Minority Health Research Articles

Health and socio-demographic background of Ukrainian minors and their families in Germany - challenges for refugee medicine

In 2022, over 1,000,000 people from Ukraine fled to Germany, mostly women and children. The aim of this study was to determine health status and socio-demographic background of Ukrainian refugee minors in Germany and to compare that to German minors. In this study, Ukrainian refugees of all ages, who voluntarily made contact with the study centres via flyers or refugee shelters, were interviewed with the help of trained interpreters from 09–12/2022. We assessed data from minors and their families on socio-economic status, general health perception, current and pre-existing infectious and non-contagious diseases, and vaccination status. The data for the minors were collected by interviewing the accompanying adults. In addition, a physical examination and serological screening for infectious and vaccine-preventable diseases were performed. Overall, 392 minors and accompanying adults (358) were included. Minors’ general and mental health were reported as “at least good" in 83% (316) and 80% (304), respectively. In 16% (63), infectious or other underlying diseases were recorded. Tuberculosis infections (7, 1.8%) and hepatitis C (2, 0.5%) were found through the serological tests. HIV could only be detected in one previously known case. Self-reported vaccinations against measles and varicella, for example, did not match serological findings (protection against measles 304; 84%; varicella 230; 64%). Conclusion: Accompanying adults often rate the general health and well-being of Ukrainian refugee minors as rather poor. Frequently, self-reported vaccinations and preexisting diseases did not match serology results; therefore, Ukrainian refugee minors without formal vaccination certificate should be offered all recommended vaccinations and be generously screened for hepatitis B, C and HIV in addition to tuberculosis.What is Known:• Infectious diseases (TB, hepatitis B/C, HIV) are more common among Ukrainian minors and vaccine hesitancy is more widespread than in many host countries and require appropriate medical care.• Displacement and war worsen medical care and have negative impact on mental health..What is New:• Although intrafamilial spread of infectious diseases was rare (in this cohort), perceived general health of Ukrainian minors is rather poor.• Semi-structured interviews—even with interpreters—are often insufficient to collect valid medical information.

Access to Breast Cancer Screening: Disparities and Determinants-AJR Expert Panel Narrative Review.

While breast cancer screening reduces mortality, disparities in access continue to limit equitable care. Medically underserved groups-including American Indian or Alaska Native, Black, Hispanic, disabled, and LGBTQ+ individuals-face significant barriers in accessing screening mammography services. This AJR Expert Panel Narrative Review leverages the National Institute on Minority Health and Health Disparities Research Framework to analyze persistent inequities in screening, focusing on race, ethnicity, socioeconomic status, disabilities, health insurance, and geography. Screening guidelines vary across organizations, complicating access for underserved groups. Legislative efforts, including breast density notification laws and the Find It Early Act, aim to address disparities but remain insufficient. Traditional risk models can yield inconsistent assessments of high-risk status and disparities in appropriate referral for genetic testing and supplemental screening. Emerging technologies like artificial intelligence (AI) promise to reduce these gaps by improving risk assessment and detection accuracy, although clinical integration requires careful evaluation to avoid exacerbating existing inequities. This article underscores the importance of policies and practices that address the needs of disabled individuals and other marginalized populations, focusing on creating inclusive and effective screening systems. Recommendations are provided to guide future research, policy development, and clinical practices aimed at mitigating disparities in breast cancer screening.

The patient's level of knowledge about analgesic drug self-medication

Introduction: Self-medication is the practice of using drugs without a doctor's prescription to overcome minor health problems, one of which is analgetic drugs to reduce pain. Although self-medication can improve the accessibility of medications, improper use can be risky for the patient's health. Adequate knowledge of the types, dosages, and ways of using analgesic medications is essential to ensure effectiveness and avoid adverse side effects. This study aims to evaluate the level of patient knowledge about analgetic drug self-medication. Methods: This study uses a quantitative design with a survey approach. Data was collected through a questionnaire distributed to 81 patients who visited the pharmacy. Results: The results of this study indicate that the percentage of respondents' answers is 8.091%. Based on these results, it can be concluded that the level of patient knowledge about self-medication of analgtic drugs is in a good category. Conclusions: The results showed that the majority of patients had sufficient knowledge about the indications and dosage of analgetic drugs, but there was a gap in understanding of potential side effects and drug interactions. This indicates the need for more intensive health education regarding self-medication, especially in the use of analgesic drugs, to reduce the risk of inappropriate use

Psychosocial, physical problems and coping strategies of patients having long term / permanent tracheostomy

BackgroundTracheostomy is a common surgical procedure in which a stoma is created in trachea by direct incision over the anterior aspect of the neck, which can cause disfigurement of the anterior neck and many other associated physical and psychosocial issues. Patients with long-term/permanent tracheostomy have to live with tracheostomy even after getting discharged from the hospital, which can further complicate the condition of the patients as they are unable to cope up with the problems associated with long-term tracheostomy. There is dearth of literature related to intensity of problems among patients having long term/ permanent tracheostomy in India. Therefore, the aim of the study is to assess psychosocial, physical problems and coping mechanism in patients with long-term/permanent tracheostomy.MethodsA cross-sectional descriptive study was conducted at ENT outpatient department and ENT Minor operation theatre, tertiary care hospital India. Total of 100 patients having long term/permanent tracheostomy were enrolled by convenient sampling. Data regarding demographics and clinical characteristics, Physical and Psychosocial problems, and Coping strategies were collected by structured questionnaires.ResultThe majority of individuals who had long-term or permanent tracheostomies had only minor health issues. Patients experienced more psychosocial issues than people in the general healthy population. The majority of patients employed active coping, acceptance, and religion as coping mechanisms, whereas the coping mechanisms which were minimally used includes: humor and substance abuse. Patients' coping strategies vary significantly according on their age, employment status, marital status, and the duration of their tracheostomy.ConclusionLong-term/Permanent tracheostomy can cause multiple physical and psychosocial issues in patients, but eventually, patients get adapted to it. Support from family members and significant others plays a vital role in better coping with tracheostomy in situ, also it is critical for health care providers to be aware of their problems and coping mechanisms so that they can provide required care and assistance.

Disparities in wellbeing in the USA by race and ethnicity, age, sex, and location, 2008–21: an analysis using the Human Development Index

The Human Development Index (HDI)-a composite metric encompassing a population's life expectancy, education, and income-is used widely for assessing and comparing human development and wellbeing at the country level, but does not account for within-country inequality. In this study of the USA, we aimed to adapt the HDI framework to measure the HDI at an individual level to examine disparities in the distribution of wellbeing by race and ethnicity, sex, age, and geographical location. We used individual-level data on adults aged 25 years and older from the 2008-21 American Community Survey (ACS) Public Use Microdata Sample. We extracted information on race and ethnicity, age, sex, location (Public Use Microdata Areas), educational attainment, and household income and size. We merged these data with estimated life tables by race and ethnicity, sex, age, location (county), and year, generated using Bayesian small-area estimation models applied to death certificate data from the National Vital Statistics System. For each individual in the ACS, we used these combined data to estimate years of education, household consumption, and expected lifespan; converted each of these three features into an index using a percentile score; and calculated the HDI as the geometric mean of these three indices. Finally, we grouped individuals into yearly HDI deciles. Years of education, household consumption, and expected lifespan-and thus the HDI-varied considerably among adults in the USA during the 2008-21 period. For most race and ethnicity and sex groups, the mean HDI increased gradually from 2008 to 2019, then declined in 2020 due to declines in expected lifespan, although there were systematic differences in the distribution of the HDI by race and ethnicity and sex. In the lowest HDI decile, there was over-representation (ie, >10% of the total population of a given race and ethnicity and sex group) of American Indian and Alaska Native (AIAN) males (50% [SE 0·2] in decile, mean annual population in decile 0·37 million [SE 0·002]), Black males (40% [<0·1], 4·67 million [0·006]), AIAN females (23% [0·1], 0·19 million [0·001]), Latino males (21% [<0·1], 3·27 million [0·006]), Black females (14% [<0·1], 1·86 million [0·004]), and Latina females (13% [<0·1], 2·07 million [0·006]). Given differences in total population size, however, White males were the largest population group in the lowest decile (27% [<0·1] of the lowest decile, 5·87 million [0·012]), followed by Black males (22% [<0·1]) and Latino males (15% [<0·1]). There were notable differences in these patterns by age group: for example, for the 25-44 years age group, the lowest HDI decile had even greater over-representation of AIAN males (66% [0·2] in decile, 0·22 million [0·001]) and Black males (46% [<0·1], 2·52 million [0·005]) than the 85 years and older age group (22% [1·1], <0·01 million [<0·001]; and 20% [0·3], 0·03 million [<0·001]). By contrast, the lowest decile had an under-representation of Asian females (2% [<0·1], 0·06 million [<0·001]) in the 25-44 years age group, but an over-representation in the 85 years and older age group (25% [0·3], 0·03 million [<0·001]). The lowest HDI decile for the 25-44 years age group was primarily male (76% [<0·1], 6·44 million [0·009]) whereas for age 85 years and older it was predominantly female (71% [0·1], 0·42 million [0·002]). In the highest HDI decile, shifts in the composition of the population by age were particularly large for White males, who made up 5% (0·1; 0·39 million [0·001]) of this decile in the 25-44 years age group, but 49% (0·2; 0·29 million [0·001]) in the 85 years and older age group. From 2012 to 2021, the proportion of the population living in the lowest HDI decile varied substantially by location, and a disproportionately high share of the population living in locations in much of the southern half of the USA, Appalachia, and Rust Belt states were in the lowest HDI decile. Substantial disparities in wellbeing exist within the USA and are heavily influenced by race and ethnicity (due to racism), sex, age, and geographical location. These disparities are not immutable, but improvement is not a given, and gains can be fleeting in the face of a crisis such as the COVID-19 pandemic. Sustained action to ensure that everyone has meaningful access to a high-quality education, the means to earn a sufficient income, and the opportunity to live a long and healthy life is needed to reduce these disparities and should focus on the populations and locations that are worst off. State of Washington and National Institute on Minority Health and Health Disparities.

Comparing Access to Allogeneic Hematopoietic Cell Transplant across the United States: Physician Density, Minority Health Social Vulnerability Index, Transplant Unmet Need and Utilization

Comparing Access to Allogeneic Hematopoietic Cell Transplant across the United States: Physician Density, Minority Health Social Vulnerability Index, Transplant Unmet Need and Utilization

When connecting with LGBTQ+ communities helps and why it does: A meta-analysis of the relationship between connectedness and health-related outcomes.

We conducted a multilevel meta-analysis of 390 effect sizes from 167 studies with 157,923 participants examining the relationship between connectedness with lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) communities and health-related outcomes, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We conducted our initial search in January 2023 in APA PsycInfo, ERIC, Medline, and Open Dissertations, selecting studies that (a) measured LGBTQ+ community connectedness, (b) measured health, and (c) provided an estimate of the relationship between LGBTQ+ community connectedness and health. We found that connectedness with LGBTQ+ communities promotes mental health (r = .11), well-being (r = .17), and physical health (r = .09). Conversely, we found that connectedness with LGBTQ+ communities promotes substance use among younger participants, likely through behavioral engagement with LGBTQ+ others. We found that connectedness with LGBTQ+ communities was related to less mental health and more suicidality for younger people, likely because younger LGBTQ+ people seek out connectedness in response to this psychological distress. We also found that connectedness was not as health-promoting for LGBTQ+ individuals with multiple marginalized identities and that psychological feelings of belongingness with LGBTQ+ communities are generally more health-promoting than behavioral community engagement. Results from a narrative review and moderation meta-analyses suggested that, contrary to predictions made by minority stress theory, connectedness with LGBTQ+ communities does not buffer the relationship between minority stressors and health. Rather, meta-analytic mediation analyses suggested that proximal minority stressors negatively impact health-related outcomes by reducing connectedness with LGBTQ+ communities and that distal minority stressors are often less impactful on health-related outcomes because they promote connectedness with LGBTQ+ communities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Social Determinants: Supporting the Mental Health of Minorities

Social Determinants: Supporting the Mental Health of Minorities

Operationalizing Macro-Level Structural Sexual Minority Stigma: A Scoping Review of the Literature

Abstract Background Structural stigma, including discriminatory laws, inequitable policies, and negative attitudes, has been conceptualized as the general societal climate and institutional conditions that shape sexual minorities’ lives, mental, and physical health. While multidimensional indices have been used globally, U.S.-based studies have largely relied on single indicators (e.g., a law or policy; presence of resources). This scoping review aimed to identify structural sexual minority stigma indicators relevant to the U.S. context, to inform comprehensive, multidimensional future operationalizations. Methods Systematic database searches in PubMed, PsycINFO, and JSTOR, and snowball techniques resulted in 70 articles. After duplicate deletion and abstract review, 25 unique indices were long-listed relevant to structural sexual minority stigma at country or state level (i.e., macro level). School (district) and county (i.e., exo level) indicators were excluded. Results From the long-listed indices, a total of 112 legal and policy indicators were narrowed down to relevant 33 macro-level indicators and grouped across seven domains: criminal justice, hate crime protections, non-discrimination, religious refusal, relationship recognition, parenting, and youth laws and policies. Two different quantifications of population attitudes were identified that aggregated social and policy opinions across states regarding sexual minority adoption, hate crimes, health benefits, labor and housing, public speaking or teaching, marriage, sodomy, and civil unions. Discussion While a large variety of legal and attitudinal indicators was identified, few U.S.-based studies used multidimensional operationalizations (e.g., law, policy, opinion) needed to reduce risk of confounding bias through population-attitudes-to-law/policy backdoor pathways. To further advance the science on structural sexual minority stigma and health globally, future studies may benefit from multidimensional approaches. Key messages • With many legal and attitudinal indicators identified, few studies used multidimensional operationalizations (e.g., law, policy, opinion) needed to reduce risk of confounding bias. • To further advance the science on structural sexual minority stigma and health globally, future studies may benefit from multidimensional approaches.

Bridging gaps: A closer look at the health of sexual and gender minorities in Austria

Abstract Austria has long lacked comprehensive data on the health and well-being of sexual and gender minorities (SGMs). The 2022 LGBTIQ+ Health Report addresses this gap by presenting a comprehensive overview of the health status of SGMs in Austria. To contextualize SGM health issues, a review of the literature, health surveys, and action plans across Europe was conducted in the initial project phase. Then a questionnaire was developed in collaboration with an expert group for quantitative data collection. A total of 1,047 individuals participated in the survey; analyses of the quantitative data were enriched by insights from ten qualitative interviews. Detailed findings cover SGMs’ health status and experiences of discrimination as well as access to healthcare and health-promoting factors. Participants rated their health status lower than the average in Austria. A high number reported encountering discrimination in healthcare, especially among intersex and trans participants. While approximately half of the respondents were satisfied with healthcare provision, around 16% expressed dissatisfaction. Finally, a significant proportion of participants reported having foregone healthcare services at least once despite having health issues. Our work underscores the importance of recognizing the diverse needs of distinct groups within the SGM spectrum. It is crucial to avoid oversimplification by grouping them into a single SGM category as this obscures the unique challenges and inequalities faced by each subgroup. The rapid evolution of terms adds complexity to this work. Moreover, attention should be directed towards intersectionality within these groups as some are hard to reach with an online survey. Navigating the seas of public health innovation, our exploration of SGM health in Austria reveals not only the challenges but also the imperative for inclusive and tailored healthcare strategies. Key messages • The 2022 LGBTIQ+ Health Report Austria reveils SGM health realities: lower health status, discrimination, and unmet healthcare needs, urging targeted interventions. • Acknowledging diverse SGM groups and evolving terminologies, our study underscores the need for nuanced, intersectional healthcare approaches.

Empowering Early Career Researchers: The Jackson Heart Study Smith Scholars Program.

The University of Mississippi Medical Center Graduate Training and Education Center houses the Robert E. Smith, MD, Scholars Program, a two-year certificate program that equips predoctoral trainees from five Mississippi universities with advanced research skills in cardiovascular epidemiology. Funded by the National Heart, Lung, and Blood Institute (NHLBI), the program focuses on addressing health disparities, minority health, and health inequities in underserved communities. Trainees receive mentorship, career coaching, and a $7,500 annual stipend, building a foundation for postdoctoral opportunities and expanding professional networks. The Smith Scholars Program emphasizes population health and provides interdisciplinary training in areas such as biostatistics, scientific communication, and cardiovascular health. It is uniquely positioned to address systemic challenges, particularly in Mississippi, a state with high cardiovascular disease prevalence and limited research funding. The program's regional advantage and its partnership with the Jackson Heart Study offer scholars exposure to health disparities in Black/African American communities, preparing them to contribute to innovative, community-based research. Additionally, it fosters collaborative science, enabling participants to overcome academic barriers and engage with large-scale health equity research efforts. The Smith Scholars Program has been instrumental in shaping the career trajectories of its participants, facilitating their transition to postdoctoral positions and independent research roles.

"First, Trust Needs to Develop": Hematologists' Perspectives on Factors Influencing Black Persons' Participation in Clinical Trials.

Cancer clinical trials are crucial for treatment standards and innovation but lack racial-ethnic diversity. Understanding physician perspectives on recruiting participants is critical due to their role in decision-making about trial candidacy and enrollment. From August 2021 to January 2022 we recruited 13 Academic hematologists experienced with treating blood cancers and enrolling clinical trial participants. Each hematologist participated in a 60-75-minute semistructured interview and completed a sociodemographic survey. Using the National Institute on Minority Health and Health Disparities multilevel model as a framework, we characterized hematologists' perceived barriers to clinical trial participation among Black persons. ATLAS.ti v9 and later v 23.2.1 was used for project management and to facilitate data analysis using the Sort and Sift, Think and Shift approach (ResearchTalk Inc). All hematologists were White, with 70% being male. Three factors influenced their perspectives on enrolling Black individuals in clinical trials: individual attitudes and beliefs, such as perceptions that Black or socioeconomically disadvantaged persons will be less willing or less compliant with the requirements for trial participation and follow-up. The need to build trusting relationships between themselves and patients prior to discussing clinical trials and the prevailing legacy of medical mistrust among the Black community. Trust was found to be the underlying factor in determining communication between hematologists and Black persons about clinical trials across all three levels. This study highlights how hematologists' attitudes, beliefs, biases, and views on trust in patient relationships influence their communication with Black individuals about clinical trials. It emphasizes the need for further research to develop interventions that address the lack of racial and ethnic diversity in trials.

Research on The Status Quo And Problems of Mental Health of Sexual Minorities in China

In recent years, with the development of the Internet, the originally marginalized sexual minorities have appeared more and more frequently in the public field of vision, but due to the existence of proximal pressure and distal pressure, the psychological problems of sexual minorities still cannot be ignored. In order to better understand the living situation and mental health level of sexual minorities, reduce public opinion and disputes caused by gender knowledge errors, through literature collection, case interview, questionnaire survey, spss statistical analysis and other research methods, we integrated the definition, status and type of sexual minorities, stressors, social support status, mental health status and influence. The results show that the stressors faced by sexual minorities can reduce their perception of social support and thus reduce their mental health level. Therefore, increasing social support for sexual minorities can improve their mental health level. Finally, through the form of innovative programs to let more people pay attention to and understand this marginalized group, and strive to eliminate the public's cognitive bias towards sexual minorities.

Climate Change, Racism, and Food Insecurity: Cyclical Impacts of Stressors Exacerbate Health Disparities.

Disadvantaged populations have higher rates of chronic disease, including heart disease, cancer, and diabetes. Race, ethnicity, lower socioeconomic status, and poverty all contribute to these disproportionate rates. Other factors, including systemic racism, climate change, poor diet, lack of food access, and epigenetic influences, that are distributed and experienced differently across vulnerable populations also play a significant role in the development of chronic diseases. This comprehensive review of contributors to chronic diseases emphasizes a unique focus on these identified emerging factors. An ad hoc literature review using OVID Medline and Web of Science was conducted. Findings from prior studies indicate that multiple stressors, both in isolation and in combination, and their negative impacts on both physical and mental health of minorities are exacerbated by climate change. Various stressors dramatically increase chronic disease risk in minority groups. Recommendations for future research to elucidate the impacts of climatic, racial, and dietary adversity with minority populations are presented. Further study in this area is critical for achieving the UN Sustainable Development Goals and improving public health outcomes.

The impact of social determinants of health on international migrants’ health outcomes: a bibliometric analysis

PurposeThe aim of this study is to conduct an in-depth exploration of the research landscape concerning the impact of social determinants of health (SDH) on the health outcomes of international migrants.Design/methodology/approachLeveraging the extensive Scopus database, this study retrieved a total of 2,255 articles spanning the years 1993–2023. The framework for analysis used the SDH categories outlined by the World Health Organization.FindingsThe research landscape exhibited an apparent increase in the number of publications, but not a net increase in the research productivity. The USA emerged as the leading contributor to research output, with the Journal of Immigrant and Minority Health emerging as the most prolific publication venue, and the University of Toronto ranking as the most prolific institution. The SDH category that received the highest number of publications was the “community and social context”. Migrants from different regions in Asia (East, Central and South Asia) and those from Latin America and the Caribbean region appeared to be the most commonly researched. Highly cited articles predominantly delved into mental health outcomes arising from discrimination and migration policies.Research limitations/implicationsThe findings proffer valuable insights for shaping future research endeavors, accentuating the imperative for diversified studies encompassing underrepresented domains, broader health outcomes and the inclusion of migrant populations from different world regions in investigative pursuits.Originality/valueThis study delivers a comprehensive analysis of the research landscape, unveiling critical trends in the realm of SDH and migrant health outcomes.

An Equitable Communication and Dissemination Model for Linking Culturally Diverse Communities to COVID-19 Services.

In 2020, the Office of Minority Health (OMH) funded the establishment of the National COVID-19 Resiliency Network (NCRN) to engage priority communities that included African American, American Indian, Alaska Native, Asian, Hispanic, Native Hawaiian, and Pacific Islander persons to aggregate culturally relevant messages, education tools, and national data sources. A mobile application and Web site supported a culturally sensitive, equity-focused communication and dissemination initiative to link communities to COVID-19 clinical, social, and behavioral health services to address health determinants. (Am J Public Health. Published online ahead of print October 16, 2024:e1-e5. https://doi.org/10.2105/AJPH.2024.307813).

Information About Sexual and Gender Minority Services and Policies on US Hospital Websites

This cross-sectional study assesses the extent to which hospitals provide information related to sexual and gender minority policies and health services on their websites.

COVID-19 Deaths and Minority Health Social Vulnerability, in the U.S., January 1, 2020 through June 24, 2023.

Health disparities, leading to worse health outcomes such as elevated COVID-19 mortality rates, are rooted in social and structural factors. These disparities notably impact individuals from lower socioeconomic backgrounds and more socially vulnerable areas. We analyzed the relationship between COVID-19 deaths and social vulnerability using the Minority Health Social Vulnerability Index (MHSVI). COVID-19 death data in the U.S. was obtained from the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics, where COVID-19 deaths were defined using the ICD-10 code U07.1. MHSVI composite scores were calculated for 3089 U.S. counties and categorized into social vulnerability quartiles, where values ranged from 0 (lowest vulnerability) to 1 (highest vulnerability). Negative binomial regression was employed to determine death rate ratios for each quartile within each theme. Finally, a multivariate negative binomial regression including all MHSVI sub-themes, excluding the overall index ranking, was used to assess the association between each theme and COVID-19 death rates independently. There were 1,134,272 COVID-19 deaths from January 1, 2020 through June 24, 2023. Adjusted rate ratios for COVID-19 deaths in the overall index ranking were 1.06 (95% CI 0.99-1.13), 1.14 (95% CI 1.06-1.22), and 1.41 (95% CI 1.31-1.52) for the second, third and fourth quartiles, respectively. Sub-themes of socioeconomic status (SES), household characteristics (HC), racial and ethnic minority status (REMS), housing type and transportation (HTT), and medical vulnerability (MV) revealed increasing death rates in higher vulnerability quartiles. The healthcare infrastructure and access (HIA) theme had decreasing death rate ratios of 0.74 (95% CI 0.71-0.78), 0.59 (95% CI 0.56-0.62), and 0.42 (95% CI 0.39-0.44) for the second, third, and fourth quartiles, respectively. Finally, the multivariate analysis showed that the HC, HTT, HIA, and MV themes were associated with COVID-19 deaths (P < 0.05). Counties that were identified as more socially vulnerable experienced higher death rates from COVID-19. These areas may need additional public health and social support during future pandemics.

Sociocultural, Behavioral, and Physical Correlates of Excessive Social Media Use, Addiction, and Motivation Toward Reduction in a Hispanic College Student Sample.

Social media use has been associated with adverse health consequences. However, there is limited research assessing correlates of social media use, addiction, failure to control use, and motivation to reduce use in a Hispanic sample. This study aimed to fill this gap by assessing factors within the National Institute of Minority Health and Health Disparities Research Framework. Participants were Hispanic college students (n = 273) residing either in the United States or Mexico who completed an online survey. Univariate analyses determined independent variables to be assessed in four linear regression models. Results indicated that weekly social media use was negatively associated with sex, attentional impulsivity, and social comparison and positively associated with social media craving (SMC). Social media addiction was positively associated with frequency of posting in Spanish, Fear of Missing Out, SMC, and home restriction of social media use. Social media self-control failure was negatively associated with acculturative language and positively associated with frequency of posting in English, attentional impulsiveness, SMC, and home restriction of social media use. Motivation to reduce social media use was positively associated with residing in the United States. Clinical implications include targeting key factors through tailored interventions aimed at promoting adaptive social media use patterns.

Community-Level Social Vulnerability and Hip and Knee Joint Replacement Surgery Receipt Among Medicare Enrollees With Arthritis.

(1) Explore associations between county minority health social vulnerability index (MH-SVI) and total joint replacement (TJR), and (2) assess associations by individual-level race/ethnicity. An expanded understanding of relevant social determinants of health is essential to inform policies and practices that promote equitable access to hip and knee TJR. Retrospective cohort study of Medicare enrollees. Centers for Medicare and Medicaid Services claims data were linked with MH-SVI. Multivariable logistic regression models were used to evaluate the odds of TJR according to the MH-SVI quartile in which enrollees resided. A total of 10,471,413 traditional Medicare enrollees in 2018 aged 67 years or older with arthritis. The main outcome was enrollee primary TJR during hospitalization. The main exposure was the MH-SVI (composite and 6 themes) for the county of enrollee residence. Results were stratified by enrollee race/ethnicity. Asian American, Native Hawaiian, or Pacific Islander (AANHPI), Black or African American (Black), and Hispanic enrollees comparatively had 26%-41% lower odds of receiving TJR than White enrollees. Residing in counties within the highest quartile of composite and socioeconomic status vulnerability measures were associated with lower TJR overall and by race/ethnicity. Residing in counties with increased medical vulnerability for Black and White enrollees, housing type and transportation vulnerability for AANHPI and Hispanic enrollees, minority status and language theme for AANHPI enrollees, and household composition vulnerability for White enrollees were also associated with lower TJR. Higher levels of social vulnerability were associated with lower TJR. However, the association varied by individual race/ethnicity. Implementing multisectoral strategies is crucial for ensuring equitable access to care.