Search Results (110)

Experiences of discrimination and/or microaggressions may negatively affect mental health among university students. We assessed the association between experiences of discrimination, microaggressions, and combined exposure on poor behavioral health (PBH) among university students in Spring 2023 (N = 45,386) using cross-sectional data from the American College Health Association’s National College Health Assessment III. PBH (an index of severe psychological distress and substance use risk) was reported by 42.9% of students. More than half of sexual and gender minority (SGM) youth reported PBH, and had a high prevalence of discrimination and microaggressions. Among racial/ethnic groups, Black/African American students had the highest prevalence of experiences of discrimination and microaggressions. Minoritized groups who experienced discrimination or microaggressions consistently reported a higher prevalence of PBH compared to their counterparts not reporting these experiences; the opposite pattern was observed among cisgender, heterosexual, and White participants. In the logistic regression models, experiences of both discrimination and microaggressions were associated with an over 2-fold increase in odds of PBH, controlling for demographic variables, compared to those experiencing neither. Interaction effects revealed that experiences of microaggressions did not consistently and differentially predict PBH across subgroups of minority youth. Efforts to increase resilience on university campuses may improve behavioral health. Full article

Background: Transgender and gender expansive (TGE) people experience high rates of interpersonal victimization, which has been linked to high rates of post-traumatic stress disorder (PTSD, a highly disabling and under-studied mental illness among TGE people). This systematic review identifies, classifies, critically appraises, and synthesizes the peer-reviewed literature describing the association between interpersonal victimization and post-traumatic stress among TGE people. This review collates what is known about the associations between victimization and PTSD among TGE people and makes recommendations to guide future research and intervention development. Methods: Searches were conducted across five databases (PubMed, Embase, Web of Science, PsycInfo, and CINAHL) following PRISMA guidelines. Inclusion criteria were: English language; peer-reviewed original research; articles describing the association between victimization and PTSD among TGE youth or adults; reporting TGE-specific data. Exclusion criteria were: reviews, commentaries without original data, dissertations or theses, conference abstracts, animal studies, studies without TGE-specific findings, and case studies. Quality appraisal was completed for all studies, which included a discussion of bias. Data extraction was completed by two independent authors, and conflicts were resolved by a third. Data were stratified by gender identity, race or ethnicity, and type of violence for further synthesis. Results: 25 studies were evaluated for design, measure quality, and key findings. Findings were highly consistent across studies: multiple forms of interpersonal violence (e.g., childhood maltreatment, sexual violence, intimate partner violence, and transgender-specific victimization) were significantly associated with PTSD symptom severity or diagnosis across diverse identities and geographic contexts. All studies examining childhood sexual abuse reported significant associations with PTSD outcomes, highlighting early life as a critical period of vulnerability. Samples were disproportionately White and adult, with limited examination of intersectional experiences shaped by race, ethnicity, and socioeconomic status. Discussion: Interpersonal violence-related PTSD among TGE populations reflects a pervasive and systemic pattern of trauma rooted in structural discrimination rather than isolated individual risk. Addressing this inequity requires multilevel prevention and intervention strategies. Future research should prioritize longitudinal designs, culturally responsive measurement tools, and intersectional analyses to inform prevention, clinical care, and policy responses. The majority of studies were cross-sectional designs, so causality cannot be inferred. Additionally, the samples were disproportionately White and adult, which may bias the magnitude of associations reported and limit generalizability to racially and ethnically diverse TGE populations. Although many studies reported race and ethnicity descriptively, none disaggregated violence-related PTSD outcomes by racial or ethnic group within TGE samples, representing a critical limitation for intersectional analysis. Full article

Perinatal mental health (PMH) conditions are the most common complications of pregnancy and the first postpartum year. Adverse childhood experiences (ACEs) are increasingly recognized as important contributors to PMH, particularly postpartum depression and anxiety (PPD/A). This study examines a broad range of ACEs—including parental mental illness and substance use, incarceration, death, divorce, discrimination, economic hardship, and forced migration—to assess their influence on PPD/A. Using a modified explanatory sequential mixed-methods design, phase I included an online survey of racially, ethnically, and socioeconomically diverse U.S. women (n = 306) who delivered a live infant in the past year. Hierarchical regression showed that while ACEs initially predicted PPD/A, this association was no longer significant when social support, material hardship, and discrimination were added to the model. These current life circumstances emerged as stronger direct predictors of PPD/A than ACEs. In phase II, purposive and stratified sampling identified participants with ACE scores ≥ 4 for interviews (n = 22). Qualitative findings identified social support, financial security, work flexibility and choice, and time for self-care as central protective factors in adjustment to motherhood when these resources aligned with mothers’ individual needs and values. Results can inform clinical counseling, ACEs screening, and policies to strengthen PMH support. Full article

Background: The term immigrant health paradox describes how immigrants often have better health outcomes than their American-born counterparts. While existing literature treats this phenomenon as broadly generalizable, emerging research indicates that its expression varies across cultural and migration contexts. Understanding how the immigrant health paradox may appear across specific ethnic groups requires research that maps variation rather than assumes uniformity. Objectives: This study seeks to describe patterns, explore variation by nativity, and identify factors associated with well-being among the Vietnamese population in the United States (US). By focusing on descriptive trends and contextual influences, the study aims to generate new insights into how the paradox may manifest—or diverge—in the Vietnamese context. Methods: We conducted an online survey asking participants about their depressive disorders, physical and mental health status, demographics, socioeconomic status, social networks, and experiences with daily discrimination. Descriptive statistics were used to describe the study sample. Linear regression and ordinal logistic regression were performed to explore the relationships. Results: In this exploratory analysis, we did not observe indications of the Vietnamese immigrant health paradox. Material factors, especially perceptions of financial needs, as well as psychological factors, were somewhat associated with how Vietnamese people living in the US assess their health. Conclusions: The absence of the Vietnamese immigrant health paradox in the US underscores the need for nuanced health models that reflect diversity within immigrant groups. Their experiences reveal how migration histories, structural barriers, and racialization shape health outcomes in ways that differ from expectations. Full article

Youth from racial minority backgrounds frequently report encountering racial discrimination within their school. These experiences can create additional barriers to their pursuit of higher education. This study explored whether critical thinking can protect and enhance youth college aspirations despite discrimination. We examined whether critical thinking protects against the impact of racial discrimination on beliefs about future college plans in a racially/ethnically diverse sample of 189 adolescents (Mage = 14.47, SD = 1.402, 66.8% female) using a cross-sectional approach. Results indicated that among adolescents with low and moderate critical thinking skills, higher levels of in-school racial discrimination were linked to lower beliefs in their future college attendance. This suggests that in environments where racial discrimination is prevalent, individuals with lower critical thinking skills are more susceptible to negative effects on their college expectations. Conversely, for adolescents with high critical thinking skills, the relationship between in-school racial discrimination and beliefs about college plans was not significant. These findings emphasize the importance of developing critical thinking skills through interventions and policies to mitigate the adverse effects of in-school racial discrimination and to promote college access and success among underrepresented racial minority youth. Full article

Background/Objectives: Persistent inequities in healthcare experiences and outcomes among marginalized racial/ethnic groups and sexual and gender minority (SGM) populations have been well documented. However, disparities in perceptions of discrimination and bias between patients and health providers remain insufficiently understood. This review synthesizes the current evidence on how these groups differently perceive discrimination, how bias manifests in clinical encounters, and how intersecting identities shape healthcare experiences. Methods: A comprehensive review using SANRA guidelines examined racial/ethnic discrimination, SGM-related bias, provider implicit attitudes, minority stress processes, and structural determinants of inequity in healthcare settings. Articles were identified through systematic search strategies across major databases, and their conceptual, methodological, and theoretical contributions were analyzed. Results: Across studies, marginalized patients consistently reported discrimination, stigma, and mistrust in healthcare, whereas providers often underestimated the prevalence and impact of these experiences. Evidence indicates that implicit pro-White biases among providers influence communication quality, clinical decision-making, and patient comfort. Structural racism and intersecting minority statuses further compound disparities, contributing to delayed care, unmet health needs, and poorer outcomes. Limited alignment between patient and provider perceptions suggests a gap in recognition of inequitable treatment and its drivers. Conclusions: Healthcare inequities arise from interconnected, interpersonal, and structural mechanisms. Addressing these disparities requires multilevel interventions targeting provider training, institutional policy reform, and system-level barriers. Integrating both patient and provider perspectives is essential for developing equitable, affirming models of care and improving health outcomes for racial/ethnic and SGM populations. Full article

Background: This study’s objective was to be the first to explore the ethnicity/cultural origins, gender identity, ability/disability, sexual orientation, socioeconomic background, and harassment/discrimination experiences of Canadian radiation oncologists (ROs). Methods: Following a literature review and input from content experts, an ethics-approved national cross-sectional electronic survey was developed in English and French and electronically distributed to all ROs in Canada (n = 598). Descriptive statistics summarized responses. Comparisons between groups were performed using Chi-square tests, and content analysis was performed on open-ended responses. Results: The survey was completed in full by 42.5% of ROs (254/598). Most respondents were male (62.9%), 35–44 years old (39.2%), and heterosexual (94.3%). 41.2% identified as belonging to a racialized group, which is higher than the overall Canadian population (27%), but Black, Indigenous, and Southeast Asian ROs were underrepresented (1.9% vs. 4%, <1% vs. 5% and 1.6% compared to 4%, respectively). A significant subset analysis showed that only 20% (21/105) of racialized ROs were women, whereas Caucasian women comprised 49.3% (74/150) of Caucasian respondents (p < 0.001). While 75.4% of respondents reported job satisfaction, 42.1% reported experiencing workplace discrimination/harassment within the past 5 years; most commonly, this was perpetrated by fellow faculty (31.7%; 58/183) or patients or their family members (31.7%; 58/183). Respondents felt that gender, race/ethnicity, and age were the three top reasons for discrimination/harassment, with double the amount of racialized ROs reporting harassment compared to White ROs (p < 0.001). Nearly half (45.2%; 114/252) did not understand how to report, or felt uncomfortable reporting, workplace discrimination/harassment. Conclusions: This study highlights high harassment and discrimination rates amongst Canadian ROs, especially amongst racialized women, which may affect career satisfaction and attrition rates. Compared to census data, Black, Indigenous, and Southeast Asian ROs were underrepresented, and amongst racialized ROs, racialized women were significantly underrepresented. These findings underscore the need for targeted diversity initiatives, improved mentorship programs, and stronger institutional policies to address harassment and foster an inclusive work environment. Full article

This article examines how Slovenia’s post-communist approach to diversity management marginalizes minorities from the former Yugoslav republics. The constitution grants cultural rights and parliamentary representation to Italian and Hungarian minorities, but communities from Bosnia, Serbia, North Macedonia, Kosovo, and Croatia are excluded from these protections. Recognised mainly by religious affiliation, these groups have limited access to formal minority rights. Their fight for recognition is fragmented, lacking unified political representation, and the 1992 “erasure”—the removal of thousands from the permanent resident registry after independence—still undermines their sense of belonging. Drawing on theories of racialized citizenship, belonging, multiculturalism, and social mobility, the article examines how exclusionary legal frameworks create hierarchies of belonging that hinder mobility for these unrecognised minorities. The qualitative interviews with descendants of Bosnian migrants reveal intergenerational struggles with recognition, ambivalent experiences of citizenship, and discrimination. Set in the post-communist Eastern European context, the study argues that even under the pressures of EU integration, citizenship regimes remain divided along ethnic lines. This division maintains structural inequalities and marginalizes certain groups despite their long-term residence and formal citizenship. The study contributes to debates on ethnicised citizenship and diversity management by showing how legal exclusion, historical legacies, and fragmented minority politics limit belonging and mobility in post-communist societies. Full article

This study examined how ethnic-racial socialization (ERS)—cultural-egalitarianism, preparation for bias, and promotion of mistrust—mediate the influence of neighborhood and parental cultural contexts on youth self-esteem and ethnic-racial identity (ERI). Participants included 184 youth (Mage = 13.38; 57.5% female) and 144 parents (Mage = 40.62) from Black and Latino families living in a new destination context. Data were analyzed using multiple group path analysis. Findings revealed distinct patterns for Black and Latino families. Neighborhood disadvantage was negatively associated with preparation for bias and promotion of mistrust beliefs. Neighborhood diversity was positively related to promotion of mistrust, while neighborhood cohesion positively influenced cultural-egalitarianism and preparation for bias beliefs. Each ERS belief was associated with youth perceptions of the corresponding ERS practice. In Latino families, preparation for bias beliefs also supported cultural-egalitarianism practices. ERS practices were linked to youth outcomes. Cultural-egalitarianism was positively associated with self-esteem and, for Latino youth, with centrality and private regard. In contrast, preparation for bias and promotion of mistrust were negatively associated with self-esteem and public regard. Additionally, neighborhood factors, parental discrimination, parental ERI, and ERS beliefs were directly linked to youth self-esteem and ERI. Findings underscore how broader sociocultural contexts shape ERS and, in turn, adolescent development. Full article

Background/Objectives: Migrant youth often experience multiple, intersecting systems of oppression (e.g., racism, poverty, and discrimination) that may contribute to disparities in pediatric pain prevalence, severity, and management. However, pain in migrant youth remains poorly understood. This rapid scoping review will examine the nature and extent of the existing literature on pain among migrant youth. Methods: This protocol has been preregistered on the Open Science Framework. The review will follow guidelines for conducting and reporting rapid and scoping reviews, and will be guided by PCC (population, concept, context) and PROGRESS-Plus methodological frameworks. Electronic searches will be conducted in MEDLINE, CINAHL, and Scopus for primary research studies published since 2015 that describe and examine pain among migrant youth (age < 18 years). Two reviewers will independently screen titles, abstracts, and full texts, with disagreements resolved by consensus or a third reviewer. Data charting will be piloted on 5–10 studies, then independently conducted by two reviewers. Extracted data will include study characteristics (authors, year, purpose, methodology); participant sociodemographic information (e.g., racial and/or ethnic identity, age, sex, gender identity, sexual orientation, socioeconomic position); migration status; countries of origin and destination; definition and characteristics of pain; and measures of systemic factors (e.g., racism). Results: Findings will be synthesized descriptively and interpreted within sociocultural and geopolitical contexts to better understand pain among migrant youth. Conclusions: This review will aim to provide critical insights into the intersections between migration and pediatric pain, offering guidance for future research, clinical practice, and policy to improve pain management and outcomes for migrant youth. Full article

Ethnicity-based public health inequities continue worldwide, reflecting established failures in law, governance, and social justice. International legal instruments, including the International Covenant on Economic, Social and Cultural Rights (ICESCR), the Convention on the Elimination of All Forms of Racial Discrimination (CERD), and the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP), obligate states to provide equitable access to healthcare and address structural components of inequality. This article critically evaluates the effectiveness of these frameworks in advancing health equity, adopting a black-letter legal approach integrated with the social determinants of health models to assess whether ratified commitments have translated into quantifiable changes for marginalized ethnic populations. Case studies from Canada, Australia, and the United States—high-capacity health systems with entrenched inequities—portray the gap between normative commitments and practical implementation. Findings demonstrate that while international law has shaped discourse, promoted civil society advocacy, and influenced select policy reforms, weak enforcement, reliance on voluntary compliance, and insufficient accountability mechanisms curb its capability to generate consistent outcome-based change. Recommendations include establishing a framework convention on global health equity, strengthening the WHO’s mandate on racial justice, improving ethnic-disaggregated data reporting, and ingraining affected communities in policymaking. Normative strength is apparent, but operational impact remains dependent on an enforceable framework and sustained political will. Full article

Background/Objectives: Discrimination has wide-ranging implications, affecting patients’ trust in healthcare professionals and their intentions to seek care. It can cause barriers that can affect access to care, especially among racial and ethnic minority groups in mental healthcare settings. Hence, we aim to examine the relationship between racial discrimination and reasons for using telehealth services. Method: Using the 2022 Health Information National Trends Survey (HINTS-6), we isolated 6017 participants who reported on discrimination inquiry. The primary dependent variable in this study is self-reported discrimination in healthcare, while the main independent variable is the reason for the most recent telehealth visit, and several socio-demographic variables were included as covariates, including age, sex, education, income, and marital status. Descriptive statistics were generated, and multivariable regression analysis was estimated as well, with a p-value < 0.05. Results: Non-Hispanic Black individuals had significantly higher odds of reporting discrimination compared to non-Hispanic White individuals (crude OR: 11.85, 95% CI: 7.67–18.309). Similarly, Hispanic individuals (crude OR: 4.626, 95% CI: 2.899–7.384) and individuals of other racial backgrounds (crude OR: 6.883, 95% CI: 4.04–11.729) had significantly increased odds of experiencing discrimination. Conclusions: The findings of this study offer critical insights into the determinants of perceived discrimination within telehealth services. Given the sustained integration of telehealth into healthcare delivery, it is imperative to develop and implement targeted strategies that provide education and resources to promote health equity among Non-Hispanic Black patients. Full article

Background: Health equity can only be achieved when every individual has access to quality healthcare without fear of being discriminated against. This study analyzed the sociodemographic characteristics associated with self-reported racial discrimination when receiving medical care in the United States. Methods: This quantitative cross-sectional study utilized the 2022 National Trends Survey 6. We performed a logistic regression analysis using 6102 survey responses from study participants who answered the question about perceived discrimination. Results: Older adults aged 75 years and above had significantly lower odds of reporting perceived discrimination when receiving medical care compared to those aged 18–34 years (AOR = 0.24; 95% CI: 0.10–0.58). The odds of reporting perceived discrimination were significantly higher among non-Hispanic Blacks (AOR = 7.30; 95% CI: 4.48–11.88), Hispanics (AOR = 3.56; 95% CI: 2.45–5.17), non-Hispanic Asians (AOR = 5.95; 95% CI: 2.25–15.73), and individuals identifying as non-Hispanic Other (AOR = 10.91; 95% CI: 5.42–21.98), compared to non-Hispanic Whites. Compared to individuals from households earning less than USD 20,000, the odds of reporting perceived discrimination when receiving medical care were significantly lower among individuals from households earning between USD 50,000 and <USD 75,000 (AOR = 0.42; 95% CI: 0.23–0.78) and those earning USD 75,000 or more (AOR = 0.43; 95% CI: 0.22–0.83). Conclusions: Despite having a multicultural and ethnically diverse population, racial discrimination persists in the United States and has become a barrier to achieving health equity. Health organizations should implement policies that ensure health workers attend mandatory anti-racism training. Full article

Access to traditional financial institutions plays a key role in enhancing positive financial outcomes. However, some consumers within the United States experience discrimination from these same institutions. In particular, discrimination based on race and gender has historically been tied to outcomes such as lower service quality and a lack of access to credit. While the previous literature has discussed some of the discriminatory practices that these groups have faced, there is a lack of research on how these groups respond to discrimination from financial institutions. Through a series of logistic regressions, the authors analyzed how race, ethnicity, and gender are related to reporting experiences of discrimination. The authors then explored how consumers react to discrimination by looking at five reported reactions. Primary results show that Black consumers were more likely than most other racial groups to experience financial discrimination. Additionally, women were less likely than men to report financial discrimination. Race was shown to be a significant factor in four of the five reactions to discrimination, while gender was a factor in two of the reactions. The findings further show that after experiencing financial discrimination, most individuals turned to non-traditional financial services as a direct result of the bias or racism. Full article

The COVID-19 pandemic significantly disrupted higher education worldwide, imposing strict isolation measures, transitioning learning online, and exacerbating existing social and economic inequalities. This literature review examines the pandemic’s impact on the mental health of college students, with a focus on those belonging to minority groups, including racial, ethnic, migrant, gender, sexuality-based, and low-income populations. While elevated levels of anxiety, depression, and loneliness were observed across all students, findings indicate that LGBTQ+ and low-income students faced the highest levels of psychological distress, due to compounded stressors such as family rejection, unsafe home environments, and financial insecurity. Racial and ethnic minority students reported increased experiences of discrimination and reduced access to culturally competent mental healthcare. International and migrant students were disproportionately affected by travel restrictions, legal uncertainties, and social disconnection. These disparities underscore the need for higher education institutions to implement targeted, inclusive mental health policies that account for the unique needs of at-risk student populations during health crises. Full article