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Disaster Medicine and Public Health... Mar 2023Coronavirus disease 2019 (COVID-19) and future pandemics have become a reality, and planners must understand how attitudes during COVID-19 may influence future...
OBJECTIVE
Coronavirus disease 2019 (COVID-19) and future pandemics have become a reality, and planners must understand how attitudes during COVID-19 may influence future preparedness activities. This study explores how personal experiences of Americans during the pandemic, attitudes about institutions, and views of social change could either pose challenges or help with planning for the next pandemic.
METHODS
A longitudinal survey capturing health attitudes and COVD-19-related experiences was fielded 3 times over the course of the pandemic among historically underserved individuals in US society (racial/ethnic minority and low-income populations).
RESULTS
COVID-19-related experiences increased over time. Attitudes about federal and state government and businesses' ability to respond to the pandemic varied by COVID-19-related experience and having any COVID-19-related experience was associated with a lower likelihood of reporting positive attitudes about institutions. Respondents generally perceived that COVID-19 presented an opportunity for positive social change, and those with COVID-19-related experiences had the greatest likelihood of selecting "reduce income inequality" as their top prioritized change. Those with COVID-19-related experiences were less likely to endorse other policy priorities such as protecting freedoms.
CONCLUSIONS
Anticipating potential backlash or other sentiments could improve pandemic responsiveness. Strengthening public institutions is crucial to ensuring their effectiveness during a pandemic. Pandemic planning could exploit opportunities to take other social policy actions where views seem to converge.
Topics: Humans; United States; COVID-19; Pandemics; Ethnicity; Minority Groups; Social Media; Attitude to Health
PubMed: 36927518
DOI: 10.1017/dmp.2023.38 -
BMC Public Health Mar 2022In older adults, including those with a migrant background, ill health is associated with less internet use. However, it is not known what are the specific...
BACKGROUND
In older adults, including those with a migrant background, ill health is associated with less internet use. However, it is not known what are the specific self-perceived barriers to internet use among older migrants with different health conditions. The aim of this study was to investigate the associations between different health conditions and self-perceived barriers to internet use among older migrants.
METHODS
We used the Care, Health and Ageing of Russian-speaking Minority in Finland (CHARM) study, which is a nationally representative survey of community-dwelling Russian-speaking adults aged ≥50 years living in Finland (N=1082, 57% men, mean age 63.2 years, standard deviation 8.4 years, response rate 36%). Postal survey data were collected in 2019. Health indicators were self-rated health (SRH), depressive symptoms, cognitive functioning, and doctor-diagnosed conditions. Linear regression analyses were used to investigate the associations between health indicators and a summary scale consisting of the following barriers of internet use: (1) internet use is too complicated and hard to learn; (2) having concerns about safety issues; (3) internet use is too expensive; (4) physical limitations hinder the internet use; (5) memory problems hinder the internet use. In addition, the two most commonly reported barriers (the first two) were examined separately using logistic regression analyses. The analyses were adjusted for age, sex, education, marital status, local language proficiency, and income support, and the health conditions, and were performed with weights accounting for the survey design and non-response.
RESULTS
After adjustments, spine/back problems (b=0.13; p=0.049), depressive symptoms (b=0.40; p=0.007), and problems in learning new things (b=0.60; p<0.0005) were associated with higher level of overall barriers to internet use. In addition, a number of health conditions were associated with individual barriers, albeit some health conditions appeared protective.
CONCLUSIONS
In general, older migrants with declining health experience more barriers to internet use than their counterparts with better health. To provide better access to healthcare for older adults, including older migrants, rapidly changing devices, software and apps need to be modified and adapted for those with specific health-related needs.
Topics: Aged; Aging; Female; Humans; Internet; Internet Use; Male; Middle Aged; Minority Groups; Surveys and Questionnaires; Transients and Migrants
PubMed: 35321678
DOI: 10.1186/s12889-022-12874-x -
American Society of Clinical Oncology... Jun 2023The theme of the 2023 American Society of Clinical Oncology Annual Meeting is Partnering With Patients: The Cornerstone of Cancer Care and Research. As we aim to partner...
The theme of the 2023 American Society of Clinical Oncology Annual Meeting is Partnering With Patients: The Cornerstone of Cancer Care and Research. As we aim to partner with patients to improve their health care, digital tools have the potential to enhance patient-centered cancer care and make clinical research more accessible and generalizable. Using electronic patient-reported outcomes (ePROs) to collect patients' reports of symptoms, functioning, and well-being facilitates patient-clinician communication and improves care and outcomes. Early studies suggest that racial and ethnic minority populations, older patients, and patients with less education may benefit even more from ePRO implementation. Clinical practices looking to implement ePROs can refer to the resources of the PROTEUS Consortium (Patient-Reported Outcomes Tools: Engaging Users & Stakeholders). Beyond ePROs, in response to the COVID-19 pandemic, cancer practices have rapidly adopted other digital tools (eg, telemedicine, remote patient monitoring). As implementation grows, we must be aware of the limitations of these tools and implement them in ways to promote optimal function, access, and ease of use. Infrastructure, patient, provider, and system-level barriers need to be addressed. Partnerships across all levels can inform development and implementation of digital tools to meet the needs of diverse groups. In this article, we describe how we use ePROs and other digital health tools in cancer care, how digital tools can expand access to and generalizability of oncology care and research, and prospects for broader implementation and use.
Topics: Humans; Ethnicity; Health Equity; Pandemics; Minority Groups; COVID-19; Patient Reported Outcome Measures; Neoplasms
PubMed: 37290027
DOI: 10.1200/EDBK_390678 -
The Journal of Bone and Joint Surgery.... Dec 2022In the United States, female and minority representation in the field of orthopaedic surgery remains low, and there are few reports regarding orthopaedic society...
BACKGROUND
In the United States, female and minority representation in the field of orthopaedic surgery remains low, and there are few reports regarding orthopaedic society leadership composition, selection criteria, and academic participation. We aimed to determine the demographic composition of national orthopaedic societies and report the academic participation metrics of leadership.
METHODS
This was a mixed-methods study using surveys and publicly available data from national orthopaedic societies for the 2020 to 2021 year. Twenty-four orthopaedic society websites were queried for their transparency in leadership selection and demographic information, including sex, racial, and ethnic composition of overall society and board membership. Data were collected regarding the academic participation of board leadership.
RESULTS
In total, 19 (79%) of the 24 national orthopaedic societies publish survey data regarding sex and racial demographics. One society elected not to participate, and there was no response from 4 others. Sixteen (89%) of the societies collect sex-related data from their membership, and 19 (100%) report sex-related data for their board members. Five (28%) collect data regarding the race and ethnicity of their general membership, and 10 (53%) report data regarding the race and ethnicity of board members. The average membership was 89% male and 11% female, and the leadership boards were 86% male and 14% female. In the societies that reported on race and ethnicity, on average, 80% of the members were White and 85% of the board members were White. Few societies (13%) publicly list their presidential nominating criteria, and none list their criteria for nonpresidential-line positions. Female sex and ≤10 years in practice were significantly associated with lower Hirsch index (h-index) scores, but these differences dissipated beyond 10 years.
CONCLUSIONS
There is a lack of sex, racial, and ethnic diversity in orthopaedic society leadership. More robust recording of these data by societies can help track improvements in diversity among members and leaders. Academic participation may be one component of leadership selection, but other factors play an important role. Overall transparency of leadership selection criteria could be clarified among orthopaedic societies.
Topics: Humans; Male; Female; United States; Orthopedics; Leadership; Ethnicity; Minority Groups; Orthopedic Procedures; Societies, Medical
PubMed: 35833633
DOI: 10.2106/JBJS.21.01395 -
Development and Psychopathology Aug 2023Substance use increases throughout adolescence, and earlier substance use may increase risk for poorer health. However, limited research has examined whether stress...
Substance use increases throughout adolescence, and earlier substance use may increase risk for poorer health. However, limited research has examined whether stress responses relate to adolescent substance use, especially among adolescents from ethnic minority and high-adversity backgrounds. The present study assessed whether blunted emotional and cortisol responses to stress at age 14 related to substance use by ages 14 and 16, and whether associations varied by poverty status and sex. A sample of 277 Mexican-origin youth (53.19% female; 68.35% below the poverty line) completed a social-evaluative stress task, which was culturally adapted for this population, and provided saliva samples and rated their anger, sadness, and happiness throughout the task. They also reported whether they had ever used alcohol, marijuana, cigarettes, and vaping of nicotine at age 14 and again at age 16. Multilevel models suggested that blunted cortisol reactivity to stress was associated with alcohol use by age 14 and vaping nicotine by age 16 among youth above the poverty line. Also, blunted sadness and happiness reactivity to stress was associated with use of marijuana and alcohol among female adolescents. Blunted stress responses may be a risk factor for substance use among youth above the poverty line and female adolescents.
Topics: Humans; Adolescent; Female; Male; Ethnicity; Nicotine; Hydrocortisone; Minority Groups; Substance-Related Disorders; Stress, Psychological
PubMed: 35758286
DOI: 10.1017/S0954579422000244 -
Psychoneuroendocrinology Jul 2021Sexually-diverse individuals (those who seek sexual or romantic relationships with the same and/or multiple genders) and gender-diverse individuals (those whose gender... (Review)
Review
Sexually-diverse individuals (those who seek sexual or romantic relationships with the same and/or multiple genders) and gender-diverse individuals (those whose gender identity and/or expression differs from their birth-assigned sex/gender) have disproportionately high physical health problems, but the underlying biological causes for these health disparities remain unclear. Building on the minority stress model linking social stigmatization to health outcomes, we argue that systemic inflammation (the body's primary response to both physical and psychological threats, indicated by inflammatory markers such as C-reactive protein and proinflammatory cytokines) is a primary biobehavioral pathway linking sexual and gender stigma to physical health outcomes. Expectations and experiences of social threat (i.e., rejection, shame, and isolation) are widespread and chronic among sexually-diverse and gender-diverse individuals, and social threats are particularly potent drivers of inflammation. We review research suggesting that framing "minority stress" in terms of social safety versus threat, and attending specifically to the inflammatory consequences of these experiences, can advance our understanding of the biobehavioral consequences of sexual and gender stigma and can promote the development of health promoting interventions for this population.
Topics: Gender Identity; Health Status Disparities; Humans; Inflammation; Minority Groups; Sexual Behavior; Sexual and Gender Minorities; Social Marginalization; Social Stigma
PubMed: 34090051
DOI: 10.1016/j.psyneuen.2021.105215 -
Medical Education Online Dec 2024This mixed-methods study quantified and characterized incidents of microaggressions experienced by Asian American medical students. The authors report on their impact... (Review)
Review
PURPOSE
This mixed-methods study quantified and characterized incidents of microaggressions experienced by Asian American medical students. The authors report on their impact and suggest improvements to create a more equitable and supportive learning environment.
METHOD
Quantitative and qualitative data were collected from 305 participants who self-identified as Asian American or Pacific Islander. An online, anonymous survey was sent to US medical students through the Asian Pacific American Medical Student Association (APAMSA). Questions explored incidence, characteristics of, and response to microaggressions. We conducted four focus groups to further characterize students' experiences. Data were organized and coded, and thematic analysis was used to identify core themes.
RESULTS
Racial microaggressions were prevalent among Asian American medical students. Nearly 70% ( = 213) of survey respondents reported experiencing at least one incident during their medical training to date. The most common perpetrators were patients ( = 151, 70.9%) and fellow medical students ( = 126, 59.2%), followed by professors ( = 90, 42.3%). The most prevalent themes included being perceived as a perpetual foreigner, the assumption of timidness, and ascription of the model minority myth. Students rarely reported the incident and usually did not respond immediately due to fear of retaliation, uncertainties about the experience or how to respond appropriately, and perception that they would bear the burden of advocacy alone. Experiences with microaggressions led to feelings of frustration and burnout and had a negative impact on mental health. Recommendations were made to improve the anonymous reporting systems in medical schools, and to increase diversity and inclusion in medical education and leadership.
CONCLUSIONS
Asian American medical students face high exposure to racial microaggressions during their medical education that adversely impact their mental health. Changes are needed in medical training to create a more equitable and inclusive learning environment.
Topics: Humans; Asian; Microaggression; Minority Groups; Students, Medical; Racism; Psychological Well-Being
PubMed: 38159282
DOI: 10.1080/10872981.2023.2299534 -
Maternal and Child Health Journal Aug 2022The Maternal and Child Health (MCH) Pipeline Training Program, promotes development of a diverse health workforce by training undergraduate students from...
INTRODUCTION
The Maternal and Child Health (MCH) Pipeline Training Program, promotes development of a diverse health workforce by training undergraduate students from underrepresented minorities. We aimed to evaluate the success of this program based on three domains: (1) demographic characteristics, (2) academic and career development, and (3) attitudes towards the field of MCH and the training programs among graduates.
METHODS
Three domains of success were determined through a collaborative effort between current program directors and the funding agency project officers. The survey with questions related to the three domains was distributed via an online platform to graduates from seven sites (one former site and six current sites). Data were analyzed and presented utilizing descriptive statistics.
RESULTS
The survey was distributed to 550 graduates, 162 responded (37% response rate). Demographically, 78% were female, 54% were Black/African American, 22% were Latinx and 83% did not report any disability. Eighty percent of respondents applied to graduate/professional schools, 67% received admission. Graduates often continued to work in MCH fields (70%). Majority felt confident and knowledgeable in the field (89%) and agreed the faculty were supportive at their training sites (90%).
CONCLUSION
The study highlights successes in recruiting from underrepresented minorities, particularly Black/African Americans and first-time college goers in the family into the MCH Pipeline Training Programs. Programs were successful in furthering academic and career development for most trainees. Attitudes towards MCH and the training programs were overwhelmingly positive. Continued support of these programs is critical in addressing health disparities and achieving health equity.
Topics: Career Choice; Child; Child Health; Female; Humans; Male; Minority Groups; Students; Surveys and Questionnaires; Universities
PubMed: 35821359
DOI: 10.1007/s10995-022-03458-7 -
Maternal and Child Health Journal Jul 2022The Maternal and Child Health (MCH) Pipeline Training Program, promotes development of a diverse health workforce by training undergraduate students from...
INTRODUCTION
The Maternal and Child Health (MCH) Pipeline Training Program, promotes development of a diverse health workforce by training undergraduate students from underrepresented minorities. We aimed to evaluate the success of this program based on three domains: (1) demographic characteristics, (2) academic and career development, and (3) attitudes towards the field of MCH and the training programs among graduates.
METHODS
Three domains of success were determined through a collaborative effort between current program directors and the funding agency project officers. The survey with questions related to the three domains was distributed via an online platform to graduates from seven sites (one former site and six current sites). Data were analyzed and presented utilizing descriptive statistics.
RESULTS
The survey was distributed to 550 graduates, 162 responded (37% response rate). Demographically, 78% were female, 54% were Black/African American, 22% were Latinx and 83% did not report any disability. Eighty percent of respondents applied to graduate/professional schools, 67% received admission. Graduates often continued to work in MCH fields (70%). Majority felt confident and knowledgeable in the field (89%) and agreed the faculty were supportive at their training sites (90%).
CONCLUSION
The study highlights successes in recruiting from underrepresented minorities, particularly Black/African Americans and first-time college goers in the family into the MCH Pipeline Training Programs. Programs were successful in furthering academic and career development for most trainees. Attitudes towards MCH and the training programs were overwhelmingly positive. Continued support of these programs is critical in addressing health disparities and achieving health equity.
Topics: Career Choice; Child; Child Health; Female; Humans; Male; Minority Groups; Students; Surveys and Questionnaires; Universities
PubMed: 35192126
DOI: 10.1007/s10995-021-03370-6 -
Frontiers in Cellular and Infection... 2020Human cytomegalovirus (HCMV) infects ~50% of adults in the United States. HCMV infections may cause vascular inflammation leading to cardiovascular disease, but the...
Human cytomegalovirus (HCMV) infects ~50% of adults in the United States. HCMV infections may cause vascular inflammation leading to cardiovascular disease, but the existing evidence is inconsistent. We investigated demographic predictors of HCMV infection and explored associations between HCMV infection status, the intensity of anti-HCMV Immunoglobulin G (IgG) antibody response, and biomarkers of inflammation and endothelial function which are known predictors of cardiovascular disease. We conducted a cross-sectional study of 694 adults residing in the Raleigh-Durham-Chapel Hill, NC metropolitan area. Serum samples were tested for IgG antibody response to HCMV, and for biomarkers of vascular injury including soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1 (sVCAM-1), C-reactive protein (CRP), and serum amyloid A (SAA). Associations between HCMV and biomarker levels were analyzed using two approaches with HCMV serostatus modeled as a binary variable and as an ordinal variable with five categories comprised of seronegative individuals and quartiles of anti-HCMV antibody responses in seropositive individuals. HCMV seroprevalence in the study population was 56%. Increased body mass index, increased age, female gender, racial/ethnic minority status, and current smoking were significantly associated with HCMV seropositivity in a multivariate regression analysis. HCMV seropositivity was also associated with 9% (95% confidence interval 4-15%) and 20% (0.3-44%) increases in median levels of sICAM-1 and CRP, respectively, after adjusting for covariates. The association between HCMV seropositivity and median levels of sVCAM-1 and SAA were positive but not statistically significant. Significant positive associations were observed between the intensity of anti-HCMV IgG responses and levels of sICAM-1 and sVCAM-1 (-values 0.0008 and 0.04 for linear trend, respectively). To our knowledge, this is the first epidemiological study to show a relationship between anti-HCMV IgG responses and vascular injury biomarkers sICAM-1 and sVCAM-1 in the general population. HCMV infections are associated with vascular injury and inflammation biomarkers in adult residents of North Carolina.
Topics: Adult; Age Factors; Biomarkers; C-Reactive Protein; Cross-Sectional Studies; Cytomegalovirus Infections; Ethnicity; Female; Humans; Intercellular Adhesion Molecule-1; Male; Minority Groups; Risk Factors; Seroepidemiologic Studies; Serum Amyloid A Protein; Vascular Cell Adhesion Molecule-1; Vascular System Injuries
PubMed: 32733818
DOI: 10.3389/fcimb.2020.00334