American Race Research Articles

“The Jim Crow Army Must Have a Scapegoat”: Justice, Cowardice, and the Court Martial of Lieutenant Leon Gilbert (Korea, 1950)

The story of Lieutenant Leon Gilbert—a Black United States Army officer court-martialed during the Korean War—challenged the United States’ self-declared postwar mission to free oppressed peoples across the world, while continuing to subjugate African Americans at home. Although many critics judged Gilbert’s refusal to return to battle as an act of cowardice, others viewed him as a victim, and even a hero. The Gilbert case revealed that although African Americans were ostensibly making progress in the newly desegregated United States military, the fight for racial justice continued to be impeded by white Americans’ perceptions of Black inadequacy. Amidst a war purportedly being fought for principles of democracy and freedom, Gilbert’s court martial highlighted the connection between American racism and United States foreign policy, as Black military personnel became scapegoats for their nation’s military failures. The prosecution and persecution of Gilbert thus exposed the tension between American rhetoric and American racism.

Revisiting the Association of ECOG Performance Status With Clinical Outcomes in Diverse Patients With Cancer.

The ECOG performance status (PS) scale was developed to support national clinical trials, but the degree to which ECOG PS predicts clinical outcomes in patient subgroups outside of clinical trials is relatively unknown. This study examined associations between ECOG PS and adverse outcomes in a diverse community oncology population. In this retrospective cohort study, demographic and clinical characteristics, including the most recent ECOG PS between January 1, 2017, and December 31, 2019, were examined for patients receiving cancer treatment within Kaiser Permanente Northern California (KPNC). Proportional hazard models were used to evaluate the effect of ECOG PS on adverse outcomes. A total of 21,730 patients were identified. Overall, most patients had an ECOG PS of 0 (42.5%) or 1 (42.5%). In multivariable analysis, an ECOG PS of 3 or 4 was associated with higher risk of 30-day emergency department visits (adjusted hazard ratio [aHR], 3.85; 95% CI, 3.47-4.26), 30-day hospitalizations (aHR, 4.70; 95% CI, 4.12-5.36), and 6-month mortality (aHR, 7.34; 95% CI, 6.64-8.11) compared with an ECOG PS of 0. Additionally, we found that upper gastrointestinal and stage IV cancers were associated with a higher risk of adverse outcomes compared with breast and stage I cancers, respectively. When adjusted for ECOG PS, African American race, Asian race, and female sex were associated with a lower risk of mortality than White race and male sex. An ECOG PS of 3 or 4 was more predictive of mortality in younger patients and those with breast cancer (P<.001). ECOG PS and upper gastrointestinal and stage IV cancers were independently associated with increased risk of emergency department visits, hospitalizations, and mortality, whereas African American and Asian race and female sex were associated with decreased risk of mortality. An ECOG PS of 3 or 4 was more predictive of an increased risk of mortality in younger patients and patients with breast cancer. These findings can enhance the use of ECOG PS for clinical decision-making and defining eligibility for clinical trials.

Surgical outcomes for non-small cell lung carcinoma by race and surgical facility types in the United States.

11167 Background: Successful outcomes of surgical treatment of cancer requires expertise and high-quality supportive services for surgical care. Previous studies have shown that case volume and availability of other in-house supportive services affect surgical outcomes. Latest studies have shown that this gap has now significantly reduced. Issues related to access, availability of funding for latest technologies and continuous medical education still exist and likely still impact the surgical outcomes. The objective of the study is to understand the impact of surgical center related factors on survival outcomes for cancer patients based on race and other demographic features. Methods: We conducted a retrospective analysis of patients diagnosed with Stage I-III Non-small cell lung cancer (NSCLC) between 2004 to 2020 using the National Cancer Database (NCDB). Patients were divided into 4 cohorts of NCDB assigned facility type (Community Cancer Program, Comprehensive Community Cancer Program, Academic/Research Program, Integrated Network Cancer Program). Racial and other demographic data was analyzed for each of the facility types. Differences in categorical variables were evaluated using a Chi-square test. Results: 298,393 adenocarcinoma and 129,144 squamous cell carcinoma patients underwent surgery for NSCLC between 2004-2020. 326,798 patients with clinical stages I-III were selected for the analysis. Most surgeries were performed at the academic/research programs and comprehensive community programs. Utilization of each facility type was uniform across all races. The 30-day mortality rate was lowest for the academic/research programs (Community Cancer Program 3.1%, Comprehensive Community Cancer Program 2.6%, Academic/Research Program 1.8%, Integrated Network Cancer Program 2.3%; p=0.000). 30-day mortality rate was higher for American Indian, Aleutian, or Eskimo racial subgroups amongst all age-groups at all the surgical facility types especially for Stage IIIB NSCLC (White: 6%, Black: 3.4%, American Indian, Aleutian, or Eskimo: 14.3%, p=0.006). For each race, the 30-day mortality rate was better at the academic/research programs. Females had lower 30-day mortality for all racial subgroups. Having private insurance was associated with the lowest 30-day mortality rate. This was noted for all races across all the facility types. Lower income status was associated with higher mortality rates across all facility types. This difference was statistically significant for white patients. Majority of patients had less than 10 days of length of stay at all the surgical facility types. Conclusions: Outcomes of NSCLC surgery are significantly better at academic/research programs where a higher number of procedures are performed and access to latest surgical technologies is available. Short-term mortality rates are higher for American Indian, Aleutian, or Eskimo racial subgroup.

Improving lung cancer health equity by applying deep learning to low dose CT screening of minority and disadvantaged patients.

1584 Background: In the US, disparities in lung cancer mortality exist for African American, Hispanic, and other minorities. Standard of care low dose CT screening (LDCT) detects early-stage disease and improves mortality, yet disparities are perpetuated in screening by eligibility criteria derived from cohorts underrepresenting these minorities. One such cohort is the National Lung Screening Trial (NLST) cohort which is 92% White. Consequently, guidelines for lung cancer screening may be insufficient to address the unique needs of diverse populations. We hypothesize that Artificial Intelligence prediction of future lung cancer risk from an individual’s LDCT can partially mitigate racial and ethnic disparities and improve health system practice guidelines by individualizing screening risk as compared to current general guidelines. Here, we benchmark a Resnet18 3D neural network trained on NLST LDCT images, Sybil, on the diverse patient population of the University of Illinois Health system (UIH) which is 20% White and 60% African American. Methods: A real-world cohort from UIH consisting of 1,450 CT studies was evaluated alongside 60,378 CT studies from the NLST cohort. All CT studies evaluated by the model were not used in model training. Using Youden’s J index as a probability cutoff, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were evaluated. Receiver operating characteristic (ROC) and precision-recall (PR) curves were generated to assess model performance between cohorts. NLST data were truncated to achieve equivalent incidence of lung cancer with UIH when generated PR curves. Results: Multi-year prediction performance (ROC-AUC and PR-AUC) between cohorts are summarized (Table). For prediction of lung cancer within 1-year of LDCT in the UIH cohort, the model respectively demonstrated sensitivity, specificity, positive predictive value, and negative predictive value among White (0.80, 0.77, 0.54, 0.92), African American (0.84, 0.78, 0.39, 0.97) races and Hispanic (0.75, 0.73, 0.60, 0.84) and non-Hispanic (0.87, 0.77, 0.42, 0.97) ethnicities. Conclusions: Model performance was similar between the NLST (92% White) and a diverse, real-world cohort at UIH (20% White) though decreases in ROC-AUC performance in year 1 predictions and may be due to insufficient representation of minority populations during model training. Prospective studies involving larger and more representative patient populations should be conducted to further optimize the model and evaluate its clinical utility to improve lung cancer health equity in minority populations.[Table: see text]

In Patients With Rotator Cuff Tears, Female, Hispanic, African American, Asian, Socially Deprived, Federally Insured, and Uninsured Patients Are Less Commonly Treated Surgically

The purpose of the current study was to evaluate socioeconomic factors affecting whether a patient undergoes rotator cuff repair after a diagnosis of a rotator cuff tear. From 2009 through 2018, claims for adult (≥18 years of age) patients who were diagnosed with a primary rotator cuff injury were identified in the New York Statewide Planning and Research Cooperative System (SPARCS) database via International Classification of Diseases (ICD)-9th Revision-Clinical Modification (CM) and ICD-10-CM diagnostic codes. SPARCS is a comprehensive all-payer database collecting all inpatient and outpatient pre-adjudicated claims in New York. ICD-9-CM and ICD-10-CM codes were used to identify the initial diagnosis for each patient. Current Procedural Terminology codes were used to identify subsequent rotator cuff surgery. The procedures identified were linked with the initial diagnosis, and patients were noted as either having or not having rotator cuff surgery. Logistic regression analysis was performed for variables including age, sex, race, Social Deprivation Index (SDI), Charlson Comorbidity Index, and primary insurance type to determine the effect of patient factors on the likelihood of having surgery after a diagnosis of rotator cuff injury. Of the 67,584 rotator cuff patients included in the analysis, 19,770 (29.3%) of the patients underwent surgical intervention. From the logistic regression, females relative to males (odds ratio [OR]= 0.798, P < .0001), increased SDI (OR= 0.994, p < .0001), African American compared with White race (OR= 0.694, P < .0001), Asian compared with White (OR= 0.832, P < .0001), Hispanic compared with White (OR= 0.693, P < .0001), other race (OR= 0.58, P < .0001), those with Medicare (OR= 0.601, P < .0001) or Medicaid (OR= 0.614, P < .0001) relative to private insurance, and self-pay relative to private insurance (OR= 0.727, P < .0001) were all associated with decreased odds of undergoing rotator cuff surgery. Older patients (OR= 1.012, P < .0001) and Workers' Compensation relative to private insurance (OR= 1.664, P < .0001) had increased odds of undergoing surgery. The results of the current study identified disparities in the likelihood of undergoing rotator cuff repair after a diagnosis of a rotator cuff tear based on patient demographic and socioeconomic factors. Individuals with higher SDI; African American, Asian, Hispanic, or other non-White races; and those with Medicare, Medicaid, or self-pay insurance had decreased odds of surgery, whereas older age and Workers' Compensation insurance were associated with increased odds of undergoing surgery. Level IV, retrospective case series.

Examining knowledge of cancer-related family history in an urban underserved patient population.

e22550 Background: An accurate assessment of family history of cancer is essential in assigning cancer risk, and in decision making regarding the timing and method of cancer screening. However, obtaining a complete and accurate cancer-related family history, including first- and second-degree relatives, is often challenging in underserved communities. Familial dynamics such as single parent households, kinship care, and estrangement may act as barriers to an individual’s knowledge of their family health history. Presently, Electronic Medical Record systems constrain users to a binary documentation of cancer history as either ‘yes’ or ‘no’. However, patients may be unaware or uncertain of their family’s cancer history. These unknowns are not captured, resulting in poor understanding of patient knowledge regarding their family history of cancer. Objective: To assess knowledge of cancer-related family history for first- and second-degree relatives among an urban underserved patient population. Funding source: The American Cancer Society. Methods: University of Illinois Health patients aged 45-75 years without a history of colorectal cancer, who received an order for colorectal cancer screening through fecal immunochemical testing or screening colonoscopy were eligible to participate. A total of 88 respondents completed a 23-item telephone survey assessing knowledge of their family cancer health history using a 5-point Likert scale. Surveys were administered in both English and Spanish languages. Results: Of the 88 survey participants, 50 (57%) were female, 54 (61%) were of black or African American race, and 31 (36%) were of Hispanic or Latino ethnicity. On a single-item question assessing overall knowledge of their cancer-related family history, 35 (39.7%) responded they know it well or very well, versus 13 (14.8%) with little or no knowledge. On knowledge of maternal cancer related history, 8 participants (9.1%) reported little or no knowledge of their mother’s cancer history, and 29 participants (33%) reported little or no knowledge of their maternal relatives’ cancer history. On knowledge of their father’s cancer history, 35 (39.8%) reported little or no knowledge of their father’s cancer history, and 48 participants (54.5%) reported little or no knowledge of their paternal relatives’ cancer history. Conclusions: This original research study addresses the current gap in understanding patient knowledge regarding familial cancer health history. Survey results demonstrate a striking discrepancy between respondent reported overall knowledge of cancer-related family history, and knowledge of their maternal and paternal cancer histories. Moreover, respondents reported increased knowledge of their mother’s versus father’s cancer history p &lt; 0.0001. Improved recognition of unknown family history in first- and second-degree family members may improve cancer-risk assessment.

Factors influencing the mortality risk of heart failure in patients receiving antineoplastic immunotherapy: A national inpatient database study 2016-2020.

e24011 Background: Immunotherapy is increasingly being used for management of solid and lymphoproliferative tumors due to their more desirable side effect profile as compared to traditional cancer therapies. However, these medications are associated with cardiac complications and little is known about the factors influencing the prognosis in these patients. Methods: This is a retrospective analysis of the National Inpatient Database from 2016 to 2020 using the International Classification of Diseases (ICD) 10 codes performed with STATA BE 18.0. Chi square test was used for crude analysis and multivariate logistic regression was performed to assess the risk of inpatient death among cancer patients with heart failure receiving immunotherapy. Results were adjusted for potential confounders like age, gender, race, hypertension, diabetes, coronary artery disease, smoking, and alcohol consumption. Multicollinearity of the model was assessed using Variance Inflation Factor (VIF) post-estimation test. Results: Out of 5166 cancer patients receiving immunotherapy with a mean age of 43.63 土 26.33 years and 41% females, 45 patients had heart failure. Logistic regression showed that heart failure was significantly associated with mortality (LR 𝜒² 38.74, p value &lt; 0.001) on adjusting for potential confounders. Although the effect size was small, increased age (OR 1.025, CI 1.01-1.04) had a significantly higher risk of mortality. Patients belonging to the female gender and white, hispanic, and asian races had a lower risk of mortality while those belonging to the african american race and those with coronary artery disease had a higher mortality risk, although not statistically significant. Diabetes and alcohol consumption had a fourfold and sixfold increased risk of mortality respectively. Hypertension and smoking that are known to increase mortality risk in heart failure patients showed a paradoxically protective effect in this cohort. Conclusions: This study highlights the importance of risk stratification and prognostication among patients with heart failure receiving antineoplastic immunotherapy. Increased age, african american race, diabetes, alcohol consumption, and coronary artery disease have shown an increased mortality risk in these patients. [Table: see text]

The Immune System Is a Complex System: Inflammatory Morbidity and Systemic Racism

This article examines the relationship between social inequity and the immune system, emphasizing some of the many ways that systemic racism and other forms of marginalization can undermine health. Of much sociological concern, chronic stressors increase inflammation and consequent susceptibility to health morbidities and, ultimately, mortality by burdening marginalized group members in ways that adversely affect immune regulation and functioning. As with social systems more generally, the immune system is a cross-scale complex system of many regulating, coordinating, and interacting parts, within both itself and the other bodily systems it protects. Along these lines, we thus propose that to properly conceptualize how social conditions undermine immune functioning and health, it is important to consider the immune system beyond its component mechanisms and parts. This view is akin to the way critical race theory proposes that “systemic racism” in the United States is a collaborative arrangement of social structures whose explanatory richness and historical durability can only be fully understood as a gestalt. We therefore seek, where possible, to emphasize the systems nature of the immune system similarly to the sociological insight that society comprises complex systems whose interrelated structures interact in dynamic and sometimes unpredictable ways. We scaffold this discussion within the literature on systemic racism in the United States, emphasizing inflammation as a key marker of immune demand and dysregulation and highlighting some implications for health inequities among marginalized populations more generally.

Acting as we feel: Which emotional responses to the climate crisis motivate climate action

The current study assessed emotional responses and emotion regulation strategies to the climate crisis, and their relationship to pro-environmental behaviour cross-sectionally using self-report online surveys. 1307 participants were recruited through convenience sampling from six European countries, alongside a distinct sample of 1040 participants representative of age, sex, and ethnicity in the United States. Our findings replicated the well-known association that stronger negative emotions to the climate crisis are associated with more pro-environmental behaviour. The relationship between climate emotions and pro-environmental behaviour was moderated by resignation in the US sample, by cognitive reappraisal and other-blame in the European sample and mediated by rumination in both samples. Furthermore, latent profiles of emotional responses were identified. In both samples, there was one distinct class demonstrating strong climate emotions, and a group with very low or no climate emotions (alongside with two/three groups with moderate emotional intensity in the European and the US samples, respectively). Findings also revealed that members of the emotional group were more likely to take climate action and tend to engage more in emotion regulation than the unemotional group. Our results highlight the crucial role of emotions and emotion regulation strategies in mitigating the climate crisis by taking pro-environmental action.

Pulmonary hypertension in the intensive care unit after pediatric allogeneic hematopoietic stem cell transplant: incidence, risk factors, and outcomes.

To determine the incidence, risk factors, and outcomes of pulmonary hypertension (PH) in the pediatric intensive care unit (PICU) after pediatric hematopoietic stem cell transplant (HCT). This was a retrospective study of pediatric patients who underwent allogeneic HCT between January 2008-December 2014 at a center contributing to the Center for International Blood and Marrow Transplant Research data registry. Incidence of PH was assessed from PICU diagnostic codes from records merged from the Virtual Pediatric Systems database. Regression and survival analyses identified factors associated with post-HCT PH. Additional post-HCT morbidities and survival after PH were also assessed. Among 6,995 HCT recipients, there were 29 cases of PH, a cumulative incidence of 0.42% (95% CI 0.27%-0.57%) at 60 months post-HCT. In the sub-cohort of 1,067 patients requiring intensive care after HCT, this accounted for a PH prevalence of 2.72% (95% CI 1.74-3.69%). There was an increased risk of developing PH associated with Black/African American race, metabolic disorders, partially HLA-matched or cord blood allografts, graft-versus-host prophylaxis regimen, and lower pre-HCT functional status. Patients who developed PH had significant PICU comorbidities including heart failure, pulmonary hemorrhage, respiratory failure, renal failure, and infections. Survival at 6 months after diagnosis of post-HCT PH was 51.7% (95% CI 32.5%-67.9%). PH is a rare but serious complication in the pediatric post-HCT population. A significant burden of additional comorbidities, procedural interventions, and risk of mortality is associated with its development. Close monitoring and prompt intervention for this severe complication are necessary in this vulnerable population.

A Feminist Critique of Women Portrayal in NGUGI WA THIONGO’S Devil on the Cross

African American Literature demonstrates that the Black Women's Feminism Caucus acknowledged that black women faced a dual patriarchal oppression from within their own community and from white society. This paper examines how Devil on the Cross portrays a Kikuyu woman striving for liberation and transformative change in Kenyan society. Employing a feminist perspective, the researcher contends that Ngugi Wa Thiong'o illustrates the plight of women in Kenyan society, interpreting feminism within its cultural framework. Building on this foundation, the study advocates for the designation of essential services such as police protection, justice, shelters, helplines, and community support services, ensuring they receive adequate support and resources to operate during pandemics and other public emergencies affecting women and girls. It emphasizes the necessity of involving women and women's civil society organizations in policy formulation, development, and implementation to integrate their knowledge, experiences, and needs into response strategies. Furthermore, it stresses the importance of prioritizing prevention and protection against gender-based and domestic violence in national responses by collecting detailed data on the prevalence of such violence and identifying which demographics of women and girls are most vulnerable. Keywords: Domestic violence, Feminist critique, Fiction, Women emancipation, Women portrayal

Jeannie N. Shinozuka, Biotic borders: Transpacific plant and insect migration and the rise of anti-Asian racism in America, 1890-1950, Chicago and London: The University of Chicago Press, 2022.

Jeannie N. Shinozuka, Biotic borders: Transpacific plant and insect migration and the rise of anti-Asian racism in America, 1890-1950, Chicago and London: The University of Chicago Press, 2022.

African American Race and Medicaid Insurance are Associated With Increased Frequency of Unplanned Return to Operating Room After Lower Extremity Bypass for Chronic Limb-threatening Ischemia

African American Race and Medicaid Insurance are Associated With Increased Frequency of Unplanned Return to Operating Room After Lower Extremity Bypass for Chronic Limb-threatening Ischemia

Choosing to End African American Health Disparities in Patients With Systemic Lupus Erythematosus.

Systemic lupus erythematosus (SLE) is three times more common and its manifestations are more severe in African American women compared to women of other races. It is not clear whether this is due to genetic differences or factors related to the physical or social environments, differences in health care, or a combination of these factors. Health disparities in patients with SLE between African American patients and persons of other races have been reported since the 1960s and are correlated with measures of lower socioeconomic status. Risk factors for these disparities have been demonstrated, but whether their mitigation improves outcomes for African American patients has not been tested except in self-efficacy. In 2002, the first true US population-based study of patients with SLE with death certificate records was conducted, which demonstrated a wide disparity between the number of African American women and White women dying from SLE. Five years ago, another study showed that SLE mortality rates in the United States had improved but that the African American patient mortality disparity persisted. Between 2014 and 2021, one study demonstrated racism's deleterious effects in patients with SLE. Racism may have been the unmeasured confounder, the proverbial "elephant in the room"-unnamed and unstudied. The etymology of "risk factor" has evolved from environmental risk factors to social determinants to now include structural injustice/structural racism. Racism in the United States has a centuries-long existence and is deeply ingrained in US society, making its detection and resolution difficult. However, racism being man made means Man can choose to change the it. Health disparities in patients with SLE should be addressed by viewing health care as a basic human right. We offer a conceptual framework and goals for both individual and national actions.

The Polysemic Comedy of Too Busy to Work

ABSTRACT This article examines cultural, narrative and stylistic features of Too Busy to Work, a 1932 film starring Will Rogers. While, on the surface, the movie could be seen as a simple light comedy about the travelogue of a hobo name Jubilo, close examination reveals a tragicomedy interested in issues of justice, marriage, political parody, food, money, work, and a Civil War era song that is used both as a personal identity marker and an illustration of the general complexities of race in the United States. Too Busy to Work instead leads the careful critic to a complex visual text that asks unanswerable social questions. Thus, the film should be studied and remembered as interesting, unusual, and complex.

Race, historical redlining, and contemporary transportation noise disparities in the United States.

Legacies of discriminatory federal housing practices-e.g., racialized property appraisal by the Home Owners' Loan Corporation (HOLC) and institutionalized redlining by the Federal Housing Administration-include disparate present-day environmental health outcomes. Noise pollution is health-harming, but just one study has associated contemporary noise with redlining in some HOLC-mapped United States (US) cities, while two national studies found associations between greater neighborhood-level people of color composition and increased noise. No studies have examined noise pollution exposure disparities across all HOLC-mapped cities or based on the intersection of race/ethnicity and redlining. We address three objectives: (1) Assess disparities in fine-scale, per person transportation noise exposures by historical redlining status across all HOLC-mapped cities. (2) Quantify disparities in noise exposures by race/ethnicity nationwide. (3) Explore interactions between redlining status and race/ethnicity in noise exposures. We analyzed three data sources: (1) complete digital HOLC maps of ordered investment risk grades (A-D), (2) fine-scale (30 m) estimates of transportation noise levels (year-2020), and (3) sociodemographic characteristics of individuals in year-2020 census blocks. We find an approximately monotonic association for excess transportation noise with HOLC grade, marked by a pronounced exposure increase (17.4 dBA or 3× loudness) between contemporary residents of grade A (highest-graded) and D (lowest-graded) neighborhoods, a pattern consistent across HOLC-mapped cities. People of color experience ~7 dBA greater (2× louder) excess transportation noise exposures than White people nationwide, a pattern consistent across US counties. Noise exposure disparities are larger by HOLC grade than by race/ethnicity. However, contemporary racial/ethnic noise exposure disparities persist within each HOLC grade at levels approximating those disparities existing in ungraded areas, indicating that historical redlining is one of multiple discriminatory practices shaping contemporary national soundscape injustices. Findings illustrate how historical redlining and broader racialized inequalities in US society have shaped environmental injustices nationwide. Excessive noise exposures harm human health. Communities of color in the United States experience disparate noise exposures, although previous studies are limited by reliance upon aggregated data. They are also disproportionately concentrated in historically redlined areas. Legacies of redlining include persistent racial and economic inequalities and environmental health disparities. Here, we conduct the first complete national examination of contemporary noise pollution disparities with respect to historical redlining and race/ethnicity. Findings advance understanding of the historical roots and enduring salience of race-based disparities in noise pollution exposures and can inform efforts to address these disparities through noise pollution policy-making.

A Claim of Conscience: The Duty to Prove Oneself a Resistor

An important question that arises as regards a member in a gravely unjust system is whether by any act of “resistance,” undertaken at personal risk, he or she proved himself to be set against that system. This was the question posed by de-Nazification experts employed by the U.S. military in occupied Germany after World War II.1 A similar question is posed today by social movements, such as Black Lives Matter, reacting against historical racism in the United States. We argue that, today, those who in conscience, as members of a gravely unjust system, have wanted to reject vaccinations developed or tested using cell lines derived from abortion, should be understood and evaluated in the same way. We believe that such an approach provides perhaps the best hope for the re-invigoration of society through the pro-life ideals embodied in the “gospel of life.”

Trajectories of State-Level Sepsis-Related Mortality by Race and Ethnicity Group in the United States.

Background: Recent reports on the national temporal trends of sepsis-related mortality in the United States (US) suggested improvement of outcomes in several race and ethnicity groups. However, it is unknown whether national data reflect state-level trajectories. Methods: We used the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death data set to identify all decedents with sepsis in the US during 2010-2019. Negative binomial regression models were fit to estimate national and state-level trends of age-adjusted sepsis-related mortality rates within race and ethnicity groups. Results: There were 1,852,610 sepsis-related deaths in the US during 2010-2019. Nationally, sepsis-related mortality rates decreased among Blacks and Asians, were unchanged among Hispanics and Native Americans, and rose among Whites. The percent of states with similar trends were 30.0% among Blacks, 32.1% among Asians, 74.3% among Hispanics, 75.0% among Native Americans, and 66.7%% among Whites, while trending in opposite direction from 3.6% among Asians to 15.0% among Blacks. Conclusions: National trends in sepsis-related mortality in the US did not represent state-level trajectories in race ethnicity groups. Gains in sepsis outcomes among race and ethnicity groups at the national level were not shared equitably at the state level.

Identifying Barriers and Facilitators to Accessing Care for Historically Marginalized Communities Affected by Parkinson Disease: A Qualitative Study.

Parkinson disease (PD) is the second most common neurodegenerative disease. Members of the Black Diaspora (MBD) and Hispanic/Latinx people are less likely to receive a timely diagnosis following the onset of symptoms and more likely to experience greater disease severity due to late diagnosis. Historically marginalized populations (i.e., MBD, Hispanic, and Latinx communities) are not accurately represented in research; this, along with many other barriers, compounds underreporting and lack of recognition of PD. It is important to understand barriers to early diagnosis and healthcare access for these historically marginalized populations from the community's perspective. Our team conducted two focus groups to identify barriers and facilitators to PD healthcare-seeking behavior. We sought to identify which barriers are modifiable to ultimately improve engagement in neurological care for MBD and Hispanic individuals affected by PD. We enrolled 15 participants (13 female; African/African American/Black n = 10, Hispanic/Puerto Rican n = 3, other n = 2) for two focus groups. Discussions revealed sources of barriers to healthcare-seeking behavior in three main domains: legacy of racism in the United States, ancestral cultural environment, and healthcare system access. These sources influenced individuals' PD knowledge and familiarity. Additionally, participants expressed a desire to know more about PD and called for increased community-based programming for education and awareness. This paper uses a community-based participatory research approach to describe the experiences of MBD, Hispanic, and Latinx people in Manhattan and the surrounding areas in relation to possible sources of healthcare disparities and delayed PD diagnosis. These sources have broad implications and should be addressed through collaborative community programming.

Seeing One Another: The Creation of the Sawubona Healing Circles

In 2020, the Association of Black Psychologists (ABPsi) drew attention to the history of racism in the United States on the creation and exacerbation of extant medical racial inequities to the detriment of Black individuals. Recognizing that solutions based solely in Western frameworks cannot fully address the mental health needs of Black individuals, ABPsi devoted collaborative efforts to develop culturally grounding healing responses for the unique experiences of race-based invisibility and trauma. Additionally, amid the pandemic, individuals of African-descent experienced various mass racial traumas, including a wave of widely publicized police violence. Beginning with COVID-19, these intersecting pandemics of racism elucidated the need for healing, particularly culturally grounding healing. In consultation with the Black Family Summit, ABPsi developed a pilot investigation, the Sawubona Healing Circle (SHC) initiative, which are culturally grounding healing circles to support Black first responders. Using an African-centered worldview, the circles recognize and validate the specific constellation of anti-Black traumas and stressors, equipping them with African-centered healing methods. This paper outlines the theory, development, implementation, and initial evaluation of the SHC intervention.