-risk events. Full article

This article explores the strategies used by government-sponsored institutions dedicated to addressing systemic barriers to employment for racialized immigrants in Edmonton. The research involved conducting in-depth semi-structured interviews with service providers, employment program coordinators from different settlement and employment agencies, and a research and training centre operating in Edmonton, Alberta. The first objective is to understand the barriers racialized immigrants face through the hiring and promotion process. The second objective is to understand the support provided by those institutions and the impact of their equity policies on how they assist racialized Canadians in finding gainful employment. Lastly, this study explores the impact of the COVID-19 pandemic and the Black Lives Matter movement on the employment of racialized immigrants in Edmonton. The results show that around 50% of employment service providers acknowledged that visible minority immigrants face barriers while integrating into the labour market, including racial microaggressions in their jobs. In addition, the findings indicate a lack of programs tailored to the needs of racialized job seekers. Participants in this study reported that the Black Lives Matter movement raised awareness among employers regarding racial issues in the workplace. Hence, there is a demonstrated need for employers to undergo training to recognize and address racism in hiring, promoting, and retaining racialized employees at Canadian workplaces. Interviewees recognized that the COVID-19 pandemic negatively impacted racialized employees and newcomers. They recommended that Canadian companies establish educational programs that emphasize the importance and benefits of racial diversity, equity, and inclusion in the hiring process. Full article

Although the COVID-19 pandemic has caused the need for the largest mass vaccination campaign ever undertaken to date, African, Caribbean, and Black (ACB) populations have shown both a disproportionately high degree of negative impacts from the pandemic and the lowest willingness to become vaccinated. This scoping review aims to investigate low vaccine uptake in ACB populations relative to public health in high-income countries. A search was conducted in MEDLINE(R) ALL (OvidSP), Embase (OvidSP), CINAHL (EBSCOHost), APA PsycInfo (OvidSP), the Cochrane Central Register of Controlled Trials (OvidSP), the Cochrane Database of Systematic Reviews (OvidSP), the Allied and Complimentary Medicine Database (Ovid SP), and the Web of Science following the Joanna Briggs Institute (JBI) framework for scoping reviews, supplemented by PRISMA-ScR. Theoretical underpinnings of the intersectionality approach were also used to help interpret the complexities of health inequities in the ACB population. The eligibility criteria were based on the population, concept, context (PCC) framework, and publications from 2020–19 July 2022 which discussed vaccine uptake amongst ACB people in high-income countries were included. Analysis was carried out through thematic mapping and produced four main themes: (1) racism and inequities, (2) sentiments and behaviors, (3) knowledge and communication, and (4) engagement and influence. This study has contributed to the identification and definition of the issue of low vaccine uptake in ACB populations and has illustrated the complexity of the problems, as vaccine access is hampered by knowledge, psychological, socioeconomic, and organizational barriers at the individual, organizational, and systemic levels, leading to structural inequities that have manifested as low vaccine uptake. Full article

People from Black and Asian backgrounds are more likely to die from COVID-19 but less likely to be vaccinated, threatening to exacerbate health inequalities already experienced by ethnic minority groups. The literature suggests that mistrust rooted in structural inequality (including socioeconomic position and experience of racism) may be a key barrier to COVID-19 vaccine uptake. Understanding and addressing structural inequality is likely to lead to longer-term impacts than information alone. The aim of this study is to draw on health and sociological theories of structure and agency to inform our understanding of how structural factors influence vaccine confidence. We conducted qualitative interviews and focus groups with 22 people from London and the surrounding areas from December 2021 to March 2022. Fourteen participants were members of the public from ethnic minority backgrounds, and seven were professionals working with the public to address concerns and encourage vaccine uptake. Our findings suggest that people from ethnic minority backgrounds make decisions regarding COVID-19 vaccination based on a combination of how they experience external social structures (including lack of credibility and clarity from political authority, neglect by health services, and structural racism) and internal processes (weighing up COVID-19 vaccine harms and benefits and concerns about vaccine development and deployment). We may be able to support knowledge accumulation through the provision of reliable and accessible information, particularly through primary and community care, but we recommend a number of changes to research, policy and practice that address structural inequalities. These include working with communities to improve ethnicity data collection, increasing funding allocation to health conditions where ethnic minority communities experience poorer outcomes, greater transparency and public engagement in the vaccine development process, and culturally adapted research recruitment processes. Full article