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Transmitting Trauma: A systematic review of vicarious racism and child health
Abstract
Racism is a pervasive stressor. Although most research focuses on direct targets, racism can also have unintended victims. Because children's lives are inevitably linked to the experiences of other individuals, and they are in critical phases of development, they are especially vulnerable to such stressors. Despite the growing body of literature on children's direct exposure to racism, little is known about the relationship between vicarious racism (i.e. secondhand exposure to racism) and child health. To examine the state of this literature, we performed a systematic review and screened 1371 articles drawn from 7 databases, with 30 studies meeting inclusion criteria. For these 30, we reviewed research methodology, including conceptualization and measurement of vicarious exposure, sample characteristics, significant associations with child health outcomes, and mediators and/or moderators of those associations. Most studies were published after 2011 in urban areas in the U.S., employed longitudinal designs, and focused on African American populations. Socioemotional and mental health outcomes were most commonly reported with statistically significant associations with vicarious racism. While all studies examined racism indirectly experienced by children, there was no standard definition of vicarious racism used. We organize the findings in a schematic diagram illustrating indirectly-experienced racism and child health outcomes to identify current gaps in the literature and ways in which to bridge those gaps. To further the field, vicarious racism should be uniformly defined and directly measured using psychometrically validated tools. Future studies should consider using children as the informants and follow children into early adulthood to better understand causal mechanisms. Given the recent national exposure to racially-charged events, a deeper understanding of the association between vicarious racism and child health is crucial in fueling research-informed social action to help children, families, and communities exposed to racism. PROSPERO registration number: CRD42016039608.
... 2 Racism also affects health throughout the life course by directly impacting AYA through different mechanisms altering their brain and bodies, parents' ability to protect and nurture AYA, and a neighborhood's ability to help AYA thrive. 3 Studies in adults have extensively documented the effects of psychological stress from racial discrimination. 4 More recent studies are beginning to illuminate how that same stress impacts the lives of adolescents. ...
... 6 Witnessing discrimination of their parents, often referred to as vicarious racism, also appears to have adverse effects on physiology, asthma, and poor sleep. 3,5,7 Furthermore, when vicarious racism affects neighborhoods, it contaminates all structural systems AYA interact with by decreasing access and receipt of health and social services, augmenting the disproportionate disciplinary referrals AYA of color receive (eg, suspensions and entry into the juvenile justice system), and increasing the involvement of child welfare systems. 3 Unfortunately, health care providers often underestimate the pervasiveness of racism in US culture and how racism impacts (overtly and subconsciously) the care they provide. ...
... 3,5,7 Furthermore, when vicarious racism affects neighborhoods, it contaminates all structural systems AYA interact with by decreasing access and receipt of health and social services, augmenting the disproportionate disciplinary referrals AYA of color receive (eg, suspensions and entry into the juvenile justice system), and increasing the involvement of child welfare systems. 3 Unfortunately, health care providers often underestimate the pervasiveness of racism in US culture and how racism impacts (overtly and subconsciously) the care they provide. This disconnection by providers was exemplified recently when a Journal of the American Medical Association editor's podcast proclaimed that physicians could not be racist. ...
Racism is woven within the fabric of the United States culture, structures, and systems, including its healthcare system. There is extensive research on adults demonstrating racial discrimination's physical and mental health impacts, and the evidence showing similar disproportionate effects for adolescents of color continues to grow. Furthermore, the devastation of the coronavirus pandemic has paralleled the resurgence of white nationalism movements and adverse outcomes associated with the over-policing of Black and Brown communities. Scientific evidence continues to illustrate how sociopolitical determinants of health and experiencing vicarious racism amplify overt racism and implicit bias actions individually and within health care structures. Therefore, evidence-based strategic interventions are desperately needed to ensure the health and well-being of adolescents and young adults.
... Research has focused on experiences of interpersonal discrimination in which youth are directly mistreated by their peers, teachers, or other adults based on their race and ethnicity. However, a growing body of literature now documents youth's exposure to vicarious racism and its links to youth's health and wellbeing (see Heard-Garris et al., 2018, for a review). Still, the acknowledgment of youth's exposure to family-level vicarious racism as articulated in the abovementioned examples is largely missing. ...
... We expand this work to center youth's active awareness of family members' experiences. That is, in addition to the documented downstream effects of transmitting trauma (Heard-Garris et al., 2018), such as parenting processes that occur after a discriminatory event takes place, youth may exhibit their own psychosocial and biobehavioral outcomes in direct response to the discriminatory encounter if they are present or actively aware of it. ...
... The extent to which the type and target affect youth outcomes may be closely linked to youth's emotional proximity and degree of perceived similarity to the family member that is victimized. We are aware of no research on emotional proximity in the context of experiences of racial discrimination (Heard-Garris et al., 2018). However, we can draw from evidence in research on community violence to postulate how emotional proximity may relate to the impact of family-level vicarious racism. ...
Vicarious exposure to discrimination can result in multiple negative outcomes in youth. In this article, we offer a conceptual model that articulates the intersecting contextual factors and potential moderators for U.S. Latine youth's exposure to family‐level vicarious racism, and explore how that affects youth and family responses. We define and describe youth's exposure to family‐level vicarious racism, considering the ramifications of these experiences through family processes and cultural values. We conclude by arguing that research on discrimination and racism in Latine families needs to account for family‐level processes.
... Despite burgeoning research on this topic, a key limitation to the study of vicarious racism is a lack of validated self-report instruments. Indeed, in a systematic review of 30 studies of vicarious racism among children, the authors described a lack of psychometrically validated measures to assess this construct [14]. Among these studies and others that focus on adults, authors have adapted measures of direct racism or created their own scales for assessing vicarious racism, without assessing factor structure, reliability, and validity [12][13][14][15][16][17][18]. ...
... Indeed, in a systematic review of 30 studies of vicarious racism among children, the authors described a lack of psychometrically validated measures to assess this construct [14]. Among these studies and others that focus on adults, authors have adapted measures of direct racism or created their own scales for assessing vicarious racism, without assessing factor structure, reliability, and validity [12][13][14][15][16][17][18]. For example, the aforementioned study that assessed the association between vicarious racism and SLE disease activity among Black women created their own four-item measure of vicarious racism [12]. ...
... Although this measure was developed through a literature review of vicarious racism, additional studies are needed that assess its psychometric properties. Validating measures of vicarious racism may also promote standardization of definitions and tools, which can further the field conceptually and through meta-research [14]. ...
Vicarious racism occurs when hearing about or observing people of the same racial and/or ethnic group experience racism. Healthcare workers may face unique experiences of vicarious racism through witnessing or hearing about racism that their patients and colleagues face. However, there are no validated measures of vicarious racism for the healthcare worker population. In this study, we developed and conducted an initial evaluation of the Vicarious Racism in Healthcare Workers Scale. We developed the 12-item scale based on a qualitative study exploring the experiences of racism among healthcare workers and existing literature on the topic. We administered the scale to a cohort of 259 healthcare workers identifying as a racialized minority to evaluate its factor structure, internal consistency, and construct validity. Factor analysis yielded two factors: racism in social networks and racism in society at-large. This two-factor solution had good model fit (standardized root mean square residual = 0.061). The internal consistencies of the overall scale, social networks subscale, and society subscale were excellent (α = 0.93, 0.92, and 0.89, respectively). We found evidence in support of convergent validity; scale scores were higher among Black healthcare workers compared with non-Black healthcare workers and those with greater social support needs. Scale scores were positively correlated with directly experienced racism and symptoms of posttraumatic stress, depression, and anxiety. The scale demonstrated discriminant validity; scale scores did not differ based on gender or job. The Vicarious Racism in Healthcare Workers Scale demonstrated favorable psychometric properties and may be used to assess vicarious racism in this population.
... In the racial socialization context, parental capacity for perspective taking and empathy can be made more challenging because of the threat that racism and discrimination pose Heard-Garris et al., 2018;Smith-Bynum et al., 2016). It is distressing for parents to hear about discriminatory incidents their children experience Heard-Garris et al., 2018;Peters & Massey, 1983). ...
... In the racial socialization context, parental capacity for perspective taking and empathy can be made more challenging because of the threat that racism and discrimination pose Heard-Garris et al., 2018;Smith-Bynum et al., 2016). It is distressing for parents to hear about discriminatory incidents their children experience Heard-Garris et al., 2018;Peters & Massey, 1983). It is distressing for parents to be the cope with racial discrimination (Condon et al., 2022) and to process racist events happening to friends and family members or in the news (Anderson, Jones et al., 2020;Bor et al., 2018;Smith-Bynum et al., 2016). ...
Critical action—defined as actions and behaviors aimed at disrupting systems of oppression—is a developmental asset for Black and Latinx youth. Over the past two decades, research on Black and Latinx youth’s critical action has proliferated, particularly with respect to the development of quantitative measures. In this chapter, we review current conceptualizations and measures of critical action. We then highlight potential barriers (e.g., citizenship status) and facilitators (e.g., ethnic-racial identity) of critical action for Black and Latinx youth, with special consideration of differences during childhood, adolescence, and adulthood. Our review reveals the need for further measurement development that accounts for (1) experiences unique to specific ethnic-racial groups, (2) a wider spectrum of critical action, and (3) intention, frequency, and risk of critical action. We also assert that future research should consider how various contextual and demographic factors impact critical action across the lifespan. We conclude with recommendations for research on Black and Latinx youth’s critical action.KeywordsCritical actionBlack youthLatinx youthMeasurementRacismSociopolitical development
... In the racial socialization context, parental capacity for perspective taking and empathy can be made more challenging because of the threat that racism and discrimination pose Heard-Garris et al., 2018;Smith-Bynum et al., 2016). It is distressing for parents to hear about discriminatory incidents their children experience Heard-Garris et al., 2018;Peters & Massey, 1983). ...
... In the racial socialization context, parental capacity for perspective taking and empathy can be made more challenging because of the threat that racism and discrimination pose Heard-Garris et al., 2018;Smith-Bynum et al., 2016). It is distressing for parents to hear about discriminatory incidents their children experience Heard-Garris et al., 2018;Peters & Massey, 1983). It is distressing for parents to be the cope with racial discrimination (Condon et al., 2022) and to process racist events happening to friends and family members or in the news (Anderson, Jones et al., 2020;Bor et al., 2018;Smith-Bynum et al., 2016). ...
This chapter applies critical multiracial theory to advance the conceptualization and measurement of multiracial experiences and identity in developmental science. We aim to illustrate the complexity in how multiracials navigate, negotiate, and challenge (mono)racism and white supremacy in the United States. First, we investigate the historic exclusion and invisibility of multiracials in developmental science, as well as how multiracials complicate traditional understandings of racism, racial formation, and racial identity. Next, we review past and present approaches taken to study the theory and measurement of multiracial experiences and identity. In addition, we introduce a new Model of Multiracial Racialization that situates multiracial racialization experiences (including racial identity, racial identification, and racial category) within six ecological levels: (1) Individual Characteristics; (2) Interpersonal Experiences; (3) Contextual Factors; (4) Social, Economic, and Political Environments; (5) Systems of Oppression; and (6) Time. Finally, we offer specific examples of research topics and questions that attend to each level of our model with the hope of stimulating future research and advancing our developmental science understanding of multiraciality.KeywordsMultiracial Racial identity Multiracial racialization Racial formation Critical race theory
... In the racial socialization context, parental capacity for perspective taking and empathy can be made more challenging because of the threat that racism and discrimination pose Heard-Garris et al., 2018;Smith-Bynum et al., 2016). It is distressing for parents to hear about discriminatory incidents their children experience Heard-Garris et al., 2018;Peters & Massey, 1983). ...
... In the racial socialization context, parental capacity for perspective taking and empathy can be made more challenging because of the threat that racism and discrimination pose Heard-Garris et al., 2018;Smith-Bynum et al., 2016). It is distressing for parents to hear about discriminatory incidents their children experience Heard-Garris et al., 2018;Peters & Massey, 1983). It is distressing for parents to be the cope with racial discrimination (Condon et al., 2022) and to process racist events happening to friends and family members or in the news (Anderson, Jones et al., 2020;Bor et al., 2018;Smith-Bynum et al., 2016). ...
Children, youth, and families who are displaced from or voluntarily leave their homelands, such as refugees, migrant workers, third culture children and adults, international students and scholars, and transnational adoptees, are largely overlooked in developmental science. Based on their unique migration histories, they experience mixed feelings about their real or imagined homelands, different forms of discrimination and racism, and challenges to developing a sense of place and belonging in hostlands across generations. In this chapter, we provide a conceptual lens to understand how diaspora as a social and psychological phenomenon can affect different domains of human development (e.g., acculturation, parent-child relationships, ethnic-racial identity development, and ethnic-racial socialization) and highlight correlates and consequences of the diaspora experience (e.g., discrimination, health, and well-being). We present a person-level perspective that attends to the diversity of lived experiences for diasporic individuals and families, positioned within specific sociohistorical contexts and structural forces of racism, classism, and sexism. Throughout this chapter, we also situate ourselves as authors from unique diaspora communities. We conclude with recommendations for how to best study this growing but overlooked population.KeywordsDiasporaImmigrant communitiesIndividual differencesAcculturationEthnic-racial identityEthnic-racial socialization
... Similarly, the clusters of health outcome 22:4 measures that were examined by cross-sectional design included infant health outcomes [26,29,30,50], chronic conditions [27,47,48,53], access and quality of healthcare [49,52], quality of life [30,47,48], communicable diseases [22,32], and mental health [28,31]. The other study designs that were found in the studies include case (n = 1/54 articles; 1.9%) [59], cohort (n = 2/54 articles; 3.7%) [60,61], ecological (n = 2/54 articles; 3.7%) [62,63], longitudinal cohort (n = 2/54 articles; 3.7%) [64,65], longitudinal randomized controlled trial (n = 1/54 articles; 1.9%) [66], non-experimental survey (n = 3/54 articles; 5.7%) [67][68][69], prospective study (n = 1/54 articles; 1.9%) [70], quasiexperimental (n = 1/54 articles; 1.9%) [11], retrospective cohort (n = 1/54 articles; 1.9%) [71], sequential quantitative and qualitative (n = 1/54 articles; 1.9%) [72], exploratory qualitative (n = 3/54 articles; 5.7%) [73][74][75], grounded theory (n = 1/54 articles; 1.9%) [76], integrative review (n = 1/54 articles; 1.9%) [77], metaanalysis (n = 2/54 articles; 3.7%) [78,79], and policy surveillance (n = 1/54 articles; 1.9%) [13] (Fig. 4). ...
... The other methodological challenges were related to sample size and sampling method (n = 3/54 articles; 5.5%) [54,64,66,68], study population (n = 4/54 articles; 7.4%) [40,65,74,76], study duration (n = 1/54 articles; 1.9%) [13], study approach (n = 3/54 articles; 3.5%) [45,72,73], lack of availability of data on structural level (n = 2/54 articles; 3.7%) [57,68], weighted SODH score (n = 1/54 articles; 1.9%) [71], use of secondary data (n = 1/54 articles; 1.9%) [28], bias, confounding and misclassification (n = 2/54 articles; 3.7%) [29,32]. Although cross-sectional was commonly used study design, it was associated with several methodological challenges and limitations in terms of temporal ordering of variables, biases towards type II errors for physical outcomes. ...
Background
Globally, structural racism has been well documented as an important social determinant of health (SODH) resulting in racial inequality related to health. Although studies on structural racism have increased over the years, the selection of appropriate designs, measures, and indexes of measurement that respond to SODH has not been comprehensively documented. Therefore, the lack of evidence seems to exist. This scoping review was conducted to map and summarize global evidence on the use of various designs, measures, and indexes of measurement when studying structural racism as a social determinant of health.
Methods
We performed a scoping review of global evidence from 2000 to 2022 published in 5 databases: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, Web of Science, ProQuest, and relevant grey literature on structural racism. We conducted a systematic search using keywords and subject headings around 3 concepts. We included peer reviewed original research/review articles which conceived the framework of social determinants of health (SODH) and studied structural racism.
Results
Our review identified 1793 bibliographic citations for screening and 54 articles for final review. Articles reported 19 types of study design, 87 measures of exposure and 58 measures of health outcomes related to structural racism. 73 indexes or scales of measurement were used to assess health impacts of structural racism. Majority of articles were primary research ( n = 43/54 articles; 79.6%), used quantitative research method ( n = 32/54 articles; 59.3%) and predominantly conducted in the United States ( n = 46/54 articles; 85.2.6%). Cross-sectional study design was the most used design ( n = 17/54 articles; 31.5%) followed by systematic review ( n = 7/54 articles; 13.0%) and narrative review ( n = 6/54 articles; 11.1%). Housing and residential segregation was the largest cluster of exposure with the highest impact in infant health outcome.
Conclusions
Our review found several key gaps and research priorities on structural racism such as lack of longitudinal studies and availability of structural or ecological data, lack of consensus on the use of consolidated appropriate measures, indexes of measurement and appropriate study designs that can capture complex interactions of exposure and outcomes related to structural racism holistically.
... Another reason why this is important to understand is because there is mounting evidence that exposure to vicarious structural racism-defined as witnessing the effects of racist structural conditions or practices on members of one's own racial or ethnic group [20,21]-may negatively impact the health of minoritized people [22][23][24]. Much of the research in this area has used a quasi-experimental design comparing health indicators before and after a racialized event, such as an immigration raid [22] or police shootings of unarmed Black people [23]. ...
... The results of this study suggest that Twitter users were aware of the role of structural racism in the FWC. Given the growing body of research demonstrating that vicarious, or second-hand, exposure to racism can negatively impact health [20,[22][23][24], our findings could have implications for minority health and health disparities. More work is needed to understand the public health impacts of the FWC, including impacts on those who were not directly exposed to the lead-contaminated water in Flint. ...
The Flint Water Crisis (FWC) was an avoidable public health disaster that has profoundly affected the city’s residents, a majority of whom are Black. Although many scholars and journalists have called attention to the role of racism in the water crisis, little is known about the extent to which the public attributed the FWC to racism as it was unfolding. In this study, we used natural language processing to analyze nearly six million Flint-related tweets posted between April 1, 2014, and June 1, 2016. We found that key developments in the FWC corresponded to increases in the number and percentage of tweets that mentioned terms related to race and racism. Similar patterns were found for other topics hypothesized to be related to the water crisis, including water and politics. Using sentiment analysis, we found that tweets with a negative polarity score were more common in the subset of tweets that mentioned terms related to race and racism when compared to the full set of tweets. Next, we found that word pairs that included terms related to race and racism first appeared after the January 2016 state and federal emergency declarations and a corresponding increase in media coverage of the FWC. We conclude that many Twitter users connected the events of the water crisis to race and racism in real-time. Given growing evidence of negative health effects of second-hand exposure to racism, this may have implications for understanding minority health and health disparities in the US.
... Further expanding on critical consciousness theory that suggests discriminatory experiences could trigger critical reflection for minoritized adolescents. It can be speculated that exposure to broader media coverage on social injustices might act as an experience of discrimination and trigger critical consciousness for immigrant adolescents (Heard-Garris et al., 2018;Mathews et al., 2020). ...
Immigrants currently account for close to 14% of the United States’ population with one in four children growing up in an immigrant household. Yet, little is known about how immigrant parents and their adolescents dialogue about race and ethnicity within the evolving sociopolitical environment. Traditionally, the adolescents’ role in racial-ethnic socialization (RES) has been conceptualized as receivers of messages around race and ethnicity from their parents. However, differential rates at which adolescents and parents acculturate to the mainstream society could lead the adolescent to possess a more contemporary understanding of the social and racial landscape in the United States, thereby becoming the “deliverer” of messages on racial socialization rather being just a “receiver.” To inform our understanding of the potential process of how adolescents might be positioned to socialize their parents on race/ethnicity, this paper integrates key aspects of RES, racial-ethnic identity, and critical consciousness among Latinx and Asian immigrant adolescents to inform a conceptual model of adolescent-directed RES. The current conceptual model highlights several important avenues for future research to empirically assess individual and familial factors associated with adolescent-directed RES.
... Considera-se que o racismo possui uma série de efeitos negativos, sobre o desenvolvimento cognitivo e social das crianças; está associado ao baixo desempenho acadêmico; a problemas externalizantes de comportamento (ex: agressividade) e quadros de ansiedade e depressão (Heard-Garris et al., 2018;Rutland & Killen, 2015). Ademais, verifica-se que as intervenções para o combate ao racismo na infância não só favorecem à saúde e bem-estar das crianças negras, mas também auxiliam a prevenir expressões de preconceito e discriminação, na fase adulta, período em que atitudes racistas estão mais consolidadas e resistentes à modificação (Devine et al., 2012;Williams & Mohammed, 2013). ...
O presente estudo é resultado de um projeto interventivo realizado em uma escola pública de ensino fundamental, na cidade de Aracaju (Sergipe, Brasil), com a finalidade de promover ações de combate ao racismo entre os alunos e, ao mesmo tempo, desenvolver estratégias de valoração da identidade racial das crianças e adolescentes negros. Essa iniciativa foi amparada no projeto de trabalho de extensão da Universidade Federal de Sergipe. Trabalhamos com aproximadamente 80 alunos, do 1º ao 5º ano do ensino fundamental, a maioria negra. Foram realizadas atividades planejadas para intervir nos seguintes eixos: Autoaceitação: valorização positiva da identidade social; Reconhecimento das diferenças e respeito à diversidade; Desenvolvimento de atitudes positivas para diferentes grupos. Os resultados evidenciaram mudanças na identidade racial das crianças, pelo aumento da autoestima individual e grupal, orgulho racial e atitudes intergrupais positivas. Palavras-chave: Escola; Identidade racial; Combate ao racismo; Intervenção.
... Vicarious trauma can influence children's beliefs in a fair and just world, and accompanying feelings of despair and helplessness that can come with living in a world that is unfair, unjust, and unsafe (Heard-Garris et al., 2018). Several recent studies have documented the deleterious impact of the police killing of a Black person, not only on Black people in the immediate community where the murder took place, but also on Black people outside that community. ...
This newsletter entry aims to educate practitioners about the foundational concepts of trauma. It defines four types of trauma, and how each of them relates to societal injustice. Implications for trauma-informed care are discussed.
... It is likely that many of the parents in our study were describing vicarious discrimination -or secondhand exposure to discrimination via someone else's experience (Agnew, 2002). Several studies have documented the psychological consequences of vicarious discrimination, particularly among parents who experience discrimination indirectly through their children (Heard-Garris et al., 2018;Herda, 2021). This may be particularly relevant for our participants due to the centrality of the family and implications of familial connections in LDS culture, as parents must also face microaggressions that specifically target them for their role as a parent of an LGBTQ+ teen. ...
Like other teens in conservative religious environments, LGBTQ+ teens raised in the Church of Jesus Christ of Latter‐day Saints (CJCLDS) likely experience unique microaggressions. Furthermore, like other conservatively religious parents of LGBTQ+ teens, active Latter‐day Saint (LDS) parents who openly support their LGBTQ+ teens likely both witness microaggressions toward their teens and may personally experience microaggressions. The present study sought to understand parents' and teens' experiences of microaggressions in conservative religious contexts by focusing specifically on the microaggressions experienced by (a) LGBTQ+ teens raised in the CJCLDS and (b) their active LDS parents. Thematic analysis of separate interviews with 19 dyads of LGBTQ+ teens and their active LDS parents (38 total interviews) revealed various ways in which they experienced verbal, nonverbal, and environmental microaggressions. We highlight parents' and teens' shared experiences of microaggressions that may be uniquely related to their religious contexts, such as assumptions that LGBTQ+ teens or their parents are not faithful and exclusionary Church policies. Additionally, we identified microaggressions that specifically targeted parents of LGBTQ+ teens, such as comments suggesting parents should limit their support for their teens. Finally, we found that parents had vicarious experiences with microaggressions through witnessing or learning about microaggressions that targeted their teens. Findings highlight the ways that the religious contexts in which microaggressions occur can influence the way that microaggressions are communicated to and experienced by LGBTQ+ teens – and their parents.
... In addition to uncertainty, vicarious racism, defined as "secondhand exposure to the racial discrimination and/or prejudice directed at another individual" (Heard-Garris et al., 2018), was also a source of distress among educators working with immigrant communities. Some participants noted feeling pain in regards to the racism their community was experiencing. ...
A growing body of literature indicates that Latinx immigrant families are adversely affected by restrictive immigration policies and anti-immigrant rhetoric. Little is known about how educators working with Latinx immigrant communities in restrictive immigration climates fare. Using mixed-methods, this study sought to better understand how the work and well-being of educators working with Latinx immigrant communities can be affected by a charged immigration climate. Using survey data from 88 educators in New York City and interview data from 17 educators in New York, California, Arizona, and Texas, we find that efficacy to help distressed children varies among educators. School-based resources such as clear, proactive organizational communication, supportive leadership that is attune to the needs and strengths of the immigrant community and communal coping are associated with educator efficacy to address student distress. Qualitative findings triangulate quantitative data; absent structural supports, educators working in Latinx immigrant communities can be adversely impacted by a charged immigration climate due to increases in work complexity, their own immigration-related worry, and experiences of vicarious racism. Recommendations for supports for educators working with Latinx immigrant communities are discussed.
... Personal and vicarious discrimination One factor that may be relevant in understanding how A/ AA experience COVID-related racism is whether they personally or vicariously (i.e., indirectly) experienced discriminatory incidents. Although studies typically document the negative effects of personal discrimination, vicarious discrimination may also be harmful to BIPOC because it transmits racial trauma and pervasive stress to a broader community (Heard-Garris et al., 2018). Therefore, the examination of personal discrimination does not fully capture A/AA experiences of racial discrimination. ...
Despite appearing positive, the model minority myth (MMM), or the perception that Asian Americans are "problem-free" minorities, maintains unfair racial hierarchies and discredits the pervasiveness of systemic racism faced by Asian Americans and other Black, Indigenous, and people of Color. This study investigated the role of internalized MMM in Asian/Asian Americans' (A/AA) experiences during the syndemic of COVID-19 and our society's racial reckoning. Using a mixed methods approach, we analyzed A/AA college students' open-ended responses to a query about their experiences as A/AA during COVID-19, which resulted in qualitative themes of Personal and Vicarious Discrimination, Vigilance, Safety due to Ethnicity, Safety due to Environment, and No Difference during COVID-19. We then conducted a series of logistic and linear regression models to examine how internalized MMM and sociodemographic factors (i.e., ethnic group, gender, and generational status) were associated with qualitative themes and quantitative measures of COVID-related discrimination. Overall, findings demonstrated that greater internalized MMM, as well as identifying as South Asian, male, and an international/first-generation immigrant student, were linked to fewer qualitative and quantitative reports of vicarious discrimination. We conclude with implications for research and practice in community psychology that further examine the racialized experiences among A/AA college students and ultimately seek to challenge the MMM and racial hierarchies perpetuating systems of oppression.
... For example, living in areas with higher rates of hate crimes is associated with poor physical health outcomes, including hypertension, diabetes, and obesity (17). Similarly, witnessing discrimination during childhood has been linked to a broad array of socioemotional and mental health consequences (18). Extant research on vigilance demonstrates that anticipating discrimination is associated with sleep impairment (19), obesity (20), and depressive symptoms (21). ...
The onset of the COVID-19 pandemic spurred increased racial animus toward Asians and Asian Americans (A/AA) who have since been contending with increased racism and violence. While some of the harm associated with this increased prejudice may derive from personally experienced discrimination, the COVID-19 pandemic has also been marked by an increase in vicarious exposure to discrimination as well as increased anticipation of discrimination, both of which may be taxing for the mental and physical health of A/AA. The goal of this study, accordingly, was to examine the effects of personal experiences of discrimination, vicarious exposure to discrimination, and anticipated discrimination on depressive symptoms, physical health symptoms, sleep quality, and sleep disturbances among A/AA. Results from our two-wave field survey demonstrated that experiencing and anticipating discrimination were associated with mental and physical health symptoms as well as sleep disturbances. Further, personal experiences of discrimination interacted with vicarious discrimination to determine physical health symptoms such that greater vicarious exposure weakened the relationship between experienced discrimination and physical health symptoms. These findings demonstrate the need to mobilize resources to combat the multipronged, negative implications of the recent rise in anti-Asian prejudice during the COVID-19 pandemic.
... It is no surprise that marginalized children and adolescents face interlocked manifestations of oppression at the individual and community level due to systemic racism. Numerous studies have demonstrated the deleterious impact of DOPRS on mental health and well-being (e.g., Heard-Garris et al., 2018;Huynh, 2012;Jones & Neblett, 2017;Pachter & Coll, 2009;Trent et al., 2019). Not only have DOPRS been shown to impact child and adolescent development, but these effects also have implications for adulthood as it is described as a social determinant of health and impacts mental and physical health (e.g., depression, anxiety, trauma, heart health; Currie et al., 2019;Hope et al., 2015). ...
Youth from historically marginalized racial and/or ethnic backgrounds often face discrimination, oppression, prejudice, racism, and segregation (DOPRS). These experiences, in turn, impact well-being and psychological functioning. Though the field of clinical child psychology is on the path to address DOPRS in clinical practice, there is sparce guidance for clinicians. Liberation psychology aims to address oppression through understanding history, acknowledging and naming DOPRS, community solidarity, and healing. Liberation psychology may be a vehicle for clinical child psychologists to address the impacts of DOPRS and empower children and adolescents to promote joy and healing within clinical settings. The literature is reviewed and synthesized to provide practical guidance so clinical child psychologists may translate liberation psychology into clinical practice. Several conceptual frameworks are presented that may help in implementing liberation psychology. Suggestions are provided for how clinical child psychologists may move beyond notions of cultural competence to a psychologist-activist model. Specific methods to create a foundation of liberation psychology in mental health treatment are discussed, such as utilizing empowerment, community, critical consciousness, and ethnic-racial socialization. Finally, specific practice considerations are provided for clinical child psychologists when applying liberation psychology in treatment.
... 64 Systematic racism, ''a system of structuring opportunity and assigning value based on the social interpretation of how one looks (page 1),'' 65 is a known SDOH 66 that has negative consequences for childhood health. [66][67][68][69][70] Nonetheless, racism is not currently incorporated in conventionally used SDOH frameworks-including the Healthy People 2020 framework. ...
Objective: To examine the associations between social determinants of health (SDOH) and prevalent overweight/obesity status and change in adiposity status among American Indian and Alaska Native (AI/AN) children. Methods: The study sample includes 23,950 AI/AN children 2-11 years of age, who used Indian Health Service (IHS) from 2010 to 2014. Multivariate generalized linear mixed models were used to examine the following: (1) cross-sectional associations between SDOH and prevalent overweight/obesity status and (2) longitudinal associations between SDOH and change in adiposity status over time. Results: Approximately 49% of children had prevalent overweight/obesity status; 18% had overweight status and 31% had obesity status. Prevalent severe obesity status was 20% in 6-11-year olds. In adjusted cross-sectional models, children living in counties with higher levels of poverty had 28% higher odds of prevalent overweight/obesity status. In adjusted longitudinal models, children 2-5 years old living in counties with more children eligible for free or reduced-priced lunch had 15% lower odds for transitioning from normal-weight status to overweight/obesity status. Conclusions: This work contributes to accumulating knowledge that economic instability, especially poverty, appears to play a large role in overweight/obesity status in AI/AN children. Research, clinical practice, and policy decisions should aim to address and eliminate economic instability in childhood.
... Finally, children from low-income backgrounds have higher levels of exposure to trauma, including natural disasters and community violence (Lieberman-Cribbin et al. 2021, Rosen et al. 2018. Further, children from impoverished and minoritized backgrounds are often more likely to experience racialized trauma through direct or vicarious discriminatory experiences (Heard-Garris et al. 2018). Thus, these children often present with greater levels of trauma symptoms, including hyperarousal, hypervigilance, and dissociation (Osofsky et al. 2017, Perry et al. 1995. ...
Given the high rates of child poverty in the United States, socioeconomic disparities exist regarding children's physical and mental health. These disparities are particularly pronounced for children of color, who are more likely to experience poverty compounded by the vestiges of historical and systemic racism. Physical health disparities include higher rates of mortality, growth impairments, allergies, respiratory difficulties, tooth decay, and injuries. Disparities have also been found in the mental health arena, including a higher likelihood of internalizing and externalizing disorders, as well as trauma symptoms, and differences in the timing of diagnosis of, types of, and treatments for mental health disorders. Familial, neighborhood, service, and systemic contextual factors further solidify these disparities. It is critical to address the structural causes of these disparities and their consequences to promote more positive outcomes in affected children. A system of care that integrates economic programs, child care and education supports, parenting interventions, and appropriate physical and mental health care is essential to meet the health needs of children from impoverished backgrounds.
Expected final online publication date for the Annual Review of Developmental Psychology, Volume 4 is December 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
... Exposure to online racial/ethnic discrimination has been associated with more mental health concerns [22,26] and unhealthy behaviors such as alcohol use [28] among adolescents and young adults of color. Vicarious exposure to online racial/ethnic discrimination is also associated with worse health outcomes for adults [37] and youth [38]. For example, adolescents' exposure to media-based vicarious racial/ ethnic discrimination generates feelings of helplessness that contribute to depressive symptoms and negative emotion cycling [39]. ...
Sleep quality in young adulthood sets the stage for long-term health. Racial/ethnic sleep disparities between White college-attending young adults and college-attending young adults of color exist. The stress of experiencing racial/ethnic discrimination makes it difficult for college-attending young adults of color to get good quality sleep. Yet it remains unclear if experiencing online racial/ethnic discrimination also has consequences for sleep quality, and if this association may vary by frequency of social media use. To investigate the role of racial/ethnic discrimination on sleep quality, we conducted an online survey of 154 college-attending young adults (Mage = 19.51) who identified as Black (42.2%), Latinx (16.9%), Asian (20.8%), or Bi-/multi-racial (20.1%) from a predominantly White university. Results indicated that more exposure to racial/ethnic discrimination was associated with worse sleep quality for young adults of color. Results suggest that online racial/ethnic discrimination has a similar negative impact on sleep quality regardless of the frequency of social media use. Increased attention to negative race-related experiences online as one potential risk factor for poor long-term health for young adults of color is needed, regardless of how many hours they spend on social media. Structural interventions, screening for stress due to exposure to online racial/ethnic discrimination, and facilitating opportunities to prepare for this exposure may be an important priority for sleep health and reduction of racial/ethnic health disparities.
Social media platforms (i.e., Twitter, Tik Tok, YouTube, Snapchat) transmit
traumatic imagery of racist encounters that dehumanize racially marginalized
Americans. Behavioral and social sciences have long documented the adverse
effects of media on young adults which include negative physical and mental
health outcomes. However, evidence is sparse on the health-related impact
of viewing gender-specific, racially motivated violence via social media.
Through an interdisciplinary approach, with theories from psychology, sociology, and communications, we propose a novel framework called the
Vicarious Intersectional Trauma (VIT) Conceptual Model. The proposed
model situates the Racial Encounter Coping Appraisal and Socialization
Theory (RECAST) as a foundational theory understanding the pathways by
which traumatic racial encounters impact health among Black Americans.
We expand on RECAST by integrating Agenda Setting Theory, Cultivation
Theory, and Intersectionality Theory, to facilitate a better understanding
of the health-related implications of consuming intersectional violence on
social media. Our interdisciplinary work contributes to literature promoting
health equity by expanding an existing theory to address the intersections of
gender and race on the perception of traumatic imagery and how genderedracial socialization affects subsequent coping mechanisms.
Research has consistently linked discrimination and poorer health; however, fewer studies have focused on immigration-related discrimination and mental health outcomes. Drawing on quantitative surveys (N = 1,131) and qualitative interviews (N = 63) with Latino undergraduate students who are undocumented or U.S. citizens with undocumented parents, we examine the association between perceived immigration-related discrimination and mental health outcomes and the process through which they are linked. Regression analyses identify an association between immigration-related discrimination and increased levels of depression and anxiety; this relationship did not vary by self and parental immigration status. Interview data shed light on this result as immigration-related discrimination manifested as individual discrimination as well as vicarious discrimination through family and community members. We contend that immigration-related discrimination is not limited to individual experiences but rather is shared within the family and community, with negative implications for the mental health of undocumented immigrants and mixed-status family members.
Objectives
It is known that parental experiences of perceived racism are associated with poorer mental health in children. However, little is known about the mechanism of transmission of intergenerational racism among Aboriginal Australians. This study aims to explore the causal effect of Aboriginal mothers’ experience of perceived racism on children’s social and emotional well-being mediated by parenting sense of competence.
Method
Pregnant Aboriginal women (N = 159) reported their experiences of perceived racism using the Measure of Indigenous Racism Experiences instrument, and completed a five year follow-up survey, reporting their sense of parenting competence using the Parenting Sense of Competence Scale and their child’s social and emotional well-being using the Strengths and Difficulties Questionnaire. A single causal mediation analysis was used to examine the causal effects while accounting for confounding variables (mother’s age, education, and socioeconomic status).
Results
Mothers who experienced perceived racism in at least one setting were at an increased odds of their child experiencing social and emotional difficulties (OR = 1.28, 95% CI [0.55, 2.98]). This effect was not mediated by parenting sense of competence, despite an effect between parenting competence and children’s social and emotional well-being (OR = 0.44, 95% CI [0.19, 1.06]).
Conclusions
The findings suggest that maternal experiences of perceived racism has a longitudinal effect on their children’s social and emotional well-being, which is not mediated through the mothers’ parenting sense of competence. These findings highlight the importance of reducing racism as these may have far-reaching effects across generations on socio-social and emotional well-being.
Objectives
To characterise psychological distress during the COVID-19 pandemic among collegiate athletes and assess whether racial and ethnic differences in psychological distress are attenuated when accounting for inequitable exposure to structural and social determinants of health.
Methods
Participants were collegiate athletes on teams competing in the National Collegiate Athletic Association (n=24 246). An electronic questionnaire was distributed by email, open for completion 6 October to 2 November 2020. Multivariable linear regression models were used to assess the cross-sectional associations between meeting basic needs, death or hospitalisation due to COVID-19 of a close contact, race and ethnicity, and psychological distress.
Results
Athletes racialised as Black had higher levels of psychological distress than their white peers (B=0.36, 95% CI 0.08 to 0.64). Psychological distress was higher among athletes who had more difficulties meeting basic needs, and who had a close contact die or be hospitalised with COVID-19. After adjusting for these structural and social factors, Black athletes experienced less psychological distress than white peers (B=−0.27, 95% CI −0.54 to −0.01).
Conclusions
The present findings provide further evidence of how inequitable structural and social exposures are associated with racial and ethnic differences in mental health outcomes. Sports organisations should ensure the mental health services available for their athletes are appropriate for meeting the needs of individuals experiencing complex and traumatic stressors. Sports organisations should also consider whether there are opportunities to screen for social needs (eg, related to food or housing insecurity), and to connect athletes with resources to help meet those needs.
Research regarding the impact of racism on stress among young men who have sex with men (YMSM) is sparse. Secondary data were assessed from a 2018-2020 national mHealth prevention trial for YMSM aged 13-18 years (N = 542). Linear regression models examined associations between perceived stress and interpersonal and vicarious racism, adjusting for covariates. Stratified models by race/ethnicity were included. A subanalysis (n = 288) examined associations between nine interpersonal racial discriminatory events and perceived stress. Over 50% of participants experienced racial discrimination. In the multivariable models, exposure to interpersonal (β = 1.43, p-value: .038) and vicarious (β = 1.77, p-value: .008) racism was associated with perceived stress because there were four interpersonal racial discriminatory events. Stratified analysis by race/ethnicity found significant associations between interpersonal and vicarious racism and perceived stress among some racial/ethnic groups. Racial discrimination was common among YMSM, making them susceptible to the possible effects of vicarious and interpersonal racism on stress.
Even in the context of major advances in medicine, racial minorities continue to suffer worse medical outcomes. Although race is defined as a social, nonscientific construct, researchers have continued to use it as proxy to explain genetic and evolutionary differences among patients. Poorer health outcomes among Black Americans are known to be related to the psychosocial and physiological stress of racism. Black communities experience premature health deterioration because of the cumulative effects of social, economic, and political oppression and marginalization. Additionally, recent assertions that racism is best seen as a chronic disease has added value to understanding the effect of racism on the health of Black people. Using evidence-based information to assess the health of Black patients is a key step to assist clinicians in promptly addressing this chronic threat to the health of Black patients.
São investigadas as percepções de crianças sobre ocorrências de racismo direto (quando a própria criança foi a vítima) e vicário (quando a criança observa outros sendo vítimas) e apresenta-se uma revisão da literatura sobre possíveis soluções para o enfrentamento do racismo na infância. Dois estudos foram realizados. No primeiro participaram 60 crianças negras e brancas, de 6 a 11 anos, entrevistadas em suas escolas, em uma cidade do interior da Bahia. Uma história de discriminação racial foi utilizada como estimulo para relatos pessoais de racismo. Das crianças negras, 59,5% relataram racismo direto e 89,2% racismo observado; 60,9% das brancas relataram racismo observado contra pessoas negras. No segundo estudo foi realizado um levantamento de estudos, dentro do escopo da Psicologia social, que obtiveram sucesso tanto na redução do racismo quanto no fortalecimento da identificação das crianças negras com seu grupo de pertença. São apresentadas intervenções baseadas na Hipótese do Contato Intergrupal, na Educação Multicultural, Hipóteses baseadas na Categorização e Contra Estereótipo. No conjunto, este trabalho aponta para a persistência do racismo na sociedade brasileira, cuja manifestação produz impactos psicológicos e emocionais nas crianças negras. Pôr em prática as estratégias interventivas para o enfrentamento ao racismo apresentadas pode ajudar a solucionar essa problemática.
Palavras-chave: experiências de racismo; enfrentamento ao racismo; crianças.
Falar sobre identidade é sempre uma tarefa intrigante e deveras difícil, já
que a identidade é um fenômeno que envolve múltiplos níveis e reconhecimentos (Galinkin & Zauli, 2011). E quando a identidade diz respeito a crianças, o
tema torna-se mais profundo por conta das peculiaridades dessa fase do desenvolvimento, sobretudo, porque as variáveis que integram o processo de forma-
ção da identidade possuem grande potencial influenciador em todo processo.
A condição social da criança é uma delas, pois, se uma criança estiver em situação
de vulnerabilidade social certamente terá impactos significativos na formação
de sua identidade, ou se pertencer a uma “raça” desvalorizada terá os mesmos
prejuízos, podendo estes impactos serem potencializados se a criança tiver uma
identidade racial desvalorizada e estiver em situação de vulnerabilidade social.
De modo que buscou-se investigar se a socialização praticada pelos profissionais
Serviços de Convivência e Fortalecimento de Vínculos – SCFV promove o fortalecimento da identidade racial de crianças em situação de vulnerabilidade social.
Abordar diferentes facetas da Psicologia em um só trajeto é um interessante desafio entre a especificidade e a integralidade. Percorrer da saúde e desenvolvimento humano à psicologia social, entrelaçando questões sociais relevantes, exige outro importante esforço. Tudo isso, de modo bem concatenado e fundamentado, pode ser encontrado neste livro. Pesquisas
em Psicologia, Saúde e Sociedade traz para os leitores, estudantes e
pesquisadores, variadas temáticas de estudo em Psicologia, visando a informar e bem formar perspectivas de compreensão e ação para variados interesses.
National attention toward recent highly publicized police killings and the coronavirus disease 2019 pandemic, which has disproportionately impacted communities of color, highlight the continued systematic oppression of racial and ethnic minorities in the United States. Furthermore, burgeoning evidence demonstrates that police contact is associated with adverse health outcomes for Black and Latinx youth beyond the loss of life. This article seeks to describe the historical and contemporary context of youth's experiences with the police and present the state of the science linking police contact to poor health. The evidence suggests that police contact is a critical determinant of health for racial and ethnic minority children and that pediatric clinicians, researchers, and policymakers have a role in mitigating the detrimental impact of policing on child health.
Research indicates that individuals who are not part of mainstream cultures may be disproportionately vulnerable to bully victimization. In response to culturally-motivated bullying vignettes, we explored bystander intervention/upstanding behavioral intentions in an experimental design involving 294 college student participants. Participants were randomly assigned to conditions that presented vignettes involving race-, gender-, and sexual orientation-based bullying. Race of victim was significantly related to upstanding behaviors. Perceived emergency of the situation and previous experience with upstanding interventions were also predictive of upstanding behavior. Empathy for the victims and intentions to comfort them were the primary rationales cited for preferring specific upstanding behaviors. Findings have implications for designing culturally-motivated bullying prevention programs in school and campus settings.
Through qualitative in‐depth interviews with Black mothers, this study explores the role of their children's experiences of anti‐Black racism on their own perceived stress—that is, vicarious racism‐related stress. Racism is a system of inequality impeding the health and well‐being of Black families. Specifically, because of the interconnected nature of mother–child relationships, vicarious racism is a pathway for Black maternal stress. This study examines two broad research questions: (1) How do mothers articulate the stress suffered due to their children's experiences of anti‐Black racism? (2) How are mothers perceiving this stress shaping their mental, emotional, and physical well‐being? This study utilized qualitative in‐depth interviews with 35 Black mothers of children in adolescence and emerging/young adulthood. Mothers in this study discussed thinking about their children's experiences of racism often or daily, an experience defined in this study as hyperawareness. Hyperawareness was the primary source of vicarious racism‐related stress for mothers, through either their children's actualized experiences via rumination or anticipated experiences via hypervigilance. Regardless of whether the experience was actual or anticipated, mothers identified the stress suffered shaping their mental, emotional, and physical well‐being. Through a Black feminist lens, this article reveals how Black mothers distinctly identify what vicarious experiences of racism are, and how they generate stress within their familial context. This study extends previous family, race, and well‐being scholarship by exploring various forms of racism that may be contributing to Black maternal health and well‐being.
Objective:
To estimate associations between police use of force (PUOF) in local jurisdictions and birth outcomes of Black women compared to White women.
Methods:
Using birth records linked to municipal police department data on PUOF incidents, we estimated associations between overall and racialized PUOF and birth outcomes of 75,461 Black women and 278,372 White women across 430 municipalities in New Jersey (2012-2016).
Results:
Overall PUOF was not associated with birth outcomes of Black or White women. A 1% increase in racialized PUOF was associated with a 0.06% increase in the odds of low birth weight (β: 0.06; 95% CI: 0.03-0.09) and preterm birth (β: 0.06; 95% CI: 0.03-0.10) among Black women but had no associations with birth outcomes of White women.
Conclusions:
Lack of associations between overall PUOF and birth outcomes coupled with significant associations between racialized PUOF and birth outcomes, among Black women only, is consistent with mounting evidence that structural racism adversely affects the health of Black people in the U.S.
Policy implications:
The findings point to the need to address health inequalities at the structural level.
The goal was to examine direct and indirect associations between racial discrimination and parenting among African American mothers and fathers. Experiences of racial discrimination are common among African Americans, with well‐documented effects on individual functioning. Greater attention to associations between racial discrimination and family functioning, including parenting, is needed, as are tests of whether these associations might arise indirectly through depressive symptoms. Data from 346 African American families were used to examine correlations between racial discrimination and nurturant involved parenting, consistent discipline, and educational involvement among mothers and fathers, and to examine indirect effect models testing linkages through depressive symptoms. There was minimal evidence of significant direct (bivariate) associations between racial discrimination and parenting. There were, however, significant negative indirect effects from racial discrimination to nurturant involved parenting and to consistent discipline through depressive symptoms for mothers and fathers. Higher levels of racial discrimination were associated with lower levels of nurturant involved parenting and consistent discipline through higher depressive symptoms. Conceptual models describing the effects of racial discrimination on families should integrate indirect effects through individual functioning. Interventions focused on supporting African American parents should address the harmful effects of racial discrimination on individual and family well‐being.
Black women suffer disproportionately from healthcare inequities in comparison to their White counterparts. Using the Public Health Critical Race framework, this article explores the lasting effects of systemic racism on the health outcomes of Black women across the lifespan. A case study and specific strategies are presented to examine how clinicians, educators, and policymakers can work with Black women to mitigate and eliminate health inequities.
Racial socialization research emerged in opposition to the corpus of theories and studies that failed to include youth of color in research conceptualization and research designs. Informed by 12 years of observational research, I present the Theory of Racial Socialization in Action (TRSA). I present a conceptual framework for the TRSA and describe the evidence that undergirds its four theoretical assumptions. This chapter also describes the ways the TRSA complements and extends both foundational and newer theories in racial socialization theory. This chapter also describes the development of the Racial Socialization Observational Task and Coding System (RSOTCS), a measurement tool designed to assess observed race-related communication for use with African American adolescents and their families. This chapter concludes with a discussion of the applications of the TRSA and the RSOTCS to families of different racial-ethnic backgrounds. Suggestions for adapting the RSOTCS for use with families of different racial-ethnic backgrounds are provided in this chapter.KeywordsRacial socializationTheoryAdolescentsParentingAfrican American familiesZone of proximal developmentObservational methods
Racial discrimination measurement largely has ignored differences within and across BIPOC groups, resulting in the underestimation of racism in youths’ contexts. In this chapter, we highlight guidelines for the advancement of racial discrimination measurement. First, methodological triangulation—the use of multiple methods—is needed to identify the nuanced nature of racial discrimination in youths’ contexts. Specifically, we stress the utility of daily diary methods, qualitative methods, experimental methods, and mixed methods for nuanced investigation of the prevalence and consequences of racial discrimination. Second, research must focus on measurement of White youths’ perpetration and cost of racism. We also stress methodological triangulation for investigations of Whiteness among youth. Finally, we posit recommendations for the novel implementation of these methods in future investigations. To truly level up, scholars advancing racial discrimination research must dedicate renewed focus to methods that efficiently and accurately measure racial discrimination and Whiteness in youths’ contexts.KeywordsRacial discriminationDaily diaryQualitativeExperimental methodologiesMixed methodsWhiteness
Background:
Exposure to ethnic- and race-related stress (e.g., racism, racial discrimination, and micro-aggression) can impair parenting and parent-child relations.
Objective:
This study examines the exposure of Palestinian parents in Israel to two levels of racism, interpersonal racism (IPR) and perceived collective racism (PCR), and the relationship of each to perpetrating child abuse. Further, the study examines the moderating role of coping strategies on these relationships.
Participants and setting:
The study was conducted among a systematic semi-random sample of 770 Palestinian parents in Israel (500 mothers and 270 fathers) aged 21-66 (M = 38.7, SD = 7.84).
Methods:
Participants filled out a self-administered questionnaire that included items from several instruments.
Results:
Regression analysis revealed that PCR and avoidance coping significantly predict psychological, R2 = 0.072, p < 0.001, and physical, R2 = 0.088, p < 0.001, child abuse. Interestingly, the moderating effects of coping strategies varied somewhat. High avoidance-coping (e.g., distraction, denial, withdrawal) worsened PCR's effect on child abuse, while low avoidance-coping mitigated it but augmented IPR's effect on child abuse. Further, frequently using problem-oriented coping (e.g., analyzing the situation) worsened IPR's effect on child abuse. Child abuse risk increased when parents experienced high PCR levels and frequently used avoidance coping. Likewise, it increased when they experienced high IPR levels and used either high problem-oriented coping or low avoidance-coping.
Conclusions:
Understanding when coping strategies buffer the impact of racism on the parent-child relationship and when they exacerbate it can contribute to interventions with parents experiencing IPR and PCR.
This article examines anticipatory economic stress—or the stress of future economic crises or events that may negatively impact material well‐being—for LGBTQ adults. Using qualitative interview data from 76 LGBTQ adults, three main sources of anticipatory economic stress emerged: the family, the workplace, and health care. Following an intersectionality framework, these anticipatory economic stressors are experienced differently across gender and racial lines, heightening anticipatory economic stress for LGBTQ people of color and transgender respondents. This article has significant implications for understanding the role of future economic stress in the present and provides important insight into what specific forms of anticipatory economic stress that shape the lives of LGBTQ individuals.
Children represent some of the most vulnerable and most valuable members of society. When acutely ill or injured, pediatric emergency departments (EDs) provide first line, specialized care for children and adolescents. Unique and unpredictable, the pediatric ED environment requires a wide range of health care professionals to care for children and their families and often includes hospital-employed security professionals and local law enforcement personnel to ensure safe and protective spaces paramount for optimal patient care. However, an active policing presence within environments designed to promote healing can paradoxically contribute to harm, particularly for Black and Brown patients. As health care systems pledge to dismantle structural racism and achieve health equity, efforts must include anti-racist reforms of threat management systems within clinical environments. We propose assessment and evaluation of current security and police encounters within pediatric EDs. We call for institution of policies that mitigate biases, address medical mistrust, distinguish clinical from criminal aggression, and minimize punitive contact with police. We outline a multitiered, patient-centered approach to disruptive and violent acts that prioritizes prevention, early intervention, and de-escalation strategies with a goal of reducing the perceived need for policing presence in pediatric EDs.
The late Black feminist scholar, bell hooks, suggested that the margin can be a place of radical possibility, where marginalized people nourish their capacity for collective resistance. On the margin, it is possible to generate a counter-language. In this paper, we chronicle, describe and reflect upon how bell hooks' ideas inspired the creation of a national 2-day conference titled, ‘Listening to the Margins’. This conference was focused on understanding the intersectional experiences of childhood disability and race with a view to better supporting racialized disabled children, youth, and their families. This conference was needed because intersectional experiences of childhood disability and race have been silenced in childhood disability studies, critical race studies, and various other resistance-oriented systems of thought. Racialized children with disabilities and their families are often unsupported as they navigate Euro-centric healthcare systems. Reflecting on lessons learned from our conference, we suggest several strategies for advancing meaningful research programs with racialized disabled children. Strategies include centering the art of listening, amplifying the margin, engaging the arts to promote empathy, embracing psychosocial support in work on ableism and racism, developing clinical tools and practices that are grounded in lived patient experiences, and advancing decolonizing research that recognizes the role research has historically played in perpetuating colonial violence. In totality, this article unpacks how sitting on the margins, as bell hooks suggested, has allowed us to occupy a place of discomfort and creativity necessary to disrupt dominant discourses. In so doing, we have made space for the hidden narratives of racialized disabled children and their families.
Background:
The COVID-19 pandemic has been accompanied by a myriad of racist incidents targeting minorities in the U.S. Young adults are susceptible to direct and vicarious (indirect) pandemic-related racial discrimination. We sought to examine associations between both types of discrimination experiences and psychological distress among college students across different racial groups.
Methods:
We analyzed self-reported data from 64,041 undergraduate students from the Spring 2021 American College Health Association-National College Health Assessment. Logistic regression examined odds of severe distress predicted by self-reported exposure to direct and vicarious racial discrimination.
Results:
Even after controlling for sociodemographic characteristics and prior mental health diagnoses, there was a significant association between direct discrimination and distress among Asian (AOR: 1.3, p < 0.001), Hispanic (AOR: 1.6, p < 0.001), and Multiracial (AOR: 1.4, p < 0.001) students. Vicarious discrimination significantly predicted distress among White (AOR: 1.4, p < 0.001), Asian (AOR: 1.4, p < 0.001), Hispanic (AOR: 1.5, p < 0.001), and Multiracial (AOR: 1.3, p < 0.001) students. Black students did not exhibit significantly increased odds of distress associated with either direct or vicarious racial discrimination.
Limitations:
Self-reported variables are susceptible to recall bias. Minority racial group analyses may be underpowered.
Conclusions:
Our findings reveal an overall link between both direct and vicarious racial discrimination and distress across several racial groups. Further studies should examine effective mental health interventions and anti-racism initiatives to support students who have experienced both direct and vicarious discrimination due to COVID-19.
Racial disparities in health are a major public health problem in the United States, especially when comparing chronic disease morbidity and mortality for Black versus White Americans. These health disparities are primarily due to insidious anti-Black racism that permeates American history, current culture and institutions, and interpersonal interactions. But how does racism get under the skull and the skin to influence brain and bodily processes that impact the health of Black Americans? In the present article, we present a model describing the possible neural and inflammatory mechanisms linking racism and health. We hypothesize that racism influences neural activity and connectivity in the salience and default mode networks of the brain and disrupts interactions between these networks and the executive control network. This pattern of neural functioning in turn leads to greater sympathetic nervous system signaling, hypothalamic-pituitary-adrenal axis activation, and increased expression of genes involved in inflammation, ultimately leading to higher levels of proinflammatory cytokines in the body and brain. Over time, these neural and physiological responses can lead to chronic physical and mental health conditions, disrupt well-being, and cause premature mortality. Given that research in this area is underdeveloped to date, we emphasize opportunities for future research that are needed to build a comprehensive mechanistic understanding of the brain-body pathways linking anti-Black racism and health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
In this chapter, I explore my experience with psychological stress during the first year of my doctoral candidature that resulted from the intersection of the COVID-19 pandemic and global Black Lives Matter protests. As a qualitative researcher, I draw on my own autoethnographic vignettes (Ellis. The ethnographic I: A methodological novel about autoethnography. AltaMira Press, 2004) to provide an account of the personal challenges which may be generalizable to minoritised doctoral students during crisis situations. I use the Transactional Model of Stress and Coping (Lazarus and Folkman. Stress, appraisal and coping. Springer, 1984) to identify with and understand the stressors I faced as an insider—a Black, female doctoral student—and share the adaptive coping strategies that I used to be able to focus on my PhD. As a result, I prove the claim that the PhD became my saviour.KeywordsPsychological distressCoping strategiesTransactional model of stress and copingAutoethnographyBlack feminist autoethnographyCOVID-19Black Lives Matter protestsDoctoral studentsMinoritised groups
Rationale:
Much of the research linking racism-related stressors to poor health has focused on fairly non-violent forms of racism that directly impact individuals under study. Exposure to particularly extreme and/or violent racist events are increasingly visible via smartphone recordings and social media, with consistent anecdotal reports of the effects of seeing and hearing about these events on sleep among minorities who racially identify with the victims.
Objective:
This study examines whether exposure to direct and vicarious racism-related events (RREs), including more extreme events, are associated with sleep quality. Additionally, we examine effects of less and more violent direct RREs and vicarious RREs witnessed in person and via social media.
Methods:
Among 422 African-American women, we assessed exposure to RREs using a modified version of the Race-Related Events Scale and assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Linear regression analyses were used to model continuous global sleep.
Results:
Direct (β = 0.24 [95% CI: 0.13, 0.35]) RREs were associated with worse continuous global sleep quality scores in analyses adjusted for sociodemographics and risk factors for poor sleep. More violent direct RREs (β = 0.59 [95% CI: 0.30, 0.89]) had stronger associations with poor sleep quality than less violent direct RREs (β = 0.25 [95% CI: 0.11, 0.40]). Vicarious RREs overall (β = 0.04 [95% CI: 0.14, 0.21]) and those witnessed via social media (β = -0.07 [95% CI: 0.29, 0.14]) were not associated with global sleep quality; conversely, vicarious RREs witnessed in person were (β = 0.52 [95% CI: 0.21, 0.83]).
Conclusion:
Extreme, direct experiences of racism, particularly those that are violent in nature, are associated with poor sleep quality. However, extreme vicarious experiences are not-- unless witnessed in person.
The last several years have seen accelerated activity and discourse directed at antiracism. Specifically following the 2020 murder of George Floyd, institutions across the country engaged in a range of introspective exercises and transparent reckonings examining their practices, policies, and history insofar as equity and racism is concerned. The authors of this article, both active protagonists in this domain, have been, and continue to be, part of ongoing national efforts and have learned much about the strategies and tactics necessary to initiate, engage, and sustain traction on the path to antiracism.
Many racial–ethnic minoritized individuals are repeatedly exposed to subtle actions reflecting racial slights, termed racial microaggressions (RMAs), which are associated with adjustment problems in early adult and adult populations. Early adolescence represents a unique developmental period when minoritized youth begin their racial–ethnic identity exploration and are subjected to stereotypes and prejudice, thereby making them vulnerable to RMAs. Based upon the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist, a systematic literature search, screening and review of RMA literature focusing on high schoolers and younger youth was conducted and yielded 54 publications. This paper reviewed the publications and identified gaps in the field such as the need for systematic research on early adolescents including the frequency and severity of RMAs and the important contributions of peers, parents and teachers for RMA victims, and the need for more evidence-based programming for middle schoolers. Findings suggest that developing school-based microaggression antiracism programs is clearly needed for minoritized and White youth.
Impact Statement
Racial microaggressions are harmful to minoritized youth’s well-being, including higher rates of suicidal ideation even after accounting for experiences of overt discrimination. The current systematic review suggests a great need for helping school staff provide an inclusive, equitable classroom and for empowering other adults to better support minoritized youth in handling racial microaggressions. The authors propose that school psychologists can fill this critical gap given their important role in providing socio–emotional support to both students and staff.
Creating an environment that supports mental health—whether minimizing symptoms of mental health disorders or optimizing subjective well-being—is an ongoing and evolving process for sports organizations. Taking a quality improvement approach to meeting organizational needs related to mental health promotion means being reflexive, intentional, and strategic in planning, implementing, and studying changes, and acting (e.g., course correcting) based on what you find. This process is, in large part, subjective. Organizations should clarify their values, and use these values to guide their quality improvement decision-making. To the extent these values include a commitment to equity, each stage of the quality improvement process should include reflection on whose voices are being heard, whose perspectives and preferences are being centered, and who is deciding what constitutes “success.”KeywordsMental healthOrganizationQuality improvementEquitySport
Frequent daily discrimination compounds the negative health impacts of those with multiple marginalized identities, including pregnant mothers and their children. We used a dyadic, moderated, mediated model of 296 young, expectant, poor, urban, primarily minority couples. In this study, we explored if a multiple pathway discrimination model explained the relationship between multiple marginalized identities and health (depression and stress). We also examined if a mediated (discrimination moderated by gender) model, within a minority-stress and intersectional framework explained the relationship with depression and stress for couples. We observed that frequent daily discrimination was associated with negative health outcomes (depression and stress). Women reported significantly more depression than men. Frequent daily discrimination mediated the relationship between multiple marginalized identities and depression and stress and having a partner with multiple marginations increased one’s personal depression and stress. Our observations suggest that discrimination’s impact on health is experienced during pregnancy and the more marginalized identities one carries, the more impact it may have. Further, having a partner with multiple marginalized identities also impacts the depression and stress reported by women. Inventions to address depression and stress outcomes may be strengthened by considering multiple marginalized identities and include couples.
Mental and behavioral health conditions are common among children and adolescents in the United States. The purpose of this state-of the-art review article is to describe inequities in mental and behavioral health care access and outcomes for children and adolescents, characterize mechanisms behind the inequities, and discuss strategies to decrease them. Understanding the mechanisms underlying these inequities is essential to inform strategies to mitigate these health disparities. Half of United States children with a treatable mental health disorder do not receive treatment from a mental health professional. Children and adolescents in racial, ethnic, sexual, sex, and other minority groups experience inequities in access to care and disparities in outcomes for mental and behavioral health conditions. Suicide rates are nearly twice as high in Black compared to White boys 5 to 11 years old and have been increasing disproportionately among adolescent Black girls 12 to 17 years old. Children identifying as a sexual minority have >3 times increased odds of attempting suicide compared to heterosexual peers. Adverse experiences of children living as part of a minority group, including racism and discrimination, have immediate and lasting effects on mental health. Poverty and an uneven geographic distribution of resources also contribute to inequities in access and disparities in outcomes for mental and behavioral health conditions. Strategies to address inequities in mental and behavioral health among United States children include investing in a diverse workforce of mental health professionals, improving access to school-based services, ensuring equitable access to telehealth, and conducting quality improvement with rigorous attention to equity.
This study examined whether Mexican-American parents' experiences with discrimination are related to adolescent psychological adjustment over time. The extent to which associations between parent discrimination and adolescent adjustment vary as a function of parents' ethnic socialization of their children was also examined. Participants included 344 high school students from Mexican or Mexican-American backgrounds (primarily second generation; ages 14-16 at Wave 1) and their primary caregivers who completed surveys in a 2-year longitudinal study. Results revealed that parent discrimination predicted internalizing symptoms and self-esteem among adolescents 1 year later. Additionally, adolescents were more likely to report low self-esteem in relation to parents' increased experiences of discrimination when parents conveyed ethnic socialization messages to them.
In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators. (46 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The association between experienced racial discrimination and poor health is now well documented, particularly among adult populations. However, longitudinal studies of the association between racism and child health are limited, and evidence on how racial discrimination experienced by members of children's immediate environment impact on child development, and the mechanisms by which this occurs, is scarce. We examined the longitudinal association between maternal, family, and area-level experiences of racial discrimination, and children's socioemotional development. We proposed that exposure to racial discrimination would be detrimental to children's socioemotional development via two mother-centred stress pathways: a worsening in maternal mental health, and an increase in harsh parenting practices. Data on ethnic minority mothers and their children were drawn from waves 3 to 5 (2006-2012) of the UK Millennium Cohort Study. Results of longitudinal path analyses show a strong association between maternal and family experiences of racial discrimination in wave 3, and a worsening in mother's mental health in wave 4. Maternal and family experiences of racial discrimination at wave 3 had an indirect effect on children's socioemotional development at wave 5. This occurred mainly via a worsening in mother's mental health, although some events of racial discrimination experienced by the mother and other family members also impacted negatively on children's socioemotional development via an increase in harsh parenting practices. We found a direct effect of maternal and family experiences of racial discrimination on children's socioemotional development. Our findings document the harm of growing up in a racist environment on the socioemotional development of children, and provide some evidence for the role of mother-centred stress mechanisms in linking vicarious exposure to racial discrimination to children's socioemotional development.
The relationship between racial discrimination, parental functioning, and child adjustment is not well understood. The goal of the present study was to assess parental reports of discrimination in relation to depression and parenting practices, as well as on subsequent child internalizing and externalizing problems in low-income Black families. Data include a subsample of the Early Steps project, a multisite longitudinal study of financial and behaviorally at-risk families. Structural equation modeling was used to analyze our hypothesized model. Excellent model fit was established after removing externalizing problems from the model. As predicted, indirect associations were found from discrimination to parental depression, parenting, and child internalizing problems; and direct associations were found from discrimination to child internalizing problems. The results are consistent with findings suggesting that discrimination is negatively associated with adult well-being; moreover, contribute to the sparse literature on the effects of discrimination beyond the direct recipient. Finally, that parent discrimination was directly associated with child emotional problems suggests the continued need to address and treat discriminatory practices more generally.
While studies investigating the health effects of racial discrimination for children and youth have examined a range of effect modifiers, to date, relationships between experiences of racial discrimination, student attitudes, and health outcomes remain unexplored. This study uniquely demonstrates the moderating effects of vicarious racism and motivated fairness on the association between direct experiences of racism and mental health outcomes, specifically depressive symptoms and loneliness, among primary and secondary school students. Across seven schools, 263 students (54.4 % female), ranging from 8 to 17 years old (M = 11.2, SD = 2.2) reported attitudes about other racial/ethnic groups and experiences of racism. Students from minority ethnic groups (determined by country of birth) reported higher levels of loneliness and more racist experiences relative to the majority group students. Students from the majority racial/ethnic group reported higher levels of loneliness and depressive symptoms if they had more friends from different racial/ethnic groups, whereas the number of friends from different groups had no effect on minority students' loneliness or depressive symptoms. Direct experiences of racism were robustly related to higher loneliness and depressive symptoms in multivariate regression models. However, the association with depressive symptoms was reduced to marginal significance when students reported low motivated fairness. Elaborating on the negative health effects of racism in primary and secondary school students provides an impetus for future research and the development of appropriate interventions.
Systematic reviews of healthcare interventions most often focus on randomized controlled trials (RCTs). However, certain circumstances warrant consideration of observational evidence, and such studies are increasingly being included as evidence in systematic reviews.
To illustrate the use of observational evidence, we present case examples of systematic reviews in which observational evidence was considered as well as case examples of individual observational studies, and how they demonstrate various strength of evidence domains in accordance with current Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Center (EPC) methods guidance.
In the presented examples, observational evidence is used when RCTs are infeasible or raise ethical concerns, lack generalizability, or provide insufficient data. Individual study case examples highlight how observational evidence may fulfill required strength of evidence domains, such as study limitations (reduced risk of selection, detection, performance, and attrition); directness; consistency; precision; and reporting bias (publication, selective outcome reporting, and selective analysis reporting), as well as additional domains of dose-response association, plausible confounding that would decrease the observed effect, and strength of association (magnitude of effect).
The cases highlighted in this paper demonstrate how observational studies may provide moderate to (rarely) high strength evidence in systematic reviews.
In this article, the authors develop a brief questionnaire that assesses racist discrimination in the lives ofAfricanAmericans, and conduct preliminary studies with it. The Schedule of Racist Events (SRE) is an 18-item self-report inventory that assesses the frequency of racist discrimination (specific, stressful racist events) in the past year (recent racist events) and in one's entire life (lifetime racist events), and measures the extent to which this discrimination was evaluated (appraised) as stressful (appraised racist events). Results revealed that the SRE has extremely high internal consistency and split-half reliability. Racist discrimination is rampant in the lives of African Americans and is strongly related to psychiatric symptoms and to cigarette smoking. These findings highlight the negative consequences of racismandprovide evidencefor the validity of the SRE as a measure of (culturally specific) stress.
Background
The Summit of Independent European Vaccination Experts (SIEVE) recommended in 2007 that efforts be made to improve healthcare workers’ knowledge and beliefs about vaccines, and their attitudes towards them, to increase vaccination coverage. The aim of the study was to compile and analyze the areas of disagreement in the existing evidence about the relationship between healthcare workers’ knowledge, beliefs and attitudes about vaccines and their intentions to vaccinate the populations they serve.
Methods
We conducted a systematic search in four electronic databases for studies published in any of seven different languages between February 1998 and June 2009. We included studies conducted in developed countries that used statistical methods to relate or associate the variables included in our research question. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of the studies and extracted their relevant characteristics. The data were descriptively analyzed.
Results
Of the 2354 references identified in the initial search, 15 studies met the inclusion criteria. The diversity in the study designs and in the methods used to measure the variables made it impossible to integrate the results, and each study had to be assessed individually. All the studies found an association in the direction postulated by the SIEVE experts: among healthcare workers, higher awareness, beliefs that are more aligned with scientific evidence and more favorable attitudes toward vaccination were associated with greater intentions to vaccinate. All the studies included were cross-sectional; thus, no causal relationship between the variables was established.
Conclusion
The results suggest that interventions aimed at improving healthcare workers’ knowledge, beliefs and attitudes about vaccines should be encouraged, and their impact on vaccination coverage should be assessed.
Objective:
Research suggests that exposure to racism partially explains why African American women are 2 to 3 times more likely to deliver low birth weight and preterm infants. However, the physiological pathways by which racism exerts these effects are unclear. This study examined how lifetime exposure to racism, in combination with maternal blood pressure changes during pregnancy, was associated with fetal growth.
Methods:
African American pregnant women (n = 39) reported exposure to childhood and adulthood racism in several life domains (e.g., at school, at work), which were experienced directly or indirectly, meaning vicariously experienced when someone close to them was treated unfairly. A research nurse measured maternal blood pressure at 18 to 20 and 30 to 32 weeks gestation. Standardized questionnaires and trained interviewers assessed maternal demographics. Neonatal length of gestation and birth weight data were collected from medical charts.
Results:
Childhood racism interacted with diastolic blood pressure to predict birth weight. Specifically, women with two or more domains of indirect exposure to racism in childhood and increases in diastolic blood pressure between 18 and 32 weeks had lower gestational age adjusted birth weight than the other women. A similar pattern was found for direct exposure to racism in childhood.
Conclusions:
Increases in diastolic blood pressure between the second and third trimesters predicted lower birth weight, but only when racism exposure in childhood (direct or indirect) was relatively high. Understanding pregnant African American women's lifetime direct and indirect experiences with racism in combination with prenatal blood pressure may improve identification of highest risk subgroups within this population.
The present study examined the effect of caregivers' experiences of racial discrimination on their adolescent children's psychological functioning among a sample of 264 African American dyads. Potential relations between caregiver discrimination experiences and a number of indicators of adolescents' (aged 12-17) psychological functioning over time were examined. It was found that caregiver discrimination experiences were positively related to adolescents' symptoms of depression and negatively related to their psychological well-being. Additional analysis revealed interactions between the effects of caregiver discrimination experiences and family income on all 3 outcomes. Greater caregiver discrimination experiences and lower family income were risk factors for the youth in the sample. These findings underscore the deleterious consequence of caregivers' discrimination experiences on African American youth's psychological health.
Background
Racial/ethnic disparities in birth weight persist within the USA.
Purpose
The purpose of this study is to examine the association between maternal everyday discrimination and infant birth weight among young, urban women of color as well as mediators (depressive symptoms, pregnancy distress, and pregnancy symptoms) and moderators (age, race/ethnicity, and attributions of discrimination) of this association.
Methods
A total of 420 women participated (14–21 years old; 62 % Latina, 38 % Black), completing measures of everyday discrimination and moderators during their second trimester of pregnancy and mediators during their third trimester. Birth weight was primarily recorded from medical record review.
Results
Path analysis demonstrated that everyday discrimination was associated with lower birth weight. Depressive symptoms mediated this relationship, and no tested factors moderated this relationship.
Conclusions
Given the association between birth weight and health across the lifespan, it is critical to reduce discrimination directed at young, urban women of color so that all children can begin life with greater promise for health.
Recent studies show that racism may influence health inequities. As individuals grow from infancy into old age, they encounter social institutions that may create new exposures to racial bias. Yet, few studies have considered this idea fully. We suggest a framework that shows how racism and health inequities may be viewed from a life course perspective. It applies the ideas of age-patterned exposures, sensitive periods, linked lives, latency period, stress proliferation, historic period, and cohorts. It suggests an overarching idea that racism can structure one's time in asset-building contexts (e.g., education) or disadvantaged contexts (e.g., prison). This variation in time and exposure can contribute to racial inequities in life expectancy and other health outcomes across the life course and over generations.
Psychological science on pregnancy is advancing rapidly. A major focus concerns stress processes in pregnancy and effects on preterm birth and low birth weight. The current evidence points to pregnancy anxiety as a key risk factor in the etiology of preterm birth, and chronic stress and depression in the etiology of low birth weight. Key mediating processes to which these effects are attributed, that is neuroendocrine, inflammatory, and behavioral mechanisms, are examined briefly and research on coping with stress in pregnancy is examined. Evidence regarding social support and birth weight is also reviewed with attention to research gaps regarding mechanisms, partner relationships, and cultural influences. The neurodevelopmental consequences of prenatal stress are highlighted, and resilience resources among pregnant women are conceptualized. Finally, a multilevel theoretical approach for the study of pregnancy anxiety and preterm birth is presented to stimulate future research.
Although racism is increasingly acknowledged as a determinant of health, few studies have examined the relationship between racism, housing and child health outcomes.
Cross-sectional data from the Housing Improvement and Child Health study collected in ten remote indigenous communities in the Northern Territory, Australia were analysed using hierarchical logistic regression. Carer and householder self-reported racism was measured using a single item and child illness was measured using a carer report of common childhood illnesses. A range of confounders, moderators and mediators were considered, including socio-demographic and household composition, psychosocial measures for carers and householders, community environment, and health-related behaviour and hygienic state of environment.
Carer self-reported racism was significantly associated with child illness in this sample after adjusting for confounders (OR 1.65; 95% CI 1.09 to 2.48). Carer negative affect balance was identified as a significant mediator of this relationship. Householder self-reported racism was marginally significantly associated with child illness in this sample after adjusting for confounders (OR 1.43; 95% CI 0.94 to 2.18, p=0.09). Householder self-reported drug use was identified as a significant mediator of this relationship.
Consistent with evidence from adult populations and children from other ethnic minorities, this study found that vicarious racism is associated with poor health outcomes among an indigenous child population.
A child's sense of control over life and health outcomes as well as perceptions of the world as fair, equal, and just are significantly influenced by his or her social experiences and environment. Unfortunately, the social environment for many children of color includes personal and family experiences of racial discrimination that foster perceptions of powerlessness, inequality, and injustice. In turn, these perceptions may influence child health outcomes and disparities by affecting biological functioning (eg, cardiovascular and immune function) and the quality of the parent-child relationship and promoting psychological distress (eg, self-efficacy, depression, anger) that can be associated with risk-taking and unhealthy behaviors. In this article we review existing theoretical models and empirical studies of the impact of racial discrimination on the health and development of children of color in the United States. On the basis of this literature, a conceptual model of exposure to racial discrimination as a chronic stressor and a risk factor for poor health outcomes and child health disparities is presented.
Perceived discrimination has been studied with regard to its impact on several types of health effects. This meta-analysis provides a comprehensive account of the relationships between multiple forms of perceived discrimination and both mental and physical health outcomes. In addition, this meta-analysis examines potential mechanisms by which perceiving discrimination may affect health, including through psychological and physiological stress responses and health behaviors. Analysis of 134 samples suggests that when weighting each study's contribution by sample size, perceived discrimination has a significant negative effect on both mental and physical health. Perceived discrimination also produces significantly heightened stress responses and is related to participation in unhealthy and nonparticipation in healthy behaviors. These findings suggest potential pathways linking perceived discrimination to negative health outcomes.
To assess discrimination in health care, reliable, valid, and comprehensive measures of racism/discrimination are needed.
To review literature on measures of perceived race/ethnicity-based discrimination and evaluate their characteristics and usefulness in assessing discrimination from health care providers.
Literature review of measures of perceived race/ethnicity-based discrimination (1966-2007), using MEDLINE, PsycINFO, and Social Science Citation Index.
We identified 34 measures of racism/discrimination; 16 specifically assessed dynamics in the health care setting. Few measures were theoretically based; most assessed only general dimensions of racism and focused specifically on the experiences of African American patients. Acceptable psychometric properties were documented for about half of the instruments.
Additional measures are needed for detailed assessments of perceived discrimination in the health care setting; they should be relevant for a wide variety of racial/ethnic groups, and they must assess how racism/discrimination affects health care decision making and treatments offered.
Filling a critical void in the literature, Race, Racism, and the Developing Child provides an important source of information for researchers, psychologists, and students on the recent advances in the unique developmental and social features of race and racism in children's lives. Thorough and accessible, this timely reference draws on an international collection of experts and scholars representing the breadth of perspectives, theoretical traditions, and empirical approaches in this field.
Stress, coping, and minority health: Biopsychosocial perspective on ethnic health disparities Current epidemiological evidence indicates a persistent disparity in health status, morbidity, and mortality among racial/ethnic minorities relative to Caucasians. Regardless of the health and social status criteria used, African Americans, Hispanics, Native Americans, and many South Pacific and Southeast Asian groups carry a disproportionate burden of morbidity and mortality and are overrepresented among those suffering from the greatest social disadvantage (Flack et al, 1995; National Center for Health Statistics [NCHS], 2000). The social imperative we face today is to identify those factors that contribute to or maintain these persistent health disparities and to design innovative interventions to close the gaps. Driven by the dual forces of immigration and a higher birth rate among racial/ethnic minorities, the U.S. population is projected to include a plurality of persons of color by the year 2025. If the current health trends continue unabated, ...
The synonymy of Blackness with criminality is not a new phenomenon in America. Documented historical accounts have shown how myths, stereotypes, and racist ideologies led to discriminatory policies and court rulings that fueled racial violence in the post-Reconstruction era and have culminated in the exponential increase of Black male incarceration today. Misconceptions and prejudices manufactured and disseminated through various channels such as the media included references to a “brute” image of Black males. In the 21st century, this negative imagery of Black males has frequently utilized the negative connotation of the terminology “thug.” In recent years, law enforcement agencies have unreasonably used deadly force on Black males allegedly considered to be “suspects” or “persons of interest.” The exploitation of these often-targeted victims’ criminal records, physical appearances, or misperceived attributes has been used to justify their unlawful deaths. Despite the connection between disproportionate criminality and Black masculinity, little research has been done on how unarmed Black male victims, particularly but not exclusively at the hands of law enforcement, have been posthumously criminalized. This article investigates the historical criminalization of Black males and its connection to contemporary unarmed victims of law enforcement. Action research methodology in the data collection process is utilized to interpret how Black male victims are portrayed by traditional mass media, particularly through the use of language, in ways that marginalize and devictimize these individuals. This study also aims to elucidate a contemporary understanding of race relations, racism, and the plight of the Black male in a 21-century “postracial” America.
In this article, the authors examine the role of vicarious racism in the experiences of doctoral students of color. The researchers conducted semi-structured individual interviews with 26 doctoral students who self-reported experiencing racism and racial trauma during their doctoral studies. The analysis generated four themes that detail the different ways in which doctoral students of color in the study experienced vicarious racism and the consequences of this secondhand racism. These themes are (a) observed racism, (b) trickledown racism, (c) normalization of racism, and (d) racial resistance. The article concludes with implications for future research and practice.
This study investigated Mexican immigrant parents' reports of perceived workplace discrimination and their children's behavior, parents' moods, and parent-child interactions. Parents of one hundred and thirty-eight 3- to 5-year-old children were asked to complete one survey daily for 2 weeks (N = 1,592 days). On days when fathers perceived discrimination, fathers and mothers reported more externalizing child behaviors, and mothers reported fewer positive child behaviors. When mothers perceived discrimination, they reported more externalizing child behaviors; fathers reported more internalizing child behaviors. Parents reported worse mood on days with perceived discrimination. Perceived discrimination was not strongly related to parent-child interactions. For fathers, but less so for mothers, those whose psychological acculturation indicated separation had more negative relations between daily perceived workplace discrimination and child and family outcomes.
© 2015 The Author. Child Development © 2015 Society for Research in Child Development, Inc.
In 1999, only 20 studies in the public health literature employed instruments to measure self-reported experiences of discrimination. Fifteen years later, the number of empirical investigations on discrimination and health easily exceeds 500, with these studies increasingly global in scope and focused on major types of discrimination variously involving race/ethnicity, indigenous status, immigrant status, gender, sexuality, disability, and age, separately and in combination. And yet, as I also document, even as the number of investigations has dramatically expanded, the scope remains narrow: studies remain focused primarily on interpersonal discrimination, and scant research investigates the health impacts of structural discrimination, a gap consonant with the limited epidemiologic research on political systems and population health. Accordingly, to help advance the state of the field, this updated review article: (a) briefly reviews definitions of discrimination, illustrated with examples from the United States; (b) discusses theoretical insights useful for conceptualizing how discrimination can become embodied and produce health inequities, including via distortion of scientific knowledge; (c) concisely summarizes extant evidence--both robust and inconsistent--linking discrimination and health; and (d) addresses several key methodological controversies and challenges, including the need for careful attention to domains, pathways, level, and spatiotemporal scale, in historical context.
To understand the way children develop, Bronfenbrenner believes that it is necessary to observe their behavior in natural settings, while they are interacting with familiar adults over prolonged periods of time. His book offers an important blueprint for constructing a new and ecologically valid psychology of development.
This study examined the interplay of parental racial-ethnic socialization and youth multidimensional cultural orientations to investigate how they indirectly and directly influence youth depressive symptoms and antisocial behaviors. Using data from the Korean American Families (KAF) Project (220 youths, 272 mothers, and 164 fathers, N = 656), this study tested the relationships concurrently, longitudinally, and accounting for earlier youth outcomes. The main findings include that racial-ethnic socialization is significantly associated with mainstream and ethnic cultural orientation among youth, which in turn influences depressive symptoms (but not antisocial behaviors). More specifically, parental racial-ethnic identity and pride discourage youth mainstream orientation, whereas cultural socialization in the family, as perceived by youth, increases ethnic orientation. These findings suggest a varying impact of racial-ethnic socialization on the multidimensional cultural orientations of youth. Korean language proficiency of youth was most notably predictive of a decrease in the number of depressive symptoms concurrently, longitudinally, and after controlling for previous levels of depressive symptoms. English language proficiency was also associated with a decrease in depressive symptoms, implying a benefit of bilingualism.
Among US racial/ethnic minority women, we examined associations between maternal experiences of racial discrimination and child growth in the first 3 years of life. We analyzed data from Project Viva, a pre-birth cohort study. We restricted analyses to 539 mother–infant pairs; 294 were Black, 127 Hispanic, 110 Asian and 8 from additional racial/ethnic groups. During pregnancy, mothers completed the Experiences of Discrimination survey that measured lifetime experiences of racial discrimination in diverse domains. We categorized responses as 0, 1–2 or ≥3 domains. Main outcomes were birth weight for gestational age z-score; weight for age (WFA) z-score at 6 months of age; and at 3 years of age, body mass index (BMI) z-score. In multivariable analyses, we adjusted for maternal race/ethnicity, nativity, education, age, pre-pregnancy BMI, household income and child sex and age. Among this cohort of mostly (58.2%) US-born and economically non-impoverished mothers, 33% reported 0 domains of discrimination, 33% reported discrimination in 1–2 domains and 35% reported discrimination in ≥3 domains. Compared with children whose mothers reported no discrimination, those whose mothers reported ≥3 domains had lower birth weight for gestational age z-score (β −0.25; 95% CI: −0.45, −0.04), lower 6 month WFA z-score (β −0.34; 95% CI: −0.65, −0.03) and lower 3-year BMI z-score (β −0.33; 95% CI: −0.66, 0.00). In conclusion, we found that among this cohort of US racial/ethnic minority women, mothers’ report of experiencing lifetime discrimination in ≥ 3 domains was associated with lower fetal growth, weight at 6 months and 3-year BMI among their offspring.
Research on the mental health correlates of discrimination traditionally has been intra-individual, focusing exclusively on the individual directly experiencing discrimination. A small number of studies have begun to consider the links between parental experiences of discrimination and child mental health, but little is known about potential underlying mechanisms. The present study tested the independent mediating effects of parent mental health and household socioeconomic status on the associations between parental experiences of discrimination (past-year perceived discrimination and perceptions of being unaccepted culturally) and child mental health (internalizing and externalizing symptoms) using a bootstrapping analytic approach. Data were drawn from racial/ethnic minority (n = 383) and White (n = 574) samples surveyed in an urban Midwestern county. For all measures of discrimination and child mental health, findings supported an association between parental experiences of discrimination and child mental health. Whereas parent mental health served as a significant mediator in all analyses, socioeconomic status did not. Mediation findings held for both the White and racial/ethnic minority samples. Results suggest that parental experiences of discrimination and mental health may contribute to child mental health concerns, thus highlighting the role of family contexts in shaping child development.
Racial discrimination is a chronic stressor in the lives of African Americans. Chronic stress can lead to individual mental and physical health problems, which subsequently can have deleterious effects on family life. The current study explored the effects of perceived discrimination on youth outcomes and examined the potential mediating role of maternal depression. Using data from 189 African American mothers with children aged 7–14 years, maternal perceived discrimination accounted for variance in reported child externalizing behaviors over and beyond that attributable to other stressful life events and socio-demographic variables. Also, maternal depressive symptoms mediated the effect of maternal perceived discrimination on child externalizing behaviors. These results are consistent with the view that mothers’ experience of greater discrimination leads to higher maternal depression which, in turn, leads to greater externalizing behavior among their children. The findings support the need for further exploration of macrosystemic effects that can influence African American youth externalizing behaviors. The results are discussed in terms of the need to include consideration of discrimination in preventive interventions aimed at increasing support systems available to African American mothers.
The reklaonship between racial sociadization attitudes and racial identity stages is the subject of this article, with racial socialization hypothesized as one key variable to link the literatures in childhood racial awareness ad young adult racial identity. A teenage sample was selected to compare measures of racial socialization and racial identity processes. The Scale of Racial Socilizationfor Adolescents and the 50-item Racial Identity Attitude Scale (RIAS) based on Nigrescence theory were administered to 287 African American adolescents between the ages of 14 and 15 years. A principal components analysis was conducted on the RIAS to assess its appropriateness with a younger adolescent population. The factor analytic procedure yielded a three-factor solution with moderately reliablefactors. Thefactors corresponded to the Nigrescence stages of preencounter, immersion, and internalization. Results indicate that specific factors of racial socialization differentially predict all of the racial identiy stages for females and the preencounter and internalization identity stages for males. Findings also suggest that racial socialization is multidimensional, and implications for integrating it with revised multidimensional conceptualizations of racial identity are raised.
The Cochrane Handbook for Systematic Reviews of Interventions (the Handbook) has undergone a substantial update, and Version 5 of the Handbook is now available online at www.cochrane-handbook.org and in RevMan 5. In addition, for the first time, the Handbook will soon be available as a printed volume, published by Wiley-Blackwell. We are anticipating release of this at the Colloquium in Freiburg. Version 5 of the Handbook describes the new methods available in RevMan 5, as well as containing extensive guidance on all aspects of Cochrane review methodology. It has a new structure, with 22 chapters divided into three parts. Part 1, relevant to all reviews, introduces Cochrane reviews, covering their planning and preparation, and their maintenance and updating, and ends with a guide to the contents of a Cochrane protocol and review. Part 2, relevant to all reviews, provides general methodological guidance on preparing reviews, covering question development, eligibility criteria, searching, collecting data, within-study bias (including completion of the Risk of Bias table), analysing data, reporting bias, presenting and interpreting results (including Summary of Findings tables). Part 3 addresses special topics that will be relevant to some, but not all, reviews, including particular considerations in addressing adverse effects, meta-analysis with non-standard study designs and using individual participant data. This part has new chapters on incorporating economic evaluations, non-randomized studies, qualitative research, patient-reported outcomes in reviews, prospective meta-analysis, reviews in health promotion and public health, and the new review type of overviews of reviews.
Investigated gender differences in depressed mood, and the role of various interpersonal stresses, social supports, and relational involvements in accounting for this difference among 524 boys and 684 girls in Grades 9–12. Girls" higher levels of interpersonal caring orientation and involvement in the problems of significant others accounted for approximately 25% of the gender difference in distress. In a context of family stress, girls who were involved in mother"s problems or those having a strong interpersonal caring orientation had elevated depressed mood. These interactions are interpreted as suggesting that in family stress situations that negatively influence the mental health of both boys and girls, having a strong caring orientation or involvement in family problems is particularly harmful to girls. Boys, evidently, can be involved in family stresses, but are protected from negative emotional effects of this involvement. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
