Examining neighborhood and interpersonal norms and social support on fruit and vegetable intake in low-income communities.

BACKGROUND: We examined whether neighborhood-, friend-, and family- norms and social support for consumption and purchase of fruits and vegetables (F&V) were associated with F&V intake among low-income residents in subsidized housing communities. We examined baseline data from a study ancillary to the Live Well/Viva Bien intervention. Participants included 290 residents in four low-income subsidized housing sites who were ≥ 18 years of age, English and/or Spanish speaking, and without medical conditions that prevented consumption of F&V. METHODS: Linear regression models examined associations of norms and social support with F&V intake after adjustments for sociodemographic characteristics. RESULTS: In the analysis, neighborhood social support for F&V was associated with a 0.31 cup increase in F&V intake (95% CI = 0.05, 0.57). The family norm for eating F&V and family social support for eating F&V were associated with a 0.32 cup (95% CI = 0.13, 0.52) and 0.42 cup (95% CI = 0.19, 0.64) increase in F&V intake, respectively. CONCLUSIONS: To our knowledge, no other studies have examined neighborhood, family, and peer norms and social support simultaneously and in relation to F&V intake. These findings may inform neighborhood interventions and community-level policies to reduce neighborhood disparities in F&V consumption.

Association between Mean Corpuscular Hemoglobin Concentration and Future Depressive Symptoms in Women.

Insufficient hemoglobin and depression share several symptoms and often occur in the same patients. Here, we sought to clarify their relationship by investigating two indices of oxygenation at the tissue level: mean corpuscular hemoglobin concentration (MCHC) and hemoglobin level. We hypothesized that MCHC would be more informative than hemoglobin levels. This prospective, longitudinal, community-based study included 337 participants (108 men and 229 women; age range, 38-87 years) who received evaluations of MCHC, hemoglobin levels and depressive symptom scores (DSS) during baseline and follow-up examinations, which were performed in 2008-2011 and 2010-2012, respectively. MCHC and hemoglobin levels were measured as part of complete blood counts, while DSS was evaluated using the Beck Depression Inventory. Associations were analyzed using linear regression. We found a statistically significant association between baseline MCHC and follow-up DSS (ß = -0.69, p = 0.026), which remained statistically significant after controlling for potential confounders (ß = -0.71, p = 0.011). Further, when we analyzed the relationship separately for men and women, we observed that it remained stable for women before (ß = -1.00, p = 0.014) and after (ß = -1.09, p = 0.003) adjusting for confounders. The stable association indicates that MCHC may be superior to hemoglobin level as a prognostic factor for future depressive symptoms in women. MCHC is easy to measure and low MCHC is usually treatable. Therefore, screening and intervention efforts could be targeted at women with low MCHC, who appear to have elevated risks of developing depressive symptoms.

The association between discrimination and depressive symptoms among older African Americans: the role of psychological and social factors.

UNLABELLED: BACKGROUND/STUDY CONTEXT: Several studies have demonstrated a link between perceived discrimination and depression in ethnic minority groups, yet most have focused on younger or middle-aged African Americans and little is known about factors that may moderate the relationship. METHODS: Participants were 487 older African Americans (60-98 years old) enrolled in the Minority Aging Research Study. Discrimination, depressive symptoms, and psychological and social resources were assessed via interview using validated measures. Ordinal logistic regression models were used to assess (1) the main relationship between discrimination and depression and (2) resilience, purpose in life, social isolation, and social networks as potential moderators of this relationship. RESULTS: In models adjusted for age, sex, education, and income, perceived discrimination was positively associated with depressive symptoms (odds ratio [OR]: 1.20, 95% confidence interval [CI]: 1.10-1.31; p < .001). However, there was no evidence of effect modification by resilience, purpose in life, social isolation, or social networks (all ps ≤ .05). CONCLUSION: Findings provide support for accumulating evidence on the adverse mental health effects of discrimination among older African Americans. Because the association was not modified by psychological or social factors, these findings do not support a role for a buffering effect of resources on discrimination and depressive symptoms. Further studies are needed to examine a wider range of coping resources among older adults.

An integrative review of relationships between discrimination and Asian American health.

PURPOSE: Many ethnic minorities in the United States experience disproportionate rates of adverse health outcomes or health disparities. Factors such as socioeconomic status do not fully explain how these disparities are generated and maintained. Research has demonstrated that chronic experiences of discrimination are harmful to the health of African Americans and Latinos. However, there is a dearth of research examining Asian Americans' experiences with discrimination and health disparities. The purpose of this integrative review was to summarize the current literature examining discrimination and the mental and physical health of Asian Americans. DESIGN AND METHODS: Combinations of search terms related to discrimination, health, and Asian Americans were used to search five electronic databases. Inclusion criteria were primary research studies, published in English between 1980 and 2011, Asian American adults, and discrimination examined in relationship to a physical or mental health outcome. The search initially yielded 489 results; 14 quantitative studies met inclusion criteria. FINDINGS AND CONCLUSIONS: Quantitative studies in this review revealed several significant associations between discrimination and health outcomes in Asian Americans. Discrimination was significantly associated with depressive symptoms in seven studies. Three studies found associations between discrimination and physical health, including cardiovascular disease, respiratory conditions, obesity, and diabetes. Although the literature was limited by self-reported data, cross-sectional designs, and inconsistent definitions and measurement of discrimination, the findings suggest that discrimination is a significant contributor to poorer health and health disparities for Asian Americans. The findings clearly demonstrate the need for further nursing research in this area to inform evidence-based practice and social policy. CLINICAL RELEVANCE: Patient care providers can recognize discrimination as a significant stressor or purveyor of illness and explore ways to facilitate coping and resilience with their Asian American patients. Community-based participatory research approaches can be implemented by clinicians, academicians, and Asian American community partners to address the issue of discrimination and Asian American health outcomes.

Stress, adherence, and blood pressure control: A baseline examination of Black women with hypertension participating in the SisterTalk II intervention.

The prevalence of hypertension is highest among Black women, but treatment adherence is reportedly low. Stress unique to the experiences of Black Americans may be associated with low adherence and poor blood pressure control, but few studies have examined the relationships between stress, adherence, and blood pressure control among hypertensive Black women. This study seeks to fill gaps in research by examining the association between stress, adherence, and blood pressure control. The baseline sample (n = 571) of at-risk or hypertensive Black women from the SisterTalk II RCT (Northeastern USA, 2004-2006) to improve adherence to recommendations for hypertension was analyzed. Participants self-reported stress, pharmacological adherence, non-pharmacological adherence (i.e. lifestyle management such as diet and exercise), and demographics. Blood pressure and anthropometrics (BMI and waist circumference) were measured. Statistical analysis included ANOVA, t-tests, linear regression. Tests of mediation examined if adherence mediated the relationship between stress and blood pressure control. This study found that stress was associated with lower age (p < .001) and being a single parent (p < .001). Stress was also associated with higher systolic blood pressure (p = .029), and poor blood pressure control (p = .043). Participants who reported higher stress also reported lower non-pharmacological adherence (p = .042). Non-pharmacological adherence was found to mediate the association between stress and blood pressure control. Hence, results document a relationship between stress with non-pharmacological adherence and blood pressure control among Black American women. More research is necessary to examine the relationship between stress and treatment adherence.

Are Experiences of Discrimination Related to Poorer Dietary Intakes Among South Asians in the MASALA Study?

OBJECTIVE: To examine associations between self-reported discrimination and dietary intakes among South Asian (SA) people. METHODS: Data from the Mediators of Atherosclerosis in South Asians Living in America study were used to analyze the relationship between self-reported discrimination and dietary behaviors (n = 866). Self-reported discrimination was measured with the 9-item continuous Everyday Discrimination Scale. Diet was measured with a culturally tailored, validated, 163-item food frequency questionnaire for SA individuals. Dietary variables examined in these analyses included weekly consumption of fruits and vegetables and sweets. The researchers employed multiple logistic and linear regression models. RESULTS: Self-reported discrimination was unrelated to fruit and vegetable intake but was positively associated with consumption of sweets per week (P = .001). CONCLUSIONS AND IMPLICATIONS: Increased consumption of sweets may be a mechanism for SA individuals to cope with stressful experiences of discrimination. Further research examining discrimination and health behavior-related coping strategies among SA people is needed.

Self-reported discrimination and mental health among Asian Indians: Cultural beliefs and coping style as moderators.

The South Asian (SA) population has been underrepresented in research linking discrimination with health indicators; studies that focus on the unique cultural and psychosocial experiences of different SA subgroups are needed. The purpose of this study was to examine associations between self-reported discrimination and mental health among Asian Indians (AIs), and whether traditional cultural beliefs (believing that South Asian cultural traditions should be practiced in the US), coping style, and social support moderated these relationships. Asian Indians (N = 733) had been recruited from community-based sampling frames for the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study were included in this analysis. Multiple linear regression analyses were employed to evaluate relationships between discrimination and depressive symptoms, anger, and anxiety. Participants (men = 54%) were on average 55 years of age and had high levels of English proficiency, education, and income. Higher reports of discrimination were significantly associated with higher depressive symptoms, B = .27 (.05) p < .001, anger, B = .08 (.01), p < .001, and anxiety, B = .10 (.01), p < .001. Associations between discrimination and anger, B = -.005 (.002), p = .02, were weakest among those with stronger cultural beliefs. The link between discrimination and anxiety was attenuated by an active coping style, B = -.05 (.03), p = .04. In sum, self-reported discrimination appeared to adversely impact the mental health of AIs. Discrimination may be better coped with by having strong traditional cultural beliefs and actively managing experiences of discrimination.

The association between discrimination and the health of Sikh Asian Indians.

OBJECTIVE: We investigated the relationships between self-reported discrimination (SRD) and mental and physical health (self-reported physical health conditions and direct, physiologic measures [BMI, waist-to-hip ratio, and blood pressure]) among Sikh Asian Indians (AI), a group that may be particularly discriminated against because of physical manifestations of their faith, including a tendency to wear turbans or ethnic clothing. METHODS: Sikh AIs (N = 196) were recruited from Sikh gurdwaras in Queens, New York. Data were collected on SRD, social support, and self-reported health, along with multiple direct physiological measures for cardiovascular health. RESULTS: Participants who wore turbans/scarves reported higher levels of discrimination than those who did not wear turbans/scarves. As hypothesized, multiple regression analysis supported that discrimination is significantly associated with poorer self-reported mental (B = -.53, p < .001) and physical health (B = -.16, p = .04) while controlling for socioeconomic, acculturation, and social support factors. The study did not support an association between SRD and physiologic measures (elevated BMI, waist-to-hip ratio, and blood pressure). CONCLUSION: Consistent with previous discrimination and health reports, this study demonstrated an inverse relationship between discrimination and health among Sikh AIs, an understudied yet high-risk minority population. Community-based efforts are also needed to reduce the occurrence or buffer the effects of discrimination experienced by Sikh AIs. (PsycINFO Database Record