Racial Groups Research Articles

Racial and ethnic disparities in mental health among breast cancer patients and survivors in the United States.

To decompose the mental health disparities between breast cancer patients and survivors (hereafter survivors) of racial and ethnic minority groups and non-Hispanic White survivors into the contributions of individual-, interpersonal-, community-, and societal-level determinants. We used data from the 2010-2020 Medical Expenditure Panel Survey Household Component (MEPS-HC). Our primary outcome was whether the person had mental health conditions or not. We employed the Kitagawa-Oaxaca-Blinder (KOB) method to understand to what extent the differences in outcomes were explained by the differences in the determinants between non-Hispanic Black or Hispanic breast cancer survivors and non-Hispanic White survivors. We also bifurcated the Hispanic sample analysis by the US-born status (and county of origin). Confidential geographic identifiers are utilized to supplement the MEPS-HC data with information on community characteristics and local healthcare resources. The prevalence of mental health conditions among non-Hispanic Black and Hispanic breast cancer survivors was 26.1% (95% CI: 20.4, 31.7) and 28.3% (95% CI: 21.9, 34.6), respectively. These rates were higher than those for their non-Hispanic White counterparts, 19.7% (95% CI: 17.4, 21.9). In our KOB model, the disparity between non-Hispanic Black and White survivors was fully explained by differences in education, health, and family structure, with community- and societal-level determinants playing no significant role. Conversely, our KOB model did not explain any of the overall differences between Hispanic and non-Hispanic White survivors. However, for foreign-born Hispanic survivors, the disparity was fully explained by a combination of individual- and societal-level determinants. Our findings, which identify specific individual-, interpersonal-, and societal- determinants that were associated with racial and ethnic differences in mental health, can be used by clinicians and policymakers to proactively address racial and ethnic disparities in health.

Investigating What Factors Influence Users’ Rating of Harmful Algorithmic Bias and Discrimination

There has been growing recognition of the crucial role users, especially those from marginalized groups, play in uncovering harmful algorithmic biases. However, it remains unclear how users’ identities and experiences might impact their rating of harmful biases. We present an online experiment (N=2,197) examining these factors: demographics, discrimination experiences, and social and technical knowledge. Participants were shown examples of image search results, including ones that previous literature has identified as biased against marginalized racial, gender, or sexual orientation groups. We found participants from marginalized gender or sexual orientation groups were more likely to rate the examples as more severely harmful. Belonging to marginalized races did not have a similar pattern. Additional factors affecting users’ ratings included discrimination experiences, and having friends or family belonging to marginalized demographics. A qualitative analysis offers insights into users' bias recognition, and why they see biases the way they do. We provide guidance for designing future methods to support effective user-driven auditing.

Utilization of Diabetes Self-Management Education and Support Among Medicare Beneficiaries Newly Diagnosed With Diabetes in Arkansas, 12 Months Postdiagnosis (2015-2018).

The purpose of the study was to determine the rate of diabetes self-management education and support (DSMES) utilization among Medicare fee-for-service (FFS) and Medicare Advantage (MA) populations with type 2 diabetes in Arkansas. The Arkansas All-Payer Claims Database was used to identify Medicare FFS and MA beneficiaries diagnosed with type 2 diabetes from 2015 to 2018. Claims from 2013 to 2020 were analyzed to determine newly diagnosed individuals from 2015 to 2018. The criteria included 1 outpatient diabetes claim in the index year and at least 1 inpatient or outpatient claim in the 2 years following the initial claim. A total of 15 648 Medicare FFS individuals and 7520 MA individuals with newly diagnosed type 2 diabetes were identified. The use of DSMES 1 year following the diagnosis dates for both Medicare FFS and MA populations was assessed. Descriptive statistics and multiple logistic regression analyses were conducted to understand the factors associated with DSMES utilization. DSMES utilization consistently remained lower in the MA population compared to Medicare FFS (2.3% vs 4.9%). The adjusted analysis indicated that factors such as older age, living in a rural area, belonging to a racial group other than White, and MA enrollment were associated with a lower likelihood of receiving DSMES. DSMES utilization in Arkansas, where the prevalence of diabetes is higher than the national average, is notably low. There is a need for coordinated efforts at various levels to enhance access to DSMES.

Neonatal mortality among disaggregated Asian American and Native Hawaiian/Pacific Islander populations.

We compared neonatal (<28 days) mortality rates (NMRs) across disaggregated Asian American and Native Hawaiian/Pacific Islander (AANHPI) groups using recent, national data. We used 2015-2019 cohort-linked birth-infant death records from the National Vital Statistics System. Our sample included 61,703 neonatal deaths among 18,709,743 births across all racial and ethnic groups. We compared unadjusted NMRs across disaggregated AANHPI groups, then compared NMRs adjusting for maternal sociodemographic, maternalclinical, and neonatal risk factors. Unadjusted NMRs differed by over 3-fold amongst disaggregated AANHPI groups. Native Hawaiian/Pacific Islander neonates in aggregate had the highest fully-adjusted odds of mortality (OR: 1.08 [95% CI: 0.89, 1.31]) compared to non-Hispanic White neonates. Filipino, Asian Indian, and Other Asian neonates experienced significant decreases in odds ratios after adjusting for neonatal risk factors. Aggregating AANHPI neonates masks large heterogeneity and undermines opportunities to provide targeted care to higher-risk groups.

Precision Population Cancer Medicine in Brain Tumors: A Potential Roadmap to Improve Outcomes and Strategize the Steps to Bring Interdisciplinary Interventions.

Brain tumors, a significant health burden,rank as the second leading cause of cancer among adolescents and young adults and the eighth most common cancer in older adults. Despitetreatment advances, outcomesfor many brain tumor types,especiallyglioblastoma multiforme (GBM), remain poor. Precision population cancer medicine (PPCM) offerspromising avenues for improving outcomes in brain tumor management.This comprehensive reviewdelves intothe current landscape of brain tumor diagnosis and treatment,with a primary focus onthe potential of PPCM toenhancecare. The reviewexploresseveral key areas where PPCM approaches show promise. In genetics and molecular biology, the genetic heterogeneity of brain tumors poses challengesandopportunities for targeted therapies. Understanding genetic patterns canguidetreatment strategies and improve prognostication. Epigenetic modificationsarecrucialin brain tumor development and progression. Deoxyribonucleic acid(DNA) methylation patterns, particularly of theO6-methylguanine-DNA methyltransferase (MGMT) gene promoter, serve asessentialbiomarkers for treatment response and prognosis in GBM. Targeting epigenetic mechanisms could lead to novel therapeutic approaches. Non-invasive liquid biopsy techniques show potential for diagnosis, monitoring, and prognostication in brain tumors. Analysis of circulating tumor DNA and microRNAs may provide valuable information about tumor characteristics and treatment response. Advanced imaging techniques, including radiomics and radiogenomics, combined with artificial intelligence (AI) algorithms, are enhancing tumor detection, characterization, and treatment planning. These technologies can contribute to more personalized treatment approaches.In addition, emergingnanotherapeutic platforms, which involve the use of nanoparticles to deliver drugs directly to tumors,and theranostic approaches, which combine therapy and diagnostics in a single platform,offer new possibilities for targeted drug delivery and real-time treatment monitoring in brain tumors. The review also addresses socioeconomic and demographic factors influencing brain tumor incidence and outcomes. It highlightsthe starkdisparities in care access and survival rates among different racial and ethnic groups, emphasizing theurgentneed for PPCM strategies to address these inequities. Challenges in implementing PPCM for brain tumors include the blood-brain barrier, which limits drug delivery, and the need for more extensive clinical trials to validate new approaches. The authors stress the importance of interdisciplinary collaboration and data sharing to advance the field, making the audience feel united and part of a larger team. While PPCM holds great promise, the review emphasizes that it should complement, not replace, population-level interventions and standard-of-care treatments. The authors advocate for a balanced approach that leverages cutting-edge personalized strategies while ensuring broad access to effective treatments. In conclusion, PPCM represents a powerful tool in the fight against brain tumors, offering the potential for more targeted, effective, and less toxic treatments. However, realizing its full potential will require ongoing research, clinical validation, and policy interactionsto address disparities in care access.

Ethnic disparities in perceived racism, patient-provider communication and healthcare utilization: Asian Americans

ABSTRACT Background Race is a consequential sociocultural cue in healthcare contexts. Racism is associated with health disparities by influencing patient-provider communication and utilization of healthcare services. Objective This study aimed to investigate how Asian American subgroups differ in their perception of everyday racism, internalized racism, and perceived racism in healthcare settings and whether these perceptions predict their interactions with their health care providers and their utilization of healthcare services. Methods An online survey study was conducted. ANOVA tests were employed to compare the differences in perceptions of everyday racism, internalized racism, and perceived racism in the healthcare system among Filipino (N = 310), Japanese (N = 242), Chinese (N = 287), Asian Indian (N = 304), Korean (N = 199) and Vietnamese (N = 151) participants. Multiple regression analyses assessed whether perceptions of everyday racism, internalized racism, and perceived racism in the healthcare system predicted healthcare service utilization and patient-provider communication among the Asian subgroups sampled. Results There were significant group differences in perceived everyday racism (F = 8.56, p < .001), internalized racism (F = 3.46, p < .01), perceived racism in healthcare (F = 4.57, p < .001). Perceptions of racism and socioeconomic variables were found to predict patient-provider communication and utilization of healthcare services disparately across various Asian subgroups. For instance, the perception of everyday racism was a significant predictor of patient-provider communication for each of the subgroups, excluding the Vietnamese participants. Internalized racism was a significant predictor only for Filipino and Chinese participants. Surprisingly, perceived racism in healthcare was not a predictor for any of the subgroups. Conclusion Findings highlight the complex interplay of sociodemographic factors and perceived racism in shaping patient-provider communication and healthcare service utilization within the Asian American community. Implications are suggested for addressing the unique challenges faced by different Asian American subgroups and for promoting equitable healthcare access and fostering positive patient-provider relationships among the Asian American subgroups.

Risk factors for second primary breast cancer by laterality, age, and race and ethnicity.

Epidemiologic studies of risk factors for second primary breast cancer (SBC) have been conducted primarily in non-Hispanic White (NHW) women. A racially- and ethnically-diverse population-based pooled cohort of 9,639 women with first primary stage I-III invasive breast cancer (FBC) was linked with the California Cancer Registry; 618 contralateral SBC (CSBC) and 278 ipsilateral SBC (ISBC), diagnosed >6 months after FBC, were identified. Using Fine and Gray models accounting for competing risks, we assessed associations of CSBC and ISBC risk with FBC clinical characteristics and epidemiologic factors. In younger women (FBC at age <50 years), higher CSBC risk was associated with ER/PR-negative FBC [hazard ratio (HR)=1.68], breast cancer family history (HR = 2.20), and nulliparity (HR = 1.37). In older women (FBC at age ≥50 years), higher risk was associated with breast cancer family history (HR = 1.32), premenopausal status (HR = 1.49), overweight (HR = 1.39), and higher alcohol consumption (HR = 1.34). For ISBC, higher risk was associated with married status (HR = 1.94) in younger women, and overweight (HR = 1.60) among older women. For CSBC, HR estimates were generally similar across racial and ethnic groups. Even after adjustment for these risk factors, compared with NHW women, risk remained elevated for CSBC in younger African American, Asian American, and Hispanic women, and for ISBC in older African American and Hispanic women with ER/PR-positive FBC. Our findings support genetic risk evaluation, enhanced screening, and lifestyle changes in women at higher risk of SBC. Additional risk factors must contribute to the unequal burden of SBC across racial and ethnic groups.

Racial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic

The end of the COVID-19 public health emergency (PHE) provides an opportunity to fully describe pandemic-associated racial and ethnic mortality disparities. Age-specific excess mortality differences have important downstream implications, especially in minoritized race and ethnicity populations. To characterize overall and age-specific all-cause excess mortality by race and ethnicity during the COVID-19 PHE and assess whether measured differences reflected changes from prepandemic disparities. This cross-sectional study analyzed data of all US residents and decedents during the COVID-19 PHE, aggregated by observed race and ethnicity (at time of death) and age. Statistical analysis was performed from March 2020 to May 2023. COVID-19 PHE period (March 2020 to May 2023). All-cause excess mortality (incident rates, observed-to-expected ratios) and all-cause mortality relative risks before and during the PHE. For the COVID-19 PHE period, data for 10 643 433 death certificates were available; mean (SD) decedent age was 72.7 (17.9) years; 944 318 (8.9%) were Hispanic; 78 973 (0.7%) were non-Hispanic American Indian or Alaska Native; 288 680 (2.7%) were non-Hispanic Asian, 1 374 228 (12.9%) were non-Hispanic Black or African American, 52 905 (0.5%) were non-Hispanic more than 1 race, 15 135 (0.1%) were non-Hispanic Native Hawaiian or Other Pacific Islander, and 7 877 996 (74.1%) were non-Hispanic White. More than 1.38 million all-cause excess deaths (observed-to-expected ratio, 1.15 [95% CI, 1.12-1.18]) occurred, corresponding to approximately 23 million years of potential life lost (YPLL) during the pandemic. For the total population (all ages), the racial and ethnic groups with the highest observed-to-expected all-cause mortality ratios were the American Indian or Alaska Native (1.34 [95% CI, 1.31-1.37]) and Hispanic (1.31 [95% CI, 1.27-1.34]) populations. However, higher ratios were observed in the US population aged 25 to 64 years (1.20 [95% CI, 1.18-1.22]), greatest among the American Indian or Alaska Native (1.45 [95% CI, 1.42-1.48]), Hispanic (1.40 [95% CI, 1.38-1.42]), and Native Hawaiian or Other Pacific Islander (1.39 [95% CI, 1.34-1.44]) groups. In the total population aged younger than 25 years, the Black population accounted for 51.1% of excess mortality, despite representing 13.8% of the population. Had the rate of excess mortality observed among the White population been observed among the total population, more than 252 000 (18.3%) fewer excess deaths and more than 5.2 million (22.3%) fewer YPLL would have occurred. In this cross-sectional study of the US population during the COVID-19 PHE, excess mortality occurred in all racial and ethnic groups, with disparities affecting several minoritized populations. The greatest relative increases occurred in populations aged 25 to 64 years. Documented differences deviated from prepandemic disparities.

Gender Disparities on the Use and Outcomes of Mechanical Circulatory Support in Patients with Cardiogenic Shock Complicating Acute Myocardial Infarction

Cardiogenic shock complicating acute myocardial infarction (AMI-CS) remains a critical condition with high morbimortality. Despite advances, gender disparities persist in the management of this condition. Our aim was to evaluate gender differences in the utilization and outcomes of mechanical circulatory support (MCS) in AMI-CS. In addition, we addressed the management strategies for AMI-CS stratified by race/ethnicity. We performed a retrospective study using the National Inpatient Sample from 2016 to 2019, including admissions with AMI-CS. The use of MCS and outcomes were compared between genders using inverse probability of treatment weighting. Odds ratios (OR) with their 95% confidence interval (CI) were estimated. A total of 151,560 admissions for AMI-CS were analyzed, including 98,855 male and 52,705 female patients. After the inverse probability of treatment weighting adjustment, females were significantly less likely to receive MCS (OR 0.77, 95% CI 0.73 to 0.81, p <0.001) and had higher in-hospital mortality rates (OR 1.09, 95% CI 1.00 to 1.18, p = 0.045) than males. No significant gender differences were observed in major bleeding, renal replacement therapy, or mechanical ventilation. Racial disparities were also evident, with female patients across all racial groups being less likely to receive MCS compared with their male counterparts. In conclusion, significant gender disparities exist in the utilization and outcomes of MCS in patients with AMI-CS. Female patients are less likely to receive MCS and have higher in-hospital mortality rates compared with male patients. Racial minorities, including Black and Hispanic patients, experience lower utilization of MCS compared with White patients. These findings underscore the complex interplay between gender, race/ethnicity, and health care access and outcomes.

Racial diversities in lifespan bone mass: findings from the China BCL study and US NHANES.

Bone mass at different life stages is instrumental for developing effective, long-term osteoporosis prevention strategies. We aimed to investigate the developmental patterns of bone mass across the entire lifespan among the Chinese population and to compare these patterns with those of different racial groups, including Whites, Blacks, and Mexicans in the US population. Our study analyzed data from the China Body Composition Life-course (BCL, 2013-2023) Study and the US National Health and Nutrition Examination Survey (NHANES, 2005-2018). We measured bone mineral content (BMC) and density (BMD) using dual-energy x-ray absorptiometry (DXA) at various anatomical sites, including the whole-body, lumbar spine, total hip, and femoral neck. In the Chinese population, whole-body BMC and BMD increased rapidly during childhood and adolescence, with males and females achieving approximately 90.6% and 95.7% of their respective peak bone mass. Peak bone mass for whole-body, total hip, and femoral neck BMC/BMD occurred generally between the ages of 21 and 30, whereas the lumbar spine BMD peak did approximately a decade later. After reaching the peak, a gradual bone loss was observed from ages 30 to 40, with an acceleration post age 40, especially in females. Comparative analyses indicated that Chinese individuals exhibited the lowest bone mass levels and accrual rates over their lifespan, followed successively by Whites, Mexicans, and Blacks. By exploring bone mass changes and racial disparities among the Chinese and US populations, this study emphasizes the need for establishing sex- and ethnic- specific public health strategies to prioritize bone health throughout the entire life course.

Experiences of Racism in School and Associations with Mental Health, Suicide Risk, and Substance Use Among High School Students - Youth Risk Behavior Survey, United States, 2023.

Racism is a fundamental determinant of health inequities among racial and ethnic groups and is understudied among adolescents. In 2023, the national Youth Risk Behavior Survey questionnaire included an item assessing experiences of racism in the school setting among students in grades 9-12 in the United States. This report estimates the prevalence of students who reported ever having experienced racism in school and compares prevalence by racial and ethnic groups. For each racial and ethnic group, prevalence differences and prevalence ratios were estimated comparing the prevalence of indicators of poor mental health, suicide risk, and substance use among students who reported that they have ever versus never experienced racism in school. In 2023, approximately one in three high school students (31.5%) said that they had ever experienced racism in school. Reported experiences of racism were most prevalent among Asian (56.9%), multiracial (48.8%), and Black or African American (Black) (45.9%) students and least prevalent among White students (17.3%). Black and Hispanic or Latino (Hispanic) students who reported experiencing racism had a higher prevalence of all health risk behaviors and experiences investigated, including indicators of poor mental health, suicide risk, and substance use compared with students of their racial and ethnic group who reported never experiencing racism. Many of these associations were also found among multiracial and White students. Student reports of racism were associated with indicators of mental health and suicide risk among American Indian or Alaska Native (AI/AN) and Asian students. Among students of color, including AI/AN, Asian, Black, Hispanic, and multiracial students, the prevalence of seriously considering and attempting suicide was more than two times higher among students who ever compared with never experienced racism. These findings demonstrate that racism in the school setting is experienced by high school students attending public and private schools and continues to disproportionately affect students of color. Students who reported experiencing racism had a higher prevalence of indicators of poor mental health, suicide risk, and substance use. Schools can incorporate policies and practices to prevent unfair treatment on the basis of race and ethnicity and offer resources to help students cope with these experiences.

Skipping Breakfast and Academic Grades, Persistent Feelings of Sadness or Hopelessness, and School Connectedness Among High School Students - Youth Risk Behavior Survey, United States, 2023.

Breakfast consumption is positively associated with academic achievement and diet quality among students, whereas skipping breakfast has been linked with poor mental health. Data from CDC's 2023 nationally representative Youth Risk Behavior Survey were used to describe how often high school students ate breakfast in the past 7 days and the associations between skipping breakfast every day (ate breakfast on 0 of the past 7 days), experiencing persistent feelings of sadness or hopelessness, school connectedness, and self-reported grades. Prevalence estimates and corresponding 95% CIs were calculated, and t-tests were used to identify differences within demographic groups (e.g., sex, race and ethnicity, and sexual identity). Logistic regression analyses were conducted to calculate prevalence ratios describing breakfast skipping, adjusting for demographics, and stratified by sex and race and ethnicity. Most students missed breakfast ≥1 time in the past 7 days (72.6%), and 17.9% of students skipped breakfast every day, with differences by sex, sexual identity, and race and ethnicity. Overall, and among both males and females, students who experienced persistent feelings of sadness or hopelessness were more likely to skip breakfast every day. The association between feelings of sadness and hopelessness and skipping breakfast was generally consistent across racial and ethnic groups. In contrast, greater levels of school connectedness and earning mostly As or Bs were inversely associated with skipping breakfast. Students who had higher school connectedness were approximately 30% less likely to skip breakfast on all 7 days. Skipping breakfast and poor mental health co-occur among many adolescents and might impede students' readiness to learn. School efforts to make breakfast accessible and appealing to high school students might yield multiple benefits and help reinforce school administrators' efforts to recover student learning losses that occurred during the COVID-19 pandemic. Parents, school decision-makers, and organizations that partner with schools and families can use these findings to guide efforts to promote breakfast consumption.

The drivers of sustainable homeownership

AbstractThis article introduces a novel measure of homeownership sustainability—homeownership longevity—and examines patterns of sustainable homeownership across multiple mortgage characteristics from 2012 onward, using a unique and nationally representative data set of first‐time homeowners, the National Mortgage Database borrower sample. Importantly, the unit of observation is the individual borrower and the data track how long each borrower remains a homeowner throughout the sample period. The results show that first‐time homebuyers have remained homeowners at high rates since 2012 with over 60% maintaining homeownership throughout the entire sample period. Although there are statistically significant differences in expected homeownership longevity by loan origination characteristics, the absolute magnitudes of these differences are small. Notably, the disparity among racial and ethnic groups in terms of homeownership longevity is small. The high rates and relative uniformity of homeownership longevity for this population suggest that self‐selection into homeownership and existing underwriting standards have allocated mortgage credit to households highly likely to maintain homeownership.

Racialized Emotion Management among Asian Americans in the Professional Workplace

Abstract Despite growing interest in the racialization of emotion management and evidence that this racialization varies across different racial groups, minimal scholarship has attempted to interrogate how Asian Americans experience racialized feeling rules or perform racialized emotion management in the workplace. Using qualitative interviews with 35 Asian American professionals to examine these processes, I find that controlling images about Asians, particularly the “model minority” stereotype, shape the feeling rules they encounter and constrain their access to certain forms of emotional expression. Additionally, racial incidents within and outside of the workplace heighten their need to perform emotion management, which is particularly relevant given recent upticks in anti-Asian violence. This study reveals how controlling images lead to racialized feeling rules for Asian Americans and how, conversely, their racialized emotion management can reinforce stereotypes. At the same time, it shows how Asian Americans continue to experience racialization, with important implications, both within the workplace and beyond.

Relative, Absolute, and Excess Risk of Second Primary Melanomas Among Multiple Racial and Ethnic Groups—Analysis of Rare Events

Relative, Absolute, and Excess Risk of Second Primary Melanomas Among Multiple Racial and Ethnic Groups—Analysis of Rare Events

Referral Sources Across Racial and Ethnic Groups at Alzheimer's Disease Research Centers.

Despite the need to increase engagement of underrepresented groups (URG) in Alzheimer's disease and related dementias (ADRD) studies, enrollment remains low. Compare referral sources across racial and ethnic groups among participants enrolled in ADRC studies. Data for this cross-sectional secondary analysis were extracted from the National Alzheimer's Coordinating Center Uniform Data Set. We performed mixed effects logistic regression models using generalized estimating equations for professional referral versus non-professional referral by racial and ethnic group, adjusted for age, gender, education, visit year, and Clinical Dementia Rating scale (CDR) with a random effect for study site. Included in the analysis were 48,330 participants across 46 ADRCs (mean [SD] age, 71.3 [10.5] years; 20,767 female [57%]; 4,138 Hispanic [8.6%]; 1,392 non-Hispanic Asian [2.9%]; 6,766 non-Hispanic Black [14%] individuals; and 676 individuals [1.4%] of other races. Non-Hispanic Black and Asian participants had lower odds of being referred by a professional contact compared to non-Hispanic White participants (Black: adjusted OR = 0.61, 95% CI = 0.44-0.86, p = 0.005; Asian: adjusted OR = 0.65, 95% CI, p = 0.004). In participants who had completed an MRI, there was no significant difference in referral source across ethnic and racial groups. Further studies are needed to better understand the systemic and structural factors that contribute to differences in referral sources and disparities in recruitment of URG into ADRD studies.

Experiences of Racism in Health Care and Medical Mistrust Shape Cancer Prevention and Control Behaviors Among Black Residents of Black Hawk County, Iowa: A Qualitative Study.

Non-Hispanic Black Iowans have substantially higher incidence of and mortality from cancer than their non-Hispanic White (NHW) counterparts in all but the oldest age groups; rates are particularly high in Black Hawk County, which contains the city of Waterloo, a highly segregated city with a documented history of redlining and distinct racial differences in the social drivers of health. To gather perspectives on race, racism, healthcare, and engagement with cancer prevention and control behaviors, among Black individuals living in Black Hawk County, Iowa. We conducted semi-structured interviews with 20 individuals (10 male, 10 female), questions included experiences in healthcare and feelings towards the healthcare system, trust of the healthcare system, experiences of racism or other perceived biases within healthcare, and how experiences of racism/bias and/or feelings towards the healthcare system impact desire or ability to participate in cancer prevention and control activities. Almost all interviewees reported both positive and negative experiences in healthcare. Nine themes emerged from analysis of the interviews: everyday racism and racism in healthcare, medical mistrust, need for more Black healthcare professionals, communication with healthcare professionals, need to break down cultural stigma around cancer, need and desire for community education around health and cancer, ability to choose, self-advocacy, and social support. There are substantial barriers for Black individuals engaging with cancer prevention and control behaviors in Iowa. Multi-level interventions are needed to address structural, healthcare facility, and individual-level barriers to care; interventions may build on existing resiliencies within the community.

Affective Experiences of U.S. School Personnel in the Sociopolitical Context of 2021: Reflecting on the Past to Shape the Future

This study aims to explore the self-reported affective experiences of U.S. school personnel during 2021. This year found school personnel balancing remote learning, health emergencies, a global pandemic, and intense political upheaval. We contextualize school personnel experiences within the current sociopolitical context. In this sample, school personnel (n = 8052) represent all U.S. states and territories alongside representation of diverse racial and ethnic identities (n = 1901). Participants were surveyed before completing a free virtual course on emotion management. The survey included open-ended questions and scale items. Participants reported primary feelings, sources of stress and joy, and perceptions of personal and social and emotional support for themselves and students. Findings are presented in five cohorts of school personnel across the year. The primary feelings were being anxious, stressed, and overwhelmed, the stressors were lack of support, time, and resources, as well as COVID-19, and workload, and the sources of joy were students, coworkers, and teaching. Anxiety and gratitude decreased throughout the year while happiness increased. Responses differed across time and between racial groups, with Black and African American participants reporting the highest percentages of being stressed by COVID-19 and community fluctuated over time as a source of joy. Implications for the education system and opportunities for emotion management are discussed.

Effects of Dietary Quality on Vaginal Microbiome Composition Throughout Pregnancy in a Multi-Ethnic Cohort.

Background: Vaginal Lactobacillus predominance is associated with improved vaginal health and reduced pregnancy complications. Little is known about how dietary quality may improve vaginal microbial composition or about dietary interventions that may promote Lactobacillus abundance. To understand the host factors affecting vaginal microbiota during pregnancy in a multi-ethnic cohort in Hawai`i. We hypothesize that better diet quality improves vaginal microbial composition, as represented by Lactobacillus abundance and depletion of anaerobic organisms. Methods: We compared comprehensive diet quality, as measured by the Healthy Eating Index-2015 (HEI-2015), to taxonomic classifications of bacteria present within the vagina. Participants of the four predominant ethnic groups in Hawai'i (Japanese, Filipino, Non-Hispanic White and Native Hawaiian) completed Quantitative Food Frequency Questionnaires (QFFQs) and collected vaginal swabs during each trimester. 16s rRNA amplicon sequencing (V2-V9 regions) was performed on vaginal samples. HEI-2015 scores and macro- and micronutrient intake were compared with the predominant species present using the Mann-Whitney-U test, PERMANOVA, and the Pearson correlation coefficient. A mixed-effects logistics regression model was used to predict the depletion of Lactobacillus species while accounting for confounding demographic factors. Results: Matched, longitudinal data for 40 participants demonstrated three predominant Lactobacillus species: L. crispatus, L. iners, and L. gasseri, with another subset of samples with anaerobic abundance. (Primarily, Atopobium vaginae, Prevotella, and Gardnerella vaginalis.) Non-Hispanic White participants had lower amounts of Lactobacillus iners compared to other racial and ethnic groups. HEI scores correlated with the chao index and observed species number primarily in the first trimester (r = 0.25, p < 0.05). Greater carbohydrate intake was associated with a higher abundance of L. crispatus, while lower carbohydrate intake trended towards more L. iners (0.056) and anaerobic species. Conclusions: Increased carbohydrate consumption and improved diet quality may be associated with beneficial vaginal microbial composition in pregnancy.

Racial discrimination in helping situations depends on the cost of help: A large field experiment in the streets of Paris.

Decades of field experiments show that White Americans are more likely to discriminate against Black Americans when the situation provides a nonracist rationalization for withholding help from a Black target - for instance, when the cost of helping looks unreasonable. However, work on racial discrimination in helping is scarcer outside of the US context. The present experiment extends this line of research to Europe and studies differences in helping asiatique (Asian), blanc (White) and noir (Black) men and women in France. In addition, it assesses to what extent racial discrimination in the probability to provide assistance is moderated by the perceived cost of help. The study rests on a sample of over 4500 independent observations collected through a factorial design that combines 12 testers (equally apportioned in race and gender groups), two social class conditions and four observation sites. Testers asked for directions to pedestrians in front of the traffic lights of a busy road, and pedestrians could provide different forms of help that varied in perceived cost. The analysis indicates that overall asiatique and noir testers receive help less often than their blanc counterparts. It also shows that racial discrimination is stronger when the perceived cost of helping is higher.