Racial, Ethnic, and Cultural Resilience Factors in African American Youth Mental Health.

Racism constitutes a significant risk to the mental health of African American children, adolescents, and emerging adults. This review evaluates recent literature examining ethnic and racial identity, ethnic-racial socialization, religiosity and spirituality, and family and parenting as racial, ethnic, and cultural resilience factors that shape the impact of racism on youth mental health. Representative studies, purported mechanisms, and critiques of prior research are presented for each factor. Recent studies of racism and resilience revisit foundational resilience factors from prior research while reflecting new and important advances (e.g., consideration of gender, cultural context, structural racism), providing important insights for the development of prevention and intervention efforts and policy that can alleviate mental health suffering and promote health and mental health equity for African American youth.

Developing culturally-adapted mobile mental health interventions: a mixed methods approach.

Background: Black young adults suffer from psychological distress at either similar or greater rates than that of White Americans, yet they are seven times less likely to have access to or receive effective treatments. Fortunately, mobile-health (mHealth) technology may transform mental health services and address disparities in mental healthcare. The current study utilized focus groups of Black young adults to inform the development of culturally-adapted mHealth using quantitative and qualitative approaches. Methods: The study utilized a mixed-methods approach, in that qualitative (i.e., mini focus groups, n=11) and quantitative methods (i.e., self-report surveys) were used to explore the research questions. Participants included African American young adults (n=38, Mage =21). Participants completed self-report questionnaires prior to focus group facilitation. Correlational analyses were used to answer the quantitative research questions, and thematic analysis was used to answer the qualitative research questions. Results: The qualitative findings highlighted that sociocultural experiences impact mental health and treatment seeking attitudes. Despite these findings, participants highlighted a variety of desired features and content that should be incorporated into future culturally-adapted mHealth interventions. Participants also highlighted both positive and negative aspects of current mHealth technologies for mental health. Finally, the study found that on average, participants had positive attitudes towards mental health, mental health treatments, and utilizing mHealth for mental health. Participants also had strong desires for culturally-adapted mHealth interventions. Bivariate correlations also revealed significant associations between vicarious online racial discrimination and mHealth attitudes, as well as racial identity and mHealth attitudes. Conclusions: In summary, the current study highlights that there is an urgent need for mHealth technology for mental health symptoms for African American young adults and presents a variety of features, content, and design/development considerations for future researchers.

Racism measurement and influences, variations on scientific racism, and a vision.

The knowledge base regarding the impact of racism and discrimination on African American health and well-being has grown significantly since the first models of racism and health, but many questions remain. In this commentary, I discuss three challenges requiring attention in future research. The first is measurement. The second is consideration of individual and contextual influences that shape vulnerability to racism. The third challenge is racism in science itself (e.g., racial disparities in funding, absence, and erasure of African American voices in scientific discourse on health disparities). I discuss the benefits of addressing these challenges and offer a vision of what research on racism and African American health and well-being might look like as we move toward the eradication of racism and promotion of health equity.

Measuring institutional and structural racism in research on adolescence and developmental science.

Dismantling racism and oppression in adolescence requires sound measurement and rigorous methods. In this commentary, we discuss the measurement of institutional and structural racism and approaches to operationalizing structures and systems in adolescent research. Drawing on a recent framework for the conceptualization, measurement, and analysis of institutional racism and health (Needham et al., Journal of Racial and Ethnic Health Disparities, in press), we highlight several considerations for measuring institutional and structural racism. These include definitional issues, the tension between individual- and area-level measures, questions of timing, and matters of design and analysis. We conclude with suggestions to address gaps in existing literature and call for transdisciplinary training, collaboration, and partnership to promote the healthy development of Black and Indigenous People of Color (BIPOC) adolescents and young people.

Racial residential segregation and economic disparity jointly exacerbate COVID-19 fatality in large American cities.

The disproportionately high rates of both infections and deaths among racial and ethnic minorities (especially Blacks and Hispanics) in the United States during the COVID-19 pandemic are consistent with the conclusion that structural inequality can produce lethal consequences. However, the nature of this structural inequality in relation to COVID-19 is poorly understood. Here, we hypothesized that two structural features, racial residential segregation and income inequality, of metropolitan areas in the United States have contributed to health-compromising conditions, which, in turn, have increased COVID-19 fatalities; moreover, that these two features, when combined, may be particularly lethal. To test this hypothesis, we examined the growth rate of confirmed COVID-19 cases and deaths in an early 30-day period of the outbreak in the counties located in each of the 100 largest metropolitan areas in the United States. The growth curves for cases and deaths were steeper in counties located in metropolitan areas where Blacks and Hispanics are residentially segregated from Whites. Moreover, the effect of racial residential segregation was augmented by income inequality within each county. These data strongly suggest that racial and economic disparities have caused a greater death toll during the current pandemic. We draw policy implications for making virus-resilient cities free from such consequences.

Pathways from racial discrimination to cortisol/DHEA imbalance: protective role of religious involvement.

Objective: Racial discrimination (RD) is hypothesized to dysregulate the production of stress reactive hormones among African Americans. Psychological processes that may mediate the association between RD and such dysregulation (e.g. cortisol/DHEA ratio) are not well articulated. Organizational religious involvement (ORI) has been discussed as a psychological protective factor within the context of RD, but our understanding of ORI as a physiological protective factor remains limited. We evaluated whether RD was directly and indirectly (through depressive symptoms) associated with an imbalance of cortisol and DHEA hormones, and whether ORI buffered these direct and/or indirect pathways.Design: Data were drawn from the Flint Adolescent Study, an ongoing interview study of youth that began in 1994. Participants were 188 African American emerging adults (47.3% Female, ages 20-22). We used mediation and moderated-mediation analyses, as outlined by Hayes [2012. PROCESS SPSS Macro. [Computer Software and Manual]. http://www.afhayes.com/public/process.pdf], to evaluate the study aims.Results: We found that depressive symptoms mediated the association between RD and the cortisol/DHEA ratio. We also found that depressive symptoms mediated the association between RD and the cortisol/DHEA ratio for individuals reporting low and moderate levels of ORI, but not at high levels.Conclusions: Our findings support the socio-psychobiological model of racism and health [Chae et al. 2011. "Conceptualizing Racial Disparities in Health: Advancement of a Socio-Psychobiological Approach." Du Bois Review: Social Science Research on Race 8 (1): 63-77. doi:10.1017/S1742058X11000166] and suggest that the psychological toll of RD can confer physiological consequences. Moreover, ORI may disrupt pathways from RD to cortisol/DHEA ratio by buffering the psychological toll of RD.

Mental health and clinical psychological science in the time of COVID-19: Challenges, opportunities, and a call to action.

COVID-19 presents significant social, economic, and medical challenges. Because COVID-19 has already begun to precipitate huge increases in mental health problems, clinical psychological science must assert a leadership role in guiding a national response to this secondary crisis. In this article, COVID-19 is conceptualized as a unique, compounding, multidimensional stressor that will create a vast need for intervention and necessitate new paradigms for mental health service delivery and training. Urgent challenge areas across developmental periods are discussed, followed by a review of psychological symptoms that likely will increase in prevalence and require innovative solutions in both science and practice. Implications for new research directions, clinical approaches, and policy issues are discussed to highlight the opportunities for clinical psychological science to emerge as an updated, contemporary field capable of addressing the burden of mental illness and distress in the wake of COVID-19 and beyond. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Moving Health Education and Behavior Upstream: Lessons From COVID-19 for Addressing Structural Drivers of Health Inequities.

In this Perspective, we build on social justice and emancipatory traditions within the field of health education, and the field's long-standing commitment to building knowledge and shared power to promote health equity, to examine lessons and opportunities for health education emerging from the COVID-19 pandemic. Examining patterns that emerged as the pandemic unfolded in Metropolitan Detroit, with disproportionate impacts on African American and low-income communities, we consider conditions that contributed to excess exposure, mortality, and reduced access to critical health protective resources. Using a life course framework, we consider enduring impacts of the pandemic for health equity. Finally, we suggest several strategic actions in three focal areas-environment, occupation, and housing-that can be taken by health educators working in partnership with community members, researchers, and decision makers, using, for example, a community-based participatory research approach, to reduce adverse impacts of COVID-19 and promote long-term equity in health.

Racism and health: Challenges and future directions in behavioral and psychological research.

OBJECTIVES: Racism is a critical determinant of racial inequalities in health. This article discusses three pressing challenges in the study of racism as a social determinant of health and identifies ideas to guide future psychological and behavioral research. METHOD: The first challenge is moving beyond a near-exclusive focus on individual racism. The second challenge is measuring racism, and the third challenge is elucidating the developmental pathways linking racism to health outcomes. RESULTS: I recommend the consideration of institutional, cultural, and structural racism, the incorporation of developmental health and resilience perspectives, the use of diverse methods and transdisciplinary approaches, and improved education and training. CONCLUSIONS: Eliminating racism and racial health disparities will require: 1) a bold, comprehensive, and sustained agenda that addresses structural forms of racism and unpacks developmental mechanisms underlying racism and poor health; 2) improved measurement, diverse methods, and new analysis; and 3) coalition building across disciplines and with community partners, organizers, and activists. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The link between discrimination and telomere length in African American adults.

OBJECTIVE: Prior work shows that discrimination is associated with a wide array of negative health outcomes. However, the biological mechanisms through which this link occurs require more study. We evaluated the association between discrimination and leukocyte telomere length (LTL; a biological marker of systemic aging). METHOD: Cross-sectional data were from the Health and Retirement study, a study of people aged 51+ in the United States, and included 595 African American males and females. Multiple regression analyses were used to evaluate whether discrimination was independently associated with LTL. We also considered the role of potential confounders including sociodemographic factors, health factors, depressive symptoms, and stress. RESULTS: High discrimination was associated with shorter LTL after controlling for sociodemographic factors (b = -.034, SE = 0.14, p = .017). This association persisted in analyses that further adjusted for health factors, depressive symptoms, and stress. CONCLUSION: Results suggest that discrimination experiences accelerate biological aging in older African American males and females, alike. This finding helps advance our understanding of how discrimination generates greater disease vulnerability and premature death in African Americans. (PsycINFO Database Record

Racism, Racial Resilience, and African American Youth Development: Person-Centered Analysis as a Tool to Promote Equity and Justice.

Racism constitutes a significant risk to the healthy development of African American youth. Fortunately, however, not all youth who experience racism evidence negative developmental outcomes. In this chapter, we examine person-centered analysis (PCA)-a quantitative technique that investigates how variables combine across individuals-as a useful tool for elucidating racial and ethnic protective processes that mitigate the negative impact of racism. We review recent studies employing PCA in examinations of racial identity, racial socialization, and other race-related experiences, as well as how these constructs correlate with and impact African American youth development. We also consider challenges and limitations of PCA and conclude with a discussion of future research and how PCA might be used to promote equity and justice for African American and other racial and ethnic minority youth who experience racism.

Racial identity and autonomic responses to racial discrimination.

Several studies identify racial identity-the significance and meaning that individuals attribute to race-as a mitigating factor in the association between racial discrimination and adjustment. In this study, we employed a visual imagery paradigm to examine whether racial identity would moderate autonomic responses to blatant and subtle racial discrimination analogues with Black and White perpetrators. We recruited 105 African American young adults from a public, southeastern university in the United States. The personal significance of race as well as personal feelings about African Americans and feelings about how others view African Americans moderated autonomic responses to the vignettes. We use polyvagal theory and a stress, appraisal, and coping framework to interpret our results with an eye toward elucidating the ways in which racial identity may inform individual differences in physiological responses to racial discrimination.

Racial identity mediates the association between ethnic-racial socialization and depressive symptoms.

Ethnic-racial socialization has been positively linked with psychological adjustment; however, the mechanisms underlying this association remain unclear. In this study, the authors examined the mediating role of racial identity in the association between racial socialization and depressive symptoms. Participants were 211 African American young adults (62% female; mean age = 20.73, SD = 1.90) recruited from a predominately White southeastern university. Multivariate mediation analyses revealed an indirect effect of racial pride messages on depressive symptoms through private regard such that individuals who reported receiving more frequent racial pride messages were more likely to feel positively about their race, and, in turn, less likely to report depressive symptoms. Individuals who reported that their parents engaged in more socialization activities (e.g., attending cultural events) were also more likely to feel positively about their race and, in turn, report fewer depressive symptoms. These results suggest that positive feelings about one's race are important considerations in our understanding of the relation between ethnic-racial socialization and youth psychological adjustment.

The moderating capacity of racial identity between perceived discrimination and psychological well-being over time among African American youth.

This study examined the influence of racial identity in the longitudinal relation between perceptions of racial discrimination and psychological well-being for approximately 560 African American youth. Latent curve modeling (LCM) and parallel process multiple-indicator LCMs with latent moderators were used to assess whether perceptions of racial discrimination predicted the intercept (initial levels) and the slope (rate of change) of psychological well-being over time, and whether racial identity moderates these relations. The results indicated that African American adolescents who reported higher psychological responses to discrimination frequency levels at the first time point had lower initial levels of well-being. Regressing the slope factor for psychological well-being on the frequency of discrimination also revealed a nonsignificant result for subsequent well-being levels.