Legal scholarship and caselaw suggest that exposure to peer racial harassment in school (PRHS) harms student mental health and can derail students’ academic trajectories. Legal precedents call on schools to intervene to reduce student exposure to PRHS when feasible. However, little quantitative social science has explored the impacts of PRHS, explored whether exposure to PRHS varies by racial group, or identified structural factors that may protect against PRHS. We review data from over 350,000 California 6th–12th-grade students in nearly 1000 schools and estimate that exposure to PRHS is related to a twenty-percentage-point-higher depressive symptom rate for students of all racial groups, that Black students are significantly more likely to experience PRHS, that being in a school with a race-matched school counselor or psychologist is related to lower rates of both PRHS and depressive symptoms, but that White students are more likely than students of other backgrounds to be in a school where the mental health workforce reflects their racial background. The results suggest a need to reduce exposure to PRHS, particularly for Black students, and that expanding the diversity of school mental health providers could be a pathway to protecting students against PRHS and its attendant harms.

Introduction Coronavirus disease (COVID) dashboards rarely provide insights about the racialized contexts in which vaccination inequities occur. Objective The purpose of this study was to use the emerging Project REFOCUS dashboard to contextualize COVID vaccination patterns among 6 diverse communities. Methods We queried the dashboard to generate descriptive statistics on vaccination trends and racism-related contextual factors among the 6 Project REFOCUS pilot sites (Albany, Georgia, Bronx, New York, Detroit, Michigan, Helena-West Helena, Arkansas, San Antonio, Texas, and Wake County, North Carolina). Results Vaccination rates, demographic indicators, and contextual factors differed across sites. As of October 17, 2022, the proportion of people who had received at least 1 COVID vaccine dose ranged from 58.4% (Wayne County, Michigan) to 95.0% (Wake County, North Carolina). The pilot sites with the greatest percentage of Black residents (Dougherty County, Georgia, Wayne County, Michigan, and Phillips County, Arkansas) had lower proportions of fully vaccinated people. Wayne County, Michigan, had the highest level of residential segregation between Black and White residents (78.5%) and non-White and White residents (68.8%), whereas Phillips County, Arkansas, had the highest overall mortgage denial rates (38.9%). Both counties represent settings where over 75.0% of residents report Black race and over 30.0% of the population live in poverty. Discussion The dashboard integrates racism-related factors with COVID vaccination visualizations and provides a fuller picture of the context in which COVID trends are occurring. Conclusions Community organizers, researchers, policymakers, and practitioners can track racism-related factors and other social determinants of health as part of the contexts in which COVID-related inequities occur.

the disabling impact of COVID-19 is still ongoing, and its totalizing effect will be researched from this moment on. and is still yet to come, we are struck by how the central premise that motivated this series at the beginning still holds so true at this juncture. The beginning of this pandemic was centuries in the making, and it is a challenge to say which historical and/or contemporary colonial, white supremacist, patriarchal, or antilabor event was more relevant than any other in defining the trajectory of our planet since March 2020, as SARS Coronavirus-2 began to spread rapidly across the United States and the world. In the end, all events culminated in a system illprepared and ill-intentioned when it came to disaster and crisis preparedness. The system showed itself to be fully committed and fundamentally designed to maintain a counterproductive and, as some would argue, destructive control over people's lives. Not surprisingly, the system was destructive even for those it claims to serve and benefit, so much so

Introduction: Coronavirus disease (COVID) dashboards rarely provide insights about the racialized contexts in which vaccination inequities occur. Objective: The purpose of this study was to use the emerging Project REFOCUS dashboard to contextualize COVID vaccination patterns among 6 diverse communities. Methods: We queried the dashboard to generate descriptive statistics on vaccination trends and racism -related contextual factors among the 6 Project REFOCUS pilot sites (Albany, Georgia, Bronx, New York, Detroit, Michigan, HelenaWest Helena, Arkansas, San Antonio, Texas, and Wake County, North Carolina). Results: Vaccination rates, demographic indicators, and contextual factors differed across sites. As of October 17, 2022, the proportion of people who had received at least 1 COVID vaccine dose ranged from 58.4% (Wayne County, Michigan) to 95.0% (Wake County, North Carolina). The pilot sites with the greatest percentage of Black residents (Dougherty County, Georgia, Wayne County, Michigan, and Phillips County, Arkansas) had lower proportions of fully vaccinated people. Wayne County, Michigan, had the highest level of residential segregation between Black and White residents (78.5%) and non-White and White residents (68.8%), whereas Phillips County, Arkansas, had the highest overall mortgage denial rates (38.9%). Both counties represent settings where over 75.0% of residents report Black race and over 30.0% of the population live in poverty. Discussion: The dashboard integrates racismrelated factors with COVID vaccination visualizations and provides a fuller picture of the context in which COVID trends are occurring. Conclusions: Community organizers, researchers, policymakers, and practitioners can track racism -related factors and other social determinants of health as part of the contexts in which COVID-related inequities occur. Ethn Dis. 2024;34(1):1 -7; doi:10.18865/ed.34.1.1

Background Although surveillance systems used to mitigate disasters serve essential public health functions, communities of color have experienced disproportionate harms (eg, criminalization) as a result of historic and enhanced surveillance. Methods To address this, we developed and piloted a novel, equity-based scoring system to evaluate surveillance systems regarding their potential and actual risk of adverse effects on communities made vulnerable through increased exposure to policing, detention/incarceration, deportation, and disruption of access to social services or public resources. To develop the scoring system, we reviewed the literature and surveyed an expert panel on surveillance to identify specific harms (eg, increased policing) that occur through surveillance approaches. Results Scores were based on type of information collected (individual and/or neighborhood level) and evidence of sharing information with law enforcement. Scores were 0 (no risk of harm identified), 1 (potential for risk), 2 (evidence of risk), and U (data not publicly accessible). To pilot the scoring system, 44 surveillance systems were identified between June 2020 and October 2020 through an environmental scan of systems directly related to COVID-19 (n=21), behavioral and health-related services (n=11), and racism and racism-related factors (n=12). A score of 0-2 was assigned to 91% (n=40) of the systems; 9% were scored U; 30% (n=13) scored a 0. Half scored a 1 (n=22), indicating a “potential for the types of harm of concern in this analysis.” “Evidence of harm,” a score of 2, was found for 12% (n=5). Conclusions The potential for surveillance systems to compromise the health and well-being of racialized and/or vulnerable populations has been understudied. This project developed and piloted a scoring system to accomplish this equity-based imperative. The nobler pursuits of public health to improve the health for all must be reconciled with these potential harms.

Our society faces an uncertain future and the field of public health will have an important role to play in shaping this future. This article introduces the special issue The Future of Health Education & Behavior which is focused on perspectives and research led by student authors. Our call for papers encouraged student perspectives that envisioned, challenged, and critiqued the future for health education and behavior. We summarize the articles included in this issue which cover topics such as gaps or future directions for public health training programs, perspectives on pressing issues facing our society, and empirical articles on critical public health topics. Many of the articles in the special issue point boldly to a future that more directly and critically confronts systems of oppression and moves away from a traditional emphasis on individual-level behaviors. These articles can help our field evolve and adapt to fully address the most pressing issues of our time.

Approximately 25% of US older adults live with a mental health disorder. The mental health needs of this population are chiefly met by primary care providers. Primary care practices may have inadequate strategies to provide satisfactory care to mentally ill older adults. This study used Centers for Medicare and Medicaid Services data to identify factors, including racial/ethnic differences, associated with dissatisfaction with medical care quality among older adults diagnosed with a mental health disorder. Our findings suggest factors that can be addressed to improve satisfaction with medical care quality and potentially promote adherence and follow-up for mentally ill older adults.

The populations impacted most by COVID are also impacted by racism and related social stigma; however, traditional surveillance tools may not capture the intersectionality of these relationships. We conducted a detailed assessment of diverse surveillance systems and databases to identify characteristics, constraints and best practices that might inform the development of a novel COVID surveillance system that achieves these aims. We used subject area expertise, an expert panel and CDC guidance to generate an initial list of N > 50 existing surveillance systems as of 29 October 2020, and systematically excluded those not advancing the project aims. This yielded a final reduced group (n = 10) of COVID surveillance systems (n = 3), other public health systems (4) and systems tracking racism and/or social stigma (n = 3, which we evaluated by using CDC evaluation criteria and Critical Race Theory. Overall, the most important contribution of COVID-19 surveillance systems is their real-time (e.g., daily) or near-real-time (e.g., weekly) reporting; however, they are severely constrained by the lack of complete data on race/ethnicity, making it difficult to monitor racial/ethnic inequities. Other public health systems have validated measures of psychosocial and behavioral factors and some racism or stigma-related factors but lack the timeliness needed in a pandemic. Systems that monitor racism report historical data on, for instance, hate crimes, but do not capture current patterns, and it is unclear how representativeness the findings are. Though existing surveillance systems offer important strengths for monitoring health conditions or racism and related stigma, new surveillance strategies are needed to monitor their intersecting relationships more rigorously.

Over the past decade, the experimental therapeutics approach has gained currency as an organizing framework for research in mental health. However, examples of this approach outside of person-directed therapeutic and preventive interventions have been relatively uncommon. This article describes an experimental therapeutics approach to mental health and human services research that considers the role of social and ecological determinants in a person's recovery from mental disorder. To illustrate this approach, this article decomposes an employment intervention to show three of its components and identifies the targets for two components: social relationships and health insurance. These targets can be engaged by provider-, community-, or policy-level interventions. Such applications of an experimental therapeutics approach to research on mental health services can enhance the rigor of studies and thereby contribute to the well-being of persons living with mental disorders in the United States.

OBJECTIVE:To determine influences on incidence of breast milk feeding (BMF) at time of discharge and 6 months later among infants cared for in the neonatal intensive care unit (NICU). DESIGN:A 2-year prospective descriptive NICU hospital-based cohort design. SETTING:Academic Center Level III-IV NICU. PARTICIPANTS:Five hundred and thirty-five infants cared for in NICU and a subgroup of one hundred twenty-nine participant mothers who answered questionnaires. METHODS:Predischarge data were collected using maternal and infant medical records. Post-discharge data were collected from maternal questionnaires. RESULTS:At NICU discharge, biophysiologic stressors predictive of not receiving BMF included birth weight <1500 grams (p < .035), heart surgery (p = .014), and inhaled nitric oxide treatment (p = .002). Teenage mothers were less likely to BMF (p = .022). After discharge, BMF duration correlated with BMF duration of a prior infant (p < .009). Most mothers reported BMF >4 months, 91% continued pumping, and 89% indicated an interest in a hospital support group. Logistic regression analysis (R(2) 0.45) identified factors that significantly increased the likelihood of BMF > 4 months: BMF plan (p < .001), convenience (p = .018), and family as resource (p = .025). Negative associations were: awareness of immune benefits (p = .025), return to work (p = .002), and infants requiring surgical ligation of the patent ductus arterious (p = .019). CONCLUSIONS:Social and medical stressors contribute to BMF duration pre- and post-NICU discharge. We speculate that active NICU BMF support targeting vulnerable infants and their families and assisting with plans for BMF pre- and post-discharge will help overcome barriers.

The etiology of Parkinson’s disease (PD) is unknown but it is increasingly clear that genetic factors play an important role. In addition to monogenic forms of parkinsonism, there are also other inherited conditions that may present with parkinsonism or mimic classical PD. Valosin Containing Protein (VCP) is a member of the type II AAA ATPases and is associated with a rare autosomal dominant disease characterized by inclusion body myopathy, Paget’s disease of bone and Frontotemporal dementia (IBMPFD) [ [1] Kimonis V.E. Kovach M.J. Waggoner B. Leal S. Salam A. Rimer L. et al. Clinical and molecular studies in a unique family with autosomal dominant limb-girdle muscular dystrophy and Paget disease of bone. Genet Med. 2000; 2: 232-241 Crossref PubMed Scopus (105) Google Scholar ]. We present a case of PD associated with a VCP gene mutation.

This article reports a case of pulmonary hypertension in 37-week-gestational-age, pygopagus conjoined twins where B-type natriuretic peptide (BNP) was used as a cost-effective and important tool to aid effective management. Pulmonary hypertension in neonates is associated with high morbidity and mortality and multiplies the challenge of caring for conjoined twins. BNP is a peptide hormone secreted by cardiac ventricles that have undergone stress related to ventricular filling, volume overload, and pressure. BNP is commonly used in adults to assess heart failure, but its utility is less established in infants receiving neonatal intensive care. In this case, BNP testing was used as an adjunct to standard assessments for rapid diagnosis which was critical to expediting appropriate treatment management for these high-risk patients.