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BACKGROUND: In recent years, there has been growing interest in "moving beyond the individual" to measure area-level racism as a social determinant of health. Much of this work has aggregated racial prejudice data collected at the individual-level to the area-level. OBJECTIVE: As this is a rapidly emerging area of research, we conducted a systematic literature review to describe evidence of the relationship between area-level racial prejudice and health, whether results differed by race/ethnicity, and to characterize key conceptual and methodological considerations to guide future research. METHOD: We searched four interdisciplinary databases for US-based, peer-reviewed articles measuring area level racial prejudice by aggregating individual-level indicators of racial prejudice and examining associations with mental or physical health outcome(s). Data extraction followed PRISMA guidelines and also included theory and conceptualization, pathways to health, and strengths and limitations. RESULTS: Fourteen of 14,632 identified articles met inclusion criteria and were included in the review. Health outcomes spanned all-cause (n = 4) and cause-specific (n = 4) mortality, birth outcomes (n = 4), cardiovascular outcomes (n = 2), mental health (n = 1), and self-rated health (n = 1). All studies found a positive association between area-level racial prejudice and adverse health outcomes among racial/ethnic minoritized groups, with four studies also showing a similar association among Whites. Engagement with formal theory was limited and exposure conceptualization was mixed. Methodological considerations included unmeasured confounding and trade-offs between generalizability, self-censorship, and specificity of measurement. CONCLUSIONS: Future research should continue to develop the conceptual and methodological rigor of this work and test hypotheses to inform evidence-based interventions to advance population health and reduce racial health inequities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

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On March 8, 2020, there was a 650% increase in Twitter retweets using the term "Chinese virus" and related terms. On March 9, there was an 800% increase in the use of these terms in conservative news media articles. Using data from non-Asian respondents of the Project Implicit "Asian Implicit Association Test" from 2007-2020 (n = 339,063), we sought to ascertain if this change in media tone increased bias against Asian Americans. Local polynomial regression and interrupted time-series analyses revealed that Implicit Americanness Bias-or the subconscious belief that European American individuals are more "American" than Asian American individuals-declined steadily from 2007 through early 2020 but reversed trend and began to increase on March 8, following the increase in stigmatizing language in conservative media outlets. The trend reversal in bias was more pronounced among conservative individuals. This research provides evidence that the use of stigmatizing language increased subconscious beliefs that Asian Americans are "perpetual foreigners." Given research that perpetual foreigner bias can beget discriminatory behavior and that experiencing discrimination is associated with adverse mental and physical health outcomes, this research sounds an alarm about the effects of stigmatizing media on the health and welfare of Asian Americans.

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BACKGROUND: The National School Lunch and Breakfast Programs help to reduce food insecurity and improve nutrition. The Community Eligibility Provision (CEP) enables high-poverty schools to offer breakfast and lunch at no cost to all students. This study examines associations between CEP and participation among students eligible for free or reduced-price meals ("FRPM"), possibly eligible ("near-cutoff"), or ineligible ("full-price"). METHODS: Using data from the 2013-2015 Healthy Communities Study, we compared school breakfast and lunch participation between 842 students in K-8 at 80 CEP schools and 1463 students at 118 schools without CEP. Cross-sectional difference-in-difference (DID) models compared meal participation among near-cutoff and full-price groups to that in the FRPM group. RESULTS: Overall, FRPM students had high participation in school lunch and breakfast at both types of schools. In adjusted DID models, lunch participation among near-cutoff students was 12 points higher in CEP versus comparison schools (p < .05). Among full-price students, breakfast participation was 20 points higher and lunch participation 19 points higher in CEP than comparison schools (p < .001). CONCLUSIONS: Community Eligibility Provision improves access to school breakfast and lunch in high-poverty schools, particularly for students who are near or above the cutoff for FRPM eligibility.

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Objectives. To examine the impact of physical education (PE) litigation on changes in cardio-respiratory fitness among racially/ethnically and socioeconomically diverse students.Methods. We used annual school-level data for all California schools with measures of fifth graders' cardio-respiratory fitness spanning 2007-2008 through 2017-2018. A difference-in-difference design assessed changes before and after lawsuits in the proportion of students meeting fitness standards in schools in districts that were parties to PE lawsuits (n = 2715) versus in schools in districts not involved (n = 3152). We ran separate models with the proportion of students meeting fitness standards by sex, race/ethnicity, and low-income status as outcomes.Results. PE litigation led to a 1-percentage-point increase in the proportion of fifth-grade students meeting cardio-respiratory fitness standards (95% confidence interval [CI] = 0.03%, 2.0%). Effects were especially pronounced for female (1.3-percentage-point increase; 95% CI = 0.1%, 2.5%), African American (3.4-percentage-point increase; 95% CI = 0.5%, 6.2%), and low-income (2.8-percentage-point increase; 95% CI = 0.5%, 6.0%) students.Conclusions. Schools in districts subject to PE litigation showed greater improvements in student fitness, particularly among students typically at higher risk for inactivity and low fitness. Litigation may be an impactful tool for enforcing PE provision in accordance with the law.

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This article investigates the influence of family back-ground and neighborhood conditions during childhood on health later in life, with a focus on hypertension. To document the proportion of current adult racial health disparities rooted in early-life factors, I use nationally representative longitudinal data from the PSID spanning four decades. The results indicate that racial differences in early life neighborhood conditions and family background characteristics play a substantial role in explaining racial disparities in hypertension through at least age 50. Contemporaneous socioeconomic factors account for relatively little of the racial disparities in this health condition in adulthood. Second, I match the Panel Study of Income Dynamics data to county-level data on Medicaid expenditures during these cohorts' childhoods, and provide new causal evidence on the long-run returns to childhood Medicaid spending: Medicaid-induced increases in access to public health insurance led to significant reductions in the likelihood of low birth weight, increased educational attainment and adult income, and reduced adult mortality and the annual incidence of health problems.

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Using data from five waves of the Women's Employment Survey (WES; 1997-2003), we examine the links between low-income mothers' employment patterns and the emotional behavior and academic progress of their children. We find robust and substantively important linkages between several different dimensions of mothers' employment experiences and child outcomes. The pattern of results is similar across empirical approaches-including ordinary least squares and child fixed-effect models, with and without an extensive set of controls. Children exhibit fewer behavior problems when mothers work and experience job stability (relative to children whose mothers do not work). In contrast, maternal work accompanied by job instability is associated with significantly higher child behavior problems (relative to employment in a stable job). Children whose mothers work full-time and/or have fluctuating work schedules also exhibit significantly higher levels of behavior problems. However, full-time work has negative consequences for children only when it is in jobs that do not require cognitive skills. Such negative consequences are completely offset when this work experience is in jobs that require the cognitive skills that lead to higher wage growth prospects. Finally, fluctuating work schedules and full-time work in non-cognitively demanding jobs are each strongly associated with the probability that the child will repeat a grade or be placed in special education.

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The relationship between neighborhoods of residence in young adulthood and health in mid-to-late life in the United States are examined using the 1968-2005 waves of the Panel Study of Income Dynamics (PSID). The sample consists of persons who were aged 20-30 in 1968 and are followed for a period of 38 years (N=2730). Four-level hierarchical random effects models of self-assessed general health status as a function of individual, family, and neighborhood factors are estimated. Using the original sampling design of the PSID, we analyze adult health trajectories of married couples and neighbors followed from young adulthood through elderly ages to assess the magnitudes of the possible causal effects of family and neighborhood characteristics in young adulthood on health in mid-to-late life. Estimates suggest disparities in neighborhood conditions in young adulthood account for one-quarter of the variation in mid-to-late life health. Living in poor neighborhoods during young adulthood is strongly associated with negative health outcomes in later-life. This result is robust even in the presence of a reasonably large amount of potential unobservable individual and family factors that may significantly affect both neighborhood of residence and subsequent health status. Racial differences in health status in mid-to-late life are also associated with family and neighborhood socioeconomic conditions earlier in life. Three quarters of the black-white gap in health status at ages over 55 can be accounted for by differences in childhood socioeconomic status and neighborhood and family factors in young adulthood.

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OBJECTIVES: We examined the relation between low birth weight and childhood family and neighborhood socioeconomic disadvantage and disease onset in adulthood. METHODS: Using US nationally representative longitudinal data, we estimated hazard models of the onset of asthma, hypertension, diabetes, and stroke, heart attack, or heart disease. The sample contained 4387 children who were members of the Panel Study of Income Dynamics in 1968; they were followed up to 2007, when they were aged 39 to 56 years. Our research design included sibling comparisons of disease onset among siblings with different birth weights. RESULTS: The odds ratios of having asthma, hypertension, diabetes, and stroke, heart attack, or heart disease by age 50 years for low-birth weight babies vs others were 1.64 (P < .01), 1.51 (P < .01), 2.09 (P < .01), and 2.16 (P < .01), respectively. Adult disease prevalence differed substantially by childhood socioeconomic status (SES). After accounting for childhood socioeconomic factors, we found a substantial hazard ratio of disease onset associated with low birth weight, which persisted for sibling comparisons. CONCLUSIONS: Childhood SES is strongly associated with the onset of chronic disease in adulthood. Low birth weight plays an important role in disease onset; this relation persists after an array of childhood socioeconomic factors is accounted for.

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Using national data from the U.S., we find that poor health at birth and limited parental resources (including low income, lack of health insurance, and unwanted pregnancy) interfere with cognitive development and health capital in childhood, reduce educational attainment, and lead to worse labor market and health outcomes in adulthood. These effects are substantial and robust to the inclusion of sibling fixed effects and an extensive set of controls. The results reveal that low birth weight ages people in their 30s and 40s by 12 years, increases the probability of dropping out of high school by one-third, lowers labor force participation by 5 percentage points, and reduces labor market earnings by roughly 15 percent. While poor birth outcomes reduce human capital accumulation, they explain only 10 percent of the total effect of low birth weight on labor market earnings. Taken together, the evidence is consistent with a negative reinforcing intergenerational transmission of disadvantage within the family; parental economic status influences birth outcomes, birth outcomes have long reaching effects on health and economic status in adulthood, which in turn leads to poor birth outcomes for one's own children.

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