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1.
Am J Orthopsychiatry ; 2024 Mar 28.
Article in English | MEDLINE | ID: mdl-38546558

ABSTRACT

Awareness of racial health care inequities is one prerequisite to eliminating them. Although extant research has described awareness of racial health care inequities in the United States, the health impacts of such awareness on communities that are most impacted by these inequities remains unknown. Therefore, we examined associations between awareness of Black-White racial health care inequities and self-rated health for Black and White adults in the United States. We used survey data from non-Hispanic Black and White participants (N = 6,449) who responded to the national American Health Values Survey (2015-2016) to test associations between awareness of Black-White inequities in health care and self-rated health. Accurate awareness of health care inequities was associated with 47% higher odds of poorer self-rated health for Black individuals. Inaccurate awareness was associated with 36% higher odds of poorer self-rated health for White individuals. Accurate awareness may be adaptive, yet place an additional burden on Black individuals. Inaccurate awareness may harm White individuals' health. Health care system changes and alleviation of racism-related stress may be preventive supports for the health of Black individuals. Accurate awareness should be a goal for White individuals, not only to prevent health risks, but to also facilitate structural change for racial equity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

2.
SSM Popul Health ; 22: 101390, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37251508

ABSTRACT

Latinx represent a growing population in the United States (US) that continue to experience a disproportionate burden of disease. However, health disparities vary across Latinx subgroups, including Mexican, Puerto Rican, and Cuban communities, particularly when assessing self-rated health. Given the nature of political exclusion in the US, these differences may be associated with underexplored political factors, or political determinants of health, within the social environment that distinctly shape health among racial and ethnic minorities. To explore potential pathways that connect the political environment to individual-level health outcomes among Latinx subgroups, political efficacy (or one's perceptions about one's power to influence political affairs) was assessed as a correlate of self-rated health. We used secondary data from the 2016 Collaborative Multiracial Post-election Survey to conduct ordered logistic regression analysis to determine whether two domains of political efficacy, internal and external political efficacy, were correlates of self-rated health among Mexican, Puerto Rican, and Cuban subgroups as compared to non-Latinx whites in the US. We also tested for differential associations across Latinx subgroups as compared to non-Latinx whites. The sample consisted of 3156 respondents (1486 Mexicans, 484 Puerto Ricans, 159 Cubans and 1027 non-Latinx whites). Among Puerto Ricans, results revealed that lower levels of internal political efficacy were associated with higher levels of self-rated health. Conversely, among other subgroups, positive associations between internal political efficacy and self-rated health were observed. This study provides empirical evidence of a relationship between internal political perceptions and health perceptions that has not previously been established within the Latinx health disparities literature. Future investigations should continue to examine pathways that connect political determinants to individual-level health outcomes, particularly among communities that disproportionately experience political exclusion.

3.
Curr Epidemiol Rep ; 10(1): 33-43, 2023.
Article in English | MEDLINE | ID: mdl-36644596

ABSTRACT

Purpose of Review: Growing racial/ethnic diversity among America's older adults necessitates additional research specifically focused on health and well-being among aging minoritized populations. Although Black and Latinx adults in the USA tend to face worse health outcomes as they age, substantial evidence points to unexpected health patterns (e.g., the race paradox in mental health, the Latino health paradox) that challenge our understanding of health and aging among these populations. In this review, we demonstrate the value of intersectionality theory for clarifying these health patterns and highlight the ways that intersectionality has been applied to minority aging research. To advance the field, we also make several recommendations for incorporating intersectional approaches in future scholarship on minority aging. Recent Findings: Scholars have applied intersectional approaches to health and aging to unravel how social statuses and social conditions, such as race, ethnicity, gender, nativity, incarceration history, geographic region, and age, produce distinct shared experiences that shape health trajectories through multiple mechanisms. Summary: We highlight common intersectional approaches used in minority aging research and underscore the value of this perspective for elucidating the complex, and often unexpected, health patterns of aging minoritized populations. We identify several key lessons and propose recommendations to advance scholarship on minority aging.

4.
J Clin Med ; 12(2)2023 Jan 13.
Article in English | MEDLINE | ID: mdl-36675575

ABSTRACT

In the United States, 29−44% of Black women experience postpartum depressive symptoms (PDS), yet few are properly identified and/or connected to mental care services. The purpose of this secondary analysis was to examine the relationship between maternal functioning and clinical variables (PDS, maternal−infant attachment), racial variable (Black racial identity types­low race salience, assimilated and miseducated, self-hating, anti-White, multiculturalist, and conflicted), and sociodemographic characteristics (relationship status, education, insurance, childbirth type). A total of 116 women living in the southern United States were included in the analysis. Multivariate analyses revealed that Black racial identity (p = 0.02), PDS (p < 0.0001), maternal−infant attachment (p < 0.0001), and educational level (p = 0.03) were independently associated with maternal functioning. This work provides new evidence regarding the role of various clinical and racial factors on Black postpartum women's adjustment to motherhood. This analysis also adds to the growing body of evidence of reliability for the BIMF in Black postpartum women.

5.
Ethn Health ; 28(2): 182-199, 2023 02.
Article in English | MEDLINE | ID: mdl-35138201

ABSTRACT

OBJECTIVE: Although prior research suggests Asian Americans experience physical health advantages relative to other racial/ethnic groups, increasing evidence points to health inequalities within Asian American subgroups. Disparities are especially pronounced among middle-aged Asian American women, who remain an understudied population, despite studies showing that midlife corresponds with distinct social stressors and changes in the availability of protective resources, such as social support. Thus, the purpose of the study was to examine racial/ethnic differences in social support and self-rated health (SRH) among middle-aged women. DESIGN: With data from the Study of Women's Health Across the Nation (SWAN; N = 1258), we used modified Poisson regression models to estimate incidence rate ratios (IRR), examining how social support shaped the risk of fair-to-poor SRH by race/ethnicity. We tested interactions between perceived stress, social support and race/ethnicity to determine whether the stress-buffering role of social support varies by group. RESULTS: Results demonstrate racial/ethnic differences in SRH. Higher levels of social support were linked to higher fair-to-poor SRH among Chinese American women (IRR = 1.24; 95% CI [1.02, 1.52]); while greater social support conferred lower risk among White women. Interaction analyses revealed additional nuances in the stress-buffering effects of social support among Chinese American women, such that the health benefits of social support depended on levels of perceived stress (IRR = 0.75; 95% CI [0.57, 1.00]). CONCLUSIONS: These findings highlight important distinctions in the ways that psychosocial factors shape health across racial/ethnic groups. In particular, this study helps advance our understanding of important subgroup differences in the stress-buffering role of social support for Asian American midlife women. Interventions should focus on identifying sources of social strain among Asian American women that can increase the risk for poor health and identify alternative sources of support that mitigate stressors to improve health.


Subject(s)
Asian , Social Support , White , Women's Health , Female , Humans , Middle Aged , United States
6.
J Racial Ethn Health Disparities ; 10(3): 1280-1292, 2023 06.
Article in English | MEDLINE | ID: mdl-35556224

ABSTRACT

PURPOSE: Recent research suggests the determinants of and links between psychological distress and psychiatric disorder are distinct among Black Americans. Yet, these associations have not been explored among Black women, despite the unique social experiences, risks, and mental health patterns they face. The present study assessed the sociodemographic and psychosocial determinants of distress and disorder and evaluated the distress-disorder association, including whether it was conditional on sociodemographic and psychosocial characteristics among Black women. METHODS: Data were from 328 Black women in the Nashville Stress and Health Study, a cross-sectional community epidemiologic survey of Blacks and Whites in Nashville, Tennessee, and was used to assess the correlates of distress (CES-D depressive symptoms scale) and major depressive disorder (MDD; based on the CIDI). Multinomial logistic regression models estimated the extent to which greater distress was associated with higher risk of "chronic" or "resolved MDD". RESULTS: Stress exposure and marital status were associated with greater distress, while stress exposure and childhood SES were associated with elevated disorder risk. Although increased distress was associated with greater disorder risk, significant interactions indicated these associations depend on differences in age and adult socioeconomic status within this population. CONCLUSIONS: This study identifies distinct correlates of distress and disorder and shows that the distress-disorder association varies among subgroups of Black women. Results have important implications for public health research and practice, as they highlight the factors that matter most for the mental health outcomes of Black women.


Subject(s)
Depressive Disorder, Major , Mental Health , Adult , Child , Female , Humans , Black or African American , Cross-Sectional Studies , Depressive Disorder, Major/epidemiology , Depressive Disorder, Major/psychology , Tennessee/epidemiology , Psychological Distress
7.
J Aging Health ; 35(9): 660-676, 2023 10.
Article in English | MEDLINE | ID: mdl-35657773

ABSTRACT

Objectives: To evaluate the relationships between perceived neighborhood racial composition (PNRC), psychosocial risks and resources, and depressive symptoms among young (ages 22-35), middle-aged (ages 36-49), and older (ages 50+) Black Americans. Methods: Full sample and age-stratified linear regression models estimated the PNRC-depressive symptoms association and the extent to which it persisted after accounting for psychosocial risks (i.e., neighborhood disorder, other social stressors) and resources (i.e., mastery, social support, racial identity) among 627 Black Americans in the Nashville Stress and Health Study. Results: Living in racially integrated and predominately White neighborhoods was associated with elevated depressive symptoms. While psychosocial risks and resources explained a substantial portion of these associations, patterns varied across age groups. Discussion: PNRC impacts depressive symptoms among Black Americans by shaping psychosocial risks and resources. Findings underscore interconnections between contextual and psychosocial factors, as well as the distinct mental health significance of these processes across stages of adulthood.


Subject(s)
Black or African American , Depression , Residential Segregation , Adult , Humans , Middle Aged , Black or African American/psychology , Depression/epidemiology , Depression/psychology , Mental Health , Residence Characteristics/statistics & numerical data , Residential Segregation/psychology , Residential Segregation/statistics & numerical data , Young Adult , Tennessee/epidemiology
8.
Am J Health Behav ; 46(5): 515-527, 2022 10 17.
Article in English | MEDLINE | ID: mdl-36333832

ABSTRACT

OBJECTIVES: Unequal access to healthy food environments is often implicated in racial inequities in health and behaviors that are largest among college graduates. The aim of this study was to determine associations between perceived proximity to food sources and dietary behaviors between black and white college graduates. METHODS: In a cross-sectional online survey of dietary behaviors between black and white adults who have a ≥ 4-year bachelor's degree, respondents were asked how long it typically takes for them to get to grocery stores and fast-food restaurants from home. We used ordinal logit regression models to assess associations between perceived proximity to food sources and dietary behaviors. RESULTS: Among black men, perceiving that a grocery store was ≥ 10 minutes from their home was associated with lower fruit consumption (beta=-0.94, SE=0.48). Perceiving that a grocery store was ≥ 10 minutes from their home was associated with more frequent fast-food consumption among black men (beta=1.21, SE=0.39), Black women (beta=0.98, SE=0.34), and white men (beta=0.74, SE=0.30). CONCLUSIONS: The associations between perceived proximity to food sources and dietary behaviors differ by race and sex among college graduates with important implications for racial disparities in diet quality and obesity across SES.


Subject(s)
Fast Foods , Restaurants , Adult , Male , Female , Humans , Cross-Sectional Studies , Fruit , Diet
9.
J Gerontol B Psychol Sci Soc Sci ; 77(11): 1990-2005, 2022 11 23.
Article in English | MEDLINE | ID: mdl-35512278

ABSTRACT

OBJECTIVES: Substantial evidence documents the protective role of racial identity-or the meaning and significance that individuals attribute to race-among Black Americans, yet the impact of racial identity on physical health outcomes beyond young adulthood is unclear. To clarify the extent to which racial identity remains influential for physical health across the life course, this study investigated (a) the direct associations between discrimination, racial identity, and hypertension, (b) whether racial identity buffered the negative effects of discrimination, and (c) the extent to which these patterns varied among young (21-35), middle-aged (36-49), and older (>50) Black adults. METHODS: Data from the Nashville Stress and Health Study (N = 627) were used to examine two identity dimensions: "racial centrality" (i.e., importance of Black identity to one's sense of self) and "closeness to other Black people" (COBP). Modified Poisson models estimated relationships between racial identity, discrimination, and hypertension. Interactions determined whether racial identity moderated the discrimination-hypertension association within and across age groups. RESULTS: High centrality and moderate COBP were directly linked to elevated hypertension odds among young adults, but lower odds among older adults; racial identity was not directly associated with hypertension among middle-aged adults. Results also indicated that racial identity conditioned the discrimination-hypertension relationship in distinct ways across age groups. DISCUSSION: Findings underscore the significance of racial identity as sources of both psychosocial vulnerability and resilience for minority aging. Clinicians and public health professionals should consider racial identity beyond young adulthood to promote healthy aging via hypertension management among Black Americans.


Subject(s)
Hypertension , Racism , Humans , Aged , Young Adult , Adult , Middle Aged , Racism/psychology , Social Identification , Black or African American/psychology , Black People , Hypertension/epidemiology
10.
J Gerontol B Psychol Sci Soc Sci ; 77(11): 1964-1977, 2022 11 23.
Article in English | MEDLINE | ID: mdl-35147674

ABSTRACT

OBJECTIVES: Substantial evidence documents gender and racial disparities in C-reactive protein (CRP), a measure of systemic inflammation, among older adults. Yet, the comparative approaches of these studies may obscure distinct risk and protective factors associated with elevated CRP among older Black Americans. To pinpoint opportunities for intervention, this study utilizes a "within-group approach" to identify the sociodemographic, psychosocial, behavioral, and health-related correlates of elevated CRP among older Black women and men. METHOD: The sample consisted of 2,420 Black respondents aged 51 and older in the Health and Retirement Study (2006-2016). Gender-stratified, random effects logistic regression models were used to examine correlates of elevated CRP (>3.0 mg/L). RESULTS: More than 50% of Black women had elevated CRP, and younger age, Medicaid, lower mastery, religiosity, overweight/obesity, physical inactivity, and activities of daily living (ADLs) contributed to elevated CRP among this group. In contrast, elevated CRP was reported among only 37.25% of Black men, for whom financial distress was associated with lower odds of elevated CRP; religiosity, less neighborhood cohesion, current smoking, overweight/obesity, ADLs, and more chronic conditions were associated with greater odds of elevated CRP among this group. DISCUSSION: Sociodemographic factors had a limited association with elevated CRP among older Black Americans. Rather, a range of psychosocial, behavioral, and health-related factors were more influential determinants of elevated CRP among older Black Americans. Most notably, findings demonstrate distinct correlates of CRP among Black women and men, underscoring the critical need to further evaluate the risk and protective mechanisms undergirding disparities among this aging population.


Subject(s)
C-Reactive Protein , Retirement , Male , United States/epidemiology , Humans , Female , Aged , C-Reactive Protein/analysis , Overweight , Activities of Daily Living , Obesity
11.
J Am Coll Health ; 70(6): 1615-1623, 2022.
Article in English | MEDLINE | ID: mdl-33048648

ABSTRACT

Objective: The growing prevalence of obesity among college students is a major public health issue, as over one-third are overweight or obese. This study used gender-stratified multivariate analyses to examine psychological distress and social contextual factors as key determinants of obesity. Participants: Students of a large public university in Southern California (N = 2392). Methods: In-class survey administered across various departments and general education courses. Results: Among females, distress (OR = 1.02) and sophomores (OR = 1.87) were associated with increased odds of obesity; Greek life (OR = 0.53) was associated with decreased odds of obesity. Among males, distress was not associated with obesity (OR = 1.00); financial strain (OR = 1.16) was associated with increased odds of obesity. Conclusions: There are gendered patterns in obesity risk with social context having potentially protective effects among women. Enhancing psychological wellbeing as well as creating gender- and context-specific interventions may be an effective strategy to address the rising rates of obesity among the college population.


Subject(s)
Obesity/epidemiology , Obesity/psychology , Psychological Distress , Students , California , Female , Financial Stress/complications , Financial Stress/psychology , Humans , Male , Multivariate Analysis , Prevalence , Sex Factors , Social Environment , Students/psychology , Universities , Young Adult
12.
J Health Soc Behav ; 63(1): 55-70, 2022 03.
Article in English | MEDLINE | ID: mdl-34549645

ABSTRACT

A central paradox in the mental health literature is the tendency for black Americans to report similar or better mental health than white Americans despite experiencing greater stress exposure. However, black Americans' higher levels of certain coping resources may explain this finding. Using data from the Nashville Stress and Health Study (n = 1,186), we examine whether black Americans have higher levels of self-esteem, social support, religious attendance, and divine control than white Americans and whether these resources, in turn, explain the black-white paradox in mental health. In adjusted models, the black-white paradox holds for depressive symptoms and any DSM-IV disorder. Findings indicate that black Americans have higher levels of self-esteem, family social support, and religiosity than white Americans. Causal mediation techniques reveal that self-esteem has the largest effect in explaining black-white differences in depressive symptoms, whereas divine control has the largest effect in explaining differences in disorder.


Subject(s)
Mental Health , White People , Adaptation, Psychological , Black People , Humans , Race Factors
13.
J Racial Ethn Health Disparities ; 9(5): 1850-1860, 2022 10.
Article in English | MEDLINE | ID: mdl-34363186

ABSTRACT

Racial disparities in obesity are larger between Black and White college graduates compared to disparities among those who did not complete high school. A possible explanation is that Black adults with higher socioeconomic status (SES) experience unique obesogenic determinants. Black adults who have completed a 4-year college degree can report "uplift stress" from providing financial assistance to family members. The aim of this study is to determine whether the association between familial financial assistance and body mass index (BMI) varies among college-educated Black women and men. This study utilized data from an online survey of Qualtrics standing panels including 451 non-Hispanic Black college graduates. Respondents were asked if they had provided or received any monetary gift or financial help from a family member in the past 12 months as well as their height and weight. Using linear regression and multiplicative interaction terms, the association between familial financial assistance and BMI was assessed by sex. Those who reported both giving and receiving familial financial assistance had higher BMI than those who neither gave nor received assistance (ß = 2.80, standard error (s.e.) = 1.16). There was a significant interaction such that this association was observed among women only (ß = 6.67, s.e. = 2.32). Future studies should seek to understand the gendered impact of familial financial assistance on BMI in college-educated Black women.


Subject(s)
Black People , Racial Groups , Adult , Body Mass Index , Educational Status , Female , Humans , Male , Social Class
14.
J Gerontol A Biol Sci Med Sci ; 77(2): 347-356, 2022 02 03.
Article in English | MEDLINE | ID: mdl-34081108

ABSTRACT

BACKGROUND: Prior research demonstrates that Black Americans receive fewer health benefits at high levels of socioeconomic status (SES) relative to Whites. Yet, few studies have considered the role of lifetime SES (ie, changes in SES from childhood to adulthood) in shaping these patterns among older adults. This study investigates the extent to which racial disparities in allostatic load (AL), an indicator of accelerated physiological aging, vary across levels of lifetime SES among Black and White adults aged 50 and older. METHODS: With data from the Nashville Stress and Health Study, modified Poisson regression models were used to assess racial differences in the odds of high AL (4+ high-risk biomarkers) among Black and White older adults (N = 518) within each level of lifetime SES (ie, stable low SES, upward mobility, downward mobility, and stable high SES). RESULTS: Stable high SES was associated with greater odds of high AL; there was not a significant association between other lifetime SES trajectories and AL. However, the magnitude of racial disparities varied across levels of lifetime SES, with a significant Black-White difference in AL observed only among upwardly mobile (odds ratio [OR] = 1.76, 95% confidence interval [CI] = 1.24-2.51) and high SES groups (OR = 2.22, 95% CI = 1.37-3.58). CONCLUSIONS: Our study demonstrates that racial disparities in AL among older adults depend on individuals' lifetime SES trajectories and that older Black Americans receive fewer health benefits for achieving higher SES. These findings underscore the need to evaluate socioeconomic resources across the life course to clarify the extent of racial disparities among aging populations.


Subject(s)
Allostasis , Adolescent , Black or African American , Aged , Allostasis/physiology , Black People , Child , Health Status Disparities , Humans , Income , Middle Aged , Social Class , Socioeconomic Factors , Young Adult
15.
J Racial Ethn Health Disparities ; 9(4): 1488-1499, 2022 08.
Article in English | MEDLINE | ID: mdl-34165703

ABSTRACT

OBJECTIVE: Disparities in obesity highlight the need for an examination of determinants that may be uniquely experienced by race and sex. An understudied factor is household composition with the potential for variation in its obesogenic impacts. This study examines the association between household composition and body mass index (BMI) among Black, Hispanic, and White adults and determines whether income moderates these associations. METHODS: Using cross-sectional data from the 2011-2018 National Health and Nutrition Examination Survey, the number of children and adults aged ≥ 60 years in the household were reported among non-Hispanic Black and White adults as well as Hispanic adults aged 20-59 years old. Multivariable linear regressions were used to assess the associations between household composition and BMI with income as a potential moderator. RESULTS: Having multiple school-aged children was associated with higher BMI (ß = 1.34, standard error (s.e.) = 0.50) among Hispanic men, while having older adults in the household was associated with lower BMI among Black women (ß = - 3.21, s.e. = 1.42). Income moderated the associations between household composition and BMI among Black women and men. There were no associations between household composition and BMI in White women or men. CONCLUSIONS: Future studies should further explicate the mechanisms of household composition that uniquely impact obesity outcomes among Black women and men by income. Efforts to address higher BMI among those with more young children in the household should target Hispanic men.


Subject(s)
Ethnicity , Obesity , Adult , Aged , Body Mass Index , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Nutrition Surveys , Socioeconomic Factors , Young Adult
16.
Aging Ment Health ; 26(1): 196-204, 2022 01.
Article in English | MEDLINE | ID: mdl-33291956

ABSTRACT

OBJECTIVES: The Black-White mental health epidemiological paradox (i.e. Black Americans' lower or similar rates of mental disorder relative to Whites) characterizes the literature on race and mental health. Yet, research has generally paid less attention to how such findings may vary across other social statuses that shape mental health. This study assessed whether the Black-White paradox is consistent across gender, age groups, and psychiatric disorders, including lifetime mood, anxiety, and substance use disorders. METHOD: We used data from the National Comorbidity Survey-Replication (NCS-R) and National Survey of American Life (NSAL), 2001-2003 (N = 4,591 African Americans; 6,668 non-Hispanic Whites). Psychiatric disorders were measured with the World Mental Health Survey Initiative version of the WHO Composite International Diagnostic Interview (WMH-CIDI). Binary logistic regression models were conducted to assess racial patterns of lifetime mental disorders across age and gender. Wald tests were performed to assess age and gender group differences in Black-White patterns of mental disorder. RESULTS: The Black-White mental health paradox generally extends across lifetime mood, anxiety, and substance use disorders and is consistent across age and gender groups. One exception is middle-aged (45-64 years) Black men, who had higher odds of lifetime substance use disorder relative to their White male middle-aged peers. This difference is no longer statistically significant after accounting for education and employment. We also found more similarity in mental disorders between older Blacks and Whites relative to their younger counterparts, suggesting that Black-White mental health differences are most pronounced among younger age groups. CONCLUSION: Our findings contribute to the broader literature on the Black-White mental health paradox by demonstrating that this epidemiological pattern persists across various mental disorder types and, at times, depends on age group and gender. Given that Black-Whte differences are less pronounced among older adults, future research should consider the ways life course theory might inform our understanding of the paradox. Findings also suggest that substance use services are critical to address the needs of middle-aged Black men of lower socioeconomic status who are disproportionately affected by substance use disorder, yet have relatively lower mental health care utilization rates.


Subject(s)
Mental Disorders , Mental Health , Aged , Black People , Health Surveys , Humans , Male , Mental Disorders/epidemiology , Middle Aged , Prevalence , United States/epidemiology , White People
17.
Gerontologist ; 62(5): 721-731, 2022 05 26.
Article in English | MEDLINE | ID: mdl-34922345

ABSTRACT

BACKGROUND AND OBJECTIVES: Prior research documents accelerated physiological aging among African Americans due to their greater lifetime exposure to social and economic adversity. Yet, less is known about the mechanisms through which early life stressors, such as early life racial discrimination (ELRD), and later life psychosocial resources, such as racial centrality (i.e., importance of Black identity to one's sense of self), interact to shape allostatic load (AL) in adulthood. We evaluate the life course processes linking ELRD, adult racial centrality, and adult AL among older African Americans. RESEARCH DESIGN AND METHODS: Data from the Nashville Stress and Health Study included African Americans aged 50 and older (N = 260). Poisson regression models assessed the links between ELRD, adult centrality, and adult AL. Interactions determined whether ELRD conditions the centrality-AL association in adulthood. RESULTS: Adolescent ELRD conferred significantly higher levels of adult centrality and 32% increased risk of high adult AL. Greater adult centrality was linked to high adult AL, but the ELRD-adult AL association was not explained by centrality. However, ELRD and centrality interact to shape adult AL, such that racial centrality was protective against high adult AL for those who experienced racial discrimination as children or adolescents. DISCUSSION AND IMPLICATIONS: Findings highlight the multiple pathways through which racism-related stressors and psychosocial resources interact to shape physiological dysregulation in later life and underscore the health significance of racial identity for older African Americans. Clinicians and public health professionals should assess early life stressors and foster psychosocial resilience to promote healthy aging.


Subject(s)
Allostasis , Racism , Adolescent , Adult , Black or African American/psychology , Aged , Aging , Allostasis/physiology , Black People , Humans , Middle Aged , Racism/psychology
18.
Healthcare (Basel) ; 9(11)2021 Nov 09.
Article in English | MEDLINE | ID: mdl-34828574

ABSTRACT

To clarify the ways in which Black Americans' experiences of structural racism may influence their mental and physical health in distinct ways, the present study evaluated whether major discrimination moderates the association between depressive symptoms and chronic physical health conditions among this population. t-tests and chi-squared tests of significance were used to determine significant differences between women and men. The association between major discrimination and depressive symptoms was examined by assessing mean depressive symptoms scores across levels of major discrimination. ANOVA tests indicated whether there were significant differences in symptom scores across each discrimination category. Additional t-tests determined significant gender differences within each level of discrimination. Gender-stratified negative binomial models were used, and odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for the relationship between depressive symptoms, major discrimination, and chronic conditions. Our findings indicated that the association between depressive symptoms and chronic conditions depends on lifetime experiences of major discrimination among Black Americans and varies significantly between women and men. Considering that major discrimination conditioned the depressive symptom-chronic conditions association among our sample, this provides insight into potential pathways for intervention in efforts to offset the detrimental mental and physical consequences of experiencing racism.

19.
Article in English | MEDLINE | ID: mdl-34574791

ABSTRACT

To address existing gaps in public health practice, we used data from a 2014 internet panel survey of 954 Los Angeles County adults to investigate the relationships between psychosocial community characteristics (PCCs) and two key chronic disease-related dietary behaviors: fruit and vegetable (F+V) and soda consumption. Negative binomial regression models estimated the associations between 'neighborhood risks and resources' and 'sense of community' factors for each dietary outcome of interest. While high perceived neighborhood violence (p < 0.001) and perceived community-level collective efficacy (p < 0.001) were associated with higher F+V consumption, no PCCs were directly associated with soda consumption overall. However, moderation analyses by race/ethnicity showed a more varied pattern. High perceived violence was associated with lower F+V consumption among White and Asian/Native Hawaiian/Other Pacific Islander (ANHOPI) groups (p < 0.01). Inadequate park access and walking as the primary mode of transportation to the grocery store were associated with higher soda consumption among the ANHOPI group only (p < 0.05). Study findings suggest that current and future chronic disease prevention efforts should consider how social and psychological dynamics of communities influence dietary behaviors, especially among racially/ethnically diverse groups in urban settings. Intervention design and implementation planning could benefit from and be optimized based on these considerations.


Subject(s)
Fruit , Vegetables , Adult , Diet , Humans , Los Angeles , Urban Population
20.
J Health Soc Behav ; 62(2): 136-151, 2021 06.
Article in English | MEDLINE | ID: mdl-34100655

ABSTRACT

Research shows that John Henryism, a high-effort, active coping style, is associated with poor physical health, whereas others suggest it may be psychologically beneficial. As such, it is unclear whether John Henryism represents a health risk or resource for black Americans and whether its impact varies across sociodemographic and gender groups. The present study used data from a representative community sample of black Americans (n = 627) from the Nashville Stress and Health Study (2011-2014) to clarify the physical and mental health consequences of John Henryism by assessing its relationship with depressive symptoms and allostatic load (AL). Results indicate that John Henryism is associated with increased AL scores and fewer depressive symptoms. Additionally, the association between John Henryism and AL is conditional on socioeconomic status. Study results underscore the importance of evaluating both physical and mental health to clarify the health significance of John Henryism among black Americans.


Subject(s)
Black or African American , Mental Health , Adaptation, Psychological , Humans , Social Class
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