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1.
Psychol Trauma ; 16(2): 217-224, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37227832

RESUMO

OBJECTIVE: The COVID-19 pandemic has led to a rise in anti-Asian hate crimes in the United States. Previous work has established that experiencing racism increases one's dysfunctional anxiety and avoidance actions-key symptoms of race-based stress symptoms. However, the psychological impact of vicarious, or secondhand, discrimination (witnessing racism targeting one's own race group) remains less understood. METHOD: We tested the hypothesis that higher reported vicarious discrimination would be associated with higher levels of race-based stress symptoms reported by Asian American young adults (n = 135) during the pandemic using a cross-sectional analysis of the COVID-19 Adult Resilience Experiences Study (CARES). Starting in April 2020, CARES assessed sociodemographic characteristics and key psychometric scales in young adults through three waves of online surveys. RESULTS: Our multiple regression analysis showed vicarious discrimination significantly predicted race-based stress symptoms, even after controlling for direct discrimination (p < .01). This association remained significant after controlling for age, gender, subjective childhood family social status, and preexisting psychiatric disorders (p < .01). Our results demonstrate that regardless of the effect that direct discrimination might have on race-based stress symptoms, witnessing discrimination against members of one's own racial group is significantly associated with increased race-based stress symptoms (b = 2.68, p < .01). Social media was the most common source of vicarious discrimination, with one out of three participants in our sample reporting nearly daily exposure. CONCLUSION: Providers should intentionally create a space within the therapeutic setting to discuss the effects of vicarious discrimination. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Asiático , COVID-19 , Racismo , Estresse Psicológico , Humanos , Adulto Jovem , Asiático/psicologia , Estudos Transversais , Pandemias , Estados Unidos
2.
Lupus ; 33(1): 17-25, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38048450

RESUMO

OBJECTIVE: Black/African American women with systemic lupus erythematosus (SLE) experience greater organ damage and at younger ages than white women. The objective of this study was to advance research on SLE inequities by identifying sociodemographic risk profiles associated with organ damage accrual specifically among Black/African American women. METHODS: Latent profile analysis was conducted among 438 Black/African American women with SLE living in Atlanta, GA and enrolled in the Black Women's Experiences Living with Lupus (BeWELL) Study (May 2015 to April 2017). Proportional hazard and Poisson regression models examined prospective associations between sociodemographic profiles and the timing and degree of organ damage accrual over 2 years. RESULTS: Four profiles emerged: (1) "Younger/Lower SES with Uncontrolled SLE" (44.8%), (2) "Older/Lower SES with Uncontrolled SLE" (23.3%), (3) "Mid-SES with Controlled SLE" (19.6%), and (4) "Higher SES with Controlled SLE" (11.2%). Approximately 42% of participants experienced new organ damage during the follow-up period. Proportional hazard models indicated that "Older/Lower SES with Uncontrolled SLE" participants were at greatest risk of new organ damage (HR = 2.41; 95% CI = 1.39, 4.19), followed by "Younger/Lower SES with Uncontrolled SLE" participants (HR = 1.56; 95% CI = 0.92, 2.67), compared to those in the "Higher SES with Controlled SLE" profile. Poisson regression models revealed that these two groups also exhibited greater organ damage accrual (b = 0.98, SE = 0.24, 95% CI = 0.52, 1.44 and b = 0.72, SE = 0.23, 95% CI = 0.27, 1.17, respectively). CONCLUSIONS: Black/African American women with fewer socioeconomic resources and uncontrolled SLE are at greatest risk for increasing disease severity over time. Social inequities likely contribute to racial inequities in SLE progression.


Assuntos
Lúpus Eritematoso Sistêmico , Humanos , Feminino , Lúpus Eritematoso Sistêmico/epidemiologia , Lúpus Eritematoso Sistêmico/complicações , Grupos Raciais , Negro ou Afro-Americano , Índice de Gravidade de Doença , Gravidade do Paciente
3.
Psychosom Med ; 86(1): 20-29, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-37774102

RESUMO

OBJECTIVE: Psychosocial stress is a major predictor of chronic disease among African American (AA) women. Stress is a process involving exposure, appraisal of threat, coping, and psychobiologic adaptation. However, many studies focus on the frequency of stress events and/or coping; few explicitly study stress events and their appraisals; and AA women experience high levels of racial discrimination, a well-known form of social identity threat (i.e., negative experiences due to judgment based on identity). Stressors related to social identity threat may be differentially appraised and associated with divergent physiologic outcomes. This study examined the differences in the frequency and stressfulness associated with general stressors and racial discrimination in relation to blood pressure (BP) among AA women. METHODS: Multivariable regression was used on cross-sectional data from 208 middle-aged AA women residing in the San Francisco Bay Area. RESULTS: AA women reported less frequency of racial discrimination compared with general stressors, but were more likely to appraise racial discrimination events as stressful. Racial discrimination stressfulness was more strongly associated with systolic BP (SBP) than the number of racial discrimination events. There was a U-shaped association between racial discrimination stress and SBP, with those reporting "none" and "high/very high" distress having the highest SBP ( b = 12.2 [2.7 to 21.8] and b = 15.7 [1.5-29.8], respectively, versus moderate stress). Conversely, those reporting "very low" general stressfulness had the lowest SBP ( b = -7.9 [-15.8 to -0.1], versus moderate stress). Diastolic BP followed a similar pattern, although results were nonsignificant. CONCLUSIONS: This study highlights the importance of stress appraisal measures and adds to the body of evidence documenting racial discrimination as a salient psychosocial stressor for AA women.


Assuntos
Racismo , Pessoa de Meia-Idade , Humanos , Feminino , Racismo/psicologia , Pressão Sanguínea/fisiologia , Negro ou Afro-Americano , Estudos Transversais , Estresse Psicológico
4.
Brain Behav Immun ; 112: 77-84, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37286173

RESUMO

INTRODUCTION: Racial discrimination is a distinct health threat that increases disease risk among Black Americans. Psychosocial stress may compromise health through inflammatory mechanisms. This study examines incident experiences of racial discrimination and changes in the inflammatory biomarker C-reactive protein (CRP) over a two-year period among Black women with systemic lupus erythematosus (SLE)-an inflammatory autoimmune disease sensitive to psychosocial stress and characterized by stark racial inequities in outcomes. METHODS: Data are from the Black Women's Experiences Living with Lupus (BeWELL) Study. Participants (n = 380) from metropolitan Atlanta, Georgia were enrolled from April 2015 to May 2017. Incident racial discrimination was assessed bi-annually via self-report using the Experiences of Discrimination measure. CRP was assessed annually over a two-year period. Latent change score analyses modeled longitudinal within-person associations between incident racial discrimination and change in log-transformed CRP from baseline to Year 2. RESULTS: Incident experiences of racial discrimination were associated with elevated log-CRP across the two-year study period (b = 0.039, SE = 0.017, 95% CI: 0.006, 0.071). For each domain of incident racial discrimination experienced, CRP increased 3.98%. CONCLUSION: This study contributes to growing evidence on the biological consequences of racism and is the first to document an association between incident racial discrimination and changes in inflammation among Black women with SLE. Racial inequities in SLE outcomes and other diseases driven by inflammatory pathways may be explained in part through experiences of racial discrimination.


Assuntos
Negro ou Afro-Americano , Proteína C-Reativa , Inflamação , Lúpus Eritematoso Sistêmico , Racismo , Determinantes Sociais da Saúde , Feminino , Humanos , Negro ou Afro-Americano/psicologia , Proteína C-Reativa/análise , Lúpus Eritematoso Sistêmico/sangue , Lúpus Eritematoso Sistêmico/imunologia , Lúpus Eritematoso Sistêmico/psicologia , Racismo/etnologia , Racismo/psicologia , Determinantes Sociais da Saúde/etnologia , Inflamação/sangue , Inflamação/imunologia , Georgia
5.
J Health Soc Behav ; 64(4): 520-536, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37332176

RESUMO

This study investigates the relationship between allostatic load and a novel form of altruistic racism-related fear, or concern for how racism might harm another, which we term vicarious racism-related vigilance. Using a subsample of Black mothers from the African American Women's Heart & Health Study (N = 140), which includes detailed health and survey data on a community sample of Black women in the San Francisco Bay Area, this study investigates the relationship between Black mothers' experiences with racism-related vigilance as it relates to their children and allostatic load-a multisystem metric of underlying health across multiple biological systems. Findings indicate that vicarious racism-related vigilance was positively associated with allostatic load (i.e., worse health). Findings highlight the salience of vicarious racism-related vigilance for the health of Black mothers, underscoring how intersections between race, gender, and parenthood result in susceptibility to unique forms of health-harming stress.


Assuntos
Alostase , Negro ou Afro-Americano , Mães , Poder Familiar , Racismo , Estresse Psicológico , Criança , Feminino , Humanos , Negro ou Afro-Americano/psicologia , Mães/psicologia , Racismo/etnologia , Racismo/psicologia , Saúde da Mulher/etnologia , Poder Familiar/etnologia , Poder Familiar/psicologia , Estresse Psicológico/complicações , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia
6.
J Affect Disord ; 325: 747-754, 2023 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-36642315

RESUMO

BACKGROUND: The COVID-19 pandemic has been accompanied by a myriad of racist incidents targeting minorities in the U.S. Young adults are susceptible to direct and vicarious (indirect) pandemic-related racial discrimination. We sought to examine associations between both types of discrimination experiences and psychological distress among college students across different racial groups. METHODS: We analyzed self-reported data from 64,041 undergraduate students from the Spring 2021 American College Health Association-National College Health Assessment. Logistic regression examined odds of severe distress based on self-reported exposure to direct and vicarious racial discrimination. RESULTS: Even after controlling for sociodemographic characteristics and prior mental health diagnoses, there was a significant association between direct discrimination and distress among Asian (AOR: 1.3, p < 0.001), Hispanic (AOR: 1.6, p < 0.001), and Multiracial (AOR: 1.4, p < 0.001) students. Vicarious discrimination was significantly associated with distress among White (AOR: 1.4, p < 0.001), Asian (AOR: 1.4, p < 0.001), Hispanic (AOR: 1.5, p < 0.001), and Multiracial (AOR: 1.3, p < 0.001) students. Further analysis considering distress as a continuous measure revealed a significant association between vicarious discrimination and distress for Black participants (ß = 0.9, p < 0.001). LIMITATIONS: Self-reported variables are susceptible to recall bias. Minority racial group analyses may be underpowered. CONCLUSIONS: Our findings reveal an overall link between both direct and vicarious racial discrimination and distress across several racial groups. Further studies should examine effective mental health interventions and anti-racism initiatives to support students who have experienced direct or vicarious discrimination due to COVID-19.


Assuntos
COVID-19 , Angústia Psicológica , Racismo , Adulto Jovem , Humanos , Pandemias , Estudantes/psicologia
7.
Soc Sci Med ; 316: 115070, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-35690497

RESUMO

RATIONALE: John Henryism and Superwoman Schema (SWS) are dispositional characteristics adopted to overcome the challenges of chronic psychosocial stress, and have particular salience for African American women. Both show protective and harmful effects on health and share conceptual similarities and distinctions, yet there is no empirical evidence of the potential overlap resulting in uncertainty about the unique roles they may each play concerning the health of African American women. OBJECTIVE: We examined: 1) whether and to what extent John Henryism and SWS represent similar or distinct constructs relevant to the unique sociohistorical and sociopolitical position of African American women, and 2) whether the two differentially predict health outcomes. METHODS: Data are from a purposive and socioeconomically diverse sample of 208 African American women in the San Francisco Bay Area. First, we conducted a progressive series of tests to systematically examine the conceptual and empirical overlap between John Henryism and SWS: correlation analysis, exploratory factor analysis (EFA), principal component analysis and k-modes cluster analysis. Next, we used multivariable regression to examine associations with psychological distress and hypertension. RESULTS: John Henryism and SWS were moderately correlated with one another (rs = 0.30-0.48). In both EFA and cluster analyses, John Henryism items were distinct from SWS subscale items. For SWS, feeling an obligation to present an image of strength and an obligation to help others predicted higher odds of hypertension (p < 0.05); having an intense motivation to succeed predicted lower odds (p = 0.048). John Henryism did not predict hypertension. Feeling an obligation to help others and an obligation to suppress emotions predicted lower levels of psychological distress (p < 0.05) whereas John Henryism predicted higher distress (p = 0.002). CONCLUSIONS: We discuss the implications of these findings for the measurement of culturally specific phenomena and their role in contributing to the unequal burden of ill health among African American women.


Assuntos
Hipertensão , Racismo , Humanos , Feminino , Negro ou Afro-Americano , Adaptação Psicológica , Hipertensão/psicologia , Personalidade
8.
Womens Health Issues ; 33(2): 153-159, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36319516

RESUMO

INTRODUCTION: Studies suggest that higher rates of excess adiposity in Black women may in part be driven by experiences of racism. Racial microaggressions, which include unintentional and subtle slights and insults, and responses to racism such as racism-related vigilance, may contribute to adiposity in this population. This study examined these understudied racism-related facets as well as interpersonal racial discrimination in relation to adiposity in a cohort of Black women with systemic lupus erythematosus. METHODS: Data are from the Black Women's Experiences Living with Lupus (BeWELL) Study (2015-2017; n = 432). Linear regression was used to examine adiposity measures (body mass index [BMI], percent body fat, and waist-to-hip ratio), measured during a physical examination, in relation to self-reported measures of racial microaggressions, racism-related vigilance, and interpersonal racial discrimination. RESULTS: Compared with infrequent microaggressions, very frequent experiences of microaggressions were associated with 2.9 kg/m2 higher BMI (95% confidence [CI], 0.63-5.21) and 2.6% higher body fat (95% CI, 0.32-4.80) after adjusting for covariates. Racism-related vigilance, measured continuously, was positively associated with BMI (b = 0.84; 95% CI-0.08, 1.61) and percent body fat (b = 0.89; 95% CI, 0.14-1.64). Very frequent experiences of everyday discrimination were associated with a higher BMI (b = 2.70; 95% CI, 0.58-4.83) and waist-to-hip ratio (b = 0.32; 95% CI, 0.09-0.55) compared with less frequent everyday discrimination. CONCLUSIONS: Our results suggest that various dimensions of racism are associated with excess adiposity. Efforts to address obesity among Black women with systemic lupus erythematosus should consider these multiple aspects to decrease racial inequities in adiposity.


Assuntos
Lúpus Eritematoso Sistêmico , Racismo , Humanos , Feminino , Adiposidade , Negro ou Afro-Americano , Obesidade
9.
SSM Popul Health ; 18: 101112, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35535210

RESUMO

Highly public anti-Black violence may increase preterm birth in the general population of pregnant women via stress-mediated paths, particularly Black women exposed in early gestation. To examine spillover from racial violence in the US, we included a total of 49 high publicity incidents of the following types: police lethal force toward Black persons, legal decisions not to indict/convict officers involved, and hate crime murders of Black victims. National search interest in these incidents was measured via Google Trends to proxy for public awareness of racial violence. Timing of racial violence was coded in relation to a three-month preconception period and subsequent pregnancy trimesters, with the primary hypothesis being that first trimester exposure is associated with higher preterm birth odds. The national sample included 1.6 million singleton live births to US-born Black mothers and 6.6 million births to US-born White mothers from 2014 to 2017. Using a preregistered analysis plan, findings show that Black mothers had 5% higher preterm birth odds when exposed to any high publicity racial incidents relative to none in their first trimester, and 2-3% higher preterm birth odds with each log10 increase in national interest. However, post hoc sensitivity tests that included month fixed effects attenuated these associations to null. For White mothers, associations were smaller but of a similar pattern, and were attenuated when including month fixed effects. Highly public anti-Black violence may act as a national stressor, yet whether racial violence is associated with reproductive outcomes in the population is unknown and merits further research.

10.
Health Psychol ; 41(3): 211-224, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35254858

RESUMO

BACKGROUND: In recent years, there has been growing interest in "moving beyond the individual" to measure area-level racism as a social determinant of health. Much of this work has aggregated racial prejudice data collected at the individual-level to the area-level. OBJECTIVE: As this is a rapidly emerging area of research, we conducted a systematic literature review to describe evidence of the relationship between area-level racial prejudice and health, whether results differed by race/ethnicity, and to characterize key conceptual and methodological considerations to guide future research. METHOD: We searched four interdisciplinary databases for US-based, peer-reviewed articles measuring area level racial prejudice by aggregating individual-level indicators of racial prejudice and examining associations with mental or physical health outcome(s). Data extraction followed PRISMA guidelines and also included theory and conceptualization, pathways to health, and strengths and limitations. RESULTS: Fourteen of 14,632 identified articles met inclusion criteria and were included in the review. Health outcomes spanned all-cause (n = 4) and cause-specific (n = 4) mortality, birth outcomes (n = 4), cardiovascular outcomes (n = 2), mental health (n = 1), and self-rated health (n = 1). All studies found a positive association between area-level racial prejudice and adverse health outcomes among racial/ethnic minoritized groups, with four studies also showing a similar association among Whites. Engagement with formal theory was limited and exposure conceptualization was mixed. Methodological considerations included unmeasured confounding and trade-offs between generalizability, self-censorship, and specificity of measurement. CONCLUSIONS: Future research should continue to develop the conceptual and methodological rigor of this work and test hypotheses to inform evidence-based interventions to advance population health and reduce racial health inequities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
Racismo , Etnicidade , Humanos , Saúde Mental , Preconceito , Grupos Raciais
11.
ACR Open Rheumatol ; 4(5): 426-431, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35178897

RESUMO

OBJECTIVE: The study objective was to compare leukocyte telomere length (LTL) among patients with systemic lupus erythematosus (SLE) diagnosed in childhood versus adulthood. METHODS: Data are from the Black Women's Experiences Living with Lupus (BeWELL) study. Multivariable linear regression analyses that examined childhood diagnosis of SLE (diagnosed before 18 years of age), age, and their interaction in relationship to LTL were conducted, adjusting for a range of demographic, socioeconomic, and health-related covariates. RESULTS: The total analytic sample size was 415. Forty participants (9.6%) were diagnosed in childhood. There was no main effect of childhood diagnosis on LTL (b = 0.007; 95% confidence interval [CI]: -0.089 to 0.103). However, the interaction between age and childhood diagnosis was significant (b = -0.008; 95% CI: -0.016 to -0.001), indicating a steeper inverse association between age and LTL among those diagnosed in childhood compared with those diagnosed in adulthood. This interaction remained statistically significant (P = 0.024) after controlling for disease duration measured dichotomously (less than 10 years vs. 10 years or more); it was marginally significant (P = 0.083) when controlling for disease duration measured continuously. CONCLUSION: This cross-sectional analysis suggests that Black women with childhood-onset SLE may undergo accelerated LTL shortening compared with their adult-onset counterparts. This relationship persisted even after controlling for differences in SLE damage and disease duration. These findings inform research on immunosenescence mechanisms of SLE.

12.
Artigo em Inglês | MEDLINE | ID: mdl-35225636

RESUMO

OBJECTIVES: Vicarious racism-witnessing or hearing about other individuals of one's ethnic/racial group being the target of racism-has been salient among Asian Americans during the coronavirus disease (COVID-19) pandemic. There is emerging evidence that such experiences adversely impact several health-related outcomes, including sleep. The present study examines associations between vicarious racism and subjective sleep duration and quality, and the potential moderating role of ethnic/racial identity (ERI). METHOD: Multivariable regression models assessed the association between vicarious racism, private regard, and centrality on self-reported sleep disturbance and duration. The sample consisted of an online sample of 600 Asian American adults (Mage = 38.55, SDage = 17.11; 65.17% female; 60% ≥ Bachelor's degree) recruited from May to June 2020. RESULTS: Vicarious racism was associated with compromised sleep quality and duration, including after adjustment for sociodemographic variables that have been linked to sleep. Private regard toward one's own ethnic/racial group and centrality of ethnicity/race to self-identity buffered the association between vicarious racism and sleep quality and duration. Adverse effects of high vicarious racism on sleep quality and duration were lessened among respondents reporting high levels of ERI private regard and centrality. CONCLUSIONS: Findings from this study extend research on racism and sleep by examining vicarious racism, an understudied facet of racism, and by focusing specifically on Asian Americans and in the context of the COVID-19 pandemic. Future research and practice should consider expanding research on discrimination to include a broader range of unjust experiences. Vicarious racism contributes to health hazards experienced by Asian Americans during the COVID-19 pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

13.
Gerontologist ; 62(5): 762-772, 2022 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-35084030

RESUMO

BACKGROUND AND OBJECTIVES: African American women experience faster telomere shortening (i.e., cellular aging) compared with other racial-gender groups. Prior research demonstrates that race and gender interact to influence culturally specific norms for responding to socially-relevant stress and other stress-coping processes, which may affect healthy aging. RESEARCH DESIGN AND METHODS: Data are from African American Women's Heart & Health Study participants who consented to DNA extraction (n = 140). Superwoman Schema (SWS) was measured using 5 validated subscales: presenting strength, emotion suppression, resisting vulnerability, motivation to succeed, and obligation to help others. Racial identity was measured using 3 subscales from the Multidimensional Inventory of Black Identity: racial centrality, private regard, and public regard. Relative telomere length (rTL) was measured using DNA extracted from blood samples. Path analysis tested associations and interactions between SWS and racial identity dimensions with rTL. RESULTS: For SWS, higher resistance to being vulnerable predicted longer telomeres. For racial identity, high private regard predicted longer telomeres while high public regard predicted shorter telomeres. Interactions were found between public regard and 2 SWS dimensions: among women with high public regard, emotion suppression (ß = 0.20, p < .05) and motivation to succeed (ß = 0.18, p < .05) were associated with longer rTL. The interaction between high centrality and emotion suppression predicted shorter rTL (ß = -0.17, p < .05). DISCUSSION AND IMPLICATIONS: Culturally specific responses to gendered racism and racial identity, developed early in life and shaped over the life course, are important psychosocial determinants of cellular aging among African American women.


Assuntos
Negro ou Afro-Americano , Racismo , Adaptação Psicológica , Negro ou Afro-Americano/psicologia , Senescência Celular , Feminino , Humanos , Racismo/psicologia , Saúde da Mulher
15.
Am J Public Health ; 111(9): 1610-1619, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34410817

RESUMO

Objectives. To describe disparities in depression, anxiety, and problem drinking by sexual orientation, sexual behavior, and gender identity during the COVID-19 pandemic. Methods. Data were collected May 21 to July 15, 2020, from 3245 adults living in 5 major US metropolitan areas (Atlanta, Georgia; Chicago, Illinois; New Orleans, Louisiana; New York, New York; and Los Angeles, California). Participants were characterized as cisgender straight or LGBTQ+ (i.e., lesbian, gay, bisexual, and transgender people, and men who have sex with men, and women who have sex with women not identifying as lesbian, gay, bisexual, or transgender). Results. Cisgender straight participants had the lowest levels of depression, anxiety, and problem drinking compared with all other sexual orientation, sexual behavior, and gender identity groups, and, in general, LGBTQ+ participants were more likely to report that these health problems were "more than usual" during the COVID-19 pandemic. Conclusions. LGBTQ+ communities experienced worse mental health and problem drinking than their cisgender straight counterparts during the COVID-19 pandemic. Future research should assess the impact of the pandemic on health inequities. Policymakers should consider resources to support LGBTQ+ mental health and substance use prevention in COVID-19 recovery efforts.


Assuntos
COVID-19/epidemiologia , Saúde Mental/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Adolescente , Adulto , Idoso , Alcoolismo/epidemiologia , Ansiedade/epidemiologia , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2 , Fatores Socioeconômicos , Estados Unidos , População Urbana/estatística & dados numéricos , Adulto Jovem
16.
J Behav Med ; 44(6): 760-771, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34159500

RESUMO

African American women with systemic lupus erythematosus (SLE) have worse disease outcomes compared to their White counterparts. Stressors associated with race may contribute to poorer health in this population through maladaptive behavioral pathways. This study investigated relationships between stress associated with anticipating racism, smoking, and SLE disease activity. Data were from 432 African American women with SLE in the Black Women's Experiences Living with Lupus (BeWELL) Study. Controlling for sociodemographic and health-related covariates, multivariable regression analyses revealed a significant association between anticipatory racism stress (ARS) and disease activity (p = 0.00, b = 1.13, 95% CI [0.43, 1.82]). A significant interaction between ARS and smoking also indicated that smoking exacerbated the effect of ARS on disease activity (p = 0.04, b = 1.95, CI = 0.04, 3.96). Test for evidence of smoking mediating the effect of ARS on disease activity were not statistically significant (z = 1.77, p = 0.08). Findings have implications for future SLE disparities research among African American women with SLE.


Assuntos
Lúpus Eritematoso Sistêmico , Racismo , Negro ou Afro-Americano , Feminino , Humanos , Fumar
17.
Health Place ; 70: 102587, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34116496

RESUMO

Depression is a common comorbidity among Black women with systemic lupus erythematosus (SLE), an understudied autoimmune disease characterized by major racial and gender inequities. Research is needed that examines how area-level factors influence risk of depression in this population. Latent profile analysis revealed four neighborhood typologies among metropolitan Atlanta, Georgia census tracts that participants (n=438) in the Black Women's Experiences Living with Lupus (BeWELL) Study were living in: Integrated/High-SES, Moderately Segregated/Mid-SES, Highly Segregated/Mid-SES, and Highly Segregated/Low-SES. Structural equation models indicated that highly segregated census tracts were associated with the greatest levels of depression via increased subjective assessments of neighborhood disorder. Policies that invest in segregated areas and address physical and social aspects of the environment that contribute to neighborhood disorder may promote mental health among Black women with SLE.


Assuntos
Lúpus Eritematoso Sistêmico , Segregação Social , Censos , Depressão/epidemiologia , Feminino , Humanos , Lúpus Eritematoso Sistêmico/epidemiologia , Características de Residência
18.
Public Health Rep ; 136(4): 508-517, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34034574

RESUMO

OBJECTIVES: Experiences of vicarious racism-hearing about racism directed toward one's racial group or racist acts committed against other racial group members-and vigilance about racial discrimination have been salient during the COVID-19 pandemic. This study examined vicarious racism and vigilance in relation to symptoms of depression and anxiety among Asian and Black Americans. METHODS: We used data from a cross-sectional study of 604 Asian American and 844 Black American adults aged ≥18 in the United States recruited from 5 US cities from May 21 through July 15, 2020. Multivariable linear regression models examined levels of depression and anxiety by self-reported vicarious racism and vigilance. RESULTS: Controlling for sociodemographic characteristics, among both Asian and Black Americans, greater self-reported vicarious racism was associated with more symptoms of depression (Asian: ß = 1.92 [95% CI, 0.97-2.87]; Black: ß = 1.72 [95% CI, 0.95-2.49]) and anxiety (Asian: ß = 2.40 [95% CI, 1.48-3.32]; Black: ß = 1.98 [95% CI, 1.17-2.78]). Vigilance was also positively related to symptoms of depression (Asian: ß = 1.54 [95% CI, 0.58-2.50]; Black: ß = 0.90 [95% CI, 0.12-1.67]) and anxiety (Asian: ß = 1.98 [95% CI, 1.05-2.91]; Black: ß = 1.64 [95% CI, 0.82-2.45]). CONCLUSIONS: Mental health problems are a pressing concern during the COVID-19 pandemic. Results from our study suggest that heightened racist sentiment, harassment, and violence against Asian and Black Americans contribute to increased risk of depression and anxiety via vicarious racism and vigilance. Public health efforts during this period should address endemic racism as well as COVID-19.


Assuntos
Ansiedade/etnologia , Asiático/psicologia , Negro ou Afro-Americano/psicologia , COVID-19/psicologia , Depressão/etnologia , Racismo/psicologia , Adulto , Ansiedade/etiologia , Estudos Transversais , Depressão/etiologia , Feminino , Humanos , Modelos Lineares , Masculino , Racismo/estatística & dados numéricos , Estados Unidos/epidemiologia
19.
Proc Natl Acad Sci U S A ; 118(17)2021 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-33875593

RESUMO

Highly public anti-Black violence in the United States may cause widely experienced distress for Black Americans. This study identifies 49 publicized incidents of racial violence and quantifies national interest based on Google searches; incidents include police killings of Black individuals, decisions not to indict or convict the officer involved, and hate crime murders. Weekly time series of population mental health are produced for 2012 through 2017 using two sources: 1) Google Trends as national search volume for psychological distress terms and 2) the Behavioral Risk Factor Surveillance System (BRFSS) as average poor mental health days in the past 30 d among Black respondents (mean weekly sample size of 696). Autoregressive moving average (ARMA) models accounted for autocorrelation, monthly unemployment, season and year effects, 52-wk lags, news-related searches for suicide (for Google Trends), and depression prevalence and percent female (for BRFSS). National search interest varied more than 100-fold between racial violence incidents. Black BRFSS respondents reported 0.26 more poor mental health days during weeks with two or more racial incidents relative to none, and 0.13 more days with each log10 increase in national interest. Estimates were robust to sensitivity tests, including controlling for monthly number of Black homicide victims and weekly search interest in riots. As expected, racial incidents did not predict average poor mental health days among White BRFSS respondents. Results with national psychological distress from Google Trends were mixed but generally unsupportive of hypotheses. Reducing anti-Black violence may benefit Black Americans' mental health nationally.


Assuntos
Negro ou Afro-Americano/psicologia , Exposição à Violência/tendências , Saúde Mental/tendências , Adulto , Centers for Disease Control and Prevention, U.S. , Violência Étnica/psicologia , Violência Étnica/tendências , Exposição à Violência/psicologia , Feminino , Humanos , Uso da Internet/tendências , Masculino , Pessoa de Meia-Idade , Vigilância da População , Prevalência , Racismo/psicologia , Racismo/tendências , Estados Unidos , Violência/psicologia , Violência/tendências
20.
Sleep Med ; 81: 341-349, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33798979

RESUMO

OBJECTIVES: Black adults in the United States have shorter sleep durations and poorer sleep efficiency relative to White adults, yet reasons for these disparities are not well explicated. The objective of this study was to examine neighborhood safety in childhood as a mediator of subsequent racial disparities in sleep. METHODS: Data were from Black and White young adults attending a large, predominantly White university in the Southeastern United States (N = 263; 52% Black, 53% female; Mean age = 19.21 years, SD = 1.01). Sleep parameters were assessed from eight nights of wrist actigraphy (time in bed, sleep duration, and efficiency) and an established self-report measure of daytime sleepiness. Residential histories from birth through age 18 were documented, and retrospective self-reports of neighborhood safety in childhood were assessed. RESULTS: Black participants had less time in bed (p < 0.001), shorter sleep duration (p < 0.001), poorer sleep efficiency (p < 0.001), and more daytime sleepiness (p = 0.009) than White participants. Neighborhood safety mediated race differences in time in bed (p = 0.028), sleep duration (p = 0.033), and daytime sleepiness (p = 0.048), but not sleep efficiency. Findings were substantively unchanged after adjustment for family socioeconomic status, BMI, and substance use. CONCLUSIONS: Findings support the hypothesis that neighborhood safety in childhood may partially account for race differences in subsequent sleep duration and daytime sleepiness. Addressing racial inequities in childhood neighborhood safety may be an important step toward reducing racial disparities in sleep health.


Assuntos
Negro ou Afro-Americano , Disparidades nos Níveis de Saúde , Adolescente , Adulto , Feminino , Humanos , Masculino , Características de Residência , Estudos Retrospectivos , Sono , Estados Unidos , População Branca , Adulto Jovem
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