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We examined racial/ethnic inequities in the prevalence of adverse childhood experiences (ACEs) and examined the association between ACEs and selected health-related behaviors and problems. Data for this cross-sectional study come from the 2018 Maryland Youth Risk Behavior Survey/Youth Tobacco Survey, a statewide survey of high school students (n = 40,188). ACEs included caregiver verbal abuse and household food insecurity, substance use or gambling, mental illness, and involvement with the criminal justice system. We estimated the prevalence of ACEs overall and by race/ethnicity, and then used multiple logistic regression to determine associations between ACEs and emotional/behavioral problems, adjusting for race/ethnicity. Outcome variables included emotional distress, poor school performance, suicidal ideation, fighting, alcohol use, and marijuana use. More than one fifth of students reported each individual ACE. Differences in the prevalence of ACEs by race/ethnicity were statistically significant (p < .001). More than one fourth (25.8%) reported one of the five ACEs, 15.1% reported two, and 15.4% reported three or more. For each ACE, reporting having experienced it (vs. not) was associated with a >30% higher prevalence for each of the outcome variables. Among students who reported three or more ACEs (relative to none), the odds of emotional distress and suicidal ideation were more than 8 times greater. Among Maryland adolescents, ACEs are common, are inequitably distributed by race/ethnicity, and are strongly linked to behavioral health. Findings suggest the need to monitor ACEs as a routine component of adolescent health surveillance and to refocus assessment and intervention toward “upstream” factors that shape adolescent health.

While past research has examined the deleterious effects of racism on Asian Americans, fewer studies have investigated lesbian, gay, bisexual, and transgender (LGBT) Asian Americans’ unique experiences of oppression and unbelonging within the broader LGBT community. Guided by intersectionality and minority stress theoretical frameworks, the present study examined the effect of discomfort due to one’s race/ethnicity within the LBGT community on psychological wellbeing in a national sample of 480 LGBT Asian Americans from the Social Justice Sexuality Project. The moderating role of how important one considered their race/ethnicity to their identity was also examined. Regression analyses revealed that greater discomfort due to one’s race/ethnicity within the LGBT community was associated with reduced psychological wellbeing for LGBT Asian Americans who viewed their racial/ethnic identity as moderately or highly important, whereas this association was not significant for LGBT Asian Americans who considered their racial/ethnic identity as less important. These findings highlight the necessity of examining the role of racial/ethnic discomfort in relation to LGBT Asian Americans’ psychological wellbeing, as well as the extent to which LGBT Asian Americans consider their race/ethnicity as important.

Objective To examine trends in mental health care use for Black and Latinx children and adolescents. Method Data from the Medical Expenditure Panel Survey for 2010–2017 were analyzed to assess trends among youth ages 5–17 in use and expenditures for any mental health care, outpatient mental health care, and psychotropic medication prescription fills. Unadjusted trends for all youth and the subpopulation of youth reporting need for mental health care and disparities adjusting for need were examined. Results Between 2010 and 2017, Black youth rates of any past year mental health care use decreased (from 9% to 8%), while White (from 13% to 15%) and Latinx (from 6% to 8%) youth rates increased. Among the subpopulation with need and in regression analysis adjusting for need, we identified significant Black–White and Latinx–White disparities in any mental health care use and any outpatient mental health care use in 2010–2011 and 2016–2017, with significant worsening of Black–White disparities over time. White youth were more than twice as likely as Latinx youth to use psychotropic medications, and Latinx–White and Black–White disparities in psychotropic medication prescription fills persisted over time. Black–White disparities existed in overall mental health expenditures (2016–2017) and outpatient mental health expenditures (2010–2011 and 2016–2017). Conclusion Affordable, ubiquitous access to mental health care for Black and Latinx youth remains an elusive target. Significant disparities exist in receiving mental health care despite reforms and policies designed to increase mental health care access in the general population. Additional outreach and treatment strategies tailored to the cultural, linguistic, and structural needs of youth of color are required.

OBJECTIVE The aim of this study was to identify trends in the demographic constitution of applicants and matriculants to neurological surgery based on race, ethnicity, and gender. METHODS The authors conducted a cross-sectional study using compiled demographic data obtained from the Association of American Medical Colleges. Trends analyzed included proportional changes in race, ethnicity, and gender of applicants and matriculants to neurosurgical residency programs from academic years 2010–2011 to 2018–2019. RESULTS A total of 5100 applicants and 2104 matriculants to neurosurgical residency programs were analyzed. No significant change in the percentage of overall women applicants (+0.3%, 95% CI −0.7% to 1.3%; p = 0.77) or in the percentage of women matriculants (+0.3%, 95% CI −2.2% to 2.9%; p = 0.71) was observed. For applicants, no change over time was observed in the percentages of American Indian or Alaska Native (AI/AN) men (0.0%, 95% CI −0.3% to 0.3%; p = 0.65); Asian men (−0.1%, 95% CI −1.2% to 1.1%; p = 0.97); Black or African American men (−0.2%, 95% CI −0.7% to 0.4%; p = 0.91); Hispanic, Latino, or of Spanish Origin men (+0.4%, 95% CI −0.8% to 1.7%; p = 0.26); White men (+0.5%, 95% CI −2.1% to 3.0%; p = 0.27); Asian women (+0.1,% 95% CI −0.9% to 1.1%; p = 0.73); Black or African American women (0.0%, 95% CI −0.6% to 0.5%; p = 0.30); Hispanic, Latino, or of Spanish Origin women (0.0%, 95% CI −0.4% to 0.4%; p = 0.71); and White women (+0.3%, 95% CI −1.1% to 1.7%; p = 0.34). For matriculants, no change over time was observed in the percentages of AI/AN men (0.0%, 95% CI −0.6% to 0.6%; p = 0.56); Asian men (0.0%, 95% CI −2.7% to 2.7%; p = 0.45); Black or African American men (−0.3%, 95% CI −1.4% to 0.8%; p = 0.52); Hispanic, Latino, or of Spanish Origin men (+0.6%, 95% CI −0.8 to 2.0%; p = 0.12); White men (−1.0%, 95% CI −5.3% to 3.3%; p = 0.92); Asian women (+0.1%, 95% CI −1.3% to 1.5%; p = 0.85); Black or African American women (0.0%, 95% CI −0.6% to 0.7%; p = 0.38); Hispanic, Latino, or of Spanish Origin women (−0.1%, 95% CI −0.7% to 0.5%; p = 0.46); and White women (+0.3%, 95% CI −2.4% to 3.0%; p = 0.70). CONCLUSIONS Despite efforts to diversify the demographic constitution of incoming neurosurgical trainees, few significant advances have been made in recent years. This study suggests that improved strategies for recruitment and cultivating early interest in neurological surgery are required to further increase the diversification of future cohorts of neurosurgical trainees.

OBJECTIVE: Systems of care (SOCs) were developed to increase access to and quality of care for children with emotional and behavioral difficulties and their families through the provision of coordinated, community-based, culturally competent, family-driven services. SOCs focus on wraparound care that is individualized to meet each family’s needs. Previous research has illustrated significant disparities in outcomes of nonwraparound care on the basis of youths’ race-ethnicity. This study aimed to fill a research gap by examining disparities in outcomes for families receiving wraparound care coordination within an SOC. METHODS: This exploratory study examined racial-ethnic disparities in outcomes observed at intake, during service provision, and at 6-month follow-up among 1,138 youths and their caregivers who participated in wraparound care coordination as part of a statewide SOC between 2016 and 2020. Analyses of variance and regression analyses were executed to investigate whether receiving services and/or the youths’ racial-ethnic identity predicted differences in behavioral health outcomes and characteristics of or satisfaction with care. Caregiver-reported outcomes were assessed with the Ohio Scales for Youth, the Child Trauma Screen, and the Caregiver Strain Questionnaire. RESULTS: Results revealed few racial-ethnic disparities in the characteristics and outcomes of care coordination among participants at intake or in family involvement in the wraparound process. Participants across groups reported similar and significant improvement in outcomes. However, the results indicated some disparities in satisfaction with care. CONCLUSIONS: Results revealed the positive impact of care coordination on the health and well-being of youths and caregivers across racial-ethnic groups.

OBJECTIVE. Physical activity is known to improve depressive symptoms. The present study was undertaken to examine physical inactivity as a predictor of incident depression in systemic lupus erythematosus (SLE). METHODS. Data derive from the California Lupus Epidemiology Study (CLUES), a longitudinal cohort with confirmed SLE diagnoses. Physical inactivity was assessed from a single item, “I rarely or never do any physical activities,” and depressive symptoms by the 8-item Patient Health Questionnaire (PHQ-8). Analysis included those not depressed at baseline (PHQ-8 score 3-fold increased risk of incident depression among the sedentary group (HR 3.88 [95% Cl 1.67–9.03]). CONCLUSION. In this diverse SLE cohort, a simple question about physical inactivity was highly predictive of incident depression over the subsequent 2 years. Results suggest an urgent need for approaches to reduce sedentary behavior in this high-risk population.

This qualitative interview study investigated the types of parental racial-ethnic socialization messages received by Multiracial American youth over the course of their development. The Multiracial population in America is the largest demographic group among individuals under the age of 18 (Saulny, 2011), but there is a dearth of research about the development of this rapidly growing population. Multiracial youth are members of multiple racial-ethnic groups. Thus, racial-ethnic socialization is particularly complex for Multiracial families because parents typically have different racial backgrounds and experiences compared to their children. Interviews were conducted with 20 Multiracial emerging adult college students (Mage = 20.55; 10 male, 10 female) of diverse racial backgrounds to identify the types of parental racial-ethnic socialization messages they received growing up. Using thematic analysis (Braun & Clarke, 2006), nine themes of racial-ethnic socialization content emerged: Cultural socialization, racial identity socialization, preparation for bias socialization, colorblind socialization, race-conscious socialization, diversity appreciation socialization, negative socialization, exposure to diversity socialization, and silent socialization. This research advances the literature by (a) identifying domains of racial-ethnic socialization messages for Multiracial American families, (b) examining a diverse sample of male and female Multiracial youth, (c) differentiating monoracial versus Multiracial socialization messages, and (d) distinguishing the unique connotations of egalitarian socialization messages (e.g., colorblind, race-conscious, diversity appreciation). The findings have important implications for understanding the development of Multiracial American individuals and families. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

BACKGROUND: HIV pre-exposure prophylaxis (PrEP) requires continued use at an effective dosage to reduce HIV incidence. Data suggest early PrEP drop-off among many populations. We sought to describe PrEP use over the first year among racial and ethnic minority patients in the US. SETTING: Racial and ethnic minority patients initiating PrEP at a federally qualified health center in Chicago, IL METHODS: Using electronic health records, we determined the adherence (≥6 weekly doses) trajectories over the first year of PrEP use and compared baseline and time-varying patient characteristics. RESULTS: From 2,159 patients, we identified three PrEP use trajectories. Sustained use was the most common (40%) trajectory, followed by short use (30%) and declining use (29%). In adjusted models, younger age, Black race, as well as gender, sexual orientation, insurance status at baseline, and neighborhood were associated with trajectory assignment; within some trajectories, insurance status during follow-up was associated with odds of monthly adherence (≥6 weekly doses). CONCLUSION: Among racial and ethnic minorities, a plurality achieved sustained PrEP persistence. Access to clinics, insurance, and intersectional stigmas may be modifiable barriers to effective PrEP persistence; in addition, focus on younger users and beyond gay, cismale populations are needed.

Introduction Social vulnerability is an important driver of disparate surgical outcomes, however the extent to which certain types of vulnerability impact outcomes is poorly understood. Methods Medicare beneficiaries 65 years or older who underwent one of four operations were identified. Multivariable mixed-effects logistic regression was used to measure the association of four social vulnerability subthemes from the social vulnerability index (SVI) were assessed relative to the likelihood to achieve a textbook outcome (TO). Results Among 579,846 Medicare beneficiaries, median age was 74 years and most patients (536,455,92.5%) were White/non-Hispanic. On multivariable analysis, the overall impact of the composite SVI metric on the odds to achieve a postoperative TO was lower among White/non-Hispanic patients (Δ25%ile SVI:OR:0.98,95%CI:0.97–0.98) compared with ethnic/minority patients (Δ25%ile SVI:OR:0.93,95%CI:0.91–0.94). Increasing vulnerability in the subthemes of socioeconomic status (Δ25%ile SVI:ethnic/minority:OR:0.92, 95%CI:0.91–0.94) and household composition (Δ25%ile SVI:ethnic/minority:OR:0.92,95%CI:0.91–0.94) was associated with a greater likelihood not to achieve a TO among minority patients. Conclusions Worsening SES and household compositions & disability had a detrimental effect on odds of TO following surgery with the most pronounced effect on non-White minority patients.

Community-based organizations are uniquely positioned to address critical gaps in social support that contribute to inequities in maternal health. Using a human-centered design process, we held 3 design workshops with members of 15 organizations in Greater Boston, including community-based organizations, allied hospital systems, and public health departments, to assess proposed solutions for gaps in social support services during pregnancy and the first year after childbirth. The workshops focused on solutions to problems that emerged from a mixed-methods research study with community-based organizations that provide social support services; workshop attendees explored facilitators and barriers to implementing solutions. Key considerations included colocation of solutions, shared ownership of program and client data, decision making about triage and referrals, and strengthening coordination of existing programs. Collaborative design workshops surfaced potential solutions to improve coordination of services, which require addressing structural and interpersonal racism in Greater Boston.

OBJECTIVE/PARTICIPANTS: In a large, diverse sample of college students (N=2,230), this online study investigated racial/ethnic differences on type of discriminatory event experienced and perceived stress, and whether discrimination-related stress was associated with mental health symptoms. METHODS: Prevalence of lifetime/past year discriminatory events was assessed and frequency of discrimination-related stress was compared across racial/ethnic groups. Correlations between discrimination-related stress and mental health symptoms were also examined. RESULTS: All racial/ethnic groups reported experiencing all types of discriminatory events, though prevalence was lowest for White students. Racial/ethnic minority (i.e., Asian, Black, Latinx) students reported greater discrimination-related perceived stress compared to White, non-Hispanics. Across all racial/ethnic groups, discrimination-related stress was positively associated with negative mental health outcomes (e.g., anxiety/depressive symptoms). CONCLUSIONS: These results highlight the need to continue efforts to reduce discriminatory experiences of racial/ethnic minority students and to incorporate antiracism interventions in universities to mitigate the pervasive negative experiences of minority students.

BACKGROUND AND AIMS: Racial/ethnic minority children have worse liver transplant outcomes. We evaluated whether neighborhood socioeconomic deprivation affected associations between race/ethnicity and waitlist mortality. APPROACH AND RESULTS: We included children (age

Sexism and racism in academia have contributed to women and people of color being underrepresented at increasing levels of the academic hierarchy. We investigated whether people with socially marginalized identities experience disparities regarding rates of publishing and inclusion in the scientific-review process. Using a sample of academics in psychology departments at research-focused universities in the United States (n = 885), we found gender disparities for PhD holders and racial/ethnic disparities for graduate students. Specifically, female PhD holders and graduate students of color reported fewer publications and were less likely to be included in the scientific-review process compared with male PhD holders and White graduate students, respectively. Differences in research activity by gender and race/ethnicity in a contemporary sample of psychologists reflected a 'leaky pipeline' that persists in psychology departments

We evaluated the prevalence, awareness, treatment, and control of hypertension (defined as a systolic blood pressure [BP]) ≥140 mm Hg, diastolic BP ≥90 mm Hg, or a self-reported use of an antihypertensive agent) among US adults, stratified by race/ethnicity. This analysis included 16 531 nonpregnant US adults (≥18 years) in the three National Health and Nutrition Examination Survey cycles between 2013 and 2018. Race/ethnicity was defined by self-report as White, Black, Hispanic, Asian, or other Americans. Among 76 910 050 (74 449 985–79 370 115) US adults with hypertension, 48.6% (47.3%–49.8%, unadjusted) have controlled BP. When compared with BP control rates for White adults (49.0% [46.8%–51.2%], age-adjusted), BP control rates are lower in Black (39.2%, adjusted odds ratio [aOR], 0.71 [95% CI, 0.59–0.85], P P =0.003), and Asian (37.8%, aOR, 0.68 [95% CI, 0.55–0.84], P =0.001) Americans. Black adults have higher hypertension prevalence (45.3% versus 31.4%, aOR, 2.24 [95% CI, 1.97–2.56], P P =0.005) and treatment rates (60.5% versus 67.3%, aOR, 0.78 [95% CI, 0.66–0.94], P =0.010) than White adults. Asian adults have similar hypertension prevalence, lower awareness (72.5% versus 79.1%, aOR, 0.75 [95% CI, 0.58–0.97], P =0.038) but similar treatment rates. Black, Hispanic, and Asian Americans have different vulnerabilities in the hypertension control cascade of prevalence, awareness, treatment, and control. These differences can inform targeted public health efforts to promote health equity and reduce the burden of hypertension in the United States.

Some of the events of the past year have resulted in theological institutions assessing their own racial ethnic diversity and making plans for increasing that diversity. This year Atla celebrates seventy-five years of existence. This session will reflect back over the past 75 years and note what has been done. The presentation given at the ATLA Annual Conference in 2011, Sixty-Five Years of Racial Ethnic Diversity in ATLA will be the basis for the session. At the conclusion of the 2011 presentation, the vision of the future was of an association which reflected the general population in terms of percentage of racial ethnic persons. The session will chronicle events from the last 10 years, update data, and see how close to that vision the association has come. Areas of possible growth will also be noted.

In 2019, heterosexual sex accounted for 23% of new HIV diagnoses in the United States and six dependent areas (1). Although preexposure prophylaxis (PrEP) can safely reduce the risk for HIV infection among heterosexual persons, this group is underrepresented in PrEP research (2). CDC analyzed National HIV Behavioral Surveillance (NHBS) data to describe PrEP awareness among heterosexually active adults in cities with high HIV prevalence. Overall, although 32.3% of heterosexually active adults who were eligible were aware of PrEP

The current study examines whether racial/ethnic threat theory can explain juvenile court outcomes. Specifically, we look at Black population threat and Latino population threat. We also introduce ...

Introduction Racial disparities in COVID-19 morbidity and mortality have been well-documented. However, there may also be racial disparities in COVID-19 vaccination rates which, if present, would further exacerbate the existing disparities. No previously published articles have identified and quantified potential racial disparities in vaccination throughout the USA at any geography lower than the national level. Methods Using data compiled from state health departments, we calculated racial disparities in COVID-19 vaccination for the Black and Hispanic populations compared to the White population in each state. We explored the relationship between a state-level index of structural racism and the observed differences in the racial disparities in COVID-19 vaccination across states for both the Black and Hispanic populations by conducting linear regression analyses. Results Racial disparities in COVID-19 vaccination were present for both the Black and Hispanic populations in the overwhelming majority of states. There were vast differences between the states in the magnitude of the racial disparity in race-specific vaccination rates. These differences were largely explained by differences in the level of structural racism in each state. The relationship between structural racism and the racial disparities in vaccination was not entirely explained by racial differences in vaccine hesitancy or political affiliation. Conclusions There are marked racial disparities in COVID-19 vaccination throughout the USA, and structural racism is strongly associated with the magnitude of these disparities. Efforts to reduce these disparities must address not only individual behavior but must also confront the structural barriers that are inhibiting equitable vaccine distribution.

There has been an increase in the incidence of Myocardial Infarction (MI) among pregnant women in the United States. There have been no studies examining the trends in the rates of gestational MI hospitalizations by race/ethnicity;and therefore, we undertook this study. No prior studies have examined the trends in the rates of gestational MI hospitalizations by race and ethnicity. In this study, we examined temporal trends of MI-related hospitalizations among pregnant women using the Nationwide Inpatient Sample (NIS) dataset from 2009 to 2018. We performed joinpoint regression analyses to assess trends in the rates of MI by race/ethnicity during the study period. Overall, there was an increase in the rates of MI among pregnant women during the study period (from 9.7 per 100,000 hospitalizations in 2009 to 18.1 per 100,000 hospitalizations in 2018) with an average annual percentage change (AAPC) of 7.2, (95% Confidence Interval (CI)=[4.0, 10.5]. The overall rate of MI was highest in non-Hispanic (NH)-Blacks and the greatest increments in rates of MI-related hospitalizations were noted in NH-Blacks during 2013-2018, and in Hispanics during the entire study period (2009-2018). NH-Blacks and Hispanics bear a disproportionately high burden of MI among pregnant women in the US. More worrisome is the first-ever reported finding in this study of a widening Black-White disparity in MI-related hospitalizations over the past decade. Copyright © Dongarwar et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

While much attention has been focused on the impact of the COVID-19 pandemic on hate crime victimization among the Asian population, there is reason to expect that other racial/ethnic minorities ma...

Church attendance, prayer, and faith practices play a significant role in the life experiences among African Americans, especially youth. Few studies on religious behaviors among African American youth investigate the relationship between theological orientations and racial identity. These orientations include biblical principles, other-worldliness, and social legacy. A total of 187 African American adolescents ( Mage = 15) attending 18 predominantly Black churches in two Midwestern cities participated in the study. Results provided support for two theological orientations that were associated with racial/ethnic identity in distinct ways. More specifically, other-worldliness was linked to more negative feelings about the appearance of African American adolescents and being more likely to endorse negative stereotypes about African Americans. Adolescents who perceived their church as communicating a theology based upon biblical principles reported rejecting negative stereotypes about African Americans. Study findings suggest theological orientations may be associated with shaping racial/ethnic identity attitudes among African American adolescents.

The present studies examined the conditions under which low subjective socioeconomic status (SES) is associated with greater racial/ethnic prejudice among White Americans. Based on theories of intergroup threat and inclusive victim consciousness, we predicted that describing racial/ethnic minorities as disadvantaged (versus as competitive or in neutral terms) would increase empathy and reduce prejudice among White Americans who consider themselves low in SES. Study 1 provided correlational evidence that White Americans who perceived themselves as low-SES (but not high-SES) were less prejudiced against racial/ethnic minorities the more they perceived minorities as disadvantaged. In Study 2, portraying the target outgroup (Arab immigrants) as disadvantaged increased outgroup empathy, and in turn reduced prejudice, among participants induced to think of themselves as low-SES. Study 3 conceptually replicated these results using a different outgroup (Mexican Americans) and a behavioral measure of prejudice. Implications for reducing prejudice among White Americans of different socioeconomic backgrounds are discussed.

Purpose: Severe racial inequities in maternal and infant health in the United States are caused by the many forms of systemic racism. One manifestation of systemic racism that has received little attention is access to paid parental leave. The aim of this article is to characterize racial/ethnic inequities in access to paid leave after the birth of a child. Methods: We analyzed data on women who were employed during pregnancy (n=908) from the Bay Area Parental Leave Study of Mothers, a survey of mothers who gave birth in the San Francisco Bay Area in 2016–2017. We examined differences in access to government- and employer-paid leave, the duration of leave taken, and the percent of usual pay received while on leave. To explore these differences, we further examined knowledge of paid leave benefits and sources of information. Results: Non-Hispanic (NH) black and Hispanic women had significantly less access to paid leave through their employers or through government programs than their NH white and Asian counterparts. Relative to white women, Asian, Hispanic, and black women received 0.9 (p

Background: Sexual minority women may use contraception for various reasons but face notable barriers to contraceptive care, including stigma and discrimination. However, studies examining sexual orientation disparities in contraceptive care have largely relied on nonprobability samples of predominately White women and may thus not be generalizable to U.S. women overall or Black and Latina women in particular. Materials and Methods: Using data from the 2006 to 2017 National Survey of Family Growth, a large national probability sample of U.S. women 15–44 years of age (N = 25,473), we used multivariable logistic regression to estimate adjusted odds ratios for receiving a contraceptive method or prescription and contraceptive counseling from a health care provider in the past year among sexual orientation identity and racial/ethnic subgroups of heterosexual, bisexual, and lesbian White, Black, and Latina women relative to White heterosexual women. Results: Among women overall, 33.9% had received contraception and 18.3% had obtained contraceptive counseling. Black (odds ratio [OR] = 0.73, 95% confidence interval [CI]: 0.65–0.82) and Latina (OR = 0.73, 95% CI: 0.64–0.82) heterosexual women, White (OR = 0.80, 95% CI: 0.65–0.99) and Black (OR = 0.43, 95% CI: 0.32–0.58) bisexual women, and White (OR = 0.23, 95% CI: 0.13–0.43), Black (OR = 0.19, 95% CI: 0.09–0.40), and Latina (OR = 0.08, 95% CI: 0.03–0.22) lesbian women had significantly lower adjusted odds of receiving contraception compared with White heterosexual women. White (OR = 0.36, 95% CI: 0.15–0.85), Black (OR = 0.42, 95% CI: 0.18–0.98), and Latina (OR = 0.22, 95% CI: 0.09–0.53) lesbian women also had significantly lower adjusted odds of obtaining contraceptive counseling relative to White heterosexual women. Conclusions: Policies, programs, and practices that facilitate access to person-centered contraceptive care among marginalized sexual orientation identity and racial/ethnic subgroups of U.S. women are needed to promote reproductive health equity.

Purpose To document gender-specific racial-ethnic disparities in cardiovascular (CV) conditions and risk factors net of socioeconomic status (SES) across the lifespan. Methods Using pooled data from the 1999 to 2016 U.S. National Health and Nutrition Examination Survey, we document gender-specific proportions of non-Hispanic Whites, non-Hispanic Blacks, and Hispanics ages 12–69 years with various socioeconomic characteristics and CV conditions. We then further disaggregate into 10-year age groups and present unadjusted and SES-adjusted prevalence of each CV condition for each gender/racial-ethnic/age group. Results Racial-ethnic differences in the prevalence of CV conditions are large for some conditions, emerge early in adulthood, and remain relatively constant though age 69. Only small proportions of the differences can be attributed to differences in SES across groups; attenuation after adjusting for income, education, and available measures of wealth ranged from 0 to 2.3 percentage points. Black-White differences in prevalence of CV conditions differ substantially and systematically by gender; White females have larger advantages or smaller disadvantages (depending on indicator) relative to Black females than White males do relative to Black males. Conclusions Racial-ethnic disparities in CV conditions are rooted early in the life course, do not mirror socioeconomic disparities, and vary considerably by gender. Explanations likely involve early life experiences such as racial discrimination and entrenched inequality.

This study investigated childhood cancer disparities in the state of Texas based on data from 1995 to 2014 from the perspective of race/ethnicity, geographic location, and social factors. The enhan...

Author(s): Aylward, Brandon S; Gal-Szabo, Diana E; Taraman, Sharief | Abstract: AbstractThis special article uses a biosocial-ecological framework to discuss findings in the literature on racial, ethnic, and sociodemographic diagnostic disparities in autism spectrum disorder. We draw explanations from this framework on the complex and cumulative influences of social injustices across interpersonal and systemic levels.

Over the last 20 years, numerous states and the federal government enacted mandatory minimum reforms, especially for drug offenses. Yet little is known about how effective these reforms have been at the state-level in lowering drug sentences. Using quasi-experimental methods and administrative data, this study evaluates the impact of state-level mandatory minimum reforms on drug sentences and their concomitant racial-ethnic disparities. We find that state-level mandatory minimum reforms do not lower drug sentences in general or change racial-ethnic disparities statistically significantly. These findings suggest that the profound racial-ethnic bias sparked by state-level mandatory minimums are not fully ameliorated by subsequent state-level reforms.

The present study aimed to enhance our understanding of racial/ethnic minorities’ stress, and suggest possible ways to reduce their stressful feelings at work. Racial minorities were compared with non-minorities in terms of their satisfaction about diverse work environments and the effects of work environment on stressful feelings. Hypotheses were tested, using ordinary least squares (OLS) regression analyses and t-tests. According to the findings, the strain of racial/ethnic minorities was differently affected by work environment factors such as public support and goal attainability, compared to that of non-minorities. Some demographic factors also had different effects on the strain of racial/ethnic minorities.

The study's objective was to identify factors associated with differences in the rate of viral suppression among minority women with HIV/AIDS in care in the Miami-Dade County Ryan White Program (RWP). A retrospective cohort study was conducted using social characteristics and laboratory data of minority women enrolled in the Miami-Dade County RWP in 2017. Viral suppression was defined as

Objective: Inclusion of women in biomedical cancer research have the potential to close gaps in cancer health disparities and improve adjuvant therapies for women; yet samples needed to advance this area of science are lacking. We developed low-cost educational recruitment strategies to increase our collection of biospecimens from women. Materials and Methods: Women diagnosed with hormone receptor positive (HR+) breast cancer that initiated hormonal therapy were recruited from three integrated health systems. The analytical sample (n = 144) consisted of women who consented but did not return a saliva sample within 1 year of the initial assessment (baseline). Brief informational recruitment materials were developed via published literature and preliminary data. Women received recruitment materials, which included a personalized information letter, a colorful low-literacy instruction sheet, a postage-paid envelope, and collection kits. We evaluated intervention materials and performed descriptive and bivariate statistics to describe factors associated with biospecimen donation. Results: Of the total sample, 61% were white and 34% were black. Overall, 29 surveys (20%) and 25 (17%) saliva kits were returned. Women found the materials helpful and easy to read and understand. Women with higher levels of functional well-being and lower ratings of religiosity were more likely to return biospecimens (p

Background: Racial-ethnic disparities in diabetes technology use are well documented in young adults (YA) with type 1 diabetes (T1D), but modifiable targets for intervention still need to be identified. Our objective was to explore YA perspectives on technology access and support in routine clinical care. Materials and Methods: Participants were YA with T1D of Hispanic or non-Hispanic Black race-ethnicity from pediatric and adult endocrinology clinics in the Bronx, NY. We conducted semistructured individual interviews to explore how health care and personal experiences affected technology use. Interviews were audio-recorded and transcribed for analysis. We used a modified inductive coding approach with two independent coders and iterative coding processes to improve data reliability and validity. Results: We interviewed 40 YA with T1D: mean age 22 years; 62% female; 72% Medicaid insured; 72% Hispanic; 28% non-Hispanic Black; and mean hemoglobin A1C 10.3%. Themes were categorized into potentially exacerbating and alleviating factors of racial-ethnic disparities in technology use. Exacerbating factors included perceptions that providers were gatekeepers of information and prescription access to technology, providers did not employ shared decision making for use, and YA biases against technology were left unaddressed. Alleviating factors included provider optimism and tailoring of technology benefits to YA needs, and adequate Medicaid insurance coverage. Conclusions: Our results reveal potential intervention targets at the provider level to increase technology uptake among underrepresented YA with T1D. Diabetes health care providers need to be aware of inadvertent withholding of information and prescription access to technology. Provider approaches that address YA technology concerns and promote shared decision making help to mitigate racial/ethnic disparities in technology use.

We ask whether patterns of racial/ethnic and socioeconomic stratification in educational attainment are amplified or attenuated when we take a longer view of educational careers. We propose a model of staged advantage to understand how educational inequalities evolve over the life course. Distinct from cumulative advantage, staged advantage asserts that inequalities in education ebb and flow over the life course as the population at risk of making each educational transition changes along with the constraints they confront in seeking more education. Results based on data from the 2014 follow-up of the sophomore cohort of High School and Beyond offer partial support for our hypotheses. The educational attainment process was far from over for our respondents as they aged through their 30s and 40s: more than six of ten continued their formal training during this period and four of ten earned an additional credential. Patterns of educational stratification at midlife became more pronounced in some ways, as women pulled further ahead of men in their educational attainments and parental education (but not income), and high school academic achievement continued to shape educational trajectories at the bachelor’s degree level and beyond. However, African American respondents gained on White respondents during this life phase through continued formal (largely academic) training and slightly greater conditional probabilities of graduate or professional degree attainment; social background fails to predict earning an associate degree. These results, showing educational changes and transitions far into adulthood, have implications for our understanding of the complex role of education in stratification processes.

Studies document how identity related processes, including identity centrality, shape mental well being. More research, however, is needed that considers how identity centrality impacts well being for people with more than one marginalized identity. Drawing from data from 1,571 black and Latinx sexual minorities included in the Social Justice Sexuality Project, I apply an intercategorical intersectional approach to examine the association between the intersection of sexual and racial/ethnic identity centrality and mental well being. Ordinary least squares regression models show three key findings. First, I found a significant association between both racial/ethnic and sexual identity centrality and mental well being. Second, my results highlight a significant interaction effect between sexual and racial/ethnic identity centrality, indicating the relationship between centrality and well being varies across different levels of centrality. Finally, my results indicate that after adjusting for identity centrality, other predictors remain significantly associated with well being.

Effective as of October 2019, the Disproportionate Minority Contact (DMC) Mandate requires states to address racial/ethnic disparities in their juvenile justice systems without reference to any num...

BACKGROUND: Before 2007, erythropoiesis-stimulating agents (ESAs) were the highest-expenditure drug in the Medicare system. In 2007, CMS issued a reimbursement policy change for ESAs used by cancer...

Racial/ethnic minority girls have a history of being underrepresented in STEM. Yet, there is a dearth of research that identifies the mathematics experiences that predict being on a STEM pipeline. Analyzing data from the Educational Longitudinal Study (ELS: 2002), we examined the relationship between mathematics attitudes, beliefs, and enrichment activities and being on a STEM pipeline among racial/ethnic minority girls. The findings indicated that for Black and Latinx girls, higher levels of mathematics self-efficacy beliefs were associated with being on a STEM pipeline. For American Indian/Alaska Native girls, endorsing a growth mindset was associated with being on a STEM pipeline. For Asian, Hawaii/Pacific Islander girls, mathematics enjoyment was associated with being on a STEM pipeline. Yet, endorsing higher levels of participation in mathematics enrichment activities and mathematics self-efficacy beliefs was associated with lower endorsements of being on a STEM pipeline for Black and American Indian/Alaska Native girls, respectively. Results build on previous work by highlighting important mathematics experiences that impact being on a STEM pipeline for racial/ethnic minority girls.

The restaurant industry is often described as a toxic workplace due to high levels of incivility and bullying among employees. This paper presents a study investigating the negative influence of wo...

Previous research has demonstrated a relationship between black residential segregation and poor health outcomes. However, this association is less clear for the segregation of other racial/ethnic minority groups in the United States, such as Latinos and Asians. We argue that immigration may moderate this relationship, and that this could help explain these disparate results. We test this using multilevel statistical models of individual-level health data nested within Census tracts in a study of the Houston area using the 2009–2014 Kinder Houston Area Survey, the 2010 U.S. Census, and the 2006–2010 American Community Survey. We find that black and Latino residential segregation is associated with greater poor health reporting, though not for Asian segregation. Further, we find that immigration moderates this relationship for Latino segregation, such that where tract-level immigration is low, Latino segregation is positively related to poor health, but that this slope becomes flatter as immigration increases.

Addressing Latino childhood obesity requires effective health promotion programs and culturally resonant health professionals. The current profiles of public health professionals and registered dietitians point to the need to increase the number of Latino students trained in community-based participatory research and engagement of underserved populations. To address this workforce gap, the Center for Latino Community Health, Evaluation, and Leadership Training developed the Sanos y Fuertes: Healthy & Strong Graduate Research Fellowship to provide Latino graduate students with research training, professional development, and mentorship. Five cohorts of seven graduate students participated in a yearlong experiential learning program. Graduate research fellows received monthly research and professional development training from faculty, staff, and community health workers. Furthermore, fellows engaged in mentored research through the development and implementation of a Latino childhood obesity prevention curriculum and intervention. A mixed-method evaluation approach was used to assess the effectiveness of the program. Fellows completed baseline, posttraining, and follow-up assessments. Assessment surveys measured training experiences (e.g., research methods, community engagement), confidence (e.g., research methods, health education), and knowledge and skills (e.g., community health program skills). The training resulted in significant increases in skills and confidence between pre- and postassessments that were sustained at follow-up. Based on these findings, we recommend that student training programs include research as experiential learning with multidisciplinary, interprofessional teams and that community-based, community-engaged, or translational research teams include community health workers as integral members for research with marginalized, underserved populations.

Positive parenting behaviors such as parental monitoring and support can protect adolescents from alcohol use, either directly or through buffering risk factors such as perceived peer alcohol use. However, it is unclear whether such moderating effects vary as a function of race, ethnicity, and gender. This study addressed the knowledge gap by exploring racial, ethnic, and gender differences in the potential moderating effects of perceived positive parenting on the association between perceived peer alcohol use and adolescent alcohol use. Using data from the U.S. Heath Behavior in School-Aged Children study collected in 2009–2010, this study focused on 6744 adolescents from Grades 7 to 10 and five racial and ethnic groups (White, Black, Asian American, Latinx, and multiracial). Multiple regression analyses with three-way interaction effects were conducted. All three perceived positive parenting measures (i.e., maternal monitoring, paternal monitoring, and parental support) moderated the influence of perceived peer alcohol use on adolescent alcohol use among White girls and boys, but the moderating effects were inconsistent for boys and girls of color. Racial, ethnic and gender differences exist among the moderating effects of perceived positive parenting. Parenting programs designed for White adolescents need to be tailored for adolescent boys and girls of color.