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Introduction Mentoring programs are one mechanism used to increase diversity and participation of historically underrepresented groups in academic medicine. However, more knowledge is needed about the mentoring experiences and how culturally relevant concepts and perspectives may influence diverse students, trainees, and faculty success. This case study utilized the Culturally Engaging Campus Environments (CECE) model which examines the experiences of students in higher education. We used this model to examine the mentoring experiences of Black and Latine faculty and offer practical implications for the medical education continuum. Methods Our research approach is best understood through qualitative inquiry stemming from a single-case study which allowed for in-depth understanding of the contexts informing the phenomenon. Phenomenology is well positioned to contribute to understanding science and health professions. Selection criteria included individuals who self-identified as Black or Latine; inclusive of all faculty ranks and tracks. This analysis focuses on 8 semi-structured interviews, averaging 3 h in length. Results Findings centered on the area of cultural relevance, and participant narratives revealed the connection of mentoring with cultural familiarity, culturally relevant knowledge, cultural service and engagement, and cultural validation. Conclusion The use of cultural relevance indicators can inform the creation and evolution of mentoring programs towards holistic support of historically underrepresented trainees and faculty. Implications also focus on the development of mentors and championing the incorporation of cultural humility in the mentoring process. The implications in praxis offers the possibility for a new framework for culturally relevant mentoring (CRM). Through this framework we aim to enhance and facilitate inclusive learning environments and career development.

While there is an emerging body of literature that demonstrates how racism and bias negatively impact the experiences of physicians and trainees from underrepresented groups in medicine in the US, little is known about the experiences of internal medicine trainees and their learning environments. The purpose of this study was to examine these learning environments and explore trainees' perceptions of race/ethnicity-related topics. A 35-item confidential electronic survey was disseminated to trainees from 11 internal medicine training programs in the US. A total of 142 trainees participated. Purposive sampling ensured alignment with 2018 IM trainee demographics by sex, race and ethnicity. Analyses were performed including chi-square, Fisher's exact tests, and logistic regression. Key findings reveal 63% of respondents perceived disparities in the care provided to diverse patients. Two in three respondents were confident that their institution would respond to discrimination, but only 1/3 of respondents perceived appropriate reporting mechanisms. Black/African American trainees reported needing to minimize aspects of their race and were less likely to perceive their institutions as being supportive to people of color. Access to timely information about trainees' experiences with discrimination and bias in graduate medical education is imperative to disrupt systemic racism and health inequities. Findings suggest a perceived difference in health care provided to minoritized groups, a gap in formal mechanisms for reporting racism and discrimination experienced by trainees, and environments that challenge a sense of belonging. Findings add to current literature exposing the experience of underrepresented trainees in the US.

Evidence suggests that the 44.5 million U.S. residents drawing their drinking water from private wells face higher risks of waterborne contaminant exposure than those served by regulated community water supplies. Among U.S. states, North Carolina (N.C.) has the second-largest population relying on private wells, making it a useful microcosm to study challenges to maintaining private-well water quality. This paper summarizes recommendations from a two-day summit to identify options to improve drinking-water quality for N.C. residents served by private wells. The Research Triangle Environmental Health Collaborative invited 111 participants with knowledge of private-well water challenges to attend the Summit. Participants worked in small groups that focused on specific aspects and reconvened in plenary sessions to formulate consensus recommendations. Summit participants highlighted four main barriers to ensuring safe water for residents currently relying on private wells: (1) a database of private well locations is unavailable; (2) racial disparities have perpetuated reliance on private wells in some urbanized areas; (3) many private-well users lack information or resources to monitor and maintain their wells; and (4) private-well support programs are fragmented and lack sufficient resources. The Summit produced 10 consensus recommendations for ways to overcome these barriers. The Summit recommendations, if undertaken, could improve the health of North Carolinians facing elevated risks of exposure to waterborne contaminants because of their reliance on inadequately monitored and maintained private wells. Because many of the challenges in N.C. are common nationwide, these recommendations could serve as models for other states. https://doi.org/10.1289/EHP890.

Previous evidence has identified potential racial disparities in access to community water and sewer service in peri-urban areas adjacent to North Carolina municipalities. We performed the first quantitative, multi-county analysis of these disparities. Using publicly available data, we identified areas bordering municipalities and lacking community water and/or sewer service in 75 North Carolina counties. Logistic regression was performed to evaluate the relationship between race and access to service in peri-urban areas, controlling for population density, median home value, urban status, and percent white in the adjacent municipality. In the peri-urban areas analyzed, 67% of the population lacked community sewer service, and 33% lacked community water service. In areas other than those with no black residents, odds of having community water service (p<0.01) or at least one of the two services (p<0.05) were highest for census blocks with a small proportion of black residents and lowest in 100% black census blocks, though this trend did not hold for access to community sewer service alone. For example, odds of community water service were 85% higher in areas that were greater than 0% but less than 22% black than in 100% black areas (p<0.001). Peri-urban census blocks without black populations had the lowest odds of community water service, community sewer service, and at least one of the two services, but this difference was only statistically significant for sewer. Peri-urban areas lacking service with no black residents were wealthier than 100% black areas and areas with any percent black greater than 0%. Findings suggest two unserved groups of differing racial and socioeconomic status: (1) lower-income black populations potentially excluded from municipal services during the era of legal racial segregation and (2) higher-income non-black populations. Findings also suggest greater racial disparities in community water than community sewer services statewide.

Early life exposure to environmental lead (Pb) has been linked to decreased IQ, behavior problems, lower lifetime earnings, and increased criminal activity. Beginning in the 1970s, limits on Pb in paint, gasoline, food cans, and regulated water utilities sharply curtailed US environmental Pb exposure. Nonetheless, hundreds of thousands of US children remain at risk. This study reports on how unregulated private well water is an underrecognized Pb exposure source that is associated with an increased risk of teenage juvenile delinquency. We build a longitudinal dataset linking blood Pb measurements for 13,580 children under age 6 to their drinking water source, individual- and neighborhood-level demographics, and reported juvenile delinquency records. We estimate how early life Pb exposure from private well water influences reported delinquency. On average, children in homes with unregulated private wells had 11% higher blood Pb than those with community water service. This higher blood Pb was significantly associated with reported delinquency. Compared to children with community water service, those relying on private wells had a 21%(95% CI: 5 to 40%) higher risk of being reported for any delinquency and a 38% (95% CI: 10 to 73%) increased risk of being reported for serious delinquency after age 14. These results suggest that there could be substantial but as-yet-unrecognized social benefits from intervention programs to prevent children’s exposure to Pb from private wells, on which 13% of the US population relies.

The purpose of this narrative inquiry was to examine how Asian American college students made sense of themselves as racialized beings during the COVID-19 pandemic, a period that saw a drastic increase in anti-Asian hate. We were particularly interested in how emotions that students experienced in response to racism shaped their meaning-making of racial identity. We embraced tensions of a constructivist approach and a grounding in Asian critical theory to gain a more nuanced picture of Asian American college students’ meaning-making of racial identity while also problematizing and critiquing racism. Data collection consisted of three interviews with 14 participants from the Midwest and East Coast of the US. To engage the reader’s imagination and tell a nuanced story, we present findings as a fictional conversation between four individuals using direct quotes from participants. Our findings highlight the importance of considering transnational context when examining Asian American college students’ racial identity development. Our findings further showcase the role emotions played in fostering development and the agentic ways participants responded to these emotions while also underscoring the high price participants paid for the more complex understanding of their racial identity. Implications for future research and practice are discussed.

Over the past three decades, many higher education scholars have engaged in efforts to counter the stereotype that Asian Americans achieve universal and unparalleled academic success. While most of these scholars adopt an anti-oppression approach, some researchers have claimed that this literature reinforces oppressive deficit paradigms. To understand this conflict in existing literature, the current authors utilize an anti-imperialistic approach to analyze scholarship on the model minority myth. The current analysis reveals little evidence that research on the myth reinforced hegemonic deficit thinking. Instead, authors find that scholars largely utilized complex and multifaceted antideficit approaches, challenged dominant essentialist model minority frames, engaged in strategic (anti-)essentialism to navigate complex pan-racial contexts, and reframed the myth to achieve diverse purposes that speak to different audiences. Several implications for conducting critiques of literature reviews and future research on the myth are discussed.

Negative health impacts of water insecurity are often felt most in poor and rural communities and communities of color, who are more likely to be underserved by water infrastructure and disproportionately subject to socioeconomic stressors. Despite mandated efforts to allocate significant federal resources to infrastructure funding in ‘disadvantaged communities,’ communities with the most need risk systematic exclusion from access to resources, decision-making structures, and even benefits of research intended to address inequitable infrastructure services and health outcomes in their own communities. This project aims to describe groundwork and preliminary findings from community-engaged environmental research conducted within an ongoing community-based participatory research partnership in Robeson County, NC, a majority–minority county with the lowest median household income of NC’s 100 counties. Semi-structured interviews conducted with community members were analyzed to identify concerns about drinking water security (including safety, affordability, and reliability), perceptions of water quality, averting behaviors taken due to water insecurity, and ideas for improving water security. Findings suggest that there is a high level of mistrust in community water supplies, with perceptions of poor water quality driving a reliance on bottled water. Those relying on private wells expressed greater trust in their water and lower reliance on bottled water. Concerns about affordability were less prominent than those about water quality. Insufficient water reliability (low flow) was mentioned by many respondents, including those with community water service and those relying on private wells. Most supported increasing taxes to improve water security and also recommended increasing communications between water service providers and the public to improve trust. Overall, this work suggests the need for a comprehensive assessment of the quality and reliability of community water services in Robeson County, interventions to address problems identified, and much more engagement with the community about identifying and allocating funding to solve water security problems.

The 2013–2016 Ebola epidemic revived concerns about infection risks to wastewater workers. Prior research has shown that wastewater can contain a variety of known and emerging pathogens and that wastewater workers are at increased risk of infectious illnesses. However, guidelines on using personal protective equipment (PPE) to decrease these risks are lacking. We engaged 34 wastewater utility personnel and public health experts to conduct a job safety analysis identifying tasks in which workers could be exposed to pathogens and to develop a PPE selection matrix for preventing those exposures. We identified 43 relevant job tasks. Recommended PPE ranges from durable gloves (all tasks) to safety glasses (24 tasks), Tyvek suits or coveralls (4 tasks), and respiratory protection (N95 mask or face mask, depending on the activity, 10 tasks). The PPE selection matrix can serve as a guide for protecting the 120,000 wastewater workers in the United States from known and emerging pathogens.

Predominantly white institutions (PWIs) have increasingly implemented formalized diversity initiatives over the past 50 years as a response to ensuing federal legislation (e.g., 1965 Higher Education Act), student protests of the late 1960s, and the influx of Black students into PWIs. These initiatives were established to support students from historically and racially underrepresented populations, while enhancing campus diversity. The purpose of this article is to provide a critical analysis of research focused on formalized diversity, inclusion, equity, and justice (DIEJ) initiatives that have been implemented in higher education from 1968 to 2018. Our findings illustrate that while there is some higher education scholarship exploring issues of DIEJ, the number and focus of articles that analyze specific initiatives is lacking at best, but has increased over the past 20 years, with most focusing on programmatic and curricular efforts.