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Elbasheir A, Felger JC, Michopoulos V, Ely TD, Wommack EC, Carter SE, Harnett NG, Fani N. C-reactive protein moderates associations between racial discrimination and ventromedial prefrontal cortex activation during attention to threat in Black American women. Neuropsychopharmacology 2024; 49:593-599. [PMID: 37752223 PMCID: PMC10789862 DOI: 10.1038/s41386-023-01737-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/17/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023]
Abstract
Prior research has shown that racial discrimination (RD) impacts activation in threat network regions, including the ventromedial prefrontal cortex (vmPFC) and middle occipital cortex during attention to threat-relevant stimuli. However, little is known about the biological mechanisms that may modulate these effects; inflammation may be a pathway linking RD and threat network activation. As such, the current study aimed to explore whether systemic inflammation, measured by C-reactive protein (CRP) levels, may moderate the relationship between RD and activation in the vmPFC and middle occipital cortex during attention to threat. Blood samples for inflammatory marker (CRP) assays were obtained from forty Black American women (mean [SD] age, 39.93 [9.97] years; range, 22-58 years) recruited from an ongoing trauma study; participants also viewed threat-relevant stimuli as part of an attention task during fMRI. We found that CRP moderated the relationship between RD and vmPFC activation during attention to threat, such that participants with relatively higher concentrations of CRP ( ≥ 23.97 mg/L) demonstrated significant positive associations between RD and vmPFC activation [β = 0.18, CI (0.04, 0.32), t = 2.65, p = 0.01]. No significant associations were observed for participants who showed moderate (10.89 mg/L) or low (0.20 mg/L) CRP concentrations. CRP did not moderate the relationship between RD and middle occipital cortex activation. Our data present a mechanism through which RD may influence immune system activation and, in turn, threat network activation. Inflammation may contribute to brain health vulnerabilities in Black Americans via its effects on threat circuits; this merits further investigation in large-scale studies.
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Affiliation(s)
- Aziz Elbasheir
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Jennifer C Felger
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Tim D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Evanthia C Wommack
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Sierra E Carter
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | | | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
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MICHAELS ELIK, LAM‐HINE TRACY, NGUYEN THUT, GEE GILBERTC, ALLEN AMANIM. The Water Surrounding the Iceberg: Cultural Racism and Health Inequities. Milbank Q 2023; 101:768-814. [PMID: 37435779 PMCID: PMC10509530 DOI: 10.1111/1468-0009.12662] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 04/03/2023] [Accepted: 05/08/2023] [Indexed: 07/13/2023] Open
Abstract
Policy Points Cultural racism-or the widespread values that privilege and protect Whiteness and White social and economic power-permeates all levels of society, uplifts other dimensions of racism, and contributes to health inequities. Overt forms of racism, such as racial hate crimes, represent only the "tip of the iceberg," whereas structural and institutional racism represent its base. This paper advances cultural racism as the "water surrounding the iceberg," allowing it to float while obscuring its base. Considering the fundamental role of cultural racism is needed to advance health equity. CONTEXT Cultural racism is a pervasive social toxin that surrounds all other dimensions of racism to produce and maintain racial health inequities. Yet, cultural racism has received relatively little attention in the public health literature. The purpose of this paper is to 1) provide public health researchers and policymakers with a clearer understanding of what cultural racism is, 2) provide an understanding of how it operates in conjunction with the other dimensions of racism to produce health inequities, and 3) offer directions for future research and interventions on cultural racism. METHODS We conducted a nonsystematic, multidisciplinary review of theory and empirical evidence that conceptualizes, measures, and documents the consequences of cultural racism for social and health inequities. FINDINGS Cultural racism can be defined as a culture of White supremacy, which values, protects, and normalizes Whiteness and White social and economic power. This ideological system operates at the level of our shared social consciousness and is expressed in the language, symbols, and media representations of dominant society. Cultural racism surrounds and bolsters structural, institutional, personally mediated, and internalized racism, undermining health through material, cognitive/affective, biologic, and behavioral mechanisms across the life course. CONCLUSIONS More time, research, and funding is needed to advance measurement, elucidate mechanisms, and develop evidence-based policy interventions to reduce cultural racism and promote health equity.
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Affiliation(s)
- ELI K. MICHAELS
- Division of Epidemiology, School of Public HealthUniversity of California
| | - TRACY LAM‐HINE
- Division of Epidemiology & Population HealthStanford University School of Medicine
| | | | - GILBERT C. GEE
- Jonathan and Karin Fielding School of Public HealthUniversity of California
| | - AMANI M. ALLEN
- Division of Epidemiology, School of Public HealthUniversity of California
- Division of Community Health Sciences, School of Public HealthUniversity of California
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Sempértegui GA, Baliatsas C, Knipscheer JW, Bekker MHJ. Depression among Turkish and Moroccan immigrant populations in Northwestern Europe: a systematic review of prevalence and correlates. BMC Psychiatry 2023; 23:402. [PMID: 37277719 DOI: 10.1186/s12888-023-04819-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 04/26/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND This systematic review aimed to synthesize the prevalence and correlates of depressive disorders and symptoms of Turkish and Moroccan immigrant populations in Northwestern Europe, formulating evidence-informed recommendations for clinical practice. METHODS We conducted a systematic search in PsycINFO, MEDLINE, Science Direct, Web of Knowledge, and Cochrane databases for records up to March 2021. Peer-reviewed studies on adult populations that included instruments assessing prevalence and/or correlates of depression in Turkish and Moroccan immigrant populations met inclusion criteria and were assessed in terms of methodological quality. The review followed the relevant sections of the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting (PRISMA) guideline. RESULTS We identified 51 relevant studies of observational design. Prevalence of depression was consistently higher among people who had an immigrant background, compared to those who did not. This difference seemed to be more pronounced for Turkish immigrants (especially older adults, women, and outpatients with psychosomatic complaints). Ethnicity and ethnic discrimination were identified as salient, positive, independent correlates of depressive psychopathology. Acculturation strategy (high maintenance) was related to higher depressive psychopathology in Turkish groups, while religiousness appeared protective in Moroccan groups. Current research gaps concern psychological correlates, second- and third-generation populations, and sexual and gender minorities. CONCLUSION Compared to native-born populations, Turkish immigrants consistently showed the highest prevalence of depressive disorder, while Moroccan immigrants showed similar to rather moderately elevated rates. Ethnic discrimination and acculturation were more often related to depressive symptomatology than socio-demographic correlates. Ethnicity seems to be a salient, independent correlate of depression among Turkish and Moroccan immigrant populations in Northwestern Europe.
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Affiliation(s)
- Gabriela A Sempértegui
- Tranzo, Tilburg University, Tilburg, The Netherlands
- GGz Breburg, Tilburg, The Netherlands
| | - Christos Baliatsas
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513 CR, Utrecht, The Netherlands.
| | - Jeroen W Knipscheer
- Arq Psychotrauma Expert Group, Diemen, The Netherlands
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Marrie H J Bekker
- Tranzo, Tilburg University, Tilburg, The Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, VU University, Amsterdam, The Netherlands
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4
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Racism measurement and influences, variations on scientific racism, and a vision. Soc Sci Med 2023; 316:115247. [PMID: 36180279 DOI: 10.1016/j.socscimed.2022.115247] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/09/2022] [Accepted: 07/26/2022] [Indexed: 01/11/2023]
Abstract
The knowledge base regarding the impact of racism and discrimination on African American health and well-being has grown significantly since the first models of racism and health, but many questions remain. In this commentary, I discuss three challenges requiring attention in future research. The first is measurement. The second is consideration of individual and contextual influences that shape vulnerability to racism. The third challenge is racism in science itself (e.g., racial disparities in funding, absence, and erasure of African American voices in scientific discourse on health disparities). I discuss the benefits of addressing these challenges and offer a vision of what research on racism and African American health and well-being might look like as we move toward the eradication of racism and promotion of health equity.
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Danyluck C, Blair IV, Manson SM, Laudenslager ML, Daugherty SL, Brondolo E. Discrimination and Sleep Impairment in American Indians and Alaska Natives. Ann Behav Med 2022; 56:969-976. [PMID: 34864832 DOI: 10.1093/abm/kaab097] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Sleep impairment may be a key pathway through which discrimination undermines health. Links between discrimination and sleep in American Indians and Alaska Natives (AI/AN) have not been established. Further, it is unclear if such links might depend on the timing of discrimination or if socioeconomic status (SES) might buffer the impact of discrimination. PURPOSE To investigate associations between interpersonal discrimination and sleep impairment in urban AI/AN, for both lifetime and recent discrimination, and controlling for other life stressors. Education and income, indices of SES, were tested as potential moderators. METHODS A community sample of urban AI/AN (N = 303, 18-78 years old, 63% female) completed self-report measures of sleep impairment, lifetime and recent discrimination, depressive symptoms, perceived stress, other life stressors (childhood adversity and past year major events), and socio-demographic characteristics. RESULTS Lifetime discrimination was associated with impaired sleep in AI/AN after adjustment for socio-demographic characteristics, recent depressive symptoms, perceived stress, and other life stressors. Past-week discrimination was associated with sleep in unadjusted but not adjusted models. Education, but not income, was found to buffer the effects of both lifetime and past-week discrimination on sleep in adjusted models. CONCLUSION Lifetime discrimination uniquely accounts for sleep impairment and may be especially harmful in those with less education. These findings suggest targeting interventions to those most in need. Limitations include the cross-sectional nature of the data. Longitudinal and qualitative work is needed to understand how education may buffer the effects of discrimination on sleep and perhaps other health problems in AI/AN.
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Affiliation(s)
| | | | - Spero M Manson
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Goodwill JR, Taylor RJ, Watkins DC. Everyday Discrimination, Depressive Symptoms, and Suicide Ideation Among African American Men. Arch Suicide Res 2021; 25:74-93. [PMID: 31597538 DOI: 10.1080/13811118.2019.1660287] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Suicide has remained a leading cause of death among African American males, yet empirical investigations that focus on the experiences of this group are limited. Therefore, we aim to interrogate the impact of everyday discrimination as a risk factor for depressive symptoms and suicide ideation among African American men. Data were drawn from the African American male subsample of the National Survey of American Life (n = 1,271). Path analysis and tests for indirect effects were used to examine relationships between everyday discrimination, depressive symptoms, and suicide ideation. Three sources of everyday discrimination were examined (any everyday discrimination, race-based everyday discrimination, and other everyday discrimination). Study findings revealed that race-based everyday discrimination was the only type of discrimination that was significantly associated with both increased rates of depressive symptoms and suicide ideation. Further, the indirect effect from race-based everyday discrimination to suicide ideation via depressive symptoms was also statistically significant. Thus, the impact of daily encounters with discrimination extends beyond depressive symptoms and is related to higher rates of suicide ideation. Moreover, experiences with discrimination do not have to be overt to be harmful toward African American men's mental health. Culturally relevant suicide prevention interventions are needed to account for the role of discrimination in the lives of African American men.
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García-Cid A, Gómez-Jacinto L, Hombrados-Mendieta I, Millán-Franco M, Moscato G. Discrimination and Psychosocial Well-Being of Migrants in Spain: The Moderating Role of Sense of Community. Front Psychol 2020; 11:2235. [PMID: 33071850 PMCID: PMC7531257 DOI: 10.3389/fpsyg.2020.02235] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 08/10/2020] [Indexed: 11/30/2022] Open
Abstract
The discrimination migrants perceive during their adaptation process is one of the main sources of stress and it affects their well-being, health and integration severely. The present study analyses how the sense of community (SOC) can have a protective effect against the perception of discrimination and its negative consequences by verifying the following theoretical model: discrimination predicts three indicators of psychosocial well-being (psychological distress, satisfaction with life and feelings of social exclusion). Furthermore, the theoretical model proposed also considers the hypothesis that SOC has a moderating role on the effect of perceived discrimination regarding the three variables mentioned above. 1714 migrants from Eastern Europe, Africa and Latin America who live in Málaga, Spain, participated in the study. Data were collected using random-route sampling and survey methodology. After carrying out multiple regression analyses, using the PROCESS tool in SPSS 20, the theoretical model was verified: SOC reduces the negative effects of perceived discrimination for the variables psychological distress, satisfaction with life and social exclusion feelings. Therefore, migrants who have a greater SOC experience fewer negative consequences, as compared to those with a lower SOC, for whom the consequences of such variables are more negative. These results highlight the importance for migrants to rebuild social networks in the host country and develop a good SOC. Results also allow the development of intervention patterns to favor positive interactions between native population and migrants.
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Affiliation(s)
- Alba García-Cid
- Department of Social Psychology, Social Work, Social Anthropology and East Asian Studies, University of Málaga, Málaga, Spain.,Faculty of Psychology, University of Málaga, Málaga, Spain
| | - Luis Gómez-Jacinto
- Department of Social Psychology, Social Work, Social Anthropology and East Asian Studies, University of Málaga, Málaga, Spain.,Faculty of Social and Labour Studies, University of Málaga, Málaga, Spain
| | - Isabel Hombrados-Mendieta
- Department of Social Psychology, Social Work, Social Anthropology and East Asian Studies, University of Málaga, Málaga, Spain.,Faculty of Psychology, University of Málaga, Málaga, Spain
| | - Mario Millán-Franco
- Department of Social Psychology, Social Work, Social Anthropology and East Asian Studies, University of Málaga, Málaga, Spain.,Faculty of Social and Labour Studies, University of Málaga, Málaga, Spain
| | - Gianluigi Moscato
- Department of Social Psychology, Social Work, Social Anthropology and East Asian Studies, University of Málaga, Málaga, Spain.,Faculty of Social and Labour Studies, University of Málaga, Málaga, Spain
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8
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Sosoo EE, Bernard DL, Neblett EW. The influence of internalized racism on the relationship between discrimination and anxiety. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2020; 26:570-580. [PMID: 31886684 PMCID: PMC7359777 DOI: 10.1037/cdp0000320] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES This study used 2 waves of data to longitudinally examine whether internalized racism moderated the association between racial discrimination and anxiety symptom distress. METHOD Participants were 157 Black college students attending a predominantly White institution who completed measures of racial discrimination, internalized racism, and psychological distress. RESULTS Using hierarchical linear regression, results indicated a positive association between racial discrimination and subsequent anxiety symptom distress for individuals with moderate and high levels of internalization of negative stereotypes and hair change. CONCLUSIONS Findings suggest that experiences of anxiety symptom distress, in the context of racial discrimination, may differ as a function of one's acceptance and internalization of dominant White culture's actions and beliefs toward Black people. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Lui PP. Racial Microaggression, Overt Discrimination, and Distress: (In)Direct Associations With Psychological Adjustment. COUNSELING PSYCHOLOGIST 2020. [DOI: 10.1177/0011000020901714] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Scholars in diverse disciplines have examined the associations between psychological adjustment and microaggression, and overt discrimination. It remains unclear whether the roles of microaggression in adjustment outcomes can be differentiated from the roles of overt discrimination and neuroticism. I examined the extent to which racial microaggression explained unique variances of negative affect, alcohol consumption, and drinking problems while controlling for overt discrimination and neuroticism among African American, Asian American, and Latinx American college students ( N = 713). Intervening roles of psychological distress linking microaggression and overt discrimination to adjustment outcomes were also tested. Among African Americans, microaggression and overt discrimination did not consistently predict psychological adjustment. Among Asian and Latinx Americans, microaggression and overt discrimination predicted negative affect via psychological distress. Microaggression also explained the variances of alcohol use outcomes among Asian Americans. Findings are discussed in the context of an acute racism reactions model and underscore the importance of considering overt discrimination and microaggression simultaneously as determinants of psychological adjustment.
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10
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Trajectories of Discrimination across the College Years: Associations with Academic, Psychological, and Physical Adjustment Outcomes. J Youth Adolesc 2019; 49:772-789. [DOI: 10.1007/s10964-019-01147-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/09/2019] [Indexed: 12/01/2022]
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Sempértegui GA, Knipscheer JW, Baliatsas C, Bekker MHJ. Symptom manifestation and treatment effectiveness, -obstacles and -facilitators in Turkish and Moroccan groups with depression in European countries: A systematic review. J Affect Disord 2019; 247:134-155. [PMID: 30665076 DOI: 10.1016/j.jad.2018.12.060] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 12/02/2018] [Accepted: 12/20/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study examined the state of the art relevant for clinical practice on symptom manifestation of depression or depression-related idioms of distress, the treatment effectiveness and obstacles and facilitators for therapeutic success in Turkish and Moroccan immigrant populations with depression in Europe. METHODS We conducted a systematic search in PsycINFO, MEDLINE, Science Direct, Web of Knowledge, and Cochrane databases (1970- 31 July 2017). Peer-reviewed studies, with adult populations, and an instrument assessing depressive symptoms met inclusion criteria and were evaluated following quality guidelines. RESULTS We included 13 studies on symptom manifestation, 6 on treatment effectiveness, and 17 on obstacles and facilitators, published between 2000 and 2017, from Germany, the Netherlands, Austria and Sweden (n Turkish individuals = 11,533; n Moroccan individuals = 5278; n native individuals = 303,212). Both ethnic groups more often reported combined mood and somatic symptoms (and anxiety in the case of Turkish groups) than natives, and had higher levels of symptoms. There was no report on effectiveness of pharmacotherapy and there was weak evidence of the effectiveness of examined psychological treatments for depression in Turkish groups. No treatment has been examined in Moroccan groups. Salient obstacles to therapeutic success were socioeconomic problems, higher level of psychological symptoms at baseline, and negative attitudes towards psychotherapy. Possible facilitators were interventions attuned to social, cultural and individual needs. Results were most representative of first generation, low SES Turkish immigrant patients, and Moroccan-Dutch members of the general populations. CONCLUSION Turkish and Moroccan immigrants with depression presented a comorbid symptom profile with more intertwined depressive and somatic complaints. There were indications that the available therapies are insufficient for Turkish groups, but the current evidence is scarce and heterogeneous, and RCTs suffer from methodological limitations.
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Affiliation(s)
- Gabriela A Sempértegui
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Jeroen W Knipscheer
- Arq Psychotrauma Expert Group, Diemen, the Netherlands; Clinical Psychology, Utrecht University, Utrecht, the Netherlands
| | - Christos Baliatsas
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Marrie H J Bekker
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
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12
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Assari S. Education Attainment and Obesity:Differential Returns Based on Sexual Orientation. Behav Sci (Basel) 2019; 9:E16. [PMID: 30699932 PMCID: PMC6406256 DOI: 10.3390/bs9020016] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 02/06/2023] Open
Abstract
Background: Although high educational attainment is linked to better health and lower health risk behaviors, this effect may be systemically smaller for racial and ethnic minority groups compared to Whites. However, it is still unknown whether these diminished returns also apply to marginalization based on sexual orientation. Aims: In a national sample of adults which was composed of people of color, we compared straight and homosexual people for the association between education attainment and obesity. Methods: The Social Justice Sexuality Project (SJS-2010) is a cross-sectional national survey of health and wellbeing of predominantly people of color who identify as homosexual. The current analysis included 2884 adults (age 24 or more) who were either heterosexual (n = 260) or homosexual (n = 2624). The predictor variable was education attainment, and the outcome variable was obesity status (body mass index larger than 30 kg/m² [kilograms per meter squared]). Demographic factors (age and gender), household income, nativity (US born vs. immigrant), and health (self-rated health and current smoking) were the covariates. Sexual orientation was the moderator. Results: In the pooled sample, high education attainment was protective against obesity status. Sexual orientation interacted with education attainment on odds of obesity, which was suggestive of stronger protective effects of high education attainment against obesity for heterosexual than homosexual individuals. Conclusion: High education attainment better protects heterosexual than homosexual people against obesity, a pattern similar to what has been observed for comparison of Whites and non-Whites. Smaller protective effects of education attainment on health behaviors of marginalized people are possibly, due to prejudice and discrimination that they experience. Discrimination may minimize stigmatized individuals' abilities to mobilize their economic and human resources and translate them to tangible outcomes. This finding extends the Minorities' Diminished Returns theory, suggesting that it is not just race/ethnicity but possibly any marginalizing and stigmatizing social identity that results in diminished returns of socioeconomic status resources.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109-2700, USA.
- Center for Research on Ethnicity, Culture, and Health (CRECH), University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
- Department of Psychology, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA.
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Lee DB, Heinze JE, Neblett EW, Caldwell CH, Zimmerman MA. Trajectories of Racial Discrimination that Predict Problematic Alcohol Use among African American Emerging Adults. EMERGING ADULTHOOD (PRINT) 2018; 6:347-357. [PMID: 33833905 PMCID: PMC8025965 DOI: 10.1177/2167696817739022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The association between racial discrimination (discrimination) and problematic alcohol use in African American (AA) emerging adults is well documented. Few researchers, however, have studied the longitudinal relationship between discrimination and problematic alcohol use among AA male and female emerging adults. In a sample of 681 AAs aged 19-25 (51% male), we explored multiple, distinct trajectories of discrimination and socio-demographic predictors of the trajectory classifications. We also examined the relation between discrimination trajectories and problematic alcohol use and the extent to which sex modified these associations. Collectively, the findings revealed that three trajectories - high-stable, low-rising, and low-declining - characterized discrimination experiences for AA emerging adults. Males in the high-stable trajectory class reported more problematic alcohol use than males in other trajectory classes and all females. These findings lay the foundation for future research that examines gender-specific mechanisms in the discrimination-health link.
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Affiliation(s)
- Daniel B Lee
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan
| | - Justin E Heinze
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Enrique W Neblett
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, North Carolina
| | - Cleopatra H Caldwell
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Marc A Zimmerman
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
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14
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Assari S, Gibbons FX, Simons RL. Perceived Discrimination among Black Youth: An 18-Year Longitudinal Study. Behav Sci (Basel) 2018; 8:E44. [PMID: 29702587 PMCID: PMC5981238 DOI: 10.3390/bs8050044] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 04/23/2018] [Accepted: 04/25/2018] [Indexed: 01/08/2023] Open
Abstract
Background: Recent research has suggested vulnerability to perceived racial discrimination (PRD) as a mechanism behind high levels of depression seen in high socioeconomic status (SES) Black males. To better understand the effects of gender and SES on shaping experiences of PRD among Black youth in the United States, we used data from the Family and Community Health Study (FACHS) to explore the trajectory of PRD in Black youth by gender, SES, and place. Methods: Data came from FACHS, 1997⁻2017, which followed 889 children aged 10⁻12 years old at Wave 1 (n = 478; 53.8% females and n = 411; 46.2% males) for up to 18 years. Data were collected in seven waves. The main predictors of interest were gender, SES (parent education and annual family income), age, and place of residence. Main outcomes of interest were baseline and slope of PRD. Latent growth curve modeling (LGCM) was used for data analysis. Results: Gender, SES, place, and age were correlated with baseline and change in PRD over time. Male, high family income, and younger Black youth reported lower PRD at baseline but a larger increase in PRD over time. Youth who lived in Iowa (in a predominantly White area) reported higher PRD at baseline and also an increase in PRD over time. High parental education was not associated with baseline or change in PRD. Conclusion: In the United States, Black youth who are male, high income, and live in predominantly White areas experience an increase in PRD over time. Future research is needed on the interactions between gender, SES, and place on exposure and vulnerability of Black youth to PRD. Such research may explain the increased risk of depression in high SES Black males.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, SPC 5763, Ann Arbor, MI 48109-2700, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2700, USA.
| | - Frederick X Gibbons
- Department of Psychological Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Ronald L Simons
- Department of Sociology, University of Georgia, Athens, GA 30602, USA.
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15
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Assari S, Preiser B, Lankarani MM, Caldwell CH. Subjective Socioeconomic Status Moderates the Association between Discrimination and Depression in African American Youth. Brain Sci 2018; 8:E71. [PMID: 29677115 PMCID: PMC5924407 DOI: 10.3390/brainsci8040071] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/17/2018] [Accepted: 04/18/2018] [Indexed: 12/04/2022] Open
Abstract
Background: Most of the literature on the association between socioeconomic status (SES) and health is focused on the protective effects of SES. However, a growing literature suggests that high SES may also operate as a vulnerability factor. Aims: Using a national sample of African American youth, this study compared the effects of perceived discrimination on major depressive disorder (MDD) based on SES. Methods: The current cross-sectional study included 810 African American youth who participated in the National Survey of American Life-Adolescent supplement. The independent variable was perceived discrimination. Lifetime, 12-month, and 30-day MDD were the dependent variables. Age and gender were covariates. Three SES indicators (subjective SES, income, and poverty index) were moderators. We used logistic regressions for data analysis. Results: Perceived discrimination was associated with higher risk of lifetime, 12-month, and 30-day MDD. Interactions were found between subjective SES and perceived discrimination on lifetime, 12-month, and 30-day MDD, suggesting a stronger effect of perceived discrimination in youth with high subjective SES. Objective measures of SES (income and poverty index) did not interact with perceived discrimination on MDD. Conclusion: While perceived discrimination is a universally harmful risk factor for MDD, its effect may depend on the SES of the individual. Findings suggest that high subjective SES may operate as a vulnerability factor for African American youth.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Brianna Preiser
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
| | | | - Cleopatra H Caldwell
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
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Dotterer AM, James A. Can Parenting Microprotections Buffer Against Adolescents' Experiences of Racial Discrimination? J Youth Adolesc 2017; 47:38-50. [PMID: 29052120 DOI: 10.1007/s10964-017-0773-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 10/04/2017] [Indexed: 11/25/2022]
Abstract
Previous research highlights the importance and pervasiveness of racial discrimination for minority youth in the United States. Adolescents may experience either personal or group race-based discrimination. While past research found both forms of discrimination are harmful to well-being it is unknown whether parental microprotections, which may buffer against the negative effects of discrimination, protect against both forms of discrimination. Informed by ecological frameworks the present study examined whether parent microprotections (parental warmth/acceptance, cultural socialization, preparation for bias) buffered the effects of personal and group discrimination on adolescents' depressive symptoms. Participants were African American early adolescents (N = 129; 58% female) and their parents (90% mothers). Adolescents attended a Midwestern, Title 1, urban, public middle school and completed surveys in their homerooms and parents completed paper-pencil surveys at home, online or surveys via telephone. Multiple regression analyses were conducted to test whether adolescents' personal and group discrimination at school were related to their reports of depressive symptoms and evaluate whether parent microprotections buffered these associations. Results showed that parental microprotections moderated the effects of personal discrimination on depressive symptoms but did not buffer the effects of group discrimination. These results highlight the importance of distinguishing between personal and group discrimination. Further, additional protective factors need to be identified and tested to better understand parental actions that potentially buffer the negative effects of discrimination.
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Affiliation(s)
- Aryn M Dotterer
- Department of Family, Consumer, and Human Development, Utah State University, 2905 Old Main Hill, Logan, UT, 84322-2905, USA.
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Assari S, Lee DB, Nicklett EJ, Moghani Lankarani M, Piette JD, Aikens JE. Racial Discrimination in Health Care Is Associated with Worse Glycemic Control among Black Men but Not Black Women with Type 2 Diabetes. Front Public Health 2017; 5:235. [PMID: 28955703 PMCID: PMC5600936 DOI: 10.3389/fpubh.2017.00235] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 08/21/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A growing body of research suggests that racial discrimination may affect the health of Black men and Black women differently. AIMS This study examined Black patients with diabetes mellitus (DM) in order to test gender differences in (1) levels of perceived racial discrimination in health care and (2) how perceived discrimination relates to glycemic control. METHODS A total of 163 Black patients with type 2 DM (78 women and 85 men) provided data on demographics (age and gender), socioeconomic status, perceived racial discrimination in health care, self-rated health, and hemoglobin A1c (HbA1c). Data were analyzed using linear regression. RESULTS Black men reported more racial discrimination in health care than Black women. Although racial discrimination in health care was not significantly associated with HbA1c in the pooled sample (b = 0.20, 95% CI = -0.41 -0.80), gender-stratified analysis indicated an association between perceived discrimination and higher HbA1c levels for Black men (b = 0.86, 95% confidence intervals (CI) = 0.01-1.73) but not Black women (b = -0.31, 95% CI = -1.17 to -0.54). CONCLUSION Perceived racial discrimination in diabetes care may be more salient for glycemic control of Black men than Black women. Scholars and clinicians should take gender into account when considering the impacts of race-related discrimination experiences on health outcomes. Policies should reduce racial discrimination in the health care.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Daniel B. Lee
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
- Prevention Research Center, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Emily Joy Nicklett
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | | | - John D. Piette
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
- Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, United States
- Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, United States
| | - James E. Aikens
- Department of Family Medicine, Michigan Medicine, Ann Arbor, MI, United States
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Lee DB, Neblett EW. Religious Development in African American Adolescents: Growth Patterns That Offer Protection. Child Dev 2017; 90:245-259. [PMID: 28708241 DOI: 10.1111/cdev.12896] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Although religiosity promotes resilient outcomes in African American (AA) adolescents, there is a lack of research that examines the protective role of religious development in the context of stressful life events (SLEs). In 1,595 AA adolescents, a cohort-sequential design was used from ages 12 to 18 to examine subtypes of religiosity, as well as distinct developmental patterns within subtypes. The protective role of religious development was also examined in the context of SLEs. The study findings indicated two subtypes of religiosity-extrinsic and intrinsic religiosity-as well as low and high developmental patterns in the identified subtypes. Furthermore, the protective influence of extrinsic and intrinsic religiosity gradually diminished from age 12 to 18 in the context of SLEs.
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The Promise and Peril of Emerging Adulthood: Introduction to the Special Issue. COGNITIVE AND BEHAVIORAL PRACTICE 2016. [DOI: 10.1016/j.cbpra.2016.05.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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