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1.
Soc Psychol Personal Sci ; 14(4): 395-406, 2023 May.
Article in English | MEDLINE | ID: mdl-36969090

ABSTRACT

As COVID-19 spread in the United States, anti-East Asian bias increased. This article aimed to (1) show that thinking about COVID-19 heightened East Asian individuals' anxious expectations of discrimination and (2) explore these expectations' health correlates. Specifically, the paper focused on COVID-19-triggered race-based rejection sensitivity, defined as (1) East Asian individuals' expectations of rejection due to the stereotype that they spread the virus and (2) high levels of anxiety about this possibility. Study 1 (N = 412) showed that reminders of COVID-19 increased COVID-19-triggered race-based rejection sensitivity among Chinese citizens living in the United States and East Asian Americans, but not Americans of other races. Study 2 (N = 473) demonstrated that East Asian people who habitually focused on COVID-19 experienced greater COVID-19-triggered race-based rejection sensitivity and, in turn, greater sleep difficulties. Thus, societal-level shifts that target minoritized groups may increase minoritized group members' concerns about discrimination in ways that undermine their health.

2.
Emotion ; 20(2): 164-178, 2020 Mar.
Article in English | MEDLINE | ID: mdl-30676038

ABSTRACT

Feeling good is linked to better health in Western contexts. Recent studies show, however, that the affect-health link is not consistent across cultures. We suggest two reasons for such inconsistency. The first follows from research showing that North American (vs. East Asian) cultures tend to value high arousal positive (HAP) states, for example, excited, more than low arousal positive (LAP) states, for example, calm. The second is one we propose for the first time. Positive affective experience is manifest in internal feelings but also in affective practices, such as taking a bath (a highly valued affective experience in Japan) or a fitness workout (a highly valued affective experience in the United States). We hypothesized that the HAP feelings/practices-health link would be stronger in the United States versus Japan, and the LAP feelings/practices-health link would be stronger in Japan versus the United States. Using survey samples from the United States (N = 640) and Japan (N = 382), we examined how health outcomes are shaped by positive affective feelings and practices varying in arousal. In a first set of analyses, HAP feelings predicted better physical and biological health in the United States but not in Japan. No cultural differences were consistently found for the effect of LAP feelings on health. In addition, engaging in HAP practices predicted better physical and biological health in the United States whereas engaging in LAP practices predicted better physical health in Japan but not in the United States. These findings suggest that the pathways underlying the culture-health link are culturally variable. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Subject(s)
Affect , Arousal/physiology , Baths/psychology , Cultural Characteristics , Exercise/psychology , Asian People/psychology , Female , Humans , Japan/ethnology , Male , Middle Aged , Surveys and Questionnaires , United States/ethnology
3.
Proc Natl Acad Sci U S A ; 116(13): 6013-6018, 2019 03 26.
Article in English | MEDLINE | ID: mdl-30858317

ABSTRACT

As the United States becomes more diverse, the ways in which mainstream institutions recognize and address race and ethnicity will be increasingly important. Here, we show that one novel and salient characteristic of an institutional environment, that is, whether a school emphasizes the value of racial and ethnic diversity, predicts better cardiometabolic health among adolescents of color. Using a diverse sample of adolescents who attend more than 100 different schools in predominantly urban locations, we find that when schools emphasize the value of diversity (operationalized as mentioning diversity in their mission statements), students of color, but not white students, have lower values on a composite of five biomarkers of inflammation, have less insulin resistance and compensatory ß-cell activity, and have fewer metabolic syndrome signs and score lower on a continuous metabolic syndrome composite. These results suggest that institutions that emphasize diversity may play an unacknowledged role in protecting the health of people of color and, thus, may be a site for future interventions to reduce health disparities.


Subject(s)
Cultural Diversity , Racial Groups/statistics & numerical data , Schools/organization & administration , Students/statistics & numerical data , Adolescent , Biomarkers , Female , Health Status Disparities , Humans , Inflammation/epidemiology , Male , Metabolic Syndrome/epidemiology , Racism/statistics & numerical data , Risk Factors , Schools/standards , Schools/statistics & numerical data , United States/epidemiology
4.
Soc Sci Med ; 228: 126-134, 2019 05.
Article in English | MEDLINE | ID: mdl-30909156

ABSTRACT

RATIONALE: Recent research reveals that, although girls encounter some barriers in school (e.g., in science and math), on balance, boys perform worse academically. Moreover, other research has identified a correlation between exposure to a context characterized by large disparities in performance or resources and a range of negative outcomes, including negative health and well-being, among members of lower status groups. OBJECTIVE: Building on these literatures, the present research tests the relationship between gender disparities in academic performance within a school and students' health outcomes. Specifically, we investigated whether boys had worse health when they attended schools where there was a greater disparity between boys' and girls' academic performance. METHOD: We tested this hypothesis in two different samples with different health outcomes. In a sample of healthy eighth graders (Study 1; 159 girls and 81 boys), we assessed two indices of metabolic syndrome, and in a sample of children with asthma (Study 2; 122 girls and 153 boys), we assessed immune function (Th1 and Th2 cytokine production) and self-reported symptoms. Participants in both samples also reported the name of the school that they attended so that we could access publicly available information about the percentage of girls and the percentage of boys in each school who met expectations for their grade level on standardized tests. RESULTS: In both samples, the greater the gap in a school between the percentage of girls and the percentage of boys who met expectations for their grade level on standardized tests, the worse boys' health. This pattern did not emerge among girls. CONCLUSION: Results thus highlight the negative health correlates of academic disparities among members of lower-performing groups.


Subject(s)
Academic Success , Health Status Disparities , Sex Factors , Students/statistics & numerical data , Adolescent , Chicago , Child , Female , Humans , Male
5.
J Behav Med ; 42(2): 204-216, 2019 04.
Article in English | MEDLINE | ID: mdl-30264257

ABSTRACT

Much is known about the effect of parent-child relationships on child health; less is known about how parent-child relationships influence parent health. To assess the association between aspects of the parent-child relationship and parent metabolic outcomes, and whether these associations are moderated by parent gender. Five metabolic outcomes (systolic and diastolic blood pressure, heart rate, total cholesterol and glycated hemoglobin) were assessed among 261 parents (45.83 ± 5.50 years) of an adolescent child (14.57 ± 1.072 years). Parents completed questionnaires assessing their child's hassles and the quality of their days with their child. Parents' perceptions of their child's hassles were associated with parent heart rate (B = 2.954, SE = 1.267, p = 0.021) and cholesterol (B = 0.028, SE = 0.011, p = 0.010), such that greater perceived child hassles were associated with higher heart rate and cholesterol levels, on average. These associations were not moderated by parent gender (all ps > 0.30). Parent report of their day with their child was not associated with parent metabolic outcomes (all ps > 0.20). Parent gender moderated the association between parent report of their day with their child and parent systolic blood pressure (B = 13.861, SE = 6.200, p = 0.026), such that less positive reports were associated with higher blood pressure readings among fathers, but not mothers. This study suggests that parent metabolic health may in part be influenced by aspects of the parent-child relationship.


Subject(s)
Blood Pressure/physiology , Cholesterol/blood , Fathers , Glycated Hemoglobin/metabolism , Heart Rate/physiology , Mothers , Parent-Child Relations , Adolescent , Adult , Female , Humans , Male , Middle Aged , Sex Factors , Surveys and Questionnaires
6.
Health Psychol ; 37(10): 968-978, 2018 Oct.
Article in English | MEDLINE | ID: mdl-30234356

ABSTRACT

OBJECTIVE: Fulfilling family obligations-providing instrumental help to and spending time with family-is a common aspect of family relationships. However, whether fulfilling these obligations links with physical health remains unclear. In this study, we investigated whether fulfilling family obligations was associated with asthma outcomes among youth, and whether these associations differed depending on family socioeconomic status (SES). METHOD: Participants were 172 youth, 8 to 17 years of age (Mage = 12.1; 54% boys) who had been physician-diagnosed with asthma and reported on family-obligation frequency; completed the Asthma Control Test (ACT; Nathan et al., 2004), a clinical measure of asthma control; and completed a measure of airway inflammation (i.e., fractional exhaled nitric oxide). Parents also completed the ACT in reference to their asthmatic children and reported on family income. RESULTS: Fulfilling family obligations was not associated with asthma outcomes (ßs < .14, ps > .075). However, SES (family income) interacted with family obligations, such that fulfilling family obligations was associated with greater airway inflammation (interaction term ß = -.17, p = .023) and poorer parent-reported asthma control (interaction term ß = .15, p = .039), only among youth from lower SES backgrounds. Exploratory analyses suggest that these interactions were robust against covariates and were largely consistent across age and the two dimensions of family-obligation behaviors. CONCLUSION: Findings from this study suggest that among youth from lower SES backgrounds, engaging in more frequent family-obligation behaviors may have negative repercussions in terms of their asthma. (PsycINFO Database Record


Subject(s)
Asthma/therapy , Caregivers , Family , Social Class , Social Responsibility , Adolescent , Child , Exhalation , Family Relations , Female , Humans , Income , Inflammation , Male , Mental Health , Parents
7.
Dev Psychopathol ; 30(5): 1699-1714, 2018 12.
Article in English | MEDLINE | ID: mdl-30078386

ABSTRACT

The links between low socioeconomic status and poor health are well established, yet despite adversity, some individuals with low socioeconomic status appear to avoid these negative consequences through adaptive coping. Previous research found a set of strategies, called shift-and-persist (shifting the self to stressors while persisting by finding meaning), to be particularly adaptive for individuals with low socioeconomic status, who typically face more uncontrollable stressors. This study tested (a) whether perceived social status, similar to objective socioeconomic status, would moderate the link between shift-and-persist and health, and (b) whether a specific uncontrollable stressor, unfair treatment, would similarly moderate the health correlates of shift-and-persist. A sample of 308 youth (Meanage = 13.0, range 8-17), physician diagnosed with asthma, completed measures of shift-and-persist, unfair treatment, asthma control, and quality of life in the lab, and 2 weeks of daily diaries about their asthma symptoms. Parents reported on perceived family social status. Results indicated that shift-and-persist was associated with better asthma profiles, only among youth from families with lower (vs. higher) parent-reported perceived social status. Shift-and-persist was also associated with better asthma profiles, only among youth who experienced more (vs. less) unfair treatment. These findings suggest that the adaptive values of coping strategies for youth with asthma depend on the family's perceived social status and on the stressor experienced.


Subject(s)
Adaptation, Psychological , Asthma/psychology , Quality of Life , Social Class , Stress, Psychological/psychology , Adolescent , Child , Female , Humans , Income , Male , Parents , Perception
8.
J Pers Soc Psychol ; 115(3): 427-445, 2018 Sep.
Article in English | MEDLINE | ID: mdl-29771553

ABSTRACT

Current theorizing on socioeconomic status (SES) focuses on the availability of resources and the freedom they afford as a key determinant of the association between high SES and stronger orientation toward the self and, by implication, weaker orientation toward others. However, this work relies nearly exclusively on data from Western countries where self-orientation is strongly sanctioned. In the present work, we predicted and found that especially in East Asian countries, where other-orientation is strongly sanctioned, high SES is associated with stronger other-orientation as well as with self-orientation. We first examined both psychological attributes (Study 1, N = 2,832) and socialization values (Study 2a, N = 4,675) in Japan and the United States. In line with the existent evidence, SES was associated with greater self-oriented psychological attributes and socialization values in both the U.S. and Japan. Importantly, however, higher SES was associated with greater other orientation in Japan, whereas this association was weaker or even reversed in the United States. Study 2b (N = 85,296) indicated that the positive association between SES and self-orientation is found, overall, across 60 nations. Further, Study 2b showed that the positive association between SES and other-orientation in Japan can be generalized to other Confucian cultures, whereas the negative association between SES and other-orientation in the U.S. can be generalized to other Frontier cultures. Implications of the current findings for modernization and globalization are discussed. (PsycINFO Database Record


Subject(s)
Cross-Cultural Comparison , Hierarchy, Social , Social Class , Social Values , Socialization , Adult , Aged , Female , Humans , Japan/ethnology , Male , Middle Aged , United States/ethnology
9.
Curr Opin Psychol ; 18: 137-140, 2017 12.
Article in English | MEDLINE | ID: mdl-28923665

ABSTRACT

Beliefs, emotions, and other psychological resources can protect physical health. Notably, however, the particular ways of thinking, feeling, and acting that are associated with better health can vary with one's socioeconomic status (SES). Those that are most protective reflect what is afforded in and valued by the context. Specifically, in higher SES environments, where people often have the resources to be independent and influence their own destinies, beliefs that reflect independence and a focus on the individual predict better health. In contrast, in lower SES environments, where people often encounter more constraints, beliefs and coping strategies that reflect connection to others, and adjustment to the environment predict better health. Understanding these differences will help to address health disparities.


Subject(s)
Culture , Emotions , Health Status , Socioeconomic Factors , Thinking , Humans , Social Environment
10.
Health Psychol ; 36(7): 652-661, 2017 07.
Article in English | MEDLINE | ID: mdl-28541072

ABSTRACT

OBJECTIVES: Cognitive empathy in parents-reflecting the extent to which one considers the perspectives and emotions of others-is hypothesized to contribute to family social environments in ways that affect youths' physical health. Using a novel assessment technique for cognitive empathy, the current study examined associations between spontaneous parental perspective-taking and key inflammatory processes implicated in pediatric asthma. METHOD: One hundred thirty children (ages 9-17) with physician-diagnosed asthma, along with 1 parent, participated in the current study. Parents completed an interview from which statements of perspective-taking were coded and youths provided blood samples. RESULTS: Youths whose parents demonstrated greater spontaneous perspective-taking during the interview had cells that mounted smaller inflammatory responses to stimulation by nonspecific, asthma-specific, and viral analogue ligands, as well as cells that showed greater sensitivity to the anti-inflammatory effects of glucocorticoids. These results were not accounted for by parental warmth or parent or youth depressive symptoms, nor by covariates of race, age, gender, parental education level, use of asthma medications over the past week, or asthma severity. CONCLUSIONS: These findings suggest that parental perspective-taking may have implications for biological processes relevant to childhood asthma. (PsycINFO Database Record


Subject(s)
Asthma/drug therapy , Cytokines/metabolism , Parents/psychology , Adolescent , Child , Female , Humans , Male , Middle Aged
11.
Pediatrics ; 139(4)2017 Apr.
Article in English | MEDLINE | ID: mdl-28280210

ABSTRACT

BACKGROUND AND OBJECTIVES: Both the social environment and the physical environment are increasingly recognized as important to childhood diseases such as asthma. This study tested a novel hypothesis: that living in areas high in greenspace may help buffer the effects of difficult family relationships for children with asthma. METHODS: A total of 150 children (ages 9-17), physician-diagnosed with asthma, participated in this study. To assess difficulties in parent-child relationships, parents and children completed measures of harsh/inconsistent parenting and parental hostility. Residential greenspace was calculated by using satellite-derived Normalized Difference Vegetation Index with a buffer of 250 m around the residential address. Outcomes included both clinical and biological measures: asthma control and functional limitations, as well as airway inflammation (fractional concentration of exhaled nitric oxide) and glucocorticoid receptor expression in T-helper cells. RESULTS: After controlling for potential confounding variables, including family income, child demographics, and child medical variables, few main effects were found. However, interactions between residential greenspace and difficult family relationships were found for asthma control (P = .02), asthma functional limitations (P = .04), airway inflammation (P = .007), and the abundance of glucocorticoid receptor in T-helper cells (P = .05). These interactions were all in a direction such that as the quality of parent-child relationships improved, greenspace became more strongly associated with better asthma outcomes. CONCLUSIONS: These findings suggest synergistic effects of positive environments across the physical and social domains. Children with asthma appear to benefit the most when they both live in high greenspace areas and have positive family relationships.


Subject(s)
Asthma/etiology , Environmental Exposure , Family Relations/psychology , Parent-Child Relations , Parenting/psychology , Adolescent , Asthma/physiopathology , Asthma/psychology , Child , Female , Housing , Humans , Male , Surveys and Questionnaires
12.
Health Psychol ; 36(5): 493-501, 2017 05.
Article in English | MEDLINE | ID: mdl-28192001

ABSTRACT

OBJECTIVE: Frequent demands from others in relationships are associated with worse physiological and health outcomes. The present research investigated 2 potential moderators of the relationship between frequency of demands from one's family and inflammatory profiles among adolescents: (a) closeness of adolescents' relationships with their families, and (b) the frequency with which adolescents provided help to their families. METHOD: Two hundred thirty-four adolescents, ages 13-16 (Mage = 14.53; 47.83% male), completed a daily dairy in which they reported on the frequency of demands made by family members. They were also interviewed about the closeness of their family relationships and reported in the daily diary on how frequently they provided help to their families. Adolescents also underwent a blood draw to assess low-grade inflammation and proinflammatory cytokine production in response to bacterial stimulation. RESULTS: More frequent demands from family predicted higher levels of low-grade inflammation and cytokine production in response to bacterial stimulation in adolescents. Family closeness moderated the relationship between frequent demands and stimulated cytokine production such that more frequent demands predicted higher cytokine production among adolescents who were closer to their families. Furthermore, frequency of providing help moderated the relationship between frequent demands and both low-grade inflammation and stimulated cytokine production, such that more frequent demands predicted worse inflammatory profiles among adolescents who provided more help to their families. CONCLUSIONS: These findings build on previous work on family demands and health to show under what circumstances family demands might have a physiological cost. (PsycINFO Database Record


Subject(s)
Family Relations/psychology , Inflammation/therapy , Adolescent , Female , Humans , Male
13.
J Pers ; 85(2): 232-243, 2017 04.
Article in English | MEDLINE | ID: mdl-26691417

ABSTRACT

This study's goal was to conduct a preliminary test of the theory that just world beliefs can buffer against negative physiological outcomes after people experience certain types of negative life events by testing associations between just world beliefs and physiological outcomes among people with different life event histories. In a sample of 247 adults (Mage = 46.01; 24.31% men; 60.78% White), this research investigated the relationship between just world beliefs and metabolic symptoms, inflammation, and sleep among people who had recently experienced an unfair event, another type of negative event, or no negative event. Stronger just world beliefs correlated with lower metabolic risk, lower inflammation, and better sleep among people who had recently experienced an unfair event, but not among those in the other two event groups. These findings suggest that people's beliefs about the world may interact with their life experiences in ways that have implications for health-relevant outcomes.


Subject(s)
Attitude , Inflammation/metabolism , Sleep/physiology , Social Justice , Stress, Psychological/metabolism , Stress, Psychological/psychology , Adult , Body Mass Index , Cholesterol/blood , Female , Glycated Hemoglobin/metabolism , Humans , Inflammation/blood , Male , Middle Aged , Stress, Psychological/blood
14.
Psychosom Med ; 78(9): 1043-1052, 2016.
Article in English | MEDLINE | ID: mdl-27749682

ABSTRACT

OBJECTIVES: The objective of this study was to investigate 2 key dimensions of socioeconomic status (SES)-prestige and resources-and their associations with immune, behavioral, and clinical outcomes in childhood asthma. METHODS: Children ages 9 to 17 years with a physician's diagnosis of asthma (N = 150), and one of their parents participated in this study. Children and parents completed interviews and questionnaires about SES (prestige = parent education; resources = family assets), environmental exposures, and clinical asthma measures. Spirometry was conducted to assess children's pulmonary function, and blood was collected to measure cytokine production in response to nonspecific stimulation, allergen-specific stimulation, and microbial stimulation. RESULTS: Higher scores on both dimensions of childhood SES were associated with better clinical outcomes in children (ß's from |.18 to .27|, p values < .05). Higher prestige, but not resources, was associated with better home environment control behaviors and less exposure to smoke (ß's from |.21 to .22|, p values < .05). Higher resources, but not prestige, was associated with more favorable immune regulation, as manifest in smaller peripheral blood mononuclear cell (PBMC) TH1 and TH2 cytokine responses (ß's from -.18 to -.19; p values < .05), and smaller proinflammatory cytokine responses (ß = -.19; p < .05) after ex vivo stimulation. Higher resources also were associated with more sensitivity to glucocorticoid inhibition of TH1 and TH2 cytokine production (ß's from -.18 to -.22; p values < .05). CONCLUSIONS: These results suggest that prestige and resources in childhood family environments have different implications for behavioral and immunological processes relevant to childhood asthma. They also suggest that childhood SES relates to multiple aspects of immunologic regulation of relevance to the pathophysiology of asthma.


Subject(s)
Asthma , Educational Status , Health Behavior , Income/statistics & numerical data , Social Class , Adolescent , Asthma/blood , Asthma/epidemiology , Asthma/immunology , Asthma/prevention & control , Child , Female , Humans , Male
15.
Pers Soc Psychol Bull ; 42(10): 1335-48, 2016 10.
Article in English | MEDLINE | ID: mdl-27516421

ABSTRACT

Healthy eating is important for physical health. Using large probability samples of middle-aged adults in the United States and Japan, we show that fitting with the culturally normative way of being predicts healthy eating. In the United States, a culture that prioritizes and emphasizes independence, being independent predicts eating a healthy diet (an index of fish, protein, fruit, vegetables, reverse-coded sugared beverages, and reverse-coded high fat meat consumption; Study 1) and not using nonmeat food as a way to cope with stress (Study 2a). In Japan, a culture that prioritizes and emphasizes interdependence, being interdependent predicts eating a healthy diet (Studies 1 and 2b). Furthermore, reflecting the types of agency that are prevalent in each context, these relationships are mediated by autonomy in the United States and positive relations with others in Japan. These findings highlight the importance of understanding cultural differences in shaping healthy behavior and have implications for designing health-promoting interventions.


Subject(s)
Cross-Cultural Comparison , Diet, Healthy/statistics & numerical data , Social Norms , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Japan , Male , Middle Aged , Surveys and Questionnaires , United States , Young Adult
16.
Self Identity ; 15(5): 536-547, 2016.
Article in English | MEDLINE | ID: mdl-28042287

ABSTRACT

This research examines the relationship between one's theory of a good life and allostatic load, a marker of cumulative biological risk, and how this relationship differs by socioeconomic status. Among adults with a bachelor's degree or higher, those who saw individual characteristics (e.g., personal happiness, effort) as part of a good life had lower levels of allostatic load than those who did not. In contrast, among adults with less than a bachelor's degree, those who saw supportive relationships as part of a good life had lower levels of allostatic load than those who did not. These findings extend past research on socioeconomic differences in the emphasis individual or relational factors and suggest that one's theory of a good life has health implications.

17.
Psychol Sci ; 26(2): 211-20, 2015 Feb.
Article in English | MEDLINE | ID: mdl-25564521

ABSTRACT

Expression of anger is associated with biological health risk (BHR) in Western cultures. However, recent evidence documenting culturally divergent functions of the expression of anger suggests that its link with BHR may be moderated by culture. To test this prediction, we examined large probability samples of both Japanese and Americans using multiple measures of BHR, including pro-inflammatory markers (interleukin-6 and C-reactive protein) and indices of cardiovascular malfunction (systolic blood pressure and ratio of total to HDL cholesterol). We found that the link between greater expression of anger and increased BHR was robust for Americans. As predicted, however, this association was diametrically reversed for Japanese, among whom greater expression of anger predicted reduced BHR. These patterns were unique to the expressive facet of anger and remained after we controlled for age, gender, health status, health behaviors, social status, and reported experience of negative emotions. Implications for sociocultural modulation of bio-physiological responses are discussed.


Subject(s)
Anger/physiology , Cardiovascular Diseases/etiology , Cardiovascular Diseases/psychology , Inflammation/etiology , Inflammation/psychology , Aged , Cardiovascular Diseases/epidemiology , Cultural Characteristics , Female , Humans , Inflammation/epidemiology , Japan/epidemiology , Male , Middle Aged , Risk Factors , Social Environment , United States/epidemiology
18.
Soc Psychol Personal Sci ; 5(8): 855-864, 2014 Nov.
Article in English | MEDLINE | ID: mdl-25530829

ABSTRACT

Hierarchy can be conceptualized as objective social status (e.g., education level) or subjective social status (i.e., one's own judgment of one's status). Both forms predict well-being. This is the first investigation of the relative strength of these hierarchy-well-being relationships in the U.S. and Japan, cultural contexts with different normative ideas about how social status is understood and conferred. In probability samples of Japanese (N=1027) and U.S. (N=1805) adults, subjective social status more strongly predicted life satisfaction, positive affect, sense of purpose, and self acceptance in the U.S. than in Japan. In contrast, objective social status more strongly predicted life satisfaction, positive relations with others, and self acceptance in Japan than in the U.S. These differences reflect divergent cultural models of self. The emphasis on independence characteristic of the U.S. affords credence to one's own judgment (subjective status) and the interdependence characteristic of Japan to what others can observe (objective status).

19.
Med Educ ; 47(9): 867-76, 2013 Sep.
Article in English | MEDLINE | ID: mdl-23931536

ABSTRACT

CONTEXT: People from racial minority backgrounds report less trust in their doctors and have poorer health outcomes. Although these deficiencies have multiple roots, one important set of explanations involves racial bias, which may be non-conscious, on the part of providers, and minority patients' fears that they will be treated in a biased way. Here, we focus on one mechanism by which this bias may be communicated and reinforced: namely, non-verbal behaviour in the doctor-patient interaction. METHODS: We review 2 lines of research on race and non-verbal behaviour: (i) the ways in which a patient's race can influence a doctor's non-verbal behaviour toward the patient, and (ii) the relative difficulty that doctors can have in accurately understanding the nonverbal communication of non-White patients. Further, we review research on the implications that both lines of work can have for the doctor-patient relationship and the patient's health. RESULTS: The research we review suggests that White doctors interacting with minority group patients are likely to behave and respond in ways that are associated with worse health outcomes. DISCUSSION: As doctors' disengaged non-verbal behaviour towards minority group patients and lower ability to read minority group patients' non-verbal behaviours may contribute to racial disparities in patients' satisfaction and health outcomes, solutions that target non-verbal behaviour may be effective. A number of strategies for such targeting are discussed.


Subject(s)
Gestures , Healthcare Disparities , Minority Groups/psychology , Physician-Patient Relations , Communication , Culture , Health Knowledge, Attitudes, Practice , Humans , Racism , Stereotyped Behavior , Treatment Outcome
20.
Brain Behav Immun ; 34: 79-85, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23911591

ABSTRACT

Previous studies conducted in Western cultures have shown that negative emotions predict higher levels of pro-inflammatory biomarkers, specifically interleukin-6 (IL-6). This link between negative emotions and IL-6 may be specific to Western cultures where negative emotions are perceived to be problematic and thus may not extend to Eastern cultures where negative emotions are seen as acceptable and normal. Using samples of 1044 American and 382 Japanese middle-aged and older adults, we investigated whether the relationship between negative emotions and IL-6 varies by cultural context. Negative emotions predicted higher IL-6 among American adults, whereas no association was evident among Japanese adults. Furthermore, the interaction between culture and negative emotions remained even after controlling for demographic variables, psychological factors (positive emotions, neuroticism, extraversion), health behaviors (smoking status, alcohol consumption), and health status (chronic conditions, BMI). These findings highlight the role of cultural context in shaping how negative emotions affect inflammatory physiology and underscore the importance of cultural ideas and practices relevant to negative emotions for understanding of the interplay between psychology, physiology, and health.


Subject(s)
Cross-Cultural Comparison , Emotions/physiology , Interleukin-6/blood , Female , Humans , Japan , Male , Middle Aged , Personality/physiology , United States
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