Background: Racial inequities for patients with heart failure (HF) have been widely documented. HF patients who receive cardiology care during a hospital admission have better outcomes. It is unknown whether there are differences in admission to a cardiology or general medicine service by race. This study examined the relationship between race and admission service, and its effect on 30-day readmission and mortality Methods: We performed a retrospective cohort study from September 2008 to November 2017 at a single large urban academic referral center of all patients self-referred to the emergency department and admitted to either the cardiology or general medicine service with a principal diagnosis of HF, who self-identified as white, black, or Latinx. We used multivariable generalized estimating equation models to assess the relationship between race and admission to the cardiology service. We used Cox regression to assess the association between race, admission service, and 30-day readmission and mortality. Results: Among 1967 unique patients (66.7% white, 23.6% black, and 9.7% Latinx), black and Latinx patients had lower rates of admission to the cardiology service than white patients (adjusted rate ratio, 0.91; 95% CI, 0.84–0.98, for black; adjusted rate ratio, 0.83; 95% CI, 0.72–0.97 for Latinx). Female sex and age >75 years were also independently associated with lower rates of admission to the cardiology service. Admission to the cardiology service was independently associated with decreased readmission within 30 days, independent of race. Conclusions: Black and Latinx patients were less likely to be admitted to cardiology for HF care. This inequity may, in part, drive racial inequities in HF outcomes.

Individuals avoid objects that have been in physical contact with morally offensive or disgusting entities. This has been called negative magical contagion, an implicit belief in the transmission of essence by physical contact. Alternatively, individuals may avoid a negatively contaminated object because: 1) the object is a strong reminder of the original contagion source (association account); or 2) the act of interacting with the object signals specific information about the self (social communication account). We report that: 1) people often prefer to interact with an entity that they believe is more associated with a negative source rather than an entity that is less associated but has made physical contact with the same negative source; 2) while an associative account requires that contact enhances association, a study of memory for visual pairings of objects indicates that when objects are touching, their associative link (recall) is no greater than when they are in proximity; and 3) subjects continue to show aversion to (prefer to wear gloves to handle) an object that contacted a negative entity even if they are handling the object in order to physically destroy it, hence strongly signaling their rejection of that object. Association and social communication are at best partial accounts for contagion effects.

Following important work by Pizarro, Uhlmann and Salovey (2003) on moral judgments of uncontrolled/impulsive versus controlled/ deliberate action, we focus on the related issue of the moral evaluation of emotion-motivated versus principle-driven behavior. We examine: (a) the potential lesser blameworthiness of antisocial acts perceived as driven by emotion as opposed to principle; (b) how factors governing the moral evaluation of antisocial acts might extend to the evaluation of prosocial acts; and (c) how overriding a moral emotion in favor of a moral principle affects moral attributions.

Backward magical contagion describes instances in which individuals (sources) express discomfort or pleasure when something connected to them (medium; e.g., hair, a diary) falls into the possession of a negatively- or positively-perceived individual (recipient). The reaction seems illogical, since it is made clear that the source will never experience the object again, and the psychological effect appears to reverse the standard forward model of causality. Backward magical contagion was originally believed to be a belief held only within traditional cultures. Two studies examined negative backward contagion in adult Americans in online surveys. Study 1 indicated that backward contagion effects occur commonly, particularly when a recipient knows of the medium’s source. Study 2 showed that backward contagion effects tend to be neutralized when the recipient burns the object, as opposed to just possessing it or discarding it. Ironically, in traditional cultures, burning is a particularly potent cause of backward contagion.