Pathways to biomedical careers are not being pursued with equal vigilance among all students. Emerging research shows that historically underrepresented (HU) students who maintain a strong science identity are more likely to persist. However, the influence of social support on persistence is less studied, especially as it relates to science identity among doctoral students. To fill this gap, a 1-year study to assess similarities and differences among 101 HU and majority biomedical doctoral students was conducted to measure the extent to which 1) they report equivalent experiences of social support, science identity, and intentions to persist; 2) their experiences of social support predict intentions to persist 1 year later; and 3) science identity mediates the relationship between social support and intentions to persist in biomedical career pathways. Data were collected using online surveys. Results indicated that science identity significantly mediated the relationship between professional network support and persistence a year later for majority students. In contrast, for HU students, science identity mediated the relationship between instrumental, psychosocial, friend and family support, and persistence a year later. These study results provide evidence that reinforcing mentoring programs and support systems will be beneficial, especially for HU students.

Background: This qualitative study was designed to assess health care volunteers’ experiences and psychosocial impacts associated with deployment to the West Africa Ebola epidemic. Methods: In 2015, using snowball sampling, 16 US health care volunteers who had recently returned from West Africa were recruited for this study. Semi-structured interviews were conducted to collect information associated with each phase of deployment (pre, peri, and post). Results: Participants reported that they were motivated to volunteer because of a sense of responsibility and feelings of empathy and altruism. Immediately prior to deployment, most reported fear of contagion and death, as well as doubts regarding the adequacy of their training. Family members and close friends expressed high levels of concern regarding participants’ decisions to volunteer. During the deployment, participants were fearful of exposure and reported feeling emotionally and physically exhausted. They also reported feeling frustrated by extreme resource limitations, poor management of the mission, lack of clearly defined roles and responsibilities, and inability to provide high quality care. Upon return home, participants felt a sense of isolation, depression, stigmatization, interpersonal difficulties, and extreme stress. Conclusion: Preparedness of volunteers was suboptimal at each stage of deployment. All stakeholders, including volunteers, sponsoring organizations, government agencies, and professional organizations have a shared responsibility in ensuring that volunteers to medical missions are adequately prepared. This is especially critical for high risk deployments. Effective policies and practices need to be developed and implemented in order to protect the health and well-being of health care volunteers to the fullest extent possible.

Black immigrants represent a growing share of the immigrant population in the United States and may face unique barriers to health insurance coverage. Using microdata from the 2017-21 American Community Survey five-year estimates, supplemented by an imputation of documentation status, we compared Black immigrants with their US-born Black and US-born and immigrant White, Latino, and Asian American and Pacific Islander (AAPI) counterparts. We found that Black immigrants had higher uninsurance rates than almost every other group except non-Black Latino immigrants. After covariates were controlled for in multivariable regression models, Black immigrants had 9 percent higher odds of being uninsured when compared with US-born White people. There were no significant differences in adjusted insurance rates between US-born White and Black people. Non-Black Latinos had notably high odds of being uninsured, with US-born Latinos experiencing a 31 percent higher likelihood of lacking coverage and Latino immigrants reporting more than double those odds. US-born people and AAPI immigrants reported significantly lower odds of being uninsured. We offer suggestions to community organizations and program planners to improve health insurance coverage among Black immigrants.

The populations impacted most by COVID are also impacted by racism and related social stigma; however, traditional surveillance tools may not capture the intersectionality of these relationships. We conducted a detailed assessment of diverse surveillance systems and databases to identify characteristics, constraints and best practices that might inform the development of a novel COVID surveillance system that achieves these aims. We used subject area expertise, an expert panel and CDC guidance to generate an initial list of N > 50 existing surveillance systems as of 29 October 2020, and systematically excluded those not advancing the project aims. This yielded a final reduced group (n = 10) of COVID surveillance systems (n = 3), other public health systems (4) and systems tracking racism and/or social stigma (n = 3, which we evaluated by using CDC evaluation criteria and Critical Race Theory. Overall, the most important contribution of COVID-19 surveillance systems is their real-time (e.g., daily) or near-real-time (e.g., weekly) reporting; however, they are severely constrained by the lack of complete data on race/ethnicity, making it difficult to monitor racial/ethnic inequities. Other public health systems have validated measures of psychosocial and behavioral factors and some racism or stigma-related factors but lack the timeliness needed in a pandemic. Systems that monitor racism report historical data on, for instance, hate crimes, but do not capture current patterns, and it is unclear how representativeness the findings are. Though existing surveillance systems offer important strengths for monitoring health conditions or racism and related stigma, new surveillance strategies are needed to monitor their intersecting relationships more rigorously.