Posted March 8, 2023

By Jordan J. White, DrPH, MSW
Assistant Professor
Bachelors of Social Work Department
School of Social Work
Morgan State University

In the 1990s, I witnessed several community members and relatives pass away from HIV/AIDS. These experiences piqued my interest in the role of social networks, assets, and resources in health promotion in minority communities. Family members (grandparents, parents, uncles, aunts, siblings) , many of whom attended Historically Black Colleges and Universities (HBCUs), supported my interests.

I am a tenure-track Assistant Professor of Social Work at Morgan State University in Baltimore, Maryland. I am also an NIMHD Diversity Supplement awardee. I have worked in HIV prevention and community health across government, academic, corporate and community-based settings for the past decade. My Diversity Supplement has allowed me to better understand gaps in HIV care as well as strategies to address COVID-19 and Mpox (formerly known as monkeypox) vaccine hesitancy among sexual minority men.

In 2019, I was honored to become the first graduate of the Lesbian, Gay, Bisexual, Transgender and Queer Public Health Certificate Program from the Johns Hopkins Bloomberg School of Public Health, due to my longstanding interest in sexual minority health.

My main research interests focus on advancing the health and wellbeing of populations experiencing disadvantage, particularly Black and Latino sexual minority men, in the United States. While there are many inequities and health disparities that urgently need to be addressed among these populations, HIV continues to be one of the most complex. The research for my supplement was primarily conducted during the COVID-19 pandemic and Mpox outbreaks of 2022 and 2023. Black and Latino sexual minority men were two of the most affected demographic groups. A key lesson or theme from this ongoing work is the need to encourage communication between providers and patients to promote healthy sexual practices within shifting health, clinical, and sociocultural contexts.

My research has primarily focused on HIV prevention, treatment and care among these populations. I have used qualitative and quantitative methodologies to explore factors that promote health and resilience among these populations. I have engaged hundreds of Black and Latino sexual minority men in qualitative and survey research over the past decade. Anecdotally, my research during the COVID-19 pandemic and Mpox outbreak period (2020-2023) documented some of the most intersectional, challenging, and dire outcomes that I have ever encountered. One example is how Black and Latino sexual minority men are less likely to be virally suppressed than White sexual minority men, thus leading to worse Mpox outcomes.

My hope is that some of these findings and counter-narratives may help to address gaps in our knowledge of resilience and its multi-level determinants among Black and Latino sexual minority men. Future resilience-based public health interventions, policies and practices for these populations are critical to increasing health equity.

HIV continues to have a devastating impact on Black and Latino sexual minority male populations throughout the United States. The persistently high community viral load and gaps in retention in care are increasingly recognized as contributing factors to these HIV-related racial disparities. Viral suppression rates are high among Black and Latino sexual minority men who are engaged in care. Many Black and Latino sexual minority men are living with stress and stress-related comorbidities that exacerbate HIV-related racial disparities. Psychosocial approaches emphasize that subjective experiences can produce acute and chronic stress which affect physical and mental health outcomes. For some sexual minority populations, the house and ballroom community are considered sources of resilience and social support that protect members from various stressors. Understanding how a disproportionately affected subpopulation of Black and Latino sexual minority men adjust or readjust to stressors can inform future behavioral resilience interventions and may help reduce HIV-related racial disparities.

Receiving the NIMHD Diversity Supplement funding was invaluable to my research. It has allowed me to conduct primary data collection, analysis, build my research program, and provided pilot data that I hope will inform future NIH grant applications. It also has fostered collaboration between Morgan State University and the Johns Hopkins Bloomberg School of Public Health.

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Dr. Jordan White is an Assistant Professor of Social Work at Morgan State University in Baltimore, MD. He is trained as a public health and social work scientist. Dr. White’s research and practice are centered on understanding and addressing health disparities and inequities among minority populations particularly sexual minority men in the United States.

Posted on February 28, 2023

NOTE: For Black History Month, NIMHD Insights is reposting this piece with permission from the National Library of Medicine’s blog, Musing from the Mezzanine.

By Triesta Fowler, M.D.
Scientific Diversity Officer, National Institute on Minority Health and Health Disparities

Monica Webb Hooper, Ph.D.
Deputy Director, National Institute on Minority Health and Health Disparities

In honor of Black History Month 2023, we are highlighting positive and protective factors that raise awareness of and show appreciation for the myriad of cultural and community strengths that facilitate safe spaces, where the health of children and adolescents can be fortified and maintained.

“It takes a village” is a proverb that has been attributed to African cultures. For example, in Lunyoro—the language of Bunyoro, a Bantu kingdom in Western Uganda—“Omwana takulila nju emoi,” means “A child does not grow up only in a single home.” The idea behind the proverb is that although parents have the primary responsibility for raising children, the “village,” or their community, also plays an important role in how a child is raised. It is a longstanding belief that the community should and can create a safe and healthy environment in which the child grows. This belief in the power of community is an important component and strength of African American culture.

Members of the village become part of a redefined extended family that share a common culture, values, and customs. These members may include other relatives, close friends, neighbors, and a trusted religious community. These connections have been defined as “fictive kin,” or people who reinforce and extend the familial bonds beyond a biological relationship.

One area that is impacted by the village concept is caring for children, which becomes a shared responsibility across all the members of the fictive kin. Parents and their children are given the opportunity to be supported by and connected to additional community resources and to gain an increased awareness and access to what is available in the community, including opportunities to enhance a child’s learning and developmental processes. The village can also have positive effects on a child’s well-being and physical and mental health. Indeed, the social support and perceptions of cohesion in such neighborhoods are related to fewer symptoms of anxiety and depression.

As children grow up surrounded by fictive kin, they develop their own sense of community and connection to their village. Conscious community-building can also spark a sense of responsibility to give back to the community and its members beyond any personal benefit. This sense of community consists of four components: a sense of belonging, a belief that you can make a difference in your community, a feeling that needs will be met through the resources provided by the community, and an emotional connection that results from shared experiences.

This emotional connection can help address the feeling of isolation that may arise from the pressures of society such as systemic racism, and surrounding children with people who share these experiences help can increase positive coping skills and reduce mental health concerns. That is, the community has the power to act as a buffer and offer needed protection to children and adolescents.

For generations, the idea of “it takes a village” has been at the center of African American culture because it creates an environment of love, support, and protection for all its children. It highlights the belief that the environment provided by the extended family gives children the best start in life and is an investment in their future. This concept will never grow old and is something that everyone from all cultures can actively support.

During Black History Month and beyond, we encourage advocates for holistic physical and mental wellness to learn more about the importance of community-level social support—the village—and fictive kin.

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Dr. Triesta Fowler leads NIMHD diversity, equity, inclusion, and accessibility efforts in collaboration with NIMHD leadership and staff. She was previously a medical officer and Director of Communications and Outreach within the Division of Intramural Research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) leading key diversity activities. She began her work in diversity outreach and engagement at NICHD in 2007 as the director and creator of The National Child and Maternal Health Education Program.

Dr. Monica Webb Hooper is an internationally recognized translational behavioral scientist and licensed clinical health psychologist. She has dedicated her career to science that benefits and serves communities with a focus on chronic illness prevention and health behavior change. Her overarching goal is to do the work necessary to produce meaningful, positive change and assure health equity. Before joining NIMHD, Dr. Webb Hooper was a tenured Professor of Oncology, Family Medicine & Community Health, and Psychological Sciences at Case Western Reserve University and Associate Director for Cancer Disparities Research at Case Comprehensive Cancer Center.

Posted on February 22, 2023

By Shelly Pollard, MBA
NIMDH Insights Blog Editor
National Institute on Minority Health and Health Disparities

At NIMHD, we have the privilege of sharing informative and thought-provoking blog posts with our subscribers each month. In case you missed some of the highlights from last year, here is a list of the top five most popular blog posts for 2022.

1. The COVID-19 Pandemic Has Amplified the Effects of Racism on Mental Health
2. HDPulse: A Comprehensive Resource to Access Health Disparities Data and Minority Health Resources
3. Community Organizations Lead Structural Interventions Research with Novel NIH Initiative
4. Striving Towards Health Equity: Understanding the Impact of Discrimination on LGBTQ+ Communities
5. A Different Kind of Leader

For 2023, the NIMHD Insights blog has a new address and a brand-new look and feel. The blog will continue to tell stories about research, resources, people, and NIMHD-supported funding mechanisms, making the science relatable and engaging to readers. Please bookmark the new NIMHD Insights homepage https://blog.nimhd.nih.gov/ and stay tuned for more!