Concentrations Of Ethnic Minorities Research Articles

Against the odds: predictors of academic success and excellence in majority-minority schools

ABSTRACT Although schools with a high concentration of ethnic minorities often underperform, not much is known about the factors that predict high and even excellent achievement of pupils within these schools. Therefore, we examined which concrete diversity practices and key psychological processes increase or decrease the likelihood/odds for high and excellent performance on a standardized mathematics test, thereby utilizing multivariable logistic regressions among 855 10–12-year-olds in 18 majority-minority schools in Flanders, Belgium. While the odds for high and excellent mathematics scores were unaffected by language spoken at home or religiosity, they were negatively related to deficit-based assimilationist school practices, inconsistently related to meritocratic neutrality-based practices, and positively related to a strengths-based anti-racist school curriculum. Furthermore, while higher school belonging and a growth mindset increased the odds of high and excellent achievement, students’ experiences of peer or teacher discrimination decreased these odds dramatically. Implications for school effectiveness policies are discussed.

Structural Racism, Residential Segregation, and Exposure to Trauma: The Persistent Impact of Redlining.

As part of New Deal era federal housing policy, the Home Owners Loan Corporation (HOLC) developed maps grading US neighborhoods by perceived financial security. Neighborhoods with high concentrations of racial and ethnic minorities were deemed financially unstable and denied federal investment, a practice colloquially known as redlining. The aim of this study was to assess the association of historical redlining within Austin, Texas to spatial patterns of penetrating traumatic injury. Retrospective cross sectional study utilizing data from violent penetrating trauma admissions between January 1, 2014 - December 31, 2021, at the single Level 1 trauma center in Austin, Texas. Using ArcGIS, addresses where the injury took place were geocoded and spatial joining was used to match them to their corresponding census tract, for which 1935 HOLC financial designations are classified as: "Hazardous", "Definitely Declining", "Still Desirable", "Best", or "Non HOLC Graded". Tracts with designations of "Hazardous" and "Definitely Declining" were categorized as Redlined. The adjusted incidence rate ratio comparing rates of penetrating trauma among historically Redlined vs. Not Redlined and Not Graded census tracts was calculated. 1,404 violent penetrating trauma admissions were identified for the study period, of which 920 occurred within the county of interest. Among these, 5% occurred in census tracts that were Not Redlined, 13% occurred in Redlined tracts, and 82% occurred in non HOLC graded tracts. When adjusting for differences in current census tract demographics and social vulnerability, historically Redlined areas experienced a higher rate of penetrating traumatic injury (Not Redlined IRR = 0.42, 95% CI 0.19-0.94, p = 0.03; Not Graded IRR = 0.15, 95% CI 0.07-0.29, p < 0.001). Neighborhoods unfavorably classified by HOLC in 1935 continue to experience a higher incidence rate of violent penetrating trauma today. These results underscore the persistent impacts of structural racism and of historical residential segregation policies on exposure to trauma. Level IV, Prognostic and Epidemiological.

Follow Father or Mother? Understanding the Monoethnic Identification of Biethnic Children in China

Abstract In China, children’s ethnicity is often decided by their parents at the time of birth or during childhood; individuals are only allowed to be identified by a single ethnicity. Ethnic identification is therefore a contested issue shaped by the intra-family power structures that determine which parent’s ethnic heritage will be passed down. In this paper, we use China’s 2005 and 2015 inter-census surveys to examine the factors impacting the ethnic identification of children in interethnic families. We find the likelihood that children are identified with their fathers’ ethnicity decreased between 2005 and 2015. Relative to children with a minority mother and a Han father, those with a Han mother and a minority father, and those with parents from different minority groups have higher odds of following their father’s ethnicity. Being a girl, being older, having more educated parents, having urban or migrant status, and living in prefectures with a higher concentration of ethnic minorities all tend to lower the odds of identifying with the father. Moreover, stratified models demonstrate that in families where the father is the only minority parent, Islamic heritage positively predicts boys’ adoption of fathers’ ethnicity, but negatively predicts girls’ adoption. Eligibility for bonus points on the college entrance exam is negatively associated with the odds of following father when the mother is the only minority parent, but the association turns positive when the father is the only minority parent. The results illustrate the nuanced social processes involved in the social construction of ethnic identification.

Representing diversity in a liberal democracy: a case study of Australia

ABSTRACT Political representation of ethnic minorities in a liberal democratic system is a crucial step towards having the interests of ethnic minority groups heard. The under-representation of ethnic minorities in a political institution can exacerbate inequality between majority and minority populations and increase feelings of alienation among minority groups. As a country observing increasing ethnic diversity, Australia saw record-level ethnic minority candidates elected in the 2022 federal election. However, the shares of candidates and elected Members of Parliaments with ethnic minority backgrounds are still much lower than their relative shares in the population. In this regard, Australia has lagged behind other major settler countries. In this paper, we examine the political representation of ethnic minorities in Australia’s federal election. Drawing on data from the 2022 federal election and 2021 population census, we find a positive association between ethnic minority concentration and ethnic representation. However, for the two major parties, ethnic minority candidates are less likely to be in safe seats, even when the seat observes high ethnic minority concentration. Findings suggest that ethnic voting is evident but it is perhaps too early to celebrate higher levels of ethnic representation in Australian politics as political parties act as gatekeepers in safe seats.

Abstract B079: Neighborhood social vulnerability and disparities in time to kidney cancer surgical treatment in Arizona

Abstract Background: Hispanics and American Indians (AI) have a higher kidney cancer incidence and mortality in Arizona. This study assessed 1) whether racial and ethnic minority patients and patients from neighborhoods with high social vulnerability, measured using the social vulnerability Index (SVI), experience a longer time (in days) to surgical treatment for kidney cancer after clinical diagnosis, and 2) whether time to surgery, race and ethnicity, and neighborhood social vulnerability are associated with adverse pathology (upstaging to pT3), progression free survival (PFS), and overall survival (OS) in Arizona. Methods: Arizona Cancer Registry (2009-2018) data for kidney and renal pelvis cases were obtained. Logistic regression models were used to assess if SVI (&amp;lt;25, 25-49, 50-74, and ≥75 percentile) and race and ethnicity were associated with a longer time to surgical (&amp;gt;median time to surgery) and upstaging. Cox-regression hazard models were used to assess if time to surgery and SVI were associated with PFS and OS. Separate analyses were performed for each clinical stage (cT1a, cT1b, cT2, and cT3). Results: A total of 4,592 kidney and renal pelvis cases (16.6% Hispanics and 4.8% AI) were included. Hispanic and AI patients with T1 tumors had a longer time to surgery than NHW patients (median time of 56, 55, and 45 days respectively). In unadjusted models, Hispanic ethnicity was associated with a longer time to surgery for cT1a (OR 1.48, 95% CI:1.05-2.08) and cT1b (OR 1.87, 95% CI:1.14-3.07). Hispanic and AI patients were also more likely to live in neighborhoods with high SVI than NHW patients. Living in neighborhoods with high (≥75) versus low (&amp;lt;25) overall SVI increased odds of a longer time to surgical for cT1a (OR 1.54, 95% CI:1.02-2.31) and cT2 (OR 2.32, 95% CI:1.13-4.73) in adjusted models. In these adjusted models, Hispanic ethnicity was no longer significantly associated with time to surgery. Among cT1a patients, a longer time to surgery increased odds of upstaging to pT3 (OR 1.95, 95% CI: 0.99-3.84) and risk of mortality. A longer time to surgery was associated with PFS with HR 1.52 (95% CI: 1.17- 1.99) and OS with HR 1.63 (95% CI:1.26-2.11) even after adjusting for SVI. Living in neighborhoods with high concentrations of racial and ethnic minorities increased odds of upstaging (OR 2.88, 95% CI: 0.99-8.37) in cT1a and was associated with PFS in cT3 (HR 2.45, 95% CI: 1.01-4.77). Compared to patients living in neighborhoods with SVI&amp;lt;25, patients with cT1a and cT2 tumor living in neighborhoods with SVI≥75 had about a 60% increased risk of mortality (OS HR 1.57, 95% CI: 1.01-2.45 for cT1b and HR 1.66, 95%CI:1.07-2.57 for cT2). Conclusion: These findings demonstrate that high neighborhood social vulnerability is associated with increased time to surgery and risk of progression and mortality. Impact: Neighborhood-level social vulnerability partly accounts for kidney cancer disparities in Arizona. Interventions need to focus on neighborhoods with high social vulnerability to improve care coordination for kidney cancer. Citation Format: Celina I. Valencia, Patrick Wightman, Kristin Morrill, Chiu-Hsieh Hsu, Hina Arif-Tiwari, Eric Kauffman, Francine C. Gachupin, Juan Chipollini, Benjamin R. Lee, Ken Batai. Neighborhood social vulnerability and disparities in time to kidney cancer surgical treatment in Arizona [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B079.

An investigation of politicians' responses to urban diversity and disadvantage: The case of the Danish 'parallel societies'.

We examine how Danish politicians articulate views on the 'parallel society agreement' (aka, the 'ghetto-laws'), a controversial legislative intervention aiming to manage urban migration-related diversity. Through nationwide urban redevelopment aimed at facilitating residential 'mixing', the goal of the legislation is to eliminate so-called 'parallel societies'-socio-economically deprived neighbourhoods characterized by high concentrations of ethnic minorities. In-depth interviews with Danish politicians (n = 11) explored how this proposal was supported, contested or rejected in situated discourse. Following social representations theory, we focus on how 'parallel societies' were constructed in relation to differing ideas about 'mainstream society' and value-laden oppositional meaning-categories (i.e. themata). In particular, we highlight processes of socio-ethical reasoning that occurred through thematization of a shared oppositional meaning-category: 'freedom-constraint'. Views on the intervention were articulated around this oppositional meaning-category. Moreover, a connection was observed between the views articulated by individual politicians and sets of congruent ideas and images mobilized to represent 'parallel societies'. We discuss the theoretical value of taking a social representations approach to urban policy debates, and the practical limitations of dominant representations for successfully promoting intercultural dialogue and engagement-the stated goal of this intervention.

Associations among Historical Neighborhood Disinvestment, Hazardous Air Pollutants, and Current Adult Asthma Prevalence

Associations among Historical Neighborhood Disinvestment, Hazardous Air Pollutants, and Current Adult Asthma Prevalence

Abstract P658: Redlining, Neighborhood Vulnerability, and Heart Failure Outcomes Among Patients in the Southeastern US

Introduction: Disparities in heart failure (HF) outcomes are due, in part, to social determinants of health. Structural racism is thought to be a fundamental cause of health disparities. A form of structural racism, redlining, was instituted in the 1930s to disinvest in neighborhoods with a high concentration of racial and ethnic minorities, leading to neighborhoods marred by crime, poverty, and disrepair. While studies have focused on how the contemporary neighborhood impacts health outcomes, few studies have examined how historical racist policies have shaped cardiovascular disease outcomes. Additionally, no studies have focused exclusively on the Southeastern region of the US where rates of cardiovascular disease and HF are among the highest in the country. This analysis examined the association between redlining and HF outcomes (e.g., 30-day readmission and mortality) among HF patients residing in Georgia. Hypothesis: Patients residing in “definitely declining” and “hazardous” neighborhoods will have a higher risk of both 30-day readmission and 30-day mortality compared to patients residing in “best” defined neighborhoods. Methods: Data are from a retrospective cohort of patients hospitalized for acute HF within Emory Healthcare from 2010 to 2018. Patient addresses were geocoded and linked to historically redlined neighborhoods at the census tract level using Home Owners’ Loan Corporation (HOLC) maps which classified neighborhoods as: “best”, “still desirable”, “definitely declining”, or “hazardous/redlined”. Neighborhood deprivation was assessed at the census tract level using the Social Vulnerability Index. Multivariable logistic regression was used to estimate the relative risk of 30-day readmission and 30-day mortality across HOLC-graded neighborhoods adjusted for patient demographics, clinical and hospital characteristics, and neighborhood deprivation. Results: Within the full sample, redlining was not associated with either 30-day readmission (RR 0.90; 95% CI: 0.62, 1.31) or mortality (RR 1.32; 95% CI: 0.79, 2.20). Redlining was not associated with 30-day mortality among Black patients. However, residing in a historically redlined neighborhood appeared to be associated with a two-fold increased risk in 30-day readmission for Black patients although results were non-significant (RR 1.98; 95% CI: 0.52, 7.59). Conclusion: In conclusion, redlining was not associated with HF readmission or mortality across racial groups. Findings among Black patients suggest that redlining may be associated with adverse heart failure outcomes. Further research with larger samples is needed.

Relationship of Neighbourhood Social Deprivation and Ethnicity on Access to Transcatheter and Surgical Aortic Valve Replacement: A Population-Level Study.

Wide geographic variation in access to transcatheter (TAVR) and surgical (SAVR) aortic valve replacement exists, but the impact of socioethnic factors on the geographic variation of AS management in Ontario, Canada, is unknown. Neighbourhood rates of AS admissions, as a proxy for AS burden, and downstream TAVR and SAVR referrals and procedures were estimated for the 76 subregions in Ontario. To determine if the socioethnic geographic variations in referrals and procedures were concordant or discordant with AS burden, we calculated Pearson correlation coefficients to determine the relationship between AS burden and each of TAVR referrals, TAVR procedures, SAVR referrals, or SAVR procedures. We developed generalised linear models to determine the association between social deprivation indices captured in the Ontario Marginalization index and the rates of AS burden as well as TAVR/SAVR referral and procedures. There was wide geographic variation that was concordant between AS burden and the referral and procedure rates for TAVR and SAVR (correlation coefficients 0.86-0.96). Increased dependency was associated with higher rates of both TAVR/SAVR referrals and procedures (rate ratios 1.63-2.22). Neighbourhoods with a higher concentration of ethnic minorities were associated with lower AS burden as well as lower rates of both SAVR and TAVR referrals and procedures (rate ratios 0.57-0.85). An important ethnic gradient exists in AS burden and in both referral and completion of TAVR and SAVR in Ontario. Further research is necessary to understand if this gradient is appropriate or requires mitigation.

Primary Care Physician Supply by County-Level Characteristics, 2010-2019

This study evaluates and compares US trends between 2010 and 2019 in per-capita primary care physician supply by county-level racial and ethnic minority concentration, poverty, rurality, and region.

Love thy neighbours or do ethnic neighbourhood qualities matter? Ethnic price differentials in a multi-ethnic housing market

New Zealand is a multi-ethnic society that embraces multiculturism. Many studies have examined how the concentration of ethnic minorities affects residential property values within small neighbourhoods. However, very few studies have recognised that characteristics of neighbourhoods other than ethnic concentration may cause such price differentials. We use the repeat-sales model, based on more than 66,000 housing transactions in the most ethnically diverse city in New Zealand, to control the unobserved biases and identify the effects of changes in the concentration of ethnic minorities on house prices over time. We argue that the commonly perceived ethnic housing price discount may not be a consequence of taste-based discrimination but statistical discrimination of prospective homebuyers on neighbourhood qualities. After controlling neighbourhood characteristics, which can be unobserved and are assumed to be unchanged over the course of the four censuses, the effect of the ethnic price differential, either increase or decrease, becomes insignificant on house prices. The statistical discrimination hypothesis is further confirmed using the Special Housing Area (SHA) as an exogenous amenity shock in a spatial-temporal differencing model. Using the conventional hedonic model without considering the neighbourhood qualities can be misleading.

Localisation of politics and local electoral participation

ABSTRACT Nationalisation of politics generally decreased the voter participation at municipal elections by lowering their salience, but the variation in nationalisation has been underestimated. Leveraging variation in two dimensions of localisation of municipal political competition – ethnic minority concentration and number of non-partisan local lists – this paper tests whether increased stakes and salience at ‘localised’ municipal elections increase electoral participation in respective municipalities. Based on the data from Croatian local elections (2001–2017), non-partisan lists drive voter participation, particularly in smaller municipalities. The effect of ethnic minority concentration depends on the minority status of the ethnic group within a municipality.

Regional poverty and infection disease: early exploratory evidence from the COVID-19 pandemic.

This paper examines the role of regional poverty on the COVID-19 pandemic in the USA. It also explores how the effects differ with the concentration of ethnic minorities. We find that poverty is a significant and consistent determinant of higher COVID-19 infections and fatalities. Prevalent poverty areas experienced higher infections due to economic structure that require hypermobility (high mobility and interpersonal interaction)—more physical human to human contact resulting in higher deaths from limited access to health services. These are also regions where minority groups are concentrated. Disproportionate infections and fatalities occurred within the black, Hispanic, and Asian population. Our evidence is robust to state fixed effects that capture local COVID-19 mitigation policies, multi-level hierarchical modeling, spatial autoregressive assessment, and large sets of county-level health, social, and economic factors. This paper contributes to the literature on health and economic disparities and their resulting consequences for infectious diseases.

Abstract PO-273: Spatial and descriptive analysis of smoke and vape shop locations focusing on a cancer center neighboring catchment area

Abstract Background: Tobacco products cause about 1 in 5 deaths premature deaths each year. §Cancer patient survival increases approximately 30% with effective tobacco cessation intervention. Tobacco use post cancer can disrupt treatment plans including surgery delay, negatively affect treatment response, and the benefits of quitting are well-documented including accelerated healing and improved quality of life and well-being.Racial and ethnic minorities are adversely targeted by tobacco industry resulting in high tobacco use and tobacco related disease burden. With increased retailing of both tobacco and electronic nicotine delivery systems (ENDS) products, cancer centers such as City of Hope are prioritizing tobacco and ENDS control. Method: The cancer center expanded the current cessation program by: 1. Building a robust Patient EHR Tobacco Registry capturing tobacco use/exposure of cancer patients; 2. Establishing sustainable IT facilitated clinical workflow for timely and comprehensive tobacco use assessment with accompanying cessation intervention for both high-risk recent quitters and current tobacco users and facilitate basic, behavioral and clinical studies. We conducted formative geospatial analyses of dedicated smoke and vape shops linked to neighborhood demographic characteristics. The objective of the study was to analyze local data on smoke and vaping shop locations by age, socio-economic status, and racial/ethnic group. Our geospatial analysis used aggregate data from the U.S. Census, Google Maps, and Yelp. Geospatial maps were created using ArcGIS Pro with American Community Survey and U.S. Census 2010. The distributions of exclusive tobacco and vaping shop locations data were overlaid with data from the U.S. Census 2010 to generate maps of the relative geographic distributions of shops across varying area demographic characteristics. Results: In the COH network that includes community clinical sites, there are variations in tobacco use by geographic regions showed that a higher concentration of exclusive smoke and vaping shops were in areas with a higher concentration of ethnic minorities and lower income and lower status neighborhoods. Conclusion: Tobacco use is influenced by societal determinants of health (SDH) with minoritized populations having greater exposure to tobacco products that brings greater smoking rates. Tobacco cessation is a quality care issue, and a health equity and justice issue. Allocations of resources must account for the metrics of tobacco use and be responsive to both patient characteristics and community factors. Tobacco control services and research for cancer patients ought to be conducted in partnership with cancer care team. A multidisciplinary research can provide multilevel data accounting for the intersection of SDH and community level factors (e.g. density of tobacco retail, environmental exposure) with biological factors. Cancer Centers' sustainable tobacco control must involve community engagement, team science, clinical and care coordination and policy action Citation Format: Kimlin Ashing, Cary Presant, Sophia Yeung, Jonjon Macalintal, Brian Tiep, Argelia Sandoval, Dan Raz, Ravi Salgia, Loretta Erhunmwunsee, Arya Amini, Amar Merla, Heather Graves, Steven Rosen. Spatial and descriptive analysis of smoke and vape shop locations focusing on a cancer center neighboring catchment area [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-273.

Minority groups in the largest cities of Latvia

Spatial segregation of minority ethnic groups is a returning issue in public and political debates across many parts of the world. The degree of spatial concentration and segregation of ethnic minorities in European cities is well documented. However, despite Latvia's diverse migration history and relatively high minority population, particularly in the largest cities, these issues have received scant attention. This study examines the residential patterns of minority ethnic groups, presenting data on the levels and dynamics of urban residential segregation. The study includes five ethnic minorities: Russians, Belarusians, Ukrainians, Poles, and other ethnicities. We adopted a widely used methodology to examine changes in ethnic residential segregation between 2000 and 2019. The information comes from the 2000 census and the population register. We are confident in stating that overall ethnic residential segregation levels do not appear to be increasing. However, there are some differences not only between ethnic groups in the same city, but also between similar groups in different cities. Furthermore, demographic change reinforces both minority representation in established residential patterns and ethnic segregation in urban Latvia as a whole. Certain characteristics of the Latvian context, such as the dominance of owner-occupied dwellings and relatively low residential mobility, may explain the findings.

The impact of ethnic segregation on neighbourhood-level social distancing in the United States amid the early outbreak of COVID-19.

The COVID-19 pandemic has been argued to be the 'great equaliser', but, in fact, ethnically and racially segregated communities are bearing a disproportionate burden from the disease. Although more people have been infected and died from the disease among these minority communities, still fewer people in these communities are complying with the suggested public health measures like social distancing. The factors contributing to these ramifications remain a long-lasting debate, in part due to the contested theories between ethnic stratification and ethnic community. To offer empirical evidence to this theoretical debate, we tracked public social-distancing behaviours from mobile phone devices across urban census tracts in the United States and employed a difference-in-difference model to examine the impact of racial/ethnic segregation on these behaviours. Specifically, we focussed on non-Hispanic Black and Hispanic communities at the neighbourhood level from three principal dimensions of ethnic segregation, namely, evenness, exposure, and concentration. Our results suggest that (1) the high ethnic diversity index can decrease social-distancing behaviours and (2) the high dissimilarity between ethnic minorities and non-Hispanic Whites can increase social-distancing behavior; (3) the high interaction index can decrease social-distancing behaviours; and (4) the high concentration of ethnic minorities can increase travel distance and non-home time but decrease work behaviours. The findings of this study shed new light on public health behaviours among minority communities and offer empirical knowledge for policymakers to better inform just and evidence-based public health orders.

Ethnic segregation and native out-migration in Copenhagen

In this article, we study how the local concentration of ethnic minorities relates to the likelihood of out-migration by natives in Copenhagen, the capital of Denmark. In US studies, a high or increasing proportion of racial or ethnic minorities in inner-city neighborhoods is seen as an important motivation for White middle-class families’ out-migration to racially and ethnically homogeneous suburbs. The relatively egalitarian Scandinavian setting offers a contrasting case, where inner cities are less deprived and where minority groups primarily consist of immigrants and the children of immigrants who have arrived over the past few decades. We use population-wide, longitudinal administrative data covering a 12-year period, and measures of individualized neighborhoods based on exact coordinates for place of residence, to examine whether out-migration is associated with minority concentrations in the Copenhagen area. Our results largely support the presence of a native out-migration mobility pattern, in contrast to much existing literature. We also show that responses to increasing minority concentrations vary across the life course and between natives and children of immigrants.

Spatial and Descriptive Analysis of Smoke and Vape Shop Locations Focusing on a Cancer Center Neighboring Catchment Area

Tobacco products cause about 1 in 5 deaths premature deaths each year. With increased retailing of both tobacco and electronic nicotine delivery systems (ENDS) products, cancer centers such as City of Hope are prioritizing tobacco and ENDS control. Therefore, we conducted formative geospatial analyses of dedicated smoke and vape shops linked to neighborhood demographic characteristics. The objective of the study was to analyze local data on smoke and vaping shop locations by age, socio-economic status, and racial/ethnic group. Our geospatial analysis used aggregate data from the U.S. Census, Google Maps, and Yelp. Geospatial maps were created using ArcGIS Pro with American Community Survey and U.S. Census 2010. The distributions of exclusive tobacco and vaping shop locations data were overlaid with data from the U.S. Census 2010 to generate maps of the relative geographic distributions of shops across varying area demographic characteristics. Results showed that a higher concentration of exclusive smoke and vaping shops were in areas with a higher concentration of ethnic minorities and lower income and lower status neighborhoods. These findings suggest that laws and licensing should be evaluated to regulate the placement of these shops to reduce and even prevent targeting of minorities and other vulnerable populations.

COVID-19 Cases and Death in Nursing Homes: The Role of Racial and Ethnic Composition of Facilities and Their Communities

ObjectivesTo examine the extent to which the racial and ethnic composition of nursing homes (NHs) and their communities affects the likelihood of COVID-19 cases and death in NHs, and whether and how the relationship between NH characteristics and COVID-19 cases and death varies with the racial and ethnic composition of the community in which an NH is located. Methods and DesignCenters for Medicare & Medicare Services Nursing Home COVID-19 data were linked with other NH- or community-level data (eg, Certification and Survey Provider Enhanced Reporting, Minimum Data Set, Nursing Home Compare, and the American Community Survey). Setting and Participants: NHs with more than 30 occupied beds (N=13,123) with weekly reported NH COVID-19 records between the weeks of June 7, 2020, and August 23, 2020. Measurements and model: Weekly indicators of any new COVID-19 cases and any new deaths (outcome variables) were regressed on the percentage of black and Hispanic residents in an NH, stratified by the percentage of blacks and Hispanics in the community in which the NH was located. A set of linear probability models with NH random effects and robust standard errors were estimated, accounting for other covariates. ResultsThe racial and ethnic composition of NHs and their communities were both associated with the likelihood of having COVID-19 cases and death in NHs. The racial and ethnic composition of the community played an independent role in the likelihood of COVID-19 cases and death in NHs, even after accounting for the COVID-19 infection rate in the community (ie, daily cases per 1000 people in the county). Moreover, the racial and ethnic composition of a community modified the relationship between NH characteristics (eg, staffing) and the likelihoods of COVID-19 cases and death. Conclusions and ImplicationsTo curb the COVID-19 outbreaks in NHs and protect vulnerable populations, efforts may be especially needed in communities with a higher concentration of racial and ethnic minorities. Efforts may also be needed to reduce structural racism and address social risk factors to improve quality of care and population health in communities of color.

Regional ethnic concentrations and ethnic discrimination in hiring: field experimental evidence from the Netherlands

ABSTRACT As a result of global migration processes, Western societies have become increasingly ethnically diverse. Yet not all regions are equally affected by these immigration processes. The current study investigates whether and how ethnic discrimination in hiring is linked with the regional concentration of ethnic minorities, using original data of a large-scale field experiment on ethnic discrimination (N = 4.211) and detailed regional data in the Netherlands. The results show that greater exposure to ethnic minorities in a region is not clearly related with decreased (indicative of positive intergroup contact) or increased (indicative of group threat) ethnic discrimination in hiring. Rather, the findings provide more support for the familiarisation hypothesis: regional concentrations of ethnic minorities are positively associated with ethnic discrimination, however, this effect levels off and turns negative at high concentrations of ethnic minorities. This result holds particularly for minorities with non-Western migrant origins and minorities with Muslim migrant origins.