Search Results (673)

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

This study documents Black Wisconsinites’ birthing experiences and their proposed solutions to improve Black birthing people’s trust in healthcare. Between 2019 and 2022, we conducted semi-structured, longitudinal interviews (both individual and focus group interviews) with those enrolled in a local perinatal support group program for Black birthing people (N = 25), asking about their pregnancy, birthing, and postpartum experiences and their ideas for building trust in healthcare. Using the Daughtering Method and Braun and Clarke’s method of reflexive thematic analysis, we coded the interview data and then iteratively collated the codes into themes and subthemes. Participants described experiencing medical racism, including healthcare trauma and provider bias, during pregnancy and delivery. They drew connections between those experiences and the distrust they felt toward healthcare providers and the healthcare system. They provided actionable strategies that individual providers and the healthcare system can take to build the trust of Black birthing people: employ more Black providers, listen to Black birthing people, exhibit cultural humility, engage in shared decision-making, build personal connections with patients, and spend more time with patients. This study connects Black birthing people’s experiences of medical racism to feelings of medical distrust and provides community-identified actionable suggestions to build trust and shape how we combat racial disparities in healthcare provision and health outcomes. Full article

The rise in online communication platforms has significantly increased exposure to harmful discourse, presenting ongoing challenges for digital moderation and user well-being. This paper introduces the EsCorpiusBias corpus, designed to enhance the automated detection of sexism and racism within Spanish-language online dialogue, specifically sourced from the Mediavida forum. By means of a systematic, context-sensitive annotation protocol, approximately 1000 three-turn dialogue units per bias category are annotated, ensuring the nuanced recognition of pragmatic and conversational subtleties. Here, annotation guidelines are meticulously developed, covering explicit and implicit manifestations of sexism and racism. Annotations are performed using the Prodigy tool (v1. 16.0) resulting in moderate to substantial inter-annotator agreement (Cohen’s Kappa: 0.55 for sexism and 0.79 for racism). Models including logistic regression, SpaCy’s baseline n-gram bag-of-words model, and transformer-based BETO are trained and evaluated, demonstrating that contextualized transformer-based approaches significantly outperform baseline and general-purpose models. Notably, the single-turn BETO model achieves an ROC-AUC of 0.94 for racism detection, while the contextual BETO model reaches an ROC-AUC of 0.87 for sexism detection, highlighting BETO’s superior effectiveness in capturing nuanced bias in online dialogues. Additionally, lexical overlap analyses indicate a strong reliance on explicit lexical indicators, highlighting limitations in handling implicit biases. This research underscores the importance of contextually grounded, domain-specific fine-tuning for effective automated detection of toxicity, providing robust resources and methodologies to foster socially responsible NLP systems within Spanish-speaking online communities. Full article

(1) Background: Among the most important authors of spiritual autobiography, Dag Hammarskjöld and Thomas Merton must surely mentioned. The first one, a Swedish Evangelical, and the second one, an American Cistercian monk, provide valuable and interdisciplinary works. Among the topics found, their political theology is also present. Noticing its relevance, we will try there to take into account the way the aforementioned topic is reflected in their work. (2) Results: Aspects such as communism, racism, diplomacy, or love will constitute some of the topics that we will bring into attention in this research in an attempt to present the particularities, common points, and differences of the approaches of the two relevant authors, one from the Protestant space and the other from the Catholic one, both with an ecumenical vocation and openness to dialogue. (3) Methods: As for our methods, we will use the historical inquiry, the analysis of documents, and the deductive and the qualitative method. (4) Conclusions: The work will therefore investigate the aspects of political theology found in their research and will emphasize their vision, the common points, the use of Christian theology in the understanding of political and social realities, but also the differences that may occur between their approaches. At the same time, the role played by the context where they lived, worked, and wrote will be taken into attention in order to provide a more complex perspective on the relationship between their life and work. 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

Blackness, both as a racial identity and a marker of cultural difference, disrupts the hegemonic norms embedded in dominant forms of cultural capital. This article examines how first- and second-generation Haitian and Jamaican communities in Ontario and Quebec negotiate Blackness within a Canadian context. Drawing from international literature, it introduces distinctly Canadian concepts—such as polite racism, racial ignominy, and duplicity of consciousness—to illuminate local racial dynamics. Using Yosso’s (2005) framework of community cultural wealth, the study analyzes six forms of cultural capital—linguistic, aspirational, social, navigational, resistant, and familial—as employed by Afro-Caribbeans to navigate systemic exclusion. The article expands the limited Canadian discourse on Black identity and offers theoretical tools for understanding how cultural capital is shaped and constrained by race in multicultural democracies. Full article

In the U.S. public school system, White middle-class female teacher workforces have dominantly served an increasing number of students of color. While the racial interplay between teachers and students has offered insightful implications for continuing disparities in student discipline, little research has been done to link the racial match of the teaching force to their served communities. This study examines how the ethnoracial congruence between teachers and populations in their school district moderates racial gaps in in-school suspension rates between White and non-White students in Tennessee. The research demonstrates that when teachers serve communities of the same race, their schools are less likely to show a substantial gap in in-school suspensions between White students and students of color. Full article

Aboriginal and Torres Strait Islander people who inject drugs face persistent health inequities, highlighting the need for programs that meet the needs of these groups. This study explored how intersectional stigma and discrimination affect Aboriginal and Torres Strait Islander people’s access to quality healthcare. Aboriginal and Torres Strait Islander participants aged ≥18 years who had injected drugs within the past 12 months were recruited from two regional needle and syringe programs (NSPs) and a major city NSP in Queensland, Australia. Participants completed a structured survey and yarned with an Aboriginal researcher and non-Indigenous research assistant about their healthcare experiences. Through a process of reflexive and thematic analysis, three major qualitative themes emerged: participants’ social circumstances and mental health challenges made help-seeking difficult and complex; enacted stigma and racism diminished access to health services and the quality of care received; and injecting drug use was associated with disconnection from culture and community. Privileging the expertise and voices of those with lived/living experience is essential for the creation of culturally safe, inclusive, and destigmatising healthcare services for Aboriginal and Torres Strait Islander people who inject drugs. Full article

Current structural barriers experienced by First Nations in Canada shape access and engagement for testing and treatment of hepatitis C virus (HCV) infections. This non-systematic informative review considers transdisciplinary perspectives, regional data, and published literature connecting context to the disproportionate HCV burden experienced by First Nations populations in the prairie provinces of Canada, and offers examples of participatory and community-led initiatives working toward the elimination of HCV as a public health threat. First Nations in Canada are disproportionately impacted by chronic HCV infection, with a reported rate of newly diagnosed HCV cases in First Nations communities five times the respective rate in the general Canadian population in 2022. This review explores the reasons underlying the disproportionate burden of HCV infection. Significant over-representation of First Nations in the Canadian Prairies is seen in the major risk categories for HCV acquisition, and the impact of these risk factors is aggravated by barriers to accessing healthcare services and medication coverage. These barriers stem from the legacy of colonialism, discrimination, disenfranchisement, and are exacerbated by stigmatization, victimization, and racism in the justice and healthcare systems. Other contributory factors that impede access to care include inadequate healthcare clinic staffing and infrastructure in First Nations communities, and significant geographical distances between First Nations reserves and laboratories, pharmacies, and treating/prescribing healthcare providers. Recent recognition of historical harms and early steps towards nation-to-nation reconciliation, along with support for culturally connected, holistic, and First Nations-led wellness programs, instill hope that elimination strategies to eradicate HCV infection in First Nations populations will be successful in Canada. Full article

Background: Indigenous peoples in Canada endure lasting effects of colonialism including racism, marginalization, and social, political, and geographic inequities resulting in disproportionate rates of disease and inequitable healthcare. Indigenous infants and children in Canada experience a high incidence of birth complications and illnesses, and families are often left to navigate the care of their child with limited resources. Accordingly, improved, culturally responsive and safe healthcare is needed to enhance child outcomes and optimize family well-being. Purpose and Methods: A qualitative study was conducted by our research team including family members of Indigenous children with serious illnesses, a Cultural Advisor, researchers, and pediatric clinicians. In one component of the study, we explored pediatric healthcare providers’ (HCPs) experiences of caring for Indigenous families of children with serious illness. A purposive sample of 19 pediatric healthcare providers took part in semi-structured qualitative interviews or one focus group. The data were analyzed thematically to identify common experiences and priorities for improved supportive healthcare. Findings: Five themes were identified representing insights from pediatric HCPs, with a focus on barriers to effective healthcare at the interpersonal, institutional, and system levels for seriously ill Indigenous children and their families. Ideas for enhancing the social and cultural responsiveness and safety of supportive healthcare were identified. Implications and Conclusions: The findings offer valuable insights and strategies for HCPs to support holistic, comprehensive, and culturally safe and responsive healthcare. Full article

The literature details the healthcare needs of migrant people living with chronic illnesses and the consequent economic, social, and healthcare needs of their caregivers. Similarly, some studies have underscored the social and healthcare needs of 2SLGBTQIA+ (two-spirit, lesbian, gay, bisexual, transgender, queer, and intersex individuals, including diverse sexual and gender identities under the “+” symbol) adults living with chronic illnesses and their caregivers. This narrative review presents the context of migrant 2SLGBTQIA+ unpaid caregivers and how their intersecting identities influence their caregiving roles for family members with chronic illnesses. In this article, caregivers are defined as family members or chosen families who provide unpaid support that may last for three months or longer for people living with chronic illnesses. Most studies and policies overlook 2SLGBTQIA+ migrants who are also unpaid caregivers of individuals living with chronic illnesses, leaving them unsupported through discrimination at the intersection of racism, homophobia, transphobia, ageism, and ableism, forcing them to remain vulnerable to increased emotional and physical strain. There is a presence of pervasive systemic barriers, including a lack of training and education among social and healthcare providers, about the needs of migrant 2SLGBTQIA+ unpaid caregivers. Additional challenges stem from inadequate policies and insufficient targeted resources, particularly for caregivers from marginalized racial and ethnic backgrounds. The findings of this study highlight the necessity for a call to action to address these gaps and improve support systems for these highly marginalized communities. 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

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

Cumulative experiences of racism lead to stress and trauma. Racial trauma is associated with compromised functioning across psychological, social, and physical health domains. This is further complicated by any comorbidity with other mental health conditions. Many clinicians are not trained in identifying, diagnosing, and treating racial trauma. Given the pervasive nature of racism, limited clinician knowledge and experiences, as well as the impact of this condition, there is an urgent need for novel, culturally safe, and effective treatment. The newly developed Healing Racial Trauma Protocol (HRTP) shows significant promise. We explore the methodological considerations for a randomized controlled trial comparing the efficacy of the HRTP for racialized individuals suffering from racial trauma and to a control condition of treatment as usual, in reducing the severity of racial trauma and depression symptoms, as well as improved functioning. Ethical, pragmatic, and methodological considerations in trial design, research population, and treatment protocol are explored. Full article

Background/Objectives: Social participation is important for healthy aging but challenging for older immigrants because of factors such as the loss of cultural community, language and transportation barriers, ageism, and racism. This study aimed to examine (1) the type of social activities in which older immigrants from Arabic (Arab), Mandarin (East Asian), and Punjabi-speaking (South Asian) communities in Canada engage; (2) their desire for more participation in social activities; and (3) factors they perceive as preventing their engagement in more social activities. Methods: Using a cross-sectional design, we collected data, using existing measures, from 476 older immigrants between fall 2022 and winter 2023. Descriptive statistics were used to analyze the data. Results: More than 75% of participants reported engagement in three solitary activities (having a hobby, going on a day trip; and using the internet and/or email) and more than 85% participated in community-based activities with family inside and outside and with friends outside the household. Most (71%) expressed a desire to participate in more social activities in the community, but they were prevented from doing so due to factors such as language barriers or not wanting to go alone. Conclusions: Interventions are needed to facilitate community-based participation among older immigrants and improve their quality of life. Full article