The EU Referendum and Experiences and Fear of Ethnic and Racial Harassment: Variation Across Individuals and Communities in England.
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SUBMITTER: Nandi A
PROVIDER: S-EPMC8160085 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:OBJECTIVE:To describe differences in patient experiences of hospital care by preferred language within racial/ethnic groups. DATA SOURCE:2014-2015 HCAHPS survey data. STUDY DESIGN:We compared six composite measures for seven languages (English, Spanish, Russian, Portuguese, Chinese, Vietnamese, and Other) within applicable subsets of five racial/ethnic groups (Hispanics, Asian/Pacific Islanders, American Indian/Alaska Natives, Blacks, and Whites). We measured patient-mix adjusted overall, between- and within-hospital differences in patient experience by language, using linear regression. DATA COLLECTION METHODS:Surveys from 5 480 308 patients discharged from 4517 hospitals 2014-2015. PRINCIPAL FINDINGS:Within each racial/ethnic group, mean reported experiences for non-English-preferring patients were almost always worse than their English-preferring counterparts. Language differences were largest and most consistent for Care Coordination. Within-hospital differences by language were often larger than between-hospital differences and were largest for Care Coordination. Where between-hospital differences existed, non-English-preferring patients usually attended hospitals whose average patient experience scores for all patients were lower than the average scores for the hospitals of their English-preferring counterparts. CONCLUSIONS:Efforts should be made to increase access to better hospitals for language minorities and improve care coordination and other facets of patient experience in hospitals with high proportions of non-English-preferring patients, focusing on cultural competence and language-appropriate services.
| S-EPMC6341216 | biostudies-literature
Project description:Pre-electoral surveys typically attempt, and sometimes fail, to predict voting behavior on the basis of explicit measures of agreement or disagreement with a candidate or political position. Here, we assessed whether a specific brain signature of disagreement with one's social values, the event-related potential component N400, could be predictive of voting behavior. We examined this possibility in the context of the EU referendum in the UK. In the 5?weeks preceding the referendum, we recorded the N400 while participants with different vote intentions expressed their agreement or disagreement with pro- and against-EU statements. We showed that the N400 responded to statements incongruent with one's view regarding the EU. Crucially, this effect predicted actual voting behavior in decided as well as undecided voters. The N400 was a better predictor of voting choice than an explicit index of preference based on the behavioral responses. Our findings demonstrate that well-defined patterns of brain activity can forecast future voting behavior.
| S-EPMC5714220 | biostudies-literature
Project description:ObjectiveTo assess the extent to which racial/ethnic differences in ratings of patient experiences with health care represent true differences versus differences in expectations, how scales are used, or how identical physician-patient interactions are perceived by members of different groups.Study settingPrimary data collection from a nationally representative online panel (n=567), including white, African American, and Latino respondents.Study designWe administered questions on expectations of care, a series of written vignettes, a video-depicted doctor-patient interaction, and modified CAHPS Clinician and Group Doctor Communication items.Principal findingsDifferent groups reported generally similar expectations regarding physicians' behaviors and provided similar mean responses to CAHPS communication items in response to standardized encounters.ConclusionsPreliminary evidence suggests that unlike more subjective global ratings, reported disparities in more specific and objective CAHPS composites may primarily reflect differences in experiences, rather than differences in expectations and scale use, adding to our confidence in using the latter to assess disparities.
| S-EPMC3064916 | biostudies-literature
Project description:Migrant workers are considered an economic utility, especially for secondary labour markets such as that of long-term care. The dynamics of migrant workers across the globe are governed by interacting macro, state level, and micro, personal level, factors. On the macro level immigration policies, historical and current political and economic links between countries play a crucial part in such dynamics. On an individual level, choices, actions and motivations to migrate and work in certain labour sectors are entangled with and governed by macro level policies. Since 2003, the enlargement of the European Economic Area (EEA) has enabled employers in the UK to freely recruit staff from EEA countries. This article investigates reported individual motivations and the decision making process while accounting for macro factors, specifically ease of labour mobility within the EEA versus a more elaborate process when migrating to work in social care in the UK from outside the EEA. Face to face interviews were conducted with 96 migrant social care and social work staff in six diverse areas of England (2007-2009). The analysis indicates differences in stated motivations to migrate to the UK and to work in the care sector among different groups of migrants, particularly among those from Commonwealth countries, from the EEA, and migrants from other parts of the globe. The findings highlight the importance of taking into account the role of immigration policies and consequently immigration status when investigating the policy framework and delivery of care services for older people.
| S-EPMC5549116 | biostudies-other
Project description:Our objective was to compare patients' health care experiences, related to their weight, across racial and ethnic groups. In Summer 2015, we distributed a written survey with telephone follow-up to a random sample of 5400 racially/ethnically and geographically diverse U.S. adult health plan members with overweight or obesity. The survey assessed members' perceptions of their weight-related healthcare experiences, including their perception of their primary care provider, and the type of weight management services they had been offered, or were interested in. We used multivariable multinomial logistic regression to examine the relationship between race/ethnicity and responses to questions about care experience. Overall, 2811 members (53%) responded to the survey and we included 2725 with complete data in the analysis. Mean age was 52.7 years (SD 15.0), with 61.7% female and 48.3% from minority racial/ethnic groups. Mean BMI was 37.1 kg/m(2) (SD 8.0). Most (68.2%) respondents reported having previous discussions of weight with their provider, but interest in such counseling varied by race/ethnicity. Non-Hispanic blacks were significantly less likely to frequently avoid care (for fear of discussing weight/being weighed) than whites (OR 0.49, 95% CI 0.26-0.90). Relative to whites, respondents of other race/ethnicities were more likely to want weight-related discussions with their providers. Race/ethnicity correlates with patients' perception of discussions of weight in healthcare encounters. Clinicians should capitalize on opportunities to discuss weight loss with high-risk minority patients who may desire these conversations.
| S-EPMC4960010 | biostudies-literature
Project description:ObjectivesTo investigate whether health care experiences of adult Medicaid beneficiaries differ by race/ethnicity and rural/urban status.Data sourcesA total of 270 243 respondents to the 2014-2015 Nationwide Adult Medicaid Consumer Assessment of Healthcare Providers and Systems Survey.Study designLinear regression was used to estimate case mix adjusted differences in patient experience between racial/ethnic minority and non-Hispanic white Medicaid beneficiaries, and between beneficiaries residing in small urban areas, small towns, and rural areas vs large urban areas. Dependent measures included getting needed care, getting care quickly, doctor communication, and customer service.Principal findingsCompared with white beneficiaries, American Indian/Alaska Native (AIAN) and Asian/Pacific Islander (API) beneficiaries reported worse experiences, while black beneficiaries reported better experiences. Deficits for AIAN beneficiaries were 6-8 points on a 0-100 scale; deficits for API beneficiaries were 13-22 points (P's < 0.001); advantages for black beneficiaries were 3-5 points (P's < 0.001). Hispanic white differences were mixed. Beneficiaries in small urban areas, small towns, and isolated rural areas reported significantly better experiences (2-3 points) than beneficiaries in large urban areas (P's < 0.05), particularly regarding access to care. Racial/ethnic differences typically did not vary by geography.ConclusionsImproving experiences for racial/ethnic minorities and individuals living in large urban areas should be high priorities for policy makers exploring approaches to improve the value and delivery of care to Medicaid beneficiaries.
| S-EPMC6341217 | biostudies-literature
Project description:Childhood adversity is a well-established risk factor for mental health problems during adolescence. Using data from the Fragile Families and Child Wellbeing Study and latent class analysis (LCA), we examined patterns of exposure to ten adverse childhood experiences (ACEs), including socioeconomic adversity, among non-Hispanic (NH) White, NH Black, and Hispanic 9 year olds and determined associations between membership in ACE exposure "classes" and depression and anxiety scores at age 15 (N = 2849). Parental separation/divorce, economic hardship, and paternal incarceration were the most common ACEs. ACE prevalence was significantly higher among Blacks and Hispanics. ACEs clustered into four classes for Whites and Hispanics and three classes for Blacks. Over half of Whites were classified in the 'Low Adversity' class. Conversely, most Black and Hispanic adolescents were classified in the 'High Socioeconomic Adversity and Paternal Incarceration' class, characterized by above average probabilities of experiencing family economic hardship, parental separation/divorce, low maternal education, and paternal incarceration. A small share of adolescents in all three racial/ethnic groups were in the 'High Global Adversity' class, characterized by high probability of exposure to most ACEs, including physical and psychological abuse. Finally, ACE class membership was differentially associated with anxiety and depression across the three racial/ethnic groups, with generally larger differences in mental health scores across ACE groups for Whites than for Blacks and Hispanics. Our findings suggest that studies on the associations between ACEs and health outcomes that do not include childhood economic adversity risk underestimating the role of ACEs on mental health among racial/ethnic minorities. Moreover, different patterns of ACE exposure are differentially linked to anxiety and depression, and ACE group membership differences in anxiety and depression vary by racial/ethnic group. Findings suggest the need for racially tailored prevention and intervention strategies.
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Project description:In order for precision health to address health disparities, engagement of diverse racial/ethnic minority communities and the physicians that serve them is critical. A community-based participatory research approach with mixed methods was employed to gain a deeper understanding of precision health research and practice among American Indian, African American, Latino, Chinese, and Vietnamese groups and physicians that serve these communities. A survey assessed demographics and opinions of precision health, genetic testing, and precision health research. Focus groups (n=12) with each racial/ethnic minority group and physicians further explored attitudes about these topics. One hundred community members (American Indian [n=17], African American [n=13], Chinese [n=17], Latino [n=27], and Vietnamese [n=26]) and 14 physicians completed the survey and participated in the focus groups. Familiarity with precision health was low among community members and high among physicians. Most groups were enthusiastic about the approach, especially if it considered influences on health in addition to genes (eg, environmental, behavioral, social factors). Significant concerns were expressed by African American and American Indian participants about precision health practice and research based on past abuses in biomedical research. In addition, physician and community members shared concerns such as security and confidentiality of genetic information, cost and affordability of genetic tests and precision medicine, discrimination and disparities, distrust of medical and research and pharmaceutical institutions, language barriers, and physician's specialty. Engagement of racial/ethnic minority communities and the providers who serve them is important for advancing a precision health approach to addressing health disparities.
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Project description:This study examines the associations between school racial/ethnic and socioeconomic composition and school engagement levels among Mexican-origin Latinos/as, African Americans, and non-Latino/a whites. Prior research suggests that whiter and more affluent schools should promote engagement, but some studies reveal paradoxes of school segregation whereby minority and socioeconomically disadvantaged students exhibit worse outcomes in schools with white and socioeconomically advantaged peers. Using data from the Education Longitudinal Study of 2002, this study examines the associations between the percent of non-minority students in the school, average school socioeconomic status, and three engagement outcomes: Liking school, involvement in school-sponsored activities, and coursework engagement. The findings reveal an affective-behavioral trade-off for students in schools with higher proportions of white students. Students who attend whiter schools are less likely to report that they like school, but they are more engaged in coursework. This affective-behavioral paradox is not unique to any particular racial/ethnic group.
| S-EPMC5820779 | biostudies-literature
Project description:We aim to contribute to a better understanding of the dynamics that are driving EU politicization and the rising Euroscepticism of workers and unions in the public sphere. One explanation frames the rise in Euroscepticism in cultural terms, emphasizing workers' alleged primordial attachment to their nation. A second uses socioeconomic frames, linking growing Euroscepticism to the increasingly neo-liberal direction of the EU. The weight of these competing frames in the referendum campaigns on the EU Constitution in France and the Lisbon Treaty and the Fiscal Treaty in Ireland cannot be measured easily, as the categorization of a phrase as socioeconomic or cultural is in itself subject to political classification struggles. We therefore presents the findings of an inductive lexical analysis of all Irish Times, all Le Monde and all worker- or union-related articles published in almost all national media outlets during the mentioned referendum debates. This was made possible by the Alceste software package that allowed us to analyse very large corpuses of articles inductively. Our analysis reveals that socioeconomic terms dominated policy debates in both countries. The findings question existing EU politicization studies that were measuring the salience of different frame types by deductive analysis.
| S-EPMC6473535 | biostudies-literature