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This chapter provides a brief autobiographical account of her multiethnic and racial background as a Louisiana Creole in south Louisiana. The author points out that among all racial and ethnic groups in the United States, Indigenous people are the only ones that require some form of lineal Native American descent or blood quantum. The chapter provides an ancestry account of two American Indian tribes along the bayous of south Louisiana, the Chitimacha, and the United Houma Nation. While one federally recognized tribe has attempted to remove all relations to individuals of Black, Negro, or African American descent, the other has closed enrollment to new members (despite lineal descent), with the unifying factor among these communities being establishing progenitors. Finally, the author articulates how lack of access to resources related to issues such as COVID-19 has perpetuated the historical legacy of medical racism in tribal and underserved communities in the United States.

On Wednesday, January 20, 2021, Kamala Harris broke through the gender and racial barrier that has kept men at the top ranks of American politics for over two centuries. This moment singlehandedly challenged the definition of leadership and who “fits” in that traditional model. Reyes examines the challenges and highlights three lessons of leading in color in academia today, being the first Latina to chair her department. Her journey reflects similar experiences of women of color who are burdened by the emotional toll that comes with being a part of systemic change, by virtue of leading while of color. To begin dismantling systemic racism and sexism, organizations must commit to addressing the issues head-on by reexamining policies, practices, and work environments that have perpetuated systemic inequalities. Greater supports are needed for women of color to be effective as their contributions are invaluable in achieving true systemic change.

COVID-19 brought me challenges and opportunities. I lost important people in this pandemic but also accomplished a lot. COVID-19 gave me a chance to soul search, grow, and develop. I blossomed into the woman I have always wanted to be but could not find. During it all, I was awarded my undergraduate degree, got accepted to a graduate program, received a new job, and bought my first car. With every blessing came a challenge, including health problems. Still, I persevered. Opportunities continue to present themselves and I seize them. Professional successes included publishing an article, presenting at a state public health conference, being featured in my university’s annual newsletter, and nailing my dream job! I got to “See Me!”, a woman of color coming from another country, accomplishing so much in a short span of time. This chapter details a true testimony and how giving up is not an option.

When I first took the adverse childhood experiences (ACEs) quiz, I was overcome with the enormity of Black trauma contained in those ten questions. The quiz reflected my own story, as well as those of Black students, women, and families—traumas that were magnified by the impact of three pandemics: COVID-19, economic inequities, and systemic racism. The definition of trauma as “emotional responses to disastrous life events” like COVID-19 can have both short- and long-term health consequences throughout one’s lifespan. The impact of COVID-19 as Black trauma in my family will reverberate long after society heals from the last three years and moves toward living with COVID-19 symbiotically. It is imperative to recognize ACEs and their perpetual trauma to implement successful trauma-informed practices to counteract and undo the damaging effects of COVID-19 on our collective lives.

Mounting evidence suggests that differential environmental exposures significantly contribute to a wide range of population health disparities. Adopting a life course approach to maternal and child health enables readers to uncover the mechanisms by which prenatal and early life environmental exposures potentially shape both short- and long-term physical and mental health outcomes. This chapter applies the life course approach to explore the adverse influences of environmental risk factors on maternal and child health. The following four case studies will be discussed: (1) the pervasive impacts of secondhand smoke; (2) the deleterious effects of lead exposure; (3) the development of asthma; and (4) the potential origins of autism spectrum disorder. The chapter also provides recommendations for programmatic and policy interventions to reduce the prevalence of four salient environmental hazards, including secondhand smoke, lead, air pollution, and pesticides, as well as proposed future directions in research regarding these exposures.

BackgroundCancer is the second-leading cause of death in the United States. Most studies have reported rural versus urban and Black versus White cancer disparities. However, few studies have investigated racial disparities in rural areas.ObjectiveWe conducted a literature review to explore the current state of knowledge on racial and ethnic disparities in cancer attitudes, knowledge, occurrence, and outcomes in rural United States.MethodsA systematic search of PubMed and Embase was performed. Peer-reviewed articles published in English from 2004-2023 were included. Three authors independently reviewed the articles and reached a consensus.ResultsAfter reviewing 993 articles, a total of 30 articles met the inclusion criteria and were included in the present review. Studies revealed that underrepresented racial and ethnic groups in rural areas were more likely to have low cancer-related knowledge, low screening, high incidence, less access to treatment, and high mortality compared to their White counterparts.ConclusionUnderrepresented racial and ethnic groups in rural areas experienced a high burden of cancer. Improving social determinants of health may help reduce cancer disparities and promote health.

Objective: We aim to determine the association between insomnia symptoms and mental health in females and males and compare mental health care utilization and perceived barriers between females and males with insomnia symptoms. Methods: This is a cross-sectional study using the National Health Interview Survey. Insomnia symptoms included self-reported “trouble falling asleep”, ‘trouble staying asleep”, and “waking up feeling not well rested”. Mental health included self-reported anxiety and depression. Multivariable logistic regression was used to assess the association between insomnia symptoms and mental health in females and males. Results: A total of 26,691 adults were included. The mean age was 48.2 years; 51.4% were females, and 48.6% were males. Insomnia symptoms were associated with anxiety and depression for both females and males. These associations were stronger in younger adults (<50 years) than older adults (≥50 years). Females with insomnia symptoms were more likely to receive mental health care (OR = 1.7; 95% CI = 1.53, 1.87) but also to delay mental health care because of its cost (OR = 1.96; 95% CI: 1.67, 2.30) or needed mental health care but did not get it because of the cost (OR = 2.14; 95% CI: 1.82, 2.50) than their males counterpart. Conclusions: Insomnia symptoms were associated with mental health in females and males, being stronger in younger adults than older adults, with gender differences in mental health care utilization and financial barriers to mental health care. Holistic approaches involving prevention and better access to mental health care are warranted.

Pharmaceutical products, including active pharmaceutical ingredients and inactive ingredients such as packaging materials, have raised significant concerns due to their persistent input and potential threats to human and environmental health. Discourse on reducing pharmaceutical waste and subsequent pollution is often limited, as information about the toxicity of pharmaceuticals in humans is yet to be fully established. Nevertheless, there is growing awareness about ecotoxicity, and efforts to curb pharmaceutical pollution in the European Union (EU), United States (US), and Canada have emerged along with waste disposal and treatment procedures, as well as growing concerns about impacts on human and animal health, such as through antimicrobial resistance. Yet, the outcomes of such endeavors are often disparate and involve multiple agencies, organizations, and departments with little evidence of cooperation, collaboration, or oversight. Environmental health disparities occur when communities exposed to a combination of poor environmental quality and social inequities experience more sickness and disease than wealthier, less polluted communities. In this paper, we discuss pharmaceutical environmental pollution in the context of health disparities and examine policies across the US, EU, and Canada in minimizing environmental pollution.

Being a millennial person-of-color in the twenty-first century is exhaustive in itself—adding the vulnerabilities of a global pandemic magnified that undertaking. As women, we bear the responsibilities of balancing our professional life with our family life; our role as a partner or friend with our role as an individual being; and our mental health with our social health. “Grow Through What You Go Through” explores the value of saying “Yes, I can do this too” when COVID-19 gave many a reason to say, “I’ve had enough.” Between being a supportive partner and family member to many who experienced financial and educational setbacks and being an important part of preparing the next set of future nurses to lead and excel during a global pandemic, COVID-19 enlightened my perspective on who I was at the start of COVID-19 and the person I would turn out to be by the end of it.

As a tenured professor at a predominantly white institution (PWI), I am aware of the hardships we face in the academy; as a mother of three Black girls, a wife to a Black man, I am full. And yet, I must make space to see my own self clearly. Each day as a Black woman, I must set the intention to save my own life.

Globally, air pollution accounts for approximately one in eight deaths, and diarrheal diseases account for one in nine child deaths annually. Lead exposure contributes to concerns of heart disease, stroke, and developmental intellectual disability. Further, across the world, nearly 23 million people are displaced by extreme weather events each year, which have been exacerbated by climate change and contribute to physical and mental health implications for entire communities. These and many other environmentally related experiences and their subsequent health outcomes are not experienced equally by race, ethnicity, or income, with Black, Brown, and Indigenous communities and low-income communities repeatedly experiencing the heaviest of burdens. Due to a variety of historic and contemporary policy and planning decisions, these patterns of environmental injustice persist on local, national, and global scales. In response, environmental justice (EJ) is a social movement, as well as a belief that people of all backgrounds deserve access to clean air and water and a healthy community in which to thrive. This chapter heavily focuses on the USA and its environmental health inequities, policies, and historic EJ movement. However, in our globalized society, EJ is a global issue that must be addressed as such by the field of public health.

Whereas research on caregiving is well documented, less is known about gender inequalities in caregiver stress, coping mechanisms, and health outcomes, all of which may vary by race, ethnicity, and socioeconomic status. This scoping review investigated racial and ethnic disparities using the Stress Process Model among male caregivers. Several databases were searched including Academic Search Premier, Medline Complete, APA PsycInfo, CINHAL, Google, ProQuest, and Web of Science. Included were peer-reviewed articles in English, published from 1990 to 2022. A total of nine articles fulfilled inclusion criteria. Most of the articles indicated that compared to White male caregivers, African American male caregivers provided more hours of care, assisted with more activities of daily living (ADLs) and instrumental activities of daily living (IADLs), and experienced more financial stress. In terms of coping style, one study found African American male caregivers, compared to White male caregivers, held negative religious beliefs. Another study showed that they were at a higher risk for stroke than their White counterparts. The search revealed a dearth of studies on racial disparities in stress, coping, and health outcomes among male caregivers. Further research is needed on the experiences and perspectives of male minority caregivers. © 2023 by the authors.

Period poverty refers to the lack of access to or affordability of menstrual hygiene supplies such as sanitary products and the inaccessibility of washing facilities, waste disposal and educational materials. Period poverty can significantly affect menstruating individuals’ physical, mental, and reproductive health and emotional wellbeing; negatively impact educational outcomes; cause financial strain; result in absenteeism from work and school; create barriers to healthcare access; and perpetuate poor health outcomes for generations. Barriers to menstrual equity include lack of access to period support, cost, poor sanitary facilities, lack of education, social and cultural stigma, and legal restrictions. Therefore, it is crucial to actively advocate for initiatives to increase access to menstrual hygiene products, raise public awareness, and educate individuals on safe menstrual practices. Approximately 500 million girls and women worldwide and an estimated 16.9 million people in the United States experience period poverty, with the issue being particularly common among marginalized groups such as Black or Hispanic menstruating individuals and those who are homeless, living in poverty, of low income, or attending college. This article investigates the physical, psychological, educational and social impacts of inequitable access to menstrual products, menstrual education, and sanitation facilities among menstruating individuals who are Black, Hispanic or of low income within the United States. We examine the threat this poses to health equity and propose recommendations to address this pervasive issue.

Black women in the United States (U.S.) disproportionately experience adverse pregnancy outcomes, including maternal mortality, compared to women of other racial and ethnic groups. Historical legacies of institutionalized racism and bias in medicine compound this problem. The disproportionate impact of COVID-19 on communities of color may further worsen existing racial disparities in maternal morbidity and mortality. This paper discusses structural and social determinants of racial disparities with a focus on the Black maternal mortality crisis in the United States. We explore how structural racism contributes to a greater risk of adverse obstetric outcomes among Black women in the U.S. We also propose public health, healthcare systems, and community-engaged approaches to decrease racial disparities in maternal morbidity and mortality.

There are emerging concerns about the preparedness of rural communities in the United States in the face of the 2019 novel coronavirus (called SARS-CoV-2, causing the disease COVID-19) considering the existing disparities across the social determinants of health between rural and urban Americans. Taking into account the current exponential rate of spread of the coronavirus, this article critically examines the risk facing the 60 million Americans living in rural areas, discusses possible solutions pertaining to rural COVID-19 prevention, and examines measures to consider to prepare for this epidemic before it reaches rural areas.

Rural communities, compared with their urban counterparts, have higher rates of disease and adverse health conditions, fueling disparities in health outcomes. This encourages the need for effective curricula to engage students and enable them to address such disparate health outcomes as imminent health professionals. Incorporating learner-centered teaching strategies, such as collaboration and power-sharing, into public health (PH) courses can enhance student learning and help faculty enable future health professionals to address needs of rural, underserved populations. Successfully engaging students to explore issues related to rural health disparities in their education, research, and training can thereby advance PH practice. This paper describes the collaborative efforts of five PH faculty, an instructional designer, and administrators to develop a learner-centered curriculum for a newly launched PH program in a rural Midwestern United States (US) university.

Background: There is a need to develop comprehensive guidelines to encourage the promotion of oral hygiene care among older adults and to assist caregivers in this endeavor, taking into consideration the specific challenges that arise from aging, comorbidities and caregiving. Methods: This review was conducted by searching across relevant literature from meta-databases including Academic Google, PubMed, Scielo and Scopus for studies published from 2020 to 2024. PRISMA guidelines were followed. We included articles that described oral hygiene methods, caregiver education and mechanization status of older adults. Common themes, best practices, and gaps in current guidelines were tracked using extracted and analyzed data. Results: The review revealed multiple factors affecting the oral hygiene of older adults, with themes relating to physical impairment, cognitive dysfunction, and caregiver involvement. Highlighted between the approaches are individualized therapy for oral hygiene, caregiver education, and the use of technology to improve adherence to oral hygiene. Barriers like dental care access, underlying medical conditions complicating dental treatments, and cost considerations were identified. Conclusions: The findings emphasize the necessity of clear recommendations that can help caregivers and advance dental care for older adults.