Unequal opportunities from the start: Socioeconomic disparities in classroom participation in preschool.

Why do socioeconomic disparities in achievement emerge so early in life? Previous answers to this question have generally focused on the perceived deficits of parents from disadvantaged backgrounds (e.g., insufficient childrearing knowledge). Here, we instead focus on the structure of early childhood education and argue that early schooling contexts provide unequal opportunities for engagement to children of higher versus lower socioeconomic status (SES). As engagement is a longitudinal predictor of achievement, early SES disparities in engagement could serve to maintain or even exacerbate SES disparities in achievement. In Study 1 (1,236 observations; N = 98 children), we investigated preschool students' behavioral engagement during whole-class discussions-a core aspect of early childhood education. Low-SES children showed significantly lower engagement than their peers. Consistent with the claim of unequal opportunities for engagement, these differences were not accounted for by SES differences in language proficiency. As students' engagement in school is influenced by their peers' attitudes toward them, we also examined peer perceptions (Study 2, N = 94, and a meta-analysis, k = 2 studies). We found that preschoolers who show more engagement relative to others during whole-class discussions are perceived as possessing more positive qualities (e.g., intelligence). Given that higher-SES students are afforded more opportunities for engagement (see Study 1), they may be the ones benefiting from these positive peer perceptions as well, which might further boost their engagement. Our results suggest that aspects of early childhood education should be redesigned to foster engagement among all students, regardless of their SES. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Negative consequences of self-presentation on disclosure of health information: A catch-22 for Black patients?

RATIONALE: Most patients assume that it is adaptive to present oneself in a positive light when interacting with medical professionals. Here in two studies focused on Black patients we ask: might this desire to present oneself well inhibit the disclosure of health-relevant information when patients are concerned about negative and stereotypic evaluations by their health care providers? OBJECTIVE: Specifically, we explore three important questions: First, whether self-presentational efforts (e.g., working hard to sound knowledgeable or "smart") are negatively associated with disclosure of health information (e.g., not taking certain medications); Second, whether patient-provider racial congruence (e.g. Black patients interacting with a Black vs. a White doctor) moderates that relationship; and third, more broadly, what factors promote or inhibit disclosure of health information for Black patients in medical interactions. METHODS: These questions were investigated using mixed methodology (survey, experimental, qualitative) studies on CloudResearch and Prolific. RESULTS: We found a potential catch-22: participants who spend more effort self-presenting tend to be less comfortable disclosing health information to their healthcare providers. Moreover, Study 1 (N = 321) indicated that the negative relationship between self-presentation and disclosure was significant in Black-incongruent (i.e., Black patient and White provider) and White-congruent (i.e., White patient and White provider) medical interactions. Study 2 (N = 361) did not find a significant moderation by race of the provider but instead suggested that the relationship between self-presentation and disclosure was moderated by expectations of unfair treatment. Exploratory qualitative analyses suggested that some Black participants face a dilemma when deciding whether to disclose information to their healthcare providers. They weigh the kind of information they will share, and how sharing some information might lead to embarrassment and judgment. CONCLUSION: Mitigating the potentially counteractive effects of self-presentation on disclosure and working to foster contexts that encourage honest disclosure of health information may help to reduce health care inequalities.

Psychosocial context and food healthiness in top-grossing American films.

OBJECTIVE: Healthy eating is shaped by the context. To understand how healthy eating is modeled in popular media, this systematic analysis quantified which contextual factors, character behaviors, and character demographics were associated with food healthiness in popular movies. METHOD: Two researchers content-coded the contextual factors, character behaviors, and character demographics depicted across 9,093 foods in 244 top-grossing Hollywood movies released from 1994-2018. Food healthiness was calculated using the Nutrient Profile Index (0 = least healthy, 100 = healthiest) and coder reliability was assessed. Mixed effects regression models tested whether food healthiness was associated with contextual factors (e.g., geographic locations, social consumption situations, celebrations, foreground placement), character behaviors (actual consumption, food evaluations), and character demographics. RESULTS: Confirming six preregistered hypotheses (all p < .001), foods were less healthy when they were in American versus non-American settings (95% CI: Cohen's d = .29-.39), part of social consumption situations (d = .19-.28) and celebrations (d = .04-.17), and in the foreground versus background (d = .15-.24). The foods that characters actually consumed (d = .30-.42) and evaluated positively (vs. negatively, d = .37-.76) were also less healthy. However, disconfirming a gender hypothesis, female characters did not consume healthier foods than males (d = -.11-.13, p = .45). CONCLUSIONS: Top-grossing Hollywood movies depict different contexts and different character behaviors for healthier versus less healthy foods. Research is needed to understand whether depicting healthy foods in different contexts impacts viewers' beliefs and behavior. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

White patients' physical responses to healthcare treatments are influenced by provider race and gender.

The healthcare workforce in the United States is becoming increasingly diverse, gradually shifting society away from the historical overrepresentation of White men among physicians. However, given the long-standing underrepresentation of people of color and women in the medical field, patients may still associate the concept of doctors with White men and may be physiologically less responsive to treatment administered by providers from other backgrounds. To investigate this, we varied the race and gender of the provider from which White patients received identical treatment for allergic reactions and measured patients' improvement in response to this treatment, thus isolating how a provider's demographic characteristics shape physical responses to healthcare. A total of 187 White patients experiencing a laboratory-induced allergic reaction interacted with a healthcare provider who applied a treatment cream and told them it would relieve their allergic reaction. Unbeknownst to the patients, the cream was inert (an unscented lotion) and interactions were completely standardized except for the provider's race and gender. Patients were randomly assigned to interact with a provider who was a man or a woman and Asian, Black, or White. A fully blinded research assistant measured the change in the size of patients' allergic reaction after cream administration. Results indicated that White patients showed a weaker response to the standardized treatment over time when it was administered by women or Black providers. We explore several potential explanations for these varied physiological treatment responses and discuss the implications of problematic race and gender dynamics that can endure "under the skin," even for those who aim to be bias free.

Language in popular American culture constructs the meaning of healthy and unhealthy eating: Narratives of craveability, excitement, and social connection in movies, television, social media, recipes, and food reviews.

Many people want to eat healthier but struggle to do so, in part due to a dominant perception that healthy foods are at odds with hedonic goals. Is the perception that healthy foods are less appealing than unhealthy foods represented in language across popular entertainment media and social media? Six studies analyzed dialogue about food in six cultural products - creations of a culture that reflect its perspectives - including movies, television, social media posts, food recipes, and food reviews. In Study 1 (N = 617 movies) and Study 2 (N = 27 television shows), healthy foods were described with fewer appealing descriptions (e.g., "couldn't stop eating"; d = 0.59 and d = 0.37, respectively) and more unappealing descriptions (e.g., "I hate peas"; d = -.57 and d = -.63, respectively) than unhealthy foods in characters' speech from the film and television industries. Using sources with richer descriptive language, Studies 3-6 analyzed popular American restaurants' Facebook posts (Study 3, N = 2275), recipe descriptions from Allrecipes.com (Study 4, N = 1000), Yelp reviews from six U.S. cities (Study 5, N = 4403), and Twitter tweets (Study 6, N = 10,000) for seven specific themes. Meta-analytic results across Studies 3-6 showed that healthy foods were specifically described as less craveworthy (d = 0.51, 95% CI: 0.44-0.59), less exciting (d = 0.40, 95% CI: 0.31-0.49), and less social (d = 0.36, 95% CI: 0.04-0.68) than unhealthy foods. Machine learning methods further generalized patterns across 1.6 million tweets spanning 42 different foods representing a range of nutritional quality. These data suggest that strategies to encourage healthy choices must counteract pervasive narratives that dissociate healthy foods from craveability, excitement, and social connection in individuals' everyday lives.

Can Exercising and Eating Healthy Be Fun and Indulgent Instead of Boring and Depriving? Targeting Mindsets About the Process of Engaging in Healthy Behaviors.

This paper investigates mindsets about the process of health behaviors-the extent to which people associate physical activity and healthy eating with appealing (pleasurable, fun, indulgent) versus unappealing (unpleasant, boring, depriving) qualities-to promote greater engagement. Study 1 (N = 536) examined how mindsets about physical activity and healthy eating relate to current and future health behavior. Study 2 (N = 149) intervened in actual fitness classes to compare the effects of brief appeal-focused and health-focused interventions on mindsets about physical activity and class engagement. Study 3 (N = 140) designed nutrition education classes that emphasized either the appeal or the importance of fruits and vegetables for health and compared its effects on mindsets about healthy eating and actual fruit and vegetable consumption. Holding more appealing mindsets about health behaviors predicts subsequent physical activity and healthy eating (Study 1). An intervention targeting mindsets about the appeal of physical activity promotes greater participation in fitness classes than emphasizing the importance of meeting activity guidelines (Study 2). Meanwhile, interventions targeting mindsets about the appeal of healthy eating increases in-class fruit and vegetable selection more than emphasizing the importance of eating nutritious foods (Study 3), however additional work is needed to sustain such changes in eating behavior. These studies suggest mindsets about the process of health behaviors can be influential and changeable factors in motivating physical activity and healthy eating.

Nutritional Analysis of Foods and Beverages Depicted in Top-Grossing US Movies, 1994-2018.

Importance: Many countries now restrict advertisements for unhealthy foods. However, movies depict foods and beverages with nutritional quality that is unknown, unregulated, and underappreciated as a source of dietary influence. Objective: To compare nutritional content depicted in top-grossing US movies with established nutrition rating systems, dietary recommendations, and US individuals' actual consumption. Design and Setting: In this qualitative study, a content analysis was performed from April 2019 to May 2020 of the 250 top-grossing US movies released from 1994 to 2018. Main Outcomes and Measures: The proportion of movies with less healthy nutrition ratings using the Nutrient Profile Index, the proportion of movies with medium or high food nutrition ratings according to the United Kingdom's "traffic light" guidelines (in which green is low and indicates the healthiest foods; amber, medium; and red is high and indicates the least healthy foods), and how the movie-depicted nutritional content compared with US Food and Drug Administration-recommended daily levels and US individuals' actual consumption according to National Health and Nutrition Examination Survey 2015-2016 data. Secondary outcomes compared branded and nonbranded items and tested whether outcomes changed over time or for movies targeting youths. Results: Across 9198 foods and 5748 beverages, snacks and sweets (2173 [23.6%]) and alcoholic beverages (2303 [40.1%]) were most commonly depicted. Alcohol comprised 23 of 127 beverages (18.1%) in G-rated movies, 268 of 992 beverages (27.0%) in PG-rated movies, 1503 of 3592 beverages (41.8%) in PG-13-rated movies, and 509 of 1037 beverages (49.1%) in R-rated movies. Overall, 178 of 245 movies (72.7%) earned less healthy Nutrient Profile Index food ratings and 222 of 246 movies (90.2%) earned less healthy beverage ratings, which would be unhealthy enough to fail legal limits for advertising to youths in the United Kingdom. Among foods, most movies depicted medium or high (amber or red traffic light) levels of sugar (229 of 245 [93.5%]), saturated fat (208 of 245 [84.9%]), total fat (228 of 245 [93.1%]), and, to a lesser extent, sodium (123 of 245 [50.2%]). Only 1721 foods and beverages (11.5%) were visibly branded, but branded items received less healthy nutrition ratings than nonbranded items. Overall, movies failed recommended levels of saturated fat per 2000 kcal by 25.0% (95% CI, 20.6%-29.9%), sodium per 2000 kcal by 3.9% (95% CI, 0.2%-7.9%), and fiber per 2000 kcal by 45.1% (95% CI, 42.9%-47.0%). Movies also depicted 16.5% (95% CI, 12.3%-21.0%) higher total sugar content per 2000 kcal and 313% (95% CI, 298%-329%) higher alcohol content per 2000 kcal than US individuals consume. Neither food nor beverage nutrition scores improved over time or among movies targeting youths. Conclusions and Relevance: This study suggests that popular US movies depict an unhealthy diet that fails national dietary recommendations, akin to US individuals' actual diets. Depicting unhealthy consumption in media is a sociocultural problem that extends beyond advertisements and branded product placements.

Age-Related Trends in the Prevalence of Type 2 Diabetes among Japanese and White and Black American Adults.

Aim: To compare the prevalence of poor glycemic control in probability samples of Japanese and American adults, and to determine the association with their somatic phenotypes. Material and Methods: Blood samples and anthropometric measures were obtained from 382 Japanese, 32-79 years of age, randomly selected to reflect the 23 wards of Tokyo. HA1c values were compared to 1215 Americans, 35-86 years of age, from a national study across the 48 continental states, along with an over-sampling of African-Americans from one city (www.midus.wisc.edu). Body Mass Index (BMI) and Waist-hip ratio (WHR) were also assessed. Results: Many Japanese now have high HA1c approaching Caucasian-American levels, although elevated HA1c (>6.5%, 48 mmol/mol) is not nearly as prevalent as among African-Americans. Significant age-related trends were evident in both countries, with poor glycemic control occurring at younger ages in males and rarely found until old age in Japanese women. Japanese had higher HA1c levels at BMIs of 23-25, in contrast to Americans with Type 2 diabetes who more typically had a BMI over 30. Central adiposity predicted HA1c levels better than BMI, a relationship also apparent at a smaller WHR in Japan. Conclusion: The prevalence of high HA1c in Tokyo almost rivals white Americans, but those statistics are dwarfed by the 37% of Afr-Amer adults identified with Type 2 diabetes. Elevated HA1c was more common in men, reflecting central adiposity, but poor glycemic control was also widespread among overweight Afr-Amer women. Type 2 diabetes was higher among older Japanese, when more women succumb. Overall, the findings highlight the societal and clinical challenges posed by demographic trends in both countries.

Feeling excited or taking a bath: Do distinct pathways underlie the positive affect-health link in the U.S. and Japan?

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).

Behavioral Adjustment Moderates the Link Between Neuroticism and Biological Health Risk: A U.S.-Japan Comparison Study.

Neuroticism, a broad personality trait linked to negative emotions, is consistently linked to ill health when self-report is used to assess health. However, when health risk is assessed with biomarkers, the evidence is inconsistent. Here, we tested the hypothesis that the association between neuroticism and biological health risk is moderated by behavioral adjustment, a propensity to flexibly adjust behaviors to environmental contingencies. Using a U.S.-Japan cross-cultural survey, we found that neuroticism was linked to lower biological health risk for those who are high, but not low, in behavioral adjustment. Importantly, Japanese were higher in behavioral adjustment than European Americans, and as predicted by this cultural difference, neuroticism was linked to lower biological health risk for Japanese but not for European Americans. Finally, consistent with prior evidence, neuroticism was associated with worse self-reported health regardless of behavioral adjustment or culture. Discussion focused on the significance of identifying sociocultural correlates of biological health.

Culture, inequality, and health: evidence from the MIDUS and MIDJA comparison.

This article seeks to forge scientific connections between three overarching themes (culture, inequality, health). Although the influence of cultural context on human experience has gained notable research prominence, it has rarely embraced another large arena of science focused on the influence social hierarchies have on how well and how long people live. That literature is increasingly focused psychosocial factors, working interactively with biological and brain-based mechanisms, to account for why those with low socioeconomic standing have poorer health. Our central question is whether and how these processes might vary by cultural context. We draw on emerging findings from two parallel studies, Midlife in the U.S. and Midlife in Japan, to illustrate the cultural specificity evident in how psychosocial and neurobiological factors are linked with each other as well as how position in social hierarchies matters for psychological experience and biology. We conclude with suggestions for future multidisciplinary research seeking to understand how social hierarchies matter for people's health, albeit in ways that may possibly differ across cultural contexts.

Social status and anger expression: the cultural moderation hypothesis.

Individuals with lower social status have been reported to express more anger, but this evidence comes mostly from Western cultures. Here, we used representative samples of American and Japanese adults and tested the hypothesis that the association between social status and anger expression depends on whether anger serves primarily to vent frustration, as in the United States, or to display authority, as in Japan. Consistent with the assumption that lower social standing is associated with greater frustration stemming from life adversities and blocked goals, Americans with lower social status expressed more anger, with the relationship mediated by the extent of frustration. In contrast, consistent with the assumption that higher social standing affords a privilege to display anger, Japanese with higher social status expressed more anger, with the relationship mediated by decision-making authority. As expected, anger expression was predicted by subjective social status among Americans and by objective social status among Japanese. Implications for the dynamic construction of anger and anger expression are discussed.

Clarifying the links between social support and health: culture, stress, and neuroticism matter.

Although it is commonly assumed that social support positively predicts health, the empirical evidence has been inconsistent. We argue that three moderating factors must be considered: (1) support-approving norms (cultural context); (2) support-requiring situations (stressful events); and (3) support-accepting personal style (low neuroticism). Our large-scale cross-cultural survey of Japanese and US adults found significant associations between perceived support and health. The association was more strongly evident among Japanese (from a support-approving cultural context) who reported high life stress (in a support-requiring situation). Moreover, the link between support and health was especially pronounced if these Japanese were low in neuroticism.

Population differences in proinflammatory biology: Japanese have healthier profiles than Americans.

The pleiotropic cytokine, interleukin-6 (IL-6), has emerged as a key factor in the biology of aging and the physiology of inflammation. Yet much of what we know about the normal functioning of IL-6 has been generated primarily from research on European populations and Americans of European descent. Our analyses compared IL-6 levels in 382 middle-aged and older Japanese to the values found in 1209 Caucasian- and African-Americans from the Midlife in the United States survey (MIDUS). Across the life span from 30 to 80 years of age, mean IL-6 levels were strikingly lower in Japanese individuals. Significantly lower levels of C-reactive protein (CRP) and fibrinogen (FBG) provided confirmatory evidence for a population difference in proinflammatory activity. Because IL-6 release has been associated with obesity, differences in body mass index (BMI) were taken into consideration. Japanese had the lowest, and African-Americans had the highest overall BMIs, but significant group differences in IL-6 persisted even after BMI was included as a covariate in the analyses. Additional support for distinct variation in IL-6 biology was generated when systemic levels of the soluble receptor for IL-6 (sIL-6r) were evaluated. Serum sIL-6r was higher in Japanese than Americans, but was most notably low in African-Americans. Our cytokine data concur with national differences in the prevalence of age-related illnesses linked to inflammatory physiology, including cardiovascular disease. The findings also highlight the importance of broadening the diversity of people included in population studies of health and aging, especially given the relative paucity of information for some Asian countries and on individuals of Asian heritage living in the US.