Ethnicity & Health最新文献

{"title":"Through the patient lens: exploring the lived experiences of African American and Latinx adults with Chronic Kidney Disease.","authors":"Sadia Anjum Ashrafi, Minakshi Raj, Ana Selzer, Laura Quintero Silva, Rosalba Hernandez, Norman Hernandez, Katie Hopkins, Omar Ortiz, Michelle Martinez, Andiara Schwingel","doi":"10.1080/13557858.2025.2512577","DOIUrl":"10.1080/13557858.2025.2512577","url":null,"abstract":"<p><strong>Objective: </strong>Chronic Kidney Disease (CKD) disproportionately impacts African American and Latinx populations in the United States. This study utilized a participatory photo-elicitation approach to explore how African American and Latinx individuals with CKD perceive and navigate their disease journeys.</p><p><strong>Method: </strong>In this qualitative study, remote semi-structured interviews were conducted with a total of 20 African American and Latinx individuals with CKD, and the data were analyzed using reflexive thematic analysis.</p><p><strong>Results: </strong>Participants' ages ranged from 30 to 67, with 60% identifying as women and 30% reporting annual incomes <$20,000. Data analysis uncovered four key themes: (1) <i>'The Burden of CKD,'</i> highlighting the physical, social, and emotional toll on patients; (2) '<i>Navigating CKD with Positivity and Support,'</i> showcasing strategies to cultivate psychological well-being; (3) '<i>Systemic Difficulties,'</i> addressing barriers within the healthcare system; and (4) <i>'Building Bridges in the Kidney Community,'</i> illustrating advocacy efforts to combat CKD.</p><p><strong>Discussion: </strong>This study highlights the nuanced experiences of African American and Latinx individuals with CKD, highlighting their challenges and resilience. These findings emphasize the need for inclusive healthcare strategies that address these racially/ethnically diverse populations' unique needs to improve health outcomes.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"659-678"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210178","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":"Inclusive data practices: disaggregating race and assessing comorbidities among American Indian and Alaska Native individuals in PRAMS.","authors":"Micah Hartwell, KayLeigh Noblin, Jasha Lyons Echo-Hawk, Ashton Gatewood, Amy D Hendrix-Dicken","doi":"10.1080/13557858.2025.2525796","DOIUrl":"10.1080/13557858.2025.2525796","url":null,"abstract":"<p><strong>Importance: </strong>To assess potential misclassification or exclusion of American Indian and Alaska Native (AI/AN) individuals within the Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 8, we compared differences between aggregated and self-reported race variables and their impact on maternal comorbidities.</p><p><strong>Methods/design: </strong>We utilized several CDC-provided ethnoracial identity variables alongside a disaggregated variable we created. We then estimated comorbidity prevalences between these groupings to determine the impact of these methodological differences.</p><p><strong>Results: </strong>PRAMS variables, <i>MRACE_AMI</i> and <i>MAT_RACE_PU</i>, included 13,341 (no distinction between AI and AN) and 7,494 AI (excluded AN altogether), respectively. Our constructed variable (n = 13,383) included 19 ethnoracial-subgroups and 42 tribal members not selecting AI/AN race. We found significant differences in the prevalence of comorbidities by these variables. For instance, the prevalence for diabetes with <i>MAT_RACE_PU</i> was 4.93%, with <i>MRACE_AMI</i> was 4.04%, but our subgroup <i>AI (alone)</i> was 5.46%, and <i>AN (alone)</i> was 1.37%.</p><p><strong>Conclusion: </strong>Our results highlight significant disparities in maternal comorbidities among AI/AN women when different racial classification strategies are employed. Disaggregating these data revealed differences that are crucial for understanding the unique health challenges faced by various subgroups.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"718-731"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the intersectionality of the rural Hispanic/Latino Veteran population: a scoping review of health-related challenges.","authors":"Kelsea LeBeau, Janet Lopez, Melanie Orejuela, Nathaniel Eliazar-Macke, I Magaly Freytes","doi":"10.1080/13557858.2025.2486413","DOIUrl":"10.1080/13557858.2025.2486413","url":null,"abstract":"<p><strong>Introduction: </strong>The rural Veteran population is becoming more racially and ethnically diverse, with Hispanic/Latino (H/L) Veterans representing a growing proportion of rural Veterans. Despite experiencing similar challenges to those of other rural Veteran populations, rural H/L Veterans face additional health-related challenges due to sociocultural factors. A gap in knowledge for rural H/L Veterans exists; thus, research on this population is warranted.</p><p><strong>Objective: </strong>We conducted a scoping review to examine literature on rural H/L Veterans. We synthesized health-related issues, needs, and services for rural H/L Veterans, including health disparities, tailored interventions to address health disparities, and whether studies employed an intersectional approach to understand and address challenges for rural H/L Veterans.</p><p><strong>Methods: </strong>We followed Arksey and O'Malley's framework. Inclusion criteria were limited to English language articles published between 2007-2024 focusing on rural H/L Veterans in the United States and U.S. state equivalents. Two reviewers assessed selected articles.</p><p><strong>Results: </strong>Sixteen articles were included. Most articles (75%) were retrospective cohort or retrospective cross-sectional studies. Studies examined health disparities related to diabetes, suicide, depression, traumatic brain injury, PTSD, chronic pain, COVID-19 vaccination, primary care access, goals of care documentation, and multimorbidity. 'Hispanic' and/or 'Latino' terms were often used as descriptive characteristics and/or covariates and lacked clear definitions. Few studies thoroughly highlighted the intersectionality of geographic location and H/L ethnicity for Veterans. Additionally, limitations in data were noted by some studies.</p><p><strong>Conclusions: </strong>Increased research on health-related challenges experienced by rural H/L Veterans is needed. Of specific importance is research that emphasizes the intersectionality of rural H/L Veterans, acknowledges intra-ethnic diversity and cultural influence, prioritizes culturally relevant interventions, addresses data limitations, and focuses on providing equitable care. Knowledge gained can inform the development of Veteran-centric and culturally appropriate policies and practices to improve the health outcomes of rural H/L Veterans and achieve health equity.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"553-580"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774849","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":"The model isn't made for us: Ghanaian and Nigerian youths' experiences in London's mental health system: a qualitative study.","authors":"Anthony Isiwele, Carol Rivas, Gillian Stokes","doi":"10.1080/13557858.2025.2511631","DOIUrl":"10.1080/13557858.2025.2511631","url":null,"abstract":"<p><strong>Objectives: </strong>This study explores the lived experiences of Ghanaian and Nigerian youth in London's mental health system, highlighting systemic barriers, cultural misalignment, and practitioner perspectives on care models. Standardised approaches, such as Cognitive Behavioral Therapy (CBT), often fail to accommodate the cultural and systemic needs of these communities, contributing to disparities in access and engagement.</p><p><strong>Design: </strong>A qualitative study employing Interpretative Phenomenological Analysis (IPA) was conducted with 12 participants, including Ghanaian and Nigerian youth (n = 5), parents (n = 2), and mental health practitioners (n = 5). Semi-structured interviews facilitated an in-depth exploration of personal and shared experiences, analysed using idiographic and group-level thematic approaches.</p><p><strong>Results: </strong>Three overarching themes emerged: (1) '<i>They didn't really help me'</i> - highlighting system-level barriers such as long wait times, unfulfilled referrals, and marginalisation; (2) <i>Cross-racial therapeutic dynamics and practitioners' observations</i> - revealing tensions between cultural differences in therapy, mixed practitioner experiences, and challenges in building rapport; (3) <i>There hasn't been enough in the model of care</i> - illustrating the rigidity and cultural insensitivity of standardised therapeutic approaches, particularly within NHS Talking Therapy (formerly IAPT).</p><p><strong>Conclusion: </strong>The study highlights the need for a shift from cultural competence to cultural humility in mental healthcare. Addressing systemic barriers requires integrating cultural humility in practitioner training, adapting care models to accommodate diverse experiences, and fostering inclusive mental health policies. These findings advocate for rethinking mental health service delivery to ensure equitable and effective care for Ghanaian, Nigerian and diverse youth in London.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"638-658"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183611","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":"Knowledge and awareness of healthcare systems and the uptake of diabetic services among Chinese people diagnosed with type 2 diabetes in the UK.","authors":"Tarnjit Sehmbi, Ran Cao, Raju Sapkota, Shahina Pardhan","doi":"10.1080/13557858.2025.2496188","DOIUrl":"10.1080/13557858.2025.2496188","url":null,"abstract":"<p><strong>Objectives: </strong>Diabetes poses a significant public health challenge. The Chinese community has unique cultural characteristics that can influence their understanding of the diabetes healthcare system and engagement with services. This study aims to explore the knowledge and awareness of the diabetes healthcare system and the uptake of healthcare services in the UK Chinese population.</p><p><strong>Design: </strong>This study adopted a qualitative design. Three focus group discussions (FGDs) were conducted on Zoom with 22 Chinese participants with self-reported type 2 diabetes living in the UK. Participants ranged from 24 to 85 years (mean age = 66 years, SD = 17.1). A purposive sample was recruited through study adverts in Chinese community centres and snowball sampling. Data were analysed using Braun and Clarke's thematic analysis (TA).</p><p><strong>Results: </strong>This paper discusses 4 themes: Awareness and understanding of diabetes, healthcare access and utilisation, attitudes towards diabetes prevention programmes and Chinese medicine vs. Western medicine. Limited knowledge and awareness of diabetes was highlighted, with cultural factors impacting this. Factors which impacted healthcare access and utilisation were linguistic/ communication challenges, and trust and perception of the NHS. Participants were unaware of diabetes prevention programmes and highlighted that these were culturally inappropriate. Generational preferences were noted in the way participants wished to receive diabetes education. The western medical system was viewed as medication focused, therefore the older Chinese community trusted familiar natural methods of illness management.</p><p><strong>Conclusion: </strong>These findings highlight the importance of ensuring diabetes education is culturally appropriate. Generational differences in education preference should be recognised by healthcare professionals to increase healthcare engagement. These findings demonstrate the important need to educate UK healthcare professionals with the unique sociocultural contexts for this ethnic group. This study uncovers gaps in awareness and service uptake, highlighting the need for co-development of interventions that promote health equity and improve diabetes management within this population.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"602-619"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065029","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":"Differences in chronic disease prevalence by ethno-racial identity among Canadians: analyses of nationally representative self-report data.","authors":"Ramez Salama, Todd Coleman","doi":"10.1080/13557858.2025.2511621","DOIUrl":"10.1080/13557858.2025.2511621","url":null,"abstract":"<p><strong>Objective: </strong>In 2015, chronic diseases accounted for approximately three-quarters of deaths in Ontario, with the most common conditions being cancer, cardiovascular diseases, diabetes, and chronic lower respiratory diseases. Despite Canada's diversity, there is limited health research on chronic disease prevalence among visible minority populations. This study aimed to examine the relationship between visible minority status and the prevalence of chronic diseases in Canada, with a focus on self-identified ethnoracial identity.</p><p><strong>Design: </strong>Data were drawn from the 2017/18 combined cycle of the Canadian Community Health Survey (<i>n </i>= 113,290), accessed through the Statistics Canada Research Data Centre. Each enumerated visible minority group was analysed separately, except for Chinese, Korean, and Japanese participants, who were grouped into a single category due to sample size constraints. Chronic conditions were self-reported with binary 'yes/no' responses, with the exception of obesity, which was derived from reported weight and height data. Logistic regression was used to calculate bivariate and multivariable odds ratios (OR) with 95% confidence intervals (CI). Analyses were stratified by sex (male/female, as measured by the CCHS).</p><p><strong>Results: </strong>Multivariable analyses indicated that visible minority males had higher odds of reporting high cholesterol, type II diabetes, and hypertension, but lower odds of arthritis and cancer, compared white males. Filipino males had the highest odds for hypertension (OR: 2.36; 95%CI: 1.40-3.99), while South Asian males had the lowest odds of cancer (OR: 0.09; 95%CI: 0.04-0.19). Indigenous males and females consistently reported higher odds of most chronic conditions.</p><p><strong>Conclusion: </strong>Several ethno-racial groups exhibited elevated odds of specific chronic conditions, though not uniformly across all tested outcomes. These findings underscore the importance for healthcare providers, public health practitioners, and policymakers to consider the nuanced relationship between ethnoracial identity and chronic conditions. Culturally competent care and targeted health interventions should reflect this complexity.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"620-637"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227417","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":"Parent's experiences of the impact of ethnicity and skin pigmentation on perinatal care.","authors":"Frankie Fair, Amy Furness, Gina Higginbottom, Sam Oddie, Hora Soltani","doi":"10.1080/13557858.2025.2488893","DOIUrl":"10.1080/13557858.2025.2488893","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to explore the perceived impact of ethnicity and race on perinatal care among parents from diverse ethnic minority backgrounds or who had a Black, Asian, or ethnic minority child born in the UK within the last five years to better understand areas of ethnic inequality within perinatal care.</p><p><strong>Design: </strong>This study employed a focused ethnography, recruiting a purposive sample through posters, professional organisations, and social media platforms. Efforts to ensure maximum phenomenon variation included diverse ethnic and geographical representation. Semi-structured interviews using the digital platform, Zoom, explored experiences of accessing and receiving care, with a focus on challenges and perceptions related to ethnicity, race or skin pigmentation. Interview schedules underwent stakeholder validation and pilot testing. NVivo software facilitated qualitative analysis, employing an inductive approach with rigorous coding and thematic analysis.</p><p><strong>Results: </strong>Ethnic minority parental experiences (<i>n</i> = 24) revealed significant systemic challenges within the healthcare system. Three major themes were observed: Parent's voices not being heard, Systemic factors and Discrimination. Participants expressed feelings of marginalisation and inadequate communication with healthcare providers. Instances where concerns were dismissed or belittled, coupled with issues related to consent, highlighted pervasive systemic shortcomings. Structural barriers such as difficulties in scheduling appointments and perceived organisational neglect further compounded these challenges. Discriminatory attitudes and racial stereotypes also influenced the quality of care received, contributing to disparities in health outcomes and maternal wellbeing. Participants noted feelings of social isolation, exacerbated by pandemic-related restrictions and a lack of tailored support networks.</p><p><strong>Conclusion: </strong>These findings underscore the urgent need for systemic reforms aimed at ensuring culturally safe and anti-racist practice, addressing communication barriers, and reducing discriminatory practices to enhance healthcare experiences and outcomes for ethnic minority parents. This includes training all healthcare staff around cultural safety.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"581-601"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038706","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":"'Doing what I need to do': sustaining mental health, medication adherence, and engagement in care among Black women living with HIV during the COVID-19 onset of 2020.","authors":"Sannisha K Dale, Peyton R Willie, Naysha N Shahid, Maria Fernanda Silva, Reyanna St Juste, Amanda Ponce, Nadine Gardner, Felicia O Casanova","doi":"10.1080/13557858.2025.2482625","DOIUrl":"10.1080/13557858.2025.2482625","url":null,"abstract":"<p><strong>Background: </strong>The HIV epidemic and COVID-19 are disproportionately impacting Black communities. For Black women living with HIV (BWLWH), 2020 COVID-19 mandates (e.g. stay-at-home orders) may have had implications for HIV medication adherence, engagement in care, and mental health.</p><p><strong>Method: </strong>In April 2020 during COVID-19 spikes in the US, thirty Black women living with HIV in Miami, FL participated in qualitative semi-structured interviews that asked about COVID-related concerns, HIV medication adherence, engagement in care, and mental health. Interviews were audio recorded, transcribed, and coded using thematic content analysis.</p><p><strong>Results: </strong>Qualitative analyses highlighted themes around concerns (e.g. whether HIV placed them at increased risk for COVID-19, feeling confined and restricted); mental health (e.g. feeling anxious, depressed); medication adherence (adhering to HIV medication despite COVID-19); engagement in care (e.g. providers canceling appointments, being persistent in contacting providers); adaptive coping (e.g. cleaning/chores, watching series/videos, seeking/receiving social support, praying/watching virtual church services, limiting news consumption, social distancing and wearing masks); minimal use of unhelpful coping strategies (e.g. substance use, eating more unhealthy food); losses/deaths; and the need for financial, food, mental health, and community level (e.g. testing sites) resources. Additionally, survey responses to quantitative measures indicated that a significant portion of women (between 20% and 47%) had difficulties such as getting food, paying bills, getting hand sanitizer and cleaning supplies, communicating with loved ones, reduced wages/work hours, and transportation barriers.</p><p><strong>Conclusion: </strong>Our findings indicate that in the context of COVID-19 stay-at-home orders BWLWH were moderately impacted, shared concerns and mental health symptoms, and voiced the shortfalls of medical providers. Further, BWLWH exhibited resilience with regard to medication adherence and the use of adaptive coping strategies while echoing the need for additional resources and structural interventions.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"507-531"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of discrimination, inflammation, and coping style on self-rated health among South Asian individuals in the MASALA Study.","authors":"Raji Pillai, Sahiti Myneni, Constance M Johnson, Nilay S Shah, Alka M Kanaya, Jennifer E S Beauchamp","doi":"10.1080/13557858.2025.2484581","DOIUrl":"10.1080/13557858.2025.2484581","url":null,"abstract":"<p><strong>Objectives: </strong>South Asian individuals (SAs) may have heightened levels of inflammatory markers, such as C reactive protein (CRP), Tumor Necrosis Factor-α (TNF-α), leptin, and resistin, and decreased levels of anti-inflammatory adiponectin, contributing to higher cardiovascular disease (CVD) incidence. Social determinants of health, like discrimination, are also associated with risks for CVD in SAs. This study examined the associations between discrimination and inflammation and whether coping styles moderated the association between discrimination and self-rated health (SRH) among SAs in the United States.</p><p><strong>Design: </strong>Secondary analysis of data obtained from 1164 SAs (mean age = 57 years, SD = 9.4, 48% women) enrolled in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study was conducted. Discrimination was measured using the Everyday Discrimination Scale (EDS). Inflammatory markers (CRP, TNF-α, leptin, resistin) and anti-inflammatory adiponectin were measured from blood samples. SRH was self-reported by participants. Coping styles were defined as problem-focused or emotion-focused. Multiple regression with bootstrapping was used to examine associations between discrimination and inflammatory markers and adiponectin. Moderation analysis assessed whether coping styles moderated the association between discrimination and SRH.</p><p><strong>Results: </strong>No significant associations were found between discrimination and inflammation. Discrimination was inversely associated with SRH (OR = 0.969, <i>p</i> = 0.005). Emotion-focused coping moderated the association between discrimination and SRH (OR = 0.969, 95% CI = 0.940-0.999, <i>p</i> = 0.044). Among participants who used emotion-focused coping strategies, an increase in self-reported discriminatory experiences was associated with lower odds of having good or excellent SRH. Problem-focused coping did not moderate the association between discrimination and SRH.</p><p><strong>Conclusion: </strong>The unknown magnitude and duration, and the lack of variability in discrimination among participants could explain the null findings between discrimination and inflammation. Gaining a better understanding of the ways in which SAs appraise and cope with discriminatory experiences may help to develop future interventions targeted to reduce the adverse health consequences of discrimination among SAs.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"532-552"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765735","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":"The impact of cumulative trauma on health service utilization practices of Black immigrant women.","authors":"Jennifer J Lee, Bushra Sabri, Nicole E Warren, Ginger Hanson","doi":"10.1080/13557858.2025.2461167","DOIUrl":"10.1080/13557858.2025.2461167","url":null,"abstract":"<p><strong>Background: </strong>Factors that influence health service utilization among Black immigrant women with experiences of trauma are not well understood. An improved understanding of the impact of cumulative trauma on Black immigrant women's health care utilization is critical to increase access to health services for this population.</p><p><strong>Methods: </strong>Using baseline data of 147 Black immigrant women from an existing NICHD-funded study, hierarchical multiple linear regression was used to assess the impact of length of stay in the US, education, cumulative trauma frequency, everyday discrimination, and the interaction of discrimination and cumulative trauma on health service utilization. A model-building approach was used to determine covariates to include in the final model.</p><p><strong>Results: </strong>Cumulative trauma frequency was positively associated with health service usage (<i>b</i> = 0.02; <i>p</i> = 0.026). Compared to Black immigrant women who had lived in the US for longer than 10 years, those who had lived in the US between 1 and 4 years were less likely to use health services (<i>b</i> = -0.89; CI: -1.67, -0.11). Black immigrant women with bachelor's degrees were less likely to use health services compared to Black immigrant women with post-graduate degrees (<i>b</i> = -0.85; CI: -1.61, -0.09). The interaction of cumulative trauma and discrimination was also significantly associated with the behavior of utilizing health services (<i>b</i> = 0.002; CI: 0.0003, 0.004). Those who experienced higher perceived levels of discrimination and high cumulative trauma levels were more likely to use health services compared to those with lower levels of discrimination and high levels of cumulative trauma.</p><p><strong>Conclusion: </strong>Cumulative trauma experiences were positively correlated with health service utilization, and discrimination strengthened this relationship. Future work must examine long-term data for patterns of seeking health services over time, explore specific types of health services associated with cumulative trauma experiences, and study associations between health service usage and health outcomes.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"453-470"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}