Search Results (292)

The global Black Lives Matter movement and COVID-19 pandemic drew attention to the urgency of addressing entrenched structural dynamics such as racialization, gender, and colonization shaping health inequities for diverse racialized people. Canadian community-based research with racialized immigrant women recognized the need to enhance service provider capacity using a strengths-based activism approach to support client health and wellbeing. In this study, we aimed to understand the impacts of this mental health promotion practice on service providers and strategies to support them. Through purposeful convenience sampling, three focus groups were completed with 19 service providers working in settlement and mental health services in Toronto, Canada. Participants represented varied ethnicities and work experiences; most self-identified as female and racialized, with experiences living as immigrant women in Canada. Postcolonial feminist and critical mental health promotion analysis illuminated organizational and structural dynamics contributing to burnout and vicarious trauma that necessitate a focus on trauma- and violence-informed care. Transformative narratives reflected service provider resilience and activism, which aligned with and challenged mainstream biomedical approaches to mental health promotion. Implications include employing a postcolonial feminist lens to identify meaningful and comprehensive anti-oppression strategies that take colonialism, racialization, gender, and ableism and their intersections into account to decolonize nursing practices. Promoting health equity for diverse racialized women necessitates focused attention and multilevel anti-oppression strategies aligned with critical mental health promotion practices. Full article

Background: Teen dating violence (TDV) is a serious public health concern, with sexual and gender minority youth (SGMY) at elevated risk due to minority stress and systemic inequalities. This systematic review examines individual, relational, and contextual risk factors for TDV among SGMY. Methods: A systematic search was conducted in Scopus, Web of Science, and APA PsycInfo on 10 December 2024. Studies published between 2014 and 2024 focusing on teen dating violence (TDV) as an outcome among sexual and gender minority youth (SGMY) aged 13–19 were included. Study selection was independently performed by multiple reviewers using Rayyan. Risk of bias was assessed using the JBI Critical Appraisal Tools. Due to heterogeneity in the study design and measurement tools, a narrative synthesis was conducted. Results: Six risk domains emerged: (1) Demographic/Identity (e.g., gender, orientation, or race); (2) Psychological/Behavioral (e.g., distress or substance use); (3) Violence/Bullying (e.g., cyberbullying or exclusion); (4) Family/Sexual Abuse (e.g., family rejection); (5) Relational/Social (e.g., partner outing); and (6) School/Community (e.g., non-inclusive environments). Bisexual, pansexual, transgender, and racialized youth showed heightened vulnerability. Most studies were conducted in the USA and relied on non-validated TDV measures and cross-sectional designs, limiting comparability and causal inference. Conclusions: SGMY face unique, often overlooked TDV risks. There is a need for intersectional, longitudinal research and inclusive, developmentally appropriate prevention efforts that address both relational and structural factors. This review received no external funding and was not registered. Full article

“Racial Injustice, Violence, and Resistance: New Approaches from Multidimensional Perspectives” is the product of a dialogue among three experts, bridging the disciplines of economics, criminology, and sociology and bringing together expertise in racial inequality, urban sociology, international immigration, Latin America, and Latino/a/x studies [...] Full article

Introduction: Racial and ethnic disparities in end-of-life (EOL) cancer care persist, leading to lower rates of advance care planning (ACP), reduced access to palliative care, and poorer patient outcomes for minority populations. While previous research has documented these inequities, less is known about the specific interventions developed to address them, necessitating a comprehensive review of existing strategies aimed at improving EOL care for racial and ethnic populations. The objective of this scoping review is to examine the extent and characteristics of interventions and their outcomes designed to address racial and ethnic disparities in EOL cancer care in the United States. Methods: A comprehensive search of EOL cancer care interventions for minority populations was conducted in Ovid MEDLINE, CINAHL with Full Text (EBSCOhost), and Scopus (Elsevier) in September 2024. Two independent reviewers screened titles, abstracts, and full texts following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, with inclusion limited to studies conducted in the US and published in English. Results: Of 3104 screened studies, 10 met the inclusion criteria. Participants enrolled were only from Latino (n = 6 studies) or Black (n = 4 studies) populations. We identified four types of interventions, including communication skills for patients, caregivers, researchers, and clinicians (n = 2), education programs for patients (n = 1), navigation and support programs for patients and caregivers (n = 3), and training programs for health workers and community leaders (n = 4). The most effective interventions were those that addressed linguistic barriers, integrated cultural values, and involved trusted community figures. Faith-based models were particularly successful among African American patients, while bilingual navigation and family-centered ACP interventions had the greatest impact in Latino populations. Conclusions: This review highlights (1) the importance of culturally tailored interventions for specific minority populations and (2) the limited number of such interventions, which primarily target only the largest minority groups. 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

Objectives: The objective of this study was to examine the impact of the COVID-19 pandemic on racialized communities and individuals in Canada. Methods: This review followed the Joanna Briggs Institute (JBI) methodology and the PRISMA-ScR guidance on reporting scoping reviews. Ovid MEDLINE ALL, Embase Classic + Embase, CINAHL (Ebsco platform), PsycINFO, and Cochrane were searched for documents that were published after March 2020 and that reported on the social and economic impacts and health outcomes of the COVID-19 pandemic on generally healthy racialized populations that reside in Canada. Synthesis: A total of 39 documents were included in this review. Our results show racialized communities faced greater social, economic, and health impacts from the pandemic. These impacts were manifested in the form of high COVID-19 morbidity and mortality rates, increased discrimination, worsening mental health, difficulty in accessing healthcare, and challenges related to accessing food and basic necessities. Conclusion: Canadian racialized groups have been inequitably affected by the COVID-19 pandemic due to pre-existing inequalities and emerging discrimination. Responsive policy action and robust pandemic preparedness efforts are indispensable in adopting a proactive stance to prevent racialized populations from bearing a disproportionate burden of negative health crises in the future. This necessitates addressing pre-existing disparities and targeting social and economic vulnerability areas. By doing so, we can mitigate the reported social, economic, and health impacts experienced by racialized groups, including challenges related to accessing basic necessities, deteriorating mental health, and barriers to healthcare access. Full article

Health disparities among marginalized populations persist in many developed countries despite substantial population health advancements, highlighting persistent systemic inequities. Visible minorities, defined as the non-White and non-Indigenous racialized population in Canada, face earlier disease onset, worse outcomes, barriers to care, and shorter life expectancy. Conventional single-axis research frameworks, which examine factors like race, gender, or socioeconomic status in isolation, often fail to capture the complex realities of these disparities. Intersectionality theory, rooted in Black feminist thought and Critical Race Theory, offers a crucial lens for understanding how multiple systems of oppression intersect to shape health outcomes. However, its application in health research remains inconsistent, with often inadequate and tokenistic applications of this theory attributable to the limitations of a research approaches and resources, as well as biases from researchers. Integrating intersectionality with other relevant frameworks and theories in population health, such as ecosocial theory that explains how social inequalities become biologically embodied to create health inequities, strengthens the capacity to analyze health inequities comprehensively. This article advocates for thoughtful application of intersectionality in research to understand health disparities among visible minorities, urging methodological rigor, contextual awareness, and a focus on actionable interventions. By critically embedding intersectional principles into study design, researchers can move beyond describing disparities to identifying meaningful, equity-driven solutions. This approach supports a deeper, more accurate understanding of health inequities and fosters pathways toward transformative change in public health systems. Full article

While racial inequalities in assortative mating and fertility have been well documented, the role of neighborhoods has frequently been overlooked in explaining these disparities. In this study, I use restricted birth record data from the state of California with neighborhood-level socioeconomic and demographic data to explore the roles of neighborhoods and structural neighborhood inequality in mediating racial inequality in assortative mating and fertility in 2018 and 2019. Overall, neighborhood disadvantage, particularly disadvantage measured in a neighborhood’s mobility network, mediated a substantial proportion of the disparity in fathers’ educational attainment between White and Black or Hispanic mothers in California in 2018 and 2019. Additionally, while I observe evidence of Black and Hispanic neighborhoods having significantly greater fertility rates than White neighborhoods, this gap can be entirely explained by neighborhood disadvantage. Lastly, a significant share of the fertility gap between less-educated White and Black women is mediated by neighborhood disadvantage. This study motivates more research at the intersection of assortative mating and fertility at the neighborhood scale. Full article

Objective: Low birth weight is a serious public health problem even in developed countries. The objective of this study was to assess the ability of machine learning to predict low birth weight rates in big cities in the USA on an ecological/population level. Study design: The study was based on publicly available data from the Big Cities Health Inventory Data Platform. The collected data related to the 35 largest, most urban cities in the United States from 2010 to 2022. The model-agnostic approach was used to assess and visualize the magnitude and direction of the most influential predictors. Results: The models showed excellent performance with R-squared values of 0.82, 0.81, 0.81, and 0.79, and residual root mean squared error values of 1.06, 0.87, 1.03, 0.99 for KNN, Best subset, Lasso, and XGBoost, respectively. It is noteworthy that the Best subset selection approach had a high RSq and the lowest residual root mean squared error, with only a four-predictor subset. Influential predictors that appeared in three/four models were rate of chlamydia infection, racial segregation, prenatal care, percentage of single-parent families, and poverty. Other important predictors were the rate of violent crimes, life expectancy, mental distress, income inequality, hazardous air quality, prevalence of hypertension, percent of foreign-born citizens, and smoking. This study was limited by the unavailability of data on gestational age. Conclusions: The machine learning algorithms showed excellent performance for the prediction of low birth weight rate in big cities. The identification of influential predictors can help local and state authorities and health policy decision makers to more effectively tackle this important health problem. Full article

Healthcare disparities in cancer care remain pervasive, driven by intersecting socioeconomic, racial, and insurance-related inequities. These disparities manifest in various forms such as limited access to medical resources, underrepresentation in clinical trials, and worse cancer outcomes for marginalized groups, including low-income individuals, racial minorities, and those with inadequate insurance coverage, who face significant barriers in accessing comprehensive cancer care. This manuscript explores the multifaceted nature of these disparities, examining the roles of socioeconomic status, race, ethnicity, and insurance status in influencing cancer care access and outcomes. Historical and contemporary data highlight that minority racial status correlates with reduced clinical trial participation and increased cancer-related mortality. Barriers such as insurance coverage, health literacy, and language further hinder access to cancer treatments. Addressing these disparities requires a systemic approach that includes regulatory reforms, policy changes, educational initiatives, and innovative trial and treatment designs. This manuscript emphasizes the need for comprehensive interventions targeting biomedicine, socio-demographics, and social characteristics to mitigate these inequities. By understanding the underlying causes and implementing targeted strategies, we can work towards a more equitable healthcare system. This involves improving access to high-quality care, increasing participation in research, and addressing social determinants of health. This manuscript concludes with policy recommendations and future directions to achieve health equity in cancer care, ensuring optimal outcomes for all patients. Full article

Lung cancer remains the leading cause of cancer-related death in the US and worldwide. Recent advances in molecular profiling and targeted therapies have revolutionized the management of non-small cell lung cancer (NSCLC), particularly in oncogene-driven subtypes. These therapies selectively target key molecular alterations in EGFR, ALK, KRAS, ROS1, MET, RET, ERBB2 (HER2), BRAF V600E, and NTRK, resulting in substantial improvements in survival rates and quality of life for lung cancer patients. However, disparities in molecular diagnostics and precision treatments persist, disproportionately affecting minority patients. These inequities include underrepresentation in clinical trials, disparities in molecular testing, and barriers to treatment access. The limited participation of racial and ethnic minorities in landmark clinical trials raises concerns about the generalizability of findings and their applicability to diverse populations. In this review, we examine the current landscape of molecular diagnosis and precision medicine in minority patients with oncogene-driven lung cancer, highlighting challenges, opportunities, and future directions for achieving equity in precision oncology. Additionally, we discuss differences in the prevalence of oncologic driver mutations across populations and emphasize the urgent need for greater diversity in clinical research. Addressing these gaps is critical to improving survival outcomes and ensuring equitable access to personalized lung cancer care for all patients. Full article

Background: Ongoing access and equity concerns for culturally diverse populations in mental health warrant a shift from cultural competence to cultural humility training. This review aimed to systematically assess the breadth of conceptual and training literature in peer-reviewed publications drawn from PsycINFO, CINAHL plus, Google Scholar and Scopus, from 2007–2018, utilizing cultural humility as the key search term and its relevance to service provision. Methods: This method utilized a five-stage scoping review framework. Results: Results were that a total of 246 publications were extracted. Following employing an abstract review method and removing duplicates, this resulted in a full-text review of 56 publications. The emerging themes included the following: culturally informed conceptual frameworks; culturally diverse training approaches; racial inequalities in mental health services; culturally informed national and international perspectives; race and international transcultural mental health. Conclusions: Conclusions were that including cultural humility principles in service provision and training enables greater self-awareness towards racial bias and negative cultural stereotypes at both practice and organizational levels, ultimately aimed at enhancing mental health service provision by mitigating the structural barriers encountered by service users. Full article

A robust body of research examines the association between socioeconomic status (SES), particularly its economic dimension, income poverty, and child maltreatment rates. However, several key questions regarding this relationship remain underexplored. Utilizing a critical literature review, this article finds that some forms of child maltreatment (i.e., sexual abuse) do not correlate with income poverty. Moreover, evidence about the effects of other dimensions of SES, including employment and education is not monolithic. The complexity of this relationship is further influenced by the data source and unit of analysis. Studies using administrative data and analyzing SES at the family or household level frequently report a strong correlation between SES and child maltreatment. However, this relationship weakens (or in some cases disappears) when examined at the neighborhood or regional level using self-report data. Our findings also suggest that the overrepresentation of minority groups in child maltreatment statistics can be, at least in part, attributed to economic disadvantages. Furthermore, social cohesion appears to buffer the effects of income poverty and material hardship, highlighting the role of inequality in weakening social networks and exacerbating socioeconomic stressors. A developing body of literature demonstrates the link between income inequality and child maltreatment rates and indicates that policies aimed at addressing the impact of SES on child maltreatment should not only focus on alleviating poverty-related factors, such as material hardship, unemployment, and housing instability, but also target broader class disparities as the common root of many social problems. Full article

Background/Objectives: The persistent health disparities affecting Black men in the US healthcare system reflect systemic inequities that impact their health outcomes. This qualitative study employs thematic analysis to examine how Black men’s interactions with medical providers shape their healthcare experiences and to identify key factors influencing their quality of care. Methods: Through in-depth interviews with 25 Black men throughout the United States, our thematic analysis identified patterns in their reported healthcare experiences. Results: Our analysis revealed four main themes: (1) inadequate clinician communication and information, (2) clinician dismissiveness and failure to listen, (3) experiences of interpersonal racial bias in healthcare interactions, and (4) facilitators of positive, patient-centered healthcare encounters. Black men’s narratives illuminate how communication barriers, dismissive treatment, and racial bias manifest in healthcare settings, while also highlighting elements that facilitate successful patient–clinician relationships. Conclusions: The findings suggest specific approaches for improving these interactions, including clinician active listening and bias training, anti-racism medical education, accountability policies, increased clinician diversity, and patient self-advocacy strategies to address systemic factors affecting Black men’s healthcare experiences and outcomes. Full article

Background: Despite advances in glioblastoma (GBM) management, median overall survival (mOS) remains poor, and multi-modal disparities persist. We sought to evaluate trends in GBM treatment and survival outcomes from 2005–2020, with a focus on sociodemographic and geographic disparities. Methods: We conducted a retrospective US-based cohort study using the National Cancer Database (NCDB), stratifying study period into four intervals (2005–2008, 2009–2012, 2013–2016, and 2017–2020). Logistic regression was used to identified predictors of receipt of combination surgery, radiation, and chemotherapy (Sx+RT+Chemo). Kaplan–Meier and multivariable Cox proportional hazards approaches were used to assess mOS. Results: A total of 111,955 adults with GBM were included. From 2005–2008 to 2017–2020, mOS increased from 7.8 to 9.5 months, with geographically unequal gains in survival across the US. In multivariable logistic regression model adjusting for known confounders, combined Sx+RT+Chemo was less likely to be received by female patients (OR 0.90, 95% CI 0.88–0.92) vs. male, non-White patients (OR 0.90, 95% CI 0.86–0.94) vs. White, patients treated at community hospitals (OR: 0.78, 95% CI 0.76–0.80) vs. academic centers, publicly-insured patients (OR 0.74, 95% CI 0.71–0.76) or uninsured patients (OR 0.54, 95% CI 0.50–0.58) vs. privately-insured, and patients living in the South (OR 0.88, 95% CI 0.85–0.91), Midwest (OR 0.83, 95% CI 0.80–0.86), and West (OR 0.85, 95% CI 0.81–0.88) compared to the Northeast. In multivariable Cox regression, significantly poorer survival was seen amongst non-metropolitan patients, community-based hospital patients, and publicly-insured and uninsured patients (vs. privately-insured), despite adjusting for prognostic factors. Conclusions: Only modest improvement in mOS of GBM patients has occurred across 2005–2020, with persistent disparities linked to sociodemographic and structural factors, whose redressal warrants multi-pronged efforts. Full article