Are Interracial Couples at Higher Risk of Multiple Chronic Conditions? Evidence from a Nationally Representative Sample.

Interracial relationships are becoming increasingly common in the United States, yet the physical health status of individuals in interracial relationships is not well understood. Using 18 years of pooled data from the National Health Interview Study (2001-2018) (N = 264, 891), we compared the odds of having multiple chronic conditions (MCC) among adults in interracial and same-race unions. We anticipate that individuals in interracial relationships may be at higher risk of MCC than individuals in same-race relationships due to increased exposure to stressors associated with crossing racial boundaries. Findings indicate that the implications of interracial relationships on MCC depended on the racial composition of the couple. We found that White-Black couples had higher odds of MCC than both White-White and Black-Black couples, but Asian-Black and Hispanic-Black couples did not differ from their same-race couple counterparts, indicating a pronounced and unique health disadvantage for White adults paired with Black adults. We also found that Asian-White and Hispanic-White couples had higher odds of MCC relative to their same-race counterparts. In addition, minority-minority couples generally did not differ from their same-race minority couple counterparts in terms of MCC. The results of the study provide new insights into how the racial composition of interracial unions impacts health and how a closer proximity to Whiteness may be a health risk for some minority groups.

Fear of a Black Neighborhood: Anti-Black Racism and the Health of White Americans.

Does anti-Black racism harm White Americans? We advance hypotheses that address this question within the neighborhood context. Hypotheses are tested with neighborhood and survey data from a probability sample of White residents of Nashville, Tennessee. We find that regardless of neighborhood crime rates or socioeconomic compositions, Whites report heightened perceptions of crime and danger in their neighborhoods as the proportion of Black residents increases. Perceived neighborhood danger, in turn, predicts increased symptoms of psychophysiological distress. When stratified by socioeconomic status (SES), however, low-SES Whites also report perceptions of higher status when living near more Black neighbors, which entirely offsets their distress. We conclude that although anti-Black racism can ironically harm the health of White Americans, compensatory racist ideologies can also offset these harms, particularly for lower-status Whites. We situate our findings within broader discussions of anti-Black racism, residential segregation, and psychiatric disorders commonly observed among White Americans.

Religious Involvement and Allostatic Resilience: Findings from a Community Study of Black and White Americans.

Wide inequities in stress and health have been documented between Black and White women and men in the United States. This study asks: How does religion factor into these inequities? We approach this open question from a biopsychosocial perspective, developing three hypotheses for the stress-coping effects of religiosity between groups. We then test our hypotheses with survey and biomarker data from the Nashville Stress and Health Study (2011-2014), a probability sample of Black and White women and men from Davidson County, Tennessee. We find that Black women score the highest on all indicators of religiosity, followed by Black men, White women, and White men. We also find that increased divine control and religious coping predict higher levels of resiliency biomarkers for Black women only and lower levels for White respondents, especially White men. We discuss how our findings inform broader population health inequities and outline several avenues for future research.

Do early life traumas moderate the impact of cumulative pandemic stress on anger?

Do early life traumas condition the psychological consequences of pandemic stressors? Using national data from the Crime, Health, and Politics Survey (May-June 2021), we examine whether early life traumas buffer or amplify the impact of cumulative pandemic stressors (CPS) on anger, an understudied measure of emotional distress. We examine two competing perspectives. The trauma amplification perspective posits that people who experience early life traumas are especially vulnerable to subsequent stressors, while the trauma resiliency perspective suggests the opposite, that people who experience traumas in early life are less vulnerable to subsequent stressors. The trauma resiliency perspective was partially supported by our analyses. Although early life traumas abated the impact of three or more pandemic stressors on anger, we failed to observe any attenuation at lower levels of pandemic stress exposure. We extend previous research by recasting the common stress proliferation model as a stress modification model and by focusing on feelings of anger. Findings are discussed in the context of social stress, mental health, and the COVID-19 pandemic.

Inflation hardship, gender, and mental health.

Inflation hit a 40 year high in the United States in 2022, yet the impact of inflation related hardships on distress is poorly understood, particularly the impact on women, whose income is already more limited. Using data from the US Household Pulse Survey (September-November 2022), we test whether exposure to inflation hardships is associated with greater distress and whether this association is moderated by gender (n = 119,531). We draw on a list of eighteen inflation related hardships (e.g., purchasing less food, working additional jobs, delaying medical treatment) to construct an ordinal measure of exposure to inflation hardship ranging from "no inflation hardship" to "five or more inflation hardships." We observe that an increasing number of inflation hardships is associated with higher levels of distress. We find no evidence of gender differences in the magnitude of that association at lower levels of inflation hardship (four inflation hardships or less). However, our findings suggest that exposure to five or more inflation hardships is more strongly associated with distress among men compared to women. The current study provides new insights into the cumulative burden of inflation hardships on mental health and the role that gender plays in this association.

Assessment of Sociodemographics and Inflation-Related Stress in the US.

This survey study of US adults examines the association of stress experienced as a result of inflation with sociodemographic characteristics such as sex, race and ethnicity, education, and income levels.

Exposure to neighborhood poverty from adolescence through emerging adulthood and sleep duration in US adults.

Does exposure to neighborhood poverty from adolescence to early adulthood have differential influence on sleep duration across racial/ethnic groups? We used data from the National Longitudinal Study of Adolescent to Adult Health that consisted of 6756 Non-Hispanic (NH) White respondents, 2471 NH Black respondents, and 2000 Hispanic respondents and multinomial logistic models to predict respondent reported sleep duration based on exposure to neighborhood poverty during adolescence and adulthood. Results indicated that neighborhood poverty exposure was related to short sleep duration among NH White respondents only. We discuss these results in relation to coping, resilience, and White psychology.

Attribution for everyday discrimination typologies and mortality risk among older black adults: Evidence from the health and retirement study?

BACKGROUND: The present study assessed how attributions of everyday discrimination typologies relate to all-cause mortality risk among older Black adults. METHODS: This study utilized data from a subsample of older Black adults from the 2006/2008 Health and Retirement Study (HRS). Attributions for everyday discrimination (i.e., ancestry, age, gender, race, physical appearance, physical disability, sexual orientation, weight, and other factors) were based on self-reports, while their vital statuses were obtained from the National Death Index and reports from key informants (spanning 2006-2019). We applied latent class analysis (LCA) to identify subgroups of older Black adults based on their attributions to everyday discrimination. Cox proportional hazards models were used to analyze time to death as a function of LCA group membership and other covariates. RESULTS: Based on fit statistics, we selected a four-class model that places respondents into one of the following classes: Class One (7%) attributed everyday discrimination to age, race, and physical disability; Class Two (72%) attributed everyday discrimination to few/no sources, Class Three (19%) attributed everyday discrimination to race and national origin; and Class Four (2%) attributed everyday discrimination to almost every reason. After adjusting for sociodemographic, behavioral, multisystem physiological dysregulation, and socioeconomic characteristics, we found that the relative risk of death remained higher for the respondents in Class One (Hazard Ratio [H.R.]: 1.80, 95% Confidence Interval [C.I.]: (1.09-2.98) and Class Four (H.R.: 3.92, 95% C.I.: 1.62-9.49) compared to respondents in Class Two. CONCLUSIONS: Our findings illustrate the utility of using attribution for everyday discrimination typologies in research on the psychosocial dimensions of mortality risk among older Black adults. Future research should assess the mechanisms that undergird the link between everyday discrimination classes and all-cause mortality risk among older Black adults.

Increasing psychological distress among Californians from 2013 to 2020: Race/ethnic differences.

The influence of the COVID-19 pandemic on mental health is of mounting concern to population-health researchers. While early reports indicated increases in mental health problems, noticeably absent from these studies is how mental health has changed in 2020 compared to previous years (2013-2019) and whether such trends vary by race/ethnicity. The present study used repeated cross-sectional data from the California Health Interview Survey (n â€‹= â€‹168,216) to systematically document trends in psychological distress scores (Kessler-6 scale; K6) and severe psychological distress scores (K6; 13+) from 2013 to 2020 and by race/ethnicity over the same period. Among all Californians we find that the reported average psychological distress scores increased by 22% between 2013 and 2020. Reported severe psychological distress scores increased 61% from 2013 to 2020. These increases were largely concentrated in the years 2017-2020. Increases in psychological distress were also especially pronounced among non-Latino/a White Californians (29% increase in K6 from 2013 to 2020), Latino/a Californians (14% increase in K6 from 2013 to 2020), and Asian Californians (35% increase in K6 from 2013 to 2020). Multiple and logistic regression models that accounted for sociodemographic and behavioral health covariates echoed these findings. Future research should continue to investigate secular trends in mental health that coincided with the COVID-19 pandemic and carefully situate the shifts into broader temporal perspective.

Multiple Reasons for Perceived Everyday Discrimination and All-Cause Mortality Risk Among Older Black Adults.

BACKGROUND: This study assessed whether reporting multiple reasons for perceived everyday discrimination was associated with an increased risk for all-cause mortality risk among older Black adults. METHODS: This study utilized data from a subsample of older Black adults from the Health and Retirement Study (HRS), a nationally representative panel study of older adults in the United States. Our measure of multiple reasons for perceived everyday discrimination was based on self-reports from the 2006/2008 HRS waves. Respondents' vital status was obtained from the National Death Index and reports from key household informants (spanning 2006-2019). Cox proportional hazard models, which accounted for covariates linked to mortality, were used to estimate the risk of all-cause mortality. RESULTS: During the observation period, 563 deaths occurred. Twenty percent of Black adults attributed perceived everyday discrimination to 3 or more sources. In demographic adjusted models, attributing perceived everyday discrimination to 3 or more sources was a statistically significant predictor of all-cause mortality risk (hazard ratio = 1.45; 95% confidence interval = 1.12-1.87). The association remained significant (hazard ratio = 1.49; 95% confidence interval = 1.15-1.93) after further adjustments for health, behavioral, and economic characteristics. CONCLUSIONS: Examining how multiple reasons for perceived everyday discrimination relate to all-cause mortality risk has considerable utility in clarifying the unique contributions of perceived discrimination to mortality risk among older Black adults. Our findings suggest that multiple reasons for perceived everyday discrimination are a particularly salient risk factor for mortality among older Black adults.

Do Racial Differences in Coping Resources Explain the Black-White Paradox in Mental Health? A Test of Multiple Mechanisms.

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.

Race, Flourishing, and All-Cause Mortality in the United States, 1995-2016.

We assessed whether race moderates the association between flourishing and all-cause mortality. We used panel data from the Midlife in the United States Study (MIDUS) (1995-2016; n = 2,851). Approximately 19% of White respondents and 23% of Black respondents in the baseline sample died over the course of the 21-year study period (n = 564). Cox proportional hazard models showed that Blacks had a higher mortality rate relative to Whites and higher levels of flourishing were associated with a lower mortality rate. Furthermore, a significant interaction between flourishing and race in predicting death was observed. Blacks with higher levels of flourishing had a mortality rate that was not significantly different from that of Whites. However, Blacks, but not Whites, with low flourishing scores had a higher mortality rate. As such, health-promotion efforts focused on enhancing flourishing among Black populations may reduce the Black-White gap in mortalityrate.

The Black-White Paradox Revisited: Understanding the Role of Counterbalancing Mechanisms during Adolescence.

The tendency for blacks to report similar or better mental health than whites has served as an enduring paradox in the mental health literature for the past three decades. However, a debate persists about the mechanisms that underlie this paradox. Drawing on the stress process framework, we consider the counterbalancing roles of self-esteem and traumatic stress exposure in understanding the "black-white paradox" among U.S. adolescents. Using nationally representative data, we observe that blacks have higher levels of self-esteem than whites but also encounter higher levels of traumatic stress exposure. Adjusting for self-esteem reveals a net higher rate of mood disorders and distress among blacks relative to whites, and differences in traumatic stress exposure mediate this association. In the full model, we show that self-esteem and stress exposure offset each other, resulting in a null association between race and mood disorders and a reduced association between race and distress.

Prevalence and Patterning of Mental Disorders Through Adolescence in 3 Cohorts of Black and White Americans.

The tendency for US blacks to report similar or lower rates of mental disorder than whites is well-established. However, whether these disparities are stable across cohorts of black and white Americans is not well understood. In the current study, we examined black-white differences in the lifetime prevalence of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, mood, anxiety, impulse control, and substance use disorders and any mental disorders across 3 cohorts of blacks and whites aged 4-18 years. Using merged data from the National Comorbidity Survey Replication (2001-2003) and the National Comorbidity Survey Adolescent Supplement (2001-2004), we observed a change in the black-white patterning of mental disorder between 1957 and 2004. Blacks born during 1957-1969 reported lower rates of anxiety disorders than their white counterparts (odds ratio (OR) = 0.69, 95% confidence interval (CI): 0.52, 0.91); blacks born during 1970-1982 reported no difference in the rates of anxiety disorders relative to whites (OR = 0.97, 95% CI: 0.76, 1.25); and blacks born during 1983-1991 reported higher rates of anxiety disorders than whites (OR = 1.30, 95% CI: 1.18, 1.43). Similar but less distinct trends were observed for mood disorders, impulse control disorders, and any disorders. Our results suggest that the black-white patterning of mental disorder in the United States has changed across cohorts, to the disadvantage of black Americans.

Representations of race and skin tone in medical textbook imagery.

Although a large literature has documented racial inequities in health care delivery, there continues to be debate about the potential sources of these inequities. Preliminary research suggests that racial inequities are embedded in the curricular edification of physicians and patients. We investigate this hypothesis by considering whether the race and skin tone depicted in images in textbooks assigned at top medical schools reflects the diversity of the U.S. POPULATION: We analyzed 4146 images from Atlas of Human Anatomy, Bates' Guide to Physical Examination & History Taking, Clinically Oriented Anatomy, and Gray's Anatomy for Students by coding race (White, Black, and Person of Color) and skin tone (light, medium, and dark) at the textbook, chapter, and topic level. While the textbooks approximate the racial distribution of the U.S. population - 62.5% White, 20.4% Black, and 17.0% Person of Color - the skin tones represented - 74.5% light, 21% medium, and 4.5% dark - overrepresent light skin tone and underrepresent dark skin tone. There is also an absence of skin tone diversity at the chapter and topic level. Even though medical texts often have overall proportional racial representation this is not the case for skin tone. Furthermore, racial minorities are still often absent at the topic level. These omissions may provide one route through which bias enters medical treatment.