Mental health services in faith communities: the role of clergy in black churches.

A small but growing literature recognizes the varied roles that clergy play in identifying and addressing mental health needs in their congregations. Although the role of the clergy in mental health services delivery has not been studied extensively, a few investigations have attempted a systematic examination of this area. This article examines the research, highlighting available information with regard to the process by which mental health needs are identified and addressed by faith communities. Areas and issues where additional information is needed also are discussed. Other topics addressed include client characteristics and factors associated with the use of ministers for personal problems, the role of ministers in mental health services delivery, factors related to the development of church-based programs and service delivery systems, and models that link churches and formal services agencies. A concluding section describes barriers to and constraints against effective partnerships between churches, formal services agencies, and the broader practice of social work.

Age differences in patterns and correlates of the frequency of prayer.

This study examines differences by age cohort in (a) the frequency of prayer, (b) racial and gender variation in prayer, and (c) religious and sociodemographic correlates of prayer. Analyses are conducted across four age cohorts (18-30, 31-40, 41-60, > or = 61) using data from the 1988 National Opinion Research Center (NORC) General Social Survey (N = 1,481). Findings reveal that prayer is frequently practiced at all ages, but more frequently in successively older cohorts. In addition, females and, to a lesser extent, African Americans pray more frequently than males and Whites, respectively. Further, hierarchical multiple regression analyses reveal statistically significant associations across age cohorts between prayer and key measures of religious behavior, feeling, belief, and experience.

Race and gender differences in religiosity among older adults: findings from four national surveys.

Using data from four national surveys, this article presents findings on racial and gender differences in religiosity among older adults. Surveys include the second Quality of American Life study, the Myth and Reality of Aging study, wave one of Americans' Changing Lives, and the 1987 sample of the General Social Survey. These four data sources collectively include a broad range of items which tap the constructs of organizational, nonorganizational, and subjective religiosity. In all four studies, and for most indicators, results revealed significant racial and gender differences which consistently withstood controlling for sociodemographic effects, including age, education, marital status, family income, region, urbanicity, and subjective health.

Age differences in mystical experience.

Age differences are examined in reports of deja vu, ESP, clairvoyance, spiritualism, and numinous experience. According to the 1988 General Social Survey (N = 1481), these mystical experiences are somewhat more common now than in 1973, and deja vu, clairvoyance, and a composite mysticism score have increased with successively younger age cohorts. Further, private and subjective religiosity are positively related to overall mystical experience, while organizational religiosity is inversely related.

Antecedents and dimensions of religious involvement among older black adults.

This study proposed and tested a measurement model of religiosity among a sample of older (55 years of age and above) Black Americans. This model incorporates three correlated dimensions of religious involvement, termed organizational, nonorganizational, and subjective religiosity. Findings indicate that the proposed model provides a good fit to the data, is preferable to other alternative models, and exhibits convergent validity with respect to exogenous or antecedent variables (age, gender, marital status, income, education, urbanicity, and region) known to predict religious involvement. In addition, these antecedents exhibit stronger effects on subjective religiosity than on the two more behavioral dimensions of religiosity. Interpretation of these status-group differences in religiosity focuses on socialization experiences and social environment factors which may promote a religious world-view.

Ethnic differences in patient requests for pregnancy testing.

This study identifies a black-white difference in pregnancy test requests and in factors predicting such requests among 324 women tested at an academic family practice in 1986. Data were obtained from encounter sheets filled out by clinicians at the time tests were ordered. Analysis of variance revealed that blacks requested fewer pregnancy tests than whites, and that this finding remained significant (P less than .01) after controlling for the effects of gestational status and other clinical and sociodemographic factors. Blacks were less likely to be married or possess health insurance, but more likely to have been pregnant before. Logistic regressions indicated that factors predicting test requests differed by ethnicity, with symptoms and age predicting test requests among whites, and pregnancy the only significant predictor among blacks. Explanations consistent with these findings include possible ethnic differences in reactions to symptoms and economic factors. Further refinement of these hypotheses and consideration of other alternatives will advance understanding of ethnicity as a factor in test-requesting behavior, and enable clinicians to communicate with and care for black women more effectively.

Determinants of physician utilization among Mexican-Americans. A three-generations study.

Determinants of physician utilization were examined using a three-generational sample of Mexican-Americans in San Antonio. A typical version of Andersen's causal behavioral model was moderately successful in predicting physician utilization in the middle and older generations and less successful in the younger generation. Consistent with the literature, need factors (health indicators) tended to affect utilization most directly. The authors also examined whether acculturation into the larger society positively influenced utilization regardless of need, as the literature suggested. While three separate measures of acculturation had no independent effects on physician utilization, acculturation did affect utilization indirectly via the need variables in the middle generation, although these effects were not consistently in the direction of greater utilization. Generational differences in determinants of physician utilization are discussed particularly in relation to the model's greater relevance for the middle and older generations.

Socioeconomic status and infant mortality among Hispanics in a southwestern city.

PIP: Recent investigations of infant mortality in the Southwest part of the US have shown that Spanish surname infant death rates are lower than might be expected from the relatively low socioeconomic standing of the Spanish surname population, a phenomenon that appears to be confined to the neonatal componont of the infant mortality rate. The relationship between socioeconomic status (ses) and infant mortality is examined overall and separately within the Anglo and Spanish surname populations of Corpus Christ, Texas. The investigation utilizes data from the 36 Nueces County census tracts. Most recent data on infant, neonatal, and postneonatal mortality was provided by the local health department. Subjects were limited to Anglos and those whites with at least 1 Spanish surname parent. The 1979-1983 cohort is analyzed. Information from the 1980 US census was utilized to divide the 36 census tracts into 3 SES groups: high, medium and low. The most immediately striking aspect of the findings is the significant inverse gradient in Anglos between SES and both the total infant mortality rate (IMR) and the neonatal mortality (NMR), a gradient which is nonexistent in the Spanish surname population as well as overall. In addition, Anglos and Spanish persons differ significantly with respect to all IMRs and NMRs. In the high and medium SES groups and overall, all Anglo rates are lower, while in the low SES group, Spanish surname rates are lower. These findings suggest that, among Anglos, SES is a crucial factor in infant deaths, whereas, among the Spanish surname population, having a medium or high SES does not offer any additional protection against mortality. Alternatively, lower SES does not translate into significantly lower infant mortality among Spanish persons. These findings provide support for the study's hypotheses that the SES-infant mortality association is weaker among Spanish persons than among Anglos. The analysis also shows the importance of analyzing the SES-infant mortality association separately by ethnicity. Studies in larger cities and also studies utilizing matched birth and death records are needed to further elaborate these findings.^ieng