2022 Black History Month Theme: Black Health and Wellness throughout the African Diaspora

The Journal of Health Care for the Poor and Underserved is happy to join in the celebration of Black History Month 2022 with its theme of Black Health and Wellness throughout the African Diaspora. In this Note, I will highlight papers from the current issue fitting this theme.

The distribution of physicians of color—specifically Black surgeons and international medical graduates (IMGs) from the seven countries on the Trump travel ban list—came under the spotlight of Imam Xierali and Mark Nivet. They employed withdrawal mapping in the theoretical foundation of spatial accessibility to identify what regions of the U.S. would be most affected if those physicians were withdrawn. For Black surgeons, the effect would be felt most in predominantly Black areas. As the authors write, "The spatial analysis results suggest that areas in the South with a higher percentage of Black residents, urban areas on the East Coast, and Midwestern states are more dependent than the rest of the nation on Black surgical specialists for spatial accessibility to surgical care." The region most affected by the withdrawal of the travel-ban IMGs would be the Midwest. Recognizing these patterns can help shape policy with respect to increasing the numbers of physicians of color.

Turning to the larger diaspora, Eappen et al. report on interviews with providers for 126 survivors of the Boka Haram (Borno State, Nigeria) abductions and human trafficking. They detail the physical, mental, and social challenges the survivors faced when they were held captive, and how the providers employed a holistic model of care in treatment.

Two other papers put a much wider lens on health in the African Diaspora. Oleribe et al. report the epidemiology of COVID-19 in Nigeria in the first year of the pandemic, employing the data from the Nigerian Center for Disease Control. The second paper examines the distribution of cholera worldwide analyzed into temporal fragments and spatial regions. The regions most affected by cholera over time were several regions in Africa, Haiti, and South Asia.

Flint, Michigan became synonymous in 2014–2019 with drinking water contaminated by lead. In this issue, Wierda and Amini use survey data from 1,825 adults in Michigan and logistic regression to assess changes in consumption of soda, juice, and other sugar-sweetened drinks before and after the crisis. While consumption increased after the crisis, it increased much more among African Americans than Whites. The authors note that "the context of the FWC [Fline water crisis] made this a time when mistrust in local government messaging might have been a factor."

Two papers concerning Black/White cancer disparities concern us next. Shabani and colleagues review the literature on head and neck squamous cell carcinomas. They summarize by saying the African American patients are diagnosed younger, present with a higher tumor burden, are less likely to receive definitive treatment, and have increased mortality relative to Whites. Importantly, the authors note that all these conditions are reversible. Crittendon, LaNoue, and George compared the clinical care of Black and White men relating to prostate specific antigen (PSA) screening, using the large Behavioral Risk Factor Surveillance System data set. The found that perceived racism and its interaction with race was not significantly associated with any PSA outcomes. However, they also found that Black men were significantly less likely than White men to be advised of potential benefits and harms of PSA screening.

The paper, "Positive Depression Screening at the First Prenatal Visit in a Low-Income Primarily Black Population," by Edwards et al. emerges from a larger effort to improve prenatal care in areas where there are wide infant mortality disparities. The depression screen administered to the 500 patients studied through chart review revealed an extremely high rate of depression among this primarily Black group of low-income mothers. The authors argue that decreasing the disproportionately high infant mortality rates in this population depends in part on incorporating mental health care as part of prenatal care.

Finally, in the clinical area, we would like to mention the paper by Bransden, Hernandez, Mangels, and colleagues on echocardiograms of Haitian...