Blacks Research Articles

“Unquestioned Citizenship”: History, Poetry, and Black and Native Military Service in Hampton Institute’s Southern Workman

Abstract This article explores how Black race histories, Native American traditionary histories, and tribute poems published in Hampton Institute’s Southern Workman (1872–1939) used military service as an imaginative foundation for thinking about citizenship beyond legal meanings. In race and traditionary histories, writers make visible the sacrifices of Black and Native soldiers that had been overlooked in official accounts of wars throughout US history. Writers also transform these histories’ commemorative aim into tribute poems, which accomplish similar work by recognizing publicly, through imaginative verse, Black and Native military service. These writers share a hope that military service might usher in the benefits of formal citizenship. But that hope is accompanied by a sense of skepticism, in that wartime did not always yield a completely united American front. With such contingencies in mind, writers use the act of military service as inspiration for the act of writing into the historical and literary record the legacy of Black and Native commissioned and noncommissioned men and women, bestowing upon each other a sense of “unquestioned citizenship” that the nation would not.

Vitamin D Levels in the United States: Temporal Trends (2011-2018) and Contemporary Associations with Sociodemographic Characteristics (2017-2018).

Background: The most recent vitamin D data from the National Health and Nutrition Examination Survey (NHANES) have not been examined. We used data from NHANES to describe trends in 25-hydroxyvitamin D [25(OH)D] from 2011 to 2018 and for the most recent cycle (2017-2018) to identify groups with lower levels of 25(OH)D and factors predictive of 25(OH)D. Methods: The 31,628 participants were weighted to represent the entire U.S. population. For each 2-year NHANES survey cycle (2011 to 2018), we calculated the weighted median (25th and 75th percentiles) of 25(OH)D and the proportion of the population within the following categories (nmol/L): <30, 30-<50, 50-<75, 75-<125, and ≥125. For 2017-2018, we stratified by demographic and behavioral factors. Multivariate linear regression identified variables predictive of 25(OH)D. Results: The median 25(OH)D (nmol/L) increased slightly from 2013-2014 [66.5 (25th and 75th percentiles: 51.3, 83.0)] to 2017-2018 [68.7 (52.3, 87.8)], and the prevalence of 25(OH)D <50 nmol/L decreased slightly (23.4% vs. 21.3%). In 2017-2018, characteristics associated with lower 25(OH)D were age (12-39 years), male gender, non-Hispanic Black, higher BMI, lower income and education, winter season, not taking vitamin D supplements, or "never" using sunscreen. When stratified by age, race/ethnicity, and gender simultaneously, median 25(OH)D was lowest among non-Hispanic Black females aged 12-19 (38.5 nmol/L) or 20-39 (38.9 nmol/L). Predictors of 25(OH)D level differed by race/ethnicity, e.g., increasing BMI was associated with larger decrements in 25(OH)D among Mexican Americans. Conclusions: This analysis is the first to examine vitamin D levels stratified by multiple characteristics simultaneously. This strategy identified populations at higher risk for health sequelae due to low levels of vitamin D. For example, high levels of deficiency were found in non-Hispanic Black females of reproductive age.

Quantifying the experiences of Black and Dual Heritage young people in a forensic child and adolescent mental health service.

Young people from racialised backgrounds are overrepresented in justice services. This study explored differences in community support offered to young people from racialised groups referred to a forensic child and adolescent mental health service. We compared support offered to 427 young people, according to five ethnic groups. Over 20% of young people referred were Black (compared with 14% of the local population) and 15.8% were Dual White and Black Heritage (compared with 4% of the local population). Odds ratios showed that Black and Dual Heritage groups were more frequently involved with youth offending services (Black: 2.59, Dual Heritage: 2.88), gangs services (Black: 4.31, Dual Heritage: 7.13) and have a national referral mechanism (Black: 3.61, Dual Heritage: 4.01) than their White peers, but were less often in mainstream education compared with their Asian peers (Black: 0.26, Dual Heritage: 0.29). Black (odds ratio 0.35) and Dual Heritage (odds ratio 0.40) young people were less frequently diagnosed with a neurodevelopmental disorder than their White peers. Those from Black and Dual Heritage backgrounds were disproportionately disadvantaged.

Incidence of Pulmonary Hypertension in the Echocardiography Referral Population.

Incidence rates for pulmonary hypertension using diagnostic data in patients with cardiopulmonary disease are not known. To determine incidence rates of, risk factors for, and mortality hazard associated with pulmonary hypertension among patients referred for transthoracic echocardiography Methods: Retrospective cohort study using data from the Veterans Health Administration (1999-2020) and Vanderbilt University Medical Center (1994-2020). Pulmonary hypertension was defined as pulmonary artery systolic pressure >35mmHg with prevalent cases excluded. Heart failure and chronic obstructive pulmonary disease were the primary exposures of interest. The primary outcome was incident pulmonary hypertension. Secondarily, we examined mortality rate following incident diagnosis. We identified 245,067 VA patients (94% male, 20% Black) and 117,526 Vanderbilt patients (46% male, 11% Black) without pulmonary hypertension, of whom 38,882 VA patients and 8,061 Vanderbilt patients developed pulmonary hypertension. Only 18-19% of patients with echo-based pulmonary hypertension also had a diagnostic code. Hazard of pulmonary hypertension was 4-fold higher in patients with heart failure and chronic obstructive pulmonary disease compared to patients without either. Mortality rates increased from pulmonary artery systolic pressure of 35mmHg to 45mmHg then plateaued. Independent risk factors for incident pulmonary hypertension included older age, male sex, black race, and cardiometabolic comorbidities. Pulmonary hypertension incidence rates estimated by diagnostic data are higher than code-based rates. Heart failure and chronic obstructive pulmonary disease strongly associate with incident pulmonary hypertension. Pulmonary artery systolic pressure >45mmHg at diagnosis is associated with high mortality. New pulmonary hypertension on echocardiography is an important prognostic sign.

Incident Epilepsy Among US Medicare Beneficiaries, 2019: Differences by Age, Sex, and Race/Ethnicity.

Epilepsy is common among older adults, but previous incident studies have had limited ability to make comparisons across key subgroups. We aimed to provide updated epilepsy incidence estimates among older adults, comparing across age, sex, and race/ethnicity. Using a random sample of 4,999,999 US Medicare beneficiaries older than 65 years, we conducted a retrospective cohort study of epilepsy incidence using administrative claims for 2016-2019. Sampled beneficiaries were enrolled in the Fee-for-Service (FFS) program in each of 2016-2018 and had no epilepsy claims in those years. Non-Hispanic Black and Hispanic beneficiaries were oversampled to ensure adequate cases for detailed comparisons. Incidence in 2019 was identified in the Master Beneficiary Summary File as ≥1 inpatient claim or ≥2 outpatient nondrug claims occurring at least 1 day apart (ICD-10 G40.x). Incidence models were estimated by age, sex, race/ethnicity, and combinations thereof, with adjustment for the racial/ethnic oversampling. We identified 20,545 incident epilepsy cases. The overall epilepsy incidence rate (IR) was 393 per 100,000 (99% CI 385-400). Incidence peaked at ages 85-89 (504 [481-529]) and was higher for men (396 [385-407]) than women (376 [366-385]). The sex difference in IRs was constant with age. Incidence was higher for non-Hispanic Black (678 [653-702]) and Hispanic (405 [384-426]), and lower for non-Hispanic Asian/Pacific Islander (272 [239-305]) beneficiaries, compared with non-Hispanic White beneficiaries (354 [299-408]). The age-specific IRs significantly differed by race/ethnicity and sex, but only among non-Hispanic Black beneficiaries-where men had higher rates at younger ages and women at older ages. We found higher epilepsy IRs among those enrolled in the Medicare FFS system 2016-2019 than previous studies using Medicare claims data from at least a decade ago. The risk of epilepsy onset is higher for those in their late 80s, men, and non-Hispanic Black and Hispanic older adults. There is also evidence that these age-graded risks operate differently for Black men and Black women. Efforts to provide care and services that improve quality of life for older adults living with epilepsy should consider differences by multiple social characteristics simultaneously: age, sex, and race/ethnicity.

Feeling Carcerality: How Carceral Seepage Shapes Racialized Emotions

Abstract This article examines how young people experience policing and reveals the emotional weight of the carceral state. Drawing on interviews and focus groups with over forty Black and non-Black Latinx young men in Los Angeles County, I argue that the racialized emotions the young men allude to do not stem from one individual encounter with the police or any single identifiable source. Instead, they are responses to the ongoing violence of what I describe as carceral seepage: witnessing the policing of loved ones and peers, the omnipresence of police, and the vulnerability of being criminalized across social contexts (schools, healthcare settings, neighborhood settings, etc.). Integrating theories on racialized emotions and the slow violence of policing, I use carceral seepage to show the breadth of the carceral state and demonstrate how it elicits a particular set of racialized emotional responses (or racialized emotions).

Racial discrimination in helping situations depends on the cost of help: A large field experiment in the streets of Paris.

Decades of field experiments show that White Americans are more likely to discriminate against Black Americans when the situation provides a nonracist rationalization for withholding help from a Black target - for instance, when the cost of helping looks unreasonable. However, work on racial discrimination in helping is scarcer outside of the US context. The present experiment extends this line of research to Europe and studies differences in helping asiatique (Asian), blanc (White) and noir (Black) men and women in France. In addition, it assesses to what extent racial discrimination in the probability to provide assistance is moderated by the perceived cost of help. The study rests on a sample of over 4500 independent observations collected through a factorial design that combines 12 testers (equally apportioned in race and gender groups), two social class conditions and four observation sites. Testers asked for directions to pedestrians in front of the traffic lights of a busy road, and pedestrians could provide different forms of help that varied in perceived cost. The analysis indicates that overall asiatique and noir testers receive help less often than their blanc counterparts. It also shows that racial discrimination is stronger when the perceived cost of helping is higher.

Socioeconomic Factors Associated with ≥2-year Delayed Diagnosis of Neuromyelitis Optica Spectrum Disorder (NMOSD) in the United States.

The objective of this study is to explore the impact of socioeconomic factors on risk of ≥2-year delayed diagnosis of NMOSD. Consequences of delayed diagnosis in NMOSD could be as severe as complete blindness or quadriplegia. Female sex and African ancestry are risk factors for delayed diagnosis across many disease states in the US. Patients with NMOSD are disproportionately represented by women of African descent suggesting that there may be socioeconomic barriers to timely diagnosis. This retrospective cohort study of patients with NMOSD used a closed claims database linked with socioeconomic market research and American Community Survey data at the zip-9 level. Patients were included if they had at least 2 NMOSD claims ≥30 days apart between January 2018 and December 2021. Symptom onset was defined as the first claim of associated NMOSD symptoms up to 15 years prior to diagnosis. ≥2-year delayed diagnosis was defined as diagnosis at or after 2 years of symptom onset. The conceptual causal framework was illustrated with a directed acyclic graph. Multivariable regression models were used to estimate associations of patient characteristics and several socioeconomic variables with risk of ≥2-year delayed NMOSD diagnosis. In multivariable regression analysis, factors associated with ≥2-year delayed diagnosis were female sex (OR 1.44; 95%CI 1.07-1.95) and Managed Medicaid coverage (OR 1.45; 95%CI 1.11-1.89). Factors associated with diagnosis in <2 years included age≤45 (OR 1.43; 95%CI 1.06-1.94), moderate and severe comorbidity [(Moderate OR 1.62, 95%CI 1.13-2.33), (Severe OR 1.56; 95%CI 1.04-2.35)], and western US regions (OR 1.56; 95%CI 1.12-2.16). There was no impact of other socioeconomic factors on ≥2-year delayed diagnosis. However, patient-level data on race/ethnicity was not available. This study demonstrated that otherwise healthy, female, Managed Medicaid beneficiaries, age >45 years may be at highest risk for ≥2-year delayed diagnosis of NMOSD.

Experiences of Discrimination and Alcohol Involvement Among Young Adults at the Intersection of Race/Ethnicity and Gender.

Although discrimination is an important social determinant of alcohol involvement, there is a dearth of research testing these associations across race/ethnicity and gender. This is an important research gap given that experiences of discrimination and therefore links with alcohol involvement may vary as a function race/ethnicity and gender intersectional identities. We tested for measurement invariance in discrimination and alcohol involvement and examined group differences in means and covariances. The sample consisted of n = 1187 young adults (ages 18-26; n = 193 Black women, n = 209 Latina women, n = 186 White women, n = 198 Black men, n = 203 Latino men, and n = 198 White men). We found evidence for differential item functioning for discrimination and alcohol involvement that violated assumptions needed to make manifest between-group comparisons. To model the source and degree of differential item functioning, we used partial measurement invariance and dropped a discrimination item that did not reliably overlap with the latent factor for White women. After accounting for differential item functioning, Black women and men reported the highest discrimination, followed by Latinx women and men, and then White women and men. White women reported the most alcohol involvement, followed by White men, Latina women, Latino men, Black men, and Black women. Discrimination and alcohol involvement were positively associated for all groups except White women, though effect sizes varied with Black men exhibiting the largest effect. An intersectionally valid understanding of discrimination and alcohol involvement may necessitate statistical approaches that can test for (and model) differential item functioning prior to making between-group quantitative comparisons.

Closing the Dissemination Gap: Accessible Toolkits for the Rapid Replication of Evidence-Informed Interventions to Improve Health Outcomes Among People with HIV.

Despite advances in HIV care and treatment in the U.S., disparities in outcomes along the HIV care continuum persist. The widespread replication of effective and sustainable interventions that prioritize the engagement of underserved populations has been identified as a promising path to ending the HIV epidemic in the U.S. Intervention dissemination products, however, rarely provide the comprehensive and accessible information needed to replicate interventions within community settings. To bridge the divide between research and community-based implementation, the Using Evidence-informed Interventions to Improve Health Outcomes among People Living with HIV (E2i) initiative-grounded in the HIV/AIDS Bureau Implementation Science Framework-created a suite of tools to promote the rapid replication of interventions focused on transgender women, Black men who have sex with men, behavioral health integration, and identifying and addressing trauma. The resulting dissemination products are detailed and digestible multimedia toolkits that follow adult learning theory principles and align with the Template for Intervention Description and Replication criteria for adapting non-pharmacological interventions. Each E2i toolkit consists of five components: implementation guides, narrative videos of site implementation, best practice demonstration videos, interactive learning modules, and recruitment posters and brochures. Over 2 years (2022-2024), the E2i toolkit webpages amassed 7703 unique users and 17,666 pageviews. These toolkits can serve as a blueprint for designing comprehensive and accessible dissemination products for replication of HIV interventions in care settings. Dissemination products that bridge the gap between intervention research and replication in community settings are a crucial missing tool for ending the HIV epidemic.

Prenatal Substance Exposure and Infant Discharge Placement: Results From the ACT NOW Study.

It is critical that researchers gather evidence of factors that identify infants at risk of out-of-home placement based on types of substance exposures and demographic characteristics. This study applied a validated medical record data extraction tool on data derived from a multi-site (N = 30) pediatric clinical trials network (ISPCTN) study of Neonatal Opioid Withdrawal (ACT NOW study). Participants included 1808 birthing parent-infant dyads with documented NOWS scoring or prenatal opioid exposure. Non-Hispanic White pregnant persons comprised the largest proportion of the sample (69.8%), followed by Non-Hispanic Black (11.6%), Non-Hispanic Multiracial and Other race (8.5%), and Hispanic (6.2%). Most notably, infant prenatal substance exposure across alcohol, cocaine, meth/amphetamine, and opioids, had the lowest possibility of discharging to parent(s). Additionally, latent class analysis identified distinct classes of substance use during pregnancy that were associated with different probabilities of discharging to parent(s). Specifically, less than half of infants (47%-49%) in the Poly-use and Meth/amphetamine classes were discharged to their parent(s). Severity of infant withdrawal symptoms influenced placement decisions within the Poly-use and Prescription Opioid classes. Findings can inform standard practices for increasing support for pregnant persons and substance-exposed infants including identification, subsequent referrals, communication with Child Protective Services, and plans of safe care.

White NIMBYism and diversity close to home

AbstractObjectiveWe use a survey experiment to study what explains white “not in my backyard” opposition (NIMBYism) to dense and affordable housing—racial threat, material self‐interest, or both.MethodsIn a survey experiment on white U.S. respondents, we vary the presence of a racial prime about black and Latinx community organizations and the proximity of the housing development to the subject's home. We then measure levels of support for a proposed hypothetical housing development, willingness to take political action in support of or opposition to the development, and support for a number of housing‐related and redistributive policies.ResultsWe find that a racial threat, a material self‐interest threat, and a combined racial and material self‐interest threat decrease support for a proposed housing development. These effects are moderated by racial resentment, ideology, and partisanship such that the effects of the treatments are primarily driven by Republicans, conservatives, and the highly racially resentful. These groups are more threatened than others by either Latinx and black people moving in, the development being in their own neighborhood, or both.ConclusionThese findings indicate that racial and material perceived threats play important and interlocking roles in white Americans’ resistance to multifamily housing being built. In a context where local political institutions empower an unrepresentative group of disproportionately white, economically privileged neighbors to mount opposition to dense housing, it is important to understand how white opposition to new dense housing is shaped by racial and financial concerns.

American Arcadia? The Shift of the Homoerotic Gaze in Herbert List’s Work

The German photographer Herbert List (1903–75) is well known for his pictures from the Mediterranean, metaphysical still lives and portraits of young men. The latter, in particular, have garnered continuous attention due to their beauty and as examples of homosexual aesthetics in prewar and postwar Europe. A lesser-known body of work are his photographs taken in the Caribbean in 1957, including portraits of Black men. This article sheds light on List’s different homoerotic images by situating them in their art historical as well as local context. First, in an analysis of his Oriental and Orientalist representations of young men in Tunisia, I delineate his expansion of classical Greco-Roman tropes. Second, I contrast these images with List’s portraits of people of colour in the Caribbean and his critique of their historical exploitation and current living situation. In both contexts, List is complicit with as well as in contradiction to the power dynamics of European imperialism, and both follows and digresses from white European visual traditions. This analysis expands current scholarship by taking into consideration the issues of race, class and postcolonialism and their impact on the representation of bodies of colour.

Conceptualizing White Allyship among Undergraduate Students in the United States

ABSTRACT Colonialism in the U.S. has embedded anti-Blackness in social institutions, including but not limited to those of higher education. Preliminary research indicates that white allyship, or white people’s efforts to dismantle racism by advocating for and partnering with People of Color, is protective and beneficial to Black communities. However, little work has sought to clarify conceptualizations of white allyship – especially comparing the perspectives of Black and white students. To address this, the present study recruited 24 undergraduate students (12 Black, 12 white) to participate in semi-structured interviews focused on white allyship. Data were systematically transcribed, then coded using thematic analysis. Results indicated that Black and white students have somewhat similar understandings of allyship spanning from emotional support to actively resisting oppression; however, Black students generally conceptualized ally behaviors as involving more risk-taking. These data lend support to what Black Activists have been urging for years: emotional support and self-education are important ally behaviors, yet combating anti-Blackness also involves disrupting the systems that perpetuate it. Findings have implications for vested partners in education, institutions, and researchers.

CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2017-2021.

The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the Centers for Disease Control and Prevention and the National Cancer Institute, is the largest population-based registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. This report contains the most up-to-date population-based data on primary brain tumors available and supersedes all previous reports in terms of completeness and accuracy. All rates are age-adjusted using the 2000 US standard population and presented per 100,000 population. Between 2017 and 2021, the average annual age-adjusted incidence rate (AAAIR) of all primary malignant and non-malignant brain and other CNS tumors was 25.34 per 100,000 population (malignant AAAIR=6.89 and non-malignant AAAIR=18.46). This overall rate was higher in females compared to males (28.77 versus 21.78 per 100,000) and non-Hispanic Black persons compared to persons who were non-Hispanic White (26.60 versus 25.72 per 100,000), non-Hispanic American Indian/Alaska Native (23.48 per 100,000), non-Hispanic Asian or Pacific Islander (19.86 per 100,000), and Hispanic persons of all races (22.37 per 100,000). Gliomas accounted for 22.9% of all tumors. The most commonly occurring malignant brain and other CNS histopathology was glioblastoma (13.9% of all tumors and 51.5% of all malignant tumors), and the most common predominantly non-malignant histopathology was meningioma (41.7% of all tumors and 56.8% of all non-malignant tumors). Glioblastomas were more common in males, and meningiomas were more common in females. In children and adolescents (ages 0-19 years), the incidence rate of all primary brain and other CNS tumors was 6.02 per 100,000 population. There were 87,053 deaths attributed to malignant brain and other CNS tumors between 2017 and 2021. This represents an average annual mortality rate of 4.41 per 100,000 population and an average of 17,411 deaths per year. The five-year relative survival rate following diagnosis of a malignant brain or other CNS tumor was 35.7%. For a non-malignant brain or other CNS tumor the five-year relative survival rate was 92.0%.

9265 Racial/Ethnical Differences in Classic and 11-Oxygenated Androgens

Abstract Disclosure: C. Lee: None. R.J. Auchus: None. J. McDonald: None. J. Rege: None. W.E. Rainey: None. A.F. Turcu: None. Background: Malignancies modulated by sex-steroids, such as prostate and breast cancer, as well as disorders of androgen excess, like polycystic ovary syndrome, display prevalence and/or phenotype differences across races/ethnicities. Such differences have been attributed, in part, to testosterone (T). A set of adrenal-derived 11-oxygenated C19 steroids (11-oxyandrogens) has emerged as relevant to several androgen-dependent pathologies. Classic and 11-oxyandrogens are impacted differently by age and adiposity. Data on race and ethnic variations in 11-oxyandrogen concentrations are lacking. Setting and Participants: Participants in the population-based, multiethnic cohort of the Dallas Heart Study, phase 2. Measurements: T, androstenedione (A4), 11β-hydroxyandrostenedione (11OHA4), 11β-ketoandrostenedione (11KA4), 11-hydroxytosterone (11OHT), and 11-ketotestosterone (11KT) were quantified simultaneously in peripheral blood using liquid chromatography-tandem mass spectrometry. Steroids were compared across races stratified by gender, and adjusted for age and BMI, using linear mixed models in SAS (NC, USA). Results: Of the 1966 participants included, 1137 (57.8%) were women, 49% were non-Hispanic Black, 35% non-Hispanic White, and 14% Hispanic. The mean age of study participants was 51.3 +/- 10.3 years, and mean BMI was 31.0 +/- 7.1 kg/m2. Compared to White individuals of similar age and BMI, 11KT concentrations were higher in both Black women (β = 3.5 +/- 1.2, p = 0.004), and Black men (β = 5.8 +/- 1.9, p = 0.002). The immediate precursor of 11KT, 11KA4, displayed higher concentrations in Black vs. White men (β = 2.9+/- 0.7, p &amp;lt; 0.0001), with similar trends in women (β = 3.0 +/- 1.6, p = 0.056). The weak androgen 11OHT was higher in Black vs. White women (β = 3.0 +/- 0.91, p = 0.0009), but did not differ across races in men. Compared to White individuals of the corresponding gender, age- and BMI-adjusted 11OHA4 concentrations were higher in Hispanic women (β = 10.8 +/- 5.4, p = 0.043), and in Black men (β = 20.9 +/- 4.8, p &amp;lt; 0.0001). The classic androgen T was higher in Black women and men (β = 3.7 +/- 1.4 and β = 41.5 +/- 14.7, respectively, p &amp;lt; 0.01 for both), as well as in Hispanic men (β = 46.6 +/- 21.8, p = 0.03) compared to their White counterparts with similar age and BMI. A4 concentrations were similar across races. Conclusions: The bioactive androgens 11KT and T were higher in Black women and men compared to White individuals with similar age and BMI. Conversely, in Hispanic men, only T was higher compared to White men. In addition to T, 11KT might also contribute to disproportionately high prevalence of androgen-related pathologies in Black individuals. Acknowledgements: This work was supported by grant R01AG08051601 from the National Institute of Aging, and, in part, by grant UL1TR001105 from the National Center for Advancing Translational Science, National Institutes of Health. Presentation: 6/1/2024

6676 Exposure to Neighborhood Violence Rewires Glucocorticoid Receptor Binding and Drives Proliferation and Invasiveness in Lung Tumor Samples

Abstract Disclosure: H. Heath: None. J. Yoo: None. S. Akter: None. A. Jain: None. V. Sharma: None. H. McGee: None. A. Soliman: None. A. Mohamed: None. A.K. Matthews: None. R. Winn: None. Z. Madak Erdogan: None. S. Kim: None. Background: Despite the lower rates and frequency of smoking, Black men experience a higher incidence of lung cancer compared to white men. This health disparity is even more prevalent in Black men from Chicago, suggesting local neighborhood factors impacting tumorigenesis. Preliminary data indicate that, compared to white men, Black men are more likely to reside in neighborhoods with high levels of violence and have elevated levels of hair cortisol. Objective: To understand the link between lung tumorigenesis and exposure to neighborhood violence, our objective is to investigate the chromatin recruitment of the receptor for cortisol, called the glucocorticoid receptor (GR), and to correlate this recruitment with target gene expression levels. Methods: Utilizing CUT &amp; RUN, we identified the gene binding sites of GR using 15 lung tumor and corresponding healthy tissue samples from lung cancer patients living in Chicago. GR recruitment to chromatin was correlated with the neighborhood homicide rate obtained using patients’ zip codes. Spatial transcriptome profiles for these 15 lung tumor samples were obtained from the Space Ranger pipeline and gene expression hot spots of GR target genes were visualized using Loupe Browser (10x Genomics). Results: GR recruitment to regulatory regions of chromatin increases with greater zip code level violence rates. In patients from high violence neighborhoods, tumor samples had higher magnitude of binding compared to normal neighboring tissue. In tumor samples from patients living in high violence compared to low violence neighborhoods, GR binding is seen in genes that are associated with increased tumor aggressiveness. Hot-spot analysis of these genes found strong co-expression of genes associated with proliferation and invasion in samples from high violence but not low violence neighborhoods. Conclusion: Exposure to neighborhood violence may impact tumor biology via increased GR recruitment to genes associated with proliferation and invasion. Presentation: 6/2/2024

Evaluation of a National Sample of 16,671 Pediatric Burn Admissions: Identifying Predictors of Non-accidental Pediatric Burns

BackgroundBurn injuries remain one of the leading causes of injury and death in children. Studies have demonstrated a higher mortality for pediatric burns associated with non-accidental injury. Using data from a burn registry, our study aimed to discern potential factors associated with non-accidental burn injuries. MethodsWe utilized the American Burn Association database from 2016 to 2018, which collects data from over one hundred burn centers across the United States, to evaluate a large pediatric burn population. Patients aged ≤14 years were analyzed. The population was then divided into suspected non-accidental versus accidental burn injuries. A multivariable logistic regression model was utilized to evaluate for predictors of burn injuries. Additional models were used to assess the relationship between suspected non-accidental burn injury and mortality, intensive care unit (ICU) stay, and hospital length of stay. Results16,671 pediatric patients were included. Of those, 1228 (7.4%) patients suffered non-accidental burn injury. A majority of children who sustained non-accidental burn injury were younger, non-white, and sustained scald burns. The regression model demonstrated predictors for non-accidental burn injuries included younger age, Black race, chemical/corrosion burns, government insurance, and increased total body surface area (TBSA) burn. Overall mortality for the population was 0.5%. ConclusionThis evaluation of a national burn registry reveals differences in pediatric patients sustaining non-accidental burns compared to accidental burns. The findings in this study identify pediatric populations at risk for suspected non-accidental burn injuries which may assist in preparing the families for expectations after admission for a burn injury. Level of EvidenceIII.

Living less safely through the pandemic in England for people with serious mental and physical health conditions: qualitative interviews with service users and carers of Black African, Caribbean, and South-Asian descent.

COVID-19 Ethnic Inequalities in Mental health and Multimorbidities (COVEIMM) is a mixed methods study to explore whether COVID-19 exacerbated ethnic health inequalities in adults with serious mental and physical health conditions. We analysed data from electronic health records for England and conducted interviews in Birmingham and Solihull, Manchester, and South London. Sites were selected because they were pilot sites for the Patient and Carer Race Equality Framework being introduced by NHS England to tackle race inequalities in mental health. Prior to the pandemic people in England with severe mental illnesses (SMIs) faced an 11-17-year reduction in life expectancy, mostly due to preventable, long-term, physical health conditions. During the pandemic there was a marked increase in deaths of those living with an SMI. This qualitative interview study aimed to understand the reasons underlying ethnic inequalities in mortality and service use during the COVID-19 pandemic for adult service users and carers of Black African, Black Caribbean, Indian, Pakistani, and Bangladeshi backgrounds living with serious multiple long-term mental and physical health conditions. We took a participatory action research approach and qualitative interviews undertaken by experts-by-experience and university researchers Participants were purposively sampled by ethnicity, diagnoses, and comorbidities across three geographically distinct sites in England. Transcriptions were coded inductively and deductively and analysed thematically. Findings indicated multiple points along primary and secondary health pathways for mental and physical health that have the potential to exacerbate the unjust gap in mortality that exists for Black and Asian people with SMIs. Issues such as timely access to care (face-to-face and remote), being treated in a culturally appropriate manner with empathy, dignity and respect, and being able to use services without experiencing undue force, racism or other forms of intersectional discrimination were important themes arising from interviews. These poor experiences create systemic and enduring healthcare harms for racialised groups with SMIs that need to be addressed. Our findings suggest a need to address these, not only in mental health providers, but across the whole health and care system and a need to ensure more equitable healthcare partnerships with service users, carers, and communities from racialised backgrounds who are often excluded.

Bioarchaeological Approaches to African Diasporas in the Twenty-First Century: Intercontinental and Global Legacies of Displacement

ABSTRACT Bioarchaeological research offers a window into health and life experiences in the past, including the biocultural dimensions of social identities and structural inequalities experienced by enslaved and free Afro-descendants across the African diaspora. Given the long history of descendant communities and advocates contesting the authority of institutions to curate human remains in perpetuity, critical dialogues over the past several decades have stimulated new directions in the discipline of African diaspora bioarchaeology alongside increased engagement with Black scholarship and community and client-based collaborations. We build upon previous discussions and critiques to examine the current state of African diaspora bioarchaeology in global context in the early decades of the twenty-first century. We present a macro-level, chronological examination of published African diaspora and colonial African bioarchaeological research by region between 2001 and 2023 and conclude with a discussion of the current state of practices and engagement in the field and ethics of care.