This article advances the concept of racialized legal status (RLS) as an overlooked dimension of social stratification with implications for racial/ethnic health disparities. We define RLS as a ...social position based on an ostensibly race-neutral legal classification that disproportionately impacts racial/ethnic minorities. To illustrate the implications of RLS for health and health disparities in the United States, we spotlight existing research on two cases: criminal status and immigration status. We offer a conceptual framework that outlines how RLS shapes disparities through (1) primary effects on those who hold a legal status and (2) spillover effects on racial/ethnic in-group members, regardless of these individuals' own legal status. Primary effects of RLS operate by marking an individual for material and symbolic exclusion. Spillover effects result from the vicarious experiences of those with social proximity to marked individuals, as well as the discredited meanings that RLS constructs around racial/ethnic group members. We conclude by suggesting multiple avenues for future research that considers RLS as a mechanism of social inequality with fundamental effects on health.
•Racialized legal status (RLS) is a social position with fundamental health effects.•RLS stems from neutral laws exerting disparate impact on racial/ethnic minorities.•Reviews impact of two RLSs—criminal and immigration statuses—on health disparities.•Identifies individual- and group-level pathways through which RLS impacts health.•Suggests future research on how RLS shapes racial/ethnic health disparities.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
The diversity of the US physician workforce lags significantly behind the population, and the disparities in academic medicine are even greater, with underrepresented in medicine (URM) physicians ...accounting for only 6.8% of all US medical school faculty. We describe a "for URM by URM" pilot approach to faculty development for junior URM Family Medicine physicians that targets unique challenges faced by URM faculty.
A year-long fellowship was created for junior URM academic clinician faculty with funding through the Society of Teachers of Family Medicine Project Fund. Seven junior faculty applied and were accepted to participate in the fellowship, which included conference calls and an in-person workshop covering topics related to writing and career advancement.
The workshop included a mix of prepared programming on how to move from idea to project to manuscript, as well as time for spontaneous mentorship and manuscript collaboration. Key themes that emerged included how to address the high cost of the minority tax, the need for individual passion as a pathway to success, and how to overcome imposter syndrome as a hindrance to writing.
The "for URM by URM" approach for faculty development to promote writing skills and scholarship for junior URM Family Medicine physicians can address challenges faced by URM faculty. By using a framework that includes the mentors' lived experiences and creates a psychological safe space, we can address concerns often overlooked in traditional skills-based faculty development programs.
Using data from the first national probability sample of Black, White, and Latinx sexual minority people in the United States, we examined whether and how sexual identity development timing and ...pacing differs across demographic subgroups at the intersections of cohort, sex, sexual identity, and race/ethnicity. Among a sample of 1,491 participants aged 18-60 from 3 distinct birth cohorts, we measured participants' ages of sexual identity development milestones, including first same-sex attraction, first self-realization of a sexual minority identity, first same-sex sexual behavior, first disclosure to a straight friend, and first disclosure to a family member. Participants from more recent cohorts reported earlier and accelerated pacing of milestones relative to those from older cohorts. Subgroups defined by sex and sexual identity varied in milestone timing and pacing, with gay males reporting an earlier onset of some milestones than other subgroups. Those who used newer identity labels (e.g., pansexual, queer) reported younger ages of milestones relative to bisexual participants but similar ages to lesbian and gay participants. Black and Latinx participants reported some milestones at younger ages than White participants. Race-stratified models testing groups at the intersection of cohort, sex, and sexual identity revealed subgroup differences in ages of first disclosure to family, as well as differences in the time between self-realization, same-sex sexual behavior, and disclosure to a straight friend. The results suggest substantial variation in the developmental timing and pacing of milestones across social identities and the need to further examine how milestone timing is related to identity, stress, and health.
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
This study investigates the same‐day associations between discrimination and sleep among 350 adolescents ages 13–15 (M = 14.29, SD = 0.65; Asian = 41%, Black = 22%, Latinx = 37%). Assessing sleep ...duration, sleep onset latency, and wake minutes after sleep onset using wrist actigraphy, Black adolescents slept 35 min less than Asian and 36 min less than Latinx youth. Black adolescents suffered the most wake minutes after sleep onset, followed by Latinx and Asian youth. Latinx youth reported the highest levels of sleep disturbance, whereas Asian youth reported the highest levels of daytime dysfunction. Daily discrimination was associated with lower levels of same‐night sleep onset latency, more sleep disturbance, more next‐day daytime dysfunction, and higher next‐day daytime sleepiness.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
Positive contact predicts reduced prejudice, but negative contact may increase prejudice at a stronger rate. The current project builds on this work in four ways: establishing an understanding of ...contact that is grounded in subjective experience, examining the affective mediators involved in the negative contact–prejudice relationship, extending research on the effects of positive and negative contact to minority groups, and examining the contact asymmetry experimentally. Study 1 introduced anger as a mediator of the relationships between positive and negative contact and prejudice among White Americans (N = 371), using a contact measure that reflected the frequency and intensity of a wide range of experiences. Study 2 found a contact asymmetry among Black and Hispanic Americans (N = 365). Study 3 found initial experimental evidence of a contact asymmetry (N = 309). We conclude by calling for a more nuanced understanding of intergroup contact that recognizes its multifaceted and subjective nature.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected racial and ethnic minority groups, with high rates of death in African American, Native American, and LatinX ...communities. Although the mechanisms of these disparities are being investigated, they can be conceived as arising from biomedical factors as well as social determinants of health. Minority groups are disproportionately affected by chronic medical conditions and lower access to healthcare that may portend worse COVID-19 outcomes. Furthermore, minority communities are more likely to experience living and working conditions that predispose them to worse outcomes. Underpinning these disparities are long-standing structural and societal factors that the COVID-19 pandemic has exposed. Clinicians can partner with patients and communities to reduce the short-term impact of COVID-19 disparities while advocating for structural change.
Coronavirus disease 2019 (COVID-19) pandemic in the United States exposed racial disparities in morbidity and mortality. African Americans, LatinX, and Native Americans are disproportionately impacted by the disease due to biomedical and social factors brought by structural injustices.
Older minority individuals are less likely to receive adequate health care than their white counterparts. This study investigates whether perceived racism is associated with delayed/forgone care ...among minority older adults, and whether poor doctor communication mediates this relationship.
Study cohort consisted of minority participants, aged ≥65 years, in the 2015 California Health Interview Survey (N=1,756). Authors obtained data in November 2017, and statistical analyses were performed from February to April 2018. Multivariable logistic regression analyses were conducted with relevant covariates, including insurance coverage, years living in the U.S., and language. A mediation analysis was also performed.
Among minority older individuals, perceived racism was significantly associated with delayed/forgone care (AOR=3.92, 95% CI=1.38, 11.15, p=0.010). Poor doctor communication significantly and partially mediated the relationship (AOR=3.64, 95% CI=1.30, 10.21, p=0.014), accounting for 9.9% of the total effect.
Perceived racism may contribute to health disparities for older minority individuals in part through doctors communicating messages that discourage adequate utilization of health care. Future research should explore culturally sensitive communication skills that reduce this barrier to receiving adequate health care.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Genetic testing for risk of hereditary cancer can help patients to make important decisions about prevention or early detection. US and UK studies show that people from ethnic minority groups are ...less likely to receive genetic testing. It is important to understand various groups' awareness of genetic testing and its acceptability to avoid further disparities in health care. This review aims to identify and detail awareness, knowledge, perceptions, and attitudes towards genetic counselling/testing for cancer risk prediction in ethnic minority groups.
A search was carried out in PsycInfo, CINAHL, Embase and MEDLINE. Search terms referred to ethnicity, genetic testing/counselling, cancer, awareness, knowledge, attitudes, and perceptions. Quantitative and qualitative studies, written in English, and published between 2000 and 2015, were included.
Forty-one studies were selected for review: 39 from the US, and two from Australia. Results revealed low awareness and knowledge of genetic counselling/testing for cancer susceptibility amongst ethnic minority groups including African Americans, Asian Americans, and Hispanics. Attitudes towards genetic testing were generally positive; perceived benefits included positive implications for personal health and being able to inform family. However, negative attitudes were also evident, particularly the anticipated emotional impact of test results, and concerns about confidentiality, stigma, and discrimination. Chinese Australian groups were less studied, but of interest was a finding from qualitative research indicating that different views of who close family members are could impact on reported family history of cancer, which could in turn impact a risk assessment.
Interventions are needed to increase awareness and knowledge of genetic testing for cancer risk and to reduce the perceived stigma and taboo surrounding the topic of cancer in ethnic minority groups. More detailed research is needed in countries other than the US and across a broader spectrum of ethnic minority groups to develop effective culturally sensitive approaches for cancer prevention.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Experimental evidence for tipping points in social convention Centola, Damon; Becker, Joshua; Brackbill, Devon ...
Science (American Association for the Advancement of Science),
2018-Jun-08, 2018-06-08, 20180608, Volume:
360, Issue:
6393
Journal Article
Peer reviewed
Open access
Theoretical models of critical mass have shown how minority groups can initiate social change dynamics in the emergence of new social conventions. Here, we study an artificial system of social ...conventions in which human subjects interact to establish a new coordination equilibrium. The findings provide direct empirical demonstration of the existence of a tipping point in the dynamics of changing social conventions. When minority groups reached the critical mass-that is, the critical group size for initiating social change-they were consistently able to overturn the established behavior. The size of the required critical mass is expected to vary based on theoretically identifiable features of a social setting. Our results show that the theoretically predicted dynamics of critical mass do in fact emerge as expected within an empirical system of social coordination.
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BFBNIB, NMLJ, NUK, ODKLJ, PNG, SAZU, UL, UM, UPUK
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