An Analysis of Socioeconomic Determinants of the Black-White Disparity in Food Insecurity Rates in the US.

Previous research has not fully explored socioeconomic factors that influence the Black-White food insecurity disparities at the state and county levels in the United States. The goal of this study was to identify socioeconomic determinants associated with the Black-White food insecurity gap in the US at the state and county levels with rigorous quantitative investigation. The 2019 Map the Meal Gap dataset and multivariate regression analyses were used to identify factors associated with the prevalence of the Black-White disparity in food insecurity rates. Unemployment rate and median income gaps were found to be the strongest predictors of the Black-White disparity in food insecurity and the Black food insecurity rates in both state- and county-level models. Specifically, a 1% increase in Black unemployment rate compared with White unemployment rate was associated with a 0.918% and 0.232% increase in the Black-White disparity in food insecurity on average at the state and county levels, respectively. This study highlights the potential root causes of food insecurity and significant socioeconomic determinants associated with the Black-White food insecurity gap at the state and county levels in the US. Policymakers and program creators should implement action plans to address the income disparities and reduce unemployment rates among Blacks to eradicate this gap and ensure equity in food access between Blacks and Whites.

Association between distance to community health care facilities and COVID-19-related mortality across U.S. counties in the COVID-19-vaccine era.

OBJECTIVE: COVID-19 has caused tremendous damage to U.S. public health, but COVID vaccines can effectively reduce the risk of COVID-19 infections and related mortality. Our study aimed to quantify the association between proximity to a community healthcare facility and COVID-19 related mortality after COVID vaccines became publicly available and explore how this association varied across racial and ethnic groups. RESULTS: Residents living farther from a facility had higher COVID-19-related mortality across U.S. counties. This increased mortality incidence associated with longer distances was particularly pronounced in counties with higher proportions of Black and Hispanic populations.

Missing Americans: Early death in the United States-1933-2021.

We assessed how many US deaths would have been averted each year, 1933-2021, if US age-specific mortality rates had equaled the average of 21 other wealthy nations. We refer to these excess US deaths as "missing Americans." The United States had lower mortality rates than peer countries in the 1930s-1950s and similar mortality in the 1960s and 1970s. Beginning in the 1980s, however, the United States began experiencing a steady increase in the number of missing Americans, reaching 622,534 in 2019 alone. Excess US deaths surged during the COVID-19 pandemic, reaching 1,009,467 in 2020 and 1,090,103 in 2021. Excess US mortality was particularly pronounced for persons under 65 years. In 2020 and 2021, half of all US deaths under 65 years and 90% of the increase in under-65 mortality from 2019 to 2021 would have been avoided if the United States had the mortality rates of its peers. In 2021, there were 26.4 million years of life lost due to excess US mortality relative to peer nations, and 49% of all missing Americans died before age 65. Black and Native Americans made up a disproportionate share of excess US deaths, although the majority of missing Americans were White.

Racial disparities in telehealth use during the coronavirus disease 2019 pandemic.

OBJECTIVE: To investigate the impact of coronavirus disease 2019 on initial infertility consultations. DESIGN: Retrospective cohort. SETTING: Fertility practice in an academic medical center. PATIENTS: Patients presenting for initial infertility consultation between January 2019 and June 2021 were randomly selected for prepandemic (n = 500) and pandemic (n = 500) cohorts. EXPOSURE: Coronavirus disease 2019 pandemic. MAIN OUTCOME MEASURES: The primary outcome was a change in the proportion of African American patients using telehealth after pandemic onset compared with all other patients. Secondary outcomes included presentation to an appointment vs. no-show or cancellation. Exploratory outcomes included appointment length and in vitro fertilization initiation. RESULTS: The prepandemic cohort vs. the pandemic cohort had fewer patients with commercial insurance (64.4% vs. 72.80%) and more African American patients (33.0% vs. 27.0%), although the racial makeup did not differ significantly between the two cohorts. Rates of missed appointments did not differ between the cohorts, but the prepandemic cohort vs. the pandemic cohort was more likely to no-show (49.4% vs. 27.8%) and less likely to cancel (50.6% vs. 72.2%). African American patients, compared with all other patients, during the pandemic were less likely to use telehealth (57.0% vs. 66.8%). African American patients, compared with all other patients, were less likely to have commercial insurance (prepandemic: 41.2% vs. 75.8%; pandemic: 57.0% vs. 78.6%), present to their scheduled appointment (prepandemic: 52.7% vs. 73.7%; pandemic: 48.1% vs. 74.8%), and cancel vs. no-show (prepandemic: 30.8% vs. 68.2%, pandemic: 64.3% vs. 78.3%). On multivariable analysis, African American patients were less likely (odds ratio 0.37, 95% confidence interval 0.28-0.50) and telehealth users were more likely (odds ratio 1.54, 95% confidence interval 1.04-2.27) to present to their appointments vs. no-show or cancel when controlling for insurance type and timing relative to the onset of the pandemic. CONCLUSION: Telehealth implementation during the coronavirus disease 2019 pandemic decreased the overall no-show rate, but this shift did not apply to African American patients. This analysis highlights disparities in insurance coverage, telehealth utilization, and presentation for an initial consultation in the African American population during the pandemic.

Social Work Practice with Asians and Pacific Islanders

This chapter focuses on the United Nations' classification of subregions: Central Asia, East Asia, South Asia, Southeast Asia, and Pacific Islands. Asian and Pacific Islander (API) is used as an inclusive term to refer to the diverse people with origins in countries, states, territories, and jurisdictions in the identified Asia-Pacific geographic region. APIs include immigrants, refugees, United States (U.S.)-born citizens, naturalized citizens, undocumented immigrants, asylum seekers, native communities in U.S. jurisdictions, non-immigrants. Racialization in the United States occurs along a continuum, which reflects longstanding systems of racial categorization and oppression. The COVID-19 pandemic presents sociopolitical challenges for APIs with the emergence of Sinophobia. Like other Asian American communities, the South Asian community has long been described as a model minority due to its members' increasing socioeconomic status and vast educational achievements in the United States. Heterogeneity and disparities among APIs are not fully understood due to the dearth of ethnic-specific studies. Social workers should be mindful of the diverse political, colonization, and immigration histories of API clients to fully consider the person in their environment. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Racial Disparities in Healthcare

Racial disparities in medicine have been acknowledged for decades and continue to persist across healthcare systems. Minority groups face disparities in many domains, including morbidity, mortality, and prevalence of various diseases. Efforts have been made to try to reduce the amount of racial disparity seen in hospitals, but the disparity still exists in many areas. This chapter reviews some of the common areas with racial disparities occur and potential solutions. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Consensus organizing: Facilitating community change

Community organizing is the process of helping communities work together to identify and solve problems. Most organizing approaches focus on empowering and strengthening communities to solve their own problems. Locality development is a neighborhood based organizing approach to engage a broad range of key stakeholders in developing goals and taking civic action. Consensus organizing focuses on five key strategic principles and nine basic steps. There are several examples of how consensus organizing has been used to engage residents and build their capacity to create community change in community development, family services, violence prevention, and equitable development. Consensus organizing is a vehicle through which social workers can address contemporary issues that continue to impact the individuals, families, groups, and communities with which we work, including racial injustices, police brutality, as well as health, housing, food, and other equity issues exacerbated by the COVID-19 pandemic. Consensus organizers engage in advocacy and peaceful protests around inequity and racial injustices. However, they also work to create mutual interests and solutions around these long-term problems, authentically engaging residents and those affected by problems to lead the creation of solutions to some of society's most pressing issues. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Food Insecurity During the First Year of COVID-19: Employment and Sociodemographic Factors Among Participants in the CHASING COVID Cohort Study.

OBJECTIVE: While much has been reported about the impact of the COVID-19 pandemic on food insecurity, longitudinal data and the variability experienced by people working in various industries are limited. This study aims to further characterize people experiencing food insecurity during the pandemic in terms of employment, sociodemographic characteristics, and degree of food insecurity. METHODS: The study sample consisted of people enrolled in the Communities, Households and SARS-CoV-2 Epidemiology (CHASING) COVID Cohort Study from visit 1 (April-July 2020) through visit 7 (May-June 2021). We created weights to account for participants with incomplete or missing data. We used descriptive statistics and logistic regression models to determine employment and sociodemographic correlates of food insecurity. We also examined patterns of food insecurity and use of food support programs. RESULTS: Of 6740 participants, 39.6% (n = 2670) were food insecure. Non-Hispanic Black and Hispanic (vs non-Hispanic White) participants, participants in households with children (vs no children), and participants with lower (vs higher) income and education levels had higher odds of food insecurity. By industry, people employed in construction, leisure and hospitality, and trade, transportation, and utilities industries had the highest prevalence of both food insecurity and income loss. Among participants reporting food insecurity, 42.0% (1122 of 2670) were persistently food insecure (≥4 consecutive visits) and 43.9% (1172 of 2670) did not use any food support programs. CONCLUSIONS: The pandemic resulted in widespread food insecurity in our cohort, much of which was persistent. In addition to addressing sociodemographic disparities, future policies should focus on the needs of those working in industries vulnerable to economic disruption and ensure those experiencing food insecurity can access food support programs for which they are eligible.

Social determinants of perinatal mental health during the COVID-19 pandemic.

OBJECTIVE: We sought to clarify relevant social-structural determinants of perinatal mental health-material and social resources, as well as pandemic employment-related stressors, in White and BIPOC child-bearers-toward building comprehensive risk screening and prevention/intervention models that can alleviate health disparities. Each of these determinants was hypothesized to contribute to perinatal symptoms in ways that disproportionately benefit White child-bearers. METHOD: A community sample of Illinois child-bearers (n = 409 pregnant, 122 new parents) completed online questionnaires from May 2020-June 2021. Relations between composite measures of child-bearers' material resources, social resources, and pandemic employment-related stressors and mental health symptoms were tested in multiple regression models. Main effects of social determinant composites and moderated effects by race/ethnic identification were tested. RESULTS: All social determinants displayed significant unique associations with mental health in the sample, with social resources carrying the greatest weight. Although no moderated effects of composite resource measures were found, the relation between pandemic employment-related reduced resources and symptoms proved stronger in BIPOC compared to White child-bearers. CONCLUSIONS: Both stable social-structural determinants and acute crisis-related shifts contribute to perinatal mental health, with higher levels and/or impacts of resources helping to explain racial/ethnic disparities. These findings can inform more comprehensive screening and prevention protocols and policy recommendations that improve perinatal health outcomes.

A Longitudinal Investigation of the Impact of COVID-19 on Patients With Chronic Pain.

The COVID-19 pandemic prompted unexpected changes in the healthcare system. This current longitudinal study had 2 aims: 1) describe the trajectory of pandemic-associated stressors and patient-reported health outcomes among patients receiving treatment at a tertiary pain clinic over 2 years (May 2020 to June 2022); and 2) identify vulnerable subgroups. We assessed changes in pandemic-associated stressors and patient-reported health outcome measures. The study sample included 1270 adult patients who were predominantly female (74.6%), White (66.2%), non-Hispanic (80.6%), married (66.1%), not on disability (71.2%), college-educated (59.45%), and not currently working (57.9%). We conducted linear mixed effect modeling to examine the main effect of time with controlling for a random intercept. Findings revealed a significant main effect of time for all pandemic-associated stressors except financial impact. Over time, patients reported increased proximity to COVID-19, but decreased pandemic-associated stressors. A significant improvement was also observed in pain intensity, pain catastrophizing, and PROMIS-pain interference, sleep, anxiety, anger, and depression scores. Demographic-based subgroup analyses for pandemic-associated stressors revealed that younger adults, Hispanics, Asians, and patients receiving disability compensation were vulnerable groups either during the initial visit or follow-up visits. We observed additional differential pandemic effects between groups based on participant sex, education level, and working status. In conclusion, despite unanticipated changes in pain care services during the pandemic, patients receiving pain treatments adjusted to pandemic-related stressors and improved their health status over time. As the current study observed differential pandemic impacts on patient subgroups, future studies should investigate and address the unmet needs of vulnerable subgroups. PERSPECTIVE: Over a 2-year timeframe, the pandemic did not adversely influence physical and mental health among treatment-seeking patients with chronic pain. Patients reported small but significant improvements across indices of physical and psychosocial health. Differential impacts emerged among groups based on ethnicity, age, disability status, gender, education level, and working status.

Racial Disparities and Common Respiratory Infectious Diseases in Children of the United States: A Systematic Review and Meta-Analysis.

Due to the lack of sufficient data on the relationship between racial disparities and the occurrence of infectious respiratory diseases in children, the aim of this systematic review and meta-analysis is to evaluate the presence of racial gaps in the occurrence of respiratory infectious diseases in children. This study follows the PRISMA flow guidelines for systematic reviews and the standards of meta-analysis for 20 quantitative studies conducted from 2016 to 2022 including 2,184,407 participants. As evidenced from the review, in the U.S., racial disparities are present among children, with Hispanic and Black children carrying the burden of infectious respiratory disease occurrence. Several factors are contributory to these outcomes among Hispanic and Black children, including higher rates of poverty; higher rates of chronic conditions, such as asthma and obesity; and seeking care outside of the home. However, vaccinations can be used to reduce the risk of infection among Black and Hispanic children. Whether a child is very young or a teen, racial disparities are present in occurrence rates of infectious respiratory diseases, with the burden resting among minorities. Therefore, it is important for parents to be aware of the risk of infectious diseases and to be aware of resources, such as vaccines.

Racial Disparities in Mortality During the 1918 Influenza Pandemic in United States Cities.

Against a backdrop of extreme racial health inequality, the 1918 influenza pandemic resulted in a striking reduction of non-White to White influenza and pneumonia mortality disparities in United States cities. We provide the most complete account to date of these reduced racial disparities, showing that they were unexpectedly uniform across cities. Linking data from multiple sources, we then examine potential explanations for this finding, including city-level sociodemographic factors such as segregation, implementation of nonpharmaceutical interventions, racial differences in exposure to the milder spring 1918 "herald wave," and racial differences in early-life influenza exposures, resulting in differential immunological vulnerability to the 1918 flu. While we find little evidence for the first three explanations, we offer suggestive evidence that racial variation in childhood exposure to the 1889-1892 influenza pandemic may have shrunk racial disparities in 1918. We also highlight the possibility that differential behavioral responses to the herald wave may have protected non-White urban populations. By providing a comprehensive description and examination of racial inequality in mortality during the 1918 pandemic, we offer a framework for understanding disparities in infectious disease mortality that considers interactions between the natural histories of particular microbial agents and the social histories of those they infect.

Communicating Concerns, Emotional Expressions, and Disparities on Ethnic Communities on Social Media During the COVID-19 Pandemic: A Structural Topic Modeling Approach

Ethnic and racial disparities in the coronavirus (COVID-19) pandemic raise significant concerns. This study analyzes social media discourses toward four ethnic communities in the United States during the pandemic and reveals disparities in pandemic experiences among them. A total of 488,029 tweets mentioning one of the four ethnic communities, that is, Asians, Blacks, Hispanics, and Native Americans, were investigated by a structural topic modeling approach with emotional expressions and time as covariates in the topic model. The results demonstrate that discourses about Asian, Hispanics, and Native American communities were often induced by pandemic-related events, concerning topics beyond one's community, and reflecting an experience of implicit racism and an adoption of technical supports from health systems. Meanwhile, discourses about Blacks were racially related, discussing topics within the community, and reflecting an experience of explicit racism and an adoption of psychological supports from ingroup. We discuss the implications of our findings on ethnic health disparities. © 2023 SAGE Publications.

Are they still determining? Analysis of associations among ethnicity, gender, socioeconomic status, neighborhood factors, and COVID-19 vaccination

Introduction: This study explores associations among adult vaccination, ethnicity, gender, and socioeconomic variables such as educational attainment and income, as well as neighborhood factors. Methods: A telephone quota sample of New Jersey adults (N = 1,984) was used to text associations among proposed predictors of vaccination behaviors. Results: Our multivariate logistic regression analyses found that certain races/ethnicity, respondents' household income, and perceived safety of one's community were the strongest predictors of COVID-19 vaccination. The odds of COVID-19 vaccination were 52% lower for Black/African American respondents compared to white/Caucasian respondents (p = 0.001) and 44% lower for Hispanic/Latino respondents compared to white/Caucasian respondents (p = 0.001). Discussion: The results add new insights to public health communication research and suggest careful interventions across racial groups, considering existing racial disparities in vaccination. Copyright © 2023 Kim, Hong and Kim.

Spatial and racial covid-19 disparities in U.S. nursing homes.

In many parts of the world nursing home residents have experienced a disproportionate risk of exposure to COVID-19 and have died at much higher rates than other groups. There is a critical need to identify the factors driving COVID-19 risk in nursing homes to better understand and address the conditions contributing to their vulnerability during public health crises. This study investigates the characteristics associated with COVID-19 cases and deaths among residents in U.S. nursing homes from 2020 to 2021, with a focus on geospatial and racial inequalities. Using data from the Centers for Medicare and Medicaid Services and LTCFocus, this paper uses zero-inflated negative binomial regression models, Kruskal-Wallis tests, and Local Moran's I to generate statistical and geospatial results. Our analysis reveals that majority Hispanic facilities have alarmingly high COVID-19 cases and deaths, suggesting that these facilities have the greatest need for policy improvements in staffing and financing to reduce racial inequalities in nursing home care. At the same time we also detect COVID-19 hot spots in rural areas with predominately White residents, indicating a need to rethink public messaging strategies in these areas. The top states with COVID-19 hot spots are Kentucky, Pennsylvania, Illinois, and Oklahoma. This research provides new insights into the socio-spatial contexts and inequities that contribute to the vulnerability of nursing home residents during a pandemic.

Bolstering the Measurement of Racial Inequity of COVID-19 Vaccine Uptake.

Inequities in COVID-19 vaccine uptake by racialized groups have been persistent throughout the vaccine rollout, leading to disparate burdens of COVID-19 outcomes. A cross-sectional study was conducted to determine COVID-19 vaccine uptake across racialized groups within the nine-county Finger Lakes region of New York State in December 2021. Cross-matching and validation were performed across multiple health information systems for the region to reduce the percentage of vaccine records with missing race information. Additionally, imputation techniques were applied to address the remaining missing values. Uptake of ≥1 dose of the COVID-19 vaccine by race was then examined. By December 2021, 828,551 individuals in our study region had received ≥1 dose of the COVID-19 vaccine, with ~25% having missing race values. Cross-matching and validation within existing records reduced this to ~7%. Uptake of ≥1 dose of a COVID-19 vaccine was greatest among individuals identifying as White, followed by those identifying as Black. The application of imputation techniques reduced the percent of missing race values to <1%; however, this reduction did not significantly change the distribution of vaccine uptake across race groups. Utilization of relevant health information systems, accompanied by imputation techniques, stands to greatly reduce the burden of missing race data within vaccine registries, facilitating accurate targeted interventions to mitigate inequities in COVID-19 vaccination.

Reflections from academic mothers of young children on social work research and education

The COVID-19 pandemic has had a profound societal impact with unprecedented impact on women's labor force participation, including among academic mothers. Yet, persistent gendered and racialized inequities in academia remain structurally unaddressed, including in social work. We believe that as social work educators we are well-positioned to develop an academic culture that helps us refocus on what matters most;redefine excellence in teaching, service, and research;and make academic practice more equitable. To this end, we convened a group of social work academic mothers, representing various identities at teaching and research-intensive institutions, to offer collective perspectives and recommendations for structural change within the social work academy to buffer the impact of the COVID-19 pandemic and exacerbating racial and gendered disparities. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Racial framing of pandemic outcomes has conditional indirect effects on support for COVID-19 mitigation policies: Examining moral and threat-based mediating mechanisms

Two studies explored the intersection between the COVID-19 pandemic and the continuing fight for racial justice. The pandemic has exacerbated existing racial inequalities in the United States in terms of public health and economic outcomes, and it is well-established that individuals higher in racial bias are less likely to support social safety net programs such as those meant to improve public health and reduce poverty. This is particularly true among individuals who perceive racial minorities as overbenefitting from safety net programs. Accordingly, the primary focus of the current studies was to examine whether framing the pandemic in terms of its disproportionate impact on minorities would reduce support for pandemic mitigation policies. In addition, we examine whether such effects were mediated through psychological mechanisms of moral outrage and perceptions of realistic and symbolic threat, and moderated by participants' racial bias. Participants' belief in a just world was included as a covariate given its established role in predicting many related social outcomes. Results suggested that racial framing interacts with participants' racial bias to affect policy support indirectly through multiple mechanisms. Broad implications regarding the relationship between racial bias and public support for a strong social safety net are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Theorizing racialized disaster patriarchal capitalism in the age of covid-19: A framework for feminist policy change

In this concluding article, the authors use a global, intersectional feminist political economy lens to reconceptualize disaster response policy and practices that center women's lives. They extend this issue's discussion of the COVID-19 pandemic's impact on women's health and safety in ways that have exposed and expanded gender inequalities, and differently for different groups of women, to the discourse of how disaster responses have not only failed women, but have also been used opportunistically by elites to enhance racial and gendered capitalism. In the first half of the article, the authors discuss how the previous feminist literature on the gendering of disasters, with important exceptions, largely misses a critique of the ways the crisis of neoliberalism and the role of racial and gendered global capitalism sets the stage for women to be targets for disaster opportunism. At the same time, critical scholars who have taken on the analysis of disaster capitalism often ignore the well-established feminist social science on disasters. In the second half of the article, the authors bridge these two literatures and provide an intersectional gendered analysis of what they call the political economy of "racialized patriarchal disaster capitalism" as applied to select cases from the COVID crisis as illustrations. Finally, the authors discuss the theoretical implications of their analysis for feminist conceptualizations of disaster opportunism, as well as practical implications for global public health advocates, policy makers, NGOs, and feminist health activists. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

'We are trying.' Portraits of black goodness in spite of anti-Black schooling

This dissertation explores everyday interactions and opportunities for teachers and families to collaborate in spite of forces that often put Black families and schools at odds in one predominantly Black elementary school. I examine interactions among Black families and teachers to consider how organizational norms, values, and routines influence the nature of these interactions. My exploration of interactions is guided by a framework that links anti-blackness, critical race theory, and institutional theory to examine how practices and policies enable or inhibit family engagement. Using portraiture and critical race methodology, I provide a rich portrait of one school community striving to engage families, reduce chronic absenteeism, and maintain staff moral amidst unprecedented changes spurred by COVID-19. Examining the day-to day realities within one school community revealed that there are routine practices and policies that constrain interactions among Black families and Black teachers. Yet, these practices and policies also enhanced interactions by prompting advocacy and subversive action. I conclude by contending that anti-Black schooling is habitual. I show how the enactment of race-neutral policies and practices led to anti-Black outcomes and I connect these policies and practices to the interactions that took place throughout one school community during the 2020-2021 school year. Ultimately, I assert that schooling for Black students, namely those in resource deprived schools, is rife with anti-blackness that demands Black people exude Black goodness to succeed, and at times, merely survive. This study contributes to research, policy, and practice conversations on segregated schooling, racialized organizations, and family-school relations. (PsycInfo Database Record (c) 2022 APA, all rights reserved)