ABSTRACT
On March 11, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak to be a global pandemic (Cucinotta and Vanelli, 2020). While rates of psychological stress surged for all Americans in the weeks following this declaration, Census Bureau data suggested significant increases in endorsement of depressive and anxiety symptoms for Black 11 In this entry, Black and African American are utilized interchangeably, or if dictated by the citation source. and Asian Americans in the week following the public release of the death of George Floyd, a Black man whose neck was kneeled upon by a police officer. Data from the Pew Research Center indicated that 31% of Asian Americans experienced racial slurs of jokes in the 4 months after the start of the COVID-19 pandemic. Given both concerns of antagonistic attitudes and differential treatment occupy the realities of many Black People, Indigenous People, and People of Color (BIPOC) and health concerns amid a public health crisis has led some to refer to this moment of history as a "double pandemic.” The second "pandemic” to which scholars, clinicians, and clergy refer is the indelible legacy of racism, a pernicious system of prejudice, discrimination, and oppression that has operated for centuries. Indeed, though over two decades have passed since Dr. Shelly Harrell's treatise on the impact of racism on the lives of people of color, her admonition that racism is "alive and sick” is sagacious, even if unnerving (Harrell, 2000, p. 42). As a system, racism can exert stress that threatens the health and wellbeing of BIPOC individuals. Consistent with the biopsychosocial framing of this volume, the impairment of racism-related stress can manifest physically and psychologically. Moreover, given the socio-cognitive development of children and adolescents, the sequelae of racism-related stress can be particularly damaging, with differential exposure and impact depending on the intersections of various social identities (e.g., race, ethnicity, gender identity, socioeconomic standing). Despite the deleterious nature of racism-related stress, research also has elucidated a number of protective factors that moderate and mediate the pathway between racism-related stress and health for children and adolescents. In this entry, we (a) outline racism-related stress (RRS) in its multiple forms;(b) elucidate the most common health outcomes associated with RRS for BIPOC youth;(c) briefly introduce several moderators in the RRS to youth health pathway;and (d) discuss a number of developmental and intersectional considerations that influence the qualitative experiences of this pathway. Throughout the entry, we pay special attention to the ways in which these various factors operate at the neighborhood and community levels. Lastly, this entry concludes with a critical commentary. © 2023 Elsevier Inc. All rights reserved
ABSTRACT
Introduction: Globally, disparities exist in healthcare quality, accessibility and regulation (Das, & Gertler, 2007). Consequently, few countries have governing bodies overlooking healthcare-professional (HCP) practice (Epstein, & Bing, 2011). Research has suggested that HCP regulation depended on nations' human development index (HDI), gross domestic product (GDP), and safety (Ozturk, & Topcu, 2014). IPC enables partnership working between HCPs to ensure patient-centred care (Gregory, & Austin, 2016). This study thematically analysed pharmacy professional standards' documents of various countries and investigated whether nations' developmental parameters influenced pharmacy regulation. Objectives * To compare global pharmacy professional standards on IPC. * To synthesise a thematic framework to evaluate literature on IPC. * To iInvestigate the relationship between HDI, GDP, global peace index (GPI), and pharmacy regulation. Method(s): A group (N = 8) of countries were studied based on 2018 HDI classification;(N = 4) 'very high' (Australia, Hong Kong, Canada, United Kingdom) and (N = 4) 'low' (Solomon Islands, Haiti, Yemen, South Sudan). Pharmacy professional standards' documents were screened to extract IPC-related themes via a constant comparative method. This facilitated thematic framework synthesis;'pharmacists' attitudes' and 'patient outcomes' were measures of IPC. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), (N = 17) peer-reviewed journal articles from 2010-2019 studying pharmacists in sample countries were selected. Key terms searched on Medline/PubMed databases were: 'IPC', 'pharmacist' and 'professional standards'. Literature was then reviewed with reference to the thematic framework and development metrics (HDI/GDP/GPI). This study did not require ethics approval. Result(s): Of the countries (N = 8) studied, only HDI-classified 'very high' had professional standards' documents, frequently incorporating IPC. Key themes were: 'shared decision-making', 'continuity-of-care', and 'effective communication'. Seven studies referred to these themes and confirmed IPC benefits: fewer medication-related errors4. The number of IPC standards and HDI-rank for 'very high' countries, except Hong Kong, were positively correlated, suggesting possible economic impact on pharmacy sector progress. Two studies found cultural influences on Hong Kong pharmacists' attitudes as contributory to a hierarchical than IPC-approach to healthcare provision5. HDI and GPI had a strong negative correlation (r = -0.83), potentially explaining low pharmacist density and GDP healthcare expenditure in HDI-classified low. Conclusion(s): Results denote that IPC improved patient safety (Gregory, & Austin, 2016). Global differences existed in pharmacists' attitudes and IPC training. These correlated with growing gaps in HDI and GPI between HDI-classified 'very high' and 'low' countries. Qualitative analysis highlighted the need for elaboration of 'continuity-of-care' and inclusion of 'understanding roles/responsibilities of team members' in the United Kingdom's professional standards set by the General Pharmaceutical Council. Future work could study 2021/inequality-adjusted HDI data, 'high'/'medium' HDI countries to improve validity alongside COVID19 impact on GDP and pharmacy practice.
ABSTRACT
The coronavirus disease (COVID-19) pandemic has brought health and social disparities to the fore, and intensified bias and racism in the U.S. and globally. In the context of discriminatory rhetoric and anti-Asian sentiments voiced by prominent political figures, Asian Americans have been disproportionately targeted with injustice, scapegoating, and overt racism. Amid heightened sociocultural stress and national divisiveness, the present study explored whether "silver linings" might be found in the form of increased ethnic-racial identity exploration, ethnic-racial socialization, and civic engagement. Survey data from 200 Asian American parents of adolescents (58% mothers;63% foreign born, 37% U.S. born) suggest that awareness of discrimination against Asian Americans post-COVID-19 was associated with greater identity exploration and fewer socialization messages that minimize the importance of race. Awareness of discrimination against other minoritized groups (i.e., Native and Black Americans, Latinxs) was associated with greater post-COVID-19 activism. Additional socialization messages (i.e., promotion of equality, cultural pluralism) were associated with lifetime discrimination experiences and parent gender. Although negative consequences of the pandemic are indisputable, our results offer a small glimmer of hope in terms of building resistance and momentum. What is the public significance of this article? In the face of ethnic-racial bias and racism post-coronavirus disease (COVID-19), Asian American parents of adolescents explore their ethnic-racial identities, communicate positive ethnic-racial socialization messages to their children, and engage in community activism. Although negative consequences of the pandemic are indisputable, there do appear to be "silver linings" that can build resistance and civic engagement.