Population Health

The COVID-19 Pandemic Has Amplified the Effects of Racism on Mental Health

The COVID-19 Pandemic Has Amplified the Effects of Racism on Mental Health blog post
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Celia B. Fisher, Ph.D.
Marie Ward Doty University Chair in Ethics
Professor of Psychology
Director, Center for Ethics Education
Director, HIV/Drug Abuse Prevention Research Ethics Institute
Fordham University

Social Card for Insights Blog postPeople from racial and ethnic minorities in the United States have borne a disproportionately higher burden of COVID-19 infection and mortality. During the pandemic, depression and anxiety among American Indian/Alaska Native (AI/AN), Asian, Black, and Hispanic people have also increased. These disparities are rooted in long-standing racial and ethnic inequities in medical and behavioral health treatment utilization and access to culturally relevant health services.

Racial discrimination has long been documented as a psychosocial stressor among racial and ethnic minority individuals and national surveys indicate racism increased during the current pandemic. During the pandemic racially and ethnically marginalized persons in the U.S. were also more likely to be employed in the health care work force or as frontline workers in industries such as food services, pharmacies, personal care and public transportation. Employment in these positions not only increased risk of COVID-19 infection, but increased public perception that racial and ethnic groups were more likely to be infected with the coronavirus. Simultaneously, the U.S, saw an upsurge in racially based hate crimes, particularly directed against Asian Americans. The surge in racial bias and violence underscores the urgency of studying the effects of pandemic-related forms of victimization and discrimination on the mental health of racial and ethnic youth and adults in the U. S. Continue reading “The COVID-19 Pandemic Has Amplified the Effects of Racism on Mental Health”

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Embracing Community and Culture to Prevent Underage Drinking

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By George F. Koob, Ph.D.
Director, National Institute on Alcohol Abuse and Alcoholism

Photo of NIAAA Director, Dr. George F. KoobSupporting research to better understand and address alcohol-related health disparities and improve the health of underserved populations is one of the highest priorities of the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Among our efforts is NIAAA’s long-term investment in preventing underage drinking. Early initiation of alcohol consumption and heavy drinking increases the risk of alcohol use disorder (AUD) and related consequences over a person’s lifetime, and alcohol intervention efforts started at a young age can positively influence a young person’s path in life. Research indicates that prevention efforts involving the community and/or informed by the community’s cultural beliefs hold promise for preventing and reducing underage drinking.

In a decades-long project supported by NIAAA, Stacy Rasmus, Ph.D., at the University of Alaska, Fairbanks, in collaboration with the Yup’ik Native Alaskan community, is examining how tapping into a community’s culture can provide a cornerstone for youth substance misuse and suicide prevention efforts. Together, they developed the Qungasvik (Tools for Life)” Toolbox” intervention, which uses community, cultural, and historical connectedness to build protective factors against suicide and alcohol misuse at individual, family, and community levels. Research findings have shown that Qungasvik is effective in reducing co-occurring youth alcohol misuse and suicide risk, and ultimately, AUD and death by suicide. Continue reading “Embracing Community and Culture to Prevent Underage Drinking”

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Breast Cancer Is a Complex Journey

Breast Cancer Is A Complex Journey  
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By Faustine Williams Ph.D., M.P.H., M.S.
Stadtman Tenure-Track Investigator and NIH Distinguished Scholar
Health Disparities & Geospatial Transdisciplinary Research Program
Division of Intramural Research
National Institute on Minority Health and Health Disparities

Photo of Dr, Faustine Williams Although we have seen substantial progress over the last 30 years in breast cancer incidence and outcomes, geographical and racial/ethnic disparities across the cancer care continuum persist.1, 2  As shown in the NIMHD research framework, the factors contributing to these disparities are complex, numerous, and interrelated sets of individual, interpersonal, community, and societal determinants.3 However, early breast cancer detection or diagnosis and treatment initiation can lead to better outcomes. For example, the 5-year relative survival rate for localized-stage disease that has not spread to other sites/organs is 99.0%.4

Despite the advances in medicine and technology, cancer is still the word no one wants to hear. Years ago, when I interviewed breast cancer survivors about their experiences, they described it as a family experience because they could not have gone through it without the support from family and friends that helped them cope.5 The journey from diagnosis and treatment to survivorship does not just touch the affected individual, but family, friends, and loved ones as well. I thought I understood their stories, but I was wrong until I became the de facto caregiver to my friend/sister Yaa. Continue reading “Breast Cancer Is a Complex Journey”

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Storytelling Through Narrative Medicine: Measuring the Lived-Experiences of Black Women’s Reproductive Health

Storytelling Through Narrative Medicine: Measuring the Lived-Experiences of Black Women’s Reproductive Health
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By Shameka Poetry Thomas, Ph.D.
Postdoctoral Fellow
NIH Intramural Research Program
Health Disparities Unit
Social and Behavioral Research Branch
National Human Genome Research Institute

Dr. Shameka Poetry Thomas

Dr. Shameka Poetry Thomas

My grandmother was a traditional healer and a medicine-woman in Georgia’s rural South. Although I grew up in Miami’s Opa-Locka (a small urban neighborhood tucked between Miami-Gardens and the cusp of Hialeah / Little Havana), I spent most summers near middle Georgia’s farmland, listening to my grandmother. I observed how grandmother, who did not have a Ph.D., gathered Black women in circles. She described the process of listening to Black women’s pregnancies, births, and wellness experiences as “chitchatting and holding space.

Learning how to ‘hold space’ is what draws me to narrative medicine. My first dose of learning how to conduct narrative medicine, I suppose, came from my grandmother. This methodology (before I knew it was such) was simply understood as the process of sitting in kitchens and beauty salons in the South—just listening. During childhood, I was merely curious about how Black women described their pregnancies, births, and reproductive health—from their side of the story. Thus, when it came to reproductive health, my grandmother taught me a powerful tool: how to “hold space” for people’s narratives. Continue reading “Storytelling Through Narrative Medicine: Measuring the Lived-Experiences of Black Women’s Reproductive Health”

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All Health is Local: Measuring the Burden of Disease by U.S. County, Race/Ethnicity, and Socioeconomic Status

All Health Is Local
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Ali H. Mokdad, Ph.D.
Chief Strategy Officer, Population Health

Professor, Health Metrics Sciences
Institute for Health Metrics and Evaluation
University of Washington, Seattle

Ali Mokdad, Ph.D.

Ali Mokdad, Ph.D.

Despite greater public awareness about the social determinants of health, health inequities in the United States remain severe. Reducing disparities in health outcomes are a persistent challenge for policymakers, public health officials, and medical professionals. Due in part to these gaps, the U.S. underperforms against other industrialized countries in key health metrics, such as overall and healthy life expectancy. The reasons that the U.S. lags behind its peers are manifold. Most importantly, however, are the health discrepancies by geographic location, race/ethnicity, and socioeconomic status (SES). Understanding and reducing disparities among those most affected must be of central interest to policymakers to ensure that every person in the U.S. can lead a healthy life. A dearth of sufficient evidence on local health patterns produced from high-quality scientific research weakens our ability to understand the problem and design interventions. A particularly pressing need is for comprehensive and comparable examination of health outcomes for individuals in the U.S. by race/ethnicity and SES at the local level. Continue reading “All Health is Local: Measuring the Burden of Disease by U.S. County, Race/Ethnicity, and Socioeconomic Status”

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National Minority Mental Health Month: Reflections and Resources

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stock image of minorities in counseling circleMental illness does not discriminate, and more than 40 million Americans experience them each year regardless of race, ethnicity, gender identity, or socioeconomic status. July is National Minority Mental Health Month—a time to raise awareness about the unique psychological struggles that people from racial and ethnic minority communities face.

For National Minority Mental Health Month, NIMHD is sharing reflections and resources about the challenges, stigma, and access to mental health providers minorities often experience. We encourage you to educate yourself, your families, and your communities about mental health and emotional wellbeing. Continue reading “National Minority Mental Health Month: Reflections and Resources”

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Don’t Forget the Good: Reflections from LGBTQ+ Youth Before and During COVID-19

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Dr. Jeremy Goldbach

Photo of Dr. Jeremy Goldbach

By Jeremy T. Goldbach, Ph.D., LMSW
Associate Professor
Chair, USC Social Behavioral Institutional Review Board
Director, Center for LGBT Health Equity
Pronouns: He/Him
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”

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Addiction Should Be Treated, Not Penalized

Addiction Should Be Treated, Not Penalized
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

Photo of Dr. Nora Volkow

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”

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Other Impacts of COVID-19: Anti-Asian Hate

#stopasianhate

By Gilbert C. Gee, Ph.D.
Professor, Department of Community Health Sciences

UCLA Fielding School of Public Health
University of California, Los Angeles

Photo of Dr, Gilbert C. Ge

Dr. Gilbert C. Ge

The rise of COVID-19 coincided with a rise in reports about anti-Asian hate incidents in the U.S. and around the world in 2020. Analyses of social media data showed a massive 17,000% increase in negative sentiment against Asians that correlated with our former president’s infamous use of the phrase “China virus” in March of 2020, which directly contradicted calls by public health officials to use neutral terms such as “COVID-19.” 1 Other research confirms these trends2. Continue reading “Other Impacts of COVID-19: Anti-Asian Hate”

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In Search of Equity: Rethinking Race and Racism in Science and Medicine

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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

Photo of Dr. L. Ebony Boulware in a labcoat

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”

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