Ethnoracial Background Research Articles

Service utilization among adolescents seeking trauma-related care: Differences by risk for suicide and ethnoracial background.

Adolescents from ethnoracially minoritized backgrounds increasingly report high rates of attempted suicide, trauma exposure, and limited access to mental healthcare services. However, less is known regarding their use of services across different youth-serving systems. This study examines the associations and interactions between self-injurious thoughts and behaviors (SITBs), race/ethnicity, and service sector utilization (mental healthcare, general healthcare, school, and social services) among a sample of trauma-exposed and treatment-seeking adolescents. Participants were treatment-seeking adolescents (N = 4406) ages 12-17 from the National Child Traumatic Stress Network Core Data Set who had available data for SITBs, race/ethnicity, services utilized, and other key variables. Mixed effects logistic regression was used to examine main and interactive effects for whether adolescents' race/ethnicity and SITBs were associated with service utilization in each of the identified service sectors. SITBs were associated with adolescents' utilization of mental healthcare (OR = 1.38 p < 0.001), general healthcare (OR = 2.30; p < 0.001), and school services (OR = 1.38 p < 0.001). NH Black adolescents reporting SITBs were less likely to use mental health services than other NH Black youths (OR = 0.53; p = 0.004). Hispanic adolescents reporting SITBs were more likely to utilize healthcare services than other Hispanic youths (OR = 1.51; p = 0.039). Trauma-exposed adolescents reporting SITBs are more likely to utilize mental healthcare, general healthcare, and school-based services than other trauma-exposed adolescents. However, NH Black adolescents experiencing SITBs may face additional barriers to utilizing mental healthcare services. Findings can be used to develop nursing practices and policies to address barriers faced by adolescents reporting SITBs.

Examining sleep characteristics in Canada through a diversity and equity lens

ObjectiveTo examine specific sleep characteristics of adults living in Canada according to sex, gender, ethnoracial background, socioeconomic status, immigration status, sexual orientation, and language spoken at home. MethodsThis cross-sectional and nationally representative study used self-reported data from the 2021 Canadian Community Health Survey (n = 39,346 adults aged 18 years and older). Sleep characteristics (sleep duration, nighttime insomnia symptoms, unrefreshing sleep, and difficulty staying awake) were assessed and compared across groups. ResultsFemales were more likely than males to report nighttime insomnia symptoms (23.1% vs. 14.8%) and unrefreshing sleep (17.2% vs. 13.5%). The same was also observed for gender identity. Although White respondents were more likely to meet sleep duration recommendations (58.3%), they had the highest prevalence of nighttime insomnia symptoms (20.9%) compared to respondents with other ethnoracial backgrounds. Respondents coming from lower socioeconomic backgrounds were more likely to report poorer sleep compared to those coming from higher socioeconomic backgrounds. Insomnia symptoms were lower among immigrants (13.9%) compared to nonimmigrants (21.1%). Respondents with a sexual orientation not classified as heterosexual, gay, or lesbian reported poorer sleep. Finally, for language spoken at home, those who responded “French only” were more likely to meet sleep duration recommendations (64.1%) and were less likely to report unrefreshing sleep (8.8%). Nighttime insomnia symptoms were the lowest among those who reported speaking a language other than French or English at home (9.5%). ConclusionThis study highlights important sleep disparities among Canadians. Future intervention strategies should aim to reduce sleep health disparities.

Teachers' Implementation of the Identity Project Is Associated With Increases in U.S. High School Students' Ethnic-Racial Identity Exploration.

Ethnic-racial identity formation has significant consequences for positive youth development. Existing findings support the efficacy of the Identity Project, a school-based ethnic-racial identity intervention, when delivered by researchers; however, effectiveness of the program when delivered by teachers is unknown. This study examined changes in adolescents' (N = 180; 42.2% male, 50.6% female, 6.7% another gender identity; Mage = 14.11, SD = 0.33; 38.3% Latinx, 33.9% White, 15.0% Black, 9.4% Asian American, 3.3% another ethnoracial background) ethnic-racial identity exploration as a function of their teachers' implementation of the Identity Project. Findings indicated that ethnic-racial identity exploration significantly increased from pretest to posttest, and this did not vary based on familial ethnic-racial socialization, student-teacher ethnoracial match/mismatch, gender, immigrant status, or ethnoracial background. This study provides preliminary evidence that U.S. educators can be trained to efficaciously implement the Identity Project with high school students and, furthermore, that this approach to program dissemination may not only facilitate scale-up but also result in greater gains for adolescents relative to research-led implementations.

Associations between problem technology use, life stress, and self-esteem among high school students

BackgroundAdolescence is a critical period for development, with many risk factors resulting in long-term health consequences, particularly regarding mental health. The purpose of this study was to examine the associations between problem technology use, life stress, and self-esteem in a representative sample of adolescents residing in Ontario, Canada.MethodsSelf-reported data were obtained from a cross-sectional sample of 4,748 students (57.9% females) in grades 9 to 12 (mean age: 15.9 ± 1.3 years) who participated in the 2019 Ontario Student Drug Use and Health Survey. Problem technology use was measured using the 6-item Short Problem Internet Use Test, life stress was assessed using an item from the British Columbia Adolescent Health Survey and self-esteem was assessed using a global measure from the Rosenberg Self-Esteem Scale. Ordinal logistic regression models were adjusted for age, sex, ethnoracial background, subjective socioeconomic status, body mass index z-score, tobacco cigarette smoking, alcohol consumption and cannabis use.ResultsWe found that 18.3% of participants reported symptoms of moderate-to-high problem technology use, although symptoms were more common in females than males (22% vs. 14.7%, respectively). Moderate-to-high problem technology use was associated with 2.04 (95% CI: 1.77–2.35) times higher odds of reporting high life stress and 2.08 (95% CI: 1.76–2.45) times higher odds of reporting low self-esteem compared to all other response options.ConclusionsFindings from this study show that problem technology use is strongly associated with higher life stress and lower self-esteem in adolescents. This study supports the importance of developing and implementing effective strategies that help to mitigate the adverse effects of problem technology use on adolescent mental health.

Ethnoracial disparities in childhood growth trajectories in Brazil: a longitudinal nationwide study of four million children

BackgroundThe literature contains scarce data on inequalities in growth trajectories among children born to mothers of diverse ethnoracial background in the first 5 years of life.ObjectiveWe aimed to investigate child growth according to maternal ethnoracial group using a nationwide Brazilian database.MethodsA population-based retrospective cohort study employed linked data from the CIDACS Birth Cohort and the Brazilian Food and Nutrition Surveillance System (SISVAN). Children born at term, aged 5 years or younger who presented two or more measurements of length/height (cm) and weight (kg) were followed up between 2008 and 2017. Prevalence of stunting, underweight, wasting, and thinness were estimated. Nonlinear mixed effect models were used to estimate childhood growth trajectories, among different maternal ethnoracial groups (White, Asian descent, Black, Pardo, and Indigenous), using the raw measures of weight (kg) and height (cm) and the length/height-for-age (L/HAZ) and weight-for-age z-scores (WAZ). The analyses were also adjusted for mother’s age, educational level, and marital status.ResultsA total of 4,090,271 children were included in the study. Children of Indigenous mothers exhibited higher rates of stunting (26.74%) and underweight (5.90%). Wasting and thinness were more prevalent among children of Pardo, Asian, Black, and Indigenous mothers than those of White mothers. Regarding children’s weight (kg) and length/height (cm), those of Indigenous, Pardo, Black, and Asian descent mothers were on average shorter and weighted less than White ones. Regarding WAZ and L/HAZ growth trajectories, a sharp decline in average z-scores was evidenced in the first weeks of life, followed by a period of recovery. Over time, z-scores for most of the subgroups analyzed trended below zero. Children of mother in greater social vulnerability showed less favorable growth.ConclusionWe observed racial disparities in nutritional status and childhood growth trajectories, with children of Indigenous mothers presenting less favorable outcomes compared to their White counterparts. The strengthening of policies aimed at protecting Indigenous children should be urgently undertaken to address systematic ethnoracial health inequalities.

Income is not an equalizer: health development inequities by ethnoracial backgrounds in California kindergartners

BackgroundEarly childhood health development is positively associated with income, but the strength of this relationship with ethnoracial background remains unclear. This study examined the extent of health development inequities among California kindergarteners based on ethnoracial backgrounds and neighborhood-level income.MethodsThis cross-sectional study assessed health development inequities by analyzing neighborhood-level income, ethnoracial background, and health development data for California kindergarteners. Student-level data (n = 106,574) were collected through teacher report between 2010–2020 across 52 school districts and 964 schools. Student addresses were geocoded and linked to American Community Survey neighborhood income levels. Health development was measured using the Early Development Instrument, a population-level measure which includes physical health and well-being, social competence, emotional maturity, language and cognitive development, and communication skills and general knowledge domains. Outcomes included being “on-track” in each domain as well as overall health development.ResultsUsing a Generalized Estimation Equation with a log-link function, while accounting for interactions between ethnoracial background, income, and income-squared, we found significant health development inequities by ethnoracial background and neighborhood-level income. Regarding overall health development, as well as the physical, social and emotional domains, Black students had a lower likelihood of being on-track compared to the weighted average across income levels, whereas Asian students surpassed the weighted average. White students exhibited the steepest slope, and at the lowest income levels, their health development scores were akin to their Black and Hispanic/Latino/a low-income counterparts but resembled their Asian counterparts at higher income levels. For the general knowledge and communication domain, white students consistently had the highest likelihood of being on-track, while Hispanic/Latino/a students had the lowest likelihood across all income levels.ConclusionThis study examines health development inequities among California kindergarteners in diverse communities. Our analysis shows that the relationship between neighborhood-level income and kindergartners’ health development varies by domain and is weaker for students of color. Given the scarcity of population-level data on health development outcomes, these analyses offer valuable insights for identifying ecosystems necessitating support in promoting equitable early childhood health development.

Heavy social media use and posting regret are associated with lower self-esteem among middle and high school students.

Social media use has become ubiquitous among schoolchildren. This study examined the association of social media use and posting regret with self-esteem among middle and high school students, and tested whether school type (i.e., middle vs. high school) could moderate these associations. Data on 6944 schoolchildren (mean age: 15.2 ± 1.8years) were derived from the 2019 cycle of the Ontario Student Drug Use and Health Survey, a biennial repeated cross-sectional survey of students in grades 7 through 12 across Ontario, Canada. Students self-reported time spent using social media, regret of posting on social media, and their self-esteem. Ordinal logistic regression analyses were adjusted for age, sex, subjective socioeconomic status, ethnoracial background, and body mass index z-score. The proportional odds model showed that middle (OR: 2.36; 95% CI: 1.65-3.36) and high school (OR: 1.72; 95% CI: 1.44-2.06) students with daily social media use of 5h or more have higher odds of lower self-esteem across the categories of self-esteem. However, daily use of 3 to 4h was associated with lower self-esteem among middle school students (OR: 1.52; 95% CI: 1.14-2.04), but notamong their high school counterparts (OR: 1.13; 95% CI: 0.94-1.35). Posting regret was associated with lower self-esteem in high school students, but not inmiddle school students. Results suggest that heavy social media use and posting regret are associated with lower self-esteem among adolescents, and that younger students could be more vulnerable than their older counterparts.

Social Utilitarianism in Digital Interactions and Distant Worlds

Online social networks are increasingly consequential in individuals’ professional and personal lives, as many people engage online to create and maintain meaningful relationships and satisfy their needs for social connection. People tend to curate their online representations (profile pictures for different websites, videogame avatars, bitmojis, profile page bios, etc.) with almost as much regularity as their corporeal (real-world) self-presentation. As such, the current study explored the socially utilitarian choices people make when presenting themselves in both the corporeal and virtual public spheres. Participants completed a questionnaire assessing various aspects of their self-presentation and behavior in real-life, social media, and online videogames. We found several differences in self-presentation strategies in both online and offline contexts based primarily on ethnoracial background, sex, and skin tone. Minority women (particularly Multiracial women) reported dyeing their hair significantly more than White women, and the overwhelming majority reported dyeing their hair a lighter color than their natural hair color. Women use more emojis and exclamation points in emails and digital interactions than men, and they are more likely to use skin lightening filters before posting a selfie on social media. In addition, we found a descriptive pattern indicating that straight women and bisexual women dating men use more filters than lesbians and bisexual women dating women. Finally, in online videogames, men who are below average height reported creating videogame avatars that were taller than they were, individuals with darker skin tones reported creating avatars with skin tones lighter than their own, and introverts reported that they pretend to be extroverted in videogames more than extroverts reported pretending to be introverted. This study highlights the importance of online self-presentation on people’s social lives and the strategies that people utilize to align how they believe they are socially perceived with a more idealized version of themselves, or a version of themselves that will confer greater social capital than what they believe they naturally embody. Given the increasing possibilities of identity customization in the virtual public sphere, further research is needed to fully understand the complex relationship between online and offline self-presentation.

Religion or Race? Using Intersectionality to Examine the Role of Muslim Identity and Evaluations on Belonging in the United States

AbstractHow do White Americans evaluate the politics of belonging in the United States across different ethnoreligious identity categories? This paper examines this question through two competing frameworks. On the one hand, given the salience of anti-Muslim attitudes in the United States, we consider whether White Americans penalize Muslim immigrants to the United States regardless of their ethnoracial background. On the other hand, Muslim identity is often conflated by the general public with Middle Eastern and North African (MENA) ethnoracial identity. We argue MENA-Muslim identity should be understood through the lens of intersectionality. In this case, White Americans may penalize MENA-Muslims immigrants to the United States more than Muslims from other ethnoracial groups. We test these two frameworks through a conjoint experimental design wherein respondents are asked to evaluate immigrants and indicate to whom the United States should give a green card—signaling legal belonging—and how likely the immigrant is to assimilate into America—signaling cultural belonging. Although White Americans believe White Muslims may assimilate better to the United States relative to MENA-Muslims, race does not moderate how White Americans evaluate who should be allowed to belong in the United States.

Incidence, prevalence, and trajectories of suicidal ideation among clients enrolled in early intervention services for first episode psychosis in New York State.

Knowledge on how suicidal ideation (SI) varies following first episode psychosis (FEP) onset is scarce. We identified 1-year trajectories of SI and baseline predictors of emergent SI among all 1298 clients aged 16-30years enrolled between October 2013-December 2018 in OnTrackNY, a program providing early intervention services for FEP across New York State. Clinicians recorded baseline clinical and sociodemographic variables and quarterly assessments of SI over a one-year follow-up. We examined baseline correlates of baseline SI and of 1-year SI trajectory. Among clients not reporting baseline SI, we examined predictors of subsequent emergent SI. Baseline SI was reported by 349 (26.9%) clients and associated with schizoaffective disorder, previous self-injurious behavior, any alcohol or substance use, higher symptom severity, poorer social functioning, and Non-Hispanic White, Asian or Hispanic ethnoracial background. Two hundred and two (15.6% overall) clients stopped being suicidal within 6months of follow-up. Persistent SI was reported by 147 (11.3% overall) clients and, among clients not discharged before one year of follow-up, was associated with schizoaffective disorder, any alcohol use, being female, and being Hispanic or White Non-Hispanic. Among 949 (73.1%) clients not reporting baseline SI, subsequent emergent SI was reported by 139 (10.7% overall) and predicted at baseline by schizoaffective disorder, higher symptom severity, recent homelessness, and not being Hispanic. In conclusion, SI is highly prevalent and varies markedly over time among FEP early intervention clients. These results highlight the importance of ongoing assessment for SI among individuals experiencing FEP - even in the absence of baseline SI.

Social mobility through higher education: exploratory analysis of ethno-racial, gender and class intersection in professional undergraduate programmes

ABSTRACT Higher education and elite professional occupations are considered to be key sources of social mobility. In this paper, we suggest that examining patterns of admission into professional undergraduate programmes, a key route for entry into elite professional occupations, may provide important insights into social mobility through higher education. We analyse university admission offer data and assess the impact of ethno-racial, gender and class intersection on relative likelihood of student admission to six elite professional programmes (medicine, law, accounting, architecture, engineering and business management), in comparison to non-professional programmes. Our exploratory analysis provides several interesting results; though they present a generally pessimistic picture of potential social mobility through higher education. We find that higher class background is a key factor in admissions to elite professional programmes, especially evident in the exemplar traditional professions of medicine and law; presumed gender effects on entry into technical math-based professional programmes, such as engineering and accounting, are substantially moderated by class background; and ethno-racial background may mitigate some of the class penalties for women, but leads to double penalty for black men. Our findings contribute directly to the current research on impact of class origin on social mobility, especially that on class ceiling. Further, we respond to recent calls for fuller inclusion of class in intersectionality-based research by showing how class may work both through and against other social factors, such as race and gender.

Biofluid biomarkers in an ethnoracially diverse population and their association with AD

AbstractBackgroundPlasma‐based biomarkers of Alzheimer’s disease are cost‐effective, minimally invasive and highly scalable tools to aid in clinical practice and trials. There remain significant gaps in our understanding of the factors that influence their levels. The majority of fluid biomarker research has been conducted in clinical settings using CSF biomarkers with non‐Hispanic Whites. Although Hispanic and African American communities have higher rates of dementia, there is limited research on blood‐based biomarkers of AD in these communities. The current study of a sample of Mexican Americans, African Americans and Non‐Hispanic Whites investigated the performance of plasma biomarker across the three largest ethnic/racial groups in the US to assess the impact of ethnicity/race on the level of the plasma biomarkers of Aβ40, Aβ42, total tau, ptau 181 and NfL.MethodParticipants were 2200 community dwelling older adults (850 Mexican Americans (MA); 850 Non‐Hispanic Whites (NHW) and 500 African Americans (AA) drawn from The Health &amp; Aging Brain Study – Health Disparities (HABS‐HD) study. Cognitive diagnoses were assigned using an algorithm verified by consensus review. Samples were assayed using Simoa technology. Levels of each biomarker were compared for the three ethnoracial groups across cognitive diagnoses.ResultsSignificant differences were found across the groups at each level of cognitive impairment. For those with normal cognition AA had significantly lower levels of each of the biomarkers and NHW had higher levels of Aβ40, Aβ42 and NFL. MA had the highest level of t tau and p tau 181. MCI group NHW had the highest levels on all the biomarkers and AA had the lowest. NHW and MA has higher levels of Aβ40, Aβ42, total tau, ptau 181 compared to AA. NHW levels of NfL were the highest and MA and AA did not differ. For dementia there was no difference between the groups for Aβ42. NHW had significantly higher levels of Aβ40, t tau, ptau 181 and NfL than AA.ConclusionFindings support the importance of considering ethnoracial background in the clinical use of blood‐based biomarkers and the difficulty of establishing universal cutting points for these biomarkers in the diagnostic process.

Be accountable for teacher diversity

Rudy Ruiz and Faith Connolly propose a new accountability measure that captures the percentage of students in a school that have a teacher of a similar ethno-racial background. The measure would hold school districts accountable for the percentage of students who have a teacher who looks like them. Adding this measure would bring attention to recruiting and retaining teachers of color and improve outcomes for students of color.

Barriers to Police Reporting among Pregnant Ethnoracial Minority Survivors of Intimate Partner Violence

ABSTRACT Femicide is the leading cause of death among pregnant women in the United States and the risk of pregnancy-associated intimate partner femicide is significantly higher among ethnoracial minority women. In this exploratory study we examined ethnoracial differences in the rates and reasons against calling police following nonfatal intimate partner violence (IPV) victimization in a nationally representative sample of pregnant and nonpregnant female survivors. Among IPV survivors, 1 in 18 (5.6%, n = 106) were pregnant at the time of their abuse. Although the nature of IPV experienced was generally unrelated to victims’ ethnoracial background or pregnancy status, Black/non-Hispanic women differed in that their victimization during pregnancy was associated with significantly increased feelings of being unsafe and endorsement of the belief that the IPV was a private or personal matter, and increased fear of reprisal by the perpetrator or others. There was a significant interaction between pregnancy status and ethnoracial background on reporting IPV to police, with the probability of police reporting increasing non-significantly during pregnancy for White/non-Hispanic women and decreasing non-significantly for Black/non-Hispanic women. These findings highlight barriers to police reporting of IPV among pregnant Black/non-Hispanic survivors and suggest avenues for future research aimed at decreasing racial disparities in pregnancy-associated femicide.

Movement behaviours, breakfast consumption, and fruit and vegetable intake among adolescents

BackgroundIt is recommended that children and adolescents spend ≥ 60 min per day of moderate-to-vigorous physical activity, ≤ 2 h per day of recreational screen time, and 9–11 h of sleep per night for school-aged children or 8–10 h per night for adolescents. The objective of this study was to examine the associations of compliance with physical activity, screen time, and sleep duration recommendations with the frequencies of breakfast consumption and fruit and vegetable intake among adolescents.MethodsData from a cross-sectional and province-wide survey of students in grades 7–12 in Ontario (Canada) were used for this analysis (n = 12,759 students; 15.2 ± 1.8 years; 56% females). Movement behaviours and eating habits were self-reported. Multivariable ordered logistic regression analyses were adjusted for age, sex, ethnoracial background, subjective socioeconomic status, and body mass index z-score.ResultsCompliance with all three recommendations was associated with more frequent breakfast consumption (OR: 2.77; 95% CI: 2.17–3.55) and fruit and vegetable intake (OR: 2.95; 95% CI: 2.41–3.62) compared with compliance with none of the recommendations. Compliance with the different combinations of recommendations was also associated with more frequent breakfast consumption and fruit and vegetable intake, with some exceptions. There was a dose–response gradient between the number of recommendations met (3 > 2 > 1) and more frequent breakfast consumption (p < 0.001) and fruit and vegetable intake (p < 0.001), with compliance with all three recommendations being the best combination.ConclusionsThese findings suggest that compliance with the physical activity, screen time, and sleep duration recommendations is associated with more frequent breakfast consumption and fruit and vegetable intake among adolescents.

Cyberbullying involvement, parental support, and cannabis use among adolescents

BackgroundCyberbullying victimization has been associated with cannabis use among adolescents. However, it is unclear if this relationship also holds for cyberbullying perpetrators. ObjectiveThis cross-sectional study examined the association between cyberbullying involvement and cannabis use among adolescents and tested if parental support was associated with cyberbullying involvement and cannabis use. Participants and settingData from 7229 students aged 11–20 years were obtained from the 2019 Ontario Student Drug Use and Health Survey, a province-wide survey of middle and high school students across Ontario, Canada. MethodsParticipants self-reported their cannabis use frequency, their involvement in cyberbullying, and their perception of parental support. Cyberbullying involvement was operationalized as an action taking place at least two times. Multivariable logistic regression models were adjusted for age, sex, ethnoracial background, and subjective socioeconomic status. ResultsOverall, 8.6 % of students were cyberbullying victims only, 2 % were cyberbullying perpetrators only, and 2.8 % were both cyberbullying victims and perpetrators. Results showed that experience of cyberbullying victimization only (OR: 2.17; 95 % CI: 1.64–2.88), perpetration only (OR: 2.64; 95 % CI: 1.51–4.63), or both (OR: 3.34; 95 % CI: 2.12–5.28) was associated with greater odds of cannabis use. Results further indicated that higher parental support was associated with lower odds of cannabis use in a dose-response fashion. Higher parental support was also associated with a lower risk of cyberbullying involvement. ConclusionsThese findings suggest that involvement in cyberbullying in any role is associated with greater cannabis use among adolescents and that parental support is associated with less cannabis use and cyberbullying involvement.

Prevalence and correlates of anxiety symptoms among Black people in Canada: A significant role for everyday racial discrimination and racial microaggressions

ObjectiveAnxiety disorders are highly prevalent worldwide but vary significantly by country and ethnoracial background. Minimal published data exist on the prevalence of clinically significant anxiety among Black people in Canada and none using validated measures. Therefore, this study sought to establish the frequency of clinically significant anxiety symptoms among a sample of Black people living in Canada as well as examine the association with two forms of racism (racial discrimination and racial microaggressions). MethodsData collected from the Black Community Mental Health project in Canada was analyzed. Participants provided (N= 845) sociodemographic information and completed measures assessing anxiety symptomology (GAD-7), everyday racial discrimination, racial microaggressions, and resilience. Prevalence of anxiety symptomatology was determined across sociodemographic variables as well as categories of everyday racial discrimination and racial microaggressions. Two regression models were conducted to examine the relationship between anxiety symptoms and the two forms of racism controlling for sociodemographic factors. ResultsOverall, nearly a third of participants endorsed clinically significant levels of anxiety symptoms, with higher rates observed among men, unemployed people, those with higher education, people who are separated, and those with no reported family history of mental health problems. Logistic regression models demonstrated that, except for those reporting the greatest frequency of racial discrimination, there is a general linear trend such that those experiencing higher levels of racial discrimination or racial microaggressions are increasingly more likely to present with anxiety symptoms when compared to those reporting low levels of discrimination or microaggressions. Psychological resilience afforded nominal protection but only against exposure to racial microaggressions. ConclusionsRates of clinically significant anxiety are higher among Black people in Canada than reported previously. Both racial discrimination and racial microaggressions predicted higher rates of anxiety symptoms. The results are discussed in relation to previous findings from the US that report similar findings.

Alcohol and cannabis use during the COVID-19 pandemic among transgender, gender-diverse, and cisgender adults in Canada

BackgroundThis study examined whether heavy episodic drinking (HED), cannabis use, and subjective changes in alcohol and cannabis use during the COVID-19 pandemic differ between transgender and gender-diverse (TGD) and cisgender adults.MethodsSuccessive waves of web-based cross-sectional surveys. Setting: Canada, May 2020 to March 2021. Participants: 6,016 adults (39 TGD, 2,980 cisgender men, 2,984 cisgender women, and 13 preferred not to answer), aged ≥18 years. Measurements: Measures included self-reported HED (≥5 drinks on one or more occasions in the previous week for TGD and cisgender men and ≥4 for cisgender women) and any cannabis use in the previous week. Subjective changes in alcohol and cannabis use in the past week compared to before the pandemic were measured on a five-point Likert scale (1: much less to 5: much more). Binary and ordinal logistic regressions quantified differences between TGD and cisgender participants in alcohol and cannabis use, controlling for age, ethnoracial background, marital status, education, geographic location, and living arrangement.ResultsCompared to cisgender participants, TGD participants were more likely to use cannabis (adjusted odds ratio (aOR)=3.78, 95%CI: 1.89, 7.53) and to have reported subjective increases in alcohol (adjusted proportional odds ratios (aPOR)= 2.00, 95%CI: 1.01, 3.95) and cannabis use (aPOR=4.56, 95%CI: 2.13, 9.78) relative to before the pandemic. Compared to cisgender women, TGD participants were more likely to use cannabis (aOR=4.43, 95%CI: 2.21, 8.87) and increase their consumption of alcohol (aPOR=2.05, 95%CI: 1.03, 4.05) and cannabis (aPOR=4.71, 95%CI: 2.18, 10.13). Compared to cisgender men, TGD participants were more likely to use cannabis (aOR=3.20, 95%CI: 1.60, 6.41) and increase their use of cannabis (aPOR=4.40, 95%CI: 2.04, 9.49). There were no significant differences in HED between TGD and cisgender participants and in subjective change in alcohol between TGD and cisgender men; however, the odds ratios were greater than one as expected.ConclusionsIncreased alcohol and cannabis use among TGD populations compared to before the pandemic may lead to increased health disparities. Accordingly, programs targeting the specific needs of TGD individuals should be prioritized.

Disordered Eating and Body Dissatisfaction in Transgender and Gender-Expansive Adults: An Evaluation and Integration of the Gender Minority Stress and Resilience and Tripartite Influence Models

Transgender and gender-expansive (TGE) people, including transgender and nonbinary individuals, experience elevated rates of body dissatisfaction and disordered eating compared to cisgender individuals, but little is known about why. To address this research gap, we compared the ability of TGE-specific factors as proposed in the gender minority stress and resilience (GMSR) model, general psychological factors contained in the tripartite influence (TI) model, and an integration of these frameworks to explain body dissatisfaction and disordered eating among TGE individuals. Regression analyses were conducted to test the models’ abilities to explain experiences reported in a survey of 93 U.S. TGE adults, including 43 transgender women respondents (46.2%) and 31 transgender men respondents (33.3%). Participants were diverse with regard to age (M = 34.19, SD = 12.02) and ethnoracial background (e.g., 29.0% Hispanic/Latinx, 17.2% Black/African American, 6.5% American Indian/Alaska Native; 5.4% multiracial). Results demonstrated both models’ abilities to explain body dissatisfaction and disordered eating independently, except for the relationship between body dissatisfaction and the thinness-oriented TI model. An integration of the models better explained body dissatisfaction and disordered eating compared to either model alone. Notably, some findings did not align with the two frameworks, suggesting existing models may not adequately describe pathways through which disordered eating emerges in TGE populations. Specifically, body dissatisfaction showed no significant relationship with disordered eating and was not well explained by the TI model, and higher gender identity pride was related to greater disordered eating symptoms. Implications for clinical care and future research are discussed.

Experiences of discrimination and its impacts on well-being among racialised LGBTQ+ newcomers living in Waterloo region, Ontario, Canada.

Discrimination (i.e. racism, homo/bi/transphobia) at both the individual and systemic levels may negatively impact the well-being of racialised LGBTQ+ newcomers living in Waterloo Region, Ontario, Canada. Current research about the experiences of LGBTQ+ newcomers focuses predominantly on homogeneous samples of gay men living in large metropolitan city centres. The present study aims to extend the current literature by exploring the experiences of discrimination and its impacts on well-being among racialised LGBTQ+ newcomers living in a small urban area and representing a variety of intersecting identities (i.e. ethno-racial background, LGBTQ+ identity, newcomer status). Using a qualitative method, 10 individuals were invited to complete a semistructured interview between fall 2019 and summer 2020 about their experiences of discrimination in Waterloo Region, and how such experiences impact their well-being. Using an intersectional lens, a thematic analysis revealed that racialised LGBTQ+ newcomers experienced discrimination before and after settlement in Waterloo Region. Prior to settlement, participants spoke predominantly about experiences of homo/biphobia and the associated feelings of internalised oppression. Alternatively, upon settling in Waterloo Region, experiences of discrimination were predominantly racism, and, in particular, systemic racism, which manifested as an inability to access adequate services and a lack of representation in various spaces throughout Waterloo Region. These results extend previous research by identifying the service barriers experienced by racialised LGBTQ+ newcomers living in a small urban area and can be used to inform best practices for addressing these barriers in Waterloo Region and other small urban areas with similar demographics. Implications and limitations are discussed.