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OBJECTIVES: Recent studies show that chronic exposure to racial discrimination increases the occurrence of subjective cognitive decline (SCD) among Black Americans. Little research, however, has examined potential for protective factors, such as perceived partner support, to buffer these effects. METHODS: This study utilized longitudinal data over a 10-year period from the Family and Community Health Study (FACHS) to examine the associations between experiences of racial discrimination, marital status, partner support, and SCD, measured by the Everyday Cognition (ECog) Scale, among 286 middle-aged Black American women. Regression analysis and internal moderator analyses were employed to analyze the data. RESULTS: About 31% were in married relationships. Thirty-four percent reported cognitive decline, especially in forgetting object locations and dates. Chronic discrimination predicted SCD, and for those in couple relationships, partner support buffered the adverse effects of discrimination, with those in warm and supportive relationships experiencing less SCD than those in relatively unsupportive relationships or not in a relationship. CONCLUSIONS: The study's findings support the idea that racism influences SCD and underscores the importance of supportive couple relationships in promoting resilience. The results also highlight the potential value of culturally relevant family interventions and support strategies to reduce the impact of discrimination-induced stress on cognitive health.
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Race-based health disparities for racially and ethnically diverse people with orthopedic-related conditions are well documented and their experiences when seeking care deserve more attention. The purpose of this study was to understand the lived experiences of racial microaggressions occurring when racially and ethnically diverse people seek health care services for orthopedic-related conditions. We used transcendental phenomenology to understand their lived experiences of racial microaggressions while receiving orthopedic-related health care services. All participants self-identified as Black, none as Hispanic. Nineteen final codes were organized into five patterns and then into five themes-two background and three figural themes. Background themes: discrimination can occur across a lifetime, and poor treatment of poor people fuels health inequity. Figural themes: racial discrimination can come at any time and in various forms; resistance is necessary in the face of racial discrimination; and despite discriminatory encounters, health care goals are achievable. Participants shared their lived experiences of racial microaggressions while seeking care for their orthopedic-related conditions (figural) through a lens shaped by their other past experiences with varied discrimination (background). Black individuals have a longstanding relationship with racial discrimination that has a negative impact on many aspects of their lives, including their health. The results highlight ways to promote equity by capitalizing on Black individuls' goals to actively pursue health.
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OBJECTIVE: This cross-sectional study examined whether religious coping buffered the associations between racial discrimination and several modifiable cardiovascular disease (CVD) risk factors-systolic and diastolic blood pressure (BP), glycated hemoglobin (HbA1c), body mass index (BMI), and cholesterol-in a sample of African American women and men. METHODS: Participant data were taken from the Healthy Aging in Neighborhoods of Diversity Across the Life Span study (N = 815; 55.2% women; 30-64 years old). Racial discrimination and religious coping were self-reported. CVD risk factors were clinically assessed. RESULTS: In sex-stratified hierarchical regression analyses adjusted for age, socioeconomic status, and medication use, findings revealed several significant interactive associations and opposite effects by sex. Among men who experienced racial discrimination, religious coping was negatively related to systolic BP and HbA1c. However, in men reporting no prior discrimination, religious coping was positively related to most risk factors. Among women who had experienced racial discrimination, greater religious coping was associated with higher HbA1c and BMI. The lowest levels of CVD risk were observed among women who seldom used religious coping but experienced discrimination. CONCLUSION: Religious coping might mitigate the effects of racial discrimination on CVD risk for African American men but not women. Additional work is needed to understand whether reinforcing these coping strategies only benefits those who have experienced discrimination. It is also possible that religion may not buffer the effects of other psychosocial stressors linked with elevated CVD risk.
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BACKGROUND: General criminological theories contend that African Americans' substance use is due to overexposure to criminological risk factors. However, some scholars suggest that racial injustices (i.e., racial discrimination and criminal justice injustices) and racial socialization practices, which includes religiosity (church involvement), impact African American substance use. OBJECTIVE: Drawing on Unnever and Gabbidon's theory of African American offending, which considers racial injustices and racial socialization when explaining African American offending, the current research examined African American college students' substance use behavior. METHODS: African American college students (n = 131) completed an online and anonymous survey measuring substance use, criminal justice injustices, racial discrimination, racial socialization, religiosity, negative emotions, and school bonds. RESULTS: African American college students who reported marijuana use had less confidence in the police and those who engaged in heavy/binge drinking reported more negative emotions and negative encounters with the police. Additionally, negative police encounters and racial socialization practices increased the odds of heavy/binge drinking, whereas religiosity decreased the odds of heavy/binge drinking. CONCLUSION: These results suggest that a relationship exists among criminal justice injustices, perceived racial bias, racial socialization, religiosity, and African American college students' substance use. As such, the current research provides partial support for the Theory of African American Offending while demonstrating the need to consider racial experiences when examining African American substance use.
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Ethnic-racial discrimination has pervasive negative effects on Black youth's mental health; therefore, it is crucial to identify factors that provide resilience against discrimination. Two promising factors to help youth cope are ethnic-racial identity (how one feels about their ethnicity/race) and shift-and-persist coping (reappraising and accepting an uncontrollable stressor while remaining optimistic about the future). While there is existing scholarship on ethnic-racial identity among Black youth, this work has not yet assessed the impacts of shift-and-persist in this population. Using a sample of 155 Black youth (ages 13-17), the current study examined the interplay between discrimination, ethnic-racial identity, shift-and-persist coping, and internalizing symptoms. Symptoms of depression and anxiety were positively associated with discrimination and negatively associated with shift-and-persist. Significant interactions between discrimination and shift-and-persist predicting both depressive and anxiety symptoms revealed significant negative associations between shift-and-persist and internalizing symptoms at low and average, but not high discrimination levels. Effects are, thus, protective-reactive; the protective effects of shift-and-persist are not significant for youth facing high levels of discrimination. Ethnic-racial identity, surprisingly, was not significantly associated with either depressive or anxiety symptoms, nor did it interact with shift-and-persist as it has in studies of Latinx youth. By understanding the protective benefits of shift-and-persist and ethnic-racial identity in Black youth, during a pivotal period for mental health, we can provide this growing population with tools to lessen the maladaptive outcomes associated with discrimination.
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BACKGROUND: The racial/ethnic and gender disparities in cardiovascular disease (CVD) morbidity and mortality in the United States are evident. Across nearly every metric, non-Hispanic Black women have poorer overall cardiovascular health. Emerging evidence shows a disproportionately high burden of increased CVD risk factors in Black women of childbearing age, which has a far-reaching impact on both maternal and child outcomes, resulting in premature onset of CVD and further widens the racial disparities in CVD. There is growing recognition that the fundamental driver of persistent racial/ethnic disparities in CVD, as well as disparities in behavioral risk factors such as physical activity and sleep, is structural racism. Further, the lived personal experience of racial discrimination not only has a negative impact on health behaviors, but also links to various physiological pathways to CVD risks, such as internalized stress resulting in a pro-inflammatory state. Limited research, however, has examined the interaction between daily experience and health behaviors, which are influenced by upstream social determinants of health, and the downstream effect on biological/physiological indicators of cardiovascular health in non-pregnant Black women of childbearing age. METHODS/DESIGN: The BLOOM Study is an observational study that combines real-time ambulatory assessments over a 10-day monitoring period with in-depth cross-sectional lab-based physiological and biological assessments. We will use a wrist-worn actigraphy device to capture 24-h movement behaviors and electronic ecological momentary assessment to capture perceived discrimination, microaggression, and stress. Blood pressure will be captured continuously through a wristband. Saliva samples will be self-collected to assess cortisol level as a biomarker of psychological stress. Lab assessments include a fasting venous blood sample, and assessment of various indices of peripheral and cerebral vascular function/health. Participants' address or primary residence will be used to obtain neighborhood-level built environmental and social environmental characteristics. We plan to enroll 80 healthy Black women who are between 18 and 49 years old for this study. DISCUSSION: Results from this study will inform the development of multilevel (i.e., individual, interpersonal, and social-environmental levels) lifestyle interventions tailored to Black women based on their lived experiences with the goal of reducing CVD risk. GOV IDENTIFIER: NCT06150989.
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Negro o Afroamericano , Enfermedades Cardiovasculares , Humanos , Femenino , Negro o Afroamericano/estadística & datos numéricos , Negro o Afroamericano/psicología , Adulto , Determinantes Sociales de la Salud , Adulto Joven , Conductas Relacionadas con la Salud , Persona de Mediana Edad , Estados Unidos , Racismo/psicología , Factores de Riesgo , Disparidades en el Estado de Salud , Saliva/químicaRESUMEN
Despite increased risk of severe acute respiratory syndrome coronavirus 2 infections and higher rates of COVID-19-related complications, racialized and Indigenous communities in Canada have lower immunization uptake compared to White individuals. However, there is woeful lack of data on predictors of COVID-19 vaccine mistrust (VM) that accounts for diverse social and cultural contexts within specific racialized and Indigenous communities. Therefore, we sought to characterize COVID-19 VM among Arab, Asian, Black, and Indigenous communities in Canada. An online survey was administered to a nationally representative, ethnically diverse panel of participants in October 2023. Arabic, Asian, Indigenous, and Black respondents were enriched in the sampling panel. Data were collected on demographics, COVID-19 VM, experience of racial discrimination, health literacy, and conspiracy beliefs. We used descriptive and regression analyses to determine the extent and predictors of COVID-19 VM among racialized and Indigenous individuals. All racialized respondents had higher VM score compared to White participants. Among 4220 respondents, we observed highest VM among Black individuals (12.18; ±4.24), followed by Arabic (12.12; ±4.60), Indigenous (11.84; ±5.18), Asian (10.61; ±4.28), and White (9.58; ±5.00) participants. In the hierarchical linear regression analyses, Black participants, women, everyday racial discrimination, and major experience of discrimination were positively associated with COVID-19 VM. Effects of racial discrimination were mediated by addition of conspiracy beliefs to the model. Racialized and Indigenous communities experience varying levels of COVID-19 VM and carry specific predictors and mediators to development of VM. This underscores the intricate interaction between race, gender, discrimination, and VM that need to be considered in future vaccination campaigns.
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Árabes , Vacunas contra la COVID-19 , COVID-19 , Alfabetización en Salud , Pueblos Indígenas , Racismo , Humanos , Femenino , Masculino , Adulto , COVID-19/prevención & control , COVID-19/etnología , Canadá/epidemiología , Vacunas contra la COVID-19/administración & dosificación , Persona de Mediana Edad , Pueblos Indígenas/estadística & datos numéricos , Confianza , Adulto Joven , Encuestas y Cuestionarios , Conocimientos, Actitudes y Práctica en Salud , Anciano , Pueblo Asiatico , Población Negra/estadística & datos numéricos , Población Negra/psicología , SARS-CoV-2/inmunología , Vacunación/psicología , Vacunación/estadística & datos numéricos , Adolescente , EtnicidadRESUMEN
OBJECTIVE: To explore racially minoritized families' perceptions on how, and if, physicians should address children's racial identity and concepts of racism within clinical settings. STUDY DESIGN: Parents of racially minoritized children, ages 5 through 18, were interviewed to explore experiences with racial identity formation, discrimination, and the extent to which they wanted pediatricians to address these topics. Children were included at the discretion of their parents. Interviews were transcribed, coded, and analyzed through a critical race theory lens based in constructivist grounded theory. RESULTS: Parents encouraged their children to embrace their racial identities but also wanted to shield them from negative experiences of racism to preserve identity safety. Parents felt pediatricians should address racial issues in a manner specific to their child's situation. Thoughtful inclusion of race-related questions, whether in discussion or on questionnaires, is essential to prevent tension in a therapeutic relationship. There was no consensus on the use of preclinical screening. Instead, families highlighted the importance of embracing humility, trust, and respect. CONCLUSIONS: Participant families have preferences for approaches to address the effects of racism on their children's health. Pediatricians should understand the importance of identity safety and approach their discussions with cultural humility, which includes self-reflection, empathy, active listening, and flexible negotiation. Above all, pediatricians need to create a safe environment for appropriate discussion of these issues.
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The COVID-19 pandemic, polarized politics, and heightened stigma and discrimination are salient drivers for negative mental health outcomes, particularly among marginalized racial and ethnic minoritized groups. Intersectionality of race, ethnicity, foreign-born status, and educational attainment may distinctively shape an individual's experience of discrimination and mental health during such unprecedented time. The present study examines the differential associations of racial discrimination and mental health based on an individual's race, ethnicity, foreign-born status, and educational attainment during the COVID-19 pandemic. Analyses were based on a nationally representative sample of U.S. adults collected between October and November 2021 (n = 6276). We utilized multivariable linear regressions to identify the multiplicative effects of race, ethnic, foreign-born status and self-reported racial discrimination on mental health, stratified by educational attainment. Among individuals with lower educational attainment, associations between racial discrimination and poor mental health were stronger among Asians (US-born: ß = -2.07, p = 0.03; foreign-born: ß = -3.18, p = 0.02) and US-born multiracial individuals (ß = -1.96, p = 0.02) than their White counterparts. Among individuals with higher educational attainment, foreign-born Hispanics (ß = -3.66, p < 0.001) and US-born Asians (ß = -2.07, p = 0.01) reported worst mental health when exposed to racial discrimination out of all other racial, ethnic and foreign-born groups. Our results suggest that association of racial discrimination and mental health varies across racial, ethnic, foreign-born, and education subgroups. Using an intersectional approach to address the widening inequities in racial discrimination and mental health during the COVID-19 pandemic contextualizes unique experience of discrimination and provides crucial insight on the patterns of mental health among marginalized groups.
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BACKGROUND: Even though racism is pervasive, some people of color may deny experiencing racial discrimination or may report being unaffected by it. This study examines the contexts and factors that may contribute to these responses among people who use substances. METHODS: We conducted seven focus groups (5-9 participants per group, total N = 43) among Black, Latino, and Asian American adults between the ages of 21 to 44 years old who reported current use of two or more of the following substances: alcohol, cigarettes, e-cigarettes, or cannabis. Data were analyzed using reflexive thematic analysis. RESULTS: Across all three ethno-racial groups, we found some respondents minimized or denied personal experiences of racial discrimination or hesitated to identify their experiences as racial discrimination, which in turn led to respondents to express uncertainty about seeing any sort of connection between racial discrimination and substance use. Themes included a minority comparison effect; a drowning out effect; diversity and racial composition of context; passing as White; and covertness of racism. Also, there were contradictions in accounts, and responses often depended on orienting cues. CONCLUSIONS: While researchers continue to find associations between racial discrimination and substance use, some people of color may not acknowledge this connection. Recommendations include aligning definitions of racism between academic and public/popular discourse; updating measures to keep up with the evolving forms of racism using context-specific examples; combining subjective measures of racial discrimination with objective measures of racism; and dialoguing with the public to raise awareness around how racism is defined.
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BACKGROUND: The increasing pursuit of enhanced educational opportunities has led to a significant rise in international student enrollment in various fields, including nursing. Nursing is currently in its early stages and faces challenges related to racial microaggression. Understanding the dynamics of racial microaggression is crucial in countries like Turkey, where students from diverse ethnic backgrounds are accommodated. OBJECTIVE: To explore and achieve a more profound insight into the lived encounters of ethnic minority nursing students confronting racial microaggression. METHOD: The study employed a descriptive phenomenological approach. Data collection involved conducting in-depth interviews from February 1, 2023, to June 1, 2023. Analysis was performed utilizing Colaizzi's analysis method. RESULTS: Each participant in the study encountered at least one type of microaggression. The analysis identified three clear themes: "challenges in social interactions," "unfavorable learning atmosphere," and "aspirations for the future." CONCLUSION: This study highlights the crucial need to establish secure and inclusive environments that foster authentic discussions within academic settings. Faculty and educators should strengthen their ability to consider diverse perspectives in various scenarios. Moreover, integrating an up-to-date and comprehensive curriculum, along with the adoption of inclusive language, into the nursing program is essential for effectively addressing these concerns.
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Agresión , Bachillerato en Enfermería , Estudiantes de Enfermería , Humanos , Estudiantes de Enfermería/psicología , Estudiantes de Enfermería/estadística & datos numéricos , Turquía , Femenino , Masculino , Agresión/psicología , Minorías Étnicas y Raciales/psicología , Investigación Cualitativa , Adulto , Entrevistas como Asunto , Racismo/psicologíaRESUMEN
OBJECTIVE: Racial disparities in diagnosis and treatment are prevalent in child psychiatry, including disparate diagnosis rates of internalizing and externalizing disorders in Black and White children. However, limited research has investigated mechanisms that contribute to these disparities. This study examined child racial implicit associations in psychiatric clinicians and medical students to address this gap. METHOD: Psychiatrists and trainees completed an online survey including 2 race Implicit Association Tests (IATs) pairing child faces to words with either positive or negative valence, and words related to internalizing or externalizing behavioral problems. Psychiatrists and trainees' demographic predictors of implicit associations were also investigated. RESULTS: Data were analyzed from 235 psychiatrists and trainees (112 child and adolescent psychiatrists and fellows) who met inclusion criteria. Psychiatrists and trainees demonstrated greater moderate-to-strong association between Black child faces and "bad" (ie, negatively valenced) words (44.3%) vs "good" (ie, positively valenced) words (6.4%), and between externalizing words (41.7%) vs internalizing words (7.2%). Psychiatrists and trainees' demographic characteristics including being female (ß = -0.12; 95% CI = -0.23 to -0.01; p < .05), Black (ß = -0.36; 95% CI = -0.54 to -0.18; p < .001), or an attending physician (ß = -0.26; 95% CI = -0.45 to -0.06; p = .01) were significant predictors of decreased association between Black child faces and negative valence words. Being female was a significant predictor of decreased association between Black child faces and externalizing words (ß = -0.26; 95% CI = -0.45 to -0.06; p = .01). CONCLUSION: Participating psychiatrists and trainees demonstrated bias toward associating Black rather than White child faces with negative words and externalizing behavioral problems. Future research should examine the following: racial implicit associations in a more generalizable sample; the relationship between race IATs and provider behavior; and interventions to reduce racial inequities in psychiatry, including individual and systemic solutions. DIVERSITY & INCLUSION STATEMENT: We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science.
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Traumatic experiences are associated with increased experiences of positive schizotypy. This may be especially important for People of Color, who experience higher rates of trauma and racial discrimination. No study to date has examined how racial disparities in traumatic experiences may impact schizotypy. Furthermore, of the studies that have examined the relationship between trauma and schizotypy, none have examined racial discrimination as a potential moderator. The present study examined if racial discrimination moderates the relationship between trauma and multidimensional (positive, negative, and disorganized) schizotypy. In a sample of 770 college students, we conducted chi-squared analyses, analyses of variance, and stepwise regressions. We found that Black students experienced significantly higher racial discrimination and trauma than Latinx and Asian students. Furthermore, Black and Latinx students experienced significantly more multidimensional schizotypy items than Asian students. Trauma and racial discrimination explained 8 to 23% of the variance in each dimension of schizotypy. Racial discrimination did not moderate the relationships between trauma and multidimensional schizotypy. Our findings suggest that we need to examine risk factors that may prevent recovery from psychotic disorders. Additionally, disorganized schizotypy showed the most robust associations and may be a critical site of intervention.
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Developmental, clinical, and epidemiological research have demonstrated the salience of perceived racial discrimination (PRD) as a contributor to negative mental health outcomes in adolescence. This article summarizes secondary analyses of cross-sectional data from a large-scale youth survey within a predominantly rural state, to estimate the prevalence and strength of the association between PRD and serious psychological distress (SPD), suicidal ideation, and prior suicidal attempts. Data from 93,812 students enrolled in 6th, 8th, 10th, or 12th grade within 129 school districts across Kentucky were examined, to determine prevalence rates for subgroups within the cohort. Logistic regression analyses assessed the differences and established comparative strength of the association among these variables for racial/ethnic subgroups. PRD was self-reported at high rates across several demographic subgroups and was most evident among Black (24.5%) and Asian (22.1%) students. Multiracial students experienced the highest rates of both SPD and suicidality (ideation and prior attempt). Both for the entire cohort and for each racial/ethnic subgroup, PRD was significantly associated with an increased likelihood of negative mental health outcomes, although the strength of these associations varied across the subgroups and developmental levels. The implications for early intervention and prevention are discussed.
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Racism increases pain sensitization and contributes to racialized pain inequities; however, research has not tested interventions targeting racism to reduce pain. In this study, we examined whether White bystanders can act to mitigate racism's pain-sensitizing effects. To simulate racial exclusion in the laboratory, Black young adults (age 18-30; N = 92) were randomly assigned to be included or excluded by White players in a ball-tossing game (Cyberball). For half of the excluded participants, White bystanders acknowledged and apologized for the racial exclusion. Participants completed a cold pressor task to assess pain threshold, tolerance, and unpleasantness, and completed a survey assessing psychological needs (ie, belongingness, self-esteem, meaningful existence, and self-control). Participants who experienced racial exclusion reported significantly more threatened psychological needs and increased laboratory pain sensitization (ie, lower pain threshold and tolerance) than those who were included. However, when a White bystander acknowledged the racism, excluded participants reported higher levels of self-control, self-esteem, and decreased pain sensitization (pain threshold and tolerance) relative to excluded participants whose experience was not acknowledged. Our findings support that racism increased Black people's pain sensitivity and provide initial evidence for White bystander acknowledgment as a health intervention. PERSPECTIVE: Continual exposure to racism likely contributes to inequities in pain sensitization. We demonstrate that acute exposure to mild racism increases acute pain sensitization. Results suggest that a bystander acknowledging witnessed racism can buffer the acute sensitizing effects of racism on pain, pointing to the potential of interpersonal interventions targeting racism. TRIAL REGISTRATION: Clinicaltrials.gov NCT06113926.
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Negro o Afroamericano , Dolor , Racismo , Adolescente , Adulto , Femenino , Humanos , Masculino , Adulto Joven , Negro o Afroamericano/psicología , Dolor/etnología , Dolor/psicología , Umbral del Dolor/etnología , Umbral del Dolor/fisiología , Racismo/etnología , Autoimagen , BlancoRESUMEN
Although it is well-documented that school-based racial discrimination can have adverse effects on African American adolescents, the understanding of how socio-emotional factors can act as safeguards is still limited. This study explores whether emotion regulation, mentor support, and parent racial socialization help African American boys cope with school-based racial discrimination. Factors such as emotion regulation are internal assets, while mentor support and parent racial socialization are external resources. Four hundred and eighty-seven African American boys aged 12 to 18 (M = 14.33; SD = 1.62) participated. School-based racial discrimination correlated negatively with psychological well-being. Only emotion regulation and parental racial socialization were related to positive psychological well-being. However, mentor support buffered against the negative impacts of school-based racial discrimination on psychological well-being. These results underscore the significance of assets and resources in bolstering African American boys' resilience against school-based racial discrimination, with implications for interventions and future research.
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Negro o Afroamericano , Regulación Emocional , Racismo , Socialización , Humanos , Masculino , Negro o Afroamericano/psicología , Adolescente , Racismo/psicología , Niño , Adaptación Psicológica , Apoyo Social , Mentores/psicología , Instituciones Académicas , Bienestar PsicológicoRESUMEN
OBJECTIVE: Evidence suggests that racial discrimination causes stress among non-Hispanic Black women, and some Black women may cope with exposure to vicarious racial discrimination by engaging in maladaptive eating behaviors. METHODS: We examined eating behaviors among Black women (N = 254) before and after Freddie Gray's death while in police custody. Maladaptive eating behaviors were assessed using the three-factor eating questionnaire. Our independent variables included the following: (1) time period and (2) geographic proximity to the event. Three two-way analysis of covariance tests were conducted to assess potential effects of geographic proximity (close, distant), time period in relation to unrest (before, after unrest), and their interaction on emotional eating, uncontrolled eating, and cognitive restraint controlling for participant age. RESULTS: There was a statistically significant main effect of proximity to the unrest on emotional eating, F (1, 252) = 5.64, p = .018, and partial η2 = .022 such that women living in close geographic proximity to the unrest reported higher mean levels of emotional eating as compared to those living more distant to the unrest. There was also a borderline statistically significant interaction between geographic proximity and time period on cognitive restraint, F (1, 252) = 3.89, p = .050, and partial η2 = .015. CONCLUSION: Our study found a relationship between vicarious racial discrimination and maladaptive eating behaviors among Black women. Future work should examine stress related to vicarious racial discrimination and maladaptive eating behaviors longitudinally.
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OBJECTIVES: To examine the prevalence of major racial discrimination (MRD) in healthcare services and its association with COVID-19 vaccine mistrust and uptake, conspiracy theories, COVID-19-related stressors, community resilience, anxiety, depression, and stress symptoms. STUDY DESIGN: The study used a population-based cross-sectional design. METHODS: Data from the BlackVax dataset on COVID-19 vaccination in Black individuals in Canada was analyzed (n = 2002, 51.66% women). Logistic regression analyses were performed to examine the association between MRD and independent variables. RESULTS: 32.55% of participants declared having experienced MRD in healthcare services. Participants with MRD were less vaccinated against COVID-19, presented higher scores of vaccine mistrust, conspiracy beliefs, COVID-19 related stressors, depression, anxiety, and stress, and had lower scores of community resilience. They were more likely to experience depression (AOR = 2.13, P < 0.001), anxiety (AOR = 2.00, P < 0.001), and stress symptoms (AOR = 2.15, P < 0.001). Participants who experienced MRD were more likely to be unvaccinated (AOR = 1.35, P = 0.009). CONCLUSIONS: Racial discrimination experienced by Black individuals in health services is a major public health concern and threat to population health in Canada. Federal, provincial, and municipal public health agencies should adapt their programs, strategies, tools, and campaigns to address the mistrust created by racial discrimination.
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COVID-19 , Racismo , Resiliencia Psicológica , Femenino , Humanos , Masculino , Vacunas contra la COVID-19 , Estudios Transversales , Depresión/epidemiología , Salud Pública , COVID-19/epidemiología , COVID-19/prevención & control , Ansiedad/epidemiología , Canadá/epidemiología , Atención a la SaludRESUMEN
INTRODUCTION: Recent evidence suggests that exposure to the stress of racism may increase the risk of dementia for Black Americans. METHODS: The present study used 17 years of data from a sample of 255 Black Americans to investigate the extent to which exposure to racial discrimination predicts subsequent changes in serum Alzheimer's Disease Research Center (ADRC) biomarkers: serum phosphorylated tau181(p-tau181), neurofilament light (NfL), and glial fibrillary acidic protein (GFAP). We hypothesized that racial discrimination assessed during middle age would predict increases in these serum biomarkers as the participants aged into their 60s. RESULTS: Our findings indicate that exposure to various forms of racial discrimination during a person's 40s and early 50s predicts an 11-year increase in both serum p-tau181 and NfL. Racial discrimination was not associated with subsequent levels of GFAP. DISCUSSION: These findings suggest that racial discrimination in midlife may contribute to increased AD pathology and neurodegeneration later in life. HIGHLIGHTS: A 17-year longitudinal study of Black Americans. Assessments of change in serum p-tau181, neurofilament light, and glial fibrillary acidic protein. Exposure to racial discrimination during middle age predicted increases in p-tau181 and neurofilament light. Education was positively related to both p-tau181 and exposure to racial discrimination.