Identifying Factors Underlying the Decision for Sickle Cell Carrier Screening Among African Americans Within Middle Reproductive Age.

Guidelines recommend that African Americans know their sickle cell trait status to inform reproductive health decisions. Few studies have applied a behavioral theory to identify factors associated with sickle cell trait screening to inform intervention targets to increase this behavior. We applied a Sickle Cell Trait Screening Framework to identify factors associated with African Americans' intention to ask for sickle cell trait screening. Participants (N = 300), ages 18 to 35, completed a cross-sectional survey. A three-step sequential ordinary least squares regression analysis identified factors influencing intention. Results indicated socio-demographic factors (age, education), knowledge and fear beliefs (screening knowledge, perceived threat), and reasoned action approach (RAA) constructs were associated with intention. RAA constructs influenced intention over knowledge and fear beliefs with an increase in R2 of .468. Perceived behavioral control was more predictive of intention (ß = .576, p < .001). Attitude and perceived norm also had significant weights (ß = .325 and ß = .192, both p < .001, respectively). Findings from this study can inform strategies (e.g., eliminating costs associated with screening, reducing fear of painful tests) to increase sickle cell trait screening among African Americans. Ultimately, more sickle cell carriers will become aware of their trait status and be able to make informed reproductive health decisions.

Conventions of Courtship: Gender and Race Differences in the Significance of Dating Rituals.

Dating rituals include dating-courtship methods that are regularly enacted. We explored gender and race differences in the relative importance placed on certain symbolic activities previously identified by the dating literature as constituting such rituals. Using information collected from a racially diverse sample of college students (N = 680), we find that some traditional gender differences persist, but that these are also cross-cut by racial contrasts. Men, overall, place more emphasis on gifting, as well as sexual activity. Gender differences, however, are significantly greater among African Americans as compared to Whites in our sample. African American respondents are also significantly more likely than White respondents to associate meeting the family with a more serious dating relationship. Our findings highlight the need for greater efforts to uncover and account for racial differences in dating, relationships, and courtship.

Race and psychological distress: the South african stress and health study.

We analyze data from the South African Stress and Health Study, a nationally representative in-person psychiatric epidemiologic survey of 4,351 adults conducted as part of the World Mental Health Survey Initiative between January 2002 and June 2004. All blacks (Africans, Coloreds, and Indians) initially report higher levels of non-specific distress and anger/hostility than whites. Access to socioeconomic resources helps explain differences in non-specific distress between Coloreds and whites and Indians and whites. However, only when social stressors are considered do we find few differences in psychological distress (i.e., non-specific distress and anger/hostility) between Africans and whites. In addition, self-esteem and mastery have independent effects on non-specific distress and anger/hostility, but differences between Coloreds and whites in feelings of anger/hostility are not completely explained by self-esteem and mastery. The findings contribute to the international body of work on social stress theory, challenge underlying assumptions of the minority status perspective, and raise a series of questions regarding mental health disparities among South Africans.

Race-Ethnicity, Social Roles, and Mental Health: A Research Update.

Social role involvement engenders sense of purpose and meaning to life, which sustains positive mental health. Racism within American society, however, results in experiences that disadvantage ethnoracial minorities, thus making it likely that social roles do not have universal remunerations. Using the Collaborative Psychiatric Epidemiology Surveys (N = 12,526), this study explores the association between role participation and psychological distress across nine ethnoracial groups. Results indicate that engaging in many roles is associated with better mental health for all ethnoracial groups. However, the combination of social roles has distinct effects for certain groups. We discuss the implications of the study findings for medical sociology, in general, and the social roles literature, in particular.

Social sources of racial disparities in health.

Racial disparities in mortality over time reflect divergent pathways to the current large racial disparities in health. The residential concentration of African Americans is high and distinctive, and the related inequities in neighborhood environments, socioeconomic circumstances, and medical care are important factors in initiating and maintaining racial disparities in health. Efforts are needed to identify and maximize health-enhancing resources that may reduce some of the negative effects of psychosocial factors on health. Health and health disparities are embedded in larger historical, geographic, sociocultural, economic, and political contexts. Changes in a broad range of public policies are likely to be central to effectively addressing racial disparities.

Health inequalities among minority populations.

There are several challenges facing scholars studying health inequalities among minority populations. Primary among these challenges are developing adequate measures of social inequality and introducing appropriate strategies for eliminating health disparities. More research is sorely needed on both of these fronts as evidenced by the health paradox facing black, middle class men and women. This effort, however, can best move the study of health inequalities forward when juxtaposed against theoretical paradigms that embrace the complexity of the intersection of race, class, and gender.

Role sequencing: does order matter for mental health?

Role sequencing refers to the ordering of social roles. According to the normative order hypothesis, adults who follow a certain sequencing of their social roles will be better adjusted than their peers who follow other life course patterns. The normative order is defined as first entering the paid labor force, getting married, and later having children. This study tests this hypothesis by analyzing retrospective life history data from three subsamples of adults who completed the 1987--1988 National Survey of Families and Households: (1) married, working parents; (2) divorced, working parents; and (3) married, unemployed parents. The findings indicate significant race/ethnic (black/white), gender, and cohort differences in the type of role sequencing patterns that are conducive to positive mental health. For example, African Americans who work first, then have children, and later get married report better mental health than their peers who followed the normative order White men and women seem to benefit from following the normative course of role transitions. Among women, however, the psychological benefits of following typical life course patterns are especially evident among those born during the baby boom.

A research agenda for the black middle class: work stress, survival strategies, and mental health.

In this article we discuss the social position of the black middle class and two forms of work stress that appear unique to this group: token stress and social rejection. We outline a research agenda for studying: (1) the relationship between these stressors and mental health in the context of the work environment, and (2) the type of strategies that appear especially efficacious (or problematic) with regard to these problems. We begin the paper with a contextual discussion of the black middle class. We then offer a set of theoretical predictions about the relationship between work stress and mental health among middle class African Americans. We conclude the article with recommendations for future research, and we identify the implications of the research agenda for social policy efforts to diversify the workplace.