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1.6 Who am I, First Experience With Race & Sense of Self Brainstorm

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1.6 Who am I, First Experience With Race & Sense of Self Brainstorm

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Theme 1

Who am I?

I am DaiToya Littleton, my family and close friends call me Toya. I am a mother, a wife, full time postal worker and a student. I am an African American female, born and raised in the south bay area.

Who do I pretend to be?

When I have to pretend to be anyone is when I am at work. I often find myself code switching. My professional self is different from my social self. While i'm at work I cannot be my comfortable self because I am in a work setting.

Who do people think I am?

People see me as a mom and wife. They also see me the life of the party and a class clown. This is who I am 90% of the time and this is my authentic self.

Who do I wish I could be?

I wish to be a registered nurse, thus the reason i decided to go back to school. I want to continue to be a loving mom and wife.

How has race or ethnic identity played a role in any of these responses?

Race has played a role in response to who I pretend to be. Being a black women I am often seen as ghetto or urban. When in realty  am being my natural self. Due to being at work I have to code switch.

Theme 2

What was your first experience with race?

My first experience with race is when I was high school and my school was in a Mexican neighborhood. The community did not like black people and made it hard for me and my classmates to get to school. It was very unsafe and my school had to start picking up the walking students from the train station so we would not be in harms way.

How old were you?

I was in the 12th grade and about 17 years old at the time.

What emotions do you associate with the experience?

At the time I was scared. I felt as if my laugh was in danger. I also felt anger and wanted to give off the same hatred that was given towards me.

Have you ever talked about the experience?

I had to talk about the experience with the teachers and staff members at my school. I had to let them our lives were at risk if we had to continue to walk from the bus station.

How have your early experiences with race shaped your worldview?

My early experiences with race has thought me to always keep my head on a swivel. It has also taught me know the laws of the land.

Theme 3

I believe a person who identifies positively with African American Psychology has a stronger sense of self. Because they know who they are and the science and psychology behind African Americans. They have a better understanding.

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2.4 Ubuntu, Afrocentricity and Nguzo Saba

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2.4 Ubuntu, Afrocentricity and Nguzo Saba

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Theme 1

1. When it comes to the the spirit of Ubuntu, I am little biased on rather or not it is alive in today's African American culture. In my home the the spirit of Ubuntu is alive and well. We share, we have hospitality, we respect one another and are very caring. When a guest comes to my home i want to make sure they are comfortable. I offer them a seat, some water and even a snack. This is a small gesture of the spirit of Ubuntu. In my household we are also caring and respectful of one another. I make sure my house is good before I do anything. When i go outside is when I do not see the spirit of Ubuntu often. Some African Americans can come off rude or not welcoming at all. I do not think it is on purpose, but it is a defense mechanism. When you have been treated bad for so long it is hard to be kind to others. I feel like we as a people in the black community are trying to work on it.

2. African culture and African American culture are very similar in many ways. Spirituality and religion are is similar in both cultures. African culture has heavy spirituality and religious traditions. African American culture is heavily influenced the black church or Christianity. Music and dance is seen in both African and African American culture. African music and dance is vibrant and has a lot of rhythmic drumming. As African American music and dance consist of gospel, hip-hop and the blues.

Theme 2

1. Maafa is the concept of Afrocentric Psychology that I feel is most present in the African American community. Maafa is the enslavement of African people. We as a culture always look back on how we were enslaved because it had such a huge affect on the black community. It has caused black people trauma. It has left deep emotional and psychological scars that has affects our communities. The enslavement of black people has denied us economic opportunities and the ability to accumulate wealth. African Americans also face institutional racism and are discriminated in many systems such as the criminal justice system, education, healthcare and employment.

2. The concept of Afrocentric Psychology that I find least present in the African American community is Veneration of the person. Veneration of the person is the value of all life. I know it is not fair to put this on a particular race or ethnicity, but "black on black" is seen often in todays culture. This leads me to believe that there is a disregard to life. In most cases "black on black" crime happens because people tend to commit crime to those that are around them.

Theme 3

1. From the 7 Principles of Nguzo Saba, the Nia is the principle I chose that resonates with me most. The principle Nia means purpose. I chose Nia because my life has a purpose. I am a mom, wife, sister and a daughter. MY purpose in life revolves around them. My Nia in life for example is make sure I care and love on my family, that is my purpose.

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3.4 Three Self-Assessments, Racial Identity Development and Identity Resource

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3.4 Three Self-Assessments, Racial Identity Development and Identity Resource

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3.1 Multidimensions of Ethnic Self Identification

1. Within the category of Natal Measures, I chose Birthplace of self, siblings, natural parents, grandparents, and extended family because it is what I resonate with more. I know the city I live in and im very familiar with where I was raised. This is where I call home, its all i know.

2. Within the category of Behavioral Measures, I chose  Friendship and acquaintance affiliative patterns, and participation in cultural and religious activities. I chose these selections because this is how i associate who i consider friends and family.

3. Within the category of Subjective Measures, I chose self-identification of a preferred ethnic group and Role models and preferred reference groups. I resonate with these items because I self identify to the black community. Also I surround myself with people I look up to or aspire to be like.

4. Within the Situation-Contextual Measure, I chose Home-Family, Work, Community, and Recreation. These items resonate with me because this is how I chose the people around me and how important they to me.

3.2 Multigroup Ethnic Identity Measure

1. My Multigroup Ethnic Identity Measure score is 44.

2. To me this score means that I have a high sense of Ethnic Identity. I know who I am and where I come from. I am a proud member of my ethnic group.

3. I think that this means that I have a strong bond with the African American community because I understand my upbringing and my history.

4. Nothing surprised me in this analysis.

3.3 Three Self-Assessments

1. My score on the Rosenberg’s Self-Esteem Scale was a 27.

2. My score means to me that I am very confident on who I am. Self-esteem to me means how sure you are in yourself or something you are doing.

3. I believe I scored a high score because I think highly of myself. I say this because regardless of what is going own I know I will always represent my best self in any situation.

3.4 Racial Identity Development

1. The stage of Racial Identity Development that I see myself on is internalization.

2. The reason I chose the internalization stage is because I understand that there are negative qualities amongst the black community, but ever black person does not have negative qualities. We as people cannot put everyone in the same box but see them for who they are and not judge off of a stereotype.

3. I realized I have passed through the previous stages because I am not anger at all people of one particular race because of the actions of one person. I do not judge off of previous encounters but take things as they are presented to me in the moment. I also know I can be who I want to be regardless of my race, and I do not see it as a barrier to my success.

4. One thing I learned from this process is there are stages in racial identity. At first I put racial identity under one umbrella.

3.5 Find Your Racial Identity Resource

My racial identity resource is a book by Anneliese A. Singh called The Racial Healing Handbook. I chose this book because it was referred to my older cousin who I take a lot of advice from.

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1. What types racism from slide 2 have you seen in the world? What examples from slide 3 have you seen in the world? The types of racism i have seen in the world are individual racism, institutional racism and symbolic racism. Another example i have noticed is structural racism.

2. From the chapter reading, do you think that we live in a post-racial society? Please state why or why not. We do not live in a post-racial world. I believe the idea of a post-racial world is more ideal or a goal rather than a reality. In the society we currently live in race plays a huge role in shaping individuals. We as a society experience racial discrimination and prejudice. Unfortunately we are NOT judged on our character or actions, instead we are judged on our racial or ethnic background.

3. What is your personal definition of race and do you think that race is a social construct, a biological construct or something else? Please explain your reasoning. My personal definition of race is the group that one belongs to based physical features such as skin color, hair texture and facial features. Race to me is is recognized as social construct. The reason being our race is created and accepted by society. We group people based on physical characteristics.

4. Search and find one resource regarding race being a social or biological concept and post it to your Padlet. State its significance and if you agree or disagree with the resource based on your definition of race. https://libraryguides.saic.edu/learn_unlearn/foundations5 I agree with this resource because it is very informative. It states a detailed meaning that race is a social construct.

5. State one thing that you learned or one thing that stood out to you from the unit required reading, optional reading or audio material in this unit. State its significance. One thing that stood out to me in this unit is, race isnt real. But rather way to distinguish groups of people based on their characteristics.

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Foundation: Social Construction of Race

What does it mean that race is a social construct?

It's important to distinguish between Race & Ethnicity: (Ethnicity: group of people sharing tradition, common ancestry, language).
Race: A system of classification not rooted in accurate biological or scientific truth that supports dividing and empowering some social groups over others.
The construction of race reinforces a social hierarchy based on the following: This is reinforced by:

Some religious assumptions (some races are 'divine' and 'pure,' / others are unholy, or soulless)
Scientific theory (natural order aka survival of the fittest - being 'unfit' or 'weak' is a result of being an inferior race versus it being a result of genocide)
Pseudo-scientific views (groups based on visible characteristics need to be 'civilized')
Eugenics, medical practices (reproducing 'good' genes and restricting reproduction of 'bad' genes)

Just because race is socially constructed, doesn't mean that it fundamentally doesn't affect our daily lived experiences. It means that its construction can be analyzed, critiqued, and through movement: redefined.

Quote

"We want to be clear that when we talk about what it means to 'do the work' of anti-racism, reading lists aren't 'the work.' Reading lists are for catching yourself up to speed, for educating yourself so that when you go into spaces (professionally, personally, politically) to do the work, you understand the context of your own actions and of the broader history of racism. Reading lists are like the required summer reading before school starts." - Nina Berman

To Read

A Note for Getting Library Books - Fall 2020
This fall you can request circulating Flaxman & I-Share books for pickup. Full details for the pickup process are available on this page. Alternatively, you can schedule a library visit to browse, pull items, or use non-circulating materials.
Flaxman Library Materials - May take up to 3 days from request to pickup. Instructions are available here.
I-Share Books - May take up to 10 days from request to pickup. Instructions are available here.

To Research

To Listen

To Watch

To Follow

To Reflect

What does a multiracial society look like? What needs to change to get here?
Can you tell the difference between race and ethnicity?

To Act

Fractured Atlas in 2016 began race-based caucuses as a way to recognize the unique role we must take in our-anti-racism work. Read Racial Identity Caucuses. Do you have caucuses in your institution?
If you're not a part of an affinity group, find one or form one
If you are a part of an affinity group, invite someone else to join
If you want support in finding a group, DM or email Multicultural Affairs: saicdei@saic.edu.

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Research Guides: Learn & Unlearn: Anti-racism Resource Guide: Race/Culture as a Social Construct

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Research Guides: Learn & Unlearn: Anti-racism Resource Guide: Race/Culture as a Social Construct

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1. Black families are unique because of their cultural background, traditions, values and experiences through life. Black families seem to have lower percentages in many concepts surrounded by race. This makes black families unique, because regardless of this the still come out successful.

2. Some strengths from the black family are resilience, rich cultural heritage and strong family bonds. Black families to me are the example of when life gives you lemons, make lemonade. They will adapt to difficult situations and come out successful. When it comes to culture, in black families we have a lot of traditions that we do and pass on to the next generation. Also in the Black family we love on each other and stick by each others side.

3. The concept of racial socialization affects black parents because they have to teach their children how to properly navigate racial challenges. Black parents also are the ones who have to teach their children about their black heritage. This will empower black children to develop strong racial identity. It is a deep situation because it influences how black people engage in society.

4. One factor that has impacted the sense slavery is single-parent households. Which result in financial strain and a potential lack of support. Some strengths have also emerged from single-parent households. Such as resilience, strong family bonds and the determination of the parent to provide for their children.

5. https://www.childwelfare.gov/topics/systemwide/diverse-populations/black/

understanding historical racism and trauma

support for black families

unique strengths

6. I learned that marital status of black families are lower than all other races. With a percentage of only 37.5% of black people being married.

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We’re sorry, we can’t find the page you’re looking for. It might have been removed, changed its name, or is otherwise unavailable.

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https://libguides.westsoundacademy.org/resources-for-exploring-race-racism-and-racial-identiy

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Template Racial Autobiography Outline (Insert Name Here)

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1. African Americans have low representation in the STEM field because there is limited access or none at all to quality education, the lack of role models that actually look like them in the STEM field, the fear of being judged for with one might say is "acting white" when they are just educated and also not having any experience or encounters with STEM.

2. Teachers play a significant role shaping students expectations and fostering interest in STEM. Teachers are role models to their students and often open doors to many oppurtunites and experiences. When teachers guide, uplift and encourage a student it helps them be successful.

3. Implicit bias of educators cause damaging effects on students that can stop their interest in learning or experiences. Educators might not think they are being bias but they are. Implicit bias can stop a student from believing they can accomplish something. Imagine a teacher who is suppose to teach telling you that you can not do something because they have already sterotyped you as a failure.

4. This information contributes to the Imposter Phenomenon in the educational system and in the workplace for African Americans. It does not allow them to be promoted due to low expectations of their employer. It does not allow them to be their genuine self due to fear of judgement.

5. A strategy that can be implemented to counter these struggles is early introduction to stem and the many possibilites it holds. This will help mold future STEM leaders.

6. Something that stood out to me was implicit bias of educators. I was not aware that this was a thing and i have experienced it in my education journey. Being told I should not take AP classes because those credits go towards college. As if I was not able to go to college or i would not go to college.

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7.6 Intersectionality, Bias and Microaggressions 

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7.6 Intersectionality, Bias and Microaggressions 

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1. Experiencing subconscious racial slights, or microaggressions, can have a significant psychological effect on people of color. The uncertainty about being racially targeted can create stress and anxiety. Repeated slights can lead to have one feeling excluded and make them withdraw from social or professional spaces.

2. The " Mad Black Women", is a common stereotype perpetuated when racial microaggressions are thrown around towards a person of color. Black women, in particular, are often stereotyped as being "angry" or "aggressive," especially in situations where they express frustration or assert themselves.

3. Gendered Microaggressions is another issue that this theme effects. Black women are often stereotyped as the "angry Black woman" or assumptions that Black women are overly "strong" or "tough."

4. These theories can shape how individuals perceive themselves. How they are perceived by other people. Also how they navigate the world. This can challenge people of color to navigate a complex and often painful relationship with their own identity.

5. https://cvmbs.source.colostate.edu/understanding-racial-microaggressions/

6. A Strategy that would help is making it a teachable moment. This allows for meaningful conversations that helps increase awareness, reduce future harm, and build a more inclusive environment. Choosing to educate rather than confront someone can encourage greater understanding, reduce defensiveness, and foster long-term change in how people of color are perceived and treated.

7. One thing I learned is that not everyone is aware when they are being races or offending a person a of color. by there words or action. Be careful what you say to others.

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News from the College of Veterinary Medicine and Biomedical Sciences

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Our focus on racial microaggressions should be on the harm done, not on what the person doing harm meant or whether they meant to do harm.

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1. STRENGTHS: What are the strengths of Black neighborhoods and communities and how have they manifested over time?

The strengths of Black neighborhoods and communities are being able to preserve cultural identity, the creation of supportive networks that empower and uplift the community, black-owned businesses that create jobs and hope, and overcoming adversity to a certain level.

2. WEAKNESSES: What are the weaknesses of Black neighborhoods and communities and state one solution to an issue you have raised?

In black neighborhoods, we often face economic disparities because we are not given the same employment opportunities. There is limited access to a quality education, most of the good schools require a waitlist or you have to be accepted. Also higher crime rates. To solve the problem of education, schools should allow entrance to any family interested in getting a higher education.

3. OPPORTUNITIES: What are three ways in which Black neighborhoods and communities could play a role in the progressive movement of the Black community?

Establishing a financial literacy program that focuses on money management, home ownership, and banking opportunities will progress the movement in the black community. Supporting black-owned businesses and recycling the black dollar in the black community will promote economic growth. Lastly, mentorship programs, which will provide support for the youth, helping them work through challenges and follow their goals.

4. THREATS: What are three ways in which Black neighborhoods and communities could have a detrimental effect on the progressive movement of the Black community?

The lack of educational opportunities and limited access to a quality education. A lack of investment and economic opportunities within the community. Also weak leadership.

5. Find one resource that helps you understand these themes and post it to your Padlet. State the resources' significance to this unit's material.

This resource is significant because it states solutions to racial housing issues.

6. State one thing that you learned or one thing that stood out to you from the unit required reading, optional reading or audio material in this unit.

I learned that there were actual laws that prevented blacks from buying homes in the suburbs.

https://www.brookings.edu/articles/homeownership-racial-segregation-and-policies-for-racial-wealth-equity/

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In 2016, white families posted the highest median family wealth at $171,000. Black families, in contrast, had a median family wealth of $17,600.[3] Because wealth (as measured by the total amount of assets a person owns minus debts) is a critical predictor of education, health, employment, and other quality of life metrics, a strategy to maximize homeownership and home value is needed.

Lower Black homeownership and the racial wealth gap are byproducts of systemic racism, including the legacies of slavery, Jim Crow segregation, redlining, and other anti-Black policies that targeted Black people and predominately Black neighborhoods. Residential segregation facilitates the extraction of wealth and other vital resources that fuel economic and social mobility. The loss of wealth in Black communities hastens a downward socioeconomic spiral. For instance, schools predominated by Black, Latinx, and Asian students receive $23 billion less in funding than predominately white districts.[4] This is because schools primarily rely on local property taxes rather than a broader pool of funding to equalize school resources.

Furthermore, education as a solution to closing the wealth gap is inherently flawed. White college graduates have seven times more wealth than Black college graduates.[5] This racial wealth gap reveals how little a strategy singularly focused on increasing college degree attainment will have on reducing the racial wealth gap.

Additionally, subpar neighborhood resources lead to fewer banking options, more payday lenders, and less opportunity for financial literacy. Because most people start their businesses using the equity in their homes, Black business development is throttled by Black families' lack of homeownership and lack of wealth overall.

Recent public policy has not helped matters. The federal government's first Covid-19 relief package may have exacerbated the problem. The first round of Paycheck Protection Program (PPP) loans (part of the CARES Act, the federal COVID-19 relief package) gave relief only to employer firms. This framework disproportionately excluded Black businesses: 95% of Black-owned firms are non-employer businesses, compared to 78% of white-owned firms.[6] This negatively impacted entire communities. According to a Bloomberg analysis, 27% of businesses in white-majority congressional districts received PPP loans, compared with 17% of businesses in districts where minorities make up more than half the population.[7] A Stanford University study estimated that over 40% of Black-owned small businesses closed during the COVID-19 pandemic.[8] A report examining COVID-19 disparities in Detroit found that small businesses in the city, compared to those in the broader Detroit area, were less likely to receive PPP loans and less likely to receive similar amounts even if loans were allocated.[9]

Segregation and racial bias are robbing Black people of opportunities to build wealth, restricting millions from reaching their potentials. At a time when America is at a precipice of a racial awakening, it is important to provide empirical research on a set of problems that if solved, can significantly improve the racial wealth gap.

This report aims to provide an empirical analysis and overview of the role that racial residential segregation plays in 17 cities across the United States. Using a dissimilarity index that captures how far apart racial groups in a city live away from each other, we aim to provide information on cities and how racial disparities in housing fuel the racial wealth gap. We focus on homeownership rates and values, banks, credit scores, and educational attainment.

For this analysis, we rely on publicly available data sources including the US Census Bureau's American Community Survey (ACS) and the Federal Reserve System. Additionally, we utilize credit scoring data from numerous credit bureaus, accessed and compiled by the Urban Institute, as well as the ProsperityNow Scorecard. Further, we utilize credit scoring data from numerous credit bureaus, accessed and compiled by the Urban Institute, as well as the ProsperityNow Scorecard. Where possible, we center the Black population of each of the 17 cities included in the analysis, drawing comparisons when necessary to the non-Black population or white population of the city, where appropriate. We define the Black population as Black, non-Hispanic in accordance with Census conventions.

We employ a metric known as the "Dissimilarity Index," one of many possible calculations used to measure residential segregation between two groups. The index requires that researchers choose two groups to be compared as well as a certain sub-geography of a larger area (here, cities) to compare. We choose Census Tracts, as they are the unit that best approximates our conception of "neighborhoods" for which the latest Census data are available from the 2019 ACS. In addition, we choose to compare Black populations in cities with the remainder of the city entirely, not simply the white population, as is sometimes done in studies of residential segregation. This is to account for the fact that while the cohort of cities in the analysis includes widely differing shares of Latino or Hispanic population, Black and Latino or Hispanic populations are not always spatially segregated to the same degree within cities. In recognition of the fact that residential segregation exists, the index can be thought of as a measure of the proportion of the two groups which would have to move from their current location in order to achieve an evenly spread population where each neighborhood has a representative share of each group. Cities in which a high proportion of a group would have to move are more segregated.

When we study topics other than residential segregation, such as discrepancies in home values, educational attainment, income, and more, we present data that speak to the gap between Black and white populations, rather than Black and non-Black populations. As white populations often (though importantly, not always) have higher incomes, rates of homeownership, and other outcomes often show the true effect of systemic racism for Black residents of these cities.

Where possible, we use data disaggregated by race at the city level. However, in the case of unbanked and underbanked populations, disaggregated data at the city level are not reliable. Instead, we examine the unbanked and underbanked population of the nation, disaggregated by race.

In the case of home values (as reported by the Census Bureau), data are not disaggregated by the race of the homeowner or head of household. Instead, we examine home values in Black-majority neighborhoods and compare them with home values in all other neighborhoods within the city. Some cities in the cohort do not have Black-majority neighborhoods, even if they may have neighborhoods with a high Black population, and so are not included in that portion of the analysis. Median home values are computed by the Census Bureau at the neighborhood level, but the custom sub-geography of "all Black-majority neighborhoods" requires that we compute medians by hand. Rather than employing a cruder estimate of the true median, we more accurately estimated the median home value of homes in all Black-majority neighborhoods in a given city by summing the recorded tallies of homes within each income band and then interpolating linearly within the median band. The same process is used by the U.S. Census Bureau to calculate median estimates for all non-custom geographies for which they disseminate data.

There are significant differences in the racial compositions of the cities in this analysis.[10] In Redding, Chico, Albuquerque, El Paso, Fairfax, San Antonio, Phoenix, Los Angeles, and Denver, under 10% of the population is Black. Sacramento, Minneapolis, Houston, and Oakland have populations that are between 10 and 25% Black. Proportionally, the largest Black populations are located in Cleveland, Atlanta, Baltimore, and Detroit. With the exception of Cleveland, in which 48.8% of residents are Black, these cities are more than 50% Black. Detroit has the largest percentage of Black residents in the sample at 78.3%.

To measure the extent to which Black residents are segregated from other racial groups in the cities, we utilized indices of dissimilarity. The dissimilarity index represents the percentage of one of the two groups included in the analysis that would have to move in order to achieve racial compositions within smaller geographic units that match the racial composition of the entire city. A value of 0 represents a completely integrated city, while a value of 1 represents a completely segregated city in which 100 percent of one group would have to move to achieve integration. Generally, indices above 0.6 are considered high, indices between 0.3 and 0.6 are moderate, and indices below 0.3 are low.[11]

Based on these cutoffs, only two cities, Sacramento and Fairfax, have low levels of racial segregation between non-Hispanic Black residents and the rest of the city population.[14] The majority of cities exhibit moderate levels of segregation of Black residents. In Albuquerque, Oakland, Chico, Phoenix, San Antonio, El Paso, Redding, Minneapolis, Denver, Los Angeles, and Houston, between 30% and 60% of the Black population would have to move to a new Census tract to achieve a uniform distribution of Black residents.

Black residents are extremely segregated from the rest of the population in four cities, with dissimilarity indices above 0.6: Detroit, Baltimore, Cleveland, and Atlanta. In Atlanta, the city with the highest levels of Black segregation in our sample, almost 70% of Black residents would have to move to new Census tracts to produce racial distributions within Census tracts that match that of the larger city. Notably, these four cities also have the highest proportions of Black residents in the sample, which reflects the impact of historic and modern policies aimed at segregating cities, particularly those with large Black populations.

There are significant gaps in homeownership rates between Blacks and whites. The homeownership rate is defined as the ratio of owner-occupied units to all occupied units based on data from 2019. Homeownership rates are important to examine because owning a home is an essential step in building wealth.[15]

Among Black homeowners, housing comprises about 37% of total wealth, compared to about 32% for white homeowners.[16] Financial difficulties brought on by COVID-19 threaten to exacerbate the racial homeownership gap further, especially as the federal forbearance program expired June 30, 2021.[17] Only one city, Detroit, has a gap in homeownership rates between Black and white residents under 10% with Blacks owning homes at a rate of 45.9% and whites owning homes at a rate of 53.4%.[18]

There are five cities with gaps in Black and white homeownership that range from 15% to 20%: Denver, Los Angeles, Baltimore, Oakland, and Cleveland. Rates of Black homeownership in this group of cities range from 27% in Los Angeles to 42.36% in Baltimore. In contrast, Los Angeles is the only city in this group in which the homeownership rate for whites is under 50%.

In Houston, El Paso, Sacramento, Atlanta, San Antonio, and Albuquerque, the gap in homeownership rates between Blacks and whites is between 20% and 30%. Again, the majority of whites own their homes in every city in this group except Houston (which is slightly below 50% for whites). The highest Black homeownership rate of these cities, 41.08%, is in El Paso.

Fairfax, Phoenix, Chico, Minneapolis, and Redding have the biggest Black-white disparities in homeownership rates with differences of over 30%. Chico, CA has the lowest Black homeownership rate with only 10.82% of Black residents owning their homes. The largest observed Black-white gap in homeownership rate is in Redding, CA, with 56.14% of whites owning homes compared to only 16.53% of Blacks. With the exception of Minneapolis, these cities all have relatively small proportions of Black residents. Furthermore, all of these cities have dissimilarity indices under 0.6. Although levels of spatial segregation are lower in these cities than in others in our sample, Black residents face significant barriers in becoming homeowners, limiting their opportunities to build intergenerational wealth.

Beyond discrimination in individual appraisals, homes located in majority-Black neighborhoods have been chronically undervalued,[21] further exacerbating the racial wealth gap. To examine differences in home values by race, we compared the median value of homes in Black-majority Census tracts to the median value of homes in all other Census tracts. Chico, Redding, Sacramento, Denver, Albuquerque, El Paso, San Antonio, and Fairfax have no majority-Black Census tracts and are thus excluded from the analysis.

Detroit has the smallest gap in median home value between Black-minority and Black-majority neighborhoods, with homes in Black-minority neighborhoods worth about $16,043 more than those in Black-majority neighborhoods. In Cleveland, homes in Black-minority neighborhoods were valued at median prices almost twice as high as homes in Black-majority neighborhoods, with a gap in median home value of $38,297. Shockingly, these are the only two cities in the sample in which the gap in median home values is under $100,000.

In Minneapolis, the median value of homes in Black-minority neighborhoods is also almost twice as high as the median value of homes in Black-majority neighborhoods. Since housing costs are higher in Minneapolis than in Cleveland, this amounts to a difference in median value of $110,625. A similar pattern exists in Baltimore, with the median home in Black-minority neighborhoods worth over twice as much, or $138,627 more, than the median home in a Black-majority neighborhood.

In Houston, homes in Black-minority neighborhoods are valued at median prices almost three times the median prices of homes in Black-majority neighborhoods, with a difference in value of $182,092. Here, the median home value in Black-majority neighborhoods is under $100,000, while the median home value in Black-minority neighborhoods approaches $300,000.

In California cities included in this analysis, the gap in the median values of homes is extreme, partially due to exorbitant housing prices. The median value of homes in Black-minority neighborhoods in both Oakland and Los Angeles is about 1.5 times as high as the median value of homes in Black-majority neighborhoods. In Oakland, this amounts to a difference in median values of $242,212. In Los Angeles, homes in Black-minority neighborhoods are worth about $272,933 more than those in Black-majority neighborhoods.

Atlanta, the most segregated city in our sample, also exhibits the biggest racial disparity in median home values. Homes in Black-minority neighborhoods are worth almost four times, or $350,521 more than homes in Black-majority neighborhoods.

The devaluation of homes in majority-Black neighborhoods has a range of consequences. For instance, a Black man and his Japanese American wife purchased a home in 2004 in College Park, a majority-Black area outside of Atlanta, because they wanted their children to grow up in a Black community. However, low home values meant that the schools were underfunded. When they had a second child, they moved to a neighborhood with better-funded schools - this neighborhood, Candler Park, was majority-white. They sold their home in College Park in 2014 and received $144,000 less than they initially paid for it, with no tax breaks for their losses. Thus, owning a home in College Park was not an efficient method of building wealth. Their new home in majority-white Candler Park is accruing value, and one day, they will be able to sell it at a higher value, without paying taxes on up to a $500,000 gain.[22]

Even beyond the cities in this report, the devaluing of houses in predominately Black neighborhoods, or even at times, homes owned by Black people in predominately white neighborhoods, is a systemic problem. In Jacksonville, Florida, Abena (who is Black) and Alex (who is White) Horton had their home appraised. They believe that the appraisal was too low. During the second appraisal, Alex was present instead of Abena and the couple removed all signs of Abena and their biracial son. The second appraisal yielded a 40% higher value than the appraisal where Abena was present. In Hartford, Connecticut, Stephen Richmond's home value substantially increased after he removed family photos and had a white neighbor stand in for the second appraisal. Even Black celebrities fall victim to racial discrimination in housing. Comedian and actor D.L. Hughley purchased a home in southern California for $500,000. He renovated the home and added a pool. During an appraisal three years later, Hughley's home was appraised for a similar price to what he originally purchased it for. The bank flagged it as a mistake and ordered another appraisal. The second appraisal came in $160,000 higher. Hughley went on to sell the home for $770,000.[23]

Racial economic inequality in the U.S. is primarily the result of unequal investments among communities. Estimates published by ProsperityNow showing the percentage of unbanked or underbanked populations in the United States for different racial and ethnic groups often highlight inequalities in the financial health of their neighborhoods. The percentage of Blacks (46%) who are unbanked or underbanked alone is over three times the percentage of whites (14%) who experience the same struggle. Thirty-two percent of Hispanics are also either un- or under- banked.

Bank accounts are useful tools for building emergency savings and banks themselves provide a connection to mainstream financial systems and programs that provide financial assistance and community investments. The combined 24% of Black and Hispanic populations who are completely unbanked are shut out of these basic tools though which to save and accrue earnings. Only 3% of whites are completely unbanked.

Fifty-four percent of minority populations are underbanked, meaning that while they may have access to bank accounts, these communities also experience a prevalence of alternative financial services like money orders, check cashers, and same-day lenders, to manage finances.[24] These high-cost, low-quality financial services tend to trap borrowers in cycles of debt, increasing the financial vulnerability especially among communities of color and blocking efforts to build lasting wealth. Research by McKinsey & Co. reaches a similar conclusion that access to mainstream financial services is an important factor in accumulating savings that many Black Americans, unfortunately, lack-increasing access to basic banking services could save individual Black Americans up to $40,000 over their lifetime.[25]

Unequal access to lending is not the only thing that hampers efforts by Blacks to establish financial security and accrue lasting wealth. The legacies of redlining, underinvestment, and a prevalence of alternative banking within these communities that make Black people more likely to encounter discriminatory lending practices also impact credit scores.

People pay attention to credit because loans and credit can provide opportunities to start businesses, increase human and physical capital, and build wealth. These all provide paths out of historical inequality in wealth accumulation. Unfortunately, Blacks must make extraordinary efforts to overcome the discrimination that is often hidden in financial policies or products that are supposed to be bias-free. While the 1974 Equal Credit Opportunity Act barred credit-score systems from using protected information, including race, the decades of discrimination in employment, lending policies, debt collection, and criminal prosecution that have left Black families vulnerable to financial insecurity also disadvantage credit scores.[26]

Without bank accounts, families often cannot generate the data that helps establish creditworthiness. As previously explained, the lack of banking institutions also leaves communities exposed to more predatory lending practices that encourage cyclical debt and impinge on creditworthiness. While the ability to get a mortgage and pay it on time can have a positive impact on credit scoring, families without access to these financial vehicles can't build robust credit histories. Unfortunately, the history of redlining that designated Black neighborhoods as too risky for mortgage lending is still evident in the structure of U.S. cities.[27]

Places like Atlanta and Minneapolis highlight stark differences between the average credit scores in white and majority-minority neighborhoods. In these cities, the average credit score for predominantly white neighborhoods sits above 725. By contrast, the average credit score for non-white zip codes is 560 and 570 for Atlanta and Minneapolis, respectively. The demographic composition of these two cities is quite different - Atlanta is majority Black (50.1% Black) and Minneapolis is majority white (19.2% Black). However, the predominant spatial segregation along racial and ethnic lines bears markers of systemic discrimination. While these two cities have the largest gaps between credit scores and showcase the interaction of race and social status in geographic areas, nine of the cities examined have non-white communities at an over 100-point disadvantage in credit scores.

Another interesting city to examine is Detroit, which has the lowest credit scores for both white and majority minority communities across all of these cities. In comparison to other cities, Detroit has the largest percentage of Black residents in the sample at 78.3%. It has maintained a majority Black population since the 1980s. However, Detroit remains among the most segregated cities in the nation today, precisely because of redlining practices that largely blocked Black families from federally-backed mortgages and drove them into neighborhoods with sub-par amenities (e.g., health, education, banking, green spaces, safety) and sectioned "good" neighborhoods as being predominantly white.[28] This combination of subpar investments and difficulty in acquiring mortgages makes the funding for wealth-creating activities such as investing in education or entrepreneurial ventures less accessible.

In the short term, for those with low and unstable income, lack of credit can make it impossible to pay for an unexpected immediate expense. In the long term, without access to the credit needed to fund wealth-creating activities such as educational, workforce, and small business investments, communities of color continue to be harmed by the historical legacies of intentionally discriminatory financial practices.

We used educational attainment data from the 2019 ACS estimates measuring the ratio of people with higher education degrees to the population age 25 or older to highlight differences in educational investments. More than 30% of Blacks in the cities examined have a higher education degree. Albuquerque, the city reporting the highest level of Black educational attainment, still only had 44% of Blacks over the age of 25 achieve an associate degree or higher.

There are two cities, San Antonio (with 35% Black and 33% white educational attainment) and El Paso (43% Black and 35% white), in which Blacks have higher levels of post-high school degrees than whites. When examining homeownership rates with educational attainment, it is clear that education does little to mute the racial gap in homeownership, even in cities where Blacks have higher educational attainment than whites.

Detroit and Cleveland have the lowest levels of Black educational attainment out of all cities (21% and 20%, respectively). Both cities are also in the bottom half of educational attainment across all racial groups. As mentioned, inequitable access to financial resources continues to exacerbate underinvestment in factors like education, which also contribute to the lack of ability to obtain wealth. Given that these cities have a majority minority population, it is no surprise that systemic barriers to wealth creation in the form of both financial and educational resources continue to manifest across the country in twenty-first century America. [31]

Closing the racial wealth gap will not be trivial. The gap has its roots in racist policies which trace back through the decades and centuries to even before the founding of the country. The vestiges of slavery, which prevented Black Americans from building any wealth for generations, as well as Jim Crow and New Deal-era policies, which sacrificed Black wealth-building opportunities to consolidate a white middle class, means the domino effects of this stolen possibility reach far and wide in American society. Therefore, solving this disparity will require a collection of policies and initiatives to tackle the most heinous examples of racial inequity that persist today, and which continue to rob Black America of the prosperity it is due. Because housing has been the primary mechanism by which Americans have built and passed along generational wealth in the last century, correcting injustices in housing is a prime area to begin attacking the harmful influence of systemic racism.

To bolster Black homeownership nationwide, we recommend a holistic approach to the home-buying process which will create a more equitable system before, during, and after securing a mortgage:

1. Increase support for small dollar mortgage loan programs. It is a pervasive myth that homes of lower value are riskier investments for mortgages, but recent analysis from the Urban Institute shows that these buyers have comparable credit scores and their mortgages have similar loan-to-value ratios to more valuable properties.[32] As homes in Black neighborhoods are already devalued, this barrier to entry to homeownership disproportionately affects Black buyers, especially those who are first-time buyers.

2. Reduce uneven costs of mortgages for Black homeowners. Homeownership while Black is expensive. Creating a rate-and-term refinancing option would help more households reduce monthly mortgage costs and lower the barrier to homeownership.

3. Extend credit and down payment assistance to borrowers impacted by discriminatory housing and lending practices. Historical and ongoing policies such as redlining, restrictive covenants, "steering," and more have extracted wealth from Black neighborhoods for generations. While it is not enough to simply extend credit based on redlining maps drawn in the New Deal Era, past injustices must be redressed by helping to develop areas left behind by racist policies.

4. Adopt credit scoring practices with less discriminatory impacts. Current metrics of credit scoring do not account for regular payments from rent and utilities, instead they prioritize loan and credit card payments. Expanding notions of credit-building can dispel the myth that Black homeowners are risky investments.

5. Increase diversity in the appraisal profession. Nearly 9 in 10 property appraisers are white, while 2% are Black, according to Urban Institute analysis of 2019 Census data.[33] With the numerous instances of appraiser bias making headlines on a consistent basis, better representation in the profession which holds sway over much of the valuation process could go a long way to mitigating the effects of societal bias against Black neighborhoods.

6. Continue stimulus and relief efforts for homeowners and buyers in the wake of the COVID-19 pandemic. Black Americans are joining the ranks of homeowners at a steady rate, but the disparate impacts of the pandemic and associated recession mean that preexisting Black homeowners faced disproportionate difficulty with mortgage payments. Foreclosure moratoriums allowed many to hold onto their homes, but now they face repayment of deferred mortgages, and a bifurcated economy has not yet returned Black employment to pre-pandemic levels.

Through this report, we have provided a comprehensive overview of the role of segregation, discrimination, and racism in the housing market, as well as policy opportunities and recommendations to reduce these racial disparities. Implementing these evidence-based solutions will improve opportunities for potential Black homebuyers and reduce the racial wealth gap.

The Brookings Institution is a nonprofit organization devoted to independent research and policy solutions. Its mission is to conduct high-quality, independent research and, based on that research, to provide innovative, practical recommendations for policymakers and the public. The conclusions and recommendations of any Brookings publication are solely those of its authors, and do not reflect the views of the Institution, its management, or its other scholars. Support for this publication was generously provided by The Change Company, LLC. Brookings recognizes that the value it provides is in its absolute commitment to quality, independence, and impact. Activities supported by its donors reflect this commitment.

[2] Perry, Andre. 2020. Know Your Price: Valuing Black Lives and Property in America's Black Cities. Brookings Press: Washington DC.

[3] Dettling, Lisa J., Joanne W. Hsu, Lindsay Jacobs, Kevin B. Moore, and Jeffrey P. Thompson. Recent Trends in Wealth-Holding by Race and Ethnicity: Evidence from the Survey of Consumer Finances. The Federal Reserve, September 27, 2017. https://www.federalreserve.gov/econres/notes/feds-notes/recent-trends-in-wealth-holding-by-race-and-ethnicity-evidence-from-the-survey-of-consumer-finances-20170927.htm.

[10] U.S. Census Bureau. American Community Survey 2019 (5-Year Estimates). Retrieved from Social Explorer.

[11] Massey, Douglas, and Nancy Denton. American Apartheid: Segregation and the Making of the Underclass. Cambridge, MA: Harvard University Press, 1993.

[12] Saporito, Salvatore, and Daniel Casey. "Are There Relationships Among Racial Segregation, Economic Isolation, and Proximity to Green Space?" Human Ecology Review 21, no. 2 (2015): 113-32. http://www.jstor.org/stable/24875135.

[14] Analysis of 2019 5-Year ACS Estimates.

[18] Analysis of 2019 5-Year ACS Estimates.

[31] Analysis of 2019 5-Year ACS Estimates.

[32] McCargo, Alanna, Bing Bai, and Sarah Strochak. "Small-Dollar Mortgages: A Loan Performance Analysis." Urban Institute, March 6, 2019. https://www.urban.org/research/publication/small-dollar-mortgages-loan-performance-analysis.

[33] Neal, Michael, and Peter J. Mattingly. "Increasing Diversity in the Appraisal Profession Combined with Short-Term Solutions Can Help Address Valuation Bias for Homeowners of Color." Urban Institute, July 1, 2021. https://www.urban.org/urban-wire/increasing-diversity-appraisal-profession-combined-short-term-solutions-can-help-address-valuation-bias-homeowners-color.

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Homeownership, racial segregation, and policy solutions to racial wealth equity | Brookings

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Homeownership is often viewed as the entry to the American dream and the gateway to intergenerational wealth. However, this pathway is often less achievable for Black Americans who post a homeownership rate of 46.4% compared to 75.8% of white families.

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9.6 Thesis, Direction and Resources for Critical Analysis Project

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9.6 Thesis, Direction and Resources for Critical Analysis Project

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_Psych 110_ Resources and Questions for Critical Analysis Project 

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1. State the most important thing that you learned from this unit's readings and how it has deepened your understanding of Black male and female interpersonal and close relationships.

The most important thing I learned from this unit is why it is important for females to have positive friendships during adolescence years. This fact has deepened my understanding of the female interpersonal and close relationships because this is how females develop self identity, and self-worth.

2. How do long-standing stereotypes in the media of African American females being portrayed as property (i.e. in rap videos etc.) affect the psyche of those seeing these images and the African American woman's dating prospects?

The psyche of those seeing these images are effected because people will continue to see black females as property and dehumanize the black women. This can lead to distorted perceptions and biases from dating prospects.

3. What factors are contributing to the rising number of single Black unmarried females?

Contributing factors are the changes in societal norms, the economic shift in wages, and also the black male incarceration rates.

4. Why is there a stigma in the African American community against the LGBTQ community?

I believe there is a stigma in the black community against the LGBTQ community due to cultural norms and religious beliefs.

5. Find one resource that helps you understand these themes and post it to your padlet. State the resources' significance to this unit's material.

A study that explores how black men make relationship decisions.

https://www.researchgate.net/publication/303957485_Interpersonal_Relationships_Exploring_Race_and_Relationship_Decisions_Among_African_American_College_Men

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www.researchgate.net needs to review the security of your connection before proceeding.

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1. What does it mean to code switch and how does this affect an African American's success in life?

To code switch means to adjust your language, communication style, or behavior. Code switching can positively affect African American success in life because one is able to navigate through different cultural contexts including professional settings. It allows people to effectively communicate and connect with people from diverse backgrounds.

2. How does expecting code switching threaten diversity?

Code switching threatens diversity by expecting people from diverse backgrounds to to act a certain way. This makes individuals feel pressured to act a certain way to fit in the dominant culture.

3. How do the effects of code switching intersect with a persons' mental health?

This will affect an individuals identity and strain their ability to express their true selves. It also can create one to have imposter syndrome, feeling as if they do not belong in any cultural space.

4. Search online for a resource that helps you understand this topic more and post it to your Padlet. State why the resource shines some light on a perspective of this issue.

https://grad.berkeley.edu/news/announcements/lets-talk-about-code-switching-a-double-edged-sword/

This article helped me understand the benefits of code switching and how it can also have its downfalls.

5. State a strategy that you feel can be successful to address the misconceptions about code switching that exist inside and outside of the African American community.

Encouraging workplaces to have an inclusive policy that respects and accommodates diverse communication styles. Code switching happens mostly in my opinion in the professional field.

6. State one thing that you learned or one thing that stood out to you from the unit required reading, optional reading or audio material in this unit.

That African American students are less successful in online learning because we are more hands-on learners. This explains why i personally have a hard time with distant learning.

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Have you ever found yourself adjusting the way you talk or behave when transitioning from one environment to another? Perhaps you shift from casual banter with friends to adopting a more formal tone in professional settings. Many refer to this chameleon effect as code-switchinga strategy that people use to alter their self-presentation in different contexts and situations. Often, the way people adjust how they present themselves is driven by societal expectations and norms. To align with the norms of different contexts, people may switch out of various identities, including race, ethnicity, gender, sexuality, age, socioeconomic status, and disability status.

In graduate school, you may find yourself switching how you present yourself in interactions with your advisors, during a presentation, or when you are writing for publication. The demands of academic publishing and peer-review, for example, typically require a particular dialect. Using academic language to communicate your work is a learned skill, and often a survival strategy in the academic jungle, a means of securing credibility and recognition within the scholarly community. Academic language can become a necessary coat of armor, even if it means veering away from one's authentic voice. In other spaces such as the workplace, code-switching can manifest as changing the way you speak or act in adherence to the norms of the company, which are often implicit in nature.

The dual nature of code-switching: Costs and benefits

Code-switching strategies are multifaceted and varied, and can result in a variety of benefits and drawbacks. For one, people may code-switch to obtain professional opportunities, avoid stereotypes, accrue cultural capital, or attain social belonging. These outcomes may bear a positive hue, yet the shadow of code-switching looms large, casting uncertainty upon one's authentic self-expression. This incongruence in how individuals behave in different contexts can cause identity confusion and impact feelings of belonging in certain spaces. Moreover, the sustained act of code-switching can exact a mental toll, potentially leading to cognitive fatigue and burnout, as individuals remain hypervigilant to monitor their surroundings.

In a social context, successful code-switching can mean that you are more likely to earn the favor of the group enforcing norms. For example, psychology research shows that job applications that downplay or conceal one's racial minority identity (aka "resume whitening") are more likely to receive interview invitations from recruiters ( Kang et al., 2016 ). Other work by McCluney et al. (2021) suggests that employees who code-switch are viewed as more professional, compared to those who don't code-switch. Yet, there can also be downstream social consequences for those that code-switch. For example, research shows that racial/ethnic code-switching can lead to accusations of "acting white" from members of one's own racial/ethnic group ( Durkee & Williams, 2015 ).

Overall, it seems like code-switching can be a double-edged sword. Navigating code-switching in different spaces can be a multifaceted endeavor, with implications both for individuals and the institutions they engage with. Yet, at the heart of this complexity lies an undeniable reality: many institutions, including those in higher education and professional workplaces, still maintain cultural norms that have deep historical roots, originally tailored to cater to a specific demographic. For example, institutions of higher education are rooted in white cultural norms (i.e., "whiteness") and continue to perpetuate these norms ( Corces-Zimmerman et al., 2021 ). Despite the rise of institutions embracing initiatives for greater diversity, equity and inclusion, people continue to engage in code-switching within these spaces, which underscores the importance of confronting implicit norms and pressures.

What should we do about it?

Across academic and business workplaces, individuals share a responsibility to develop awareness and vigilance in addressing bias and stereotypes. This commitment to self-reflection is a crucial first step, as acknowledging the biases we unconsciously hold is essential in dismantling them. Individuals can start with taking steps to develop skills inequity and inclusion, as outlined in GradPro's Professional Development Guide . Complementing this resource are an online course dedicated to managing and reducing implicit bias ; an implicit association test to understand some of the thoughts, attitudes, and feelings you might hold outside of conscious awareness; and a tool to recognize microaggressions and the messages they signal.

It's equally important that organizations, businesses, and institutions evaluate existing practices related to diversity, equity, and inclusion. Improving representation can reduce the significance of long-standing institutional norms that have historically pressured people to code-switch. One key aspect of this is ensuring that this representation and diversity extends to senior leadership, as this helps set the tone for the entire organization and paves the way for meaningful change. Ultimately, organizations and institutions should actively seek out ways to enhance diverse representation, not merely as a matter of compliance but as a testament to their commitment to a truly inclusive culture.

As for administrators and faculty in higher education, it is essential to recognize the unique challenges graduate students grapple with in academic settings. Graduate students often feel pressure to code-switch when writing papers, participating in lab meetings, and engaging in scholarly discourse. While there may not be one-size-fits-all solutions, offering support and resources for students to navigate these challenges is critical. This could include mentorship programs, peer support networks, and workshops that empower students to find their authentic voices within the academic landscape. The emphasis should be on fostering an academic environment that encourages diversity and recognizes the value of varied perspectives, allowing students to thrive without compromising their authenticity.

For students embarking on academic or professional journeys, it can be helpful to carefully consider the environments you would like to end up working in. Seeking out spaces that align with your authentic self and actively value inclusivity can be a powerful strategy. Such environments often possess the infrastructure and ethos necessary to support diverse voices and perspectives. While it is almost inevitable that some degree of code-switching will persist in various interactions, you can make the choice to seek out work in places that genuinely embrace your identity-expression and authenticity. This choice can help you to weigh the importance of your professional goals alongside the likelihood of finding a workplace that aligns with your values and self-identity, and that not only encourages, but thrives on, the diversity you bring.

Finally, for graduate students who are dealing with some of the challenges of code-switching, such as burn-out or feelings of inauthenticity, consider accessing these resources:

Wellness resources for different student communities at Berkeley, including those for Black students ; Latinx students ; Students with disabilities ; International students ; and more.

Office for Graduate Diversity , with guidance on surviving and thriving in graduate school

Counseling and Psychological Services (CAPS) , which offers individual , , , and group counseling. To learn more about group counseling, check out the list of Fall 2023 offerings .

The Student Advocate's Office , which provides free and confidential casework services for students navigating issues

Queer Grads , a student organization that provides community for LGBTQ+ graduate students across academic disciplines. For more LGBTQ+ themed organizations and groups, see .

Resources through GenEq for Women*s (women and femmes). More broadly, check out the Gender Equity Resource Center (GenEq) for other resources.

Resources for Undocumented Graduate Students .

The Centers for Educational Justice & Community Engagement (EJCE) with collaborative offices that connect individuals within and across diverse communities.

About the Author: Nirupika Sharma is a Ph.D. candidate in Social/Personality Psychology at UC Berkeley. Her research focuses on the effects of identity on perceptions of the self and group relationships. In particular, her dissertation work investigates the psychological and social implications of code-switching. Additionally, Nirupika is co-founder of a resource hub and community aimed to help graduate students navigate the Hidden Curriculum in Psychology ( HICCUP ). Nirupika also serves as a Professional Development Liaison (PDL) at GradPro.

Have you ever found yourself adjusting the way you talk or behave when transitioning from one environment to another? Perhaps you shift from casual banter with friends to adopting a more formal tone in professional settings. Many refer to this chameleon effect as code-switchinga strategy that people use to alter their self-presentation in different contexts and situations. Often, the way people adjust how they present themselves is driven by societal expectations and norms. To align with the norms of different contexts, people may switch out of various identities, including race, ethnicity, gender, sexuality, age, socioeconomic status, and disability status.

In graduate school, you may find yourself switching how you present yourself in interactions with your advisors, during a presentation, or when you are writing for publication. The demands of academic publishing and peer-review, for example, typically require a particular dialect. Using academic language to communicate your work is a learned skill, and often a survival strategy in the academic jungle, a means of securing credibility and recognition within the scholarly community. Academic language can become a necessary coat of armor, even if it means veering away from one's authentic voice. In other spaces such as the workplace, code-switching can manifest as changing the way you speak or act in adherence to the norms of the company, which are often implicit in nature.

The dual nature of code-switching: Costs and benefits

Code-switching strategies are multifaceted and varied, and can result in a variety of benefits and drawbacks. For one, people may code-switch to obtain professional opportunities, avoid stereotypes, accrue cultural capital, or attain social belonging. These outcomes may bear a positive hue, yet the shadow of code-switching looms large, casting uncertainty upon one's authentic self-expression. This incongruence in how individuals behave in different contexts can cause identity confusion and impact feelings of belonging in certain spaces. Moreover, the sustained act of code-switching can exact a mental toll, potentially leading to cognitive fatigue and burnout, as individuals remain hypervigilant to monitor their surroundings.

In a social context, successful code-switching can mean that you are more likely to earn the favor of the group enforcing norms. For example, psychology research shows that job applications that downplay or conceal one's racial minority identity (aka "resume whitening") are more likely to receive interview invitations from recruiters ( Kang et al., 2016 ). Other work by McCluney et al. (2021) suggests that employees who code-switch are viewed as more professional, compared to those who don't code-switch. Yet, there can also be downstream social consequences for those that code-switch. For example, research shows that racial/ethnic code-switching can lead to accusations of "acting white" from members of one's own racial/ethnic group ( Durkee & Williams, 2015 ).

Overall, it seems like code-switching can be a double-edged sword. Navigating code-switching in different spaces can be a multifaceted endeavor, with implications both for individuals and the institutions they engage with. Yet, at the heart of this complexity lies an undeniable reality: many institutions, including those in higher education and professional workplaces, still maintain cultural norms that have deep historical roots, originally tailored to cater to a specific demographic. For example, institutions of higher education are rooted in white cultural norms (i.e., "whiteness") and continue to perpetuate these norms ( Corces-Zimmerman et al., 2021 ). Despite the rise of institutions embracing initiatives for greater diversity, equity and inclusion, people continue to engage in code-switching within these spaces, which underscores the importance of confronting implicit norms and pressures.

What should we do about it?

Across academic and business workplaces, individuals share a responsibility to develop awareness and vigilance in addressing bias and stereotypes. This commitment to self-reflection is a crucial first step, as acknowledging the biases we unconsciously hold is essential in dismantling them. Individuals can start with taking steps to develop skills inequity and inclusion, as outlined in GradPro's Professional Development Guide . Complementing this resource are an online course dedicated to managing and reducing implicit bias ; an implicit association test to understand some of the thoughts, attitudes, and feelings you might hold outside of conscious awareness; and a tool to recognize microaggressions and the messages they signal.

It's equally important that organizations, businesses, and institutions evaluate existing practices related to diversity, equity, and inclusion. Improving representation can reduce the significance of long-standing institutional norms that have historically pressured people to code-switch. One key aspect of this is ensuring that this representation and diversity extends to senior leadership, as this helps set the tone for the entire organization and paves the way for meaningful change. Ultimately, organizations and institutions should actively seek out ways to enhance diverse representation, not merely as a matter of compliance but as a testament to their commitment to a truly inclusive culture.

As for administrators and faculty in higher education, it is essential to recognize the unique challenges graduate students grapple with in academic settings. Graduate students often feel pressure to code-switch when writing papers, participating in lab meetings, and engaging in scholarly discourse. While there may not be one-size-fits-all solutions, offering support and resources for students to navigate these challenges is critical. This could include mentorship programs, peer support networks, and workshops that empower students to find their authentic voices within the academic landscape. The emphasis should be on fostering an academic environment that encourages diversity and recognizes the value of varied perspectives, allowing students to thrive without compromising their authenticity.

For students embarking on academic or professional journeys, it can be helpful to carefully consider the environments you would like to end up working in. Seeking out spaces that align with your authentic self and actively value inclusivity can be a powerful strategy. Such environments often possess the infrastructure and ethos necessary to support diverse voices and perspectives. While it is almost inevitable that some degree of code-switching will persist in various interactions, you can make the choice to seek out work in places that genuinely embrace your identity-expression and authenticity. This choice can help you to weigh the importance of your professional goals alongside the likelihood of finding a workplace that aligns with your values and self-identity, and that not only encourages, but thrives on, the diversity you bring.

Finally, for graduate students who are dealing with some of the challenges of code-switching, such as burn-out or feelings of inauthenticity, consider accessing these resources:

Wellness resources for different student communities at Berkeley, including those for Black students ; Latinx students ; Students with disabilities ; International students ; and more.

Office for Graduate Diversity , with guidance on surviving and thriving in graduate school

Counseling and Psychological Services (CAPS) , which offers individual , , , and group counseling. To learn more about group counseling, check out the list of Fall 2023 offerings .

The Student Advocate's Office , which provides free and confidential casework services for students navigating issues

Queer Grads , a student organization that provides community for LGBTQ+ graduate students across academic disciplines. For more LGBTQ+ themed organizations and groups, see .

Resources through GenEq for Women*s (women and femmes). More broadly, check out the Gender Equity Resource Center (GenEq) for other resources.

Resources for Undocumented Graduate Students .

The Centers for Educational Justice & Community Engagement (EJCE) with collaborative offices that connect individuals within and across diverse communities.

About the Author: Nirupika Sharma is a Ph.D. candidate in Social/Personality Psychology at UC Berkeley. Her research focuses on the effects of identity on perceptions of the self and group relationships. In particular, her dissertation work investigates the psychological and social implications of code-switching. Additionally, Nirupika is co-founder of a resource hub and community aimed to help graduate students navigate the Hidden Curriculum in Psychology ( HICCUP ). Nirupika also serves as a Professional Development Liaison (PDL) at GradPro.

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Let's Talk About Code-Switching: A Double-Edged Sword - Berkeley Graduate Division

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Have you ever found yourself adjusting the way you talk or behave when transitioning from one environment to another?

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1. What are the significant differences in terms of religious and spiritual practices of the African American community compared to the larger community?

Significant differences are that African Americans mostly practice Christianity, and our churches play an important role in our community. African Americans incorporate African traditions into our Christian faith. We also use gospel music for more than just praise and worship it is also a form of cultural expression.

2. Why do Black Millenials exhibit different religious habits compared to older African Americans who more traditionally attended historically Black protestant churches?

Technology plays a role in the different habits between generations. Millennials grew up in the age of technology and instead of traditionally going to church they can watch it online. Also, millennials have a more critical way of thinking and often question the norms of the traditional black church.

3. How does attending church affect the mental health of African Americans?

Churches can contribute to stress or internal conflict because members may feel judged or excluded due to many factors, especially those in the LBGTQ community.

4. Please locate a resource that helps you understand this theme. Analyze the resource and state the most important thing you learned from it about this topic. https://www.christianitytoday.com/2022/02/black-american-nones-faith-unaffiliation-nothing/

The most important thing I learned, is although the rate of non-Christians in the black community has grown, we still have fewer non-Christans than other ethnicities.

5. State one thing that you learned or one thing that stood out to you from the unit required reading, optional reading or audio material in this unit.

African Americans are religious than whites and latinos.

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There are more unaffiliated African Americans, but they're also more likely to return.

African Americans are among the most devout groups in religion research, often outranking other demographics in areas like religious practice, attendance, and belief.

As a result, some predicted that young Black adults would resist the moves away from faith seen among white millennials.

Even with all the shifts in the faith landscape over the past several years, Black Americans remain more religious than other groups and more likely than the average American to stay in the tradition they were raised in, according to a massive report released by Pew Research Center last year.

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But black "nones" are growing. With 3 in 10 adults in the US claiming no religious affiliation on surveys, the rise of the nones has touched every corner of American society.

Over more than a decade, the share of Black Americans who say that they have no religious affiliation has risen more dramatically than whites, Hispanics, or Asians.

But looking beyond that statistic, we see a much more nuanced view of Black religion in the United States.

In 2008, 22 percent of all Americans who participated in the Cooperative Election Study indicated that they were atheist, agnostic, or described their religion as "nothing in particular." Just 12 years later, the share of nones rose to just over 34 percent. When that rise is tracked across different racial groups, different patterns emerge.

For instance, white respondents tracked the national average nearly perfectly, with 23 percent nones in 2008, rising to 34 percent by 2020. Among Hispanic respondents. There was an increase of 11 percentage points, but for Asians-who already had the highest levels of religious unaffiliation-it was much more modest at just about 5 percent.

Among African Americans, the increase in the share of the nones was much larger, more than 15 percentage points. In 2008, African Americans were the least likely to be nones (19.5%), but by 2020 they were more likely to say that they had no religious affiliation than white or Hispanic respondents (34.9%).

But beyond that top-level statistic, the story among African Americans is much more subtle and nuanced. As previously mentioned, three response options are combined to make up the nones: atheists, agnostics, and those who say that they have no religion in particular.

When the types of nones are calculated for each racial group, a much different picture emerges. While the nones have gained the most ground among African Americans, that does not mean that there are many more Black atheists and agnostics than there were in 2008.

In fact, among Black nones, just 6 percent of them identify as atheist and another 6 percent say that they are agnostic. That means that nearly 9 in 10 Black nones are nothing in particular. That's much higher than any other racial group.

For instance, just 61 percent of white nones are nothing in particular, 63 percent of Asians, and 73 percent of Hispanics. Clearly, when African Americans leave religion behind, they are very reluctant to embrace the labels of atheist or agnostic.

There's a chapter in my book about the religious unaffiliated titled "All Nones Are Not Created Equal" about how different those three groups are really based on a number of demographic factors, but one stands out. Among those who said that they were atheists in 2010, just 3 percent identified with a religion in 2014. Among agnostics, it was 6.5 percent who embraced a religious tradition. For nothing in particulars, it was nearly 25 percent.

Thus, the data indicates that Black nones have a stronger faith background and are much more likely to embrace religion in the future than nones of other racial groups.

Despite rise of religious unaffiliation, Black Americans who still identify with a religious tradition are staying faithful. They continue to report much higher levels of church attendance than other races.

For instance, in 2020, nearly 46 percent of religious Black people describe their church attendance as weekly or more than once per week. For white respondents, just 36 percent attended weekly or more. For Hispanics that percentage was 32 percent and for Asians it was 38 percent. On the other end of the spectrum, less than 30 percent of Black respondents said that they attended church less than once per year. That's nearly 10 points lower than whites in the sample.

While the share of the nones has nearly doubled in the past 12 years among Black Americans, there's still plenty of evidence in the data that they are more open to religion than other racial groups.

In 2020, just 2 percent of all African Americans said that they were atheists, and another 2 percent were agnostics, compared to 31 percent who said that they had no religion in particular.

As previously mentioned, "nothing in particulars" are 4 to 8 times more likely to come back to religion over time compared to atheists and agnostics. That means that many of them may return to religion over time. And among those who still identify with a religious tradition, Black Americans are more active in their religious communities than any other racial group.

Even in an age of rapid secularization, the Black church still plays a crucial role in the lives of African Americans throughout the US. For Black pastors, the mission field is incredibly ripe, and many are heeding this call.

The North American Mission Board has worked in partnership with the SBC's National African American Fellowship with the SBC's National African American Fellowship to plant churches in underserved African American communities across the United States, and the first fruits of those efforts are already beginning to emerge. New efforts by Crete Collective and Dhati Lewis's forthcoming BLVD are also turning attention to such communities.

Jude 3 Project, an apologetics ministry among Black Christians led by Lisa Fields, has a discussion series called "Why I Don't Go," engaging and listening to African Americans who have left the church.

"Classical and traditional apologetics goes a lot to proving the existence of God. When you know the Black context, you realize most Black people believe that a God exists or a higher power exist," Fields said in a podcast interview last year.

"Black atheism is growing, but it's still a minority of Black people. So we have to figure out what black people are navigating, what are the challenges, and meet them there."

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Black Americans See the Biggest Shift Away from Faith - Christianity Today

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There are more unaffiliated African Americans, but they're also more likely to return.

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1. After reading this Washington Post articleLinks to an external site., can you explain why there are disparities between the amount of pain medication an African American woman would receive compared to other women in the same hospital complaining of pain?

Black women are given less pain medication than white women. Black women receive less pain treatment for chronic issues than white women. The reason being there is a perception that black women feel less pain than white women.

2. What factors are contributing to the disproportionate number of African American infants who die in childbirth and African American mothers who die in childbirth?

Stereotypes and biases in the healthcare system affect African American babies and mothers' death rates. Also, African American women have higher rates of chronic conditions that increase the risk of pregnancy and childbirth.

3. What are some solutions that can be implemented to improve the experiences of African American mothers giving birth and African American infant survival rates?

Racial disparities need to be addressed in the healthcare system. Policies should be in place that address racial disparities to make sure everyone is treated the same regardless of skin color.

4. Find one resource that helps you understand this theme and post it to your Padlet. State the resources' significance to this unit's material. https://www.americanprogress.org/article/eliminating-racial-disparities-maternal-infant-mortality/

This resource addresses the problem of African American childbirth and maternal risk. It also provides several do able solutions to this issue.

5. State one thing that you learned or one thing that stood out to you from the unit required reading, optional reading, or audio material in this unit.

One this I learned is regardless of your economic status and wealth, as a black woman you will still face pregnancy risks that money cannot fix.

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Eliminating Racial Disparities in Maternal and Infant Mortality

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This report provides a comprehensive policy framework to eliminate racial disparities in maternal and infant mortality.

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13.5 Film Analysis Outline Template (Insert Name Here)

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1. What are the outcomes of institutionally racist policy choices that exclude the needs of low-income minorities in the health care system?

This can lead to little or no access to quality healthcare which will in itself result in bad health.

2. How does the intersectionality of the unconscious bias, distrust in the healthcare system, lack of health insurance and lack of health education affect the African American community?

The unconscious bias cause disparities in treatment and also diagnosis. Most of the times health issues of a black person are not seen as severe resulting in improper diagnosis. The lack of health insurance makes it hard and expensive to access essential health services. Not being educated on health care can limit the understanding of the importance of prevention measures.

3. State THREE strategies that you feel can address the issues raised in questions one and two.

Affordable healthcare access, engagement in the community to improve communication about healthcare services and also developing health education campaigns that are targeted towards the african american community.

4. Search online for a resource that helps you understand this topic more and post it to your Padlet. State why the resource shines some light on a perspective of this issue. https://pmc.ncbi.nlm.nih.gov/articles/PMC9059791/#:~:text=In%202014%2C%2085.3%20million%20Americans,tasks%20(Taylor%2C%202018).

5. State one thing that you learned or one thing that stood out to you from the unit required reading, optional reading or audio material in this unit.

making poor health choices were passed down from generations. The older generation was not aware of the health issues that would be caused fr

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. Author manuscript; available in PMC: 2023 Jan 1.

Abstract

Background:

Population-based research and community-based interventions are integral to occupational therapy's scope of practice, yet they are underdeveloped in actual implementation. Therefore, this paper focuses on some health challenges facing the African American population, guided by the Person-Environment-Occupation-Performance Model.

Method:

Using data from an observational cross-sectional nationwide telephone survey of African American adults, we examined differences between African Americans who are receiving disability payments (RDP) and those who are employed full time (FTE) on several physical health behaviors and psychosocial health indicators. We further compared the differences between African Americans RDP versus those FTE on those physical health behaviors and psychosocial health indicators across five US regions.

Results:

Findings suggest that African Americans RDP are engaging in fewer positive physical health behaviors and experiencing worse psychosocial health compared to their counterparts FTE. There are also nuanced regional variations in the differences between African Americans RDP and FTE in physical health behaviors and psychosocial health indicators.

Conclusion:

This research highlighted some health challenges of African Americans RDP and FTE using a regional lens, demonstrating the value of OT population-based research. There is a need for OT population-specific community-based practice to address the health disparities of underserved and minority populations, such as African Americans.

Keywords: psychosocial health, physical health behaviors, community-based practice, population health

The profession of occupational therapy (OT) includes in its scope of practice addressing the needs of populations and engaging in community-based practice. Our purpose in this current paper is to demonstrate how population-level research relates to theory and can inform community-based practice. This approach includes a research study examining at a population-level African Americans who receive disability payments compared to those who are employed full time on several physical and psychosocial health indicators. We also provide a contextual perspective, investigating how regional characteristics vary for this population. Through this examination, we hope to demonstrate how population-level research can inform community-based OT practice.

Social Determinants of Health and Health Inequities in African Americans

Health inequities affecting African Americans have existed throughout the history of the United States as a result of the impact of systemic racism and social determinants of health (SDoH) ( Buis et al., 2019; DeSantis et al., 2016; Maness et al., 2021; Pan et al., 2019; Yoon et al., 2019). The SDoH are grouped by Healthy People 2030 into five broad categories: economic stability, access to quality education, health care access and quality, neighborhood and built environment, and social and community context ( Health.gov, 2021). The health inequities experienced by African Americans relative to SDoH are especially evident during the current COVID-19 pandemic, during which African Americans have been disproportionately impacted with higher COVID-19 infections and death rates compared to other racial and ethnic groups ( Kirksey et al., 2020; Rolland, 2020; Snowden & Graaf, 2021). People of color, such as African Americans, and those with low incomes are more likely to experience food insecurity when compared to their wealthier and White counterparts, a condition aggravated during the COVID-19 pandemic ( Leddy et al., 2020). Lack of access to health care supporting resources was exacerbated during the COVID-19 pandemic for people of color ( Rolland, 2020). For blue-collar workers, many of whom are minorities, including African Americans, the requirements of their work did not always permit social distancing, elevating the risk for COVID-19 exposure and infection ( Rolland, 2020).

African Americans with Disabilities

In 2014, 85.3 million Americans were living with a disability, with African Americans accounting for 34.9% of that population. Of African Americans with a disability, 20.2% had a severe disability and 9.9% needed assistance with daily tasks ( Taylor, 2018). In addition, as many as 16.2% of African American adults had been receiving treatment for depression, and 6.2% were on medication for mental health issues ( SAMHSA, 2018). African Americans experience more mental health issues than do their White counterparts because of various factors unique to their situation, including stigma, economic struggle, racism, and gaps in service provision ( Armstrong-Mensah et al., 2020). Literature ( Armstrong-Mensah et al., 2020; United States Census Bureau, 2015) suggests there exists a large population of African American adults who either have used or could benefit from OT services, with the potential for that need increasing over time.

Background and Significance

OT Addressing the Health Needs of Populations

Population health promotion is defined as "systematic efforts to build community capacity, strengthen supportive environments, and implement public health policy in order to minimize morbidity and mortality, ensure equitable opportunities, improve health and optimize the quality of life of a community" ( Mackenzie & O'Toole, 2011, p. 384). While much of traditional OT practice occurs in one-on-one and group interventions, there is a need for the profession to proactively address population-based health care needs, disease prevention, and health promotion ( AOTA, 2014, 2017, 2018, 2019, 2020; Braveman, 2016; Brownson & Scaffa, 2001; Hocking, 2011; Scaffa, 2014).

The Accreditation Council for Occupational Therapy Education (ACOTE) has set standards for entry-level occupational therapists and occupational therapy assistants, calling on educators to train students to understand the needs of populations. For example, the B.1.6 standard states that entry-level occupational therapists should "Demonstrate knowledge of global social issues and prevailing health and welfare needs of populations with or at risk for disabilities and chronic health conditions" ( AOTA, 2018, p.19). ACOTE defines population-based interventions as: "promoting the overall health status of the community by preventing disease, injury, disability, and premature death ... [including] assessment of the community's needs, health promotion and public education, disease and disability prevention, monitoring of services, and media interventions" ( AOTA, 2018, p. 41).

Given the importance of understanding and addressing the needs of populations, we next briefly review some of the OT research on African Americans, outline a relevant theoretical model, and then describe a population-level study examining potential differences between those who are receiving disability payments (RDP) and those who are employed full time (FTE) in an African American sample.

OT Literature Addressing African American Population

The OT literature on the needs of African Americans is sparse, and much of it is out of date, spanning 1990 to recent years. Belgrave (1991) examined variables correlated with African Americans' adaptation to disabilities with a study sample of 170 participants, of which only 3% were receiving OT services. Findings of the study suggested that African Americans with three psychosocial health indicators (lower perceived disability severity, higher social support, and higher self-esteem) could be predicted to have more effective adjustment to disability ( Belgrave, 1991).

Spencer et al. (2002) examined 6-month changes in scores on the Functional Independence Measure (FIM) for 17 African American elders following the transition from rehabilitation to home. Findings showed that 65% of the elders' FIM scores improved. Positive influences on elders' ability to participate in meaningful activities once again were personal values and having several relatives and friends providing caregiving. This finding points to the impact that intrapersonal factors (personal values) and interpersonal factors (multiple caregivers) may have on successful rehabilitation outcomes for this population.

In a large sample of racially and ethnically diverse participants with multiple sclerosis, Buchanan et al. (2010) found African Americans were diagnosed at a later age than their Caucasian counterparts, and that 21.1% of African Americans reported never receiving OT services. Findings of the study suggested that among African Americans, a diagnosis of multiple sclerosis was frequently accompanied by a depression diagnosis ( Buchanan et al., 2010), pointing to complex co-occurring conditions. The studies conducted by Belgrave (1991) and Buchanan (2010) indicate that during the time period they were published, OT services were not always accessed by African Americans who might have needed them. What is not clear is whether this lack of OT use was because services were not recommended, sought out, or accessible in African American communities ( Belgrave, 1991; Buchanan, 2010). It is difficult to draw conclusions about the current state of OT services with African Americans from the above studies because of the elapsed time since their publication ( Belgrave, 1991; Buchanan, 2010; Spencer et al., 2002).

A randomized control trial of African Americans with diabetes and mild cognitive impairment compared an OT behavioral intervention to a community health worker (CHW) educational intervention over the course of 12 months ( Rovner et al., 2020). Findings of the study suggested that there was no significant difference between the two treatment groups (OT vs. CHW); however, glycemic control improved for both groups ( Rovner et al., 2020).

Theoretical Model

The Person-Environment-Occupation-Performance Model (PEOP) was chosen as the theory to frame this study because it can be used to examine the needs of populations for the purposes of promoting their health and well-being. The PEOP addresses how the client's intrinsic factors (cognitive, psychological, physiological, sensory, motor, and spiritual), their environmental extrinsic factors (culture, social determinants of health, social support and social capital, education and policy, physical and natural environments, built-environment, and assistive technology), and their occupations (defined in this model as activities, tasks, and roles) overlap with and influence one another ( Baum et al., 2015). The model is based on general systems theory ( Von Bertalanffy, 1968). It uses a narrative approach (asking clients to tell their stories) with individuals, organizations, and populations, as the client's occupational identity is of particular importance ( Baum et al., 2015). When using this model, the desired outcomes for the client, whether a person, an organization, or a population, are successful participation, performance, and well-being in life ( Baum et al., 2015).

Study Purpose

The purpose of this paper is to highlight the relevance of population-level research with African Americans for informing the practice of OT and to encourage community-based practice. We do this through secondary analysis of data from a national survey of African American men and women. In light of the call for OT to address the needs of populations, and in recognition of the paucity of OT literature addressing the needs of African Americans, the aim of this population-based analysis is to help advance the profession's insight into some of the unique health issues facing the African American adult population and to facilitate community-based outreach to those with disability.

The first research question (RQ1) was: Do African American adults who are RDP differ from those who are FTE in their physical health behaviors and psychosocial health indicators? The corresponding hypothesis (H1) was: African Americans who RDP (occupation) engage in fewer positive physical health behaviors and experience more negative psychosocial health indicators (intrinsic factors) when compared to African Americans who are FTE (occupation).

The second research question (RQ2) was: Do the regional-level characteristics of the RHIAA participants vary between two types of work status: FTE versus RDP? The corresponding hypothesis for this research question (H2) was: There are regional-level differences (extrinsic factors) in African Americans who are RDP versus those who are FTE (occupation) in physical health behaviors and psychosocial health indicators (intrinsic factors).

The third research question (RQ3) was: Do the relationships in RQ1 (i.e., between intrinsic factors: physical health behaviors and psychosocial health indicators) vary regionally among African American adults, and how do the means of physical and psychosocial health indicators among African American adults who are RDP and who are FTE from five different census regions (Middle Atlantic, East North Central, South Atlantic, East South Central, and West South Central) compare? The corresponding hypothesis for this research question (H3) was: There are regional differences (extrinsic factors) in African Americans who are RDP versus those who are FTE (occupation) in physical health behaviors and psychosocial health indicators (intrinsic factors), although there is insufficient previous research or theory to postulate on the specific nature of the proposed regional differences.

As stated previously, the PEOP provides a unique guiding framework for the current study because it can be applied to examine the needs of populations to promote their health and well-being. The PEOP's intrinsic factors (physical health behaviors, psychological factors; referred to in this study as psychosocial health indicators) and extrinsic factors (represented by regional variation in this study) and occupations (employment status) will be addressed in discussing the current study. The focus will be on the interplay of associations between the occupation via employment status, the intrinsic factors of physical health behaviors and psychosocial health indicators, and the extrinsic factors of regional characteristics highlighting differences in the population of African Americans who are RDP and FTE. Since OT works with clients who have mental and behavioral health issues ( AOTA, 2020), this line of research is pertinent to the field of OT. In addition, regional characteristics where one lives or works are equally important for understanding facilitators and barriers to health care accessibility among African Americans and targeted OT needs ( Bissonnette et al., 2012; Knott et al., 2020; Leader & Michael, 2013).

Method

Study Sample

The current study was cross-sectional and used nationwide telephone interviews to collect data. The methodology for the Religion and Health in African Americans [RHIAA] (2020) study has been reported in detail elsewhere ( Holt et al., 2014; Schulz et al., 2017). Briefly, the participants were eligible if they were 21 years of age or older, self-identified as being African American, and were without a diagnosis of cancer in response to cancer screening questions included in the survey. One adult person per household was invited to participate, and those who agreed received a $25 gift card after completing the interview. The study was approved by an institutional review board at the University of Maryland, and the participants provided informed consent.

A total of 12,418 households with landlines were telephoned randomly from a national probability sample, and of these, 10,048 people were successfully contacted. After eliminating those who could not be reached by phone, were not eligible, or were not interested in participating, 3,173 participants completed the telephone interview ( Holt et al., 2014; Schulz et al., 2017).

Study Measures

Intrinsic Factors

The participants' physical health behaviors were assessed using established measures from national epidemiologic studies. Cigarette smoking and alcohol consumption were measured using the Behavioral Risk Factor Surveillance System (BRFSS), which has been shown to have acceptable test-retest reliability in the target population ( r > .70) ( Centers for Disease Control and Prevention, 2009a, 2009b; Stein et al., 1993). Physical activity in the last 7 days was measured by the short form of the International Physical Activity Questionnaire (IPAQ), which has been found to have acceptable validity for use with African Americans ( r = .26 for 10-min, r = .36 for 1-min of physical exercise) ( Craig et al., 2003; Wolin et al., 2008). Fruit and vegetable consumption was measured by a modified version of the National Cancer Institute's Five-A-Day Survey, which has a 2-week test/retest reliability of r > .70 ( Block et al., 1986; Debnam et al., 2012).

The participants' psychosocial health indicators were also assessed using established measures. Depressive symptoms were measured by the Centers for Epidemiological Studies Depression Scale (CES-D), a widely used instrument that has been validated for use with African Americans (Cronbach's α coefficient = 0.89) ( Makambi et al., 2009; Radloff, 1977; Roth et al., 2008). The participants' positive affect and negative affect were measured by the Positive and Negative Affect Schedule (PANAS) ( Watson et al., 1988) with satisfactory reliability and validity (Cronbach's alpha ranging from .86 - .90 for Positive Affect and .84 - .87 for Negative Affect). Finally, the participants' positive and negative religious coping was measured by the Brief RCOPE (Cronbach's α ranging from 0.67-0.94 for Positive Religious Coping; 0.60-0.90 for Negative Religious Coping) ( Fetzer Institute: National Institute on Aging Working Group, 1999; Pargament et al., 2011).

Occupation

During the demographic module of the telephone survey, the participants were asked about their employment status, specifically whether or not they worked for pay outside the home. Their self-reported work status was divided into five categories: FTE, part-time employed, not currently employed, retired, and RDP. Those who were RDP or FTE were chosen for our analytic sample of this paper omitting the other employment categories (part-time employed, retired, not currently employed).

Extrinsic Factors

Regional-level indicators or extrinsic factors were drawn from the 2010 American Community Survey of the US Census. The regional analysis was based on the nine US census regions: New England, Middle Atlantic, East North Central, West North Central, South Atlantic, East South Central, West South Central, Mountain, and Pacific ( United States Census Bureau, 2020). Using the self-reported addresses of the RHIAA participants, we linked the participants first to their census tracts (neighborhoods), and then the census tracts were organized into one of the nine regions. Because of a sample size of less than 30 in either those RDP or those FTE in four of the regions, the final analyses address only five regions. Therefore, we report our findings from the remaining five regions: Middle Atlantic, East North Central, South Atlantic, East South Central, and West South Central. The methodology of assigning the participants with their census tracts and regions, using Geographic Information System techniques, is described in detail elsewhere ( Knott et al., 2020).

We used the following regional-level characteristics: median age reports the median age in years of residents (21 years and above); racial/ethnic diversity is a diversity index that represents the likelihood that two persons, chosen at random from the same region, belong to different racial/ethnic groups (the index ranges from 0 to 100 with higher scores indicating greater diversity); median income and public assistance report the median household income and funds received from public assistance programs in dollars for the past 12 months; percentages of the African American and college-educated (21 years and above) populations in the region were the other two characteristics, further adding to the nuance of regional socioeconomic status.

Analyses

To determine whether or not African American adults who are RDP differ from those who are FTE (occupation) in their physical health behaviors and psychosocial health indicators (intrinsic factors), group means and standard deviations (SD) of the intrinsic factors were compared between work status or occupation using independent sample t-tests.

To examine whether the regional-level characteristics of the RHIAA participants vary between the two types of work status: FTE versus RDP, independent sample t-tests were conducted across each of the five out of nine regions in the US which we are referring to as extrinsic factors. Middle Atlantic, East North Central, South Atlantic, East South Central, and West South Central were compared between the work status or occupation of RDP versus FTE.

To measure whether the relationships between intrinsic factors (physical health behaviors and psychosocial health indicators) vary regionally among African American adults, independent sample t-tests were conducted in each of the five out of nine regions in the US (extrinsic factors). Middle Atlantic, East North Central, South Atlantic, East South Central, and West South Central were compared between the work status or occupation of RDP versus FTE. We also conducted several two-way (between groups) ANOVAs comparing the means of the physical health behaviors and psychosocial health indicators for work status and regions. For each ANOVA, our dependent variable was one of the physical health behaviors and psychosocial health indicators, and the two categorical independent variables were work status (RDP and FTE) and census regions (Middle Atlantic, East North Central, South Atlantic, East South Central, and West South Central). The assumptions for conducting a two-way ANOVA such as the normality of residuals and homogeneity of variance (via Leven's Test) were met and adjusted for where necessary. If a two-way ANOVA indicated that the interaction effect (work status*regions) was statistically significant at p < 0.05, we then conducted TukeyHSD post hoc test for the interaction effects. There were 10 combinations of work status and regions. The interactions post hoc tests compared each pair of these combinations on the means of the physical health behaviors and psychosocial health indicators.

Results

Sample Demographics

Our sample was analyzed for the descriptive characteristics of age (mean and SD), gender, education, marital status, employment, health status, and income by number (n) and percent (%). Of the 3,173 people who participated in the telephone interview across the nine regions, 355 (11.2%) were RDP, and 1,169 (36.8%) were FTE, comprising 48% of the overall sample for a total of 1,524. The remaining 1,630 (52%) of the overall sample were unemployed, employed part time, or retired and were, therefore, omitted from the analytic sample, and 19 participants did not respond. After eliminating participants from the dataset who were residents of the four regions of the US not included in the study because of the numbers in those regions being fewer than 30 in either RDP or FTE, the total analytic sample size was N = 1,381.

Fifty-nine percent of our analytic sample were female; 59% had some college education or more; 40% were currently married or living with a partner; 56% were making more than $30,000 annually; and 76% rated themselves as having good, very good, or excellent health. The participants who were FTE ( M = 3.58, SD = .95) rated themselves as significantly healthier than did the participants who were RDP ( M = 2.41, SD = 1.04), t (1376) = 19.10, p < .001. The baseline characteristics for the analytic sample participants are summarized in Table 1, followed by the distribution of the analytic sample for the five regions in Table 2 and Figure 1.

Table 1.

Variable

Female

818 (59.20)

Male

563 (40.80)

< high school

125 (9.10)

High school / GED

442 (32.00)

> some college

810 (58.70)

Never been married

201 (14.60)

Currently single

272 (19.70)

Separated or divorced

264 (19.10)

Widowed

96 (7.00)

Currently married or living with partner

546 (39.50)

Full-time employed

1052 (76.20)

Receiving disability

329 (23.80)

Poor

70 (5.10)

Fair

255 (18.50)

Good

452 (32.70)

Very good

387 (28.00)

Excellent

214 (15.50)

≤ $30,000

459 (33.20)

> $30,000

769 (55.70)

Table 2.

US Census Divisions

Work Status

RDPa
N (%)

FTEb
N (%)

Total

Figure 1.

Study Area for Regional Analysis

Regional Distribution of Sample

Figure 1 shows the five regions included in our analytic sample (see Appendix A). Table 2 shows the distribution of our analytic sample across the five regions: Middle Atlantic, East North Central, South Atlantic, East South Central, and West South Central.

Among the five selected regions, West South Central had the highest percentage of African Americans who were RDP (37.4%). The East North Central, Middle Atlantic, and South Atlantic all had lower percentages of African Americans who were RDP (21%). In terms of FTE, the participants from regions such as the Middle Atlantic, East North Central, and South Atlantic had higher percentages (79%). The lowest percentage of African Americans who were FTE was from the West South Central (62.6%).

Research Question 1

Results for RQ1: "Do African American adults who RDP differ from those who are FTE in their physical health behaviors and psychosocial health indicators?"

Intrinsic Factors: Physical Health Behaviors

As summarized in Table 3, comparing the physical health behaviors between RDP and FTE, African Americans who were RDP consumed significantly less alcohol ( t = −2.11, p = .04), ate significantly fewer fruits and vegetables ( t = −2.21, p = .03; t = −3.73, p < .001 respectively), and smoked significantly more cigarettes ( t = 5.50, p < .001) when compared to those who were FTE. African Americans RDP also engaged in significantly less walking and moderate to vigorous physical activity ( t = −6.52, p < .001; t = −3.21, p =.001; t = −6.57, p < .000 respectively) when compared to those who were FTE.

Table 3.

Physical Health Behaviors

Work Status

Mean (SD)

t (p-value) c

How many days per week had 1 drink of alcohol in past 30 days

RDPa

.44 (1.23)

FTEb

.66 (1.45)

FTE

1.35 (.48)

FTE

2.42 (1.35)

FTE

2.22 (.95)

FTE

342.79 (395.39)

FTE

181.86 (287.31)

FTE

214.67 (336.78)

Psychosocial Health Indicators

Work Status

Mean (SD)

t (p-value) c

FTE

29.21 (7.98)

Positive religious coping

RDP

10.10 (2.05)

−.92 (.36)

FTE

10.24 (2.07)

FTE

4.09 (1.67)

FTE

38.84 (8.43)

FTE

15.09 (5.66)

Intrinsic Factors: Psychosocial Health Indicators

As also summarized in Table 3, comparing the psychosocial health indicators between the participants who were RDP and those who were FTE, the RDP group had significantly higher depression scores ( t = 11.60, p < .001) and significantly higher negative religious coping scores ( t = 2.65, p < .01) in comparison to the FTE group. African Americans RDP also had significantly lower positive affect ( t = −8.48, p < .001) and significantly higher negative affect ( t = 5.54, p < .001) when compared to the FTE group. There was no statistically significant relationship when comparing FTE and RDP for positive religious coping ( t = −92, p < .36).

Research Question 2

Results for RQ2: "Do the regional-level characteristics of the RHIAA participants vary between two types of work status: FTE versus RDP?"

The above table (see Table 4) indicates that in a given region (one of the nine US Census divisions), the work status of the RHIAA participants of being either FTE or RDP is associated with the regional level variables such that RDP participants are from areas of lower median income ( t = −3.51, p < 0.001), less income from public assistance ( t = −1.97, p = 0.05), a lower percentage of population with higher college education ( t = −1.97, p = 0.05), and a higher percentage of the African American population in the region ( t = −1.77, p = 0.08).

Table 4.

Regional Variables

Work Status

Mean (SD)

t (p-value) c

Median income ($)

RDPa

38,194.01 (7483.33)

FTE b

39,781.24 (7356.40)

Public assistance income ($)

RDP

1514.30 (183.91)

FTE

1537.12 (191.45)

Racial diversity indexd

RDP

35.12 (8.01)

0.02 (0.981)

FTE

35.18 (8.94)

Median age (in years)

RDP

36.00 (0.70)

−1.26 (0.21)

FTE

36.10 (0.91)

College education (%)

RDP

14.53 (1.52)

FTE

16.65 (1.63)

African American (%)

RDP

75.10 (6.35)

FTE

74.52 (8.27)

Research Question 3

Results for RQ3: "Do the relationships in RQ1 (i.e., between intrinsic factors - physical health behaviors and psychosocial health indicators) vary regionally among African American adults, and how do the physical and psychosocial health indicators among African American adults who are RDP and FTE from five different census regions (Middle Atlantic, East North Central, South Atlantic, East South Central, and West South Central) compare?" We took a two-pronged approach to answer this question, first by running independent sample t-tests, and following that with a 2-way ANOVA. Table 5 shows the independent sample t-test of the participants' physical health behaviors and psychosocial health indicators by their work status: RDP and FTE, in each of the five US regions: Middle Atlantic, East North Central, South Atlantic, East South Central, and West South Central.

Table 5.

Physical Health Behaviors

Work Status

Middle Atlantic

East North Central

South Atlantic

East South Central

West South Central

Mean (SD)

tc

Mean (SD)

t

Mean (SD)

t

Mean (SD)

t

Mean (SD)

t

Alcohol

RDPa

1.16 (2.16)

0.05

1.03 (1.74)

−1.27

0.91 (1.71)

1.38 (4.0)

−0.77

1.38 (3.63)

0.01

FTE b

1.14 (1.78)

1.65 (2.86)

1.37 (2.04)

1.89 (3.39)

1.39 (2.05)

Fruits per day

RDP

1.91 (1.38)

2.43 (1.48)

−0.84

2.16 (1.34)

−1.59

2.39 (1.45)

1.16

2.16 (1.30)

Vegetables per day

RDP

1.91 (0.89)

2.09 (0.84)

−0.92

2.07 (0.91)

−1.07

1.87 (0.86)

1.84 (1.00)

Moderate activity

RDP

31.90 (46.46)

−1.08

39.05 (53.87)

−0.82

34.38 (57.58)

−1.11

30.49 (47.04)

−1.3

28.40 (47.44)

Psychosocial Health Indicators

Work Status

Middle Atlantic

East North Central

South Atlantic

East South Central

West South Central

Mean (SD)

tc

Mean (SD)

t

Mean (SD)

t

Mean (SD)

tc

Mean (SD)

t

Depression

RDPa

36.46 (12.90)

38.26 (10.57)

36.14 (11.79)

38.36 (10.51)

38.43 (13.07)

FTE b

29.23 (8.15)

29.86 (7.95)

28.35 (7.33)

30.24 (9.58)

29.98 (7.58)

Negative religious coping

RDP

4.46 (2.03)

0.08

4.56 (1.46)

4.49 (2.37)

4.40 (1.80)

0.56

4.47 (2.36)

1.59

Positive religious coping

RDP

9.80 (2.11)

−0.76

9.67 (2.27)

−0.86

10.20 (2.08)

0.08

10.55 (1.67)

−0.62

10.12 (2.07)

−1.44

Negative affect

RDP

19.24 (8.10)

17.08 (6.86)

1.51

18.20 (7.66)

15.98 (6.41)

0.91

19.17 (8.3)

Among the physical health behaviors, the group means of the participants RDP were lower than the participants FTE for being engaged in physical activities, such as walking and vigorous workouts (scoring limited to 180 min). These differences between the participants RDP and the participants FTE were statistically different in all the regions. Consistently, the African American participants RDP walked less and engaged in less vigorous physical activities than the African Americans FTE for all the regions. The participants RDP consumed fewer fruits and vegetables than the participants FTE in Middle Atlantic, East South, and West South Central regions. Although alcohol consumption, in general, was higher among those RDP than those FTE, the difference in group means in the South Atlantic region was in the opposite direction. In this region, the participants RDP consumed less alcohol than the participants FTE. On the contrary, smoking (another indicator of a negative physical health behavior) was more prevalent among those RDP in the regions of Middle Atlantic, East North Central, and South Atlantic, even when those RDP were engaged in less smoking across all the participants in the study.

The experience of having greater challenges with psychosocial health indicators, such as depressive symptoms and lower positive affect, was consistently evident among those RDP when compared to those FTE in all the regions. The African Americans RDP from the South Atlantic region showed both greater negative religious coping and negative affect than the African Americans FTE. In addition, the participants RDP also showed higher levels of negative religious coping only in East North Central and greater negative affect in Middle Atlantic and West South Central regions.

We also examined the main and interaction effects of work status and regions (residential location) on the physical and psychosocial health indicators among African American adults. Table 6 shows results from a 2-way ANOVA for this analysis. Table 7 provides summary of the regional comparison of means for participants RDP compared to FTE.

Table 6.

Physical Health Behaviors

Work Status

F-value (p-value)

Psychosocial Health Indicators

Work Status

F-value (p-value)

Table 7.

Variables

Comparison of Means RDPa Vs FTEb

Middle Atlantic

East North Central

South Atlantic

East South Central

West South Central

United States

Physical Health Behaviors

Psychosocial Health Indicators

As summarized in Table 6, the main effects of the work status of the African Americans were statistically significant for all the physical health behaviors except for alcohol consumption, indicating that income has a significant positive relationship with maintaining a healthy diet (e.g., consumption of fruits and vegetables) and engaging in physical activities (e.g., walking, exercise). For the African Americans engaged in vigorous physical activity, both the main effects of their work status ( F = 21.24, p < .001) and regional location ( F = 2.88, p < .01) were statistically significant. The level of vigorous physical activity that the African Americans were engaging in was explained by both their income level and their regional location.

Smoking was the only physical health behavior among the African Americans that had a statistically significant interaction between the effects of their work status and regional location (F = 2.67, p < .05). The TukeyHSD post hoc test for the interaction effects revealed nuanced statistically significant interaction combinations. In general, the African Americans who were RDP smoked significantly more cigarettes when compared to those FTE (see Table 3). Specifically, the combination of African Americans who were RDP and living in the Middle Atlantic region smoked more cigarettes than the African Americans FTE and from the regions of South Atlantic ( mean difference = −0.31, p = .01) and East South Central ( mean difference = −0.35, p < .05). Similar were the effects of the combinations of African Americans who RDP from the East North Central region compared to African Americans with FTE from the South Atlantic and East South Central regions. The African Americans who were FTE and lived in the Middle Atlantic region smoked fewer cigarettes than those FTE living in the East North Central ( mean difference = 0.18, p < .05) but more than those FTE living in the South Atlantic region ( mean difference = −0.18, p < .01).

The main effects of the work status of the African Americans were statistically significant for all the psychosocial health indicators, indicating that income has a significant relationship with depression, religious coping, and affect (see Table 6). For depression alone, both the main effects of work status (F = 187.20, p < .001) and regional location (F = 5.48, p < .001) were statistically significant, indicating that both these factors significantly interact with depressive symptoms among African Americans.

Discussion

The purpose of this paper was to highlight the relevance of population-based research with African Americans for informing the practice of OT and to encourage the development of a more diverse workforce. To do so, we examined the intrinsic factors of physical health behaviors and psychosocial health indicators comparing the occupations of African Americans RDP versus African Americans FTE using the extrinsic factors of study participants' regional context. The results of this study suggest, with the exception of drinking alcohol, that African Americans who are RDP are more likely to engage in adverse health behaviors and less likely to engage in health-promoting behaviors compared to those FTE, which may or may not be a result of their disability. Regarding physical activity, it is plausible that the African Americans RDP would be less physically active than the African Americans FTE, since living with a disability could impede engagement in physical activity, whether the disability is physical, behavioral health, cognitive, and/or developmental in nature. African Americans who were RDP also reported eating a less healthy diet and having worse psychosocial health than those in the FTE group. This points to African Americans having differential access to healthier food choices that could be because of the SDoH of food insecurity or economic instability.

Geospatial variations emerged as well, with African Americans in some regions of the country exhibiting lower levels of physical health behaviors and psychosocial health indicators than others. These variations may be the result of regional differences in income, education level, and racial diversity, as well as irregularities in the implementation of health behavior policies and interventions, such as smoking restriction and/or bans. Future research should examine the mechanisms underlying regional differences.

The findings from this study and prior research using the same sample of RHIAA study participants are relevant to the issue of a need for population-based community-based OT practice addressing the needs of African Americans. It is in the scope of practice of OT to address the needs of populations, health management, social participation, and the social context; also, participation in religious activities, the client factor of spirituality, the performance patterns of habits, and clients' physical and emotional functioning ( AOTA, 2014, 2020). For example, findings from prior studies with RHIAA participants suggested that positive health behaviors and negative health behaviors, or the lack thereof, including fruit and vegetable consumption, physical activity, alcohol consumption, and smoking, were influenced by religious involvement and the social context for African Americans ( Holt et al., 2013). These positive and negative health behaviors can be considered as habits in OT terminology ( AOTA, 2020), which we suggest can be cultivated or extinguished through OT community-based programs. Regarding religious involvement relative to health behaviors, in some cases, women responded differently from men ( Holt et al., 2015). Education level was a predictor for health behavior choices and intrinsic emotional well-being in African Americans ( Park et al., 2019). When we looked at the regional variations of positive and negative health behaviors among African Americans, socioeconomic status indicators of regions such as income, educational level, and race were also the strongest predictors ( Knott et al., 2020).

The findings from this current study point to a role for employment status and regional characteristics in shaping African Americans' physical health behaviors and psychosocial health experiences. For example, findings suggest that African Americans who RDP live in regions with lower median income, lower public assistance income, less college education, and a higher percent of African Americans when compared to their African American counterparts FTE. This suggests that fewer financial and educational resources are available to African Americans RDP regionally, again pointing to the social determinants of health of "economic stability" and "education access and quality" as contributing factors.

Relative to the PEOP model, findings suggest that the occupational identity of being employed may be important in African Americans for engagement in positive physical health behaviors. Perhaps this may stem from people who are employed being able to afford to live in areas with better access to healthier food choices and safer physical activity options (the social determinant of health "neighborhood and built environment"), unlike those who are low-income or lacking income ( Park et al., 2020). African Americans RDP are lacking the occupational identity of being an employed person, and this study suggests that this could have deleterious effects on their health ( Evans et al., 2020; Ricks et al., 2020). This evidence is supported by the extant literature suggesting that negative behavioral health outcomes are protected by people being engaged in full-time employment, living in regions with a high average household income, having access to support from public assistance programs, and living in regions comprised of individuals with high levels of education and racial diversity ( van der Noordt et al., 2014). These protective factors are addressed by the social determinant of health "economic stability."

The issue of employment status for African Americans becomes further compounded by the intersection of disability and race ( Alston et al., 1996). Research suggests that African Americans with disabilities often face disparities when compared to African Americans who do not have a disability ( Mpofu & Harley, 2006). These disparities need to be clearly articulated, better understood, and systematically addressed by occupational therapists and health care providers ( Hall, 2020; Miranda et al., 2020) not only at the individual client level but also from a regional perspective.

The socioeconomic context of neighborhoods (indicated either by demographic data from census tracts or regions as shown in this study) appears to play an important role in the health behavior of African Americans RDP. It is interesting to note that African Americans from certain regions of the country are less likely to engage in positive physical health behaviors and experience fewer positive psychosocial indicators than other populations in the same region. This research finding is important because of the health disparities between African Americans and White Americans ( Buis et al., 2019; DeSantis et al., 2016; Pan et al., 2019; Yoon et al., 2019). In general, African Americans RDP do not fare as well as those FTE in their health and level of income. Minorities, such as African Americans, tend to earn less money than their White American counterparts ( Assari et al., 2020). Physical health and mental health in African Americans with disabilities are negatively influenced by financial concerns ( American Psychological Association, 2020; Assari et al., 2020).

Evans et al. (2020) suggest that among older African Americans "financial difficulties seem to be linked to chronic pain, chronic medical conditions, self-rated health, sick days, and depressive symptoms" (p. 1). Since the social determinants of health of "economic stability," "education access and quality," and "neighborhood and built environment" were factors that appear to influence the findings of this study, the authors call for further exploration into how social determinants of health affect African Americans and suggest that providers address financial, educational, and regional issues with this population for health promotion. Occupational therapists should capitalize on their awareness of regional and associated socioeconomic variations and develop local programs leveraging the profession's unique skill set; targeting holistic occupation-based needs; and facilitating the healthy habits, routines, and coping skills of African Americans RDP at a population level.

Limitations

The data used in this study were collected via a telephone survey and are subject to self-report bias, socially desirable responses, and issues with recall memory. Landlines were used, rather than a combination of cell phones and landlines, resulting in a sample that was somewhat older than the national population; therefore, there may be some generational bias. Another limitation is the cross-sectional nature of this analysis. We cannot make any inferences about the participants' work status causing their physical health behaviors and psychosocial health indicators, or temporal inferences regarding which came first.

Implications for Future Practice, Education, and Research

For African Americans RDP, occupational therapists could develop community-based programs for increasing healthy eating and physical activity and promoting smoking cessation for the purposes of health management ( AOTA, 2017, 2020), especially in certain regions of the country. Occupational therapists could also develop group and population-level community-based programs addressing increasing positive affect and positive coping strategies for primary prevention ( AOTA, 2017). Occupational therapists could also work with gyms or fitness centers to offer workout equipment accessible to individuals who use wheelchairs and programs that make healthy physical exercise more readily accessible to those with disabilities.

To develop such programs, occupational therapists should conduct a needs assessment, keeping in mind the regional factors that may be associated with the intrinsic factors, occupations, and experiences of successful participation, performance, and well-being in the lives of African Americans with disabilities ( Baum et al., 2015). Such projects could be incorporated into entry-level OT programs when teaching students about issues facing specific populations, including African Americans with disabilities.

Regarding educational implications, teaching students how to conduct population-based needs assessments and how to develop programming that targets the specific occupational needs of African Americans (or other minorities) with or without disabilities would be a good approach. For entry-level occupational therapy clinical doctorate (OTD) programs, this also could be the basis for an OTD capstone project.

Similarly, population-based research on the occupational needs, health disparities, health inequities, and occupational injustices facing the African American community is important. Research involving gatekeepers to the African American community and incorporating community health advisors to deliver health and occupation-based content is one suggested approach. Meeting people in their communities, using their strengths and resources, facilitating resilience, and listening with a sincere desire to understand and to be of service to them will go a long way in building a rapport while at the same time providing opportunities to study and find ways to address occupational injustices at a community-based level.

Conclusion

This study reinforces the importance of population-based research in OT, addresses a gap in the OT literature, uses the unique lens of the PEOP model, and provides a foundation for building community-based practice with the African American population. This study demonstrates that population-based research can inform the profession of OT. Very little OT research has focused on the needs of African Americans. This study provides valuable information for occupational therapists serving African American clients and demonstrates that they have specific needs as a population. Breland and Ellis (2012) suggest that occupational therapists should report race and ethnicity in their research to facilitate an understanding of the diverse clients we serve. However, to date, no study has considered regional differences in OT resources. The population-based research described here can serve as a catalyst for the development of population-specific programming and a community-based practice and practice model to address the needs of African American clients.

Acknowledgments

The team would like to acknowledge the work of Tina Madison and Opinion-America, who conducted participant recruitment, retention, and data collection activities for the current study. The first author would like to thank Celia H. Schulz, PhD, OTR, for inspiring some of the initial concepts of this paper. This research was supported by a grant from the Duke University Center for Spirituality, Theology, and Health, through the John Templeton Foundation (#11993) and grants from the National Cancer Institute (#1 R01 CA 105202; #1 R01 CA154419). The study was approved by the University of Maryland Institutional Review Board (#373528-1).

Footnotes

The authors have no disclosures to report.

Contributor Information

Emily Schulz, Northern Arizona University - USA.

Debarchana Ghosh, University of Connecticut - USA.

Eddie M. Clark, Saint Louis University - USA

Beverly R. Williams, University of Alabama at Birmingham - USA

Randi Williams, Georgetown University - USA.

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# data[].attributes.attachment_link.title
Disability and Health in African Americans: Population Research and Implications for Occupational Therapy Community-Based Practice

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Population-based research and community-based interventions are integral to occupational therapy's scope of practice, yet they are underdeveloped in actual implementation. Therefore, this paper focuses on some health challenges facing the African ...

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 15.5 Psychological Adaptation and Mental Health Discussion

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 15.5 Psychological Adaptation and Mental Health Discussion

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1. What is the role of the Black Church and the mental health of the African American community?

The role of the black church and mental health of the black community is to provide a safe space. Many African Americans seek spiritual guidance and counseling within the church, which offers a stigma-free zone for discussing personal struggles.

2. How is culturally competent care vital to the success of the mental health relationship between the provider of clinical mental health services and the African American community?

It is vital for effective communication, understanding African American vernacular, traditions, and worldview helps providers connect better.

3. State THREE strategies that you feel can address the issues raised in questions one and two.

Three strategies that I feel can address these issues are community collaboration, provider training and accessible resources.

4. Search online for a resource that helps you understand this topic more and post it to your Padlet. State why the resource shines some light on a perspective of this issue.

https://genderjusticeandopportunity.georgetown.edu/wp-content/uploads/2020/06/Mental-Health-and-Communities-of-Color.pdf

This resource dives into disparities, stigma, and systemic barriers faced by African Americans in mental health. It also offers culturally specific strategies for improving access and care.

5. State one thing that you learned or one thing that stood out to you from the unit required reading, optional reading or audio material in this unit.

How the legacy of systemic racism in healthcare continues to impact African American mental health outcomes today.

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16.3 Final Recording of Film Analysis Presentation

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16.3 Final Recording of Film Analysis Presentation