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Keywords = populations of color, vulnerable communities

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33 pages, 2115 KB  
Review
PFAS Exposure, Mental Health, and Environmental Justice in the United States: Impacts on Marginalized Communities
by Shiryn D. Sukhram, Ji Kim, Sabrina Musovic, Ayotunde Anidugbe, Emiliano Corte, Tasneem Ahsan, Selvia Rofail, Nicolli Mesquita and Miguel Padilla
Int. J. Environ. Res. Public Health 2025, 22(7), 1116; https://doi.org/10.3390/ijerph22071116 - 15 Jul 2025
Viewed by 2722
Abstract
Per- and polyfluoroalkyl substances (PFASs), commonly known as “forever chemicals”, are synthetic compounds with highly stable carbon–fluorine bonds, making them resistant to environmental degradation. These chemicals accumulate in ecosystems and water supplies, posing significant risks to human health, including cancer, immune system dysfunction, [...] Read more.
Per- and polyfluoroalkyl substances (PFASs), commonly known as “forever chemicals”, are synthetic compounds with highly stable carbon–fluorine bonds, making them resistant to environmental degradation. These chemicals accumulate in ecosystems and water supplies, posing significant risks to human health, including cancer, immune system dysfunction, and neurological disorders. However, the mental health impacts of PFAS exposure remain underexplored, particularly in marginalized communities. This review examines the emerging evidence linking PFAS exposure to mental health issues such as anxiety, depression, and cognitive decline, with a focus on communities of color who face heightened vulnerability due to environmental and social health disparities. The review highlights the persistence of PFASs in the environment, common exposure pathways, and the disproportionate effects on populations living near contaminated sites. Despite some regulatory progress, U.S. regulations on PFASs are limited, especially compared to international standards. The review calls for stronger policy frameworks and emphasizes the need for environmental justice, health equity, and public awareness. By connecting environmental health, social justice, and mental well-being, the review aims to guide future research and policy reforms to mitigate the mental health consequences of PFAS exposure in vulnerable populations. Full article
(This article belongs to the Special Issue Feature Papers in Environmental Exposure and Toxicology)
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12 pages, 258 KB  
Essay
COVID-19 as a Mirror: Reflecting the Pandemic of Racism and the Historical Roots of Health Inequities
by Tiffany J. Grant
Int. J. Environ. Res. Public Health 2025, 22(2), 273; https://doi.org/10.3390/ijerph22020273 - 13 Feb 2025
Cited by 2 | Viewed by 1851
Abstract
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 [...] Read more.
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
27 pages, 6682 KB  
Article
Reflecting on City Governmental Responses to COVID-19: Focus on Design Justice
by Joongsub Kim and Stephen Vogel
Architecture 2024, 4(4), 1071-1097; https://doi.org/10.3390/architecture4040056 - 27 Nov 2024
Cited by 1 | Viewed by 1346
Abstract
In the early stages of the COVID-19 pandemic and the resultant stay-at-home mandates, local governments in some cities in the United States implemented programs in response to the pandemic. This article focuses on Slow Streets, which were several programs implemented in eleven cities [...] Read more.
In the early stages of the COVID-19 pandemic and the resultant stay-at-home mandates, local governments in some cities in the United States implemented programs in response to the pandemic. This article focuses on Slow Streets, which were several programs implemented in eleven cities (Los Angeles, Oakland, San Francisco, Seattle, Portland, Denver, Chicago, Minneapolis, Detroit, Boston, and New York) in the United States. The programs were intended to keep people healthy by providing temporary public spaces on residential roads where residents were allowed to exercise and socialize. Some practitioners characterized the programs as tactical urbanism or tactical placemaking and as agile responses to the public health crisis. The programs deserve a critical reflection, considering their potential impact on community health and the limited amount of the literature on the program in terms of design justice, which is an approach to design that prioritizes marginalized communities and challenges their structural inequality. This reflective study attempts to fill that gap in the literature of architecture and urban design. This article aims to examine whether the Slow Streets programs promoted design justice. To address that aim, we propose a social justice framework to evaluate the program, because social justice is essential to design justice. Data from publicly available information online about the eleven cities’ Slow Streets programs, interviews, surveys, focus groups, and the interdisciplinary literature support the qualitative research. The study outcomes suggest that the Slow Streets program had limited success because their attention to the priorities of underserved populations was ineffective. We argue that while the programs provided a timely response to the pandemic, the programs did not adequately address the vulnerability of low-income communities of color due to the limited consideration of design justice. Building on the lessons from social justice and human geography, the article concludes with recommendations for future practices including place-cultivating and human geography-informed design to better serve vulnerable communities of color. Full article
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12 pages, 359 KB  
Article
Pandemic Meets Endemic: The Role of Social Inequalities and Failing Public Health Policies as Drivers of Disparities in COVID-19 Mortality among White, Black, and Hispanic Communities in the United States of America
by Lorraine Frisina Doetter, Pasquale G. Frisina and Benedikt Preuß
Int. J. Environ. Res. Public Health 2022, 19(22), 14961; https://doi.org/10.3390/ijerph192214961 - 14 Nov 2022
Cited by 7 | Viewed by 2126
Abstract
The COVID-19 pandemic placed the United States of America (U.S.) under enormous strain, leaving it with higher deaths during the first wave of the outbreak compared to all other advanced economies. Blacks and Hispanics were among those hardest hit by the virus—a fact [...] Read more.
The COVID-19 pandemic placed the United States of America (U.S.) under enormous strain, leaving it with higher deaths during the first wave of the outbreak compared to all other advanced economies. Blacks and Hispanics were among those hardest hit by the virus—a fact attributed to enduring problems related to the social determinants of health adversely affecting Communities of Color (CoC). In this study, we ask which distinct factors relating to policy stringency and community vulnerability influenced COVID-19 mortality among Whites, Blacks, and Hispanics during the first year of the pandemic. To address this question, we utilized a mix of correlational and regression analyses. Findings point to the highly divergent impact of public policy and vulnerability on COVID-19 mortality. Specifically, we observed that state-led measures aimed at controlling the spread of the virus only improved mortality for Whites. However, pre-existing social determinants of health (i.e., population density, epidemiological and healthcare system factors) played a significant role in determining COVID-19 outcomes for CoC, even in the face of stringent containment measures by states. This suggests that state-led policy to address present and/or future public health crises need to account for the particular nature of vulnerability affecting Blacks and Hispanics in the U.S. Full article
(This article belongs to the Special Issue Advances in the Health Effects of Place and Social Inequality)
16 pages, 5326 KB  
Article
Understanding the Health and Health-Related Social Needs of Youth Experiencing Homelessness: A Photovoice Study
by April Joy Damian, Delilah Ponce, Angel Ortiz-Siberon, Zeba Kokan, Ryan Curran, Brandon Azevedo and Melanie Gonzalez
Int. J. Environ. Res. Public Health 2022, 19(16), 9799; https://doi.org/10.3390/ijerph19169799 - 9 Aug 2022
Cited by 11 | Viewed by 4544
Abstract
Purpose: Homelessness is a major public health problem facing millions of youths across the United States (U.S.), with lesbian gay, bisexual, transgender, questioning (LGBTQ+) youths and youths of color being disproportionately at higher risk. This study obtains an understanding of the health and [...] Read more.
Purpose: Homelessness is a major public health problem facing millions of youths across the United States (U.S.), with lesbian gay, bisexual, transgender, questioning (LGBTQ+) youths and youths of color being disproportionately at higher risk. This study obtains an understanding of the health and health-related social needs of youths experiencing homelessness during the coronavirus disease (COVID-19) pandemic. Methods: A total of 14 youths between the ages of 14 and 24 who (a) lived, worked, or attended school in New Britain, Connecticut (CT) and (b) had at least one experience of homelessness or housing insecurity worked with the research team to conduct a needs assessment regarding youth homelessness. Using photovoice, a community-based participatory research method, participants created photo narratives to share their stories and recommendations for community change. The main goals of photovoice are to enable participants to (1) record and represent their everyday realities; (2) promote critical dialogue and knowledge about person and community strengths and concerns; and (3) reach policy makers. Results: Most of the participants identified as youths of color, and half of the participants identified as members of the LGBTQ+ community. Three major themes that appeared in the youths’ narratives include the following: mental health and substance use challenges, trouble accessing basic human needs, and lack of a social support system. Conclusion: This study uplifts and empowers a vulnerable population to increase visibility around a major public health challenge from their own lived experiences. Despite the challenges that were voiced, many participants shared a sense of hope and resiliency. The major themes endorsed by the youths has the potential of informing practitioners and policy makers of how to better address the needs of youths experiencing homelessness, particularly those most at risk. Full article
(This article belongs to the Section Children's Health)
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21 pages, 602 KB  
Review
Association between Neighborhood and Racial Composition of Victims on Fatal Police Shooting and Police Violence: An Integrated Review (2000–2022)
by Hossein Zare, Nicholas S. Meyerson, Paul Delgado, Michelle Spencer, Darrell J. Gaskin and Roland J. Thorpe
Soc. Sci. 2022, 11(4), 153; https://doi.org/10.3390/socsci11040153 - 1 Apr 2022
Cited by 16 | Viewed by 9301
Abstract
Police violence is a multidimensional issue that requires consideration of the violent events and how these events reflect systemic oppression. Violence and policing practices are influenced by race and ethnicity, place/neighborhood, structural inequality, and racism. We performed an integrated literature review to critically [...] Read more.
Police violence is a multidimensional issue that requires consideration of the violent events and how these events reflect systemic oppression. Violence and policing practices are influenced by race and ethnicity, place/neighborhood, structural inequality, and racism. We performed an integrated literature review to critically evaluate the current evidence, focusing on the racial composition of communities and neighborhoods and its association with police-involved violence and fatal shootings between 2000 and 2022. We used Scopus and Web of Science to include peer-reviewed articles in English that studied racial/ethnic differences in police-involved violence in the United States between January 2000 and February 2022. We excluded prior systematic reviews, meta-analyses, and articles on drug-related arrests. Using a PRISMA approach from 651 identified articles, we included 37 articles. Our findings showed that racial/ethnic minorities are disproportionately stopped, experience a higher probability of arrest, and are more commonly subjected to police-involved fatal shootings. Victims are more likely to live in neighborhoods with lower income and distressed communities of color, higher poverty ratios, and the highest levels of criminal violence. Citizens reporting of negative interactions with police is strongly associated with race/ethnicity. Maintaining the highest standards of professional practice consistent with the law and protections guaranteed by the Constitution may reduce police violence. In addressing police violence, policymakers not only need to consider the multidisciplinary nature of vulnerability to address the needs of vulnerable populations and create a collaborative environment but also to control police violence. Considering community-based approaches, encouraging training to interact with minority individuals, and adjusting the racial composition of the police officers by the racial composition of communities are other strategies; more importantly, prioritizing strategies to reduce social inequality and structural racism are crucial. Full article
(This article belongs to the Special Issue Disparities in Criminal Justice, Race, Place and Police Violence)
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12 pages, 2299 KB  
Article
Health Disparities and Climate Change: The Intersection of Three Disaster Events on Vulnerable Communities in Houston, Texas
by Omolola E. Adepoju, Daikwon Han, Minji Chae, Kendra L. Smith, Lauren Gilbert, Sumaita Choudhury and LeChauncy Woodard
Int. J. Environ. Res. Public Health 2022, 19(1), 35; https://doi.org/10.3390/ijerph19010035 - 21 Dec 2021
Cited by 33 | Viewed by 8842
Abstract
Although evidence suggests that successive climate disasters are on the rise, few studies have documented the disproportionate impacts on communities of color. Through the unique lens of successive disaster events (Hurricane Harvey and Winter Storm Uri) coupled with the COVID-19 pandemic, we assessed [...] Read more.
Although evidence suggests that successive climate disasters are on the rise, few studies have documented the disproportionate impacts on communities of color. Through the unique lens of successive disaster events (Hurricane Harvey and Winter Storm Uri) coupled with the COVID-19 pandemic, we assessed disaster exposure in minority communities in Harris County, Texas. A mixed methods approach employing qualitative and quantitative designs was used to examine the relationships between successive disasters (and the role of climate change), population geography, race, and health disparities-related outcomes. This study identified four communities in the greater Houston area with predominantly non-Hispanic African American residents. We used data chronicling the local community and environment to build base maps and conducted spatial analyses using Geographic Information System (GIS) mapping. We complemented these data with focus groups to assess participants’ experiences in disaster planning and recovery, as well as community resilience. Thematic analysis was used to identify key patterns. Across all four communities, we observed significant Hurricane Harvey flooding and significantly greater exposure to 10 of the 11 COVID-19 risk factors examined, compared to the rest of the county. Spatial analyses reveal higher disease burden, greater social vulnerability, and significantly higher community-level risk factors for both pandemics and disaster events in the four communities, compared to all other communities in Harris County. Two themes emerged from thematic data analysis: (1) Prior disaster exposure prepared minority populations in Harris County to better handle subsequent disaster suggesting enhanced disaster resilience, and (2) social connectedness was key to disaster resiliency. Long-standing disparities make people of color at greater risk for social vulnerability. Addressing climate change offers the potential to alleviate these health disparities. Full article
(This article belongs to the Section Climate Change)
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9 pages, 687 KB  
Article
Trends in COVID-19 Health Disparities in North Carolina: Preparing the Field for Long-Haul Patients
by Thais Muratori Holanda, Claudia Alberico, Leslimar Rios-Colon, Elena Arthur and Deepak Kumar
Healthcare 2021, 9(12), 1704; https://doi.org/10.3390/healthcare9121704 - 8 Dec 2021
Cited by 5 | Viewed by 3868
Abstract
Long-term coronavirus disease 2019 (long-COVID) refers to persistent symptoms of SARS-CoV-2 (COVID-19) lingering beyond four weeks of initial infection. Approximately 30% of COVID-19 survivors develop prolonged symptoms. Communities of color are disproportionately affected by comorbidities, increasing the risk of severe COVID-19 and potentially [...] Read more.
Long-term coronavirus disease 2019 (long-COVID) refers to persistent symptoms of SARS-CoV-2 (COVID-19) lingering beyond four weeks of initial infection. Approximately 30% of COVID-19 survivors develop prolonged symptoms. Communities of color are disproportionately affected by comorbidities, increasing the risk of severe COVID-19 and potentially leading to long-COVID. This study aims to identify trends in health disparities related to COVID-19 cases, which can help unveil potential populations at risk for long-COVID. All North Carolina (NC) counties (n = 100) were selected as a case study. Cases and vaccinations per 1000 population were calculated based on the NC Department of Health and Human Services COVID-19 dashboard with reports current as of 8 October 2021, which were stratified by age groups and race/ethnicity. Then, NC COVID-19 cases were correlated to median household income, poverty, population density, and social vulnerability index themes. We observed a negative correlation between cases (p < 0.05) and deaths (p < 0.01) with both income and vaccination status. Moreover, there was a significant positive association between vaccination status and median household income (p < 0.01). Our results highlight the prevailing trend between exacerbated COVID-19 infection and low-income/under-resourced communities. Consequently, efforts and resources should be channeled to these communities to effectively monitor, diagnose, and treat against COVID-19 and potentially prevent an overwhelming number of long-COVID cases. Full article
(This article belongs to the Collection The Impact of COVID-19 on Healthcare Services)
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18 pages, 1035 KB  
Article
Local Government Approaches to Combating COVID-19 Inequities: A Durham County Department of Public Health Perspective
by Kristen Burwell-Naney, Marissa Mortiboy, John-Paul Zitta, Elizabeth Stevens, Kristen Patterson, James Christopher Salter, Michele Easterling, Lindsey Bickers Bock, Hattie Wood, Malkia Rayner and Rodney Jenkins
Int. J. Environ. Res. Public Health 2021, 18(12), 6544; https://doi.org/10.3390/ijerph18126544 - 18 Jun 2021
Cited by 5 | Viewed by 3473
Abstract
When a novel coronavirus disease (COVID-19) made major headlines in 2020, it further exposed an existing public health crisis related to inequities within our communities and health care delivery system. Throughout the COVID-19 pandemic, populations of color had higher infection and mortality rates, [...] Read more.
When a novel coronavirus disease (COVID-19) made major headlines in 2020, it further exposed an existing public health crisis related to inequities within our communities and health care delivery system. Throughout the COVID-19 pandemic, populations of color had higher infection and mortality rates, and even experienced greater disease severity compared to whites. Populations of color often bear the brunt of COVID-19 and other health inequities, due to the multifaceted relationship between systemic racism and the social determinants of health. As this relationship continues to perpetuate health inequities, the local health department is an agency that has the jurisdiction and responsibility to prevent disease and protect the health of the communities they serve. When equity is integrated into a health department’s operational infrastructure as a disease prevention strategy, it can elevate the agency’s response to public health emergencies. Collecting, reporting, and tracking demographic data that is necessary to identify inequities becomes a priority to facilitate a more robust public health response. The purpose of this paper is to present strategies of how a local health department operationalized equity in various stages of COVID-19 response and apply these methods to future public health emergencies to better serve vulnerable communities. Full article
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13 pages, 2410 KB  
Article
Community-Level Factors Associated with COVID-19 Cases and Testing Equity in King County, Washington
by Edmund Seto, Esther Min, Carolyn Ingram, BJ Cummings and Stephanie A. Farquhar
Int. J. Environ. Res. Public Health 2020, 17(24), 9516; https://doi.org/10.3390/ijerph17249516 - 18 Dec 2020
Cited by 30 | Viewed by 5855
Abstract
Individual-level Coronavirus Disease 2019 (COVID-19) case data suggest that certain populations may be more impacted by the pandemic. However, few studies have considered the communities from which positive cases are prevalent, and the variations in testing rates between communities. In this study, we [...] Read more.
Individual-level Coronavirus Disease 2019 (COVID-19) case data suggest that certain populations may be more impacted by the pandemic. However, few studies have considered the communities from which positive cases are prevalent, and the variations in testing rates between communities. In this study, we assessed community factors that were associated with COVID-19 testing and test positivity at the census tract level for the Seattle, King County, Washington region at the summer peak of infection in July 2020. Multivariate Poisson regression was used to estimate confirmed case counts, adjusted for testing numbers, which were associated with socioeconomic status (SES) indicators such as poverty, educational attainment, transportation cost, as well as with communities with high proportions of people of color. Multivariate models were also used to examine factors associated with testing rates, and found disparities in testing for communities of color and communities with transportation cost barriers. These results demonstrate the ability to identify tract-level indicators of COVID-19 risk and specific communities that are most vulnerable to COVID-19 infection, as well as highlight the ongoing need to ensure access to disease control resources, including information and education, testing, and future vaccination programs in low-SES and highly diverse communities. Full article
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9 pages, 1050 KB  
Article
Accessing Disadvantaged Pregnant Women in Houston, Texas, and Characterizing Biomarkers of Metal Exposure: A Feasibility Study
by Kristina W. Whitworth, Inkyu Han, Masoud Afshar, Yuan Mei, Pamela D. Berens, Shreela V. Sharma and Elaine Symanski
Int. J. Environ. Res. Public Health 2017, 14(5), 474; https://doi.org/10.3390/ijerph14050474 - 29 Apr 2017
Cited by 3 | Viewed by 4394
Abstract
Abstract: Communities of color or low socioeconomic status are disproportionately affected by metal exposure given spatial variability of the ambient levels of these contaminants. Despite this, there is little research characterizing metal concentrations in blood among disadvantaged populations in the U.S., especially [...] Read more.
Abstract: Communities of color or low socioeconomic status are disproportionately affected by metal exposure given spatial variability of the ambient levels of these contaminants. Despite this, there is little research characterizing metal concentrations in blood among disadvantaged populations in the U.S., especially among pregnant women who are particularly vulnerable and difficult to access. Thus, we conducted a pilot study among disadvantaged pregnant women in Houston, Texas to assess willingness to participate in key activities of an epidemiologic study and characterize exposures to 16 metals. Thirty-one women attending a Medicaid-serving prenatal clinic were included in this pilot study and completed an interviewer-administered questionnaire. We obtained and measured metal compounds in whole blood samples for 22 of these women during third-trimester prenatal visits. Median whole blood concentrations of Ni, As, Cd, and Pb were 27, 1.4, 0.6, and 6.3 µg/L, respectively. Most women were willing to participate in critical aspects of a research study, including wearing a personal air-sampling badge for 2–3 days (87.1%), receiving ultrasounds (83.9%), and providing blood draws (64.5%). Despite the small sample, our results provide evidence of women’s metal exposure and their willingness to participate in future research studies to elucidate exposure pathways and explore related health effects experienced among this population of disadvantaged pregnant women. Full article
(This article belongs to the Section Global Health)
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21 pages, 711 KB  
Review
Climate Justice in Rural Southeastern United States: A Review of Climate Change Impacts and Effects on Human Health
by Kristie S. Gutierrez and Catherine E. LePrevost
Int. J. Environ. Res. Public Health 2016, 13(2), 189; https://doi.org/10.3390/ijerph13020189 - 3 Feb 2016
Cited by 62 | Viewed by 13889
Abstract
Climate justice is a local, national, and global movement to protect at-risk populations who are disproportionately affected by climate change. The social context for this review is the Southeastern region of the United States, which is particularly susceptible to climate change because of [...] Read more.
Climate justice is a local, national, and global movement to protect at-risk populations who are disproportionately affected by climate change. The social context for this review is the Southeastern region of the United States, which is particularly susceptible to climate change because of the geography of the area and the vulnerabilities of the inhabiting populations. Negative human health effects on variable and vulnerable populations within the Southeast region due to changing climate are concerning, as health threats are not expected to produce parallel effects among all individuals. Vulnerable communities, such as communities of color, indigenous people, the geographically isolated, and those who are socioeconomically disadvantaged and already experiencing poor environmental quality, are least able to respond and adapt to climate change. Focusing on vulnerable populations in the Southeastern United States, this review is a synthesis of the recent (2010 to 2015) literature-base on the health effects connected to climate change. This review also addresses local and regional mitigation and adaptation strategies for citizens and leaders to combat direct and indirect human health effects related to a changing climate. Full article
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