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Misperceptions and stigma impact individuals and healthcare providers when adopting brain-healthy behaviors and addressing dementia. Fear of cognitive decline hinders open conversations and prevents people from accessing the care and services that could help them through earlier diagnosis and interventions. A successful strategy to enhance brain health should combat the stigma of dementia and drive systemic changes that make it easier for individuals adopt and sustain lifestyles and behaviors that support their brain health, reducing risks for cognitive decline and improving quality of life for people living with dementia.

Over the past 35 years, ethnic-racial socialization (ERS) has been a widely studied topic in psychological and cultural research. Most popular among the populations that ERS research centers are Black/African American families and youth. However, a small, but emerging body of research on the ERS processes of other racial/ethnic groups suggest that ERS is not limited to Black/African American families. Recently, scholars have begun to ask more critical questions regarding the differential effects of ethnic-racial socialization on non-Black youth’s psychological development. Therefore, the current review of research draws together studies on Black/African American, Biracial, Latinx, Asian American, and White American families to demonstrate the role of racial/ethnic group identification in soliciting the exchange of ERS messages from parents to children. The methodology used to execute this review follows a modified framework which includes four key phases of searching and selecting appropriate studies. From three multidisciplinary and psychological databases, 24 studies were selected based on the inclusion criteria set by the researcher. The studies discussed in this scoping review all revealed how racial/ethnic group identification solicits the exchange of ERS messages from parents to children in some way. Highlights 24 research studies revealed that the dynamic nature of a family’s ethnic/racial identification drives the types and frequency of certain ethnic-racial socialization messages communicated from parents to children. Black/African American families have an extensive history of prioritizing conversations that prepare Black youth for racial bias. ERS studies centering Latinx and Asian American families revealed that generational/immigration status was an important factor for what types of ERS messages were discussed in those households. White American families were more likely to engage their children in egalitarian socialization to reinforce the idea that everyone is the same and possesses equal opportunities to succeed.

Latino, Black, American Indian/Alaska Native (AI/AN), and Native Hawaiian or Other Pacific Islander people have the highest hospitalizations and death rates from COVID-19. Social inequalities have exacerbated COVID-19 related health disparities. This study examines social and structural determinants of COVID-19 vaccine uptake. Results from logistic regressions suggest Latino and Black people were less likely to be vaccinated. People that did not have health insurance, a primary care doctor and were unemployed were more than 30% less likely to be vaccinated for COVID-19. Greater perceived health inequalities in one’s neighborhood and perceived racial/ethnic discrimination were associated with a decreased odds in being vaccinated. People that suffered the loss of a household member from COVID-19 were three times more likely to have been vaccinated. Establishing policies that will increase access to health insurance and create jobs with living wages may have lasting impacts. Furthermore, collaboration with local and national community organizations can enhance the development of sustainable solutions.

Previous research on pandemics and emergencies has shown that such events often widen health inequalities in society and have a greater impact on socially disadvantaged groups. No review has so far looked at the impact of inequality factors on mental health outcomes during the novel coronavirus outbreak (COVID-19). The aim of the current review was therefore to assess the impact of inequality factors on mental health outcomes during COVID-19. After registration on PROSPERO, a systematic review was conducted for papers published up to July 31, 2020, using the databases Google Scholar, PsycINFO, PubMed (MEDLINE), and Web of Science. The following inequality factors were considered: education, income, employment, occupation, material and social deprivation, age, immigrant status, sexual orientation, functional health, cultural/racial background, sex, gender, and place of residence. Out of 1,931 references, 117 studies (300,061 participants) were included. Female sex, being of a younger age, financial insecurity, lack of access to clear messaging/information about the pandemic, proximity to large infection sites, having existing physical and/or psychological health conditions, and being subjected to abuse/stigma because of one's identity as a member of an ethnic or sexual marginalized group predicted mental health inequalities. More research is required on how inequality affects mental health in less studied vulnerable populations, such as ethnic, sexual, and gender marginalized participants, as well as how inequality factors interact to affect mental health in the long term. Recommendations for researchers, mental health practitioners, and public health authorities for mitigating adverse mental health outcomes in vulnerable populations are outlined. Public Significance Statement The findings of this review suggest that several inequality factors, such as female sex, younger age, financial insecurity, having existing chronic health conditions, and being in an ethnic or sexual marginalized group predict worse mental health outcomes during the ongoing COVID-19 pandemic. There is an urgent need for mental health services to support vulnerable populations at this time, to reduce mental health inequalities and improve long-term psychological functioning. Des recherches antérieures sur les pandémies et les urgences ont montré que de tels événements augmentent souvent les inégalités en matière de santé dans la société et ont une incidence plus grave sur les groupes socialement défavorisés. À ce jour, aucune étude n'a examiné l'incidence des facteurs d'inégalité sur les résultats en matière de santé mentale lors de l'épidémie du nouveau coronavirus (COVID-19). L'objectif de la présente étude était donc d'évaluer l'incidence des facteurs d'inégalité sur les résultats en matière de santé mentale pendant la COVID-19. Après inscription sur PROSPERO, un examen systématique a été effectué pour les articles publiés jusqu'au 31 juillet 2020, en utilisant les bases de données Google Scholar, PsycINFO, PubMed (MEDLINE) et Web of Science. Les facteurs d'inégalité suivants ont été pris en considération : éducation, revenu, emploi, profession, privation matérielle et sociale, âge, statut d'immigrant, orientation sexuelle, santé fonctionnelle, origine culturelle/raciale, sexe, genre et lieu de résidence. Sur 1 931 références, 117 études (300 061 participants) ont été incluses. Le sexe féminin, le jeune âge, l'insécurité financière, le manque d'accès à des messages/renseignements clairs sur la pandémie, la proximité d'importants sites d'infection, les conditions de santé physique et/ou psychologique existantes et le fait d'être victime d'abus/stigmatisation en raison de son identité en tant que membre d'un groupe ethnique ou sexuel marginalisé ont permis de prédire les inégalités en matière de santé mentale. Des recherches supplémentaires sont nécessaires sur la manière dont les inégalités affectent la santé mentale dans les populations vulnérables moins étudiées, telles que les participants marginalisés sur le plan ethnique, sexuel et sexospécifique, ainsi que sur la manière dont les facteurs d'inégalité interagissent pour affecter la santé mentale à long terme. Des recommandations sont formulées à l'intention des chercheurs, des praticiens de la santé mentale et des autorités de santé publique pour atténuer les effets néfastes sur la santé mentale des populations vulnérables.

Black Canadians and Americans experience disparities in access to quality mental health care and mental health overall. Implicit biases are unconscious, automatically activated attitudes and stereotypes, with the potential to yield racist behaviors. To date, research has focused on health provider bias and resultant consequences in the decision-making/treatment of racialized groups. Little has been done to characterize implicit anti-Black biases within White and non-White members of the general population or examine the relationship between biases and Black people's mental wellness. Black-White Implicit Association Test (BW-IAT; n = 450,185) data were used to detect the presence of implicit biases within 10 ethnoracial groups and compare Bias Scores between Canada and the United States. Mean BW-IAT Bias Scores were also assessed against participant explicit biases using warmth ratings and the Modern Racism Scale (MRS). Finally, state-level BW-IAT scores were used to predict state-based Black American mental health-related mortality using the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER) data set. Findings indicated: (a) the most ethnoracial groups have anti-Black implicit biases; (b) Canadian and American implicit biases are near identical; (c) explicit and implicit Bias Scores are weakly related, and Canadian and American explicit biases are near identical; and (d) implicit bias predicts poor mental health outcomes for Black Americans, even when controlling for explicit bias and White outcomes. This work underscores the need to dismantle ideologies of White superiority and the resultant oppressive attitudes, stereotypes, and behaviors present in the general population. This work also calls for accessible, province-level, race-based mental health data on underserved groups. Les Canadiens noirs et les Afro-Américains font face à des disparités en ce qui concerne leur accès à des soins de santé mentale et particulièrement des soins de santé mentale de qualité. Les préjugés implicites sont des attitudes et des stéréotypes inconscients, soient des pensées automatiques, qui peuvent potentiellement provoquer des comportements racistes. Jusqu'à présent, les recherches à ce sujet ont mis une emphase sur les préjugés des prestataires de soins de santé et les conséquences qui en découlent dans la prise de décision et le traitement des groupes racialisés. Peu d'études ont été menées dans le but de mettre en évidence les préjugés implicites anti-Noirs chez les personnes de race blanche et les personnes d'autres races parmi la population générale ou d'examiner la relation entre les préjugés et le bien-être mental des Noirs. Les données du Black-White Implicit Association Test (BW-IAT; n = 450 185) ont été utilisées pour déterminer la présence de préjugés implicites au sein de 10 groupes ethnoraciaux et comparer les scores des préjugés entre le Canada et les États-Unis. Les scores moyens des préjugés du BW-IAT ont également été évalués par rapport aux préjugés explicites des participants à l'aide des warmth ratings et du Modern Racism Scale. Par la suite, les scores BW-IAT dans les différents États ont été utilisés pour prédire le taux de mortalité lié à la santé mentale des Noirs américains à l'aide de l'ensemble de données CDC WONDER. Les résultats indiquent que (1) la plupart des groupes ethnoraciaux ont des préjugés implicites anti-Noirs; (2) les préjugés implicites canadiens et américains sont presque identiques; (3) les scores de préjugés explicites et implicites ont une faible corrélation, et les préjugés explicites canadiens et américains sont presque identiques; et (4) les préjugés implicites prédisent de conséquences négatives sur la santé mentale des Noirs américains, même en contrôlant les préjugés explicites et les résultats des personnes blanches. Ces travaux soulignent la nécessité de démanteler, au sein de la population dans son ensemble, les idéologies de supériorité de la race blanche et les attitudes, stéréotypes et comportements oppressifs qui en découlent. Ce travail appelle également à l'accessibilité des données sur la santé mentale axées sur la race des groupes faiblement desservis, au niveau provincial. Public Significance Statement To date, few researchers have explored the impact of implicit biases on the health of people of color outside of a medical setting. Fewer still have considered the relationship between implicit biases held by the general population, both White and non-White, and Black peoples' mental health. This study is among the first to focus on the measurable existence of implicit racial biases within ethnoracial groups toward Black persons in the United States and Canada, as well as the possible impacts of implicit biases on the mental health of Black people in America.

Background Previous research suggests education is inversely associated with blood pressure, but little work has examined whether this relationship differs by race and gender jointly. Identifying the most vulnerable groups may inform hypertension prevention strategies. In this population-based study, we investigate the association between education and blood pressure overall and across race-by-gender subgroups. Methods Our analytic sample included participants aged 50 + to the US Health and Retirement Study data from 2006 to 2008 ( N  = 24,526). Our exposure was education, measured as self-reported years of schooling and modeled as a spline with a knot and discontinuity at 12 years representing high school diploma. We used generalized estimating equations to estimate the relationship between education and repeated measurements of two blood pressure outcomes: systolic blood pressure (SBP) and hypertension (HTN), then included race-by-gender interactions with education to evaluate differential associations. All models were adjusted for age, birthplace, parents’ education, and survey year. Results Mean age was 64.4 years, mean SBP was 129.9 mmHg, and HTN prevalence was 63.1%. Overall, below 12 years, each additional year of education was not associated with blood pressure, while twelve years of schooling was associated with lower blood pressure (b=-1.02; 95% CI: -2.04, 0.00 for SBP) and each additional year of education after 12 years was associated with lower SBP and lower odds of HTN (e.g., SBP: b=-0.75 mmHg; 95% CI: -0.88, -0.62). We observed some differential relationships by demographic subgroup such that, among Black men, 12 years of education predicted higher odds of HTN compared to White men (interaction OR = 1.60; 95% CI: 1.02, 2.52), and each additional year of education after 12 years was associated with larger SBP benefits for White, Hispanic and Black women compared to White men. Conclusions We found an overall protective relationship between more education and blood pressure/hypertension such that each additional year of college education was associated with lower blood pressure/hypertension, particularly among White and Hispanic women. However, we also found evidence of diminished benefits to high school degree attainment among Black men compared to other groups in hypertension prevalence.

Background/Objectives: Hepatocellular carcinoma (HCC) is a leading cause of cancer diagnoses and deaths in the United States. This study serves as an update on secular trends in national HCC incidence rates while exploring potential geographic and racial/ethnic differences across all nine US census divisions. Methods: We analyzed HCC incidence data reported to the United States Cancer Statistics (USCS) database from 2001 to 2021 (excluding 2020 data, based on the Centers for Disease Control and Prevention’s cautionary recommendations for COVID-19 pandemic data usage for trend analysis). We performed trend analyses of age-adjusted incidence rates in the US overall, by census divisions, and then stratified by race/ethnicity, using the National Cancer Institute’s Joinpoint Regression Program. Results: Between 2001 and 2021, HCC incidence rates increased nationally, with an average annual percentage change (AAPC) of 2.51 (95% confidence interval (CI): 2.32–2.72); however, the rate decreased (annual percentage change (APC) −3.33 (95% CI: −4.78–−1.96) in recent years from 2018 to 2021. Division 1 had the greatest decrease (APC −6.46 (95% CI: −9.62–−3.96) from 2017 to 2021, while rates leveled in Division 6 (East South Central) and Division 7 (West South Central). HCC trends decreased substantially for non-Hispanic Black and Non-Hispanic Asian and Pacific Islander groups in almost all divisions in recent years, but trends were stable, decreased, or increased for other racial/ethnic populations. Conclusions: Despite declining national HCC incidence rates, these trends were not uniform across racial/ethnic groups or US census divisions. Race-specific interventions are needed to reduce disparities in HCC incidence in all US census divisions.

Background and objective Cultural competence intentionally enhances the quality improvement process in healthcare. Therefore, the goal of this study was to evaluate the knowledge, skills, and comfort level of cultural competence and determine the important factors contributing to health disparities among male nursing students. Methods A cross-sectional, descriptive paper-based study was conducted among male nursing students at a Saudi University between March and May 2024. Data was collected using structured, pre-validated 47-item questionnaires and analyzed using the statistical package for social science version 27. For bivariate analysis, Chi-square or Fisher’s Exact test was employed. A p -value < 0.05 was considered statistically significant. Results The response rate obtained was 86%. Approximately half of the students (50.8%; n  = 131) believed they were somewhat knowledgeable about the demographics of diverse racial and ethnic groups, while only 5% ( n  = 13) were very knowledgeable. Lifestyle (14%) and environment (12%) were important factors contributing to health disparities. The mean score for knowledge and skills of cultural competence was 67.99 ± (SD = 16.21), while it was 31.29 ± (SD = 12.31), for cross-cultural encounters and 43.32 ± (SD = 13.72) for factors contributing to health disparities. In this study, 50.4% ( n  = 130) of students reported good levels of knowledge and skills of cultural competence, and 53.5% ( n  = 138) of students showed good attitudes towards factors contributing to health disparities. There was a significant association between students’ grade point average (GPA) and knowledge and skills in cultural competence, with those having higher GPAs demonstrating higher levels of knowledge and those with GPAs above 3.5 reporting higher levels of comfort than those with GPAs below 2 ( p  = 0.045). Conversely, a significant association was found between students’ age group and GPA and their attitudes regarding variables contributing to health disparities ( p  = 0.0001). In addition, findings reveal that there is a statistically significant linear relationship between knowledge and skills of cultural competence and comfort in dealing with cross-cultural encounters ( r  = 0.438, p  = 0.01) and factors contributing to health disparities ( r  = 0.376, p  = 0.01). Conclusion This study found that male nursing students demonstrated a relatively good level of cultural competence, showing comfort in interacting with diverse cultural backgrounds and awareness of social, economic, and cultural determinants of health inequities. To further enhance their preparedness for diverse patient populations, structured training programs, real-world exposure, and reflective learning are recommended. Clinical trial number Not applicable.

INTRODUCTION Historically underrepresented racial and ethnic groups may face a higher risk and burden of dementia but continue to be underrepresented in Alzheimer's disease (AD) clinical research. Recent efforts have been insufficient to identify and address race‐related disparities in recruitment and eligibility for AD clinical trials. METHODS INTERCEPT‐AD was a Phase 1 randomized, placebo‐controlled, double‐blind, first‐in‐human study of sabirnetug (ACU193) in participants with early symptomatic AD (mild cognitive impairment [MCI] or mild dementia due to AD). Participants were referred through seven site‐selected recruitment strategies across 17 study sites in the United States (June 2021–January 2023). Numbers of pre‐screened (n = 1025), screened (n = 260), and eligible (n = 70) participants were compared by recruitment strategy. Recruitment strategy effectiveness (percentage of eligible participants among screened participants) and reasons for screening ineligibility were compared between non‐Hispanic White participants and participants from other racial and ethnic groups (i.e., participants who self‐identified as American Indian or Alaska Native, Asian, Black or African American, or Hispanic or Latino). RESULTS Local site databases were used at 13 of 17 sites (76%) and accounted for the most screened (n = 107, 41%) and eligible (n = 32, 46%) participants. Non‐Hispanic White participants were recruited from all seven recruitment strategies, whereas participants of other racial and ethnic groups were recruited primarily from site databases. Significantly more participants of other racial and ethnic groups were ineligible for the study after screening, largely due to ineligible amyloid positron emission tomography (PET) scans (+13.9%). DISCUSSION Diverse recruitment tactics, customized to capabilities of study sites and patient populations, may be more successful in recruiting diverse populations than a one‐size‐fits‐all approach. Although a diverse pool of potential participants was screened, a less diverse group was enrolled, largely due to race‐ and ethnicity‐related disparities in screening eligibility rates. Further investigation is needed to assess equitable screening methods for AD clinical trials. Highlights Site databases recruited the most screened and enrolled participants. Diverse participants were primarily recruited from site databases. The diversity of enrolled participants was lower than screened participants. More ineligible participants were from diverse racial and ethnic groups. No approach was observed to be a one‐size‐fits‐all method to recruit and enroll a diverse pool of participants.

Previous research has found that citizens' attitudes concerning police legitimacy influence their behavior toward the police. However, this relationship has yet to be studied in the context of a jury trial involving police use of force (UoF). The primary goal of this article is therefore to examine whether mock jurors' race, along with their perceptions of police legitimacy, predict verdict decisions in trials involving police UoF. We hypothesized that participants' perceptions of police legitimacy would be significantly related to their verdict decisions. Additionally, we predicted that racial minorities would be less likely to find a defendant charged with murdering a police officer guilty, and that this relationship would be mediated by perceptions of police legitimacy. We recruited 275 undergraduate students who were eligible for Canadian jury duty. One-hundred and eighty-five (67.3%) of the participants were women, 87 (31.6%) were men. One-hundred and forty-five (52.7%) participants were White, while 130 (47.3%) were non-White. Participants viewed a video of a mock trial, rendered a dichotomous verdict, and responded to the Police Legitimacy Scale. Both participants' race (OR = .44) as well as their perceptions of police legitimacy (OR = 2.08) were significantly related to their verdict decisions. Subsequent analysis revealed that the relationship between participant race and verdict was partially mediated by perceptions of police legitimacy. Our findings provide further evidence that citizens' behaviors relating to police are related to their preexisting attitudes. Des recherches antérieures ont montré que les attitudes des citoyens concernant la légitimité de la police influencent leur comportement envers la police. Toutefois, cette relation n'a pas encore été étudiée dans le contexte d'un procès avec jury impliquant l'usage de la force par la police (UoF). Le but premier de cet article est donc de déterminer si la race des jurés fictifs, ainsi que leur perception de la légitimité de la police, permettent de prédire les verdicts dans les procès impliquant l'usage de la force par la police. Nous avons émis l'hypothèse que les perceptions des participants quant à la légitimité de la police seraient clairement liées à leurs verdicts. En outre, nous avons prédit que les minorités raciales seraient moins susceptibles de juger coupable un défendeur accusé du meurtre d'un policier, et que cette relation serait arbitrée par les perceptions de légitimité de la police. Nous avons recruté 275 étudiants de premier cycle qui étaient admissibles à faire partie d'un jury canadien. Cent quatre-vingt-cinq (67,3 %) des participants étaient des femmes, et 87 (31,6 %) étaient des hommes. Cent quarante-cinq (52,7 %) des participants étaient de race blanche, tandis que 130 (47,3 %) n'étaient pas de race blanche. Les participants ont visionné la vidéo d'un procès fictif, rendu un verdict dichotomique et répondu à l'échelle de légitimité de la police. La race des participants (OR = 0,44) ainsi que leurs perceptions de la légitimité de la police (OR = 2,08) étaient liées de manière significative à leurs verdicts. Une analyse ultérieure a révélé que la relation entre la race des participants et le verdict était partiellement arbitrée par les perceptions de la légitimité de la police. Nos résultats fournissent des preuves supplémentaires que les comportements des citoyens vis-à-vis de la police sont liés à leurs attitudes préexistantes. Public Significance Statement Mock jurors' preexisting perceptions of police legitimacy were significantly related to verdict decisions in a trial involving police use of force. The more legitimate that mock jurors perceived the police to be, the more likely they were to find a defendant guilty of murdering a police officer rather than accepting his claim of self-defence. These results underscore police legitimacy's importance in community-police relations.