The impact of racial discrimination on the health of Asian Americans during the COVID-19 pandemic: a scoping review.

ABSTRACTObjective: Cases of discrimination and hate crimes against Asian Americans have surged ever since the beginning of the COVID-19 pandemic, with deleterious effects. This scoping review synthesizes the literature on how pandemic-related discrimination is associated with the health of Asian Americans.Design: First, application search terms were entered into selected databases. Next, using a set of inclusion criteria, the articles were screened and assessed for eligibility. Data from the selected articles were extracted and summarized to answer the research questions.Results: Thirty-five studies were included. Almost all the studies examined psychological well-being. The remaining studies examined physical and workplace well-being. All the studies found that discrimination was associated with poorer health outcomes.Conclusion: Further research is needed to address the gaps in knowledge about how pandemic-related discrimination is associated with various domains of health among Asian Americans.

Medical mistrust among women with intersecting marginalized identities: a scoping review.

The purpose of this scoping review is to synthesize knowledge about medical mistrust and health among women who occupy other marginalized identities; namely women who also belong to one or more of the following social groups: people of color, people of low socioeconomic status, people with disabilities, lesbian and bisexual women, and/or women who have sex with women. This scoping review is based on the methodological framework by Arksey and O'Malley (2005. "Scoping Studies: Towards a Methodological Framework." International Journal of Social Research Methodology 8: 19-32. doi:10.1080/1364557032000119616). Specific search terms were entered into selected databases. Based on a set of inclusion criteria, articles were screened and assessed for eligibility. Data from the selected articles were extracted and summarized. Forty studies were included. Thirty-one studies used quantitative methodology, of which more than half used the Group-Based Medical Mistrust Scale. The majority of studies (84%) investigated the intersection of gender with race and ethnicity. Breast cancer and HIV combined accounted for more than half of the included studies. Of those studies that examined the relationship between medical mistrust and a health outcome or health behavior, almost all reported that medical mistrust had a deleterious impact. Medical mistrust among women with intersecting marginalized identities is worthy of further study, and there is still a dearth of knowledge in the role of medical mistrust among a wide range of subgroups of women and health domains.

The Role of Social Cognition in Medical Decision Making with Asian American Patients.

Asian Americans, the fastest growing racial group in the USA, face a host of major health disparities. There are several reasons for these disparities, and one possible contributor is provider perceptions of Asian Americans, which in turn can affect their medical decision making when treating Asian American patients. There is evidence for the influence of provider perceptions on medical decision making among patients of other racial minority groups; however, literature on Asian American patients is lacking. The present paper addresses this gap in the literature by using social cognitive theory to outline the mechanisms through which provider perception of Asian American patients can affect diagnostic and treatment decisions. These mechanisms include stereotypes and implicit biases, illusory correlations, and cognitive load. Recommendations for future research and policy development are provided.

Healthcare experiences of a Black lesbian in the United States.

Little is known about the healthcare experiences of Black lesbian and bisexual women. This exploratory study examined the healthcare experiences of a 24-year-old Black lesbian and the interconnection between race, ethnicity, gender, and sexual identity in her lived experiences. Data were gathered through an in-depth audio-recorded interview. Findings revealed the risks of and barriers to self-disclosure in healthcare settings, factors that influence the quality of the patient-provider relationship, and the positive and negative healthcare experiences of this Black American lesbian. This study is an important first step in exploring the healthcare experiences of Black lesbian and bisexual women. The findings of this case study highlight themes and avenues for future research. Clinical implications and suggestions for future research are discussed.

Primary Care Providers' Perceptions of Young Cambodian American Female Patients.

There are significant health disparities among Southeast Asian Americans. As an initial step toward understanding the psychosocial factors associated with these disparities, the present study examined primary care providers' perspectives of health status, healthcare utilization, health-related behaviors, and stressors among one subset of Southeast Asian Americans-Cambodian American women between the ages of 18 and 24 years. Interviews with five primary care providers indicated that cultural, historical, psychological and social issues were associated with health outcomes and health behaviors. Results also pointed to clinical considerations and research directions that would improve treatment and understanding of health problems among young Cambodian American women.

Intimate partner violence and physical health outcomes among Southeast Asian American women.

Although intimate partner violence is prevalent among Southeast Asian American women, little is known about the associations between the experience of intimate partner violence and negative health outcomes in this population. Resnick et al. proposed a model explaining the development of health problems following violent assault. This article assesses the applicability of Resnick et al.'s model to Southeast Asian American women who have experienced intimate partner violence by reviewing cultural, historical, and social factors in this population. Our review indicates that the applicability of Resnick et al.'s model to Southeast Asian American women is mixed, with some components of the model fitting well with this population and others requiring a more nuanced and complex perspective. Future studies should take into consideration cultural, historical, and social factors.

The relationship of prejudicial attitudes to psychological, social, and physical well-being within a sample of college students in the United States.

This study examined the relationship of prejudicial attitudes to psychological, social, and physical well-being among 495 college students in the Northeast region of the United States. Prejudicial attitudes included racism, sexism, homophobia, physical disability bias, weight/body-size bias, and anti-immigrant sentiment. As a secondary objective, we examined the associations among the various forms of prejudice and their relationship to key demographic and personal characteristics. We also examined the associations between psychological, social, and physical well-being. The results indicated that specific forms of prejudice, especially racism and sexism, were negative correlates of psychological, social, and/or physical well-being. The results also indicated that there may exist a prejudicial syndrome, linking diverse forms of prejudice. Furthermore, poor functioning in one area of well-being (e.g., psychological health) is related to poor functioning in other areas of well-being (social and physical health). Overall, this study provides important implications for future research and prevention programs in the area of prejudice and well-being.

Cervical cancer screening among Southeast Asian American women.

The incidence of cervical cancer is high among Southeast Asian American women, but their participation in preventive cervical cancer screening is alarmingly low. This paper reviews the literature on factors associated with participation in cervical cancer screening among women of Vietnamese, Cambodian and Hmong descent in the United States. These factors include acculturation, age, marital status, knowledge about cervical cancer, apprehension about cervical cancer screening, financial concerns, access to health care, and physician characteristics and recommendation. Suggestions for future research include the need to investigate the role of physicians treating Southeast Asian American women, the need for more extensive up-to-date studies on the current generation of young Southeast Asian American women, and the use of more advanced assessments of acculturation. Overall, much more work is needed in order to deepen our understanding of the various ways to improve the rate of cervical cancer screening among Southeast Asian American women.

Acculturative and Psychosocial Predictors of Academic-Related Outcomes Among Cambodian American High School Students.

This study examined the acculturative and psychosocial predictors of academic-related outcomes among Cambodian American high school students from an urban school district in the state of Massachusetts. Student participants (N = 163) completed an anonymous survey that assessed demographic characteristics, acculturative experiences, intergenerational conflict, depression, and academic-related outcomes. The main results indicated that acculturative and psychosocial variables were significant predictors of academic-related outcomes. Specifically, students' Cambodian cultural orientation was positively associated with their beliefs about the utility of education and sense of school membership, while students' Anglo/White cultural orientation was positively associated with their grade point average, educational aspirations, and sense of school membership. Results also indicated that Cambodian cultural orientation was negatively associated with intergenerational conflict, which in turn was associated with depression. This study provides important information to developers of school-based and family-based prevention and intervention programs by highlighting the acculturative challenges and how academic success can be fostered for Cambodian American students.

Ambulatory cardiovascular functioning in healthy postmenopausal women with victimization histories.

Criminal victimization is a prevalent stressor among women, with potentially long-lasting emotional consequences. The present study examined associations among severity of lifetime victimization, current posttraumatic stress disorder (PTSD) symptoms, and ambulatory blood pressure (ABP) and heart rate (AHR) levels and variability. Thirty-nine healthy post-menopausal women who endorsed a history of criminal victimization completed a measure of PTSD symptom severity and participated in an average of 18 h of ambulatory cardiovascular monitoring. PTSD symptom clusters were associated with AHR. Symptom clusters and lifetime victimization severity jointly predicted ABP, with ABP the highest among severely victimized women with high levels of current intrusions. Given the prevalence of criminal victimization, biopsychosocial research on women's cardiovascular disease risk may benefit from increased attention to this stressor and its psychological sequelae.