Duke Department of Family Medicine & Community Health, Durham, NC, 701 W Main Street, 27701, USA.
Latinx Advocacy Team & Interdisciplinary Network for COVID, -19 (LATIN-19), Durham, NC, USA.
BMC Public Health. 2024 Aug 5;24(1):2105. doi: 10.1186/s12889-024-19587-3.
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.
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.
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.
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.
本研究旨在通过拉丁裔社区卫生工作者（CHW）和社区组织（CBO）的领导者了解在北卡罗来纳州，拉丁裔社区在 COVID-19 大流行期间所经历的系统性种族主义形式。
我们于 2022 年 7 月用西班牙语举行了三次焦点小组会议（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 Camara Jones 博士的《种族主义层次框架》对原始语言的数据进行了定向和总结性的定性内容分析，以确定隐性和显性讨论的系统性种族主义形式的示例。
拉丁裔 CHW 和 CBO 领导者在寻求和接受医疗服务时，隐性地讨论了许多层面的种族主义的例子，例如无证个人缺乏资源和与非拉丁裔个人的负面互动，但并未明确提到种族主义。与制度化种族主义有关的主题包括：由于语言障碍导致资源获取不平等；没有保险或没有证件；不考虑文化或社会经济差异的排斥性政策；尽管有需求但未采取行动；以及难以获得可持续的资金。与个人介导的种族主义有关的主题包括：缺乏文化意识或谦逊；针对拉丁裔人群的煽动恐惧的错误信息；以及与非拉丁裔个人、组织或机构的负面互动。与内化的种族主义有关的主题包括：害怕寻求信息或医疗保健；听天由命或绝望；以及拉丁裔 CBO 之间的竞争。同样，CHW 和 CBO 领导者讨论了一些具有系统层面影响的干预措施，而没有明确提及政策或政策变化。
我们的研究展示了社区确定的种族主义示例，并证实拉丁裔群体通常不会明确指出种族主义。这种语言上的差距限制了 CHW 和 CBO 强调不公正现象的能力，也限制了社区为自己辩护的能力。尽管通常以 COVID-19 为重点，但确定的主题代表了影响拉丁裔社区的长期系统性障碍。因此，公共和私营政策制定者必须考虑到这些语言差距，并与拉丁裔社区合作，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群体所经历的种族主义形式。
