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1.
Nursing ; 52(1): 38-43, 2022 Jan 01.
Article in English | MEDLINE | ID: covidwho-1612691

ABSTRACT

ABSTRACT: This article discusses the interconnection between the syndemic effect of racial inequities and disparities as well as the impact of the COVID-19 pandemic on Black Americans. It also highlights meaningful reforms and priorities to achieve health equity in Black communities.


Subject(s)
COVID-19 , Racism , Health Status Disparities , Healthcare Disparities , Humans , Pandemics , SARS-CoV-2 , Syndemic , United States/epidemiology
2.
J Appl Psychol ; 106(1): 1-3, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1593023

ABSTRACT

It is impossible to write this editorial without recognizing that we are living in challenging times. Unprecedented changes in how, when, where, and with whom we work have occurred in response to the COVID-19 pandemic. In addition to the threat to human life, the pandemic is expected to increase poverty and deepen preexisting inequalities for vulnerable groups such as women (United Nations, 2020) and individuals living in poorer countries (United Nations Development Programme, 2020). In the United States, the pandemic has disproportionately negatively affected racial and ethnic minority group members (https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html). For example, in the United States infection and mortality rates are especially high among African Americans (Yancy, 2020). These sobering realities, along with the recent deaths of George Floyd, Ahmaud Arbery, and Breonna Taylor, and so many others, are vivid and wrenching reminders of longstanding social injustice and systematic racism, both in the United States and around the globe. When preparing my candidate statement and vision for the journal, a global pandemic and widespread social protest were the furthest thing from my mind. However, several aspects of my vision for JAP are highly relevant to the current context. This includes increasing representation and supporting diversity, as well as improving the translation of our science for the public good. Other elements of my vision for the journal include enhancing the review process and promoting open science. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
COVID-19/psychology , Poverty/psychology , Psychology, Applied/methods , Racism/psychology , Social Justice/psychology , /psychology , Humans , Minority Groups/psychology , Pandemics , SARS-CoV-2 , Socioeconomic Factors , United States
4.
Health Promot Int ; 36(6): 1517-1520, 2021 Dec 23.
Article in English | MEDLINE | ID: covidwho-1598780
5.
Br J Soc Psychol ; 61(1): 1-18, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1596965

ABSTRACT

The unexpected transformations produced by the conjunction of COVID-19, the murder of George Floyd and the resurgence of Black Lives Matter highlight the importance of social psychological understandings and the need for a step change in theorization of the social. This paper focuses on racialization. It considers issues that social psychology needs to address in order to reduce inequalities and promote social justice. It draws on theoretical resources of intersectionality and hauntology to illuminate the ways in which social psychological research frequently makes black people visible in ways that exclude them from normative constructions. The final main part of the paper presents an analysis of an interview with the racing driver Lewis Hamilton to illustrate possible ways of humanizing racialization by giving recognition to the multiplicity and historical location of racialized positioning. The paper argues that, while social psychology has made vital contributions to the understanding of group processes and of racisms, there remains a need to humanize racialization by conducting holistic analyses of black people's (and others') intersectional identities.


Subject(s)
COVID-19 , Racism , Humans , Psychology, Social , SARS-CoV-2
6.
N Engl J Med ; 385(27): 2499-2501, 2021 Dec 30.
Article in English | MEDLINE | ID: covidwho-1592290
7.
J Med Internet Res ; 23(2): e25431, 2021 02 10.
Article in English | MEDLINE | ID: covidwho-1574637

ABSTRACT

BACKGROUND: Social media is a rich source where we can learn about people's reactions to social issues. As COVID-19 has impacted people's lives, it is essential to capture how people react to public health interventions and understand their concerns. OBJECTIVE: We aim to investigate people's reactions and concerns about COVID-19 in North America, especially in Canada. METHODS: We analyzed COVID-19-related tweets using topic modeling and aspect-based sentiment analysis (ABSA), and interpreted the results with public health experts. To generate insights on the effectiveness of specific public health interventions for COVID-19, we compared timelines of topics discussed with the timing of implementation of interventions, synergistically including information on people's sentiment about COVID-19-related aspects in our analysis. In addition, to further investigate anti-Asian racism, we compared timelines of sentiments for Asians and Canadians. RESULTS: Topic modeling identified 20 topics, and public health experts provided interpretations of the topics based on top-ranked words and representative tweets for each topic. The interpretation and timeline analysis showed that the discovered topics and their trend are highly related to public health promotions and interventions such as physical distancing, border restrictions, handwashing, staying home, and face coverings. After training the data using ABSA with human-in-the-loop, we obtained 545 aspect terms (eg, "vaccines," "economy," and "masks") and 60 opinion terms such as "infectious" (negative) and "professional" (positive), which were used for inference of sentiments of 20 key aspects selected by public health experts. The results showed negative sentiments related to the overall outbreak, misinformation and Asians, and positive sentiments related to physical distancing. CONCLUSIONS: Analyses using natural language processing techniques with domain expert involvement can produce useful information for public health. This study is the first to analyze COVID-19-related tweets in Canada in comparison with tweets in the United States by using topic modeling and human-in-the-loop domain-specific ABSA. This kind of information could help public health agencies to understand public concerns as well as what public health messages are resonating in our populations who use Twitter, which can be helpful for public health agencies when designing a policy for new interventions.


Subject(s)
Attitude to Health , COVID-19 , Public Health , Racism , Social Media , Canada , Disease Outbreaks , Humans , Natural Language Processing , North America , SARS-CoV-2 , United States
8.
Int J Environ Res Public Health ; 18(24)2021 12 12.
Article in English | MEDLINE | ID: covidwho-1572464

ABSTRACT

The populations impacted most by COVID are also impacted by racism and related social stigma; however, traditional surveillance tools may not capture the intersectionality of these relationships. We conducted a detailed assessment of diverse surveillance systems and databases to identify characteristics, constraints and best practices that might inform the development of a novel COVID surveillance system that achieves these aims. We used subject area expertise, an expert panel and CDC guidance to generate an initial list of N > 50 existing surveillance systems as of 29 October 2020, and systematically excluded those not advancing the project aims. This yielded a final reduced group (n = 10) of COVID surveillance systems (n = 3), other public health systems (4) and systems tracking racism and/or social stigma (n = 3, which we evaluated by using CDC evaluation criteria and Critical Race Theory. Overall, the most important contribution of COVID-19 surveillance systems is their real-time (e.g., daily) or near-real-time (e.g., weekly) reporting; however, they are severely constrained by the lack of complete data on race/ethnicity, making it difficult to monitor racial/ethnic inequities. Other public health systems have validated measures of psychosocial and behavioral factors and some racism or stigma-related factors but lack the timeliness needed in a pandemic. Systems that monitor racism report historical data on, for instance, hate crimes, but do not capture current patterns, and it is unclear how representativeness the findings are. Though existing surveillance systems offer important strengths for monitoring health conditions or racism and related stigma, new surveillance strategies are needed to monitor their intersecting relationships more rigorously.


Subject(s)
COVID-19 , Racism , Humans , SARS-CoV-2 , Social Stigma
9.
Med Educ Online ; 27(1): 1981803, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1528079

ABSTRACT

Coronavirus Disease 2019 (COVID-19) and the social justice movement in early 2020 awakened many Americans to the health disparities and health care inequities affecting Black communities. This heightened awareness has strengthened the call to address social determinants of health, like racism. Physicians can play an important role in dismantling racism through knowledge of implicit biases and understanding of historical trauma resulting in medical distrust as a crucial step to help advance the health of minority communities. The purpose of this project was to develop an anti-racism workshop for Graduate Medical Education. Two discussants led 1.5-hour interactive workshops. Content covered microagressions, colorblindness, tokenism, stereotypes, levels of racism, the impact of racism on health, and anti-racism concepts. Facilitated breakout sessions allowed participants to provide examples of witnessed racism and discuss application of anti-racism tools in those settings. Following the workshops, participants were asked to complete a 16-item survey to evaluate workshop effectiveness. Between July and August 2020, four workshops were delivered to 131 attendees. Fifty-nine completed post workshop surveys. Most respondents were White (75%), female (63%), and aged 31-40 (29%). Over half were faculty; 24% were residents, 8% fellows. The majority agreed they could apply knowledge to their work (95%) and found the workshop useful (95%). Over two-thirds reported being able to better identify disparities and better identify and communicate about racism. In open-ended questions, many participants requested an interactive longitudinal curriculum. Developing an antiracism workshop for an academic medical center located in the Deep South provided more insight into tangible next steps to foster an institutional culture centered on antiracism.


Subject(s)
COVID-19 , Racism , Education, Medical, Graduate , Female , Humans , SARS-CoV-2 , United States , Universities
10.
Ann Intern Med ; 174(9): 1325-1326, 2021 09.
Article in English | MEDLINE | ID: covidwho-1526997
12.
J Public Health Manag Pract ; 28(Suppl 1): S27-S37, 2022.
Article in English | MEDLINE | ID: covidwho-1526225

ABSTRACT

This article outlines a pathway for public health departments and practitioners to incorporate law into their efforts to advance equity in health outcomes. We assert that examining and applying law can accelerate public health efforts to mitigate structural and systemic inequities, including racism. Recent events such as the COVID-19 pandemic and the community impacts of policing have brought into sharp relief the inequities faced by many populations. These stark and explosive examples arise out of long-standing, persistent, and sometimes hidden structural and systemic inequities that are difficult to trace because they are embedded in laws and accompanying policies and practices. We emphasize this point with a case study involving a small, majority Black community in semirural Appalachia that spent almost 50 years attempting to gain access to the local public water system, despite being surrounded by water lines. We suggest that public health practitioners have a role to play in addressing these kinds of public health problems, which are so clearly tied to the ways laws and policies are developed and executed. We further suggest that public health practitioners, invoking the 10 Essential Public Health Services, can employ law as a tool to increase their capacity to craft and implement evidence-based interventions.


Subject(s)
COVID-19 , Health Equity , Racism , Humans , Pandemics , Public Health , Public Health Practice , SARS-CoV-2
13.
J Gen Intern Med ; 36(11): 3545-3549, 2021 11.
Article in English | MEDLINE | ID: covidwho-1525605

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has underscored the structural inequities facing communities of color and its consequences in lives lost. However, little is known about the COVID-related disparities facing Asian Americans amidst the heightened racism and violence against this community. We analyze the mortality toll of COVID-19 on Asian Americans using multiple measures. In 2020, one in seven Asian American deaths was attributable to COVID-19. We find that while Asian Americans make up a small proportion of COVID-19 deaths in the USA, they experience significantly higher excess all-cause mortality (3.1 times higher), case fatality rate (as high as 53% higher), and percentage of deaths attributed to COVID-19 (2.1 times higher) compared to non-Hispanic Whites. Mounting evidence suggest that disproportionately low testing rates, greater disease severity at care presentation, socioeconomic factors, and racial discrimination contribute to the observed disparities. Improving data reporting and uniformly confronting racism are key components to addressing health inequities facing communities of color.


Subject(s)
COVID-19 , Racism , Asian Americans , Health Status Disparities , Healthcare Disparities , Humans , SARS-CoV-2 , United States/epidemiology
14.
CMAJ Open ; 9(4): E998-E1004, 2021.
Article in English | MEDLINE | ID: covidwho-1524570

ABSTRACT

BACKGROUND: Asian Canadians and Asian Americans face COVID-19-related discrimination. The objective of this qualitative study was to explore the experiences of Asian health care workers dealing with discrimination, with a focus on racial micro-agressions, in Canada and the United States during the COVID-19 pandemic. METHODS: We adopted a qualitative descriptive approach. We used convenience and snowball sampling strategies to recruit participants. We conducted individual, in-depth semistructured interviews with Asian health care workers in Canada and the US via videoconferencing between May and September 2020. Eligible participants had to self-identify as Asian and be currently employed as a health care worker with at least 1 year of full-time employment. We used an inductive thematic approach to analyze the data. RESULTS: Thirty participants were recruited. Fifteen (50%) were Canadians and 15 (50%) were Americans; there were 18 women (60%), 11 men (37%) and 1 nonbinary person. Most of the participants were aged 25-29 years (n = 16, 53%). More than half were nurses (n = 16, 53%); the other participants were attending physicians (n = 5), physiotherapists (n = 3), resident physicians (n = 2), a midwife, a paramedic, a pharmacist and a physician assistant. Two themes emerged from the data: a surge of racial microaggressions related to COVID-19 and a lack of institutional and public acknowledgement. Participants noted that they have experienced an increase in racial microaggressions during the COVID-19 pandemic. They have also experienced threats of violence and actual violence. The largely silent organizational response to the challenges being faced by people of Asian descent and the use of disparaging terms such as "China virus" in the early stages of the pandemic were a substantial source of frustration. INTERPRETATION: Asian health care workers have experienced challenges in dealing with racial microaggressions related to COVID-19 in the US and Canada. More research should be done on the experiences of Asian Americans and Asian Canadians, both during and after the pandemic, and supportive measures should be put in place to protect Asian health care workers.


Subject(s)
Asian Americans/psychology , COVID-19/psychology , Health Personnel/psychology , Racism/psychology , Adult , Canada , Female , Humans , Interviews as Topic , Male , Pandemics , Qualitative Research , SARS-CoV-2 , United States , Workplace Violence/psychology , Xenophobia/psychology
15.
Ann Surg ; 274(6): e844-e845, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1522432
16.
Front Public Health ; 9: 772236, 2021.
Article in English | MEDLINE | ID: covidwho-1518583

ABSTRACT

Background: The mental health of racial/ethnic minorities in the U.S. has been disproportionately impacted by the COVID-19 pandemic. This study examined the extent to which disruptions in employment and housing, coronavirus-specific forms of victimization and racial bias independently and conjointly contributed to mental health risk among Asian, Black, and Latinx adults in the United States during the pandemic. Methods: This study reports on data from 401 Asian, Black, and Latinx adults (age 18-72) who participated in a larger national online survey conducted from October 2020-June 2021, Measures included financial and health information, housing disruptions and distress in response to employment changes, coronavirus related victimization distress and perceived increases in racial bias, depression and anxiety. Results: Asian participants had significantly higher levels of COVID-related victimization distress and perceived increases in racial bias than Black and Latinx. Young adults (<26 years old) were more vulnerable to depression, anxiety, and coronavirus victimization distress than older respondents. Having at least one COVID-related health risk, distress in response to changes in employment and housing disruptions, pandemic related victimization distress and perceived increases in racial bias were positively and significantly related to depression and anxiety. Structural equation modeling indicated COVID-related increases in racial bias mediated the effect of COVID-19 related victimization distress on depression and anxiety. Conclusions: COVID-19 has created new pathways to mental health disparities among racial/ethnic minorities in the U.S. by exacerbating existing structural and societal inequities linked to race. Findings highlight the necessity of mental health services sensitive to specific challenges in employment and housing and social bias experienced by people of color during the current and future health crises.


Subject(s)
COVID-19 , Crime Victims , Racism , Adolescent , Adult , Aged , Employment , Housing , Humans , Mental Health , Middle Aged , Pandemics , SARS-CoV-2 , United States/epidemiology , Young Adult
17.
PLoS One ; 16(11): e0259803, 2021.
Article in English | MEDLINE | ID: covidwho-1511832

ABSTRACT

Racial/ethnic disparities are among the top-selective underlying determinants associated with the disproportional impact of the COVID-19 pandemic on human mobility and health outcomes. This study jointly examined county-level racial/ethnic differences in compliance with stay-at-home orders and COVID-19 health outcomes during 2020, leveraging two-year geo-tracking data of mobile devices across ~4.4 million point-of-interests (POIs) in the contiguous United States. Through a set of structural equation modeling, this study quantified how racial/ethnic differences in following stay-at-home orders could mediate COVID-19 health outcomes, controlling for state effects, socioeconomics, demographics, occupation, and partisanship. Results showed that counties with higher Asian populations decreased most in their travel, both in terms of reducing their overall POIs' visiting and increasing their staying home percentage. Moreover, counties with higher White populations experienced the lowest infection rate, while counties with higher African American populations presented the highest case-fatality ratio. Additionally, control variables, particularly partisanship, median household income, percentage of elders, and urbanization, significantly accounted for the county differences in human mobility and COVID-19 health outcomes. Mediation analyses further revealed that human mobility only statistically influenced infection rate but not case-fatality ratio, and such mediation effects varied substantially among racial/ethnic compositions. Last, robustness check of racial gradient at census block group level documented consistent associations but greater magnitude. Taken together, these findings suggest that US residents' responses to COVID-19 are subject to an entrenched and consequential racial/ethnic divide.


Subject(s)
COVID-19/epidemiology , Health Status Disparities , Pandemics , Racism/psychology , African Americans/psychology , Aged , COVID-19/psychology , COVID-19/virology , Humans , Income , Mediation Analysis , Middle Aged , Minority Groups/psychology , Outcome Assessment, Health Care/standards , SARS-CoV-2/pathogenicity
19.
J Occup Environ Med ; 63(11): e813-e818, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1504744

ABSTRACT

The tremendous global toll of the COVID-19 pandemic does not fall equally on all populations. Indeed, this crisis has exerted more severe impacts on the most vulnerable communities, spotlighting the continued consequences of longstanding structural, social, and healthcare inequities. This disparity in COVID-19 parallels the unequal health consequences of climate change, whereby underlying inequities perpetuate adverse health outcomes disproportionately among vulnerable populations. As these two crises continue to unfold, there is an urgent need for healthcare practitioners to identify and implement solutions to mitigate adverse health outcomes, especially in the face of global crises. To support this need, the 2021 Clinical Climate Change Conference held a virtual meeting to discuss the implications of the convergence of the climate crisis and COVID-19, particularly for vulnerable patient populations and the clinicians who care for them. Presenters and panelists provided evidence-based solutions to help health professionals improve and adapt their practice to these evolving scenarios. Together, participants explored the community health system and national solutions to reduce the impacts of COVID-19 and the climate crisis, to promote community advocacy, and foster new partnerships between community and healthcare leaders to combat systemic racism and achieve a more just and equitable society.


Subject(s)
COVID-19 , Racism , Climate Change , Humans , Pandemics , SARS-CoV-2
20.
rev. cuid. (Bucaramanga. 2010) ; 12(2): 1-12, mayo 1, 2021.
Article in Portuguese | LILACS (Americas) | ID: covidwho-1498059

ABSTRACT

Introdução: Devido as iniquidades históricas, o contexto pandêmico do COVID-19 tem impactado de maneira distinta os segmentos sociais, exigindo um acompanhamento especial às minorias étnico-raciais que vivem em situação de vulnerabilidade. Nesse sentido, o estudo tem como objetivo analisar a vulnerabilidade da população negra brasileira frente à evolução da pandemia por COVID-19. Materiais e Métodos: Trata-se de um estudo documental, descritivo, quantitativo, realizada a partir dos boletins epidemiológicos coronavírus publicados pelo Ministério da Saúde do Brasil. Foram avaliadas duas variáveis dos boletins epidemiológicos coronavírus a partir da raça/cor: hospitalizações por síndrome respiratória aguda grave e óbito por Covid-19. Resultados: Entre os boletins nº 9 e nº 18 evidenciou-se o aumento sustentado nas taxas de internação por síndrome respiratória aguda grave (de 23,9% para 54,7%) e óbito (de 34,3% para 61,3%) entre pessoas de raça/cor negra e redução constante na hospitalização (de 73% para 43,3%) e óbito (de 62,9% para 36,5%) entre pessoas brancas. Constata-se que pessoas negras têm maiores chances de internação por SRAG e morte por COVID-19 no Brasil, o que implica maior situação de vulnerabilidade. Discussão: Acredita-se que esse cenário desfavorável entre pessoas negras se deve a dificuldade ou impossibilidade de realização de isolamento social, à prevalência de comorbidades que precipitam quadros graves do COVID-19, as dificuldades no acesso aos serviços de saúde e ao racismo institucional. Conclusão: faz-se necessário a implementação de uma rede de proteção social a esse grupo racial, com o objetivo de reduzir o acometimento da doença e a letalidade do vírus.


Introduction: Due to the historical inequality, the COVID-19 pandemic has impacted social groups differently, which calls for special assistance to ethnic-racial minorities living in a situation of vulnerability. In light of this, this study is aimed to analyze the vulnerability of the black population in Brazil to the evolution of the COVID-19 pandemic. Materials and Methods: A quantitative descriptive study following a documentary method was conducted based on the coronavirus disease epidemiological bulletins published by the Brazilian Ministry of Health. Two variables were assessed from epidemiological bulletins regarding race/color: hospitalizations for severe acute respiratory syndrome and deaths due to COVID-19. Results: A steady increase in rates of hospitalization for severe acute respiratory syndrome (from 23.9% to 54.7%) and death (from 34.3% to 61.3%) was observed among the black population in bulletins 9-18, contrary to the steady decrease in rates of hospitalization (from 73% to 43.3%) and death (from 6.29% to 36.5%) among the white people. It was also found that black people are more likely to be hospitalized for SARS infection and death due to COVID-19 in Brazil, suggesting that they are at a higher vulnerability. Discussion: This unfavorable scenario for the black population is considered to arise from the difficulty or impossibility of social integration, the prevalence of comorbidities that trigger severe COVID-19 forms, difficulties in accessing healthcare services and institutional racism. Conclusion: The implementation of a social protection network is necessary to reduce the disease infection and the mortality of the virus.


Introducción: Debido a la inequidad histórica existente, la pandemia del COVID-19 ha impactado a los grupos sociales de forma diferente, lo que exige un acompañamiento especial a las minorías étnico-raciales que viven en situación de vulnerabilidad. En este sentido, el presente estudio tiene como objetivo analizar la vulnerabilidad de la población negra brasileña frente a la evolución de la pandemia por COVID-19. Materiales y métodos: Se realizó un estudio documental descriptivo de enfoque cuantitativo a partir de los boletines epidemiológicos sobre coronavirus publicados por el Ministerio de Salud de Brasil. Se evaluaron dos variables en los boletines epidemiológicos con base en la raza/color: hospitalizaciones por síndrome respiratorio agudo grave y muertes por COVID-19. Resultados: Entre los boletines 9 y 18 se evidenció un aumento sostenido de las tasas de hospitalización por síndrome respiratorio agudo grave (del 23.9% al 54.7%) y de muerte (del 34.3% al 61.3%) entre la población negra, así como una reducción constante de la tasa de hospitalización (del 73% al 43.3%) y de muerte (del 62.9% al 36.5%) entre la población blanca. Se observó que las personas de raza negra tienen una mayor probabilidad de hospitalización por infección por SARS y muerte por COVID-19 en Brasil, lo que supone que se encuentran en una mayor situación de vulnerabilidad. Discusión: Se considera que este escenario desfavorable para las personas de raza negra se debe a la dificultad o imposibilidad de integración social, la prevalencia de comorbilidades que desencadenan cuadros graves de COVID-19, las dificultades de acceso a los servicios de salud y el racismo institucional. Conclusión: Se hace necesaria la implementación de una red de protección social para este grupo racial a fin de reducir el contagio de la enfermedad y la letalidad del virus.


Subject(s)
Humans , Male , Female , African Continental Ancestry Group , Racism , Betacoronavirus
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