Journal of urban health : bulletin of the New York Academy of Medicine
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The USA was built on legalized racism that started with enslavement and continues in the form of structural racial discrimination. This discrimination is difficult to measure because its many manifestations are hard to observe and dynamic. A useful tool would measure across settings, institutions, time periods in a person's life and the country's history. ⋯ Leading researchers and policy makers have called for improved measures of structural racism and discrimination and specifically for a lifecourse approach to measurement. This study is a step in that direction. CLASSIFICATION: Social Sciences.
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The rapid increase in fentanyl overdose deaths, particularly those also attributed to stimulants, has led to concerns about unintentional fentanyl exposure. Utilizing vital and medical record data, we identified overdose decedents from 2018 to 2021 in San Francisco who received care in the safety net system in the 3 years preceding death. ⋯ Among stimulant-fentanyl decedents, an increase in 10 years of age (adjusted odds ratio (aOR) 0.74 [95% CI:0.59-0.94]) and race other than White or Black (aOR 0.36 [95% CI:0.15-0.87]) had lower odds of evidence of pre-mortem opioid use. While not conclusive, these findings raise the possibility that a significant proportion of fentanyl overdose decedents in San Francisco may have not intended to consume an opioid on the occasion of their death.
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The COVID-19 pandemic prompted the early release of thousands of incarcerated individuals, including those with histories of intimate partner violence (IPV) perpetration. Survivor advocates stress the importance of adequate supports for decarcerated individuals during re-entry, and notification and supports for their partners or ex-partners if there is a history of IPV. This survey assessed IPV survivors' expectations of and experiences with decarceration in the state of Michigan. ⋯ By contrast, out of 72 survivors with still-incarcerated (ex-)partners, the same percentage - 64.3% - expected harmful behavior from their partner if released. Decarceration efforts may distinguish between individuals who are likely to harm versus help (ex-)partners upon release. Nonetheless, survivors reported several unmet needs, indicating the need for better re-integration services for decarcerated individuals and their families.
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Underrepresentation of Black individuals in genetic research is a longstanding issue. There are well-documented strategies to improve the enrollment of Black participants; however, few studies explore these strategies-as well as the barriers and facilitators for participation-by sampling Black people who have previously participated in genetic research. This study explores the decision-making process of Black adults who have participated in genetic research to identify best practices in the recruitment of Black subjects in genetic research. ⋯ Using thematic content analysis, 4 themes emerged from the interviews: (1) Participants are active players in health system, (2) information is power, and transparency is key, (3) therapeutic alliances and study characteristics facilitate participation, and (4) race pervades the research process. The decision to participate in genetic research for the participants in our study was prompted by participants' internal motivations and facilitated by trust in their doctor, trust in the institution, and ease of participation. Most participants viewed their enrollment in genetic research in the context of their own racial identity and the history of medical racism in the USA.
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From March 2020 through May 2021, nightlife venues were shut down and large gatherings were deemed illegal in New York City (NYC) due to COVID-19. This study sought to determine the extent of risky party attendance during the COVID-19 shutdown among people who attend electronic dance music parties in NYC. During the first four months that venues were permitted to reopen (June through September 2021), time-space sampling was used to survey adults (n = 278) about their party attendance during the first year of the shutdown (March 2020-March 2021). ⋯ Attending >10 parties was associated with increased risk for never wearing a mask (aPR = 2.74, 95% CI: 1.11-6.75) and for no other attendees wearing masks (aPR = 4.22, 95% CI: 1.26-14.07). Illegal dance parties continued in NYC during the COVID-19 shutdown. Prevention and harm reduction efforts to mitigate risk of COVID-19 transmission during such shutdowns are sorely needed.