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Abstract
In recent decades, there has been remarkable growth in scientific research examining the multiple ways in which racism can adversely affect health. This interest has been driven in part by the striking persistence of racial/ethnic inequities in health and the empirical evidence that indicates that socioeconomic factors alone do not account for racial/ethnic inequities in health. Racism is considered a fundamental cause of adverse health outcomes for racial/ethnic minorities and racial/ethnic inequities in health. This article provides an overview of the evidence linking the primary domains of racism-structural racism, cultural racism, and individual-level discrimination-to mental and physical health outcomes. For each mechanism, we describe key findings and identify priorities for future research. We also discuss evidence for interventions to reduce racism and describe research needed to advance knowledge in this area.
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Affiliation(s)
- David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA;
- Department of African and African American Studies and Department of Sociology, Harvard University, Cambridge, Massachusetts 02138-3654, USA
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Jourdyn A Lawrence
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA;
| | - Brigette A Davis
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA;
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152
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Abstract
In recent decades, there has been remarkable growth in scientific research examining the multiple ways in which racism can adversely affect health. This interest has been driven in part by the striking persistence of racial/ethnic inequities in health and the empirical evidence that indicates that socioeconomic factors alone do not account for racial/ethnic inequities in health. Racism is considered a fundamental cause of adverse health outcomes for racial/ethnic minorities and racial/ethnic inequities in health. This article provides an overview of the evidence linking the primary domains of racism-structural racism, cultural racism, and individual-level discrimination-to mental and physical health outcomes. For each mechanism, we describe key findings and identify priorities for future research. We also discuss evidence for interventions to reduce racism and describe research needed to advance knowledge in this area.
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Affiliation(s)
- David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA;
- Department of African and African American Studies and Department of Sociology, Harvard University, Cambridge, Massachusetts 02138-3654, USA
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Jourdyn A Lawrence
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA;
| | - Brigette A Davis
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA;
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153
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Watson-Singleton NN, Hill LK, Case AD. Past Discrimination, Race-Related Vigilance, and Depressive Symptoms: The Moderating Role of Mindfulness. Mindfulness (N Y) 2019; 10:1768-1778. [PMID: 31803305 DOI: 10.1007/s12671-019-01143-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objectives African Americans experience numerous adverse health consequences due to race-related stress. Yet, mindfulness may serve as a relevant and vital protective factor in the link between race-related stressors and depressive symptoms for this population. Methods Data from 190 African American participants, ages 18-53, were used to investigate if past discrimination and race-related vigilance, two types of race-related stressors, interactively predicted greater depressive symptomatology among this sample. We also assessed if mindfulness moderated the association between race-related stressors, as indicated by past discrimination and race-related vigilance, and depressive symptomatology. Results Our results indicated that past discrimination and race-related vigilance did not interactively predict depressive symptomatology in our sample; however, these stressors were independently related to greater depressive symptoms. Additionally, we found that greater levels of mindfulness were associated with lower levels of depressive symptoms, and mindfulness significantly moderated the association between both race-related stressors and depressive symptoms. Conclusions These findings support mindfulness' ability to buffer the negative health consequences of past discrimination and race-related vigilance for African Americans. Additional conclusions and future research directions are discussed.
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Affiliation(s)
| | - LaBarron K Hill
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Andrew D Case
- Department of Psychological Science, University of North Carolina at Charlotte
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154
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Appropriated racial oppression: Implications for mental health in Whites and Blacks. Soc Sci Med 2019; 230:295-302. [PMID: 31054520 DOI: 10.1016/j.socscimed.2019.03.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 02/23/2019] [Accepted: 03/10/2019] [Indexed: 12/14/2022]
Abstract
Racism has been examined in its many forms. Scholarship regarding how individuals personally experience, cope with, and manage racial oppression is still developing. The term "appropriated racial oppression" reframes the construct "internalized racism" as a process whereby members of a group appropriate a dominant group's ideology, adapt their behavior, and perceive a subordinate status as deserved, natural, and inevitable. The expression of appropriated racial oppression is based on a variety of complicated and interacting processes, such as incentivized societal norms, critical consciousness, and racial socialization. We conceptualize appropriated racial oppression as a mediated process that yields both direct and indirect health outcomes for both non-dominant and dominant groups. The latter is critical because little research examines how racism affects dominant groups and their health. In this commentary, we examine two examples where appropriating racial oppression may confer both negative and adaptive outcomes. Although we highlight examples rooted in White and Black racial experiences, we briefly consider implications for intersectional and multiple marginalized identities as well. Future research recommendations for psychology, public health and interdisciplinary research are discussed.
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155
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Active coping moderates associations among race-related stress, rumination, and depressive symptoms in emerging adult African American women. Dev Psychopathol 2019; 30:1817-1835. [PMID: 30451137 DOI: 10.1017/s0954579418001268] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Cross-sectional and longitudinal research has shown that race-related stress is associated with increased depressive symptoms among racial/ethnic minorities. Rumination has long been considered a maladaptive self-regulatory response to race-related stress, and growing evidence suggests that it may be an important link in the relation between race-related stress and depression. More adaptive forms of self-regulation, such as active coping, may counteract the negative impact of rumination. We examined the influence of rumination on the relation between race-related stress and depressive symptoms in a sample (N = 69) of young adult (mean age = 20 ± 1.5 years) African American women. We also considered the possible moderating effects of John Henryism, a form of persistent and determined goal striving, and vagally mediated heart rate variability, a purported biomarker of coping. Anticipatory race-related stress was indirectly associated with depressive symptoms through rumination: estimate = 0.07, 95% confidence interval [0.01, 0.16]. Both John Henryism and vagally mediated heart rate variability moderated the relationship between race-related stress and rumination; however, only John Henryism reliably influenced the indirect association between race-related stress and depression through rumination. We discuss these findings in the context of growing research examining the interplay between cultural and biological factors in the risk for poorer mental health.
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156
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Molina KM, Estrella ML, Durazo-Arvizu R, Malcarne VL, Llabre MM, Isasi CR, Ornelas IJ, Perreira KM, Penedo FJ, Brondolo E, Gallo L, Daviglus ML. Perceived discrimination and physical health-related quality of life: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study. Soc Sci Med 2019; 222:91-100. [PMID: 30623798 PMCID: PMC6377306 DOI: 10.1016/j.socscimed.2018.12.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 12/14/2018] [Accepted: 12/26/2018] [Indexed: 12/19/2022]
Abstract
RATIONALE The aim of this study was to examine the direct associations of perceived personal and group discrimination with physical health-related quality of life (HRQoL) among Latinx adults. We also tested whether ethnic identity and depression symptoms sequentially mediate these associations. METHOD This population-based study included 5313 Latinx adults, ages 18-74 years, from the Hispanic Community Health Study/Study of Latinos (2008-11) and its Sociocultural Ancillary Study (2010-11). Participants were recruited from the Bronx; NY; Chicago, IL; Miami, FL; and San Diego, CA. Self-reported perceived personal and group discrimination, ethnic identity, depression symptoms, and physical HRQoL were ascertained through interviewer-administered surveys. Survey-weighted path analysis was used to examine direct and indirect effects simultaneously in one analytic model controlling for demographic covariates. RESULTS Path analysis indicated that higher perceived personal discrimination was directly associated with poorer physical HRQoL and this association was only mediated by depression symptoms. In contrast, perceived group discrimination was not directly associated with physical HRQoL. However, each of the direct paths linking perceived group discrimination to physical HRQoL were statistically significant: perceived group discrimination was positively associated with ethnic identity, and ethnic identity was negatively associated with depression symptoms, and, in turn, depression symptoms were negatively associated with physical HRQoL. Our model accounted for 18% of the variance of physical HRQoL. CONCLUSIONS Perceived personal and group discrimination are differently associated with physical HRQoL. Results highlight the importance of considering self-perceptions of different discrimination forms when evaluating its impact on the physical HRQoL of Latinx adults.
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Affiliation(s)
- Kristine M Molina
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA.
| | - Mayra L Estrella
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Einstein College of Medicine, Bronx, NY, USA
| | - India J Ornelas
- Department of Health Service, University of Washington, Seattle, WA, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Frank J Penedo
- Department of Medical Social Sciences, Psychology & Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | | | - Linda Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
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157
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Sheehan CM, Frochen SE, Walsemann KM, Ailshire JA. Are U.S. adults reporting less sleep?: Findings from sleep duration trends in the National Health Interview Survey, 2004-2017. Sleep 2019; 42:5185637. [PMID: 30452725 PMCID: PMC6941709 DOI: 10.1093/sleep/zsy221] [Citation(s) in RCA: 134] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 10/23/2018] [Indexed: 02/06/2023] Open
Abstract
Study Objectives To document trends in self-reported sleep duration for the noninstitutionalized U.S. civilian population from 2004 to 2017 and examine how sleep trends vary by race/ethnicity. Methods We use data from the National Health Interview Survey (NHIS) for U.S. noninstitutionalized adults aged 18-84 from 2004 to 2017 (N = 398 382). NHIS respondents were asked how much they slept in a 24-hour period on average, which we categorized as ≤6 hr (short sleep), 7-8 hr (adequate sleep), and ≥9 hr (long sleep). We used multinomial logistic regression models to examine trends in self-reported sleep duration and assess race/ethnic differences in these trends. Our models statistically adjusted for demographic, socioeconomic, familial, behavioral, and health covariates. Results The prevalence of short sleep duration was relatively stable from 2004 to 2012. However, results from multinomial logistic regression models indicated that there was an increasing trend toward short sleep beginning in 2013 (b: 0.09, 95% CI: 0.05-0.14) that continued through 2017 (b: 0.18, 95% CI: 0.13-0.23). This trend was significantly more pronounced among Hispanics and non-Hispanic blacks, which resulted in widening racial/ethnic differences in reports of short sleep. Conclusions Recent increases in reports of short sleep are concerning as short sleep has been linked with a number of adverse health outcomes in the population. Moreover, growing race/ethnic disparities in short sleep may have consequences for racial and ethnic health disparities.
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Affiliation(s)
- Connor M Sheehan
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ
| | - Stephen E Frochen
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA
| | | | - Jennifer A Ailshire
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA
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158
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Allen AM, Thomas MD, Michaels EK, Reeves AN, Okoye U, Price MM, Hasson RE, Syme SL, Chae DH. Racial discrimination, educational attainment, and biological dysregulation among midlife African American women. Psychoneuroendocrinology 2019; 99:225-235. [PMID: 30286445 PMCID: PMC6289261 DOI: 10.1016/j.psyneuen.2018.09.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 08/31/2018] [Accepted: 09/03/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To examine the association between self-reported racial discrimination and allostatic load, and whether the association differs by socioeconomic position. METHODS We recruited a purposive cross-section of midlife (ages 30-50) African American women residing in four San Francisco Bay area counties (n = 208). Racial discrimination was measured using the Experience of Discrimination scale. Allostatic load was measured as a composite of 15 biomarkers assessing cardiometabolic, neuroendocrine, and inflammatory activity. We calculated four composite measures of allostatic load and three system-specific measures of biological dysregulation. Multivariable regression was used to examine associations, while adjusting for relevant confounders. RESULTS In the high education group, reporting low (b = -1.09, P = .02, 95% CI = -1.99, -0.18) and very high (b = -1.88, P = .003, 95% CI = -3.11, -0.65) discrimination was associated with lower allostatic load (reference=moderate). Among those with lower education, reporting low (b = 2.05, P = .008, 95% CI = 0.55,3.56) discrimination was associated with higher allostatic load. Similar but less consistent associations were found for poverty status. Associations were similar for cardiometabolic functioning, but not for neuroendocrine or inflammatory activity. CONCLUSIONS Racial discrimination may be an important predictor of cumulative physiologic dysregulation. Factors associated with educational attainment may mitigate this association for African American women and other groups experiencing chronic social stress.
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Affiliation(s)
- Amani M Allen
- Divisions of Community Health Sciences and Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA.
| | - Marilyn D Thomas
- Division of Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA.
| | - Eli K Michaels
- Division of Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA.
| | - Alexis N Reeves
- Division of Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA.
| | - Uche Okoye
- Division of Community Health Sciences, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA.
| | - Melisa M Price
- Division of Community Health Sciences, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA.
| | - Rebecca E Hasson
- Schools of Kinesiology and Public Health, University of Michigan, 2110 Observatory Lodge/1402 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
| | - S Leonard Syme
- Divisions of Community Health Sciences and Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA.
| | - David H Chae
- Department of Human Development and Family Studies, College of Human Sciences, Auburn University, 210 Spidle Hall, Auburn, GA, 36849, USA.
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159
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Hisler GC, Brenner RE. Does sleep partially mediate the effect of everyday discrimination on future mental and physical health? Soc Sci Med 2019; 221:115-123. [DOI: 10.1016/j.socscimed.2018.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 09/27/2018] [Accepted: 12/02/2018] [Indexed: 01/17/2023]
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160
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Jochman JC, Cheadle JE, Goosby BJ, Tomaso C, Kozikowski C, Nelson T. Mental Health Outcomes of Discrimination among College Students on a Predominately White Campus: A Prospective Study. SOCIUS : SOCIOLOGICAL RESEARCH FOR A DYNAMIC WORLD 2019; 5:10.1177/2378023119842728. [PMID: 31819906 PMCID: PMC6900932 DOI: 10.1177/2378023119842728] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Racial discrimination is a social stressor harmful to mental health. In this paper, we explore the links between mental health and interpersonal discrimination-related social events, exposure to vicarious racism via social media, and rumination on racial injustices using a daily diary design. We utilize data from a racially diverse sample of 149 college students with 1,489 unique time observations at a large predominantly White university. Results show that interpersonal discrimination-related social events predicted greater self-reported anger, anxiety, depressive symptoms, and loneliness both daily and on average over time. Vicarious racism from day-to- day was associated with increased anxiety symptoms. In contrast, rumination was not associated with negative mental health outcomes. These findings document an increased day-to-day mental health burden for minority students arising from frustrating and alienating social encounters experienced individually or learned about vicariously.
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Affiliation(s)
- Joseph C Jochman
- University of Nebraska-Lincoln Department of Sociology Oldfather Hall 711
| | - Jacob E Cheadle
- University of Texas at Austin, Department of Sociology, Patton Hall 2.622F,
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161
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Hernández D, Siegel E. Energy insecurity and its ill health effects: A community perspective on the energy-health nexus in New York City. ENERGY RESEARCH & SOCIAL SCIENCE 2019; 47:78-83. [PMID: 32280598 PMCID: PMC7147484 DOI: 10.1016/j.erss.2018.08.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
This study examines the effects of a novel construct - energy insecurity - on adverse health in a community-based sample in New York City. Using a 2015 cross-sectional study of 2,494 households in Washington Heights, we described the socio-demographic characteristics of energy insecure households and examined the association between energy insecurity and health outcomes using logistic regression models. Twenty-seven percent of participants were energy insecure. Racial/ethnic minorities, households with children, long-term neighborhood residents, and those with poor housing conditions were more likely to be energy insecure; meanwhile, middle income households were not fully protect against energy insecurity. Energy insecurity was significantly associated with poor respiratory, mental health, and sleep outcomes; it was not associated with metabolic disorders, accidents, or neighborhood violence and cohesion. This study indicates that energy insecurity may explain some existing respiratory and mental health-related disparities in vulnerable populations. More research on energy insecurity is needed along with refinement of its measurement.
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Affiliation(s)
- Diana Hernández
- Sociomedical Sciences, Columbia University, Mailman School of Public Health, 722 W 168th Street, New York, NY, 10032, USA
- Corresponding author. (D. Hernández), (E. Siegel)
| | - Eva Siegel
- Epidemiology, Columbia University, Mailman School of Public Health, 722 W 168th Street, New York, NY, 10032, USA
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162
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Williams DR. Stress and the Mental Health of Populations of Color: Advancing Our Understanding of Race-related Stressors. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2018; 59:466-485. [PMID: 30484715 PMCID: PMC6532404 DOI: 10.1177/0022146518814251] [Citation(s) in RCA: 418] [Impact Index Per Article: 69.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
This article provides an overview of research on race-related stressors that can affect the mental health of socially disadvantaged racial and ethnic populations. It begins by reviewing the research on self-reported discrimination and mental health. Although discrimination is the most studied aspect of racism, racism can also affect mental health through structural/institutional mechanisms and racism that is deeply embedded in the larger culture. Key priorities for research include more systematic attention to stress proliferation processes due to institutional racism, the assessment of stressful experiences linked to natural or manmade environmental crises, documenting and understanding the health effects of hostility against immigrants and people of color, cataloguing and quantifying protective resources, and enhancing our understanding of the complex association between physical and mental health.
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Affiliation(s)
- David R Williams
- 1 Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- 2 Department of African and African American Studies and of Sociology, Harvard University, Cambridge, MA, USA
- 3 Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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163
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Lee H, Hicken MT. Racism and the Health of White Americans. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:21-23. [PMID: 30354862 DOI: 10.1080/15265161.2018.1513607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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164
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Thompson-Burdine J, Sutzko DC, Nikolian VC, Boniakowski A, Georgoff PE, Prabhu KA, Matusko N, Minter RM, Sandhu G. Impact of a resident's sex on intraoperative entrustment of surgery trainees. Surgery 2018; 164:583-588. [PMID: 30041964 DOI: 10.1016/j.surg.2018.05.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/04/2018] [Accepted: 05/01/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Optimizing intraoperative education is critical for development of autonomous residents. Faculty decisions concerning intraoperative entrustment determine the degree to which a resident gains intraoperative responsibility. Accordingly, residents exhibit entrustable behaviors that further faculty entrustment in the operating room. Little empiric evidence exists evaluating how the sex of a resident influences faculty-resident decisions of entrustment. Studies involving perception-based measurements of autonomy report inequities for women residents. We sought to assess faculty behaviors in entrustment in relation to resident sex using OpTrust, a third-party objective measurement tool. METHODS From September 2015 to June 2017 at the University of Michigan, surgical cases were observed and entrustment behaviors were rated using OpTrust. Critical case sampling was used to generate variation in operation type, case difficulty, faculty-resident pairings, faculty experience, and the level of the resident's training. Independent sample t-tests were conducted to compare faculty entrustment scores, as well as resident entrustability scores. RESULTS A total of 56 faculty and 73 residents were observed across 223 surgical cases from 4 surgical specialties: general, plastic, thoracic, and vascular. There was no difference in faculty entrustment or entrustability scores between women and men (2.54 vs 2.35, P = .117 and 2.32 vs 2.22, P = .393, respectively). CONCLUSION Using OpTrust scores, we found that a resident's sex does not appear to influence faculty entrustment in the OR. Faculty entrustment scores for women and men residents are similar across cases. This observation suggests that during the intraoperative interaction, faculty are not extending entrustment or opportunities for autonomy differently to women or men. Future research is needed to identify and measure perioperative elements that inform resident autonomy, which may contribute to inequities for women residents.
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165
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Assari S, Miller RJ, Taylor RJ, Mouzon D, Keith V, Chatters LM. Discrimination Fully Mediates the Effects of Incarceration History on Depressive Symptoms and Psychological Distress Among African American Men. J Racial Ethn Health Disparities 2018; 5:243-252. [PMID: 28405962 PMCID: PMC6556396 DOI: 10.1007/s40615-017-0364-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/21/2017] [Accepted: 03/23/2017] [Indexed: 10/19/2022]
Abstract
AIM Using a nationally representative sample of African American men, this study investigated the associations between lifetime history of incarceration, discrimination, and mental health (e.g., depressive symptoms and psychological distress). We hypothesized that discrimination would fully mediate the association between incarceration history and mental health outcomes among African American men. METHODS Using a cross-sectional design, our analysis included 1271 African American men who participated in the National Survey of American Life (NSAL), 2001-2003. Incarceration history was the main independent variable. Depressive symptoms and psychological distress were the dependent variables. Everyday discrimination was the mediator. Age, education, and income were covariates. Structural equation models (SEMs) were used for data analysis. RESULTS Among African American men, incarceration history was positively associated with perceived discrimination, depressive symptoms, and psychological distress. Everyday discrimination fully mediated the associations between incarceration history and both depressive symptoms and psychological distress. CONCLUSION Discrimination may play an important role in the mental health problems of African American men with a history of incarceration. These findings have public policy implications as well as clinical implications for mental health promotion of African American men. Policies that reduce preventable incarceration or at least reduce subsequent discrimination for those who have been incarcerated may enhance mental health of previously incarcerated African American men.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, 4250 Plymouth Road, SPC 5763, Ann Arbor, MI, 48109-2700, USA.
| | | | - Robert Joseph Taylor
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
- Program for Research on Black Americans, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Dawne Mouzon
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA
| | - Verna Keith
- Race and Ethnic Studies Institute, Texas A&M University, College Station, TX, USA
| | - Linda M Chatters
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
- Program for Research on Black Americans, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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166
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Goosby BJ, Cheadle JE, Strong-Bak W, Roth TC, Nelson TD. Perceived Discrimination and Adolescent Sleep in a Community Sample. THE RUSSELL SAGE FOUNDATION JOURNAL OF THE SOCIAL SCIENCES : RSF 2018; 4:43-61. [PMID: 38707763 PMCID: PMC11068330 DOI: 10.7758/rsf.2018.4.4.03] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Sleep is a key restorative process, and poor sleep is linked to disease and mortality risk. The adolescent population requires more sleep on average than adults but are most likely to be sleep deprived. Adolescence is a time of rapid social upheaval and sensitivity to social stressors including discrimination. This study uses two weeks of daily e-diary measures documenting discrimination exposure and concurrent objective sleep indicators measured using actigraphy. We assess associations between daily discrimination and contemporaneous sleep with a diverse sample of adolescents. This novel study shows youth with higher average discrimination reports have worse average sleep relative to their counterparts. Interestingly, youth reporting daily discrimination have better sleep the day of the report than youth who do not.
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Affiliation(s)
- Bridget J Goosby
- Sociology and co-directors of the LifeHD: Life in Frequencies Health Disparities Research Lab at the University of Nebraska-Lincoln
| | - Jacob E Cheadle
- Sociology and co-directors of the LifeHD: Life in Frequencies Health Disparities Research Lab at the University of Nebraska-Lincoln
| | - Whitney Strong-Bak
- doctoral candidate and graduate research assistant in the School Psychology Program
| | - Taylor C Roth
- doctoral student and graduate research assistant in the department of psychology at the University of Nebraska-Lincoln
| | - Timothy D Nelson
- psychology and director of the Pediatric Health Lab at the University of Nebraska-Lincoln
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167
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Prasad B, Saxena R, Goel N, Patel SR. Genetic Ancestry for Sleep Research: Leveraging Health Inequalities to Identify Causal Genetic Variants. Chest 2018; 153:1478-1496. [PMID: 29604255 DOI: 10.1016/j.chest.2018.03.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 03/02/2018] [Accepted: 03/19/2018] [Indexed: 02/08/2023] Open
Abstract
Recent evidence has highlighted the health inequalities in sleep behaviors and sleep disorders that adversely affect outcomes in select populations, including African-American and Hispanic-American subjects. Race-related sleep health inequalities are ascribed to differences in multilevel and interlinked health determinants, such as sociodemographic factors, health behaviors, and biology. African-American and Hispanic-American subjects are admixed populations whose genetic inheritance combines two or more ancestral populations originating from different continents. Racial inequalities in admixed populations can be parsed into relevant groups of mediating factors (environmental vs genetic) with the use of measures of genetic ancestry, including the proportion of an individual's genetic makeup that comes from each of the major ancestral continental populations. This review describes sleep health inequalities in African-American and Hispanic-American subjects and considers the potential utility of ancestry studies to exploit these differences to gain insight into the genetic underpinnings of these phenotypes. The inclusion of genetic approaches in future studies of admixed populations will allow greater understanding of the potential biological basis of race-related sleep health inequalities.
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Affiliation(s)
- Bharati Prasad
- Department of Medicine, University of Illinois at Chicago, and Jesse Brown VA Medical Center, Chicago, IL.
| | - Richa Saxena
- Center for Genomic Medicine and Department of Anesthesia, Pain, and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA
| | - Namni Goel
- Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Sanjay R Patel
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA
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168
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Hicken MT, Lee H, Hing AK. The weight of racism: Vigilance and racial inequalities in weight-related measures. Soc Sci Med 2018; 199:157-166. [PMID: 28372829 PMCID: PMC5617791 DOI: 10.1016/j.socscimed.2017.03.058] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 03/22/2017] [Accepted: 03/27/2017] [Indexed: 02/08/2023]
Abstract
In the United States, racial/ethnic inequalities in obesity are well-documented, particularly among women. Using the Chicago Community Adult Health Study, a probability-based sample in 2001-2003 (N = 3105), we examined the roles of discrimination and vigilance in racial inequalities in two weight-related measures, body mass index (BMI) and waist circumference (WC), viewed through a cultural racism lens. Cultural racism creates a social environment in which Black Americans bear the stigma burden of their racial group while White Americans are allowed to view themselves as individuals. We propose that in this context, interpersonal discrimination holds a different meaning for Blacks and Whites, while vigilance captures the coping style for Blacks who carry the stigma burden of the racial group. By placing discrimination and vigilance within the context of cultural racism, we operationalize existing survey measures and utilize statistical models to clarify the ambiguous associations between discrimination and weight-related inequalities in the extant literature. Multivariate models were estimated for BMI and WC separately and were stratified by gender. Black women had higher mean BMI and WC than any other group, as well as highest levels of vigilance. White women did not show an association between vigilance and WC but did show a strong positive association between discrimination and WC. Conversely, Black women displayed an association between vigilance and WC, but not between discrimination and WC. These results demonstrate that vigilance and discrimination may hold different meanings for obesity by ethnoracial group that are concealed when all women are examined together and viewed without considering a cultural racism lens.
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Affiliation(s)
- Margaret T Hicken
- Institute for Social Research, University of Michigan, United States.
| | - Hedwig Lee
- Department of Sociology, University of Washington, United States
| | - Anna K Hing
- Department of Community Health Sciences, University of California, Los Angeles, United States
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169
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McCluney CL, Schmitz LL, Hicken MT, Sonnega A. Structural racism in the workplace: Does perception matter for health inequalities? Soc Sci Med 2018; 199:106-114. [PMID: 28552294 PMCID: PMC5696122 DOI: 10.1016/j.socscimed.2017.05.039] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 05/12/2017] [Accepted: 05/17/2017] [Indexed: 01/13/2023]
Abstract
Structural racism has been linked to racial health inequalities and may operate through an unequal labor market that results in inequalities in psychosocial workplace environments (PWE). Experiences of the PWE may be a critical but understudied source of racial health disparities as most adults spend a large portion of their lives in the workplace, and work-related stress affects health outcomes. Further, it is not clear if the objective characteristics of the workplace are important for health inequalities or if these inequalities are driven by the perception of the workplace. Using data from the 2008 to 2012 waves of the Health and Retirement Study (HRS), a probability-based sample of US adults 50 years of age and older and the Department of Labor's Occupational Information Network (O*NET), we examine the role of both standardized, objective (O*NET) and survey-based, subjective (as in HRS) measures of PWEs on health and Black-White health inequalities. We find that Blacks experience more stressful PWEs and have poorer health as measured by self-rated health, episodic memory function, and mean arterial pressure. Mediation analyses suggest that these objective O*NET ratings, but not the subjective perceptions, partially explain the relationship between race and health. We discuss these results within the extant literature on workplace and health and health inequalities. Furthermore, we discuss the use of standardized objective measures of the PWE to capture racial inequalities in workplace environment.
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Affiliation(s)
- Courtney L McCluney
- University of Virginia, Darden School of Business, 100 Darden Blvd, Charlottesville, VA 22903, United States.
| | - Lauren L Schmitz
- University of Michigan, Population Studies Center, Institute for Social Research, 426 Thompson Street, Ann Arbor, MI 48104, United States.
| | - Margaret T Hicken
- University of Michigan, Survey Research Center, Institute for Social Research, 426 Thompson Street, Ann Arbor, MI 48104, United States
| | - Amanda Sonnega
- University of Michigan, Health and Retirement Study, Institute for Social Research, 426 Thompson Street, Ann Arbor, MI 48104, United States
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170
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Kiat JE, Cheadle JE, Goosby BJ. The impact of social exclusion on anticipatory attentional processing. Int J Psychophysiol 2018; 123:48-57. [PMID: 29154954 PMCID: PMC10859167 DOI: 10.1016/j.ijpsycho.2017.11.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 10/16/2017] [Accepted: 11/15/2017] [Indexed: 12/22/2022]
Abstract
The importance of understanding how we anticipate and prepare for social rejection is underscored by the mental and physical toll of continual social vigilance. In this study, we investigate the impact of social rejection on anticipatory attentional processes using the well-known Cyberball task, a paradigm in which participants engage in a game of catch with virtual avatars who after an initial period of fair-play (inclusion condition) then exclude the participant from the game (exclusion condition). The degree of anticipatory attention allocated by subjects towards the avatars was assessed by measuring P3b responses towards the avatars' preparatory actions (i.e. the phase preceding their exclusionary actions) using high density EEG. The results of the study show that relative to the inclusion, participants exhibit elevated levels of anticipatory attentional allocation towards the avatars during the exclusion block. This shift was however significantly moderated by participants' self-reported cognitive regulation tendencies. Participants with higher levels of self-reported cognitive reappraisal tendencies showed larger anticipatory P3b increases from the inclusion to exclusion block relative to participants with reduced levels of reappraisal tendencies. These results highlight the impact of social exclusion on anticipatory neural processing and the moderating role of cognitive reappraisal on these effects.
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Affiliation(s)
- John E Kiat
- 238 Burnett Hall, Department of Psychology, The University of Nebraska-Lincoln, Lincoln, NE 68588-0308, USA.
| | - Jacob E Cheadle
- 737 Oldfather Hall, Department of Sociology, The University of Nebraska-Lincoln, Lincoln, NE 68588-0324, USA
| | - Bridget J Goosby
- 741 Oldfather Hall, Department of Sociology, The University of Nebraska-Lincoln, Lincoln, NE 68588-0324, USA
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171
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Hoggard LS, Hill LK. Examining How Racial Discrimination Impacts Sleep Quality in African Americans: Is Perseveration the Answer? Behav Sleep Med 2018; 16:471-481. [PMID: 27690630 PMCID: PMC5378656 DOI: 10.1080/15402002.2016.1228648] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND African Americans experience more problematic and disordered sleep than White Americans. Racial discrimination has been implicated in this disparity. However, the mechanisms by which discrimination disrupts sleep are unclear. It has been theorized that Perseverative Cognition (PC), characterized by recurrent patterns of reflective (i.e., rumination) and anticipatory (i.e., worry) negative thinking about personally relevant stressors, may reflect the functional mechanism linking discrimination to sleep. The present study is the first to empirically examine the dual components of PC as a candidate functional mechanism in the association between racial discrimination and subjective sleep quality. PARTICIPANTS Sixty-eight self-identified African American college students (55.9% female; Mage = 20.18, SD = 2.93) were recruited at a large predominantly white public university in the Midwest. METHODS The participants completed the Perceived Ethnic Discrimination Questionnaire (PEDQ), Pittsburgh Sleep Quality Index (PSQI), Penn State Worry Questionnaire (PSWQ), and Ruminative Responses Scale (RRS). RESULTS After adjusting for age, gender, and social class, results revealed a significant indirect effect of racial discrimination (RD) on subjective sleep quality through rumination, 95% CI [.008, .125], but not worry. RD was positively associated with rumination, b =.50, SE =.16, p = .003, and rumination, in turn, was positively associated with poorer sleep quality, b = .09, SE = .04, p = .012. CONCLUSIONS As both RD and poor sleep quality have been directly linked to heart disease, diabetes, depression, and a number of other maladies, our findings suggest that RD, sleep, and coping strategies (e.g., rumination) employed to manage RD experiences may be important targets for addressing racial disparities in health.
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Affiliation(s)
- Lori S. Hoggard
- Center for Health Equity Research, Department of Social Medicine and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina,Institute of African American Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - LaBarron K Hill
- c Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , North Carolina.,d Center for Biobehavioral Health Disparities Research , Duke University , Durham , North Carolina.,e Center for the Study of Aging and Human Development , Duke University Medical Center , Durham , North Carolina
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172
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Alcántara C, Patel SR, Carnethon M, Castañeda S, Isasi CR, Davis S, Ramos A, Arredondo E, Redline S, Zee PC, Gallo LC. Stress and Sleep: Results from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. SSM Popul Health 2017; 3:713-721. [PMID: 29104908 PMCID: PMC5663240 DOI: 10.1016/j.ssmph.2017.08.004] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Hispanics/Latinos face specific sociocultural stressors associated with their marginalized status in the United States. While stress is known to cause poor sleep, the differential effects of the specific stressors faced by Hispanics/Latinos have not been evaluated. Using cross-sectional data from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study, we conducted weighted generalized linear models to evaluate the associations of acculturation stress, ethnic discrimination, and chronic moderate/severe stress with self-reported sleep outcomes (insomnia symptoms, daytime sleepiness, sleep duration) in individual and aggregate models adjusted for site, socio-demographics, behavioral, and medical conditions. Participants included 5313 Hispanic/Latino adults; 43.5% ≥ age 45, 54.8% female, and 22.0% US-born. Chronic moderate/severe stress, ethnic discrimination, and acculturation stress were each positively associated with sleep. In the adjusted aggregate model, only chronic moderate/severe stress was associated with insomnia symptoms (exp(b) = 1.07 for each additional stressor, 95% CI = 1.05, 1.09). Both acculturation stress (exp(b) = 1.05 for each additional SD, 95% CI = 1.02, 1.10) and ethnic discrimination (exp(b) = 1.05 for each additional SD, 95% CI = 1.01, 1.08) were associated with daytime sleepiness. Each SD increase in ethnic discrimination related to a 16% and 13% increased prevalence of short (< 7 h) (RRR = 1.16, 95% CI = 1.02, 1.31) and long sleep duration (> 9 h) (RRR = 1.13, 95% CI = 1.00, 1.27), respectively. These associations were consistent across sex. Acculturation stress and ethnic discrimination are associated with poor sleep in Hispanics/Latinos. Future research should explore whether behavioral sleep interventions minimize the impact of sociocultural stressors on sleep. Latina/os face unique stressors associated with their marginalized status in the USA. We explored the association of sociocultural stressors with Latina/o sleep. Acculturation stress and ethnic discrimination were associated with daytime sleepiness. Only chronic psychosocial stress was associated with insomnia symptoms. Ethnic discrimination was associated with both short and long sleep duration.
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Affiliation(s)
| | - Sanjay R Patel
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Mercedes Carnethon
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Sheila Castañeda
- School of Public Health, San Diego State University, San Diego, CA
| | | | - Sonia Davis
- Department of Biostatistics, University of North Carolina at Chapel Hill-Gillins School of Global Public Health, Chapel Hill, NC
| | - Alberto Ramos
- University of Miami Miller School of Medicine, Miami, FL
| | - Elva Arredondo
- School of Public Health, San Diego State University, San Diego, CA
| | - Susan Redline
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Phyllis C Zee
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA
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173
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Bellatorre A, Choi K, Lewin D, Haynie D, Simons-Morton B. Relationships Between Smoking and Sleep Problems in Black and White Adolescents. Sleep 2017; 40:2706415. [PMID: 28364464 DOI: 10.1093/sleep/zsw031] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2016] [Indexed: 11/14/2022] Open
Abstract
Study Objectives The relationship between sleeping and smoking during adolescence remains unclear and is likely complex. We aim to evaluate the longitudinal reciprocal associations between sleep problems, sleep duration, and smoking among non-Hispanic white (NHW) and non-Hispanic black (NHB) youth. Design Prospective cohort study. Setting NEXT Generation Health Study. Participants A national sample (N = 1394) of NHB and NHW 10th graders were surveyed annually between 2009 (Wave 1) and 2012 (Wave 3). Interventions N/A. Measurements and Results Past 30-day smoking, chronic difficulty falling asleep, recent difficulty falling asleep, difficulty staying asleep, and weekday and weekend sleep duration were measured at each wave. Using structural equation models, we observed significant autocorrelations over time for sleep problems and sleep duration. We found significant reciprocal, prospective relationships between smoking and sleep problems. The strengths of the relationships differed by race, with a stronger association between sleep problems and subsequent smoking for NHB than NHW youth. Conversely, a stronger association between smoking and subsequent sleep problems for NHW than NHB youth was observed. These association were independent of demographics, snoring or sleep apnea, body mass index, depressive symptoms, alcohol use, and soda consumption. Conclusions Reciprocal and prospective relationships exist for youth smoking and sleep problems and duration in both NHW and NHB youth. Further research is needed to unravel the complex relationship between the direct effects of nicotine, lifestyle choices that may link smoking and sleep problems, and racial differences.
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Affiliation(s)
- Anna Bellatorre
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Betheseda, MD
| | - Kelvin Choi
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Betheseda, MD
| | - Daniel Lewin
- George Washington University School of Medicine, Washington, DC
| | - Denise Haynie
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Bruce Simons-Morton
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
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174
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Abstract
Racial/ethnic minorities experience a disproportionate risk of both suboptimal sleep and obesity, and the relationship between sleep and obesity may differ by race/ethnicity for modifiable and non-modifiable reasons. Because many people of color have historically lived and continue to largely live in disadvantaged, obesogenic physical and social environments, these greater adverse exposures likely negatively affect sleep, resulting in physiological dysregulation. Physiological dysregulation may, in turn, lead to increased obesity risk and subsequent health consequences, which are likely more influential than potential genetic differences in race, a social construct. The purpose of this article is to describe potential environmental, genetic, and epigenetic determinants of racial/ethnic differences in the sleep-obesity relationship and to review current epidemiological findings regarding either racial/ethnic minority specific estimates of the association or disparities in the relationship. Using the socioecological framework as a conceptual model, I describe sleep and obesity as socially patterned and embedded in modifiable physical and social contexts with common causes that are influenced by upstream social conditions. I also provide examples of sleep and obesity-related studies that correspond with the downstream, intermediate, and upstream factors that likely contribute to commonly observed racial/ethnic disparities in the sleep-obesity relationship. The review concludes with broad recommendations for (1) advancing research methodology for epidemiological studies of disparities in the link between sleep and obesity, (2) future research topics, as well as (3) several broad policies and structures needed to address racial/ethnic disparities in sleep health and obesity.
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Affiliation(s)
- Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA.
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175
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Williams MT, Taylor RJ, Mouzon DM, Oshin LA, Himle JA, Chatters LM. Discrimination and symptoms of obsessive-compulsive disorder among African Americans. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2017; 87:636-645. [PMID: 28816492 DOI: 10.1037/ort0000285] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This study examined symptoms of obsessive-compulsive disorder (OCD) in a nationally representative sample of African American adults (n = 3,570) and correlations between OCD symptom dimensions and experiences of discrimination. Two categories of discrimination were examined, everyday racial discrimination and everyday nonracial discrimination (e.g., because of gender, age, and weight), to determine if racial discrimination had a unique impact on OCD symptoms. Results indicated that everyday racial discrimination was related to both categories of obsessions and all 4 categories of compulsions. Everyday nonracial discrimination, however, was not related to any of the categories of obsessions or compulsions. This indicates that racial discrimination is uniquely related to obsessions and compulsions for African Americans. The implications of these findings are discussed. (PsycINFO Database Record
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Affiliation(s)
- Monnica T Williams
- Department of Psychological Sciences, College of Liberal Arts and Sciences, University of Connecticut
| | - Robert Joseph Taylor
- School of Social Work, Program for Research on Black Americans, Institute for Social Research, University of Michigan
| | - Dawne M Mouzon
- Edward J. Bloustein School of Planning and Public Policy, Institute for Health, Health Care Policy, and Aging Research, Rutgers University
| | - Linda A Oshin
- Department of Psychological Sciences, College of Liberal Arts and Sciences, University of Connecticut
| | - Joseph A Himle
- Department of Psychiatry, School of Social Work, University of Michigan
| | - Linda M Chatters
- Schools of Social Work and Public Health, Program for Research on Black Americans, Institute for Social Research, University of Michigan
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176
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Heissel JA, Sharkey PT, Torrats-Espinosa G, Grant K, Adam EK. Violence and Vigilance: The Acute Effects of Community Violent Crime on Sleep and Cortisol. Child Dev 2017; 89:e323-e331. [PMID: 28741650 DOI: 10.1111/cdev.12889] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The data combine objectively measured sleep and thrice-daily salivary cortisol collected from a 4-day diary study in a large Midwestern city with location data on all violent crimes recorded during the same time period for N = 82 children (Mage = 14.90, range = 11.27-18.11). The primary empirical strategy uses a within-person design to measure the change in sleep and cortisol from the person's typical pattern on the night/day immediately following a local violent crime. On the night following a violent crime, children have later bedtimes. Children also have disrupted cortisol patterns the following morning. Supplementary analyses using varying distances of the crime to the child's home address confirm more proximate crimes correspond to later bedtimes.
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177
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Goosby BJ, Straley E, Cheadle JE. Discrimination, Sleep, and Stress Reactivity: Pathways to African American-White Cardiometabolic Risk Inequities. POPULATION RESEARCH AND POLICY REVIEW 2017. [DOI: 10.1007/s11113-017-9439-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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178
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Abstract
This study examined the relationship between work dissatisfaction and sleep problems among Canadian adults in the latter half of life, as well as how gender and social contact moderate this relationship. Data were obtained from the Canadian General Social Survey, Cycle 21 (2007), which sampled adults aged 45 and older in 2007. Analyses focused on individuals with employment as their main activity. Analyses show that work dissatisfaction positively predicts trouble sleeping. There are no significant gender differences in this relationship. Social contact with friends buffers this relationship, but social contact with family does not, and buffering does not vary significantly between men and women. This research contributes to knowledge on sleep problems by showing that work dissatisfaction is adversely associated with sleep problems among Canadians in the latter half of life, but social contact with friends can weaken this deleterious relationship.
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179
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Owens SL, Hunte HER, Sterkel A, Johnson DA, Johnson-Lawrence V. Association Between Discrimination and Objective and Subjective Sleep Measures in the Midlife in the United States Study Adult Sample. Psychosom Med 2017; 79:469-478. [PMID: 28114149 PMCID: PMC5413390 DOI: 10.1097/psy.0000000000000428] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Evidence suggests that sleep quality is worse in nonwhite minorities compared with whites. Poor sleep is associated with higher levels of perceived interpersonal discrimination, which is consistently reported among minorities. However, the literature is limited in exploring discrimination with both objective and subjective sleep outcomes in the same sample. We examined the relationship between discrimination and markers of subjective and objective sleep in a racially diverse sample. METHODS The analytic sample included 441 participants of the Midlife in the United States II (MIDUS) study (M [SD] age, 46.6 [1.03]; female, 57.9%; male, 42.1%; nonwhite, 31.7%). Complete data were available for 361 participants. Sleep measures included the Pittsburgh Sleep Quality Index, sleep latency, wake after sleep onset, and sleep efficiency derived from 7-day actigraphy. Discrimination was measured with the Williams Everyday Discrimination Scale. Ordinary least squares and logistic regression models were used to assess the relationship between discrimination and the subjective and objective measures of sleep. RESULTS After adjusting for covariates, respondents with higher discrimination scores were significantly more likely to experience poor sleep efficiency (odds ratio, 1.12; p = .005) and report poorer sleep quality (odds ratio, 1.09; p = .029) on the basis of the Pittsburgh Sleep Quality Index. Higher discrimination scores were also associated with longer wake after sleep onset (b = 0.032, p < .01) and more sleep difficulties (b = 0.049, p = .01). Discrimination attenuated all differences in the sleep measures between whites and nonwhites except for sleep efficiency. CONCLUSIONS The findings support the model that discrimination acts as a stressor that can disrupt subjective and objective sleep. These results suggest that interpersonal discrimination explains some variance in worse sleep among nonwhites compared with whites.
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Affiliation(s)
- Sherry L Owens
- From the Department of Social and Behavioral Sciences (Owens, Hunte), West Virginia University, Morgantown, West Virginia; Department of Psychiatry and Behavioral Sciences (Sterkel), Stanford University, Stanford, California; Division of Sleep Medicine (Johnson), Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts; and Department of Public Health and Health Sciences (Johnson-Lawrence), University of Michigan-Flint, Flint, Michigan
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180
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Anxiety sensitivity and racial differences in sleep duration: Results from a national survey of adults with cardiovascular disease. J Anxiety Disord 2017; 48:102-108. [PMID: 27760717 PMCID: PMC5663191 DOI: 10.1016/j.janxdis.2016.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/03/2016] [Accepted: 10/04/2016] [Indexed: 11/22/2022]
Abstract
Although Blacks sleep between 37 and 75min less per night than non-Hispanic Whites, research into what drives racial differences in sleep duration is limited. We examined the association of anxiety sensitivity, a cognitive vulnerability, and race (Blacks vs. White) with short sleep duration (<7h of sleep/night), and whether anxiety sensitivity mediated race differences in sleep duration in a nationally representative sample of adults with cardiovascular disease. Overall, 1289 adults (115 Black, 1174 White) with a self-reported physician/health professional diagnosis of ≥1 myocardial infarction completed an online survey. Weighted multivariable logistic regressions and mediation analyses with bootstrapping and case resampling were conducted. Anxiety sensitivity and Black vs. White race were associated with 4%-84% increased odds, respectively, of short sleep duration. Anxiety sensitivity mediated Black-White differences in sleep duration. Each anxiety sensitivity subscale was also a significant mediator. Implications for future intervention science to address sleep disparities are discussed.
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181
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Chen JH, Shiu CS. Sexual Orientation and Sleep in the U.S.: A National Profile. Am J Prev Med 2017; 52:433-442. [PMID: 28062273 DOI: 10.1016/j.amepre.2016.10.039] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 10/05/2016] [Accepted: 10/25/2016] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Sexual minorities often experience poorer health than non-sexual minorities. However, extant knowledge remains limited regarding the sleep characteristics, a risk factor for chronic diseases and excess mortality, of sexual minorities compared with non-sexual minorities at the population level. METHODS This study analyzed the 2013-2014 National Health Interview Survey, Adult Sample (n=68,960) to examine the reported sleep duration and sleep disturbances (i.e., not feeling rested, difficulty falling asleep, and waking up at night) by sexual orientation (i.e., homosexual [n=1,149], bisexual [n=515], and other sexual minorities [n=144]). Statistical analysis, conducted in 2015, used multinomial logistic and logistic regressions to estimate the associations between sexual orientation and sleep variables. RESULTS Adult sexual minorities had higher risks of sleep disturbances than heterosexual adults. Differences in SES and physical and mental health conditions partly explained the gaps. Sexual minority women had greater odds of waking up at night than sexual minority men did, but sexual minority adults who were also racial minorities showed no differences in odds of sleep disturbances compared to white sexual minority adults. Results found that sexual orientation was not associated with an increased risk of short or long sleep duration. CONCLUSIONS This study documented substantial disparities in sleep disturbances between sexual minorities and non-sexual minorities. These gaps cannot simply be explained by social and demographic factors. Interventions that target sexual minorities should pay attention to disparities in sleep and investigate methods to promote sleep health of sexual minorities.
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Affiliation(s)
- Jen-Hao Chen
- Department of Health Sciences, University of Missouri, Columbia, Missouri.
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182
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Mouzon DM, Taylor RJ, Woodward A, Chatters LM. Everyday Racial Discrimination, Everyday Non-racial Discrimination, and Physical Health Among African Americans. JOURNAL OF ETHNIC & CULTURAL DIVERSITY IN SOCIAL WORK 2017; 26:68-80. [PMID: 28286428 PMCID: PMC5342249 DOI: 10.1080/15313204.2016.1187103] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Past research has identified a link between discrimination and health outcomes among people of color. Perceptions of the cause of discrimination (racial vs. other) seem to be important for mental health; however, this relationship has not been fully examined for physical health. Using data from the National Survey of American Life, we find that, among African Americans, racial discrimination and overall discrimination regardless of attribution are associated with negative health outcomes while non-racial discrimination is not. The results suggest that racial discrimination has a unique adverse effect on physical health for African Americans that practitioners need to better understand.
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Affiliation(s)
- Dawne M Mouzon
- Rutgers, The State University of New Jersey, Edward J. Bloustein School of Planning and Public Policy and Institute for Health, Health Care Policy, and Aging Research, 33 Livingston Avenue, New Brunswick, NJ 08901
| | | | | | - Linda M Chatters
- University of Michigan, School of Social Work ; University of Michigan, School of Public Health
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Bellatorre A, Choi K, Lewin D, Haynie D, Simons-Morton B. Relationships Between Smoking and Sleep Problems in Black and White Adolescents. Sleep 2017. [PMID: 28364464 DOI: 10.1093/sleep/zsw031.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Study Objectives The relationship between sleeping and smoking during adolescence remains unclear and is likely complex. We aim to evaluate the longitudinal reciprocal associations between sleep problems, sleep duration, and smoking among non-Hispanic white (NHW) and non-Hispanic black (NHB) youth. Design Prospective cohort study. Setting NEXT Generation Health Study. Participants A national sample (N = 1394) of NHB and NHW 10th graders were surveyed annually between 2009 (Wave 1) and 2012 (Wave 3). Interventions N/A. Measurements and Results Past 30-day smoking, chronic difficulty falling asleep, recent difficulty falling asleep, difficulty staying asleep, and weekday and weekend sleep duration were measured at each wave. Using structural equation models, we observed significant autocorrelations over time for sleep problems and sleep duration. We found significant reciprocal, prospective relationships between smoking and sleep problems. The strengths of the relationships differed by race, with a stronger association between sleep problems and subsequent smoking for NHB than NHW youth. Conversely, a stronger association between smoking and subsequent sleep problems for NHW than NHB youth was observed. These association were independent of demographics, snoring or sleep apnea, body mass index, depressive symptoms, alcohol use, and soda consumption. Conclusions Reciprocal and prospective relationships exist for youth smoking and sleep problems and duration in both NHW and NHB youth. Further research is needed to unravel the complex relationship between the direct effects of nicotine, lifestyle choices that may link smoking and sleep problems, and racial differences.
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Affiliation(s)
- Anna Bellatorre
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Betheseda, MD
| | - Kelvin Choi
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Betheseda, MD
| | - Daniel Lewin
- George Washington University School of Medicine, Washington, DC
| | - Denise Haynie
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Bruce Simons-Morton
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
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Stepanikova I, Oates GR. Perceived Discrimination and Privilege in Health Care: The Role of Socioeconomic Status and Race. Am J Prev Med 2017; 52:S86-S94. [PMID: 27989297 PMCID: PMC5172593 DOI: 10.1016/j.amepre.2016.09.024] [Citation(s) in RCA: 123] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 09/09/2016] [Accepted: 09/15/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION This study examined how perceived racial privilege and perceived racial discrimination in health care varied with race and socioeconomic status (SES). METHODS The sample consisted of white, black, and Native American respondents to the Behavioral Risk Factor Surveillance System (2005-2013) who had sought health care in the past 12 months. Multiple logistic regression models of perceived racial privilege and perceived discrimination were estimated. Analyses were performed in 2016. RESULTS Perceptions of racial privilege were less common among blacks and Native Americans compared with whites, while perceptions of racial discrimination were more common among these minorities. In whites, higher income and education contributed to increased perceptions of privileged treatment and decreased perceptions of discrimination. The pattern was reversed in blacks, who reported more discrimination and less privilege at higher income and education levels. Across racial groups, respondents who reported foregone medical care due to cost had higher risk of perceived racial discrimination. Health insurance contributed to less perceived racial discrimination and more perceived privilege only among whites. CONCLUSIONS SES is an important social determinant of perceived privilege and perceived discrimination in health care, but its role varies by indicator and racial group. Whites with low education or no health insurance, well-educated blacks, and individuals who face cost-related barriers to care are at increased risk of perceived discrimination. Policies and interventions to reduce these perceptions should target structural and systemic factors, including society-wide inequalities in income, education, and healthcare access, and should be tailored to account for racially specific healthcare experiences.
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Affiliation(s)
- Irena Stepanikova
- Department of Sociology, University of Alabama at Birmingham, Birmingham, Alabama; Research Centre for Toxic Compounds in the Environment, Masaryk University, Brno, Czech Republic;.
| | - Gabriela R Oates
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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Hill LK, Hoggard LS, Richmond AS, Gray DL, Williams DP, Thayer JF. Examining the association between perceived discrimination and heart rate variability in African Americans. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2017; 23:5-14. [PMID: 28045306 PMCID: PMC5755701 DOI: 10.1037/cdp0000076] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Previous research attempting to delineate the role of discrimination in racial/ethnic disparities in hypertension has focused largely on blood pressure, which is chiefly governed by the sympathetic branch of the autonomic nervous system. Consequently, few studies have considered the role of the parasympathetic branch and particularly its regulation of the heart via the vagus nerve. METHOD In the present cross-sectional study, we employed hierarchical linear regressions to examine associations between perceived ethnic discrimination and resting heart rate variability (HRV), an important biomarker of parasympathetic cardiac modulation and overall health, in a sample (N = 103) of young, healthy African American participants (58% female, Mage = 19.94 years, SD = 2.84). RESULTS After accounting for demographic factors and health status characteristics, lifetime discrimination emerged as an inverse predictor of HRV. When subdomains of discrimination were considered, discrimination attributable to threats or actual acts of aggression was also predictive of lower HRV. CONCLUSIONS Our findings suggest that a greater lifetime burden of discrimination and discriminatory harassment and/or assault is associated with lower resting HRV in African Americans. The implications of these findings are discussed in the context of past, present and emerging research emphasizing biological linkages between discrimination and health. (PsycINFO Database Record
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Affiliation(s)
- LaBarron K Hill
- Center for the Study of Aging and Human Development, Duke University Medical Center
| | - Lori S Hoggard
- Department of Psychology, University of North Carolina at Chapel Hill
| | | | - DeLeon L Gray
- Department of Educational Psychology, North Carolina State University
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Lee H, Hicken MT. Death by a thousand cuts: The health implications of black respectability politics. SOULS : A CRITICAL JOURNAL OF BLACK POLITICS, CULTURE, AND SOCIETY 2016; 18:421-445. [PMID: 29187782 PMCID: PMC5703418 DOI: 10.1080/10999949.2016.1230828] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The authors introduce the concept of "vigilance," capturing behaviors that reflect attempts to navigate racialized social spaces on a daily basis. Specifically, vigilant behaviors include care about appearance and language to be treated with respect, avoidance of social spaces, and psychological preparation for potential prejudice and discrimination. Furthermore, these behaviors align with those discussed in Black respectability politics debates. Using data from a population-representative sample of Black adults in Chicago, they report that vigilance is associated with poor physical and mental health indexed through chronic health conditions, depressive symptoms, and self-rated health.
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Affiliation(s)
- Hedwig Lee
- University of Washington, Department of Sociology
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187
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Cunningham TJ, Wheaton AG, Ford ES, Croft JB. Racial/ethnic disparities in self-reported short sleep duration among US-born and foreign-born adults. ETHNICITY & HEALTH 2016; 21:628-638. [PMID: 27150351 PMCID: PMC5206750 DOI: 10.1080/13557858.2016.1179724] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Racial/ethnic health disparities are infrequently considered by nativity status in the United States, although the immigrant population has practically doubled since 1990. We investigated the modifying role of nativity status (US- vs. foreign-born) on racial/ethnic disparities in short sleep duration (<7 h), which has serious health consequences. DESIGN Cross-sectional data from 23,505 US-born and 4,326 foreign-born adults aged ≥ 18 years from the 2012 National Health Interview Survey and multivariable log-linear regression were used to estimate prevalence ratios (PR) for reporting short sleep duration and their corresponding 95% confidence intervals (CI). RESULTS After controlling for sociodemographic covariates, short sleep was more prevalent among blacks (PR 1.29, 95% CI: 1.21-1.37), Hispanics (PR 1.18, 95% CI: 1.08, 1.29), and Asians (PR 1.37, 95% CI: 1.16-1.61) than whites among US-born adults. Short sleep was more prevalent among blacks (PR 1.71, 95% CI: 1.38, 2.13) and Asians (PR 1.23, 95% CI: 1.02, 1.47) than whites among the foreign-born. CONCLUSION Among both US- and foreign-born adults, blacks and Asians had a higher likelihood of short sleep compared to whites. US-born Hispanics, but not foreign-born Hispanics, had a higher likelihood than their white counterparts. Future research should aim to uncover mechanisms underlying these disparities.
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Affiliation(s)
- Timothy J Cunningham
- a Division of Population Health , National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Anne G Wheaton
- a Division of Population Health , National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Earl S Ford
- a Division of Population Health , National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Janet B Croft
- a Division of Population Health , National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta , GA , USA
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188
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St-Onge MP, Grandner MA, Brown D, Conroy MB, Jean-Louis G, Coons M, Bhatt DL. Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association. Circulation 2016; 134:e367-e386. [PMID: 27647451 DOI: 10.1161/cir.0000000000000444] [Citation(s) in RCA: 551] [Impact Index Per Article: 68.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Sleep is increasingly recognized as an important lifestyle contributor to health. However, this has not always been the case, and an increasing number of Americans choose to curtail sleep in favor of other social, leisure, or work-related activities. This has resulted in a decline in average sleep duration over time. Sleep duration, mostly short sleep, and sleep disorders have emerged as being related to adverse cardiometabolic risk, including obesity, hypertension, type 2 diabetes mellitus, and cardiovascular disease. Here, we review the evidence relating sleep duration and sleep disorders to cardiometabolic risk and call for health organizations to include evidence-based sleep recommendations in their guidelines for optimal health.
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189
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Kiat JE, Straley E, Cheadle JE. Why won't they sit with me? An exploratory investigation of stereotyped cues, social exclusion, and the P3b. Soc Neurosci 2016; 12:612-625. [PMID: 27557430 DOI: 10.1080/17470919.2016.1223167] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The importance of understanding how we anticipate and prepare for being socially excluded is underscored by the numerous adverse mental and physical consequences of social rejection. In this study, we adapted a social exclusion paradigm, the Lunchroom task, to investigate the use of social context cues in the formation of social outcome expectations as indexed by the P3b, an ERP component associated with attention orientation and context updating. In this task, Black and White participants were presented with either neutral or stereotyped cues prior to being exposed to simulated inclusion versus exclusion outcome scenarios. Black participants showed evidence of (1) a significantly reduced P3b response to exclusions preceded by stereotyped cues relative to neutral cue-related exclusions and (2) a marginally significant increase in the P3b response to inclusions relative to exclusions when both were preceded by stereotyped cues. Both of these findings suggest a key role for the use of social cues in the formation of outcome expectations. In line with our hypothesis that the random intermixing of inclusion and exclusion outcomes would prevent formation of outcome expectations when coupled with the absence of self-relevant cues, no overall P3b modulations were observed among a comparison group of White participants.
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Affiliation(s)
- John E Kiat
- a Department of Psychology , The University of Nebraska-Lincoln , Lincoln , NE , USA
| | - Elizabeth Straley
- b Department of Sociology , The University of Nebraska-Lincoln , Lincoln , NE , USA
| | - Jacob E Cheadle
- b Department of Sociology , The University of Nebraska-Lincoln , Lincoln , NE , USA
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Molina KM, James D. Discrimination, internalized racism, and depression: A comparative study of African American and Afro-Caribbean adults in the US. GROUP PROCESSES & INTERGROUP RELATIONS 2016; 19:439-461. [PMID: 28405176 PMCID: PMC5386401 DOI: 10.1177/1368430216641304] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Emerging research suggests that both perceptions of discrimination and internalized racism (i.e., endorsement of negative stereotypes of one's racial group) are associated with poor mental health. Yet, no studies to date have examined their effects on mental health with racial/ethnic minorities in the US in a single study. The present study examined: (a) the direct effects of everyday discrimination and internalized racism on risk of DSM-IV criteria of past-year major depressive disorder (MDD); (b) the interactive effects of everyday discrimination and internalized racism on risk of past-year MDD; and (c) the indirect effect of everyday discrimination on risk of past-year MDD via internalized racism. Further, we examined whether these associations differed by ethnic group membership. We utilized nationally representative data of Afro-Caribbean (N = 1,418) and African American (N = 3,570) adults from the National Survey of American Life. Results revealed that experiencing discrimination was associated with increased odds of past-year MDD among the total sample. Moreover, for Afro-Caribbeans, but not African Americans, internalized racism was associated with decreased odds of meeting criteria for past-year MDD. We did not find an interaction effect for everyday discrimination by internalized racism, nor an indirect effect of discrimination on risk of past-year MDD through internalized racism. Collectively, our findings suggest a need to investigate other potential mechanisms by which discrimination impacts mental health, and examine further the underlying factors of internalized racism as a potential self-protective strategy. Lastly, our findings point to the need for research that draws attention to the heterogeneity within the U.S. Black population.
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191
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Powell LR, Jesdale WM, Lemon SC. On Edge: the impact of race-related vigilance on obesity status in African-Americans. Obes Sci Pract 2016; 2:136-143. [PMID: 27275395 PMCID: PMC4891700 DOI: 10.1002/osp4.42] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective Nearly half of African–Americans are classified as obese. Perceived racism has been associated with obesity, yet the internal experiences of racism have received little attention. African–Americans who face racism may ‘ready themselves’ to cope through survival strategies, including race‐related vigilance. This study explores the association between race‐related vigilance and obesity in African–Americans. Design and methods The Reactions to Race module of the Behavioral Risk Factor Surveillance Survey (years 2002–2010) was used. Our sample size consisted of 12,214 African–Americans. Race‐related vigilance was assessed as ‘How often do you think about your race?’ and classified as never, <daily, daily and >daily. Obesity was dichotomized as body mass index ≥ 30 kg m−2 vs. <30 kg m−2 using self‐reported weight and height. Multivariable logistic models assessed the association between race‐related vigilance and obesity. Results Seventeen percent of respondents reported thinking about their race >daily; 14% daily; 31% <daily and 39% reported never thinking about their race. Compared with those who reported never thinking about their race, the adjusted odds of obesity were 0.91, 95% CI: 0.72–1.15 among those thinking about their race <daily; 1.09, 95% CI: 0.81–1.46 among those thinking about their race daily; and 1.37, 95% CI: 1.07–1.76 among those thinking about their race >daily. Conclusions Frequently thinking about one's race was a risk factor for obesity in African–Americans in this study. Internalized impacts of racism captured through race‐related vigilance may be particularly detrimental to African–Americans, driving their risk for obesity.
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Affiliation(s)
- Lauren R Powell
- Clinical and Population Health Research Doctoral Program, Department of Quantitative Health Sciences, Department of Medicine, Division of Behavioral and Preventive Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01655 USA
| | - William M Jesdale
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts 01655 USA
| | - Stephenie C Lemon
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts 01655 USA, (508) 856-4098 - telephone, (508) 856-3840 - fax
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Spence ND, Wells S, Graham K, George J. Racial Discrimination, Cultural Resilience, and Stress. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2016; 61:298-307. [PMID: 27254805 PMCID: PMC4841285 DOI: 10.1177/0706743716638653] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Racial discrimination is a social determinant of health for First Nations people. Cultural resilience has been regarded as a potentially positive resource for social outcomes. Using a compensatory model of resilience, this study sought to determine if cultural resilience (compensatory factor) neutralized or offset the detrimental effect of racial discrimination (social risk factor) on stress (outcome). METHODS Data were collected from October 2012 to February 2013 (N = 340) from adult members of the Kettle and Stony Point First Nation community in Ontario, Canada. The outcome was perceived stress; risk factor, racial discrimination; and compensatory factor, cultural resilience. Control variables included individual (education, sociability) and family (marital status, socioeconomic status) resilience resources and demographics (age and gender). The model was tested using sequential regression. RESULTS The risk factor, racial discrimination, increased stress across steps of the sequential model, while cultural resilience had an opposite modest effect on stress levels. In the final model with all variables, age and gender were significant, with the former having a negative effect on stress and women reporting higher levels of stress than males. Education, marital status, and socioeconomic status (household income) were not significant in the model. The model had R(2) = 0.21 and adjusted R(2) = 0.18 and semipartial correlation (squared) of 0.04 and 0.01 for racial discrimination and cultural resilience, respectively. CONCLUSIONS In this study, cultural resilience compensated for the detrimental effect of racial discrimination on stress in a modest manner. These findings may support the development of programs and services fostering First Nations culture, pending further study.
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Affiliation(s)
| | - Samantha Wells
- Social and Epidemiological Research Department, Centre for Addiction and Mental Health, London, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada School of Psychology, Deakin University, Australia
| | - Kathryn Graham
- Social and Epidemiological Research Department, Centre for Addiction and Mental Health, London, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada Department of Psychology, Western University, London, Ontario, Canada National Drug Research Institute, Curtin University, Perth, Western Australia
| | - Julie George
- Social and Epidemiological Research Department, Centre for Addiction and Mental Health, London, Ontario, Canada Mental Health and Addiction Services, Kettle & Stony Point Health Services, Kettle & Stony Point First Nation, Ontario, Canada
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Paine SJ, Harris R, Cormack D, Stanley J. Racial Discrimination and Ethnic Disparities in Sleep Disturbance: the 2002/03 New Zealand Health Survey. Sleep 2016; 39:477-85. [PMID: 26446108 DOI: 10.5665/sleep.5468] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 09/05/2015] [Indexed: 12/20/2022] Open
Abstract
STUDY OBJECTIVES Research on the relationship between racial discrimination and sleep is limited. The aims of this study were to: (1) examine the independent relationship between ethnicity, sex, age, socioeconomic position, experience of racial discrimination and self-reported sleep disturbances, and (2) determine the statistical contribution of experience of racial discrimination to ethnic disparities in sleep disturbances. METHODS The study used data from the 2002/03 New Zealand Health Survey, a nationally-representative, population-based survey of New Zealand adults (≥ 15 years). The sample included 4,108 self-identified Māori (indigenous New Zealanders) and 6,261 European adults. Outcome variables were difficulty falling asleep, frequent nocturnal awakenings, and early morning awakenings. Experiences of racial discrimination across five domains were used to assess overall racial discrimination "ever" and the level of exposure to racial discrimination. Socioeconomic position was measured using neighborhood deprivation, education, and equivalized household income. RESULTS Māori had a higher prevalence of each sleep disturbance item than Europeans. Reported experiences of racial discrimination were independently associated with each sleep disturbance item, adjusted for ethnicity, sex, age group, and socioeconomic position. Sequential logistic regression models showed that racial discrimination and socioeconomic position explained most of the disparity in difficulty falling asleep and frequent nocturnal awakening between Māori and Europeans; however, ethnic differences in early morning awakenings remained. CONCLUSIONS Racial discrimination may play an important role in ethnic disparities in sleep disturbances in New Zealand. Activities to improve the sleep health of non-dominant ethnic groups should consider the potentially multifarious ways in which racial discrimination can disturb sleep.
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Affiliation(s)
| | - Ricci Harris
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Donna Cormack
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - James Stanley
- Dean's Department, University of Otago, Wellington, New Zealand
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195
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Jackson CL, Redline S, Emmons KM. Sleep as a potential fundamental contributor to disparities in cardiovascular health. Annu Rev Public Health 2016; 36:417-40. [PMID: 25785893 DOI: 10.1146/annurev-publhealth-031914-122838] [Citation(s) in RCA: 250] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Optimal sleep is integral to health but is commonly not obtained. Despite its wide-ranging public health impact, sleep health is considered only rarely by policy makers, employers, schools, and others whose policies and structures can adversely affect sleep. An inadequate duration of sleep and poor-quality sleep are prevalent in minority and low-income populations, and may be fundamental to racial and socioeconomic status inequities that contribute to a range of health conditions, including cardiovascular disease (CVD). This review examines the relationship between sleep and disparities in CVD. We describe the public health importance of sleep and the role of sleep duration, as well as the two most common disorders (sleep apnea and insomnia) as risk factors for a number of chronic diseases. We use a multilevel model focused on population health and health disparities, which is based on the notion that individual behaviors, such as sleep, are influenced by complex and dynamic interrelations among individuals and their physical and social environments. We also describe modifiable factors that contribute to insufficient sleep and circadian misalignment, propose potential interventions in various sectors (e.g., neighborhoods, schools, workplaces) that can address social structures that contribute to disparities, and recommend areas for future research. Integrating sleep into public health research will identify novel approaches for closing gaps in health disparities.
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Affiliation(s)
- Chandra L Jackson
- Clinical and Translational Science Center, Harvard Catalyst, Harvard Medical School, Boston, Massachusetts 02115;
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Jean-Louis G, Grandner MA, Youngstedt SD, Williams NJ, Zizi F, Sarpong DF, Ogedegbe GG. Differential increase in prevalence estimates of inadequate sleep among black and white Americans. BMC Public Health 2015; 15:1185. [PMID: 26611643 PMCID: PMC4661980 DOI: 10.1186/s12889-015-2500-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 11/17/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The National Health Interview Survey (NHIS) was used to ascertain whether increases in inadequate sleep differentially affected black and white Americans. We tested the hypothesis that prevalence estimates of inadequate sleep were consistently greater among blacks, and that temporal changes have affected these two strata differentially. METHODS NHIS is an ongoing cross-sectional study of non-institutionalized US adults (≥18 years) providing socio-demographic, health risk, and medical factors. Sleep duration was coded as very short sleep [VSS] (<5 h), short sleep [SS] (5-6 h), or long sleep [LS] (>8 h), referenced to 7-8 h sleepers. Analyses adjusted for NHIS' complex sampling design using SAS-callable SUDAAN. RESULTS Among whites, the prevalence of VSS increased by 53% (1.5% to 2.3%) from 1977 to 2009 and the prevalence of SS increased by 32% (19.3% to 25.4 %); prevalence of LS decreased by 30% (11.2% to 7.8%). Among blacks, the prevalence of VSS increased by 21% (3.3% to 4.0%) and the prevalence of SS increased by 37% (24.6 % to 33.7%); prevalence of LS decreased by 42% (16.1% to 9.4%). Adjusted multinomial regression analysis showed that odds of reporting inadequate sleep for whites were: VSS (OR = 1.40, 95% CI = 1.13-1.74, p < 0.001), SS (OR = 1.34, 95 % CI = 1.25-1.44, p < 0.001), and LS (OR = 0.94, 95% CI = 0.85-1.05, NS). For blacks, estimates were: VSS (OR = 0.83, 95% CI = 0.60-1.40, NS), SS (OR = 1.21, 95% CI = 1.05-1.50, p < 0.001), and LS (OR = 0.84, 95% CI = 0.64-1.08, NS). CONCLUSIONS Blacks and whites are characteristically different regarding the prevalence of inadequate sleep over the years. Temporal changes in estimates of inadequate sleep seem dependent upon individuals' race/ethnicity.
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Affiliation(s)
- Girardin Jean-Louis
- Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, 227 East 30th St, New York, NY, 10016, USA.
| | - Michael A Grandner
- Department of Psychiatry at the University of Arizona College of Medicine, 550 East Van Buren, Tucson, AZ, 85004, USA.
| | - Shawn D Youngstedt
- College of Nursing and Health Innovation, College of Health Solutions, Arizona State University, Phoenix, AZ, 85004, USA.
| | - Natasha J Williams
- Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, 227 East 30th St, New York, NY, 10016, USA.
| | - Ferdinand Zizi
- Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, 227 East 30th St, New York, NY, 10016, USA.
| | - Daniel F Sarpong
- Center for Minority Health & Health Disparities Research and Education, Xavier University of Louisiana, New Orleans, LA, USA.
| | - Gbenga G Ogedegbe
- Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, 227 East 30th St, New York, NY, 10016, USA.
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Hébert JR, Braun KL, Kaholokula JK, Armstead CA, Burch JB, Thompson B. Considering the Role of Stress in Populations of High-Risk, Underserved Community Networks Program Centers. Prog Community Health Partnersh 2015. [PMID: 26213406 DOI: 10.1353/cpr.2015.0028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cancer disparities are associated with a broad range of sociocultural determinants of health that operate in community contexts. High-risk populations may be more vulnerable to social and environmental factors that lead to chronic stress. Theoretical and empirical research indicates that exposure to contextual and sociocultural stress alters biological systems, thereby influencing cancer risk, progression, and, ultimately, mortality. OBJECTIVE We sought to describe contextual pathways through which stress likely increases cancer risk in high-risk, underserved populations. METHODS This review presents a description of the link between contextual stressors and disease risk disparities within underserved communities, with a focus on 1) stress as a proximal link between biological processes, such as cytokine responses, inflammation, and cancer and 2) stress as a distal link to cancer through biobehavioral risk factors such as poor diet, physical inactivity, circadian rhythm or sleep disruption, and substance abuse. These concepts are illustrated through application to populations served by three National Cancer Institute-funded Community Networks Program Centers (CNPCs): African Americans in the Deep South (the South Carolina Cancer Disparities Community Network [SCCDCN]), Native Hawaiians ('Imi Hale-Native Hawaiian Cancer Network), and Latinos in the Lower Yakima Valley of Washington State (The Center for Hispanic Health Promotion: Reducing Cancer Disparities). CONCLUSIONS Stress experienced by the underserved communities represented in the CNPCs is marked by social, biological, and behavioral pathways that increase cancer risk. A case is presented to increase research on sociocultural determinants of health, stress, and cancer risk among racial/ethnic minorities in underserved communities.
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Abstract
Race/ethnic and socioeconomic status (SES) disparities in obesity are substantial and may widen in the future. We review nine potential mechanisms that recent research has used to explain obesity disparities. Those nine mechanisms fall into three broad groups-health behaviors, biological factors, and the social environment-which incorporate both proximate and upstream determinants of obesity disparities. Efforts to reduce the prevalence of obesity in the US population and to close race/ethnic and SES disparities in obesity will likely require the use of multifaceted interventions that target multiple mechanisms simultaneously. Unfortunately, relatively few of the mechanisms reviewed herein have been tested in an intervention framework.
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Affiliation(s)
- Patrick M Krueger
- Department of Health and Behavioral Sciences, University of Colorado Denver | Anschutz Medical Campus, Administration Building, 1201 5th Street, Denver, CO, 80217, USA.
| | - Eric N Reither
- Department of Sociology and the Yun Kim Population Research Laboratory, Utah State University, 0730 Old Main Hill, Logan, UT, 84322, USA.
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199
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Sims M, Diez-Roux AV, Gebreab SY, Brenner A, Dubbert P, Wyatt S, Bruce M, Hickson D, Payne T, Taylor H. Perceived discrimination is associated with health behaviours among African-Americans in the Jackson Heart Study. J Epidemiol Community Health 2015; 70:187-94. [PMID: 26417003 DOI: 10.1136/jech-2015-206390] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 09/11/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND Using Jackson Heart Study data, we examined associations of multiple measures of perceived discrimination with health behaviours among African-Americans (AA). METHODS The cross-sectional associations of everyday, lifetime and burden of discrimination with odds of smoking and mean differences in physical activity, dietary fat and sleep were examined among 4925 participants aged 35-84 years after adjustment for age and socioeconomic status (SES). RESULTS Men reported slightly higher levels of everyday and lifetime discrimination than women and similar levels of burden of discrimination as women. After adjustment for age and SES, everyday discrimination was associated with more smoking and a greater percentage of dietary fat in men and women (OR for smoking: 1.13, 95% CI 1.00 to 1.28 and 1.19, 95% CI 1.05 to 1.34; mean difference in dietary fat: 0.37, p<0.05 and 0.43, p<0.01, in men and women, respectively). Everyday and lifetime discrimination were associated with fewer hours of sleep in men and women (mean difference for everyday discrimination: -0.08, p<0.05 and -0.18, p<0.001, respectively; and mean difference for lifetime discrimination: -0.08, p<0.05 and -0.24, p<0.001, respectively). Burden of discrimination was associated with more smoking and fewer hours of sleep in women only. CONCLUSIONS Higher levels of perceived discrimination were associated with select health behaviours among men and women. Health behaviours offer a potential mechanism through which perceived discrimination affects health in AA.
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Affiliation(s)
- Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Ana V Diez-Roux
- School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Samson Y Gebreab
- Metabolic, Cardiovascular and Inflammatory Disease Genomics Branch, National Human Genome Research Institute (NHGRI), Bethesda, Maryland, USA
| | - Allison Brenner
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Patricia Dubbert
- Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, North Little Rock, Arkansas, USA
| | - Sharon Wyatt
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Marino Bruce
- Department of Sociology and Criminology, Jackson State University, Jackson, Mississippi, USA
| | - DeMarc Hickson
- Center for Research, Evaluation and Environmental & Policy Change, My Brother's Keeper, Inc, Jackson, Mississippi, USA
| | - Tom Payne
- Department of Otolaryngology & Communicative Sciences, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Herman Taylor
- Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, Georgia, USA
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200
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Paradies Y, Ben J, Denson N, Elias A, Priest N, Pieterse A, Gupta A, Kelaher M, Gee G. Racism as a Determinant of Health: A Systematic Review and Meta-Analysis. PLoS One 2015; 10:e0138511. [PMID: 26398658 PMCID: PMC4580597 DOI: 10.1371/journal.pone.0138511] [Citation(s) in RCA: 1256] [Impact Index Per Article: 139.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 08/30/2015] [Indexed: 12/20/2022] Open
Abstract
Despite a growing body of epidemiological evidence in recent years documenting the health impacts of racism, the cumulative evidence base has yet to be synthesized in a comprehensive meta-analysis focused specifically on racism as a determinant of health. This meta-analysis reviewed the literature focusing on the relationship between reported racism and mental and physical health outcomes. Data from 293 studies reported in 333 articles published between 1983 and 2013, and conducted predominately in the U.S., were analysed using random effects models and mean weighted effect sizes. Racism was associated with poorer mental health (negative mental health: r = -.23, 95% CI [-.24,-.21], k = 227; positive mental health: r = -.13, 95% CI [-.16,-.10], k = 113), including depression, anxiety, psychological stress and various other outcomes. Racism was also associated with poorer general health (r = -.13 (95% CI [-.18,-.09], k = 30), and poorer physical health (r = -.09, 95% CI [-.12,-.06], k = 50). Moderation effects were found for some outcomes with regard to study and exposure characteristics. Effect sizes of racism on mental health were stronger in cross-sectional compared with longitudinal data and in non-representative samples compared with representative samples. Age, sex, birthplace and education level did not moderate the effects of racism on health. Ethnicity significantly moderated the effect of racism on negative mental health and physical health: the association between racism and negative mental health was significantly stronger for Asian American and Latino(a) American participants compared with African American participants, and the association between racism and physical health was significantly stronger for Latino(a) American participants compared with African American participants. Protocol PROSPERO registration number: CRD42013005464.
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Affiliation(s)
- Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalization, Faculty of Arts and Education, Deakin University, Melbourne, Victoria, Australia
| | - Jehonathan Ben
- Alfred Deakin Institute for Citizenship and Globalization, Faculty of Arts and Education, Deakin University, Melbourne, Victoria, Australia
| | - Nida Denson
- School of Social Sciences and Psychology, University of Western Sydney, Sydney, New South Wales, Australia
| | - Amanuel Elias
- Alfred Deakin Institute for Citizenship and Globalization, Faculty of Arts and Education, Deakin University, Melbourne, Victoria, Australia
| | - Naomi Priest
- Australian Centre for Applied Social Research Methods, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Alex Pieterse
- Division of Counseling Psychology, University at Albany, State University of New York, New York, New York, United States of America
| | - Arpana Gupta
- Oppenheimer Center for Neurobiology of Stress, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Margaret Kelaher
- Centre for Health Policy Programs and Economics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Gilbert Gee
- Department of Community Health Sciences, University of California, Los Angeles, Fielding School of Public Health, Los Angeles, California, United States of America
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