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Gaydosh L, Harris KM. Institutional Context Shapes the Physical Health of College Graduates Differently for U.S. White, Black, and Hispanic Adults. Demography 2024; 61:933-966. [PMID: 38809598 DOI: 10.1215/00703370-11380743] [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] [Indexed: 05/30/2024]
Abstract
Greater educational attainment is generally associated with healthier and longer lives. However, important heterogeneity in who benefits from educational attainment, how much, and why remains underexplored. In particular, in the United States, the physical health returns to educational attainment are not as large for minoritized racial and ethnic groups compared with individuals racialized as White. Yet, our current understanding of ethnoracial differences in educational health disparities is limited by an almost exclusive focus on the quantity of education attained without sufficient attention to heterogeneity within educational attainment categories, such as different institution types among college graduates. Using biomarker data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), we test whether the physical health of college graduates in early adulthood (aged 24-32) varies by institution type and for White, Black, and Hispanic adults. In considering the role of the college context, we conceptualize postsecondary institutions as horizontally stratified and racialized institutional spaces with different implications for the health of their graduates. Finally, we quantify the role of differential attendance at and returns to postsecondary institution type in shaping ethnoracialized health disparities among college graduates in early adulthood.
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Affiliation(s)
- Lauren Gaydosh
- Department of Sociology and Population Research Center, University of Texas at Austin, Austin, TX, USA
| | - Kathleen Mullan Harris
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Williams E, Harris LK, Zhang S, Cortés YI. Daily spiritual experiences and allostatic load trajectories: a longitudinal study of midlife African American women. Menopause 2024; 31:530-536. [PMID: 38595203 PMCID: PMC11126357 DOI: 10.1097/gme.0000000000002353] [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] [Indexed: 04/11/2024]
Abstract
OBJECTIVE This study aimed to evaluate the association between daily spiritual experiences and allostatic load (AL) trajectories in midlife African American women. METHODS A longitudinal analysis of public-use data from 727 African American women in the Study of Women's Health Across the Nation (SWAN) was performed. We included African American women who completed the Daily Spiritual Experiences Scale at SWAN visit 4 (2000-2001) and had AL data at three or more study visits over 7 years. AL was calculated at each visit using 10 biomarkers: systolic and diastolic blood pressure, body mass index, C-reactive protein, high-density lipoprotein cholesterol, total cholesterol, waist-to-hip ratio, fasting serum glucose, triglycerides, and dehydroepiandrosterone. Group-based trajectory modeling identified women with similar patterns of AL. We used multinomial logistic regression to estimate associations between daily spiritual experiences (some days or less, most days, daily, many times a day) and AL trajectories. FINDINGS Our sample had a mean ± SD age of 49.9 ± 2.66 years, 47% were early perimenopausal, and 17% earned <$19,999 annually. The mean ± SD AL score was 2.52 ± 1.68. Three AL trajectories were identified: low (35.1%), moderate (44.7%), and high (20.2%). In age-adjusted models, women who reported daily comfort in religion and spirituality were less likely to follow a high AL trajectory (odds ratio, 0.41; 95% CI, 0.18-0.93); the association was attenuated when controlling for depressive symptoms (odds ratio, 0.48; 95% CI, 0.19-1.21). CONCLUSIONS Findings from this study do not support an independent association between spirituality in African American women and AL trajectories in midlife. Studies with a larger sample and additional measures of spirituality are warranted in this population.
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Affiliation(s)
- Elizabeth Williams
- From the University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, NC
| | - Latesha K Harris
- From the University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, NC
| | - Shuo Zhang
- Duke University School of Medicine, Durham, NC
| | - Yamnia I Cortés
- Division of Community and Primary Health, Duke University School of Medicine, MRI Service Center, University of Iowa College of Nursing, Iowa City, IA
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Chen YT, Zhou Y, Williams S, Cantor J, Taylor BG, Lamuda PA, Pollack HA, Schneider J. Racial discrimination and mental health in the context of anti-Asian xenophobia: An intersecting approach of race, ethnicity, nativity, and socioeconomic status. SSM - MENTAL HEALTH 2024; 5:100292. [PMID: 39036441 PMCID: PMC11259006 DOI: 10.1016/j.ssmmh.2023.100292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024] Open
Abstract
The COVID-19 pandemic, polarized politics, and heightened stigma and discrimination are salient drivers for negative mental health outcomes, particularly among marginalized racial and ethnic minoritized groups. Intersectionality of race, ethnicity, foreign-born status, and educational attainment may distinctively shape an individual's experience of discrimination and mental health during such unprecedented time. The present study examines the differential associations of racial discrimination and mental health based on an individual's race, ethnicity, foreign-born status, and educational attainment during the COVID-19 pandemic. Analyses were based on a nationally representative sample of U.S. adults collected between October and November 2021 (n = 6276). We utilized multivariable linear regressions to identify the multiplicative effects of race, ethnic, foreign-born status and self-reported racial discrimination on mental health, stratified by educational attainment. Among individuals with lower educational attainment, associations between racial discrimination and poor mental health were stronger among Asians (US-born: β = -2.07, p = 0.03; foreign-born: β = -3.18, p = 0.02) and US-born multiracial individuals (β = -1.96, p = 0.02) than their White counterparts. Among individuals with higher educational attainment, foreign-born Hispanics (β = -3.66, p < 0.001) and US-born Asians (β = -2.07, p = 0.01) reported worst mental health when exposed to racial discrimination out of all other racial, ethnic and foreign-born groups. Our results suggest that association of racial discrimination and mental health varies across racial, ethnic, foreign-born, and education subgroups. Using an intersectional approach to address the widening inequities in racial discrimination and mental health during the COVID-19 pandemic contextualizes unique experience of discrimination and provides crucial insight on the patterns of mental health among marginalized groups.
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Affiliation(s)
- Yen-Tyng Chen
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA
| | - Yuqing Zhou
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Sharifa Williams
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA
| | - Joel Cantor
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA
- Center for State Health Policy, Institute for Health, Rutgers University, New Brunswick, NJ, USA
| | - Bruce G. Taylor
- Public Health Department, NORC at the University of Chicago, Chicago, IL, USA
| | - Phoebe A. Lamuda
- Public Health Department, NORC at the University of Chicago, Chicago, IL, USA
| | - Harold A. Pollack
- School of Social Service, Administration Admissions, University of Chicago, Chicago, IL, USA
| | - John Schneider
- School of Social Service, Administration Admissions, University of Chicago, Chicago, IL, USA
- Department of Medicine and Public Health Sciences, University of Chicago, Chicago, IL, USA
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Lewis KR, Grossman K, Jones NE, Horner M. "Mentally you don't function the same": a Qualitative Examination of the Normalization, Embodiment, and Psychological Impact of Everyday Racism. J Racial Ethn Health Disparities 2024; 11:631-642. [PMID: 36884132 DOI: 10.1007/s40615-023-01548-y] [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: 09/07/2022] [Revised: 01/20/2023] [Accepted: 02/20/2023] [Indexed: 03/09/2023]
Abstract
Everyday racism consists of covert and oppressive practices that uphold systems of power and reproduce White supremacy through subtle forms of repetitive and normalized discriminatory actions. While attention to the material and physical damage everyday racism evokes upon Black Americans is receiving increased attention, inconsistencies regarding its conceptualization and operationalization are impeding our understanding of the impact of everyday racism. Utilizing critical race theory (CRT) as an analytical framework, this article intends to respond to gaps in the literature and deepen the understanding of the psychological burden experiences of everyday racism places upon a sample of (n = 40) Black Americans. We engaged with the racial realism and Whiteness as property tenets to analyze individual in-depth interviews and (1) enhance our interrogation of micro/macro-level interactions and (2) aid in the conceptualization of everyday racism. Three themes emerged from the data: hypervigilance and the normalization of everyday racism, mental preparation for navigating White spaces, and the mental health impact of everyday racism. Participant narratives reveal how the normalization of everyday racism impacts them on a psychological and corporeal (i.e., bodily) level. Their accounts also spoke to how Whiteness operates as a property right that exacerbates everyday racism and places invisible boundaries upon how they navigate space. This study provides conceptual clarity about the realities of racism, deeper awareness of structural and individual measures, and an in-depth understanding of how often taken for granted and assumed "normal" forms of racism generate pathways to negative mental health outcomes.
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Affiliation(s)
- Kaleea R Lewis
- Department of Public Health, University of Missouri - Columbia, School of Health Professions, Room 805, Columbia, MO, 65211, USA.
| | - Kandice Grossman
- Department of Sociology, University of Missouri - Columbia, College of Arts and Science, Columbia, MO, 65211, USA
| | - Nicole E Jones
- Department of Sociology and Criminology & Law, University of Florida, Gainesville, FL, USA
| | - Melissa Horner
- Department of Sociology, University of Missouri - Columbia, College of Arts and Science, Columbia, MO, 65211, USA
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Agbonlahor O, DeJarnett N, Hart JL, Bhatnagar A, McLeish AC, Walker KL. Racial/Ethnic Discrimination and Cardiometabolic Diseases: A Systematic Review. J Racial Ethn Health Disparities 2024; 11:783-807. [PMID: 36976513 PMCID: PMC10044132 DOI: 10.1007/s40615-023-01561-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 03/29/2023]
Abstract
INTRODUCTION Racial discrimination has been identified as a risk factor for cardiometabolic diseases, the leading cause of morbidity and mortality among racial/ethnic minority groups; however, there is no synthesis of current knowledge on the association between discrimination and cardiometabolic diseases. The objective of this systematic review was to summarize evidence linking racial/ethnic discrimination and cardiometabolic diseases. METHODS The review was conducted based on studies identified via electronic searches of 5 databases (PubMed, Google Scholar, WorldWideScience.org, ResearchGate and Microsoft Academic) using terms related to discrimination and cardiometabolic disease. RESULTS Of the 123 eligible studies included in the review, 87 were cross-sectional, 25 longitudinal, 8 quasi-experimental, 2 randomized controlled trials and 1 case-control. Cardiometabolic disease outcomes discussed were hypertension (n = 46), cardiovascular disease (n = 40), obesity (n = 12), diabetes (n = 11), metabolic syndrome (n = 9), and chronic kidney disease (n = 5). Although a variety of discrimination measures was employed across the studies, the Everyday Discrimination Scale was used most often (32.5%). African Americans/Blacks were the most frequently studied racial/ethnic group (53.1%), and American Indians the least (0.02%). Significant associations between racial/ethnic discrimination and cardiometabolic disease were found in 73.2% of the studies. DISCUSSION Racial/ethnic discrimination is positively associated with increased risk of cardiometabolic disease and higher levels of cardiometabolic biomarkers. Identifying racial/ethnic discrimination as a potential key contributor to the health inequities associated with cardiometabolic diseases is important for addressing the significant burden borne by racial/ethnic minorities.
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Affiliation(s)
- Osayande Agbonlahor
- Department of Communication, University of Louisville, Louisville, KY USA
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
| | - Natasha DeJarnett
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- Division of Environmental Medicine, School of Medicine, University of Louisville, Louisville, KY USA
| | - Joy L. Hart
- Department of Communication, University of Louisville, Louisville, KY USA
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- Division of Environmental Medicine, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
| | - Alison C. McLeish
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY USA
| | - Kandi L. Walker
- Department of Communication, University of Louisville, Louisville, KY USA
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
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Suslovic B, Lett E. Resilience is an Adverse Event: A Critical Discussion of Resilience Theory in Health Services Research and Public Health. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024; 44:339-343. [PMID: 36856261 PMCID: PMC10919062 DOI: 10.1177/2752535x231159721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Resilience, the individual trait of being able to persist and cope with, often recurrent, negative experiences, has experienced an explosion in recent years as a topic of study. In this commentary, we critique this surge and problematize the co-occurring development of the "resilience as treatment" paradigm. We show that resilience is an expectation foisted primarily on historically and contemporarily oppressed and excluded populations often in response to systemic and structural forms of discrimination. We argue that this represents a fundamental mismatch of intervention and problem; offering an individual-level solution to a structural toxin. In doing so, we re-contextualize resilience as an adverse event, more analogous to scar tissue than a reliable treatment paradigm. Our essay concludes with offering alternatives to resilience that originate with the holistic trauma and liberation health frameworks. These paradigms are united in that, in contrast to resilience, they emphasize healing from structural violence, rather than adapting to it.
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Affiliation(s)
- Brianna Suslovic
- The Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, IL, USA
| | - Elle Lett
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, MA, USA
- Center for Applied Transgender Studies, Chicago, IL, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Garland M, Wilbur J, Schoeny M, Reed M, Semanik P, Halloway S, Waters T. Determinants of Physical Activity Among Black Women During Pregnancy. J Obstet Gynecol Neonatal Nurs 2024; 53:172-184. [PMID: 38072009 DOI: 10.1016/j.jogn.2023.11.006] [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: 05/16/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 01/21/2024] Open
Abstract
OBJECTIVE To describe associations among background determinants of physical activity, modifiable theoretical determinants of physical activity, and measures of physical activity during the second and third trimesters of pregnancy among Black women. DESIGN Longitudinal cohort. SETTING Medical center obstetric clinic. PARTICIPANTS Pregnant Black women (n = 40 in second trimester, n = 38 in third trimester) METHODS: We measured background determinants (demographic and pregnancy characteristics, discrimination, and neighborhood walkability) during the second trimester. We measured modifiable theoretical determinants (self-efficacy and social support) and physical activity using self-report and device measures during the second and third trimesters. We used paired t tests to determine differences in the modifiable theoretical determinants from the second trimester to third trimester and used Pearson correlations among background and modifiable determinants and physical activity measures during the second trimester. RESULTS Participants' physical activity levels were low during the second and third trimesters (32% and 22% met recommendation, respectively). We found no changes in self-efficacy or social support between trimesters and found no associations between these modifiable determinants and actual physical activity. We found a positive correlation between previous pregnancies and physical activity measured by devices, r(36) = .33, p = .048. Pregnancy-specific stress, r(38) = -.40, p = .013, was negatively correlated, and age, r(38) = .38, p = .017, was positively correlated with self-reported physical activity. CONCLUSIONS Low levels of physical activity during pregnancy coupled with the absence of an association with modifiable factors affecting pregnancy physical activity indicate a need to further examine the social, cultural, and environmental determinants of physical activity.
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Daniels KP, D Thomas M, Chae DH, Allen AM. Black Mothers' Concern for Their Children as a Measure of Vicarious Racism-Related Vigilance and Allostatic Load. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2023; 64:520-536. [PMID: 37332176 DOI: 10.1177/00221465231175942] [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] [Indexed: 06/20/2023]
Abstract
This study investigates the relationship between allostatic load and a novel form of altruistic racism-related fear, or concern for how racism might harm another, which we term vicarious racism-related vigilance. Using a subsample of Black mothers from the African American Women's Heart & Health Study (N = 140), which includes detailed health and survey data on a community sample of Black women in the San Francisco Bay Area, this study investigates the relationship between Black mothers' experiences with racism-related vigilance as it relates to their children and allostatic load-a multisystem metric of underlying health across multiple biological systems. Findings indicate that vicarious racism-related vigilance was positively associated with allostatic load (i.e., worse health). Findings highlight the salience of vicarious racism-related vigilance for the health of Black mothers, underscoring how intersections between race, gender, and parenthood result in susceptibility to unique forms of health-harming stress.
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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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Li C, Andrzejak SE, Jones SR, Williams BM, Moore JX. Investigating the association between educational attainment and allostatic load with risk of cancer mortality among African American women. BMC Womens Health 2023; 23:448. [PMID: 37620873 PMCID: PMC10463695 DOI: 10.1186/s12905-023-02529-3] [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: 03/01/2023] [Accepted: 07/05/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND African American (AA) women navigate the world with multiple intersecting marginalized identities. Accordingly, AA women have higher cumulative stress burden or allostatic load (AL) compared to other women. Studies suggest that AA women with a college degree or higher have lower AL than AA women with less than a high school diploma. We examined the joint effect of educational attainment and AL status with long-term risk of cancer mortality, and whether education moderated the association between AL and cancer mortality. METHODS We performed a retrospective analysis among 4,677 AA women within the National Health and Nutrition Examination Survey (NHANES) from 1988 to 2010 with follow-up data through December 31, 2019. We fit weighted Cox proportional hazards models to estimate adjusted hazard ratios (aHRs) of cancer death between educational attainment/AL (adjusted for age, income, and smoking status). RESULTS AA women with less than a high school diploma living with high AL had nearly a 3-fold increased risk (unadjusted HR: 2.98; 95%C CI: 1.24-7.15) of cancer death compared to AA college graduates living with low AL. However, after adjusting for age, this effect attenuated (age-adjusted HR: 1.11; 95% CI: 0.45-2.74). AA women with high AL had 2.3-fold increased risk of cancer death (fully adjusted HR: 2.26; 95% CI: 1.10-4.57) when compared to AA with low AL, specifically among women with high school diploma or equivalent and without history of cancer. CONCLUSIONS Our findings suggest that high allostatic load is associated with a higher risk of cancer mortality among AA women with lower educational attainment, while no such association was observed among AA women with higher educational attainment. Thus, educational attainment plays a modifying role in the relationship between allostatic load and the risk of cancer death for AA women. Higher education can bring several benefits, including improved access to medical care and enhanced medical literacy, which in turn may help mitigate the adverse impact of AL and the heightened risk of cancer mortality among AA women.
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Affiliation(s)
- Cynthia Li
- Georgia Cancer Center, Augusta University, 1410 Laney Walker Blvd, 30912, Augusta, GA, USA
| | | | - Samantha R Jones
- Department of Family and Community Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | | | - Justin Xavier Moore
- Center for Health Equity Transformation, Department of Behavioral Science, University of Kentucky, Lexington, KY, USA.
- Community Impact Office, Markey Cancer Center, University of Kentucky, Lexington, KY, USA.
- Department of Internal Medicine, University of Kentucky, Lexington, KY, USA.
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Cohodes EM, McCauley S, Pierre JC, Hodges HR, Haberman JT, Santiuste I, Rogers MK, Wang J, Mandell JD, Gee DG. Development and validation of the Dimensional Inventory of Stress and Trauma Across the Lifespan (DISTAL): A novel assessment tool to facilitate the dimensional study of psychobiological sequelae of exposure to adversity. Dev Psychobiol 2023; 65:e22372. [PMID: 37073593 DOI: 10.1002/dev.22372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/16/2022] [Accepted: 01/04/2023] [Indexed: 04/20/2023]
Abstract
Decades of research underscore the profound impact of adversity on brain and behavioral development. Recent theoretical models have highlighted the importance of considering specific features of adversity that may have dissociable effects at distinct developmental timepoints. However, existing measures do not query these dimensions in sufficient detail to support the proliferation of this approach. The Dimensional Inventory of Stress and Trauma Across the Lifespan (DISTAL) was developed with the aim to thoroughly and retrospectively assess the timing, severity (of exposure and reaction), type, persons involved, controllability, predictability, threat, deprivation, proximity, betrayal, and discrimination inherent in an individual's exposure to adversity. Here, we introduce this instrument, present descriptive statistics drawn from a sample of N = 187 adults who completed the DISTAL, and provide initial information about its psychometric properties. This novel measure facilitates the expansion of research focused on assessing the relative impact of exposure to key dimensions of adversity on the brain and behavior across development.
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Affiliation(s)
- Emily M Cohodes
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Sarah McCauley
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Jasmyne C Pierre
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - H R Hodges
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Jason T Haberman
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Isabel Santiuste
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Marisa K Rogers
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Jenny Wang
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Jeffrey D Mandell
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut, USA
| | - Dylan G Gee
- Department of Psychology, Yale University, New Haven, Connecticut, USA
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12
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Grayson SC, Cummings MH, Wesmiller S, Bender C. The Cancer Genomic Integration Model for Symptom Science (CGIMSS): A Biopsychosocial Framework. Biol Res Nurs 2023; 25:210-219. [PMID: 36206160 PMCID: PMC10236443 DOI: 10.1177/10998004221132250] [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] [Indexed: 11/15/2022]
Abstract
Current nursing research has characterized symptom clusters and trajectories in individuals with breast cancer. The existing literature describes the relationship between symptoms and biological variables and the potential moderating effects of individual and social factors. The genomic profiling of breast cancer has also been an area of much recent research. Emerging evidence indicates that incorporating cancer genomics into symptom science research can aid in the prognostication of symptoms and elucidate targets for symptom management interventions. The aim of this paper is to outline a model to integrate cancer genomics into symptom science research, illustrated using breast cancer and psychoneurological (PN) symptoms as an example. We present a review of the current literature surrounding breast cancer genomics (specifically cancer genomic instability) and the biological underpinnings of the PN symptom cluster. Advances in both of these areas indicate that inflammation may serve as the bridge between cancer genomics and the PN symptom cluster. We also outline how the integration of cancer genomics into symptom science research synergizes with current research of individual and social factors in relation to symptoms. This model aims to provide a framework to guide future biopsychosocial symptom science research that can elucidate new predictive methods and new targets for intervention.
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Affiliation(s)
- Susan C. Grayson
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Susan Wesmiller
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Catherine Bender
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
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13
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Li C, Andrzejak SE, Jones SR, Williams BM, Moore JX. Investigating the Association between Educational Attainment and Allostatic Load with Risk of Cancer Mortality among African American Women. RESEARCH SQUARE 2023:rs.3.rs-2644466. [PMID: 37034626 PMCID: PMC10081371 DOI: 10.21203/rs.3.rs-2644466/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Background African American (AA) women navigate the world with multiple intersecting marginalized identities. Accordingly, AA women have higher cumulative stress burden or allostatic load (AL) compared to other women. AL correlates with poorer health outcomes and increased risk of cancer death. However, research indicates AA women with a college degree or higher have lower AL than AA women with less than a high school diploma. We examined whether educational attainment differences and AL status in AA women are associated with long-term risk of cancer mortality. Methods We performed a retrospective analysis among 4,677 AA women respondents using National Health and Nutrition Examination Survey (NHANES) data from 1988 through 2010 with follow up data through December 31, 2019. We fit Cox proportional hazards models to estimate adjusted hazard ratios (aHRs) of cancer death between educational attainment/AL (adjusted for age, sociodemographic, and health factors). Results AA women with less than a high school diploma living with high AL had nearly a 3-fold increased risk (unadjusted HR: 2.98; 95%C CI: 1.24â€"7.15) of cancer death compared to AA college graduates living with low AL. However, after adjusting for age, the increased risk of cancer death in those with less than a high school diploma and high AL attenuated (age-adjusted HR: 1.11; 95% CI: .45-2.74). Conclusions Differences in educational attainment and AL in AA women were not associated with increased risk of cancer mortality when adjusted for age. Previous studies have shown that increased allostatic load is associated with increased risk of cancer death. However, for African American women, higher educational attainment does not modify the risk of cancer mortality. The benefits that may come along with higher education such as increased access to medical care and better medical literacy do not change the risk of cancer mortality in AA women.
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14
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Daniels TE, Mathis KJ, Gobin AP, Lewis-de Los Angeles WW, Smith EM, Chanthrakumar P, de la Monte S, Tyrka AR. Associations of early life stress with leptin and ghrelin in healthy young adults. Psychoneuroendocrinology 2023; 149:106007. [PMID: 36577337 PMCID: PMC9931677 DOI: 10.1016/j.psyneuen.2022.106007] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Childhood adversity is a major risk factor for cardiometabolic health problems. Stress-related changes in diet suggest a role for endocrine factors that influence dietary intake, such as leptin and ghrelin. These hormones influence metabolism and may contribute to the relationship of early adversity, mental, and cardiometabolic health. This study examined levels of leptin and ghrelin in a sample of young adults with and without early life stress (ELS). METHODS Young adults ages 18-40 (N = 200; 68.5% female) were recruited from the community. Participants with ELS (N = 118) had childhood maltreatment, and a subset, n = 92 (78.0%) also had parental loss, and n = 65 (55.1%) also had a current psychiatric disorder. Control participants (N = 82) had no maltreatment, parental loss, or psychiatric disorders. Standardized interviews and self-reports assessed demographics, adversity, medical/psychiatric history, and health behaviors. Exclusion criteria included medical conditions and current medications other than hormonal contraceptives. Body Mass Index (BMI) and other anthropometrics were measured, and fasting plasma was assayed for total ghrelin and leptin with the Bio-Plex Pro Human Diabetes Panel. RESULTS While ELS was significantly associated with greater leptin (r = .16, p = .025), a finding which held when adjusted for age and sex (F(3196)= 28.32, p = .011), this relationship was abolished when accounting for BMI (p = .44). Participants with ELS also had significantly lower total ghrelin (r = .21, p = .004), which held adjusting for age and sex (p = .002) and was attenuated (p = .045) when the model included BMI (F=46.82, p < .001). Current psychiatric disorder was also a significant predictor of greater leptin (r = .28, p < .001) and lower ghrelin (r = .29, p = .003). In the model with ELS and covariates, psychiatric disorder remained significant (F=7.26, p = .008) and ELS was no longer significant (p = .87). Associations with severity and recent perceived stress were also examined. CONCLUSION The relationship of ELS and leptin was no longer significant when accounting for BMI, suggesting potential avenues for intervention. Ghrelin findings persisted after correction for BMI, which may be secondary to physiological differences in the regulation of these hormones (leptin is produced by adipocytes, whereas ghrelin is produced primarily in the GI tract). Lastly, these findings suggest that psychiatric functioning may be a key component contributing to the relationship of lower total ghrelin and childhood adversity.
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Affiliation(s)
- Teresa E Daniels
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA; Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA.
| | | | - Asi Polly Gobin
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - William W Lewis-de Los Angeles
- Department of Pediatrics, Hasbro Children's Hospital and Bradley Hospital, RI, USA; Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Eric M Smith
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | | | - Suzanne de la Monte
- Warren Alpert Medical School, Brown University, Providence, RI, USA; Departments of Medicine, Neurology, and Pathology and Laboratory Medicine, Rhode Island Hospital, Women and Infants Hospital of Rhode Island, and Providence VA Medical Center, Providence, RI, USA
| | - Audrey R Tyrka
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA; Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
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15
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Shariff-Marco S, Sangaramoorthy M, Ellis L, Thomsen C, Roh JM, Kroenke C, Valice E, Kwan ML, Ambrosone C, Kushi L, Gomez SL. Impact of Racial/Ethnic Discrimination on Quality of Life Among Breast Cancer Survivors. Am J Epidemiol 2023; 192:367-376. [PMID: 36458447 PMCID: PMC10372860 DOI: 10.1093/aje/kwac208] [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: 04/19/2022] [Revised: 11/15/2022] [Accepted: 11/30/2022] [Indexed: 12/04/2022] Open
Abstract
Although racial/ethnic disparities in health-care access, treatment, and cancer outcomes are well documented, the impact of racial/ethnic discrimination on cancer survivorship is unclear. We examined associations between quality of life (QoL) and self-reported discrimination among 3,991 women with breast cancer recruited during 2006-2013 from the Pathways Study in the Kaiser Permanente Northern California integrated health-care system, using linear regression models. Overall, 31% of women reported experiencing racial/ethnic discrimination, with differences by race/ethnicity (82% among non-Hispanic Black women vs. 19% among non-Hispanic White women) and nativity (40% among foreign-born Hispanic women vs. 76% among US-born Asian-American women). Experiencing racial/ethnic discrimination was associated with lower QoL in fully adjusted models. The mean QoL score was 119.6 (95% confidence interval (CI): 102.0, 137.1) for women who did not report discrimination, 115.5 (95% CI: 98.0, 133.0) for those who reported some discrimination/less than the median level, and 110.2 (95% CI: 92.7, 127.7) for those who reported more discrimination/greater than or equal to the median level. Discrimination was associated with lower QoL among women who used passive coping strategies or lived in neighborhoods with high neighborhood socioeconomic status, neighborhoods with high levels of segregation, or non-ethnic enclaves. Among breast cancer survivors, clinically meaningful differences in QoL scores were associated with racial/ethnic discrimination. Additional studies are needed to understand potential pathways through which these social factors affect survivorship outcomes.
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Affiliation(s)
- Salma Shariff-Marco
- Correspondence to Dr. Salma Shariff-Marco, Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, 550 16th Street, MH-2633, San Francisco, CA 94158 (e-mail: )
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16
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Letzen JE, Hunt C, Kuwabara H, McGill LS, Reid MJ, Hamilton KR, Buenaver LF, Burton E, Sheinberg R, Wong DF, Smith MT, Campbell CM. Preliminary Evidence for the Sequentially Mediated Effect of Racism-Related Stress on Pain Sensitivity Through Sleep Disturbance and Corticolimbic Opioid Receptor Function. THE JOURNAL OF PAIN 2023; 24:1-18. [PMID: 36167231 PMCID: PMC10863672 DOI: 10.1016/j.jpain.2022.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/10/2022] [Accepted: 09/01/2022] [Indexed: 02/08/2023]
Abstract
Sleep disturbance predicts worse pain outcomes. Because sleep disturbance inequitably impacts Black adults - with racism as the upstream cause - understanding how racism-related stress impacts pain through sleep might help minimize racialized pain inequities. This preliminary study examined sequential mediation of the effect of racism-related stress on experimental pain through sleep disturbance and corticolimbic μOR function in pain-free non-Hispanic Black (NHB) and White (NHW) adults. Participants completed questionnaires, actigraphy, positron emission tomography, and sensory testing. We reproduced findings showing greater sleep disturbance and pain sensitivity among NHB participants; greater sleep disturbance (r = .35) and lower pain tolerance (r=-.37) were significantly associated with greater racism-related stress. In a sequential mediation model, the total effect of racism-related stress on pain tolerance (β=-.38, P = .005) weakened after adding sleep disturbance and ventromedial prefrontal cortex (vmPFC) μOR binding potential (BPND) as mediators (β = -.18, P = .16). The indirect effect was statistically significant [point estimate = -.003, (-.007, -.0003). Findings showed a potential sequentially mediated effect of racism-related stress on pain sensitivity through sleep disturbance and vmPFC μOR BPND. As policy efforts are enacted to eliminate the upstream cause of systemic racism, these results cautiously suggest that sleep interventions within racism-based trauma informed therapy might help prevent downstream effects on pain. PERSPECTIVE: This preliminary study identified the effect of racism-related stress on pain through sleep disturbance and mu-opioid receptor binding potential in the ventromedial prefrontal cortex. Findings cautiously support the application of sleep interventions within racism-based trauma-informed therapy to prevent pain inequities as policy changes function to eliminate all levels of racism.
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Affiliation(s)
- Janelle E Letzen
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland..
| | - Carly Hunt
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Hiroto Kuwabara
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland
| | - Lakeya S McGill
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland
| | - Matthew J Reid
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Katrina R Hamilton
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Luis F Buenaver
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Emily Burton
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Rosanne Sheinberg
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Dean F Wong
- Departments of Radiology, Psychiatry, Neurology, Neurosciences, Washington University School of Medicine, Mallinckrodt Institute of Radiology, St, Louis Missouri
| | - Michael T Smith
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Claudia M Campbell
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
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17
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Perez AD, Dufault SM, Spears EC, Chae DH, Woods-Giscombe CL, Allen AM. Superwoman Schema and John Henryism among African American women: An intersectional perspective on coping with racism. Soc Sci Med 2023; 316:115070. [PMID: 35690497 DOI: 10.1016/j.socscimed.2022.115070] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 05/13/2022] [Accepted: 05/22/2022] [Indexed: 01/11/2023]
Abstract
RATIONALE John Henryism and Superwoman Schema (SWS) are dispositional characteristics adopted to overcome the challenges of chronic psychosocial stress, and have particular salience for African American women. Both show protective and harmful effects on health and share conceptual similarities and distinctions, yet there is no empirical evidence of the potential overlap resulting in uncertainty about the unique roles they may each play concerning the health of African American women. OBJECTIVE We examined: 1) whether and to what extent John Henryism and SWS represent similar or distinct constructs relevant to the unique sociohistorical and sociopolitical position of African American women, and 2) whether the two differentially predict health outcomes. METHODS Data are from a purposive and socioeconomically diverse sample of 208 African American women in the San Francisco Bay Area. First, we conducted a progressive series of tests to systematically examine the conceptual and empirical overlap between John Henryism and SWS: correlation analysis, exploratory factor analysis (EFA), principal component analysis and k-modes cluster analysis. Next, we used multivariable regression to examine associations with psychological distress and hypertension. RESULTS John Henryism and SWS were moderately correlated with one another (rs = 0.30-0.48). In both EFA and cluster analyses, John Henryism items were distinct from SWS subscale items. For SWS, feeling an obligation to present an image of strength and an obligation to help others predicted higher odds of hypertension (p < 0.05); having an intense motivation to succeed predicted lower odds (p = 0.048). John Henryism did not predict hypertension. Feeling an obligation to help others and an obligation to suppress emotions predicted lower levels of psychological distress (p < 0.05) whereas John Henryism predicted higher distress (p = 0.002). CONCLUSIONS We discuss the implications of these findings for the measurement of culturally specific phenomena and their role in contributing to the unequal burden of ill health among African American women.
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Affiliation(s)
- Amanda D Perez
- Divisions of Community Health Sciences and Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA.
| | - Suzanne M Dufault
- Divisions of Community Health Sciences and Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA
| | - Erica C Spears
- Louisiana Public Health Institute, 400 Poydras St., Suite 1250, New Orleans, LA 70130, USA
| | - David H Chae
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St, New Orleans, LA, 70112, USA
| | - Cheryl L Woods-Giscombe
- School of Nursing, The University of North Carolina at Chapel Hill, Carrington Hall, CB #7460, Chapel Hill, NC, 27599-7460, USA
| | - Amani M Allen
- Divisions of Community Health Sciences and Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA
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18
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Parnell RN, Lacey KK, Wood M. Coping and Protective Factors of Mental Health: An Examination of African American and US Caribbean Black Women Exposed to IPV from a Nationally Representative Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15343. [PMID: 36430062 PMCID: PMC9690353 DOI: 10.3390/ijerph192215343] [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: 09/21/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
Existing research continues to highlight the harm that intimate partner violence (IPV) can pose to health and well-being. However, little is done to understand the effectiveness of coping and protective mechanisms in helping women manage under adverse circumstances. The current study addresses the mental health of US Black women and the role of coping and protective moderators. An analysis of data from the National Survey of American Life (2001-2003), the most comprehensive survey on the health of US Blacks, was conducted. The association between severe physical intimate partner violence and mental health outcomes were confirmed. Resilience moderated the relationship between severe intimate partner violence and mood disorder among US Black women, but this differed between African American and Caribbean Blacks. Resilience, emotional family support, and spirituality reduced the likelihood of having a mental health condition for some African American and Caribbean Black women, while the opposite was found for religiosity. Demographic factors were also associated with mental health conditions and behaviors. The study draws our attention to potential coping and protective mechanisms that could be incorporated into counseling and intervention practices while recognizing factors that may be harmful to the mental health of individuals.
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Affiliation(s)
- Regina N. Parnell
- Department of Occupational Therapy, Wayne State University, Detroit, MI 48201, USA
| | - Krim K. Lacey
- Department of Sociology and African and African American Studies, University of Michigan-Dearborn, Dearborn, MI 48128, USA
| | - Maxine Wood
- Department of Humanities, York University, Toronto, ON M3J 1P3, Canada
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19
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McLoughlin S, Präg P, Bartley M, Kenny RA, McCrory C. Intergenerational Social Mobility and Allostatic Load in Midlife and Older Ages: A Diagonal Reference Modeling Approach. J Gerontol B Psychol Sci Soc Sci 2022; 78:154-166. [PMID: 36008104 PMCID: PMC9890911 DOI: 10.1093/geronb/gbac122] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES This study aims to understand the association of life-course intergenerational social mobility with allostatic load (AL) burden in midlife and older ages in Ireland. METHODS The study involved biological data for 3,987 older adults participating in The Irish Longitudinal Study on Ageing (TILDA). Intergenerational social mobility was characterized using the cross-classification of origin socioeconomic position (SEP; i.e., father's occupation) and destination SEP (i.e., own occupation). AL was operationalized using 12 biomarkers tapping cardiovascular, metabolic, renal, and immune system dysregulation. Diagonal reference modeling (DRM) and ordinary least square regression techniques were applied to explore the effect of social mobility on AL burden. RESULTS A total of 55.5% experienced intergenerational mobility: 37.5% were upwardly mobile, 18.0% were downwardly mobile. A social gradient in AL was observed among the socially non-mobile. Destination SEP (b = 0.74, 95% CI = 0.57, 0.92) predominated in influence over origin, although both life stages exerted significant influence on later-life AL. Social mobility in either direction was not associated with AL burden. Mobility coefficients were substantially small across a large variety of model specifications. DISCUSSION Findings provide evidence for an accumulation model of social inequalities in which disparities in health are diluted rather than increased by social mobility (i.e., gradient constraint), with the socially mobile having an AL score that is intermediate between their origin class and destination class. This implies that the effects of origin SEP on health are not immutable, but are instead responsive to changing socioeconomic circumstances across the life course.
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Affiliation(s)
- Sinéad McLoughlin
- Address correspondence to: Sinéad McLoughlin, The Irish Longitudinal Study on Ageing (TILDA), Trinity Central, Trinity College Dublin, 152-160 Pearse Street, Dublin 2, Ireland. E-mail:
| | - Patrick Präg
- Center for Research in Economics and Statistics (CREST), ENSAE, Institut Polytechnique de Paris, Palaiseau, France
| | - Mel Bartley
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland,Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
| | - Cathal McCrory
- The Irish Longitudinal Study on Ageing (TILDA), Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
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20
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Causadias JM, Alcalá L, Morris KS, Yaylaci FT, Zhang N. Future Directions on BIPOC Youth Mental Health: The Importance of Cultural Rituals in the COVID-19 Pandemic. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:577-592. [PMID: 35731555 PMCID: PMC10036168 DOI: 10.1080/15374416.2022.2084744] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Culture plays an important role in the development of mental health, especially during childhood and adolescence. However, less is known about how participation in cultural rituals is related to the wellbeing of youth who are Black, Indigenous, and People of Color (BIPOC), and part of the Global Majority. This is crucial amid the COVID-19 pandemic, a global event that has disproportionally affected BIPOC youth and disrupted participation in rituals. The goal of this paper is to promote advances in clinical child and adolescent psychology focused on rituals. We begin by defining culture and rituals and examining their role on development. We illustrate these issues with the Lunar New Year in China, Maya rituals in México, Ramadan in Turkey, and Black graduations and Latinx funerals in the United States. We discuss how the pandemic has affected participation in these rituals and their potential impact on BIPOC children and adolescents' mental health. We propose future directions and recommendations for research.
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Affiliation(s)
- José M. Causadias
- School of Social and Family Dynamics, Arizona State University, United States
| | - Lucía Alcalá
- Department of Psychology, California State University, Fullerton, United States
| | - Kamryn S. Morris
- School of Social and Family Dynamics, Arizona State University, United States
| | - Fatima T. Yaylaci
- Department of Psychology, Fatih Sultan Mehmet Vakıf University, Turkey
| | - Na Zhang
- Human Development and Family Sciences, University of Connecticut, United States
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21
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Diamond LM, Alley J. Rethinking minority stress: A social safety perspective on the health effects of stigma in sexually-diverse and gender-diverse populations. Neurosci Biobehav Rev 2022; 138:104720. [PMID: 35662651 DOI: 10.1016/j.neubiorev.2022.104720] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/25/2022] [Accepted: 05/30/2022] [Indexed: 12/13/2022]
Abstract
For over two decades, the minority stress model has guided research on the health of sexually-diverse individuals (those who are not exclusively heterosexual) and gender-diverse individuals (those whose gender identity/expression differs from their birth-assigned sex/gender). According to this model, the cumulative stress caused by stigma and social marginalization fosters stress-related health problems. Yet studies linking minority stress to physical health outcomes have yielded mixed results, suggesting that something is missing from our understanding of stigma and health. Social safety may be the missing piece. Social safety refers to reliable social connection, inclusion, and protection, which are core human needs that are imperiled by stigma. The absence of social safety is just as health-consequential for stigmatized individuals as the presence of minority stress, because the chronic threat-vigilance fostered by insufficient safety has negative long-term effects on cognitive, emotional, and immunological functioning, even when exposure to minority stress is low. We argue that insufficient social safety is a primary cause of stigma-related health disparities and a key target for intervention.
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Affiliation(s)
- Lisa M Diamond
- Department of Psychology, University of Utah, Salt Lake City, UT, USA.
| | - Jenna Alley
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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22
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DeAngelis RT. "Moving on Up? Neighborhood Status and Racism-Related Distress among Black Americans". SOCIAL FORCES; A SCIENTIFIC MEDIUM OF SOCIAL STUDY AND INTERPRETATION 2022; 100:1503-1532. [PMID: 35847476 PMCID: PMC9285664 DOI: 10.1093/sf/soab075] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
At all levels of socioeconomic status, Black Americans can expect to live shorter and sicker lives than their White counterparts. This study advances the perspective that anti-Black stigma from Whites precludes Blacks from reaping the full health rewards of higher status, particularly within the context of neighborhoods. To test this hypothesis, I merge census data with rich survey and biomarker data from the Nashville Stress and Health Study, a representative sample of Black and White adults from Davidson County, Tennessee (n = 1,252). Initially, I find that Blacks who reside in higher-status and mostly White communities exhibit lower levels of neuroendocrine stress hormones, relative to their peers living in disadvantaged Black neighborhoods. But Blacks in higher-status areas also report more perceived discrimination. In turn, perceived discrimination is associated with chronic bodily pain, as well as elevated stress hormones and blood pressure tied to high goal-striving stress, or fears of being blocked from reaching life goals. After accounting for racism-related stressors, Blacks exhibit comparable levels of physiological distress regardless of neighborhood context. The inverse is true for Whites, who report fewer stressors in higher-status neighborhoods, and less physiological distress than Blacks overall. Findings are discussed within the context of social evolutionary theories of the human brain and are dovetailed with broader racial health disparities in the United States.
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Affiliation(s)
- Reed T. DeAngelis
- Department of Sociology and the Carolina Population Center, University of North Carolina at Chapel Hill
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23
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Williams BM, Laurent C, Chawla R, Moore JX. Examining educational attainment and allostatic load in non-Hispanic Black women. BMC Womens Health 2022; 22:75. [PMID: 35300673 PMCID: PMC8928016 DOI: 10.1186/s12905-022-01641-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 02/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background Research suggests that non-Hispanic Black (henceforth, Black) women and people with lower educational attainment have higher levels of allostatic load (AL). This study sought to determine the association between educational attainment and AL among a large sample of Black women.
Methods We analyzed data among 4177 Black women from the National Health and Nutrition Examination Survey years 1999–2018. AL score was defined as the total for abnormal measures of eight biomarkers. We further categorized participants with AL score greater than or equal to 4 as having high AL. We calculated mean estimates of total allostatic load scores using generalized linear models. We performed modified Poisson Regression models with robust variance estimation to estimate prevalence ratios (PRs) of high allostatic load and their associated 95% confidence intervals (CIs) by educational attainment.
Results Black women with a college degree or higher had the lowest prevalence of high allostatic load (31.8% vs. 42.7%, 36.3%, 36.6%), and age adjusted mean allostatic load scores (mean = 1.90 vs. mean = 2.34, mean = 1.99, mean = 2.05) when compared to Black women with less than a high school diploma, high school diploma or GED, and some college or associates degree respectively. Even after accounting for age, poverty-to-income ratio, smoking, congestive heart failure, and heart attack, Black college graduates had an 14.3% lower prevalence of high allostatic load (PR = 0.857, 95% CI 0.839–0.876) when compared to Black women with lower educational attainment. Conclusions Black women with a baccalaureate degree or higher educational attainment had lower allostatic load compared to Black women with less than a high school education. This finding further confirms higher education is a social determinant of health. Future research should explore differences in AL by more granular degree types. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01641-0.
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Affiliation(s)
- Brittany Marie Williams
- Department of Educational Leadership and Higher Education, St. Cloud State University, St. Cloud, MN, USA
| | - Christian Laurent
- Cancer Prevention, Control, and Population Health Program, Department of Medicine, Georgia Cancer Center, Augusta University, 1410 Laney Walker Blvd CN-2135, Augusta, GA, 30912, USA
| | - Rishab Chawla
- Cancer Prevention, Control, and Population Health Program, Department of Medicine, Georgia Cancer Center, Augusta University, 1410 Laney Walker Blvd CN-2135, Augusta, GA, 30912, USA
| | - Justin Xavier Moore
- Cancer Prevention, Control, and Population Health Program, Department of Medicine, Georgia Cancer Center, Augusta University, 1410 Laney Walker Blvd CN-2135, Augusta, GA, 30912, USA. .,Institute of Preventive and Public Health, Medical College of Georgia, Augusta University, Augusta, GA, USA.
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Cothran FA, Chang E, Beckett L, Bidwell JT, Price CA, Gallagher-Thompson D. A Landscape of Subjective and Objective Stress in African-American Dementia Family Caregivers. West J Nurs Res 2022; 44:239-249. [PMID: 34865588 PMCID: PMC8908689 DOI: 10.1177/01939459211062956] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Stress is a significant part of daily life, and systemic social inequities, such as racism and discrimination, are well-established contributors of chronic stress for African Americans. Added exposure to the stress of caregiving may exacerbate adverse health outcomes. This secondary analysis describes subjective and objective stress in African American family caregivers, and relationships of subjective and objective stress to health outcomes. Baseline data from 142 African American dementia family caregivers from the "Great Village" study were described using means and frequencies; regression models and Pearson's correlation were used to examine associations between demographics, social determinants of health, and health outcomes. Mixed models were used to examine change and change variation in cortisol. Most caregivers had moderate degrees of stress. Stress was associated with sleep disruption and depressive symptoms, and discrimination appeared to be an independent contributor to depressive symptoms. This work provides a foundation for interpreting subjective and objective indicators of stress to tailor existing multicomponent interventions.
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Affiliation(s)
- Fawn A. Cothran
- Family Caregiving Institute at the Betty Irene Moore School of Nursing; University of California, Davis
| | - Emily Chang
- Department of Statistics; Department of Public Health Sciences, University of California, Davis
| | - Laurel Beckett
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis
| | - Julie T. Bidwell
- Family Caregiving Institute at the Betty Irene Moore School of Nursing; University of California, Davis
| | - Candice A. Price
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis
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Michaels EK, Board C, Mujahid MS, Riddell CA, Chae DH, Johnson RC, Allen AM. Area-level racial prejudice and health: A systematic review. Health Psychol 2022; 41:211-224. [PMID: 35254858 PMCID: PMC8930473 DOI: 10.1037/hea0001141] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
BACKGROUND In recent years, there has been growing interest in "moving beyond the individual" to measure area-level racism as a social determinant of health. Much of this work has aggregated racial prejudice data collected at the individual-level to the area-level. OBJECTIVE As this is a rapidly emerging area of research, we conducted a systematic literature review to describe evidence of the relationship between area-level racial prejudice and health, whether results differed by race/ethnicity, and to characterize key conceptual and methodological considerations to guide future research. METHOD We searched four interdisciplinary databases for US-based, peer-reviewed articles measuring area level racial prejudice by aggregating individual-level indicators of racial prejudice and examining associations with mental or physical health outcome(s). Data extraction followed PRISMA guidelines and also included theory and conceptualization, pathways to health, and strengths and limitations. RESULTS Fourteen of 14,632 identified articles met inclusion criteria and were included in the review. Health outcomes spanned all-cause (n = 4) and cause-specific (n = 4) mortality, birth outcomes (n = 4), cardiovascular outcomes (n = 2), mental health (n = 1), and self-rated health (n = 1). All studies found a positive association between area-level racial prejudice and adverse health outcomes among racial/ethnic minoritized groups, with four studies also showing a similar association among Whites. Engagement with formal theory was limited and exposure conceptualization was mixed. Methodological considerations included unmeasured confounding and trade-offs between generalizability, self-censorship, and specificity of measurement. CONCLUSIONS Future research should continue to develop the conceptual and methodological rigor of this work and test hypotheses to inform evidence-based interventions to advance population health and reduce racial health inequities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Eli K. Michaels
- Division of Epidemiology, School of Public Health, University of California, Berkeley
| | - Christine Board
- Division of Epidemiology, School of Public Health, University of California, Berkeley
| | - Mahasin S. Mujahid
- Division of Epidemiology, School of Public Health, University of California, Berkeley
| | - Corinne A. Riddell
- Division of Epidemiology, School of Public Health, University of California, Berkeley
- Division of Biostatistics, School of Public Health, University of California, Berkeley
| | - David H. Chae
- Department of Global Community Health & Behavioral Sciences, Tulane School of Public Health and Tropical Medicine
| | | | - Amani M. Allen
- Division of Epidemiology, School of Public Health, University of California, Berkeley
- Division of Community Health Sciences, School of Public Health, University of California, Berkeley
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Van Dyke ME, Kramer MR, Kershaw KN, Vaccarino V, Crawford ND, Lewis TT. Inconsistent Reporting of Discrimination Over Time Using the Experiences of Discrimination Scale: Potential Underestimation of Lifetime Burden. Am J Epidemiol 2022; 191:370-378. [PMID: 34017974 PMCID: PMC9214248 DOI: 10.1093/aje/kwab151] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 04/27/2021] [Accepted: 05/05/2021] [Indexed: 12/12/2022] Open
Abstract
Studies documenting self-reported experiences of discrimination over the life course have been limited. Such information could be important for informing longitudinal epidemiologic studies of discrimination and health. We characterized trends in self-reports of racial, socioeconomic status, and gender discrimination over time measured using the Experiences of Discrimination Scale, with a focus on whether individuals' reports of lifetime discrimination were consistent over time. Overall experiences of discrimination and the number of settings in which discrimination was reported in 1992, 2000, and 2010 were examined among 2,774 African-American and White adults in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Reports of "ever" experiencing discrimination decreased for all forms of discrimination across the 3 study visits. Approximately one-third (30%-41%) of the sample inconsistently reported ever experiencing any discrimination over time, which contributed to the observed decreases. Depending on the form of discrimination, inconsistent reporting patterns over time were more common among African-American, younger, less educated, and lower-income individuals and women-groups who are often most exposed to and severely impacted by the health effects of discrimination. Our findings highlight the possible underestimation of the lifetime burden of discrimination when utilizing the Experiences of Discrimination Scale to capture self-reports of discrimination over time.
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Affiliation(s)
- Miriam E Van Dyke
- Correspondence to Dr. Miriam Van Dyke, Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322 (e-mail: )
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Webb EK, Bird CM, deRoon-Cassini TA, Weis CN, Huggins AA, Fitzgerald JM, Miskovich T, Bennett K, Krukowski J, Torres L, Larson CL. Racial Discrimination and Resting-State Functional Connectivity of Salience Network Nodes in Trauma-Exposed Black Adults in the United States. JAMA Netw Open 2022; 5:e2144759. [PMID: 35072718 PMCID: PMC8787596 DOI: 10.1001/jamanetworkopen.2021.44759] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/29/2021] [Indexed: 12/21/2022] Open
Abstract
Importance For Black US residents, experiences of racial discrimination are still pervasive and frequent. Recent empirical work has amplified the lived experiences and narratives of Black people and further documented the detrimental effects of racial discrimination on both mental and physical health; however, there is still a need for further research to uncover the mechanisms connecting experiences of racial discrimination with adverse health outcomes. Objective To examine neurobiological mechanisms that may offer novel insight into the association of racial discrimination with adverse health outcomes. Design, Setting, and Participants This cross-sectional study included 102 Black adults who had recently experienced a traumatic injury. In the acute aftermath of the trauma, participants underwent a resting-state functional magnetic resonance imaging scan. Individuals were recruited from the emergency department at a Midwestern level 1 trauma center in the United States between March 2016 and July 2020. Data were analyzed from February to May 2021. Exposures Self-reported lifetime exposure to racial discrimination, lifetime trauma exposure, annual household income, and current posttraumatic stress disorder (PTSD) symptoms were evaluated. Main Outcomes and Measures Seed-to-voxel analyses were conducted to examine the association of racial discrimination with connectivity of salience network nodes (ie, amygdala and anterior insula). Results A total of 102 individuals were included, with a mean (SD) age of 33 (10) years and 58 (57%) women. After adjusting for acute PTSD symptoms, annual household income, and lifetime trauma exposure, greater connectivity between the amygdala and thalamus was associated with greater exposure to discrimination (t(97) = 6.05; false discovery rate (FDR)-corrected P = .03). Similarly, racial discrimination was associated with greater connectivity between the insula and precuneus (t(97) = 4.32; FDR-corrected P = .02). Conclusions and Relevance These results add to the mounting literature that racial discrimination is associated with neural correlates of vigilance and hyperarousal. The study findings extend this theory by showing that this association is apparent even when accounting for socioeconomic position, lifetime trauma, and symptoms of psychological distress related to an acute trauma.
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Affiliation(s)
- E. Kate Webb
- Department of Psychology, University of Wisconsin–Milwaukee
| | - Claire M. Bird
- Department of Psychology, Marquette University, Milwaukee, Wisconsin
| | - Terri A. deRoon-Cassini
- Division of Trauma & Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee
| | - Carissa N. Weis
- Institute for Health and Equity, Department of Epidemiology, Medical College of Wisconsin, Milwaukee
| | - Ashley A. Huggins
- Brain Imaging and Analysis Center, Duke University, Durham, North Carolina
| | | | | | | | - Jessica Krukowski
- Department of Psychology, Marquette University, Milwaukee, Wisconsin
| | - Lucas Torres
- Department of Psychology, Marquette University, Milwaukee, Wisconsin
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Thomas MD, Mendez RM, Zhang Y, Wang Y, Sohail S, Chae DH, Márquez-Magaña L, Sellers R, Woods-Giscombé CL, Allen AM. OUP accepted manuscript. THE GERONTOLOGIST 2022; 62:762-772. [PMID: 35084030 PMCID: PMC9154235 DOI: 10.1093/geront/gnac005] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Indexed: 11/30/2022] Open
Abstract
Background and Objectives African American women experience faster telomere shortening (i.e., cellular aging) compared with other racial–gender groups. Prior research demonstrates that race and gender interact to influence culturally specific norms for responding to socially-relevant stress and other stress-coping processes, which may affect healthy aging. Research Design and Methods Data are from African American Women’s Heart & Health Study participants who consented to DNA extraction (n = 140). Superwoman Schema (SWS) was measured using 5 validated subscales: presenting strength, emotion suppression, resisting vulnerability, motivation to succeed, and obligation to help others. Racial identity was measured using 3 subscales from the Multidimensional Inventory of Black Identity: racial centrality, private regard, and public regard. Relative telomere length (rTL) was measured using DNA extracted from blood samples. Path analysis tested associations and interactions between SWS and racial identity dimensions with rTL. Results For SWS, higher resistance to being vulnerable predicted longer telomeres. For racial identity, high private regard predicted longer telomeres while high public regard predicted shorter telomeres. Interactions were found between public regard and 2 SWS dimensions: among women with high public regard, emotion suppression (β = 0.20, p < .05) and motivation to succeed (β = 0.18, p < .05) were associated with longer rTL. The interaction between high centrality and emotion suppression predicted shorter rTL (β = −0.17, p < .05). Discussion and Implications Culturally specific responses to gendered racism and racial identity, developed early in life and shaped over the life course, are important psychosocial determinants of cellular aging among African American women.
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Affiliation(s)
- Marilyn D Thomas
- Departments of Epidemiology & Biostatistics and Psychiatry & Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
- Address correspondence to: Marilyn D. Thomas, PhD, MPH, Departments of Epidemiology & Biostatistics and Psychiatry & Behavioral Sciences, University of California, San Francisco, 1001 Potrero Avenue, Box 0852, San Francisco, CA 94110, USA. E-mail:
| | - Rebecca M Mendez
- Department of Biology, San Francisco State University, San Francisco, California, USA
| | - Youchuan Zhang
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Yijie Wang
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Saba Sohail
- Department of Biology, San Francisco State University, San Francisco, California, USA
| | - David H Chae
- Department of Global Community Health and Behavioral Sciences, Tulane University, School of Public Health & Tropical Medicine, New Orleans, Louisiana, USA
| | | | - Rob Sellers
- Office of Diversity, Equity & Inclusion, University of Michigan, Ann Arbor, Michigan, USA
| | - Cheryl L Woods-Giscombé
- School of Nursing, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA
| | - Amani M Allen
- School of Public Health, Divisions of Community Health Sciences and Epidemiology, University of California, Berkeley, Berkeley, California, USA
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Levy ME, Waters A, Sen S, Castel AD, Plankey M, Molock S, Asch F, Goparaju L, Kassaye S. Psychosocial stress and neuroendocrine biomarker concentrations among women living with or without HIV. PLoS One 2021; 16:e0261746. [PMID: 34941922 PMCID: PMC8699620 DOI: 10.1371/journal.pone.0261746] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/09/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Women living with HIV (WLWH) experience psychosocial stress related to social-structural vulnerabilities. To investigate neuroendocrine pathways linking stress and increased cardiovascular disease risk among WLWH, we evaluated associations between psychosocial stress (i.e., perceived stress, posttraumatic stress, and experiences of race- and gender-based harassment) and a composite neuroendocrine biomarker index among WLWH and women without HIV. METHODS In 2019-2020, Women's Interagency HIV Study participants in Washington, DC completed a questionnaire and provided blood and 12-hour overnight urine samples for testing of serum dehydroepiandrosterone sulfate (DHEA-S) and urinary free cortisol, epinephrine, and norepinephrine. Psychosocial stress was measured using the Perceived Stress Scale, PTSD Checklist-Civilian Version, and Racialized Sexual Harassment Scale. Latent profile analysis was used to classify participants into low (38%), moderate (44%), and high (18%) stress groups. Composite biomarker index scores between 0-4 were assigned based on participants' number of neuroendocrine biomarkers in high-risk quartiles (≥75th percentile for cortisol, epinephrine, and norepinephrine and ≤25th percentile for DHEA-S). We evaluated associations between latent profile and composite biomarker index values using multivariable linear regression, adjusting for socio-demographic, behavioral, metabolic, and HIV-related factors. RESULTS Among 90 women, 62% were WLWH, 53% were non-Hispanic Black, and median age was 55 years. In full multivariable models, there was no statistically significant association between psychosocial stress and composite biomarker index values among all women independent of HIV status. High (vs. low) psychosocial stress was positively associated with higher mean composite biomarker index values among all monoracial Black women (adjusted β = 1.32; 95% CI: 0.20-2.43), Black WLWH (adjusted β = 1.93; 95% CI: 0.02-3.83) and Black HIV-negative women (adjusted β = 2.54; 95% CI: 0.41-4.67). CONCLUSIONS Despite a null association in the overall sample, greater psychosocial stress was positively associated with higher neuroendocrine biomarker concentrations among Black women, highlighting a plausible mechanism by which psychosocial stress could contribute to cardiovascular disease risk.
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Affiliation(s)
- Matthew E. Levy
- Department of Epidemiology, Milken Institute School of Public Health at the George Washington University, Washington, DC, United States of America
- Westat, Rockville, Maryland, United States of America
- * E-mail:
| | - Ansley Waters
- Department of Epidemiology, Milken Institute School of Public Health at the George Washington University, Washington, DC, United States of America
- Division of Clinical Epidemiology, Office of Epidemiology, Virginia Department of Health, Richmond, Virginia, United States of America
| | - Sabyasachi Sen
- Division of Endocrinology, George Washington University School of Medicine and Health Sciences, Washington, DC, United States of America
| | - Amanda D. Castel
- Department of Epidemiology, Milken Institute School of Public Health at the George Washington University, Washington, DC, United States of America
| | - Michael Plankey
- Department of Medicine, Georgetown University Medical Center, Washington, DC, United States of America
| | - Sherry Molock
- Department of Psychology, The George Washington University, Washington, DC, United States of America
| | - Federico Asch
- Cardiovascular Core Laboratories and Cardiac Imaging Research, MedStar Health Research Institute, MedStar Heart and Vascular Institute, Washington, DC, United States of America
| | - Lakshmi Goparaju
- Department of Medicine, Georgetown University Medical Center, Washington, DC, United States of America
| | - Seble Kassaye
- Department of Medicine, Georgetown University Medical Center, Washington, DC, United States of America
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Spears EC, Allen AM, Chung KW, Martz CD, Hunter EA, Fuller-Rowell TE, Lim SS, Drenkard C, Chae DH. Anticipatory racism stress, smoking and disease activity: the Black women's experiences living with lupus (BeWELL) study. J Behav Med 2021; 44:760-771. [PMID: 34159500 DOI: 10.1007/s10865-021-00235-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 06/05/2021] [Indexed: 10/21/2022]
Abstract
African American women with systemic lupus erythematosus (SLE) have worse disease outcomes compared to their White counterparts. Stressors associated with race may contribute to poorer health in this population through maladaptive behavioral pathways. This study investigated relationships between stress associated with anticipating racism, smoking, and SLE disease activity. Data were from 432 African American women with SLE in the Black Women's Experiences Living with Lupus (BeWELL) Study. Controlling for sociodemographic and health-related covariates, multivariable regression analyses revealed a significant association between anticipatory racism stress (ARS) and disease activity (p = 0.00, b = 1.13, 95% CI [0.43, 1.82]). A significant interaction between ARS and smoking also indicated that smoking exacerbated the effect of ARS on disease activity (p = 0.04, b = 1.95, CI = 0.04, 3.96). Test for evidence of smoking mediating the effect of ARS on disease activity were not statistically significant (z = 1.77, p = 0.08). Findings have implications for future SLE disparities research among African American women with SLE.
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Affiliation(s)
- Erica C Spears
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA.
| | - Amani M Allen
- Divisions of Community Health Sciences and Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
| | - Kara W Chung
- Department of Human Development and Family Studies, College of Human Sciences, Auburn University, Auburn, AL, USA
| | - Connor D Martz
- Department of Human Development and Family Studies, College of Human Sciences, Auburn University, Auburn, AL, USA
| | - Evelyn A Hunter
- Department of Special Education, Rehabilitation & Counseling, College of Education, Auburn University, Auburn, AL, USA
| | - Thomas E Fuller-Rowell
- Department of Human Development and Family Studies, College of Human Sciences, Auburn University, Auburn, AL, USA
| | - S Sam Lim
- Department of Medicine, Division of Rheumatology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Christina Drenkard
- Department of Medicine, Division of Rheumatology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - David H Chae
- Department of Global Community Health and Behavioral Science, School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA, USA
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Guidi J, Lucente M, Sonino N, Fava GA. Allostatic Load and Its Impact on Health: A Systematic Review. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:11-27. [PMID: 32799204 DOI: 10.1159/000510696] [Citation(s) in RCA: 402] [Impact Index Per Article: 134.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/06/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Allostatic load refers to the cumulative burden of chronic stress and life events. It involves the interaction of different physiological systems at varying degrees of activity. When environmental challenges exceed the individual ability to cope, then allostatic overload ensues. Allostatic load is identified by the use of biomarkers and clinical criteria. OBJECTIVE To summarize the current knowledge on allostatic load and overload and its clinical implications based on a systematic review of the literature. METHODS PubMed, PsycINFO, Web of Science, and the Cochrane Library were searched from inception to December 2019. A manual search of the literature was also performed, and reference lists of the retrieved articles were examined.We considered only studies in which allostatic load or overload were adequately described and assessed in either clinical or non-clinical adult populations. RESULTS A total of 267 original investigations were included. They encompassed general population studies, as well as clinical studies on consequences of allostatic load/overload on both physical and mental health across a variety of settings. CONCLUSIONS The findings indicate that allostatic load and overload are associated with poorer health outcomes. Assessment of allostatic load provides support to the understanding of psychosocial determinants of health and lifestyle medicine. An integrated approach that includes both biological markers and clinimetric criteria is recommended.
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Affiliation(s)
- Jenny Guidi
- Department of Psychology, University of Bologna, Bologna, Italy,
| | | | - Nicoletta Sonino
- Department of Statistical Sciences, University of Padova, Padova, Italy.,Department of Psychiatry, State University of New York at Buffalo, Buffalo, New York, USA
| | - Giovanni A Fava
- Department of Psychiatry, State University of New York at Buffalo, Buffalo, New York, USA
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Christian LM, Cole SW, McDade T, Pachankis JE, Morgan E, Strahm AM, Kamp Dush CM. A biopsychosocial framework for understanding sexual and gender minority health: A call for action. Neurosci Biobehav Rev 2021; 129:107-116. [PMID: 34097981 PMCID: PMC8429206 DOI: 10.1016/j.neubiorev.2021.06.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 05/26/2021] [Accepted: 06/01/2021] [Indexed: 12/29/2022]
Abstract
The number of US adults identifying as lesbian, gay, bisexual, transgender, or a different sexual identity has doubled since 2008, and about 40 % of the sexual and gender minority population identify as people of color. Minority stress theory posits that sexual and gender minorities are at particular risk for stress via stigma and discrimination at the structural, interpersonal, and individual levels. This stress, in turn, elevates the risk of adverse health outcomes across several domains. However, there remains a conspicuously limited amount of research on the psychoneuroimmunology of stress among sexual and gender minorities. We developed the Biopsychosocial Minority Stress Framework which posits that sexual minority status leads to unique experiences of minority stress which results in adverse health behavioral factors, elevated psychological distress and sleep disturbance, and immune dysregulation. Moderators in the model include both individual differences and intersectional identities. There is a crucial need to understand the biological-psychological axis of stress among the increasingly visible sexual and gender minority population to increase their health, longevity, and quality of life.
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Affiliation(s)
- Lisa M Christian
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
| | - Steve W Cole
- Department of Psychiatry & Biobehavioral Sciences and Medicine, UCLA School of Medicine, Los Angeles, CA, USA
| | - Thomas McDade
- Department of Anthropology, Northwestern University, Evanston, IL, USA; Institute for Policy Research, Northwestern University, Evanston, IL, USA; Child and Brain Development Program, Canadian Institute for Advanced Research, Toronto, ON, Canada
| | - John E Pachankis
- Yale School of Public Health, New Haven, CT, USA; Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, USA
| | - Ethan Morgan
- College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Anna M Strahm
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Claire M Kamp Dush
- Minnesota Population Center, University of Minnesota, Minneapolis, MN, USA; Department of Sociology, University of Minnesota, Minneapolis, MN, USA
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Chen S, Mallory AB. The effect of racial discrimination on mental and physical health: A propensity score weighting approach. Soc Sci Med 2021; 285:114308. [PMID: 34399293 PMCID: PMC8451383 DOI: 10.1016/j.socscimed.2021.114308] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 07/19/2021] [Accepted: 08/05/2021] [Indexed: 02/07/2023]
Abstract
RATIONALE The preponderance of research documents the negative consequences of racial discrimination for the mental and physical well-being across several racial/ethnic groups including Black Americans, Hispanic Americans, and Asian Americans. Despite this large body of research, few studies have attempted to evaluate racial discrimination as a casual factor of worse health among racial minority groups. The current study utilized nationally representative data to estimate the causal effect of racial discrimination on cardiovascular disease (CVD), self-rated physical health (SRH), body mass index (BMI), depression disorder, and substance use disorder. In addition, we examined whether the effect of racial discrimination on health was moderated by socio-demographic characteristics (i.e., age, race/ethnicity, sex, socioeconomic status, marital status, geographic location, and health insurance coverage). METHODS Data were from the combined National Survey of American Life and the National Latino and Asian American Study. We applied a propensity score weighting approach to estimate the differences between individuals who reported ever (N = 4358) or never (N = 1836) experiencing racial discrimination on a list of health outcomes (e.g., CVD, SRH, BMI, depression disorder, and substance use disorder). RESULTS Participants who reported ever experiencing racial discrimination were about 5 % higher CVD risk, had 0.12 points lower SRH, a 3 % higher probability of a depression disorder, and a 2 % higher probability of a substance use disorder. Moderation effects by race/ethnicity, sex, socioeconomic status, geographic region, and health insurance coverage were found. CONCLUSION Our study represents one of the first attempts to apply a propensity score weighting approach to causally link racial discrimination to worse health for racial minority individuals. This study adds to a larger body of research documenting the negative association between racial discrimination and health.
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Affiliation(s)
- Shanting Chen
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 East Dean Keeton Street, Stop A2702, Austin, TX, 78712, United States.
| | - Allen B Mallory
- Human Development and Family Science, The Ohio State University, United States.
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Diamond LM, Dehlin AJ, Alley J. Systemic inflammation as a driver of health disparities among sexually-diverse and gender-diverse individuals. Psychoneuroendocrinology 2021; 129:105215. [PMID: 34090051 DOI: 10.1016/j.psyneuen.2021.105215] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 01/28/2023]
Abstract
Sexually-diverse individuals (those who seek sexual or romantic relationships with the same and/or multiple genders) and gender-diverse individuals (those whose gender identity and/or expression differs from their birth-assigned sex/gender) have disproportionately high physical health problems, but the underlying biological causes for these health disparities remain unclear. Building on the minority stress model linking social stigmatization to health outcomes, we argue that systemic inflammation (the body's primary response to both physical and psychological threats, indicated by inflammatory markers such as C-reactive protein and proinflammatory cytokines) is a primary biobehavioral pathway linking sexual and gender stigma to physical health outcomes. Expectations and experiences of social threat (i.e., rejection, shame, and isolation) are widespread and chronic among sexually-diverse and gender-diverse individuals, and social threats are particularly potent drivers of inflammation. We review research suggesting that framing "minority stress" in terms of social safety versus threat, and attending specifically to the inflammatory consequences of these experiences, can advance our understanding of the biobehavioral consequences of sexual and gender stigma and can promote the development of health promoting interventions for this population.
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Miller HN, LaFave S, Marineau L, Stephens J, Thorpe RJ. The impact of discrimination on allostatic load in adults: An integrative review of literature. J Psychosom Res 2021; 146:110434. [PMID: 33810863 PMCID: PMC8172431 DOI: 10.1016/j.jpsychores.2021.110434] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 03/15/2021] [Accepted: 03/21/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of the paper is to critically review the current state of the literature on the association between discrimination and allostatic load (AL) in adults and determine whether this association differs by sociodemographic characteristics. METHODS An extensive literature search was conducted in PubMed, CINAHL, PsycINFO, and Embase to identify studies that investigated the association between discrimination and AL. The search was limited to the English language, articles that were peer-reviewed and articles that were published within the last 10 years. RESULTS A total of 11 studies met the eligibility criteria for this review, 8 of which were cross-sectional and 3 of which were longitudinal. There was heterogeneity in the type of discrimination measured, the composition of AL summary score, and the analytic approach utilized to examine the relationship of interest. Nine studies found a significant, positive association between discrimination and AL. The types of discrimination found to be positively associated with AL included lifetime discrimination, childhood racial discrimination, everyday discrimination, and everyday weight discrimination. One study found that this association differed by educational attainment. CONCLUSION There is evidence that discrimination is associated with AL. Longitudinal studies with diverse samples are needed to further explore this association and how it differs based on sociodemographic characteristics.
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Affiliation(s)
- Hailey N Miller
- Duke University School of Nursing, United States of America.
| | - Sarah LaFave
- Johns Hopkins University School of Nursing, United States of America.
| | - Lea Marineau
- Johns Hopkins University School of Nursing, United States of America.
| | - Janna Stephens
- The Ohio State University College of Nursing, United States of America.
| | - Roland J Thorpe
- Johns Hopkins University Bloomberg School of Public Health, United States of America.
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Copeland JL, Currie CL, Chief Moon-Riley K. Physical Activity Buffers the Adverse Impacts of Racial Discrimination on Allostatic Load Among Indigenous Adults. Ann Behav Med 2021; 55:520-529. [PMID: 32870255 PMCID: PMC8171801 DOI: 10.1093/abm/kaaa068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background Racial discrimination has been associated with biological dysfunction among ethnic minorities. The extent to which regular physical activity (PA) may buffer this association is unknown. Purpose To examine the association between past-year racial discrimination and allostatic load (AL) stratified by PA within a sample of Indigenous adults. Methods Data were collected from Indigenous adults attending university in a city in western Canada between 2015 and 2017. The Experiences of Discrimination Scale was used to assess discrimination and the Godin–Shephard Leisure-Time Physical Activity Questionnaire assessed PA. A composite of seven biomarkers assessing neuroendocrine, cardiovascular, metabolic, and immune system function measured AL. Linear regression models examined associations adjusted for confounders (N = 150). Results In the insufficiently active group, every 1 point increase in racial discrimination (up to a maximum of 9) resulted in approximately one third of a point increase in AL score. In the sufficiently active group, the association between racial discrimination and AL score was not statistically significant. Conclusions A growing body of research suggests racial discrimination is associated with multisystem biological dysregulation and health risks. Increased action to address racism in society is a priority. As that work unfolds, there is a need to identify effective tools that racialized groups can use to buffer the effects of racism on their health. The present findings suggest that engagement in regular PA may attenuate the pernicious effects of discrimination on biological dysfunction.
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Affiliation(s)
- Jennifer L Copeland
- Department of Kinesiology and Physical Education, Faculty of Arts and Science, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Cheryl L Currie
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada
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Aririguzo C, Spencer BS, Freysteinson W. "You're acting womanish!" A qualitative descriptive study of the experiences of African American women in menopausal transition. J Women Aging 2021; 34:258-275. [PMID: 34024266 DOI: 10.1080/08952841.2021.1915095] [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] [Indexed: 10/21/2022]
Abstract
This study explores how African American women understand and experience menopausal transition. Data were collected from 14 women in individual interviews and a focus group of seven participants. Transcripts were analyzed using content analysis. Black Feminist Thought and Womanist Thought were the frameworks used to understand the experiences of participants. Key themes emerged including silence as a form of survival, resilience amidst the chaos, socialization for self-preservation and empowerment, and reshaping and reclaiming womanhood. African American women need to be approached from a culturally sensitive care model to address their care during this phase and to optimize health outcomes.
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Affiliation(s)
- Corletta Aririguzo
- College of Nursing and Health Sciences, Texas A&M University Corpus Christi, Corpus Christi, Texas, USA
| | - Becky S Spencer
- College of Nursing and Health Sciences, Texas Woman's University, Denton, Texas, USA
| | - Wyona Freysteinson
- College of Nursing and Health Sciences, Texas Woman's University, Houston, Texas, USA
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38
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Bello MS, Liautaud MM, De La Cerda JT, Pang RD, Ray LA, Ahluwalia JA, Leventhal AM. Association of frequency of perceived exposure to discrimination with tobacco withdrawal symptoms and smoking lapse behavior in African Americans. Addiction 2021; 116:914-925. [PMID: 32860477 PMCID: PMC7914272 DOI: 10.1111/add.15238] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/23/2020] [Accepted: 08/24/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS Frequent experiences of discrimination could increase vulnerability to tobacco withdrawal and smoking lapse in populations subject to tobacco-related health disparities. This laboratory study (2013-17) examined whether individual differences in perceived exposure to discrimination in one's daily life predicted tobacco withdrawal symptoms and smoking lapse behavior following acute tobacco deprivation in African American smokers. DESIGN Mixed design with the between-subjects continuous variable of perceived discrimination crossed with the within-subject variable of tobacco deprivation status (deprived versus non-deprived). SETTING Academic medical center in Los Angeles, CA, USA. PARTICIPANTS African American non-treatment seeking daily cigarette smokers (n = 607, ≥ 10 cig/day). MEASUREMENTS At a baseline visit, self-reported frequency of perceived exposure to discrimination in one's daily life was measured [everyday discrimination scale (EDDS)]. At two subsequent counterbalanced experimental visits (16-hour tobacco deprivation versus ad-libitum smoking), self-report assessments of various tobacco withdrawal symptom domains [Brief Questionnaire of Smoking Urges), Wisconsin Smoking Withdrawal Scale (WSWS), Profile of Mood States (POMS), Snaith-Hamilton Pleasure Scale (SHAPS) and Current Impulsivity Scale (CIS)) and a behavioral smoking lapse analogue task were measured. FINDINGS Adjusted models demonstrated that greater frequency of perceived exposure to discrimination was associated with larger deprivation-induced increases in acute urges to smoke to alleviate negative mood, several negative mood states and subjective cognitive functioning-effect sizes were small in magnitude (βs = 0.09-0.13; Ps < 0.02). Data were inconclusive for associations between perceived exposure to discrimination and deprivation-induced changes in cravings, urges to smoke for pleasure, positive mood reduction, other symptoms or smoking reinstatement behavior. CONCLUSIONS Frequency of perceived exposure to discrimination appears to be modestly associated with increased severity of some deprivation-induced tobacco withdrawal symptoms in African American smokers.
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Affiliation(s)
- Mariel S. Bello
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Madalyn M. Liautaud
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Julianne T. De La Cerda
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Raina D. Pang
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lara A. Ray
- University of California Los Angeles, Department of Psychology, Los Angeles, CA, USA
| | - Jasjit A. Ahluwalia
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Adam M. Leventhal
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Farmer HR, Wray LA, Haas SA. Race, Gender, and Socioeconomic Variations in C-Reactive Protein Using the Health and Retirement Study. J Gerontol B Psychol Sci Soc Sci 2021; 76:583-595. [PMID: 32064519 PMCID: PMC7887729 DOI: 10.1093/geronb/gbaa027] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To clarify the relationships among race, gender, and socioeconomic status (SES) with C-reactive protein (CRP). METHOD The present study analyzed data from 6,521 Black and White respondents aged 51 and older in the Health and Retirement Study, a nationally representative sample of midlife and older adults, to address two aims. We sought to (i) assess the independent associations between race, gender, and SES with CRP concentrations and (ii) test whether race, gender, and SES interacted to produce unequal CRP concentrations cross-sectionally and over a 4-year follow-up. RESULTS The results demonstrated that race, gender, and SES were each independently associated with baseline CRP, but only SES was associated with CRP at follow-up. Furthermore, race, gender, and education interacted to produce differential CRP levels at baseline. There were incremental benefits for each additional level of education for White men and women, but the relationship between education and CRP was more complicated for Black men and women. Compared with other race/gender groups with less than high school, Black women had the highest and Black men had the lowest levels of CRP. There were no apparent benefits to CRP for Black women with college compared with Black women with high school, while Black men with less than high school and college had similar concentrations of CRP. DISCUSSION In clarifying the complexity inherent in CRP disparities, this work contributes to a greater understanding of the biological mechanisms underlying racial disparities in leading causes of morbidity and mortality in the United States.
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Affiliation(s)
- Heather R Farmer
- Department of Population Health Sciences, Duke University Medical Center, Durham, North Carolina
| | - Linda A Wray
- Department of Biobehavioral Health, The Pennsylvania State University, University Park
| | - Steven A Haas
- Department of Sociology and Demography, The Pennsylvania State University, University Park
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Larrabee Sonderlund A, Schoenthaler A, Thilsing T. The Association between Maternal Experiences of Interpersonal Discrimination and Adverse Birth Outcomes: A Systematic Review of the Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041465. [PMID: 33557227 PMCID: PMC7913961 DOI: 10.3390/ijerph18041465] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/13/2021] [Accepted: 02/01/2021] [Indexed: 11/30/2022]
Abstract
In the present systematic review, we argue that maternal experiences of interpersonal discrimination at least partially account for the disproportionate rates of adverse birth outcomes in minority populations. Since the 1990s, research in this area has slowly, but steadily increased, shedding more light on the insidious nature of interpersonal discrimination and its toxic health effects. With the aim of bringing this topic to the fore in academic as well as clinical settings, this paper provides a state-of-the-art review of the empirical knowledge on the relationship between maternal experiences of discrimination and birth outcomes. Of 5901 articles retained in the literature search, 28 met the predefined inclusion criteria. Accounting for a range of health and behavioral factors, the vast majority of these studies support the notion that maternal experiences of interpersonal discrimination predict a range of adverse birth outcomes, including preterm birth, low birth weight, and various physiological markers of stress (allostatic load) in both mother and child pre- and postpartum. Several moderators and mediators of this relationship were also identified. These related primarily to the type (first-hand and vicarious), timing (childhood, adolescence, and adulthood), frequency, and pervasiveness of discrimination experienced, as well as to maternal mental health and coping. More research into these factors, however, is required to definitively determine their significance. We discuss these findings as they relate to the general health repercussions of interpersonal discrimination, as well as in terms of applied prenatal care and interventions. Ultimately, we argue that assessing maternal experiences of interpersonal discrimination in prenatal care may represent a considerable asset for mitigating existing majority-minority disparities in adverse birth outcomes.
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Affiliation(s)
| | | | - Trine Thilsing
- Department of Public Health, University of Southern Denmark, 5230 Odense, Denmark;
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41
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Cain-Shields L, Glover L, Young B, Sims M. Association between goal-striving stress and rapid kidney function decline among African Americans: the Jackson Heart Study. J Investig Med 2021; 69:382-387. [PMID: 33335024 PMCID: PMC8057281 DOI: 10.1136/jim-2020-001510] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2020] [Indexed: 11/04/2022]
Abstract
African Americans (AAs) are disproportionately affected by kidney disease and also report higher psychosocial stressors than other racial groups. Goal-striving stress (GSS) is an understudied psychosocial stressor related to attempting to accomplish one's life goals. Given the numerous social determinants that contribute to health inequities among AAs, stress from goal striving may also disproportionately affect the health of AAs and in particular kidney disease outcomes. The objective of this study was to explore the association between GSS and rapid kidney function decline (RKFD) in an AA cohort. Using examination 1 (2000-2004) and examination 3 (2009-2013) data from the Jackson Heart Study (n=2630), we examined associations of baseline levels of GSS with RKFD among AAs using multivariable Poisson regression models, adjusting for sociodemographics, health behaviors, chronic disease and discrimination. We also explored baseline cortisol as a mediator. The incidence of RKFD in this sample was 7.34% (mean years of follow-up: 8.06±0.84 years). The mean GSS score was 3.80 (±4.88) and total GSS score ranged from 0 to 36. Those who reported high (vs low) GSS were 1.60 times more likely to experience RKFD after full adjustment (incidence rate ratio (IRR) 1.60; 95% CI 1.11 to 2.14, p=0.01). After confirming cortisol as a mediator and adding it to the model, those who reported high (vs low) GSS had 1.58 times the rate of RKFD (IRR 1.58; 95% CI 1.09 to 2.30, p=0.0153). Stress related to not achieving goals was associated with a greater risk of RKFD in this sample of AAs.
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Affiliation(s)
- Loretta Cain-Shields
- Department of Data Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - LáShauntá Glover
- Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Bessie Young
- Division of Nephrology and Kidney Research Institute, University of Washington, Seattle, Washington, USA
- Veterans Affairs, Hospital and Specialty Medicine and Center for Innovation, Seattle, Washington, USA
| | - Mario Sims
- School of Medicine, Jackson Heart Study, University of Mississippi Medical Center, Jackson, Mississippi, USA
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42
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Thomas MD, Sohail S, Mendez RM, Márquez-Magaña L, Allen AM. Racial Discrimination and Telomere Length in Midlife African American Women: Interactions of Educational Attainment and Employment Status. Ann Behav Med 2020; 55:601-611. [PMID: 33289498 DOI: 10.1093/abm/kaaa104] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Over the life course, African American (AA) women have faster telomere attrition, a biological indicator of accelerated aging, than White women. Race, sex, age, and composite socioeconomic status (SES) modify associations of institutional racial discrimination and telomere length. However, interactions with everyday racial discrimination have not been detected in AA women, nor have interactions with individual socioeconomic predictors. PURPOSE We estimated statistical interaction of institutional and everyday racial discrimination with age, education, employment, poverty, and composite SES on telomere length among midlife AA women. METHODS Data are from a cross-section of 140 AA women aged 30-50 years residing in the San Francisco Bay Area. Participants completed questionnaires, computer-assisted self-interviews, physical examinations, and blood draws. Adjusted linear regression estimated bootstrapped racial discrimination-relative telomere length associations with interaction terms. RESULTS Racial discrimination did not interact with age, poverty, or composite SES measures to modify associations with telomere length. Interactions between independent SES variables were nonsignificant for everyday discrimination whereas institutional discrimination interacted with educational attainment and employment status to modify telomere length. After adjusting for covariates, we found that higher institutional discrimination was associated with shorter telomeres among employed women with lower education (β = -0.020; 95% confidence interval = -0.036, -0.003). Among unemployed women with higher education, higher institutional discrimination was associated with longer telomeres (β = 0.017; 95% confidence interval = 0.003, 0.032). Factors related to having a post-high school education may be protective against the negative effects of institutional racism on cellular aging for AA women.
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Affiliation(s)
- Marilyn D Thomas
- University of California, San Francisco, Department of Epidemiology & Biostatistics, San Francisco, CA, USA.,University of California, San Francisco, Department of Psychiatry, San Francisco, CA, USA
| | - Saba Sohail
- San Francisco State University, Department of Biology, San Francisco, CA, USA
| | - Rebecca M Mendez
- San Francisco State University, Department of Biology, San Francisco, CA, USA
| | | | - Amani M Allen
- University of California, Berkeley, Department of Epidemiology, School of Public Health, Berkeley, CA, USA.,University of California, Berkeley, Department of Community Health, School of Public Health, Berkeley, CA, USA
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Cave L, Cooper MN, Zubrick SR, Shepherd CCJ. Racial discrimination and allostatic load among First Nations Australians: a nationally representative cross-sectional study. BMC Public Health 2020; 20:1881. [PMID: 33287764 PMCID: PMC7720631 DOI: 10.1186/s12889-020-09978-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 11/26/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Increased allostatic load is linked with racial discrimination exposure, providing a mechanism for the biological embedding of racism as a psychosocial stressor. We undertook an examination of how racial discrimination interacts with socioecological, environmental, and health conditions to affect multisystem dysregulation in a First Nations population. METHODS We conducted latent class analysis (LCA) using indicators of life stress, socioeconomic background, and physical and mental health from a nationally representative sample of Australian Aboriginal adults (N = 2056). We used LCA with distal outcomes to estimate the effect of the latent class variable on our derived allostatic load index and conducted a stratified analysis to test whether allostatic load varied based on exposure to racial discrimination across latent classes. RESULTS Our psychosocial, environmental, and health measures informed a four-class structure; 'Low risk', 'Challenged but healthy', 'Mental health risk' and 'Multiple challenges'. Mean allostatic load was highest in 'Multiple challenges' compared to all other classes, both in those exposed (4.5; 95% CI: 3.9, 5.0) and not exposed (3.9; 95% CI: 3.7, 4.2) to racial discrimination. Allostatic load was significantly higher for those with exposure to racial discrimination in the 'Multiple challenges' class (t = 1.74, p = .04) and significantly lower in the 'Mental health risk' class (t = - 1.67, p = .05). CONCLUSIONS Racial discrimination may not always modify physiological vulnerability to disease. Social and economic contexts must be considered when addressing the impact of racism, with a focus on individuals and sub-populations experiencing co-occurring life challenges.
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Affiliation(s)
- Leah Cave
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia, 6872, Australia.
- School of Population and Global Health, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia, 6009, Australia.
| | - Matthew N Cooper
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia, 6872, Australia
| | - Stephen R Zubrick
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia, 6872, Australia
- Centre for Child Health Research, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia, 6009, Australia
| | - Carrington C J Shepherd
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia, 6872, Australia
- Ngangk Yira Research Centre for Aboriginal Health & Social Equity, Murdoch University, 90 South Street, Murdoch, Western Australia, 6150, Australia
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Manns-James L, Anthony MK, Neal-Barnett A. Racial Discrimination, Racial Identity, and Obesity in Collegiate African American Women. J Racial Ethn Health Disparities 2020; 8:1217-1231. [PMID: 33029746 DOI: 10.1007/s40615-020-00880-x] [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: 05/07/2020] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate relationships among racial discrimination, explicit racial identity, and obesity in young collegiate African American (AA) women aged 18-25. DESIGN Researchers recruited 136 women who self-identified as AA from a large Midwestern university. Racial discrimination (RD) was measured using lifetime overt experiences of discrimination, recent microaggressions, and vicarious RD directed towards close others. Explicit racial identity included dimensions of private regard, public regard, and centrality. Generalized obesity (elevated body mass index) and abdominal obesity (increased fat distribution in the midsection) were measured biometrically using kg/m2 and waist circumference, respectively. Hierarchical multiple regression was employed to explore main and interaction effects. RESULTS After controlling for adverse life events and income, overt RD, recent microaggressions, and private regard directly accounted for variance in both BMI and waist circumference. Public regard and centrality moderated relationships between RD variables and waist circumference. CONCLUSIONS RD and racial identity accounted for up to 13% of variance in BMI and waist circumference in main effects models among young collegiate AA women. While obesity is a multifactorial phenomenon, racial discrimination and racial identity may affect observed racial disparities in obesity rates among young women.
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Affiliation(s)
- Laura Manns-James
- Department of Midwifery and Women's Health, Frontier Nursing University, Versailles, KY, USA.
| | - Mary K Anthony
- College of Nursing, Kent State University, Kent, OH, USA
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McLoughlin S, Kenny RA, McCrory C. Does the choice of Allostatic Load scoring algorithm matter for predicting age-related health outcomes? Psychoneuroendocrinology 2020; 120:104789. [PMID: 32739647 DOI: 10.1016/j.psyneuen.2020.104789] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 12/27/2022]
Abstract
Allostatic Load (AL) is posited to provide a measure of cumulative physiological dysregulation across multiple biological systems and demonstrates promise as a sub-clinical marker of overall health. Despite the large heterogeneity of measures employed in the literature to represent AL, few studies have investigated the impact of different AL scoring systems in predicting health. This study uses data for 4477 participants aged 50+ years participating in the Irish Longitudinal Study on Ageing (TILDA) to compare the utility of 14 different scoring algorithms that have been used to operationalise AL (i.e. count-based high-risk quartiles, deciles, two-tailed cut-points, z-scores, system-weighted indices, clinical cut-points, sex-specific scores, and incorporating medication usage). Model fit was assessed using R2, Bayesian Information Criterion (BIC), and the area under the Receiver Operating Characteristic curve (AUC). The measure incorporating medications predicted walking speed and SRH marginally better than others. In general, AL was not predictive of grip strength. Overall, the results suggest that the choice of AL scoring algorithm exerts a relatively modest influence in predicting a number of important health outcomes.
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Affiliation(s)
- Sinead McLoughlin
- The Irish Longitudinal Study on Ageing (TILDA), Trinity Central, Trinity College Dublin, 152-160 Pearse Street, Dublin 2, Ireland.
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity Central, Trinity College Dublin, 152-160 Pearse Street, Dublin 2, Ireland; Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Cathal McCrory
- The Irish Longitudinal Study on Ageing (TILDA), Trinity Central, Trinity College Dublin, 152-160 Pearse Street, Dublin 2, Ireland
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Cuevas AG, Ong AD, Carvalho K, Ho T, Chan SW(C, Allen JD, Chen R, Rodgers J, Biba U, Williams DR. Discrimination and systemic inflammation: A critical review and synthesis. Brain Behav Immun 2020; 89:465-479. [PMID: 32688027 PMCID: PMC8362502 DOI: 10.1016/j.bbi.2020.07.017] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 07/01/2020] [Accepted: 07/13/2020] [Indexed: 12/21/2022] Open
Abstract
Exposure to discrimination or unfair treatment has emerged as an important risk factor for illness and disease that disproportionately affects racial and ethnic minorities. Discriminatory experiences may operate like other stressors in that they activate physiological responses that adversely affect the maintenance of homeostasis. Research suggests that inflammation plays a critical role in the pathophysiology of stress-related diseases. Recent findings on discrimination and inflammation are discussed. We highlight limitations in the current evidence and provide recommendations for future studies that seek to examine the association between discrimination and inflammation.
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Affiliation(s)
- Adolfo G. Cuevas
- Department of Community Health, Tufts University, United States,Corresponding author at: Tufts University, Department of Community Health, 574 Boston Ave, Suite 208, Medford, MA 02155, United States. (A.G. Cuevas)
| | - Anthony D. Ong
- Department of Human Development, Cornell University, United States,Department of Medicine, Weill Cornell Medical College, United States
| | - Keri Carvalho
- Department of Community Health, Tufts University, United States
| | - Thao Ho
- Department of Community Health, Tufts University, United States
| | | | | | - Ruijia Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, United States
| | - Justin Rodgers
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, United States
| | - Ursula Biba
- Department of Community Health, Tufts University, United States
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, United States,Department of African and African American Studies, Harvard University, United States
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African American Women's Perceptions of Cardiovascular Disease After Myocardial Infarction: A Phenomenological Inquiry. J Cardiovasc Nurs 2020; 34:503-510. [PMID: 31498163 DOI: 10.1097/jcn.0000000000000614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The primary cause of death among African American women older than 50 years is cardiovascular disease. Cardiovascular disease affects more than 16.8 million Americans and occurs when plaque builds up in the arteries that provide blood to the heart. This often leads to a partial or complete blockage, causing a myocardial infarction (heart attack). There is limited research regarding the lived experiences of African American women before and after a myocardial infarction. OBJECTIVE The purpose of this qualitative study was to explore the experiences of African American women living in the southern region of the United States who have experienced a myocardial infarction. METHODS A hermeneutic phenomenological framework guided the study. Semistructured, audiotaped interviews were conducted to elicit narratives from 7 participants. Interview data were transcribed verbatim and then coded and analyzed using Colaizzi's phenomenological analysis framework. RESULTS The findings revealed 6 major themes: life before myocardial infarction, causes of my myocardial infarction, myocardial infarction warning signs, life after myocardial infarction, cardiac rehabilitation, and family support. Lifestyle changes must be implemented to prevent a second blockage. Attending cardiac rehabilitation and incorporating regular physical exercise are recommended to help prevent further heart damage and to improve quality of life.
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Clarke LS, Corwin E, Dunlop A, Hankus A, Bradner J, Paul S, Jiao Y, Smith AK, Patrushev N, Mulle J, Read TD, Hogue CJR, Pearce BD. Glucocorticoid receptor sensitivity in early pregnancy in an African American cohort. Am J Reprod Immunol 2020; 84:e13252. [PMID: 32320110 PMCID: PMC7416519 DOI: 10.1111/aji.13252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 02/28/2020] [Accepted: 04/04/2020] [Indexed: 01/23/2023] Open
Abstract
PROBLEM Disruption in homeostatic feedback loops between inflammatory mediators and the hypothalamic-pituitary-adrenal (HPA) axis is a key mechanism linking chronic stress to inflammation and adverse health outcomes, including those occurring during pregnancy. In particular, alterations in glucocorticoid sensitivity may occur as a result of chronic stress, including that due to racial discrimination, and may be implicated in the persistent adverse maternal and infant health outcomes experienced by African Americans. While there are a few large-scale studies in human pregnancy that measure both cytokines and HPA axis hormones, to our knowledge, none directly measure glucocorticoid sensitivity at the cellular level, especially in an African American population. METHOD OF STUDY We measured the full range of the dexamethasone (DEX) dose-response suppression of TNF-α in first-trimester blood samples from 408 African American women and estimated leukocyte cell type contribution to the production of TNF-α. RESULTS The mean (SD) DEX level needed to inhibit TNF-α production by 50% (ie, DEX IC50 ) was 9.8 (5.8) nmol/L. Monocytes appeared to be the main driver of Uninhibited TNF-α production, but monocyte counts explained only 14% of the variation. Monocyte counts were only weakly correlated with the DEX IC50 (r = -.11, P < .05). Moreover, there was no statistically significant correlation between the DEX IC50 and circulating pro-inflammatory (CRP, IL-6, IFN-γ) or anti-inflammatory (IL-10) mediators (P > .05). CONCLUSION These findings challenge some prior assumptions and position this comprehensive study of glucocorticoid sensitivity as an important anchor point in the growing recognition of interindividual variation in maternal HPA axis regulation and inflammatory responses.
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Affiliation(s)
- Lasha S Clarke
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, Georgia, 30322, USA
| | - Elizabeth Corwin
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, Georgia, 30322, USA
| | - Anne Dunlop
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, Georgia, 30322, USA
| | - Allison Hankus
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, Georgia, 30322, USA
| | - Josh Bradner
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA
| | - Sudeshna Paul
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, Georgia, 30322, USA
| | - Yunshen Jiao
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, Georgia, 30322, USA
| | - Alicia K Smith
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 101 Woodruff Cir NE, Atlanta, Georgia, 30322, USA
| | - Nikolay Patrushev
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, Georgia, 30322, USA
| | - Jennifer Mulle
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA
| | - Timothy D Read
- Department of Medicine, Department of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, 30322, USA
| | - Carol JR Hogue
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, Georgia, 30322, USA
| | - Bradley D Pearce
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, Georgia, 30322, USA
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Forrester SN, Taylor JL, Whitfield KE, Thorpe RJ. Advances in Understanding the Causes and Consequences of Health Disparities in Aging Minorities. CURR EPIDEMIOL REP 2020; 7:59-67. [PMID: 33868898 PMCID: PMC8045783 DOI: 10.1007/s40471-020-00234-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW The purpose was to discuss appropriate methods for advancing our understanding of health disparities or minority aging including life-course perspectives, biological measures, pain measurement, and generational approaches. RECENT FINDINGS Life course perspectives provide an orientation for studying older minorities that concomitantly captures exposures and stressors that may lead to earlier onset of disease and premature mortality. The use of biological markers to study health disparities in older minorities is necessary in order to identify pathways between psychosocial factors and health outcomes. Work focusing on pain disparities should include explorations of relationships between psychosocial factors, and subjective and objective measures of pain. Studying families can provide insight into genetic associations and coping styles in older minorities. SUMMARY Methodological approaches that take life course, biology, and social factors into account may help identify causal pathways between social determinants of health and health outcomes among older minorities. Once these causal pathways have been identified, more strategies and interventions that strive toward health equity across older adults of all race/ethnic groups can be developed.
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Affiliation(s)
- Sarah N Forrester
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School
| | | | | | - Roland J Thorpe
- Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health
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Currie CL, Motz T, Copeland JL. The Impact of Racially Motivated Housing Discrimination on Allostatic Load among Indigenous University Students. J Urban Health 2020; 97:365-376. [PMID: 32495119 PMCID: PMC7305270 DOI: 10.1007/s11524-020-00446-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Allostatic load (AL) is an aggregate measure of wear and tear on the body due to the chronic activation of the stress response system. The goal of this study was to examine the association between racially motivated housing discrimination (HD) and AL score within a sample of Indigenous university students. Data for this cross-sectional study were collected from Indigenous adults attending university in a small city in western Canada between 2015 and 2017 (N = 104; mean age = 27.8 years). An item adapted from the Experience of Discrimination Scale was to assess racially motivated HD in the past 12 months. AL was measured as a composite of 7 biomarkers assessing neuroendocrine, cardiovascular, metabolic, and immune system function. Bias-corrected and accelerated bootstrapped linear regression models were used to examine associations adjusting for age, income, parenthood, and other situations in which discrimination had been experienced. Indigenous university students who experienced racially motivated HD in the past year (16.8% of the sample) had an average AL score of approximately 4, which was almost double that of their peers who had not. In an adjusted model, racially motivated HD was associated with a 1.5 point increase in AL score. This model explained 35% of the adjusted variance in AL score, of which racially motivated HD explained 24%. These results suggest Indigenous adults who experienced racially motivated HD in the past year had early and more pronounced wear and tear on neuroendocrine, cardiovascular, metabolic, and immune system functioning in young and middle adulthood than Indigenous peers who did not. These findings combine with others to highlight the need for increased efforts to prevent racially motivated HD in urban centers.
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Affiliation(s)
- Cheryl L Currie
- Faculty of Health Sciences, University of Lethbridge, M3083 Markin Hall, 4401 University Drive, Lethbridge, AB, T1K3M4, Canada.
| | - Takara Motz
- Faculty of Health Sciences, University of Lethbridge, M3083 Markin Hall, 4401 University Drive, Lethbridge, AB, T1K3M4, Canada
| | - Jennifer L Copeland
- Department of Kinesiology and Physical Education, Faculty of Arts & Science, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K3M4, Canada
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