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Journal of Urban Health : Bulletin of... Feb 2023Recent investments in built environment infrastructure to create healthy communities have highlighted the need for equity and environmental justice. Although the... (Review)
Review
Recent investments in built environment infrastructure to create healthy communities have highlighted the need for equity and environmental justice. Although the benefits of healthy community design (e.g., connecting transportation systems and land use changes) are well established, some reports suggest that these changes may increase property values. These increases can raise the risk of displacement for people with low incomes and/or who are from racial and ethnic minority groups, who would then miss out on benefits from changes in community design. This review scanned the literature for displacement mitigation and prevention measures, with the goal of providing a compilation of available strategies for a wide range of audiences including public health practitioners. A CDC librarian searched the Medline, EbscoHost, Scopus, and ProQuest Central databases, and we identified grey literature using Google and Google Scholar searches. The indexed literature search identified 6 articles, and the grey literature scan added 18 articles. From these 24 total articles, we identified 141 mitigation and prevention strategies for displacement and thematically characterized each by domain using an adapted existing typology. This work provides a well-categorized inventory for practitioners and sets the stage for future evaluation research on the implementation of strategies and practices to reduce displacement.
Topics: Humans; United States; Minority Groups; Ethnicity; Racial Groups
PubMed: 36580236
DOI: 10.1007/s11524-022-00698-4 -
Annals of Family Medicine 2022As a psychiatry residency program director of Asian descent at a historically Black institution, I provided forums for my majority-Black residents to process their...
As a psychiatry residency program director of Asian descent at a historically Black institution, I provided forums for my majority-Black residents to process their feelings about the racial turmoil of the past couple of years. At the same time, I was downplaying anti-Asian racism. This tendency slowed my response to the recent rise of anti-Asian violence and how it affected my Asian residents and others. It comes in part from the flawed stereotype that Asians are model minorities, which influences both Asians and non-Asians alike. I was aware of this stereotype and educated others on it years ago, but it still led to me suppress my own feelings about the violence. Reviewing my past experiences with racism and discussing these issues in my various communities helped me acknowledge my feelings and learn to speak up about this significant issue. Taking anti-Asian racism seriously will validate the experience of a significant proportion of the American population and the medical workforce, and it is one of multiple steps necessary to address it.
Topics: Humans; Learning; Minority Groups; Racism; United States
PubMed: 35879070
DOI: 10.1370/afm.2819 -
BMJ Open Jun 2023This review examined the factors influencing communication and engagement with ethnic and racial minority groups in Australia during the COVID-19 pandemic. It aimed to... (Review)
Review
OBJECTIVES
This review examined the factors influencing communication and engagement with ethnic and racial minority groups in Australia during the COVID-19 pandemic. It aimed to answer two main questions: (1) what communication problems people from these communities typically faced during the pandemic? and (2) what strategies and recommendations were suggested to enhance communication and engagement for ethnic and racial minorities during the current COVID-19 pandemic and any similar events in the future?
DESIGN
Scoping review.
DATA SOURCES
PubMed, EMBASE, Cochrane Library, PsychINFO and CINAHL. Grey literature was searched within organisations' websites and a Google search of key terms.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
We included original research, case studies, reports (including government and charity reports), systematic and scoping articles and literature reviews in English, published from January 2020 to August 2022.
DATA EXTRACTION AND SYNTHESIS
Two researchers independently assessed the literature for eligibility and extracted data from the included literature. The selected papers were analysed and summarised into themes relevant to the research questions. The final review included 38 studies combining published academic papers and grey literature.
RESULTS
Key themes relating to communication and engagement issues included a lack of trust in authority, a lack of access to information and ineffective communication channels and a lack of timely and culturally responsive materials. To reduce the issues, the papers spoke about the key role of community organisations to provide local support and community leaders as trusted spokespersons. Lastly, key recommendations to reduce inequity and strengthen future pandemic responses focused on the need for collaborations and consultations, increasing the number of bilingual workers and supporting community-led communication efforts.
CONCLUSIONS
The insights gained from the activities and experiences documented in this review during the COVID-19 pandemic should be incorporated into future decision-making and interventions to enhance communication and engagement strategies.
Topics: Humans; COVID-19; Ethnic and Racial Minorities; Pandemics; Minority Groups; Communication
PubMed: 37344110
DOI: 10.1136/bmjopen-2022-069552 -
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 -
Journal of Surgical Education 2022Examine underrepresented minority (URM) recruitment and diversity education initiatives provided by residency programs in ophthalmology and other specialties, and...
OBJECTIVE
Examine underrepresented minority (URM) recruitment and diversity education initiatives provided by residency programs in ophthalmology and other specialties, and identify means to support programs as they work to enhance diversity efforts.
DESIGN
Cross-sectional study.
SETTING
Multi-center survey of residency program leadership of the Association of University Professors of Ophthalmology, Johns Hopkins Medicine, University of Utah, and the University of California, Los Angeles.
PARTICIPANTS
Residency program leadership (i.e., residency program directors and associate residency program directors) RESULTS: Our survey response rate was 34% (63/188); 56% percent of responses were from ophthalmology and 44% were from other specialties. Across all specialties, programs with a large number of clinical faculty and trainees were associated with having ≥1 URM resident in their program (p = 0.026 and p = 0.028, respectively). There was no significant difference between ophthalmology and other specialties with regard to the number of URM residents. Ninety-two percent of programs utilized strategies to recruit URM applicants. While certain strategies were more common for ophthalmology than other specialties, information sessions for URM students (62%) and a unique review of all URM residency applicants by a separate committee/person (46%) were most commonly used overall. Although 92% of residency program leadership believed it was highly important for health professionals to receive formal diversity training, only 54% of programs had a diversity education curriculum for both trainees and faculty, 11% had a curriculum for faculty only, and 3% had a curriculum for trainees only. Barriers to implementation of curricula included lack of faculty expertise (30%) and curricular time (30%).
CONCLUSIONS
An overwhelming majority of programs in our study utilized strategies to recruit URM applicants, but 22% had 0 URM residents in their program. To address the reported barriers to diversity education implementation, shared central resources/diversity education toolkits should be created to provide programs with needed support.
Topics: Cross-Sectional Studies; Curriculum; Humans; Internship and Residency; Minority Groups; Surveys and Questionnaires; United States
PubMed: 34952819
DOI: 10.1016/j.jsurg.2021.11.016 -
Clinical Pharmacology and Therapeutics Aug 2019Health disparities exist among minorities in the United States, with differences seen in disease prevalence, mortality, and responses to medications. These differences... (Review)
Review
Health disparities exist among minorities in the United States, with differences seen in disease prevalence, mortality, and responses to medications. These differences are multifactorial with genetic variation explaining a portion of this variability. Pharmacogenomics aims to find the effect of genetic variations on drug response, with the goal of optimizing drug therapy and development. Although genome-wide association studies have been useful in unbiasedly surveying the genome for genetic drivers of clinically relevant phenotypes, most of these studies have been conducted in mainly participants of European and Asian descent, contributing to a growing health disparity in precision medicine. Diversity is important to pharmacogenomic studies, and there may be real advantages to the use of these complex genomes in pharmacogenomics. In this review we will outline some of the advantages and confounders of pharmacogenomics in minorities, describe the role of genetic variation in pharmacologic pathways, and highlight a number of population-specific findings.
Topics: Biotransformation; Health Status Disparities; Humans; Minority Groups; Pharmacogenetics; Pharmacogenomic Variants
PubMed: 31038731
DOI: 10.1002/cpt.1491 -
International Journal of Geriatric... Mar 2022People from ethnic minority backgrounds living with dementia are more likely to be diagnosed later and have less access to health and social care support than their...
INTRODUCTION
People from ethnic minority backgrounds living with dementia are more likely to be diagnosed later and have less access to health and social care support than their White counterparts in the United Kingdom (UK). Covid-19 has exacerbated health inequalities and diminished trust from underserved communities in the government and health services. The wider aim of the study was to explore the impact of covid-19 on Black and South-Asian people living with dementia and their carers as well as exploring the experiences of dementia care. The present paper specifically explores their views on trust and mistrust using an ecological model.
METHOD
Semi-structured interviews were conducted with 11 family carers and four people living with dementia from South Asian or Black communities living in the community. Thematic analysis was used to analyse data.
DESIGN
An exploratory qualiative design was used.
RESULTS
Four main themes were developed exploring trust at the structural, organisational, community and individual level. At the structural level, participants discussed the inequity of Covid-19, some lack of trust in the UK Government and confusion in its messaging, and the anxiety sometimes leading to curtailment of media usage. At the organisational level, there was some evidence of a perceived lack of person-centred and culturally sensitive care from healthcare professionals, as well as concerns around care homes as places of safety. At the neighbourhood community level, participants discussed both a distrust as well as a strengthening of relationships and, at the individual level, factors such as knowledge of services, identity, and faith influenced their experience of the pandemic.
CONCLUSIONS
People living with dementia need support at all levels and this study highlights how the pandemic impacted each level. Ways to improve trust in the Government and health professionals alongside culturally adapted health messaging should be explored. Alongside this, an examination of how cultural values and norms may influence help-seeking responses to dementia and increase trust in services may be helpful post-pandemic.
Topics: COVID-19; Caregivers; Dementia; Ethnicity; Humans; Minority Groups; Pandemics; SARS-CoV-2; Trust; United Kingdom
PubMed: 35137453
DOI: 10.1002/gps.5689 -
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 -
Journal of Clinical Child and... Jan 2008This article reviews research on evidence-based treatments (EBTs) for ethnic minority youth using criteria from Chambless et al. (1998), Chambless et al. (1996), and... (Meta-Analysis)
Meta-Analysis Review
This article reviews research on evidence-based treatments (EBTs) for ethnic minority youth using criteria from Chambless et al. (1998), Chambless et al. (1996), and Chambless and Hollon (1998). Although no well-established treatments were identified, probably efficacious or possibly efficacious treatments were found for ethnic minority youth with anxiety-related problems, attention-deficit/hyperactivity disorder, depression, conduct problems, substance use problems, trauma-related syndromes, and other clinical problems. In addition, all studies met either Nathan and Gorman's (2002) Type 1 or Type 2 methodological criteria. A brief meta-analysis showed overall treatment effects of medium magnitude (d = .44). Effects were larger when EBTs were compared to no treatment (d = .58) or psychological placebos (d = .51) versus treatment as usual (d = .22). Youth ethnicity (African American, Latino, mixed/other minority), problem type, clinical severity, diagnostic status, and culture-responsive treatment status did not moderate treatment outcome. Most studies had low statistical power and poor representation of less acculturated youth. Few tests of cultural adaptation effects have been conducted in the literature and culturally validated outcome measures are mostly lacking. Recommendations for clinical practice and future research directions are provided.
Topics: Acculturation; Adolescent; Black People; Child; Cultural Competency; Ethnicity; Evidence-Based Medicine; Hispanic or Latino; Humans; Mental Disorders; Minority Groups; White People
PubMed: 18444061
DOI: 10.1080/15374410701820174 -
Primary Health Care Research &... Nov 2020The purpose of this paper is to describe the recruitment strategies, the response rates and the reasons for non-response of Malaysian public and private primary care...
AIM
The purpose of this paper is to describe the recruitment strategies, the response rates and the reasons for non-response of Malaysian public and private primary care doctors in an international survey on the quality, cost and equity in primary care.
BACKGROUND
Low research participation by primary care doctors, especially those working in the private sector, is a challenge to quality benchmarking.
METHODS
Primary care doctors were sampled through multi-stage sampling. The first stage-sampling unit was the primary care clinics, which were randomly sampled from five states in Malaysia to reflect their proportions in two strata - sector (public/private) and location (urban/rural). Strategies through endorsement, personalised invitation, face-to-face interview and non-monetary incentives were used to recruit public and private doctors. Data collection was carried out by fieldworkers through structured questionnaires.
FINDINGS
A total of 221 public and 239 private doctors participated in the study. Among the public doctors, 99.5% response rates were obtained. Among the private doctors, a 32.8% response rate was obtained. Totally, 30% of private clinics were uncontactable by telephone, and when these were excluded, the overall response rate is 46.8%. The response rate of the private clinics across the states ranges from 31.5% to 34.0%. A total of 167 answered the non-respondent questionnaire. Among the non-respondents, 77.4 % were male and 22.6% female (P = 0.011). There were 33.6% of doctors older than 65 years (P = 0.003) and 15.9% were from the state of Sarawak (P = 0.016) when compared to non-respondents. Reason for non-participation included being too busy (51.8%), not interested (32.9%), not having enough patients (9.1%) and did not find it beneficial (7.9%). Our study demonstrated the feasibility of obtaining favourable response rate in a survey involving doctors from public and private primary care settings.
Topics: Adult; Aged; Ethnicity; Female; Humans; Malaysia; Male; Middle Aged; Minority Groups; Primary Health Care; Surveys and Questionnaires
PubMed: 33213564
DOI: 10.1017/S1463423620000511