Social capital, anticipated ethnic discrimination and self-reported psychological health: a population-based study

Social sharing of emotion during the collective crisis of COVID-19

We collected data from two sources - social media and online questionnaires - to investigate the emotional consequences of social sharing during the COVID-19 pandemic. Study 1 tracked and analysed sentiment of tweets posted over the course of a month in the crisis period and found that users who tweeted more frequently about COVID-19 expressed decreasing negative sentiment and increasing positive sentiment over time. Granger causality tests confirmed that this association was better interpreted in the forward direction (sharing levels predicting sentiment) than in the reverse direction (sentiment predicting sharing levels). Study 2 focused on immediate emotional consequences of sharing COVID-19-related events and found that participants reported improved overall affect about an event after sharing it, especially when that event was a personal experience rather than a news story. Reported positive feelings about both kinds of events were also significantly higher after sharing. Taken together, both studies suggested that social sharing is linked with emotional relief and may therefore help people to deal with their negative experiences during a persistent collective crisis.

Institutional Trust as a Protective Factor during the COVID-19 Pandemic in China

Previous research has demonstrated that institutional trust protects subjective well-being during pandemics. However, the potential mediation mechanisms underlying this linkage remain unclear. This study constructs a mediating model to investigate the effect of institutional trust on subjective well-being and the mediating roles of belief in a just world and fear of COVID-19 in the Chinese context. To this end, we survey a sample of 881 participants. The results show that institutional trust, belief in a just world, fear of COVID-19, and subjective well-being (i.e., life satisfaction, positive affect, and negative affect) are significantly interrelated. The results also indicate a significant impact of institutional trust on life satisfaction, positive affect, and negative affect. Belief in a just world and fear of COVID-19, independently and in sequence, mediate the relationship between institutional trust and subjective well-being.

Social Capital as Protection Against the Mental Health Impact of the COVID-19 Pandemic

The corona pandemic has a huge impact on the mental wellbeing of the Dutch population. Based on a large-scale panel survey (N = 22,696) on the social impact of COVID-19, this article firstly examines which social groups are most susceptible to the mental health consequences of the pandemic. Secondly, we examine whether social capital provides protection against this impact. We find that the mental health impact of COVID-19 is considerable and that it increased over the course of 2020. Women, young people, respondents with low incomes and/or poor self-perceived health, experience relatively more fear and stress due to the pandemic. We do not find a difference between respondents with or without a migration background. Social capital (received support, trust in people and in institutions) has the expected effect: the more support and trust, the less fear and stress. There is a mediation effect. Older people, respondents with high incomes and/or good health experience less fear and stress, partly because they have more social capital. This is different for females. They would experience even more fear and stress, compared to men, were it not for the fact that they have more social capital. Hence we conclude that social capital indeed provides some protection against the negative mental health consequences of COVID-19.

Trust and well-being of postpartum women during the COVID-19 crisis: Depression and fear of COVID-19

During crisis, trust has been found to have a buffering effect in the prevention of the deterioration of mental well-being, as trust is considered to reflect the individual's capability to gain social resources including both formal and informal support. Additionally, during the COVID-19 pandemic, political trust has been found to reduce anxiety. Taking these findings into account, this study explores the association of generalised and political trust with mental well-being on current postpartum women who were particularly at risk due to a decline in social support leaving them an increased burden of caring newborns during the pandemic. We conducted a crosssectional survey in October 2020 in Japan (n=558). Depressive symptoms (above the cutoff of the Edinburgh Postnatal Depression Scale (EPDS)) and Fear of Coronavirus-19 Scale (FCV-19S) scores were used as mental well-being indicators. Generalised and political trust were captured by binary variables. Results of regression analyses, in which covariates were fully adjusted, showed that higher generalised trust had a statistically significant association with lower possibility of depressive symptoms and a lower FCV-19S score, while political trust was not significantly associated with either indicator. For further understanding, we divided respondents into two groups; women living in cities where higher COVID-19 cases were reported and women living in areas with lower COVID-19 cases, to test whether the role of trust differs depending on the infection spread status. It was found that a higher generalised trust was significantly associated with a lower probability of having depressive symptoms in the areas with lower COVID-19 cases. However, statistical significance was not observed in the areas with high COVID-19 cases. This highlighted that even postpartum women who were normally capable of receiving formal and informal social support need to be taken care of in the current situation.

The Intergenerational Transmission of Discrimination: Children's Experiences of Unfair Treatment and Their Mothers' Health at Midlife

A growing body of research suggests that maternal exposure to discrimination helps to explain racial disparities in children's health. However, no study has considered if the intergenerational health effects of unfair treatment operate in the opposite direction-from child to mother. To this end, we use data from mother-child pairs in the National Longitudinal Survey of Youth 1979 to determine whether adolescent and young adult children's experiences of discrimination influence their mother's health across midlife. We find that children who report more frequent instances of discrimination have mothers whose self-rated health declines more rapidly between ages 40 and 50 years. Furthermore, racial disparities in exposure to discrimination among children explains almost 10% of the black-white gap but little of the Hispanic-white gap in self-rated health among these mothers. We conclude that the negative health impacts of discrimination are likely to operate in a bidirectional fashion across key family relationships.

Perceived discrimination, health and mental health among immigrants in Norway: the role of moderating factors

BACKGROUND

Ethnic discrimination is a relatively common experience among immigrants and ethnic minorities. The experience of discrimination can have detrimental effects on an individual's health and well-being. This study investigated the association between perceived discrimination and general health and mental health among immigrants in Norway, in order to identify potential protective factors.

METHODS

Using data from the Living Conditions Survey among Immigrants 2016, our sample consisted of 4294 participants aged 16-66 years from 12 different countries. Participants were asked about a variety of themes including health and mental health, perceived discrimination, sense of belonging and language proficiency.

RESULTS

Around 27% of participants reported perceived discrimination. While perceived discrimination was not associated with general health, logistic regression analyses indicated that it was associated with 1.86 higher odds of mental health problems, even after adjusting for sociodemographic and psychosocial variables. Further, interaction analyses suggested that sense of belonging and trust in others moderated the relationship. Those with higher levels of trust did not have increased odds of mental health problems when experiencing discrimination, while those with low levels of trust did. In line with rejection sensitivity theory, the association between perceived discrimination and mental health was stronger for participants who had a strong sense of belonging to their own country of origin but not to Norway compared with those who had a sense of belonging to both.

CONCLUSIONS

Improved integration strategies could potentially improve the mental health of immigrants as well as increase the acceptability of diversity, which in turn, could reduce discrimination towards immigrants. Limitations and suggestions for further research are discussed.

Stress and the Mental Health of Populations of Color: Advancing Our Understanding of Race-related Stressors

This article provides an overview of research on race-related stressors that can affect the mental health of socially disadvantaged racial and ethnic populations. It begins by reviewing the research on self-reported discrimination and mental health. Although discrimination is the most studied aspect of racism, racism can also affect mental health through structural/institutional mechanisms and racism that is deeply embedded in the larger culture. Key priorities for research include more systematic attention to stress proliferation processes due to institutional racism, the assessment of stressful experiences linked to natural or manmade environmental crises, documenting and understanding the health effects of hostility against immigrants and people of color, cataloguing and quantifying protective resources, and enhancing our understanding of the complex association between physical and mental health.

No experience required: Violent crime and anticipated, vicarious, and experienced racial discrimination

There is a growing body of evidence linking racial discrimination and juvenile crime, and a number of theories explain this relationship. In this study, we draw on one popular approach, Agnew's general strain theory, and extend prior research by moving from a focus on experienced discrimination to consider two other forms, anticipated and vicarious discrimination. Using data on black, white, and Hispanic youth, from the Project on Human Development in Chicago Neighborhoods (PHDCN), we find that experienced, anticipated, and to a lesser extent, vicarious discrimination, significantly predict violent crime independent of a set of neighborhood, parental, and individual level controls, including prior violent offending. Additional analyses on the specific contexts of discrimination reveal that violence is associated with the anticipation of police discrimination. The effects tend to be larger for African American than Hispanic youth, but the differences are not statistically significant. These findings support the thesis that, like other strains, discrimination may not have to be experienced directly to influence offending.

Social capital and health and job related outcomes: the case of a large municipality

Purpose

– The purpose of this paper is to investigate the relationship between workplace social capital and health and job related outcomes in a large Danish municipality.

Design/methodology/approach

– Data used in this cross-sectional study are based on an electronic employee survey conducted in 2012 in a large municipality. Of the total population of 5,672 individuals, the number of participants amounted to 4,162, leading to a response rate of 73.4 percent. Binary logistic regression analysis is used as a statistical method, and odds ratios and their corresponding 95 percent confidence intervals have been estimated.

Findings

– The level of social capital is fairly high in the municipality (3.75 on a five-point scale). Social capital is related to health (OR=0.420) and psychological distress (OR=0.282) but has an even stronger relationship to job satisfaction and commitment (OR is 9.889 and 7.800, respectively). The study contributes with the conclusion that different sub-dimensions of social capital are related to health and job related outcomes. Therefore, managers need to be specific about what exactly they want to achieve with the implementation of social capital in municipalities.

Originality/value

– Research of the relationship between social capital and health and job related outcomes based on a case study approach of a municipality are limited. This paper makes an original contribution in providing evidence of the importance of social capital for Danish municipal sector employees’ health, job satisfaction, and commitment in a work context.

Racism, other discriminations and effects on health

We study the probability of perceived racism/other forms of discrimination on immigrant and Spanish populations within different public spheres and show their effect on the health of immigrants using a cross-sectional design (ENS-06).

VARIABLES

perceived racism/other forms of discrimination (exposure), socio-demographic (explicative), health indicators (dependent). Frequencies, prevalences, and bivariate/multivariate analysis were conducted separately for men (M) and women (W). We estimated the health problems attributable to racism through the population attributable proportion (PAP). Immigrants perceived more racism than Spaniards in workplace (ORM = 48.1; 95% CI 28.2-82.2), and receiving health care (ORW = 48.3; 95% CI 24.7-94.4). Racism and other forms of discrimination were associated with poor mental health (ORM = 5.6; 95% CI 3.9-8.2; ORW = 7.3; 95% CI 4.1-13.0) and injury (ORW = 30.6; 95% CI 13.6-68.7). It is attributed to perceived racism the 80.1% of consumption of psychotropics (M), and to racism with other forms of discrimination the 52.3% of cases of injury (W). Racism plays a role as a health determinant.

Mistrust of mental health services: ethnicity, hospital admission and unfair treatment

AIMS

To explore the role of psychiatric admission, diagnosis and reported unfair treatment in the relationship between ethnicity and mistrust of mental health services.

METHODS

The Mental Illness-Related Investigations on Discrimination (MIRIAD) study was a cross-sectional study of 202 individuals using secondary mental health services in South London. Two structural equation models were estimated, one using Admission (whether admitted to hospital for psychiatric treatment in the past 5 years) and one using involuntary admission to hospital in the past 5 years.

RESULTS

Increased mistrust was directly associated with the latent variable 'unfair treatment by mental health services and staff' and with Black or mixed ethnicity in both models. Those with a diagnosis of schizophrenia spectrum (as compared to depression and bipolar disorder) had a lower average score on the latent variable, suggesting that on average they reported less unfair treatment. We found evidence of increased reporting of unfair treatment by those who had an admission in the past 5 years, had experienced involuntary admission, and for people of Black of mixed Black and White ethnicity.

CONCLUSIONS

Neither prevalence of schizophrenia spectrum nor rates of hospital admission explained the greater mistrust of mental health services found among people of Black and mixed Black and White ethnicity compared with White ethnicity. Rather, people of Black and mixed Black and white ethnicity may be more likely to experience unfair treatment, generating mistrust; furthermore, this group is more likely to express mistrust even after accounting for reporting of unfair treatment by mental health services and staff.

Discrimination and sleep: a systematic review

An increasing body of literature indicates that discrimination has a negative impact on health; poor sleep may be an underlying mechanism. The primary objective of this review was to examine existing studies on the relationship between discrimination and sleep to clarify (a) the potential role of discrimination in shaping population patterns of sleep and sleep disparities, and (b) the research needed to develop interventions at individual and institutional levels. We identified articles from English-language publications in PubMed and EBSCO databases from inception through July 2014. We employed a broad definition of discrimination to include any form of unfair treatment and all self-reported and objectively assessed sleep outcomes, including duration, difficulties, and sleep architecture. Seventeen studies were identified: four prospective, 12 cross-sectional, and one that utilized a daily-diary design. Fifteen of the 17 studies evaluated interpersonal discrimination as the exposure and the majority of studies included self-reported sleep as the outcome. Only four studies incorporated objective sleep assessments. All 17 studies identified at least one association between discrimination and a measure of poorer sleep, although studies with more detailed consideration of either discrimination or sleep architecture revealed some inconsistencies. Taken together, existing studies demonstrate consistent evidence that discrimination is associated with poorer sleep outcomes. This evidence base can be strengthened with additional prospective studies that incorporate objectively measured aspects of sleep. We outline important extensions for this field of inquiry that can inform the development of interventions to improve sleep outcomes, and consequently promote well-being and reduce health inequities across the life course.

Self-reported experiences of discrimination and health: scientific advances, ongoing controversies, and emerging issues

Over the past two decades, research examining the impact of self-reported experiences of discrimination on mental and physical health has increased dramatically. Studies have found consistent associations between exposure to discrimination and a wide range of Diagnostic and Statistical Manual of Mental Disorders (DSM)-diagnosed mental disorders as well as objective physical health outcomes. Associations are seen in cross-sectional as well as longitudinal studies and persist even after adjustment for confounding variables, including personality characteristics and other threats to validity. However, controversies remain, particularly around the best approach to measuring experiences of discrimination, the significance of racial/ethnic discrimination versus overall mistreatment, the need to account for "intersectionalities," and the importance of comprehensive assessments. These issues are discussed in detail, along with emerging areas of emphasis including cyber discrimination, anticipatory stress or vigilance around discrimination, and interventions with potential to reduce the negative effects of discrimination on health. We also discuss priorities for future research and implications for interventions and policy.

Racial/ethnic disparities in hypertension prevalence: reconsidering the role of chronic stress

OBJECTIVES

We investigated the association between anticipatory stress, also known as racism-related vigilance, and hypertension prevalence in Black, Hispanic, and White adults.

METHODS

We used data from the Chicago Community Adult Health Study, a population-representative sample of adults (n = 3105) surveyed in 2001 to 2003, to regress hypertension prevalence on the interaction between race/ethnicity and vigilance in logit models.

RESULTS

Blacks reported the highest vigilance levels. For Blacks, each unit increase in vigilance (range = 0-12) was associated with a 4% increase in the odds of hypertension (odds ratio [OR] = 1.04; 95% confidence interval [CI] = 1.00, 1.09). Hispanics showed a similar but nonsignificant association (OR = 1.05; 95% CI = 0.99, 1.12), and Whites showed no association (OR = 0.95; 95% CI = 0.87, 1.03).

CONCLUSIONS

Vigilance may represent an important and unique source of chronic stress that contributes to the well-documented higher prevalence of hypertension among Blacks than Whites; it is a possible contributor to hypertension among Hispanics but not Whites.

A Question of Color

This study describes the relative influence of facial skin color, lifetime exposure to racial discrimination, chronic stress, and traditional prehypertension risk factors (family history of hypertension and age) on resting blood pressure and body mass index (BMI) among 196 southern African American (AA) female undergraduate students. Stepwise regression analyses indicated that skin color was the strongest predictor of systolic blood pressure (SBP), diastolic blood pressure (DBP), and BMI. Skin color, chronic stress, and family history of hypertension predicted 53% of the SBP variance. Skin color, chronic stress, and family history of hypertension predicted 30.2% of the DBP variance. Racism and age were not significant predictors of SBP or DBP. Of the variance in BMI, 33% was predicted by skin color, chronic stress, and racism. Age and family history of hypertension were not predictors of BMI. The current study provides evidence of the relationship of skin color and chronic stress to blood pressure among young southern AA women. The study identifies an important relationship between increased racial stress exposure and heavier BMIs, a predictor of prehypertensive risk.

"Every shut eye, ain't sleep": The role of racism-related vigilance in racial/ethnic disparities in sleep difficulty

Although racial/ethnic disparities in health have been well-characterized in biomedical, public health, and social science research, the determinants of these disparities are still not well-understood. Chronic psychosocial stress related specifically to the American experience of institutional and interpersonal racial discrimination may be an important determinant of these disparities, as a growing literature in separate scientific disciplines documents the adverse health effects of stress and the greater levels of stress experienced by non-White compared to White Americans. However, the empirical literature on the importance of stress for health and health disparities specifically due to racial discrimination, using population-representative data, is still small and mixed. In this paper, we explore the association between a novel measure of racially-salient chronic stress - "racism-related vigilance" - and sleep difficulty. We found that, compared to the White adults in our sample, Black (but not Hispanic) adults reported greater levels of vigilance. This vigilance was positively associated with sleep difficulty to similar degrees for all racial/ethnic groups in our sample (White, Black, Hispanic). Black adults reported greater levels of sleep difficulty compared to White adults. This disparity was slightly attenuated after adjustment for education and income. However, this disparity was completely attenuated after adjustment for racism-related vigilance. We found similar patterns of results for Hispanic compared to White adults, however, the disparities in sleep difficulty were smaller and not statistically significant. Because of the importance of sleep quality to health, our results suggest that the anticipation of and perseveration about racial discrimination is an important determinant of racial disparities in health.

Social determinants of self-perceived discrimination in Spain

OBJECTIVES

To analyse the association between self-perceived discrimination and social determinants (social class, gender, country of origin) in Spain, and further to describe contextual factors which contribute to self-perceived discrimination.

METHODS

Cross-sectional design using data from the Spanish National Health Survey (2006). The dependent variable was self-perceived discrimination, and independent and stratifying variables were sociodemographic characteristics (e.g. sex, social class, country of origin, educational level). Logistic regression was used.

RESULTS

The prevalence of self-perceived discrimination was 4.2% for men and 6.3% for women. The likelihood of self-perceived discrimination was higher in people who originated from low-income countries: men, odds ratio (OR) 5.59 [95% confidence interval (CI) 4.55-6.87]; women, OR 4.06 (95% CI 3.42-4.83). Women were more likely to report self-perceived discrimination by their partner at home than men [OR 8.35 (95% CI 4.70-14.84)]. The likelihood of self-perceived discrimination when seeking work was higher among people who originated from low-income countries than their Spanish counterparts: men, OR 13.65 (95% CI 9.62-19.35); women, OR 10.64 (95% CI 8.31-13.62). In comparison with Spaniards, male white-collar workers who originated from low-income countries [OR 11.93 (95% CI 8.26-17.23)] and female blue-collar workers who originated from low-income countries (OR 1.6 (95% CI 1.08-2.39)] reported higher levels of self-perceived discrimination.

CONCLUSIONS

Self-perceived discrimination is distributed unevenly in Spain and interacts with social inequalities. This particularly affects women and immigrants.

Migration and health: a study of effects of early life experiences and current socio-economic situation on mortality of immigrants in Sweden

OBJECTIVES

Previous research has demonstrated mortality differences between immigrants and natives living in Sweden. The aim of this study is to investigate the effects of early life conditions in the country of birth and current socio-economic conditions in adult life in Sweden on cardiovascular, cancer, all other cause and total mortality among immigrants and natives in Sweden.

DESIGN

The cohort data concerning individual demographic characteristics and socio-economic conditions stems from the Swedish Longitudinal Immigrant Database (SLI), a register-based representative database, and consists of individuals from 11 countries of birth, born between 1921 and 1939, who were residents in Sweden between 1980 and 2001. The associations between current socio-economic conditions as well as infant mortality rates (IMR) and Gross Domestic Product (GDP) per capita in the year and country of birth, and total, cardiovascular, cancer and 'all other' mortality in 1980-2001 were calculated by survival analysis using Cox proportional hazards regression to calculate hazard rate ratios.

RESULTS

The effects of current adult life socio-economic conditions in Sweden on mortality are both stronger and more straightforward than the effects of early life conditions in the sense that higher socio-economic status is significantly associated with lower mortality in all groups of diagnoses; however, we find associations between infant mortality rates (IMR) in the year and country of birth, and cancer mortality among men and women in the final model.

CONCLUSIONS

Socioeconomic conditions in Sweden are more strongly associated with mortality than early life indicators IMR and GDP per capita in the year of birth in the country of origin. This finding has health policy and other policy implications.

Social Capital and Human Mortality: Explaining the Rural Paradox with County-Level Mortality Data

The "rural paradox" refers to standardized mortality rates in rural areas that are unexpectedly low in view of well-known economic and infrastructural disadvantages there. We explore this paradox by incorporating social capital, a promising explanatory factor that has seldom been incorporated into residential mortality research. We do so while being attentive to spatial dependence, a statistical problem often ignored in mortality research. Analyzing data for counties in the contiguous United States, we find that: (1) the rural paradox is confirmed with both metro/non-metro and rural-urban continuum codes, (2) social capital significantly reduces the impacts of residence on mortality after controlling for race/ethnicity and socioeconomic covariates, (3) this attenuation is greater when a spatial perspective is imposed on the analysis, (4) social capital is negatively associated with mortality at the county level, and (5) spatial dependence is strongly in evidence. A spatial approach is necessary in county-level analyses such as ours to yield unbiased estimates and optimal model fit.

The effect of perceived discrimination on the health of immigrant workers in Spain

BACKGROUND

Discrimination is an important determinant of health inequalities, and immigrants may be more vulnerable to certain types of discrimination than the native-born. This study analyses the relationship between immigrants' perceived discrimination and various self-reported health indicators.

METHODS

A cross-sectional survey was conducted (2008) amongst a non-random sample of 2434 immigrants from Ecuador, Morocco, Romania and Colombia in four Spanish cities: Barcelona, Huelva, Madrid and Valencia. A factorial analysis of variables revealed three dimensions of perceived discrimination (due to immigrant status, due to physical appearance, and workplace-related). The association of these dimensions with self-rated health, mental health (GHQ-12), change in self-rated health between origin and host country, and other self-reported health outcomes was analysed. Logistic regression was used adjusting for potential confounders (aOR-95%CI). Subjects with worsening self-reported health status potentially attributable to perceived discrimination was estimated (population attributable proportion, PAP %).

RESULTS

73.3% of men and 69.3% of women immigrants reported discrimination due to immigrant status. Moroccans showed the highest prevalence of perceived discrimination. Immigrants reporting discrimination were at significantly higher risk of reporting health problems than those not reporting discrimination. Workplace-related discrimination was associated with poor mental health (aOR 2.97 95%CI 2.45-3.60), and the worsening of self-rated health (aOR 2.20 95%CI 1.73- 2.80). 40% (95% CI 24-53) PAP of those reporting worse self-rated health could be attributable to discrimination due to immigrant status.

CONCLUSIONS

Discrimination may constitute a risk factor for health in immigrant workers in Spain and could explain some health inequalities among immigrant populations in Spanish society.

Discrimination and subjective well-being: protective influences of membership in a discriminated category

BACKGROUND

Research reveals that discrimination has harmful effects on health and quality of life. Among the most frequent types of discrimination pertains gender and age discrimination. Research results show that discriminatory behaviours based on gender afflict predominantly women; age discrimination afflicts mainly older adults. At the same time, it has been found that members of these traditionally discriminated categories often use strategies that mitigate the effects of discrimination.

HYPOTHESES

Discrimination will have detrimental effects on subjective well-being. But its effects will be most harmful for persons who are not members of the traditionally discriminated categories.

METHODS

These hypotheses were tested on data from three waves of the European Social Survey that the Czech Republic also participated in. Data were analyzed in a series of multilevel random coefficients regression analyses with respondents nested within states and states nested within years of study.

RESULTS

Both perceived gender discrimination and perceived age discrimination have negative effects on subjective well-being. However, gender discrimination had more harmful effects on the subjective well-being of men than women and age discrimination had the most harmful effects on the subjective well-being of people in their middle ages, not the elderly ones.

CONCLUSION

Discrimination does not need to have most harmful effects on the quality of life of members of the categories that are discriminated against most often.

Social capital and health in a national cohort of 82,482 Open University adults in Thailand

We report associations between social capital and health among 82,482 adults in a national cohort of Open University students residing throughout Thailand.After adjusting for covariates, poor self-assessed health was positively associated with low social trust (OR = 1.88; 95% CI 1.76-2.01) and low social support (OR = 1.79; 95% CI 1.63-1.95). In addition, poor psychological health was also associated with low social trust (OR = 2.52; 95% CI 2.41-2.64) and low social support (OR = 1.80; 95% CI 1.69-1.92). Females, elderly, unpartnered, low income, and urban residents were associated with poor health. Findings suggest ways to improve social capital and heath in Thailand and other middle-income countries.

Perceived Discrimination, Identification, Social Capital, and Well-Being

This study examined racism, ethnic and majority identification, cognitive aspects of social capital (i.e., a sense of trust), and perceived stress and evaluated the relationships between these variables and two indices of adjustment (physical health, psychological well-being) in three minority ethnic community samples in Scotland, United Kingdom. Pakistani ( n = 211, 101 female), Indian ( n = 155, 81 female), and African and Caribbean ( n = 244, 119 female) individuals participated in semistructured interviews. Racism was associated with higher levels of perceived stress, lower levels of social capital, higher levels of minority identity, and lower levels of majority identity. Racism was also associated with psychological well-being (though in different ways for different groups) and with poorer physical health. Minority identification was positively associated with psychological well-being and negatively with perceived stress, while majority identification was positively associated with social capital and negatively with physical health. Implications of these findings are discussed with reference to the literature.

Perceptions of the use of khat among Somali immigrants living in Swedish society

AIMS

The aim of this study was to gain a better understanding of Somali immigrants' perceptions of the use of khat when living in Swedish society. Using khat is illegal in Sweden.

METHODS

A phenomenographic design was used to capture different perception of using khat. Fourteen interviews were conducted with both men and women. The information was subjected to phenomenographic analysis.

RESULTS

Perceptions of the habit of chewing khat among Somalis living in Sweden vary. The use of khat is perceived as a kind of food or as a drug. To use khat is perceived as having a physical impact on individual health, as well as an impact on social and family life. Using khat also has an impact on people's time, because time is needed to indulge the habit. Furthermore, using khat is perceived as a medium for cultural and community cohesiveness. The Somalis preferred preventive measures in place to counter the use of khat in Sweden.

CONCLUSIONS

The use of a phenomenographic design which captured the variation in perceptions of the habit of using khat among Somali immigrants' living in Swedish society is helpful in guiding individual strategies in health promotion activities.

Social inequality and health: the role of social capital

The aim of the article is to examine whether and to what degree the unequal distribution of social capital in the population explains the relationship between socioeconomic position and health in Norway. Theoretical insight and empirical evidence seem to suggest that social capital mediates the effect of socioeconomic position on health outcomes. However, only a few studies have addressed this question and those that have done so have used few and simple indicators of social capital. This study is based on a nationwide cross-sectional survey (N = 3190) commissioned by Statistics Norway. The survey was designed to cover a comprehensive set of variables measuring different aspects of the theoretical construct of social capital. Two health outcomes, self-perceived health and longstanding illness, were analysed. The results showed that the mediating role of social capital between socioeconomic position and health was negligible for both health outcomes. After controlling for socio-demographic variables and socioeconomic position, only neighbourhood satisfaction and generalised trust showed a significant association with self-perceived health, whereas none of the social capital variables had any significant association with longstanding illness. Some theoretical and methodological implications of the results are discussed.

Discrimination and racial disparities in health: evidence and needed research

This paper provides a review and critique of empirical research on perceived discrimination and health. The patterns of racial disparities in health suggest that there are multiple ways by which racism can affect health. Perceived discrimination is one such pathway and the paper reviews the published research on discrimination and health that appeared in PubMed between 2005 and 2007. This recent research continues to document an inverse association between discrimination and health. This pattern is now evident in a wider range of contexts and for a broader array of outcomes. Advancing our understanding of the relationship between perceived discrimination and health will require more attention to situating discrimination within the context of other health-relevant aspects of racism, measuring it comprehensively and accurately, assessing its stressful dimensions, and identifying the mechanisms that link discrimination to health.

Discrimination and racial disparities in health: evidence and needed research

This paper provides a review and critique of empirical research on perceived discrimination and health. The patterns of racial disparities in health suggest that there are multiple ways by which racism can affect health. Perceived discrimination is one such pathway and the paper reviews the published research on discrimination and health that appeared in PubMed between 2005 and 2007. This recent research continues to document an inverse association between discrimination and health. This pattern is now evident in a wider range of contexts and for a broader array of outcomes. Advancing our understanding of the relationship between perceived discrimination and health will require more attention to situating discrimination within the context of other health-relevant aspects of racism, measuring it comprehensively and accurately, assessing its stressful dimensions, and identifying the mechanisms that link discrimination to health.

Discrimination and racial disparities in health: evidence and needed research

This paper provides a review and critique of empirical research on perceived discrimination and health. The patterns of racial disparities in health suggest that there are multiple ways by which racism can affect health. Perceived discrimination is one such pathway and the paper reviews the published research on discrimination and health that appeared in PubMed between 2005 and 2007. This recent research continues to document an inverse association between discrimination and health. This pattern is now evident in a wider range of contexts and for a broader array of outcomes. Advancing our understanding of the relationship between perceived discrimination and health will require more attention to situating discrimination within the context of other health-relevant aspects of racism, measuring it comprehensively and accurately, assessing its stressful dimensions, and identifying the mechanisms that link discrimination to health.

Epidemiology and the macrosocial determinants of health

In the past two decades, public health researchers have taken renewed interest in investigating the role of social factors in health. This holds substantial promise in terms of identifying manipulable social factors that are amenable to policy intervention. Most existing empirical and conceptual epidemiologic work, however, has focused on the more proximal social determinants, such as interpersonal relations. These factors, although perhaps easier to study epidemiologically, are much less relevant to policy makers than more "macrosocial" factors such as taxation policies. Limited epidemiologic attention to macrosocial determinants of health is ironic given that macrosocial factors such as the rapid industrialization and urbanization in the 19th century contributed to the organization of public health practice and, tangentially, to academic public health research. We suggest here that greater investment in the study of macrosocial determinants has the potential to make a significant and unique contribution to the greater public health agenda and should be a prominent aspect of social epidemiologic inquiry in the coming decades.

Culture and psychiatric symptoms in Puerto Rican children: longitudinal results from one ethnic group in two contexts

BACKGROUND

The development of youth psychopathology may be associated with direct and continuous contact with a different culture (acculturation) and to distress related to this process (cultural stress). We examine cultural experiences of Puerto Rican families in relation to youth psychiatric symptoms in two different contexts: one in which migrant Puerto Ricans reside on the mainland as an ethnic minority and another in which they reside in their place of origin.

SAMPLE

Probability samples of 10- to 13-year-old youth of Puerto Rican background living in the South Bronx, New York City (SB) and in the San Juan Metropolitan area in Puerto Rico (PR) (N = 1,271) were followed over time. measures: Three assessments of internalizing psychiatric symptoms (elicited through the DISC-IV) and of antisocial behaviors (ASB) quantified through a six-point index were carried out. Independent variables included scales of adult and child acculturation and cultural stress, and other putative correlates.

DATA ANALYSIS

Within each study site, multilevel linear regression models were examined.

RESULTS

Parental acculturation was associated with ASB in youth at both sites, but youth acculturation itself was not related to psychiatric symptoms. At both contexts, cultural stress was a more consistent correlate of youth psychiatric symptoms than acculturation after controlling for nativity, maternal education, child gender, stressful life events and parental psychopathology. However, the strength of the youth cultural stress association decreased over time.

CONCLUSION

The association between cultural factors and child psychiatric symptoms is not restricted to contexts where an ethnic group is a minority.