Background: Stigmatization associated with the COVID-19 pandemic, whereby certain groups are believed to be a potential source of COVID-19, resulted in COVID-19-related racism through direct interpersonal instances and vicarious (i.e., witnessed) experiences. However, few studies assessed both direct and vicarious COVID-19-related racism across racial/ethnic groups using mixed methods.

Objectives: To examine whether direct and vicarious COVID-19-related racism varied across racial/ethnic groups, and themes in participants’ descriptions of racism experiences.

Methods: Using a nationally representative survey of U.S. adults (January-March 2021), direct and vicarious COVID-19-related racism were assessed by single-item measures, respectively: 1)participants were the target of racism because they were thought to belong to a group more likely to get COVID-19; 2)participants witnessed racism against others who were thought to belong to a group more likely to get COVID-19. Logistic regression examined associations between COVID-19-related racism and race/ethnicity (N=5476). Qualitative analyses identified themes in open-ended responses elaborating on racism experiences.

Results: All racial/ethnic groups besides Hispanic/Latino (English-Language Preferred) were significantly more likely to experience direct (aORs=2.06-4.92) and vicarious (aORs=1.63-3.02) racism than White adults. Asian (aOR=4.92,95%CI=2.84-8.50) and Hispanic/Latino (Spanish-Language Preferred) adults (aOR=4.74,95%CI=2.58-8.72) were most likely to report direct racism. Multiracial (aOR=3.02,95%CI=2.18-4.18) and Asian (aOR=2.54,95%CI=1.88-3.42) adults were most likely to report vicarious racism. Qualitative responses included many forms of racism (e.g., physical, verbal, covert) and settings where racism occurred (e.g., stores, healthcare facilities, online).

Conclusion: Findings suggest COVID-19-related racism is common in communities of color and manifests in different forms and settings, thereby highlighting the need to reduce/prevent the perpetration of racism.

The disproportionate rates of unhealthy food in many communities of color in the US may contribute to health inequities and food insecurity. Gentrification, including early and rapid phases of gentrification, has been associated with residents’ increased adverse health outcomes. This study adds to the growing body of research on this issue by examining the relationship between gentrification, the food environment, food habitus (the interplay between food chances and food choices), and health in New York City. We used a mixed methods approach to assess the food landscape in NYC between 1990 and 2014 using group-based trajectory modeling and the National Establishments Time-Series database, census data, and in-depth interviews with mothers from the Columbia Center for Children’s Environmental Health study. The growth in the food environment was unevenly distributed. While healthy food chances declined, unhealthy food chances quickly grew, commanding a dominant presence in all neighborhoods. Gentrifying neighborhoods surprisingly experienced the most remarkable growth in unhealthy food chances compared to other neighborhoods. A cross-tabulation of the food chance trajectories indicated the presence of food ecologies that exhibit both healthy and unhealthy food chances. There was a strong association between the type of food ecology and gentrification status (p < 0.001). The in-depth interviews corroborated these findings and revealed that food insecurity is a by-product of gentrification in two ways. First, neighborhoods in the early stages of gentrification are inundated with unhealthy food chances, such as fast-food chains, without adequate access to quality, fresh, healthy foods. Secondly, when healthy food chances finally arrive in resource areas through gentrification, families are forced to relocate to areas without access to fresh, affordable healthy foods due to the increased cost of living. This cycle of food insecurity is inequitable and a result of historical racial segregation, exploitative capitalistic markets, and racist stereotypes. Speculators invest in unhealthy food chances aligned with pre-existing stereotypes, assumptions, and beliefs that such communities do not or will not consume healthier foods. Therefore, a cycle of structural racism reinvents itself through this investment in unhealthy food chances, constructing food deserts and swamps bestowed upon communities experiencing poverty and disproportionate adverse cardiovascular health conditions. There is a need for strengthened policy focused on the relationship between gentrification mitigation and health outcomes.

Background:

According to the World Health Organization, vaccine hesitancy is one of the top 10 global threats and the increase in vaccination hesitancy observed during the COVID-19 epidemic may lead to a resurgence of preventable diseases. Research has shown that vaccine hesitancy differs along sociodemographic lines and therefore, may disproportionally affect the most vulnerable populations.

Objectives:

While some research has looked at vaccine hesitancy in relation to particular vaccines, none have examined general vaccine hesitancy, its relationship to demographic variables, health care access, or experiences of racial discrimination. This study fills gaps in that knowledge.

Methods:

Demographics, healthcare access, experiences with racial discrimination, and vaccine hesitancy were obtained from survey data (N= 2,022 US adults), with racial/ethnic populations intentionally oversampled to avoid aggregation of data. We performed a partial proportional odds ordinal logistic regression to predict the odds of being more vaccine hesitant.

Results:

As expected, age, gender, race, and education were predictors of vaccine hesitancy. Healthcare access and racial discrimination were also both significantly associated with vaccine hesitancy. Those without a primary care provider and those who had to forego healthcare due to cost had greater odds of vaccine hesitancy (OR=1.35; OR=1.29, respectively), and for every 1-point increase in racial discrimination score, odds of being more vaccine hesitant increased by a factor of 1.03.

Conclusion:

Associations between vaccine hesitancy, healthcare access, and racial discrimination support the importance of equitable access to healthcare as well as the importance of addressing policies, systems, and environmental factors to address vaccine hesitancy.

Objectives: This presentation explores mental health among multiracial and multiethnic adults in the United States, and the impact of intersectional identities, environmental factors, prejudice events, social and interpersonal support, social inclusion, and strength in ethnic identity.
Methods: A cross-sectional survey was distributed Feb-June 2022 (Sample A, n=347) and Oct-Dec 2022 (Sample B, n=1012). A subset of participants (n=17) participated in semi-structured interviews.
Results: Participants in each survey sample endorsed symptoms for depression (A: 40.6%, B: 42.1%), anxiety (A: 41.5%, B: 40.5%), PTSD (A: 32.9%, B: 40.4%), and suicidal behaviors (A: 21.1%, B: 25.4%). Multiracial and multiethnic adults described navigating bias and stigma from cultures, communities, and providers when seeking mental wellness. Respondents demonstrated resilience and strength, and emphasized the importance of secure identity formation, impact of group specific processes, reducing barriers to mental health care, and need for culturally responsive care.
Conclusions: This study highlights the complex mental health needs of multiracial and multiethnic adults in the United States requiring future research and public health intervention. Multiracial adults have a high prevalence of mental health conditions, consistent with prior research. Intersectionality, prejudice events, strength in ethnic identity, and social support impact mental health.