Blacks Research Articles

Percent Final Height Is a Novel Method That Identifies Differences Between the Rate of Development in American Children of Different Races.

The Greulich & Pyle (G&P) Radiographic Atlas of Skeletal Development uses hand x-rays obtained between 1926 and 1942 on children of Caucasian ancestry. Our study uses modern Caucasian, Black, Hispanic, and Asian children to investigate patterns of development as a function of percent final height (PFH). A retrospective review, at a single institution, was conducted using children who received a hand x-ray, a height measurement taken within 60 days of that x-ray, and a final height. BA and CA were compared between races. PFH was calculated by dividing height at the time of the x-ray by their final height. To further evaluate differences between races in CA or BA, PFH was then modeled as a function of CA or BA using a fifth-degree polynomial regression, and mean ages at the 85th PFH were compared. Patients were then divided into Sanders stages 1, 2-4, and 5-8 and the mean PFH, CA, and BA of the Asian, Black, and Hispanic children were compared with the White children using Student t test. P values less than 0.05 were considered significant. We studied 498 patients, including 53 Asian, 83 Black, 190 Hispanic, and 172 White patients. Mean BA was significantly greater than CA in Black males (1.27y) and females (1.36y), Hispanic males (1.12y) and females (1.29y), and White females (0.74y). Hispanic and Black patients were significantly more advanced in BA than White patients ( P <0.001). At the 85th PFH, White and Hispanic males were older than Black males by at least 7 months ( P <0.001), and White females were significantly older than Hispanic females by 6.4 months ( P <0.001). At 85th PFH for males, Hispanic and Black males had greater BA than White males by at least 5 months ( P <0.001), and Asian females had a greater BA than Black females by at least 5 months ( P <0.001). Compared with White children, Hispanic children were significantly younger at Sanders 2-4 than White children, and Black children were skeletally older at Sanders 5-8. BA was greater than CA by ≥1 year in Black and Hispanic children, and that these children had a significantly greater BA than their White counterparts. Black males and Hispanic females reached their 85th PFH at younger ages, and Hispanic males and Asian females were the most skeletally mature at their 85th PFH. Our results suggest that BA and CA may vary as a function of race, and further studies evaluating growth via the 85th PFH may be necessary. Therapeutic Study - Level IV.

Trends and Disparities in the Utilization of Thymectomy for Myasthenia Gravis in the United States.

In 2016, a randomized controlled trial demonstrated the clinical efficacy of trans-sternal thymectomy for patients with non-thymomatous myasthenia gravis (MG). Whether large-scale changes occurred in clinical practice after this trial is unknown. We performed a retrospective longitudinal cross-sectional analysis using National Inpatient Sample (NIS) data from 2012 to 2019. Our study included hospitalized adults at least 18 years of age diagnosed with MG without an associated thymoma. We used joinpoint regression to analyze annual trends in thymectomy volume and surgical approach (minimally invasive vs trans-sternal) from 2012 to 2019. Using logistic regression models, we examined patient and hospital-level factors that may have influenced whether thymectomy was performed, such as age, sex, race, insurance payor, hospital size and teaching status, and Elixhauser Comorbidity Index. Sampling weights were applied to account for the complex survey design of NIS. The total number of thymectomy procedures increased by 69.8% per year (95% CI 40.1-105.8) between 2012 and 2019. Trans-sternal thymectomies increased by 62.8% per year (95% CI 35.8-95.2) and minimally invasive thymectomies by 83.7% per year (95% CI 38.1-144.3). Thymectomies were significantly more likely to occur in 2017-2019 compared with 2012-2016 (OR 1.93, 95% CI 1.62-2.31). In a multivariable regression model, several factors decreased the odds of patients with MG having a thymectomy: older age, Black race (OR 0.62, 95% CI 0.49-0.77), female (OR 0.73, 95% CI 0.63-0.86), and higher Elixhauser Comorbidity Index. Patients in medium (OR 1.82, 95% CI 1.30-2.55) or large (OR 2.81, 95% CI 2.07-3.82) size and urban teaching hospitals (OR 6.09, 95% CI 2.65-13.97) were more likely to undergo thymectomy. Thymectomy is being performed more frequently for non-thymomatous MG, especially after 2016 after publication of a positive phase III clinical trial. There are several disparities in thymectomy utilization that warrant further attention.

Identifying Pregnant Patients With Suspected Intimate Partner Violence.

Intimate partner violence (IPV) is the leading cause of death in pregnant women. Although it can be difficult to identify patients experiencing IPV, injuries to the head, neck, or face due to an assault are known to correlate with intentional injury. The objective of this study is to assess the contemporary burden of IPV in pregnancy and describe the patient characteristics. The National Inpatient Sample was queried for all pregnant women between January 2016 and December 2019. Patients were divided into two groups: suspected IPV (SIPV) and no-SIPV groups. We defined SIPV as any pregnant patient with an identified head, neck, or face injuries categorized as intentional assault. Multivariable logistic regression analysis was performed to assess the association between SIPV and variables of interest. A total of 28,540 pregnant patients presented with traumatic injuries with 530 (.02%) identified as SIPV. Suspected IPV patients were younger (25 vs 27 years, P = .012), more likely to be of Black race (46% vs 28%, P = .002), more likely to be in the lowest income quartile (51% vs 38%, P = .031), less likely to have private insurance (12% vs 34%, P < .001), and have higher rates of substance use disorder (35% vs 18%, P < .001). Black race and history of substance use disorder were associated with increased odds of SIPV-related injuries (odds ratio [OR]: 2.01, interquartile range [IQR]: 1.27-3.16, P = .003 and OR: 2.30, IQR 1.54-3.43, P < .001, respectively). Our results suggest that there are significant racial and socioeconomic disparities in potential risk for IPV during pregnancy.

A lifesaving improvised peritoneal dialysis on a toddler with acute kidney injury following a swarm of bees’ sting at Iringa Regional Referral Hospital, Southern Highland—Tanzania: a case report

BackgroundPeritoneal dialysis as one of the nephrology services in children with acute kidney injury is a safe and cost-effective modality of treatment in low and lower-middle income countries. Despite evidence of its effectiveness in limited resource settings, the service is still provided only in tertiary level healthcare facilities in Tanzania.Case presentationIn this case report, we narrate the survival of a 22-month-old male patient of African descent with an acute kidney injury following a swarm of bees’ stings at home. A lifesaving, although low-quality and high-risk, peritoneal dialysis was performed for 5 days at Iringa Regional Referral Hospital, a secondary level health facility in rural Tanzania with lack of standard and recommended expertise, laboratory investigations, and equipment.ConclusionLower- and middle-income countries in collaboration with stake holders should ensure that this service is available, accessible, and safe in the lower-level health facilities, given that access to the tertiary-level facilities is inadequate and time limited, hence serving a larger population.

Abstract A155: Perceived interpersonal racism in healthcare settings and cancer screening

Abstract Introduction: Black and Hispanic people frequently report that perceptions of their race or ethnicity underlie racist and discriminatory experiences in many settings. In the healthcare field, these interpersonal racist experiences can severely impact the decision to receive care and the general health of the patient. Previous studies assessing the role of perceived racial discrimination in the healthcare setting and cancer screenings struggled with low sample sizes that precluded meaningful conclusions. Also, a methodological issue not considered in prior studies is the large degree of uncertainty reported by racialized groups in their assessment of perceived racism and its relevance to the measurement of this construct. In response to these data limitations and newly available nationally representative Behavioral Risk Factor Surveillance System data, we assessed the relationship of perceived racial discrimination in the healthcare setting associated with timely cancer screening across racial/ethnic groups. Methods: Data was collected from the 2022 Behavioral Risk Factor Surveillance System, which is a nationally representative state level population-based household survey with 28 states and the District of Columbia administering the optional modules assessing perceived racial discrimination. Perceived racism in healthcare was measured with the question: “Within the past 12 months when seeking health care, do you feel your experiences were worse than, the same as, or better than for people of other races?”. The outcomes were USPSTF recommendation concordant up-to-date colorectal, cervical, and breast cancer screening. Survey weighted logistic regression models adjusted for age, sex, education, and state estimated prevalence differences stratified by race/ethnicity. Results: Colorectal, cervical, and breast cancer screening were lower in White persons who reported worse (aPD vs. "better": -11.6%, -15.8%, -19.3%) and uncertain (don’t know) experiences of racial discrimination (aPD vs. "better": -7.4%, -4.1%, -5.0%). Among Black people, colorectal and cervical screening were only lower in those reporting uncertain experiences (aPD vs. "better": -10.8% and -12.0%). Among Hispanic persons, breast cancer screening prevalence was lowest in those who reported uncertain and worse racial discrimination (aPD vs. “better”: -12.4% and -15.9%). Conclusions: In this large generalizable sample, perceived racial discrimination in the healthcare setting was associated with cancer screening for both White and Black persons, but in different ways. Worse interpersonal racism in the healthcare setting was associated with lower cancer screening in White persons; but being uncertain relative to other race groups was largely associated with worse cancer screening among Black persons. Uncertainty in self-reported, racist experiences must be considered in institutional efforts to measure and address racism in healthcare settings. Citation Format: Jessica Star, Priti Bandi, Kilan Ashad-Bishop. Perceived interpersonal racism in healthcare settings and cancer screening [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A155.

Abstract A047: Neighborhood disadvantage and multiple myeloma risk among Black women living in the United States

Abstract Introduction: Multiple myeloma (MM) is a rare cancer of the plasma cells. Black men and women are at a greater than 2-fold increased risk of MM as compared to other racial/ethnic groups. In 2021, Black women living in the United States (U.S.) were diagnosed with MM at a rate of 13.9 per 100,000 women, and incidence has increased by more than 30% since 2000. Factors associated with the neighborhood in which Black women live and work may be one area to consider to disentangle this racial disparity in MM incidence and reduce the burden of disease for Black women. Methods: We evaluated the association between two neighborhood-level indices and MM within the Black Women’s Health Study, a longitudinal cohort of 59,000 self- identified Black women ages 21-69 at enrollment in 1995. Participant addresses at baseline were geocoded and linked with U.S. Census Bureau and American Community Survey data. We conducted a factor analysis to a create neighborhood concentrated disadvantage (nDIS) score, which included 6 variables: percentage of individuals below the poverty line, percentage of individuals on public assistance, percentage of female headed households, percentage unemployed, percentage of individuals ≤18 years, and percentage of Black residents. A neighborhood socioeconomic status (nSES) score included median household income, median housing value, percentage of households receiving interest, dividend or net rental income, percentage of adults aged ≥25 years who completed college, percentage of employed persons aged ≥16 years in occupations classified as managerial, executive or professional, and percentage of families with children that are not headed by a single female. We used Cox proportional hazards regression to calculate hazard ratios (HRs) and 95% confidence intervals (CI) for the association of quartiles of nSES and nDIS in relation to MM risk. Multivariable models were adjusted for age, body mass index, educational attainment, alcohol consumption, physical activity, and cigarette smoking. Results: During follow-up through 2021, we identified 276 incident cases of MM. Multivariable-adjusted HRs were 1.43 (95% CI: 1.00, 2.03) for women living in the highest quartile of neighborhood disadvantage relative to the lowest quartile, and 1.23 (95% CI: 0.86, 1.76) for women living in neighborhoods in the lowest quartiles of nSES compared to the highest. Conclusions: Black women in the U.S. living in neighborhoods of high concentrated disadvantage have an increased risk for MM compared to women who live in more advantaged communities, even after adjustment for individual SES as measured by educational attainment. Future studies to further tease apart specific neighborhood-level factors (e.g., walkability, chronic stress, environmental pollution, opportunities to engage in healthy behaviors) that might influence risk of MM would be beneficial. Ultimately, community reinvestment may offer an opportunity to reduce the increasing burden of MM among Black women. Citation Format: Etienne X. Holder, Julie R. Palmer, Kimberly A. Bertrand. Neighborhood disadvantage and multiple myeloma risk among Black women living in the United States [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A047.

Abstract A054 Liver cancer mortality by structural disadvantage and race: An analysis of U.S. area-level factors

Abstract Introduction: Racial/ethnic and sex disparities in liver cancer (LC) mortality are well established; yet little is known about the contributions of county-level social risks on these disparities. Methods: We used U.S. national death certificate data from the National Center for Health Statistics (2018-2022) for LC mortality. County-level estimates of income inequality (ratio of household income at the 80th and 20th percentile), and median household income were obtained using the American Community Survey. Severe housing problems (percentage of households with 1 of 4 housing problems: overcrowding, high housing costs, lack of kitchen facilities, or lack of plumbing facilities) were abstracted from the U.S. Department of Housing and Urban Development (HUD) and U.S. Census Bureau. We estimated age-adjusted mortality rates (MR) and MR rate ratios (aRR) across metrics of county-level social risk grouped in quartiles overall and by race/ethnicity. Results: There were 101,088 liver cancer (LC) deaths from 2018-2022 (MR=6.16 per 100,000). Areas of highest county-level income inequality had 31% higher LC mortality compared to areas within the lowest quartile (aRR=1.31). LC MRs were 45% higher in counties with the lowest vs. highest median household income (aRR=1.45). Men and women in the highest quartile of severe housing problems had 29% and 22% higher LC MR (aRR=1.29 and 1.22, respectively), than those in the lowest quartiles. Men and women in the lowest quartile of median household income had 43% and 49% higher LC mortality than those in the highest median income quartiles (aRR=1.43 and 1.49, respectively). Within the highest quartile of income inequality, American Indian/Alaskan Native (AI/AN) persons had the highest LC mortality rates (MR=7.07), followed by Hispanic (MR=6.75), Black (MR=6.48), and Asian (MR=5.83) individuals. Similarly, in the highest quartile of severe housing problems, AI/AN persons had the highest LC mortality rate (MR 7.74), while Hispanic persons had 58% higher MR (MR 7.01), followed by Black (MR=6.19), Asian (MR=5.85) and White (MR=4.07) individuals. In the lowest median household income quartile, compared to White persons (MR=5.91), AI/AN persons had the highest MR (MR=8.86), and Hispanic persons had a 70% increase in mortality (MR=8.48). Among counties with the highest income inequality, compared to White persons (aRR=1.15), Black persons had an 80% increase in mortality (aRR=1.43). For those in the most concentrated quartile of severe housing problems, compared to White persons (aRR=1.07), AI/AN persons had an 80% increase in mortality (MR=1.34).Conclusion: All county-level indicators of highest social risk were associated with greater liver cancer mortality, but do not appear to fully account for racial and ethnic disparities in mortality. Therefore, place- based interventions are needed to address the role of county-level economic attributes in liver cancer mortality disparities. Citation Format: Jennifer K. McGee-Avila, Wayne R. Lawrence, Natalie Joe, Cameron B. Haas, Meredith S Shiels. Liver cancer mortality by structural disadvantage and race: An analysis of U.S. area-level factors [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A054.

Abstract C018: MicroRNA and tRNA fragments as biomarkers for prostate cancer aggressiveness in self-reported black and white men: Results of a pilot study

Abstract C018: MicroRNA and tRNA fragments as biomarkers for prostate cancer aggressiveness in self-reported black and white men: Results of a pilot study

Abstract B002: Cancer health equity and research advocacy program among immigrant communities

Abstract Introduction: In an effort to ensure an all-inclusive initiative that would close the disparity gap among the immigrant communities in Florida, we developed a pilot project under the Inclusive Cancer Care Research Equity (iCCaRE) for Black Men Consortium with generous support from the Mayo Clinic Comprehensive Cancer Center (MCCCC). The objective is to train cancer advocates to engage their communities and develop and implement cancer prevention and screening navigation programs. The central hypothesis for this program is that community-driven cancer advocacy will significantly improve cancer awareness, knowledge, prevention, risk reduction, screening uptake, and early detection among Black immigrants. Methods: We collaborated with immigrant communities’ leaders to brainstorm on the current state of healthcare access and disparities experienced by Black immigrants and to set program and research priorities through listening sessions. Cancer advocates were trained to engage their communities to (1) develop and implement cancer risk reduction and education programs using train-the-trainer approach, (2) mobilize the resources within the community for cancer health promotion, prevention, and screening strategies, (3) partner with key stakeholders to accomplish targeted objectives; (4) raise funds to support advocacy activities; and (5) develop and successfully organize community-centered programs. Results: We are currently working with 10 Black immigrant organizations, including immigrant churches across different ethnicities, including Nigeria, Ghana, Cameroon, Liberia, South Africa, Haiti, Jamaica, and across different cities in the United States. Eighteen community cancer advocates, including breast and prostate cancer survivors, caregivers, and community influencers, were trained to engage the immigrant communities in cancer risk reduction and research in Florida using multiple channels, including in-person community programs and online engagement approaches. We have engaged 720 immigrants in cancer risk reduction education and the need to participate in research during advocate-led in-person community outreaches. We currently have 26 immigrants who have volunteered in the Mayo Clinic Community Research Registry. The program is ongoing, and we anticipate that more than 750 will be engaged, and 100 will volunteer to be registered in the Mayo Clinic Community Research Registry. Conclusion: Advocate-led advocacy in immigrant communities will provide evidence for compelling arguments about the feasibility and availability of the Black immigrant population for robust and sustainable research and program engagements to eliminate disparity and advance cancer health equity. Citation Format: Opeyemi O. Bolajoko, Caleb Ramirez, Shannon Pressey, Noreen A. Stephenson, Vinessa A. Gordon, Binta Onyibe, Kingsley Efe, Austin Okaiwele, Mubo Oloruntobo, Brittany M. Norris, Folakemi T. Odedina. Cancer health equity and research advocacy program among immigrant communities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B002.

Survival outcomes after omission of surgery for ductal carcinoma in situ

Clinical trials of active surveillance (AS) for Ductal Carcinoma in Situ (DCIS) are underway. We sought to understand the historical management of biologically favorable DCIS and to determine the outcomes of patients who did not have immediate surgery. Using data from the NCDB from 2004 to 2017, the selected cohort included women >40 years of age, with low or intermediate grade and hormone receptor (HR) positive DCIS. AS was defined as either no surgery or surgery >12 months from diagnosis. Women in the AS group were compared to women who had immediate surgery. A Cochran-Armitage test was used to assess the trend of AS over year of diagnosis. Kaplan-Meier curves were estimated to compare overall survival (OS), stratified by age (<50, 50–64, ≥65), and Cox proportional hazard models were used to determine the effects of prognostic factors on survival distributions. 74,367 women met study inclusion criteria; 2384 (3.2%) were treated with AS. The proportion of patients in the AS cohort increased yearly, peaking in 2017 at 4.2% (p < 0.01). On multivariable analysis, increasing age (OR 1.02, p < 0.01), black race (OR 1.7, p < 0.001), and being uninsured (OR 2.2, p < 0.001) were associated with increased likelihood of AS. In women <50 years of age, OS outcomes were similar, with 10-year OS of 97.4% in the immediate surgery cohort versus 99.1% in AS cohort (p = 0.43). The proportion of patients with DCIS treated with AS has remained small but is increasing over time. AS of biologically favorable DCIS in younger, healthier women is not associated with adverse survival.

Healing Love: Toward a Theory of Communion for Black Men

ABSTRACT Guided by the three core tenets of a Black feminist love-politic, this article offers a framework of communion for Black men within higher education. Emanating from the embodied experiences of Black men in academe participating in the “site” of communion (i.e. The Gathering) through an Association for the Study of Higher Education (ASHE) virtual symposium session, four core dimensions of theory emerged: spiritual, relational, material, and political. Life-notes from each session participant are used to capture each dimension of communion. Implications for praxis related to the spiritual and material well-being of Black men within higher education are offered.

California’s AB 101

In 2021, California governor Gavin Newsom signed into law AB 101, which requires that all students graduating high school by 2029–2030 must take an ethnic studies course. California is the only state in the nation with this graduation requirement. This article explores the historical and contemporary factors that pushed California to legislate and implement AB 101. We utilize a historical case study approach focusing on different student-led movements that embraced ethnic studies to combat educational inequalities. To do so, we pinpoint three historical phases in which ethnic studies became implemented throughout the state. In the first phase, influential scholars in the early and mid-twentieth century produced scholarship about historically marginalized people of color, which became foundational for the study of Black, Chicana/o, Asian American, and Indigenous people. The second phase involved students of color fighting for a culturally relevant curriculum, as demonstrated by the 1968 Third World Liberation Front, the 1968 East Los Angeles Chicano walkouts, El Plan de Santa Bárbara, and Chicanx/Latinx student hunger strikes in the 1990s. Lastly, the third phase consists of contemporary students, parents, educators, and activists successfully petitioning their local school districts to mandate ethnic studies as a high school graduation requirement. Despite these gains, far-right organizations in cities like Santa Barbara have mobilized to push back against both the ethnic studies requirement and progressive social justice groups like Just Communities Central Coast. This resistance initially derailed AB 331, an earlier ethnic studies bill that Governor Newsom vetoed based on accusations that it was “anti-Semitic.” A revised version, AB 101, was then introduced and passed. While momentous, we contend, AB 101 is still limited; reaching its full potential would require greater teacher credentialing and the expansion of ethnic studies to K–8 students.

Projections of Extreme Temperature–Related Deaths in the US

ImportanceExtreme heat in the US is increasing due to climate change, while extreme cold is projected to decline. Understanding how extreme temperature along with demographic changes will affect population health is important for devising policies to mitigate the health outcome of climate change.ObjectiveTo assess the burden of extreme temperature–related deaths in the contiguous US currently (2008-2019) and estimate the burden in the mid–21st century (2036-2065).Design, Setting, and ParticipantsThis cross-sectional study used historical (1979-2000) daily mean temperatures to calculate monthly extreme heat (&amp;amp;gt;97.5th percentile value) and extreme cold days (&amp;amp;lt;2.5th percentile value) for all contiguous US counties for 2008 to 2019 (current period). Temperature projections from 20 climate models and county population projections were used to estimate extreme temperature–related deaths for 2036 to 2065 (mid–21st century period). Data were analyzed from November 2023 to July 2024.ExposureCurrent monthly frequency of extreme heat days and projected mid–21st century frequency using 2 greenhouse gas emissions scenarios: Shared Socioeconomic Pathway (SSP)2-4.5, representing socioeconomic development with a lower emissions increase, and SSP5-8.5, representing higher emissions increase.Main Outcomes and MeasuresMean annual estimated number of extreme temperature–related excess deaths. Poisson regression model with county, month, and year fixed effects was used to estimate the association between extreme temperature and monthly all-cause mortality for older adults (aged ≥65 years) and younger adults (aged 18-64 years).ResultsAcross the contiguous US, extreme temperature days were associated with 8248.6 (95% CI, 4242.6-12 254.6) deaths annually in the current period and with 19 348.7 (95% CI, 11 388.7-27 308.6) projected deaths in the SSP2-4.5 scenario and 26 574.0 (95% CI, 15 408.0-37 740.1) in the SSP5-8.5 scenario. The mortality data included 30 924 133 decedents, of whom 15 573 699 were males (50.4%), with 6.3% of Hispanic ethnicity, 11.5% of non-Hispanic Black race, and 79.3% of non-Hispanic White race. Non-Hispanic Black adults (278.2%; 95% CI, 158.9%-397.5%) and Hispanic adults (537.5%; 95% CI, 261.6%-813.4%) were projected to have greater increases in extreme temperature–related deaths from the current period to the mid–21st century period compared with non-Hispanic White adults (70.8%; 95% CI, −5.8% to 147.3%).Conclusions and RelevanceThis cross-sectional study found that extreme temperature–related deaths in the contiguous US were projected to increase substantially by mid–21st century, with certain populations, such as non-Hispanic Black and Hispanic adults, projected to disproportionately experience this increase. The results point to the need to mitigate the adverse outcome of extreme temperatures for population health.

The effect of social factors on eye movements made when judging the aesthetic merit of figurative paintings

In the present study we explore how social factors (group contact, individuating experience, implicit racial bias) influence the eye movements made during the visual exploration when judging their aesthetic merit of figurative paintings depicting White and Black sitters. An opportunity sample of participants visiting a gallery in Liverpool viewed ten artworks while their eye movements were recorded and completed a set of individual difference measures. The individual difference measures indicated self-report of art interest, social contact and individuating experience with both Black and White communities, and implicitly held racial bias. The results showed that, despite viewing the paintings for less time, the majority of participants reported paintings showing Black sitters as more interesting, emotionally moving, and pleasurable then those depicting White sitters. However, if a participant reported limited social contact with Black community, and a negative implicit racial bias against them, their rating of aesthetic merit of paintings showing Black sitters was reduced, viewing time increased, and fixations became more focused on faces. The influence of social factors on the viewing of paintings showing White sitters was limited to aesthetic rating. The results are discussed in terms of how social factors influence eye movements when viewing paintings in a real-world setting.

The Atrato River as a Bearer and Co-creator of Rights: Unveiling Black People’s Legal Mobilization Processes in Colombia

Abstract In 2016, Colombia’s Constitutional Court recognized the Atrato River as the first water body in Latin America to have its own rights. This article interrogates the historical roots of the judicial decision declaring the river a rights holder. Drawing on my long-term engagement with social organizations as an activist, lawyer, and then researcher, I illuminate the influence of Black people from the Atrato River in the transformation of law in at least three areas: ethnic territorial rights, transitional justice, and river rights. To do so, I combine interdisciplinary theoretical critique with socio-legal research using community-based and autoethnographic approaches to trace the community methods and historical practices of political contestation deployed along the rivers. Thus, I conceptualize how an organic and distinctive style of claiming and creating rights has been constructed in the basin. Moreover, by listening to the voices of the riverine representatives, I argue that the river is a nonhuman existence that has participated in the processes of rights-making in conjunction with local communities and a broader mosaic of allied actors. However, I also outline how legal systems still function to overlook crucial socio-legal claims of marginalized and resistant communities.

An empirical investigation of ethnic-cultural procedural fairness effects and their boundary conditions among three societal groups in South Africa

ABSTRACT Ethnic-cultural procedural fairness refers to the perception that societal actors use fair and unbiased procedures to make decisions vis-à-vis one’s ethnic-cultural group. Prior research using ethnic-cultural minority samples has convincingly shown that such perceptions are associated with a range of desirable outcomes. Yet, this body of evidence has so far limited its scope to European and North American samples. Moreover, more research is needed on the underlying psychological processes. Therefore, the central aim of the present study was to investigate ethnic-cultural procedural fairness effects among three societal groups in South Africa. In Study 1 (N = 326 black South Africans), we observed relationships between ethnic-cultural fairness perceptions and positive institutional and intergroup attitudes. Institutional and social trust respectively mediated these associations. Study 2 (N = 747) replicated these findings among white (n = 595), but not among coloured South Africans (n = 152). Notably, across both studies, we also obtained evidence for moderation. That is, procedural fairness effects on institutional attitudes were significantly smaller among socioeconomically burdened black participants, and procedural fairness effects on intergroup attitudes were fully curbed among white participants who reported high levels of perceived group discrimination. Taken together, our results call for enhanced attention to procedural fairness obstacles outside of typical WEIRD settings.

Factors associated with fall risk increasing drug use in older black and white men and women: the Health ABC Study

BackgroundMost older adults use medications that may increase falls, often defined as fall risk increasing drugs or “FRIDs”. Two definitions for FRIDs, the Centers for Disease Control and Prevention’s (CDC) Stopping Elderly Accidents, Deaths & Injuries (STEADI-Rx) and Swedish National Board of Health and Welfare (SNBHW) definitions, are widely accepted, though include different FRIDs in their definitions. Whether factors associated with FRID use in older adults differ by definition is unknown.MethodsWe hypothesized that factors for FRID use will vary by FRID definition in 1,352 community-dwelling older Black and White adults with medication information in the Health, Aging and Body Composition Study (Health ABC; 2007–08 clinic visit; 83.4 ± 2.8 years; 54.1% women; 65.1% White). Multivariable logistic regression and multivariable negative binomial regression, progressively entering groups of covariates (demographics, lifestyle/behavior factors, and multimorbidity), modeled FRID use (yes/no) and count.ResultsOf 87.0% participants using SNBHW FRIDs, 82.9% used cardiac medications, with lower use of all other FRIDs (range:1.1-12.4%). Of 86.6% participants using STEADI-Rx FRIDs, 80.5% used cardiac medications, with lower use of all other FRIDs (range:1.1-16.1%). Participants with FRID use by either definition were more likely to have chronic health conditions, a hospitalization in the prior year, higher non-FRIDs medication counts, higher Center for Epidemiologic Studies Depression Scale (CES-D) scores, and less physical activity (all p < 0.05). Participants with STEADI-Rx FRID use had poorer vision and higher Modified Mini-Mental State (3MS) scores. In multivariable logistic regression for SNBHW use, hypertension, body mass index (BMI), 3MS scores, and non-FRID count were positively associated with FRID use and poorer vision and Digit Symbol Substitution Test (DSST) scores were negatively associated. In addition to SNBHW factors, higher CES-D scores were associated with STEADI-Rx FRID use. In multivariable negative binomial regression, hypertension, higher BMI, CES-D scores, and non-FRID count were associated with higher FRID count and sleep problems with lower FRID count for both definitions. Higher 3MS and lower DSST scores were associated with higher STEADI-Rx FRID count. Women had lower SNBHW FRID count after adjustments.ConclusionsRisk factors for FRID use in older adults differ slightly by STEADI-Rx and SNBHW FRIDs definition, but are largely similar.

The Synergistic Health Threats of State Laws Targeting Marginalized Groups in the United States

Discriminatory state laws have deleterious effects on the health of socially marginalized groups. Health care clinicians, institutions, researchers, and research funders have tended to view different discriminatory laws in isolation, focusing on particular issues or groups. In contrast, intersectionality calls attention to the overlapping and synergistic systems of oppression that discriminatory legislation promotes or upholds, warranting an integrated analysis of these laws. In this analytic essay, we assess discriminatory state laws simultaneously and discuss their implications for health care clinicians, institutions, and researchers. We present a multifunctional model of law and population health that describes how discriminatory law affects health outcomes among marginalized groups. We then draw on publicly available legislation trackers to identify 30 states that have enacted legislation since 2020 that targets Black people and other people of color; lesbian, gay, bisexual, and queer people; transgender and nonbinary people; and women and other birthing people. Finally, we call for a coordinated, multilateral, and forceful effort by health care professionals, institutions, researchers, and research funders to counter these laws and address their predictable health consequences. ( Am J Public Health. Published online ahead of print September 19, 2024:e1–e9. https://doi.org/10.2105/AJPH.2024.307830 )

Four More Years! or So What?

Abstract This study investigated the mental health significance of Barack Obama’s 2012 presidential re-election among Blacks. Upon his re-election, we hypothesized Blacks would either feel symbolic empowerment or relative deprivation. They would feel symbolic empowerment because a man who identifies as Black won re-election to the nation’s highest office. His second victory should generate optimism, given his status as a historic first. Alternatively, they would feel relative deprivation because The Great Recession from 2007 to 2009 curtailed what Obama could achieve. More important, he withered when afforded opportunities to challenge White supremacy and championed individual responsibility. Using a quasi-experimental design with nationally representative survey data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS), we predicted Blacks’ preelection and postelection poor mental health days. We found no time period main effects. However, Black men with less than a college degree experienced 1.11 more poor mental health days postelection whereas Black men with a college degree or more experienced 2.93 fewer poor mental health days postelection. These findings support relative deprivation theory.

Adaptation of the socioecological model to address disparities in engagement of Black men in prostate cancer genetic testing

BackgroundBlack men consistently have higher rates of prostate cancer (PCA)- related mortality. Advances in PCA treatment, screening, and hereditary cancer assessment center around germline testing (GT). Of concern is the significant under-engagement of Black males in PCA GT, limiting the benefit of precision therapy and tailored cancer screening despite longstanding awareness of these disparities. To address these critical disparities, the Socioecological Model (SEM) was employed to develop comprehensive recommendations to overcome barriers and implement equitable strategies to engage Black males in PCA GT.MethodsClinical/research experts, national organization leaders, and community stakeholders spanning multiple regions in US and Africa participated in developing a framework for equity in PCA GT grounded in the SEM. A novel mixed-methods approach was employed to generate key areas to be addressed and informed statements for consensus consideration utilizing the modified Delphi model. Statements achieving strong consensus (> =75% agreement) were included in final equity frameworks addressing clinical/community engagement and research engagement.ResultsAll societal levels of the SEM (interpersonal, institutional, community, and policy/advocacy) must deliver information about PCA GT to Black males that address benefits/limitations, clinical impact, hereditary cancer implications, with acknowledgment of mistrust (mean scores [MS] 4.57-5.00). Interpersonal strategies for information delivery included engagement of family/friends/peers/Black role models to improve education/awareness and overcome mistrust (MS 4.65-5.00). Institutional strategies included diversifying clinical, research, and educational programs and integrating community liaisons into healthcare institutions (MS 4.57-5.00). Community strategies included partnerships with healthcare institutions and visibility of healthcare providers/researchers at community events (MS 4.65–4.91). Policy/advocacy included improving partnerships between advocacy and healthcare/community organizations while protecting patient benefits (MS 4.57-5.00). Media strategies were endorsed for the first time at every level (MS 4.56-5.00).ConclusionThe SEM-based equity frameworks proposed provide the first multidisciplinary strategies dedicated to increase engagement of Black males in PCA GT, which are critical to reduce disparities in PCA-mortality through informing tailored screening, targeted therapy, and cascade testing in families.