PDF(Pubmed)
Abstract：
BACKGROUND: The purpose of this study is to increase understanding of the forms of systemic racism experienced by Latinx communities in North Carolina during the COVID-19 pandemic as identified by Latinx community health workers (CHWs) and community-based organization (CBO) leaders.
METHODS: We held three focus groups in July 2022 (N = 16) with CHWs and CBO leaders in Spanish to discuss policy and community interventions that improved access to resources during the COVID-19 pandemic; policy or community interventions needed to improve care of Latinx communities; and lessons learned to improve the health of Latinx communities in the future. We performed directed and summative qualitative content analysis of the data in the original language using the Levels of Racism Framework by Dr. Camara Jones to identify examples of implicitly and explicitly discussed forms of systemic racism.
RESULTS: Latinx CHWs and CBO leaders implicitly discussed numerous examples of all levels of racism when seeking and receiving health services, such as lack of resources for undocumented individuals and negative interactions with non-Latinx individuals, but did not explicitly name racism. Themes related to institutionalized racism included: differential access to resources due to language barriers; uninsured or undocumented status; exclusionary policies not accounting for cultural or socioeconomic differences; lack of action despite need; and difficulties obtaining sustainable funding. Themes related to personally-mediated racism included: lack of cultural awareness or humility; fear-inciting misinformation targeting Latinx populations; and negative interactions with non-Latinx individuals, organizations, or institutions. Themes related to internalized racism included: fear of seeking information or medical care; resignation or hopelessness; and competition among Latinx CBOs. Similarly, CHWs and CBO leaders discussed several interventions with systems-level impact without explicitly mentioning policy or policy change.
CONCLUSIONS: Our research demonstrates community-identified examples of racism and confirms that Latinx populations often do not name racism explicitly. Such language gaps limit the ability of CHWs and CBOs to highlight injustices and limit the ability of communities to advocate for themselves. Although generally COVID-19 focused, themes identified represent long-standing, systemic barriers affecting Latinx communities. It is therefore critical that public and private policymakers consider these language gaps and engage with Latinx communities to develop community-informed anti-racist policies to sustainably reduce forms of racism experienced by this unique population.
METHODS: We held three focus groups in July 2022 (N = 16) with CHWs and CBO leaders in Spanish to discuss policy and community interventions that improved access to resources during the COVID-19 pandemic; policy or community interventions needed to improve care of Latinx communities; and lessons learned to improve the health of Latinx communities in the future. We performed directed and summative qualitative content analysis of the data in the original language using the Levels of Racism Framework by Dr. Camara Jones to identify examples of implicitly and explicitly discussed forms of systemic racism.
RESULTS: Latinx CHWs and CBO leaders implicitly discussed numerous examples of all levels of racism when seeking and receiving health services, such as lack of resources for undocumented individuals and negative interactions with non-Latinx individuals, but did not explicitly name racism. Themes related to institutionalized racism included: differential access to resources due to language barriers; uninsured or undocumented status; exclusionary policies not accounting for cultural or socioeconomic differences; lack of action despite need; and difficulties obtaining sustainable funding. Themes related to personally-mediated racism included: lack of cultural awareness or humility; fear-inciting misinformation targeting Latinx populations; and negative interactions with non-Latinx individuals, organizations, or institutions. Themes related to internalized racism included: fear of seeking information or medical care; resignation or hopelessness; and competition among Latinx CBOs. Similarly, CHWs and CBO leaders discussed several interventions with systems-level impact without explicitly mentioning policy or policy change.
CONCLUSIONS: Our research demonstrates community-identified examples of racism and confirms that Latinx populations often do not name racism explicitly. Such language gaps limit the ability of CHWs and CBOs to highlight injustices and limit the ability of communities to advocate for themselves. Although generally COVID-19 focused, themes identified represent long-standing, systemic barriers affecting Latinx communities. It is therefore critical that public and private policymakers consider these language gaps and engage with Latinx communities to develop community-informed anti-racist policies to sustainably reduce forms of racism experienced by this unique population.
摘要：
背景：这项研究的目的是增加对北卡罗来纳州拉丁裔社区在COVID-19大流行期间经历的系统性种族主义形式的理解，这是拉丁裔社区卫生工作者(CHW)和社区组织(CBO)领导人确定的。
方法：我们于2022年7月与CHW和CBO领导人以西班牙语举行了三个焦点小组（N=16），讨论了在COVID-19大流行期间改善资源获取的政策和社区干预措施；改善拉丁裔社区护理所需的政策或社区干预措施；以及未来改善拉丁裔社区健康的经验教训。我们使用CamaraJones博士的“种族主义水平框架”对原始语言的数据进行了定向和总结性的定性内容分析，以确定隐含和明确讨论的系统性种族主义形式的示例。
结果：LatinxCHW和CBO领导人在寻求和接受医疗服务时含蓄地讨论了各种种族主义的例子，例如缺乏无证件个人的资源以及与非拉丁裔个人的负面互动，但没有明确命名种族主义。与制度化的种族主义有关的主题包括：由于语言障碍而导致的资源获取差异；没有保险或没有证件的身份；没有考虑到文化或社会经济差异的排他性政策；尽管有需要，但缺乏行动；难以获得可持续的资金。与个人调解种族主义有关的主题包括：缺乏文化意识或谦卑；针对拉丁裔人口的煽动恐惧的错误信息；以及与非拉丁裔个人的负面互动，组织,或机构。与内化种族主义有关的主题包括：害怕寻求信息或医疗；辞职或绝望；以及拉丁裔CBO之间的竞争。同样，CHW和CBO领导人讨论了一些具有系统级影响的干预措施，但没有明确提及政策或政策变化。
结论：我们的研究证明了社区确定的种族主义例子，并证实了拉丁裔人口通常没有明确地命名种族主义。这种语言差距限制了CHW和CBO突出不公正的能力，并限制了社区为自己辩护的能力。尽管通常以COVID-19为重点，确定的主题代表了长期存在的，影响拉丁社区的系统性障碍。因此，至关重要的是，公共和私人决策者必须考虑这些语言差距，并与拉丁裔社区接触，制定社区知情的反种族主义政策，以可持续地减少这一独特人口所经历的种族主义形式。
方法：我们于2022年7月与CHW和CBO领导人以西班牙语举行了三个焦点小组（N=16），讨论了在COVID-19大流行期间改善资源获取的政策和社区干预措施；改善拉丁裔社区护理所需的政策或社区干预措施；以及未来改善拉丁裔社区健康的经验教训。我们使用CamaraJones博士的“种族主义水平框架”对原始语言的数据进行了定向和总结性的定性内容分析，以确定隐含和明确讨论的系统性种族主义形式的示例。
结果：LatinxCHW和CBO领导人在寻求和接受医疗服务时含蓄地讨论了各种种族主义的例子，例如缺乏无证件个人的资源以及与非拉丁裔个人的负面互动，但没有明确命名种族主义。与制度化的种族主义有关的主题包括：由于语言障碍而导致的资源获取差异；没有保险或没有证件的身份；没有考虑到文化或社会经济差异的排他性政策；尽管有需要，但缺乏行动；难以获得可持续的资金。与个人调解种族主义有关的主题包括：缺乏文化意识或谦卑；针对拉丁裔人口的煽动恐惧的错误信息；以及与非拉丁裔个人的负面互动，组织,或机构。与内化种族主义有关的主题包括：害怕寻求信息或医疗；辞职或绝望；以及拉丁裔CBO之间的竞争。同样，CHW和CBO领导人讨论了一些具有系统级影响的干预措施，但没有明确提及政策或政策变化。
结论：我们的研究证明了社区确定的种族主义例子，并证实了拉丁裔人口通常没有明确地命名种族主义。这种语言差距限制了CHW和CBO突出不公正的能力，并限制了社区为自己辩护的能力。尽管通常以COVID-19为重点，确定的主题代表了长期存在的，影响拉丁社区的系统性障碍。因此，至关重要的是，公共和私人决策者必须考虑这些语言差距，并与拉丁裔社区接触，制定社区知情的反种族主义政策，以可持续地减少这一独特人口所经历的种族主义形式。
