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A growing literature explores spatial patterns of regional and neighborhood correlates of sexual minority (e.g., lesbian, gay, bisexual) concentration. Such patterns have implications for health and wellbeing if there are differences in health-promoting or health-hindering resources in neighborhoods or regions. We conducted a systematic review to assess sexual minority concentration in relation to area unit characteristics. We included only records published after 1973 and made no exclusions by geography or language. We searched 11 databases (Academic Search Complete, CINAHL, Embase, GeoBase, GeoRef, LGBT Life, PsycINFO, PubMed/MEDLINE, Scopus, Sociological Abstracts, Web of Science) on November 19-21, 2016. We searched reference lists of included records. We used the following inclusion criteria: (1) Record is a quantitative study (that is, it uses statistics to describe or associate two or more variables); (2) Record is about (a) migration or internal migration of, (b) area unit selection by, or (c) concentration of sexual minority people (defined by identity, behavior, or attraction); (3) Criterion 2 is linked to the characteristics of regions or neighborhoods (at any spatial scale). Dual independent coding resulted in 51 records meeting inclusion criteria from the original pool of 5,591. From these records, we identified the 647 reported results linking sexual minority concentration with area unit characteristics. Of these, 132 were unadjusted relationships between sexual minority concentration and four theory-informed domains of neighborhood influence on health. We identified greater concentration of sexual minorities in regions with more resources and in more urban regions. A limited but troubling literature at the neighborhood level suggested potentially higher concentrations of sexual minorities in neighborhoods with fewer resources. There are substantial gaps in the literature. We discuss the implications of our findings and gaps in relation to key theories of sexual minority health. The review was not registered with PROSPERO because it was not eligible for registration at the time of the research project's initiation due to the outcome of interest.

Background The overweight/obesity epidemic is a public health issue in the United States (US), that disproportionately affect certain racial/ethnic minority groups. Perceived discrimination has been implicated as a health risk factor. However, research on race/ethnicity, perceived discrimination, and obesity has been mixed. Researchers suggest that perceptions of discrimination may be dependent upon nativity status. This study evaluated the role that nativity status and race/ethnicity play in the relationship between perceived discrimination and overweight/obesity. Methods We used Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (2004–2005) [ N  = 33,319]). Multinomial logistic regression assessed a three-way interaction (perceived discrimination × race/ethnicity × nativity) on overweight and obesity, adjusting for sociodemographic factors and health-related behaviors. Results The three-way interaction was significant for overweight [F (17, 49) = 3.35; p  < 0.001] and obesity [F (17, 49) = 5.05; p  < 0.001]. Among US-born individuals, US-born non-Hispanic Blacks had a decreased risk of being obese compared to US-born non-Hispanic Whites at mean levels of perceived discrimination [aRRR = 0.71; 95% CI (0.51–0.98); p  = 0.04). Among foreign-born individuals, foreign-born South Americans had an increased risk of being overweight at mean levels of perceived discrimination compared to foreign-born non-Hispanic Whites [aRRR = 8.07; 95% CI (1.68–38.77); p  = 0.01], whereas foreign-born Dominicans had a decreased risk of being obese compared to foreign-born non-Hispanic Whites [aRRR = 0.05; 95% CI (0.01–0.20); p  < 0.001]. Conclusion Perceived racial discrimination is a risk factor for overweight/obesity for certain groups. Race/ethnicity and nativity may play important roles in the relationship between perceived discrimination and overweight/obesity. Future research is needed to identify the behavioral and psychological pathways that link perceived discrimination and overweight/obesity.

Smoking prevalence is higher among sexual minorities compared to their heterosexual peers. However, very little is known about potential racial differences in smoking among sexual minority populations. We examined differences by race in smoking status among a robust sample of sexual minorities. We used data from the 2010 Social Justice Sexuality project, a large national convenience sample of sexual minority adults that oversampled individuals from racial minority groups. Log-Poisson multivariable regression models were employed to determine the risk of current smoking among sexual minority individuals by race after controlling for socio-demographic characteristics. Among smokers, 22.35% identified as White, 26.98% identified as Black, 19.38% identified as Latino/Hispanic, 5.58% identified as Asian American, and 25.67% were other/multiracial. In fully adjusted gender stratified models, Black men (adjusted risk ratio [aRR] = 0.61, 95% confidence interval [CI] = 0.50, 0.75) and Asian American men (aRR = 0.61, 95% CI = 0.50, 0.75) were at lower risk of smoking compared to White men. Black women were the only to remain statistically significant for decreased risk of smoking in fully adjusted gender stratified models (aRR = 0.78, 95 % CI = 0.65, 0.95). Among sexual minorities, Black and Asian American individuals consistently were at decreased risk of current smoking compared to their White peers. Future research should seek to understand the mechanisms that contribute to decreased smoking status among racial sexual minorities.

Abstract Previous research shows data quality and nonsampling bias error reduce accuracy of COVID-19 vaccination coverage in the Census' Household Pulse Survey. However, it is unclear how these issues relate to older sexual minority populations. Moreover, previous research has shown that sexual minority older adults survey nonparticipation rates are similar to their heterosexual older adult peers. Yet, it is less clear whether racial/ethnic variability in nonparticipation rates and patterns of missingness among sexual minority older adults exist. The current investigation utilizes repeated pooled data from the Census' Household Pulse Survey (N=329,078) to fill these gaps. Findings reveal nonsampling bias error contributing to inflated racial/ethnic inequities in vaccination coverage among older sexual minorities, with distinct racial/ethnic variability in missingness patterns among sexual minority older adults. The paper concludes with recommendations for improving survey-based research and details suggestions to improve recruitment strategies that minimize nonsampling bias.

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disorder with significant disparate impact on African American women. The current study sought to highlight how the Peer Approaches to Lupus Self-management (PALS) intervention worked bi-directionally wherein both women with SLE leading the disease self-management program (mentors), and those participants who served as mentees, were empowered toward greater disease self-efficacy. Data was captured for this study in two formats from the seven mentors participating in the pilot study: 1) mentor logs and 2) mentor interviews with the principle investigator. This information was then analyzed for themes relating to their experience within the study. We found that empowerment was facilitated by mentors taking their mentorship responsibilities seriously and seeking several avenues for collaboratively developing success with their mentees. Mentors reported that although challenges arose, their desire for success resulted in multiple approaches to be flexible and responsive to the needs of their mentees. Additionally, reciprocity was found to be a vital element of the program. Key thematic areas supported our ability to demonstrate the usefulness of a peer mentoring program for SLE disease self-management on evoking empowerment through reciprocal relationships among mentors and mentees within our study population. Furthermore the feedback from PALS participants yielded very rich and contextual information that can be used as a thematic guide for developing and refining evidence-based interventions that seek to incorporate empowerment into disease self-management efforts for women suffering from SLE.

Objectives. We examined disparities in health insurance coverage for racial/ethnic minorities in same-sex relationships. Methods. We used data from the 2009 to 2011 American Community Survey on nonelderly adults (aged 25–64 years) in same-sex (n = 32 744), married opposite-sex (n = 2 866 636), and unmarried opposite-sex (n = 268 298) relationships. We used multinomial logistic regression models to compare differences in the primary source of health insurance while controlling for key demographic and socioeconomic factors. Results. Adults of all races/ethnicities in same-sex relationships were less likely than were White adults in married opposite-sex relationships to report having employer-sponsored health insurance. Hispanic men, Black women, and American Indian/Alaska Native women in same-sex relationships were much less likely to have employer-sponsored health insurance than were their White counterparts in married opposite-sex relationships and their White counterparts in same-sex relationships. Conclusions. Differences in coverage by relationship type and race/ethnicity may worsen over time as states follow different paths to implementing health care reform and same-sex marriage.

Community-based participatory research (CBPR) and community-engaged research have been established in the past 25 years as valued research approaches within health education, public health, and other health and social sciences for their effectiveness in reducing inequities. While early literature focused on partnering principles and processes, within the past decade, individual studies, as well as systematic reviews, have increasingly documented outcomes in community support and empowerment, sustained partnerships, healthier behaviors, policy changes, and health improvements. Despite enhanced focus on research and health outcomes, the science lags behind the practice. CBPR partnering pathways that result in outcomes remain little understood, with few studies documenting best practices. Since 2006, the University of New Mexico Center for Participatory Research with the University of Washington’s Indigenous Wellness Research Institute and partners across the country has engaged in targeted investigations to fill this gap in the science. Our inquiry, spanning three stages of National Institutes of Health funding, has sought to identify which partnering practices, under which contexts and conditions, have capacity to contribute to health, research, and community outcomes. This article presents the research design of our current grant, Engage for Equity, including its history, social justice principles, theoretical bases, measures, intervention tools and resources, and preliminary findings about collective empowerment as our middle range theory of change. We end with lessons learned and recommendations for partnerships to engage in collective reflexive practice to strengthen internal power-sharing and capacity to reach health and social equity outcomes.

BackgroundEvidence suggests neighborhood contexts play a vital role in shaping the availability and diversity of youth sport and participation rates, especially for African American or Black girls. Currently, no index captures interscholastic sport opportunities (eg, sport diversity) within and across school districts and specifically applied to African American or Black girls.ObjectiveTo visualize the inequalities present in interscholastic sport opportunities for girls across school districts using a novel index in a selected study area of St Louis City and County, Missouri, and discuss the implications for African American or Black girls.DesignCross-sectional study.SettingDatabase secondary analysis.Patients or Other ParticipantsData for 47 public high schools in the 23 St Louis City and County school districts.Main Outcome Measure(s)We gathered data from the 2014-2018 American Community Survey and Missouri State High School Activities Association. We assessed sport diversity for girls by constructing a sport diversity index (SDI) that uses an entropy index as its foundation. Census-tract data were used to examine the association with neighborhood demographics and contributors to school district income and sport diversity. Descriptive spatial statistics were calculated to evaluate distributions in St Louis City and County, with the bivariate local indicator of spatial autocorrelation used to determine any correlations between variables of interest.ResultsThe St Louis City school district, which has areas with high rates of renter-occupied housing and poverty and high percentages of non-Hispanic African American or Black students, had the lowest SDI for girls, contrasted with the school districts in St Louis County, which showed an inverse pattern on average. The SDI for girls was correlated with the percentages of renter-occupied housing and poverty. The SDI for girls was also correlated with race: an increasing presence of the non-Hispanic African American or Black population was associated with decreased sport diversity for girls.ConclusionsThe SDI for girls demonstrated a spatial association with neighborhood-level determinants of sport-opportunity availability for non-Hispanic African American or Black girls in St Louis. The role of social and political determinants of health in shaping community context and resultant health in athletic training research, policy, and practice should be considered. (Autor).

Sexual minorities exhibit elevated rates of cigarette smoking, although disparate patterns exist when examining racial/ethnic differences among sexual minorities in the United States. Evidence suggests examining differing neighborhood contexts may help illuminate drivers of tobacco-related outcomes among sexual minorities, especially with respect to racial/ethnic variations among this understudied population. Adapting a framework of whiteness and health, the current project examined the role of racial residential segregation and neighborhood disadvantage as neighborhood contexts significantly associated with cigarette smoking across the adult lifespan. Using data from the 2010 Social Justice Sexual Project, merged with U.S. Census data, I find that residing in a gayborhood serves as a novel metric of racial residential segregation among sexual minorities. In addition, I find that racial/ethnic differences among sexual minorities exist when considering residing in neighborhoods characterized with high levels of disadvantage. Most importantly, I show intersectional variations in the relationship between gayborhood residence and cigarette smoking; wherein, white sexual minorities residing in gayborhood exhibited the highest rates of cigarette smoking compared to their racial/ethnic peers residing in both gayborhoods and outside of gayborhoods. This association was robust even after controlling for a host of individual-markers of sociodemographic difference and varying levels of neighborhood disadvantage.