This mixed-methods study aimed to gain knowledge of the lived experience of posttraumatic growth (PTG) in 32 low-income Black mothers whose New Orleans’ homes were damaged or destroyed by Hurricane Katrina, and half of whom had relocated indefinitely to Houston. Data from in-depth interviews with participants were examined in conjunction with quantitative scores on the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996). Participants were interviewed face-to-face on a range of postdisaster experiences, including positive changes, in 2009. Participants also completed the PTGI via a telephone survey within six months of being interviewed. Most (26 out of 32) participants described experiencing PTG within the 5 domains of the PTGI, with the domains most frequently coded, in descending order, being New Possibilities, Relating to Others, Personal Strength, Appreciation for Life, and Spiritual Change. PTG stemmed heavily from exposure to opportunities in survivors’ postdisaster communities, including increased racial diversity, improved neighborhoods, and new educational and economic opportunities. Participants’ frequency of all PTG codes was associated with their overall PTGI scores with a small-to-moderate effect size (r = .32; p = .078) in a relationship that trended toward significance. Without minimizing the catastrophic losses they entail, disasters may in some cases create spaces for PTG for survivors, including through new opportunities in areas where survivors formerly experienced oppression. Policymakers should examine how to make such opportunities available, visible and accessible to individuals absent a disaster.
Background Racial and ethnic diversity of healthcare workers have benefits on team functioning and patient care. However, a significant barrier to retaining diverse providers is discrimination. Objective To assess the predictors, perpetrators, and narratives of racial discrimination among healthcare workers. Design Survey study. Participants Healthcare workers employed at academic hospitals. Main Measures We assessed prevalence and perpetrators of racial and ethnic discrimination using the General Ethnic Discrimination Scale. We included an open-ended question asking respondents to recount experiences of discrimination and analyzed responses using grounded theory. Key Results Of the 997 participants, 12.2% were females from backgrounds underrepresented in medicine (URM), 4.0% URM males, 10.1% Asian females, 4.7% Asian males, 49.1% non-Hispanic White females, and 19.8% non-Hispanic White males. Among healthcare workers of color, 85.2% reported discrimination. Over half of URM females (51.4%), URM males (52.6%), and Asian females (62.5%) reported discrimination by patients. About 20–25% of URM females, URM males, and Asian females reported discrimination by teachers, supervisors, co-workers, and institutions. In adjusted binary logistic models, URM females had 10.14 odds (95% confidence interval [95%CI]: 5.13, 20.02, p <.001), URM males 6.23 odds (95%CI: 2.59, 14.98, p <.001), Asian females 7.90 odds (95%CI: 4.07, 15.33, p <.001), and Asian males 2.96 odds (95% CI: 1.47, 5.97, p =.002) of reporting discrimination compared with non-Hispanic White males. Needing more support was associated with 2.51 odds (95%CI: 1.54, 4.08, p <.001) of reporting discrimination. Our qualitative findings identified that the murder of George Floyd intensified URM healthcare workers’ experiences of discrimination through increased fear of violence and requests for unpaid diversity work. Asian healthcare workers reported that pandemic-related anti-Asian violence shaped their experiences of discrimination through increased fear of violence and care refusal from patients. Conclusions Our findings provide insights into experienced discrimination among healthcare workers and opportunities for hospitals to create programs that improve inclusivity.
Racial and gender discrimination are risk factors for adverse mental health outcomes in the general population; however, the effects of discrimination on the mental health of healthcare workers needs to be further explored, especially in relation to competing stressors. Thus, we administered a survey to healthcare workers to investigate the associations between perceived racial and gender discrimination and symptoms of depression, anxiety, posttraumatic stress, and burnout during a period of substantial stressors related to the COVID-19 pandemic and a national racial reckoning. We used multivariable linear regression models, which controlled for demographics and pandemic-related stressors. Of the 997 participants (Mean Age = 38.22 years, SD = 11.77), 688 (69.01%) were White, 148 (14.84%) Asian, 86 (8.63%) Black, 73 (7.32%) Latinx, and 21 (2.11%) identified as another race. In multivariable models, racial discrimination predicted symptoms of depression (B = 0.04; SE: 0.02; p = .009), anxiety (B = 0.05; SE: 0.02; p = .004), and posttraumatic stress (B = 0.01; SE: 0.01; p = .006) and gender discrimination predicted posttraumatic stress (B = 0.11; SE: 0.05; p = .013) and burnout (B = 0.24; SE: 0.07; p = .001). Discrimination had indirect effects on mental health outcomes via inadequate social support. Hospital-wide diversity and inclusion initiatives are warranted to mitigate the adverse mental health effects of discrimination.
Muslim Americans have been increasingly the targets of discrimination. Whereas prior research suggests that higher perceived discrimination is associated with more severe symptoms of posttraumatic stress disorder (PTSD) in various minority groups, only 1 prior study has explored this topic among Muslim Americans. The current study included 145 Muslim American college students and assessed PTSD symptoms in reference to both participants' self-identified worst lifetime Diagnostic and Statistical Manual of Mental Disorders (DSM) trauma and lifetime discrimination. Higher past-year perceived discrimination was associated with more severe DSM trauma-and discrimination-related PTSD symptoms. No significant differences were detected in the severity of overall DSM trauma-and discriminationrelated PTSD symptoms, or in key predictors of each outcome; however, participants reported significantly more severe intrusion symptoms in reference to their worst DSM trauma than to discrimination. The results suggest that discrimination can trigger PTSD symptoms directly and exacerbate PTSD symptoms related to traumatic events as defined in the DSM.
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