Factors Related to Immigrant/Nonimmigrant Children's Experience of Being Bullied: An Analysis Using the Multiple Disadvantage Model.

Applying the multiple disadvantage model, a study of children in the United States examined experiences of being bullied in terms of 5 factors: social disorganization, social structural factors, social relationships, mental health and access to care, and acculturation. The study was a secondary data analysis of 19,882 immigrant and non-immigrant children, using data from the 2018 National Survey of Children's Health. Logistic regression results show children's likelihood of being bullied to be associated positively with racial discrimination; child mental health problem (either attention deficit/hyperactivity disorder, depression, anxiety, behavioral/conduct problem, or Tourette Syndrome); family substance use; being female; being age 6-10; being age 11-13; and parent education level. Likelihood of being bullied was associated negatively with safe neighborhood; being Black; being Asian; family cohesiveness; neighbor support; parent mental health; being a first- or second-generation immigrant; and parent age. The results imply the usefulness of interventions promoting racial harmony and family support.

Ethnicity and Self-reported Depression Among Hispanic Immigrants in the U.S.

Viewed to be healthier than ethnic Hispanics born in the United States, Hispanic immigrants represent numerous subgroups with clearly heterogeneous geographic, cultural, structural, and social origins. This study asked how the factors length of U.S. residency, social status, lifestyle, and health care might explain self-reported depression within 5 large, discrete subgroups comprising immigrants from, in turn, Mexico, Puerto Rico, Cuba, the Dominican Republic, and other nations in Central and South America. The study also examined ethnicity's potential role moderating self-reported depression's associations. With pooled data from National Health Interview Surveys 1999-2015, it evaluated each ethnic group separately. Self-reported depression was associated generally with lengthening residence in the U.S., with being female, with poverty, with unemployment, with lack of education, and with lifestyle and health-care factors. These associations were not uniform across ethnic groups, however. Where self-reported depression is concerned, descriptive results suggest the proverbial health advantage may largely accrue specifically to Hispanic immigrants of Cuban and of Central/South American origin.

Violent Victimization, Stressful Events, and Depression: A Longitudinal Study of Young Adults in the U.S.

We surveyed a sample of young adults in the United States to determine (1) whether/how depression is affected by violent victimization during childhood and/or by recent stressful events, as well as (2) whether any observed links between depression and violent victimization and/or stressful events would be uniform across racial/ethnic groups. Using data from the National Longitudinal Survey of Youth 1997 cohort, we measured respondent depression in 5 interview waves dating 2004-2015. Our final sample for analysis numbered 22,549 person-waves. Our study showed that violent victimization in childhood, and recent stressful events, as well, alike exacerbated depression. Moreover, as we analyzed, in turn, the data for each ethnic subsample, we observed differential patterns in depression's associations with victimization. Childhood violent victimization-and also recently encountered stress-has a significant role in the development of depression in adulthood; this role appears to be moderated by race/ethnicity.

Data spanning three decades illustrate racial disparities in likelihood of obesity.

Obesity rates have risen significantly in recent decades, with underprivileged Americans associated with higher rates of the condition. Risks associated with obesity, furthermore, appear unequally distributed across different racial/ethnic groups, according to the literature. The present study examined racial disparities in obesity as a function of socioeconomic factors, using a sample of American adults from a 32-year longitudinal study. We accounted for the time factor as we evaluated obesity's associations with selected socioeconomic factors; we also examined race/ethnicity's moderating role in obesity-socioeconomic status associations over time. We used data from the National Longitudinal Survey of Youth (NLSY) to obtain a final sample of 118,749 person-waves for analysis. A subsample of person-waves numbering 65,702 represented data from White respondents; one numbering 31,618 represented data from Black respondents; and one numbering 21,429 represented data from Hispanic respondents. Needing to consider repeated measures of the same variables over time, we chose generalized estimated equations (GEE) for use in the data analysis. Speaking generally, the obtained results suggested that for the two smaller subsamples, minority race/ethnicity could have introduced disadvantages that helped explain links between obesity and race/ethnicity. Results also showed that White-Black disparities in obesity have widened slightly in the past three decades, while White-Hispanic disparities have stabilized during the same time period.

Providing Health Care to Maltreated Children Receiving Child Welfare Services.

This study sought associations between maltreated children's receipt of needed health care and five other variables or sets of variables: medical need, social structural factors, access to care, demographic factors, and child welfare intervention. Data for this study came from longitudinal records derived for a sample of 1,465 children (extracted from all records in a national data set) for whom maltreatment had been substantiated. Children in the sample had, following substantiation, either remained in the home or been placed in kinship care or other out-of-home setting. Generalized estimating equations were applied to the data. The results supported a negative association between the sample's receipt of needed health care and three factors: general physical health, age, and remaining in the home after substantiation. Data analysis also supported a positive association between receiving needed care and Medicaid receipt, family income of between 100 percent and 200 percent of federal poverty level, family income above 200 percent of federal poverty level, needed health care services included in child welfare case plan, and wave 2 interview. The study's implications for social work practice include the necessity of accurately identifying children's health problems, of addressing health needs in the case plan, and of coordinating meaningfully with health professionals.

Health of Women Surviving Intimate Partner Violence: Impact of Injury and Fear.

This study examined associations between experiencing physical violence and stalking perpetrated by an intimate partner, and the number of health problems women reported. The sample of 2,626 women who survived intimate partner violence (IPV) was extracted from the National Intimate Partner and Sexual Violence Survey 2010. Results showed associations between greater number of health problems and the following seven factors: injury, fear, poor mental health, advanced age, less education, lower income, and marriage; no association was found between number of health problems and number of incidents of physical violence, stalking, or both (in preceding year). The results imply that IPV has long-term adverse impacts on women's physical health.

Racial/Ethnic Differences in Cigarette Use: The Roles of Mental Illness and Health-Care Access/Utilization.

BACKGROUND: Empirical evidence supports a hypothesis that cigarettes may be used to cope with mental illness. Little research, however, addresses how race/ethnicity is linked to mental health and cigarette use. OBJECTIVES: This study applied the self-medication hypothesis. It asked whether mental status was associated, via health-care access/utilization, with the cigarette use outcomes of four racial/ethnic groups. It also tested whether race/ethnicity moderated any such associations. METHODS: We used nationally representative data from the 2009-2010 and 2011-2012 National Health and Nutrition Examination Surveys to link cigarette use to mental status and health-care access/utilization. The final sample included 3827 White respondents, 1635 African-American respondents, 1144 Mexican-American respondents, and 781 Hispanic American (other than Mexican-American) respondents. RESULTS: Consistent with earlier research and the self-medication hypothesis, we observed a positive relationship between cigarette use and mental status. Associations of cigarette use and health-care access/utilization sometimes failed to take expected directions. CONCLUSIONS: We concluded from the findings that race/ethnicity's moderating role in associations between cigarette use and health-care access was generally more advantageous to Whites than other groups examined. Where treatment is delayed by lack of access to, or lack of trust in, care providers, mental health may worsen-and it is often minority Americans who lack access and trust. If minority Americans' health is to improve, shrinking racial health disparities, then access to adequate health care must be available to them, facilitating prompt treatment of mental and other illness.

A Longitudinal Analysis of Factors Associated with Therapeutic Alliances.

This study examined the impact, on therapeutic alliances, made by client motivation to change, insight, mistrust, and other factors; as well as therapist's clinical experience. This secondary data analysis used a sample of 212 client respondents extracted from the Treatment of Depression Collaborative Research Program's data set. Results of generalized least squares random-effects modeling showed a significant impact exerted by client social-adjustment difficulties, insight, alcohol use, and gender; and client-therapist matching gender. Also, four elements of therapeutic alliances-regard, empathic understanding, unconditionality, and congruence-had four unique patterns of significant factors. To foster therapeutic alliances, therapists need to help clients develop awareness of and insight into the clients' social-adjustment difficulties; therapists should also be particularly sensitive to expectations of clients of the opposite sex. Implications for future research are suggested.

Social Risk and Protective Factors in Adolescents' Reduction and Cessation of Alcohol Use.

BACKGROUND: Adolescents' alcohol use is related to many health problems, injuries, and violent acts, some with fatal consequences. A gap exists in the literature discussing risk/protective factors in change from non-heavy drinking to non-drinking, and also for change from heavy drinking to non-heavy drinking or non-drinking. OBJECTIVE: This secondary study examined some risk and protective factors involved when adolescent non-heavy drinkers and adolescent heavy drinkers curb or terminate their drinking. METHOD: The temporal-ordered analysis evaluated 570 nonheavy drinkers and 374 heavy drinkers (all adolescents), a sample extracted from Wave 1 and Wave 2 of the National Longitudinal Study of Adolescent to Adult Health, or Add Health. RESULTS: We observed positive associations between likelihood of change from heavy/non-heavy drinking to nondrinking and 5 characteristics: neighborhood attachment, maternal receipt of public assistance, African American ethnicity, maternal involvement, physical maltreatment, depressive feelings, and substance-abuse treatment. We observed negative associations between this outcome and peer drinking, delinquent behaviors, drug use, and emotional maltreatment. Positive associations were found between likelihood of change from heavy drinking to non-heavy drinking and both maternal involvement and depressive feelings, while a negative association was found between this outcome and delinquent behaviors. CONCLUSIONS: Reduction/cessation interventions should, at the individual level, focus on ending adolescent drinkers' associations with alcohol-using and delinquent peers. Interventions require supportive roles for parents, schools, and communities.

Racial/Ethnic Differences in Emotional Health: A Longitudinal Study of Immigrants' Adolescent Children.

First, discrimination was conceptualized as a major source of stress for immigrants' adolescent children. Next, such children's emotional health (indicated by measures of self-esteem and depression) was examined for possible associations with discrimination, psychosocial supports, and social structure; additionally, race/ethnicity's possible moderating role in such associations was evaluated. Data from the first 2 waves of the Children of Immigrants Longitudinal Study (1991-2006) were employed, focusing on 3 groups: Asians, Hispanics, and Whites. Linear regression analyses were used to weigh how discrimination, psychosocial supports, and social structure measured at Wave 1 and Wave 2 related to self-esteem and depression measured at Wave 2. Asians exhibited the highest level of depression and were most likely to perceive discrimination; Asians' self-esteem was also low, compared to other groups'. Discrimination and psychosocial supports appeared to operate differentially in explaining the 3 groups' emotional health.

Racial Disparities in Children's Health: A Longitudinal Analysis of Mothers Based on the Multiple Disadvantage Model.

This secondary data analysis of 4373 mothers and their children investigated racial disparities in children's health and its associations with social structural factors, social relationships/support, health/mental health, substance use, and access to health/mental health services. The study drew on longitudinal records for mother-child pairs created from data in the Fragile Families and Child Wellbeing Study. Generalized estimating equations yielded results showing children's good health to be associated positively with mother's health (current health and health during pregnancy), across three ethnic groups. For African-American children, good health was associated with mothers' education level, receipt of informal child care, receipt of public health insurance, uninsured status, and absence of depression. For Hispanic children, health was positively associated with mothers' education level, receipt of substance-use treatment, and non-receipt of public assistance. Implications for policy and intervention are discussed.

Depression and Substance Use: A Temporal-Ordered Model.

BACKGROUND AND OBJECTIVES: This study sought empirical evidence for the self-medication hypothesis. It asked whether diagnosis of depression, together with the use of mental-health care, leads to substance use. METHODS: Data came from the 5-wave, longitudinal Fragile Families and Child Wellbeing (FFCW) Study, an investigation of a cohort of nearly 5,000 births, which over sampled non-marital births. FFCW examined newborns' biological mothers and fathers, all of whom lived in the United States. The adults were initially interviewed between 1998 and 2000 (the period of the cohort's births); they were then re-interviewed for four times over 10 years. FFCW measured mental health-related variables, level of drug use, and social structural and demographic factors, all of which are also measured by the present study. Respondents in our study's two final subsamples had responded to every FFCW interview item we would use in constructing our final model's variables. Our subsample of mothers totaled 3,477 women, from whom 5,987 person-waves were derived. Our subsample of fathers totaled 2,096 men, yielding 3,543 person-waves. RESULTS: We used STATA generalized estimating equations for panel data, and found some evidence to support the self-medication hypothesis. In addition, our results indicated that the relationship of substance use to the use of mental-health care was gender-specific. Conclusions/Importance: Empirical evidence from this study only partially supported the self-medication hypothesis; the co-occurrence of depression and substance abuse in our sample was also reflective of social structural and demographic variables and of prior substance use variables.

Race, Employment Disadvantages, and Heavy Drinking: A Multilevel Model.

We intended to determine (1) whether stress from employment disadvantages led to increased frequency of heavy drinking and (2) whether race had a role in the relationship between such disadvantages and heavy drinking. Study data came from the National Longitudinal Survey of Youth, a prospective study that has followed a representative sample of youth since 1979. Our study employed data from 11 particular years, during which the survey included items measuring respondents' heavy drinking. Our final sample numbered 10,171 respondents, which generated 75,394 person-waves for data analysis. Both of our hypotheses were supported by results from multilevel mixed-effects linear regression capturing the time-varying nature of three employment disadvantages and of the heavy-drinking outcome. Results show that more-frequent heavy drinking was associated with employment disadvantages, and that disadvantages' effects on drinking were stronger for Blacks and Hispanics than for Whites. That worsening employment disadvantages have worse effects on minority groups' heavy drinking (compared to Whites) probably contributes to the racial health disparities in our nation. Policies and programs addressing such disparities are especially important during economic downturns.

Race, unemployment rate, and chronic mental illness: a 15-year trend analysis.

PURPOSE: Before abating, the recession of the first decade of this century doubled the US unemployment rate. High unemployment is conceptualized as a stressor having serious effects on individuals' mental health. Data from surveys administered repeatedly over 15 years (1997-2011) described changes over time in the prevalence of chronic mental illness among US adults. The data allowed us to pinpoint changes characterizing the White majority--but not Black, Hispanic, or Asian minorities--and to ask whether such changes were attributable to economic conditions (measured via national unemployment rates). METHODS: We combined 1.5 decades' worth of National Health Interview Survey data in one secondary analysis. We took social structural and demographic factors into account and let adjusted probability of chronic mental illness indicate prevalence of chronic mental illness RESULTS: We observed, as a general trend, that chronic mental illness probability increased as the unemployment rate rose. A greater increase in probability was observed for Blacks than Whites, notably during 2007-2011, the heart of the recession CONCLUSIONS: Our results confirmed that structural risk posed by the recent recession and by vulnerability to the recession's effects was differentially linked to Blacks. This led to the group's high probability of chronic mental illness, observed even when individual-level social structural and demographic factors were controlled. Future research should specify the particular kinds of vulnerability that created the additional disadvantage experienced by Black respondents.

The role of immigration status in heavy drinking among Asian Americans.

We examined the role of Asian Americans' immigration status in their heavy drinking, using a national sample of 3,574 Asian American adults during 2008 to 2011 when surveyed by the National Health Interview Survey. Our results, with relevant social structural factors controlled, show that U.S.-born Asian Americans exhibited the highest heavy-drinking levels, followed by long-time-resident Asian immigrants, then recent-resident Asian immigrants (our three main subsamples). The higher heavy-drinking levels characterizing U.S.-born Asians who were male and younger, as compared to immigrant Asians who were male and younger, helped explain differential heavy-drinking levels across subsamples. The study's limitations are noted.

Problem drinking's associations with social structure and mental health care: race/ethnicity differences.

This research used a nationally representative sample of 12,756 respondents self-identified as White, Black, Hispanic, or Asian to examine problem drinking in relationship to social structure and mental healthcare factors. Associations between problem drinking and particular factors varied by racial/ethnic group. Results also indicated that Whites' problem-drinking rates were higher than those of Hispanics, Blacks, and Asians. Americans sometimes use alcohol to manage stress stemming from social disadvantage and inadequate material resources. Across racial/ethnic groups, drinking level was associated with the type and degree of such disadvantage. Additionally, the presence of a mental health problem was associated with problem drinking.

Access to and utilization of health services as pathway to racial disparities in serious mental illness.

Often considered to fare better than White Americans in terms of mental health, African-Americans are nevertheless more vulnerable to chronic, persistent conditions should they become mentally ill, the literature suggests. The present study used data from the 2009 National Health Interview Survey to examine race differences in the prevalence rates of serious mental illness and race's role in relationships among such illness and variables of (a) social status and (b) health services. Results showed that non-Hispanic Blacks' level of reported chronic mental illness (in the past 30 days) exceeded that of non-Hispanic Whites. The results indicate that variables describing respondents' mental health care, along with their age and alcohol consumption, affect serious mental illness differently among African-Americans compared to Whites. Implications concerning racial disparities in mental health are discussed.

Domestic violence and treatment seeking: a longitudinal study of low-income women and mental health/substance abuse care.

A study with 591 low-income women examined domestic violence's role in treatment seeking for mental health or substance abuse problems. (The women resided in one of two California counties.) Following Aday's behavioral model of health services utilization, the secondary data analysis considered the women's need, enabling, and predisposing factors. Generalized estimating equations analyzed the women's longitudinal records of treatment seeking. Results showed that those in the sample who were likely to seek treatment had experienced three or more controlling behaviors and only one abusive behavior. Multivariate data analysis showed treatment-seeking women were likely to be white and older; responsible for few dependent children; not graduates of high school; employed; not participating in Medicaid; diagnosed; and perceiving a need for treatment. The implications of these results for services and policies are discussed.

Risk and Protective Factors in Children Bullying Perpetration: Application of the Multiple Disadvantage Model.

This secondary study examined bullying perpetration's relationships with social disorganization, social structural factors, social relationships, mental health, and access to health insurance and care. A sample of 30,173 children age 6 to 17 years was extracted from the 2021 National Survey of Children's Health for secondary data analysis. Logistic regression results demonstrated that these children's likelihood of bullying perpetration was positively associated with racial discrimination, child age 6 to 10 years, child age 11 to 13 years, parent education level, employed parent, neighbor support, family violence, difficulty parenting the child, child difficulty with peers, child behavioral/conduct problems, family substance use problem, and child receipt of mental health services; such likelihood also had negative associations with safe neighborhood, Black, Asian, other non-Hispanic ethnic minority, parent age, and family cohesiveness. Implications included interventions to promote awareness of racial discrimination for families as well as bully prevention programs in schools and communities.

Factors Contributing to the Health of 0- to 5-Year-Old Low-Birth-Weight Children in the United States: Application of the Multiple Disadvantage Model.

This secondary data analysis of 1731 low-birth-weight children and their parents in the United States investigated children's health and its associations with social disorganization, social structural factors, social relationships, health/mental health, and access to health insurance/services. The study drew on data from the 2021 National Survey of Children's Health. Logistic regression yielded results showing low-birth-weight children's excellent/very good/good health to be associated positively with parents' education and health. In turn, child health was associated negatively with being Black, having a family income at or below the 100% federal poverty level, difficulty parenting the child, child chronic health condition(s), parent mental health, and substance use in the family. The implications of the present findings in terms of interventions promoting maternal and child health as well as participation in government assistance programs for low-income families are discussed.