Structural racism and intimate partner violence perpetration among racially diverse men transitioning into fatherhood: an anti-racist approach to IPV prevention

Cruz S.S., Margerison C., Gemmill A., Ha S., Hurd T., Jensen J., Goldman-Mellor S.

Albert M.A., Churchwell K., Desai N., Johnson J.C., Johnson M., Khera A., Mieres J., Rodriguez F., Velarde G., Williams D.R., Wu J.C.

During the COVID-19 pandemic, the American Heart Association created a new 2024 Impact Goal with health equity at its core, in recognition of the increasing health disparities in our country and the overwhelming evidence of the damaging effect of structural racism on cardiovascular and stroke health. Concurrent with the announcement of the new Impact Goal was the release of an American Heart Association presidential advisory on structural racism, recognizing racism as a fundamental driver of health disparities and directing the American Heart Association to advance antiracist strategies regarding science, business operations, leadership, quality improvement, and advocacy. This policy statement builds on the call to action put forth in our presidential advisory, discussing specific opportunities to leverage public policy in promoting overall well-being and rectifying those long-standing structural barriers that impede the progress that we need and seek for the health of all communities. Although this policy statement discusses difficult aspects of our past, it is meant to provide a forward-looking blueprint that can be embraced by a broad spectrum of stakeholders who share the association’s commitment to addressing structural racism and realizing true health equity.

Willie T.C., Katague M., Halim N., Gupta J.

Objective To examine distinct patterns of IPV perpetration and examined gender equitable attitudes as a correlate of these patterns among men from six countries in Asia and the Pacific. Design 2011–12 UN Multi-country Study on Men and Violence cross-sectional study. Setting Households in Bangladesh, Cambodia, China, Indonesia, Sri Lanka and Papua New Guinea. Participants 10,178 men aged 18–49 years residing in Bangladesh, Cambodia, China, Indonesia, Sri Lanka and Papua New Guinea. Primary outcomes measure Our primary outcome was distinct patterns of IPV perpetration which were derived from multilevel latent class analyses. Results The odds of being assigned to the Low All Forms of IPV Perpetration class than the High All Forms of IPV Perpetration class was lower for men in the middle tertile group than men in the high tertile group for gender equitable attitudes. The odds of being assigned to the High Emotional IPV Perpetration class than the High All Forms of IPV Perpetration class was greater for men in the low tertile group than men in the high tertile group for gender equitable attitudes. The odds of being assigned to the High Physical/Emotional/Economic IPV Perpetration class than the High All Forms of IPV Perpetration class was lower for men in the low tertile group than men in the high tertile group for gender equitable attitudes. Conclusions Gender transformative interventions that use an adaptive, personalized approach to men’s typology of IPV perpetration may be beneficial to reduce violence against for women in the Asia-Pacific region.

Maldonado A.I., Murphy C.M., Davis M., Evans M.K., Zonderman A.B.

This study had three goals: (a) to examine the association between racial discrimination and intimate partner violence (IPV) perpetration; (b) to determine whether this relationship is explained by mental health (MH) symptoms; and (c) to determine whether these associations vary by poverty status or gender.During the Wave 4 (2013-2017) visit of the Healthy Aging in Neighborhoods of Diversity Longitudinal Study (HANDLS), Black adults who were in a relationship (N = 433; mean age = 55.26, SD = 9.30; 51% men) provided self-report data on IPV perpetration; frequency of racial discrimination; and levels of anxiety, depression, and posttraumatic stress symptoms. Multigroup mediation models used these cross-sectional data to test whether racial discrimination was associated with MH symptoms, which in turn were associated with IPV perpetration, determining the significance of direct and indirect pathways and whether any pathways varied by poverty status or gender.Racial discrimination was associated with more MH symptoms, which in turn was associated with IPV perpetration. The negative effect of discrimination on MH was stronger for Black women than Black men and for Black adults with household incomes below 125% of the Federal poverty line than those with incomes above this cutoff.Efforts to prevent and treat IPV in the Black community should address the negative effects of racial discrimination experiences on MH and partner aggression, especially among those with multiple marginalized identities. IPV prevention efforts may be enhanced through an overarching commitment to dismantle structural racism and intersectional forms of oppression. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Kelly L.C., Spencer C.M., Keilholtz B., McAllister P., Stith S.M.

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Chantarat T., Van Riper D.C., Hardeman R.R.

Structural racism is a complex system of inequities working in tandem to cause poor health for communities of color, especially for Black people. However, the multidimensional nature of structural racism is not captured by existing measures used by population health scholars to study health inequities. Multidimensional measures can be made using complex analytical techniques. Whether or not the multidimensional measure of structural racism provides more insight than the existing unidimensional measures is unknown.We derived measures of Black-White residential segregation, inequities in education, employment, income, and homeownership, evaluated for 2,338 Public Use Microdata Areas (PUMAs) in the United States (US), and consolidated them into a multidimensional measure of structural racism using a latent class model. We compared the median COVID-19 vaccination rates observed across 54 New York City (NYC) PUMAs by levels (high/low) of structural racism and the multidimensional class using the Kruskal-Wallis test. This study was conducted in March 2021.Our latent class model identified three structural racism classes in the US, all of which can be found in NYC. We observed intricate interactions between the five dimensions of structural racism of interest that cannot be simply classified as "high" (i.e., high on all dimensions of structural racism), "medium," or "low." Compared to Class A PUMAs with the median rate of two-dose completion of 6·9%, significantly lower rates were observed for Class B PUMAs (5·5%, p = 0·04) and Class C PUMAs (5·2%, p = 0·01). When the vaccination rates were evaluated based on each dimension of structural racism, significant differences were observed between PUMAs with high and low Black-White income inequity only (7·2% vs. 5·3%, p = 0·001).Our analysis suggests that measuring structural racism as a multidimensional determinant of health provides additional insight into the mechanisms underlying population health inequity vis-à-vis using multiple unidimensional measures without capturing their joint effects.This project is funded by the Robert J. Jones Urban Research and Outreach-Engagement Center, University of Minnesota. Additional support is provided by the Minnesota Population Center, which is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grant P2C HD041023).

Hardeman R.R., Hardeman-Jones S.L., Medina E.M.

AbstractStructural racism is a fundamental cause of racial inequities in health in the United States. Structural racism is manifested in inequality in the criminal justice system; de facto segregation in education, health care, and housing; and ineffective and disproportionately violent policing and economic disenfranchisement in communities of color. The inequality that Black people and communities of color face is the direct result of centuries of public policy that made Black and Brown skin a liability. The United States is now in an unprecedented moment in its history with a new administration that explicitly states, “The moment has come for our nation to deal with systemic racism . . . and to deal with the denial of the promise of this nation—to so many.” The opportunities for creating innovative and bold policy must reflect the urgency of the moment and seek to dismantle the systems of oppression that have for far too long left the American promise unfulfilled. The policy suggestions made by the authors of this article speak to the structural targets needed for dismantling some of the many manifestations of structural racism so as to achieve health equity.

Unnever J.D., Stults B.J., Messner S.F.

We advance a structural racism approach to understanding the variation in homicide across the U.S. states. We conceptualize structural racism by juxtaposing the conditions for Blacks with those for Whites across multiple domains. We also include two ideological beliefs, racial resentments and Whites perceptions that their racialized social status is threatened by minority gains. The results show that higher Black homicide rates are associated with greater exposure to structural racism and that states with more Whites who harbor racial resentments have higher rates of Black homicides. We also found that states with more Whites who feel that their status is threatened exhibit higher rates of White homicides. However, the results reveal that structural racism exhibits a non-significant association with White homicide rates. We conclude that the challenge going forward is to develop strategies that can undo the oppression of Blacks without enhancing attitudes of Whites that promote criminality.

Kivisto A.J., Mills S., Elwood L.S.

Pregnancy-associated femicide accounts for a mortality burden at least as high as any of the leading specific obstetric causes of maternal mortality, and intimate partners are the most common perpetrators of these homicides. This study examined pregnancy-associated and non-pregnancy-associated intimate partner homicide (IPH) victimization among racial/ethnic minority women relative to their non-minority counterparts using several sources of state-level data from 2003 through 2017. Data regarding partner homicide victimization came from the National Violent Death Reporting System, natality data were obtained from the Centers for Disease Control and Prevention’s National Center for Health Statistics, and relevant sociodemographic information was obtained from the U.S. Census Bureau. Findings indicated that pregnancy and racial/ethnic minority status were each associated with increased risk for partner homicide victimization. Although rates of non-pregnancy-associated IPH victimization were similar between Black and White women, significant differences emerged when limited to pregnancy-associated IPH such that Black women evidenced pregnancy-associated IPH rates more than threefold higher than that observed among White and Hispanic women. Relatedly, the largest intraracial discrepancies between pregnant and non-pregnant women emerged among Black women, who experienced pregnancy-associated IPH victimization at a rate 8.1 times greater than their non-pregnant peers. These findings indicate that the racial disparities in IPH victimization in the United States observed in prior research might be driven primarily by the pronounced differences among the pregnant subset of these populations.

Kuersten-Hogan R., McHale J.P.

This overview describes the changes and challenges families commonly encounter during the transition to parenthood. Family theories are introduced as framework for conceptualizing prenatal family dynamics and relationships observed during pregnancy. We frame prenatal family dynamics within family systems and structural family theories as well as within less frequently invoked theories, such as the bioecological systems theory, family life course perspective, attachment theory, social-learning theory, family life cycle, and family stress perspectives. While none of these theories were expressly developed to explain prenatal family dynamics, they can be expanded to allow for predictions about and interpretations of prenatal interactions in different family systems.

Berggren K., Gottzén L., Bornäs H.

Connell R.

Brassel S.T., Settles I.H., Jellison W.A., Dodson C.

Cave L., Cooper M.N., Zubrick S.R., Shepherd C.C.

The association between racial discrimination and adverse health outcomes has been documented across an increasing body of evidence in recent years, although a close examination of longitudinal studies has not yet taken place. This review applied a life course lens in examining the evidence for a longitudinal association between racial discrimination exposure during childhood and adolescence, and later mental and physical health outcomes.Medline, PsycINFO, Global Health, ERIC, CINAHL Plus, Academic Search Premier and SocINDEX were searched from earliest records to October 2017 for eligible articles. Results were described through a narrative synthesis of the evidence.Findings from 46 studies reported in 88 empirical articles published between 2003 and 2017 were identified. Studies were primarily based on cohorts from the United States, comprised of young people aged 11-18 years, and were published since 2010. Data were most frequently collected over two to three timepoints at intervals exceeding 12 months. Statistically significant associations with racial discrimination were most commonly reported for behaviour problems including delinquency and risk-taking behaviour, with significant adverse effects found in 74% of these associations. Statistically significant adverse effects were also reported in 63% of associations with health-harming behaviours including substance use, and 61% found associations with mental health outcomes. Consistently significant associations were reported between accumulated racism and later health outcomes, and the health effects of racism were reported to vary with developmental periods, although few studies featured these analyses.Evidence from this review highlights that the duration and timing of exposure to racial discrimination matters. This review emphasises the need to gain evidence for the mechanisms linking early racism exposure to adverse health outcomes in later life. Future longitudinal research can address this need by capitalising on prospective cohort studies and ensuring that proposed analysis informs variable selection and timing of data collection.

Williams D.R., Lawrence J.A., Davis B.A., Vu C.

To provide an overview of the empirical research linking self-reports of racial discrimination to health status and health service utilization.A review of literature reviews and meta-analyses published from January 2013 to 2019 was conducted using PubMed, PsycINFO, Sociological Abstracts, and Web of Science. Articles were considered for inclusion using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) framework.Twenty-nine studies met the criteria for review. Both domestic and international studies find that experiences of discrimination reported by adults are adversely related to mental health and indicators of physical health, including preclinical indicators of disease, health behaviors, utilization of care, and adherence to medical regimens. Emerging evidence also suggests that discrimination can affect the health of children and adolescents and that at least some of its adverse effects may be ameliorated by the presence of psychosocial resources.Increasing evidence indicates that racial discrimination is an emerging risk factor for disease and a contributor to racial disparities in health. Attention is needed to strengthen research gaps and to advance our understanding of the optimal interventions that can reduce the negative effects of discrimination.