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Since the development of the COVID-19 vaccinations, questions surrounding race have been prominent in the literature on vaccine uptake. Early in the vaccine rollout, public health officials were concerned with the relatively lower rates of uptake among certain racial/ethnic minority groups. We suggest that this may also be patterned by racial/ethnic residential segregation, which previous work has demonstrated to be an important factor for both health and access to health care.

In this study, we examine county-level vaccination rates, racial/ethnic composition, and residential segregation across the U.S. We compile data from several sources, including the American Community Survey (ACS) and Centers for Disease Control (CDC) measured at the county level.

We find that just looking at the associations between racial/ethnic composition and vaccination rates, both percent Black and percent White are significant and negative, meaning that higher percentages of these groups in a county are associated with lower vaccination rates, whereas the opposite is the case for percent Latino. When we factor in segregation, as measured by the index of dissimilarity, the patterns change somewhat. Dissimilarity itself was not significant in the models across all groups, but when interacted with race/ethnic composition, it moderates the association. For both percent Black and percent White, the interaction with the Black-White dissimilarity index is significant and negative, meaning that it deepens the negative association between composition and the vaccination rate.

The analysis is only limited to county-level measures of racial/ethnic composition and vaccination rates, so we are unable to see at the individual-level who is getting vaccinated.

We find that segregation moderates the association between racial/ethnic composition and vaccination rates, suggesting that local race relations in a county helps contextualize the compositional effects of race/ethnicity.

This study examines chronic illness, disability and social inequality within an exposure-vulnerabilities theoretical framework.

Using the National Survey of Drug Use and Health (NSDUH), a preeminent source of national behavioral health estimates of chronic medical illness, stress and disability, for selected sample years 2005–2014, we construct and analyze two foundational hypotheses underlying the exposure-vulnerabilities model: (1) greater exposure to stressors (i.e., chronic medical illness) among racial/ethnic minority populations yields higher levels of serious psychological distress, which in turn increases the likelihood of medical disability; (2) greater vulnerability among minority populations to stressors such as chronic medical illness exacerbates the impact of these conditions on mental health as well as the impact of mental health on medical disability.

Results of our analyses provided mixed support for the vulnerability (moderator) hypothesis, but not for the exposure (mediation) hypothesis. In the exposure models, while Blacks were more likely than Whites to have a long-term disability, the pathway to disability through chronic illness and serious psychological distress did not emerge. Rather, Whites were more likely than Blacks and Latinx to have a chronic illness and to have experienced severe psychological distress (both of which themselves were related to disability). In the vulnerability models, both Blacks and Latinx with chronic medical illness were more likely than Whites to experience serious psychological distress, although Whites with serious psychological distress were more likely than these groups to have a long-term disability.

Several possibilities for understanding the failure to uncover an exposure dynamic in the model turn on the potential intersectional effects of age and gender, as well as several other covariates that seem to confound the linkages in the model (e.g., issues of stigma, social support, education).

This study (1) extends the racial/ethnic disparities in exposure-vulnerability framework by including factors measuring chronic medical illness and disability which: (2) explicitly test exposure and vulnerability hypotheses in minority populations; (3) develop and test the causal linkages in the hypothesized processes, based on innovations in general structural equation models, and lastly; (4) use national population estimates of these conditions which are rarely, if ever, investigated in this kind of causal framework.

First-generation college students in the United States are a unique demographic that is often characterized by the institutions that serve them with a risk-laden and deficit-based model. However, our analysis of the transcripts of open-ended, semi-structured interviews with 22 “first-gen” respondents suggests they are actively deft, agentic, self-determining parties to processes of identity construction that are both externally imposed and potentially stigmatizing, as well as exemplars of survivance and determination. We deploy a grounded theory approach to an open-coding process, modeled after the extended case method, while viewing our data through a novel synthesis of the dual theoretical lenses of structural and radical/structural symbolic interactionism and intersectional/standpoint feminist traditions, in order to reveal the complex, unfolding, active strategies students used to make sense of their obstacles, successes, co-created identities, and distinctive institutional encounters. We find that contrary to the dictates of prevailing paradigms, identity-building among first-gens is an incremental and bidirectional process through which students actively perceive and engage existing power structures to persist and even thrive amid incredibly trying, challenging, distressing, and even traumatic circumstances. Our findings suggest that successful institutional interventional strategies designed to serve this functionally unique student population (and particularly those tailored to the COVID-moment) would do well to listen deeply to their voices, consider the secondary consequences of “protectionary” policies as potentially more harmful than helpful, and fundamentally, to reexamine the presumption that such students present just institutional risk and vulnerability, but also present a valuable addition to university environments, due to the unique perspective and broader scale of vision their experiences afford them.

Recent academic studies, as well as media reporting, have devoted substantial attention to the ongoing “crisis of democracy.” Democratic “backsliding” of Central and Eastern Europe – sometimes referred to as an effort to establish a new system of “illiberal democracy” – is one of the most visible symptoms of this crisis. This narrative is supported by the quantitative metrics of democratic quality, reflecting professional community views on the appropriate criteria to define and assess democracy. However, once general public views expressed in the survey item of “satisfaction with democracy” are taken into account, the picture changes markedly. This chapter analyzes quantitative metrics reflecting expert community consensus and the general public assessment of the quality of democracy in the 27 EU members over the period 2010–2019. It documents substantial divergence between the perspectives of the experts and the general public – while expert-based indexes portray Central and Eastern European backsliding as the most significant trend in the EU democratic landscape, public opinion identifies a very different set of democracy's successes and failures. As experts and the general public fail to arrive at mutually accepted criteria of democratic performance evaluation, public debate has become futile. Meaningful discussion and systemic corrections have become unlikely, creating conditions easily exploitable by the populists, eager to frame it as an example of “elite” detachment from the “ordinary people”.

The disparities of COVID-19 vaccination rates between the rural and urban areas have become apparent during this pandemic. There is a need to understand the root causes of vaccine hesitancy demonstrated by the rural population to increase coverage and to contain the disease spread throughout the United States. This study aimed to explore other factors influencing vaccine hesitancy among rural dwellers besides the geography-related barriers such as poor health care access and individuals having no or suboptimal insurance coverage.

By reviewing existing data and literature about vaccination, health literacy, and behaviors, and prevailing ideologies, we discuss the potential causes of vaccine hesitancy in rural areas that could create barriers for successful public health efforts related to vaccine coverage and provide suggestions to ameliorate the situation.

Geography-related barriers, health literacy, and preconceived notions are key determinants of adopting healthy behaviors and complying with public health authorities' recommendations among rural individuals during a public-health crisis. We argue that ideology, which is much deeper than preconception or misconception on vaccination, should be incorporated as a key factor to redefine the term “vulnerable populations” in public health research.

The limitation of our study is that we have not found an effective way to encourage the populations who hold conservative religious and political ideologies to join the efforts for public health. Even though geography-related barriers may strongly impact the rural dwellers in achieving optimal health, the various forms of ideologies they have toward certain health behaviors cannot be discounted to understand and address vaccine-related disparities in rural areas. There is a need to redefine the term “vulnerable population” particularly as it relates to rural areas in the United States. During large-scale public health disasters, scholars and public health authorities should consider the ideologies of individuals, in addition to other factors such as race/ethnicity, area of residence (rural vs. urban), and socioeconomic factors influencing the existing vulnerabilities and health disparities.

This study compared different types of full-time caregiver (e.g., children, older adults, COVID-19 patients) and subgroups (e.g., disability, race/ethnicity, sexual orientation) in the United States during the COVID-19 pandemic for potentially meaningful distinctions.

Data from the 9,854 full-time caregivers identified in Phase 3.2 (July 21–October 11, 2021) of the US Census Household Pulse Survey (HPS) were analyzed in this study using multinomial logistic regression to examine relationships between caregiver types, marginalized subgroups, generation, and vaccination status.

The prevalence of caregiving was low, but the type of full-time caregiving performed varied by demographic group (i.e., disability, race/ethnicity, sexual orientation, gender, generation, and vaccination status). The relative risk of being a COVID-19 caregiver remained significant for being a member of each of the marginalized groups examined after all adjustments.

To date, the HPS has not been analyzed to predict the type of full-time informal caregiving performed during the COVID-19 pandemic or their characteristics. Research limitations of this analysis include the cross-sectional, experimental dataset employed, as well as some variable measurement issues.

Prior informal caregiver research has often focused on the experiences of those caring for older adults or children with special healthcare needs. It may be instructive to learn whether and how informal caregivers excluded from paid employment during infectious disease outbreaks vary in meaningful ways from those engaged in other full-time caregiving. Because COVID-19 magnified equity concerns, examining demographic differences may also facilitate customization of pathways to post-caregiving workforce integration.

This chapter explores creative drawing mediums in research practice and education, through speculative drawing methods, and the use of temporal mediums such as film, animation, and augmented reality [AR] to move outside entrenched perspectives of communicating towards more inclusive storytelling narratives. Architectural representation mediums provide means of conveying rich layers of information, having evolved through cultural influences and technologies with their origins in Western world views. However, these methods of drawing are limited in how they convey multiple and diverse views or social understandings, ultimately delivering static representations. The student and staff approaches discussed in this chapter demonstrate approaches that recalibrate from a singular, designer-led perspective to one that is multivalent, considering and engaging other stakeholders in the negotiations and conversations of the spaces in our built environments. Through making architectural communication more accessible and inclusive of diverse audiences and voices, alternative world views can be both enabled and facilitated.

Across the United States (US), COVID-19 vaccination coverage was lower in rural counties compared to urban counties, exacerbating rural health inequities. While rural communities fall short of the public health goal to vaccinate all who are eligible, most rural residents have chosen to vaccinate for COVID-19. The aim of this study was to better understand rural New Mexicans' attitudes and beliefs about COVID-19 vaccines.

We conducted and analyzed 51 in-depth, semi-structured interviews with adults living in rural New Mexican counties, covering a range of topics related to the pandemic, including vaccines. These interviews were conducted in the Summer of 2021 after the vaccines were widely available to all adults over the age of 18 and youth between the ages of 12–17, but not yet available for children under 12 years.

Two major perspectives were identified: (1) the idea that COVID-19 vaccinations are a tool that individuals can use to achieve freedom and protection and (2) the view which regarded vaccines as an infringement of personal rights and one's autonomy of health. For people who viewed the vaccine as a tool for freedom, several themes emerged, including (1) a preference for vaccine manufacturers, specifically a preference for Pfizer, and (2) frustrations related to vaccine access, specifically, older adults expressed frustrations with the difficulty of scheduling vaccination appointments. However, most participants felt as though they had enough vaccination resources. For people who viewed vaccines (and vaccine mandates) as limiting their freedom, additional themes emerged: (1) overarching distrust of government and the perception that vaccines were an extension of government and (2) distrust in the vaccines themselves, including a perceived lack of research on the vaccines and a perception that the vaccine was developed in too short of a period. Some of the people who hold these beliefs are also vaccinated. We draw from social psychology theories to better understand how people who hold a rural identity come to establish different beliefs and practices compared to larger metropolitan regions. While political identity is a contributor, of our participants, the group who were most likely to report not being vaccinated were the “independent” or “unaffiliated voters.” Our findings can help craft culturally responsive vaccine initiatives for rural communities.