Using Syndemics and Intersectionality to Explain the Disproportionate COVID-19 Mortality Among Black Men

Holliday, Christopher S.; Enyia, Okechuku Kelechi; Ellison, Jennifer M.; Jaeger, Emily Cornish

doi:10.1177/00333549211026799

Cited by 25 publications

(29 citation statements)

References 84 publications

(112 reference statements)

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“…A foundational challenge here is that many EBIs were not developed with or tested among settings or populations that experience inequities or with the goal of promoting health equity and may unintentionally contribute to or exacerbate inequities [ 110 – 112 ]. This results in part from the reductionist way in which EBIs are often developed, deployed (a linear, “cause and effect” approach), and tested [ 113 ], paying inadequate attention to the complex and interrelated social determinants of health and root causes of health inequities (e.g., structural racism, inequitable allocation of resources and opportunities) [ 114 – 118 ].…”

Section: Selected Debates About Evidencementioning

confidence: 99%

Revisiting concepts of evidence in implementation science

et al. 2022

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Background Evidence, in multiple forms, is a foundation of implementation science. For public health and clinical practice, evidence includes the following: type 1 evidence on etiology and burden; type 2 evidence on effectiveness of interventions; and type 3: evidence on dissemination and implementation (D&I) within context. To support a vision for development and use of evidence in D&I science that is more comprehensive and equitable (particularly for type 3 evidence), this article aims to clarify concepts of evidence, summarize ongoing debates about evidence, and provide a set of recommendations and tools/resources for addressing the “how-to” in filling evidence gaps most critical to advancing implementation science. Main text Because current conceptualizations of evidence have been relatively narrow and insufficiently characterized in our opinion, we identify and discuss challenges and debates about the uses, usefulness, and gaps in evidence for implementation science. A set of questions is proposed to assist in determining when evidence is sufficient for dissemination and implementation. Intersecting gaps include the need to (1) reconsider how the evidence base is determined, (2) improve understanding of contextual effects on implementation, (3) sharpen the focus on health equity in how we approach and build the evidence-base, (4) conduct more policy implementation research and evaluation, and (5) learn from audience and stakeholder perspectives. We offer 15 recommendations to assist in filling these gaps and describe a set of tools for enhancing the evidence most needed in implementation science. Conclusions To address our recommendations, we see capacity as a necessary ingredient to shift the field’s approach to evidence. Capacity includes the “push” for implementation science where researchers are trained to develop and evaluate evidence which should be useful and feasible for implementers and reflect community or stakeholder priorities. Equally important, there has been inadequate training and too little emphasis on the “pull” for implementation science (e.g., training implementers, practice-based research). We suggest that funders and reviewers of research should adopt and support a more robust definition of evidence. By critically examining the evolving nature of evidence, implementation science can better fulfill its vision of facilitating widespread and equitable adoption, delivery, and sustainment of scientific advances.

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Section: Selected Debates About Evidencementioning

confidence: 99%

Revisiting concepts of evidence in implementation science

et al. 2022

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“…10 While 5 articles published in PHR in 2021 mentioned "racism" anywhere in the text, using this collection's criteria, which are similar to those of Hardeman et al 11 and Krieger et al, 9 we highlight the 3 articles published in volume 136 that named "racism" in their titles or abstracts. [12][13][14] Other articles published in PHR in 2021 discussed racism and its health implications, 15,16 but it is critical to highlight the ones that named and centered on racism rather than those that only mentioned it as a discussion point to explain observed patterns. Of 3 such articles, 2 were research and 1 was a systematic review (Table 4).…”

Section: Racism and Health Publications In Phrmentioning

confidence: 99%

“…In addition to the collection of articles that explicitly mention racism in the title or abstract, several articles published in 2021 discussed the health harms of racism as a fundamental cause of poor health and health disparities. For example, Griffith and colleagues 15 root their explanation of the disproportionate mortality that Black men have experienced during the COVID-19 pandemic in structural racism. Structural racism helps to explain why Black men—who already have the shortest life expectancy of any racial or ethnic group of men or women—had the greatest decline in life expectancy of 3.0 years from 2019 to 2020 in the provisional life expectancy estimates published in February 2021.…”

Section: Racism and Health Publications In Phrmentioning

confidence: 99%

Public Health Reports in 2021: Impact Factor Increase and New Article Collections on Racism and COVID-19

et al. 2022

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In 2021, PHR launched the Public Health Reports: Year in Review article series to inform its contributors and readers about its latest publication metrics, content, and planned improvements. 3 The series started with a review of the journal's publications and operations in 2020. This second installment compares 2021 and 2020 data and adds a few new metrics that were not captured in 2020 (eg, turnaround times associated with postacceptance editing). While the journal's content continues to be assembled into issues, the realities of scholarly publishing increasingly demand that articles be published online as soon as possible. To allow for historic volume-based comparison, the analysis of PHR's 2021 published content was performed by volume, not online publication date, making an exception for time-sensitive COVID-19 articles, which were analyzed by online publication date.

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“…In the IIT-ICM, we “center” the experiences of BLH-FEW, focus on racism and discrimination (not just race/ethnicity) and contextual barriers, attend to counter-narratives, and highlight strengths and resilience [ 27 ]. Further, we attend to barriers to/facilitators of health inequities (such as low rates of COVID-19 testing for BLH-FEW populations in this case) at multiple levels of influence [ 28 ], namely, at individual, social, and structural levels [ 29 ], similar to other racial/ethnic health disparities [ 5 ]. The IIT-ICM highlights that these multi-level influences are shaped by the larger culture, primary among them structural racism, discrimination, and past and present maltreatment of BLH populations by institutions and systems [ 30 ].…”

Section: Introductionmentioning

confidence: 99%

Using the multiphase optimization strategy (MOST) framework to optimize an intervention to increase COVID-19 testing for Black and Latino/Hispanic frontline essential workers: A study protocol

Gwadz¹,

Cleland

Lizardo³

et al. 2022

BMC Public Health

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Background Among those at highest risk for COVID-19 exposure is the large population of frontline essential workers in occupations such food service, retail, personal care, and in-home health services, among whom Black and Latino/Hispanic persons are over-represented. For those not vaccinated and at risk for exposure to COVID-19, including frontline essential workers, regular (approximately weekly) COVID-19 testing is recommended. However, Black and Latino/Hispanic frontline essential workers in these occupations experience serious impediments to COVID-19 testing at individual/attitudinal- (e.g., lack of knowledge of guidelines), social- (e.g., social norms), and structural-levels of influence (e.g., poor access), and rates of testing for COVID-19 are insufficient. Methods/design The proposed community-engaged study uses the multiphase optimization strategy (MOST) framework and an efficient factorial design to test four candidate behavioral intervention components informed by an integrated conceptual model that combines critical race theory, harm reduction, and self-determination theory. They are A) motivational interview counseling, B) text messaging grounded in behavioral economics, C) peer education, and D) access to testing (via navigation to an appointment vs. a self-test kit). All participants receive health education on COVID-19. The specific aims are to: identify which components contribute meaningfully to improvement in the primary outcome, COVID-19 testing confirmed with documentary evidence, with the most effective combination of components comprising an “optimized” intervention that strategically balances effectiveness against affordability, scalability, and efficiency (Aim 1); identify mediators and moderators of the effects of components (Aim 2); and use a mixed-methods approach to explore relationships among COVID-19 testing and vaccination (Aim 3). Participants will be N = 448 Black and Latino/Hispanic frontline essential workers not tested for COVID-19 in the past six months and not fully vaccinated for COVID-19, randomly assigned to one of 16 intervention conditions, and assessed at 6- and 12-weeks post-baseline. Last, N = 50 participants will engage in qualitative in-depth interviews. Discussion This optimization trial is designed to yield an effective, affordable, and efficient behavioral intervention that can be rapidly scaled in community settings. Further, it will advance the literature on intervention approaches for social inequities such as those evident in the COVID-19 pandemic. Trial registration ClinicalTrials.gov: NCT05139927; Registered on 11/29/2021. Protocol version 1.0. May 2, 2022, Version 1.0

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Using Syndemics and Intersectionality to Explain the Disproportionate COVID-19 Mortality Among Black Men

Cited by 25 publications

References 84 publications

Revisiting concepts of evidence in implementation science

Revisiting concepts of evidence in implementation science

Public Health Reports in 2021: Impact Factor Increase and New Article Collections on Racism and COVID-19

Using the multiphase optimization strategy (MOST) framework to optimize an intervention to increase COVID-19 testing for Black and Latino/Hispanic frontline essential workers: A study protocol

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