Substance Abuse Among Blacks Across the Diaspora.

BACKGROUND: Lower rates of substance abuse are found among Black Americans compared to Whites, but little is known about differences in substance abuse across ethnic groups within the black population. OBJECTIVES: We examined prevalence rates of substance abuse among Blacks across three geographic regions (US, Jamaica, Guyana). The study also sought to ascertain whether length of time, national context and major depressive episodes (MDE) were associated with substance abuse. METHODS: We utilized three different data sources based upon probability samples collected in three different countries. The samples included 3,570 African Americans and 1,621 US Caribbean Black adults from the 2001-2003 National Survey of American Life (NSAL). An additional 1,142 Guyanese Blacks and 1,176 Jamaican Blacks living in the Caribbean region were included from the 2005 NSAL replication extension study, Family Connections Across Generations and Nations (FCGN). Mental disorders were based upon DSM-IV criteria. For the analysis, we used descriptive statistics, chi-square, and multivariate logistic regression analytic procedures. RESULTS: Prevalence of substance abuse varied by national context, with higher rates among Blacks within the United States compared to the Caribbean region. Rates of substance abuse were lower overall for women, but differ across cohorts by nativity and length of time in the United States, and in association with major depressive episode. CONCLUSIONS: The study highlights the need for further examination of how substance abuse disparities between US-based and Caribbean-based populations may become manifested.

Acceptability and use of waist-worn physical activity monitors in Jamaican adolescents: lessons from the field.

OBJECTIVE: We report our experience with a validated waist-worn activity monitor in Jamaican adolescents attending urban high schools. Seventy-nine adolescents from the Global Diet and Activity Research (GDAR) study, recruited from 5 urban Jamaican high schools (two coeducational (n = 37), two all-female schools (n = 32) and one all-boys school (n = 10)) were asked to wear Actigraph wGT3X-BT accelerometers for 7 days (24-h), removing the device only when bathing or swimming. They also logged wake up and bed times in an activity diary. Accelerometry was considered valid if at least 4 days with ≥ 10-h monitor wear were recorded. Validity was compared by adolescent demographic and school characteristics. We also reviewed the students' written feedback on objective physical activity measurement. RESULTS: Participants, 80.5% female, had a mean age of 15.5 ± 0.8 years with 60% attending schools in low-income communities. Accelerometer return rates were > 98% with 84% providing valid data. Validity did not vary by age group, sex and school setting. While participants were excited about participating in the accelerometer sub-study, commonly reported challenges included monitor discomfort during sleep and maintaining the study diary. Objective measurement of physical activity using 24-h waist-worn accelerometers is feasible and acceptable in Jamaican adolescents.

Migration and the Health of Non-migrant Family: Findings from the Jamaica Return(ed) Migrants Study.

Research on the association between migration and health among nonmigrant family in Jamaica is limited. Data from the 2012 Jamaica Return(ed) Migrants Study (N = 621) and weighted regression models were used to investigate the association between migration and health among left-behind women (n = 323) and men (n = 298) in Jamaica. Compared to women whose children lived in Jamaica, women who had a child abroad reported lower odds of good mental health (OR = 0.46, 95% CI 0.21, 0.97). Men in this situation were less satisfied with their lives (b = - 2.370, p = 0.031). Women reported better physical (b = - 2.113, p = 0.010) and mental (b = - 3.119, p = 0.039) health scores when a parent, but not a grandparent, lived abroad. Men with a migrant spouse/partner reported significantly more physical illness symptoms than men whose spouse/partner lived in Jamaica (b = 3.215, p = 0.013). Migration exerts disparate health impacts on left-behind family and may disrupt social relationships.

Gender Differences in Prevalence and Risk Factors Associated With Substance Use in 50- to 65-Year-Old Jamaicans.

ABSTRACT: The purpose of this study was to evaluate gender-specific differences in prevalence and risk factors for alcohol, tobacco, and marijuana use among 50- to 65-year-old Jamaicans. We performed secondary analysis of the 2016 Jamaica National Drug Use Prevalence Survey. The dependent variables were self-reported use of tobacco, alcohol, and marijuana in the 30 days before the survey. The independent variables included general, socioeconomic, and community characteristics and concomitant substance use. Gender-stratified multiple Poisson regressions were conducted. The survey included 1,099 individuals aged 50-65 years; 50.3% were men. Reported use was significantly higher in men than in women: alcohol (54.9% vs. 17.8%), marijuana (22.4% vs. 2.2%), and tobacco (19.2% vs. 3.9%). High income was associated with alcohol use in women, whereas low and middle incomes were associated with marijuana use among men. Being employed was associated with tobacco use among women and with alcohol use among men. Rural residence was associated with alcohol use in women and with marijuana use in men. High neighborhood disorder was associated with tobacco use in women and alcohol and marijuana use in men. Concomitant substance use increased the likelihood of alcohol, tobacco, and marijuana use in men and women. We conclude that gender-sensitive strategies to substance use prevention and treatment are needed in Jamaica.

Maternal Social Disadvantage and Newborn Telomere Length in Archived Dried Blood Spots from the Michigan Neonatal Biobank.

Telomeres are the protective caps at the ends of eukaryotic chromosomes. Short telomere length is associated with morbidity and mortality among adults and may mark the biological impact of social experiences. Using archived dried blood spots from the Michigan Neonatal Biobank, this study examined markers of maternal social disadvantage (educational attainment, receipt of public assistance, marital status, and race/ethnicity) from linked birth certificates as predictors of telomere length at birth in a sample of 192 singleton neonates born to non-Hispanic black, non-Hispanic white, and Latina mothers aged 20-35 years. Consistent with two recent studies in newborns, but counter to the idea that maternal social disadvantage is associated with shorter offspring telomere length, we found that infants born to black mothers had longer telomeres than those born to white mothers (b = 0.12, SE = 0.06, p = .05). However, black/white differences in newborn telomere length varied by receipt of public assistance. Among newborns whose mothers received WIC and/or Medicaid, there were no significant black/white differences in telomere length (b = 0.09, SE = 0.08, p = .25). In contrast, among those whose mothers did not receive public assistance-just 6 out of 69 infants born to black mothers versus 41 out of 69 infants born to white mothers-we found that babies born to black mothers had longer telomere length than babies born to white mothers (b = 0.37, SE = 0.16, p = .03). The interaction between black race/ethnicity and receipt of public assistance did not reach the conventional threshold for statistical significance (b = -0.22, SE = 0.15, p = .13), suggesting that this finding may be due to chance. No other markers of maternal social disadvantage were related to infant telomere length. Although replication of these results in a larger sample with more infants born to black mothers with relatively high socioeconomic status is needed, this study offers preliminary support for the hypothesis that race/ethnic differences in newborn telomere length depend on social context.

Substance use, mental disorders and physical health of Caribbeans at-home compared to those residing in the United States.

This study compares the health conditions of domestic Caribbeans with those living in the United States to explore how national context and migration experiences might influence substance use (i.e., alcohol or drug) and other mental and physical health conditions. The study is based upon probability samples of non-institutionalized Caribbeans living in the United States (1621), Jamaica (1216) and Guyana (2068) 18 years of age and over. Employing descriptive statistics and multivariate analytic procedures, the results revealed that substance use and other physical health conditions and major depressive disorder and mania vary by national context, with higher rates among Caribbeans living in the United States. Context and generation status influenced health outcomes. Among first generation black Caribbeans, residing in the United States for a longer length of time is linked to poorer health outcomes. There were different socio-demographic correlates of health among at-home and abroad Caribbeans. The results of this study support the need for additional research to explain how national context, migratory experiences and generation status contribute to understanding substance use and mental disorders and physical health outcomes among Caribbean first generation and descendants within the United States, compared to those remaining in the Caribbean region.