American Race Research Articles

Considering sociocultural contexts of racism in psychological research on black forgiveness

AbstractIn this paper, we argue that a cultural context of racism in the United States influences the representation and outcomes of Black forgiveness. Previous research in psychology has focused on the positive social and emotional benefits of forgiveness; however, the consequences of Black forgiveness are not always straightforward. We review prior research and highlight real‐world examples that suggest Black people are often pressured and expected to forgive racism. This pressure to forgive overshadows calls for justice and encourages forgiveness as a more palatable, less antagonistic response to racism. Furthermore, we argue that this expectation suppresses Black emotions by stigmatizing negative emotional reactions to racism in favor of forgiveness. We conclude by proposing future lines of research in social psychology that do not reinforce a pressure for Black forgiveness, that foster a study of forgiveness that incorporates social justice, and that considers new lines of forgiveness research that are culturally sensitive to Black experiences.

Reflections from the wading pool: Detoxifying racist psychological waters while submerged in their waves.

Psychology, like water, is not inherently toxic. However, historical and contemporary currents, particularly those pertaining to racism in the United States, have poisoned the field and caused harm to Black communities. As early-career scholars, the authors note both the importance of and challenges inherent in rectification, especially in light of the American Psychological Association's (APA) resolutions in 2021 aimed at addressing and redressing systemic racism within psychology and beyond. Through a primary focus on anti-Black racism and the use of an extended metaphor of water, we utilize personal reflection, interviews, and historical accounts to better understand how racism has impacted the field of psychology from within to better consider efforts to reduce its impact on the greater Black American community. We note how the APA was founded with and perpetuated racist scholarship and practice and consider the founding and subsequent resistance of the Association of Black Psychologists (ABPsi) as a cautionary tale to depict what can happen when the water becomes too toxic. We then seek to use this history of internal dynamics to better understand a superordinate goal, that is, how to extend antiracism efforts outward. We interviewed venerable Black psychologists and provided our own recommendations to consider what is necessary to support healing among Black communities impacted by racism. We conclude by acknowledging that although the waves of psychology can be consuming, terse, and painful, our ability to detoxify the water is possible with perspectives that cultivate deep pools of inquiry, mutual understanding, and action. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Factors Associated with Patient Engagement in a Health and Social Needs Case Management Program.

Many patients offered case management services to address their health and social needs choose not to engage. Factors that drive engagement remain unclear. We sought to understand patient characteristics associated with engagement in a social needs case management program and variability by case manager. Between August 2017 and February 2021, 43,347 Medicaid beneficiaries with an elevated risk of hospital or emergency department use were offered case management in Contra Costa County, California. Results were analyzed in 2022 using descriptive statistics and multilevel logistic regression models to examine 1) associations between patient engagement and patient characteristics and 2) variation in engagement attributable to case managers. Engagement was defined as responding to case manager outreach and documentation of at least 1 topic to mutually address. A sensitivity analysis was performed by stratifying the pre-COVID-19 and COVID-19 cohorts. A total of 16,811 (39%) of eligible patients engaged. Adjusted analyses indicate associations between higher patient engagement and female gender, age 40 and over, Black/African American race, Hispanic/Latino ethnicity, history of homelessness, and a medical history of certain chronic conditions and depressive disorder. The intraclass correlation coefficient indicates that 6% of the variation in engagement was explained at the case manager level. Medicaid patients with a history of housing instability and specific medical conditions were more likely to enroll in case management services, consistent with prior evidence that patients with greater need are more receptive to assistance. Case managers accounted for a small percentage of variation in patient engagement.

A historic apology: The American Psychological Association's commitment to dismantling systemic racism and advancing racial equity in psychology.

In 2021, the American Psychological Association offered an apology to people of color for harms, actions, and inactions and accepted responsibility for contributing to systemic inequities. The field of psychology has a complicated and long history of contributing to American racism and the belief in human hierarchy. This article illustrates the strategy the American Psychological Association followed to issue an apology at a scale that incorporated the voices and perspectives of the association's senior leaders and racial equity experts. The authors shed light on the organizational changes that were necessary to approve the apology and the changes that followed the apology to create long-term, institutional, and sustainable change and advance racial equity within psychology and society. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Discordant and Concordant Substance Use and Daily Partner Violence in Adolescent and Young Adult Relationships With Baseline Dating Violence

PurposeIntimate partner violence (IPV) and substance use in adolescents and young adults (AYAs) are significant public health issues in the United States. Together, they can harm emotional regulation and romantic relationship functioning. This study examines the role of concordant and discordant substance use on IPV within AYA relationships. MethodsA prospective cohort of community-recruited AYA women in a heterosexual dating relationship with past-month IPV completed four months of daily surveys via a cell phone. Each day, participants reported any IPV perpetration and/or victimization, their alcohol and drug use, and observed partner substance use. Concordant substance use was coded when the participant and partner used drugs or alcohol on the same day. Discordant use was coded when only the participant or partner used drugs or alcohol on a given day. Alcohol and drug use were modeled separately. Generalized estimating equations accounted for the correlation of repeated measures. ResultsParticipants (N = 143) were 18.2 (1.1) years old, 93% African American race. Discordant alcohol and drug use was associated with same-day victimization, perpetration, and co-occurring violence compared to concordant nonuse. Similarly, concordant alcohol use, drug use, and alcohol/drug use were associated with increased odds of victimization, perpetration, and co-occurring violence compared to concordant nonuse. DiscussionDaily data illustrated that dyadic patterns of substance use are associated with IPV. These findings may facilitate the development of effective and developmentally appropriate IPV intervention programs for AYA that also integrate strategies to reduce substance use.

Impact of Social Vulnerability on Cardiac Arrest Mortality in the United States, 2016 to 2020.

Cardiac arrest is 1 of the leading causes of morbidity and mortality, with an estimated 340 000 out-of-hospital and 292 000 in-hospital cardiac arrest events per year in the United States. Survival rates are lower in certain racial and socioeconomic groups. We performed a county-level cross-sectional longitudinal study using the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research multiple causes of death data set between 2016 and 2020 among individuals of all ages whose death was attributed to cardiac arrest. The Social Vulnerability Index is a composite measure that includes socioeconomic vulnerability, household composition, disability, individuals from racial and ethnic minority groups status and language, and housing and transportation domains. We examined the impact of social determinants on cardiac arrest mortality stratified by age, race, ethnicity, and sex in the United States. All age-adjusted mortality rate (cardiac arrest AAMRs) are reported as per 100 000. Overall cardiac arrest AAMR during the study period was 95.6. The cardiac arrest AAMR was higher for men compared with women (119.6 versus 89.9) and for the Black population compared with the White population (150.4 versus 92.3). The cardiac arrest AAMR increased from 64.8 in counties in quintile 1 of Social Vulnerability Index to 141 in quintile 5, with an average increase of 13% (95% CI, 9.8%-16.9%) in AAMR per quintile increase. Mortality from cardiac arrest varies widely, with a >2-fold difference between the counties with the highest and lowest social vulnerability, highlighting the differential burden of cardiac arrest deaths throughout the United States based on social determinants of health.

Predictors of Prolonged Mechanical Ventilation in Pediatric Patients with Hemolytic Uremic Syndrome

AbstractThis study aimed to analyze factors associated with mechanical ventilation (MV) and prolonged MV (≥12 days) in pediatric hemolytic uremic syndrome (HUS) patients. Retrospective multicenter cohort study analyzed data from 3,831 pediatric HUS (age <18 years) patients between 2004 and 2018 from Pediatric Health Information System database. Multivariate logistic regression was used to pinpoint factors associated with MV and prolonged MV. Among 3,831 patients analyzed, 769 (20%) patients required MV, 166 (23.6%) of them were prolonged MV. Factors independently associated with prolonged MV include African American (adjusted odds ratio [aOR]: 1.98, 95% confidence interval [CI]: 1.11–3.54, p = 0.02), children aged between 1 and 5 years (aOR: 7.69, 95% CI: 3.71–15.93, p < 0.001), pneumonia (aOR: 2.54, 95% CI: 1.51–4.25, p < 0.001), pneumothorax (aOR: 2.41, 95% CI: 1.08–5.39, p = 0.032), liver dysfunction (aOR: 3.22, 95% CI: 1.68–6.16, p < 0.001), ileus with perforation (aOR: 1.83, 95% CI: 1.03–3.25, p = 0.039), and sepsis (aOR: 1.97, 95% CI: 1.26–3.08, p = 0.003). In pediatric HUS cases, 20% required MV, and 23.6% of them were prolonged MV. Factors associated with prolong MV include African American race, children aged between 1 and 5 years, pneumonia, pneumothorax, liver dysfunction, ileus with perforation, and sepsis.

Oppressed Become the Oppressor: Psychoanalytical Intersections of Trauma in Toni Morrison’s the Bluest Eye

This paper explores the intricate interplay of racism, trauma, and identity in Toni Morrison's novel The Bluest Eye. It delves into the challenges faced by African Americans within a predominantly white society by utilizing current trauma theory and Black feminist concepts. The theoretical framework includes cultural trauma theories, including the contributions from scholar Evelyn J. Schreiber, and insights from feminist thinkers like Bell Hooks and Patricia Hill Collins. Moreover, through an intersectional analysis, the study scrutinizes how gender, racial, class, and generational trauma intertwine to mold individuals’ experiences and self-perception. Therefore, by amalgamating trauma theories with feminist perspectives, the research provides valuable insights into the struggles of the characters and the societal dynamics portrayed in Morrison's novel, The Bluest Eye.

Pediatric and Young Adult Trauma Recidivism.

Unintentional injury is the leading cause of death among children. Much can be gleaned from the adult literature in understanding the characteristics that lead to recidivism in efforts to establish interventions for prevention. Our study aims to evaluate the rates, demographics, and features of pediatric trauma recidivism. This was a retrospective single-institution review at a level-1 pediatric trauma center of children and young adults (ages 0-28) with traumatic injuries from January 2008 to April 2023. Patients with 1 or more prior visits to our institution's trauma center (recidivists) were identified and compared with those with single admissions. Chi-square tests were used to statistically analyze the two groups. Pediatric/young adult trauma recidivists were 4.4% of the total trauma population captured (n = 14,613). Of the total trauma group, 55% were under 18 years old. Recidivists had higher percentages of patients who were male (82% vs 69%, P < .01), African American (36% vs 24%, P < .01), involved in penetrating trauma (33% vs 17%, P < .01), self-pay/uninsured (17% vs 12%, P < .01), and have abuse reported (5% vs 4%, P = .04). The primary county for recidivism patients was Forsyth with most patients from a specific zip code in an urban area of the county. The average time between visits for recidivists was 1,066days. Pediatric/young adult trauma recidivism is associated with specific characteristics including male, African American race, penetrating trauma, and uninsured status. Recidivists are primarily presenting from a zip code with low socioeconomic status. It is critical to develop targeted interventions to help this population in trauma prevention.

They put me on a train: Assimilation and the Australian railways

AbstractThis article explores the involvement of the Australian railways in the forcible removal of Aboriginal children. Focusing on the visions and voices of Aboriginal peoples who were taken away from their families by train, the article considers how railways were used in the attempted assimilation of First Nations peoples into White society. The last train ride, an artwork by South Australian Yankunytjatjara artist and Stolen Generations survivor Kunyi McInerney, serves as a point of departure to study how the settler colonial infrastructure of rail operationalised the Australian government policies of assimilation. I ask how railway infrastructures have affected Aboriginal peoples and how Aboriginal peoples have responded to railway infrastructures. In centring the artworks and narratives of Aboriginal people taken away by train, I extend an invitation to readers to rethink geography through the visual expressions and stories of First Nations peoples. Close attention to the perspectives of affected peoples opens possibilities to view infrastructures in a different light. The visions and voices of Aboriginal families impacted by assimilation policies show that the railways played a pivotal role in the separation of Aboriginal children from families and that railway infrastructures have also been sites of resistance to and subversion of assimilation and child removal. Paying careful attention to First Nations voices and visions, the article informs how the Australian railways have been complicit in assimilation policies and how Aboriginal peoples have used the railways to resist and survive such settler colonial projects.

Kinship and Care: Racial Disparities in Potential Dementia Caregiving in the United States From 2000 to 2060.

Although the family plays a pivotal role in older adults' care, there is limited research on how evolving demographic trends affect older adults' support networks and how the trends vary by race. To fill this gap, we examine the influence of shifting family demographics on future care needs for older adults with dementia, emphasizing the unequal health and potential caregiving burdens by race in the United States. Using demographic models of kinship, we estimate the availability of potential caregivers, and dementia prevalence among one's kin by race, kin type, and the age of a focal person from 2000 to 2060. We introduce an index called the Dementia Dependency Ratio to assess dementia caregiving demands at the population level, taking into account the age and kinship structure of the population. Our findings suggest that Black individuals tend to have more children, grandchildren, and nieces/nephews as they age. However, Black individuals also tend to have more kin with dementia compared to their White counterparts. This elevated prevalence of dementia among Black kinship networks counterbalances the advantage of having more kin as potential caregivers. A further projection analysis suggests that the racial gap in caregiving demand within the kinship network will widen in the next 4 decades if the racial gap in dementia prevalence remains unchanged. These findings emphasize the urgency of reducing racial inequality in dementia prevalence rates and increasing public support for families with extended members affected by dementia. With the shrinkage of nuclear families and population aging in the next few decades, extended family members may undertake more caregiving responsibilities for dementia. We call for a kinship perspective in understanding dementia care in future research.

Relationship Between Different Ethnic Groups and COVID-19

Current studies on COVID-19 do not sufficiently investigate the link between various racial and ethnic groups and the pandemic, despite growing awareness of disparities in race in the United States. However, the current research findings showed a heightened incidence of COVID-19 among Black individuals in this country, suggesting an increased prevalence of infection within this specific demographic. The relationship between different ethnic groups and COVID-19 is complex and influenced by various factors, including genetic composition, socioeconomic factors, pre-existing health gap, and immune reaction. Furthermore, those are the indirect factors related to stress that may contribute to increased vulnerability to COVID-19 in certain populations, including African-American/Black People, Hispanics, and other minority groups. It's important to address the fact that these factors are complex, multifaceted, and influenced by biological, social, economic, and psychological factors. It's urgent to address these underlying issues to reduce health disparities to improve the overall well-being of marginalized communities. Public health efforts should focus on promoting equity in access to healthcare, education, and economic opportunities to mitigate the impact of stress on health outcomes.

Racial microaggressions in U.S. and Canadian contexts: Identity, perceptions of severity and the use of mindset signalling to repair harm

AbstractMicroaggressions are behaviours constituting indirect or unintentional discrimination, but little is known about how group identity affects perceptions of their harm. Canada and the United States have similar socio‐cultural backgrounds, but different socio‐political climates, with greater political polarisation and arguably stronger ties between politics and race in the United States (Pew research, 2020). Thus, the interplay between ethnic/racial identity (ERI), political identity, and perceived harm of microaggressions may differ across these countries. In a recent study of Canadians, perceived microaggression harm was associated with leftward political orientation rather than ERI. Here, we extend this work to a U.S. sample. In two experiments (N = 99; N = 210), White participants and Participants of Colour rated the severity of microaggressions and reported their political orientation and the strength of their ERI. Microaggression severity ratings were associated with left‐leaning political orientation, regardless of ERI. In Experiment 2, vignettes in which the perpetrator of a microaggression sought reparation by signalling a “reparatory open‐mindedness” reduced severity ratings compared to instances in which the source doubled down on the microaggression. Interestingly, the size of this reduction in perceived severity was smaller than for Canadian participants. Thus, perceived microaggression harm is governed by similar forces in Canada and the United States, but signalling mindset, while still effective, leads to smaller reductions in perceived harm in the United States. This could indicate differences in intergroup trust and polarization between these nations. This work underscores the role of political orientation in perceptions of microaggressions and highlights the efficacy of mindset signalling in mitigating their harm.

Gendered Anti-Blackness: Policing Black Women and the Making of the Modern City

The Streets Belong to Us makes a significant contribution to multiple fields, most principally the history of race, gender, sexuality, incarceration, and state violence in the United States. It is a definitive history of the changing nature of police power, and the ways that it defined, defended, and enforced the logics that undergirded racial segregation. Illuminating the significant degree to which urban policymaking and planning depended on state violence, Anne Fischer compels us to better appreciate the relation between the making and the remaking of the modern city and the consolidation of police power. To do so, we must see that this connection was made possible through the surveillance, harassment, and sexual criminalization of Black women. Women’s bodies, particularly Black women’s bodies, acted as the constitutive material that made up the very fabric of state power and racial segregation. Along with presenting an analysis of the racial and gendered dimensions of morals law enforcement, The Streets Belong to Us moves Black women out of the shadows of urban history by grounding the analysis within the intellectual production by Black feminist organizers and scholars. Their concept of gendered anti-Blackness proved indispensable to feminist antiviolence struggles of the late twentieth century.

“That Fight Still Goes On”: Narratives of Integration and Activism

Discussions of Black history and school desegregation in many K-12 schools have been narrowed to a few heroic figures and moments. Historic representations are currently challenged by a nationwide movement to uphold White supremacy and deny the violent history of racism in the US. The revisionist claims are challenged in this qualitative narrative research project that presents stories gathered from 10 Black educators in Augusta, Georgia, who recount their stories of desegregating schools and institutions as students or educators. This oral history narrative project imagines these stories as the basis for engaging K-12 teachers and students in creating new curricula.

Biotic Borders: Transpacific Plant and Insect Migration and the Rise of Anti-Asian Racism in America, 1890–1950

Biotic Borders: Transpacific Plant and Insect Migration and the Rise of Anti-Asian Racism in America, 1890–1950

Carbapenem-resistant Acinetobacter baumannii complex in the United States—An epidemiological and molecular description of isolates collected through the Emerging Infections Program, 2019

BackgroundUnderstanding the epidemiology of carbapenem-resistant A. baumannii complex (CRAB) and the patients impacted is an important step towards informing better infection prevention and control practices and improving public health response. MethodsActive, population-based surveillance was conducted for CRAB in 9 U.S. sites from January 1-December 31, 2019. Medical records were reviewed, isolates were collected and characterized including antimicrobial susceptibility testing and whole genome sequencing. ResultsAmong 136 incident cases in 2019, 66 isolates were collected and characterized; 56.5% were from cases who were male, 54.5% were from persons of Black or African American race with non-Hispanic ethnicity, and the median age was 63.5 years. Most isolates, 77.2%, were isolated from urine, and 50.0% were collected in the outpatient setting; 72.7% of isolates harbored an acquired carbapenemase gene (aCP), predominantly blaOXA-23 or blaOXA-24/40; however, an isolate with blaNDM was identified. The antimicrobial agent with the most in vitro activity was cefiderocol (96.9% of isolates were susceptible). ConclusionsOur surveillance found that CRAB isolates in the U.S. commonly harbor an aCP, have an antimicrobial susceptibility profile that is defined as difficult-to-treat resistance, and epidemiologically are similar regardless of the presence of an aCP.

Perioperative Delta Weight and Pediatric Obstructive Sleep Apnea Resolution after Adenotonsillectomy.

The first-line treatment for pediatric obstructive sleep apnea (OSA) is adenotonsillectomy. Post-operative weight gain is a well-documented phenomenon. We hypothesized that higher peri-adenotonsillectomy delta weight correlates with lower rates of OSA resolution in pediatric patients. This was a retrospective cohort study consisting of 250 patients from 2 to 17 years of age at a tertiary academic medical center between January 2021 and December 2022. Polysomnography results and body mass index (BMI) changes were collected through the electronic health record. Univariate and multivariate logistical regression analyses were performed, adjusting for confounding factors. Perioperative delta weight and pre-operative baseline AHI values were significant predictors of residual OSA. For every 1-kilogram gain in weight, the odds of residual OSA (AHI >5) increase by 6.0% (OR = 1.06, 95% CI = 1.02-1.10, p < 0.002), and the odds of residual severe OSA (AHI > 10) increase by 8% (OR = 1.08, 95% CI = 1.04-1.12, p < 0.001). Increased AHI, Black/African American race, and male sex were also factors associated with incomplete OSA resolution. Increased peri-adenotonsillectomy delta weight is associated with higher rates of residual OSA in children. Patients and families should be counseled about appropriate weight loss and control methods before adenotonsillectomy. IV Laryngoscope, 134:4141-4147, 2024.

Association between sociodemographic factors, clinic characteristics and mental health screening rates in primary care.

Screening for mental health problems has been shown to be effective to detect depression and initiate treatment in primary care. Current guidelines recommend periodic screening for depression and anxiety. This study examines the association of patient sociodemographic factors and clinic characteristics on mental health screening in primary care. In this retrospective cohort study, electronic medical record (EMR) data from a 14-month period from 10/15/2021 to 12/14/2022 were analyzed. Data were retrieved from 18 primary care clinics from the Corewell Health healthcare system in West Michigan. The main outcome was documentation of any Patient Health Questionnaire (PHQ-4/PHQ-9/GAD-7) screening in the EMR within the 14-month period at patient level. General linear regression models with logit link function were used to assess adjusted odds ratio (aOR) of having a documented screening. In total, 126,306 unique patients aged 16 years or older with a total of 291,789 encounters were included. The prevalence of 14-month screening was 79.8% (95% CI, 79.6-80.0). Regression analyses revealed higher screening odds for patients of smaller clinics (<5,000 patients, aOR 1.88; 95% CI 1.80-1.98 vs. clinics >10.000 patients), clinics in areas with mental health provider shortages (aOR 1.69; 95% CI 1.62-1.77), frequent visits (aOR 1.80; 95% CI, 1.78-1.83), and having an annual physical / well child visit encounter (aOR 1.52; 95% CI, 1.47-1.57). Smaller positive effect sizes were also found for male sex, Black or African American race, Asian race, Latinx ethnicity (ref. White/Caucasians), and having insurance through Medicaid (ref. other private insurance). The 14-month mental health screening rates have been shown to be significantly lower among patients with infrequent visits seeking care in larger clinics and available mental health resources in the community. Introducing and incentivizing mandatory mental health screening protocols in annual well visits, are viable options to increase screening rates.

Differences in Pertussis Incidence by Race and Ethnicity in the United States, 2010-2017.

An increased pertussis burden has been demonstrated among Hispanic or Latino and American Indian or Alaska Native (AI/AN) infants. However, data on potential disparities among other age and racial groups are limited. We analyzed pertussis cases reported through Enhanced Pertussis Surveillance from 2010 to 2017. Pertussis and severe pertussis incidence were calculated by race (White, Black or African American, AI/AN, and Asian or Pacific Islanders), ethnicity (Hispanic or Latino and non-Hispanic or non-Latino), and age. Compared with White persons, overall incidence was lower among Black or African American (incidence rate ratio [IRR], .57; 95% confidence interval [CI], .53-.61), AI/AN (IRR, 0.65; 95% CI, .58-.72), and Asian or Pacific Islander persons (IRR, 0.39; 95% CI, .35-.43). Overall incidence of pertussis was higher (1.5-fold; 95% CI, 1.37-1.60) among Hispanic or Latino compared with non-Hispanic or non-Latino adults, potentially related to household size or lower pertussis vaccine uptake among adult Hispanic or Latino cases. Severe pertussis incidence was similar among Black or African American and AI/AN persons compared with White persons. Among infants, severe pertussis incidence was 1.4-fold higher (95% CI, 1.03-1.82) among Black or African American infants than among White infants, and 2.1-fold higher (95% CI, 1.67-2.57) among Hispanic or Latino infants than non-Hispanic or non-Latino infants. The contrast between lower reported incidence but similar or higher severe pertussis incidence among Black or African American and AI/AN persons compared with White persons warrants further investigation and may reflect underdiagnosis or underreporting of mild disease.