The Science of Research on Racial/Ethnic Discrimination and Health - Journal Supplement

The National Cancer Institute's Division of Cancer Control and Population Sciences has released The Science of Research on Racial/Ethnic Discrimination and Health, a supplement to the American Journal of Public Health. The theme issue aims to highlight the need for and state of empirical research on racial/ethnic discrimination and its association with the health and health care received by racial/ethnic minority populations.

The issue's themed section opens with an article that reviews current measures, research approaches, data resources, and results of research on race/ethnicity-based health care discrimination. Subsequent articles center on issues of measurement, implicit bias, perception of discrimination and institutional racism. Several of the articles were written by presenters from a 2011 conference that examined the research and research methods used for investigating the role of racial/ethnic discrimination in health. This theme issue illustrates the state of the field, describes current methodology, identifies research gaps and suggests areas that should be considered for future research. 

The full text of each article is available free of charge:

• Research on Race/Ethnicity and Health Care Discrimination: Where We Are and Where We Need to Go (editorial)
• The Lived Experience of Race and Its Health Consequences
• Methods for the Scientific Study of Discrimination and Health: An Ecosocial Approach
• Under the Radar: How Unexamined Biases in Decision-Making Processes in Clinical Interactions Can Contribute to Health Care Disparities
• The State of Research on Racial/Ethnic Discrimination in The Receipt of Health Care
• A Life Course Perspective on How Racism May Be Related to Health Inequities
• Research on Discrimination and Health: An Exploratory Study of Unresolved Conceptual and Measurement Issues
• The Associations of Clinicians' Implicit Attitudes About Race With Medical Visit Communication and Patient Ratings of Interpersonal Care
• The Influence of Implicit Bias on Treatment Recommendations for 4 Common Pediatric Conditions: Pain, Urinary Tract Infection, Attention Deficit Hyperactivity Disorder, and Asthma
• Implicit Stereotyping and Medical Decisions: Unconscious Stereotype Activation in Practitioners' Thoughts About African Americans
• An Experimental Investigation of Possible Memory Biases Affecting Support for Racial Health Care Policy
• Discrimination and the Stress Response: Psychological and Physiological Consequences of Anticipating Prejudice in Interethnic Interactions
• Experiences and Perceptions of Medical Discrimination Among a Multiethnic Sample of Breast Cancer Patients in the Greater San Francisco Bay Area, California

Read more on the National Cancer Institute website. View videos of presentations from the 2011 Science of Research on Discrimination and Health Conference. Order a printed copy of the issue online from the NCI Publications Locator.

Perceived Discrimination and Substance Use among Rural African American Adolescents

High levels of discrimination are linked to increases in substance use for African American adolescent males, indicates a study titled Perceived Discrimination and Longitudinal Increases in Adolescent Substance Use: Gender Differences and Mediational Pathways. The study was published in the American Journal of Public Health.

Researchers examined whether or not adolescents’ perceptions of discrimination are associated with increases in substance use and the processes that mediate this association. A sample of 573 African American youths residing in rural Georgia, with an average age of 16, provided data on their experiences with discrimination, substance abuse, school engagement and affiliations with substance-using peers. Perceived discrimination among male youths was significantly related to increases in substance use; this association was mediated by the contributions of perceived discrimination to decreases in school engagement and increases in affiliations with substance-using peers. Further analysis also indicated that discrimination influences substance use rather than the reverse correlation.  

The authors recommend public health efforts designed to prevent substance use among male African American youths should include a focus on discriminatory experiences and strategies for coping with them.

Read more on the American Public Health Association website. Read the full-text of the study (pdf).

Improving Outcomes in an Era of Health Care Reform: The Need for Addressing Health Disparities

Magellan Health Services and ACMHA, The College for Behavioral Health Leadership presented a webinar geared towards behavioral health providers, including peer specialists andƒ systems administrators titled Improving Outcomes in an Era of Health Care Reform: The Need for Addressing Health Disparities. A major thrust of health care reform is its emphasis on clinical outcomes. As behavioral health providers and systems administrators grapple with the challenges this brings, reducing disparities based on geography, race and ethnicity, gender, and other known factors will be an important strategy for achieving this goal. This webinar was designed so participants are able to:

• Describe how reducing and eliminating health disparities is connected to improved clinical outcomes
• List five types of disparities in behavioral health care
• Describe the difference between individual and organizational cultural competence
• Describe the links between cultural and linguistic competence, quality care, and addressing disparities
• Develop an action to take within their own organization to improve cultural and linguistic competence

Watch the webinar recording.

Other webinars by Magellan Health Services and ACMHA include:

• Evolving Peer Support: Recovery Coaching, Whole Health, and System Integration
• Children's Crisis and School-based Mental Health Services

Access archived webinars on the Magellan Health Services website.

Learning to Support LGBT Children’s Mental Health & Well-Being: The Family Acceptance Project

While there are a range of support services for LGBT youth, few services have focused on the role or needs of families of LGBT adolescents, particularly families that are Spanish-speaking. This prompted Dr. Caitlin Ryan and Dr. Rafael Diaz to start the Family Acceptance Project (FAP) in 2002—the first research, education, family intervention and policy project to help ethnically and religiously diverse families support their LGBT children. FAP is affiliated with San Francisco State University. Their team has conducted the first in-depth research on what happens in Latino families when LGBT young people come out during adolescence. 

This research, conducted in English and Spanish with LGBT youth, young adults and families, identified more than 100 ways that families express acceptance and rejection of their LGBT children. This includes rejecting behaviors such as telling an adolescent that they shame the family or not letting the youth talk about their LGBT identity. It also includes accepting or supportive behaviors such as expressing affection, advocating for a gay or transgender youth when they are discriminated against by others or helping an LGBT youth get accurate information about their sexual orientation or gender identity.

For the first time research shows that families and caregivers have a dramatic and compelling impact on their LGBT children’s physical health, mental health and well-being. It was found that LGBT young people whose parents and caregivers reject them report high rates of depression, substance abuse, suicide attempts and risk for HIV infection. It was also discovered that LGBT young people whose parents support them show much higher rates of self-esteem and greater well-being, with better overall health and lower rates of health and mental health problems. 

Using this research, the FAP team has been working with Latino and other families with LGBT children for the past decade to develop a new family model to help families support their LGBT children. This new approach shows ethnically and religiously diverse families how to reduce their gay or transgender children’s risk for mental health problems and how to promote their well-being by engaging in supportive behaviors. By empowering Latino and other families with this new info, FAP has been able to show that parents and caregivers can learn to support their LGBT children once they learn how their reactions affect their LGBT children. This approach helps increase family support for young people with underlying mental health concerns. It also prevents homelessness and placement in foster care and juvenile justice programs that include high rates of LGBT out-of-home youth.

Read more on the National Alliance on Mental Illness website. Read more about the Family Acceptance Project. Download the Supportive Families, Healthy Children Booklet in English | Spanish | Chinese.

National Minority Mental Health Awareness Month Planning Webinar—June 5, 2012

July is National Minority Mental Health Awareness Month which offers organizations of all types and sizes a wonderful opportunity to create mental health awareness in diverse communities. This year we mark the 5th year Anniversary of this effort and our fourth year partnering with the National Alliance on Mental Illness (NAMI) to celebrate it. Along the way, different organizations have hosted a variety of events and activities in communities across the country. Join the celebration this year and bring much needed information to your community! In order to help you get started and to share ideas of activities you could implement, we will be hosting a planning webinar on Tuesday, June 5, 2012 1:00-2:00 pm Eastern Time. This webinar will provide strategies, tips and ideas you could use to mark the month. It will focus on social media related activities and on activities you could host at the community level. This will provide a broad array of options that you could implement. You will hear from people who have successfully implemented celebration activities before and who will share lessons learned. Here are a few ways you can get involved:

• Register for the webinar.
• Share your story on the National Minority Mental Health Awareness Month Facebook page.
• Tweet using the hashtag #MinorityMentalHealth
• Read more about National Minority Mental Health Awareness Month on the NAMI website.

Presenters:

Yolonda Clay, M.S. is the Multicultural Outreach Coordinator for NAMI Lexington, Kentucky. After coming to NAMI through the Family-to-Family program in 2006, Yolonda continued involvement by attending and facilitating support groups, teaching Family-to-Family and becoming an In Our Own Voice presenter. She helped establish NAMI Lexington’s Multicultural Action Committee (known as the MAC DIVAS and DADIS) and continues to strive to bring a diverse face to mental health in Kentucky through various multicultural and faith outreach and advocacy initiatives. Yolonda is also a KY Peer Support Specialist and a QPR Gatekeeper “Suicide Prevention” trainer.

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