Our findings suggest that the transgender population is a racially diverse population present across US communities. Inequalities in the education and socioeconomic status have negative implications for the health of the transgender population.
In population health research, it is important to consider socioecological perspectives that include cultural attitudes and beliefs which permeate all levels (intrapersonal, interpersonal, institutional/community, and structural/policy). Given the specificity of target populations centered on identity -ethnic and others -it is appropriate and warranted to centralize cultural studies theories into health determinant investigations. Cultural studies, which focus explicitly on identity exploration and impacts, have much to contribute to health research. In accordance with the transdisciplinary nature of population health and bearing in mind the significant role of ethnic identity in health outcomes, it is beneficial to utilize critical race theory (CRT) as a theoretical framework and analysis tool for population health research. This article will: (1) briefly overview a recent mental health study employing CRT, and a commentary that emphasizes how CRT can contribute to the sociology of mental health; and (2) propose ways CRT can be used in psychosocial health research.
Young transgender women, especially those of color, are negatively impacted by suicidality, HIV, residential instability, survival sex work, and other challenges. This study used an oral narrative approach to collect life histories of 10 young black transwomen between 18 and 24 years of age residing in Detroit, Michigan. This study used grounded theory analysis to explore institutional violence, discrimination, and harassment (VDH). Participants described their experiences navigating three community institutions (schools, the criminal justice system, and churches) and broader society. Results highlight VDH through gender policing at school, sexual victimization in the criminal justice system, and negative judgment of gender variation in faith-based institutions. Participants reference the essential role of support systems, including other transgender individuals, in both their gender identity development and the navigation of institutions. Significant policy intervention is needed to protect and support transwomen, and prevent VDH perpetuated against them. Across all institutions, policy and practice interventions can focus on use of transgender appropriate and sensitive language, prevention of physical and sexual assaults, and antidiscrimination measures. Specific policy recommendations and future research directions are outlined.
The extent to which socially-assigned and culturally mediated social identity affects health depends on contingencies of social identity that vary across and within populations in day-to-day life. These contingencies are structurally rooted and health damaging inasmuch as they activate physiological stress responses. They also have adverse effects on cognition and emotion, undermining self-confidence and diminishing academic performance. This impact reduces opportunities for social mobility, while ensuring those who "beat the odds" pay a physical price for their positive efforts. Recent applications of social identity theory toward closing racial, ethnic, and gender academic achievement gaps through changing features of educational settings, rather than individual students, have proved fruitful. We sought to integrate this evidence with growing social epidemiological evidence that structurally-rooted biopsychosocial processes have population health effects. We explicate an emergent framework, Jedi Public Health (JPH). JPH focuses on changing features of settings in everyday life, rather than individuals, to promote population health equity, a high priority, yet, elusive national public health objective. We call for an expansion and, in some ways, a re-orienting of efforts to eliminate population health inequity. Policies and interventions to remove and replace discrediting cues in everyday settings hold promise for disrupting the repeated physiological stress process activation that fuels population health inequities with potentially wide application.
It is critical to develop practical, effective, ecological, and decolonizing approaches to indigenous suicide prevention and health promotion for the North American communities. The youth suicide rates in predominantly indigenous small, rural, and remote Northern communities are unacceptably high. This health disparity, however, is fairly recent, occurring over the last 50 to 100 years as communities experienced forced social, economic, and political change and intergenerational trauma. These conditions increase suicide risk and can reduce people’s access to shared protective factors and processes. In this context, it is imperative that suicide prevention includes—at its heart—decolonization, while also utilizing the “best practices” from research to effectively address the issue from multiple levels. This article describes such an approach: Promoting Community Conversations About Research to End Suicide (PC CARES). PC CARES uses popular education strategies to build a “community of practice” among local and regional service providers, friends, and families that fosters personal and collective learning about suicide prevention in order to spur practical action on multiple levels to prevent suicide and promote health. This article will discuss the theoretical underpinnings of the community intervention and describe the form that PC CARES takes to structure ongoing dialogue, learning, solidarity, and multilevel mobilization for suicide prevention.
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