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Black Americans’ COVID vaccine hesitancy stems more from today’s inequities than historical ones

UCLA study urges medical community to pursue changes that build better trust

Woman receives vaccine shot

Centers for Disease Control and Prevention


Holly Ober | October 27, 2022

Key takeaways:
• Doctors and distrust.
Black Americans are more likely than whites to report poor interactions with their physicians.
• Not history but here and now.
These personal experiences — rather than wrongs of the past — tend to heighten their distrust of the health care system and lead to skepticism about COVID-19 vaccines.

Early in the COVID-19 pandemic, the vaccination rate in the Black community lagged well behind that of whites, a gap many in the media speculated was the result of fears based on historical health-related injustices like the infamous Tuskegee Syphilis Study.

But new research by UCLA psychologists shows that vaccine hesitancy and mistrust of medical professionals among Black Americans may hinge more on their current unsatisfactory health care experiences than on their knowledge of past wrongs.

The findings, the researchers say, clearly illustrate the need for both broad and specific changes within the medical community to improve experiences and build better trust with Black patients. The research is published in the journal Health Psychology.

“History is important, no doubt, but Black Americans do not have to reach into the past for examples of inequity in health care — many have experienced it themselves,” said Kimberly Martin, who led the research as a UCLA doctoral student and is now a UC President’s Postdoctoral Scholar at UC San Francisco.

In the first of two studies, Martin and her UCLA colleagues surveyed approximately 300 Black and white participants in December 2020, just as vaccines were becoming available. Black respondents expressed less trust in medical professionals and reported significantly less positive experiences with the health care system than their white counterparts. They were also less likely to report an intention to get vaccinated.

Participants were also queried about their familiarity with the 1932–72 Tuskegee Syphilis Study, in which the U.S. government studied Black men with syphilis without their informed consent and intentionally withheld treatment, leading to medical complications, fatalities and transmission of the disease to family members. Some 66% of Black participants and 62% of white participants said they were familiar with the study, though Black participants generally knew more about it. Familiarity, however, was not associated with greater medical mistrust or vaccine hesitancy in either group, the researchers found.

Ultimately, the authors concluded, Black respondents’ trust in medical professionals had been undermined by a lack of positive health care experiences, contributing to a hesitancy to get vaccinated.

“A damaging narrative suggested in popular media has been that Black Americans were less likely to want a COVID-19 vaccination primarily because of the Tuskegee study,” said Martin, who along with her co-researchers found that the study had been mentioned 168 times in TV news reports on vaccine hesitancy between October 2020 and November 2021. “However, Tuskegee is only one of many relevant historical examples of medical mistreatment toward Black Americans, and this framing completely disregards current inequity and injustice in health care.”

Co-author Annette Stanton, a distinguished professor of psychology at UCLA, said implications that Black Americans can and should “get over the past” as a means to reducing health inequities are not only offensive but misguided, given the findings.

“The findings point to Black Americans’ present-day experiences in the medical system as an important factor among multiple contributors to inequities, and physicians and health systems can indeed take action to improve these experiences,” she said. “Respectful, competent and caring medical professionals can be agents of change.”

A second study, conducted several months after the first, surveyed a nationally representative sample of more than 12,750 Black and white Americans and found no statistically significant racial difference in the proportion of those who had been vaccinated or were intending to get vaccinated. But once again, Black participants reported less medical trust than whites. Black respondents also reported feeling less cared-for by their physicians than white respondents, which the researchers said contributes to lower levels of trust.

Among those who were not yet vaccinated, both Black and white participants who had less trust in the medical community and felt less cared-for by their personal physician were also less likely to report an intention to get vaccinated.

The current studies add to an extensive body of research showing that Black Americans have worse health care experiences than whites. And while the vaccination gap between Blacks and whites has decreased, issues of inequitable treatment and medical mistrust remain and need to be addressed in the context of present-day experiences, the researchers emphasized.

“Characterizing race-related disparities in health care experiences as a relic of the past excludes current medical experiences and absolves the current health care system from making needed change,” said co-author Kerri Johnson, a UCLA professor of communication and psychology.

Johnson and the other authors said that going forward, health care professionals and researchers need to identify and implement changes that could provide Black Americans with more equitable and satisfying health care experiences.


This article originally appeared in the UCLA Newsroom. For more news and updates from the UCLA College, visit college.ucla.edu/news.

Keeping Our First Responders in LA County Hospitals Safe

A photo of a first responder receives safety glasses and goggles.

A first responder receives safety glasses and goggles. (Photo Courtesy of UCLA Department of Chemistry and Biochemistry)

The Department of Chemistry and Biochemistry, spurred on by Professor Neil Garg, donated hundreds of safety glasses and goggles to help keep first responders in Los Angeles County hospitals safe. The distribution, orchestrated in a single weekend, was a way to express thanks to the selfless medical personnel in Los Angeles.

This post originally appeared on the Department of Chemistry and Biochemistry’s Facebook.

A photo of a student meditating during a break.

UCLA Students Find COVID-19 Silver Linings

Commentary on mindful awareness training by Sara Melzer, Professor Emerita of French & Francophone Studies:

Surprising as it may sound, some of my UCLA students are finding meaning during the pandemic. One student reports: “I’m excited at the inner changes this quarantine is bringing out in me.” Almost all the students are discovering that their lives are fuller than they had realized – when they re-direct their attention. This training is the work of a mindful awareness.

Mindfulness is not necessarily spiritual or mystical, although it can be. Mainly, it trains our most fundamental faculty: our attention. If skillfully cultivated, our attention can dramatically transform our experience and promote well-being, even during a crisis. This claim may seem astonishing because we are not taught to value our attention, even though it is the ever-present background to all thought and experience.

Mindfulness highlights the vast potential of this resource. Our attention is a muscle — a mental muscle that needs to be trained, just as athletes train their bodies, insists Shinzen Young, founder of Unified Mindfulness and my teacher for 20 years.

My students experienced the power of their attention to transform their relationship to pain in a class experiment where I had them hold ice-cubes in one hand, for two rounds. In round one, I offered no guidance and they relied on their standard coping strategy. After five minutes, they were in agony. In round two, I guided them to hold the ice mindfully. One student reported, “I felt blissfully calm. I could have held the ice forever.”

What made the difference? Their attention – what they focused on and how. In the first round, they tightened their bodies and narrowed their lens to block the pain. This mental image, a cortical homunculus, simulates the brain mapping the body from the inside: hands swell up like balloons and dwarf the body.

A photo of a student meditating during a break.

A student meditating during a break. (Photo Credit: Christian Ibarra)

Their hand defined their whole body. When we are in pain, physical or emotional, we often identify with the ailing part and let it become the whole.

Alternatively, we can re-frame our attention. I invited my students to expand their focus beyond their hands to include their feet, where they noticed pockets of calm.  I activated their attention’s telescopic lens when I had them zoom their awareness out, first to sounds inside the room, then outside, before extending to the silence beyond. While they felt their hands throb, they simply included it within a wider attentional field. The impact of the ice was diffused. Just as a few drops of red dye can define the water’s color in a fish-bowl, but not in a lake, my students could dilute and transform their experience of pain by enlarging their attentional frame.

The momentary shift of attention is actually not the hard part. Keeping it there is. To achieve this, Unified Mindfulness emphasizes sensory clarity as a key attentional skill. It can open up our awareness to a fascinating “something” within the seeming “nothing” of our ordinary experience. Take the breath, for example. Using a microscopic lens, we zero in on the outbreath to notice a subtle release of air. Other forms of release – in the jaws, shoulders, rib cage – ripple out. This inter-connectedness is a source of wonder.

Sensory clarity helps anchor our attention because our sensory world becomes more richly layered and attention-grabbing.  One student wrote, “I invited my family to join me in my mindful eating exercise. For desert, we had grapes — just ordinary grapes. They exploded with extraordinary taste sensations. Waves of sweetness, then sourness rippled out towards my ears, then throughout my whole body. It was so satisfying I almost felt full.” When we tune into the nuanced layers of something as ordinary as an exhale or a grape, any experience can anchor our attention and nourish us.

Managing our attention in this way contrasts with our standard notion of concentration. The term “concentration” in English mainly signifies a forcible narrowing of focus to bear down on an object. But our bodies tighten and we slip back into a version of the ice-cube scenario. What we resist, persists! Mindfulness, however, emphasizes that the truest concentration comes from an ease that unifies our energies. Coupled with sensory clarity, concentration holds our attention not through coercion, but fascination and wonder.

Of course, the COVID crisis is much more serious than ice-cubes. But the underlying principle still pertains: include the ailing part within a larger whole so that fear does not occupy all our attentional space or define our whole life. One student described how a shift in her attention helped ease her panic after learning that the “shelter-in-place” would continue longer than expected. Initially, she was glued to social media which convinced her “all of life was closing up shop.” Finally, she remembered she had a choice. She could re-frame her attention to include her anxiety within a wider container that diluted its power. She did not deny her fear but included it within a larger lens. As poet Maya Angelou wrote: “You may not control all the events that happen to you, but you can choose not to be reduced by them.”

When all their attention was not colonized by fear, my students freed up energy to explore what was available to them. I had asked them to notice their COVID-19 Silver Linings. Since they were on the look-out for them, they found them. They used their mindfulness muscle to soak their awareness into them and anchor their attention there. Many experienced a surprising inner freedom when they discovered creative resources they didn’t know they had.

Creativity thrives when we are confronted with constraints. Let us seize this opportunity to turn our focus towards what remains possible and open up their hidden depths. In this way lies freedom and well-being.

Sara E. Melzer is a Humanities Professor of French and Francophone Studies at the University of California, Los Angeles. Her latest book is Colonizer or Colonized: The Hidden Stories of Early Modern French Culture. Currently, she is working to integrate mindfulness into Higher Education through UCLA’s EPIC program

Andrea Bertozzi (Photo Credit: Courtesy of Andrea Bertozzi)

Mathematics professors earn NSF grant to calculate COVID-19 transmission rates

A photo of Andrea Bertozzi

Andrea Bertozzi (Photo Credit: Courtesy of Andrea Bertozzi)

Uncertainty about COVID-19 transmission rates has been one of the major challenges for health care systems in the United States and around the world.

UCLA mathematics professors Andrea Bertozzi and Mason Porter will use mathematical modeling, incorporating the specific features of COVID-19, to provide insights to those who are developing strategies to mitigate the spread of the disease.

Bertozzi and Porter have been awarded a $200,000 rapid-response research grant from the National Science Foundation, which has called for proposals with the potential to address the spread of COVID-19.

Many public health and infectious disease experts believe the actual transmission of COVID-19 is likely much higher than what has been publicly reported. The UCLA project will extend prior research on contagions, factoring in multiple transmission methods, human behavior patterns, current data and more. It also will provide training for a postdoctoral scholar, a doctoral student and two undergraduates.

Bertozzi and her research team have already published a preprint of a research paper on the challenges of modeling and forecasting the spread of COVID-19, and she and Porter are conducting research on another related paper as part of the project.

Bertozzi holds UCLA’s Betsy Wood Knapp Chair for Innovation and Creativity.

The award is co-funded by NSF programs in applied mathematics and computational mathematics and its office of multidisciplinary activities.

This article originally appeared in the UCLA Newsroom.

 

A photo of the sidewalk with chalk that says "Play your part, stay apart"

Play your part, stay apart: Advice and insight on physical distancing

A photo of the sidewalk with chalk that says "Play your part, stay apart"

Play your part, stay apart (Photo Credit: Jessica Wolf)

It has been a month since the wide-ranging safer-at-home directive went into effect in Los Angeles on March 17, following, and followed by, similar policies in other states and countries around the world.

It’s been hard. It’s wreaked havoc on our economy, our communities and our sense of emotional well-being. People understandably want to connect, go outside, share physical spaces, make a living, enjoy friends and family.

We asked Daniel Fessler, professor of anthropology and director of the UCLA Bedari Kindness Institute to help unpack why physical distancing feels so counterintuitive even while it represents one of the greatest mass acts of kindness — what scientists call “prosocial” behavior — we have witnessed as a species.

Why is it so hard to stay away from the people we are closest to socially? 

Our evolved mental mechanisms prioritize close social relationships over disease avoidance because those relationships were so important to the survival of our ancestors. One of the results of this is that we underestimate the risk of contagion that is posed by those to whom we are emotionally close. And as a consequence, people visit their relatives and close friends, and by so doing, they put at risk those whom they love the most.

The truth is, you’re probably even more dangerous to your loved ones than you are to strangers. After all, when’s the last time that you hugged a stranger on the street? If you care about the welfare of people you care about, then stay away from them.

Why is it so hard for us to fully accept that we might be dangerous to others, even if we don’t feel sick?  

Our evolved mental mechanisms are only attuned to overt cues of illness, so it’s difficult for us to grasp that we can be symptom-free and still infectious.

We can sort of understand that in an abstract way, but it’s hard for us to understand it in an emotional way. Likewise, our evolved mechanisms are attuned to harm that is tangible and immediate. The harm that we can do others is transmitted invisibly in this current situation and occurs after a delay of days or weeks. I’m quite confident that none of those college students who were partying on the beach in Florida during spring break would ever intentionally run over an elderly person in a crosswalk, but they’re potentially doing exactly that by contracting and spreading the virus.

How do we remind ourselves that staying away from one another physically is actually a huge act of kindness right now? 

As individuals, we all have a role to play in mitigating the impact of this disease. But problematically, social distancing doesn’t feel like prosocial behavior. And the reason it doesn’t feel like prosocial behavior is because in the world of our ancestors, helping other people and working together meant working face-to-face and side-by-side. You can think, for example, about how good it feels to help a stranger on the street or to work as a team to clean up trash on a beach or repaint an elementary school.

These things feel really good, right? And this is because our evolved psychological mechanisms are sensitive to cues that we are part of a prosocial cooperative group.

You may also think about how great it feels to do the wave with a huge crowd at a sporting event or to sing the national anthem together with thousands of people. These things are emotionally moving. They feel great because we are sensitive to the situation in which we’re coordinating our actions with those of many people around us towards a common goal.

Yet in the current crisis, for most of us, the first prosocial action that we must engage in is to stay away from other people. And ordinarily, staying away from other people can feel selfish. So staying away from other people doesn’t feel like we’re helping anyone.

I encourage everyone to think creatively. How can you help? For example, millions of kids are out of school right now. Can you tutor children via video link? Maybe just read a child a story. Many small businesses are in danger of going bankrupt. Can you purchase products or services at a distance that will help them to stay afloat?

Or maybe you can help deliver meals or medication to the elderly or to children who normally rely on school lunches and school nurses for their needs — of course, conducting yourself appropriately with regard to the safeguards of hygiene and social distancing when you are making those deliveries. Think outside the box. Get some ideas online. Find a way to help other people while still playing your part and staying apart.

What can we do to encourage others to continue to practice safe distancing until city and state leaders relax guidelines?

If you see someone ignoring social distancing guidelines, you need to acknowledge in discussion with them that you understand that it may seem safe because neither you nor they feel sick right now. But despite this, it doesn’t mean that either of you can’t transmit the virus to the other or to someone else. How we feel physically is simply not an accurate index of whether we might harm other people by being near them. Those kinds of conversations, of course, you need to hold at a safe distance, six feet or so.

In having those conversations, it’s helpful to think about language. Language can reflect the priorities and needs at the moment. People coin new words all the time. Just think, for example: Phrases like “gig economy,” “screen time” or “trending” weren’t things a few years back. I find acronyms particularly useful in this regard. You can Google the origins of two of my favorites — snafu (situation normal, all fouled up) and fubar (fouled up beyond all recognition) — two terms that were coined during other desperate emergency times.

We can coin a new acronym, a new word: PYPSA. It stands for “Play Your Part, Stay Apart.” You can use the word as praise for people who are doing a great job of social distancing: “Hey, man, way to go! You’re really PYPSA-ing,” and remind people who might forget or who might underestimate the importance of social distancing.

This article originally appeared in the UCLA Newsroom.

A photo of James Lloyd-Smith.

Study reveals how long COVID-19 remains infectious on cardboard, metal and plastic

The virus that causes COVID-19 remains for several hours to days on surfaces and in aerosols, a new study published in the New England Journal of Medicine found.

The study suggests that people may acquire the coronavirus through the air and after touching contaminated objects. Scientists discovered the virus is detectable for up to three hours in aerosols, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel.

A photo of James Lloyd-Smith in his office.

James Lloyd-Smith

“This virus is quite transmissible through relatively casual contact, making this pathogen very hard to contain,” said James Lloyd-Smith, a co-author of the study and a UCLA professor of ecology and evolutionary biology. “If you’re touching items that someone else has recently handled, be aware they could be contaminated and wash your hands.”

The study attempted to mimic the virus being deposited onto everyday surfaces in a household or hospital setting by an infected person through coughing or touching objects, for example. The scientists then investigated how long the virus remained infectious on these surfaces.

The study’s authors are from UCLA, the National Institutes of Health’s National Institute of Allergy and Infectious Diseases, the Centers for Disease Control and Prevention, and Princeton University. They include Amandine Gamble, a UCLA postdoctoral researcher in Lloyd-Smith’s laboratory.

In February, Lloyd-Smith and colleagues reported in the journal eLife that screening travelers for COVID-19 is not very effective. People infected with the virus — officially named SARS-CoV-2 — may be spreading the virus without knowing they have it or before symptoms appear. Lloyd-Smith said the biology and epidemiology of the virus make infection extremely difficult to detect in its early stages because the majority of cases show no symptoms for five days or longer after exposure.

“Many people won’t have developed symptoms yet,” Lloyd-Smith said. “Based on our earlier analysis of flu pandemic data, many people may not choose to disclose if they do know.”

The new study supports guidance from public health professionals to slow the spread of COVID-19:

  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose and mouth.
  • Stay home when you are sick.
  • Cover coughs or sneezes with a tissue, and dispose of the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces using a household cleaning spray or wipe.

This article originally appeared in the UCLA Newsroom.