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Black People & PTSD

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Black People, Post-Traumatic Stress Disorder (PTSD) and the Risk of Death From Coronavirus (COVID-19)

Nationwide —Here are some facts: Black people have been found to be more likely to die from COVID-19 infection than white people, both in the United Kingdom and the United States of America. Black people also have a higher rate of PTSD diagnosis than white people. PTSD can result in suppression of the immune system. Immunosuppression is associated with a higher risk of death from COVID-19. It is thus not unreasonable to question whether PTSD-induced immunosuppression is contributing to the elevated risk of dying from COVID-19 amongst black people.

Data reveals that Black people are more than four times more likely to die from COVID-19 than white people in England and Wales and that even after adjusting for age, socioeconomic conditions and prior health, the figures show that Black people remain twice as likely to die from COVID-19 than white people in England and Wales, according to the Office for National Statistics.1 Some suggest sickle cell disease is the explanation, however this is unlikely, being already in a shielded group they are likely to have little or no ongoing expo-sure to COVID-19. Other contributary factors which have been highlighted are obesity, over-crowding and frontline working, however these are likely to be already adjusted for within socioeconomic status.

This article proposes that PTSD-induced immunosuppression contributes to raised mortality from COVID-19. PTSD is a condition which occurs after a traumatic experience where symptoms persist of reliving the distressing event and there is hypervigilance, numbing, mood changes including negativity about the self, the world and the future. There is avoidance of people and situations that act as reminders of the event and sleep and concentration disturbance. Physical symptoms including Neurological, Respiratory and Cardiovascular symptoms also occur in PTSD.2

What is the evidence that Black people have higher rates of PTSD?

The Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2014 found doubling of the rate of PTSD amongst black adults at 8.3 per compared to white adults at 4.2 though assumed that the differences could not be relied on because of the small sizes involved.3

One study found that when PTSD affects US race/ethnic minorities, it is usually untreated and likely to become chronic and persistent and suggested that the large disparities in treatment indicate a need for investment in accessible and culturally sensitive treatment options.4 A separate two year follow up study found that African Americans with PTSD experience high number of traumas and most do not receive treatment.5

Findings from large-scale national studies suggest African Americans have a 9.1% prevalence rate for PTSD.6 This suggests that almost one in ten Black people becomes traumatized. This is an underestimate due to known under-diagnosis of PTSD in black people.7 Studies of racial discrimination and race-related stress have shown that when an individual reports psychological distress from racism, trauma was often not considered.8

Why would Black people be at increased risk of PTSD?

In addition to traumatic experiences that a person of any race or ethnicity might face, race-specific traumas include micro-aggressions and the erosion of a fundamental requirement for human beings – a sense of belonging. A striking example of that undermining of belonging was witnessed by the Windrush generation in the UK. Black people face challenges to a sense of belonging to desirable social, housing, occupational groups and on a wider scale there are challenges to the black person’s right to belong in a country such as the UK, a crude example being the ‘go back to where you came from’ statement. A sense of belonging is an intrinsic human need. The psychologist Maslow’s hierarchy of human needs defined self-actualization and self-esteem as requiring the secure foundations created by a sense of belonging.

Another often overlooked contributory factor to the large prevalence of traumas affecting Black people is Intergenerational transmission of trauma. Parent-child attachment patterns are known to replicate through generations within families. Going back to slavery and post-slavery eras, forced black familial disruption was part of the mechanism that enabled forced labour and enrichment of slave owners and others and this involved brutal disregard for the integrity of the black family unit by white oppressors. Yet another overlooked factor is vicarious trauma and witnessing shootings of unarmed black people can give rise to a sense of threat to the black viewer’s sense of their own safety.

What is the evidence that PTSD suppresses the immune system?

A study of 1,550 male workers with a previous history of PTSD concluded that PTSD produces immunosuppression and has long-term implications for health.9 This finding is now widely accepted amongst mental health professionals and a questionnaire commonly used as a tool to diagnose PTSD is the IES-r.10 A cut-off point of 37 and above in the IES-r is commonly accepted by mental health workers as associated with immunosuppression.

Treatment of PTSD

PTSD in Black people is treatable with a growing number of psychotherapies including prolonged exposure therapy, EMDR, cognitive processing therapy, somatic experiencing, if delivered by psychotherapists with training and knowledge of diversity matters. Medication is sometimes but not always required.

Conclusion

There now exists evidence for higher death rates of Black people from COVID-19 compared to White people as well as evidence that Black people have a higher rate of PTSD diagnosis than White people and furthermore that PTSD is associated with immunosuppression and we know that immunosuppression is associated with a higher risk of death from COVID-19. The proposed association described here between PTSD-induced immunosuppression and increased risk of death from COVID-19 needs to be explored further and in addition, high PTSD rates in black people need to be recognised and treated as both a mental and physical health priority.

References

1. Office of National Statistics. Release date: 7 May 2020. Coronavirus (COVID-19) related deaths by ethnic group, England and Wales: 2 March 2020 to 10 April 2020 obtained on 12 May 2020

2. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Publishing

3. Adult Psychiatric Morbidity Survey. (2014) retrieved on 11 May 2020 from https://www.ethnicity-facts-figures.service.gov.uk/health/mental-health/adults-with-post-traumatic-stress-disorder-ptsd-in-the-month-prior-to-survey/latest

4. Roberts, A.L., Gilman, S.E., Breslau, J.N., Breslau, N., & Koenen, K.C. (2011). Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychol Med.

5. Pérez Benítez, C., Sibrava, N., Kohn-Wood, L., Bjornsson, A., Zlotnick, C., Weisberg, R. & Keller, M. (2014). Posttraumatic stress disorder in African Americans: A two year follow-up study. Psychiatry Research-neuroimaging Volume: 220, Issue: 1, pp 376-383

6. Himle, J.A., Baser, R.E., Taylor, R.J., Campbell, R. D. & Jackson J.S. (2009). Anxiety disorders among African Americans, blacks of Caribbean descent, and non-Hispanic whites in the United States, Journal of Anxiety Disorders, 23(5): 578-590.

7. Williams M., Malcoun E. & Bahojb Nouri L. (2015) Assessment of Posttraumatic Stress Disorder with African Americans. In: Benuto L., Leany B. (eds) Guide to Psychological Assessment with African Americans. Springer, New York, NY

8. Carter, R. (2007). Racism and Psychological and Emotional Injury: Recognizing and Assessing Race-Based Traumatic Stress. The counselling psychologist Volume: 35 issue: 1, page(s): 13-105

9. Noriyuki Kawamura, Yoshiharu Kim & Nozomu Asukai (2001) Suppression of Cellular Immunity in Men with a past history of Posttraumatic stress disorder. Retrieved on 11 May 2020 from https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.158.3.484

10. Weiss, D.S., & Marmar, C.R. (1997). The Impact of Event Scale-Revised. In J.P. Wilson, & T.M. Keane (Eds.), Assessing Psychological Trauma and PTSD: A Practitioner’s Handbook (pp. 399-411). New York: Guilford Press

Source: Anne Coker

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Applications open for positions on the Small Business Advisory Commission

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Applications are open for the Small Business Advisory Commission and can be found online using the City’s web-based application for boards and commissions at: https://webapp9.sanantonio.gov/BoardCommApplication/vacanciesApply by April 21 for priority review­­­­­­­­­­­­­.  


The mission of the Small Business Advisory Commission is to review upcoming policies, regulations and issues affecting small businesses, outside of the SBEDA Ordinance, and provide recommendations to City staff, Mayor and City Council.

The newly established Small Business Advisory Commission will consist of 15-members, of which 11 positions will be Mayor and Council District specific appointments and four positions appointed at-large. The 15-Member Commission will consist of at least one small business member/organization residing and/or operating within each of the ten (10) Council Districts; and a diverse representation of the small business and non-profit community who demonstrate the following desired technical expertise, identities, and perspectives:

  • 2 small business professional and/or trade organizations
  • 2 non-profit small business service provider organizations
  • 4 small business owners with less than 10 employees
  • 4 small business owners with 10-50 employees
  • 3 small business owners representing the City’s targeted industries

To learn more about the Small Business Advisory Commission, visit the City of San Antonio’s website. For more information about the open positions, contact Melinda L. Uriegas, Assistant City Clerk, at (210) 207-7255 or (210) 207-7254. 

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30,000 COVID-19 vaccine appointments

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The San Antonio Metropolitan Health District continues to work with state and local partners to distribute COVID-19 vaccines to critical populations, within the phases designated by the Texas Department of State Health Services (DSHS).

30,000 first dose Pfizer vaccine appointments will be available starting tomorrow, Thursday, March 25th at 7 p.m. on the Metro Health COVID-19 vaccine registration website. Appointments available will be from April 6th to May 1st.

The 311 Customer Service COVID Hotline is allocated appointments to ensure residents without internet access can book their appointments by phone. The Hotline operating hours are Monday-Friday, 8a.m.- 5 p.m. and Saturday and Sunday from 8:00 a.m. – 12:00 p.m.


Immunizations with a safe and effective COVID-19 vaccine is a critical component of the strategy to reduce COVID-19-related illnesses, hospitalizations, and deaths and to help restore community and societal functioning. The goal is to have enough COVID-19 vaccine for all people who wish to be vaccinated. However, currently there continues to be limited supply of COVID-19 vaccine. 
 

Individuals who decide to opt-in to the City of San Antonio’s text alert system, can text VACCINE to 55000 or in Spanish VACUNA to 55000. By signing up they will receive a text notifying them of locations that have appointments available. Opting to this text alert system will not sign you up for a vaccine or add you on a wait list. This is an additional method to inform the community when new appointments are available. At this time notifications will be for the Alamodome, Wonderland of the Americas operated by University Health, UT Health San Antonio, and WellMed.

 For more information, please visit covid19.sanantonio.gov   

FOUR WAYS TO SIGN UP FOR COVID-19 ALERTS

  1. Download the Ready South Texas app, available in the iTunes and Google Play stores
  2. Text COSAGOV to 55000 to receive SMS text message updates
  3. Follow @COSAGOV on Facebook, Twitter and Instagram
  4. Bookmark covid19.sanantonio.gov
  5. Text Vaccine to 55000

Public service announcements on social distancing, prevention and testing are available here.

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Spurs Sports & Entertainment Hiring and Scholarship Opportunities

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SS&E is hiring for a range of opportunities:

  • Digital Engagement, Groundkeepers, Food Truck Operators, Camp Coaches, Box Office and more
  • If you or someone you know is interested, please apply here: https://www.nba.com/spurs/our-jobs

Spurs Give is excited to announce that the Angelo Drossos Memorial Scholarship is now open!

  • The scholarship recipient will receive $3,000 to pursue their education.
  • Students may apply by April 23, 2021 using this link Drossos Schlolarship

Spurs Sports Academy:

  • In-person summer camps for children with available dates June–August
  • Camps open to children ages 6-18 and include skills training camp, Coyote camp, Spurs player camp and overnight camp.
  • Registration by April 2 includes a $50 discount Spurs.com/SummerCamps
  • Participants receive a Spurs camp jersey and a Spurs camp memory photo
  • Health and Safety protocols can be found here Spurs.com/CampSafety

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