Photo of Dr. Jeremy Goldbach
By Jeremy T. Goldbach, Ph.D., LMSW
Chair, USC Social Behavioral Institutional Review Board
Director, Center for LGBT Health Equity
University of Southern California
Suzanne Dworak-Peck School of Social Work
I remember it like yesterday. I stepped into the small, cramped meeting room of a local LGBTQ drop-in center. The room served triple duty as a social milieu, computer lab, and meeting room. Posters and homemade art covered the walls, displayed proudly everywhere the eye could see like wallpaper, almost demanding inspiration and hope from passive onlookers. The warm room, paired with the anxiety that no title or position can ever seem to overcome, made my hands clammy. I had arrived seeking feedback on an intervention we had been developing for nearly a decade. Bracing myself for the brutal honesty only found in adolescence, I opened the floor. “So, what do you think?” Continue reading “Don’t Forget the Good: Reflections from LGBTQ+ Youth Before and During COVID-19”
Addiction Should Be Treated, Not Penalized
NOTE: NIMHD Insights is reposting this op-ed piece with permission from the Health Affairs Blog. It is written by the Director of NIH’s National Institute on Drug Abuse (NIDA), Dr. Nora D. Volkow, and is available in Spanish on the NIDA website.
By Nora D. Volkow, M.D.
Director of the National Institute on Drug Abuse
Dr. Nora D. Volkow
The COVID-19 pandemic has highlighted the large racial health disparities in the United States. Black Americans have experienced worse outcomes during the pandemic, continue to die at a greater rate than White Americans, and also suffer disproportionately from a wide range of other acute and chronic illnesses. These disparities are particularly stark in the field of substance use and substance use disorders, where entrenched punitive approaches have exacerbated stigma and made it hard to implement appropriate medical care. Abundant data show that Black people and other communities of color have been disproportionately harmed by decades of addressing drug use as a crime rather than as a matter of public health.
We have known for decades that addiction is a medical condition—a treatable brain disorder—not a character flaw or a form of social deviance. Yet, despite the overwhelming evidence supporting that position, drug addiction continues to be criminalized. The U.S. must take a public health approach to drug addiction now, in the interest of both population well-being and health equity. Continue reading “Addiction Should Be Treated, Not Penalized”
Boulwared - Lab Coat
Black History Month
In Search of Equity: Rethinking Race and Racism in Science and Medicine
By L. Ebony Boulware, M.D., M.P.H.
Chief, Division of General Internal Medicine, Department of Medicine
Director, Duke Clinical and Translational Science Institute
Duke University School of Medicine
Dr. L. Ebony Boulware
Recent events compel us to reckon, yet again, with the ongoing legacy of systemic racism in the U.S. The merciless murders of George Floyd, Ahmaud Arbery, Breonna Taylor, and countless other Black individuals through police violence reflect an epidemic of brutality that manifests ongoing and profound racially mediated structural social inequities in the U.S. Compounding this, the recent higher COVID-19 death rates among Black and Hispanic communities have made it clear that race-based structural inequities are directly tied to poor health and further threaten the lives of Black and other minoritized individuals.1 These intersecting realities have brought many in the fields of science and medicine to consider how race and racism are harmfully operationalized through many aspects of our collective experiences. Continue reading “In Search of Equity: Rethinking Race and Racism in Science and Medicine”
Photo of Dr. Joseph Keawe‘aimoku Kaholokula
Joseph Keawe‘aimoku Kaholokula, Ph.D.
Professor and Chair
Department of Native Hawaiian Health
John A. Burns School of Medicine
University of Hawai‘i at Mānoa
The coronavirus disease 2019 (COVID-19) pandemic has spotlighted the health inequities of Native Hawaiians and Pacific Islanders (NHPI) and provided the podium from which to amplify their voices.
Historically, the voices of NHPI were drowned out by other numerically larger health-disparate racial/ethnic groups in the U.S. Their unique health concerns are often overlooked because their data has been aggregated—grouped together—with those of Asian Americans, an arbitrary practice that has done a disservice to both groups.1 NHPI know that resources follow the data, which is why they have been voicing their support for disaggregating—separating out—the data for NHPI and Asian Americans for decades, but to little avail.
Along comes COVID-19 to amplify their voices as to why data disaggregation is important. Continue reading “Amplifying the Voice of Native Hawaiian and Pacific Islander Communities Amid the COVID-19 Crisis”
NIMHD Co-authors - COVID-19 PI Forum
Jennifer Alvidrez, Ph.D.
Rick Berzon, Dr.P.H., P.A.
Dorothy Castille, Ph.D.
Nancy L. Jones, Ph.D., M.A.
CDR Nadra Tyus, Dr.P.H., M.P.H.
Division of Scientific Programs
The impact of the COVID-19 outbreak has strained daily life for people living in the United States, affecting nearly every sector including biomedical research. The disruption has also disproportionally affected the lives and livelihoods of populations that experience health disparities, which are also the populations that NIMHD’s research addresses.
To provide an opportunity to better understand the impact of COVID-19 on researchers and research funded by the institute, NIMHD hosted four COVID-19 NIMHD Investigator Forums this summer. NIMHD staff who hosted the events were Drs. Jennifer Alvidrez, Rick Berzon, Dorothy Castille, Nancy Jones and Nadra Tyus. We knew that the COVID-19 pandemic created many challenges for our research community and learned of the creative strategies they developed to navigate these challenges using their extensive connections with health disparity communities. We structured the forum to hear directly from NIMHD Principal Investigators (PIs) about their observations and thoughts in three areas:
1) Impact of COVID-19 on the communities where research is conducted
2) Strategies to modify recruitment, data collection, and/or intervention protocols
3) Understanding and addressing the impact of the pandemic on study outcomes. Continue reading “NIMHD Investigator Forums on the Impact of COVID-19 on Research Communities”
July Is the Best Month to Start a
New Year of Working on Mental Health
Harold W. Neighbors, Ph.D.
Division of Intramural Research
National Institute on Minority Health and Health Disparities
Dr. Harold W. Neighbors
When I started graduate school in the mid-1970s, I had just one seemingly simple research question. I wanted to know: “Who had the higher rate of mental illness, Black or White Americans?” I remember the puzzled looks from fellow students, as most of them already knew the answer – “Blacks of course!” Their reasoning made good sense – life was harder for Blacks in the United States, and a life spent fighting against racial discrimination can lead to emotional damage.
So, I began my investigation, uncovering layer after layer of complexity surrounding what I thought was a simple question. My motivations were both professional and personal. Personally, like many families, Black and White, mine had revealed a few semi-private stories about “bad nerves” (the preferred language of emotional distress used to describe mental health problems) that were offered for consumption in the smallest of morsels. And even though my curiosity was never quite satisfied, I instinctively knew not to push for too many details. Professionally, there was my first “big” assignment as a graduate research assistant on a new, innovative study, the “National Survey of Black Americans”1. I wrote my dissertation on one aspect of the subject: help-seeking behavior for mental health problems, using data from the National Survey of Black Americans. My dissertation research told me that Black Americans need to stop, look, listen, and most importantly, tell the truth about our feelings. The key to sound mental health is what people of color decide to do about profound sadness, feelings of helplessness resulting from attacks on our self-esteem, and hopelessness due to unjust institutional impediments that erode aspirations for achieving one’s best life2. My investigation revealed that when feelings become unbearably painful, they are symptoms. Once you are symptomatic, you need to get help. It is just that simple; and difficult; and complicated. Continue reading “National Minority Mental Health Awareness Month Blog Series”
American Indian/Alaska Native Mental Health: Our Voices, Traditions and Values to Strengthen our Collective Wellness
Victoria M. O’Keefe, Ph.D. (Cherokee/Seminole Nations of Oklahoma)
Mathuram Santosham Endowed Chair in Native American Health, Assistant Professor, Licensed Clinical Psychologist
Associate Director, Center for American Indian Health
Department of International Health, Social & Behavioral Interventions
Johns Hopkins Bloomberg School of Public Health
Dr. Victoria M. O’Keefe
My late grandma, Virginia Feather Revas, was a Cherokee Nation citizen, a fluent speaker of ᏣᎳᎩ ᎦᏬᏂᎯᏍᏗ (Cherokee language), and a Community Health Representative (CHR) for our tribe. CHRs are embedded within their tribe and serve important roles in health promotion for their communities.1 My grandmother served our tribe proudly and instilled in me the importance of working on behalf of our people. My favorite memories with her, from visits to Oklahoma, were going to our family’s creek to catch ᏥᏍᏛᎾ (crawfish) for dinner, attending stomp dances and pow wows, and admiring her talent for beadwork and quilt making. These memories are important teachings that I value now more than ever.
Continue reading “National Minority Mental Health Awareness Month Blog Series”
Centering Structural Inequities in Conversations on Mental Health Among People of Color
Margarita Alegría, Ph.D.
Chief, Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Mongan Institute
Professor, Departments of Medicine & Psychiatry, Harvard Medical School
Dr. Margarita Alegría
There has been tremendous attention brought to mental health as part of the coronavirus pandemic. The good news is that there is now almost universal recognition that when our mental health is precarious, costs are immeasurable. What has become more apparent is how this cost is much higher for people of color. But why is their burden of mental illness so much greater? What can help shed light on how mental illness impacts racial and ethnic minorities so adversely and profoundly, even when they have lower or similar prevalence rates of mental health disorders when compared to White people1? Continue reading “National Minority Mental Health Awareness Month Blog Series”