Mental Health Inequities and Disparities among African American Adults in the United States: The Role of Race

Although the rate of mental illness among African Americans and Whites in the United Sates are similar, African Americans tend to have the worst mental health outcomes in the country. This is due to several inequities, particularly those associated with race such as discrimination, provider bias, stereotyping, weak socio-economic status, limited access to health insurance, poor quality mental health care, treatment gaps, culture, and stigma related to mental health care. Recognizing that the differences in mental health outcomes among minority populations in the United States is also driven by race and not just by brain chemistry, or environmental exposures, and developing strategies that target the issue of race, will not only lead to increased access to mental health services among African Americans, but will generally improve upon their mental health status. This article discusses mental health disparities among African Americans, the inequities that cause them, and strategies for addressing the disparities with a focus on race

Reducing Inequities in Adverse Birth Outcomes among African American Women in the United States: A Focus on the Life Course Perspective

Adverse birth outcomes are the leading cause of death among infants globally, and the second leading cause of infant deaths in the United States. African-American women have disproportionately higher rates of preterm birth, low birth weight, and infant mortality compared to other racial groups. This is due in part to social inequities, as well as differential exposures to and experience of risk and protective factors before, during, and after pregnancy. The life course perspective framework posits that adverse birth outcomes are not primarily due to experiences during pregnancy, but experiences (environmental exposures, biological, social and behavioral factors, as well as life experiences) across the life course. These experiences negatively affect birth outcomes in current and future generations. Reducing the adverse birth outcome gap between African Americans and other racial groups requires not only increasing access to prenatal care, but also addressing the differential cumulative impact of social inequities and early life disadvantages experienced by the former. It is therefore critically important to focus on the life course perspective when framing solutions to bridge racial disparities in adverse birth outcomes

E-cigarette Risk Factors and Effects on Adolescent Health in the United States

Despite their adverse health effects, e-cigarette use has increased considerably among adolescents (people aged 10-19 years) in the United States. This is due to a number of factors including peer pressure, the availability of a variety of e-liquid flavors, the targeted marketing of these products to adolescents, and the belief by adolescents that e-cigarettes are less harmful to health than tobacco products. Just as traditional tobacco products, e-cigarettes have been found to be harmful to health and responsible for multiple adverse health conditions in adolescents, including inhibited growth and development, poor mental health, certain cancers, lung damage, nicotine dependency, future drug use, and social stigmatization. While the United States government realizes the harmful effects of e-cigarettes on adolescents, and although it has put in place certain policies to regulate the issue, e-cigarette use continues to be a public health problem among adolescents. This article discusses e-cigarettes, their use, risk factors, and health effects on adolescents in the US. It also proposes strategies for safeguarding adolescent health

HIV destigmatization: perspectives of people living with HIV in the Kumasi Metropolis in Ghana

BackgroundHuman immunodeficiency virus (HIV)-related stigma has been identified as one of the principal factors that undermines HIV prevention efforts and the quality of life of people living with HIV (PLWH) in many developing countries including Ghana. While studies have been conducted on HIV-related stigma reduction, very few have sought the views of PLWH on how this might be done. The purpose of the study was to (i) identify factors that cause HIV-related stigma in Ghana from the perspective of PLWH, (ii) identify challenges that HIV-related stigma poses to the treatment and care of PLWH, and (iii) to obtain recommendations from PLWH on what they think various groups (community members, health care providers, and adolescents) including themselves should do to help reduce HIV-related stigma in Ghana.MethodsA mixed methods cross-sectional study design was used to collect data from 404 PLWH at the Suntreso Government Hospital in the Kumasi Metropolis of Ghana across six domains using Qualtrics from November 1–30, 2022. Quantitative data was analyzed using the Statistical Package for Social Sciences (SPSS) version 26 and the Statistical Analysis System (SAS) version 9.4. Qualitative data was analyzed using a thematic approach.ResultsMost of the study participants (70.5%) said HIV-related stigma in Ghana is due to ignorance. Of this population, 90.6% indicated that they had experienced stigma because they have HIV, causing them to feel depressed (2.5%), ashamed (2.2%), and hurt (3.0%). Study participants (92.8%) indicated that the challenges associated with HIV-related stigma has affected their treatment and care-seeking behaviors. Recommendations provided by study participants for HIV destigmatization include the need for PLWH not to disclose their status (cited 94 times), community members to educate themselves about HIV (96.5%), health care providers to identify their stigmatizing behaviors (95.3%), health care providers to avoid discriminating against PLWH (96.0%), and the need for adolescents to be educated on HIV and how it is transmitted (97.0%).ConclusionIt is important for the government and HIV prevention agencies in Ghana to target and address co-occurring HIV-related stigma sources at various levels of intersection simultaneously This will help to shift harmful attitudes and behaviors that compromise the health and wellbeing of PLWH effectively

Culture, Depression, and Coping Mechanisms among African Americans

Culture is a dynamic force that significantly affects health. It comprises beliefs, norms and values, and determines how populations view certain things. In the area of mental health, it determines whether one will seek help or not, the type of help they will seek, the type of support system they will have, and how they will cope with mental illness. There are six racial groups in the United States, each with its unique sub-culture. Belonging to the African American racial group, African Americans have their perceptions about mental illness, stigma, treatment and care, as well as preferred coping mechanisms. This paper discusses the effects culture has on depression among African Americans. It also examines the coping mechanisms this population employs to deal with depression, and proposes strategies for addressing their mental health issues

Ebola Virus Disease in sub-Saharan Africa: Addressing Gaps to Handle Future Outbreaks

Between 2014 and 2016, the three West African countries of Guinea, Liberia and Sierra Leone experienced the deadliest Ebola virus disease (EVD) outbreak in sub-Saharan Africa. Two years later, a tenth epidemic recurred in the Democratic Republic of Congo (DRC), specifically in the North Kivu and Ituri provinces, which lasted until June 2020. Though they occurred in different countries, a review of how the EVD outbreaks in Guinea, Liberia, Sierra Leone, and the DRC were handled by the respective country governments, reveal gaps in disease detection, response and action due to lack of surveillance, an EVD preparedness plan, and weak health systems. This perspective discusses the EVD outbreaks in Guinea, Liberia, Sierra Leone, and the DRC, their effects, and draws attention to gaps that need to be addressed by these countries in order to be better prepared to handle future outbreaks. Acting on the proposed recommendations will not only benefit Guinea, Liberia, Sierra Leone, and the DRC in the future, but will be of benefit to EVD susceptible countries in sub-Saharan Africa, as we live in a global community where diseases are no respecters of boundaries

Voluntary Counseling and Testing, Antiretroviral Therapy Access, and HIV-Related Stigma: Global Progress and Challenges

To date, about 37 million people are living with the human immunodeficiency virus (HIV) and an estimated 680,000 people have died from acquired immune deficiency syndrome (AIDS) related illnesses globally. While all countries have been impacted by HIV, some have been significantly more impacted than others, particularly countries in sub-Saharan Africa. The purpose of this paper was to identify progress made in HIV prevention globally, particularly in the areas of voluntary counseling and testing (VCT) uptake, access to antiretroviral therapy (ART), and HIV-related stigma. With the development of ART, a cocktail of medications for the treatment of HIV, VCT uptake increased, as it became apparent that the medication would only be prescribed after an HIV diagnosis through testing. Widely considered a critical gateway to HIV prevention and treatment, VCT is being implemented in many countries, and as a result, about 38 million people living with HIV in 2018 had access to ART. Regardless of this success, major challenges still remain. We did an electronic search of 135 articles in English related to global HIV progress and challenges indexed in PubMed, ResearchGate, Google, and other search engines from 1998 to 2021. Sixty articles met the inclusion criteria for this paper. Data on trends in ART coverage were obtained from the Joint United Nations Programme on HIV/AIDS (UNAIDS) website. These data were used to show ART coverage globally in World Health Organization (WHO) regions. It was found that while global successes have been chalked in the areas of VCT uptake and ART coverage, HIV-related stigma has impeded greater success. This paper summarizes and discusses global successes and challenges in HIV prevention efforts in the past four decades with a focus on VCT, ART, and HIV-related stigma

Maternal Opioid Abuse and Neonatal Abstinence Syndrome in the United States

In the past decade, the United States has experienced an increase in deaths related to nonmedical and medical opioid overdose. This is due to a number of factors including an increase in recreational opioid use, and the over prescription of opioids for various conditions such as during pregnancy, injury, and illness. The over utilization of opioids during pregnancy in the United States has led to an increase in adverse neonatal birth outcomes including poor fetal growth, preterm birth, stillbirth, neonatal abstinence syndrome in neonates, and an increase in maternal mortality among mothers. These are dire consequences that should not be ignored. This paper discusses opioid abuse during pregnancy and its effects on neonates in the United States. It also discusses some challenges associated with the diagnosis of neonatal abstinence syndrome and provides recommendations for addressing the issue Additionally, it discusses what mothers can do to prevent neonatal abstinence syndrome

Utilization of Rapid Diagnostic Testing in sub-Saharan Africa: Challenges and Effects on HIV Prevention

The human immunodeficiency virus (HIV) remains a global threat to health. To prevent and control the disease caused by the virus, developed and developing countries continue to invest heavily in research and equipment so as to accurately detect the virus. The utilization of highly sensitive and effective rapid diagnostic tests (RDTs) have the potential to detect HIV in high-burden countries, especially those in sub-Saharan Africa (SSA). Yet, in SSA, challenges associated with HIV-RDT result inaccuracy, HIV misdiagnosis, poor tester capacity, and the improper storage of HIV-RDT kits have negatively impacted the benefits, and threaten to undermine HIV prevention. This paper focuses on the utilization of RDTs in HIV diagnosis in SSA, HIV-RDT challenges, and the effects of HIV-RDT challenges on HIV prevention. Subsequent to reviewing available literature, the authors found that although HIV-RDTs can negatively impact HIVprevention efforts in SSA due to the likelihood of false positive HIV diagnoses, they generally provide quick results for people in resource poor settings, and do not require them to return to the testing sites to obtain their results. Obtaining accurate rapid HIV results means people who test positive can immediately seek care and take steps to prevent future transmission of the virus. Copyright © 2020 Armstrong-Mensah et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited