Highly public anti-Black violence is associated with poor mental health days for Black Americans.

Highly public anti-Black violence in the United States may cause widely experienced distress for Black Americans. This study identifies 49 publicized incidents of racial violence and quantifies national interest based on Google searches; incidents include police killings of Black individuals, decisions not to indict or convict the officer involved, and hate crime murders. Weekly time series of population mental health are produced for 2012 through 2017 using two sources: 1) Google Trends as national search volume for psychological distress terms and 2) the Behavioral Risk Factor Surveillance System (BRFSS) as average poor mental health days in the past 30 d among Black respondents (mean weekly sample size of 696). Autoregressive moving average (ARMA) models accounted for autocorrelation, monthly unemployment, season and year effects, 52-wk lags, news-related searches for suicide (for Google Trends), and depression prevalence and percent female (for BRFSS). National search interest varied more than 100-fold between racial violence incidents. Black BRFSS respondents reported 0.26 more poor mental health days during weeks with two or more racial incidents relative to none, and 0.13 more days with each log10 increase in national interest. Estimates were robust to sensitivity tests, including controlling for monthly number of Black homicide victims and weekly search interest in riots. As expected, racial incidents did not predict average poor mental health days among White BRFSS respondents. Results with national psychological distress from Google Trends were mixed but generally unsupportive of hypotheses. Reducing anti-Black violence may benefit Black Americans' mental health nationally.

Social inequities in neighborhood health amenities over time in the Wasatch Front Region of Utah: Historical inequities, population selection, or differential investment?

Socially disadvantaged groups generally are more likely to reside in areas with less desirable conditions. We examined longitudinal relationships between neighborhood resident characteristics and amenities from 1990 to 2010 in an urban area of Utah, U.S. Four temporal patterns of social inequities are described using mixed-effects models: historical inequities; differential selection into amenity-rich tracts; differential investment in amenities; and simultaneous twenty-year change. Results indicate historical differences by neighborhood socioeconomic status, with lower status tracts having fewer green/natural amenities and higher air pollution in 1990 but also greater walkability and more food stores. Differences in amenities by neighborhood socioeconomic status widened over time as aggregate socioeconomic status disproportionately increased in tracts with more green/natural amenities, less air pollution, and lower walkability in 1990, consistent with differential selection. Tract percentage non-Hispanic White did not predict historical differences, but tracts that were less walkable and had fewer healthy food stores in 1990 experienced larger subsequent increases in racial/ethnic diversity. Tracts with higher relative to lower percentage non-Hispanic White in 1990 had larger decreases in air pollution but declining green/natural amenities. This study shows how social inequities in neighborhood amenities change over time, providing evidence of historical socioeconomic differences increasing from differential resident selection.

Does a Rising Median Income Lift All Birth Weights? County Median Income Changes and Low Birth Weight Rates Among Births to Black and White Mothers.

Policy Points Policies that increase county income levels, particularly for middle-income households, may reduce low birth weight rates and shrink disparities between Black and White infants. Given the role of aggregate maternal characteristics in predicting low birth weight rates, policies that increase human capital investments (e.g., funding for higher education, job training) could lead to higher income levels while improving population birth outcomes. The association between county income levels and racial disparities in low birth weight is independent of disparities in maternal risks, and thus a broad set of policies aimed at increasing income levels (e.g., income supplements, labor protections) may be warranted. CONTEXT: Low birth weight (LBW; <2,500 grams) and infant mortality rates vary among place and racial group in the United States, with economic resources being a likely fundamental contributor to these disparities. The goals of this study were to examine time-varying county median income as a predictor of LBW rates and Black-White LBW disparities and to test county prevalence and racial disparities in maternal sociodemographic and health risk factors as mediators. METHODS: Using national birth records for 1992-2014 from the National Center for Health Statistics, a total of approximately 27.4 million singleton births to non-Hispanic Black and White mothers were included. Data were aggregated in three-year county-period observations for 868 US counties meeting eligibility requirements (n = 3,723 observations). Sociodemographic factors included rates of low maternal education, nonmarital childbearing, teenage pregnancy, and advanced-age pregnancy; and health factors included rates of smoking during pregnancy and inadequate prenatal care. Among other covariates, linear models included county and period fixed effects and unemployment, poverty, and income inequality. FINDINGS: An increase of $10,000 in county median income was associated with 0.34 fewer LBW cases per 100 live births and smaller Black-White LBW disparities of 0.58 per 100 births. Time-varying county rates of maternal sociodemographic and health risks mediated the association between median income and LBW, accounting for 65% and 25% of this estimate, respectively, but racial disparities in risk factors did not mediate the income association with Black-White LBW disparities. Similarly, county median income was associated with very low birth weight rates and related Black-White disparities. CONCLUSIONS: Efforts to increase income levels-for example, through investing in human capital, enacting labor union protections, or attracting well-paying employment-have broad potential to influence population reproductive health. Higher income levels may reduce LBW rates and lead to more equitable outcomes between Black and White mothers.

Habitual sleep as a contributor to racial differences in cardiometabolic risk.

Insufficient and disrupted sleep is linked with cardiovascular and metabolic dysregulation and morbidity. The current study examines the degree to which differences in sleep between black/African American (AA) and white/European American (EA) adults explain racial differences in cardiometabolic (CMB) disease risk. Total sleep time and sleep efficiency (percent of time in bed asleep) were assessed via seven nights of wrist actigraphy among 426 participants in the Midlife in the United States Study (31% AA; 69% EA; 61% female; mean age = 56.8 y). CMB risk was indexed as a composite of seven biomarkers [blood pressure, waist circumference, hemoglobin A1c (HbA1c), insulin resistance, triglycerides, HDL cholesterol (HDL-C), and C-reactive protein]. Covariates included sociodemographic characteristics and relevant health behaviors. Results indicated that AAs relative to EAs obtained less sleep (341 vs. 381 min) and had lower sleep efficiency (72.3 vs. 82.2%) (P values < 0.001). Further, 41% and 58% of the racial difference in CMB risk was explained by sleep time and sleep efficiency, respectively. In models stratified by sex, race was indirectly associated with CMB risk via sleep time and efficiency only among females (explaining 33% and 65% of the race difference, respectively). Indirect effects were robust to alternative model specifications that excluded participants with diabetes or heart disease. Consideration of sleep determinants and sleep health is therefore needed in efforts to reduce racial differences in CMB disease.

Racial Disparities in Blood Pressure Trajectories of Preterm Children: The Role of Family and Neighborhood Socioeconomic Status.

Racial disparities in cardiovascular disease mortality in the United States remain substantial. However, the childhood roots of these disparities are not well understood. In the current study, we examined racial differences in blood pressure trajectories across early childhood in a sample of African-American and European-American low-birth-weight preterm infants. Family and neighborhood socioeconomic status (SES), measured at baseline, were also examined as explanations for subsequent group disparities. Analyses focused on 407 African-American and 264 European-American children who participated in the Infant Health and Development Program, a US longitudinal study of preterm children born in 1985. Blood pressure was assessed on 6 occasions between the ages of 24 and 78 months, in 1987-1992. Across this age range, the average rate of change in both systolic and diastolic blood pressure was greater among African-American children than among European-American children. Neighborhood SES explained 29% and 24% of the racial difference in the average rate of change in systolic and diastolic blood pressure, respectively, whereas family SES did not account for group differences. The findings show that racial differences in blood pressure among preterm children emerge in early childhood and that neighborhood SES accounts for a portion of racial disparities.

Racial discrimination mediates race differences in sleep problems: A longitudinal analysis.

OBJECTIVES: To examine changes in sleep problems over a 1.5-year period among Black or African American (AA) and White or European American (EA) college students and to consider the role of racial discrimination as a mediator of race differences in sleep problems over time. METHOD: Students attending a large, predominantly White university (N = 133, 41% AA, 57% female, mean age = 18.8, SD = .90) reported on habitual sleep characteristics and experiences of racial discrimination at baseline and follow-up assessments. A latent variable for sleep problems was assessed from reports of sleep latency, duration, efficiency, and quality. Longitudinal models were used to examine race differences in sleep problems over time and the mediating role of perceived discrimination. Covariates included age, gender, parent education, parent income, body mass index, self-rated physical health, and depressive symptoms. Each of the individual sleep measures was also examined separately, and sensitivity analyses were conducted using alternative formulations of the sleep problems measure. RESULTS: AAs had greater increases in sleep problems than EAs. Perceived discrimination was also associated with increases in sleep problems over time and mediated racial disparities in sleep. This pattern of findings was similar when each of the sleep indicators was considered separately and held with alternative sleep problems measures. CONCLUSIONS: The findings highlight the importance of racial disparities in sleep across the college years and suggest that experiences of discrimination contribute to group disparities. (PsycINFO Database Record

Racial and socioeconomic disparities in body mass index among college students: understanding the role of early life adversity.

The role of early life adversity (ELA) in the development of health disparities has not received adequate attention. The current study examined differential exposure and differential vulnerability to ELA as explanations for socioeconomic and racial disparities in body mass index (BMI). Data were derived from a sample of 150 college students (M age  = 18.8, SD = 1.0; 45 % African American; 55 % European American) who reported on parents' education and income as well as on exposure to 21 early adverse experiences. Body measurements were directly assessed to determine BMI. In adjusted models, African American students had higher BMI than European Americans. Similarly, background socioeconomic status was inversely associated with BMI. Significant mediation of group disparities through the pathway of ELA was detected, attenuating disparities by approximately 40 %. Furthermore, ELA was more strongly associated with BMI for African Americans than for European Americans. Efforts to achieve health equity may need to more fully consider early adversity.

Racial disparities in the health benefits of educational attainment: a study of inflammatory trajectories among African American and white adults.

OBJECTIVE: The current study examined the prospective effects of educational attainment on proinflammatory physiology among African American and white adults. METHODS: Participants were 1192 African Americans and 1487 whites who participated in Year 5 (mean [standard deviation] age = 30 [3.5] years), and Year 20 (mean [standard deviation] age = 45 [3.5]) of an ongoing longitudinal study. Initial analyses focused on age-related changes in fibrinogen across racial groups, and parallel analyses for C-reactive protein and interleukin-6 assessed at Year 20. Models then estimated the effects of educational attainment on changes in inflammation for African Americans and whites before and after controlling for four blocks of covariates: a) early life adversity, b) health and health behaviors at baseline, c) employment and financial measures at baseline and follow-up, and d) psychosocial stresses in adulthood. RESULTS: African Americans had larger increases in fibrinogen over time than whites (B = 24.93, standard error = 3.24, p < .001), and 37% of this difference was explained after including all covariates. Effects of educational attainment were weaker for African Americans than for whites (B = 10.11, standard error = 3.29, p = .002), and only 8% of this difference was explained by covariates. Analyses for C-reactive protein and interleukin-6 yielded consistent results. CONCLUSIONS: The effects of educational attainment on inflammation levels were stronger for white than for African American participants. Why African Americans do not show the same health benefits with educational attainment is an important question for health disparities research.

Racial and Ethnic Disparities in Blood Pressure and Glycemic Control in the US Community Health Center Patient Population.

OBJECTIVE: To describe blood pressure and glycemic control by racial/ethnic group in the US Community Health Center (CHC) patient population, and whether center characteristics, proxying for higher resource levels and better quality of care, were associated with greater rates of controlled cardiometabolic conditions. METHODS: Data came from the Uniform Data System, representing aggregate patient clinical data for individual health centers in 2019. Descriptive analyses were conducted weighting by health center patient populations to produce race-specific national rates of blood pressure and glycemic control, and linear regression is used to test whether cardiometabolic control rates varied by center characteristics. RESULTS: Hypertension was controlled for 67.2% of non-Hispanic White, 66.9% of Hispanic, and 56.7% of non-Hispanic Black patients. Diabetes was controlled for 70.7% of non-Hispanic White, 65.7% of Hispanic, and 66.1% of non-Hispanic Black patients. The rate of blood pressure control was 2.54 to 3.99 percentage points higher across racial/ethnic groups in health centers that adopted a patient-centered medical home (PCMH) model of care relative to non-PCMH centers, while glycemic control was 1.08 to 2.27 pp. higher as a function of PCMH certification. Results for other center characteristics did not show consistent patterns across racial groups or outcomes. CONCLUSION: This study documented racial and ethnic health disparities in the CHC patient population after major expansion of the CHC program. CHCs with PCMH certification have improved clinical outcomes among patients with hypertension and diabetes across racial/ethnic groups relative to centers without this certification.

Built Environment, Natural Environment, and Mental Health.

Mental health disorders have become a global problem, garnering considerable attention. However, the root causes of deteriorating mental health remain poorly understood, with existing literature predominantly concentrating on socioeconomic conditions and psychological factors. This study uses multi-linear and geographically weighted regressions (GWR) to examine the associations between built and natural environmental attributes and the prevalence of depression in US counties. The findings reveal that job sprawl and land mixed use are highly correlated with a lower risk of depression. Additionally, the presence of green spaces, especially in urban area, is associated with improved mental health. Conversely, higher concentrations of air pollutants, such as PM2.5 and CO, along with increased precipitation, are linked to elevated depression rates. When considering spatial correlation through GWR, the impact of population density and social capital on mental health displays substantial spatial heterogeneity. Further analysis, focused on two high depression risk clustering regions (northwestern and southeastern counties), reveals nuanced determinants. In northwestern counties, depression rates are more influenced by factors like precipitation and socioeconomic conditions, including unemployment and income segregation. In southeastern counties, population demographic characteristics, particularly racial composition, are associated with high depression prevalence, followed by built environment factors. Interestingly, job growth and crime rates only emerge as significant factors in the context of high depression risks in southeastern counties. This study underscores the robust linkages and spatial variations between built and natural environments and mental health, emphasizing the need for effective depression treatment to incorporate these multifaceted factors.