National origins, social context, timing of migration and the physical and mental health of Caribbeans living in and outside of Canada.

Objectives: Differences in health among migrant groups are related to the length of stay in host countries. We examined the health of people reporting Caribbean ethnic origins within and outside of Canada; and the possible associations between length of stay and poorer physical and mental health outcomes.Method: Analyses were conducted on population data collected in Canada (2000/2001, 2003, 2005), Jamaica (2005) and Guyana (2005). Physician-diagnosed and self-rated health measures were used to assess physical and mental health statuses.Results: Rates of chronic conditions were generally higher among people reporting Caribbean ethnic origins in Canada compared to those living in the Caribbean region. Self-rated fair or poor general health rates, however, were higher among participants in the Caribbean region. Higher rates of any mood disorders were also found among Caribbean region participants in comparison to those in Canada. Logistic regression analyses revealed that new Caribbean immigrants (less than 10 years since immigration) in Canada had better physical health than those who were more established. Those who immigrated more than 20 years ago showed consistently better health conditions than those who had immigrated between 11 and 20 years ago. This healthy immigration effect, however, was not present for all chronic conditions among all Caribbean origin migrant groups. Moreover, mood disorders were highest among new immigrants compared to older immigrants.Conclusions: When and where ethnic Caribbeans migrate to and emigrate from matters in health statuses. These results have implications for policies related to health and well-being in support of ethnic Caribbean origin individuals who relocate to Canada. The paper concludes with suggestions for future studies regarding the health of ethnic origin Caribbeans living within and outside their regions of birth.

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.

Severe physical violence and Black women's health and well-being.

OBJECTIVES: We evaluated the association between intimate partner violence and the mental and physical health status of US Caribbean Black and African American women. METHODS: We used 2001 to 2003 cross-sectional data from the National Survey of American Life-the most detailed study to date of physical and mental health disorders of Americans of African descent. We assessed participants' health conditions by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (Washington, DC; American Psychological Association) Composite International Diagnostic Interview. RESULTS: We found differences in health conditions between abused African American and Caribbean Black women. There were increased risks for lifetime dysthymia, alcohol dependence, drug abuse, and poor perceived health for African American victims of partner abuse, and binge eating disorder was associated with partner violence among Caribbean Black women. CONCLUSIONS: Severe intimate partner violence was associated with negative mental and physical health outcomes for US Black women, with different patterns between African American and Caribbean Blacks. Understanding intimate partner violence experiences of US Black women requires recognition of key intragroup differences, including nativity and immigrant status, and their differential relationships to women's health.

Coping and Protective Factors of Mental Health: An Examination of African American and US Caribbean Black Women Exposed to IPV from a Nationally Representative Sample.

Existing research continues to highlight the harm that intimate partner violence (IPV) can pose to health and well-being. However, little is done to understand the effectiveness of coping and protective mechanisms in helping women manage under adverse circumstances. The current study addresses the mental health of US Black women and the role of coping and protective moderators. An analysis of data from the National Survey of American Life (2001-2003), the most comprehensive survey on the health of US Blacks, was conducted. The association between severe physical intimate partner violence and mental health outcomes were confirmed. Resilience moderated the relationship between severe intimate partner violence and mood disorder among US Black women, but this differed between African American and Caribbean Blacks. Resilience, emotional family support, and spirituality reduced the likelihood of having a mental health condition for some African American and Caribbean Black women, while the opposite was found for religiosity. Demographic factors were also associated with mental health conditions and behaviors. The study draws our attention to potential coping and protective mechanisms that could be incorporated into counseling and intervention practices while recognizing factors that may be harmful to the mental health of individuals.

Help-Seeking Behaviors and Barriers Among Black Women Exposed to Severe Intimate Partner Violence: Findings From a Nationally Representative Sample.

This article examined general help-seeking utilization and barriers among U.S. Black women reporting severe physical intimate partner violence (IPV). Data from the National Survey of American Life (NSAL), the largest and most detailed survey on Blacks residing in the United States, were analyzed. Among U.S. Black women reporting severe physical IPV, many sought the help of a psychiatrist (13.8%) or other mental health professionals (14.0%). Multivariate findings revealed associations between help-seeking utilization and sociodemographic factors. Queries from open responses suggested potential cultural and ethnic differences between African American and Caribbean Black women reporting intimate partner violence in relation to barriers to help-seeking.

Intimate Partner Violence and the Role of Child Maltreatment and Neighborhood Violence: A Retrospective Study of African American and US Caribbean Black Women.

Background: Research suggests that intimate partner violence (IPV) is associated with childhood maltreatment and violence exposure within the neighborhood context. This study examined the role of child maltreatment and violence exposure on intimate partner violence, with the moderating effects of mental disorders (IPV) among US Black women. Methods: Data from the National Survey of American Life (NSAL), the largest and most complete sample on the mental health of US Blacks, and the first representative sample of Caribbean Blacks residing in the United States was used to address the study objectives. Descriptive statistics, chi-square test of independence, t-test, and logistic regression procedures were used to analyze the data. Results: Bivariate results indicate an association between child abuse and intimate partner victimization among US Black women. Witnessing violence as a child as well as neighborhood violence exposure was also related to IPV but shown to differ between African American and Caribbean Black women. Multivariate findings confirmed the influence of mental disorders and social conditions on US Black women's risk for IPV. Moderating effects of child maltreatment and mental disorders in association with adult IPV were not found. Conclusions: The study addressed the short and long-term impact of child maltreatment and the contribution to the cycle of intimate violence among US Black women including African American and Caribbean Blacks. The study suggests the need for prevention and intervention efforts to improve structural conditions for at-risk populations and communities predisposed to violence and other negative outcomes. Possibilities for future research are also discussed.

Severe Intimate Partner Violence, Sources of Stress and the Mental Health of U.S. Black Women.

Background: We investigate the mental health risk of U.S. Black women by examining the roles of intimate partner violence (IPV), major discrimination, neighborhood characteristics, and sociodemographic factors using one of the largest and most complete datasets on U.S. Blacks. Materials and Methods: The National Survey of American Life (NSAL) used a slightly modified version of the World Health Organization Composite International Diagnostic Interview (WHO-CIDI) with a sample of 6082 participants. We also assess intraracial group differences based on ethnicity and nativity status (U.S.-born African American, U.S.-born Caribbean Black, and foreign-born Caribbean Black). Results: The study provides evidence that severe physical intimate partner violence (SPIPV) is a significant threat to the mental health of U.S. Black women. Bivariate and multivariate analyses indicate that those with a history of SPIPV were at greater risk for mental disorders than women who did not experience violence by a spouse or partner. Racial discrimination was associated with higher odds of anxiety and substance disorders, whereas gender discrimination was associated with higher odds of mood disorders. Neighborhood drug problems also increased the odds of mood, anxiety, and substance use disorders. Older age and being an Afro-Caribbean immigrant were associated with lower odds of three of four mental disorders. Conclusions: Findings from the study indicate the need for community and clinical interventions aimed at addressing IPV and other community factors that influence Black women's mental health.

Social and economic influences on disparities in the health of racial and ethnic group Canadian immigrants.

OBJECTIVE: To examine social, economic, and migratory influences on the health of racial and ethnic minority groups in Canada, with a special focus on Caribbean immigrants. METHODS: Combined annual cycles (2011-2016) of the Canadian Community Health Survey (CCHS) data totaling over 300,000 adult Canadian residents were aggregated. Descriptive statistics and multivariable logistic regression models were used to examine the prevalence and associated factors of (1) cardiovascular disease diagnosed by a healthcare professional, and (2) self-rated general health among racial and ethnic groups. RESULTS: Caribbeans in general, Black and other non-White Canadians had significantly higher odds (adjusted for age/sex) of reporting any cardiovascular disease compared with White Canadians. Only non-Caribbean Blacks had higher odds of self-rated fair or poor general health compared with White Canadians. Multivariate logistic regression models revealed that after controlling for social and demographic factors, immigration status and years since migration, Caribbean non-Blacks and Black Caribbeans were at higher odds of having a doctor-reported cardiovascular health condition compared with White Canadians. Caribbean non-Blacks also had higher odds of fair or poor self-rated health than White Canadians. CONCLUSION: The results of this study highlight the need for additional investigations of other potential influences on physical health statuses, especially among migrants and those of African ancestry who might be more prone to adverse health outcomes.

RéSUMé: OBJECTIF: Examiner les influences socioéconomiques et migratoires sur la santé des minorités raciales et ethniques au Canada, en particulier les immigrants caribéens. MéTHODE: Les données des cycles annuels combinés (2011-2016) de l'Enquête sur la santé dans les collectivités canadiennes (ESCC) totalisant plus de 300 000 résidents canadiens adultes ont été regroupées. Des statistiques descriptives et des modèles de régression logistique multivariée ont été utilisés pour examiner la prévalence et les facteurs connexes 1) des maladies cardiovasculaires diagnostiquées par un professionnel des soins de santé et 2) de la santé générale autoévaluée au sein de groupes raciaux et ethniques. RéSULTATS: Les Caribéens en général, les Noirs et les autres Canadiens non blancs présentaient une probabilité sensiblement plus élevée (ajustée selon l'âge et le sexe) de déclarer n'importe quelle maladie cardiovasculaire que les Canadiens blancs. Seuls les Noirs non caribéens présentaient une probabilité supérieure de faire état d'une santé générale autoévaluée passable ou mauvaise que les Canadiens blancs. Les modèles de régression logistique multivariée ont révélé qu'en tenant compte des facteurs sociodémographiques, du statut d'immigration et du nombre d'années depuis la migration, les Caribéens non noirs et les Caribéens noirs présentaient une probabilité plus élevée d'avoir un trouble de santé cardiovasculaire déclaré par un médecin que les Canadiens blancs. Les Caribéens non noirs présentaient aussi une probabilité plus élevée de faire état d'une santé autoévaluée passable ou mauvaise que les Canadiens blancs. CONCLUSION: Les résultats de l'étude soulignent la nécessité de pousser la recherche sur les autres facteurs susceptibles d'influencer l'état de santé physique, surtout chez les migrants et les personnes d'origine africaine qui pourraient être plus sujets à des résultats sanitaires indésirables.

Physical Intimate Partner Violence, Childhood Physical Abuse and Mental Health of U.S. Caribbean Women: The Interrelationship of Social, Contextual, and Migratory Influences.

The literature has shown an increased risk for mental health conditions among victims of domestic violence. Few studies have examined the relationship between mental health disorders and domestic violence among Caribbean women, and how the association might be influenced by migratory and contextual factors. This study addresses the mental well-being of U.S. Caribbean Black women victims of domestic violence, and the relationships between acculturation, discrimination, and demographic influences. An analysis of data from the 2001-2003 National Survey of American Life (NSAL) re-interview, the first and most complete study on U.S. Caribbean Blacks, was conducted. Bivariate analysis revealed an association between acts of physical domestic violence and mental health conditions, with generally higher risk among women who reported both severe physical intimate partner violence and childhood physical abuse. Multivariate logistic regression indicates an association between specific mental disorders and acts of domestic violence. Acculturation, length of residence in the United States, age, education, poverty, and country of origin were also associated with mental health. The study highlights future directions for exploration including additional investigation of the influence of acculturation on the physical health of victims of domestic violence.

Severe Physical Intimate Partner Violence and the Mental and Physical Health of U.S. Caribbean Black Women.

BACKGROUND: Intimate partner violence is a threat to women's health. Relative to other racial/ethnic groups, African American and immigrant women are at an increased risk for violence. However, despite the growing presence of Caribbean Black immigrants in this country, few studies have examined the association between severe physical intimate partner violence (SPIPV) and the health of Caribbean Black women currently residing in the United States. This study examined the mental and physical health of U.S. Caribbean Black women with and without a history of SPIPV. We also explored the role of generational status-first, second, or third-in association with the physical and mental health of abused Caribbean Black women. METHODS: Data from the National Survey of American Life, the largest and the only known representative study on Caribbeans residing in the United States, were analyzed. The World Health Organization (WHO) World Mental Health Composite International Diagnostic Interview (WMH-CIDI) was used to determine DSM-IV mental disorders. The presence of physical health conditions was based on respondents' self-reports of physician diagnoses. RESULTS: The findings indicate an association between SPIPV and the mental and physical health status of U.S. Caribbean Black women. Rates of physical conditions and mental health disorders were generally higher among women with a history of SPIPV than those without a history. Generational status also played a role in women's health outcomes. CONCLUSIONS: The study has interventions and preventive implications for both detecting and addressing the health needs of U.S. Caribbean Black women who experience severe physical abuse by an intimate partner.

Prevalence and Factors Associated With Severe Physical Intimate Partner Violence Among U.S. Black Women: A Comparison of African American and Caribbean Blacks.

This study explored prevalence rates and factors associated with lifetime severe physical intimate partner violence among U.S. Black women. Data from the National Survey of American Life were examined. Rates of severe physical intimate partner violence were higher among African American women compared with U.S. Caribbean Black women. Risk factors associated with reported abuse were similar to those found in earlier studies but differed by ethnic backgrounds. Demographic, resource, and situational factors were associated with severe physical intimate partner violence among U.S. Black women in general but made unique contributions by ethnic group. Implications and suggestions for future studies were discussed.

Relationship of social and economic factors to mental disorders among population-based samples of Jamaicans and Guyanese.

BACKGROUND: There have been growing concerns about increasing mental health problems in the Caribbean region. This study explores rates and factors associated with selected mental health disorders within 2 Caribbean countries: Jamaica and Guyana. METHODS: Probability samples of 1218 Jamaicans and 2068 Guyanese participants were used. A modified version of the WHO Composite International Diagnostic Interview (WHO CIDI) defined by the Diagnostic Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) was administered in order to assess lifetime mental disorders. Descriptive statistics, χ2 and hierarchical regression analytic procedures were used to examine rates and factors associated with mental disorders. RESULTS: Rates of mental health conditions were different across contexts and were generally higher for Guyanese compared with Jamaicans for alcohol abuse (3.6% vs 2.2%), drug abuse (1.4% vs 1.3%), substance abuse (4.7% vs 2.7%) and mania (0.4% vs 0.1%). The rate of depression, however, was higher among Jamaicans than Guyanese (7.4% vs 4.1%). There were also noticeable differences in rates in both countries, due to social and economic factors, with social factors playing a larger contributory role in the mental health status of individuals across countries. CONCLUSIONS: The results of this study suggest the need for more indepth analyses of factors contributing to mental health conditions of peoples within the Caribbean region, including the influence of additional sources of stress, quality of care and help-seeking behaviours of individuals.

The mental health of US Black women: the roles of social context and severe intimate partner violence.

OBJECTIVE: Black women continue to have rates of mental health conditions that can be negative for their well-being. This study examined the contribution of social and contextual factors and severe physical intimate partner violence on the mental health of US Black women (African-American and Caribbean Black). SETTING: Data were largely collected via in-person community interviews at participants' homes. PARTICIPANTS: We studied 3277 African-American and Black Caribbean women from the 2001-2003 National Survey of American Life (NSAL), the largest and most complete sample of Blacks residing in the USA. PRIMARY AND SECONDARY OUTCOMES: Key outcomes included an array of psychiatric disorders based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). RESULTS: Bivariate results revealed noticeably high rates of any anxiety disorder, post-traumatic stress disorder, any substance disorder, alcohol abuse disorder, suicide ideation and attempts, and any overall mental disorder among African-American women relative to Caribbean Black women. Multiple social and contextual factors were associated with various mental disorders among both sets of Black women in multivariate models, with the most consistent associations found for severe physical intimate partner violence. Everyday discrimination was associated with anxiety disorders (95% AOR=2.08 CI 1.23 to 3.51), eating disorders (95% AOR=2.69 CI 1.38 to 5.22), and any disorder (95% AOR=2.18 CI 1.40 to 3.40), while neighbourhood drug problems contributed to mood (95% AOR=1.19 CI 1.04 to 1.36), substance disorders (95% AOR=1.37 CI 1.11 to 1.69) and any disorder (95% AOR=1.18 CI 1.03 to 1.34). CONCLUSIONS: Severe physical intimate partner violence, discrimination, and to a lesser extent, neighbourhood problems are important predictors of Black women's health, findings that inform intervention and clinical services tailored to meet the needs of Black women from diverse ethnic and cultural backgrounds.

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.

The impact of different types of intimate partner violence on the mental and physical health of women in different ethnic groups.

Intimate partner violence, including threats, stalking, emotional, physical, and sexual assault by a spouse or partner, has significant influences on the well-being of women of all racial and social backgrounds. This study of a nationally representative sample of women from varying racial and ethnic groups examined specific types of violent acts on health and well-being. An association between intimate partner violence and poor physical and mental health was found. Types of partner violence also had different associations with the well-being of women of different racial and ethnic backgrounds. Social and demographic factors played an important role in moderating women's outcomes. Suggestions for future studies are discussed.

A comparison of women of color and non-Hispanic White women on factors related to leaving a violent relationship.

This study compares women of color and non-Hispanic White women regarding the influence of socioeconomic status, family investment, and psychological abuse on leaving a violent relationship. It was found that most women who left stayed away for less than a month. Women of color and non-Hispanic White women did not differ in their length or rate of leaving, although women of color left more frequently when they did leave. Factors associated with leaving for both groups were threat with a weapon, psychological abuse, being single, and having fewer adults in the household. Women of color with higher socioeconomic status were less likely to leave, which was not the case for non-Hispanic White women. Non-Hispanic White women were more likely to leave if they had lived with their partners less than 5 years and had children at home.