Journal articles on the topic 'Hispanic American gays – Social conditions'

Background: Parental educational attainment is protective against chronic medical conditions (CMCs). According to the minorities’ diminished returns (MDRs) theory, however, the health effects of socioeconomic status (SES) indicators are smaller for socially marginalized groups such as racial and ethnic minorities rather than Whites. Aims: To explore racial and ethnic differences in the effect of parental educational attainment on CMCs in a nationally representative sample of American youth. Methods: In this cross-sectional study, we used baseline data of 10,701 12–17 years old youth in the Population Assessment of Tobacco and Health (PATH; 2013). Parental educational attainment was the independent variable. The dependent variable was the number of CMCs in youth. Age, gender, and family structure were covariates. Race and ethnicity were the focal moderators. Linear and multinomial regression were applied to analyze the data. Results: Overall, higher parental educational attainment was associated with a lower number of CMCs. Race and ethnicity, however, showed significant interactions with parental educational attainment on a number of CMCs as well as 2+ CMCs, suggesting that the effect of parenting educational attainment on CMCs is significantly smaller for Black and Hispanic than White youth. Conclusions: In the United States, race and ethnicity alter the health gains that are expected to follow parental educational attainment. While White youth who are from highly educated families are most healthy, Black and Hispanic youth from highly educated families remain at higher risk for CMCs. That means, while the most socially privileged group, Whites, gain the most health from their parental education, Blacks and Hispanics, the least privileged groups, gain the least. The result is a disproportionately high number of CMCs in middle-class Blacks and Hispanics. Economic, social, public, and health policy makers should be aware that health disparities are not all due to lower SES of the disadvantaged group but also diminished returns of SES resources for them. Youth physical health disparities due to race and ethnicity exist across all SES levels.

Public health specialists, policy makers, social scientists, and politicians, for different reasons, have welcomed the “Hispanic” label. The label presumably identifies an ethnic group that is also a minority group (i.e., a group historically subject to economic exploitation and racial discrimination). Consequently, its consistent use by federal and state agencies would produce large quantities of comparable data useful for research, and for policy making and implementation. Critics have argued that the label is racist, it mystifies the real reasons for the disproportionately high proportion of people of Mexican and Puerto Rican descent in disadvantaged social and economic conditions, and stands in the way of a fair implementation of affirmative action. Latino, a race-neutral term with historical roots, has been suggested as an alternative to be used in conjunction with national origin or regional forms of self-identification. In this article, I argue that any standardized terminology is unavoidably flawed and conducive to the development of racist or, at best, trivial stereotypical analysis of the data thus produced. The “Hispanic” label does not identify an ethnic group or a minority group, but a heterogeneous population whose characteristics and behavior cannot be understood without necessarily falling into stereotyping. The label should be abandoned; social scientists and policy makers should, instead, acknowledge the existence of six aggregates, qualitatively different in their socioeconomic stratification, needs, and form of integration in the U.S. economy: two minority groups (people of Mexican and Puerto Rican descent), and four immigrant populations (Cubans, Central American refugees, Central American immigrants, and South American immigrants).

SummaryUsing data from The National Epidemiologic Survey on Alcohol and Related Conditions, the strength of social networks and the association of self-reported health among American Indians and Alaska Natives (AI/AN) and non-Hispanic Whites (NHW) were compared. Differences in social network–health relationships between AI/ANs and NHWs were also examined. For both groups, those with fewer network members were more likely to report fair or poor health than those with average or more network members, and persons with the fewest types of relationships had worse self-reported health than those with the average or very diverse types of relationships. Furthermore, small social networks were associated with much worse self-reported health in AI/ANs than in NHWs.

Racial/ethnic differences in health are evident among men. Previous work suggests associations between mental and physical health but few studies have examined how mood/anxiety disorders and chronic physical health conditions covary by age, race, and ethnicity among men. Using data from 1,277 African American, 629 Caribbean Black, and 371 non-Hispanic White men from the National Survey of American Life, we examined associations between race/ethnicity and experiencing one or more chronic physical health conditions in logistic regression models stratified by age and 12-month mood/anxiety disorder status. Among men <45 years without mood/anxiety disorders, Caribbean Blacks had lower odds of chronic physical health conditions than Whites. Among men aged 45+ years with mood/anxiety disorders, African Americans had greater odds of chronic physical health conditions than Whites. Future studies should explore the underlying causes of such variation and how studying mental and chronic physical health problems together may help identify mechanisms that underlie racial disparities in life expectancy among men.

This paper explores the reasons why, in the aftermath of 9/11, the interests of Muslim women and Muslim gays have become the civilizing mission in the “war on terror.” In critically examining how pervasive American and European notions of patriotism, liberalism, secularism, and freedom have been couched within the discourseof sexual rights, I explain why this new politics of belonging is inseparable from the new politics of exclusion. This shift has had consequences for progressive social movements. Whereas in social and cultural analysis nationalism has long been associated with male dominance, sexual control, and heteronormativity, certain articulations of feminism and lesbian/gay liberation are now intimately linked with the reinforcement of ethno-cultural boundaries within the western framework. A required allegiance to sexual liberties and rights has been employed as a technology of control and exclusion – what Joan Scott calls a “politics of sexclusion.” This paper elucidates how Muslim gays are joining Muslim women, whose “liberation,” as postcolonial feminists have long argued, has traditionally been used to justify imperialism. I conclude by discussing bodies as a site for the materialization of power and resistance, as related to Luce Irigaray’s notion of an “ethics of sexual difference,” in an attempt to provide the phenomenological conditions of an “alternative space” in which the Muslim as “other” can be heard. The critical role of such a methodology is not to restore a lost historical and obliterated native, but to let her emerge in her difference. This ontology studies the varying ontic meanings of a localized phenomenon, their constitution as different realities and objectivities (i.e., as entities, occurrences, processes, events, (and facts), to shift our focus from identifying the Muslim other to asking “How do we experience the Muslim other as ‘other’?”

This paper explores the reasons why, in the aftermath of 9/11, the interests of Muslim women and Muslim gays have become the civilizing mission in the “war on terror.” In critically examining how pervasive American and European notions of patriotism, liberalism, secularism, and freedom have been couched within the discourseof sexual rights, I explain why this new politics of belonging is inseparable from the new politics of exclusion. This shift has had consequences for progressive social movements. Whereas in social and cultural analysis nationalism has long been associated with male dominance, sexual control, and heteronormativity, certain articulations of feminism and lesbian/gay liberation are now intimately linked with the reinforcement of ethno-cultural boundaries within the western framework. A required allegiance to sexual liberties and rights has been employed as a technology of control and exclusion – what Joan Scott calls a “politics of sexclusion.” This paper elucidates how Muslim gays are joining Muslim women, whose “liberation,” as postcolonial feminists have long argued, has traditionally been used to justify imperialism. I conclude by discussing bodies as a site for the materialization of power and resistance, as related to Luce Irigaray’s notion of an “ethics of sexual difference,” in an attempt to provide the phenomenological conditions of an “alternative space” in which the Muslim as “other” can be heard. The critical role of such a methodology is not to restore a lost historical and obliterated native, but to let her emerge in her difference. This ontology studies the varying ontic meanings of a localized phenomenon, their constitution as different realities and objectivities (i.e., as entities, occurrences, processes, events, (and facts), to shift our focus from identifying the Muslim other to asking “How do we experience the Muslim other as ‘other’?”

This study examines the prevalence of morbidity and disability among older Mexican Americans using 5-year age groups. Twenty-year panel data from the Hispanic Established Populations for the Epidemiological Study of the Elderly are used to make detailed comparisons by nativity and gender. Results show that prevalence rates for most chronic conditions for both males and females do not vary by nativity. For disabilities, nativity is a significant predictor of increased instrumental activity of daily living disability for foreign-born females and reduced activity of daily living disability for U.S.-born males. Additionally, results show significant interactions between nativity and age cohorts, with the gap increasing with age for males and decreasing with age for females. These results have important implications for health services and health policy. Given the rapid aging of the Mexican American population, the prevention and treatment of medical conditions, particularly among the foreign-born, should be a major public health priority to reduce dependence from disabilities.

This article examines how absolute and relative income levels, social capital, and racial/ethnic composition interact to explain variation in age-adjusted mortality rates across the 48 contiguous U.S. states. Our data showed that social capital had a powerful, negative effect on age-adjusted mortality rates —higher social capital states had lower age-adjusted mortality rates. After controlling for other variables, median income moderately related to mortality, but unexpectedly three measures of inequality did not. Finally, states' percent African American positively related to mortality, though indirectly and mediated entirely by social capital. In contrast, the strong negative effect of percent Hispanic/Latino on mortality was partially suppressed by its negative association with social capital. Our understanding of the substantial impact of social conditions on mortality can help inform public policies and actions that may foster healthier and longer lives.

Health equity can be defined as the absence of disadvantage to individuals and communities in health outcomes, access to health care, and quality of health care regardless of one’s race, gender, nationality, age, ethnicity, religion, and socioeconomic status. Health equity concerns those disparities in public health that can be traced to unequal, systemic economic, and social conditions. Despite significant improvements in the health of the overall population, health inequities in America persist. Racial and ethnic minorities continue to experience higher rates of morbidity and mortality than non-minorities across a range of health issues. For example, African-American children with asthma have a seven times greater mortality rate than Non-Hispanic white children with the illness. While cancer is the second leading cause of death among all populations in the U.S., ethnic minorities are especially burdened with the disease.

Background: As suggested by the Minorities’ Diminished Returns (MDRs) theory, educational attainment shows a weaker protective effect for racial and ethnic minority groups compared to non-Hispanic Whites. This pattern, however, is never shown for hospitalization risk. Objectives: This cross-sectional study explored racial and ethnic variations in the association between educational attainment and hospitalization in the United States. Methods: Data came from the National Health Interview Survey (NHIS 2015). The total sample was 28,959 American adults. Independent variable was educational attainment. The main outcome was hospitalization during the last 12 months. Age, gender, employment, marital status, region, obesity, and number of cardiovascular conditions were covariates. Race and ethnicity were the effect modifiers. Logistic regression models were utilized to analyze the data. Results: From all participants, 16.2% were Black and 11.6% were Hispanic with a mean age of 51 years. Overall, higher education levels were associated with lower odds of hospitalization, independent of all confounders. Educational attainment showed significant interactions with race (odds ratio [OR] =1.04, 95% CI = 1.01-1.08) and ethnicity (OR = 1.04, 95% CI =1.01-1.07) on hospitalization, indicating smaller protective effects of educational attainment on hospitalization of Hispanics and Blacks than nonHispanic Whites. Conclusion: The protective effects of educational attainment on population health are smaller for Blacks and Hispanics compared to non-Hispanic Whites. To prevent health disparities, the diminished returns of educational attainment should be minimized for racial and ethnic minorities. To do so, there is a need for innovative and bold economic, public, and social policies that do not limit themselves to equalizing socioeconomic status, but also help minorities leverage their available resources and gain tangible outcomes.

Abstract Models of successful aging underscore the critical role of external social resources in older adults’ health and well-being. Neighborhood socioeconomic position is known to influence health, but little is known about the linkages between neighborhood conditions, social relationships and health among older adults. We identified a cohort of 12,434 adults (aged 65+) who attended a Medicare Annual Wellness Visit from the NEOCARE Learning Health Registry. NEOCARE includes electronic health record (EHR) and neighborhood data from 1999-2017 on over 3 million unique Northeast Ohio individuals. The study population was 60% White, 32% Black or African American, 64% female, and 90% non-Hispanic. Over 60% were ages 65-74, 29% 75-84, and 10% 85 years or older (range from 65 to 101). We used ANOVA and chi square tests to examine variation in social support by quintile of the census tract area deprivation index. Compared to those in less disadvantaged neighborhoods, older adults in more disadvantaged neighborhoods were more likely to report needing help with care needs (Bonferroni-corrected x2=95.21, df=4, n=8,967, p<.001) but were less likely to report having help at home (x2=85.72, 4, n=12,354, p<.001). Similarly, adults in more disadvantaged neighborhoods reported less help available to them compared to those in more advantaged communities (F=39.31, df=4, n=12,099, p<.001). Furthermore, older adults living in more disadvantaged neighborhoods experienced significantly less functional independence (F=3.68, df=4 , n=8,571, p<.01). Our results suggest that the pathway from neighborhood socioeconomic conditions to successful aging includes perceived social needs and social support.

Abstract Few studies have investigated the healthcare utilization of Mexican-American Medicare beneficiaries. We used data from 1,196 Hispanic-EPESE participants aged >75 years that has been linked with Medicare claims to describe the healthcare utilization of older Mexican-Americans and determine common reasons for hospitalizations. Participants were followed for two-years (eight-quarters). We estimated the probability of >1 hospitalization, emergency room (ER) admissions, and outpatient visits per quarter. The percentage of participants who had >1 hospitalizations, ER admissions, and outpatient visits for each quarter ranged from 10.6%-13.2%, 14.6%-19.5%, and 77.2%-80.5%, respectively. Twenty-three percent of hospitalizations were for circulatory conditions and 17% were for respiratory conditions. Older age (OR=1.26) and Spanish language (OR=1.51) were associated with hospitalizations. Women had higher odds than men to have an outpatient visit (OR=1.61). Greater education was associated with ER admissions (OR=0.72). Continued research is needed to identify social determinants and health characteristics associated with healthcare utilization among older Mexican-Americans.

We examined parent-reported adverse childhood experiences (ACEs) and associated outcomes among American Indian and Alaska Native (AI/AN) children aged 0–17 years from the 2011-2012 National Survey of Children’s Health. Bivariate and multivariable analyses of cross-sectional data on 1,453 AI/AN children and 61,381 non-Hispanic White (NHW) children assessed race-based differences in ACEs prevalence and differences in provider-diagnosed chronic emotional and developmental conditions, health characteristics, reported child behaviors, and health services received as a function of having multiple ACEs. AI/AN children were more likely to have experienced 2+ ACEs (40.3% versus 21%), 3+ ACEs (26.8% versus 11.5%), 4+ ACEs (16.8% versus 6.2%), and 5+ ACEs (9.9% versus 3.3%) compared to NHW children. Prevalence rates for depression, anxiety, and ADHD were higher among AI/AN children with 3+ ACEs (14.4%, 7.7%, and 12.5%) compared to AI/ANs with fewer than 2 ACEs (0.4%, 1.8%, and 5.5%). School problems, grade failures, and need for medication and counseling were 2-3 times higher among AI/ANs with 3+ ACEs versus the same comparison group. Adjusted odds ratio for emotional, developmental, and behavioral difficulties among AI/AN children with 2+ ACEs was 10.3 (95% CI = 3.6–29.3). Race-based differences were largely accounted for by social and economic-related factors.

Older men and women have been found to be more vulnerable to negative outcomes should they contract Covid19, particularly if they also have comorbid conditions such as type 2 diabetes. Cultural, racial, ethnic, and social class differences exist in vulnerability to Covid19 and in the prevalence of type 2 diabetes. In the United States, for example, diabetes rates for minority and immigrant populations are higher than for non-Hispanic whites. During the a social health crisis, it is helpful to explore the ways that illness management and associated vulnerability influences the ways that minority elders attempt to maintain and promote their well-being. This paper presents a case study example of an older immigrant woman, diagnosed with type 2 diabetes, and her struggle to manage her illness during a pandemic. The risk of developing diabetes in the United States is 3 to 1 and risks increase with age (American Diabetes Association, 2020). Almost 50 % of black women as well as Hispanic men and women will develop diabetes in their lifetime (CDC, 2019). Disparities such as these have their origin in intersecting risk factors such as health care and lifestyle factors such as tress, poverty, weight, diet, and exercise patterns. Being a member of an ethnic minority and being overweight are the two significant factors associated with the onset of type 2 diabetes. During the coronavirus epidemic, these same factors also increase the risk for infection and for greater complications, even death as a result of infection (Society for Women’s Health Research, 2020). This essay illustrates the increased vulnerability and challenges including loneliness facing older women with type 2 diabetes during pandemic isolation. 

This study examined whether urgency, a disposition to rash action under conditions of strong emotion, moderates associations between internalizing symptoms and alcohol use and related expectancies. Data from the Camden Youth Development Study, a longitudinal, community-based study of early adolescents ( N = 144, mean age at intake = 11.9 years; 65% Hispanic, 30% African-American; 50% male), were used. Self-report questionnaire measures of depressive symptoms, social and generalized anxiety symptoms, urgency, alcohol use, and alcohol expectancies were used. Mixed models were used to examine the effects of internalizing symptoms, urgency, and their interaction on alcohol use and expectancy trajectories over time. Depressive symptoms interacted with urgency such that youth with high levels of both tended to have elevated levels of global positive alcohol expectancies. Social anxiety symptoms interacted with urgency to be associated with increasing levels of social behavior alcohol expectancies such that youth with high levels of both tended to experience particular increases in these expectancies over time. Generalized anxiety was not found to be associated with alcohol-related constructs. Therefore, high levels of urgency combine with depressive and social anxiety symptoms to be associated with particularly increased risk for alcohol expectancies that are associated with later alcohol use and problems, indicating particular risk for youth with these combinations of personality traits and psychopathology symptoms.

Background Previous studies have shown that various social determinants of health (SDOH) may have contributed to the disparities in COVID-19 incidence and mortality among minorities and underserved populations at the county or zip code level. Objective This analysis was carried out at a granular spatial resolution of census tracts to explore the spatial patterns and contextual SDOH associated with COVID-19 incidence from a Hispanic population mostly consisting of a Mexican American population living in Cameron County, Texas on the border of the United States and Mexico. We performed age-stratified analysis to identify different contributing SDOH and quantify their effects by age groups. Methods We included all reported COVID-19–positive cases confirmed by reverse transcription–polymerase chain reaction testing between March 18 (first case reported) and December 16, 2020, in Cameron County, Texas. Confirmed COVID-19 cases were aggregated to weekly counts by census tracts. We adopted a Bayesian spatiotemporal negative binomial model to investigate the COVID-19 incidence rate in relation to census tract demographics and SDOH obtained from the American Community Survey. Moreover, we investigated the impact of local mitigation policy on COVID-19 by creating the binary variable “shelter-in-place.” The analysis was performed on all COVID-19–confirmed cases and age-stratified subgroups. Results Our analysis revealed that the relative incidence risk (RR) of COVID-19 was higher among census tracts with a higher percentage of single-parent households (RR=1.016, 95% posterior credible intervals [CIs] 1.005, 1.027) and a higher percentage of the population with limited English proficiency (RR=1.015, 95% CI 1.003, 1.028). Lower RR was associated with lower income (RR=0.972, 95% CI 0.953, 0.993) and the percentage of the population younger than 18 years (RR=0.976, 95% CI 0.959, 0.993). The most significant association was related to the “shelter-in-place” variable, where the incidence risk of COVID-19 was reduced by over 50%, comparing the time periods when the policy was present versus absent (RR=0.506, 95% CI 0.454, 0.563). Moreover, age-stratified analyses identified different significant contributing factors and a varying magnitude of the “shelter-in-place” effect. Conclusions In our study, SDOH including social environment and local emergency measures were identified in relation to COVID-19 incidence risk at the census tract level in a highly disadvantaged population with limited health care access and a high prevalence of chronic conditions. Results from our analysis provide key knowledge to design efficient testing strategies and assist local public health departments in COVID-19 control, mitigation, and implementation of vaccine strategies.

Despite higher rates of prostate cancer–related mortality and later stage of prostate cancer diagnosis, Black/African American men are significantly less likely than non-Hispanic White men to use early detection screening tools, like prostate-specific antigen (PSA) testing for prostate cancer. Lower screening rates may be due, in part, to controversy over the value of prostate cancer screenings as part of routine preventive care for men, but Black men represent a high-risk group for prostate cancer that may still benefit from PSA testing. Exploring the role of social factors that might be associated with PSA testing can increase knowledge of what might promote screening behaviors for prostate cancer and other health conditions for which Black men are at high risk. Using multilevel logistic regression, this study analyzed self-report lifetime use of PSA test for 829 Black men older than 45 years across 381 Philadelphia census tracts. This study included individual demographic and aggregated social capital data from the Public Health Management Corporation’s 2004, 2006, and 2008 waves of the Community Health Database, and sociodemographic characteristics from the 2000 U.S. Census. Each unit increase in community participation was associated with a 3 to 3.5 times greater likelihood of having had a PSA test (odds ratio = 3.35). Findings suggest that structural forms of social capital may play a role in screening behaviors for Black men in Philadelphia. A better understanding of the mechanism underlying the link between social capital and screening behaviors can inform how researchers and interventionists develop tools to promote screening for those who need it.

Background and Purpose: In April 2014, the municipal water source for Flint, Michigan was changed from Lake Huron to the Flint River. Although residents reported concerns about the quality of tap water and resulting health problems, officials insisted that the water was safe. This study examined relationships between self-reported tap water quality during the water crisis and health conditions among Flint residents. Methods: Participants from each residential Census Tract in the City of Flint were recruited via address lists, online social media, and community-based events. The survey included mental and physical health items from the CDC’s Behavioral Risk Factor Surveillance System and an item on tap water quarter quality experiences. Analyses were weighted to be demographically representative. Results: Participants (N = 277) rated their tap water quality (taste, smell, appearance) as Poor (57%), Fair (20%), Good (13%), Very Good (6%), and Excellent (3%). Controlling for age, gender, years of education, whether respondents were African American or Hispanic/Latino/a, and population demographics, lower perceived tap water quality was associated with worse mental and physical health across all indicators. Conclusion: This study demonstrates associations of tap water quality experiences with reported poor physical and mental health among adults in Flint during the Flint Water Crisis.

Purpose. The Child and Adolescent Trial for Cardiovascular Health is a multi-site study of a school-based intervention designed to reduce or prevent the development of risk factors for cardiovascular disease. The goal was to change (or prevent) related risk behaviors and the psychosocial variables that theoretically influence those behaviors. Design. A nested design was used in which schools served as the primary unit of analysis. Twenty-four schools participated at each of four sites (Austin, San Diego, Minneapolis, and New Orleans). Each site had 10 control and 14 intervention schools. Setting and Subject. Ninety-six schools (with more than 6000 students) in the four sites were randomized to three treatment conditions: control, school-based interventions, and school-plus-family interventions. The sample included approximately equal numbers of males and females and was 67.5% white, 13.9% African-American, 13.9% Hispanic, and 4.7% other. Measures. The psychosocial determinants measured included improvements in dietary knowledge, intentions, self-efficacy, usual behavior, perceived social reinforcement for healthy food choices, and perceived reinforcement and self-efficacy for physical activity. Results. The findings indicated significant improvements in all the psychosocial determinants measured (p < .0001). The results revealed a greater impact in the school-plus-family intervention schools for two determinants, usual dietary behavior and intentions to eat heart-healthy foods. Conclusions. These findings support theory-based interventions for changing selected psychosocial determinants of cardiovascular disease risk behavior among children.

Abstract Over seven million U.S. adults are estimated to have undiagnosed diabetes and are at heightened risk of diabetes complications and poorer long-term glycemic control. Key to addressing undiagnosed diabetes is identifying how persons encounter diabetes testing in everyday life and the contextual factors that lead to consulting a health care provider. As part of the NIA-funded Subjective Experience of Diabetes Study we examined the pathways through which community-living African-American and non-Hispanic White older adults with type 2 diabetes (T2D) (N=75) received their T2D diagnosis. Systematic, thematic analyses using ATLAS.ti reveals three primary routes to diabetes diagnosis: diagnosis through continuity of primary care, diagnosis through happenstance testing, and diagnosis following the exacerbation of symptoms. While diagnosis as part of routine care was the least reported (N=13), participants’ accounts suggest diagnosis in primary care validates the patient-provider relationship and provides an occasion to calmly establish a treatment plan. More frequently, however, diagnosis occurs through fortuitous encounters with glucose tests, e.g., through work or community research projects (N=15) or after symptoms become alarming and disrupt daily life (N=47). Participants’ experiences in these latter two categories reveal the critical role of insurance and social prompts in the decision to consult a clinical provider regarding symptoms. At the same time, the abundance of over-the-counter therapies treating conditions commonly found early in the emergence of diabetes can delay clinical follow up. These findings highlight the importance of social prompts and community-based testing in the fight to reduce undiagnosed diabetes.

Females are more likely than males to participate in evidence-based health promotion and disease prevention programs targeted for middle-aged and older adults. Despite the availability and benefits of Stanford’s Chronic Disease Self-Management Education (CDSME) programs, male participation remains low. This study identifies personal characteristics of males who attended CDSME program workshops and identifies factors associated with successful intervention completion. Data were analyzed from 45,375 male CDSME program participants nationwide. Logistic regression was performed to examine factors associated with workshop attendance. Males who were aged 65–79 (OR = 1.27, p < .001), Hispanic (OR = 1.22, p < .001), African American (OR = 1.13, p < .001), Asian/Pacific Islander (OR = 1.26, p < .001), Native Hawaiian (OR = 3.14, p < .001), and residing in nonmetro areas (OR = 1.26, p < .001) were more likely to complete the intervention. Participants with 3+ chronic conditions were less likely to complete the intervention (OR = 0.87, p < .001). Compared to health-care organization participants, participants who attended workshops at senior centers (OR = 1.38, p < .001), community/multipurpose facilities (OR = 1.21, p < .001), and faith-based organizations (OR = 1.37, p < .001) were more likely to complete the intervention. Men who participated in workshops with more men were more likely to complete the intervention (OR = 2.14, p < .001). Once enrolled, a large proportion of males obtained an adequate intervention dose. Findings highlight potential strategies to retain men in CDSME programs, which include diversifying workshop locations, incorporating Session Zero before CDSME workshops, and using alternative delivery modalities (e.g., online).

Abstract Title A Clinician's Experience in Initiation and Navigation of a Support group for Sickle Cell Disease Patients - Can we Break Patient Bias? Introduction: A 2010 qualitative research study by the Journal of the Health Care for the Underserved validates the finding that African Americans are suspicious of health care programs that are targeted specifically for African American as they believe that the system would have ill-intent. This adversarial relation with health care providers persists in the aftermath of the Tuskegee experiment and other historical research abuses. This is particularly relevant to sickle cell disease (SCD) as it affects minorities, especially the black population. SCD is one of the most common genetic disorders in the nation affecting approximately 100,000 Americans. 1 in 365 African American and 1 in 16,300 Hispanic American are affected by SCD. Chronic pain with frequent episodes of vasoocclusive or pain crises (VOC) are defining clinical features of the disease. Opioids are required during VOC for effective treatment and often is a source of difficulty for patients negotiating the health care system. Over time, SCD can cause multiple organ complications including strokes, cardiopulmonary disease, renal disease and neurocognitive deficits. The disease is associated with a decreased life expectancy. Methods Case vignettes of real-life experiences of adult patient with SCD were used to highlight the basis of suspicion of health care providers and health care systems. 25 adult patients aged > 18years old were allowed to express their concern with joining and attending a monthly support group by questionnaire. We captured the various narratives, sought to address their concern through individualized in person dialogue with the social worker, and then invited them again to attend. Results: There were several reasons presented by patients for their reluctant to attend the support group sessions. These included difficulty with transportation, competing demands such as need to provide for family, lack of child care, educational level and ability to comprehend in a group environment, hospitalizations, frequent overwhelmingly concerns over privacy and confidentiality including use of photographs for media event by the hospital. After social work provider intervention including providing taxi vouchers, 80% of patients could be convinced to attend their first monthly group sessions. Retention rates of approximately 90% were achieved though we did note that participation was influenced by weather and competing domestic events. Conclusions: Our study highlights the difficulty SCD patients had with trusting health care providers including social workers. However, the majority of patients could be convinced to attend support groups sessions by acknowledging and addressing their concerns. The study highlighted the various challenges patient had negotiating health care systems; and we highlight the difficulties surrounding trust of providers. However, we demonstrated feasibility in achieving the goals by addressing their legitimate concern. Printed Program Description: This program will explore historical practices that influence minority patient's engagement in groups and research and discuss best practices on how to address this. References Scharff, Darcell P., et al. "More than Tuskegee: Understanding Mistrust about Research Participation." Journal of Health Care for the Poor and Underserved, vol. 21, no. 3, 2010, pp. 879-897., doi:10.1353/hpu.0.0323. Nguyen, Bich-May. "The Most Shocking and Inhuman." Family Medicine, vol. 51, no. 1, 2019, pp. 5-7., doi:10.22454/fammed.2019.175092. Singhal, Astha, et al. "Racial-Ethnic Disparities in Opioid Prescriptions at Emergency Department Visits for Conditions Commonly Associated with Prescription Drug Abuse." Plos One, vol. 11, no. 8, 2016, doi:10.1371/journal.pone.0159224. Cohen, Rachel D. "Distrust Of Health Care System May Keep Black Men Away From Prostate Cancer Research." NPR, NPR, 17 Oct. 2018, www.npr.org/sections/health-shots/2018/10/17/658101432/distrust-of-health-care-system-may-keep-black-men-away-from-prostate-cancer-rese. Center for Disease Control and Prevention. (2019) Sickle Cell Disease (SCD) [online]. Available at: https://www.cdc.gov/ncbddd/sicklecell/data.html (Accessed: 8/29/2019). Disclosures No relevant conflicts of interest to declare.

Background: Despite the considerable increase in computer and internet use over the past two decades, few studies have examined socioeconomic, demographic, and health characteristics associated with computer and internet use in the United States. Community-level differences in computer and internet use and associated disparities in health and mor tality indicators have not been analyzed. This study examines these associations at the individual and community level using national census, health, and mortality data.
 Methods: We analyzed data from the 2017 American Community Survey (ACS) Micro-data Sample, the 2013-2017 ACS Summary File, 2013-2017 National Vital Statistics System, and 2019 County Health Rankings and Roadmaps. Health and socioeconomic characteristics associated with broadband internet and computer use among adults aged ≥18 were modeled by logistic regression (N=2,385,595).
 Results: In 2017, 89.7% of Asian/Pacific Islanders (APIs) had broadband internet service, compared with 66.0% of American Indians/Alaska Natives (AIANs), 77.2% of Blacks/African-Americans, 78.8% of Hispanics, and 83.5% of non-Hispanic Whites. APIs (97.4%) were more likely than other racial/ethnic groups to own or use a computer (including smartphones), while AIANs (80.3%) were less likely. Socioeconomic gradients in internet and computer use were marked. Those below the poverty level and with less than a high school education reported 18 and 15 percentage points lower rates of internet and computer use respectively. Compared to metropolitan areas, nonmetropolitan areas had lower internet access (80.3% vs. 69.7%) and computer use (88.4% vs. 80.5%). Rural areas and small urban towns had the lowest level of internet and computer use. Risks of disabilities and lack of health insurance were greater among persons with lower broadband internet and computer access. Communities with low internet and computer use had seven years shorter life expectancy than communities with high use and were at increased risks of mortality from various chronic conditions, poor health, mental distress, hospitalization, smoking, obesity, and physical inactivity.
 Conclusions and Implications for Translation: Significant socioeconomic and racial/ethnic disparities in internet and computer use and associated health inequalities exist in the US. Closing the social divide in internet and computer use can positively impact individual empowerment, educational attainment, economic growth, community development, access to health care and health-related information, and health promotions efforts.
 Key words: • Digital divide • broadband internet • computer use • disability • health insurance • causespecific mortality • morbidity • health behaviors
 
 Copyright © 2020 Singh et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial.

Background In the United States, racial and ethnic minorities are disproportionately affected by COVID-19, with persistent social and structural factors contributing to these disparities. At the intersection of race/ethnicity and gender, women of color may be disadvantaged in terms of COVID-19 outcomes due to their role as essential workers, their higher prevalence of pre-existing conditions, their increased stress and anxiety from the loss of wages and caregiving, and domestic violence. Objective The purpose of this study is to examine racial and ethnic differences in the prevalence of COVID-19 outcomes, stressors, fear, and prevention behaviors among adult women residing in the United States. Methods Between May and June 2020, women were recruited into the Capturing Women’s Experiences in Outbreak and Pandemic Environments (COPE) Study, a web-based cross-sectional study, using advertisements on Facebook; 491 eligible women completed a self-administered internet-based cross-sectional survey. Descriptive statistics were used to examine racial and ethnic differences (White; Asian; Native Hawaiian or other Pacific Islander; Black; Hispanic, Latina, or Spanish Origin; American Indian or Alaskan Native; multiracial or some other race, ethnicity, or origin) on COVID-19 outcomes, stressors, fear, and prevention behaviors. Results Among our sample of women, 16% (73/470) reported COVID-19 symptoms, 22% (18/82) were concerned about possible exposure from the people they knew who tested positive for COVID-19, and 51.4% (227/442) knew where to get tested; yet, only 5.8% (27/469) had been tested. Racial/ethnic differences were observed, with racial/ethnic minority women being less likely to know where to get tested. Significant differences in race/ethnicity were observed for select stressors (food insecurity, not enough money, homeschooling children, unable to have a doctor or telemedicine appointment) and prevention behaviors (handwashing with soap, self-isolation if sick, public glove use, not leaving home for any activities). Although no racial/ethnic differences emerged from the Fear of COVID-19 Scale, significant racial/ethnic differences were observed for some of the individual scale items (eg, being afraid of getting COVID-19, sleep loss, and heart racing due to worrying about COVID-19). Conclusions The low prevalence of COVID-19 testing and knowledge of where to get tested indicate a critical need to expand testing for women in the United States, particularly among racial/ethnic minority women. Although the overall prevalence of engagement in prevention behaviors was high, targeted education and promotion of prevention activities are warranted in communities of color, particularly with consideration for stressors and adverse mental health.

OBJECTIVES/SPECIFIC AIMS: Objective: The Rockefeller University Center for Clinical and Translational Science (RU-CCTS), Clinical Directors Network (CDN), and Carter Burden Network (CBN), a multisite senior services organization serving East Harlem, NY, formed a community-academic partnership to examine the use of a simple validated surrogate measure of overall health status and frailty in this population. Many CBN seniors are racial/ethnic minorities, low-income, and suffer from multiple chronic conditions, depression and food insecurity. Multiple biological, musculoskeletal, psychosocial and nutritional factors contribute to frailty, which has been defined variously in senior health outcomes research. The CTSA-funded Pilot Project aims to: (1) Engage CBN seniors and stakeholders in priority-setting, joint protocol development, research conduct, analysis, and dissemination; (2) Characterize the health status of the CBN seniors using validated measures; (3) Establish database infrastructure for current and future research; (4) Understand how health and senior activities information can be used to create programs to improve senior health. METHODS/STUDY POPULATION: Methods: (1) CEnR-Navigation, a collaborative program/process that consists of semistructured meetings and activities facilitated by expert Navigators, was used for partnership development and to engage Carter Burden seniors to refine priorities and research questions, provide feedback on study design and conduct, and analyze and disseminate results. (2) Standard physical measurements and validated survey instruments were used to collect health information; target enrollment is 240 seniors across 2 sites (1 hosted within a subsidized housing facility and Social Model Adult Day Program). (3) A REDCap-based platform was designed for data capture and import. Individual attendance at senior activities for the prior year was extracted from existing records. The primary outcome is frailty, as measured by validated walk/balance tests (Short Physical Performance Battery). Secondary outcomes include measures of engagement, and association of use of services/activities with the primary outcome. RESULTS/ANTICIPATED RESULTS: (1) In total, 29 residents and 14 other stakeholders engaged in partnership-building, study design and implementation. (2) From May to November 2017, 98 participants were enrolled from site 1 (a residential site). Enrollment at site 2 (a senior center), begun in November, is projected for February completion. Characteristics of site 1 participants: median age=63.6 years; Hispanic, 44.90% (44); White, 13.89% (10), Black, 62.50% (45); Asian, 4.17% (3); American Indian or Alaskan Native, 2.78% (2), and Other, 16.67% (12). Educational attainment: 51.04% (49) had not completed high school; 19.79% (19) were high school graduates; 18.75% (18) completed some college, and 10.42% (10) were college graduates. For the 85 participants reporting annual income: 64.71% (55) reported <$10,000; 28.24% (24) reported $10,000–$15,000; 7.06% (6) were among the ranges from $15,000 to $50,000. The average body mass index (BMI) was 30, which is obese. For 83.67% (82) of site 1 participants, the BMI was in the range of overweight or obese. Half of participants (49) reported health literacy barriers in the Single Item Health Literacy Survey. Demographics and Frailty assessments (walk and balance tests) for participants enrolled at both sites will be reported. (3) Activity participation data for July 2016–November 2017 were recovered for 507 sessions at site 1 and are being analyzed. DISCUSSION/SIGNIFICANCE OF IMPACT: Here we report progress in developing a sustainable community-academic partnership, infrastructure and research capacity with the CBN senior services organization, and characterizing this at-risk population, of whom 71% have a high school education or less, 93% live in extreme poverty, and 84% are overweight or obese. A simple validated frailty measure in seniors will enable the acceleration of community-based translational research addressing senior health, and examine changes in this measure in relationship to the utilization of senior services.

OBJECTIVES/SPECIFIC AIMS: The Rockefeller University Center for Clinical and Translational Science (RU-CCTS), Clinical Directors Network (CDN), and Carter Burden Network (CBN), a multi-site senior services organization serving East Harlem, NY, formed a community-academic research partnership to characterize the health of the CBN seniors (many who are racial/ethnic minorities, low-income, and suffering from multiple chronic conditions) and to explore the use and associations of a measure of overall health status and frailty in this population. A simple validated measure of health status could standardize and streamline community-based translational research to study the impact of CBN’s services on health outcomes. The CCTS-funded Pilot Project aims to: 1) Engage CBN seniors and stakeholders in priority-setting, joint protocol development, research conduct, analysis and dissemination; 2) Characterize the health status of the CBN seniors using validated measures; 3) Establish an electronic database infrastructure for current and future research; 4) Understand how health and senior activities information can be used to implement programs to improve senior health and well-being. METHODS/STUDY POPULATION: 1) We used Community Engaged Research Navigation (CEnR-Nav) methods to facilitate partnership development, and to engage CBN seniors and stakeholders in each step of the research; 2) Research staff conducted recruitment, informed consent, and physical assessments (e.g., pulse, blood pressure, BMI); and administered validated surveys to collect health status information. 3) Data were captured on a REDCap-based platform. The primary outcome, frailty, was measured by the validated Short Physical Performance Battery (SPPB). 4) Secondary outcomes include the association of use of services/activities with the primary outcome. Research participants consented to sharing of their health, demographic and services utilization data compiled by CBN staff and the NYC Department for the Aging (DFTA). DFTA provided comparison datasets of de-identified health and demographic data for clients attending other NYC DFTA-funded senior centers. RESULTS/ANTICIPATED RESULTS: 1) 43 residents and stakeholders engaged in partnership-building, study design and implementation. 2) 218 participants from two senior centers were enrolled. Mean age, 68 ± 11 years; 58% Hispanic; 33% African American, 23% White, 1% Asian, 18% Unknown, 17% Other; 69% reported <$20000 annual income; 40% had not completed high school; 30% scored as moderately or severely frail; 83% were overweight or obese; and 33% reported a history of diabetes. 84% had uncontrolled high blood pressure; many participants were previously aware of their hypertension diagnosis. 3) A REDcap database was developed to store historical and prospective data. 4) Across frailty categories, there was a significant difference in utilization of non-meal (p = 0.0237) and meal services (p = 0.0127) and there was an inverse proportional relationship between the number of meal and non-meal visits, and frailty. Additional associations among health status measures (e.g., SPPB, demographics, biological measures: pulse, blood pressure, BMI; psychosocial and nutritional scales) and CBN service utilization (i.e., meals vs. non-meals activities) will be presented. DISCUSSION/SIGNIFICANCE OF IMPACT: We developed a community-academic research partnership, infrastructure and capacity, built through our Community-Engaged (CEnR-Nav) model, to conduct a pilot study characterizing the health status and services utilization of low-income minority seniors. Our pilot study identified an urgent health priority, uncontrolled hypertension in 84% of CBN’s seniors. We then leveraged the team’s expertise and CBN’s meal services program to develop a research proposal for external funding to conduct a community-based multi-component intervention study. Replacement of a typical Western diet with the Dietary Approaches to Stop Hypertension (DASH) diet has been proven to reduce blood pressure in hypertensive and normotensive individuals in as little as 14 days, yet effective implementation has been lacking, and it is relatively untested in community-living seniors who receive their meals in settings such as CBN. We are also exploring mechanistic questions that relate to blood pressure control, such as the impact of the DASH diet on inflammation, which may lead to a better understanding of the underlying mechanism of action of the DASH diet. Our community partner, CBN, was awarded the DHHS-ACL nutrition innovation grant to conduct this 2-year study with CDN and RU-CCTS. The resulting study developed out of the community engaged pilot study represents a unique combination of community-centered care, within an implementation science framework (with embedded mechanistic measures under development). This is an example of the novel, full-spectrum approach to translational research that the RU-CCTS/CDN Community Engaged Research Core has been developing over the last decade. The research to characterize CBN clients’ health status is now being extended to address cardiovascular health by way of intervening on diet quality and food insecurity, a key component of the social determinants of health, in partnership with agencies outside of the healthcare delivery system. The outcomes of the DASH Diet implementation study will also serve to inform the broader aging service provider network and the healthcare community about the impact of senior center congregate meal composition and services on health outcomes.

Abstract Background and Purpose Hispanic ethnic density (HED) is associated with salubrious health outcomes for Hispanics, yet recent research suggests it may also be protective for other groups. The purpose of this study was to test whether HED was protective for other racial-ethnic groups. We tested whether social support or neighborhood social integration mediated the association between high HED and depressive symptoms (CES-D) and physical morbidity 5 years later. Lastly, we tested whether race-ethnicity moderated both main and indirect effects. Methods We used Waves 1 (2005–2006), and 2 (2010–2011) from The National Social Life, Health, and Aging Project, a national study of older U.S. adults. Our sample was restricted to Wave 1 adults who returned at Wave 2, did not move from their residence between waves, and self-identified as Hispanic, non-Hispanic White (NHW), or non-Hispanic Black (NHB; n = 1,635). We geo-coded respondents’ addresses to a census-tract and overlaid racial–ethnic population data. Moderated-mediation models using multiple imputation (to handle missingness) and bootstrapping were used to estimate indirect effects for all racial–ethnic categories. Results Depressive symptoms were lower amongst racial-ethnic minorities in ethnically (Hispanic) dense neighborhoods; this effect was not stronger in Hispanics. HED was not associated with physical morbidity. Sensitivity analyses revealed that HED was protective for cardiovascular events in all racial–ethnic groups, but not arthritis, or respiratory disease. Social support and neighborhood social integration were not mediators for the association between HED and outcomes, nor were indirect effects moderated by race–ethnicity. Conclusions This study offers some evidence that HED may be protective for some conditions in older adults; however, the phenomena underlying these effects remains a question for future work.

Abstract Background Communities with more Black or Hispanic residents have higher coronavirus rates than communities with more White residents, but relevant community characteristics are underexplored. The purpose of this study was to investigate poverty-, race- and ethnic-based disparities and associated economic, housing, transit, population health and health care characteristics. Methods Six-month cumulative coronavirus incidence and mortality were examined using adjusted negative binomial models among all U.S. counties (n = 3142). County-level independent variables included percentages in poverty and within racial/ethnic groups (Black, Hispanic, Native American, Asian), and rates of unemployment, lacking a high school diploma, housing cost burden, single parent households, limited English proficiency, diabetes, obesity, smoking, uninsured, preventable hospitalizations, primary care physicians, hospitals, ICU beds and households that were crowded, in multi-unit buildings or without a vehicle. Results Counties with higher percentages of Black (IRR = 1.03, 95% CI: 1.02–1.03) or Hispanic (IRR = 1.02, 95% CI: 1.01–1.03) residents had more coronavirus cases. Counties with higher percentages of Black (IRR = 1.02, 95% CI: 1.02–1.03) or Native American (IRR = 1.02, 95% CI: 1.01–1.04) residents had more deaths. Higher rates of lacking a high school diploma was associated with higher counts of cases (IRR = 1.03, 95% CI: 1.01–1.05) and deaths (IRR = 1.04, 95% CI: 1.01–1.07). Higher percentages of multi-unit households were associated with higher (IRR = 1.02, 95% CI: 1.01–1.04) and unemployment with lower (IRR = 0.96, 95% CI: 0.94–0.98) incidence. Higher percentages of individuals with limited English proficiency (IRR = 1.09, 95% CI: 1.04–1.14) and households without a vehicle (IRR = 1.04, 95% CI: 1.01–1.07) were associated with more deaths. Conclusions These results document differential pandemic impact in counties with more residents who are Black, Hispanic or Native American, highlighting the roles of residential racial segregation and other forms of discrimination. Factors including economic opportunities, occupational risk, public transit and housing conditions should be addressed in pandemic-related public health strategies to mitigate disparities across counties for the current pandemic and future population health events.

Abstract Background Compared to Whites, African Americans have elevated risk for earlier onset fatal and nonfatal chronic conditions and accelerated aging. Despite these persistent race disparities, the causes remain poorly understood. The purpose of this study was to define a biopsychosocial risk typology that might explain accelerated aging in African Americans. Methods Analyses were based on the African American and White subsample of the Health and Retirement Study (N = 8269). Latent class analysis was used to identify risk types. Chronic health conditions, salivary telomere length (STL), emotional support from family, negative interaction with family, early life adversities, and discrimination were used as class indicators. Latent class multinomial logistic regression was used to identify racial and demographic differences in risk type membership. Results Three distinct risk types were identified: high risk, health risk, and psychosocial risk. African Americans were more likely than Whites to be assigned to the high-risk type characterized by chronic health conditions, shorter STL, strained social relationships and high psychosocial stress. African Americans were less likely than Whites to be assigned to the health risk type characterized by chronic health conditions, shorter STL, optimal social relationships, and low psychosocial stress. Conclusions The biopsychosocial risk typology accounted for population heterogeneity, identified high-risk profiles, and modifiable factors within risk types that can inform current clinical interventions. The risk types also revealed different patterns of risk and resilience factors and shed light on the interplay between telomere length, stress exposure, chronic disease, and accelerated aging in African Americans.

Background: Little is known about the link between perceived neighborhood walkability and prevalence of chronic disease. Even less is known regarding this association among Hispanic/Latino adults, despite exhibiting high rates of chronic diseases. Stress due to racial discrimination is a harmful social determinant of health in Hispanics/Latinos. Having both low perceived neighborhood walkability and high racial discrimination stress may exacerbate the chronic disease status of Hispanics/Latinos. Among a U.S. national sample of Hispanic/Latino adults, this cross-sectional study aims to examine (1) the associations among overall perceived neighborhood walkability, racial discrimination stress, and having a chronic health condition; and (2) whether overall perceived neighborhood walkability moderates the hypothesized association between racial discrimination stress and having a chronic health condition.Methods: In January 2018, 798 Hispanic/Latino adults (M age = 39.7 years, SD = 15.1; 58.6% female; 70.0% U.S. born; 52.0% Mexican/Mexican American) responded to a survey via Qualtrics Panels. Surveys included the Neighborhood Environment Walkability Scale-Abbreviated, Hispanic Stress Inventory-2, and self-reported presence/absence of chronic health conditions (e.g., hypertension, heart disease). A logistic regression was conducted testing for the moderation of the main effect of racial discrimination stress on the presence of a chronic health condition by overall perceived neighborhood walkability.Results: After controlling for age, body mass index, and income, racial discrimination stress was inversely associated with overall perceived neighborhood walkability (b = −0.18, p < 0.001) and positively associated with having a chronic health condition (OR = 1.02; 95% CI [1.00, 1.03]). While overall perceived neighborhood walkability was not associated with having a chronic health condition, perceived crime safety was inversely associated with having a chronic health condition (OR = 0.94; 95% CI [0.89, 0.99]). Perceived crime safety moderated the positive association between discrimination stress and having a chronic health condition, such that the association was only significant among those who perceived their neighborhood to be less safe (β = −0.004, 95% CI [−0.01, −0.00]).Conclusions: Overall perceived neighborhood walkability was inversely associated with racial discrimination stress, but not associated with having a chronic health condition. Perceived neighborhood crime safety, but not infrastructure or aesthetics, matters when it comes to the link between racial discrimination stress and having a chronic health condition among Hispanics/Latinos.

Abstract At the end of the eighteenth century, the large-scale warfare that confronted the major European powers exceeded their financial capabilities. This, in turn, affected the operational effectiveness of their military machinery and disturbed its disciplinary order. Consequently, by the 1790s, French, British, and Dutch naval crews resorted to mutiny on an enormous scale. They were driven by fatigue, harsh conditions of service, and disagreements with higher command. Decades later, the Real Armada witnessed a series of riots, resembling those of its rival powers but linked to the struggles for independence in the Hispanic-American colonies. Nearly all historians have overlooked the Spanish case, but the motives and direct consequences of the Spanish mutinies are worthy of explanation as part of global processes driven by the Age of Revolutions. Moreover, they offer an opportunity to improve the knowledge of early modern Spanish naval society.

Abstract In this qualitative study, authors examine women’s sexual risk and protective factors based on their experiences of intimate partner violence (IPV) and positioning within society relative to power. This analysis examines sexual risk and protective factors across intersectional identities—including gender, race, socioeconomic conditions, and age—among women survivors of IPV. The sample (N = 28) included women of diverse ages (range = 22–60 years) and races (57 percent White, 14 percent African American, 11 percent Hispanic, 7 percent Native American, 7 percent multiracial, and 4 percent South Asian). Findings demonstrated that IPV experiences differentially affect women’s sexual health according to intersectional identities and across various levels of environmental context by influencing the (in)stability of their lives and their experiences of (dis)empowerment. This analysis offers a nuanced understanding of how social workers can support women in planning for their own sexual health and safety and shows how an intersectional feminist framework enriches our understanding of the grand challenge to “build healthy relationships to end violence.”

Background: Short sleep duration (e.g., <9 hours (hrs) for 6-12 years and <8 hrs for 13-18 years) is highly prevalent and associated with cardiometabolic risk among adolescents. Significant racial disparities in sleep duration among adolescents have been found. Investigating mechanisms driving sleep disparities is important for informing interventions to reduce disparities. Neighborhood and household stressors may contribute to racial disparities in sleep among adolescents as prior literature have found them to be patterned by race/ethnicity and associated with sleep duration. This study examined neighborhood and household context as mediators in the association between race/ethnicity (a proxy for sociocultural factors such as racism) and sleep duration among adolescents. Methods: Participants (n=13,019) were from Waves I and II of the National Longitudinal Study of Adolescent to Adult Health, a nationally representative multi-ethnic sample of adolescents and their health in adulthood. Sleep duration was self-reported in whole hours per day and categorized based on age-specific cut-offs for short sleep (6-12 years: <9 hrs, 13-18 years: <8 hrs, 19-25 years: <7 hrs) vs. recommended (6-13 years: 9-11 hrs, 14-17 years: 8-10 hrs, 18-25 years: 7-9 hrs). Neighborhood factors included neighborhood socioeconomic status (SES) (e.g. census tract measures: proportions of female-headed households, individuals below the poverty threshold, individuals receiving public assistance, adults with < high school education, and adults unemployed), perceived safety and social cohesion. Household factors included living in a single parent household and household SES (e.g. highest parental education, income, and occupation). Structural equation modeling (SEM) was used to simultaneously assess mediation of neighborhood and household context in the association between race/ethnicity and short sleep duration adjusting for age and sex. Results: The sample was 4% Asian, 15% African American (AA), 2% American Indian (AI), 12% Hispanic, and 66% non-Hispanic White (NHW) and mean age 15 years (SD=.1). In SEM, AAs (β=.055, p<.001) and Asians (β=.047, p=.047) were more likely to have short sleep duration than NHW. Higher household SES was associated with a greater probability for short sleep duration (β=.061, p=.004) in the total sample. Only household SES was a significant mediator, explaining 11.6%, 9.9%, and 42.4% of AA-NHW, AI-NHW, and Hispanic-NHW differences, respectively. Conclusion: Although household SES partially explained racial disparities, improving household SES conditions for racial/ethnic minority adolescents may not reduce disparities, given that higher household SES was positively associated with short sleep duration. Future studies should explore buffers for racial/ethnic minority adolescents in the context of SES to inform interventions and reduce disparities in sleep.

AbstractBackgroundAlthough periods of HIV antiretroviral therapy (ART) discontinuation have deleterious health effects, ART is not always sustained. Yet, little is known about factors that contribute to such ART non-persistence among long-term HIV survivors. The present study applied a convergent parallel mixed-methods design to explore the phenomena of stopping/starting and sustaining ART, focusing on low-socioeconomic status African American or Black and Latino persons living with HIV (PLWH) who face the greatest challenges.MethodsParticipants (N = 512) had poor engagement in HIV care and detectable HIV viral load. All received structured assessments andN = 48 were randomly selected for in-depth interviews. Quantitative analysis using negative binomial regression uncovered associations among multi-level factors and the number of times ART was stopped/started and the longest duration of sustained ART. Qualitative data were analyzed using a directed content analysis approach and results were integrated.ResultsParticipants were diagnosed 18.2 years ago on average (SD = 8.6), started ART a median five times (Q1 = 3, Q3 = 10), and the median longest duration of sustained ART was 18 months (Q1 = 6, Q3 = 36). Factors associated with higher rates of stops/starts were male sex, transgender identity, cannabis use at moderate-to-high-risk levels, and ART- and care-related stigma. Factors associated with lower rates of stops/starts were older age, more years since diagnosis, motivation for care, and lifetime injection drug use (IDU). Factors associated with longer durations of sustained ART were Latino/Hispanic ethnicity, motivation for ART and care, and recent IDU. Factors associated with a shorter duration were African American/Black race, alcohol use at moderate-to-high-risk levels, and social support. Qualitative results uncovered a convergence of intersecting risk factors for stopping/starting ART and challenges inherent in managing HIV over decades in the context of poverty. These included unstable housing, which contributed to social isolation, mental health distress, and substance use concerns, the latter prompting selling (“diverting”) ART. Primarily complementary quantitative and qualitative findings described mechanisms by which risk/protective factors operated and ways PLWH successfully restart and/or sustain ART.ConclusionsThe field focuses substantially on ART adherence, but greater attention to reducing the frequency of ART non-persistence is needed, along with creating social/structural conditions favorable for sustained ART.

Structural racism manifests as an historical and continued invisibility of Asian Americans, whose experiences of disparities and diverse needs are omitted in research, data, and policy. During the pandemic, this invisibility intersects with rising anti-Asian violence and other persistent structural inequities that contribute to higher COVID-19 mortality in older Asian Americans compared to non-Hispanic whites. This perspective describes how structural inequities in social determinants of health—namely immigration, language and telehealth access, and economic conditions—lead to increased COVID-19 mortality and barriers to care among older Asian Americans. Specifically, we discuss how the historically racialized immigration system has patterned older Asian immigrant subpopulations into working in frontline essential occupations with high COVID-19 exposure. The threat of “public charge” rule has also prevented Asian immigrants from receiving eligible public assistance including COVID-19 testing and vaccination programs. We highlight the language diversity among older Asian Americans and how language access remains unaddressed in clinical and non-clinical services and creates barriers to routine and COVID-19 related care, particularly in geographic regions with small Asian American populations. We discuss the economic insecurity of older Asian immigrants and how co-residence in multigenerational homes has exposed them to greater risk of coronavirus transmission. Using an intersectionality-informed approach to address structural inequities, we recommend the disaggregation of racial/ethnic data, meaningful inclusion of older Asian Americans in research and policy, and equitable investment in community and multi-sectoral partnerships to improve health and wellbeing of older Asian Americans.

We Break Up, I Publish: Theorising and Emotional Processing like Taylor Swift In 2007 after the rather painful end of my first long-term same-sex relationship I asked myself two questions (and like a good graduate student wrote a paper about it that was subsequently published): (1) what is love; (2) and if love exists, are queer and straight love somehow different. I asked myself the second question because, unlike my previous “straight” breakups (back when I honestly thought I was straight), this one was different, was far more messy, and seemed to have a lot to do with the fact that my then fresh ex-boyfriend and I had dramatically different ideas about how the relationship should look, work, be codified, or if it should or could be codified. It was an eye-opening experience since the truth that these different ideas existed—basically his point of view—really only “came out” in my mind through the act and learning involved in that breakup. Until then, from a Queer Theory perspective, you could have described me as a “man who had sex with men,” called himself homosexual, but was so homonormative that if you’d approached me with even a light version of Michel Foucault’s thoughts on “Friendship as a Way of Life” I’d have looked at you as queerly, and cluelessly, as possible. Mainstream Queer Theory would have put the end of the relationship down to the difference and conflict between what is pejoratively called the “marriage-chasing-Gay-normaliser,” represented by me, and the “radical-Queer(ness)-of-difference” represented by my ex-boyfriend, although like a lot of theory, that misses the personal (which I recall being political...), and a whole host of non-theoretical problems that plagued that relationship. Basically I thought Queer/Homosexual/Lesbian/Transgendered and the rest of the alphabet soup was exactly the same as Straight folks both with respect to a subjective understanding of the self, social relations and formations, and how you acted or enacted yourself in public and private except in the bedroom.. I thought, since Canada had legalised same-sex marriage, all was well and equal (other than the occasional hate-crime which would then be justly punished). Of course I understood that at that point Canada was the exception and not the rule with respect to same-sex rights and same-sex marriage, so it followed in my mind that most of our time collectively should be spent supporting those south of the border or overseas who still faced restrictions on these basic rights, or out-and-out violence, persecution and even state-sanctioned death for just being who they are and/or trying to express it. And now, five years on, stating that Canada is the exception as opposed to the rule with respect to the legalisation of same-sex marriage and the codification of same-sex rights in law has the potential to be outdated as the recent successes of social movements, court rulings and the tenor of political debate and voting has shifted internationally with rapid speed. But it was only because of that breakup that these theoretical and practical issues had come out of my queer closet and for the first time I started to question some necessary link between love and codification (marriage), and how the queer in Queer relationships does or potentially can disrupt this link. And not just for Queers, but for Straight folk too, which is the primary point that should be underlined now and is addressed at the end of this paper. Because, embittered as I was at the time, I still basically agree with the theoretical position that I came to in that paper on love—based on a queering of the terms of Alain Badiou—where I affirmed that love resisted codification, especially in its queer form, because it is fidelity to an act and truth between two or more partners which resists the rigid walls of State-based codification (Potts, Love Hurts; Badiou, Ethics and Saint Paul). But as one of the peer reviewers for this paper rightly pointed out, the above distinctions between my ex and myself implicitly rely upon a State-centric model of rights and freedoms, which I attacked in the first paper, but which I freely admit I am guilty of utilising and arguing in favour of here. But that is because I am interested, here, not in talking about love as an abstract concept towards which we should work in our personal relationships, but as the state of things, and specifically the state of same-sex marriage and the discourse and images which surrounds it, which means that the State does matter. This is specifically so given the lack of meaningful challenges to the State System in Canada and the US. I maintain, following Butler, that it is through power, and our response to the representatives of power “hailing us,” that we become bodies that matter and subjects (Bodies That Matter; The Psychic Life of Power; and Giving An Account of Oneself). While her re-reading of Althusser in these texts argues that we should come to a philosophical and political position which challenges this State-based form of subject creation and power, she also notes that politically and philosophically we have yet to articulate such a position clearly, and I’d say that this is especially the case for what is covered and argued in the mainstream (media) debate on same-sex marriage. So apropos what is arguably Foucault’s most mature analysis of “power,” and while agreeing that my State-based argument for inclusion and rights does indeed strengthen the “biopolitical” (The History of Sexuality 140 and 145) control over, in this case, Queer populations, I argue that this is nonetheless the political reality with which we are working in and analyzing, and that is my concern here. Despite a personal desire that this not be the case, the State or state sanctioned institutions do continue to hold a monopoly of power in conferring subjecthood and rights. To take a page from Jeremy Bentham, I would say that arguing from a position which does not start from or seriously consider the State as the current basis for rights and subjecthood, though potentially less ethically problematic and more in line with my personal politics, is tantamount to talking and arguing about “nonsense on stilts.” “Caught in a Bad Romance?” Comparing Homonationalist Trajectories and the Appeal of Militarist Discourse to LGBT Grassroots Organisations In comparing the discourses and enframings of the debate over same-sex marriage between Canada in the mid 1990s and early 2000s and in the US today, one might presume that how it came to say “I do” in Canada and how it might or might not get “left at the altar” in the US, is the result of very different national cultures. But this would just subscribe to one of a number of “cultural explanations” for perceived differences between Canada and the US that are usually built upon straw-man comparisons which then pillorise the US for something or other. And in doing so it would continue an obscuration that Canada, unlike the US, is unproblematically open and accepting when it comes to multicultural, multiracial and multisexual diversity and inclusion. Which Canada isn’t nor has it ever been. When you look at the current discourse in both countries—by their key political representatives on the international stage—you find the opposite. In the US, you have President Barack Obama, the first sitting President to come out in favour of same-sex marriage, and the Secretary of State, Hillary Clinton, setting same-sex rights at home and abroad as key policy planks (Gay Rights are Human Rights). Meanwhile, in Canada, you have Prime Minister Stephen Harper, in office since 2006, openly support his Conservative Party’s “traditional marriage” policy which is thankfully made difficult to implement because of the courts, and John Baird, the badly closeted Minister of Foreign Affairs, who doesn’t mention same-sex rights at home or with respect to foreign relations—unless it is used as supplementary evidence to further other foreign policy goals (c.f. Seguin)—only showing off his sexuality outside of the press-gallery to drum up gay-conservative votes or gay-conservative fundraising at LGBTQ community events which his government is then apt to pull funding for (c.f. Bradshaw). Of course my point is not to just reverse the stereotypes, painting an idyllic picture of the US and a grim one of Canada. What I want to problematise is the supposed national cultural distinctions which are naturalised when arguments are made through them as to why same-sex marriage was legalised in Canada, while the Defense of Marriage Act still stands in the US. To follow and extend Jasbir Puar’s argument from Terrorist Assemblages, what we see in both same-sex marriage debates and discourses is really the same phenomenon, but, so far, with different outcomes and having different manifestations. Puar contends that same-sex rights, like most equalising rights for minority groups, are only granted when all three of the following conditions prevail: (1) in a state or narrative of exception, where the nation grants a minority group equal rights because “the nation” feels threatened from without; (2) only on the condition that normalisation (or homonormalisation in the case of the Queer community) occurs, with those who don’t conform pushed further from a place in the national-subject; (3) and that the price of admission into being the “allowed Queer” is an ultra-patriotic identification with the Nation. In Canada, the state or narrative of exception was an “attack” from within which resulted in the third criterion being downplayed (although it is still present). Court challenges in a number of provinces led in each case to a successful ruling in favour of legalising same-sex marriage. Appeals to these rulings made their way to the Supreme Court, who likewise ruled in favour of the legalisation of same-sex marriage. This ruling came with an order to the Canadian Parliament that it had to change the existing marriage laws and definition of marriage to make it inclusive of same-sex marriage. This “attack” was performed by the judiciary who have traditionally (c.f. Makin) been much less partisan in appointment or ruling than their counterparts in the US. When new marriage laws were proposed to take account of the direction made by the courts, the governing Liberal Party and then Prime Minister Paul Martin made it a “free vote” so members of his own party could vote against it if they chose. Although granted with only lacklustre support by the governing party, the Canadian LGBTQ community rejoiced and became less politically active, because we’d won, right? International Queers flocked to Canada—one in four same-sex weddings since legalisation in Canada have been to out of country residents (Postmedia News)—as long as they had the proper socioeconomic profile (which is also a racialised profile) to afford the trip and wedding. This caused a budding same-sex marriage tourism and queer love normalisation industry to be built around the Canada Queer experience because especially at the time of legalisation Canada was still one of the few countries to allow for same-sex marriages. What this all means is that homonationalism in Canada is much less charged. It manifests itself as fitting in and not just keeping up with the Joneses when it comes to things like community engagement and Parent Teacher Association (PTA) meetings, but trying to do them one better (although only by a bit so as not to offend). In essence, the comparatively bland process in the 1990s by which Canada slowly underwent a state of exception by a non-politically charged and non-radical professional judiciary simply interpreting the Canadian Charter of Rights and Freedoms at the provincial and then the federal level is mirrored in the rather bland and non-radical homonationalism which resulted. So unlike the US, the rhetoric of the LGBT community stays subdued unless there’s a hint that the right to same-sex divorce might get hit by Conservative Party guns, in which case all hell breaks loose (c.f. Ha). While the US is subject to the same set of logics for the currently in-progress enactment of legalising same-sex marriage, the state of exception is dramatically different. Puar argues it is the never-ending War on Terror. This also means that the enframings and debate in the US are exceptionally charged and political, leading to a very different type of homonationalism and homonationalist subject than is found in Canada. American homonationalism has not radically changed from Puar’s description, but due to leadership from the top (Obama, Clinton and Lady Gaga) the intensity and thereby structured confinement of what is an acceptable Queer-American subject has become increasingly rigid. What is included and given rights is the hyper-patriotic queer-soldier, the defender of the nation. And what reinforces the rigidity of what amounts to a new “glass closet” for queers is that grassroots organisations have bought into the same rhetoric, logic, and direction as to how to achieve equality as the Homecoming advertisement from the Equal Love Campaign in Britain shows. For the other long-leading nation engaged in the War on Terror narrative, Homecoming provides the imagery of a gay member of the armed services draped in the flag proposing to his partner at the end of duty overseas that ends with the following text: “All men can be heroes. All men can be husbands. End discrimination.” Can’t get more patriotic—and heteronormative with the use of the term “husbands”—than that. Well, unless you’re Lady Gaga. Now Lady Gaga stands out as a public figure whom has taken an explicitly pro-queer and pro-LGBT stance from the outset of her career. And I do not want to diminish the fact that she has been admirably effective in her campaigning and consistent pro-queer and pro-LGBT stance. While above I characterised her input above as leadership from the top, she also, in effect, by standing outside of State Power unlike Obama and Clinton, and being able to be critical of it, is able to push the State in a more progressive direction. This was most obviously evidenced in her very public criticism of the Democratic Party and President Obama for not moving quickly enough to adopt a more pro-queer and pro-LGBT stance after the 2008 election where such promises were made. So Lady Gaga plays a doubled role whereby she also acts as a spokesperson for the grassroots—some would call this co-opting, but that is not the charge made here as she has more accurately given her pre-existing spotlight and Twitter and Facebook presence over to progressive campaigns—and, given her large mainstream media appeal and willingness to use this space to argue for queer and LGBT rights, performs the function of a grassroots organisation by herself as far as the general public is concerned. And in her recent queer activism we see the same sort of discourse and images utilised as in Homecoming. Her work over the first term of Obama’s Presidency—what I’m going to call “The Lady Gaga Offensive”—is indicative: she literally and metaphorically wrapped herself in the American flag, screaming “Obama, ARE YOU LISTENING!!! Repeal ‘Don’t Ask, Don’t Tell’ and [have the homophobic soldiers] go home, go home, go home!” (Lady Gaga Rallies for Repeal of Don’t Ask, Don’t Tell). And presumably to the same home of otherness that is occupied by the terrorist or anything that falls under the blanket of “anti-American” in Puar’s critique of this approach to political activism. This speech was modelled on her highly successful one at the National Equality March in 2009, which she ended with “Bless God and Bless the Gays.” When the highly watched speeches are taken together you literally can’t top them for Americanness, unless it is by a piece of old-fashioned American apple-pie bought at a National Rifle Association (NRA) bake-sale. And is likely why, after Obama’s same-sex “evolution,” the pre-election ads put out by the Democratic Party this year focused so heavily on the repeal of “Don’t Ask, Don’t Tell” and the queer patriotic soldier or veteran’s obligation to or previous service in bearing arms for the country. Now if the goal is to get formal and legal equality quickly, then as a political strategy, to get people onside with same-sex marriage, and from that place to same-sex rights and equal social recognition and respect, this might be a good idea. Before, that is, moving on to a strategy that actually gets to the roots of social inequality and doesn’t rely on “hate of ‘the other’” which Puar’s analysis points out is both a byproduct of and rooted in the base of any nationalist based appeal for minoritarian rights. And I want to underline that I am here talking about what strategy seems to be appealing to people, as opposed to arguing an ethically unproblematic and PC position on equality that is completely inclusive of all forms of love. Because Lady Gaga’s flag-covered and pro-military scream was answered by Obama with the repeal of “Don’t Ask, Don’t Tell” and the extension of some benefits to same-sex couples, and has Obama referring to Gaga as “your leader” in the pre-election ads and elsewhere. So it isn’t really surprising to find mainstream LGBT organisations adopting the same discourse and images to get same-sex rights including marriage. One can also take recent poll numbers from Canada as indicative as well. While only 10 percent of Canadians have trust in political parties, and 17 and 16 percent have trust in Parliament and Prime Minister Harper respectively, a whopping 53 percent have trust in the Canadian Forces (Leblanc). One aspect that undergirds Puar’s argument is that especially at a "time of war," more than average levels of affection or trust is shown for those institutions that defend “us,” so that if the face of that institution is reinscribed to the look of the hyper-patriotic queer-soldier (by advertising of the Homecoming sort which is produced not by the State but by grassroots LGBT organisations), then it looks like these groups seem to be banking that support for Gays and Lesbians in general, and same-sex marriage in specific, will further rise if LGBT and Queer become substantively linked in the imagination of the general public with the armed forces. But as 1980s Rockers Heart Asked: “But There’s Something That You Forgot. What about Love?” What these two homonationalist trajectories and rhetorics on same-sex marriage entirely skip over is how exactly you can codify “love.” Because isn’t that the purpose of marriage? Saying you can codify it is like grasping at a perfectly measured and exact cubic foot of air and telling it to stay put in the middle of a hurricane. So to return to how I ended my earlier exploration of love and if it could or should be codified: it means that as I affirm love, and as I remain in fidelity to it, I subject myself in my fundamental weakness constantly to the "not-known;" to constant heartbreak; to affirmations which I cannot betray as it would be a betrayal of the truth process itself. It's as if at the very moment the Beatles say the words 'All you need is love' they were subjected to wrenching heartbreak and still went on: 'All you need is love...' (Love Hurts) Which is really depressing when I look back at it now. But it was a bad breakup, and I can tend to the morose in word choice and cultural references when depressed. But it also remains essentially my position. If you impose “till death or divorce do us part” on to love you’re really only just participating in the chimera of static love and giving second wind to a patriarchal institution which has had a crappy record when it comes to equality. It also has the potential to preserve asymmetrical roles “traditional marriage” contains from when the institution was only extended to straight couples. And isn’t equality the underlying philosophical principle and political position that we’re supposedly fighting for if we’re arguing for an equal right to get married? Again, it’s important to try and codify the same rights for everyone through the State at the present time because I honestly don’t see major changes confronting the nation state system in Canada or the US in the near future. We remain the play-children of a digitally entrenched form of Foucaultian biopower that is State and Capital directed. Because while the Occupy Wall Street movements got a lot of hay in the press, I’ve yet to see any substantive or mainstreamed political change come out of them—if someone can direct me to their substantive contribution to the recent US election I’d be happy to revise my position—which is likely to our long term detriment. So this is a pragmatic analysis, one of locating one node in the matrices of power relations, of seeing how mainstream LGBT political organisations and Lady Gaga are applying the “theoretical tool kits” given to us by Foucault and Puar, and seeing how these organisations and Gaga are applying them, but in this case in a way that is likely counter to authorial intention(s) and personal politics (Power/Knowledge 145, 193; Terrorist Assemblages). So what this means is that we’re likely to continue to see, in mainstream images of same-sex couples put out by grassroots LGBT organisations, a homonationalism and ideological construction that grows more and more out of touch with Queer realities—the “upper-class house-holding PTA Gay”; although on a positive note I should point out that the Democratic Party in the US seems to be at least including both white and non-white faces in their pre-election same-sex marriage ads—and one that most Queers don’t or can’t fit themselves into especially when it comes down to the economic aspect of that picture, which is contradictory and problematic (c.f. Christopher). It also means that in the US the homonationalism on the horizon looks the same as in Canada except with a healthy dose of paranoia of outsiders and “the other” and a flag draped membership in the NRA, that is, for when the queer super-soldier is not in uniform. It’s a straightjacket for a closet that is becoming smaller because it seeks, through the images projected, inclusion for only a smaller and smaller social sub-set of the Lesbian and Gay community and leaves out more and more of the Queer community than it was five years ago when Puar described it. So instead of trying to dunk the queer into the institution of patriarchy, why not, by showing how so many Queers, their relationships, and their loving styles don’t fit into these archetypes help give everyone, including my “marriage-chasing-Gay-normaliser” former self a little “queer eye, for all eyes.” To look at and see modern straight marriage through the lenses and reasons LGBT and Queer communities (by-and-large) fought for years for access to it: as the codification and breakdown of some rights and responsibilities (i.e. taking care of children); as an act which gives you straightforward access to health benefits and hospital visitation rights; as an easy social signifier for others of a commitment to another person that doesn’t use diluted language like “special friend;” and because when it comes down to it that “in sickness and in health” part of the vow—in the language of a queered Badiou, a vow can be read as the affirmation of a universal and disinterested truth (love) and a moment which can’t be erased retrospectively, say, by divorce—seems like a sincere way to value at least one of those you really care for in the world. And hopefully it, as a side-benefit, it acts as a reminder but is not the actuality of that first fuzzy feeling which (hopefully) doesn’t go away. But I learned my lesson the first time and know that the fuzzy feeling might disappear as it often does. It doesn’t matter how far we try and cram it into any variety of homonationalist closets, since it’ll always find a way to not be there, no matter how tight you thought you’d locked the door to keep it in for good if it wants out. Because you can’t keep emotions by contract: so at the end of the day the logical, ethical and theoretically sound position is to argue for the abolition of marriage as an institution. However, Plato and others have been making that argument for thousands of years, and it still doesn’t seem to have gained popular traction. And we also need to realise, contrary to the opinion of my former self and The Beatles, that you really do need more than love as fidelity to an event of you and your partner’s making when you are being denied your partners health benefits just because you are a same-sex couple, especially when those health benefits could be saving your life. And if same-sex marriage codification is a quick fix for that and similar issues for those who can fit into the State sanctioned same-sex marriage walls, which admittedly leaves some members of the Queer community who don’t overlap out, as part of an overall and more inclusive strategy that does include them then I’m in favour of it. That is, till the time comes that Straight and Queer can, over time and with a lot of mutual social learning, explore how to recognise and give equal rights with or without State based codification to the multiple queer and sometimes polyamorous relationship models that already populate the Gay and Straight worlds right now. So in the meantime continue to count me down as a “marriage-chasing-Gay.” But just pragmatically, not to normalise, as one of a diversity of political strategies for equality and just for now. References Badiou, Alain. Ethics: An Essay on the Understanding of Evil. New York: Verso, 2001. ———. Saint Paul: The Foundation of Universalism, Stanford: Stanford UP, 2003. Bradshaw, James. “Pride Toronto Denied Federal Funding.” The Globe and Mail. 7 May. 2012 ‹http://www.theglobeandmail.com/news/toronto/pride-toronto-denied-federal-funding/article1211065/›. Butler, Judith. Gender Trouble: Feminism and the Subversion of Identity. New York: Routledge,1990. ———. Bodies That Matter: On the Discursive Limits of “Sex”. New York: Routledge, 1993. ———. Excitable Speech: A Politics of the Performative. New York: Routledge, 1997. ———. The Psychic Life of Power: Theories of Subjection. Stanford: Stanford UP, 1997. ———. Giving an Account of Oneself. New York: Fordham UP, 2005. Christopher, Nathaniel. “Openly Gay Men Make Less money, Survey Shows.” Xtra! .5 Nov. 2012 ‹http://www.xtra.ca/public/Vancouver/Openly_gay_men_make_less_money_survey_shows-12756.aspx›. Clinton, Hillary. “Gay Rights Are Human Rights, And Human Rights Are Gay Rights.” United Nations General Assembly. 26 Dec. 2011 ‹http://thinkprogress.org/lgbt/2011/12/06/383003/sec-clinton-to-un-gay-rights-are-human-rights-and-human-rights-are-gay-rights/?mobile=nc›. Foucault, Michel. Power/Knowledge: Selected Interviews and Other Writings 1972-1977. Ed. Colin Gordon. Trans. Colin Gordon, Leo Marshall, John Mepham, Kate Soper. New York: Random House,1980. —. Discipline and Punish: The Birth of the Prison. Trans. Alan Sheridan. Toronto: Random House, 1977. —. The History of Sexuality Volume One: An Introduction. Trans. Robert Hurley. New York: Random House, 1978. Heart. “What About Love.” Heart. Capitol Records, 1985. CD. Ha, Tu Thanh. “Dan Savage: ‘I Had Been Divorced Overnight’.” The Globe and Mail. 12 Jan. 2012 ‹http://www.theglobeandmail.com/news/politics/dan-savage-i-had-been-divorced-overnight/article1358211/›. “Homecoming.” Equal Love Campaign. ‹http://www.youtube.com/watch?v=a54UBWFXsF4›. Leblanc, Daniel. “Harper Among Least Trusted Leaders, Poll Shows.” The Globe and Mail. 12 Nov. 2012 ‹http://www.theglobeandmail.com/news/politics/harper-among-least-trusted-leaders-poll-shows/article5187774/#›. Makin, Kirk. “The Coming Conservative Court: Harper to Reshape Judiciary.” The Globe and Mail. 24 Aug. 2012 ‹http://www.theglobeandmail.com/news/politics/the-coming-conservative-court-harper-to-reshape-judiciary/article595398/›. “Lady Gaga Rallies for Repeal of ‘Don’t Ask, Don’t Tell’ in Portland, Maine.” 9 Sep. 2010 ‹http://www.youtube.com/watch?v=g4rGla6OzGc›. “Lady Gaga Speaks at Gay Rights Rally in Washington DC as Part of the National Equality March.” 11 Oct. 2009 ‹http://www.youtube.com/watch?v=7jepWXu-Z38›. “Obama’s Stirring New Gay Rights Ad.” Newzar.com. 24 May. 2012 ‹http://newzar.com/obamas-stirring-new-gay-rights-ad/›. Postmedia News. “Same-sex Marriage in Canada will not be Revisited, Harper Says.” 12 Jan. 2012 ‹http://news.nationalpost.com/2012/01/12/same-sex-marriage-in-canada-will-not-be-revisited-harper-says/›. Potts, Graham. “‘Love Hurts’: Hunter S. Thompson, the Marquis de Sade and St. Paul Queer Alain Badiou’s Truth and Fidelity.” CTheory. rt002: 2009 ‹http://www.ctheory.net/articles.aspx?id=606›. Puar, Jasbir. Terrorist Assemblages: Homonationalism in Queer Times. London: Duke UP, 2007. Seguin, Rheal. “Baird Calls Out Iran on Human Rights Violations.” The Globe and Mail. 22 Oct. 2012 ‹http://www.theglobeandmail.com/news/politics/baird-calls-out-iran-on-human-rights-violations/article4628968/›.

All history of this area and the general talk and all of that is that 1973 was a turning point and the Aquarius Festival is credited with having turned this region around in so many ways, but I think that is a myth ... and I have to honour the truth; and the truth is that old Dicke Donelly came and did a Welcome to Country the night before the festival. (Joseph in Joseph and Hanley)In 1973 the Australian Union of Students (AUS) held the Aquarius Arts and Lifestyle Festival in a small, rural New South Wales town called Nimbin. The festival was seen as the peak expression of Australian counterculture and is attributed to creating the “Rainbow Region”, an area with a concentration of alternative life stylers in Northern NSW (Derrett 28). While the Aquarius Festival is recognised as a founding historical and countercultural event, the unique and important relationships established with Indigenous people at this time are generally less well known. This article investigates claims that the 1973 Aquarius Festival was “the first event in Australian history that sought permission for the use of the land from the Traditional Owners” (Joseph and Hanley). The diverse international, national and local conditions that coalesced at the Aquarius Festival suggest a fertile environment was created for reconciliatory bonds to develop. Often dismissed as a “tree hugging, soap dodging movement,” the counterculture was radically politicised having sprung from the 1960s social revolutions when the world witnessed mass demonstrations that confronted war, racism, sexism and capitalism. Primarily a youth movement, it was characterised by flamboyant dress, music, drugs and mass gatherings with universities forming the epicentre and white, middle class youth leading the charge. As their ideals of changing the world were frustrated by lack of systematic change, many decided to disengage and a migration to rural settings occurred (Jacob; Munro-Clarke; Newton). In the search for alternatives, the counterculture assimilated many spiritual practices, such as Eastern traditions and mysticism, which were previously obscure to the Western world. This practice of spiritual syncretism can be represented as a direct resistance to the hegemony of the dominant Western culture (Stell). As the new counterculture developed, its progression from urban to rural settings was driven by philosophies imbued with a desire to reconnect with and protect the natural world while simultaneously rejecting the dominant conservative order. A recurring feature of this countercultural ‘back to the land’ migration was not only an empathetic awareness of the injustices of colonial past, but also a genuine desire to learn from the Indigenous people of the land. Indigenous people were generally perceived as genuine opposers of Westernisation, inherently spiritual, ecological, tribal and communal, thus encompassing the primary values to which the counterculture was aspiring (Smith). Cultures converged. One, a youth culture rebelling from its parent culture; the other, ancient cultures reeling from the historical conquest by the youths’ own ancestors. Such cultural intersections are rich with complex scenarios and politics. As a result, often naïve, but well-intended relations were established with Native Americans, various South American Indigenous peoples, New Zealand Maori and, as this article demonstrates, the Original People of Australia (Smith; Newton; Barr-Melej; Zolov). The 1960s protest era fostered the formation of groups aiming to address a variety of issues, and at times many supported each other. Jennifer Clarke says it was the Civil Rights movement that provided the first models of dissent by formulating a “method, ideology and language of protest” as African Americans stood up and shouted prior to other movements (2). The issue of racial empowerment was not lost on Australia’s Indigenous population. Clarke writes that during the 1960s, encouraged by events overseas and buoyed by national organisation, Aborigines “slowly embarked on a political awakening, demanded freedom from the trappings of colonialism and responded to the effects of oppression at worst and neglect at best” (4). Activism of the 1960s had the “profoundly productive effect of providing Aborigines with the confidence to assert their racial identity” (159). Many Indigenous youth were compelled by the zeitgeist to address their people’s issues, fulfilling Charlie Perkins’s intentions of inspiring in Indigenous peoples a will to resist (Perkins). Enjoying new freedoms of movement out of missions, due to the 1967 Constitutional change and the practical implementation of the assimilation policy, up to 32,000 Indigenous youth moved to Redfern, Sydney between 1967 and 1972 (Foley, “An Evening With”). Gary Foley reports that a dynamic new Black Power Movement emerged but the important difference between this new younger group and the older Indigenous leaders of the day was the diverse range of contemporary influences. Taking its mantra from the Black Panther movement in America, though having more in common with the equivalent Native American Red Power movement, the Black Power Movement acknowledged many other international struggles for independence as equally inspiring (Foley, “An Evening”). People joined together for grassroots resistance, formed anti-hierarchical collectives and established solidarities between varied groups who previously would have had little to do with each other. The 1973 Aquarius Festival was directly aligned with “back to the land” philosophies. The intention was to provide a place and a reason for gathering to “facilitate exchanges on survival techniques” and to experience “living in harmony with the natural environment.” without being destructive to the land (Dunstan, “A Survival Festival”). Early documents in the archives, however, reveal no apparent interest in Australia’s Indigenous people, referring more to “silken Arabian tents, mediaeval banners, circus, jugglers and clowns, peace pipes, maypole and magic circles” (Dunstan, “A Survival Festival”). Obliterated from the social landscape and minimally referred to in the Australian education system, Indigenous people were “off the radar” to the majority mindset, and the Australian counterculture similarly was slow to appreciate Indigenous culture. Like mainstream Australia, the local counterculture movement largely perceived the “race” issue as something occurring in other countries, igniting the phrase “in your own backyard” which became a catchcry of Indigenous activists (Foley, “Whiteness and Blackness”) With no mention of any Indigenous interest, it seems likely that the decision to engage grew from the emerging climate of Indigenous activism in Australia. Frustrated by student protestors who seemed oblivious to local racial issues, focusing instead on popular international injustices, Indigenous activists accused them of hypocrisy. Aquarius Festival directors, found themselves open to similar accusations when public announcements elicited a range of responses. Once committed to the location of Nimbin, directors Graeme Dunstan and Johnny Allen began a tour of Australian universities to promote the upcoming event. While at the annual conference of AUS in January 1973 at Monash University, Dunstan met Indigenous activist Gary Foley: Gary witnessed the presentation of Johnny Allen and myself at the Aquarius Foundation session and our jubilation that we had agreement from the village residents to not only allow, but also to collaborate in the production of the Festival. After our presentation which won unanimous support, it was Gary who confronted me with the question “have you asked permission from local Aboriginal folk?” This threw me into confusion because we had seen no Aboriginals in Nimbin. (Dunstan, e-mail) Such a challenge came at a time when the historical climate was etched with political activism, not only within the student movement, but more importantly with Indigenous activists’ recent demonstrations, such as the installation in 1972 of the Tent Embassy in Canberra. As representatives of the counterculture movement, which was characterised by its inclinations towards consciousness-raising, AUS organisers were ethically obliged to respond appropriately to the questions about Indigenous permission and involvement in the Aquarius Festival at Nimbin. In addition to this political pressure, organisers in Nimbin began hearing stories of the area being cursed or taboo for women. This most likely originated from the tradition of Nimbin Rocks, a rocky outcrop one kilometre from Nimbin, as a place where only certain men could go. Jennifer Hoff explains that many major rock formations were immensely sacred places and were treated with great caution and respect. Only a few Elders and custodians could visit these places and many such locations were also forbidden for women. Ceremonies were conducted at places like Nimbin Rocks to ensure the wellbeing of all tribespeople. Stories of the Nimbin curse began to spread and most likely captivated a counterculture interested in mysticism. As organisers had hoped that news of the festival would spread on the “lips of the counterculture,” they were alarmed to hear how “fast the bad news of this curse was travelling” (Dunstan, e-mail). A diplomatic issue escalated with further challenges from the Black Power community when organisers discovered that word had spread to Sydney’s Indigenous community in Redfern. Organisers faced a hostile reaction to their alleged cultural insensitivity and were plagued by negative publicity with accusations the AUS were “violating sacred ground” (Janice Newton 62). Faced with such bad press, Dunstan was determined to repair what was becoming a public relations disaster. It seemed once prompted to the path, a sense of moral responsibility prevailed amongst the organisers and they took the unprecedented step of reaching out to Australia’s Indigenous people. Dunstan claimed that an expedition was made to the local Woodenbong mission to consult with Elder, Uncle Lyle Roberts. To connect with local people required crossing the great social divide present in that era of Australia’s history. Amy Nethery described how from the nineteenth century to the 1960s, a “system of reserves, missions and other institutions isolated, confined and controlled Aboriginal people” (9). She explains that the people were incarcerated as a solution to perceived social problems. For Foley, “the widespread genocidal activity of early “settlement” gave way to a policy of containment” (Foley, “Australia and the Holocaust”). Conditions on missions were notoriously bad with alcoholism, extreme poverty, violence, serious health issues and depression common. Of particular concern to mission administrators was the perceived need to keep Indigenous people separate from the non-indigenous population. Dunstan described the mission he visited as having “bad vibes.” He found it difficult to communicate with the elderly man, and was not sure if he understood Dunstan’s quest, as his “responses came as disjointed raves about Jesus and saving grace” (Dunstan, e-mail). Uncle Lyle, he claimed, did not respond affirmatively or negatively to the suggestion that Nimbin was cursed, and so Dunstan left assuming it was not true. Other organisers began to believe the curse and worried that female festival goers might get sick or worse, die. This interpretation reflected, as Vanessa Bible argues, a general Eurocentric misunderstanding of the relationship of Indigenous peoples with the land. Paul Joseph admits they were naïve whites coming into a place with very little understanding, “we didn’t know if we needed a witch doctor or what we needed but we knew we needed something from the Aborigines to lift the spell!”(Joseph and Hanley). Joseph, one of the first “hippies” who moved to the area, had joined forces with AUS organisers. He said, “it just felt right” to get Indigenous involvement and recounted how organisers made another trip to Woodenbong Mission to find Dickee (Richard) Donnelly, a Song Man, who was very happy to be invited. Whether the curse was valid or not it proved to be productive in further instigating respectful action. Perhaps feeling out of their depth, the organisers initiated another strategy to engage with Australian Indigenous people. A call out was sent through the AUS network to diversify the cultural input and it was recommended they engage the services of South African artist, Bauxhau Stone. Timing aligned well as in 1972 Australia had voted in a new Prime Minister, Gough Whitlam. Whitlam brought about significant political changes, many in response to socialist protests that left a buoyancy in the air for the counterculturalist movement. He made prodigious political changes in support of Indigenous people, including creating the Aboriginal Arts Board as part of the Australian Council of the Arts (ACA). As the ACA were already funding activities for the Aquarius Festival, organisers were successful in gaining two additional grants specifically for Indigenous participation (Farnham). As a result We were able to hire […] representatives, a couple of Kalahari bushmen. ‘Cause we were so dumb, we didn’t think we could speak to the black people, you know what I mean, we thought we would be rejected, or whatever, so for us to really reach out, we needed somebody black to go and talk to them, or so we thought, and it was remarkable. This one Bau, a remarkable fellow really, great artist, great character, he went all over Australia. He went to Pitjantjatjara, Yirrkala and we arranged buses and tents when they got here. We had a very large contingent of Aboriginal people come to the Aquarius Festival, thanks to Whitlam. (Joseph in Joseph and Henley) It was under the aegis of these government grants that Bauxhau Stone conducted his work. Stone embodied a nexus of contemporary issues. Acutely aware of the international movement for racial equality and its relevance to Australia, where conditions were “really appalling”, Stone set out to transform Australian race relations by engaging with the alternative arts movement (Stone). While his white Australian contemporaries may have been unaccustomed to dealing with the Indigenous racial issue, Stone was actively engaged and thus well suited to act as a cultural envoy for the Aquarius Festival. He visited several local missions, inviting people to attend and notifying them of ceremonies being conducted by respected Elders. Nimbin was then the site of the Aquarius Lifestyle and Celebration Festival, a two week gathering of alternative cultures, technologies and youth. It innovatively demonstrated its diversity of influences, attracted people from all over the world and was the first time that the general public really witnessed Australia’s counterculture (Derrett 224). As markers of cultural life, counterculture festivals of the 1960s and 1970s were as iconic as the era itself and many around the world drew on the unique Indigenous heritage of their settings in some form or another (Partridge; Perone; Broadley and Jones; Zolov). The social phenomenon of coming together to experience, celebrate and foster a sense of unity was triggered by protests, music and a simple, yet deep desire to reconnect with each other. Festivals provided an environment where the negative social pressures of race, gender, class and mores (such as clothes) were suspended and held the potential “for personal and social transformation” (St John 167). With the expressed intent to “take matters into our own hands” and try to develop alternative, innovative ways of doing things with collective participation, the Aquarius Festival thus became an optimal space for reinvigorating ancient and Indigenous ways (Dunstan, “A Survival Festival”). With philosophies that venerated collectivism, tribalism, connecting with the earth, and the use of ritual, the Indigenous presence at the Aquarius Festival gave attendees the opportunity to experience these values. To connect authentically with Nimbin’s landscape, forming bonds with the Traditional Owners was essential. Participants were very fortunate to have the presence of the last known initiated men of the area, Uncle Lyle Roberts and Uncle Dickee Donnely. These Elders represented the last vestiges of an ancient culture and conducted innovative ceremonies, song, teachings and created a sacred fire for the new youth they encountered in their land. They welcomed the young people and were very happy for their presence, believing it represented a revolutionary shift (Wedd; King; John Roberts; Cecil Roberts). Images 1 and 2: Ceremony and talks conducted at the Aquarius Festival (people unknown). Photographs reproduced by permission of photographer and festival attendee Paul White. The festival thus provided an important platform for the regeneration of cultural and spiritual practices. John Roberts, nephew of Uncle Lyle, recalled being surprised by the reaction of festival participants to his uncle: “He was happy and then he started to sing. And my God … I couldn’t get near him! There was this big ring of hippies around him. They were about twenty deep!” Sharing to an enthusiastic, captive audience had a positive effect and gave the non-indigenous a direct Indigenous encounter (Cecil Roberts; King; Oshlak). Estimates of the number of Indigenous people in attendance vary, with the main organisers suggesting 800 to 1000 and participants suggesting 200 to 400 (Stone; Wedd; Oshlak: Joseph; King; Cecil Roberts). As the Festival lasted over a two week period, many came and left within that time and estimates are at best reliant on memory, engagement and perspectives. With an estimated total attendance at the Festival between 5000 and 10,000, either number of Indigenous attendees is symbolic and a significant symbolic statistic for Indigenous and non-indigenous to be together on mutual ground in Australia in 1973. Images 3-5: Performers from Yirrkala Dance Group, brought to the festival by Stone with funding from the Federal Government. Photographs reproduced by permission of photographer and festival attendee Dr Ian Cameron. For Indigenous people, the event provided an important occasion to reconnect with their own people, to share their culture with enthusiastic recipients, as well as the chance to experience diverse aspects of the counterculture. Though the northern NSW region has a history of diverse cultural migration of Italian and Indian families, the majority of non-indigenous and Indigenous people had limited interaction with cosmopolitan influences (Kijas 20). Thus Nimbin was a conservative region and many Christianised Indigenous people were also conservative in their outlook. The Aquarius Festival changed that as the Indigenous people experienced the wide-ranging cultural elements of the alternative movement. The festival epitomised countercultural tendencies towards flamboyant fashion and hairstyles, architectural design, fantastical art, circus performance, Asian clothes and religious products, vegetarian food and nudity. Exposure to this bohemian culture would have surely led to “mind expansion and consciousness raising,” explicit aims adhered to by the movement (Roszak). Performers and participants from Africa, America and India also gave attending Indigenous Australians the opportunity to interact with non-European cultures. Many people interviewed for this paper indicated that Indigenous people’s reception of this festival experience was joyous. For Australia’s early counterculture, interest in Indigenous Australia was limited and for organisers of the AUS Aquarius Festival, it was not originally on the agenda. The counterculture in the USA and New Zealand had already started to engage with their Indigenous people some years earlier. However due to the Aquarius Festival’s origins in the student movement and its solidarities with the international Indigenous activist movement, they were forced to shift their priorities. The coincidental selection of a significant spiritual location at Nimbin to hold the festival brought up additional challenges and countercultural intrigue with mystical powers and a desire to connect authentically to the land, further prompted action. Essentially, it was the voices of empowered Indigenous activists, like Gary Foley, which in fact triggered the reaching out to Indigenous involvement. While the counterculture organisers were ultimately receptive and did act with unprecedented respect, credit must be given to Indigenous activists. The activist’s role is to trigger action and challenge thinking and in this case, it was ultimately productive. Therefore the Indigenous people were not merely passive recipients of beneficiary goodwill, but active instigators of appropriate cultural exchange. After the 1973 festival many attendees decided to stay in Nimbin to purchase land collectively and a community was born. Relationships established with local Indigenous people developed further. Upon visiting Nimbin now, one will see a vibrant visual display of Indigenous and psychedelic themed art, a central park with an open fire tended by local custodians and other Indigenous community members, an Aboriginal Centre whose rent is paid for by local shopkeepers, and various expressions of a fusion of counterculture and Indigenous art, music and dance. While it appears that reconciliation became the aspiration for mainstream society in the 1990s, Nimbin’s early counterculture history had Indigenous reconciliation at its very foundation. The efforts made by organisers of the 1973 Aquarius Festival stand as one of very few examples in Australian history where non-indigenous Australians have respectfully sought to learn from Indigenous people and to assimilate their cultural practices. It also stands as an example for the world, of reconciliation, based on hippie ideals of peace and love. They encouraged the hippies moving up here, even when they came out for Aquarius, old Uncle Lyle and Richard Donnelly, they came out and they blessed the mob out here, it was like the hairy people had come back, with the Nimbin, cause the Nimbynji is the little hairy people, so the hairy people came back (Jerome). References Barr-Melej, Patrick. “Siloísmo and the Self in Allende’s Chile: Youth, 'Total Revolution,' and the Roots of the Humanist Movement.” Hispanic American Historical Review 86.4 (Nov. 2006): 747-784. Bible, Vanessa. Aquarius Rising: Terania Creek and the Australian Forest Protest Movement. BA (Honours) Thesis. University of New England, Armidale, 2010. Broadley, Colin, and Judith Jones, eds. Nambassa: A New Direction. Auckland: Reed, 1979. Bryant, Gordon M. Parliament of Australia. Minister for Aboriginal Affairs. 1 May 1973. Australian Union of Students. Records of the AUS, 1934-1991. National Library of Australia MS ACC GB 1992.0505. Cameron, Ian. “Aquarius Festival Photographs.” 1973. Clarke, Jennifer. Aborigines and Activism: Race, Aborigines and the Coming of the Sixties to Australia. Crawley: University of Western Australia Press, 2008. Derrett, Ross. Regional Festivals: Nourishing Community Resilience: The Nature and Role of Cultural Festivals in Northern Rivers NSW Communities. PhD Thesis. Southern Cross University, Lismore, 2008. Dunstan, Graeme. “A Survival Festival May 1973.” 1 Aug. 1972. Pamphlet. MS 6945/1. Nimbin Aquarius Festival Archives. National Library of Australia, Canberra. ---. E-mail to author, 11 July 2012. ---. “The Aquarius Festival.” Aquarius Rainbow Region. n.d. Farnham, Ken. Acting Executive Officer, Aboriginal Council for the Arts. 19 June 1973. Letter. MS ACC GB 1992.0505. Australian Union of Students. Records of the AUS, 1934-1991. National Library of Australia, Canberra. Foley, Gary. “Australia and the Holocaust: A Koori Perspective (1997).” The Koori History Website. n.d. 20 May 2013 ‹http://www.kooriweb.org/foley/essays/essay_8.html›. ---. “Whiteness and Blackness in the Koori Struggle for Self-Determination (1999).” The Koori History Website. n.d. 20 May 2013 ‹http://www.kooriweb.org/foley/essays/essay_9.html›. ---. “Black Power in Redfern 1968-1972 (2001).” The Koori History Website. n.d. 20 May 2013 ‹http://www.kooriweb.org/foley/essays/essay_1.html›. ---. “An Evening with Legendary Aboriginal Activist Gary Foley.” Conference Session. Marxism 2012 “Revolution in the Air”, Melbourne, Mar. 2012. Hoff, Jennifer. Bundjalung Jugun: Bundjalung Country. Lismore: Richmond River Historical Society, 2006. Jacob, Jeffrey. New Pioneers: The Back-to-the-Land Movement and the Search for a Sustainable Future. Pennsylvania: Penn State Press, 1997. Jerome, Burri. Interview. 31 July 2012. Joseph, Paul. Interview. 7 Aug. 2012. Joseph, Paul, and Brendan ‘Mookx’ Hanley. Interview by Rob Willis. 14 Aug. 2010. Audiofile, Session 2 of 3. nla.oh-vn4978025. Rob Willis Folklore Collection. National Library of Australia, Canberra. Kijas, Johanna, Caravans and Communes: Stories of Settling in the Tweed 1970s & 1980s. Murwillumbah: Tweed Shire Council, 2011. King, Vivienne (Aunty Viv). Interview. 1 Aug. 2012. Munro-Clarke, Margaret. Communes of Rural Australia: The Movement Since 1970. Sydney: Hale and Iremonger, 1986. Nethery, Amy. “Aboriginal Reserves: ‘A Modern-Day Concentration Camp’: Using History to Make Sense of Australian Immigration Detention Centres.” Does History Matter? Making and Debating Citizenship, Immigration and Refugee Policy in Australia and New Zealand. Eds. Klaus Neumann and Gwenda Tavan. Canberra: Australian National University Press, 2009. 4. Newton, Janice. “Aborigines, Tribes and the Counterculture.” Social Analysis 23 (1988): 53-71. Newton, John. The Double Rainbow: James K Baxter, Ngati Hau and the Jerusalem Commune. Wellington: Victoria University Press, 2009. Offord, Baden. “Mapping the Rainbow Region: Fields of Belonging and Sites of Confluence.” Transformations 2 (March 2002): 1-5. Oshlak, Al. Interview. 27 Mar. 2013. Partridge, Christopher. “The Spiritual and the Revolutionary: Alternative Spirituality, British Free Festivals, and the Emergence of Rave Culture.” Culture and Religion: An Interdisciplinary Journal 7 (2006): 3-5. Perkins, Charlie. “Charlie Perkins on 1965 Freedom Ride.” Youtube, 13 Oct. 2009. Perone, James E. Woodstock: An Encyclopedia of the Music and Art Fair. Greenwood: Greenwood Publishing Group, 2005. Roberts, John. Interview. 1 Aug. 2012. Roberts, Cecil. Interview. 6 Aug. 2012. Roszak, Theodore. The Making of a Counter Culture: Reflections on the Technocratic Society and Its Youthful Opposition. New York: University of California Press,1969. St John, Graham. “Going Feral: Authentica on the Edge of Australian culture.” The Australian Journal of Anthropology 8 (1997): 167-189. Smith, Sherry. Hippies, Indians and the Fight for Red Power. New York: Oxford University Press, 2012. Stell, Alex. Dancing in the Hyper-Crucible: The Rite de Passage of the Post-Rave Movement. BA (Honours) Thesis. University of Westminster, London, 2005. Stone, Trevor Bauxhau. Interview. 1 Oct. 2012. Wedd, Leila. Interview. 27 Sep. 2012. White, Paul. “Aquarius Revisited.” 1973. Zolov, Eric. Refried Elvis: The Rise of the Mexican Counterculture. Berkeley: University of California Press, 1999.

Introduction This article argues in favour of same-sex marriage, but only under certain conditions. Same-sex marriage ought to be introduced in the Australian context in order to remedy the formal inequalities between lesbian, gay, bisexual and transgender (LGBT) citizens and their heterosexual/cisgendered counterparts. One common method of justifying the introduction of formal same-sex relationship recognition has been via the promotion of LGBT “normalcy.” This article explores such a trend by analysing popular media and advertising, since media representations and coverage have been shown to affect the way the general public “learns, understands, and thinks about an issue” (Li and Lui 73). This article finds that the promotion of normalcy can, in fact, perpetuate hetero-norms, and only offer LGBT people an imaginary social equality. Such normalisation, it is suggested, is detrimental to a wider goal of gaining respect for LGBT people regardless, not in spite of, their identity and relationships. Yet, this article maintains that such imaginary equality can be avoided, so long as a plurality of possibilities for one’s intimate and familial life are actively legitimated and promoted. Australian Same-Sex Relationship Recognition The Relationships Act 2003 (Tas) was the first piece of Australian legislation to formally recognise same-sex relationships. This act allowed Tasmanian residents to register a partnership, although these unions were not recognised in any other Australian State. However, despite this State-based movement, as well as other examples of same-sex unions gaining increasing recognition in the West, not all legal changes have been positive for LGBT people. One example of this was the Howard Government’s 2004 reformation of the Marriage Act 1961 (Cwlth), which made explicit that marriage could only take place between one man and one woman to the exclusion of all others, and also refused to acknowledge same-sex marriages performed legally overseas. Furthermore, 2012 saw the failure of several Bills which sought the introduction of same-sex marriage at both the State and Federal level. Thus, same-sex marriage is still illegal in Australia to-date. But, despite these major setbacks, other progress towards same-sex relationship recognition has continued. At the Federal level, different-sex and same-sex de facto relationship recognition became formally equal over the period of 2008-9. Furthermore, it is both official Greens and Australian Labor Party policy to support equal marriage rights. At the State level, the example of recognising same-sex civil unions/registered partnerships has been followed by Victoria, the Australian Capital Territory, New South Wales, and Queensland. There are several reasons why same-sex couples may desire the right to marry. Some reasons are practical; in any given Nation-State where same-sex couples are without the right to marry, then same-sex partners are unable to claim the same benefits and undertake the same obligations as heterosexual married couples. They are formally unequal. On the basis of their empirical research Jowett and Peel argue that formal equality is a motivating factor for the same-sex marriage movement, noting that a likely incentive to engage in these unions would be security, since LGBT people have heretofore lived and continue to live with a very real threat of discrimination. This is largely why the option of civil unions was created in the West. The measure was first introduced by Denmark in 1989, and its purpose was to be a marriage-like institution, existing solely for the recognition of same-sex couples (Broberg 149). Although civil unions should theoretically offer same-sex couples the same legal benefits and obligations that heterosexual married couples receive, this is widely believed to be false in practice. The Netherlands has almost achieved full equality, at 96%; however, countries such as Belgium rate poorly, at 48% (Waaldijk 9). As such, it has been argued that civil unions are not sufficient alternatives to marriage. Amitai Etzioni claims, “many gay people feel strongly that unless they are entitled to exactly the same marriages as heterosexuals, their basic individual rights are violated, which they (and many liberals) hold as semisacred” (qtd. in Shanley 65). This opinion demonstrates that formal equality is a key concern of the same-sex marriage debate. However, it is not the only concern. The organisation Australian Marriage Equality (AME), which has been at the forefront of the fight for same-sex marriage since its establishment in 2004, claims that “Civil unions are not as widely understood or respected as marriage and creating a separate name for same-sex relationships entrenches a different, discriminatory, second-class status for these relationships” (Greenwich, The Case for Same-Sex Marriage 3). They claim further that, if recognition continues to be refused, it maintains the message that same-sex partners are not capable of the level of love and commitment associated with marriage (Greenwich, The Case for Same-Sex Marriage). Thus, AME claim that not only do the legal entitlements of civil unions frequently fail to be formally equivalent, but even the difference in name contributes to the ongoing discrimination of LGBT people. Although neither marriage nor civil unions are federally available to same-sex couples in Australia, AME argue that marriage must be primarily endorsed, then (Greenwich, A Failed Experiment 1). The argument is, if Australia were to introduce civil unions, but not marriage, civil unions would reify the second-class status of homosexuals, and would present same-sex relationships and homosexuality as inferior to different-sex relationships and heterosexuality. Thus, the title “marriage” is significant, and one strategy for demonstrating that LGBT people are fit for this title has been by promoting representations of sameness to the heterosexual mainstream. To achieve the status that goes along with the ability to marry, same-sex couples have typically tried to get their relationships publicly recognised and legally regulated in two ways. They have sought to (a) demonstrate that LGBT people do structure their relationships and familial lives according to the heteropatriarchal normative stereotypes of traditional family values, and/or (b) they emphasise the “born this way” aspect of LGBT sexuality/gender identity, refusing to situate it as a choice. This latter aspect is significant, since arguments based on natural “facts” often claim that what is true by nature cannot be changed, and/or what is true by nature is good (Antony 12). These two strategies thus seek to contribute to a shift in the public perception of homosexuals, homosexuality, and same-sex relationships. The idea, in other words, is to promote the LGBT subject as being a “normal” and “good” citizen (Jowett and Peel 206). Media Representations of Normal Gays In Australia, the normalcy of same-sex relationships has been advocated perhaps most obviously in television adverting. One such advertisement is run by Get Up! Action for Australia, an independent, grass-roots advocacy organisation. This ad is shot from a first-person perspective, where the camera is the eyes of the subject. It follows the blossoming of a relationship: from meeting a man on a boat, to exchanging phone numbers, dating, attending social events with friends, sharing special occasions, meeting each other’s families, sharing a home, caring for sick family members, and so forth, finally culminating in a proposal for marriage. Upon the proposal it is revealed that the couple consists of two young-adult, white, middle-class men. The purpose of this advertisement is to surprise the audience member, as the gay couple’s relationship follows the same trajectory of what is typically expected in a heterosexual relationship. The effect, in turn, is to shock the audience member into recognising that same-sex couples are just like different-sex couples. Hopefully, this will also serve to justify to the audience member that LGBT people deserve the same legal treatment as heterosexuals. The couple in this advertisement appear to be monogamous, their relationship seems to have blossomed over a length of time, they support each other’s families, and the couple comes to share a home. Projecting images like these suggests that such aspects are the relevant features of marriage, which LGBT people mimic. The second Australian advertisement from AME, features a young-adult, interracial, gay couple, who also appear to be middle-class. In this advertisement the families of the two partners, Ivan and Chris, comment on the illegal status of same-sex marriage in Australia. The ad opens with Ivan’s parents, and notes the length of their marriage—45 years. Ivan later claims that he wants to get married because he wants to be with Chris for life. These signals remind the viewer that marriage is supposed to be a life-long commitment, despite the prevalence of divorce. The advertisement also focuses on Chris’s parents, who claim that thanks to their son’s relationship their family has now expanded. The ad cuts between segments of spoken opinion and shots of family time spent at dinner, or in a park, and so on. At one point Ivan states, “We’re not activists; we’re just people who want to get married, like everyone else.” This reiterates the “normalcy” of the desire to marry in general, which is confirmed by Chris’s statement when he says, “It means that everyone would accept it. It’s sort of like a normal... A sense of normalcy.” This implies that to be seen as normal is both desirable and good; but more to the point, the ad positions LGBT people as if they are all already normal, and simply await recognition. It does not challenge the perception of what “normalcy” is. Finally, the advertisement closes with the written statement: “Marriage: It’s about family. Everyone’s family.” This advertisement thus draws connections between the legal institution of marriage and socially shared normative conceptions of married family life. While these two advertisements are not the only Australian television ads which support this particular vision of same-sex marriage, they are typical. What is interesting is that this particular image of homosexuality and same-sex relationships is becoming increasingly common in popular media also. For example, American sitcom Modern Family features a gay couple who share a house, have an adopted daughter, and maintain a fairly traditional lifestyle where one works full time as a lawyer, while the other remains at home and is the primary care-giver for their daughter. Their relationship is also monogamous and long-term. The couple is white, and they appear to have a middle-class status. Another American sitcom, The New Normal, features a white gay couple (one is Jewish) who also share a home, are in a long-term monogamous relationship, and who both have careers. This sitcom centres on this couple’s decision to have a child and the life of the woman who decides to act as their surrogate. This couple are also financially well off. Both of these sitcoms have prime Australian television slots. Although the status of the couples’ relationships in the aforementioned sitcoms is not primarily focussed on, they each participate in a relationship which is traditionally marriage-like in structure. This includes long-term commitment, monogamy, sharing a home and economic arrangements, starting and raising a family, and so on. And it is the very marriage-like aspects of same-sex relationships which Australian equal marriage advocates have used to justify why same-sex marriage should be legal. The depiction of on-screen homosexual couples (who are gay, rather than lesbian, bisexual, or trans) and the public debate in favour of same-sex marriage both largely promote and depend upon the perception of these relationships as effectively "the same" as heterosexual relationships in terms of structure, goals, commitment, life plans, lifestyle, and so on. A comment should be made on the particular representations in the examples above. The repetition of images of the LGBT community as primarily male, white, young-adult, middle-class, straight-looking, monogamous, and so on, comes at the expense of distancing even further those who do not conform to this model (Borgerson et. al. 959; Fejes 221). These images represent what Darren Rosenblum calls “but-for queers,” meaning that but-for their sexual orientation, these people would be just the same as “normal” heterosexuals. Rosenblum has commented on the increased juridical visibility of but-for queers and the legal gains they have won; however, he criticises that these people have been unable to adequately challenge heterosexism since their acceptance is predicated on being as much like normative heterosexuals as possible (84-5). Heterosexism and heteronormativity refer to the ways in which localised practices and centralised institutions legitimise and privilege heterosexuality, seeing it as fundamental, natural, and normal (Cole and Avery 47). If the only queers who gain visibility thanks to these sitcoms and advertisements are but-for queers, the likelihood that heterosexism will be challenged with the legal recognition of same-sex marriage drastically decreases. Appeals to sameness and normalcy typically refuse to critically examine heteronormative standards of acceptability. This results in the continued promotion of the “sexually involved couple,” realised according to particular normative standards, as the appropriate, best, or even natural trajectory for one’s intimate life. Thus, a key reason that some LGBT people have rejected marriage as an appropriate goal is because assimilative inclusion does not offer a legitimately respected social identity to LGBT people as a whole. When legal changes promoting the equality of LGBT people are predicated on their assimilation to heteronormative relationship criteria, this can only achieve “imaginary” equality and the illusion of progress, while real instances of homophobia, discrimination, marginalisation and hostility towards LGBT people continue (Richardson 394). Thus, given the highly specified representations of “normal” LGBT people, it is fair to conclude that there is a biased representation of same-sex relationships on-screen in terms of sex, race, ability, wealth, monogamy, and so on. The assimilationist strategy of publicising particularly gay identity and relationships as just like heterosexuality appears to depoliticise queerness and render lesbians, bisexuals, and transgender people more or less invisible. This can be problematic insofar as the subversive role that queer identity could play in bringing about social change regarding acceptability of other sexual and intimate relationships is lessened (Richardson 395-6). The question that emerges at this point, then, is whether same-sex marriage is doomed to perpetuate hetero-norms and designate all other non-conformists as socially, morally, and/or legally inferior. Pluralisation Ironically, while some activists reject civil unions, their introduction may be crucial to support a “pluralisation strategy.” AME is, in fact, not opposed to civil unions, so long as they do not pretend to be marriage (Greenwich, A Failed Experiment 1). However, AME’s main focus is still on achieving marriage equality, rather than promoting a diverse array of relationship recognition. A pluralisation strategy, though, would seek to question the very normative and hierarchical status of marriage, given the strategy’s key aim of greater options for legally regulated relationship recognition. Regarding polyamorous relationships specifically, Elizabeth Emens has argued that,The existence of some number of people choosing to live polyamorous lives should prompt us all to [...] think about our own choices and about the ways that our norms and laws urge upon us one model rather than pressing us to make informed, affirmative choices about what might best suit our needs and desires.” (in Shanley 79) While non-monogamous relationships have frequently been rejected, even by same-sex marriage activists, since they too threaten traditional forms of marriage, the above statement clearly articulates the purpose of the pluralisation strategy: to challenge people to think about the way norms and laws press one model upon people, and to challenge that model by engaging in and demanding recognition for other models of intimate and familial relationships. When a variety of formal options for legalising various types of relationships is legislated for, this allows people greater choice in how they can conceive and structure their relationships. It also creates a political space where norms can be publicly assessed, criticised, and re-evaluated. Thus, the goal to be achieved is the representation of multiple relationship/family structures as being of equal worth, rather than fixing them in a relationship hierarchy where traditional marriage is the ideal. There exist many examples of people who “do relationships differently”—whether they are homosexual, polyamorous, asexual, step-families, and so on—and the existence of these must come to be reflected as equally valuable and viable options in the dominant social imaginary. Representations in popular media are one avenue, for example, which advocates of this pluralisation strategy might employ in order to achieve such a shift. Another avenue is advocacy. If advocacy on the importance of formally recognising multiple types of relationships increased, this may balance the legitimacy of these relationships with marriage. Furthermore, it may prevent the perpetuation of hetero-norms and increase respect for LGBT identity, since they would be less likely to be pressured into assimilation. Thus, same-sex marriage activists could, in fact, gain from taking up the cause of refusing one single model for relationship-recognition (Calhoun 1037). In this sense, then, the emergence of civil union schemes as an alternative to marriage in the West has potentially yielded something very valuable in the way of increasing options regarding one’s intimate life, especially in the Australian context where diverse recognition has already begun. Interestingly, Australia has come some way towards pluralisation at the State level; however, it is hardly actively promoted. The civil union schemes of both Tasmania and Victoria have a provision entitling “caring couples” to register their relationships. A “caring couple” involves two people who are not involved in a sexual relationship, who may or may not be related, and who provide mutual or one-sided care to the other. The caring couple are entitled to the same legal benefits as those romantic couples who register their relationships. One can infer then, that not only sexual relationships, but those of the caring couple as in Tasmania and Victoria, or possibly even those of a relationship like one “between three single mothers who are not lovers but who have thrown in their lot together as a family,” could be realised and respected if other alternatives were available and promoted alongside marriage (Cornell, in Shanley 84). While Australia would have quite some way to go to achieve these goals, the examples of Tasmania and Victoria are a promising start in the right direction. Conclusion This paper has argued that marriage is a goal that LGBT people should be wary of. Promoting limited representations of same-sex oriented individuals and couples can perpetuate the primacy of hetero-norms, and fail to deliver respect for all LGBT people. However, despite the growing trend of justifying marriage and homosexuality thanks to “normalcy”, promotion of another strategy—a pluralisation strategy—might result in more beneficial outcomes. It may result in a more balanced weight of normative worth between institutions and types of recognition, which may then result in citizens feeling less compelled to enter marriage. Creating formal equality while pursuing the promotion of other alternatives as legitimate will result in a greater acceptance of queer identity than will the endorsement of same-sex marriage justified by LGBT normalcy. While the latter may result in speedier access to legal benefits for some, the cost of such a strategy should be underscored. 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