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Sabbath EL, Pan Y, McTernan ML, Peters SE, Lovett SM, Stelson EA, Wagner GR, Hopcia K, Boden LI. Adding injury to insult: Unfair treatment at work and occupational injury among hospital patient-care workers. Am J Ind Med 2024; 67:667-676. [PMID: 38738969 DOI: 10.1002/ajim.23616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/03/2024] [Accepted: 05/03/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND Hospital patient-care workers have high occupational injury rates. While physical hazards within hospital work environments are established determinants of injury, social exposures may also contribute. This study examined how reports of unfair treatment at work, a dimension of work-related experiences of discrimination, were associated with injury among hospital-based patient-care workers. METHODS We used data from the Boston Hospital Workers Health Study, a longitudinal cohort of nurses and nursing assistants at two Boston-area hospitals. In 2018, we conducted a worker survey asking about three types of unfair treatment at work and occupational injuries during the past year. We used mixed-effects logistic regression models to evaluate associations between specific types, total load, and high-frequency exposure of unfair treatment with injury, adjusting for age, gender, race and ethnicity, job title, and unit type. RESULTS Among 1001 respondents, 21% reported being humiliated in front of others at work, 28% reported being watched more closely than other workers, and 47% reported having to work twice as hard as others for the same treatment. For each type of unfair treatment, we observed a monotonic relationship with occupational injury wherein increasing frequency of exposure was associated with increased odds of injury. We also observed monotonic relationships between total load and high-frequency exposure to unfair treatment and odds of injury. CONCLUSIONS Work-related unfair treatment is associated with injury among hospital workers. Programs and policies that focus on preventing unfair treatment may lessen injury burden in hospital workers.
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Affiliation(s)
- Erika L Sabbath
- Boston College School of Social Work, Chestnut Hill, Massachusetts, USA
| | - Yixin Pan
- Academic Research Services, Boston College, Chestnut Hill, Massachusetts, USA
| | - Melissa L McTernan
- Academic Research Services, Boston College, Chestnut Hill, Massachusetts, USA
| | - Susan E Peters
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sharonda M Lovett
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Elisabeth A Stelson
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Gregory R Wagner
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Karen Hopcia
- Occupational Health Services, Mass General Brigham, Somerville, Massachusetts, USA
| | - Leslie I Boden
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
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Lin TW, Rospenda KM, Richman JA. Relationships between school harassment and problematic drinking in a college sample: Is need for approval a moderator? JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1534-1542. [PMID: 35737976 DOI: 10.1080/07448481.2022.2082846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 05/05/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
Objectives: Examines whether a personality characteristic, need for approval, moderates the relationship between harassment exposure and alcohol misuse over time in a college sample, and compare the results between genders. Participants: Six waves of data (fall 2011 to fall 2015) were collected from 1,240 study participants sampled from eight colleges and universities in the Midwestern United States. Methods: Two-level mixed modeling was conducted separately for exposure to sexual and generalized harassment and modeled separately for women and men. Results: In men only, need for approval significantly moderated the relationship between generalized harassment and binge drinking over time, where a higher need for approval put male students at increased risk. Conclusions: Harassment is a risk factor contributing to high levels of drinking among college students. School counseling centers and mental health professionals should take this factor into consideration, as well as individual personality characteristics when addressing student health and wellness.
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Affiliation(s)
- Tracy W Lin
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kathleen M Rospenda
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Judith A Richman
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois, USA
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Elbasheir A, Katrinli S, Kearney BE, Lanius RA, Harnett NG, Carter SE, Ely TD, Bradley B, Gillespie CF, Stevens JS, Lori A, van Rooij SJH, Powers A, Jovanovic T, Smith AK, Fani N. Racial Discrimination, Neural Connectivity, and Epigenetic Aging Among Black Women. JAMA Netw Open 2024; 7:e2416588. [PMID: 38869898 DOI: 10.1001/jamanetworkopen.2024.16588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
Importance Racial discrimination increases the risk of adverse brain health outcomes, potentially via neuroplastic changes in emotion processing networks. The involvement of deep brain regions (brainstem and midbrain) in these responses is unknown. Potential associations of racial discrimination with alterations in deep brain functional connectivity and accelerated epigenetic aging, a process that substantially increases vulnerability to health problems, are also unknown. Objective To examine associations of racial discrimination with brainstem and midbrain resting-state functional connectivity (RSFC) and DNA methylation age acceleration (DMAA) among Black women in the US. Design, Setting, and Participants This cohort study was conducted between January 1, 2012, and February 28, 2015, and included a community-based sample of Black women (aged ≥18 years) recruited as part of the Grady Trauma Project. Self-reported racial discrimination was examined in association with seed-to-voxel brain connectivity, including the locus coeruleus (LC), periaqueductal gray (PAG), and superior colliculus (SC); an index of DMAA (Horvath clock) was also evaluated. Posttraumatic stress disorder (PTSD), trauma exposure, and age were used as covariates in statistical models to isolate racial discrimination-related variance. Data analysis was conducted between January 10 and October 30, 2023. Exposure Varying levels of racial discrimination exposure, other trauma exposure, and posttraumatic stress disorder (PTSD). Main Outcomes and Measures Racial discrimination frequency was assessed with the Experiences of Discrimination Scale, other trauma exposure was evaluated with the Traumatic Events Inventory, and current PTSD was evaluated with the PTSD Symptom Scale. Seed-to-voxel functional connectivity analyses were conducted with LC, PAG, and SC seeds. To assess DMAA, the Methylation EPIC BeadChip assay (Illumina) was conducted with whole-blood samples from a subset of 49 participants. Results This study included 90 Black women, with a mean (SD) age of 38.5 (11.3) years. Greater racial discrimination was associated with greater left LC RSFC to the bilateral precuneus (a region within the default mode network implicated in rumination and reliving of past events; cluster size k = 228; t85 = 4.78; P < .001, false discovery rate-corrected). Significant indirect effects were observed for the left LC-precuneus RSFC on the association between racial discrimination and DMAA (β [SE] = 0.45 [0.16]; 95% CI, 0.12-0.77). Conclusions and Relevance In this study, more frequent racial discrimination was associated with proportionately greater RSFC of the LC to the precuneus, and these connectivity alterations were associated with DMAA. These findings suggest that racial discrimination contributes to accelerated biological aging via altered connectivity between the LC and default mode network, increasing vulnerability for brain health problems.
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Affiliation(s)
- Aziz Elbasheir
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Seyma Katrinli
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Breanne E Kearney
- Department of Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Ruth A Lanius
- Department of Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Nathaniel G Harnett
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | | | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
- Atlanta Veterans Affairs Medical Center, Atlanta, Georgia
| | - Charles F Gillespie
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Adriana Lori
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan
| | - Alicia K Smith
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
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Sheikhattari P, Barsha RAA, Apata J, Assari S. Race by Education Intersectional Differences in Exposure to Tobacco Advertisement in Baltimore City. JOURNAL OF LUNG HEALTH AND DISEASES 2023; 7:9-17. [PMID: 38264144 PMCID: PMC10805540 DOI: 10.29245/2689-999x/2023/2.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Objective This study aimed to examine the intersectional effects of race and educational attainment on tobacco advertising exposure among adults in Baltimore, given the growing evidence on differential influence of education for Black and White populations. Methods A survey was conducted in Baltimore, collecting data on educational attainment, demographics, and tobacco advertising exposure among adults (n = 3028, 22.7% 18 - 29, 17.9% 30 - 39, 23.4% 40 - 49, 20.9% 50-59, and 11.1% 60+ years old). The sample included both Black and White adult individuals. Logistic regression analyses were employed to assess the association between educational attainment and tobacco advertising exposure, without and with interaction with race, adjusting for relevant covariates such as age, gender, and employment. Sensitivity analysis also controlled for smoking status. Results The study results indicated that while high educational attainment is associated with less exposure to tobacco ads, highly educated Black adults report significantly higher tobacco advertising exposure compared to highly educated White adults. Same results were observed after controlling for smoking status. Conclusion Educational attainment may not exhibit a large protective effect against environmental risks such as tobacco ad exposure for Black populations, possibly because of segregation and racism that hinder highly educated Black people ability to move to low-risk neighborhoods.
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Affiliation(s)
- Payam Sheikhattari
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD, USA
- The Prevention Sciences Research Center, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA
| | - Rifath Ara Alam Barsha
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD, USA
| | - Jummai Apata
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD, USA
| | - Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
- Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
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Hale JW, Pacheco JA, Lewis CS, Swimmer L, Daley SM, Nazir N, Daley CM, Choi WS. Everyday discrimination for American Indian tribal college students enrolled in the Internet All Nations Breath of Life program. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2679-2685. [PMID: 34871137 PMCID: PMC9167892 DOI: 10.1080/07448481.2021.1987246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/06/2021] [Accepted: 09/26/2021] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Identify factors associated with perceived discrimination, including depression, body image satisfaction, body mass index (BMI), social support, stress, and self-reported social status. PARTICIPANTS A total of 249 American Indian tribal college students. METHODS Students were recruited for an Internet-based smoking cessation program. A total of 249 students answered the Everyday Discrimination Scale questions to assess perceived discrimination. We conducted bivariate analyses to determine potential significant associations between perceived discrimination and health outcomes at baseline. RESULTS We found 63% of the sample reported racial discrimination. Among those who reported moderate/severe depression, 87% reported discrimination. Among those who were not satisfied with their body image, 70% reported racial discrimination. CONCLUSION Reports of racial discrimination are highly prevalent among our participants. We found reports of discrimination are significantly associated with depression and dissatisfaction with body image. Our study highlights a high priority population that perceives racial discrimination, potentially increasing their risk for adverse health outcomes.
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Affiliation(s)
- Jason W Hale
- American Indian Health Research & Education Alliance, Inc., Institute for Indigenous Studies, College of Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Joseph A Pacheco
- American Indian Health Research & Education Alliance, Inc., Institute for Indigenous Studies, College of Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Charley S Lewis
- American Indian Health Research & Education Alliance, Inc., Institute for Indigenous Studies, College of Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Luke Swimmer
- American Indian Health Research & Education Alliance, Inc., Institute for Indigenous Studies, College of Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Sean M Daley
- American Indian Health Research & Education Alliance, Inc., Institute for Indigenous Studies, College of Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Niaman Nazir
- American Indian Health Research & Education Alliance, Inc., Center for American Indian Community Health, Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Christine M Daley
- American Indian Health Research & Education Alliance, Inc., Institute for Indigenous Studies, College of Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Won S Choi
- American Indian Health Research & Education Alliance, Inc., Center for American Indian Community Health, Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas, USA
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Daniel S, McKeever B, Breslin R, Clare R, Klahr A, Brown SEV. Diversity, equity, and inclusion correlates of racial/ethnic harassment and discrimination in the U.S. military. MILITARY PSYCHOLOGY 2023; 35:552-565. [PMID: 37903170 PMCID: PMC10617373 DOI: 10.1080/08995605.2022.2139122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/13/2022] [Indexed: 11/13/2022]
Abstract
As one of the most racially/ethnically diverse workplaces in the United States, the Department of Defense (DoD) has been on the forefront in driving diversity initiatives. Yet, racial/ethnic harassment and discrimination (REHD) in the military persist and threaten mission readiness. Despite this, limited research exists identifying factors that influence REHD in the U.S. military that could be leveraged for prevention and intervention. In this study, we sought to identify how diversity, equity, and inclusion (DEI) factors in the workplace are associated with REHD in order to identify potential targets for prevention and policy efforts to improve racial/ethnic relations in the U.S. military. Using the 2017 Workplace and Equal Opportunity Survey of Active Duty Members, we found military, leadership, and unit DEI climate factors were the top predictors of REHD, though the relative importance of each predictor varied by racial/ethnic minority status. In particular, we found military and leadership attention to REHD to be the top predictors for Racial/Ethnic Minority active duty members whereas workplace hostility was the top predictor for non-Hispanic White active duty members. Implications for programs and policies surrounding REHD in the U.S. military are discussed.
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Affiliation(s)
- Samantha Daniel
- Health & Resilience Research, DoD Office of People Analytics, Alexandria, Virginia
| | - Brice McKeever
- Military Analytics Research, Fors Marsh Group, Arlington, Virginia
| | - Rachel Breslin
- Health & Resilience Research, DoD Office of People Analytics, Alexandria, Virginia
| | - Rachel Clare
- Health & Resilience Research, DoD Office of People Analytics, Alexandria, Virginia
| | - Ashlea Klahr
- Health & Resilience Research, DoD Office of People Analytics, Alexandria, Virginia
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Maglalang DD, Avila JC, Ahluwalia JS, Murphy CM, Alexander AC, Nollen NL. The Role of Financial Strain and Educational Attainment on Smoking Abstinence of African Americans and Whites Who Smoke. Ethn Dis 2022; 32:223-230. [PMID: 35909641 PMCID: PMC9311309 DOI: 10.18865/ed.32.3.223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Objective To examine if reduced financial strain and higher educational attainment would confer less advantage for successful cessation among African Americans than for White individuals. Design A secondary data analysis of the Quit2Live study, a smoking cessation intervention for individuals who smoke. Setting Recruited participants from a metropolitan city in the Midwest. Participants The sample included 224 African American and 225 White individuals who smoke. Main Outcome Measures Our outcome variable was cotinine-verified smoking abstinence at the end-of-treatment (week 12). Our explanatory variables were a combination of financial strain (high, low) and educational attainment (high, low). Methods We implemented a logistic regression analysis and a two-way interaction of the combined financial strain and educational attainment variable and race on smoking abstinence. Results About 25% of the study participants were low financial strain and high education, 41% high financial strain and high education, 23% high financial strain and low education, and 11% low financial strain and low education. A greater proportion of African Americans vs Whites were in the high financial strain/low educational attainment category (28% vs 18%, P = .01). Participants with high financial strain and low educational attainment had substantially lower odds of abstinence (OR = .29 [95% CI: .12, .68]) compared to participants with low financial strain and high educational attainment. Contrary to our hypothesis, race did not moderate this association. Conclusion Findings highlight the constraining role of high financial strain and low educational attainment, irrespective of race, on smoking abstinence among smokers actively engaged in a quit attempt.
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Affiliation(s)
- Dale Dagar Maglalang
- Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence RI, Address correspondence to Dale Dagar Maglalang, PhD, MA, MSW; Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI.
| | - Jaqueline C. Avila
- Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence RI
| | - Jasjit S. Ahluwalia
- Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence RI,Department of Medicine, Alpert Medical School, Brown University; Legoretta Cancer Center, Brown University, Providence RI
| | - Cara M. Murphy
- Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence RI
| | - Adam C. Alexander
- Department of Family and Preventive Medicine, The University of Oklahoma Physicians Family Medicine Center; TSET Health Promotion Research Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Nicole L. Nollen
- Department of Population Health, University of Kansas School of Medicine; University of Kansas Cancer Center, Kansas City, KS
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Gullett LR, Alhasan DM, Jackson WB, Jackson CL. Employment Industry and Occupational Class in Relation to Serious Psychological Distress in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8376. [PMID: 35886224 PMCID: PMC9320061 DOI: 10.3390/ijerph19148376] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 12/10/2022]
Abstract
Occupational characteristics may influence serious psychological distress (SPD) and contribute to health inequities; yet, few studies have examined multiple employment industries and occupational classes in a large, racially diverse sample of the United States. Using data from the National Health Interview Survey, we investigated employment industry and occupational class in relation to SPD in the overall population and by race/ethnicity, gender, age, household income, and health status. We created eight employment industry categories: professional/administrative/management, agricultural/manufacturing/construction, retail trade, finance/information/real estate, educational services, health care/social assistance, accommodation/food services, and public administration/arts/other services. We also created three occupational class categories: professional/management, support services, and laborers. SPD was measured using the Kessler Psychological Distress Scale and scores ≥13 indicated SPD. We adjusted for confounders and used Poisson regression to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). Among the 245,038 participants, the mean age was 41.7 ± 0.1 years, 73% were Non-Hispanic (NH)-White, and 1.5% were categorized as having SPD. Compared to the professional/administrative/management industry, working in other industries (e.g., manufacturing/construction (PR = 0.82 [95% CI: 0.70-0.95]) and educational services (PR = 0.79 [95% CI: 0.66-0.94])) was associated with lower SPD. Working in support services and laborer versus professional/management positions were both associated with 19% higher prevalence of SPD (95% CI: 1.04-1.35; 95% CI: 1.04-1.38, respectively). Furthermore, working in a support services or laborer versus professional/management position was associated with higher SPD in most employment industries. Industry-specific workplace interventions to equitably improve mental health are warranted.
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Affiliation(s)
- Lauren R. Gullett
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, NC 27709, USA; (L.R.G.); (D.M.A.)
| | - Dana M. Alhasan
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, NC 27709, USA; (L.R.G.); (D.M.A.)
| | - W. Braxton Jackson
- Social & Scientific Systems, Inc., A DLH Holdings Company, Durham, NC 27703, USA;
| | - Chandra L. Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, NC 27709, USA; (L.R.G.); (D.M.A.)
- Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA
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9
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Areguin MA, Stewart AJ. Latina farmworkers' experiences: Maintaining dignity in an oppressive workplace. GENDER WORK AND ORGANIZATION 2022. [DOI: 10.1111/gwao.12788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Maira A. Areguin
- Departments of Women's and Gender Studies and Psychology University of Michigan Ann Arbor Michigan USA
| | - Abigail J. Stewart
- Departments of Women's and Gender Studies and Psychology University of Michigan Ann Arbor Michigan USA
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Thomas-Hawkins C, Flynn L, Zha P, Ando S. The effects of race and workplace racism on nurses' intent to leave the job: The mediating roles of job dissatisfaction and emotional distress. Nurs Outlook 2022; 70:590-600. [PMID: 35523600 DOI: 10.1016/j.outlook.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/01/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is scant evidence of quantifiable effects of workplace racism on nurses' job-related outcomes. PURPOSE The study aimed to examine associations among race, workplace racism, emotional distress, job dissatisfaction, and intent to leave among hospital-based nurses. METHODS This study used a correlational design with six measures in a statewide sample of 788 hospital-based nurses. FINDINGS Non-White nurses intended to leave the job at a higher rate than White nurses. Non-White nurses reported negative racial climates, multiple racial microaggression experiences, and high job dissatisfaction and emotional distress. Non-white race and workplace racism had significant individual effects on intent to leave. Job dissatisfaction and emotional distress significantly mediated indirect effects of non-White race, negative racial climates, and racial microaggressions on nurses' intent to leave. DISCUSSION In efforts to retain nurses of color in hospitals, there is an urgent need to mitigate workplace racism in these settings.
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Affiliation(s)
| | - Linda Flynn
- Division of Nursing Science, Rutgers University School of Nursing, Newark, NJ
| | - Peijia Zha
- Division of Nursing Science, Rutgers University School of Nursing, Newark, NJ
| | - Sakura Ando
- Rutgers University School of Nursing, Newark, NJ
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11
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Kearney MD, Barg FK, Alexis D, Higginbotham E, Aysola J. Employee Health and Wellness Outcomes Associated With Perceived Discrimination in Academic Medicine: A Qualitative Analysis. JAMA Netw Open 2022; 5:e2145243. [PMID: 35089355 PMCID: PMC8800072 DOI: 10.1001/jamanetworkopen.2021.45243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IMPORTANCE Organizational culture and workplace interactions may enhance or adversely impact the wellness of all members of learning and work environments, yet a nuanced understanding of how such experiences within health care organizations impact the health and wellness of their membership is lacking. OBJECTIVE To identify and characterize the reported health and wellness outcomes associated with perceived discrimination among academic medicine faculty, staff, and students. DESIGN, SETTING, AND PARTICIPANTS This qualitative study analyzed anonymously submitted written narratives from 2016 that described experiences related to inclusion in the workplace or lack thereof. Narratives that described health outcomes associated with work- or school-based discrimination were purposively sampled. Participants were faculty, staff, and students at health-related schools or hospitals affiliated with the University of Pennsylvania. Data analysis was performed from March 2019 to January 2020. EXPOSURES Self-reported experiences, both witnessed and personal, of discrimination in the workplace. RESULTS A total of 315 narratives were collected, and 115 narratives from 115 participants were analyzed. Most respondents identified as female (70 respondents [60.9%]), non-Hispanic White (68 respondents [59.1%]), and heterosexual (89 respondents [77.4%]) and had worked at the institution for at least 1 year (99 respondents [86.0%]). The outcomes associated with adverse workplace experiences were broad and ranged in nature from emotional to mental and physical. Most reported outcomes were emotional (101 respondents [87.8%]), and more than 1 in 10 narratives (14 respondents [12.2%]) described a mental or physical health outcome. Many of the participants felt devaluated, overexerted, and hopeless, resulting in clinically relevant manifestations, such as increased stress and anxiety levels and even elevated blood pressure. CONCLUSIONS AND RELEVANCE This qualitative study identified a continuum of negative outcomes on employee health and well-being associated with perceived discrimination and chronic exclusion in the workplace. These findings suggest the need for organizations to promote inclusion as a component of workplace wellness interventions.
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Affiliation(s)
- Matthew D. Kearney
- Department of Family Medicine and Community Health and Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Center for Health Equity Advancement, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Frances K. Barg
- Department of Family Medicine and Community Health and Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Dominique Alexis
- Office of Inclusion and Diversity, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Eve Higginbotham
- Office of Inclusion and Diversity, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
| | - Jaya Aysola
- Office of Inclusion and Diversity, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
- Penn Medicine Center for Health Advancement, Perelman School of Medicine, University of Pennsylvania, Philadelphia
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12
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Bloom EL, Bogart A, Dubowitz T, Collins RL, Ghosh-Dastidar B, Gary-Webb TL, Troxel W. Longitudinal Associations Between Changes in Cigarette Smoking and Alcohol Use, Eating Behavior, Perceived Stress, and Self-Rated Health in a Cohort of Low-Income Black Adults. Ann Behav Med 2022; 56:112-124. [PMID: 33970236 PMCID: PMC8691395 DOI: 10.1093/abm/kaab029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Black adults in the U.S. experience significant health disparities related to tobacco use and obesity. Conducting observational studies of the associations between smoking and other health behaviors and indicators among Black adults may contribute to the development of tailored interventions. PURPOSE We examined associations between change in cigarette smoking and alcohol use, body mass index, eating behavior, perceived stress, and self-rated health in a cohort of Black adults who resided in low-income urban neighborhoods and participated in an ongoing longitudinal study. METHODS Interviews were conducted in 2011, 2014, and 2018; participants (N = 904) provided at least two waves of data. We fit linear and logistic mixed-effects models to evaluate how changes in smoking status from the previous wave to the subsequent wave were related to each outcome at that subsequent wave. RESULTS Compared to repeated smoking (smoking at previous and subsequent wave), repeated nonsmoking (nonsmoking at previous and subsequent wave) was associated with greater likelihood of recent dieting (OR = 1.59, 95% CI [1.13, 2.23], p = .007) and future intention (OR = 2.19, 95% CI [1.61, 2.98], p < .001) and self-efficacy (OR = 1.64, 95% CI [1.21, 2.23], p = .002) to eat low calorie foods, and greater odds of excellent or very good self-rated health (OR = 2.47, 95% CI [1.53, 3.99], p < .001). Transitioning from smoking to nonsmoking was associated with greater self-efficacy to eat low calorie foods (OR = 1.89, 95% CI [1.1, 3.26], p = .021), and lower perceived stress (β = -0.69, 95% CI [-1.34, -0.05], p = .036). CONCLUSIONS We found significant longitudinal associations between smoking behavior and eating behavior, perceived stress, and self-rated health. These findings have implications for the development of multiple behavior change programs and community-level interventions and policies.
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Affiliation(s)
| | | | | | | | | | - Tiffany L Gary-Webb
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
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13
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Acculturation and Depressive Symptoms Among Dominicans in New York City. J Immigr Minor Health 2021; 24:1186-1195. [PMID: 34822049 DOI: 10.1007/s10903-021-01316-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 01/09/2023]
Abstract
Little is known about the association between acculturation and mental health among Dominican populations in the United States. Data came from a community survey of Dominican residents of New York City (n = 2744). Associations between two indicators of acculturation, proportion of life spent in the U.S. and interview language (English/Spanish), with lifetime depressive symptoms (Patient Health Questionnaire-9 score ≥ 5) were examined using logistic regression overall and by gender. In adjusted models, respondents with English-language interview and above-median proportion of life spent in the U.S. had 77% higher odds (95% CI 1.28, 2.44) of lifetime depressive symptoms than those with Spanish-language interview and below-median proportion of life spent in the U.S. There was some evidence of elevated odds of depressive symptoms among men with English-language interview and below-median proportion of life spent in the U.S. Additional research is needed to elucidate gender-specific impacts of acculturation on mental health in this population.
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14
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Brown P, Watts V, Hanna M, Rizk M, Tucker E, Saddlemire A, Peteet B. Two Epidemics and a Pandemic: The Collision of Prescription Drug Misuse and Racism during COVID-19. J Psychoactive Drugs 2021; 53:413-421. [PMID: 34694200 DOI: 10.1080/02791072.2021.1992048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The present study investigated the relationship between perceived racial discrimination and prescription drug misuse (PDM) among Asian, Black, and Latinx Americans during the COVID-19 crisis. U.S. racial/ethnic minorities may have been uniquely affected by two national and one global pandemic: the opioid crisis, racism, and COVID-19. Opioid death rates increased among many groups prior to the pandemic. This country witnessed an increase in racialized acts against people of color across the spectrum in the spring and summer months of the world's COVID-19 outbreak. While studies have shown a clear link between perceived racial discrimination and substance abuse outside of the global pandemic, no identified studies have done so against the backdrop of a global health pandemic. Separate hierarchical regressions revealed a significant association between perceived racial discrimination and PDM for Black Americans, Asian Americans, and Latinx individuals. Findings build on the scant literature on PDM in diverse samples and establish a relationship between perceived racial discrimination and PDM, as previously identified for other abused substances. Future post-pandemic substance misuse interventions should consider the influence of perceived racial discrimination as they help individuals recover from the aftermath of this stressful trifecta.
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Affiliation(s)
- P Brown
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - V Watts
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - M Hanna
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - M Rizk
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - E Tucker
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - A Saddlemire
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - B Peteet
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
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15
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Kronenfeld JP, Goel N. An Analysis of Individual and Contextual-Level Disparities in Screening, Treatment, and Outcomes for Hepatocellular Carcinoma. J Hepatocell Carcinoma 2021; 8:1209-1219. [PMID: 34611524 PMCID: PMC8487287 DOI: 10.2147/jhc.s284430] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/02/2021] [Indexed: 12/11/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and affects patients of all genders, races, ethnicities, and socioeconomic status. While the causes of HCC are numerous, the primary etiology is cirrhosis from alcohol and non-alcoholic fatty liver disease in the United States and from infectious agents such as Hepatitis B and Hepatitis C in the developing world. In patients at-risk for developing HCC, screening is recommended with ultrasound imaging and alpha fetoprotein laboratory tests. In socioeconomically vulnerable patients, however, individual-level barriers (eg, insurance status) and contextual-level disparities (eg, health facilities) may not be readily available, thus limiting screening. Additional challenges faced by racial/ethnic minorities can further challenge the spectrum of HCC care and lead to inadequate screening, delayed diagnosis, and unequal access to treatment. Efforts to improve these multilevel factors that lead to screening and treatment disparities are critical to overcoming challenges. Providing health insurance to those without access, improving societal challenges that confine patients to a lower socioeconomic status, and reducing challenges to seeking healthcare can decrease the morbidity and mortality of these patients. Additionally, engaging with communities and allowing them to collaborate in their own healthcare can also help to attenuate these inequities. Through collaborative multidisciplinary change, we can make progress in tackling disparities in vulnerable populations to achieve health equity
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Affiliation(s)
- Joshua P Kronenfeld
- Division of Surgical Oncology, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Neha Goel
- Division of Surgical Oncology, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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16
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Kcomt L, Evans-Polce RJ, Engstrom CW, West BT, Boyd CJ, McCabe SE. Moderate-to-Severe Tobacco Use Disorder and Discrimination among U.S. Sexual Minority Older Adults. J Gerontol B Psychol Sci Soc Sci 2021; 76:1400-1407. [PMID: 33864063 DOI: 10.1093/geronb/gbab067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The dearth of research on age-related differences in risk factors for tobacco use disorder (TUD) among sexual minorities, particularly among older adults, can obscure the differential needs of sexual minority age groups for tobacco prevention and cessation. We examined the association of cumulative ethnic/racial discrimination and sexual orientation discrimination with moderate-to-severe TUD among U.S. sexual minority adults aged 50 years and older. METHODS We analyzed cross-sectional data from the National Epidemiologic Survey of Alcohol and Related Conditions-III (NESARC-III, n=36,309 U.S. adults). Our sample consisted of 1,258 adults (lesbian/gay, bisexual, and heterosexual-identified adults with same-sex attraction/behavior) aged ≥50 years. Multivariable logistic regression analyses estimated the association of cumulative lifetime ethnic/racial discrimination and sexual orientation discrimination with past-year moderate-to-severe TUD and tested whether the association differed for adults aged 50-64 years versus those aged ≥65 years. RESULTS An estimated 8.1% of the sample met criteria for moderate-to-severe TUD. Lifetime ethnic/racial discrimination and sexual orientation discrimination was not significantly associated with moderate-to-severe TUD for adults aged ≥50 years. However, a significant 2-way interaction was found between discrimination and age. In age-stratified analyses, greater discrimination was significantly associated with greater risk for moderate-to-severe TUD for adults aged ≥65 years, but not adults aged 50-64 years. DISCUSSION Greater cumulative discrimination based on ethnicity/race and sexual orientation was associated with increased risk for moderate-to-severe TUD among sexual minority adults aged ≥65 years. Our findings underscore the importance of age considerations in understanding the role of discrimination in the assessment and treatment of TUD.
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Affiliation(s)
- Luisa Kcomt
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI
| | - Rebecca J Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI
| | | | - Brady T West
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI.,Institute for Social Research, University of Michigan, Ann Arbor, MI.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI
| | - Carol J Boyd
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI.,Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI.,Addiction Center, Department of Psychiatry, Rachel Upjohn Building, University of Michigan, Ann Arbor, MI
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI.,Institute for Social Research, University of Michigan, Ann Arbor, MI.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI.,Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI.,Rogel Cancer Center, University of Michigan, Ann Arbor, MI.,Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI
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17
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Kronenfeld JP, Graves KD, Penedo FJ, Yanez B. Overcoming Disparities in Cancer: A Need for Meaningful Reform for Hispanic and Latino Cancer Survivors. Oncologist 2021; 26:443-452. [PMID: 33594785 DOI: 10.1002/onco.13729] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/29/2020] [Indexed: 12/12/2022] Open
Abstract
Hispanic and Latino (HL) cancer survivors are at a critical disadvantage compared with non-Hispanic White (NHW) patients regarding sociodemographic adversities and access to equitable treatment options. By 2030, there will be about four million HL cancer survivors in the U.S., representing nearly 20% of survivors in this country. Hispanics and Latinos are subjected to significant challenges in accessing and receiving equitable care relative to NHWs. Hispanics and Latinos also experience lower rates of health insurance and financial resources, limiting health care options. These disparities often originate from disparate social determinants of health, including lower funding for education and school programs, greater neighborhood stressors and violence, lower access to healthy and affordable food, and greater barriers to community health and exercise opportunities. Even among HL cancer survivors with proper access to health care, they experience disparate treatment options, including low inclusion in clinical trials and/or access to experimental therapies. A solution to these barriers necessitates complex and systemic changes that involve, for example, investing in public health programs, increasing the diversity and cultural awareness of the medical workforce, and promoting research opportunities such as clinical trials that are inclusive of HLs. Only through meaningful reform will equitable cancer care be available for all in the U.S. regardless of racial and/or ethnic background. This article reviews some of the critical social determinants of health and biases relevant to HL cancer survivors and provides recommendations for achieving cancer health equity. IMPLICATIONS FOR PRACTICE: Hispanics and Latinos experience a significant and often disproportionate cancer-related burden compared with non-Hispanic and Latino White individuals and other racial and ethnic groups. Meaningful reform to achieve health equity in oncology should focus on approaches to gaining trust among diverse patients, cultural and community sensitivity and engagement in oncology care and research, diversifying the workforce, and improving inclusion in clinical trial participation. Taken together, these recommendations can lead to exemplary and equitable care for all patients.
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Affiliation(s)
- Joshua P Kronenfeld
- University of Miami Miller School of Medicine & Sylvester Comprehensive Cancer Center, Miami, Florida, USA
| | - Kristi D Graves
- Georgetown University Lombardi Comprehensive Cancer Center, Washington, District of Columbia, USA
| | - Frank J Penedo
- University of Miami Miller School of Medicine & Sylvester Comprehensive Cancer Center, Miami, Florida, USA
| | - Betina Yanez
- Northwestern University Feinberg School of Medicine and Lurie Comprehensive Cancer Center, Chicago, Illinois, USA
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18
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Kronenfeld JP, Graves KD, Penedo FJ, Yanez B. Overcoming Disparities in Cancer: A Need for Meaningful Reform for Hispanic and Latino Cancer Survivors. Oncologist 2021. [PMID: 33594785 DOI: 10.1002/onco.13729.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Hispanic and Latino (HL) cancer survivors are at a critical disadvantage compared with non-Hispanic White (NHW) patients regarding sociodemographic adversities and access to equitable treatment options. By 2030, there will be about four million HL cancer survivors in the U.S., representing nearly 20% of survivors in this country. Hispanics and Latinos are subjected to significant challenges in accessing and receiving equitable care relative to NHWs. Hispanics and Latinos also experience lower rates of health insurance and financial resources, limiting health care options. These disparities often originate from disparate social determinants of health, including lower funding for education and school programs, greater neighborhood stressors and violence, lower access to healthy and affordable food, and greater barriers to community health and exercise opportunities. Even among HL cancer survivors with proper access to health care, they experience disparate treatment options, including low inclusion in clinical trials and/or access to experimental therapies. A solution to these barriers necessitates complex and systemic changes that involve, for example, investing in public health programs, increasing the diversity and cultural awareness of the medical workforce, and promoting research opportunities such as clinical trials that are inclusive of HLs. Only through meaningful reform will equitable cancer care be available for all in the U.S. regardless of racial and/or ethnic background. This article reviews some of the critical social determinants of health and biases relevant to HL cancer survivors and provides recommendations for achieving cancer health equity. IMPLICATIONS FOR PRACTICE: Hispanics and Latinos experience a significant and often disproportionate cancer-related burden compared with non-Hispanic and Latino White individuals and other racial and ethnic groups. Meaningful reform to achieve health equity in oncology should focus on approaches to gaining trust among diverse patients, cultural and community sensitivity and engagement in oncology care and research, diversifying the workforce, and improving inclusion in clinical trial participation. Taken together, these recommendations can lead to exemplary and equitable care for all patients.
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Affiliation(s)
- Joshua P Kronenfeld
- University of Miami Miller School of Medicine & Sylvester Comprehensive Cancer Center, Miami, Florida, USA
| | - Kristi D Graves
- Georgetown University Lombardi Comprehensive Cancer Center, Washington, District of Columbia, USA
| | - Frank J Penedo
- University of Miami Miller School of Medicine & Sylvester Comprehensive Cancer Center, Miami, Florida, USA
| | - Betina Yanez
- Northwestern University Feinberg School of Medicine and Lurie Comprehensive Cancer Center, Chicago, Illinois, USA
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19
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Lopez-Vergara HI, Rosales R, Scheuermann TS, Nollen NL, Leventhal AM, Ahluwalia JS. Social determinants of alcohol and cigarette use by race/ethnicity: Can we ignore measurement issues? Psychol Assess 2020; 32:1075-1086. [PMID: 32924524 DOI: 10.1037/pas0000948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Psychometric critiques of cross-cultural research emphasize testing whether instruments measure the same construct across cultural groups. We tested for measurement invariance (by race/ethnicity) of instruments used to evaluate the relationship between alcohol and tobacco use with perceived discrimination and socioeconomic status (SES). Tests of psychometric equivalence across race/ethnicity focused on: the latent organization of constructs (configural invariance); if observed indicators have equal factor loadings or "true score" variance (metric invariance); and whether manifest indicators change uniformly contingent on change in the latent variable (scalar invariance). A cross-sectional survey of 2,376 cigarette smokers (794 Black, 786 Latinx, 796 White; mean age = 43 [SD = 12]; 58% female) was recruited via an online research panel. Discrimination was indicated by self-report; SES was indicated by self-reported education, employment, income, and the "SES Ladder;" alcohol use was indicated by frequency and typical quantity of drinking, and frequency of heavy drinking; tobacco use was indicated by frequency of smoking, cigarettes per smoking day, and time to first cigarette. All instruments demonstrated configural invariance; either full metric invariance (alcohol and discrimination) or partial metric invariance (tobacco and SES); and all constructs demonstrated partial scalar invariance. Results support psychometric critiques; for example, all of the SES indicators violated assumptions of classical measurement theory for valid between group comparisons. All of our instruments displayed some degree of systematic bias in measurement across race/ethnicity. Studies testing ethnic/racial differences may need to move beyond classical measurement theory, and may benefit from using statistical approaches that can test for (and model) bias in measurement. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | - Robert Rosales
- Center for Alcohol and Addiction Studies, Brown University
| | | | - Nikki L Nollen
- Department of Population Health, University of Kansas Medical School
| | - Adam M Leventhal
- Department of Preventive Medicine, University of Southern California
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20
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Lin H, Chang C, Liu Z. Alcohol drinking as a mediator of the influence of smoking prevalence on second-hand smoke exposure in workplaces: a mediation analysis. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:67. [PMID: 32883304 PMCID: PMC7469319 DOI: 10.1186/s13011-020-00307-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/19/2020] [Indexed: 11/16/2022]
Abstract
Objective Both alcohol drinking and second-hand smoke (SHS) exposure have shown a strong association with smoking behaviour. This study uses mediation analysis to clarify the process underlying the relationship between smoking prevalence and SHS exposure and the extent to which this relationship is mediated by alcohol use in the workplace. Method A total of 14,195 employees from 81 companies in China participated in this survey. Mediation analysis was used to establish the mediation effect of alcohol drinking. Structural equation modelling (SEM) was used to evaluate the role of alcohol drinking when a smoke-free (SF) workplace policy was imposed. Results For males, approximately 6.3% of the effects on SHS exposure were mediated through the channel of alcohol use. For females, this channel mediated 14.1% of the total effects. SF policy was negatively associated with smoking prevalence and SHS exposure. The indirect effect of the SF policy on reducing SHS exposure by controlling smoking behaviour was significant. For smokers, worksite smoking bans were negatively associated with the smoking amount and drinking behaviour, and the indirect effect of this policy on promoting smokers’ intention to quit by reducing the smoking amount and controlling drinking behaviour was significant. Conclusion This study confirmed that alcohol drinking is among the channels that mediate the association between smoking prevalence and SHS exposure in workplaces. Our results also find a spillover effect of SF workplace policy and call for effective interventions for alcohol use, which may influence the outcomes of SF policy implementation.
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Affiliation(s)
- Haoxiang Lin
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Postal address: 38. Xueyuan Rd, Haidian District, Beijing, China
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Postal address: 38. Xueyuan Rd, Haidian District, Beijing, China.
| | - Zhao Liu
- Tobacco Medicine and Tobacco Cessation Center, China-Japan Friendship Hospital, Postal address: No.2 Yinghuadongjie, Chaoyang District, Beijing, China.
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21
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Webb Hooper M, Calixte-Civil P, Verzijl C, Brandon KO, Asfar T, Koru-Sengul T, Antoni MH, Lee DJ, Simmons VN, Brandon TH. Associations between Perceived Racial Discrimination and Tobacco Cessation among Diverse Treatment Seekers. Ethn Dis 2020; 30:411-420. [PMID: 32742143 PMCID: PMC7360180 DOI: 10.18865/ed.30.3.411] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objectives This study investigated a) racial/ethnic differences in past-year discrimination experiences and b) associations between discrimination and smoking abstinence. Design Prospective, longitudinal analysis of smoking status. Perceived past-year discrimination was assessed at baseline. ANCOVAs and intent-to-treat hierarchical logistic regressions were conducted. Setting Dual-site (Tampa, FL and Miami, FL) randomized controlled trial testing the effects of a group cessation intervention plus pharmacotherapy. Participants Treatment-seeking adult smokers (N=347; non-Hispanic White, non-Hispanic African American/Black, or Hispanic). Main Outcome Measures Biochemically verified 7-day point prevalence abstinence (7-day ppa) was assessed immediately post-intervention and at 6-month follow-up. Results After controlling for covariates, African Americans/Blacks reported greater perceived discrimination compared with non-Hispanic Whites (P=.02), and Hispanics (P=.06). Non-Hispanic Whites and Hispanics did not differ in perceived racial/ethnic discrimination experiences over the past year. Irrespective of race/ethnicity, past-year perceived discrimination was inversely associated with 7-day ppa, both post-intervention (AOR=.97, CI: .95-.99) and at 6-months (AOR=.98, CI: .96-.99). Among African Americans/Blacks, past-year perceived discrimination was inversely associated with 7-day ppa, both post-intervention (AOR=.95, CI: .92-.97) and at 6-months (AOR=.97, CI: .94-.99). Perceived discrimination was unrelated to 7-day ppa among Hispanics. Among non-Hispanic Whites, past-year perceived discrimination was inversely associated with post-intervention 7-day ppa (AOR=.95, CI: .91-.99), but not 6-months. Conclusions Perceived racial/ethnic discrimination was greater among African American/Black smokers compared with non-Hispanic Whites. Perceived discrimination was negatively associated with tobacco cessation in the full sample, and for African Americans at 6-months post-intervention. These data have implications for intervention delivery and health disparities.
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Affiliation(s)
- Monica Webb Hooper
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD (former affiliation when study was conducted: Case Western Reserve University School of Medicine, Case Comprehensive Cancer Center, Cleveland, OH)
| | | | | | | | - Taghrid Asfar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | | | - David J. Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Vani N. Simmons
- Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
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22
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Barajas CB, Jones SCT, Milam AJ, Thorpe RJ, Gaskin DJ, LaVeist TA, Furr-Holden CDM. Coping, Discrimination, and Physical Health Conditions Among Predominantly Poor, Urban African Americans: Implications for Community-Level Health Services. J Community Health 2020; 44:954-962. [PMID: 30915675 DOI: 10.1007/s10900-019-00650-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
African Americans and ethnic minorities experience racial discrimination in a variety of settings. Racial discrimination is a potent stressor that has been linked to psychosocial stress and poor physical health. To cope with discriminatory experiences and daily life event stressors, African Americans frequently use the concept of John Henryism (a high effort coping strategy with prolonged exposure to stress). This cross-sectional analysis explored the relationship between racism/discrimination, John Henryism, and health problems in a predominately African American sample. Data were collected through health care screenings for hypertension, diabetes, and obesity and a self-report survey to assess experiences of discrimination and use of John Henryism. Logistic and linear regression models were used to assess the relationship between the John Henryism score, racism/discrimination score, and health problems among 352 participants. John Henryism was associated with a decrease in systolic blood pressure (b = - 12.50, 95% CI = - 23.05, - 1.95) among men, after adjusting for experiences of racism/discrimination and demographic characteristics. Experiences of racism/discrimination were associated with an increase in systolic blood pressure (b = 11.23, 95% CI = 0.38, 22.09) among men, after adjusting for John Henryism and demographic characteristics. Among women, there was no association found between John Henryism and experiences of racism/discrimination with systolic blood pressure. No association was found between John Henryism and experiences of racism/discrimination with being overweight/obese in women nor men. The study found that John Henryism was positively associated with the health of men, while experiences of racism/discrimination were negatively associated with their health. Limitations of the study are discussed, and recommendations are made to guide future research exploring the concept of John Henryism as a relevant factor between stress, racial discrimination and poor health.
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Affiliation(s)
- Clara B Barajas
- Division of Public Health, College of Human Medicine, Michigan State University, 200 East 1st Street, Flint, MI, 48502, USA
| | - Shawn C T Jones
- Department of Psychology, Virginia Commonwealth University, Richmond, USA
| | - Adam J Milam
- Division of Public Health, College of Human Medicine, Michigan State University, 200 East 1st Street, Flint, MI, 48502, USA. .,The Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA.
| | - Roland J Thorpe
- The Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Darrell J Gaskin
- The Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Thomas A LaVeist
- The Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA.,Tulane University School of Public Health and Tropical Medicine, New Orleans, USA
| | - C Debra M Furr-Holden
- Division of Public Health, College of Human Medicine, Michigan State University, 200 East 1st Street, Flint, MI, 48502, USA. .,The Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA.
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23
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Rogers CJ, Forster M, Vetrone S, Unger JB. The role of perceived discrimination in substance use trajectories in Hispanic young adults: A longitudinal cohort study from high school through emerging adulthood. Addict Behav 2020; 103:106253. [PMID: 31869743 DOI: 10.1016/j.addbeh.2019.106253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 08/31/2019] [Accepted: 12/05/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE Associations between discrimination and substance use have been identified cross-sectionally in multiple populations including Hispanics. However, there is limited research exploring this phenomenon longitudinally in Hispanic youth over the transition from adolescence through emerging adulthood (EA). METHODS Hispanic youth in Southern California (n = 1457) completed surveys over 11 years, from 2006 to 2017, including three high school collection waves and five EA collection waves. Multinomial logistic regression models were used to explore the associations between perceived discrimination during high school and cigarette and marijuana use in both high school and EA, controlling for gender, socioeconomic status, acculturation, and EA discrimination. RESULTS Compared with those who never used cigarettes or marijuana in high school and EA, perceived discrimination in high school was a significant predictor of two patterns of use: high school initiators who discontinued use of smoking (RRR = 1.677, 95%CI = 1.292-2.176) and/or marijuana (RRR = 1.464, 95%CI = 1.162-1.844), and high school initiators who continued smoking (RRR = 1.492, 95%CI = 1.196-1.861) and/or marijuana use (RRR = 1.249, 95%CI = 1.052-1.482) into EA. For late initiators who did not use in high school but started in EA, perceived high school discrimination was a significant predictor for cigarette smoking (RRR = 1.193, 95%CI = 1.036-1.373) but not for marijuana use. CONCLUSIONS Perceived discrimination during adolescence is associated with substance use trajectories across both adolescence and EA. Culturally tailored prevention programs that provide training in skills to cope with psychosocial stressors could improve Hispanic adolescent health.
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Affiliation(s)
- Christopher J Rogers
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, 2001 N. Soto Street, Los Angeles, CA 90033, United States.
| | - Myriam Forster
- Department of Health Sciences, California State University, Northridge. 18111 Nordhoff St., Northridge, CA 91330, United States
| | - Steven Vetrone
- Department of Health Sciences, California State University, Northridge. 18111 Nordhoff St., Northridge, CA 91330, United States
| | - Jennifer B Unger
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, 2001 N. Soto Street, Los Angeles, CA 90033, United States
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Melanda FN, Dos Santos HG, Urbano MR, de Carvalho WO, González AD, Mesas AE, de Andrade SM. Poor Relationships and Physical Violence at School Are Associated With More Forms of Psychological Violence Among Brazilian Teachers: A Cross-Sectional Study. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:1294-1310. [PMID: 29294667 DOI: 10.1177/0886260517696857] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Our purpose was to identify individual and work-related factors that are associated with psychological violence (PV) and are related to a higher number of PV forms among teachers. This cross-sectional study included 789 elementary and high school teachers in a municipality in southern Brazil. Data were obtained through interviews and a self-administered questionnaire. PV was characterized by reports of insults from students, humiliation by colleagues or teachers, and threats in the 12 months preceding the study. Factors associated with the number of PV forms were also investigated. Poisson regression models were used for the analyses. More than half (64.1%) of the teachers reported at least one event of PV, 38.3% reported only one form, 21.5% reported two forms, and 4.3% reported all three surveyed forms. After adjustments, poor relationships with superiors or students and having suffered physical violence at school remained associated with at least one PV episode. The same variables were associated with the number of forms of PV, as were age (inverse relationship) and violence outside of school. The higher the number of aggregated factors, the more estimated forms of PV, particularly among the younger teachers. These results highlight the importance of adopting strategies that promote a nonviolent and safe school environment for teachers, which will in turn improve work conditions, the quality of education, and teachers' health.
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Lipira L, Rao D, Nevin PE, Kemp CG, Cohn SE, Turan JM, Simoni JM, Andrasik MP, French AL, Unger JM, Heagerty P, Williams EC. Patterns of alcohol use and associated characteristics and HIV-related outcomes among a sample of African-American women living with HIV. Drug Alcohol Depend 2020; 206:107753. [PMID: 31785536 PMCID: PMC6980681 DOI: 10.1016/j.drugalcdep.2019.107753] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 11/13/2019] [Accepted: 11/14/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Alcohol use is common among people living with HIV and negatively impacts care and outcomes. African-American women living with HIV are subject to vulnerabilities that may increase risk for alcohol use and associated HIV-related outcomes. METHODS We used baseline data from a randomized controlled trial of an HIV-related stigma-reduction intervention among African-American women living with HIV in Chicago and Birmingham (2013-2015). Patterns of alcohol use [any use, unhealthy alcohol use (UAU), heavy episodic drinking (HED)] were measured using the AUDIT-C. We assessed demographic, social, and clinical characteristics which may influence alcohol use and HIV-related outcomes which may be influenced by patterns of alcohol use in bivariate and multivariable analyses. RESULTS Among 220 African-American women living with HIV, 54 % reported any alcohol use, 24 % reported UAU, and 27 % reported HED. In bivariate analysis, greater depressive symptoms, lower religiosity, lower social support, marijuana, and crack/cocaine use were associated with patterns of alcohol use (p < 0.05). Marijuana and cocaine/crack use were associated with patterns of alcohol use in adjusted analysis (p < 0.05). In adjusted analysis, any alcohol use and HED were associated with lower likelihood of ART adherence (ARR = 0.72, 95 % CI: 0.53-0.97 and ARR = 0.65, 95 % CI: 0.44-0.96, respectively), and UAU was associated with lack of viral suppression (ARR = 0.78, 95 % CI: 0.63-0.96). CONCLUSIONS Findings suggest any and unhealthy alcohol use is common and associated with poor HIV-related outcomes in this population. Regular alcohol screening and intervention should be offered, potentially targeted to subgroups (e.g., those with other substance use).
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Affiliation(s)
- Lauren Lipira
- Department of Health Services, University of Washington, 1959 NE Pacific St, Magnuson Health Sciences Center, Room H-680, Seattle, WA, 98195-7660, United States; Department of Global Health, University of Washington, Harris Hydraulics Laboratory, Box 357965, Seattle, WA, 98195-7965, United States.
| | - Deepa Rao
- Department of Global Health, University of Washington, Harris Hydraulics Laboratory, Box 357965, Seattle, WA, 98195-7965, United States; Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Box 356560, Room BB1644, Seattle, WA, 98195-6560, United States.
| | - Paul E. Nevin
- Department of Global Health University of Washington Harris Hydraulics Laboratory Box 357965 Seattle, Washington, 98195-7965
| | - Christopher G. Kemp
- Department of Global Health University of Washington Harris Hydraulics Laboratory Box 357965 Seattle, Washington, 98195-7965
| | - Susan E. Cohn
- Department of Medicine, Northwestern University Feinberg School of Medicine 645 North Michigan Avenue Suite 926 Chicago, Illinois, 60611
| | - Janet M. Turan
- Department of Health Care Organization and Policy School of Public Health University of Alabama at Birmingham Ryals Public Health Building (RPHB) 1665 University Boulevard Birmingham, Alabama, 35294-0022
| | - Jane M. Simoni
- Department of Psychology University of Washington 119A Guthrie Hall, Box 351525 Seattle, Washington, 98195-1525
| | - Michele P. Andrasik
- Vaccine and Infectious Disease Division Fred Hutch 1100 Fairview Ave N. Mail Stop E5-110 Seattle, Washington, 98109
| | - Audrey L. French
- Stroger Hospital of Cook County Ruth M. Rothstein CORE Center 2020 W. Harrison St Chicago, Illinois, 60612
| | - Joseph M. Unger
- Department of Health Services University of Washington 1959 NE Pacific St Magnuson Health Sciences Center, Room H-680 Seattle, Washington, 98195-7660,Public Health Sciences Division Fred Hutch 1100 Fairview Ave N. Mail Stop M3-C102 Seattle, Washington, 98109
| | - Patrick Heagerty
- Department of Biostatistics, University of Washington, Box 357232, Seattle, WA, 98195-7232, United States.
| | - Emily C. Williams
- Department of Health Services University of Washington 1959 NE Pacific St Magnuson Health Sciences Center, Room H-680 Seattle, Washington, 98195-7660,Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care VA Puget Sound Health Care System Health Services Research & Development 1660 S. Columbian Way (S-152) Seattle, Washington, 98108
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Stone AL, Elbers-Carlisle SK. Workplace Racial Discrimination, Negative Emotions Based on Treatment Due to Race, and Substance Use. Subst Use Misuse 2020; 55:1925-1934. [PMID: 32669029 DOI: 10.1080/10826084.2020.1781178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Experiencing racial discrimination may be associated with poor health outcomes including negative emotional states and substance use. The workplace is a setting where people may experience discriminatory treatment. Objectives: This study examined associations, between negative emotions due to treatment based on race (NE), workplace racial discrimination (WRD), and substance use outcomes (drinking and smoking), stratified by race. Methods: Data from the cross-sectional 2014 Behavioral Risk Factor Surveillance System (BRFSS), Minnesota and New Mexico sub-samples, were analyzed. This study excluded non-Hispanic white participants, resulting in a sample of n = 3098 adult, U.S. residents. Multivariable logistic regression models were utilized to examine the associations, and possible interactions, between WRD, NE, and substance use (alcohol and tobacco). Results: Prior to stratification, WRD was not associated with drinking or smoking after controlling for NE and other sociodemographic variables, however, NE was associated with heavy drinking. NE appeared to account for some of the observed bivariate associations between WRD and heavy drinking and daily smoking. Post-stratification, WRD was associated with heavy drinking for non-Hispanic other respondents, even after controlling for NE. For non-Hispanic black participants, NE was associated with smoking after controlling for WRD. A stratified interaction analysis of WRD*NE revealed that there was only an association between NE and heavy drinking for Hispanic participants who did not experience WRD. Conclusions: The relationship between WRD and substance use may be in part accounted for by NE. Further exploration is needed to more fully understand why associations exist for some race/ethnicity groups but not others.
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Affiliation(s)
- Andrea L Stone
- School of Nursing and Health Studies, University of Washington Bothell, Bothell, Washington, USA
| | - Shauna K Elbers-Carlisle
- School of Nursing and Health Studies, University of Washington Bothell, Bothell, Washington, USA
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Swift SL, Glymour MM, Elfassy T, Lewis C, Kiefe CI, Sidney S, Calonico S, Feaster D, Bailey Z, Zeki Al Hazzouri A. Racial discrimination in medical care settings and opioid pain reliever misuse in a U.S. cohort: 1992 to 2015. PLoS One 2019; 14:e0226490. [PMID: 31860661 PMCID: PMC6924655 DOI: 10.1371/journal.pone.0226490] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 11/26/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND In the United States whites are more likely to misuse opioid pain relievers (OPRs) than blacks, and blacks are less likely to be prescribed OPRs than whites. Our objective is to determine whether racial discrimination in medical settings is protective for blacks against OPR misuse, thus mediating the black-white disparities in OPR misuse. METHODS We used data from 3528 black and white adults in the Coronary Artery Risk Development in Young Adults (CARDIA) study, an ongoing multi-site cohort. We employ causal mediation methods, with race (black vs white) as the exposure, lifetime discrimination in medical settings prior to year 2000 as the mediator, and OPR misuse after 2000 as the outcome. RESULTS We found black participants were more likely to report discrimination in a medical setting (20.3% vs 0.9%) and less likely to report OPR misuse (5.8% vs 8.0%, OR = 0.71, 95% CI = 0.55, 0.93, adjusted for covariates). Our mediation models suggest that when everyone is not discriminated against, the disparity is wider with black persons having even lower odds of reporting OPR misuse (OR = 0.63, 95% CI = 0.45, 0.89) compared to their white counterparts, suggesting racial discrimination in medical settings is a risk factor for OPR misuse rather than protective. CONCLUSIONS These results suggest that racial discrimination in a medical setting is a risk factor for OPR misuse rather than being protective, and thus could not explain the seen black-white disparity in OPR misuse.
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Affiliation(s)
- Samuel L. Swift
- Center for Health Equity in Kidney Disease, University of New Mexico School of Medicine, Albuquerque, NM, United States of America
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States of America
| | - Tali Elfassy
- Division of Epidemiology, Department of Public Health Sciences, University of Miami, Miami, FL, United States of America
| | - Cora Lewis
- Division of Preventative Medicine, Department of Medicine, University of Alabama, Tuscaloosa, AL, United States of America
| | - Catarina I. Kiefe
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Boston, MA, United States of America
| | - Stephen Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Sebastian Calonico
- Department of Health Policy and Management, Columbia University, New York, NY, United States of America
| | - Daniel Feaster
- Division of Biostatistics, Department of Public Health Sciences, University of Miami, Miami, FL, United States of America
| | - Zinzi Bailey
- Jay Weiss Institute for Health Equity, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, United States of America
| | - Adina Zeki Al Hazzouri
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
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Stepanova EV, Echevarria DJ, Collier AD, Cruz CS, Kirkland N, Drobes DJ. Discrimination, Stress and Reactivity to Alcohol Cues. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2019. [DOI: 10.1521/jscp.2019.38.10.836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: Our study investigated whether discrimination affects psychologi-cal/physiological stress and alcohol craving. Method: Participants (N = 92) were asked to recall and write about (a) a neutral, (b) a negative, or (c) a discriminatory experience in the past and then completed a cue-reactivity procedure assessing their alcohol craving. In addition, we assessed levels of perceived stress before and after the discrimination manipulation, chronic substance use and craving, prior perceived discrimination, and strength of racial/ethnic identity. Results: Results revealed a small effect in which the discrimination condition increased alcohol cue-elicited craving relative to the other conditions. Chronic craving moderated effects of discrimination on cortisol levels. Self-reported stress levels were increased in the discrimination and negative memory conditions relative to baseline. Strength of racial identity served as a protective factor for substance abuse in those who reported chronic high levels of discrimination. Discussion: We discussed the direct link established between acute exposure to discrimination and craving, and experimental evidence for the relationship between discrimination and self-reported stress, but also addressed potential limitations of this work. It is further discussed how some individual differences factors (e.g., chronic craving) predict physiological stress in discriminatory settings. This work underscored the role of racial identity as a protective factor against alcohol abuse in individuals reporting high levels of discrimination.
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Fekedulegn D, Alterman T, Charles LE, Kershaw KN, Safford MM, Howard VJ, MacDonald LA. Prevalence of workplace discrimination and mistreatment in a national sample of older U.S. workers: The REGARDS cohort study. SSM Popul Health 2019; 8:100444. [PMID: 31321281 PMCID: PMC6612926 DOI: 10.1016/j.ssmph.2019.100444] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/27/2019] [Accepted: 06/30/2019] [Indexed: 11/17/2022] Open
Abstract
Although workplace discrimination and mistreatment (WDM) has recently drawn widespread media attention, our understanding of the prevalence of these phenomena remains limited. In the current study, we generated national prevalence estimates of WDM from a community-based cohort of employed black and white men and women aged ≥48 years. Measures of WDM in the current job were obtained by computer-assisted telephone interview (2011-2013) involving dichotomous responses (yes or no) to five questions and deriving a composite measure of discrimination (yes to at least one). Prevalence estimates and age- and region-adjusted prevalence ratios were derived with use of SUDAAN software to account for the complex sample design. Analyses were stratified by race and sex subgroups. This sample represents over 40 million U.S. workers aged ≥48 years. The prevalence of workplace discrimination ranged from a high of 25% for black women to a low of 11% for white men. Blacks reported a 60% higher rate of discrimination compared to whites; women reported a 53% higher prevalence of discrimination, compared with men. The prevalence of workplace mistreatment ranged from 13% for black women to 8% for white men. Women reported a 52% higher prevalence of mistreatment compared to men, while differences by race were not significant. Mistreatment was 4-8 times more prevalent among those reporting discrimination than among those reporting none. Subgroup differences in mistreatment were confined to the wage-employed. Findings suggest that middle age and older wage-employed blacks and women experience the highest prevalence of WDM; moreover, discrimination is strongly associated with mistreatment. This study contributes to our understanding of at-risk segments of the U.S. labor market and the need for targeted interventions to reduce WDM.
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Affiliation(s)
- Desta Fekedulegn
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Toni Alterman
- Surveillance Branch, Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Luenda E. Charles
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Kiarri N. Kershaw
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Monika M. Safford
- Weill Cornell Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Virginia J. Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Leslie A. MacDonald
- Industrywide Studies Branch, Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
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Jones SCT, Brooks JH, Milam AJ, Barajas CB, LaVeist TA, Kane E, Furr-Holden CDM. Racial discrimination, John Henryism coping, and behavioral health conditions among predominantly poor, urban African Americans: Implications for community-level opioid problems and mental health services. JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 47:1032-1042. [PMID: 30791117 PMCID: PMC6581591 DOI: 10.1002/jcop.22168] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/23/2019] [Accepted: 01/30/2019] [Indexed: 05/10/2023]
Abstract
The current study examined the relationship between John Henryism Active Coping (JHAC), experiences of racial discrimination, and behavioral health outcomes in a community sample of 319 Black adults. Assessments included primary health care screenings as well as self-reported survey questions to assess JHAC, experiences of discrimination, and self-reported behavioral health. Logistic regression models, adjusted for control variables, found a significant relationship between JHAC and having an opioid problem (odds ratio [OR] = 0.95, p = 0.003) and needing mental health services (OR = 0.95, p < 0.001), such that higher levels of coping were associated with lower odds of reporting an opioid problem and needing mental health services. Notably, racial discrimination was not significantly independently associated with behavioral health. Implications for interventions and community programming are discussed.
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Affiliation(s)
| | | | - Adam J Milam
- Michigan State University
- Johns Hopkins University
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Haeny AM, Sartor CE, Arshanapally S, Ahuja M, Werner KB, Bucholz KK. The association between racial and socioeconomic discrimination and two stages of alcohol use in blacks. Drug Alcohol Depend 2019; 199:129-135. [PMID: 31048089 PMCID: PMC6684260 DOI: 10.1016/j.drugalcdep.2019.02.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 02/13/2019] [Accepted: 02/16/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND This study aimed to characterize the associations of racial and socioeconomic discrimination with timing of alcohol initiation and progression from initiation to problem drinking in Black youth. METHODS Data were drawn from a high-risk family study of alcohol use disorder. Mothers and their offspring (N = 806; Mage = 17.87, SDage = 3.91; 50% female) were assessed via telephone interview. Cox proportional hazards regression analyses were used to examine associations between discrimination and timing of first drink and progression from first drink to problem drinking in two separate models. Predictor variables were considered in a step-wise fashion, starting with offspring racial and socioeconomic discrimination, then adding (2) maternal racial and/or socioeconomic discrimination experiences; (3) religious service attendance and social support as potential moderators; and (4) psychiatric and psychosocial risk factors and other substance use. RESULTS Offspring racial discrimination (HR: 2.01, CI: 1.17-3.46 ≤ age 13) and maternal experiences of discrimination (HR: 0.79, CI: 0.67-0.93) were associated with timing of initiation in the unadjusted model only; offspring socioeconomic discrimination predicted timing of initiation among female offspring, even after adjusting for all covariates (HR: 1.49, CI: 1.14-1.93). Socioeconomic discrimination predicted a quicker transition from first use to problem drinking exclusively in the unadjusted model (HR: 1.70, CI: 1.12-2.58 ≤ age 18). No moderating effects of religious service attendance or social support were observed for either alcohol outcome. CONCLUSIONS Findings suggest socioeconomic discrimination is a robust risk factor for initiating alcohol use in young Black female youth and should be considered in the development of targeted prevention programs.
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Affiliation(s)
- Angela M. Haeny
- Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue New Haven, CT 06511, United States
| | - Carolyn E. Sartor
- Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue New Haven, CT 06511, United States,Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO 63110, United States
| | - Suraj Arshanapally
- Yale School of Public Health, 60 College St, New Haven, CT 06510, United States
| | - Manik Ahuja
- Brown School of Social Work, Washington University, 1 Brookings Dr., St. Louis, MO 63130, United States
| | - Kimberly B. Werner
- Missouri Institute of Mental Health, University of Missouri-St. Louis, 4633 World Pkwy Cir, St. Louis, MO 63134, United States
| | - Kathleen K. Bucholz
- Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO 63110, United States
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Everyday discrimination indirectly influences smoking cessation through post-quit self-efficacy. Drug Alcohol Depend 2019; 198:63-69. [PMID: 30878768 DOI: 10.1016/j.drugalcdep.2019.01.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Although studies have shown an association between discrimination and current smoking, the influence of discrimination on smoking cessation is an understudied area in tobacco research. The current study evaluated the influence of everyday discrimination on smoking cessation and examined self-efficacy as a potential mediator of this association. METHODS Participants (N = 146), who were recruited from a safety-net hospital in Dallas County, Texas, from 2011 to 2013, completed a self-report measure of perceived discrimination one week before the scheduled quit attempt and self-efficacy for quitting was assessed one day after the scheduled quit date. Biochemically-verified 7-day point prevalence abstinence was assessed weekly, through the fourth week after the scheduled quit date. Structural equation modeling was used to evaluate the indirect effect of perceived discrimination on smoking cessation via self-efficacy for quitting. RESULTS Analyses indicated significant indirect effect of discrimination on smoking cessation through self-efficacy at Weeks 1 (B = .09, SE = .04, p = .02) and 4 (B = .07, SE = .03, p = .03). A higher frequency of discrimination was associated with lower self-efficacy one day after the scheduled quit date, and lower self-efficacy increased the likelihood of smoking one and four weeks after the scheduled quit attempt. CONCLUSIONS Findings suggest that perceptions of discrimination reduce the likelihood of smoking cessation via diminished self-efficacy. Future research is needed to identify intervention strategies to reduce the frequency of discrimination experiences and attenuate the negative impact of discrimination and low self-efficacy on smoking cessation.
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Patrão AL, Almeida MDC, Matos SMA, Goes EF, Nogueira C, Aquino EML. Association Between Perceived Discrimination and Alcohol and Tobacco Consumption in ELSA-Brasil Cohort: Focusing on Gender Differences. Subst Use Misuse 2019; 54:1214-1225. [PMID: 30799670 DOI: 10.1080/10826084.2019.1573838] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Discrimination is detrimental to physical and mental health, particularly insofar as health-risk behaviors are concerned. Particular attention has been paid to excess alcohol consumption and smoking in view of the ready availability of these substances in Western societies. OBJECTIVES To determine whether an association exists between perceived discrimination and excess alcohol intake and smoking in women and men enrolled in the ELSA-Brasil cohort study. METHODS The sample included in the ELSA-Brasil cohort consisted of 15,105 civil servants. Data from waves 1 and 2 of the study were used. A multidimensional questionnaire was used to collect sociodemographic characteristics and evaluate perceived discrimination, alcohol consumption, and smoking. RESULTS An association was found between excess alcohol intake and perceived discrimination only in the men, with this association remaining significant in the youngest age group, in university-educated individuals, and in the group classified as middle-class. An association was found between smoking and lifetime perceived discrimination in women, particularly in those ≥60 years of age, brown-skinned women, those who had completed elementary school, and those classified as upper social class. This same association was found in the men, mainly those of 50-59 years of age, white-skinned males, those who had completed high school, those with a university education, and those classified as upper social class. Conclusions/Importance: Investing in public health policies aimed at combating the different forms of discrimination would appear essential. Not only does discrimination contribute to social injustice, but it also encourages health-risk behaviors such as excess alcohol intake and smoking.
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Affiliation(s)
- Ana Luísa Patrão
- a Institute of Collective Health , Federal University of Bahia , Salvador , Brazil
| | | | - Sheila M Alvim Matos
- a Institute of Collective Health , Federal University of Bahia , Salvador , Brazil
| | | | - Conceição Nogueira
- c c Faculty of Psychology and Educational Sciences , Porto University , Porto , Portugal
| | - Estela M L Aquino
- a Institute of Collective Health , Federal University of Bahia , Salvador , Brazil
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Examining Race/Ethnicity Differences in the Association Between the Experience of Workplace Racial Discrimination and Depression or Negative Emotions. J Racial Ethn Health Disparities 2018; 6:874-882. [PMID: 30264336 DOI: 10.1007/s40615-018-0524-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 08/10/2018] [Accepted: 08/17/2018] [Indexed: 10/28/2022]
Abstract
This study examines associations and potential interactions between race/ethnicity, workplace racial discrimination, depression, and negative emotional symptoms experienced due to treatment based on race. Data for this study come from the 2014 Behavioral Risk Factor Surveillance System (BRFSS), an annual telephone survey of US residents, aged 18 and older. Respondents from MN and NM (n = 13,655) completed a module titled Reactions to Race, which contained items assessing workplace racial discrimination and negative emotions experienced based on treatment due to race, as well as standard BRFSS items assessing a diagnosis of depression. Results support previous research concluding that non-Hispanic White survey respondents are less likely to experience racial discrimination in the workplace than other race/ethnicity groups, but were more likely to report both depression and negative emotions. Analyses stratified by race/ethnic group suggest that, after controlling for gender, marital status, education, and income, there was an association between experiencing workplace racial discrimination and reporting negative emotions due to treatment based on race (all p values < 0.001). Of note, this association was strongest for non-Hispanic White respondents.
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Plascak JJ, Hohl B, Barrington WE, Beresford SA. Perceived neighborhood disorder, racial-ethnic discrimination and leading risk factors for chronic disease among women: California Behavioral Risk Factor Surveillance System, 2013. SSM Popul Health 2018; 5:227-238. [PMID: 30094318 PMCID: PMC6077127 DOI: 10.1016/j.ssmph.2018.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 06/01/2018] [Accepted: 07/08/2018] [Indexed: 11/23/2022] Open
Abstract
Social environmental factors are theoretically identified as influential drivers of health behaviors – tobacco smoking, alcohol consumption, and physical activity – related to chronic disease disparities. Empirical studies investigating relationships involving social environmental factors have found that either greater interpersonal racial-ethnic discrimination or perceived neighborhood disorder were associated with adverse health behaviors, with potentially larger effects among women. We simultaneously tested whether measures of perceived racial-ethnic discrimination and perceived neighborhood disorder were associated with physical activity, alcohol consumption and tobacco smoking; lifestyle risk factors of major chronic disease among women. Data were from the 2013 California Behavioral Risk Factor Surveillance System. In addition to demographic and socioeconomic factors, women self-reported experiences with racial-ethnic discrimination and perception of neighborhood disorder (i.e., crime safety, traffic safety, and aesthetics/physical disorder). Survey-, and inverse probability of censoring-weighted regression models of each chronic disease risk factor were used to investigate associations involving racial-ethnic discrimination and neighborhood disorder, controlling for potential confounders. Perceiving racial-ethnic discrimination and greater neighborhood disorder were associated with a greater tobacco smoking prevalence. Experiences of racial-ethnic discrimination were associated with greater alcohol consumption among African American and Latino women, but not White women. Similarly, African American women reporting experiences with racial-ethnic discrimination report engaging in physical activity about half as much time as women reporting no racial-ethnic discrimination. Increases in perceived neighborhood disorder were associated with increases in alcohol consumption. All associations with social environmental factors were adjusted for potential confounders and each other. Neighborhood disorder and racial-ethnic discrimination may be important, independent contributors to chronic disease risk through relationships with tobacco smoking, alcohol consumption, and physical activity. Neighborhood disorder was associated with tobacco smoking and alcohol consumption. Racial ethnic discrimination was associated with tobacco smoking. Race/ethnicity and discrimination interaction affecting alcohol, physical activity. Limited to women, associations independent of each other and additional confounders. Neighborhood disorder, discrimination independent pathways to adverse health.
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Affiliation(s)
- Jesse J Plascak
- Department of Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Bernadette Hohl
- Department of Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Wendy E Barrington
- Department of Psychosocial and Community Health, School of Nursing, University of Washington, Seattle, WA, USA
| | - Shirley Aa Beresford
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
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Blosnich JR, Lehavot K, Glass JE, Williams EC. Differences in Alcohol Use and Alcohol-Related Health Care Among Transgender and Nontransgender Adults: Findings From the 2014 Behavioral Risk Factor Surveillance System. J Stud Alcohol Drugs 2018; 78:861-866. [PMID: 29087820 DOI: 10.15288/jsad.2017.78.861] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Little is known regarding patterns of alcohol use and alcohol-related care among transgender adults. This study examined alcohol use and alcohol-related care across transgender status in a probability sample of U.S. adults. METHOD We conducted secondary analyses of the 2014 Behavioral Risk Factor Surveillance System survey, focusing on adults in eight states that administered both an Alcohol Screening and Brief Intervention module and a Gender Identity module (n = 58,381). Measurements included transgender status, sociodemographic characteristics, alcohol consumption (any alcohol use, risky drinking, heavy episodic drinking, and any unhealthy alcohol use), and alcohol-related care (alcohol screening during healthcare visits and advice about unhealthy alcohol use). We tested the association between transgender status and alcohol consumption and alcohol-related care using multivariable logistic regression models adjusted for sociodemographic characteristics. RESULTS Approximately 0.6% of respondents (n = 283) self-identified as transgender. Overall, there were no significant differences in alcohol consumption or screening between transgender and nontransgender adults. A greater proportion of transgender than nontransgender adults reported being advised to reduce alcohol use (20.7% vs. 7.8%, p = .012). However, this difference was not significant after adjusting for other sociodemographic characteristics (adjusted odds ratio = 2.31, 95% CI [0.91, 5.86], p = .077). CONCLUSIONS In this representative sample from eight U.S. states, we did not find differences related to transgender status in rates of alcohol use or of alcohol-related care.
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Affiliation(s)
- John R Blosnich
- Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
| | - Keren Lehavot
- Denver-Seattle Center of Innovation for Veteran-Centered Value-Driven Care, Veterans Affairs Puget Sound Health Services Research & Development, Seattle, Washington.,Department of Psychiatry and Behavioral Science, University of Washington, Seattle, Washington.,Department of Health Services, University of Washington, Seattle, Washington
| | - Joseph E Glass
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Emily C Williams
- Denver-Seattle Center of Innovation for Veteran-Centered Value-Driven Care, Veterans Affairs Puget Sound Health Services Research & Development, Seattle, Washington.,Department of Health Services, University of Washington, Seattle, Washington
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Rose SW, Mayo A, Ganz O, Perreras L, D'Silva J, Cohn A. Perceived racial/ethnic discrimination, marketing, and substance use among young adults. J Ethn Subst Abuse 2018; 18:558-577. [PMID: 29424638 DOI: 10.1080/15332640.2018.1425949] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Perceived experiences of discrimination have been linked to negative health behaviors including tobacco, alcohol, and marijuana use across various racial/ethnic groups. Tobacco and alcohol marketing exposure have also been linked with substance use. This study examined the independent and interacting effects of perceived experiences of discrimination and exposure to alcohol and tobacco marketing, and receptivity to marijuana marketing on substance use in an online survey of a multiethnic sample of young adults in 6 metropolitan areas (n = 505). African Americans (mean (M) = 1.96, 9% 5CI [1.84, 2.09]) and Hispanics (M = 1.98, 95% CI [1.87, 2.09]) reported higher levels of perceived discrimination than Whites (M = 1.52, 95% CI [1.40, 1.64]), p < .001. African Americans had higher levels of exposure to tobacco and alcohol marketing; Hispanics reported higher levels of exposure to alcohol marketing and receptivity to marijuana promotion. Discrimination and marketing exposure were independently associated with higher odds of all 3 outcomes, controlling for covariates (AOR from 2.1 to 3.4 for discrimination; AOR from 1.4 to 13.8 for marketing). Models showed a significant interaction of discrimination and tobacco marketing on past 30-day cigarette use (F = 5.5; p = .02). Individuals with high levels of tobacco marketing exposure were likely to report high past 30-day cigarette use regardless of level of discrimination, while those with low exposure were only at increased risk of reporting cigarette use at higher levels of discrimination. Both perceived discrimination and marketing exposure play a role in substance use. Interventions should consider discrimination as a significant risk factor underlying vulnerability to substance use among young adults.
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Affiliation(s)
| | - Ashley Mayo
- Truth Initiative Schroeder Institute , Washington , DC
| | - Ollie Ganz
- Truth Initiative Schroeder Institute , Washington , DC.,George Washington University Milken Institute School of Public Health , Washington , DC
| | | | - Joanne D'Silva
- Truth Initiative Schroeder Institute , Washington , DC.,University of Maryland School of Public Health , College Park , Maryland
| | - Amy Cohn
- Battelle Memorial Institute , Arlington , Virginia.,Georgetown University Medical Center , Washington , DC
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Reno JM, Thakore N, Cormack LK, Schallert T, Bell RL, Maddox WT, Duvauchelle CL. Negative Affect-Associated USV Acoustic Characteristics Predict Future Excessive Alcohol Drinking and Alcohol Avoidance in Male P and NP Rats. Alcohol Clin Exp Res 2017; 41:786-797. [PMID: 28118495 DOI: 10.1111/acer.13344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 01/14/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Negative emotional status and adverse emotional events increase vulnerability to alcohol abuse. Ultrasonic vocalizations (USVs) emitted by rats are a well-established model of emotional status that can reflect positive or negative affective responses in real time. Most USV studies assess counts, yet each USV is a multidimensional data point characterized by several acoustic characteristics that may provide insight into the neurocircuitry underlying emotional response. METHODS USVs emitted from selectively bred alcohol-naïve and alcohol-experienced alcohol-preferring and nonpreferring rats (P and NP rats) were recorded during 4-hour sessions on alternating days over 4 weeks. Linear mixed modeling (LMM) and linear discriminant analysis (LDA) were applied to USV acoustic characteristics (e.g., frequency, duration, power, and bandwidth) of negative affect (22 to 28 kilohertz [kHz])- and positive (50 to 55 kHz) affect-related USVs. RESULTS Hundred percent separation between alcohol-naïve P and NP rats was achieved through a linear combination (produced by LDA) of USV acoustic characteristics of 22- to 28-kHz USVs, whereas poor separation (36.5%) was observed for 50- to 55-kHz USVs. 22- to 28-kHz LDA separation was high (87%) between alcohol-experienced P and NP rats, but was poor for 50- to 55-kHz USVs (57.3%). USV mean frequency and duration were the highest weighted characteristics in both the naïve and experienced 22- to 28-kHz LDA representations suggesting that alcohol experience does not alter the representations. LMM analyses of 22- to 28-kHz USV acoustic characteristics matched the LDA results. Poor LDA separation was observed between alcohol-naïve and alcohol-experienced P rats for both 22- to 28-kHz and 50- to 55-kHz USVs. CONCLUSIONS Advanced statistical analysis of negative affect-associated USV data predicts future behaviors of excessive alcohol drinking and alcohol avoidance in selectively bred rats. USV characteristics across rat lines reveal affect-related motivation to consume alcohol and may predict neural pathways mediating emotional response. Further characterization of these differences could delineate particular neurocircuitry and methods to ameliorate dysregulated emotional states often observed in human alcohol abusers.
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Affiliation(s)
- James M Reno
- Waggoner Center for Alcohol and Addiction Research , The University of Texas at Austin, Austin, Texas.,Department of Psychology , College of Liberal Arts, The University of Texas at Austin, Austin, Texas
| | - Neha Thakore
- Waggoner Center for Alcohol and Addiction Research , The University of Texas at Austin, Austin, Texas.,Division of Pharmacology and Toxicology , College of Pharmacy, The University of Texas at Austin, Austin, Texas
| | - Lawrence K Cormack
- Department of Psychology , College of Liberal Arts, The University of Texas at Austin, Austin, Texas
| | - Timothy Schallert
- Waggoner Center for Alcohol and Addiction Research , The University of Texas at Austin, Austin, Texas.,Department of Psychology , College of Liberal Arts, The University of Texas at Austin, Austin, Texas
| | - Richard L Bell
- Department of Psychiatry , Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, Indiana
| | - W Todd Maddox
- Cognitive Design and Statistical Consulting , LLC, Austin, Texas
| | - Christine L Duvauchelle
- Waggoner Center for Alcohol and Addiction Research , The University of Texas at Austin, Austin, Texas.,Division of Pharmacology and Toxicology , College of Pharmacy, The University of Texas at Austin, Austin, Texas
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Parker LJ, Hunte H, Ohmit A, Furr-Holden D, Thorpe RJ. The Effects of Discrimination Are Associated With Cigarette Smoking Among Black Males. Subst Use Misuse 2017; 52:383-391. [PMID: 27779434 PMCID: PMC6331212 DOI: 10.1080/10826084.2016.1228678] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
UNLABELLED Previous research has demonstrated that experiencing interpersonal discrimination is associated with cigarette smoking. Few studies have examined the relationship between the effects of physical and emotional discrimination and cigarette usage, and none have examined this relationship among Black men. The aim of this study was to examine the association between the effects of physical and emotional discrimination and cigarette smoking. METHODS Data from the Indiana Black Men's Health Study, a community-based sample of adult Black men, was used to conduct multivariate logistic regression to examine the relationship between the physical and emotional effects of discrimination and smoking, net of healthcare and workplace discrimination, age, education, household income, and being married. RESULTS After adjusting for having an emotional response to discrimination, health care and workplace discrimination, age, education, household income, and being married, males who had a physical response to discrimination (e.g., upset stomach or headache) had higher odds of cigarette use (odds ratio (OR): 1.95, 95% confidence interval (CI): 1.15-3.30) than men who did not have a physical response to discrimination. CONCLUSION Findings from the study suggest that Black males may use cigarette smoking as a means to mitigate the stress associated with experiences of discrimination. Future research is needed further to explore if and how Black males use cigarette smoking to cope with unfair treatment.
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Affiliation(s)
- Lauren J Parker
- a Program for Research on Men's Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , USA
| | - Haslyn Hunte
- b School of Public Health, Social & Behavioral Sciences , West Virginia University , Morgantown , West Virginia , USA
| | - Anita Ohmit
- c Indiana Minority Health Coalition , Indianapolis , Indiana , USA
| | - Debra Furr-Holden
- d Department of Mental Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , USA
| | - Roland J Thorpe
- a Program for Research on Men's Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , USA
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Mutambudzi M. Association between workplace psychosocial factors and mental health in Black, Hispanic, and White women: Cross-sectional findings from the National Health Interview Survey. Women Health 2016; 57:1129-1144. [DOI: 10.1080/03630242.2016.1263273] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Miriam Mutambudzi
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, Galveston, Texas, USA
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Ornelas IJ, Lapham GT, Salgado H, Williams EC, Gotman N, Womack V, Davis S, Penedo F, Smoller S, Gallo LC. Binge drinking and perceived ethnic discrimination among Hispanics/Latinos: Results from the Hispanic community health study/study of Latinos sociocultural ancillary study. J Ethn Subst Abuse 2016; 15:223-239. [PMID: 26643869 PMCID: PMC5214998 DOI: 10.1080/15332640.2015.1024374] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The study assessed whether overall perceived ethnic discrimination and four unique discrimination types were associated with binge drinking in participants from the Hispanic Community Health Study/Study of Latinos who also completed the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (n = 5,313). In unadjusted analyses that were weighted for sampling strategy and design, each unit increase in discrimination type was associated with a 12-63% increase in odds of binge drinking; however, after adjusting for important demographic variables including age, sex, heritage group, language, and duration of U.S. residence, there was no longer an association between discrimination and binge drinking. Further research still needs to identify the salient factors that contribute to increased risk for binge drinking among Hispanics/Latinos.
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Affiliation(s)
- India J Ornelas
- a Department of Health Services , University of Washington , Seattle , Washington
| | - Gwen T Lapham
- b Group Health Research Institute , Seattle , Washington
| | - Hugo Salgado
- c Graduate School of Public Health , San Diego State University , San Diego , California
| | - Emily C Williams
- d Veterans Affairs (VA) Puget Sound Health Care System , Health Services Research & Development (HSR&D) Center of Innovation for Veteran-Centered and Value-Driven Care , Seattle , Washington
| | - Nathan Gotman
- e Collaborating Studies Coordinating Center , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina
| | - Veronica Womack
- f Feinberg School of Medicine , Northwestern University , Chicago , Illinois
| | - Sonia Davis
- e Collaborating Studies Coordinating Center , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina
| | - Frank Penedo
- f Feinberg School of Medicine , Northwestern University , Chicago , Illinois
| | - Sylvia Smoller
- g Department of Epidemiology & Population Health , Albert Einstein College of Medicine , Bronx , New York, New York
| | - Linda C Gallo
- c Graduate School of Public Health , San Diego State University , San Diego , California
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Gilbert PA, Zemore SE. Discrimination and drinking: A systematic review of the evidence. Soc Sci Med 2016; 161:178-94. [PMID: 27315370 PMCID: PMC4921286 DOI: 10.1016/j.socscimed.2016.06.009] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 06/06/2016] [Accepted: 06/08/2016] [Indexed: 11/17/2022]
Abstract
Although it is widely accepted that discrimination is associated with heavy and hazardous drinking, particularly within stress and coping frameworks, there has been no comprehensive review of the evidence. In response, we conducted a systematic review of the English language peer-reviewed literature to summarize studies of discrimination and alcohol-related outcomes, broadly defined. Searching six online data bases, we identified 938 non-duplicative titles published between 1980 and 2015, of which 97 met all inclusion criteria for our review and reported quantitative tests of associations between discrimination and alcohol use. We extracted key study characteristics and assessed quality based on reported methodological details. Papers generally supported a positive association; however, the quantity and quality of evidence varied considerably. The largest number of studies was of racial/ethnic discrimination among African Americans in the United States, followed by sexual orientation and gender discrimination. Studies of racial/ethnic discrimination were notable for their frequent use of complex modeling (i.e., mediation, moderation) but focused nearly exclusively on interpersonal discrimination. In contrast, studies of sexual orientation discrimination (i.e., heterosexism, homophobia) examined both internalized and interpersonal aspects; however, the literature largely relied on global tests of association using cross-sectional data. Some populations (e.g., Native Americans, Asian and Pacific Islanders) and types of discrimination (e.g., systemic/structural racism; ageism) received scant attention. This review extends our knowledge of a key social determinant of health through alcohol use. We identified gaps in the evidence base and suggest directions for future research related to discrimination and alcohol misuse.
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Affiliation(s)
- Paul A Gilbert
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145N. Riverside Drive, N414 CPHB, Iowa City, IA 52242, USA; Alcohol Research Group, Public Health Institute, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA.
| | - Sarah E Zemore
- Alcohol Research Group, Public Health Institute, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA
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