African American Family Caregivers' Experiences and Mental Health: A Convergent Mixed-Methods Study.

BACKGROUND: Caregiving in the African American community is informed by strong cultural expectations but may be associated with negative experiences and poor mental health outcomes. OBJECTIVE: The purpose of this convergent mixed-methods study is to understand the relationship between caregiving experiences and mental health and explore stress management strategies in African American family caregivers of adults with chronic or disabling conditions. METHODS: African American family caregivers (N = 100) were recruited using community-engaged methods and completed a sociodemographic questionnaire, the Caregiver Reaction Assessment scale, and the Center for Epidemiologic Studies Depression (CES-D-10) Scale. A subsample (n = 24) participated in semi-structured interviews. Data were analyzed using linear regression and content analysis. A matrix was developed to integrate quantitative and qualitative results. RESULTS: Participants were on average 59 years old. Most were women and provided care to a parent. Lack of family support (B = 1.37, P = .03) and impact of caregiving on caregivers' finances (B = 1.74, P = .004), schedule (B = 2.92, P < .001), and health (B = 3.26, P < .001) were associated with depressive symptoms and were reported as stressful experiences. Negative interactions with the care recipient and caring for multiple people emerged as other sources of stress. Participants used independent and interpersonal coping strategies, as well as strategies to facilitate their caregiving role to reduce their stress. Values of reciprocity, limited use of community-based resources, and mental health stigma emerged as important cultural considerations. CONCLUSIONS: Our findings suggest the need for culturally-sensitive interventions to improve communication and care coordination within African American family caregiving networks and educational programs about mental health and caregiving resources endorsed by trusted community sources.

Racial/Ethnic Differences in Loneliness Among Older Adults: The Role of Income and Education as Mediators.

Background and Objectives: Loneliness is a major public health concern; however, limited research has examined the mechanisms contributing to racial/ethnic inequities in loneliness. Race/ethnicity has been hypothesized to be a distal factor influencing loneliness, and racial/ethnic inequities in loneliness may be attributable to socioeconomic factors (e.g., income and education). Our study seeks to confirm these hypotheses by examining mechanisms that contribute to racial/ethnic inequities in loneliness. In other words, if racial/ethnic differences in loneliness among older adults are mediated by income and education. Research Design and Methods: Data came from the Health and Retirement Study Leave-Behind Questionnaire, 2014-2016. Loneliness was measured by the UCLA 3-item loneliness scale. Race/ethnicity categories were White, Black, and Hispanic/Latino. The mediator variables were household income and education. Multivariable linear regression models were used to determine differences in loneliness by race/ethnicity. The Karlson-Holm-Breen (KHB) mediation method was used to determine if income and education mediated racial/ethnic differences in loneliness. Results: In models examining income and education together, a complete mediation was found between White and Black older adults, in that income and education completely mediated differences in loneliness between these groups. A partial mediation was found between White and Hispanic, and Black and Hispanic older adults. When examining income and education separately, we found that income solely accounted for racial/ethnic differences in loneliness compared to education. Discussion and Implications: Our study is the first to explicitly determine if socioeconomic factors mediate race/ethnicity differences in loneliness among a national sample of older adults. These findings illustrate that income may have greater proximate effects for loneliness among older adults in comparison to education. Additionally, these findings can inform evidence-based interventions to reduce loneliness among older adults. Interventions that enhance quality of life and provide opportunities for socialization for racialized low-income older adults may help decrease racial/ethnic inequities in loneliness.

Elder Abuse in Older Adults With Dementia: Protective Factors and Adverse Effects.

With the rapid increase in the aging population, more attention has been paid to studying older adults with dementia. Despite the fact that older adults with dementia are more likely to be abused compared to their cognitively intact counterparts, little attention has been paid to abuse within this population. This systematic review, conducted using the PRISMA model, aims to critically examine, evaluate, and synthesize literature on protective factors and adverse effects of elder abuse by informal caregivers among individuals with dementia. A search was undertaken using the Ageline, Medline, CINAHL, and PsycINFO databases for peer-reviewed articles published in English up to June 2023. A total of 291 articles were identified by the systematic search, and 8 articles were included in the review. The results showed that protective factors related to elder abuse are mainly examined at a perpetrator level, including caregiver-related, relational, and contextual factors. Adverse effects, specifically an increased risk of various medical conditions and poor medication adherence, were identified but less frequently discussed. The findings indicated future directions for practitioners, researchers, and policymakers to better serve older adults with dementia and their caregivers.

Chronic stress exposure, social support, and sleep quality among African Americans: findings from the National Survey of American Life-Reinterview.

OBJECTIVE: The purpose of this study was to determine whether social support from extended family and church members moderate the association between chronic stress exposure and sleep quality in a nationally representative sample of African American adults. DESIGN: Data from African American respondents aged 18 and older were drawn from the National Survey of American Life-Reinterview. The analytic sample for this study included 1,372 African American adults who attended religious services at least a few times a year, as the church-based relationship measures were only assessed for these individuals. Self-reported sleep quality was assessed by sleep satisfaction, trouble falling asleep, and restless sleep. Chronic stress exposure was measured by a nine-item index. OLS and logistic regression were used to estimate the relationship between chronic stress exposure, extended family and church relationships, and sleep quality. RESULTS: The data indicated that chronic stress exposure was associated with decreased sleep satisfaction, increased likelihood of trouble falling asleep and restless sleep. Receiving emotional support from family and more frequent contact with church members were associated with decreased restless sleep. Emotional family support moderated the associations between chronic stress exposure and trouble falling asleep and restless sleep. The positive associations between chronic stress exposure and these two sleep quality measures were attenuated among respondents who received high levels of emotional support from their family. CONCLUSIONS: Together, these findings underscore the detriment of chronic stress exposure to African Americans' sleep quality and suggest that extended family members are effective stress coping resources and play an important role in this population's sleep quality.

Correlates of Spirituality among African American and Black Caribbean Emerging Adults.

Spirituality is a significant cultural strength and resource for Black emerging adults. Numerous studies show that increasing numbers of emerging adults tend to identify themselves as being spiritual but not religious. However, no studies to date have identified the demographic correlates of spirituality for Black emerging adults from different ethnic groups (i.e., African American vs. Black Caribbean). Data from the National Survey of American Life was used to identify the demographic correlates of 2 indicators of spirituality (e.g., self-rated spirituality and subjective spirituality) for 802 African American and 428 Black Caribbean emerging adults using linear regression. For African Americans, being a woman predicted both greater self-rated spirituality and subjective spirituality. However, among Black Caribbeans men rated spirituality higher in importance than women. African Americans who reported higher educational attainment tended to report higher levels of self-rated spirituality and subjective spirituality. Romantic status for Black Caribbeans, whether they had no romantic involvement or a current romantic partner, was associated with lower self-ratings of spirituality. Unmarried cohabitating individuals in both ethnic groups tended to report lower levels of self-related spirituality. Unemployment for Black Caribbeans was associated with lower subjective spirituality. Findings are of interest to those who serve and work with Black emerging adults.

The role of subjective, interpersonal, and structural social isolation in 12-month and lifetime anxiety disorders.

BACKGROUND: Anxiety disorders are among the most prevalent psychiatric conditions worldwide, and the incidence of anxiety disorders among adults in the U.S. have increased over the last decade. Anxiety disorders can have debilitating effects on multiple areas of functioning and quality of life. Recently, social isolation has emerged as an important public health problem associated with worse health and well-being outcomes. Research on the connection between social isolation and mental health has found that multiple dimensions of social isolation may negatively impact mental health, but few inquiries have focused on the association between social isolation and anxiety. This study examined the relationships between multiple dimensions of social isolation and anxiety disorders in a nationally representative sample of adults aged 18 and older. METHODS: The sample includes 6082 individuals from the National Survey of American Life. This study examined whether three different dimensions of social isolation-subjective, interpersonal, and structural-were associated with 12-month and lifetime anxiety disorders (any anxiety disorder, posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder (PD), social anxiety disorder (SAD), and agoraphobia (AG). Logistic regressions were used to test the associations between the three social isolation variables and the anxiety outcomes. RESULTS: This study found that of the three dimensions of social isolation, subjective isolation was most consistently related to both lifetime and 12-month anxiety disorders. Those who were subjectively isolated had increased odds of meeting criteria for any anxiety disorder, PTSD, GAD, PD, and AG over the past 12 months and throughout their lifetimes. Structural isolation was negatively associated with lifetime and 12-month AG. CONCLUSIONS: Public health approaches should include mental health and primary care providers and need to target social isolation, especially subjective isolation, which may be key in preventing anxiety disorders and the worsening of anxiety disorders. Future public health research is needed on how and in what ways the differing dimensions of social isolation impact mental health.

"So, Do Not Fear": Religion and the prevalence, persistence, and severity of anxiety disorders among Black Americans.

BACKGROUND: There is a dearth of scholarship that explicates the effects of religious participation on anxiety disorders among Black Americans. A better understanding of the links between religious participation, a coping resource, and anxiety disorders among Black Americans remains essential, given Black Americans are less likely than their white counterparts to seek professional treatment for mental health problems, leading to greater unmet mental health needs. The aim of this study was to investigate whether religious participation is associated with the prevalence, persistence, and severity of anxiety disorders among Black adults. METHODS: We used a national sample of Black adults (N = 4999) from the National Survey of American Life, a cross-sectional study conducted from 2001 to 2003. Five anxiety disorders were assessed: posttraumatic stress disorder, generalized anxiety disorder, panic disorder, social anxiety disorder, and agoraphobia. Three dimensions of religious participation were assessed: organizational, non-organizational, and subjective religious participation. Weighted logistic and linear regressions were estimated to examine the associations between religious participation and anxiety disorders. RESULTS: Findings indicate that organizational religious participation and subjective religiosity were associated with lower odds of anxiety disorders and decreased severity. Findings for non-organizational religious participation in relation to the prevalence, persistence, and severity of anxiety disorders were mixed. LIMITATIONS: The study limitations include the utilization of self-reported measures, cross-sectional study design, and age of the data set. CONCLUSIONS: Different dimensions of religious participation have differing effects on anxiety disorders. Religious participation may be an important resource for Black Americans in coping and preventing anxiety disorders.

Trajectories of depressive symptoms among older African Americans: the influence of neighborhood characteristics and gender.

OBJECTIVES: Focusing on older African Americans, this study aims to (1) identify 9-year trajectories of depressive symptoms, (2) examine the association between baseline neighborhood characteristics (i.e., social cohesion and physical disadvantage) and trajectories of depressive symptoms, and (3) test whether the effects of neighborhood characteristics on depressive symptoms trajectories differ by gender. METHODS: Data came from the National Health and Aging Trend Study. Older African Americans at baseline were selected (N = 1662) and followed up for eight rounds. Depressive symptom trajectories were estimated using group-based trajectory modeling. Weighted multinomial logistic regressions were conducted. RESULTS: Three trajectories of depressive symptoms were identified: "persistently low," "moderate and increasing," and "high and decreasing" (Objective 1). Objective 2 and 3 were partially supported. Specifically, high perceived neighborhood social cohesion was associated with a lower relative risk of being on the "moderate and increasing" versus the "persistently low" trajectory (RRR = 0.64, p < 0.01). The association between neighborhood physical disadvantage and depressive symptom trajectories was stronger among older African American men compared to women. CONCLUSIONS: High levels of neighborhood social cohesion may protect against increasing depressive symptoms in older African Americans. Compared to women, older African American men may be more vulnerable to negative mental health effects of neighborhood physical disadvantage.

Racial discrimination and 12-month and lifetime anxiety disorders among African American men and women: Findings from the National Survey of American Life.

BACKGROUND: The purpose of this study was to assess the associations between racial discrimination and 12-month and lifetime DSM-IV anxiety disorders among African American men and women. METHODS: Data was drawn from the African American sample of the National Survey of American Life (N = 3570). Racial discrimination was assessed with the Everyday Discrimination Scale. 12-month and lifetime DSM-IV outcomes were any anxiety disorder, posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder (PD), social anxiety disorder (SAD), and agoraphobia (AG). Logistic regressions were utilized to assess the relationships between discrimination and anxiety disorders. RESULTS: The data indicated that racial discrimination was associated with increased odds for 12-month and lifetime anxiety disorders, AG, and PD and lifetime SAD among men. Regarding 12-month disorders among women, racial discrimination was associated with increased odds for any anxiety disorder, PTSD, SAD, and PD. With respect to lifetime disorders among women, racial discrimination was associated with increased odds for any anxiety disorder, PTSD, GAD, SAD, and PD. LIMITATIONS: The limitations of this study include the utilization of cross-sectional data, self-reported measures, and the exclusion of non-community dwelling individuals. CONCLUSIONS: The current investigation showed that African American men and women are not impacted by racial discrimination in the same ways. These findings suggest that the mechanisms through which discrimination operates among men and women to influence anxiety disorders is potentially a relevant target for interventions to address gender disparities in anxiety disorders.

Everyday Discrimination, Neighborhood Perceptions, and Incidence of Activity Limitations Among Middle-Aged and Older African Americans.

OBJECTIVES: This study aims to examine the relationship between everyday discrimination, neighborhood perceptions, and the incidence of daily activity limitations (i.e., activities of daily living [ADL] and instrumental activities of daily living [IADL]) among middle-aged and older African Americans. This study also examines whether neighborhood perceptions moderate the association between discrimination and the incidence of daily activity limitations. METHODS: Data were from the 2006 to 2016 waves of the Health and Retirement Study. African Americans aged 50 or older free of ADL limitations (N = 1,934) and IADL limitations (N = 2,007) at baseline were selected. Cox proportional hazards regression models were performed to test the study aims. Multiple imputations were applied to handle missing data. RESULTS: One-unit increase in everyday discrimination was associated with a 25% (p < .05) higher risk of ADL limitation onset. Perceived neighborhood social cohesion and physical disadvantage moderated the association between discrimination and IADL limitation onset. DISCUSSION: Everyday discrimination represents a significant stressor that negatively affects older African Americans' performance of daily activities. Community-level efforts that improve neighborhood perceptions are needed to alleviate the negative effects of discrimination on the incidence of activity limitations.

Correlates of Physical and Emotional Strain Among Older Adult Caregivers.

Caregiving can be physically challenging and emotionally draining for older caregivers. The existing research on physical and emotional strain mainly focuses on the general caregiver population. Using the Stress Process Model, this study aims to expand on existing caregiving literature by identifying correlates of physical and emotional strain among older caregivers. Hierarchical OLS regressions were performed on data selected from the 2015 Caregiving in the U.S. Survey (N = 701). Several risk factors for physical strain and emotional strain were identified: Assistance with ADLs and IADLs, the number of health problems of the care recipient, and the receipt of formal support were positively associated with physical and emotional strain. Moreover, providing care to parents/parents-in-law was associated with higher levels of emotional strain than providing care to non-relatives. The number of care recipients was positively associated with emotional strain. Older African Americans experienced lower levels of physical strain than their white counterparts. The findings uncover the individual differences among older caregivers and provide insights into how these differences uniquely influence caregiving strain. Moreover, the study identifies a risk and protective profile of caregiving strain, which can help practitioners direct services and resources to older caregivers who are particularly at risk for caregiving strain.

Sociodemographic Factors and Neighborhood/Environmental Conditions Associated with Social Isolation Among Black Older Adults.

Objectives: To investigate sociodemographic factors and neighborhood/environmental conditions associated with social isolation (SI) among Black older adults. Methods: We utilized data from the 2014 and 2016 Leave-Behind Questionnaire from the Health and Retirement Study (HRS LBQ) among those who self-identified as Black (N = 2.323). Outcome variables for our study included SI from adult children, other family members, friends, disengagement from social participation and religious services, being unmarried, and living alone. These indicators were also combined into an overall SI index. Critical predictors included gender, age, household income, education, employment status, neighborhood cohesion, neighborhood disorder, urbanicity, and region of residence. Results: Sociodemographic factors of gender, education and household income were significantly associated with SI indicators. Additionally, some neighborhood/environmental conditions were associated with SI indicators. Discussion: SI was found to be patterned by sociodemographic factors. These results can be used to develop effective interventions to mitigate SI among Black older adults.

Discrimination and social isolation among African Americans: The moderating role of skin tone.

OBJECTIVES: Discrimination is an urgent public health problem. A number of major cities and counties across the United States has declared racism a public health crisis. While there is a growing body of research on the discrimination-health connection, less is known regarding the social relational consequences of discrimination. The present study addresses this knowledge gap by investigating the relationship between discrimination, skin tone, and objective and subjective social isolation using a nationally representative sample of African Americans. METHOD: This analysis was based upon the African American subsample (N = 3,570) of the National Survey of American Life. Discrimination was assessed with the Everyday Discrimination Scale. Objective and subjective isolation differentiated between respondents who were (a) socially isolated from both family and friends, (b) socially isolated from friends only, (c) socially isolated from family only, and (d) not socially isolated. Skin tone was self-reported. Multinomial logistic regression analyses were used to test the study hypotheses. RESULTS: The analyses indicated that more frequent discriminatory experiences were associated with increased risk for subjective and objective social isolation. Skin tone moderated the association between discrimination and subjective isolation; the discrimination-isolation relationship was stronger among participants with darker skin tones. CONCLUSIONS: These findings shed light on African Americans' nuanced experiences with discrimination and colorism. Further, the data demonstrate heterogeneity in the vulnerability to the adverse effects of discrimination within the African American population; the relationship between discrimination and subjective isolation was stratified by skin tone. This underscores the well-documented and persistent racialized social stratification system in the United States (PsycInfo Database Record (c) 2022 APA, all rights reserved).

How Skin Tone Influences Relationships Between Discrimination, Psychological Distress, and Self-Rated Mental Health Among Older African Americans.

OBJECTIVES: As within-group differences have emerged as a key area of inquiry for health disparities among African Americans, skin tone has been identified as an important factor. This study aims to examine: (a) the moderating role of skin tone in the relationship between discrimination, self-rated mental health, and serious psychological distress (SPD) and (b) whether this moderating effect differs across genders in a nationally representative sample of older African Americans. METHODS: Analyses were conducted on a subsample of African Americans aged 55+ (N = 837) from the National Survey of American Life. The mental health outcomes were SPD and self-rated mental health. Discrimination was assessed with the Everyday Discrimination Scale. Skin tone was self-reported. Multiple linear regressions tested the study aims. RESULTS: Discrimination was associated with worse self-rated mental health and SPD in the total sample and among women. Skin tone moderated the association between discrimination and SPD in the total sample and among men and women. The associations between discrimination and mental health outcomes were stronger among darker-skinned respondents than lighter respondents. Gender-stratified analyses indicated skin tone moderated the association between discrimination and self-rated mental health for men but not women. DISCUSSION: This study contributes to the emerging body of literature on skin tone, discrimination, and mental health. Uncovering mechanisms behind the "why" is an important next step in understanding how skin tone influences the relationship between discrimination and mental health. The negative psychological effects associated with darker complexion provide several areas to be examined.

The Role of Church Support Networks in the Relationship between Discrimination and Psychiatric Disorders among Older African Americans.

Background: Few studies have examined the effects of discrimination on mental health specifically among older African Americans despite it being a common experience in this population. Further, knowledge on social resources, such as social relationships, that could mitigate the effects of discrimination is limited in this population. Given the historical and contemporaneous importance of the Black church in African American communities, church members are important support network members and a major source of social support for older African Americans. Purpose: To address these knowledge gaps, this study will (1) examine the association between racial discrimination and psychiatric disorders; and (2) determine whether church relationships moderate the impact of racial discrimination on psychiatric disorders. Methods: Data from African American respondents aged 55 and older were drawn from the National Survey of American Life (N = 837). Church relationship variables included receipt of emotional support from, frequency of contact with, and subjective closeness to church members. Regression analyses were used to test the study aims. Results: Analyses indicated that more frequent experiences of racial discrimination were associated with meeting criteria for any DSM-IV disorder and a greater number of DSM-IV disorders. Significant interactions revealed that frequency of contact with and subjective closeness to church members mitigated the association between discrimination and meeting criteria for any 12-month disorder and number of 12-month disorders. Conclusions and Implications: Altogether, these findings support the literature on the detrimental effects of discrimination on the mental health of older African Americans and provide a more nuanced understanding of the role of church members in the lives of older African Americans. The study findings suggest that church relationships are effective stress coping resources for older African Americans dealing with discrimination. Given the importance and relevance of church members, initial clinical assessments should assess clients' level of religious involvement and relationships with church members.

Race, Ethnicity, and Age Differences in Social Relationships and Obesity: Findings From the National Survey of American Life.

ObjectiveThe purpose of this study was to examine race, ethnicity, and age differences in the association between social relationships and body weight in a nationally representative sample of African American, Caribbean Black, and non-Hispanic White adults. Methods: Data were drawn from the 2001-2003 National Survey of American Life (N = 5684). Multiple linear regressions were conducted to examine the links between race, ethnicity, and age with social relationships and weight. Results: Although African American respondents had higher BMI than non-Hispanic White respondents, Caribbean Black respondents did not differ from White respondents in BMI. Emotional support from family members was both positively and negatively associated with weight depending on age, race, and ethnicity. Discussion: Social relationships are an important contributing factor to obesity and obesity-related risks in adults. Study findings demonstrate the intersection of race, ethnicity, and age and how these complex relationships influence the association between social relationships and body weight.

COVID-19 hardships and self-reported sleep quality among American adults in March and April 2020: Results from a nationally representative panel study.

OBJECTIVE: To analyze the association between coronavirus disease 2019 (COVID-19) hardships and self-reported sleep troubles in a nationally representative sample of adults in the United States. DESIGN: Prospective study in March and April 2020. SETTING: Population-based. PARTICIPANTS: About 8130 respondents who participated in the Pew Research Center's American Trends Panel in March and April of 2020. MEASUREMENTS: Self-reported sleep troubles were defined as a report of 3 or more days per week with trouble sleeping in March and April (separately). Respondents were asked about COVID-19 stressors such as COVID-19 Threat and COVID-19-specific hardships including pay cuts/hours reductions, job loss, and childcare difficulties. Logistic regression models were fit to test associations between COVID-19 hardships and sleep troubles adjusted for sociodemographic covariates (age, gender, race/ethnicity, region, marital status, nativity, education, income, health insurance, and past diagnosis of mental health problems). RESULTS: Reported sleep troubles increased from March (29.0%) to April (31.4%). For March, we found that COVID threat, losing a job, getting a pay cut, and difficulty with childcare were separately associated with sleep troubles. In April, COVID-19 threat and difficulty with childcare, but not losing a job or getting a pay cut were associated with sleep troubles even after additionally accounting for reported sleep troubles in March. CONCLUSIONS: We found that COVID-19-specific stressors, especially a broad measure of COVID-19 Threat and stress over childcare, were associated with sleep troubles in March and April. These findings identified novel stressors related to COVID-19, which may affect the sleep of the American population.

Religious Involvement and Sleep Among Older African Americans.

Objective: This study sought to determine whether religious involvement is associated with sleep quality in a nationally representative sample of older African Americans. Methods: The analytic sample included African American respondents aged 55+ from the National Survey of American Life-Reinterview (N = 459). Religious involvement variables included service attendance, reading religious texts, watching religious television programs, listening to religious radio programs, prayer, and subjective religiosity. Sleep outcomes were restless sleep and sleep satisfaction. Multiple linear regression analysis was used. Results: Watching religious television programs was associated with more restless sleep. Respondents who attended religious services less than once a year, at least once a week, or nearly every day reported greater sleep satisfaction than respondents who never attended religious services. Subjective religiosity was associated with lower sleep satisfaction. Discussion: The findings demonstrate the importance of examining a variety of religious involvement domains, which could point to different explanatory pathways between religious involvement and sleep.

Hope, Purpose, and Religiosity: The Impact of Psychosocial Resources on Trajectories of Depressive Symptoms Among Middle-Aged and Older Blacks.

Objective: We assessed the effects of hope, purpose in life, and religiosity on trajectories of depressive symptoms among middle-aged and older Blacks, with a focus on age differences in these associations. Methods: Data come from 1906 respondents from the 2006-2016 Health and Retirement Study. Linear mixed models were estimated and included interactions between age and time and between age and each psychosocial resource. Results: Depressive symptoms decreased for Blacks ages 51-64, did not change for those 65-74, and increased among Blacks age 75+. Hope and purpose in life were inversely associated with symptom levels but were not associated with change over time in symptomology. Associations were stronger among the youngest age group and weakest among the oldest. Religiosity was unrelated to depressive symptoms. Discussion: Psychosocial resources protect against depressive symptoms in age-dependent ways among middle-aged and older Blacks. Differences in these effects may be related to aging, cohort, and selection effects.

COVID-19 and Psychological Distress: Racial Differences Among Middle-Aged and Older Adults.

BACKGROUND AND OBJECTIVES: COVID-19 has disproportionately impacted older adults and Black individuals. Research has focused on physical outcomes, with less attention to the psychological effects of COVID-19. The objective of this study was to examine the interplay between perceptions of the COVID-19 outbreak as a threat to one's day-to-day life, race, and psychological distress among middle-aged and older men and women. RESEARCH DESIGN AND METHODS: Analyses were conducted on a subsample of self-identified non-Latino Whites and Black individuals aged 50 and older (N = 3,834) from the American Trends Panel. Psychological distress was assessed with 5 items adapted from the Center for Epidemiologic Studies Depression Scale and Generalized Anxiety Disorder-7. Perceived COVID-19 day-to-day threat was assessed with a single question. Negative binomial regressions tested the study aim. RESULTS: Perceptions of COVID-19 day-to-day threat were positively associated with psychological distress. Black individuals reported lower distress than Whites. Regardless of gender, greater perceptions of COVID-19 day-to-day threats were associated with greater distress among both White respondents and Black respondents. However, this association was weaker among Black respondents than White respondents. Among men only, the association between COVID-19 day-to-day threat and distress varied by race, patterned similarly to the race differences identified in the total sample. This association did not vary by race among women. DISCUSSION AND IMPLICATIONS: This study contributes to the emerging literature focused on older adults and COVID-19 related stressors and psychological distress. An intersectional lens shows how structural oppression may shape perceptions of the pandemic. Future work should consider coexisting intersections in marginalized identities and mental health during COVID-19.