Perceived discrimination and cognitive function among older Puerto Ricans in Boston: The mediating role of depression.

OBJECTIVES: To examine (1) the association between perceived discrimination, including everyday perceived discrimination and major lifetime perceived discrimination, and cognitive function and (2) the mediating role of depression between discrimination and cognitive function among older Puerto Ricans. METHODS: Data came from the Boston Puerto Rican Health Study, collected from 562 Puerto Ricans aged 60+. Structural Equation Modelling was used to examine the association between discrimination and cognitive function and the mediating effect of depression. RESULTS: Everyday perceived discrimination was negatively associated with cognitive function, which was fully mediated by depression. Major Lifetime perceived discrimination was not associated with cognitive function. CONCLUSIONS: The findings contribute new information regarding the impact of perceived discrimination on cognitive function among older Puerto Ricans and underscore the importance of assessing experiences of discrimination to prevent depression and cognitive decline in this population.

Examining Housing Environments and Health Status of Older Adults with Physical Disabilities in South Korea.

The present study examined the relationships between housing environments and health and well-being among older adults with physical disabilities in South Korea. Data are from the 2014 National Survey on Persons with Disabilities. We modelled four health and well-being outcomes - perceived stress, depressive symptoms, suicidal ideation, and life satisfaction - by various housing environments among 2,077 older adults with physical disabilities. The results illustrate that home ownership and perceived house accessibility are associated with health and well-being. Findings indicate that efforts to promote the health of older adults with physical disabilities need to be accompanied by improvements in their housing environment.

Unfair treatment, coping strategies, and depression among Puerto Ricans in Boston.

OBJECTIVES: Unfair treatment is a chronic social stressor with negative consequences for the mental health status of socially disadvantaged individuals. How individuals cope with stressful situations may reduce or amplify the mental burden associated with unfair treatment. The present study focuses on identifying coping strategies that mitigate the association between unfair treatment and the risk of clinical depression among Puerto Ricans, 1 of the largest Latinx subgroups in the U.S. METHOD: Data were from the third wave of the Boston Puerto Rican Health Study. Using logistic regression, we tested the moderating roles of 12 types of coping strategies in the associations between recent experiences of perceived unfair treatment and depression among 963 Puerto Rican adults, aged 49 to 81, living in the Boston, MA metropolitan area. RESULTS: Increased exposure to perceived unfair treatment was associated with higher odds of being at risk of clinical depression. Results suggest that coping strategies such as planning, acceptance, humor, and religion significantly mitigate the association between recent unfair treatment and depression. CONCLUSIONS: Our findings offer guidance on developing a culturally sensitive therapy for Puerto Ricans that promotes specific types of coping strategies to reduce the mental burden of unfair treatment. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Racial discrimination, ethnic-racial socialization, and cultural identities among Asian American youths.

OBJECTIVES: This study investigates whether and how racial discrimination is associated with ethnic-racial socialization in the family and how distinct aspects of ethnic-racial socialization influence children's ethnic and American identity among Filipino American and Korean American families. METHOD: The data are obtained from the Midwest Longitudinal Study of Asian American Families Project (N = 1,580; 379 Filipino American youths and 377 parents, and 410 Korean American youths and 414 parents; Mage of youths = 15.01). Using the bootstrapping and maximum likelihood with missing values approaches, we conducted path analyses to test the hypothesized associations concurrently and longitudinally for each ethnic group. RESULTS: Youth-reported racial discrimination was directly associated with weaker American identity, both concurrently and longitudinally. In concurrent models, racial discrimination experienced by both youth and parents was positively associated with youth-reported preparation for bias, which in turn was linked with stronger ethnic identity among Filipinos, whereas no indirect pathways reached statistical significance among Koreans. In longitudinal models, parent-reported discrimination was linked with higher levels of promotion of mistrust among both groups, which predicted weaker ethnic identity among Filipino youth but stronger American identity among Korean youth. CONCLUSIONS: The present study highlights how exposure to racial discrimination may have a lasting influence in cultural identity development among Asian Americans and possibly through ethnic-racial socialization in the family, which might have been shaped by such experiences. Our results also underscore the importance of considering the experiences of both children and parents in studies of discrimination and ethnic-racial socialization. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Psychological Cost of Racial Discrimination: What is the Role of Residential Segregation?

Racial discrimination is known to harm health, but to what extent the health burden of racial discrimination is contingent on residential contexts is understudied. This study examines the moderating role of racial residential segregation in the relationship between racial discrimination and psychological distress. Nationally representative data from the 2002-2003 National Latino and Asian American Study were merged with metropolitan-level data from the U.S. Census. Logistic regression models were used to test the independent and joint contributions of racial discrimination and residential segregation to psychological distress among Asians and Latinxs, stratified by nativity status. Higher residential segregation (measured by the interaction index) is associated with lower odds of distress among U.S.-born Asians but not among other groups. As for the moderating effect, residential segregation exacerbates the positive association between discrimination and distress among foreign-born Asians (measured by the dissimilarity index) and foreign-born Latinxs (measured by the interaction index), but not among their respective U.S.-born counterparts. Taken together, the present study highlights that strategies to mitigate the psychological burden of racial discrimination need to move beyond individual-level efforts to incorporate neighborhood-based approaches. In particular, results provide empirical support for efforts to reduce residential segregation, particularly among immigrants who are discriminated against.

Defining Nonmedical Use of Prescription Opioids Within Health Care Claims: A Systematic Review.

BACKGROUND: Health insurance claims data may play an important role for health care systems and payers in monitoring the nonmedical use of prescription opioids (NMPO) among patients. However, these systems require valid methods for identifying NMPO if they are to target individuals for intervention. Limited efforts have been made to define NMPO using administrative data available to health systems and payers. We conducted a systematic review of publications that defined and measured NMPO within health insurance claims databases in order to describe definitions of NMPO and identify areas for improvement. METHODS: We searched 8 electronic databases for articles that included terms related to NMPO and health insurance claims. A total of 2613 articles were identified in our search. Titles, abstracts, and article full texts were assessed according to predetermined inclusion/exclusion criteria. Following article selection, we extracted general information, conceptual and operational definitions of NMPO, methods used to validate operational definitions of NMPO, and rates of NMPO. RESULTS: A total of 7 studies met all inclusion criteria. A range of conceptual NMPO definitions emerged, from concrete concepts of abuse to qualified definitions of probable misuse. Operational definitions also varied, ranging from variables that rely on diagnostic codes to those that rely on opioid dosage and/or filling patterns. Quantitative validation of NMPO definitions was reported in 3 studies (e.g., receiver operating curves or logistic regression), with each study indicating adequate validity. Three studies reported qualitative validation, using face and content validity. One study reported no validation efforts. Rates of NMPO among the studies' populations ranged from 0.75% to 10.32%. CONCLUSIONS: Disparate definitions of NMPO emerged from the literature, with little uniformity in conceptualization and operationalization. Validation approaches were also limited, and rates of NMPO varied across studies. Future research should prospectively test and validate a construct of NMPO to disseminate to payers and health officials.

COVID-19 Racial Discrimination and Depressive Symptoms among Asians Americans: Does Communication about the Incident Matter?

Since the outbreak of COVID-19, Asians in the US have experienced a spike of racism. The goal of this paper is to examine the association between racial discrimination amid COVID-19 pandemic and depressive symptoms among Asian subgroups and to test whether communications about the incident with various sources moderate this relationship. Data come from an online survey conducted among 245 Asian Americans. Multiple linear regression analyses were conducted. COVID-19 racial discrimination was positively associated with depressive symptoms, and this association did not vary between Chinese Americans and other Asian subgroups. Communications with a spouse/partner buffered the mental burden of racial discrimination. Those who shared their experience in online ethnic communities displayed stronger depressive symptoms than who did not. These results suggest the potential benefit of communication with a spouse/partner in mitigating the mental burden of discrimination and call for more online mental health support for Asians.

Brokering Resources during a Pandemic: Exploring How Organizations and Clinics Responded to the Needs of Immigrant Communities during COVID-19.

Though COVID-19 has had sweeping implications, many immigrant groups in the United States have been disproportionately affected. The purpose of the present study is to explore the impact of COVID-19 on immigrant communities and how local immigrant-serving organizations (ISOs) have responded during the pandemic. The authors conducted in-depth qualitative interviews with executive directors and program coordinators of 31 ISOs and health clinics in Kentucky, North Carolina, and South Carolina. Findings highlight the needs of immigrants and refugees during the pandemic, including economic burden, lack of information, and limited access to testing and treatment for COVID-19. The authors find that ISOs have responded to these needs by providing basic supports, partnering with other local organizations to channel needed resources to immigrant communities, and collaborating with state-level entities to improve outreach, testing, and treatment. The authors also identify mechanisms that enabled the organizations to make nimble accommodations during the pandemic as well as the burden and compromises that these organizations have experienced. The authors argue that ISOs represent an important aspect of safety nets available for immigrants and provide insights into how other organizations can prepare for public health crises like COVID-19 in the future.

The Association between Racial Discrimination, Posttraumatic Stress Disorder, and Cardiovascular-Related Conditions Among Non-Hispanic Blacks: Results from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III).

OBJECTIVES: To test the association between racial discrimination and cardiovascular-related conditions and whether PTSD mediates this relationship in a nationally representative sample of non-Hispanic Blacks. METHODS: We used data from the 2013 National Epidemiologic Survey on Alcohol and Related Conditions to conduct logistic regression analyses to examine the association between racial discrimination, PTSD, and cardiovascular-related conditions. We also performed mediation analyses to assess whether the association between racial discrimination and cardiovascular conditions was partly explained by PTSD. RESULTS: Racial discrimination was positively associated with both PTSD and cardiovascular-related conditions. Additionally, PTSD was positively associated with cardiovascular conditions. Results from the fully adjusted mediation models suggest that PTSD significantly mediated the association between racial discrimination and cardiovascular conditions. CONCLUSIONS: Our results demonstrate an association between racial discrimination and cardiovascular-related conditions that is significantly mediated by PTSD. To improve cardiovascular functioning among non-Hispanic Blacks, health care professionals in conjunction with Black communities must adopt culturally competent screening for and treatment for PTSD. To address racial differences in cardiovascular conditions, public health efforts must address institutional policies that negatively alter health opportunities among the Black population.

White College Students' Racial Prejudice and Perceptions of Racial Hate Crime.

This study investigated how racial prejudice influences White college students' perceptions of hate crime. We also examined the moderating effects of the race of the victim of hate crimes and the absence of hate crime laws. Our sample included 581 White students in a predominantly White university located in a state that does not have a hate crime law. The study was set up in a 2 (race of the victim and the perpetrator) × 3 (level of assault) factorial design. Participants rated their perceptions of three scenarios (i.e., non-racially biased simple assault, racially biased simple assault, and racially biased aggravated assault). The dependent variables were perceptions of hate crime and willingness to report. The key independent variable was participants' level of racial prejudice. The moderators included race of the victim in each scenario and whether participants' state of origin has a hate crime law. Results suggest that higher levels of modern racism were associated with lower perceptions of hate crime and lower willingness to report racially biased simple and aggravated hate crime. When the victim was White, participants with higher levels of racial prejudice were more likely to perceive a hate crime and more willing to report it. The opposite was true when the victim was Black. The absence of state hate crime laws and race of victim were significant moderators. Our study suggests that racial prejudice is associated with lower perceptions of hate crime and willingness to report. Furthermore, the moderating effect of the race of victims provides insights on how racial prejudice can lead to a differential perception of hate crime, depending on whether one's racial in-group is targeted. Our findings also highlight the importance of having state-level hate crime laws to mitigate the linkage between modern racism and perceptions of hate crime.

"Which Clinic? Pre-Covid or Post-Covid?": Immigration Policy Uncertainty, Immigrant Serving Organization, and the Response to COVID-19.

BACKGROUND: This article examines how immigration policy uncertainty during the Trump presidency shaped how immigrant serving organizations (ISOs) responded to the needs of immigrant community members in the first six months of the COVID-19 pandemic. METHODS: We draw on semi-structured interviews conducted over the summer of 2020 with 31 directors and program coordinators of ISOs and health clinics in three southern states (KY, NC, SC). RESULTS: Responding to anti-immigrant policies laid the groundwork for organizations to respond quickly and nimbly to COVID-19 related upheavals. However, organizational flexibility may signal organizational precarity, especially given the long-term impacts of both Trump administration immigration policies and the COVID-19 pandemic. DISCUSSION: Our findings underline how ISOs facilitate access to health and social services for immigrant families. Our findings suggest that this organizational adaptability may signal a relationship between organizational precarity and immigration policy uncertainty that could have an impact well beyond the pandemic.

Race and Ethnicity in the Social Work Grand Challenges.

Race, ethnicity, and racism (RER) are interconnected with the critical problems tackled in the Grand Challenges for Social Work (GCSW). Yet, the extent to which the GCSW discuss the central role of RER is less clear. This article investigates how the GCSW integrate RER in their discourse. Using content analysis, authors examined all 21 concept papers that comprise the 12 initial GCSW to determine their attention to RER. Authors assessed whether each paper made any reference to race or ethnicity, whether race or ethnicity was considered as a primary theme, and whether racism was mentioned. Nine GCSW had at least one paper that mentioned race or ethnicity; seven had at least one paper that treated race and ethnicity as a major construct. Five GCSW contained at least one paper that discussed racism's impacts on their topical interests. None of the papers analyzed in the study defined or specified their conceptualization of racism. The GCSW are strategically positioned to widen and deepen social work's focus on RER, and the recent adoption of the 13th GCSW to "Eliminate racism" is an important first step. Authors encourage the social work field to embrace a more explicit, renewed, and continued commitment to eradicating systemic racism.

The role of racial/ethnic identity in the association between racial discrimination and psychiatric disorders: A buffer or exacerbator?

The present study tests whether and how racial/ethnic identity moderates the psychological burden associated with racial discrimination. The theoretical concept of identity-relevant stressors suggests that racial discrimination will be associated with stronger psychological burden for people who put more values on their racial/ethnic backgrounds (i.e., racial/ethnic identity as an exacerbator). Conversely, racial/ethnic identity may be a protective resource to buffer any negative mental health consequences of racial discrimination (i.e., racial/ethnic identity as a buffer). We adjudicate these two competing hypotheses, while also examining whether the moderating effect of racial/ethnic identity varies by race/ethnicity or nativity. The data are from the 2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. Our findings reveal a race/ethnicity-dependent pattern: High racial/ethnic identity functions as an exacerbator for Whites, American Indians/Alaska Natives, and Latinxs, but moderate racial/ethnic identity functions as a buffer for Asians and Blacks in handling racial discrimination. In addition, the moderating effect of racial/ethnic identity is more pronounced among the U.S.-born than the foreign-born. The present study contributes to the knowledge base by showing that racial/ethnic identity does not universally protect-nor does it universally exacerbate-the psychiatric burden of racial discrimination. Rather, whether it mitigates or intensifies the mental burden of racial discrimination depends on its level and race/ethnicity.

Residential Segregation and Racial/Ethnic Disparities in Ambient Air Pollution.

Race and ethnicity are consequential constructs when it comes to exposure to air pollution. Persistent environmental racial/ethnic inequalities call for attention to identifying the factors that maintain them. We examined associations between racial residential segregation and racial/ethnic inequalities in exposure to three types of air pollutants. Using data from the Panel Study of Income Dynamics (1990-2011), the U.S. Census (1990- 2010), and the Environmental Protection Agency, we tested the independent and joint contributions of race/ethnicity and metropolitan-level residential segregation on individual levels of exposure to air pollution nationwide. We found that racial and ethnic minorities were exposed to significantly higher levels of air pollution compared to Whites. The difference between minorities and Whites in exposure to all three types of air pollution was most pronounced in metropolitan areas with high levels of residential segregation. The environmental inequities observed in this study call for public health and policy initiatives to ameliorate the sources of racial/ethnic gaps in pollution exposure. Given the links between the physical environment and health, addressing such uneven environmental burdens may be a promising way to improve population health and decrease racial/ethnic inequalities therein.

Racial Discrimination and Mental Health in the USA: Testing the Reverse Racism Hypothesis.

OBJECTIVE: The present study examined whether the health disadvantages consequent of racial discrimination experienced by four racial/ethnic minority groups are equivalent with that of the dominant racial group. METHOD: Data was derived from the 2013 National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression and heterogeneous choice models were used to test the moderating role of race/ethnicity in regards to the associations between racial discrimination and ten DSM-V diagnoses. RESULTS: Non-Hispanic blacks reported the highest levels of experiencing racial discrimination, while Non-Hispanic whites reported the lowest. Exposure to racial discrimination was associated with higher odds of psychiatric disorders for non-Hispanic blacks, non-Hispanic Asian/Pacific Islanders, and Hispanics than it was for non-Hispanic whites, while non-Hispanic American Indians/Alaska Natives had lower odds of psychiatric disorders. CONCLUSIONS: Analyses indicated that racial discrimination poses stronger mental health disadvantages on racial/ethnic minorities than it does to non-Hispanic whites. This finding not only refutes the notion of reverse racism, but also calls for more efforts to close the racial/ethnic health gap for those exposed to racial discrimination.

Early-Life Air Pollution Exposure, Neighborhood Poverty, and Childhood Asthma in the United States, 1990⁻2014.

Ambient air pollution is a well-known risk factor of various asthma-related outcomes, however, past research has often focused on acute exacerbations rather than asthma development. This study draws on a population-based, multigenerational panel dataset from the United States to assess the association of childhood asthma risk with census block-level, annual-average air pollution exposure measured during the prenatal and early postnatal periods, as well as effect modification by neighborhood poverty. Findings suggest that early-life exposures to nitrogen dioxide (NO2), a marker of traffic-related pollution, and fine particulate matter (PM2.5), a mixture of industrial and other pollutants, are positively associated with subsequent childhood asthma diagnosis (OR = 1.25, 95% CI = 1.10⁻1.41 and OR = 1.25, 95% CI = 1.06⁻1.46, respectively, per interquartile range (IQR) increase in each pollutant (NO2 IQR = 8.51 ppb and PM2.5 IQR = 4.43 µ/m³)). These effects are modified by early-life neighborhood poverty exposure, with no or weaker effects in moderate- and low- (versus high-) poverty areas. This work underscores the importance of a holistic, developmental approach to elucidating the interplay of social and environmental contexts that may create conditions for racial-ethnic and socioeconomic disparities in childhood asthma risk.

Racial and ethnic differences in associations between psychological distress and the presence of binge drinking: Results from the California health interview survey.

INTRODUCTION: Racial and ethnic minorities often suffer from poorer health than Whites given their exposure to more stressors and fewer resources that buffer the effects of stress. Given that alcohol is often consumed to alleviate the negative moods, the present study hypothesized that psychological distress may impact the involvement in binge drinking differently across racial and ethnic groups. METHODS: We used data from the California Health Interview Survey (CHIS) from 2007 to 2012. The sample consisted of 130,556 adults including African Americans (N=6541), Asians (N=13,508), Latinos (N=18,128), and Whites (N=92,379). Binary logistic regression analysis was used with consideration for complex survey design. RESULTS: The results indicated that psychological distress was significantly associated with binge drinking across all racial and ethnic groups. However, this association differed by race and ethnicity adjusting for age, gender, marital status, education, poverty, and employment status. The results revealed that psychological distress had the largest effect on binge drinking for Asian Americans, particularly Filipinos and South Asians, compared to Whites. CONCLUSIONS: This study highlights the importance of examining racial and ethnic differences in the impacts of psychological distress on alcohol consumption. Future research is needed to better understand the potential factors that mediate the effects of psychological distress on binge drinking specific to each racial and ethnic group in order to develop culturally sensitive interventions and hence decrease the alcohol-related racial health disparities.