School of Social Sciences, Humanities, and Arts

Shared clinical decision-making (SCDM) about HPV vaccination has been recommended for U.S. mid-adults aged 27-45 since 2019. To explore barriers and facilitators to HPV vaccination in this population, we conducted 14 virtual focus groups with 86 unvaccinated mid-adults (34 men and 52 women) in Californias medically underserved Inland Empire between September 2020 and January 2021. We systematically analyzed the focus group data using the rigorous and accelerated data reduction (RADaR) technique to identify key themes. Identified barriers included: lack of awareness, vaccine hesitancy, and perceived unaffordability (cited in 14 groups); lack of healthcare provider communication and insufficient time (13 groups); fear of moral judgment (12 groups); lack of motivation and information needs (10 groups); and lack of reliable transportation and foregone care during the COVID-19 pandemic (3 groups). Proposed facilitators included: tailored HPV vaccine information for mid-adults, cost mitigation, and improved vaccine accessibility (12 groups); healthcare provider-initiated conversations (6 groups); and vaccine reminders (4 groups). These findings highlight challenges to HPV vaccination among U.S. mid-adults eligible for SCDM and point to actionable strategies for improvement. Specifically, tailored educational interventions, decision-making tools for pharmacists, and integrating HPV vaccination into other healthcare encounters may enhance vaccination efforts in areas with limited primary care resources.

This article examines how U.S. immigration law extends into the health care safety net, enacting medical legal violence that diminishes noncitizens' health chances and transforms clinical practices. Drawing on interviews with health care workers in three U.S. states from 2015 to 2020, I ask how federal citizenship-based exclusions within an already stratified health care system shape the clinical trajectories of noncitizens in safety-net institutions. Focusing specifically on cancer care, I find that increasingly anti-immigrant federal policies often reshape clinical practices toward noncitizens with a complex, life-threatening condition as they approach a "specialty care cliff" by (1) creating time penalties that keep many noncitizens in a protracted state of injury and (2) deterring noncitizens from seeking care through threats of immigration enforcement. Through these processes, medical legal violence also creates the potential for moral injury among health care workers, who must adapt clinical practices in response to socio-legal boundaries of belonging.

Abstract: Scientific research on the mechanisms to address global warming and its consequences continues to proliferate in the context of an accelerating climate emergency. The concept of climate action includes multiple meanings, and several types of actors employ its use to manage the crisis. The term has evolved to incorporate many of the suggested strategies to combat global warming offered by international bodies, states, nongovernmental organizations, the private sector, and social movements. The present work offers a classification scheme to build a shared understanding of climate action through a lens of environmental justice and just transitions developed by sociologists and others. The classification system includes major institutional and noninstitutional forms of climate action. By identifying the primary forms of climate action, analysts, scholars, policymakers, and activists can better determine levels of success and how different forms of climate action may or may not complement one another in the search for equitable solutions in turning back the rapid heating of the planet.

Abstract: US immigration law increasingly excludes many immigrants materially and symbolically from vital safety-net resources. Existing scholarship has emphasized the public charge rule as a key mechanism for enacting these exclusionary trends, but less is known about how recent public charge uncertainty has shaped how noncitizens and healthcare workers negotiate safety-net resources. Drawing on ethnographic observations and interviews with 80 safety-net workers and patients in three US states from 2015 to 2020, I argue that intensifying anti-immigrant rhetoric surrounding public charge has extended a sense of surveillance into clinical spaces in previously unexamined ways. Drawing on theories of medical legal violence, system avoidance, and legal estrangement, I demonstrate how these dynamics undermined immigrants' health chances and compromised clinic workers' efforts to facilitate care. I also reveal how participants responded to this insinuation of legal violence in healthcare spaces by promoting situational trust in specific procedures and institutions.

Abstract: To make greater strides in reducing city-level greenhouse gas emissions, more collaboration between civil society and local governments is necessary. Participation in neighborhood and town meetings about climate change sets the stage for enduring community involvement in resiliency and mitigation planning. This study examines the correlates of individual interest in attending local climate meetings. The work is based on a random sample of 1950 registered voters in Fresno, California (the fifth-largest city in the state). The findings suggest that those individuals with ties to capacity-building organizations in the labor and community sectors were the most willing to attend meetings about climate change. The types of civic engagement activities encouraged by labor unions and community-based organizations (CBOs) were also associated with a greater willingness to participate in gatherings about global warming. Increasing public participation in local climate programs may be enhanced by investing in the types of civic organizations that specialize in mobilizing residents to engage in municipal initiatives.

Researchers have found that gentrification is less likely in Black neighborhoods than in White or Latinx neighborhoods, and that gentrification looks different in Black neighborhoods. For example, researchers have found that Black neighborhoods experience marginal gentrification—changes in the educational level but not the income of residents. This study uses Census and National Historical Geographic Information System (NHGIS) data to explore the relationship between gentrification and racial change in Washington, DC between 2000 and 2019. We measure gentrification using four distinct but related measures: change in home value, rent, average educational level, and household income. The results show a positive association between changes in the percentage of residents with college degrees and the percentage of White residents in neighborhoods that were majority Black in 2000. We also find a positive association between changes in the percentage of Latinx residents and the average rent. We do not find a significant relationship between racial change and changes in home value and average income. Our findings point to the importance of including race in models of gentrification as well as using different measures of gentrification to capture it more fully.