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2.
Am J Public Health ; 112(10): 1412-1415, 2022 10.
Article in English | MEDLINE | ID: covidwho-2141106
4.
Front Public Health ; 10: 958999, 2022.
Article in English | MEDLINE | ID: covidwho-2119875

ABSTRACT

Racism against people of Asian descent increased by over 300% after the COVID-19 pandemic outbreak in the United States, with one in five Asian Americans reporting direct experiences with overt discrimination. Large-scale efforts and resources initially, and quite understandably, prioritized investigating the physiological impact of the coronavirus, which has partially delayed research studies targeting the psychological effects of the pandemic. Currently, two studies tracked the unique relationships between psychosocial factors, such as experiencing everyday racism, and the self-reported wellbeing of Asian Americans in the United States and compared these associations with Latinx Americans. Study 1 (April 2020-April 2021) examined how Asian and Latinx Americans varied in their levels of wellbeing, fear of the coronavirus, internalized racism, and everyday experiences with racism. Study 2 (September 2021-April 2022) included the same variables with additional assessments for victimization distress. We used the CDC Museum COVID-19 Timeline to pair collected data from our studies with specific moments in the pandemic-from its known origins to springtime 2022. Results highlighted how slow and deleterious forms of racist violence could wear and tear at the wellbeing of targeted people of color. Overall, this research underscores the possible hidden harms associated with slow-moving forms of racism, as well as some of the unseen stressors experienced by people of color living in the United States.


Subject(s)
COVID-19 , Racism , Humans , United States/epidemiology , Racism/psychology , Asian Americans/psychology , COVID-19/epidemiology , Pandemics , Violence
5.
Proc Natl Acad Sci U S A ; 119(47): e2212183119, 2022 Nov 22.
Article in English | MEDLINE | ID: covidwho-2119279

ABSTRACT

About one in six Asian Americans have fallen victim to anti-Asian racism during the COVID-19 pandemic [J. Lee, K. Ramakrishnan, aapidata.com/blog/discrimination-survey-2022/]. By examining anti-Asian racism in the United States primarily as a domestic issue, most prior studies have overlooked the connections between shifting US-China relations and Americans' prejudices against the Chinese in China and, by extension, East Asian Americans. This study investigates the patterns and perceptual bases of nationality-based prejudices against Chinese amid the COVID-19 pandemic in the United States. Our nationally representative online survey experiment reveals that Americans assess a hypothetical Chinese person in China as inferior in multiple social and psychological characteristics to an otherwise identical Japanese person in Japan or East Asian American. Furthermore, subjects who perceive China as more threatening to America's national interests assess Chinese more negatively, especially in terms of trustworthiness and morality, suggesting that perceived China threats propel Americans' negative stereotypes about Chinese. A contextual analysis further indicates that counties with a higher share of Trump voters in 2016 tend to perceive all East Asian-origin groups similarly as a racial outgroup. By contrast, residents in predominantly Democrat-voting counties tend to perceive Chinese in China more negatively relative to Asian Americans, despite broadly viewing East Asians more favorably. Overall, this study underscores the often-overlooked relationships between the prevailing anti-Asian sentiments in the United States and the US-China geopolitical tensions and America's domestic political polarization.


Subject(s)
COVID-19 , Racism , Humans , United States/epidemiology , COVID-19/epidemiology , Pandemics , Prejudice , Racism/psychology , Asian Americans/psychology , Morals , China
6.
Front Public Health ; 10: 961215, 2022.
Article in English | MEDLINE | ID: covidwho-2109876

ABSTRACT

Since the COVID-19 pandemic, anti-Asian racism has surged, yet little is known about Asian Americans' experiences of social support. Therefore, we designed a qualitative, intrinsic, revelatory case study to examine the nature and quality of social support for Asian Americans during the first 6 months of the pandemic. Our sample consisted of 193 Asian Americans (from over 32 U.S. states) disclosing their experiences of inadequate social support. They described their support network as (1) Being unable to relate, (2) Encouraging their silence, (3) Minimizing anti-Asian racism, (4) Denying anti-Asian racism, and (5) Victim-blaming. Regarding our participants' recommendations for increasing social support for Asian Americans, a total of seven recommendations emerged: (1) Legitimize anti-Asian racism, (2) Teach Asian American history, (3) Destigmatize mental health resources to make them accessible for Asian American families (4) Promote bystander intervention trainings, (5) Build solidarity with and beyond Asian Americans to dismantle racism, (6) Increase media attention on anti-Asian racism, and (7) Elect political leaders who will advocate for Asian Americans. Altogether, our findings underscore the need for systemic forms of advocacy to combat anti-Asian racism, and shed light on the injurious nature of social support for Asian American victims of racism.


Subject(s)
COVID-19 , Racism , Humans , Asian Americans/psychology , Racism/psychology , Pandemics , Social Support
9.
Child Adolesc Psychiatr Clin N Am ; 31(2): 261-275, 2022 04.
Article in English | MEDLINE | ID: covidwho-2093307

ABSTRACT

Black, Indigenous, and other Youth of Color (BIPOC youth) experience racism from a young age. These experiences have both immediate and long-term impacts on their health and wellbeing. Systemic racism contributes to the inequitable distribution of health resources and other social determinants of health, creating barriers to accessing care. Substance use disorders and sexual/nonsexual risk behaviors have been linked to experiences of racism in BIPOC youth. The legacy of generational racial trauma can frame behaviors and attitudes in the present, undermining health and survival in this group. BIPOC youth also face difficulties navigating spheres characterized as white spaces. Ethnic-racial socialization may promote resilience and help with coping in the context of racial stress. While many professional health organizations have embraced dismantling racism, a shift in the narrative on racial values will be critical for preventing adversity and achieving health equity for BIPOC youth.


Subject(s)
Racism , Adaptation, Psychological , Adolescent , African Americans , Humans , Sexual Behavior , Socialization
10.
J Gen Intern Med ; 37(9): 2323-2326, 2022 07.
Article in English | MEDLINE | ID: covidwho-2075553

ABSTRACT

INTRODUCTION: In the context of marked health disparities affecting historically marginalized communities, medical schools have an obligation to rapidly scale up COVID-19 education through the lens of structural racism. AIM: To develop and implement a virtual curriculum on structural racism in a required COVID-19 course for medical students using "just-in-time" training. SETTING: Academic medical institution during the height of COVID-19 in the spring of 2020. PARTICIPANTS: Three hundred ninety-three 3rd and 4th-year medical students prior to re-entry into clinical care. PROGRAM DESCRIPTION: Three educational sessions focused on (1) racial health disparities, (2) othering and pandemics, and (3) frameworks to address health inequity. The virtual teaching methods included narrated recorded presentations, reflections, and student-facilitated small group dialogue. PROGRAM EVALUATION: In matched pre- and post-surveys, participants reported significant changes in their confidence in achieving the learning objectives and high satisfaction with small group peer facilitation. DISCUSSION: The use of "just-in-time" training exploring the intersection between COVID-19 and structural racism facilitated the delivery of time-relevant and immediately clinically applicable content as students were preparing to re-enter a transformed clinical space. Similar approaches can be employed to adapt to changing healthcare landscapes as academic medical centers strive to build more equitable health systems.


Subject(s)
COVID-19 , Health Equity , Racism , Curriculum , Humans , Systemic Racism
11.
Ethn Dis ; 32(3): 243-256, 2022.
Article in English | MEDLINE | ID: covidwho-2067447

ABSTRACT

Background: Racism persists, underscoring the need to rapidly document the perspectives and experiences of Black, Indigenous and People of Color (BIPOC) groups as well as marginalized populations (eg, formerly incarcerated people) during pandemics. Objective: This methods paper offers a model for using Public Health Critical Race Praxis (PHCRP) and related critical methodologies (ie, feminist and decolonizing methods) to inform the conceptualization, methods, and dissemination of qualitative research undertaken in response to the evolving COVID-19 pandemic. Sample: Using purposive snowball sampling, we identified organizations involved with health equity and social justice advocacy among BIPOC and socially marginalized populations. Focus group participants (N=63) included community members, organizers, activists, and health workers. Design: We conducted topic-specific (eg, reproductive justice) and population-specific (eg, Asian and Pacific Islander) focus groups (N=16 focus groups) in rapid succession using Zoom software. Methods: A self-reflexive, iterative praxis guided theorization, data collection and analysis. We obtained community input on study design, the semi-structured discussion guide, ethical considerations and dissemination. Applying PHCRP, we assessed our assumptions iteratively. We transcribed each interview verbatim, de-identified the data, then used two distinct qualitative techniques to code and analyze them: thematic analysis to identify unifying concepts that recur across focus groups and narrative analysis to keep each participant's story intact. Results: The praxis facilitated relationship-building with partners and supported the iterative assessment of assumptions. Logistical constraints included difficulty ensuring the confidentiality of virtual discussions. Conclusions: These novel approaches provide an effective model for community-engaged qualitative research during a pandemic.


Subject(s)
COVID-19 , Health Equity , Racism , Humans , Pandemics , Public Health/methods , Qualitative Research
12.
PLoS Comput Biol ; 18(10): e1010516, 2022 10.
Article in English | MEDLINE | ID: covidwho-2065097

ABSTRACT

In 2020, the combination of police killings of unarmed Black people, including George Floyd, Breonna Taylor, and Ahmaud Arbery, and the Coronavirus Disease 2019 (COVID-19) pandemic brought about public outrage over long-standing inequalities in society. The events of 2020 ignited global attention to systemic racism and racial inequalities, including the lack of diversity, equity, and inclusion in the academy and especially in science, technology, engineering, mathematics, and medicine (STEMM) fields. Racial and ethnic diversity in graduate programs in particular warrants special attention as graduate students of color report experiencing alarming rates of racism, discrimination, microaggressions, and other exclusionary behaviors. As part of the Graduate Dean's Advisory Council on Diversity (GDACD) at the University of California Merced, the authors of this manuscript held a year-long discussion on these issues and ways to take meaningful action to address these persistent issues of injustices. We have outlined 10 rules to help graduate programs develop antiracist practices to promote racial and ethnic justice, equity, diversity, and inclusion (JEDI) in the academy. We focus on efforts to address systemic causes of the underrepresentation and attrition of students from minoritized communities. The 10 rules are developed to allow graduate groups to formulate and implement rules and policies to address root causes of underrepresentation of minoritized students in graduate education.


Subject(s)
COVID-19 , Racism , COVID-19/epidemiology , COVID-19/prevention & control , Ethnicity , Humans , Pandemics/prevention & control , Racial Groups
13.
Nurs Clin North Am ; 57(3): 453-460, 2022 09.
Article in English | MEDLINE | ID: covidwho-2049058

ABSTRACT

Health equity endorses that all persons are respected equally, and society must exert intentional efforts to eradicate inequities. Race, frequently taught as an impartial risk factor for disease, is a facilitator of structural inequities stemming from racist policies. Nursing educators must help students understand the impact of structural racism on patient populations, communities, and society at large. This article illustrates the face of structural racism, highlights how structural racism impacts health care outcomes, and provides meaningful ways for educators to unmute racism and facilitate race-related discourse in the classroom to counter the impact of structural racism on health equity.


Subject(s)
Health Equity , Racism , Humans , Racism/prevention & control , Systemic Racism
14.
Nurse Educ Pract ; 64: 103459, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2042054

ABSTRACT

AIM: This study aimed to explore the thoughts and feelings of Asian American nursing students regarding Anti-Asian racism that they might anticipate or experience during their clinical training. BACKGROUND: Asian Americans have long been viewed as perpetual foreigners and coronavirus disease 2019 has reinforced that negative view. Asian American nursing students may anticipate and experience racial discrimination during their clinical training, which could negatively affect their mental health. DESIGN: This is a qualitative research study using focus group discussions. METHOD: Focus group discussions were conducted over Zoom and audiotaped. The audiotapes were transcribed and validated for accuracy. A thematic analysis was performed using NVivo10. Emerging themes and subthemes were compared and discussed until agreements were made. RESULTS: Nineteen students participated in four focus group meetings, of which, 13 (68 %) had clinical training and six (32 %) were preclinical students. Four major themes emerged: (a) looking forward to hands-on learning opportunities, (b) enduring racial microaggressions, (c) maintaining professionalism in the face of racial microaggressions and (d) standing up for oneself and other Asian American healthcare workers. Preclinical students were anxiously waiting for clinical training so that they could have hands-on learning experiences. They anticipated that anti-Asian racism in clinical settings would be similar to what they had experienced on the streets and therefore, they were not afraid of it. Students who had clinical training reported experiencing a variety of racial microaggressions that varied from "side-eyes" to "verbal assault" and occurred at three levels: patients, nurses and clinical instructors. They reported that most of the microaggressions were familiar to them, but some, especially coming from their clinical instructors, were unique to clinical settings. CONCLUSION: Asian American nursing students experienced racial microaggressions during their clinical training which came from patients, nurses on the unit and their clinical instructors. Nevertheless, the students strove to maintain professionalism and stand up for themselves and other Asian healthcare workers as they gained confidence in clinical knowledge and skills.


Subject(s)
COVID-19 , Racism , Students, Nursing , Aggression/psychology , Asian Americans/psychology , Focus Groups , Humans , Microaggression , Pandemics , Racism/psychology
15.
Cien Saude Colet ; 27(10): 3861-3870, 2022 Oct.
Article in Portuguese, English | MEDLINE | ID: covidwho-2039490

ABSTRACT

Institutional racism is prevalent in the health services in Brazil and is based on concrete power relations that subjugate, dominate and exclude blacks from having adequate access to health care and health institutions. This critical essay analyzes the importance of expanding the debate, and the production of knowledge about the health of the black population (HBP), focusing on two points: the role of the National Policy for the Integral Health of the Black Population (PNSIPN) and the importance of including the skin color item in the health information systems; and the need for a process of permanent training of professionals, including contents related to the understanding of racism as an element of the social determination of health/disease and heir effects. To demonstrate how structural and institutional racism have affected the black population, we bring also examples of the quilombola populations in the context of the Covid-19 pandemic in the country since 2020. It is concluded that the promotion of care, the reduction of inequities and the quality of health care need to undergo changes in several dimensions, such as the strengthening of the SUS, the daily fight against structural and institutional racism, among others.


O racismo institucional impera nos serviços de saúde no Brasil, fundados em relações concretas de poder que subjugam, dominam e excluem negros/as do adequado acesso aos serviços e instituições de saúde. Este ensaio crítico analisa a importância da ampliação do debate e da produção do conhecimento sobre a saúde da população negra (SPN), focando dois pontos: o papel da Política Nacional de Saúde Integral da População Negra (PNSIPN) e a importância da inserção do quesito cor nos sistemas de informação em saúde; e a necessidade de um processo de formação permanente dos/as profissionais, inserindo conteúdos relacionados à compreensão do racismo como um dos elementos de determinação social de saúde/doença e seus efeitos. Para demonstrar como o racismo estrutural e institucional tem afetado a população negra, trazemos também exemplos das populações quilombolas no contexto da pandemia de COVID-19 no país a partir de 2020. Conclui-se que a promoção do cuidado, a redução das iniquidades e a qualidade da atenção à saúde precisam passar por mudanças em várias dimensões, como o fortalecimento do SUS e o combate cotidiano ao racismo estrutural e institucional.


Subject(s)
COVID-19 , Racism , Blacks , Brazil , Humans , Pandemics
16.
Harm Reduct J ; 19(1): 96, 2022 08 25.
Article in English | MEDLINE | ID: covidwho-2038772

ABSTRACT

BACKGROUND: Increased opioid-related morbidity and mortality in racialized communities has highlighted the intersectional nature of the drug policy crisis. Given the racist evolution of the war on drugs and the harm reduction (HR) movement, the aim of this study is to explore racism within harm reduction services through the perspectives of our participants. METHODS: We conducted a qualitative descriptive study to explore the perspectives of racialized service users and providers on racism in the HR movement in the Greater Toronto and Hamilton Area (GTHA). Four racialized service users and four racialized service providers participated in semi-structured interviews that were audio-recorded, transcribed, and analysed thematically. RESULTS: Five themes related to racism in HR were generated: (1) whiteness of harm reduction as a barrier to accessing services, (2) diversifying HR workers as a step towards overcoming distrust, (3) drop-in spaces specific to Black, Indigenous, and people of colour are facilitators to accessing harm reduction, (4) lack of representation in HR-related promotional and educational campaigns, and (5) HR as a frontier for policing. CONCLUSIONS: Our findings suggest that structural and institutional racism are prevalent in HR services within the GTHA, in the form of colour-blind policies and practices that fail to address the intersectional nature of the drug policy crisis. There is a need for local HR organizations to critically reflect and act on their practices and policies, working with communities to become more equitable, inclusive, and accessible spaces for all people who use drugs.


Subject(s)
Harm Reduction , Racism , Analgesics, Opioid , Humans , Police , Qualitative Research
17.
J Health Care Poor Underserved ; 33(3): 1700-1714, 2022.
Article in English | MEDLINE | ID: covidwho-2021445

ABSTRACT

This commentary first provides lists of rationales for and against intervening to flatten an epidemic curve instead of letting the natural spike occur. The context is the U.S. COVID-19 experience, but the analyses apply to any communicable disease epidemic. After briefly exploring various reasons for flatter instead of spiked curves, it explores in detail the observation that flattened curves increase risks to essential workers and low-income and minority populations. Racism is the specific form of inequality highlighted, because discussions of race currently dominate civic discourse and have generated important new literature. Three forms of racism/inequality are distinguished: simple, systemic or institutional, and structural. Structural racism is distinct from the other forms by lacking intentionality, rendering praise or blame inappropriate. The commentary concludes that flattening exacerbates structural inequality. Nonetheless, societies should mitigate and compensate victims of inequality due to prolonging an epidemic.


Subject(s)
COVID-19 , Epidemics , Racism , COVID-19/epidemiology , Humans , Minority Groups , Policy
18.
Psychoanal Q ; 91(2): 209-238, 2022.
Article in English | MEDLINE | ID: covidwho-2017070

ABSTRACT

The author focuses on some of her experiences as the COVID-19 pandemic began and her retrospective understanding of those experiences. She describes having drawn on memories from her early life to arrive at this understanding; she discusses how this process has allowed her to move past certain countertransferential obstacles in her clinical work during the early days of the pandemic and to listen to her patients with more optimal analytic attentiveness. The author also discusses concurrent sociopolitical events, such as Donald Trump's presidency and George Floyd's murder, and how these impacted her analytic work. Illustrative clinical vignettes are presented.


Subject(s)
COVID-19 , Psychoanalysis , Psychoanalytic Therapy , Countertransference , Female , Homicide , Humans , Pandemics , Racism , Retrospective Studies
19.
BMC Health Serv Res ; 22(1): 1113, 2022 Sep 02.
Article in English | MEDLINE | ID: covidwho-2009393

ABSTRACT

BACKGROUND: Despite a publicly funded system, health care in Canada has been shown to be deeply inequitable, particularly toward Indigenous people. Based on research identifying key dimensions of equity-oriented health care as being cultural safety, harm reduction and trauma- and violence-informed care, an intervention to promote equity at the organizational level was tested in primary health care, refined and adapted, and tested in Emergency Departments (EDs). METHODS: In partnership with clinical, community and Indigenous leaders in three diverse EDs in one Canadian province, we supported direct care staff to tailor and implement the intervention. Intervention activities varied in type and intensity at each site. Survey data were collected pre- and post-intervention from every consecutive patient over age 18 presenting to the EDs (n = 4771) with 3315 completing post-visit questions in 4 waves at two sites and 3 waves (due to pandemic constraints) at the third. Administrative data were collected for 12 months pre- and 12 months post-intervention. RESULTS: Throughout the study period, the participating EDs were dealing with a worsening epidemic of overdoses and deaths related to a toxic drug supply, and the COVID 19 pandemic curtailed both intervention activities and data collection. Despite these constraints, staff at two of the EDs mounted equity-oriented intervention strategies; the other site was experiencing continued, significant staff shortages and leadership changeover. Longitudinal analysis using multiple regression showed non-significant but encouraging trends in patient perceptions of quality of care and patient experiences of discrimination in the ED. Subgroup analysis showed that specific groups of patients experienced care in significantly different ways at each site. An interrupted time series of administrative data showed no significant change in staff sick time, but showed a significant decrease in the percentage of patients who left without care being completed at the site with the most robust intervention activities. CONCLUSIONS: The trends in patient perceptions and the significant decrease in the percentage of patients who left without care being completed suggest potential for impact. Realization of this potential will depend on readiness, commitment and resources at the organizational and systems levels. TRIAL REGISTRATION: Clinical Trials.gov #NCT03369678 (registration date November 18, 2017).


Subject(s)
COVID-19 , Racism , Adolescent , COVID-19/epidemiology , Canada , Delivery of Health Care , Emergency Service, Hospital , Humans , Racism/prevention & control , Violence
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