Stigma as a facilitator of the 2022 mpox outbreak.

Disparities in autism research and practices based on race and ethnicity are evident across many outcomes and life course stages. However, most of the research has focused on outlining differences and not the underlying systemic inequities driving these disparities. In this conceptual paper, we aim to shift the focus by outlining mechanisms of structural racism within the institutions of science, healthcare, and residential segregation and educational systems in the United States (U.S.). We argue that these and other forms of institutional racism constitute structural racism that are influencing the racial and ethnic disparities we see in autism services and care. For each of these institutions, we identify institutional racism related to autism and offer an example of how it shapes interpersonal racism and adverse outcomes, including misdiagnosis, delayed diagnosis, unequal access to educational services, and differential treatment in clinical encounters. We then provide anti-racism approaches in autism research and practice for each of these institutions that addresses institutional and interpersonal racism shaping autism inequities among racial and ethnic minorities. We conclude with a call to action to clinicians, researchers, and others to prioritize and disrupt the impacts of structural, institutional, and interpersonal racism through targeted anti-racism approaches.

Systemic racism and its white racial frame are essential concepts for understanding contemporary racial group dynamics, especially racial group conflict in the United States and other nations fundamentally shaped by European colonialism and slavery systems. The following provides some background on the conceptual developments of systemic racism and the white racial frame and discussion of the theoretical importance of incorporating analyses that deconstruct systemic white racism and the white racial frame. In the process, we identify the centrality of critical black thought in systemic racism analysis and highlight certain deficiencies of mainstream racial analysis.

Learning From the Past and Working in the Present to Create an Antiracist Future for Academic Medicine.

Parallels, particularities, problems and positive possibilities related to institutional sexism and racism

Why Social Distance Demands Social Justice: Systemic Racism, COVID-19, and Health Security in the United States.

“Now I just need something sweet”: Racism, emotional eating, and health among African Americans

The frequent police killings during the COVID-19 pandemic forced a reckoning among Americans from all backgrounds and propelled the Black Lives Matter movement into a global force. This manuscript addresses major issues to aid practitioners in the effective treatment of African Americans via the lens of Critical Race Theory and the Bioecological Model. We place the impacts of racism on Black families in historical context and outline the sources of Black family resilience. We critique structural racism embedded in all aspects of psychology and allied fields. We provide an overview of racial socialization and related issues affecting the parenting decisions in Black families, as well as a detailed overview of impacts of structural racism on couple dynamics. Recommendations are made for engaging racial issues in therapy, providing emotional support and validation to couples and families experiencing discrimination and racial trauma, and using Black cultural strengths as therapeutic resources.

The intersection of endemic structural racism and the global health crisis secondary to the COVID-19 pandemic represents a syndemic, defined as the aggregation of 2 or more endemic and epidemic conditions leading to adverse repercussions for health. Long-standing inequities have placed Black individuals at disproportionate risk for negative postpartum mental health outcomes. Studies are urgently needed to understand how the COVID-19 pandemic has added to this risk (eg, syndemic associations). To examine the association between the syndemic and the postpartum mental health of Black birthing individuals. A longitudinal cohort of Black birthing individuals were followed up from pregnancy (April 17 to July 8, 2020) through the early postpartum period (August 11, 2020, to March 2, 2021) from urban university medical center prenatal clinics. Pregnant Black participants were recruited via email and completed 2 online surveys. Composite variables capturing negative experiences of the COVID-19 pandemic and racism (structural racism [general], structural racism [neighborhood], and interpersonal racism) were created. Logistic regressions examined main and interactive associations between these variables and postpartum depression (Edinburgh Postnatal Depression Scale) and anxiety (Generalized Anxiety Disorder 7-item scale). The mean (SD) age of 151 Black participants was 30.18 (5.65) years. The association between higher negative COVID-19 pandemic experiences and postpartum depression may be influenced by experiences of interpersonal racism and general systemic racism. Negative COVID-19 pandemic experiences were associated with greater likelihood of screening positive for depression only at higher levels of systemic racism (odds ratio, 2.52; 95% CI, 1.38-4.60) and interpersonal racism (odds ratio, 1.90; 95% CI, 1.04-3.48) but not at lower levels of systemic or interpersonal racism. Similarly, negative COVID-19 experiences were associated with anxiety only at higher levels of interpersonal racism (odds ratio, 1.85; 95% CI, 0.86-4.01) but not at lower levels of interpersonal racism. Overall, 44 (29%) met screening criteria for postpartum depression and 20 (13%) for postpartum anxiety. In this longitudinal cohort study of Black birthing individuals, the experience of the syndemic was associated with negative postpartum mental health. Associations between interpersonal racism, structural racism, and negative COVID-19 pandemic experiences were associated with greater risk for postpartum depression and anxiety. Research is needed to address how systemic racism perturbs biobehavioral pathways to magnify associations between acute stressors and mental health. Such research can inform the creation of effective, culturally informed preventive interventions to improve the postpartum mental health of Black individuals.

Although a range of factors shapes health and well-being, institutionalized racism (societal allocation of privilege based on race) plays an important role in generating inequities by race. The goal of this analysis was to review the contemporary peer-reviewed public health literature from 2002-2015 to determine whether the concept of institutionalized racism was named (ie, explicitly mentioned) and whether it was a core concept in the article. We used a systematic literature review methodology to find articles from the top 50 highest-impact journals in each of 6 categories (249 journals in total) that most closely represented the public health field, were published during 2002-2015, were US focused, were indexed in PubMed/MEDLINE and/or Ovid/MEDLINE, and mentioned terms relating to institutionalized racism in their titles or abstracts. We analyzed the content of these articles for the use of related terms and concepts. We found only 25 articles that named institutionalized racism in the title or abstract among all articles published in the public health literature during 2002-2015 in the 50 highest-impact journals and 6 categories representing the public health field in the United States. Institutionalized racism was a core concept in 16 of the 25 articles. Although institutionalized racism is recognized as a fundamental cause of health inequities, it was not often explicitly named in the titles or abstracts of articles published in the public health literature during 2002-2015. Our results highlight the need to explicitly name institutionalized racism in articles in the public health literature and to make it a central concept in inequities research. More public health research on institutionalized racism could help efforts to overcome its substantial, longstanding effects on health and well-being.

This paper discusses the recent backlash against public monuments spurred by Black Lives Matter (BLM) protests in North America and elsewhere following the killing by police of George Floyd, an unarmed African-American man in the United States. Since this event, protestors have taken to the streets to bring attention to police brutality, systemic racism, and racial injustice faced by Black and Indigenous people and people of colour in the United States, Canada, Great Britain and some European countries. In many of these protests, outraged citizens have torn down, toppled, or defaced monuments of well-known historic figures associated with colonialism, slavery, racism, and imperialism. Protestors have been demanding the removal of statues and monuments that symbolize slavery, colonial power, and systemic and historical racism. What makes these monuments problematic and what drives these deliberate and spectacular acts of defiance against these omnipresent monuments? Featuring an interview with art historian Charmaine A. Nelson, this article explores the meanings of these forceful, decolonial articulations at this moment. The interview addresses some complex questions related to monumentalization and the public sphere, symbolism and racial in/justice. In so doing, it suggests that monuments of the future need to be reimagined and redefined contemporaneously with shifting social knowledge and generational change.

Toward Greater Pre-exposure Prophylaxis Equity: Increasing Provision and Uptake for Black and Hispanic/Latino Individuals in the U.S.

Reviewed by: From #BlackLivesmatter to Black Liberation by Keeanga-Yamahtta Taylor Adam Szetela FROM #BlackLivesMatter TO BLACK LIBERATION. By Keeanga-Yamahtta Taylor. Chicago: Haymarket Books. 2016. Similar to Herbert Marcuse's An Essay on Liberation (1969), Keeanga-Yamahtta Taylor's latest contribution is a timely and much needed intervention. Both intellectually rigorous and accessible, From #BlackLivesMatter to Black Liberation is a historical exposition of the conditions that contributed to the reemergence of Black radicalism in the United States. It is also a persuasive case that #BLM's fight against racism must also be a fight against capitalism. In chapter one, Taylor looks at the mutually reinforcing ideas of American exceptionalism and "culture of poverty." Through a meticulous analysis of public policy and political rhetoric, she explains that the manufactured connection between Black poverty and Black culture allows conservatives and liberals to portray America as a country where anyone can make it. The oppression experienced by Blacks is imagined as a failure of the Black family and Black role models, not a failure of the state. This absolves the federal government from intervening through social welfare. In chapter two, Taylor locates the emergence of "colorblindness" as a reactionary political theory. For Taylor, this "ideological tool, initially wielded by conservatives in the Nixon era to resist the growing acceptance of 'institutional racism' as the central explanation for Black inequality," denies structural racism and perpetuates a politics that blames Blacks for their own suffering (17–18). With a careful attention to Black history, [End Page 114] Taylor looks at the ways that this narrative became dominant in the late 1960s after the decline of the radical Black power movements. Chapter three, "Black Faces in High Places," makes the convincing case that more Black people in positions of power will do nothing to alleviate the institutional racism that permeates America. As she historicizes the rise of Black politicians, police chiefs, and elites Taylor evinces the reality that this "progress" has not blunted mass incarceration, police brutality, the destruction of public housing, and other areas where Black Americans suffer disproportionality. Chapter four elaborates the specifics of "The Double Standard of Justice" that exists in America. While chapter five, "Barack Obama: The End of an Illusion" builds on chapter three with an examination of Obama's failure to address "critical issues facing African Americans" (19). Chapters six and seven look at the rise of #BLM under the first Black president as a sign that Black Americans are again embracing "institutional racism" as a schematic for understanding reality. They are also engaging in forms of activism that diverge from party politics. A central strength of #BlackLivesMatter is Taylor's meticulous demystification of the meritocratic myth that pervades American culture and politics. Like Michelle Alexander and Cedric Johnson, she utilizes demographic statistics, rhetorical analysis, and comparative-historical analysis to illuminate the new guises of institutional racism. Most importantly, she targets not just conservative politicians, but liberals like Obama and Al Sharpton who propagandize American exceptionalism, "culture of poverty" narratives, and meagre reformist policies that can be assimilated into a political-economy of racism and class privilege. Taylor's intelligent rebuke of prominent antiracist author Tim Wise alone makes her book worth reading. Ultimately, Taylor makes a compelling final argument that antiracist movements must also be socialist. Capitalism is a system that disproportionality exploits minorities, but it is also a system that exploits people of all races and ethnicities. For Taylor, police are the repressive state apparatus that recreates class power as it systematically disem-powers and persecutes the poor. As Black Americans are overrepresented among the poorer classes, it is unsurprising that they are disproportionality targeted at a higher rate than whites. Yet, while it is important to recognize these disparities, such differences do "not say much about who benefits from the inequality of our society" (212). For Taylor, a political-economy built on slavery, mass incarceration, the destruction of the social welfare state, and wage slavery—"the pivot around which all other inequalities and oppressions turn" (206)—will not be disrupted by Black elites who represent the interests of the ruling class. It will only be challenged by an intersectional politics that sees Black liberation as part...

This article posits that racialized administrative power is the status quo in the United States and results from a wicked problem broadly construed as institutional racism. Acknowledging a baseline reality of racialized administrative power in the United States allows public administration theory to more directly grapple with the institutional racism that paradoxically may seem too big and complex to empirically study yet simultaneously too important and urgent to ignore. This article offers three contributions to the development of public administration theory from this conceptual frame of racialized administrative power as the status quo. First, by conceptualizing institutional racism as a wicked problem, a case is outlined to replace an assumption of neutral administrative power with a baseline assumption of racialized administrative power in the United States. Second, the article explores two prominent areas of theory in public administration—representative bureaucracy and administrative burden—to demonstrate how a baseline assumption of racialized administrative power can reorient and expand theoretical questions and research. Third, the article discusses the epistemological implications for public administration theory and research based on an assumption that racialized administrative power is the status quo. These contributions offer a step forward in addressing the need for public administration theory to better account for the institutional racism that pervades the management and performance of public organizations in the United States.

Although Black Americans are not substantially more likely to be diagnosed with COVID-19, hospitalization rates and death rates are considerably higher than for White Americans. The aim of this study was to assess the relationship between systemic racism generally, and residential segregation in particular, and racial/ethnic disparities in deaths due to COVID-19. To assess racial disparities in COVID-19 and systemic racism in US states, we calculated descriptive statistics and bivariate Pearson correlations. Using data on deaths through December 2020, we developed a weighted logistic mixed model to assess whether state-level systemic racism generally and residential segregation, in particular, predicted the probability of COVID-19 deaths among Americans, considering key sociodemographic factors. Residential segregation is a stronger predictor of COVID-19 deaths among Black Americans, as compared to systemic racism more generally. Looking at the interaction between residential segregation and COVID-19 death rates by race, residential segregation is associated with negative outcomes for Black and White Americans, but disproportionately impacts Black state residents (P<.001), who have 2.14 times higher odds of dying from COVID-19 when residential segregation is increased. To understand and address disparities in infectious disease, researchers and public health practitioners should acknowledge how different forms of systemic racism shape health outcomes in the United States. More attention should be given to the mechanisms by which infectious disease pandemics exacerbate health disparities in areas of high residential segregation and should inform more targeted health policies. Such policy changes stand to make all American communities more resilient in the face of new and emerging infectious diseases.

BackgroundIn the United States, Black and Latino children with asthma are more likely than White children with asthma to require emergency department visits or hospitalizations because of an asthma exacerbation. Although many cite patient-level socioeconomic status and access to health care as primary drivers of disparities, there is an emerging focus on a major root cause of disparities—systemic racism. Current conceptual models of asthma disparities depict the historical and current effects of systemic racism as the foundation for unequal exposures to social determinants of health, environmental exposures, epigenetic factors, and differential healthcare access and quality. These ultimately lead to biologic changes over the life course resulting in asthma morbidity and mortality.MethodsAt the 2022 American Thoracic Society International Conference, a diverse panel of experts was assembled to identify gaps and opportunities to address systemic racism in childhood asthma research. Panelists found that to examine and address the impacts of systemic racism on children with asthma, researchers and medical systems that support biomedical research will need to 1) address the current gaps in our understanding of how to conceptualize and characterize the impacts of systemic racism on child health, 2) design research studies that leverage diverse disciplines and engage the communities affected by systemic racism in identifying and designing studies to evaluate interventions that address the racialized system that contributes to disparities in asthma health outcomes, and 3) address funding mechanisms and institutional research practices that will be needed to promote antiracism practices in research and its dissemination.ResultsA thorough literature review and expert opinion discussion demonstrated that there are few studies in childhood asthma that identify systemic racism as a root cause of many of the disparities seen in children with asthma. Community engagement and participation in research studies is essential to design interventions to address the racialized system in which patients and families live. Dissemination and implementation studies with an equity lens will provide the multilevel evaluations required to understand the impacts of interventions to address systemic racism and the downstream impacts. To address the impacts of systemic racism and childhood asthma, there needs to be increased training for research teams, funding for studies addressing research that evaluates the impacts of racism, funding for diverse and multidisciplinary research teams including community members, and institutional and financial support of advocating for policy changes based on study findings.ConclusionsInnovative study design, new tools to identify the impacts of systemic racism, community engagement, and improved infrastructure and funding are all needed to support research that will address impacts of systemic racism on childhood asthma outcomes.