Journal of Racial and Ethnic Health Disparities最新文献

{"title":"Sex, Race, and Geographic Disparities in Mortality of Cardiovascular Diseases due to Thyroid Dysfunction: A 21-Year Longitudinal Analysis Using CDC WONDER Database (1999-2020).","authors":"Muhammad Shaheer Bin Faheem, Shamikha Cheema, Muhammad Bilal Masood, Syed Ibrahim Ali, Farhan Ahmed, Muhammad Ahmed Abbasi, Ibrahim Rashid","doi":"10.1007/s40615-025-02712-2","DOIUrl":"https://doi.org/10.1007/s40615-025-02712-2","url":null,"abstract":"<p><strong>Background: </strong>There are many prognostic factors causing morbidity and mortality due to cardiovascular diseases with ischemic heart disease, stroke, heart failure, atrial fibrillation, and Rheumatic heart disease being major contributors. Thyroid dysfunction also plays an important role in deaths caused by CVDs. The study evaluates the role of hypo and hyperthyroidism which are one of the important causes of CVDs.</p><p><strong>Methods: </strong>Death certificates were sourced out from the database of Centers of Disease and Control (CDC) WONDER from 1999 to 2020 in United States. Various factors like sex, race, urbanization and geographical location according to state were used to calculate age adjusted mortality rates (AAMR) at a significance level of less than 0.05. Age-adjusted and crude mortality rates per 1,000,000 population were estimated. The Annual Percentage Changes (APC) were determined by using the Joinpoint Regression Program.</p><p><strong>Results: </strong>Overall, 423,620 deaths were reported between 1999-2020, with AAMRs first increasing from 86.3 in 1999 to 92.9 in 2003, followed by a decline to 87.8 in 2004 and a gradual decrease through 2018 (APC -0.37; p < 0.05), after which a sharp rise occurred until 2020 (APC 14.25; p < 0.05). The males and females show similar mortality trends except for more deaths reported among females (106.2) than in males (59.5). In racial category, NH Whites were reported with highest AAMR (93.7), followed by American Indian or Alaskan Native (89.7), Black or African American (66.8), Hispanics (62.9), while lowest being in Asian or Pacific Islanders (40.2). Throughout the study period, non-metropolitan areas had the highest AAMR values (107.7) than medium/small metropolitan areas (96.1) with large metropolitan areas (77.1) having lowest throughout. Six states have shown the AAMR in the 90th percentile with West Virginia being highest whereas the state of Nevada has the lowest AAMR value.</p><p><strong>Conclusion: </strong>The findings in this study show significant sex and racial disparities providing an insight of the importance regarding mortality due to thyroid dysfunction in cardiovascular diseases. Addressing risk factors and precipitating events requires targeted health policy actions in order to improve outcomes for impacted populations.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and Ethnic Community Composition and Geographic Distance to Substance Use Disorder Treatment Across the Rural and Urban Divide.","authors":"Sophia N D Negaro, Peiyin Hung, Gabriel A Benavidez, Olivia M Hinds, Jan M Eberth, Skylar Gross, Christina M Andrews","doi":"10.1007/s40615-025-02683-4","DOIUrl":"https://doi.org/10.1007/s40615-025-02683-4","url":null,"abstract":"<p><strong>Objectives: </strong>To examine whether geographic driving distance to substance use disorder (SUD) treatment varies by racial/ethnic concentration of residents in urban and rural communities.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis at the ZIP Code Tabulation Area (ZCTA) level using data from the Substance Abuse and Mental Health Service Administration (SAMHSA) 2021 Behavioral Health Treatment Services Locator. We conducted logistic regressions to examine rural-urban differences in driving distances to SUD treatment facilities among ZCTAs with a high relative concentration of a single racial/ethnic group.</p><p><strong>Results: </strong>Urban ZCTAs with a high concentration of Black or Hispanic residents had greater odds of having a SUD treatment facility (odds ratio [OR] = 2.39, confidence interval [CI] [2.04, 2.81] and OR = 2.20, CI [1.86, 2.61], respectively), while ZCTAs with a high concentration of White and American Indian/Alaska Natives (AI/AN) communities had lower odds (OR = 0.26, CI [0.23, 0.30] and OR = 0.55, CI [0.47, 0.63], respectively), compared to all other ZCTAs.</p><p><strong>Conclusions: </strong>SUD treatment facilities, which have historically faced heavy stigmatization, are more likely to be placed in communities with a high concentration of Black and Hispanic residents. Consequently, White ZCTAs were less likely to have a SUD treatment facility nearby than other communities. This is important evidence to explore in determining whether stigmatization may play a role in treatment availability.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is BMI Enough? Body Composition Profiles and Cardiometabolic Risk in Hmar Tribe of Northeast India.","authors":"Abigail Lalnuneng","doi":"10.1007/s40615-025-02698-x","DOIUrl":"https://doi.org/10.1007/s40615-025-02698-x","url":null,"abstract":"<p><strong>Background: </strong>Body mass index (BMI) is widely used to assess health risk but overlooks fat and lean mass. This limitation is particularly salient for Indigenous/Tribal South Asian populations, who exhibit distinct body composition and cardiometabolic profiles. This study explores the distributions of BMI, fat mass index (FMI), and fat-free mass Index (FFMI) among the Hmar tribe of Northeast India, and evaluates their predictive utility for hypertension, with sex-specific focus.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 1207 adults (598 men, 609 women) using anthropometry, skinfolds, and bioelectrical impedance. BMI was classified using WHO (1995) and WHO Asia-Pacific (2000) criteria. Polynomial regressions generated sex-specific FFMI and FMI reference ranges. ROC analysis evaluated the predictive utility of BMI, FMI, and FFMI for hypertension.</p><p><strong>Results: </strong>FFMI/BFMI ranged 16.3-19.2/2.2-5.8 kg/m² (men) and 15.1-17.5/3.5-7.6 kg/m² (women) under WHO cutoffs; narrower under Asia-Pacific: 16.3-18.5/2.2-4.5 (men), 15.1-16.7/3.5-6.3 (women), differing from other populations reflecting ethnic variability. Overweight and/or obesity prevalence increased from 32.06% (WHO, 1995) to 49.96% (WHO, 2000). Despite similar BMI and FFMI across sexes, significant differences were observed in FMI (WHO 1995: χ² = 8.26, p < 0.05; WHO 2000 χ² = 9.46, p < 0.05). Hypertension affected 21% of participants. FFMI emerged as the strongest predictor of hypertension in men (AUC = 0.704), while BMI was more predictive in women (AUC = 0.761).</p><p><strong>Conclusion: </strong>BMI alone is insufficient for assessing cardiometabolic risk among the Hmars. Sex-specific differences in FMI and FFMI, and their predictive value for hypertension, highlight the need for body composition-based population-sensitive screening strategies.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the \"Paradox\" in Black-White Alcohol Outcomes: Examining High-Effort Coping and Health Behaviors with a Focus on Black Populations and College Students.","authors":"Rachel Ayala Guzman, Abby L Braitman","doi":"10.1007/s40615-025-02694-1","DOIUrl":"https://doi.org/10.1007/s40615-025-02694-1","url":null,"abstract":"<p><p>Despite experiencing more physical health disadvantages and psychosocial stressors, Black Americans consistently report better mental health outcomes compared to White Americans-a phenomenon commonly referred to as the Black-White health paradox. Alcohol research has identified another racial paradox suggesting Black Americans are at greater risk for alcohol-related problems despite drinking less than White Americans, which is known as the Black-White alcohol paradox. While both paradoxes are well-documented, few studies have examined their potential overlap or how insights from one might inform understanding of the other. Although the alcohol paradox is usually examined among older adults, it may be important to consider factors related to the health paradox among a younger population at-risk for problematic alcohol use: college students. This narrative review argues the importance of examining high-effort-coping (HEC; i.e., John Henryism), a culturally-relevant form of coping with social and economic adversity that has primarily been examined among Black populations. HEC is associated with poorer physical health yet better mental health, similar to the Black-White health paradox. Little is known on how HEC may play a role in health-harming behaviors, such as alcohol use. This paper aims to (1) review and highlight gaps in research using Black and White samples that have examined HEC in relation to health behaviors and college student health outcomes, (2) review studies on HEC and substance use and how it can be applicable to college students, and (3) offer recommendations for integrating HEC in future health behavior research using the Black-White alcohol paradox as an example.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences and Perspectives of Racially Diverse Patients 5 Years Post-Bariatric Surgery: Qualitative Findings from the BELONG II Study.","authors":"Laurel D Hansell, Clarissa W Hsu, Jessica M Mogk, Silvia R Paz, Darren D Moore, Mayra M Macias, Bhumi B Bhakta, Cecelia L Crawford, Debi Ellis, Cecilia Lopez, Tonce Jackson, Reggie Graves, Vincent Corralejo, Marlaine Figueroa Gray, Deborah R Young, Adam Drewnowski, Kristina H Lewis, Sameer B Murali, Karen J Coleman","doi":"10.1007/s40615-025-02635-y","DOIUrl":"https://doi.org/10.1007/s40615-025-02635-y","url":null,"abstract":"<p><strong>Introduction: </strong>Severe obesity and associated negative outcomes have increased in prevalence in America. Furthermore, people who identify as African American/Black (Black), Hispanic/Latine (Hispanic), Native Hawaiian/Pacific Islander (HPI), or American Indian/Alaskan Native (AIAN) suffer disproportionate impacts from obesity. Bariatric surgery is one of the most effective treatments for severe obesity. However, many patients with diverse ethnic backgrounds are less likely to receive bariatric surgery compared to their White counterparts, and when they do, they may have less weight loss and higher complication rates. This study seeks to describe the experiences of patients an average of 5 years after bariatric surgery.</p><p><strong>Methods: </strong>Semi-structured qualitative interviews were conducted between September 2021 and March 2022 with participants who received bariatric surgery within a large integrated health system. Interviews aimed to understand the perspectives of patients from diverse racial and ethnic backgrounds regarding weight loss and regain. Interviews were audio-recorded and transcribed for thematic analysis.</p><p><strong>Results: </strong>A total of 68 interviews were collected; 29% self-identified as Black, 29% as Hispanic, 15% as HPI or AIAN, and 27% as White; 53% were identified as women. In general, the experiences of the patients in this sample were very similar, with few differences between racial and ethnic groups. However, Black, Hispanic, HPI, and AIAN participants were more likely than White participants to express concerns about losing too much weight.</p><p><strong>Discussion: </strong>This study highlights important implications for practice. Culturally relevant patient goals regarding weight loss should be incorporated into shared decision-making, and follow-up support should extend several years after surgery.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building Trust: The Perspectives of COVID-19 Vaccination Efforts among African American Community Health Workers in HHS Region 4.","authors":"Cicily A Gray, Mary Ann Bodine Al-Sharif, Latesha Elopre, Omar T Sims, Sirry Alang","doi":"10.1007/s40615-025-02675-4","DOIUrl":"https://doi.org/10.1007/s40615-025-02675-4","url":null,"abstract":"<p><strong>Introduction: </strong>Viral outbreaks such as COVID-19 have historically and disproportionately impacted low SES communities and communities of color. African Americans were disproportionately impacted by COVID-19 compared to others. At the height of the pandemic, vaccination was critical to mitigating the impact of the highly transmissible SARS-CoV2 virus. Despite this, hesitancy contributed to poor vaccination rates among adults in the United States. African Americans were more likely to report hesitancy and hesitancy associated with medical mistrust and structural barriers. Since vaccination is multifaceted and context specific, factors influencing vaccination should be considered within the appropriate context.</p><p><strong>Study purpose: </strong>The current study examines perspectives of COVID-19 vaccination efforts among African American Community Health Workers (CHWs) in HHS Region 4 through Critical Discourse Analysis (CDA) using an ecological framework.</p><p><strong>Results: </strong>Findings indicate equitable vaccination efforts empowered underserved communities. Moreover, findings imply equitable vaccination efforts improved trustworthiness of government and public health officials despite political tensions. Findings also revealed CHWs tend to trust COVID-related information provided by the CDC which is associated with acceptance. Despite religious tensions around vaccination, \"The Church\" emerged as a trustworthy location to receive COVID-19 information and vaccination.</p><p><strong>Conclusion: </strong>This research highlights the importance of community-centered public health interventions and trustworthiness. Community Health Workers (CHWs) hold established trust within marginalized communities. \"The Church\" is a trusted and uniquely positioned institution able to facilitate health interventions and deliver essential health-related services.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Mixed-Methods Examination of Fertility Desires and Reproductive Planning Among Low-Income Black Fathers.","authors":"Adaobi Anakwe, Wilson Majee, Abigail Olajire, Rhonda BeLue","doi":"10.1007/s40615-025-02663-8","DOIUrl":"https://doi.org/10.1007/s40615-025-02663-8","url":null,"abstract":"<p><strong>Background: </strong>Reproductive life planning (RLP) supports the achievement of fertility goals for both men and women, yet most studies focus on women. Black fathers living with low income, a vulnerable population at risk for multiple unplanned pregnancies and negatively stereotyped as reproductively irresponsible, are rarely asked about their RLP. This study aimed to examine the relationship between Black fathers' fertility desires and pregnancy prevention strategies and explore their contextual nuance.</p><p><strong>Methods: </strong>A concurrent mixed-methods approach was conducted using quantitative data (n = 36) and qualitative data (n = 17) among Black fathers living with low income and participating in a Midwestern urban community-based fatherhood program. Differences between groups were compared using Fisher's exact test, and thematic analyses examined the relationship between drivers of participants' fertility desires and reproductive planning practices.</p><p><strong>Results: </strong>Participants had a median age of 33 years. Findings indicated that participants' fertility desires were not associated with pregnancy prevention (p = 0.251). Most interview participants desired pregnancies and recognized the need for a reproductive life plan. Health before pregnancy and financial stability were important determinants of fertility planning, and using pregnancy contraception was dependent, among other factors, on navigating trust with a partner. Overall, participants thought that using an adult mindset, in which they considered the consequences of unprotected sex, was key to family planning.</p><p><strong>Conclusion: </strong>Findings highlight a breadth of factors influencing Black fathers' RLP and underscore the need for robust, tailored services. Community-based organizations already working with Black fathers can be leveraged to increase reproductive health awareness and facilitate reproductive life planning.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in Allostatic Load Among Different Races: A Comprehensive Scoping Review.","authors":"Olanike Gloria Olowokere, Olutola Esther Olasehinde, Titilayo Ifeoluwa Bisi-Adeniyi, Abimbola Fatima Onyia, Opeyemi Christiana De Campos, Oluwakemi Anuoluwapo Rotimi, Solomon Oladapo Rotimi","doi":"10.1007/s40615-025-02697-y","DOIUrl":"https://doi.org/10.1007/s40615-025-02697-y","url":null,"abstract":"<p><strong>Background: </strong>Allostatic load measures the cumulative stress, and it varies across populations. Its accurate measurement among racial groups is essential for understanding the effects of chronic stress on health. This review is aimed at investigating disparities in allostatic load between races and exploring the underlying mechanisms driving these disparities.</p><p><strong>Methods: </strong>A systematic search of literature was conducted, resulting in the inclusion of 296 relevant studies. These studies investigated a wide range of allostatic load biomarkers from the cardiovascular, metabolic, neuroendocrine, and immune systems. They involved diverse racial and ethnic populations with variations in age, gender, socioeconomic status (SES), and stress exposure.</p><p><strong>Results: </strong>The review revealed disparities in allostatic load biomarkers across different population groups. The extensive examination of a wide range of biomarkers in the selected studies showed systolic and diastolic blood pressure (DBP), heart rate/pulse rate, high-density lipoprotein cholesterol, glycosylated hemoglobin (HbA1c), body mass index, total cholesterol (TC), C-reactive protein, and interleukin-6 (IL-6)/IL-6 receptor as the most frequently used biomarkers across populations. Socioeconomic status, age, racial discrimination, stressful life events, and adverse health outcomes were associated with allostatic load across different racial groups.</p><p><strong>Conclusion: </strong>Disparities exist in previous studies on allostatic load due to differences in biomarker inclusion, calculation methods, study types, and populations studied. In addition, the roles of factors like social determinants of health, discrimination, and constitutive factors like genetics and age were discussed.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health in Relation to Xenophobic Experiences among African University Students in South Africa.","authors":"Akeem Adedolapo, Merga B Feyasa, Muneeb Salie, Soraya Seedat","doi":"10.1007/s40615-025-02682-5","DOIUrl":"https://doi.org/10.1007/s40615-025-02682-5","url":null,"abstract":"<p><strong>Objectives: </strong>Despite students from the African continent making up the majority of international students in South Africa, no studies have specifically assessed the association between xenophobia and perceived mental health outcomes in this population. We sought to ascertain the prevalence, types, associated features, and mental health associations of xenophobic experiences at a South African Higher Education Institution. Specifically, we examined xenophobic experiences and everyday discrimination of African postgraduate students as well as the impact of these experiences.</p><p><strong>Design: </strong>We conducted a cross-sectional study of African postgraduate students between December 2020 and March 2021. One hundred and sixty-one participants completed the online survey.</p><p><strong>Results: </strong>Nearly half (72; 44.52%) reported experiencing xenophobia. Univariate analysis showed statistically significant associations between xenophobia and depression (p = 0.021), anxiety (p = 0.009), and PTSD symptoms (p = 0.001), but not with alcohol use (p = 0.687). On multivariate analysis, social support had a significant moderating effect on the association between xenophobia and PTSD severity (p = 0.008).</p><p><strong>Conclusion: </strong>Findings from this study can inform interventions, such as improved access to mental health care for African international students in South Africa that may produce substantial benefits in terms of mental health and related outcomes.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profiles of Antiracist and Antisocial Online Behaviors among Asian American College Instagram Users: Associations with Academic Adjustment and Substance Use.","authors":"Yea Won Park, Xiangyu Tao, Celia B Fisher","doi":"10.1007/s40615-025-02681-6","DOIUrl":"https://doi.org/10.1007/s40615-025-02681-6","url":null,"abstract":"<p><p>Asian American college students spend more time online compared to their peers, and since the COVID-19 pandemic, online racism against Asian Americans has continued to increase. In response, students may engage in positive behaviors such as antiracist actions and coping with racism, while negative behaviors such as online antisocial behaviors and problematic internet use (PIU) are also common. However, little research has examined how these experiences influence Asian American students' academic adjustment, partly because the model minority myth portrays them as uniformly high-achieving and well-adjusted. Theories further underscore the importance of cultural factors in shaping both Asian American students' behaviors and their adjustment. This study examined co-occurring patterns of four online behaviors (antiracist actions, coping with racism, antisocial behaviors, and PIU), and their links to three domains of college adjustment (educational, relational, and psychological) substance use, and their associations with cultural factors. Participants were 235 Asian American students (M_age = 20.36, SD = 1.50, 47.2% women) who completed an online survey. Latent profile analysis revealed three profiles. The Antiracist (highest antiracist/coping, low antisocial behavior, moderate PIU) profile reported higher overall college adjustment. Both the Antisocial (moderate antiracist/coping, highest antisocial and PIU) and Low Engagement profiles reported lower college adjustment, but the Antisocial profile reported greater substance use whereas the Low Engagement profile reported lower substance use. Cultural correlates were differentially related across profiles. Findings highlight both protective and maladaptive roles of online behaviors and highlight the importance of considering cultural factors, and their impact on college adjustment and substance use.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}