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Scholars and activists working both within and outside the massive health-related machinery of government and the private sector and within and outside communities of color address the same fundamental questions: Why do health disparities exist? Why have they persisted over such a long time? What can be done to significantly reduce or eliminate them?

This study assesses distress in the lives of farming population in Ghana's northern interior. Whereas recent studies addressing mental health in Africa produce evidentially sound analyses of the correlated role of food and water insecurity, this study engages with how and why worries over educational costs feature so prominently in a measure of psychosocial well-being. While it is significant that education identifiably figures in escalating the experience with distress, my contention is that what is more important is putting that escalation into the context of why. I use Narotzky and Besnier's framework for understanding the economy as the interactions between crisis, value, and hope to situate a mixed methods study concerned with how distress is proximately shaped by the interactive socioeconomic features of daily life (paying school fees, buying food, cultivating maize, etc.) but ultimately shaped by structural features of the political economy that direct people's objectives amid chronic crisis. My proposition is that because education is where value resides, it is a primary vehicle by which people are acting in crisis in a hopeful manner. In this way, this study leverages the tools of economic anthropology within debates about how to best assess the ways in which health and illness are shaped by socioeconomic realms.

In this chapter, the author critically examines the deeply entrenched practices and theories within counselor education, revealing their roots in historically dominant, Eurocentric, and often racially oppressive assumptions. This study brings to light the pervasive impact of these traditional approaches, illuminating their role in perpetuating racial oppression and disparities in mental health care. The author presents a compelling argument for adopting Critical Race Theory (CRT) as an effective pedagogical and clinical practice framework in the counseling profession, a step toward its much-needed liberation. CRT's tenets are examined as a robust alternative, promoting socially just outcomes in counseling and psychotherapy. The article highlights CRT's capacity to address the well-established relationship between racism, white supremacy, and minority mental health. It proposes a groundbreaking model for praxis, predicated on CRT, which holds potential not only to challenge and disrupt oppressive structures but also to pave the way for the liberation of both the oppressed and the oppressor. This seminal work prompts a re-envisioning of counselor education, asserting a call for a transformative shift toward a liberation-based, social justice pedagogy.

Organisations and systems of care working within both specific and non-specific trauma-informed approaches must adapt a multicultural lens, in design, delivery and evaluation of services and interventions. Cultural and social factors can directly influence the exposure of individuals to traumatic events (Roberts, Austin, Corliss, Vandermorris, & Koenen, 2010). At the same time, social and cultural identities influence the development and experience of trauma and symptoms, including treatment outcomes (Marsella, 2010; Wilson, 2007). In this chapter, Ravind Jeawon and I provide some of the essential factors that trauma-responsive systems may wish to consider. The first part of this chapter deals with the idea of multicultural identities and practices and highlights some of the outcomes associated with accessing behavioural healthcare. The impact of intersectionality and microaggression on those from diverse backgrounds is also considered. Finally, a guiding framework is provided that examines what needs to be implemented across organisations in order to provide the system with a multicultural lens in which to view and deliver appropriate services. Crucially, multicultural responsiveness will not come from tick box training regimes, it is something that needs to be kept on the agenda and is a lifelong trajectory.

Purpose: Fear of deportation and its relationship to healthcare access has been less studied among immigrant Latinx men who have sex with men (MSM), a population at risk for HIV and characterized by their multiple minority statuses. The first step is to accurately measure their fear of deportation.

Approach: We used an exploratory sequential mixed methods design. Eligibility criteria were that research participants be ages 18–34 years; Latinx; cisgender male; having had sex with another male; residing in the District of Columbia metro area; and not a US citizen or legal permanent resident. In Study 1, we used in-depth interviews and thematic analysis. Using participants' interview responses, we inductively generated 15 items for a fear of deportation scale. In Study 2, we used survey data to assess the scale's psychometric properties. We conducted independent samples t-test on the associations between scale scores and barriers to healthcare access.

Findings: For the 20 participants in Study 1, fear of deportation resulted in chronic anxiety. Participants managed their fear through vigilance, and behaviors restricting their movement and social network engagement. In Study 2, we used data from 86 mostly undocumented participants. The scale was internally consistent (α = 0.89) and had a single factor. Those with higher fear of deportation scores were significantly more likely to report avoiding healthcare because they were worried about their immigration status (p = 0.007).

Originality: We described how fear of deportation limits healthcare access for immigrant Latinx MSM.

Research implications: Future research should examine fear of deportation and HIV risk among immigrant Latinx MSM.

The COVID-19 pandemic has impacted every community across the globe, but the global COVID-19 data show that the United States remains the most affected country where well over 666,000 people died, and approximately 40 million citizens became ill due to the virus' spread by mid-2021 (CDC, 2021). It is also noteworthy that extreme racial disparities in rates of COVID-19 cases and deaths are high in the United States, specifically among African American population. This situation is particularly evident among African American population in Alabama's Black Belt. Subsequently, COVID-19, racial disparities, and health inequalities have become central to the national and regional conversation. This chapter examines the associations between COVID-19, social determinants of health, and the systematic health disparity in African American population in Alabama's Black Belt region using Geographic Information Systems and the concept of uneven spatial development. Understanding the relationship between COVID-19 and these disparities within a spatial context vital to developing pathways to overcome the pandemic's effects and combat the systemic discrimination in this region. The derived policy recommendation could apply to other regions experiencing social inequality and health disparity.

Racism occurs in many ways and varies across countries, evolving and adapting to sociocultural history, as well as contemporary economic, political and technological changes. This chapter discusses the multilevel dimensions of racism and its diverse manifestations across multiracial societies. It examines how different aspects of racism are mediated interpersonally, and embedded in institutions, social structures and processes, that produce and sustain racial inequities in power, resources and lived experiences. Furthermore, this chapter explores the direct and indirect ways racism is expressed in online and offline platforms and details its impacts on various groups based on their intersecting social and cultural identities. Targets of racism are those who primarily bear the adverse effects. However, racism also affects its perpetrators in many ways, including by limiting their social relations and attachments, and by imposing social and economic costs. This chapter thus analyses the many aspects of racism both from targets and perpetrators' perspectives.

Purpose: We review theory and research to suggest how research on sexual and gender minority (SGM) population health could more completely account for social class.

Approach: First, we review theory on social class, gender, and sexuality, especially pertaining to health. Next, we review research on social class among SGM populations. Then, we review 42 studies of SGM population health that accounted for one or more components of social class. Finally, we suggest future directions for investigating social class as a fundamental driver of SGM health.

Findings: Social class and SGM stigma are both theorized as “fundamental causes” of health, yet most studies of SGM health do not rigorously theorize social class. A few studies control socioeconomic characteristics as mediators of SGM health disparities, but that approach obscures class disparities within SGM populations. Only two of 42 studies we reviewed examined SGM population health at the intersections of social class, gender, and sexuality.

Research implications: Researchers interested in SGM population health would benefit from explicitly stating their chosen theory and operationalization of social class. Techniques such as splitting samples by social class and statistical interactions can help illuminate how social class and SGM status intertwine to influence health.

Originality: We synthesize theory and research on social class, sexuality, and gender pertaining to health. In doing so, we hope to help future research more thoroughly account for social class as a factor shaping the lives and health of SGM people.

Anger responding to government-imposed COVID-19 pandemic mandates is examined in relation to 2021 international reports of street protests in cities, with a focus on Perth, Western Australia. Angry protestors displayed a variety of signs and symbols, united under banners demanding freedom. A multi-disciplinary analysis attends to distrust in public health mandates in the global context of an insecure biosphere. Mandates can signify symbolic death, and anger an ‘immune’ response to lifeworld constraints. Anger among nurses and vaccine-hesitant protestors signifies ethical rejection of super-imposed mandates, and fear of alleged vaccine harms. Official pandemic communications are held to be ill-timed, lacking information meaningful to diverse citizens' needs, and offset by poorly contextualised data and unreliable pre-packaged interpretations communicated via digital technologies. A novel hypothesis proposes semiotic misrecognition of the global nature of communications from intersecting ecosocial crises may underlie protestors' anger. Modelling of a management system to validate broad contextual knowledges may restore meaningful balance and public solidarity, to creatively respond to future human crises.

This chapters discusses the power structures affecting access to healthcare and the quality of received care including factors like gender, ethnicity, social and economic status among others from an intersectional perspective. Structural changes are necessary to decrease the health inequalities and vulnerabilities during the pandemic. An intersectional approach helps to display the interactions of different power structures and social categories which put people at differential risk of infection and/or mortality of COVID-19. The intersectional approach should be used not only to understand the pandemic impact on people but also when planning the healthcare policies, care plans and support services.