Search Results (253)

Chronic exposure to structural violence and environmental hazards may disrupt stress regulation, trigger inflammation, and impair iron metabolism in women. Iron deficiency has been associated with depression, but the combined impact of environmental stressors and anemia on maternal mental health remains understudied. We analyzed associations between 28 neighborhood-level environmental stressors, hemoglobin levels, and depressive symptoms (measured by the Patient Health Questionnaire-9) during early pregnancy, using retrospective data from 1964 pregnant patients (2015–2019) at an urban health center in Chicago. Demographic and residential data were linked to environmental indicators from the Chicago Health Atlas. Factor analysis reduced the environmental variables, and multivariable regression models examined associations with PHQ-9 scores at first pregnancy encounter. Participants were predominantly non-Hispanic Black (56%) and Hispanic (27%), with 13% anemic and 16% screening positive for depressive symptoms. Poverty, non-Hispanic Black race, single status, public or no insurance, and unemployment were associated with higher depressive symptoms. Among anemic individuals, neighborhood crime was significantly associated with depressive symptoms, while hemoglobin levels and gestational age were not. These findings highlight how environmental and social inequities contribute to maternal mental health disparities and support the need for integrated, equity-focused prenatal care interventions. Full article

Background: Maternal mortality remains a significant public health challenge in Brazil, reflecting persistent social, racial, and regional inequalities. Objectives: This study aimed to analyze trends and characteristics of maternal deaths in Brazil from 2000 to 2020, identifying sociodemographic and clinical risk factors. Methods: A retrospective, population-based study was conducted using secondary data from the Sistema de Informações sobre Mortalidade (SIM) of the Brazilian Ministry of Health. Descriptive and comparative statistical analyses were performed, including chi-square (χ²) goodness-of-fit tests and 95% confidence intervals calculated by the Wilson method. Variables were stratified by region, age, race, education, type and period of death, and investigation status. Results: A total of 40,907 maternal deaths were recorded. From 2000 to 2020, Brazil recorded 40,907 maternal deaths. The maternal mortality ratio decreased from approximately 74 deaths per 100,000 live births in 2000 to 57 per 100,000 in 2020, representing a 23% reduction over two decades. Most deaths occurred among young, Brown women with low education levels, particularly in the Southeast and Northeast regions. Direct obstetric causes accounted for two-thirds of cases, and most deaths occurred in hospital settings, mainly during the early puerperium. Conclusions: Despite progress, maternal mortality in Brazil remains above the WHO target and is strongly influenced by social inequities. Strengthening primary care, improving referral networks, expanding postpartum follow-up, and enhancing surveillance systems are essential for preventing avoidable deaths and achieving reproductive justice. Full article

Risk assessment instruments are widely used in U.S. juvenile justice systems to predict recidivism. However, concerns persist that these tools may embed systemic inequities by relying on indicators shaped by racialized disadvantage and community-level deprivation. This study examines whether race/ethnicity, detention and placement histories, and neighborhood disadvantage predict juvenile recidivism, and whether these effects vary across contexts. Using public data from the Florida Department of Juvenile Justice and a longitudinal cohort of 2877 youth (11,508 assessments, 2015–2018), generalized estimating equations modeled rearrest within 365 days. Detention history significantly predicted rearrest; placement history showed limited effects. Neighborhood disadvantage did not predict rearrest directly but significantly amplified the effect of prior detention. Race and SDI interactions revealed divergent patterns across groups. These findings underscore the need to contextualize risk assessments within structural inequities and to reform predictive tools to support equity-centered, rehabilitative decision-making. Full article

Inequalities in enrollment in STEM persist for those entering higher education as first-generation college students, underserved racial and ethnic groups, female and nonbinary individuals, and those from lower socioeconomic backgrounds. The current study aims to better understand the relationship students have with graduate school success factors by redistributing the Graduate Student Success Survey+ (GSSS+) at an R2 institution in the southeastern United States. Exploratory factor analysis was used to test the survey’s validity, with 242 participants. A 7-factor, 40-item model was developed, comprising the following subscales: mentor support, peer support, imposter phenomenon, financial support, microaggressions (related to race and gender), access and opportunity (for research, writing, and presentations), and resilience. Item analysis identified perceived barriers (e.g., microaggressions, imposter phenomenon, and financial stress) for underserved students (i.e., females, underserved racial and ethnic groups, and part-time students). Regression analysis on resilience revealed a positive relationship with mentor support, peer support, and financial support. A negative relationship with resilience was associated with a greater perception of imposter phenomenon. Findings from this study underscore the need for additional support from mentors and other university entities to foster a stronger sense of resilience in students, along with increased opportunities for participation in research, academic writing, and publication. Full article

Background/Objectives: Solitary plasmacytoma of bone (SPB) results from abnormal proliferation of plasma cells and accounts for 2–5% of all plasmacytic malignancies. Radiation therapy is the standard of care in treating SPB due to its efficacy in controlling disease progression and optimizing patient survival. However, prior studies have highlighted disparities in radiation therapy receipt among various cancer types. In this study, we aim to investigate whether similar sociodemographic and clinical disparities exist in the treatment of SPB through use of the Surveillance, Epidemiology, and End Results (SEER) database. Methods: The SEER database was queried for biopsy-confirmed cases of SPB between 2000 and 2021 using the ICD-O-3 histology code 9731/3 and primary site codes C40.0–41.9. Chi-square tests, Fisher’s exact tests, and multivariable logistic regression were completed using SPSS v29.0.2, with significance set to p < 0.05. Results: A total of 4139 patients were identified, of which 75.3% received treatment with radiation therapy. Multivariable analysis revealed that low-income patients making less than $74,999 annually (aOR 0.80, 95% CI 0.67–0.97), as well as those from non-Hispanic Asian/Pacific Islander (aOR 0.49, 95% CI 0.33–0.73) and Hispanic (aOR 0.77, 95% CI 0.60–0.98) racial and ethnic groups, were significantly less likely to receive radiation therapy. Conclusions: These findings reveal notable disparities in radiation therapy utilization for SPB patients based on income and race and ethnicity, emphasizing the need for interventions to address systemic inequities, improve access to care, and ensure that all patients receive high-quality cancer care to optimize long-term outcomes. Full article

Cardiovascular disease disproportionately affects women in the United States. CVD outcomes are closely tied to a multitude of factors including lifestyle habits and socioeconomic status which create a complex interweb of determinants of health that place certain age and racial groups at higher risk over others. Such inequities highlight the need for targeted prevention strategies to address the unique risks faced by different populations. In this study, a state-wide analysis examining the mortality rates among women aged 35 years or older in Florida from 2018 to 2023 was done in order to identify high risk groups to better inform evidence-based public heath interventions that are tailored to the population’s needs. Mortality rates were extracted from the CDC Wonder Database. Age-adjusted and crude mortality rates, per 100,000 women, were calculated and stratified by ten-year age groups, Hispanic origin, race, and major CVD subtypes based on various ICD-10 codes. From the ICD-10 113 Cause List, “The Diseases of the Heart” were the cause of the majority of the deaths; however, “Other Forms of Chronic Ischemic Heart Diseases” was the leading subtype. Crude rates for the “Ischemic Heart Diseases” decreased 110.9 per 100,000 women in 2018 to 101.5 per 100,000 women in 2023. Yet, the most common cause of CVD-related mortality remains ischemic heart disease. Across the study period, non-Hispanic women experienced more than twice the crude mortality rate of Hispanic women. Racial breakdowns showed that White women had the highest CVD mortality, followed by Black women, who had elevated rates of heart failure and heart attacks in comparison to other minority groups. Asian women had the lowest rates across all cardiovascular subtypes. These findings underscore the persistent age and racial differences in cardiovascular outcomes emphasize the urgent need for culturally informed, community-specific preventative interventions to improve cardiovascular care and reduce mortality within high-risk populations. Full article

Background: Investigating human exposure to toxic contaminants through dietary consumption is critical to identify disease risk factors and health guidelines. Methods: In this study, we developed a cross-sectional online survey to collect information about dietary patterns and related food consumption habits among adults (age ≥ 18) and adolescents (ages 13–17) in Southern California, focusing on popular staple foods and/or those targeted most commonly under California’s Proposition 65 law for lead and acrylamide exposure. Results: Results identified root vegetables, rice, leafy greens, pasta/noodles, tea, juice, and seafood to be among the most heavily consumed foods by mass, while the daily intake of many foods such as stuffed grape leaves, tamarind/chili candy and herbs/spices varied by age and race/ethnicity, suggesting that many of Proposition 65’s pollution allowances may be exacerbating issues of health inequity and environmental injustice. Moreover, findings from this study indicate that the methods of exposure assessment often applied under Prop 65, especially relating to herbs/spices, are likely to underestimate single-day exposures, thus allowing unsafe products on the market without warning labels. Conclusions: Study outcomes are broadly relevant to environmental health and nutrition science, with particular relevance to public health practitioners and California’s Prop 65 regulators and other stakeholders. Full article

Stigmatized views of emotionality form within familial, cultural, and societal contexts and serve as a mechanism impacting youth mental health and substance misuse with notable ties to health equity. Yet critical questions remain regarding the impact of racial identity on emotionality stigma in urban groups and the moderating relationship between race and emotionality stigma on youth mental health and substance misuse. The current study aimed to investigate emotionality stigma as a mechanism of health inequity by exploring the relationships between racial identity, emotionality stigma, and adolescent mental health and substance misuse. Urban adolescents (n = 85) recruited from a combined mental health and substance use treatment program reported on their stigmatized views of emotionality, mental health, and substance use. Participants primarily identified as multicultural (60.3%) and socioeconomically disadvantaged, with 55.2% requiring transportation assistance and 63.8% being either insured through Medicaid or uninsured. Findings suggest a link between racial identity and emotionality stigma that was associated with attachment (β = −3.43, p < 0.001) as well as substance misuse type (β = 5.36, p < 0.001) and polysubstance use (β = −6.53, p < 0.001) for urban adolescents in combined treatment. This study is the first to provide empirical support for the interconnected role of sociocultural factors and emotionality stigma and calls for systems-level change to address emotionality stigma individually, communally, and socially. Full article

This article analyzes the dynamics of racial mixing in two regions with diverse colonial administrations in the second half of the eighteenth century: St. Augustine in the province of East Florida (under British and Spanish rule) and New Orleans in the province of Louisiana (under French and Spanish rule). Baptismal records for Black and Brown individuals were used, compiling nominal data from a sample of Afro-descendants born in the latter half of the eighteenth century. Whenever available, information was collected regarding racial classification—for both the baptized individuals and their parents—as well as legal status (enslaved or free) and birth legitimacy. The analysis is conducted from a critical intersectionality framework, highlighting how race, legal status, and gender served as amplifiers of inequality. Among the main results, we must highlight gender and racial classification that, thus, emerge as key differentiators for explaining the legal status and legitimacy of baptized individuals, and they also indicate systemic asymmetries in parental relationships. Full article

Background: This systematic review examines the lived experiences of Black students in UK higher education (HE), focusing on their encounters with racism and racial disadvantage, and how institutional and social factors contribute to these experiences. Methods: We conducted a systematic search across seven databases (Academic Search Complete, Education Abstracts, PsycINFO, Race Relations Abstracts, Scopus, Web of Science, and SocINDEX) in April 2023, with periodic updates. The grey literature, which refers to research and information produced outside of traditional academic publishing and distribution channels, was reviewed. This includes reports, policy briefs, theses, conference proceedings, government documents, and materials from organisations, think tanks, or professional bodies that are not commercially published or peer-reviewed but can still offer valuable insights relevant to the topic. Hand searches were also included. Studies were included if they were peer-reviewed, published between 2012 and 2024, written in English, and focused on the experiences of Black students in UK higher education. Both qualitative and quantitative studies with a clear research design were eligible. Studies were excluded if they lacked methodological rigour, did not focus on the UK HE context, or did not disaggregate Black student experiences. Risk of bias was assessed using standard qualitative appraisal tools. Thematic analysis was used to synthesise findings. Results: Nineteen studies were included in the review. Two main themes emerged: (1) diverse challenges including academic barriers and difficulties with social integration, and (2) the impact of racism and institutional factors, such as microaggressions and biased assessments. These issues contributed to mental fatigue and reduced academic performance. Support systems and a sense of belonging helped mitigate some of the negative effects. Discussion: The evidence was limited by potential bias in reporting and variability in study quality. Findings reveal persistent racial inequalities in UK HE that affect Black students’ well-being and outcomes. Institutional reforms, increased representation, and equity-focused policies are needed. Future research should explore effective interventions to reduce the awarding gap and support Black student success Full article

Background/Objectives: This study investigates disparities in physical fitness among Connecticut K-12 students post-COVID-19, highlighting persistent inequities across race, socioeconomic status, language proficiency, and dis/ability. Methods: Utilizing state-wide data from Connecticut’s EdSight portal, the research reveals a significant decline in student physical fitness compared to pre-pandemic levels, notably lagging behind academic recovery. Results: Findings underscore stark disparities, with marginalized groups such as students with disabilities, English learners, and racially minoritized students consistently performing lower than their peers. District-level analyses further illustrate pronounced inequities, where affluent, predominantly White districts achieved nearly four times higher fitness scores compared to economically disadvantaged, racially diverse districts. Conclusions: These disparities reflect systemic resource allocation issues and align with the framework of stratification economics, emphasizing structural inequities rather than individual deficits. The study advocates for equity-based funding, mandatory physical education monitoring, culturally responsive teaching practices, and systemic policy reforms to ensure equitable access to physical education resources and holistic student well-being. Full article

This conceptual paper advocates for the use of Testimonio as a critical methodological approach in sport-based youth development (SBYD) research, particularly with Latine youth. Recent scholarship has called for critical methodologies that center race, expose systemic inequities, and challenge entrenched power structures in SBYD research. Testimonio does precisely that. Rooted in Latine ways of knowing, Testimonio has long been used to document the injustices faced by Latine communities in both Latin America and the United States. Defined by its five pillars—(1) bearing witness, (2) denouncing injustices, (3) consciousness-raising, (4) social justice orientation, and (5) transformational power—Testimonio is widely used in the fields of education, psychology and sociology, yet it remains absent in SBYD research. This paper argues that Testimonio offers a powerful means of capturing the lived realities of Latine youth that traditional research methods often overlook or erase. Preliminary considerations and best practices are offered for scholars and practitioners seeking to employ Testimonio within SBYD contexts. Full article

The COVID-19 pandemic impacted mental health. This cross-sectional study analyzed the perception of concern related to the pandemic in Jundiaí-SP, June 2020. Participants consisted of residents of households selected by probability sampling and individuals with respiratory symptoms who sought Basic Health Units (UBS). The participants underwent rapid testing for SARS-CoV-2 and answered a questionnaire. The outcome was the perception of concern about pandemic and the independent variables were socioeconomic characteristics, behavioral variables, signs and symptoms, and rapid test results. Bivariate analysis was performed and variables with p < 0.20 were included in a binary logistic regression model (p < 0.05) using SPSS 20.0. A total of 2432 individuals participated in the study, including 1181 from UBS and 1251 from households. Females (OR: 1.42; CI: 1.18–1.71), black and mixed race participants (OR: 1.40; CI: 1.15–1.71), participants with an income up to 3 minimum wages (MW) (up to 1 MW: OR: 2.58; CI: 1.80–3.70; 1 to 3 MW: OR: 1.64; CI: 1.35–1.98), and younger participants (18–39 years: OR: 3.07; CI: 2.39–3.94; 40–59 years: OR: 2.42; CI: 1.89–3.10) were more concerned. Greater concern was perceived by more vulnerable individuals, regardless of testing positive for COVID-19 which is important to subsidize public mental health policies and crisis interventions, focusing on reducing race, gender and socioeconomic inequalities. Full article

This study examines whether and how community schools’ integrated student support services (academic, socioemotional, health, and family support) contributed to improving whole-child/youth development and reducing systemic inequalities of students’ learning/wellness outcomes across New York State under the Every Student Succeeds Act (ESSA). Applying a quasi-experimental method with propensity score matching to the state’s 2018–2023 school survey and report card databases, it provides new evidence on the efficacy of community school programs on average and by subgroups (race/ethnicity, poverty, disability, English language learner, and housing status). The results of matched comparisons between community schools and non-community schools are mixed, after considering their differences in terms of student demographics and baseline conditions. Overall, community schools showed policy implementation fidelity with more state funding, policy-aligned practices, and school-based health centers/clinics. However, community schools had no discernable impacts on academic achievement and chronic absenteeism overall, except that the operation of school-based health centers was associated with a reduction in absenteeism. In contrast, community schools had more positive impacts on high school graduation rates, particularly among disadvantaged minority students; the impacts are attributable to policy-aligned practices, set-aside funding, and school-based health center dental programs. Educational policy and research implications are discussed. Full article

Black gay and bisexual older men face numerous barriers across the life course that can contribute to negative health and well-being as they age. Drawing on strengths-based social determinants discussed in the health literature and literature on intersectionality, justice, and critical consciousness, this study examines qualitative data from seventeen Black gay and bisexual older men about sources and strategies of resilience and thriving amidst intersecting systems of power and oppression that shape health inequities. The findings revealed an evolution of positive support networks across their life courses, including biological family and families of choice such as “houses” and support groups. Early and ongoing negative experiences relating to intersecting positionalities (e.g., race, gender, sexual orientation) also provided sources of strength and resilience. Participants identified three strategies for building resilience and thriving: naming external ignorance, acknowledging common struggles, and reconciling contradictions. These strategies reflected various levels of critical consciousness that helped them navigate complex and intersecting systems of power that they encountered as Black gay men across the life course. Overall, the findings underscore the importance of considering intersecting systems of power and critical consciousness when examining resilience and social determinants of health and contribute new insights on a vastly understudied population. Full article