Major Ethnic Minority Research Articles

Unveiling health inequities: Exploring the role of social capital and public trust in bridging racial disparities in health‐care coverage for Hispanics

AbstractObjectiveThis study examines the racial disparity in health‐care coverage between Hispanics and whites. Racial disparities in accessing health‐care services have worsened in the United States, exacerbating social and economic inequality between whites and racial/ethnic minority groups. While existing research primarily attributes these disparities to income differences among racial groups, this study focuses on the mediating role of social capital and the moderating role of public trust in formal institutions, while controlling for income and other socioeconomic factors.MethodsDrawing on a survey data set collected in the Austin area of Texas in 2020, we test a series of regression models using mediating and moderating analyses.ResultsWe find that Hispanics, as a major ethnic minority group, have lower levels of social capital compared to whites, which contributes to the gap in health‐care coverage. The results indicate that social capital has mediating effects in positively transmitting the effect of being Hispanic on access to health‐care coverage. In addition, trust in nonprofits positively moderates the main relationship.ConclusionThe study suggests that promoting social capital for Hispanics can help bridge racial disparities in accessing healthcare. Our study provides policy recommendations for nonprofits to collaborate with government agencies.

Different motivation, different achievements: the relationship of motivation and dedication to academic pursuits with final grades among Jewish and Arab undergraduates studying together

Much research has indicated disparities between majority and minority groups in academic achievements. In Israel, differences have been recorded between the ethnic majority of students of Jewish origin and the ethnic minority of students of Arab origin. One possible reason for these findings might be differences in motivation, influenced by the respective cultures of the Jewish ethnic majority and Arab ethnic minority. The present research examined the relationship between differences in academic achievements of 73 students of Jewish origin and 74 students of Arab origin studying together and patterns of motivation and dedication to academic pursuits. The findings indicate considerable differences between the two populations in final grades and in motivational patterns and dedication to academic pursuits. In addition, in each of the research populations, different motivations were associated with a higher level of grades.

Ethnic identity centrality across the adult lifespan: Aging, cohort, and period effects among majority and minority group members.

Ethnic identity is a major area of study across many disciplines including psychology, sociology, anthropology, and political science. Yet, little is known about changes in ethnic identity across the adult lifespan, and whether such changes are driven by normal aging processes (aging effects), unique societal influences linked with one's formative years (cohort effects), or social changes during a specific time frame (period effects). We address these key oversights by utilizing 13 annual waves of longitudinal panel data from a nationwide random sample of both ethnic majority (N = 49,660) and Indigenous ethnic minority (N = 8,325) group members in New Zealand to examine changes in ethnic identity centrality using cohort-sequential latent growth modeling. This approach helps to identify changes in mean levels of ethnic identity centrality over time and whether such changes are driven by aging, cohort, and/or period effects. Our data reveal that, among both ethnic majority and ethnic minority individuals, changes in ethnic identity centrality were informed by a combination of normative aging processes, societal circumstances that reflected the unique historical context in which people grew to maturity, and societal changes during the 13 annual assessments of our study. Collectively, these results demonstrate for the first time that ethnic identity centrality in adulthood is subject to lifelong changes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The relationship between Myanmar’s past and its future

Outside Myanmar, the 2021 coup d’état has often been portrayed as the end of a hopeful period for the country. In this Adelphi book, however, Aaron Connelly and Shona Loong argue that the Aung San Suu Kyi government that preceded it was a false dawn, unlikely to fulfil the international community’s aspirations for a stable, peaceful and strong Myanmar. Instead, the movement opposing the 2021 coup holds much greater promise – despite the bloody conflict that dominates the news today. Connelly and Loong survey three fundamental relationships that have shaped Myanmar before and after the coup – between the military and the state, between the majority Burmese and ethnic minorities, and between Myanmar and the world – to explain how opposition to the coup has shifted all of them in a more liberal, pluralist and cosmopolitan direction.

The relationship between Myanmar and the world

Outside Myanmar, the 2021 coup d’état has often been portrayed as the end of a hopeful period for the country. In this Adelphi book, however, Aaron Connelly and Shona Loong argue that the Aung San Suu Kyi government that preceded it was a false dawn, unlikely to fulfil the international community’s aspirations for a stable, peaceful and strong Myanmar. Instead, the movement opposing the 2021 coup holds much greater promise – despite the bloody conflict that dominates the news today. Connelly and Loong survey three fundamental relationships that have shaped Myanmar before and after the coup – between the military and the state, between the majority Burmese and ethnic minorities, and between Myanmar and the world – to explain how opposition to the coup has shifted all of them in a more liberal, pluralist and cosmopolitan direction.

The relationship between the centre and the periphery

Outside Myanmar, the 2021 coup d’état has often been portrayed as the end of a hopeful period for the country. In this Adelphi book, however, Aaron Connelly and Shona Loong argue that the Aung San Suu Kyi government that preceded it was a false dawn, unlikely to fulfil the international community’s aspirations for a stable, peaceful and strong Myanmar. Instead, the movement opposing the 2021 coup holds much greater promise – despite the bloody conflict that dominates the news today. Connelly and Loong survey three fundamental relationships that have shaped Myanmar before and after the coup – between the military and the state, between the majority Burmese and ethnic minorities, and between Myanmar and the world – to explain how opposition to the coup has shifted all of them in a more liberal, pluralist and cosmopolitan direction.

The relationship between the armed forces and the state

Outside Myanmar, the 2021 coup d’état has often been portrayed as the end of a hopeful period for the country. In this Adelphi book, however, Aaron Connelly and Shona Loong argue that the Aung San Suu Kyi government that preceded it was a false dawn, unlikely to fulfil the international community’s aspirations for a stable, peaceful and strong Myanmar. Instead, the movement opposing the 2021 coup holds much greater promise – despite the bloody conflict that dominates the news today. Connelly and Loong survey three fundamental relationships that have shaped Myanmar before and after the coup – between the military and the state, between the majority Burmese and ethnic minorities, and between Myanmar and the world – to explain how opposition to the coup has shifted all of them in a more liberal, pluralist and cosmopolitan direction.

Introduction

Outside Myanmar, the 2021 coup d’état has often been portrayed as the end of a hopeful period for the country. In this Adelphi book, however, Aaron Connelly and Shona Loong argue that the Aung San Suu Kyi government that preceded it was a false dawn, unlikely to fulfil the international community’s aspirations for a stable, peaceful and strong Myanmar. Instead, the movement opposing the 2021 coup holds much greater promise – despite the bloody conflict that dominates the news today. Connelly and Loong survey three fundamental relationships that have shaped Myanmar before and after the coup – between the military and the state, between the majority Burmese and ethnic minorities, and between Myanmar and the world – to explain how opposition to the coup has shifted all of them in a more liberal, pluralist and cosmopolitan direction.

Education and Inter-Ethnic Attitudes among Recent Immigrants in the Netherlands

Recent researchshows that better educated and structurally integrated immigrants do not articulate more positive attitudes toward the ethnic majority than immigrants who have lower levels of educational attainment, described as evidence of an “integration paradox.” While these findings have important implications for theories of immigrant integration, they stand in contrast with theories of intergroup relations, e.g., intergroup contact theory. Importantly, these findings also challenge the strong theoretical expectation that higher levels of education generate more positive intergroup attitudes, that is, the universality of the educational effect. Using four waves from ‘New Immigrants Survey Netherlands’ (NIS2NL) survey, I investigate attitudinal differences toward both the ethnic majority and other ethnic minorities in the Netherlands for four recent immigrant groups by focusing on the highest level of education from their country of origin. First, I analyze whether the relationship between education and outgroup attitudes differs toward the ethnic majority and toward ethnic minorities. Second, I look at how attitudes toward outgroups change over time. Findings indicate that immigrants with higher levels of educational attainment hold more positive attitudes toward other ethnic minority groups, and these attitudes are stable over time. Attitudes toward the ethnic majority, however, are initially very positive but become less so over time, regardless of level of education. The findings shed new light on the universality of the educational effect on interethnic attitudes by showing that higher levels of education among immigrants have a potential “liberalizing” effect only toward minority groups, but not toward the ethnic majority.

Associations Between Early Life Adversity and Youth Psychobiological Outcomes: Dimensional and Person-Centered Approaches.

Exposure to early life adversity (ELA) is associated with increased externalizing symptoms (e.g., aggression and oppositionality), internalizing symptoms (e.g., withdrawal and anxiety), and biological indicators of accelerated aging (e.g., telomere length) in childhood. However, little is known about how distinct dimensions of ELA, such as threat and deprivation, impact youth psychobiological outcomes. The present study includes data from the Future of Families and Child Wellbeing Study (FFCWS), a large population-based, birth cohort study of majority (approximately 75%) racial and ethnic minority youth born between 1998 and 2000 across 20 large cities in the United States. The present study includes a subset of the original sample (N = 2,483, 51.6% male) who provided genetic data at age 9. First, confirmatory factor analyses were conducted, which revealed four distinct dimensions of ELA (home threat, community threat, neglect, and lack of stimulation) when children were age 3. Second, latent profile analyses identified an eight-profile solution based on unique patterns of the four ELA dimensions. Lastly, latent profiles were used to predict associations with child psychological and biological outcomes at age 9. Results suggest that exposure to specific combinations of ELA is differentially associated with internalizing and externalizing behaviors in childhood, but not with telomere length. Findings have implications for personalized early intervention and prevention efforts aimed at reducing ELA exposure to protect against downstream negative mental health outcomes for diverse youth.

Reframing Climate Change Resilience: An Intersectional Perspective of Ethnicity and Gender from Vietnam

This study breaks away from traditional macroeconomic-data-based research that often overlooks the subjective experiences of communities and social groups in assessing their resilience to external stressors. Instead, we conducted a nuanced analysis of self-assessments provided by 364 household heads in the Nam Dong District, Thua Thien Hue Province, Vietnam, to gain a comprehensive understanding of household resilience. Our investigation focused on two upland communities—the Kinh majority and Co Tu ethnic minority households—evaluating their resilience levels in terms of the five livelihood capitals and identifying significant disparities among different ethnic and gender groups. Our findings reveal notable differences in livelihood resilience to climate change and variability among these groups, particularly for women, the poor, and ethnic minorities who exhibit lower resilience levels. This underscores the need for policies and programs designed to improve resilience capacity while taking into account these groups’ cultural and social norms. We suggest focusing on improving financial, human, and social capitals to increase households’ resilience to external shocks. Specifically, building resilience for disadvantaged groups must go hand in hand with promoting their overall well-being and alleviating poverty. Additionally, we recommend tailored training programs to raise awareness among households and strengthening institutional systems to enhance overall resilience.

Measuring spatial accessibility to adult day services for older adults using GIS

Adult day services (ADS) provide community-based long-term care for older adults with chronic medical, cognitive, or mental health conditions and/or disabilities that are at risk of needing institutional care. This study aims to (a) measure and compare the spatial accessibility to ADS across major racial and ethnic minority older adult groups, and to (b) identify underserved urban areas which have limited access to ADS. Using Geographic Information Systems (GIS), we found little variation across ethnic and racial groups in accessibility to ADS; instead, most differences are between rural and urban areas. Underserved areas with a high older adult population in Los Angeles County were identified. Future research should incorporate other factors such as the organization’s capability, culture compatibility, types of services, and quality of services which may impact on ADS use among older adults.

Ethnic digital divide? Evidence on mobile phone adoption

ABSTRACT Between 2006 and 2014, Vietnam experienced a true information technology revolution. In rural areas, mobile phone ownership increased from 18% to 89%. I use a panel dataset from this period to study the ‘digital divide’ between the ethnic majority group and ethnic minorities. I find that underprivileged ethnic minorities are lag behind in phone adoption. These differences are fully explained by standard factors of demand and by education level, that is, I do not find unobservable barriers in adoption. Analysis using spatial data on digital mobile network coverage reveals that infrastructure is also not a barrier to adoption, even in remote regions of Vietnam. Results are robust to alternative model specifications.

PROMOTING POSITIVE AGING IN COMMUNITY-DWELLING SOUTH ASIAN AMERICANS: AN EXPLORATORY QUALITATIVE STUDY

Abstract Between 2010 and 2017, South Asians were the fastest-growing major ethnic minority group in the US, growing at a rate of 40% over the previous decade (SAALT, 2019). This exponential growth, along with a rapidly aging US population, implies that a significant proportion of the South Asian American population will be 65 years or older in the coming years; yet research on the lived experiences/needs of older South Asian Americans is limited. To address this gap, this qualitative study explored barriers and facilitators to healthy or positive aging in a sample of community-dwelling South Asian Americans 50 years and older. In-depth, semi-structured interviews were conducted with 32 South Asian American older adults (18 women and 14 men). Thematic analysis of the interview data showed that level of acculturation, proficiency in English, cultural beliefs/practices, awareness about available health and social services, degree of religiosity, and the density of social networks were key determinants of healthy aging. Compared to those who were US-born or had immigrated earlier in life, participants who had immigrated later in life (post-retirement) appeared more financially and/or emotionally dependent on their adult children and expressed ambivalence vis-à-vis future caregiving arrangements and intergenerational co-residence. Nearly all participants shared that helping their adult children with childcare, cooking, or other household chores gave them a sense of purpose and made them feel valued. Study findings suggest that along with culturally appropriate programs and policies to support healthy aging, increased volunteering opportunities may enhance subjective well-being in South Asian American older adults.

Abstract 698: Establishing and characterizing patient derived models from racial/ethnic minority gastric cancer patients to advance cancer precision health equity

Abstract Gastric cancer (GC) is the second leading cause of cancer-related deaths worldwide. While overall incidence and mortality rates have dropped in recent decades, GC remains a significant cause of health disparities for all major US racial and ethnic minority groups (Black/African Americans, Hispanic/Latino Americans, Asian Americans, Native Hawaiians and Pacific Islanders, American Indians and Alaskan Natives), who are all at least twice as likely to be diagnosed with and die from GC compared to non-Hispanic whites (NHW). Despite such high minority cancer burden, few FDA-approved targeted therapies are available for GC. This can be partially explained by limited availability of cancer genome data and patient-derived models from racial/ethnic minority populations, hampering gene target identification and drug efficacy studies. Our group has spearheaded the development of the University of California Minority Patient-Derived Xenograft Development and Trial Center (UCaMP) with the goal of addressing these critical issues for GC patient care. Thus far, we have characterized over 30 GC samples from racial/ethnic minorities (mGC), establishing patient-derived organoid lines (mPDOs) for more than half. Genomic analyses have revealed a significantly lower prevalence of chromosomal instability and higher prevalence of genomically stable GC tumors compared to TCGA, which consists predominantly of NHW patients. Our analyses have also identified high prevalence of alterations within the cell cycle regulation/cyclin-dependent kinase (CDK) and PI3K/AKT/mTOR (PI3K) pathways, both of which are therapeutically targetable by inhibitors already FDA-approved for other cancer types. At the individual gene level, these mGC patients demonstrate distinct patterns of somatic mutations, with fewer PIK3CA activating mutations, which is the most commonly mutated gene in the PI3K pathway among TCGA, and TP53 deleterious mutations while demonstrating significantly more deleterious mutations in the PTEN tumor suppressor gene. Indeed, when we treat our mPDOs with PI3K and CDK inhibitors, we observe significant responses in vitro. We are now generating genome-edited mPDO lines from normal gastric tissue to model specific alterations observed in our mGC cohort for functional characterization within GC pathogenesis and drug response validation. Our findings highlight an important molecular distinction of GC development in racial/ethnic US minorities, providing a rationale for alternative treatments to address GC health disparities. Citation Format: Nicole B. Halmai, Hongyong Zhang, Paul C. Lott, Ana Estrada-Florez, Ted Toal, Alexa Morales Arana, Rasika Venkatesh, Elizabeth Quino, Alma Poceros Coba, Guadalupe Carvajal, Javier Torres, UCaMP consortium, Luis G. Carvajal-Carmona. Establishing and characterizing patient derived models from racial/ethnic minority gastric cancer patients to advance cancer precision health equity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 698.

NHS-Galleri Trial Design: Equitable study recruitment tactics for targeted population-level screening with a multi-cancer early detection (MCED) test.

TPS6606 Background: Cancer is a leading cause of premature death globally. Early detection can reduce cancer mortality by reducing the number of cancers diagnosed at a late stage. A blood-based MCED test (Galleri) was developed that can detect cancer signals and predict cancer origin with a single blood draw. The NHS-Galleri trial is a randomized controlled trial (RCT) assessing the clinical utility of this MCED test in a targeted screening population alongside current screening programs. Screening adherence is lower among certain individuals (eg, those with lower socioeconomic status), despite healthcare being free at the point of access in England. NHS-Galleri utilizes innovative strategies to optimize equity in study recruitment, with the goal of enrolling a representative sample. Methods: This pragmatic, blinded RCT is currently enrolling 140,000 asymptomatic participants by inviting ̃1.3 million residents aged 50-77 in select postcodes of England via the NHS DigiTrials service. Regions were selected to include areas of high cancer mortality, socioeconomic deprivation, and ethnic diversity; eligible participants will be identified from these regions. A variety of methods are employed to enroll a representative study population (defined as including a reasonable number of participants from all socioeconomic statuses and all major ethnic minority groups). These methods include the use of mobile phlebotomy clinics that facilitate access in economically deprived areas, monitoring of participant representativeness by postcode with dynamic adjustment of enrollment, providing interpreters and wheelchair accessibility, and targeted local campaigns. Blood will be collected at 3 annual visits (baseline, year 1, year 2) unless cancer is diagnosed. After baseline blood collection, participants will be randomized 1:1 to the intervention (blood sample analyzed by the MCED test) or control (blood sample stored for potential future MCED testing) arm. Only participants in the intervention arm with “cancer signal detected” will have results returned and be referred for investigations and possible treatment. Participants in the intervention arm without “cancer signal detected” and all in the control arm will remain blinded and return for annual visits. All participants will be reminded to continue guideline-based screening and report unusual/concerning symptoms to a doctor. The primary study objective is a significant reduction in the absolute numbers of stage III & IV cancers diagnosed in the intervention versus control arm 3.5 years after randomization. Cancer-specific mortality will be assessed during trial follow-up. Exploratory endpoints include assessing the primary objective by participant age, gender, socioeconomic status, and ethnicity. Clinical trial information: ISRCTN91431511.

The psychology behind malevolent rumors: A study of the relationship between ethnic group identities and the spread of rumors about majority Danes and ethnic minorities

With the advent of social media, fake news, conspiracy theories, and misinformation have emerged as major societal concerns. But why do citizens disseminate untrustworthy information online? I examine this question by testing how identification with societal groups affects citizens’ uptake of malevolent rumors about competing groups. I test the theoretical expectations in a survey study administered to large groups of majority Danes and ethnic minorities living in Denmark. The results show that participants identifying as Danes or immigrants are much more likely to believe and share malevolent rumors about the other group, and that these associations are mostly driven by outgroup anger rather than ingroup love. The article deepens our understanding of majority-minority relationships in a digital world as well as the challenges that must be overcome in order to stop the spread of online misinformation.

Economic contact in service encounters between groups in protracted conflict

AbstractThe study examines whether qualitative and quantitative characteristics of intercultural service encounters (ISEs) between majority customers and ethnic minority service providers are associated with better attitudes toward the entire minority group. The study was conducted in Israel through an online survey of 402 respondents. The study revealed that the customers derived pleasure from high perceived value of services and from taking advantage of a good deal. This pleasure, in turn, was positively related to attitudes toward the outgroup. High perceived value of service was associated with higher frequency of ISE that may be interpreted as repurchasing behavior. Overall, the total effect of perceived value of services between majority population and ethnic minority on attitudes toward this minority was significant and positive. Thus, economic beneficiality, which is a very important component of ISE, may contribute to improving relationships between groups in deep conflict.

Colonoscopy Following an Abnormal Fecal Test Result from an Annual Colorectal Cancer Screening Program in a Federally Qualified Health Center.

Individuals with an abnormal fecal immunochemical test (FIT) result have an elevated risk of colorectal cancer, and the risk increases if the follow-up colonoscopy is delayed. Of note, rates of follow-up colonoscopy are alarmingly low in federally qualified health centers (FQHCs), US health care settings that serve a majority racial and ethnic minority patient population. We assessed factors associated with colonoscopy after an abnormal FIT result and used chart-abstracted data to assess reasons (including process measures) for lack of follow-up as part of an annual, mailed-FIT outreach program within a large, Latino-serving FQHC. As part of the National Institutes of Health-funded PROMPT study, we identified patients with an abnormal FIT result and used logistic regression to assess associations between patient demographics and receipt of follow-up colonoscopy, controlling for patients' preferred language. We report on time (days) to referral and time to colonoscopy. For charts with an abnormal FIT result but no evidence of colonoscopy, we performed a manual abstraction and obtained the reason for the absence of colonoscopy. When there was no evidence of colonoscopy in a patient's electronic health record (EHR), we performed an automated query of the administrative claims database to identify colonoscopy outcomes. We identified 324 patients with abnormal FIT results from July to October 2018. These patients were mostly publicly insured (Medicaid 53.1%, Medicare 14.5%), 81.8% were aged 50 to 64 years, 55.3% were female, 80.3% were Hispanic/Latino, and 67.3% preferred to speak Spanish. We found that 108/324 (33.3%) patients completed colonoscopy within 12 months, and the median time to colonoscopy was 94 days (IQR: 68-176). Common barriers to colonoscopy completion, obtained from chart-abstracted data, were: no documentation following referral to gastrointestinal (GI) specialist or GI consultation (41.6%), no referral to GI specialist following abnormal fecal test (34.2%), and absence of a valid insurance authorization (6.5%). Multi-level strategies are needed to provide optimal care across the cancer continuum for FQHC patients. In order to reduce the risk of CRC and realize the return on fecal testing investment, concerted system-level efforts are urgently needed to improve rates of follow-up colonoscopy among FQHC patients and redress racial and ethnic disparities in CRC screening outcomes.

Impact of the COVID-19 pandemic on racial and ethnic minorities in Japan.

This study compared clinico-epidemiological characteristics between Japanese and non-Japanese coronavirus disease 2019 (COVID-19) patients under the pandemic in Japan. We retrospectively analysed nationwide data of hospitalised COVID-19 patients before 31 March 2021. Epidemic curves were constructed to identify the case distribution over time. A total of 28 093 patients were Japanese and 1335 patients were non-Japanese. The major racial and ethnic minorities were East Asians (n = 521), South Asians (n = 260) and Latin Americans (n = 270). Non-Japanese patients were younger and more likely to travel to COVID-19 endemic countries (7.7%), had meals with other people (17.8%), stayed in crowded places (17.9%) and worked mainly in restaurants (6.6%) and service facilities in nightlife businesses (5.2%). In the matched cohorts, we found no clear disparities in time to admission and clinical prognoses. The epidemic curve for non-Japanese patients showed a small peak in the first wave and no definite waves for the second or third waves. Racial and ethnic minorities were at less risk of severe disease but were at a greater risk of COVID-19 exposure; however, the healthcare system in Japan may provide them with equal opportunities to access inpatient care with Japanese. Further research on their social determinants of health in Japan is required.