Allostatic Load in Childhood, Adolescence, and Young Adulthood: Are Assumptions of Measurement Invariance Warranted?

OVERVIEW: Allostatic load represents the cumulative toll of chronic mobilization of the body's stress response systems, as indexed by biomarkers. Higher levels of stress and disadvantage predict higher levels of allostatic load, which, in turn, predict poorer physical and mental health outcomes. To maximize the efficacy of prevention efforts, screening for stress- and disadvantage-associated health conditions must occur before middle age-that is, during childhood, adolescence, and young adulthood. However, this requires that models of allostatic load display properties of measurement invariance across age groups. Because most research on allostatic load has featured older adults, it is unclear if these requirements can be met. METHODS: To address this question, we fit a series of exploratory and confirmatory analytic models to data on eight biomarkers using a nationally representative sample of N = 4260 children, adolescents, and young adults drawn from the National Health and Nutrition Examination Survey dataset. RESULTS: Exploratory and confirmatory models indicated that, consistent with allostatic load theory, a unidimensional model was a good fit to the data. However, this model did not display properties of measurement invariance; post-hoc analyses suggested that the biomarkers included in the final confirmatory model were most strongly intercorrelated among young adults and most weakly intercorrelated among adolescents. CONCLUSIONS: These results underscore the importance of testing assumptions about measurement invariance in allostatic load before drawing substantive conclusions about stress, disadvantage, and health by directly comparing levels of allostatic load across different stages of development, while underscoring the need to expand investigations of measurement invariance to samples of longitudinal data.

Necessary, burdensome, or threatening? Awareness of Black-White disparities in health care access and self-rated health for Black and White Americans.

Awareness of racial health care inequities is one prerequisite to eliminating them. Although extant research has described awareness of racial health care inequities in the United States, the health impacts of such awareness on communities that are most impacted by these inequities remains unknown. Therefore, we examined associations between awareness of Black-White racial health care inequities and self-rated health for Black and White adults in the United States. We used survey data from non-Hispanic Black and White participants (N = 6,449) who responded to the national American Health Values Survey (2015-2016) to test associations between awareness of Black-White inequities in health care and self-rated health. Accurate awareness of health care inequities was associated with 47% higher odds of poorer self-rated health for Black individuals. Inaccurate awareness was associated with 36% higher odds of poorer self-rated health for White individuals. Accurate awareness may be adaptive, yet place an additional burden on Black individuals. Inaccurate awareness may harm White individuals' health. Health care system changes and alleviation of racism-related stress may be preventive supports for the health of Black individuals. Accurate awareness should be a goal for White individuals, not only to prevent health risks, but to also facilitate structural change for racial equity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Black Young Adult Superwomen in the Face of Gendered Racial Microaggressions: Contextualizing Challenges With Acceptance and Avoidance and Emotional Eating.

BACKGROUND: Black young adult women (ages 18-35) are at disproportionate risk for obesity and emotional eating. Emotional eating interventions target psychological flexibility, such as reducing experiential avoidance and increasing acceptance of food-related thoughts. Yet Black women face gendered racism, and some endorse roles that reduce psychological flexibility, such as the superwoman schema role. Culturally centered stress and coping has often been overlooked, leading to an incomplete understanding of processes that engender emotional eating and the implications for appropriate and effective interventions for Black young adult women. PURPOSE: We investigated direct and indirect pathways of associations between stress from gendered racial microaggressions to emotional eating through the endorsement of superwoman schema and two aspects of psychological flexibility. METHODS: Black young adult women (N = 504; Mage = 24.72; 75.2% African American; 98.4% cisgender) participated in an online survey wherein they reported demographics, stress from gendered racial microaggressions, superwoman schema, experiential avoidance, acceptance of food-related thoughts, and emotional eating. Path analysis was conducted to examine direct and indirect effects. RESULTS: Results provided evidence for indirect associations between more stress from gendered racial microaggressions and more emotional eating. More stress was associated with greater endorsement of the superwoman schema which was associated with more experiential avoidance and less acceptance of food-related thoughts, which were each associated with more emotional eating. CONCLUSIONS: Endorsement of superwoman schema and concomitant avoidance and less acceptance may be one way that gendered racial stress propels emotional eating. Future research could test intervention components that disrupt this path.

Emotional eating is eating in order to alleviate negative emotions, like those from stress. Black young adult women face particular forms of stress from being mistreated at the intersection of their race and gender. This research was needed to better understand processes that engender emotional eating for Black young adult women so that appropriate and effective interventions can be developed for this group. In this correlational study, Black young adult women (ages 18­35) completed an online survey wherein they answered questions about their experiences, thoughts, and behaviors. The study results indicated that stress from mistreatment due to being a Black woman was associated with endorsing a need to be strong. This need to be strong was associated with avoiding experiences that may lead to negative emotional states and being less accepting of distressing thoughts about food. More avoidance and less acceptance were each associated with more emotional eating. Therefore, if emotional eating or obesity-related interventions already target acceptance and avoidance, but do not reference or contextualize them for Black young adult women­particularly in terms of stress from mistreatment as a Black woman and the need to be strong­such interventions may be less effective.

To social distance or to not social distance? COVID-19 social impact and safety profiles, social determinants, and mental health of Black adults.

The impact of COVID-19 on Black adults' social networks and their perceptions of the safety of social gatherings are intertwined. Yet, we know little about the role of this intersection and social determinants on Black adults' mental health. The goal of this study was to examine profiles of COVID-19 impact and safety for Black adults in the United States, their association with mental health, and the role of sociodemographic, health, and employment social determinants. We used latent class analysis and data from Black adults from the nationally representative survey of the Understanding Coronavirus in America Study (January-February 2021; N = 593) to construct profiles and test associations between profiles, social determinants, and mental health. Black adults in the low visitation safety profile had worse mental health than those in the high home safety profile. Older, retired, and insured Black adults were less likely to be impacted by COVID-19. Both the impact of COVID-19 on social networks and perceptions of safety of engaging with others are important for Black adults' mental health. Age, retirement, and health insurance play a role. Reducing distress and social isolation from COVID-19 impact and safety fears may bolster the mental health of Black adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Intersections of Racial/Ethnic and Religious Identities on Bodily Well-Being for Black College-Attending Emerging Adults.

Black undergraduates face threats to healthy weight and body image (i.e., bodily well-being). Having a strong racial/ethnic identity can promote health during emerging adulthood. However, less is known about the intersections of racial/ethnic and religious identities on the bodily well-being of Black college-attending emerging adults, despite evidence to indicate that aspects of religiosity are also associated with health. We use quantitative data from 767 Black college-attending emerging adults in the Multi-University Study of Identity and Culture to examine the independent contributions of racial/ethnic and religious identity for bodily health, and test a potential interaction between racial/ethnic and religious identity on bodily health outcomes. Results from a multivariate linear regression model indicate that Black college-attending emerging adults with both high religious identity and high racial/ethnic identity exploration had higher body mass index and less positive body image. Findings suggest ways to strengthen the development of culturally appropriate public health prevention and intervention efforts that target body image and weight for Black college-attending emerging adults. IMPACT STATEMENT: Black college-attending emerging adults face challenges to their health, particularly threats to healthy weight and body image during this period of psychosocial transitions. The developmental process of navigating racial/ethnic and religious identities during this time raises challenges and opportunities for health promotion for this population. Yet, research that explores the role of these identities remains scarce. We found that Black college-attending emerging adults had higher body mass index and more negative body image when they reported more racial/ethnic identity exploration coupled with higher religious identities. Results shed light on the complex ways that navigating both racial/ethnic and religious identities may put some Black college-attending emerging adults at greater health risk. Health education and promotion practice focused on improving Black emerging adult health in college contexts should ensure that behavioral interventions are appropriately nuanced and situated in these populations' developmental and cultural considerations.

Examining Exposure to Messaging, Content, and Hate Speech from Partisan News Social Media Posts on Racial and Ethnic Health Disparities.

We investigated the content of liberal and conservative news media Facebook posts on race and ethnic health disparities. A total of 3,327,360 liberal and conservative news Facebook posts from the United States (US) from January 2015 to May 2022 were collected from the Crowd Tangle platform and filtered for race and health-related keywords. Qualitative content analysis was conducted on a random sample of 1750 liberal and 1750 conservative posts. Posts were analyzed for a continuum of hate speech using a newly developed method combining faceted Rasch item response theory with deep learning. Across posts referencing Asian, Black, Latinx, Middle Eastern, and immigrants/refugees, liberal news posts had lower hate scores compared to conservative posts. Liberal news posts were more likely to acknowledge and detail the existence of racial/ethnic health disparities, while conservative news posts were more likely to highlight the negative consequences of protests, immigration, and the disenfranchisement of Whites. Facebook posts from liberal and conservative news focus on different themes with fewer discussions of racial inequities in conservative news. Investigating the discourse on race and health in social media news posts may inform our understanding of the public's exposure to and knowledge of racial health disparities, and policy-level support for ameliorating these disparities.

How We Get Free: Graduate Training as an Opportunity for Equitable Participation and Liberation.

In this conceptual article, we assert that psychology should be transformed to adopt the explicit goal of working toward the liberation of people oppressed by society rather than striving for mere equality. To achieve such a transformation, it is necessary to reenvision graduate training in psychology. Graduate training in psychology is an important vehicle by which psychologists can become prepared to use research and practice to eradicate inequities in society. Therefore, we propose six pillars for liberation-focused graduate training in psychology: critical unlearning/unknowing, cooperative modes of production, prioritizing indigenous knowledge, embedded interdependence, systems-level action, and prioritizing members of oppressed groups. Although this conceptualization may engender resistance, we argue that there are many potential pathways by which graduate training may use liberation psychology to work equitably with oppressed groups to seek justice.

Too Manly and Too Straight? Perceived Sexual Orientation of Black and White Men and Women.

Using data from an online survey assessing perceptions of 12 target1 photos of Black and White males2 and females, the current study examined a moderated mediation model of sexual orientation perceptions (N = 310). Results indicated that perceived masculinity/femininity was not a mediator in the association between target gender and perceived sexual orientation. Black male targets were perceived to be more heterosexual than White male targets, Black female targets were perceived as less heterosexual than White female targets, and Black targets were perceived as more masculine than White targets. These findings may indicate rigid gender- and sexuality-related expectations for Black men. Black women who are perceived as gay may be more at risk of related interpersonal harm than White women. Black sexual minority individuals may face challenges in navigating identity concealment or disclosure. Future research should explore the potential antecedents and consequences of perceptions of Black individuals' sexual orientation.

"Now I just need something sweet": Racism, emotional eating, and health among African Americans.

BACKGROUND: The Environmental Affordances Model theorizes that systemic racism disproportionately exposes African Americans in the United States to chronic everyday stressors (e.g., individual racism) while simultaneously shaping the availability of coping resources (e.g., fast food outlets) and engagement in self-regulatory strategies (e.g., emotional eating). Greater engagement in self-regulatory strategies is theorized to preserve mental health while contributing to medical morbidities and mortality. OBJECTIVE: However, few studies have tested the Environmental Affordances Model, limiting our understanding of how the proposed pathways operate in the lives of African Americans. METHODS: In the present study, the associations between systemic racism (institutional racism, cultural racism, neighborhood disadvantage), chronic everyday stressors (exposure to individual racism), emotional eating, and mental (anxiety symptomatology) and physical (self-rated overall physical health) health are assessed in a sample of 751 African Americans aged 18 to 88. RESULTS: The path analysis reveals that institutional and cultural racism are both positively associated with individual racism. Neighborhood disadvantage is inversely associated with individual racism. Individual racism is significantly associated with greater anxiety symptomatology but is unrelated to self-rated overall physical health. Institutional and cultural racism are associated with emotional eating although individual racism and neighborhood disadvantage are not. Moreover, engagement in emotional eating exacerbates, rather than mitigates, the impacts of individual racism on anxiety symptomatology. CONCLUSIONS: We conclude that institutional and cultural racism contribute to individual racism experiences and emotional eating whereas emotional eating exacerbates associations among individual racism and anxiety symptomatology.

Not Just Time on Social Media: Experiences of Online Racial/Ethnic Discrimination and Worse Sleep Quality for Black, Latinx, Asian, and Multi-racial Young Adults.

Sleep quality in young adulthood sets the stage for long-term health. Racial/ethnic sleep disparities between White college-attending young adults and college-attending young adults of color exist. The stress of experiencing racial/ethnic discrimination makes it difficult for college-attending young adults of color to get good quality sleep. Yet it remains unclear if experiencing online racial/ethnic discrimination also has consequences for sleep quality, and if this association may vary by frequency of social media use. To investigate the role of racial/ethnic discrimination on sleep quality, we conducted an online survey of 154 college-attending young adults (Mage = 19.51) who identified as Black (42.2%), Latinx (16.9%), Asian (20.8%), or Bi-/multi-racial (20.1%) from a predominantly White university. Results indicated that more exposure to racial/ethnic discrimination was associated with worse sleep quality for young adults of color. Results suggest that online racial/ethnic discrimination has a similar negative impact on sleep quality regardless of the frequency of social media use. Increased attention to negative race-related experiences online as one potential risk factor for poor long-term health for young adults of color is needed, regardless of how many hours they spend on social media. Structural interventions, screening for stress due to exposure to online racial/ethnic discrimination, and facilitating opportunities to prepare for this exposure may be an important priority for sleep health and reduction of racial/ethnic health disparities.

Psychotic experiences among Black college students in the United States: The role of socioeconomic factors and discrimination.

BACKGROUND: Psychosis is more prevalent among Black individuals compared with White individuals. However, it is unknown whether this disparity exists among college populations in the United States, and if so, what factors contribute to the disparity. METHODS: We analyzed data from Black and White young adult students using the Health Minds Study (2020-2021), which is a survey administered at 140 colleges in the U.S. Using mediation analysis, we examined the extent to which the relation between race and psychotic experiences was mediated by socioeconomic factors (past and current financial distress, food insecurity, parental education) and discrimination. RESULTS: Approximately 38 % of Black students and 30 % of White students reported lifetime psychotic experiences. Including all socioeconomic factors together in the same model accounted for just over half (50.2 %) the association between race and psychotic experiences. We then conducted additional analyses examining discrimination, all the socioeconomic factors plus discrimination accounted for 81.5 % of the association between race and psychotic experiences. When disentangling the mediators, food insecurity and discrimination accounted for the largest percentages of the association. The effects of past financial distress and parental education were modified by race. CONCLUSION: Black college students were more likely to report lifetime psychotic experiences than their White counterparts. Moreover, socioeconomic factors and discrimination made significant contributions to this racial difference.

Affect reactivity and lifetime racial discrimination among Black college students: The role of coping.

Black individuals face psychological distress resulting from lifetime experiences of racial discrimination, and these experiences may be especially harmful to Black college students as they forge their social identities. One way to examine psychological distress induced by racial discrimination is by assessing affect reactivity, or the degree to which aspects of individuals' mood changes in response to a stressor. This quantitative investigation examines the association between lifetime racial discrimination frequency and stress responses to acute racial discrimination via two aspects of affect reactivity, valence and arousal, and if coping strategies moderate this association. A sample of 239 Black college students (Mage = 19.59, SDage = 2.15, 68.6% female) completed an online questionnaire that included measures of racial discrimination, coping, and demographics. They then attended a laboratory visit during which their affective responses to a stress task were collected. Regression analyses indicated an interaction between lifetime racial discrimination and social support coping on arousal reactivity in response to acute racial discrimination. For individuals who reported low levels of social support coping, more frequent lifetime racial discrimination was associated with a decrease in arousal. For individuals who reported high levels of social support coping, more frequent lifetime racial discrimination was associated with an increase in arousal. Implications for the mental health of Black college students exposed to racial discrimination and avenues for further investigation are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Centering the Heterogeneity of Black Adolescents' Experiences: Guidance for Within-Group Designs among African Diasporic Communities.

Despite notable improvements in theory and methods that center the lived experiences of Black adolescents, White supremacy endures in developmental science. In this article, we focus on one methodological manifestation of White supremacy-sampling decisions that assume Black adolescents are a homogeneous group. We examine overlooked concerns about within-group designs with Black adolescents, such as the erasure of some African diasporic communities in the United States. We first describe the homogeneity assumption and join other scholars in advocating for within-group designs. We next describe challenges with current approaches to within-group designs. We then provide recommendations for antiracist research that makes informed within-group design sampling decisions. We conclude by describing the implications of these strategies for researchers and developmental science.

Anti-racism activism among Black adolescents and emerging adults: Understanding the roles of racism and anticipatory racism-related stress.

This study examines associations between individual racism, anticipatory racism-related stress, and anti-racism activism among Black adolescents (n = 443; Mage  = 15.6; 57.4% female) and emerging adults (n = 447; Mage  = 23.8; 77.6% female). The authors tested competing hypotheses about associations between individual racism and anti-racism activism on anticipatory racism-related stress. Findings indicated anticipatory racism-related stress may be both a catalyst and consequence of engagement in anti-racism activism for Black adolescents and emerging adults. Results for each age group varied by type of stress (physiological; psychological) and activism (low-risk; high-risk). Supporting youth engagement in anti-racism activism without increasing anticipatory racism-related stress is a key priority for meaningfully advancing scholarship on the development of anti-racism and pursuit of racial justice.

Ethnic Identity in Arab Americans: Gender, Religious Upbringing, and Age Differences.

Arab Americans constitute a diverse, sizeable ethnic minority in the United States. However, limited research has examined the content of Arab American ethnic identity and whether this ethnic identity differs by demographic factors. In the present study, we developed measures of Arab American ethnic identity and cultural practice, and assessed differences in those variables by gender, religious affiliation (Muslim, Christian), and age. Arab American adults recruited online from Amazon Mechanical Turk (N = 391) completed an adaptation of the Multidimensional Inventory of Black Identity and a measure of cultural practice that was created for this study based on pre-existing scales. Items loaded onto dimensions of identity (ethnic centrality, private regard, public regard), and subscales showed invariance across gender and religious upbringing. When examining group differences in ethnic identity, we found that attitudes regarding being Arab American varied by gender, such that Arab American women reported higher private regard and lower public regard than men. In turn, participants raised in Muslim households reported higher ethnic centrality and cultural practice than those raised in Christian households, potentially related to Muslims' status as a religious minority in the United Status. Finally, young adults were lower in centrality and private regard than older adults, suggesting either that ethnic identity may develop into adulthood or that young adults' ethnic identity may be influenced by growing up in American society post-9/11. Taken together, findings illustrate the heterogeneity in the ethnic identity of Arab Americans; further research is needed to understand individual differences in Arab Americans' ethnic identity.

Gender discrimination and women's HPA activation to psychosocial stress during the postnatal period.

Stress due to discrimination may contribute to physiological dysregulation and health risk during the postnatal period. This study examined longitudinal associations between gender discrimination and women's cortisol responses to subsequent stress. Mothers (N = 79) reported gender discrimination and completed mother-infant stress tasks with saliva sampling for cortisol at 6, 12, and 18 months postnatal. Multilevel modeling results indicated more overall gender discrimination was associated with higher cortisol. Changes in gender discrimination were not associated with cortisol over time. Gender discrimination may be a factor in women's postnatal stress and associated health risk via the sensitization of physiological stress responses.

State-Level Sexism and Gender Disparities in Health Care Access and Quality in the United States.

In this investigation, we examined the associations between state-level structural sexism-a multidimensional index of gender inequities across economic, political, and cultural domains of the gender system-and health care access and quality among women and men in the United States. We linked administrative data gauging state-level gender gaps in pay, employment, poverty, political representation, and policy protections to individual-level data on health care availability, affordability, and quality from the national Consumer Survey of Health Care Access (2014-2019; N = 24,250). Results show that higher state-level sexism is associated with greater inability to access needed health care and more barriers to affording care for women but not for men. Furthermore, contrary to our hypothesis, women residing in states with higher state-level sexism report better quality of care than women in states with lower levels of sexism. These findings implicate state-level sexism in perpetuating gender disparities in health care.

State-Level Sexism and Women's Health Care Access in the United States: Differences by Race/Ethnicity, 2014-2019.

Objectives. To quantify racial/ethnic differences in the relationship between state-level sexism and barriers to health care access among non-Hispanic White, non-Hispanic Black, and Hispanic women in the United States. Methods. We merged a multidimensional state-level sexism index compiled from administrative data with the national Consumer Survey of Health Care Access (2014-2019; n = 10 898) to test associations between exposure to state-level sexism and barriers to access, availability, and affordability of health care. Results. Greater exposure to state-level sexism was associated with more barriers to health care access among non-Hispanic Black and Hispanic women, but not non-Hispanic White women. Affordability barriers (cost of medical bills, health insurance, prescriptions, and tests) appeared to drive these associations. More frequent need for care exacerbated the relationship between state-level sexism and barriers to care for Hispanic women. Conclusions. The relationship between state-level sexism and women's barriers to health care access differs by race/ethnicity and frequency of needing care. Public Health Implications. State-level policies may be used strategically to promote health care equity at the intersection of gender and race/ethnicity. (Am J Public Health. 2021;111(10):1796-1805. https://doi.org/10.2105/AJPH.2021.306455).

Black adolescents' anticipatory stress responses to multilevel racism: The role of racial identity.

Black adolescents face the stressful experience of racism in their everyday lives, which has negative implications for their health and well-being. In the current study, we explored experiences of individual, institutional, and cultural racism in relation to anticipatory racism-related stress responses (e.g., prolonged negative thinking, arousal in expectation of future racism) among Black adolescents (N = 442). We also examined whether three dimensions of racial identity, centrality, private regard, and public regard, moderate those relationships. We found that more experiences of racism at each level were related to greater anticipatory racism-related stress responses, measured as more cognitive activation of racial stressors, appraisal of coping strategies, and anticipation of future racism. We also found that some relationships between experiences of racism and anticipatory stress varied by regard. The positive relation between individual racism and perseverative cognition was stronger for those with low public regard. Similarly, the positive association between cultural racism and psychological anticipation was stronger for those with low public regard. The positive association between institutional racism and physiological anticipation of future racism was stronger for those with higher private regard. These findings contribute to the growing literature on the pervasiveness of racism in the lives of Black youth and the utility of racial identity to reduce harm from racism. (PsycInfo Database Record (c) 2021 APA, all rights reserved).