Experiences Of Discrimination Research Articles

Associations Between Patient/Caregiver Trust in Clinicians and Experiences of Healthcare-Based Discrimination.

Higher trust in healthcare providers has been linked to better health outcomes and satisfaction. Lower trust has been associated with healthcare-based discrimination. Examine associations between experiences of healthcare discrimination and patients' and caregivers of pediatric patients' trust in providers, and identify factors associated with high trust, including prior experience of healthcare-based social screening. Secondary analysis of cross-sectional study using logistic regression modeling. Sample consisted of adult patients and caregivers of pediatric patients from 11 US primary care/emergency department sites. Of 1,012 participants, low/medium trust was reported by 26% identifying as non-Hispanic Black, 23% Hispanic, 18% non-Hispanic multiple/other race, and 13% non-Hispanic White (P = .001). Experience of any healthcare-based discrimination was reported by 32% identifying as non-Hispanic Black, 23% Hispanic, 39% non-Hispanic multiple/other race, and 26% non-Hispanic White (P = .012). Participants reporting low/medium trust had a mean discrimination score of 1.65/7 versus 0.57/7 for participants reporting high trust (P < .001). In our adjusted model, higher discrimination scores were associated with lower trust in providers (aOR 0.74, 95%CI = 0.64, 0.85). A significant interaction indicated that prior healthcare-based social screening was associated with reduced impact of discrimination on trust: as discrimination score increased, odds of high trust were greater among participants who had been screened (aOR = 1.28, 95%CI = 1.03, 1.58). Patients and caregivers reporting more healthcare-based discrimination were less likely to report high provider trust. Interventions to strengthen trust need structural antiracist components. Increased rapport with patients may be a potential by-product of social screening. Further research is needed on screening and trust.

COVID-19 vaccine mistrust, health literacy, conspiracy theories, and racial discrimination among a representative ethnically diverse sample in Canada: The vulnerability of Arab, Asian, Black, and Indigenous peoples.

Despite increased risk of severe acute respiratory syndrome coronavirus 2infections and higher rates of COVID-19-related complications, racialized and Indigenous communities in Canada have lower immunization uptake compared to White individuals. However, there is woeful lack of data on predictors of COVID-19 vaccine mistrust (VM) that accounts for diverse social and cultural contexts within specific racialized and Indigenous communities. Therefore, we sought to characterize COVID-19 VM among Arab, Asian, Black, and Indigenous communities in Canada. An online survey was administered to a nationally representative, ethnically diverse panel of participants in October 2023. Arabic, Asian, Indigenous, and Black respondents were enriched in the sampling panel. Data were collected on demographics, COVID-19 VM, experience of racial discrimination, health literacy, and conspiracy beliefs. We used descriptive and regression analyses to determine the extent and predictors of COVID-19 VM among racialized and Indigenous individuals. All racialized respondents had higher VM score compared to White participants. Among 4220 respondents, we observed highest VM among Black individuals (12.18; ±4.24), followed by Arabic (12.12; ±4.60), Indigenous (11.84; ±5.18), Asian (10.61; ±4.28), and White (9.58; ±5.00) participants. In the hierarchical linear regression analyses, Black participants, women, everyday racial discrimination, and major experience of discrimination were positively associated with COVID-19 VM. Effects of racial discrimination were mediated by addition of conspiracy beliefs to the model. Racialized and Indigenous communities experience varying levels of COVID-19 VM and carry specific predictors and mediators to development of VM. This underscores the intricate interaction between race, gender, discrimination, and VM that need to be considered in future vaccination campaigns.

Health Care Discrimination and Immigration Fears: Unpacking COVID-19 Vaccine Hesitancy in Latino Adults.

Objectives. To examine the relationship between health care discrimination and COVID-19 vaccine hesitancy attributed to fears of immigration status complications among unvaccinated Latino adults and to determine whether the association differs among immigrants and US-born individuals. Methods. After universal adult eligibility for the COVID-19 vaccine, a nationally representative sample of 12 887 adults was surveyed using online and mobile random digit dialing from May 7 to June 7, 2021. The analytic sample (n = 881) comprised unvaccinated Latino adults. We examined the association between individual and cumulative health care discrimination measures and COVID-19 vaccine hesitancy assignable to immigration-related fears. Results. Using a cumulative measure of health care discrimination, each additional experience corresponded to a 28% higher odds of reporting vaccine hesitancy Because of immigration-related fears. Findings were consistent across US-born and immigrant Latino adults. Four of the 5 discriminatory experiences were positively associated with vaccine hesitancy, including the absence of optimal treatment options, denial or delayed access to necessary health care, physician communication barriers, and lack of specialist referrals. Conclusions. Findings confirm a positive association between health care discrimination and COVID-19 vaccine hesitancy attributable to immigration-related fears among Latino adults, regardless of immigration status. (Am J Public Health. 2024;114(S6):S505-S509. https://doi.org/10.2105/AJPH.2024.307668) [Formula: see text].

Framing resilience linked to parental ethnic‐racial socialization as hidden: A hidden resilience conceptual framework

AbstractParental ethnic‐racial socialization is a source of adolescents' resilience against ethnic‐racial discrimination. Recent meta‐analyses have documented the promotive aspects of ethnic‐racial socialization (i.e., how ethnic‐racial socialization is directly related with adolescents' adjustment regardless of their discrimination experiences). However, extant empirical studies have produced conflicting results about the protection or moderating role of ethnic‐racial socialization, with studies suggesting that ethnic‐racial socialization buffers, exacerbates, or does not moderate the impacts of ethnic‐racial discrimination. We offer a reconceptualization of existing studies' findings and draw from existing theories to propose Hidden Resilience as a new conceptual framework that highlights how resilience and the positive benefits linked to ethnic‐racial socialization may not be noticeable when studies use psychosocial measures but is rather hidden “underneath the skin.” Conversations about racism may momentarily feel uncomfortable, upsetting, or stressful for youth, but such conversations can help youth learn how to cope with ethnic‐racial discrimination in the long term. Following a review of studies supporting our conceptual framework, we provide suggestions for future research to expand the field's understanding of resilience linked to ethnic‐racial socialization.

The effects of online and institutional racism on the mental health of African Americans.

Although a wealth of literature has documented the adverse physical and mental health effects associated with exposure to racism, little scholarly attention has focused on the specific impact of online racism. Online experiences of racism have increased significantly over the years, and the intersection of online and "offline" racism makes it difficult for African Americans to find respite from overall experiences of racial discrimination in their daily lives. To address this gap in the literature, the present study was designed to examine the possible compounded effect of online and institutional racism by investigating whether offline institutional racism would serve as a moderator of the effects of online racism on psychological outcomes in a sample of African Americans. One hundred and eighty-two African Americans answered survey data on their experiences of institutional and online racism, as well as their overall mental health. Moderated regressions and simple slope analyses were performed to examine the effects of online, institutional, and the interaction of online and institutional racism on psychological symptoms (i.e., psychological distress and well-being). Online racism was the strongest and most consistent predictor of all outcome variables. The interaction of online and institutional racism was significantly associated with psychological distress but not well-being. Findings suggest that participants who endorsed institutional racism experience increased severity in psychological symptoms in relation to increased exposure to online racism. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Roles of Identity Centrality and Affirmation in the Associations Between Discrimination and Mental Health Among Bi+ Adults

Bi+ individuals are at increased risk for mood and anxiety disorders compared to heterosexual and lesbian/gay individuals in part due to unique experiences of discrimination. Minority stress theory posits that associations between discrimination and adverse mental health outcomes may be stronger for those with higher identity centrality and lower identity affirmation, but few studies have tested these hypotheses. Therefore, the current study examined whether identity centrality and affirmation moderated the associations between discrimination and depression and anxiety symptoms among 715 bi+ adults. In bivariate analyses, discrimination was positively associated with depression and anxiety symptoms, whereas identity centrality and affirmation were not significantly associated with either. However, in multivariate analyses, identity centrality and affirmation were negatively associated with depression and anxiety symptoms, respectively. Neither identity centrality nor affirmation moderated any associations. These findings raise the question whether identity characteristics moderate associations between discrimination and mental health, but replication is needed.

노인의 차별경험과 인권감수성의 관계에 대한 연구:사회적지지와 자아존중감의 다중매개효과 분석

The purpose of this study is to enhance the human rights sensitivity to older people by confirming the effect of discrimination experiences of the elderly on human rights sensitivity, and the multiple mediation effects of social support and self-esteem. For the study, a questionnaire survey was conducted on 502 senior citizens aged 65 or older. To analyze the data, multiple mediation effect analysis was conducted using SPSS macro PROCESS v.4.2, and the significance of the mediation effect was confirmed through bootstrapping. The main research results are as follows. First, it was found that the discrimination experience of the elderly affected negatively on their self-esteem and social support, so it is confirmed the need for intervention to lower the negative perceptions by discrimination experience. Second, among the mediation variables, social support completely mediated the relationship between the discrimination experience of the elderly and human rights sensitivity. It is argued that the role of the elderly group that can offset the experience of discrimination should be strengthened. Based on the study results, the researchers suggested practical and policy suggestions such as revitalizing human rights education for the elderly and developing a campaign to improve awareness of the elderly

Dignity of Work and at Work: The Relationship between Workplace Dignity and Health among Latino Immigrants during the COVID-19 Pandemic.

Latino immigrants living in the United States were highly vulnerable to the health and economic consequences brought on by the COVID-19 pandemic. We use the conceptual framing of workplace dignity, worth that is acknowledged based on performance of job responsibilities, to explore Latino immigrants' experiences during the early months of the pandemic. A qualitative study was conducted with La Clínica del Pueblo (La Clínica), a community health center serving low-income Latino immigrants. From June to December 2020, we conducted in-depth video interviews with 29 Latino immigrant clients to explore pandemic-related challenges, including workplace changes, discriminatory experiences, and effects on health. We conducted thematic analysis using Dedoose software. Nearly half of participants were undocumented immigrants. Most participants were unemployed or underemployed due to the pandemic and 26-49 years of age; one-third were still working, and one-quarter were 50 years or older. About half were cisgender women and two were transgender women. Employed participants experienced a lack of dignity through being socially isolated and stigmatized at work; receiving no compensation for their extra labor or for sick leave; and experiencing discriminatory labor practices. Unemployed participants experienced a lack of dignity in being the first to lose their jobs without government support; losing self-esteem; and not being rehired. Participants associated denial of dignity with worsening health conditions and increased anxiety and depression. Our study suggests that denial of workplace dignity-through job loss, underemployment, and poor working conditions-is linked to adverse health outcomes for Latino immigrants. More research should recognize workplace dignity as an important social determinant of health.

Labor market discrimination and suicidal ideation: A longitudinal study of Korean women

This study investigates the impact of gender discrimination in the labor market on suicidal ideation among Korean women, taking into consideration women's multiple social locations and their discriminatory experiences across various aspects of employment. Analysis using waves 4 to 8 data of the Korean Longitudinal Survey of Women and Family, with response rates ranging from 68.3% to 78.2%, indicates that gender discrimination in hiring, dismissal, promotion, job allocation, training, wage, and sexual harassment is strongly associated with suicidal thoughts among women. This relationship remains significant even after controlling for stress, depression, and other forms of discrimination. Subgroup analysis further highlights that women with lower income levels are particularly susceptible to the adverse effects of gender discrimination. The findings underscore the importance of policy intervention to mitigate labor market discrimination against women as a crucial step in preventing suicides among Korean women.

Exploring the experiences of school-going children with HIV in Eswatini: A qualitative inquiry.

Infection by human immunodeficiency virus (HIV) is a major disease in children, affecting an estimated 1.8 million children and adolescents worldwide. Eswatini has the highest prevalence of HIV in the world. Only 76% of children in Eswatini are on anti-retroviral treatment. This study aimed to gain an in-depth understanding of the lived experience of school-going children with HIV in Eswatini. Being aware of these children's experiences can assist schools in supporting them. The study was conducted in four primary health care facilities in Eswatini. Employing a qualitative, exploratory, descriptive research design, 12 school-going children with HIV were interviewed through semi-structured face-to-face interviews. The data were coded, categorised and clustered into themes and sub-themes using Georgi's data analysis. Ethical considerations and measures to ensure trustworthiness were adhered to throughout the study. The findings revealed three themes: Experiences after HIV disclosure, experience of disclosure and discrimination, and experience of desire to fulfil educational needs. Six sub-themes were identified: A feeling of sadness and worry relating to knowledge of HIV diagnosis, a desire to disclose their status to their teachers but not to their peers, a need for protection against discrimination, a desire to learn, illness affecting their learning and expectation for teachers to be supportive in their educational needs.Conclusion and contribution:The findings of the study guided recommendations that may assist, the Eswatini Ministry of Health, schools, parents and caregivers, and siblings to support school-going children with HIV.

Investigating the Moderating Effect of HIV Status Disclosure on the Link Between Discrimination Experience and Psychological Distress Among People Living with HIV in Japan Infected Through Sexual Contact

Investigating the Moderating Effect of HIV Status Disclosure on the Link Between Discrimination Experience and Psychological Distress Among People Living with HIV in Japan Infected Through Sexual Contact

Co-Culture Communication of Disabled Characters in the Movie Dancing in the Rain

The film Dancing in the Rain tells the story of Banyu, a mentally retarded person who experiences discrimination and bullying. As a mentally retarded person, Banyu has limitations in interaction and communication. Even though he often gets bullied, Banyu has two friends who always support him, namely Radin and Kirana. This research aims to determine the communication strategies of disabled groups in the film Dancing in the Rain. The film shows several scenes of interaction and communication between disabled characters in society. The theory used in the research is Mark Orbe's Co-Culture to analyze communication strategies. This research uses qualitative methods for data collection. The analysis uses the descriptive method of the Charles Sanders Pierce Semiotics model. This semiotic model consists of three, namely representamen (sign), object, and interpretant. Researchers used 18 scenes in the film that show Banyu's interactions with friends and the community. The results of this research show that people with disabilities use non-assertive separation and non-assertive accommodation strategies. Apart from that, there was a change in communication, namely assertive accommodation. As a disabled person, Banyu is more sincere and open to his two friends Radin and Kirana

Racial discrimination and health-care system trust among American adults with and without cancer.

Racial and ethnic minoritized groups report disproportionately lower trust in the health-care system. Lower health-care system trust is potentially related to increased exposure to racial discrimination in medical settings, but this association is not fully understood. We examined the association between racial discrimination in medical care and trust in the health-care system among people with and without a personal cancer history. We examined racial discrimination and trust in a nationally representative American adult sample from the Health Information National Trends Survey 6. Racial discrimination was defined as any unfair treatment in health care on the basis of race or ethnicity. Trust in the health-care system (eg, hospitals and pharmacies) was grouped into low, moderate, and high trust. Multinomial logistic regression models were used to compare low and moderate trust relative to high trust in the health-care system and estimate odds ratios (ORs) and 95% confidence intervals (CIs). A total of 5813 respondents (15% with a personal cancer history) were included; 92% (n = 5355) reported no prior racial discrimination experience during medical treatment. Prior experiences of racial discrimination were positively associated with low (OR = 6.12, 95% CI = 4.22 to 8.86) and moderate (OR = 2.70, 95% CI = 1.96 to 3.72) trust in the health-care system relative to high trust. Similar associations were observed when stratifying by personal cancer history. Respondents who reported racial discrimination during medical encounters had lower trust in the health-care system, especially respondents with a personal cancer history. Our findings highlight the need to address racial discrimination experiences during medical care to build patient trust and promote health-care access.

Hiding in plain sight: Black women speak on racist patriarchy and Black patriarchy in unmarked and marked spaces on campus

Black undergraduate women who attend a HPWI are impacted by racist patriarchy and Black patriarchy. To examine patriarchies across campus, I explored unmarked spaces on campus which are generic, white spaces; and racially marked spaces, such as the Black Student Center. To better understand how racist patriarchy and Black patriarchy shape Black women’s college experiences, I utilized qualitative methods and an ethnography to center their experiences of discrimination and marginalization. Using a critical race feminism framework, I interviewed 25 Black undergraduate women who attended a state-flagship university in the Mid-Southern region of the US and conducted ethnographic fieldwork on campus. The findings show that Black women experienced overt racial hostility from white males in unmarked spaces on campus, while also experiencing objectification and social subordination from Black men in marked spaces. My findings demonstrate that HPWI’s are patriarchal structures that create gendered racial violence against Black women.

“A balancing act”: parents’ longitudinal perspectives of weight-related discussions with their children following obesity treatment

Weight-related discussions during childhood may have long-lasting effects on children’s body image and well-being. However, little is known about how parents frame these discussions with children who have undergone treatment for obesity. Our study aimed to explore how parents perceive weight-related discussions, several years after their children started obesity treatment. This qualitative study is part of the 4-year follow-up of the More and Less study, a randomized controlled trial examining the effectiveness of a parental support program as part of obesity treatment for preschool-aged children in Stockholm, Sweden. Semi-structured interviews were conducted with 33 parents (79% mothers, 48% with a university degree, 47% with foreign background) of 33 children (mean age 9.3 years (SD 0.7), 46% girls), transcribed and analyzed using realist informed thematic analysis. Three main themes, encompassing three subthemes were developed. Under the first theme, Parental attitudes and concerns, parents emphasized the importance of discussing weight and health behaviors with their children, yet found it challenging due to uncertainties about how to approach it safely and sensitively. A few parents found the conversation manageable, citing their own experiences of having overweight or their style of communication with the child as facilitating the conversation. Under the second theme, The significance of time and context, parents said they engaged in weight-related conversations with their children more frequently as the children matured, driven by their growing self-awareness. Parents also expressed how contextual factors, such as gender and the presence of others, shaped conversations. Parents perceived boys as more resilient, thus exposing them to more negative weight talk. The third theme, Navigating weight stigma, revealed how parents employed strategies such as nurturing their children’s self-confidence, downplaying the significance of appearance and emphasizing health when discussing weight to shield their children from weight stigma. Taken together, we found that many parents need support to navigate weight-related discussions. Addressing weight stigma is part of children’s obesity management process, as children may be bullied, teased, or experience discrimination in different social settings. More research is needed to explore how young children undergoing obesity treatment experience weight stigma and to understand gendered differences in these experiences.

Social Stratification and Gender Spectrum

Purpose- This paper explored through the dimensions of what social stratification is, what gender spectrum is, the social stratification of LGBTQ community, the status of LGBTQ community in India, the problems faced by LGBTQ community in India and suggestions for social inclusion of the community. Design/methodology- The present study employed descriptive research to identify characteristics, frequencies, trends and categories related to the gender spectrum. It studies the unique intersectionality of aspects like socioeconomic classes, ethnicities, nationalities, backgrounds and religions combined with the numerous overlapping aspects of an individual’s identity. Findings- The main findings highlight that regardless of the constitutional readings, no unambiguous law has been ratified to ban the discrimination based on sexual orientation. Members of LGBTQ+ community are more likely to experience intolerance, discrimination, harassment and threat of violence due to their sexual orientation, than those that identify themselves as heterosexual. The exclusion and discrimination have major impacts on the lives of LGBTQ people.

Structural violence and necropolitics among Indigenous Peoples living with HIV who use substances in the Prairie provinces during COVID-19

BackgroundWithin Manitoba and Saskatchewan, pre-existing health inequities amongst Indigenous groups were intensified during the COVID-19 pandemic. Service disruptions in the health and social service sector—combined with the effects of intersectional stigma—disproportionately impacted Indigenous peoples living with HIV (IPLH). IPLH experience structural violence and necropolitical exclusion through systemic forms of stigma situated within Canada's expansive colonial history. Utilizing the theoretical foundations of structural violence and necropolitics, this qualitative study examines how the COVID-19 pandemic amplified preceding states of inequity for IPLH. MethodsSemi-structured interviews were conducted with 60 participants. The sample comprised of those with lived experience (n = 45) as well as those who provided services for IPLH (n = 15). Indigenous Storywork guided the data collection and analysis process. Topics explored within each interview included access to health and social services, harm reduction, substance use, and experiences in providing services during COVID-19 pandemic. Thematic analysis was used to identify common themes throughout each story. ResultsOur results indicate that the COVID-19 pandemic exposed and amplified pre-existing forms of structural violence and necropolitical logics for IPLH within Manitoba and Saskatchewan. Specifically, we describe how structural violence and necropolitics are manifested via three main avenues— (i) restrictions and removal of care, (ii) bureaucracy and institutional care politics, and (iii) discrimination and systemic racism within the Canadian healthcare system. ConclusionThe COVID-19 pandemic within Manitoba and Saskatchewan sparked massive changes in service provision within settler-colonial and neoliberal institutions of care. For those services that remained open to IPLH, masking requirements, questionnaire requirements, scheduling requirements, and a lack of in-person services acted as only some of the barriers described by community members as detrimental to care access. Increased experiences of discrimination in health care on the basis of substance use or HIV status further limited access to needed services.

Depathologization of trans* experience in ICD-11: Suggestions for context-sensitive psychotherapeutic work.

The current changes to the treatment recommendations and the diagnostic categorization of trans* identities in the ICD-11 require a new consideration of past therapeutic methods and approaches. The depathologization of trans* lives in the ICD-11 finally enables trans* people to access psychotherapeutic services more freely, as the compulsory therapy that has thus far been required for access to transition-related treatments, as well as the so-called "diagnosis" and "treatment" of "transsexuality", have been removed. Trans* people will nevertheless be interested in qualified psychotherapeutic treatment options. Due to the decades-long discrimination and treatment in the health system that has disregarded the human rights of trans* people, a trans*-affirmative approach is necessary, one that takes into account the context of the treatment and critically reflects upon one's own position as a health professional. This affirmative and self-reflective approach provides the basis upon which therapeutic concerns and topics related to a life lived in accordance with a self-determined (gender) identity, related needs, and the fulfillment of those needs, can be discussed. The consequences of experiences of discrimination, violence and exclusion are, moreover, important elements of therapy that require a structural and social contextualization in order to address internalized trans*-negativity and to empower trans* people in their self-assertion.

Discrimination Experiences among Asian American and Pacific Islander Adults during the COVID-19 Pandemic and Their Association with Mental Health Outcomes: Updated Findings from the COMPASS Study.

Reports of escalated discrimination experiences among Asian American and Native Hawaiian Pacific Islanders (AANHPI) continue. Using the original and follow-up surveys of the COVID-19 Effects on the Mental and Physical Health of AAPI (Asian American and Pacific Islanders) Survey Study (COMPASS I and COMPASS II) (n = 3177), we examined changes over approximately a 1-year period in discrimination experiences attributable to being AAPI and factors associated with worse mental health outcomes. Experiences of discrimination remained high in COMPASS II with 60.6% (of participants (compared to 60.2% among the same people in COMPASS I) reporting one or more discrimination experiences, and 28.6% reporting worse mental health outcomes. Experiences of discrimination were associated with modest but significant increase in the odds of worse mental health: adjusted OR 1.02 (95% CI 1.01-1.04). Being younger, being of Native Hawaiian/Pacific Islander or Hmong descent (relative to Asian Indian), and having spent 50% or less of their lifetime in the US (vs. US born), were significantly associated with worse mental health. The fall-out from the pandemic continues to adversely impact AANHPI communities. These findings may help influence policy initiatives to mitigate its effects and support interventions designed to improve mental health outcomes.

Improving kidney care for people with severe mental health difficulties: A thematic analysis of personal and family members' perspectives.

People with severe mental health difficulties (SMHDs) often have poorer access to kidney healthcare. To better understand the barriers and facilitators to kidney healthcare for this population, we conducted interviews with nine individuals with SMHDs and four family members. Through reflexive thematic analysis, we generated three themes: (1) 'One size doesn't fit all' describes the need for individualised kidney healthcare, adapted to meet the specific needs of each person with a SMHD. (2) 'You just can't say, "I'm only dealing with your kidney here"' describes how fragmentation of physical and mental healthcare services can lead to poorer outcomes for people with SMHDs, underscoring the need for coordinated care. (3) 'Just treat me with respect' describes the impact of healthcare provider attitudes. Overall, participants praised the dedication and kindness of renal clinicians. However, some participants also described experiences of stigma and discrimination, and called for additional education for healthcare providers regarding SMHDs.