Examining the Impacts of a Developmentally Appropriate, Culturally Relevant Virtual School on Student Outcomes

The rapid shift to online learning due to COVID-19 provides an opportunity to examine at scale the feasibility and impact of addressing students' cultural and developmental needs within a virtual environment. Given limited knowledge of this type of virtual schooling, this mixed-method study examined third–fifth grade students' experiences attending a culturally responsive and developmentally appropriate virtual summer literacy program. Findings indicate that students were more receptive to the virtual programming than their traditional schooling (pre-COVID), which positively affected their racial-ethnic and learner identities. Given the findings, implications for educational stakeholders are discussed. [ FROM AUTHOR] Copyright of Urban Education is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Black-White Risk Differentials in Pediatric COVID-19 Hospitalization and Intensive Care Unit Admissions in the USA.

PURPOSE: The COVID-19 morbidity with SARS-CoV-2 as a causative pathogenic microbe remains a pandemic with children experiencing less mortality but with severe manifestations. The current study aimed to assess SARS-CoV-2 cumulative incidence, COVID-19 hospitalization, and ICU admission with respect to racial differentials. MATERIALS AND METHODS: A cross-sectional nonexperimental epidemiologic design was used to examine pediatric COVID-19 data from CDC during 2020. The variables assessed were ICU admissions, hospitalization, sex, race, and region. The Chi-Square (X2) statistic was used to examine the independence of the variables by race, while the binomial regression model was used to predict racial risk differentials in hospitalization and ICU admissions. RESULTS: The pediatric COVID-19 data observed the cumulative incidence of hospitalization to be 96,376, while ICU admission was 12,448. Racial differences were observed in hospitalization, ICU admissions, sex, and region. With respect to COVID-19 hospitalization, Black/African American (AA) children were two times as likely to be hospitalized compared to their White counterparts, prevalence risk ratio (pRR) = 2.20, 99% confidence interval (CI = 2.12-2.28). Similarly, Asians were 45% more likely to be hospitalized relative to their White counterparts, pRR = 1.45, 99% CI = 1.32-1.60. Regarding ICU admission, there was a disproportionate racial burden, implying excess ICU admission among Black/AA children relative to their White counterparts, pRR = 5.18, 99% CI = 4.44-6.04. Likewise, Asian children were 3 times as likely to be admitted to the ICU compared to their White counterparts, pRR = 3.36, 99% CI = 2.37-4.77. Additionally, American Indians/Alaska Natives were 2 times as likely to be admitted to ICU, pRR = 2.54, 99% CI = 0.82-7.85. CONCLUSION: Racial disparities were observed in COVID-19 hospitalization and ICU admission among the US children, with Black/AA children being disproportionately affected, implying health equity transformation.

Racial differences in COVID-19 severity associated with history of substance use disorders and overdose: Findings from multi-site electronic health records in New York City.

Substance use disorders (SUD) are associated with increased risk of worse COVID-19 outcomes. Likewise, racial/ethnic minority patients experience greater risk of severe COVID-19 disease compared to white patients. Providers should understand the role of race and ethnicity as an effect modifier on COVID-19 severity among individuals with SUD. This retrospective cohort study assessed patient race/ethnicity as an effect modifier of the risk of severe COVID-19 disease among patients with histories of SUD and overdose. We used merged electronic health record data from 116,471 adult patients with a COVID-19 encounter between March 2020 and February 2021 across five healthcare systems in New York City. Exposures were patient histories of SUD and overdose. Outcomes were risk of COVID-19 hospitalization and subsequent COVID-19-related ventilation, acute kidney failure, sepsis, and mortality. Risk factors included patient age, sex, and race/ethnicity, as well as medical comorbidities associated with COVID-19 severity. We tested for interaction between SUD and patient race/ethnicity on COVID-19 outcomes. Findings showed that Non-Hispanic Black, Hispanic/Latino, and Asian/Pacific Islander patients experienced a higher prevalence of all adverse COVID-19 outcomes compared to non-Hispanic white patients. Past-year alcohol (OR 1.24 [1.01-1.53]) and opioid use disorders (OR 1.91 [1.46-2.49]), as well as overdose history (OR 4.45 [3.62-5.46]), were predictive of COVID-19 mortality, as well as other adverse COVID-19 outcomes. Among patients with SUD, significant differences in outcome risk were detected between patients of different race/ethnicity groups. Findings indicate that providers should consider multiple dimensions of vulnerability to adequately manage COVID-19 disease among populations with SUDs.

Politics, not Vulnerability: Republicans Discriminated against Chinese-born Americans throughout the COVID-19 Pandemic

Asian Americans became targets of increasingly hostile behavior during the COVID-19 pandemic. What motivated this? Fears of contagion arising from a behavioral immune system may have motivated hostility toward Asian Americans, especially among those Americans vulnerable to COVID-19. Additionally, stigmatizing rhetoric from right-wing figures may have legitimated anti-Asian behavior among those Americans who held stronger anti-Asian sentiments to begin with or who were more receptive to right-wing rhetoric. We explore these possibilities using a behavioral game with a representative sample of Americans at two points: in May and October 2020. Participants were partnered with a U.S.- or Chinese-born American in a give-or-take dictator game. The average American discriminated against Chinese-born Americans in May but not October 2020, when China was no longer a COVID-19 hotspot. But among Republicans, who may have held stronger anti-Asian sentiments to begin with and who were likely more receptive to right-wing rhetoric, discrimination - that is, differential treatment - was both stronger in May compared to non-Republicans and persisted into October 2020. Notably, Americans who were more vulnerable to COVID-19 were not especially likely to discriminate. © New York University in Abu Dhabi Corporation - Abu Dhabi, 2023. Published by Cambridge University Press on behalf of The Race, Ethnicity, and Politics Section of the American Political Science Association.

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.

Digital mental health interventions for college students of color: Understanding uptake and enhancing engagement

College students of color have significant mental health needs, but they are less likely to receive treatment than their white counterparts (Lin et al., 2022). Given students of color are a high need, understudied, and underserved group, increased attention to their mental health and strategies targeting mental health equity are imperative. Digital mental health interventions (DMHI) have been proposed as mechanisms for disparity reduction, and research indicates DMHI are effective in college student populations (Lattie et al., 2019). However, less is known about DMHI preferences, needs, and usage among students of color. Addressing pertinent questions about DMHI reach and uptake for this population can support efforts to advance health equity. This dissertation comprised two studies that explored the following research questions: Can DMHI enhance racial/ethnic equity in college student mental health treatment receipt? (Study 1) What are key barriers to DMHI uptake for college students of color and what strategies might enhance DMHI uptake in this population? (Study 2). Study 1 evaluated racial/ethnic differences in mental health problems and treatment enrollment within a largescale screening and treatment research initiative on a diverse college campus. Results illustrated racial/ethnic differences in student depression, anxiety, and suicidality. Students of color were less likely to have received prior mental health treatment compared to white students but were no less likely to initiate digital and face-to-face treatment through the research initiative. DMHI uptake rates were comparable to prior studies, with just 8.7% of those eligible initiating use of the DMHI. Given these findings, Study 2 employed a modified Delphi design to generate expert consensus on barriers to DMHI uptake and strategies to improve uptake among college students of color. Cross-disciplinary experts (n=35) participated in a three-round survey. Results revealed important barriers to uptake, including factors associated with the user, program, technology, and environment. Strategies were coded within four implementation levels, including DMHI design, marketing and outreach, orientation and onboarding, and campus/community-level efforts. Analyses yielded a subset of promising strategies rated highly important and feasible. These findings provide guidance for future efforts focused on tailoring and implementing DMHI uptake strategies through co-creation with students of color. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Families' Job Characteristics and Economic Self-Sufficiency: Differences by Income, Race-Ethnicity, and Nativity

Policy debates about whether wages and benefits from work provide enough resources to achieve economic self-sufficiency rely on data for workers, not working families. Using data from the Current Population Survey, we find that almost two-thirds of families working full time earn enough to cover a basic family budget, but that less than a quarter of low-income families do. A typical low-income full-time working family with wages below a family budget would need to earn about $11.00 more per hour to cover expenses. This wage gap is larger for black, Hispanic, and immigrant families. Receipt of employer-provided benefits varies—health insurance is more prevalent than pension plans—and both are less available to low-income families, and black, Hispanic, and immigrant working families. Findings suggest that without policies to decrease wage inequality and increase parents' access to jobs with higher wages and benefits, child opportunity gaps by income, race-ethnicity, and nativity will likely persist.

Factors associated with US caregivers' uptake of pediatric COVID-19 vaccine by race and ethnicity.

OBJECTIVES: To assess differences in willingness to vaccinate children against COVID-19, and factors that may be associated with increased acceptance, among US caregivers of various racial and ethnic identities who presented with their child to the Emergency Department (ED) after emergency use authorization of vaccines for children ages 5-11. STUDY DESIGN: A multicenter, cross-sectional survey of caregivers presenting to 11 pediatric EDs in the United States in November-December 2021. Caregivers were asked about their identified race and ethnicity and if they planned to vaccinate their child. We collected demographic data and inquired about caregiver concerns related to COVID-19. We compared responses by race/ethnicity. Multivariable logistic regression models served to determine factors that were independently associated with increased vaccine acceptance overall and among racial/ethnic groups. RESULTS: Among 1916 caregivers responding, 54.67% planned to vaccinate their child against COVID-19. Large differences in acceptance were noted by race/ethnicity, with highest acceptance among Asian caregivers (61.1%) and those who did not specify a listed racial identity (61.1%); caregivers identifying as Black (44.7%) or Multi-racial (44.4%) had lower acceptance rates. Factors associated with intent to vaccinate differed by racial/ethnic group, and included caregiver COVID-19 vaccine receipt (all groups), caregiver concerns about COVID-19 (White caregivers), and having a trusted primary provider (Black caregivers). CONCLUSIONS: Caregiver intent to vaccinate children against COVID-19 varied by race/ethnicity, but race/ethnicity did not independently account for these differences. Caregiver COVID-19 vaccination status, concerns about COVID-19, and presence of a trusted primary provider are important in vaccination decisions.

Race, Class, and Place Modify Mortality Rates for the Leading Causes of Death in the United States, 1999-2021.

BACKGROUND: Race and ethnicity, socioeconomic class, and geographic location are well-known social determinants of health in the US. Studies of population mortality often consider two, but not all three of these risk factors. OBJECTIVES: To disarticulate the associations of race (whiteness), class (socioeconomic status), and place (county) with risk of cause-specific death in the US. DESIGN: We conducted a retrospective analysis of death certificate data. Bayesian regression models, adjusted for age and race/ethnicity from the American Community Survey and the county Area Deprivation Index, were used for inference. MAIN MEASURES: County-level mortality for 11 leading causes of death (1999-2019) and COVID-19 (2020-2021). KEY RESULTS: County "whiteness" and socioeconomic status modified death rates; geospatial effects differed by cause of death. Other factors equal, a 20% increase in county whiteness was associated with 5-8% increase in death from three causes and 4-15% reduction in death from others, including COVID-19. Other factors equal, advantaged counties had significantly lower death rates, even when juxtaposed with disadvantaged ones. Patterns of residual risk, measured by spatial county effects, varied by cause of death; for example: cancer and heart disease death rates were better explained by age, socioeconomic status, and county whiteness than were COVID-19 and suicide deaths. CONCLUSIONS: There are important independent contributions from race, class, and geography to risk of death in the US.

Gender and Racial/Ethnic Disparities in Undergraduate and Graduate Students' Mental Health and Treatment Use Amid the COVID-19 Pandemic.

The COVID-19 pandemic has negatively impacted numerous people?s mental health and created new barriers to services. To address the unknown effects of the pandemic on accessibility and equality issues in mental health care, this study aimed to investigate gender and racial/ethnic disparities in mental health and treatment use in undergraduate and graduate students amid the COVID-19 pandemic. The study was conducted based on a largescale online survey (N = 1,415) administered during the weeks following a pandemic-related university-wide campus closure in March 2020. We focused on the gender and racial disparities in current internalizing symptomatology and treatment use. Our results showed that in the initial period of the pandemic, students identified as cis women (p < .001), non-binary/genderqueer (p < .001), or Hispanic/Latinx (p = .002) reported higher internalizing problem severity (aggregated from depression, generalized anxiety, intolerance of uncertainty, and COVID-19-related stress symptoms) compared to their privileged counterparts. Additionally, Asian (p < .001) and multiracial students (p = .002) reported less treatment use than White students while controlling for internalizing problem severity. Further, internalizing problem severity was associated with increased treatment use only in cisgender, non-Hispanic/Latinx White students (pcis man = 0.040, pcis woman < 0.001). However, this relationship was negative in cis-gender Asian students (pcis man = 0.025, pcis woman = 0.016) and nonsignificant in other marginalized demographic groups. The findings revealed unique mental health challenges faced by different demographic groups and served as a call that specific actions to enhance mental health equity, such as continued mental health support for students with marginalized gender identities, additional COVID-related mental and practical support for Hispanic/Latinx students and promotion of mental health awareness, access, and trust in non-White, especially Asian, students are desperately needed.

Lessons Learned from Health Disparities in Coronavirus Disease-2019 in the United States.

In the United States, the coronavirus disease-2019 (COVID-19) pandemic has disproportionally affected Black, Latinx, and Indigenous populations, immigrants, and economically disadvantaged individuals. Such historically marginalized groups are more often employed in low-wage jobs without health insurance and have higher rates of infection, hospitalization, and death from COVID-19 than non-Latinx White individuals. Mistrust in the health care system, language barriers, and limited health literacy have hindered vaccination rates in minorities, further exacerbating health disparities rooted in structural, institutional, and socioeconomic inequities. In this article, we discuss the lessons learned over the last 2 years and how to mitigate health disparities moving forward.

COVID-19 vaccination willingness and uptake among rural Black/African American, Latino, and White adults.

PURPOSE: The purpose of this study was to assess differences in COVID-19 vaccine willingness and uptake between rural and nonrural adults, and within rural racial-ethnic groups. METHODS: We utilized data from the COVID-19's Unequal Racial Burden online survey, which included 1,500 Black/African American, Latino, and White rural adults (n = 500 each). Baseline (12/2020-2/2021) and 6-month follow-up (8/2021-9/2021) surveys were administered. A cohort of nonrural Black/African American, Latino, and White adults (n = 2,277) was created to compare differences between rural and nonrural communities. Multinomial logistic regression was used to assess associations between rurality, race-ethnicity, and vaccine willingness and uptake. FINDINGS: At baseline, only 24.9% of rural adults were extremely willing to be vaccinated and 28.4% were not at all willing. Rural White adults were least willing to be vaccinated, compared to nonrural White adults (extremely willing: aOR = 0.44, 95% CI = 0.30-0.64). At follow-up, 69.3% of rural adults were vaccinated; however, only 25.3% of rural adults who reported being unwilling to vaccinate were vaccinated at follow-up, compared to 95.6% of adults who were extremely willing to be vaccinated and 76.3% who were unsure. Among those unwilling to vaccinate at follow-up, almost half reported distrust in the government (52.3%) and drug companies (46.2%); 80% reported that nothing would change their minds regarding vaccination. CONCLUSIONS: By August 2021, almost 70% of rural adults were vaccinated. However, distrust and misinformation were prevalent among those unwilling to vaccinate at follow-up. To continue to effectively combat COVID-19 in rural communities, we need to address misinformation to increase COVID-19 vaccination rates.

Differential patterns by area-level social determinants of health in COVID-19 related mortality and non-COVID-19 mortality: a population-based study of 11.8 million people in Ontario, Canada.

BACKGROUND: Social determinants of health (SDOH) have been associated with COVID-19 outcomes. We examined differential patterns in COVID-19-related mortality by SDOH accounting for confounders and compared these patterns to those for non-COVID-19 mortality. METHODS: Residents of Ontario, Canada aged ≥20 years were followed from March-01-2020 to March-02-2021. COVID-19-related death was defined as death within [-7,30] days of a positive COVID-19 test. Area-level SDOH from 2016 Census included: median household income; proportion with diploma or higher educational-attainment; proportion essential workers, racially-minoritised groups, recent immigrants, apartment buildings, and high-density housing; and average household size. We examined associations between SDOH and COVID-19-related mortality using cause-specific hazard models, treating non-COVID-19 mortality as competing risks, and vice-versa. RESULTS: Of 11,810,255 individuals, we observed 3,880(0.03%) COVID-19-related deaths and 88,107(0.75%) non-COVID-19 deaths. After accounting for individual-level demographics, baseline health, and other area-level SDOH, the following area-level SDOH were associated with increased hazards of COVID-19-related death (hazard ratios[95% confidence intervals]: lower income (1.30[1.04-1.62]), lower educational-attainment (1.27[1.07-1.52]), higher proportions essential workers (1.28[1.05-1.57]), racially-minoritised groups (1.42[1.08-1.87]), apartment buildings (1.25[1.07-1.46]), and large vs. medium household size (1.30[1.12-1.50]). In comparison, areas with higher proportion racially-minoritised groups were associated with a lower hazard of non-COVID-19 mortality (0.88[0.84-0.92]). CONCLUSIONS: Area-level SDOH are associated with COVID-19-related mortality after accounting for demographic and clinical factors. COVID-19 has reversed patterns of lower non-COVID-19 mortality among racially-minoritised groups vs. their counterparts. Pandemic responses should include strategies (e.g., 'hotspot' and risk-group tailored vaccination) to address disproportionate risks and inequitable reach of, and access to, preventive interventions associated with SDOH.

Racial and Ethnic Disparities in Mental Health and Mental Health Care During The COVID-19 Pandemic.

During the pandemic, the overall mental health of the US population declined. Given higher rates of COVID-19 infections and deaths experienced by communities of color along with greater exposure to pandemic-related stressors (e.g., unemployment, food insecurity), we expect that the decline in mental health during the pandemic was more pronounced among Black, Hispanic, and Asian adults, with these groups also having less access to mental health services. We examine two nationally representative US surveys: the 2019 National Household Interview Survey (NHIS; N = 30,368) and the 2020-2021 Household Pulse Survey (HPS; N = 1,677,238). We find mental health of Black, Hispanic, and Asian respondents worsened relative to White respondents during the pandemic, with significant increases in depression and anxiety among racialized minorities compared to Whites. There is also evidence of especially high mental health burden for Black adults around the murder of George Floyd by police and for Asian adults around the murder of six Asian women in Atlanta. White respondents are most likely to receive professional mental health care before and during the pandemic, and Black, Hispanic, and Asian respondents demonstrate higher levels of unmet mental health care needs during the pandemic than White respondents. Our results indicate that within the current environment, White adults are at a large and systemic advantage buffering them from unexpected crises-like the COVID-19 pandemic. Without targeted interventions, the long-term social consequences of the pandemic and other co-occurring events (e.g., death of Black and Hispanic people by police) will likely include widening mental health disparities between racial/ethnic groups.

Factors Associated with Healthcare Delays Among Adults Over 50 During the COVID-19 Pandemic.

BACKGROUND: Adults over 50 have high healthcare needs, but also face high coronavirus disease 2019 (COVID-19)-related vulnerability. This may result in reluctance to enter public spaces, including healthcare settings. Here, we examined factors associated with healthcare delays among adults over 50 early in the COVID-19 pandemic. METHODS: Using data from the 2020 wave of the Health and Retirement Study (N=7615), we evaluated how race/ethnicity, age, geographic region, and pandemic-related factors were associated with healthcare delays. RESULTS: In our sample, 3 in 10 participants who were interviewed from March 2020 to June 2021 reported delays in medical or dental care in the early stages of the COVID-19 pandemic. Non-Hispanic Whites (OR: 1.37; 95% CI: 1.19-1.58) and those of other racial/ethnic backgrounds (OR: 1.31; 95% CI: 1.02-1.67) delayed care more than Non-Hispanic Blacks. Other factors associated with delayed care included younger age, living in the Midwest or West, knowing someone diagnosed with or who died from COVID-19, and having high COVID-19-related concerns. There were no differences in care delays among adults aged >70; however, among those ≤70, those who knew someone diagnosed with COVID-19 were more likely to delay care than those who did not. Additionally, among those ≤70, Non-Hispanic Whites and those of other racial/ethnic backgrounds delayed care more than Non-Hispanic Blacks and Hispanics. CONCLUSIONS: There is considerable heterogeneity in care delays among older adults based on age, race/ethnicity, and pandemic-related factors. As the pandemic continues, future studies should examine whether these patterns persist.

The Effects of Race/Ethnicity, Age, and Area Deprivation Index (ADI) on COVID-19 Disease Early Dynamics: Washington, D.C. Case Study.

The COVID-19 pandemic and its associated mitigation strategies have significant psychosocial, behavioral, socioeconomic, and health impacts, particularly in vulnerable US populations. Different factors have been identified as influencers of the transmission rate; however, the effects of area deprivation index (as a measure of social determinants of health, SDoH) as a factor on COVID-19 disease early dynamics have not been established. We determined the effects of area deprivation index (ADI) and demographic factors on COVID-19 outcomes in Washington, D.C. This retrospective study used publicly available data on COVID-19 cases and mortality of Washington, D.C., during March 31st-July 4th, 2020. The main predictors included area deprivation index (ADI), age, and race/ethnicity. The ADI of each census block groups in D.C. (n=433) were obtained from Neighborhood Atlas map. Using a machine learning-based algorithm, the outcome variables were partitioned into time intervals: time duration (Pi, days), rate of change coefficient (Ei), and time segment load (Pi×Ei) for transmission rate and mortality. Correlation analysis and multiple linear regression models were used to determine associations between predictors and outcome variables. COVID-19 early transmission rate (E1) was highly correlated with ADI (SDoH; r= 0.88, p=0.0044) of the Washington, D.C. community. We also found positive association between ADI, age (0-17 years, r=0.91, p=0.0019), and race (African American/Black, r=0.86; p=0.0068) and COVID-19 outcomes. There was high variability in early transmission across the geographic regions (i.e., wards) of Washington, D.C., and this variability was driven by race/ethnic composition and ADI. Understanding the association of COVID-19 disease early transmission and mortality dynamics and key socio-demographic risk factors such as age, race, and ADI, as a measure of social determinants, will contribute to health equity/equality and distribution of economic resources/assistance and is essential for future predictive modeling of the COVID-19 pandemic to limit morbidity and mortality.

Fear, Political Legitimization, and Racism: Examining Anti-Asian Xenophobia During the COVID-19 Pandemic

Unfortunately, there is a long history linking pandemics to Anti-Asian prejudice and xenophobia;these negative outcomes have been particularly pronounced during the COVID-19 pandemic. Some scholars have suggested that these relationships are driven by fear, wherein individuals respond to disease threat by "othering” that threat. Other research has implicated the role of the state, including the political rhetoric of former President Trump, in exacerbating bias by enabling a divisive political environment. Yet, very few existing studies have been able to assess the nature of these impacts or examine the mechanisms behind observed increases in xenophobia. To that end, this research presents results from a survey administered in May 2020 to respondents residing in the U.S., which assessed COVID-19-related attitudes and behaviors, as well as anti-Asian prejudicial attitudes. Using these data, we assessed the direct and interactive relationship between perceptions of risk (i.e., fear), exposure to COVID-19 information, support for Trump, and anti-Asian prejudice. Results reveal that fear—and support for Trump—are associated with increased anti-Asian prejudice, but that exposure to more information about COVID-19 is associated with decreased prejudice;we also note complex interactions between each of these factors. © The Author(s) 2022.

Cultural and Social Factors in Care Delivery Among African American Caregivers of Persons With Dementia: A Scoping Review.

Cultural and social factors significantly influence the care provided to persons with dementia. This scoping review aimed to map emerging evidence on the influence of cultural and social factors on care delivery among Africa American caregivers of persons with dementia, especially during the COVID-19 pandemic. Using a systematic scoping review approach, we identified 21 studies on cultural and social factors influencing care delivery. The search included EMBASE, CINAHL, the Cochrane Database of Systematic Reviews, JBI Evidence Synthesis, and Epistemonicos. A narrative synthesis of the data revealed that cultural and social factors greatly influence African American caregivers of persons with dementia and COVID-19 in care delivery, who perceive caregiving as a responsibility and not just a job. These caregivers are additionally guided by their racial identity and faith beliefs, integrating family values and culture into caregiving. African American caregivers showed compassion and resilient care selfperceptions. Supporting compassionate care delivery by African American caregivers requires an understanding of the social and cultural factors which drive their commitment to quality care for older adults with dementia in a pandemic environment.

College students' underlying perceptions of COVID-19 threat, healthcare discrimination, and healthcare system inequities associated with self-rated health across racial/ethnic groups in the U.S.

Background: COVID-19-related health perceptions may differentially impact college students' stress, and in turn, their mental and physical health. This study examined racial/ethnic differences in college students' underlying perceptions of COVID-19 threat, healthcare discrimination, and U.S. healthcare system inequities and their associations with self-rated mental and physical health. Methods: Four-hundred-thirty-two university students completed an online survey (December 2020-December 2021). Latent class analyses identified classes of perceived COVID-19 threat (i.e., severity, susceptibility), healthcare discrimination, and U.S. healthcare system inequities. Regression analyses examined whether class membership varied by race/ethnicity and was associated with self-rated mental and physical health. Results: Class 1 members (27.3% of the sample) were more likely to identify as Hispanic or Latino, Non-Hispanic Asian, Non-Hispanic Black or African American, and Non-Hispanic Multiracial vs. Non-Hispanic White (vs. Class 4). Class 1 had high perceived COVID-19 threat, medium perceived healthcare discrimination, and high perceived U.S. healthcare system inequities, as well as higher odds of poorer mental and physical health (vs. Class 4). Conclusions: College students' underlying perceptions of COVID-19 threat, healthcare discrimination, and U.S. healthcare system inequities were associated with poorer health. Given that students with these perceptions were more likely to belong to minoritized racial/ethnic groups, concerns over COVID-19 risk and healthcare may partially explain racial/ethnic disparities in college students' health. This study contributes to a limited body of evidence on college students' perceptions of the U.S. healthcare system and suggests important ways that structural inequalities and racial/ethnic disparities in COVID-19 risk, healthcare discrimination, and concerns over U.S. healthcare system inequity may affect college students' health.

Understanding Mobility Change in Response to COVID-19: A Los Angeles Case Study.

The COVID-19 pandemic has affected people's lives throughout the world. Governments have imposed restrictions on business and social activities to reduce the spread of the virus. In the US, the pandemic response has been largely left to state and local governments, resulting in a patchwork of policies that frequently changed. We examine travel behavior across income and race/ethnic groups in Los Angeles County over several stages of the pandemic. We use a difference-in-difference model based on mobile device data to compare mobility patterns before and during the various stages of the pandemic. We find a strong relationship between income/ethnicity and mobility. Residents of low-income and ethnic minority neighborhoods reduced travel less than residents of middle- and high-income neighborhoods during the shelter-in-place order, consistent with having to travel for work or other essential purposes. As public health rules were relaxed and COVID vaccines became available, residents of high-income and White neighborhoods increased travel more than other groups, suggesting more discretionary travel. Our trip purpose model results show that residents of low-income and ethnic minority neighborhoods reduced work and shopping travel less than those of White and high-income neighborhoods during the shelter-in-place order. Results are consistent with higher-income workers more likely being able to work at home than lower-income workers. In contrast, low-income/minorities apparently have more constraints associated with work or household care. The consequence is less capacity to avoid virus risk. Race and socioeconomic disparities are revealed in mobility patterns observed during the COVID-19 pandemic.