RESUMO
Research has established relationships between social determinants of health (SDOH) and mental health, with mixed findings on which ethnoracial groups are most vulnerable to deleterious outcomes. The current study examines ethnoracial differences in SDOH and their associations with acute mental health symptoms among patients hospitalized after emergency care. Using data collected in a multi-site study of 1,318 diverse adults admitted to inpatient units, we performed analyses using linear regression models. Findings show that Multiracial/Indigenous and Black adults had significantly higher discrimination and financial stress scores. However, compared with White adults, the positive association between extreme discrimination and acute mental health symptoms was diminished among Latinx (B=-2.3; p=.02) and Black individuals (B=-1.6; p=.05) as was the positive association between financial insecurity and acute mental health symptoms for Black adults (B=-2.3; p=.04). This study provides evidence of differential experiences of SDOH and mental health challenges that may warrant tailored interventions.
Assuntos
Determinantes Sociais da Saúde , Humanos , Determinantes Sociais da Saúde/etnologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Hospitalização/estatística & dados numéricos , Negro ou Afro-Americano/estatística & dados numéricos , Negro ou Afro-Americano/psicologia , Transtornos Mentais/etnologia , Estresse Financeiro/etnologia , Estresse Financeiro/psicologia , Hispânico ou Latino/psicologia , Hispânico ou Latino/estatística & dados numéricos , População Branca/estatística & dados numéricos , População Branca/psicologia , Saúde Mental/etnologia , Adulto Jovem , Etnicidade/estatística & dados numéricos , Etnicidade/psicologia , Idoso , Estados Unidos/epidemiologiaRESUMO
OBJECTIVES: Racial-ethnic disparities in experiences of economic hardship during the pandemic are well documented in the population overall and among older adults. Existing research shows that this economic hardship was much less common at older than younger ages. Little is known about the intersection of racial-ethnic and age disparities in pandemic-related hardship in later life. This research report investigated racial-ethnic gaps in economic hardship by age group among older adults. METHODS: Data were from the 2018 and 2020 U.S. Health and Retirement Study (HRS) including the 2020 coronavirus disease 2019 module. We estimated Heckman-corrected linear probability models to examine differences in experiences of pandemic-related economic hardship in the 2020 HRS by race-ethnicity (non-Hispanic White, non-Hispanic Black, U.S.-born Hispanic, foreign-born Hispanic) across age groups (55-64, 65-74, 75+). In the multivariable analysis, we controlled for sociodemographic characteristics, participation in social programs, pre-existing health conditions and behaviors, and economic resources from the 2018 HRS. RESULTS: Experiences of economic hardship declined with age within each racial-ethnic group. Racial-ethnic gaps in hardship remained at older ages without any controls. However, when all controls were added, racial-ethnic gaps in economic hardship were eliminated for those ages 75+. Individual characteristics prior to the pandemic explained racial-ethnic differences in hardship for the oldest adults (75+) but did not explain gaps for those ages 55-74. DISCUSSION: Results point to structural factors generating new racial-ethnic gaps in pandemic-related economic hardship among those approaching retirement (ages 55-74) that did not affect the oldest adults (ages 75+).
Assuntos
COVID-19 , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Etários , Negro ou Afro-Americano/estatística & dados numéricos , COVID-19/etnologia , COVID-19/epidemiologia , Etnicidade/estatística & dados numéricos , Estresse Financeiro/etnologia , Disparidades nos Níveis de Saúde , Hispânico ou Latino/estatística & dados numéricos , Pandemias/economia , Pobreza/estatística & dados numéricos , Pobreza/etnologia , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Estados Unidos/etnologia , Brancos/estatística & dados numéricosRESUMO
OBJECTIVE: To compare dimensions of financial hardship and self-reported sleep quality among Black women with versus without systemic lupus erythematosus (SLE). METHODS: Participants were 402 Black women (50% with validated diagnosis of SLE) living in Georgia between 2017 and 2020. Black women with SLE were recruited from a population-based cohort established in Atlanta, and Black women without SLE were recruited to be of comparable age and from the same geographic areas as SLE women. Financial hardship was measured using three different scales: financial adjustments, financial setbacks, and financial strain. Sleep was assessed continuously using the Pittsburgh Sleep Quality Index (PSQI) scale. Each dimension of financial hardship was analyzed separately in SLE-stratified multivariable linear regression models and adjusted by sociodemographic and health status factors. RESULTS: Dimensions of financial hardship were similarly distributed across the two groups. Sleep quality was worse in Black women with, versus without, SLE (p < .001). Among Black women with SLE, financial adjustment was positively associated with a 0.40-unit increase in poor sleep quality (95% CI = 0.12-0.67, p = .005). When accounting for cognitive depressive symptoms, financial setbacks and strain were somewhat attenuated for Black women with SLE. Overall, no associations between financial hardships and sleep quality were observed for the women without SLE. CONCLUSIONS: Black women with SLE who experience financial hardships may be more at risk for poor sleep quality than Black women without SLE. Economic interventions targeting this population may help improve their overall health and quality of life.
Assuntos
Negro ou Afro-Americano , Estresse Financeiro , Lúpus Eritematoso Sistêmico , Qualidade do Sono , Humanos , Lúpus Eritematoso Sistêmico/etnologia , Lúpus Eritematoso Sistêmico/economia , Feminino , Negro ou Afro-Americano/estatística & dados numéricos , Adulto , Pessoa de Meia-Idade , Estresse Financeiro/etnologia , GeorgiaRESUMO
Predictors of health across the life-course do not maintain the same significance in very late life and the role of financial strain in health outcomes of very old adults remain unclear. Data from adults aged 74 + in waves 5 and 7 of the Hispanic Established Population for the Epidemiological Study of the Elderly (n = 772) study was used to evaluate the role of financial strain on the health of older Mexican Americans who have the highest poverty rate of any racial or ethnic group in the United States. We evaluate the association between episodic (one wave) and persistent financial strain (two waves), with follow-up health outcomes (self-rated health, ADL (limitations in activities of daily living)/IADL (limitations in instrumental activities of daily living) disability, and depressive symptoms). Adults with persistent strain were twice as likely to experience depressive symptoms and three times more likely to experience IADL limitations than the unstrained. Our findings highlight the role of stress proliferation and allostatic load processes leading to deteriorated health over time.
Assuntos
Atividades Cotidianas , Depressão , Nível de Saúde , Americanos Mexicanos , Humanos , Masculino , Idoso , Feminino , Americanos Mexicanos/estatística & dados numéricos , Americanos Mexicanos/psicologia , Atividades Cotidianas/psicologia , Idoso de 80 Anos ou mais , Depressão/epidemiologia , Depressão/etnologia , Depressão/psicologia , Estados Unidos/epidemiologia , Estados Unidos/etnologia , Estresse Financeiro/etnologia , Estresse Financeiro/psicologiaRESUMO
OBJECTIVES: The present study examined how different family level (family financial stress, family violence) and individual (food insecurity, gender, race) determinants of health were associated with mental health among Puerto Rican adolescents living in the U.S. during the COVID-19 pandemic. METHOD: A sample consisting of 119 Puerto Rican adolescents, aged 13 to 17, was collected via Qualtrics Panels between November 2020 and January 2021. We examined the association between family financial stress experienced during the pandemic and psychological distress. We also evaluated whether the association between family financial stress and psychological distress was moderated by family violence, food insecurity, and the participant's gender and race. RESULTS: Findings showed that food insecurity positively predicted psychological distress. Results also showed that participants' race moderated the association between family financial stress and psychological distress. Specifically, we found that while there was a significant positive association between family financial stress and psychological distress among Puerto Rican adolescents who identified as a racial minority, this association was nonsignificant among White Puerto Rican adolescents. CONCLUSION: Our research highlights the significant role of COVID-19 related family financial stress and food insecurity on Puerto Rican adolescents' poor mental health during the COVID-19 pandemic.