Blacks Research Articles

Adapting Group Prenatal Care for Telehealth: A COVID-Era Innovation to Address Barriers to Care for Latinx Clients.

The use of telehealth prenatal care increased exponentially during the coronavirus disease 2019 (COVID-19) pandemic, but there is no literature describing its use for group prenatal care during this time. The COVID-19 pandemic also exacerbated structural barriers to care that disproportionately affect Black and Latinx people. Telehealth enabled pregnant people to access health care and minimize infectious risks. Telehealth group prenatal care (T-GPNC) incorporated the essential elements of CenteringPregnancy with telehealth is an innovative care delivery method borne out of necessity during the COVID-19 pandemic that has potential to mitigate structural barriers to care. Mary's Center is a federally qualified health center (FQHC) in Washington, DC, and Maryland that rapidly pivoted to individual telehealth prenatal care early in the pandemic. Mary's Center used our experience with group care and guidance from the Centering Healthcare Institute on virtual Centering to launch T-GPNC. This new model included home self-monitoring equipment and video classrooms, mixed with in-person individual care visits. We used a team-based approach with nurses, midwives, and community health workers to provide holistic care to pregnant people. Our robust care coordination team also connected them to home visiting, mental health services, and nutrition counseling. The purpose of this article is to describe how Mary's Center modified the CenteringPregnancy model of group prenatal care for telehealth, following the hallmarks of CenteringPregnancy, and met the needs of Spanish-speaking clients, henceforth Latinx clients. A secondary purpose is to demonstrate how telehealth can expand access to health care and remove structural barriers that may prevent pregnant people from attending in-person appointments. We also discuss the structural inequities in digital access and literacy in the context of program implementation.

Dissonance and disobedience in Brazilian quilombola heritages

ABSTRACT This article discusses Brazilian quilombo heritage by focusing on three dimensions of the intersection between this heritage and emancipation: 1) the emancipatory power of heritage, 2) the possibilities that result from emancipating heritage from a consonant approach, and 3) the possibilities of emancipation from heritage. Quilombos are collective societies formed mainly by people of African descent who created independent communities outside the Brazilian slavery system. Using a case study based on ethnographic and archival research conducted at the Quilombo Campinho da Independência and the city of Paraty between 2015 and 2024, I begin by detailing the dominant heritage narratives in the town of Paraty and then examine how suppressed quilombo voices navigate these narratives in legal and metaphorical terms for emancipatory purposes. Ultimately, the article pushes for approaching heritage from multiple scales and angles.

Clinical presentation, risk factors and six-month outcomes in Ugandan women with peripartum cardiomyopathy: prospective case-control study

Abstract Background Peripartum Cardiomyopathy (PPCM) frequently affects women of African descent. There is scarcity of data pertaining to the clinical presentation and outcomes of PPCM patients in Uganda, particularly when employing modern diagnostic tools and adhering to guideline-directed medical therapy (GDMT). Purpose We aimed to delineate the clinical characteristics, echocardiographic findings, and 6-month outcomes among women in Uganda diagnosed with PPCM. Methods Prospective case-control design conducted from June 2022 to August 2023. We enrolled 80 PPCM cases and 80 matched controls. Inclusion criteria comprised: (i) peripartum state, (ii) signs and symptoms of HF, (iii) left ventricular (LV) ejection fraction ≤ 45%, and (iv) exclusion of alternative causes of HF. Controls were healthy women matched for age and parity. Over a 6-month period, enrolled PPCM cases were diligently monitored while on GDMT. All participants underwent a physical examination, 12-lead electrocardiography, and a detailed echocardiography incorporating global longitudinal strain measurements at both baseline and the 6-month follow-up. Results At baseline, amongst the cases, the mean age was 33.6 ± 6.6 years, mean parity was 3±2.1 pregnancies. HF onset occurred within 9.5±6.5 weeks post-delivery. A total of 20 (25.0%) cases presented in NYHA Class 4 with dyspnea as the predominant symptom in 79.95% of cases. Atrial fibrillation (AF) was observed in 2(2.5%) patients. In comparison with healthy controls, high gravidity (0.2±1.0; p<0.001) was identified as the only predictor of PPCM in this study. (Table 1) At 6-months follow up, the mean LV ejection fraction (LVEF) showed improvement from 35.7±-11.0% to 45.9 ± 15.7% (p<0.001) accompanied by a reduction in left ventricular diameter (LVD) from 6.1±0.7 cm to 5.5±1cm(p<0.001). At the 6-month follow-up, recovery (LVEF ≥ 50%) occurred in 37 cases (55%), and 52 (65%)patients were asymptomatic (NYHA Class 1) at the 6-month follow-up. Six-month mortality data were available for 5(6.3%) women, and one patient successfully underwent the insertion of an Implantable Cardioverter-defibrillator for recurrent Ventricular Tachycardia. Regarding GDMT, 55 participants received Bromocriptine as part of their medication. Twenty(25%) patients received anticoagulation for AF(n=2) or intracardiac thrombus (n=6, 1.67%) (Figure 1) resulting in 2(2.5%) strokes within the 6-month follow-up. Conclusion The current study demonstrated a comparable mortality rate on GDMT, aligning with contemporary global studies at 7.5%. The observed high thrombus burden in patients may indicate suboptimal adherence to anticoagulation therapy. While the incidence of PPCM remains undefined in Uganda, the primary predisposing factor identified was high gravidity. A noteworthy proportion of patients exhibited incomplete LV recovery, suggesting the need for larger studies to comprehensively define the maternal and fetal outcomes in Uganda.Figure 1Table 1

Without Risk Reduction: How Black Men’s Well-being and Humanity Are Compromised in Mobile Public Spaces

Much of the urban research on the daily experiences of Black men in American society has focused on Black men as perpetrators, as victims of street and gang violence, or with some carceral connection. These earlier studies highlight how racist tropes of Black men as dangerous and thus to be feared situate Black men for continuous, targeted, and aggressive actions by the state and other social actors. This places a social tax on Black men who are then bound to exercises of embodied negotiations in public social spaces where they navigate both being shunned and “disappeared” while also hyper-visible. Drawing on ethnographic data collected across several years, this article examines how Black men are targeted for aggression in mobile public spaces in Chicago, Illinois. We use public transportation as a space of interrogation because of the uniqueness of mobile places where riders and transit personnel are temporarily confined while mobile and with limited options to escape the dangers of racism and racial aggression. In these spaces, we find that (1) Black men are threatened with harm, (2) their bodies are treated as sites of fear, and (3) their well-being is risked through an institutional breach of duty to provide safety for them as passengers and transit personnel.

Socioeconomic and Racial Disparities in Primary Open-Angle Glaucoma in the US.

Socioeconomic status is a potentially significant, although difficult to isolate, factor in determining glaucoma severity. To analyze the level of glaucoma severity (mild, moderate, or severe) based on demographic factors, including age, gender, ethnicity, insurance profile, and zip code, and to use this data to extrapolate the effect of socioeconomic status (SES) and race on glaucoma severity at the community level in Memphis, TN. 2913 patients from a tertiary care center with three clinic locations in Memphis, TN who had been given the diagnosis of Primary Open Angle Glaucoma (POAG) through use of the ICD-10 codes for mild (H40.1111, H40.1121, H40.1131), moderate (H40.1112, H40.1122, H40.1132) and severe (H40.1113, H40.1123, H40.1133) POAG between January 2016 and July 2021 were included in this study. Diagnoses were made after a complete glaucoma workup consisting of Snellen visual acuity, applanation IOP measurement, gonioscopy, automated Humphreys Visual Fields (10-2 and 24-2), and optic nerve OCT. Demographic information, including age, gender, ethnicity, insurance profile, and zip code, was also collected with disease severity for each patient. SES was approximated using zip code-level census poverty data and insurance profiles. Statistical analyses were performed, including descriptive, multivariable ordinal logistic modeling and stepwise multivariable linear modeling. Glaucoma severity was shown to increase with poverty rate (OR=1.089, P<0.0071), age (OR=1.030, P<0.0001), male sex (OR=1.374, P<0.0001), and Black race (OR=1.896, P<0.0001). Severity was shown to be decreased in patients with private insurance compared to Medicare (OR=0.895, P<0.093) and those from Shelby County compared to other counties (OR=0.703, P<0.0001). Our findings indicate that worsening glaucoma severity was associated with higher poverty rates in our patient population. However, isolating socioeconomic status (SES) as an independent factor influencing the incidence and severity of glaucoma remains challenging, given the strong correlation between race and SES.

Top-down racial biases in size perception: A registered replication and extension of

Biases in the perception and judgment of members of race-based and ethnicity-based minority groups are prevalent, often resulting in detrimental outcomes for these individuals. One such bias is a threat-related stereotype, associating specific race and ethnicity-based social groups with aggressiveness, violence, and criminality. In the US context, Black men are often victims of such bias. Recent evidence suggests that threat-related stereotypes are also linked to biased perceptions, such that perceivers overestimate the body size of Black relative to White men, even in the absence of perceptual differences between them. That is, mere top-down social category information was sufficient to induce perceptual biases in size perception related to threat (Wilson et al., 2017, Study 7). Considering the novelty of this finding and its theoretical importance, we suggested a registered replication of this finding to assess its robustness across laboratories, participants, and social groups. We conducted a direct replication (Study 1, N = 280) of the effect reported by Wilson and colleagues, followed by a conceptual replication (Study 2, N = 280) that tested the generalization of the original findings to another population (Israeli residents) and a different target social group (Muslim Israelis) frequently stereotyped as threatening in this population. Participants did not overestimate the body size of Black or Muslim Israeli targets, pointing to a failed replication of the original effect. These findings suggest that the effects of purely top-down social category information on threat-related perception and judgment are less robust than previously assumed.

Large-scale analysis reveals racial disparities in the prevalence of ADHD and conduct disorders

The primary purpose of this study is to highlight trends in the prevalence of attention deficit/hyperactivity disorders (ADHD) and conduct disorders (CD) between non-Hispanic White and non-Hispanic Black populations and identify potential diagnostic disparities between these groups. De-identified electronic health record data on the TriNetX platform of patients diagnosed with ADHD, CD, or both between January 2013 and May 2023 from 50 healthcare organizations in the US were used to investigate racial and sex disparities in the prevalence of ADHD and CD diagnoses. With a cohort of 849,281 ADHD patients and 157,597 CD patients, non-Hispanic White individuals were ~ 26% more likely to receive ADHD diagnosis and ~ 61% less likely to be diagnosed with CD than non-Hispanic Black individuals. The mean age of diagnosis of ADHD was over 8 years older for White patients than for Black patients, with a disproportionately higher number of White patients diagnosed in adulthood, compared to a comparatively negligible number of Black patients diagnosed with ADHD in the same age group. Additionally, Black females were the cohort least likely to be diagnosed with ADHD, while White females were the cohort least likely to be diagnosed with CD. Race disparities exist between Black and White populations, and sex disparities exist within each population. More information is needed to determine contributors to these differences, although implicit biases and systemic racism may be key contributing factors. Presenting evidence and increasing awareness of culturally relevant diagnoses can reduce unconscious bias and move toward more informed and objective psychiatric evaluations.

End-of-life in Hepatocellular Carcinoma: How Palliative Care and Social Factors Impact Care and Cost.

Investigate the impacts of palliative care consults, race, and socioeconomic status on the prevalence of invasive procedures in patients with hepatocellular carcinoma (HCC). Palliative care, race, and socioeconomic status can all influence end-of-life care preferences, but their roles in HCC have not been adequately explored. This is a cross-sectional study of patients with HCC from 2016 to 2019 using the National Inpatient Sample. Terminal and nonterminal hospitalizations were assessed with logistical regression evaluating associations between palliative care, race, income, and procedures along with do-not-resuscitate orders and cost. Procedures included mechanical ventilation, tracheostomy, and cardiopulmonary resuscitation (CPR) among others. A total of 217,060 hospitalizations in patients with HCC were included, 18.1% of which included a palliative care encounter. The mean age was 65.0 years (SD = 11.3y), 73.9% were males and 55.5% were white. Procedures were increased in terminal hospitalizations in black [CPR adjusted odds ratio (aOR) = 2.57, P < 0.001] and Hispanic patients (tracheostomy aOR = 3.64, P = 0.018) compared with white patients. Palliative care encounters were associated with reduced procedures during terminal hospitalizations (mechanical ventilation aOR = 0.47, P < 0.001, CPR aOR = 0.24, P < 0.001), but not in nonterminal hospitalizations. No association between income and end-of-life procedures was found. Palliative care was associated with decreased mean cost in terminal ($23,608 vs $31,756, P < 0.001) and nonterminal hospitalizations ($15,786 vs $19,914, P < 0.001). Palliative care is associated with less aggressive end-of-life care and decreased costs in patients with HCC. Black and Hispanic race were both associated with more aggressive end-of-life care.

Abnormal blood pressure among individuals evaluated for tuberculosis infection in a U.S. public health tuberculosis clinic.

Tuberculosis infection (TBI) has been associated with increased cardiovascular risks. We aimed to characterize abnormal blood pressure (BP) readings in individuals with TBI. We conducted a retrospective study of adults with TBI presenting for their initial medical visit at a large midwestern U.S. public health clinic between 2019 and 2020. Abnormal BP was defined as having a systolic BP≥130mmHg and/or a diastolic BP≥80mmHg. Of 310 individuals with TBI, median age was 36years (interquartile range 27-48), 34% were male, 64% non-US-born; 58 (18.7%) were previously diagnosed with hypertension. The prevalence of any hypertension (i.e., had a history of hypertension and/or an abnormal BP reading) was 64.2% (95% confidence interval 58.7-69.4). Any hypertension was independently associated with older age, male sex, higher body mass index, and individuals of Black race. In conclusion, any hypertension was present in over half of the adults evaluated for TBI in our clinic. Established hypertension risk factors were also common among this group, suggesting that individuals with TBI could benefit from clinical and public health interventions aiming to reduce the risk of future cardiovascular events.

Prognostic impact of switching to the 2021 chronic kidney disease epidemiology collaboration creatinine-based equation in Caucasian patients with type 2 diabetes: the Renal Insufficiency and Cardiovascular events (RIACE) Italian Multicenter Study

BackgroundA Chronic Kidney Disease (CKD) Epidemiology Collaboration (EPI) formula not including a Black race coefficient has been recently developed and is now recommended in the US. The new (2021) equation was shown to yield higher estimated glomerular filtration rate (eGFR) values than the old (2009) one in a non-Black general population sample, thus reclassifying a significant number of individuals to a better eGFR category. However, reclassified individuals were previously shown to have a lower risk of progression to end-stage kidney disease, but higher adjusted risks for all-cause death and morbidity and mortality from cardiovascular disease than those not reclassified. This study evaluated the prognostic impact of switching from the 2009 to the 2021 CKD-EPI equation in non-Black individuals with type 2 diabetes.MethodsThe Renal Insufficiency And Cardiovascular Events (RIACE) was a prospective cohort study enrolling 15,773 Caucasian patients in 19 Italian centers in 2006–2008. Cardiometabolic risk profile, treatments, complications, and comorbidities were assessed at baseline and eGFR was calculated with the two equations. Vital status was retrieved on 31 October 2015 for 15,656 participants (99.3%).ResultsWith the 2021 equation, the eGFR value increased in all patients, except for 293 individuals with a 2009 eGFR ≥ 105 ml·min− 1·1.73 m− 2. The median difference was 4.10 ml·min− 1·1.73 m− 2 and was higher in males, older individuals and those in the G2 category. Reclassification decreased the percentage of patients with reduced eGFR from 17.28 to 13.96% and with any CKD from 36.23 to 34.03%. Reclassified individuals had better cardiometabolic risk profile and lower prevalence of complications and use of medications than non-reclassified individuals. Risk of death versus the 2009 G1 category was lower for reclassified than non-reclassified participants in all eGFR categories and, particularly, in each 2009 eGFR category, though difference was significant only in the G4-G5 category. The Receiver Operator Characteristic curves were statistically, but not clinically different with the two equations.ConclusionChanging from the 2009 to the 2021 CKD-EPI equation results in higher eGFR and lower CKD prevalence, with a lower risk of death in reclassified patients with an eGFR < 30 ml·min− 1·1.73 m− 2, but virtually no impact on mortality prediction.Trial registration: ClinicalTrials.gov, NCT00715481, retrospectively registered 15 July, 2008.

The hidden costs: a qualitative analysis exploring the experience of prostate cancer treatment-related side effects on sexual function and urinary incontinence among Black survivors and their caregivers.

Prostate cancer (PCa) disproportionately affects Black men in the U.S., leading to high incidence and mortality rates. Post-treatment challenges, such as sexual dysfunction and urinary incontinence, significantly impact quality of life yet are frequently overlooked. The purpose of this study was to characterize the experience of treatment-related side effects around sexual function and urinary incontinence among Black survivors of PCa and their caregivers. We conducted semi-structured virtual interviews with 11 Black survivors of PCa and 11 caregivers (22 total participants). Survivors were eligible if they were diagnosed and treated for PCa within the last decade and caregivers were eligible if they self-identified as a caregiver for a Black survivor. Interviews were transcribed verbatim and analyzed using a qualitative descriptive approach. During interviews, participants spontaneously discussed topics covering sexual dysfunction and urinary incontinence. Key themes identified from interview discussions included the physical experience of PCa treatment, knowledge of the impact of PCa treatment on life quality, and the process of navigating survivorship care. Although they received peer and familial support, survivors expressed a desire for clinicians to initiate discussions on sexual dysfunction and urinary incontinence. Caregivers recounted their experiences while providing support to the survivor. The findings underscore the need for clinicians to prioritize discussions on sexual dysfunction and urinary incontinence with patients, and for enhancement of care pathways and resources for these issues in survivorship care. Trained professionals, such as occupational and physical therapists, social workers, genetic counselors, and psychologists, have the potential to fill this survivorship care gap.

Discrimination and health outcomes in England's black communities amid the cost-of-living crisis: evaluating the role of inflation and Bank Rates

ABSTRACT This study utilised longitudinal data from Black History Month events in London from 2021 to 2023. Novel findings revealed that increased inflation and Bank Rates, related to the cost-of-living crisis, were associated with greater discrimination and deteriorations in both general and mental health for Black individuals. Moreover, it was found that during the cost-of-living crisis period, i.e. 2022–2023, discrimination was more adversely related to general and mental health deterioration compared to the period before the cost-of-living crisis, i.e. 2021. In addition, women, non-native individuals, non-heterosexual individuals, the unemployed, economically inactive individuals, those with lower educational attainment, and older individuals experienced higher levels of discrimination and reduced general and mental health compared to reference groups. The findings of the study contribute to the literature by demonstrating the intertwined associations of macroeconomic deteriorations and discrimination with the health of the Black community, and its subgroup differences, providing a basis for targeted policies.

Feasibility of the MIND+SOUL Culturally Tailored Brain Healthy Diet: A Pilot Study

Alzheimer’s disease (AD) disproportionately impacts Black Americans, who are three times more likely to develop AD. While heart-healthy diets have shown potential in reducing AD risk, research on adapted dietary interventions for Black American communities remains limited. This pilot study assessed the feasibility and acceptability of an adapted brain healthy diet intervention (MIND + SOUL) and explored changes in cardiometabolic risk and cognition. Twenty-nine participants completed the 12-week intervention, which included culturally tailored health education, cooking classes, health coaching, and groceries. Feasibility was assessed by attendance and retention rates, while acceptability was measured by two questionnaires. Participants had a mean age of 70.3, with 10.3% male. The intervention demonstrated high feasibility (89.3% retention) and acceptability (mean = 71.9, SD = 8.59), with meaningful improvements in body mass index (estimate = −0.54, P = 0.009), dietary intake (estimate = 28.39, P = 0.042), and executive function (estimate = 3.32, P &lt; 0.001). However, no significant changes in blood-based biomarkers were observed. The MIND + SOUL intervention demonstrated high feasibility and acceptability, improvements in body composition, cognitive function, and dietary behaviors, despite no significant changes in blood-based biomarkers. Findings suggest potential benefits for reducing AD risk factors and promoting healthy aging. Clinical Trials Registry: ClinicalTrials.Gov; NCT05414682.

Dialysis Facility Staffing Ratios and Kidney Transplant Access Among Adolescents and Young Adults

Patient to staff ratios vary across US dialysis facilities and have been associated with patient outcomes in older adults. To determine whether patient to nurse or patient to social worker staff ratios are associated with access to kidney transplant for adolescents and young adults. Retrospective cohort study including patients aged 12 to 30 years who started dialysis between 2005 and 2019 at 8490 US facilities according to the US Renal Data System, the national end-stage kidney disease registry. Time-updated quartile of patient to nurse and patient to social worker ratios at dialysis facilities. Fine-Gray models were used to relate the exposure to the incidence of waitlisting and kidney transplant, accounting for the competing risk of death. Subgroup analysis by age at dialysis initiation (<22 vs ≥22 years) was performed. Follow-up was censored in January 2020. A total of 54 141 participants were included (median age, 25 years [IQR, 21-28]; 54.4% male; 4.3% of Asian race, 35.3% of non-Hispanic Black race). The median patient to staff ratios were 14.4 patients per nurse (IQR, 10.3-18.9) and 91.0 patients per social worker (IQR, 65.2-115.0). During a median follow-up of 2.6 years, 39.9% of patients (n = 21 598) received a transplant. In adjusted analysis, the highest (vs lowest) quartile of patient to nurse ratios was associated with 14% lower incidence of transplant (subhazard ratio [SHR], 0.86 [95% CI, 0.82-0.91]). The highest (vs lowest) quartile of patient to social worker ratios was associated with lower incidence of waitlisting (SHR, 0.95 [95% CI, 0.91-0.99]) and transplant (SHR, 0.85 [95% CI, 0.81-0.89]). For both staff ratios, there was an interaction with age at dialysis initiation, such that the association was more pronounced in patients starting dialysis at younger than 22 years (SHR, 0.71 [95% CI, 0.65-0.78] for the highest vs lowest quartile for nursing; SHR, 0.74 [95% CI, 0.68-0.80] for social work) compared with those 22 years and older (SHR, 1.00 [95% CI, 0.94-1.06] for nursing; SHR, 0.96 [95% CI, 0.91-1.02] for social work) for the outcome of transplant. Adolescents and young adults receiving care at dialysis facilities with higher patient to staff ratios had reduced access to waitlisting and transplant, particularly if they were younger than 22 years of age at dialysis initiation.

Trends in Age and Prostate-Specific Antigen at Prostate Cancer Diagnosis between 2010 and 2019.

Recent studies have shown that de novo metastatic prostate cancer incidence in the U.S. increased from 2010 to 2019. Plausible explanations include delayed detection following recommendations against prostate cancer screening or upstaging associated with use of more sensitive imaging technologies. Using Surveillance, Epidemiology and End Results cases and controlling for aging of the population, we found the median age and prostate-specific antigen (PSA) level at prostate cancer diagnosis increased by 1.4 years of age (95% CI 1.3-1.5) and 1.4 ng/mL (95% CI 1.4-1.5) over this period, consistent with the delayed detection hypothesis. Racial differences were noted, with 75th percentiles of PSA at diagnosis increasing by 4.3 ng/mL (95% CI 3.7-4.8) over this time period for non-Hispanic Black men compared to 3.0 ng/mL (95% CI 2.8-3.2) for non-Hispanic White men. Overall, patient characteristics at diagnosis suggest that delayed detection contributed at least in part to increases in de novo metastatic disease.

Outdoor physical activity is not associated with better mental health in a sample of predominantly Black people, but spending time in parks is

Spending time outdoors may bolster mental health via relaxation and physical activity. Yet, most studies use self-report and involve majority White samples from higher income areas. Findings may not hold true using device-derived measurement, among minoritized participants, or in low-income neighborhoods. Our objectives were to test whether: i) time spent outdoors in physical activity is associated with mental health; ii) the effect is modified by the positive or negative outdoor conditions (amount of greenness or vacant houses/lots encountered while outdoors); iii) there is a correlation between our measures of outdoor conditions and perceived neighborhood conditions; and iv) there is a different relationship between time spent outdoors in parks (as an indicator of intentional nature exposure) and mental health. The sample of 112 participants (87 % Black/African American persons) from 11 Detroit, MI neighborhoods wore a GPS and accelerometer for one week (May-Oct 2021) and completed a survey. We calculated exposure to greenness, vacant lots/houses while outdoors, and perceived neighborhood aesthetics. We fitted regression models for mental health measures separately and included time spent outdoors in PA, age, sex, and days with high precipitation. We then fitted models stratified by outdoor conditions. Last, we examined whether a similar relationship could be detected for time spent outdoors in parks. On average, ∼30 % of PA was conducted outdoors, and 56 % of outdoor time involved PA. We observed an unexpected positive association between outdoor PA and anxiety (coef: 0.33, 95 % CI: 0.14–0.51), depression (coef: 0.31, 95 % CI: 0.15–0.47), and perceived stress score (coef: 0.18, 95 % CI: 0.07–0.29). When stratified, we found consistent and/or larger associations for those exposed to high levels of vacant homes, high greenness (both aerial and street-level), low levels of vacant lots, and low perceived neighborhood aesthetics. Importantly and in contrast, we observed the opposite trend when examining time spent in parks (coef: −0.05, 95 % CI: −0.10--0.01). These results contrast many studies showing positive relationships between time outdoors and mental health and highlight the need for research with diverse populations and better measures of outdoor conditions and intentionality of greenspace contact.

Then and Now, Newsroom Diversity Matters for Mississippi’s Black Journalists

ABSTRACT Mississippi newsrooms should be among America’s most diverse. More than a third of residents are Black, and U.S. journalism organizations have long stated a goal of achieving racial parity with the communities they serve. Through the frame of social identity and critical race theory, the researchers analyzed 12 in-depth interviews with Black Mississippi journalists. The findings from these interviews indicate a wide range of challenges in Mississippi newsrooms, with the assertion that achieving diversity is contingent on having diverse leadership. The study explores what these journalists believe is necessary to foster a newsroom culture where minority journalists feel better supported and more empowered to express their opinions, The results also highlight apprehensions about the coverage of Black communities in Mississippi markets, particularly in the capital city of Jackson, where most of the population is Black. Interviewees expressed dissatisfaction with the disproportionate allocation of news reporting resources to cover minority criminal activities, a practice attributed by Campbell, C. P. (1995. Race, Myth and the News. Sage) to a legacy of white supremacy.

Justifying Political Violence: African American Attitudes Toward Protests Against Police Attacks on Black People

Concern over the breadth of support for political violence is rising among scholars. However, important unanswered questions remain: First, are attitudes toward political violence, as commonly measured, too abstract to have any real-life meaning? Second, how do ever-present contextual factors shape judgments in the events in which violence materializes? Third, given that African Americans are so often on the receiving end of violence, how supportive are Black people of the use of political violence? Finally, what accounts for variability among Black people in attitudes toward violence—what role is played by experiences with unfair treatment by the police and in-group attachments and identities? Based on a nationally representative panel survey of African Americans, I provide empirical answers to each of these important questions. Black support for political violence is indeed connected to both identities and experiences, as well as to core values such as support for the rule of law.

A Novel Time Use Approach on Daily Active Engagement with Life: The Intersectionality of Race and Gender.

Active engagement with life (AE) is an integral aspect of successful aging. Using time diary data, this study explored how U.S. older adults structure their daily lives involving social participation and productive engagement, and the extent to which these patterns differ by race and gender. We used American Time Use Survey (ATUS) data (n = 17,990) and sequence and cluster analyses to identify distinctive daily AE patterns. Multivariable linear regression models were used to evaluate associations between AE patterns and self-rated health, and the moderating roles of race and gender. Five AE clusters were identified: Low Degree of AE (26%), Moderate Unpaid Work & Light Social Participation (39%), Persistent Unpaid Work (20%), Persistent Paid Work (10%), and Persistent Social Participation (4%). White women were the most likely and Black men the least likely to have any AE. Compared to "Low Degree of AE", all other AE clusters were associated with better self-rated health, with these associations varying by gender and race. The strongest positive association was observed for "Persistent Paid Work", especially among women. Racial differences in the association between AE and health were more prominent among women than men. Differences by AE were less pronounced among Black women in comparison to White women. We found that the association between AE and self-rated health varies by race and gender. Persistent structural barriers may prevent older adults from historically minoritized backgrounds, particularly Black women, from benefiting from AE.

Leveraging Multiple Administrative Data Sources to Reduce Missing Race and Ethnicity Data: A Descriptive Epidemiology Cross-Sectional Study of COVID-19 Case Relative Rates.

Understanding race and ethnicity (RE) differentials improves health outcomes. However, RE data are consistently missing from electronic laboratory reports, the primary source of COVID-19 case metrics. We addressed the missing RE differentials and compared vaccinated and unvaccinated cases from March 1, 2020, to May 30, 2023, in New York State (NYS), excluding New York City. This descriptive epidemiology cross-sectional study linked the NYS Electronic Clinical Laboratory Reporting System (ECLRS) with NYS Immunization Information System (NYSIIS) to address the missing RE data in the ECLRS system. The primary metric was the COVID-19 case relative risk (RR) for each RE relative to white individuals. There were 4,212,741 COVID-19 cases with 39% (1,624,818) missing RE data in ECLRS; missing RE data declined to 17% (726,023) after matching with NYSIIS. For those aged 65years or older (after matching), 42% were missing in 2020, which declined by 17% by 2023. In May 2021, COVID-19 RRs for vaccinated individuals were 1.09 (95% CI 0.90-1.32), 1.11 (95% CI 0.87-1.43), 1.13 (95% CI 0.93-1.39), and 1.89 (95% CI 1.01-3.52), and for unvaccinated individuals were 1.73 (95% CI 1.66-1.82), 0.84 (95% CI 0.78-0.92), 3.10 (95% CI 2.98-3.22), and 3.49 (95% CI 3.05-3.98) respectively for Hispanic, Asian/Pacific Islander, Black people, and American Indian/Alaska Native individuals. Matching case data with vaccine registries reduce missing RE data for COVID-19 cases. Disparity was lower in vaccinated than in unvaccinated individuals indicating that vaccination mitigated RE disparities early in the pandemic. This underscores the value of interoperable systems with automated matching for disparity analyses.