1
|
Sekher TV, Pai M, Muhammad T. Subjective social status and socio-demographic correlates of perceived discrimination among older adults in India. BMC Geriatr 2024; 24:617. [PMID: 39030500 PMCID: PMC11265011 DOI: 10.1186/s12877-024-05114-x] [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: 11/11/2023] [Accepted: 05/29/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND Considering India's diversity, marked by differences in caste, class, ethnicity, religion, region, and language, discrimination can take on varying forms across social-structural locations. We examined the association between subjective social status (SSS) and perceived discrimination, and assessed the sociodemographic correlates of perceived discrimination among older persons in India. METHODS Data come from the 2017-18 wave 1 of the Longitudinal Aging Study in India (LASI) with a sample of 30,253 adults 60 years or older. SSS was examined using the Macarthur scale with a ladder technique. Perceived discrimination was evaluated with the Everyday Discrimination Scale. Multivariable logistic regression models examined the odds of reporting discrimination by its types and attributions. RESULTS 39% of older adults reported low SSS, whereas 7.3% reported high SSS. Older adults with low SSS had significantly higher odds of experiencing some discrimination than those with high SSS. Compared to high-SSS peers, low-SSS individuals attributed age, gender, caste, financial, and health status as reasons for discrimination. Older women attributed gender as a reason for discrimination. Caste was reported as a reason for discrimination by rural but not urban dwellers. Relative to northerners, those from southern India reported age, financial, and health statuses as reasons for discrimination. CONCLUSIONS That low-SSS older adults reported age, gender, caste, financial status, and health status as reasons for discrimination and that this association persisted after considering objective indicators of socioeconomic status (SES) is suggestive of SSS as independently consequential for perceived discrimination. These findings are useful for care providers and practitioners as they encourage older patients -- especially those with low SSS who may feel stigmatized -- to seek care, comply with care regimen, and engage in behaviors that protect and promote health.
Collapse
Affiliation(s)
- T V Sekher
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Manacy Pai
- Department of Sociology and Criminology, Kent State University, Kent, OH, 44242, USA
| | - T Muhammad
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, 16802, USA.
| |
Collapse
|
2
|
Fuller-Rowell TE, Zeringue MM, Saini EK, Yip T, El-Sheikh M. Do Sleep Problems Exacerbate the Mental Health Consequences of Discrimination Among Adults? Psychosom Med 2024; 86:324-333. [PMID: 38588054 DOI: 10.1097/psy.0000000000001305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
OBJECTIVE An emerging literature suggests that sleep may play an important role in moderating the association between discrimination and mental health problems among adolescents. However, few if any studies have considered this topic among adults. Addressing this knowledge gap, the current study examined multiple sleep parameters as moderating variables in the association between discrimination and mental health problems among adults. METHODS Participants were 874 adults residing in small towns and semirural contexts within the Southeastern region of the United States ( Mage = 41 years, SD = 7; 57% female; 31% Black, 69% White; 52% income-to-needs < 2). Sleep duration and night-to-night variability in duration were assessed using wrist actigraphy. Established self-report measures were used to assess global sleep problems, experiences of discrimination, and mental health problems (anxiety, depression, and externalizing symptoms). RESULTS Experiences of discrimination were associated with more depression, anxiety, and externalizing problems. Two out of three sleep parameters were found to moderate the effects of discrimination on mental health. The association between discrimination and externalizing problems (but not anxiety or depression) was attenuated among those with less night-to-night variability in sleep duration. The associations between discrimination and anxiety and externalizing problems (but not depression) were attenuated among those with fewer global sleep problems. Less variability in sleep duration and fewer global sleep problems were also directly associated with lower levels of depression, anxiety, and externalizing problems. CONCLUSIONS Greater consistency in sleep duration from night-to-night, and fewer overall sleep problems appear to mitigate risk of mental health problems among adults, particularly in contexts where discrimination is prevalent.
Collapse
Affiliation(s)
- Thomas E Fuller-Rowell
- From the Department of Human Development and Family Science (Fuller-Rowell, El-Sheikh), Auburn University, Auburn, Alabama; Department of Psychology (Zeringue), Middle Tennessee State University, Murfreesboro, Tennessee; Department of Human Development and Family Studies (Saini), Pennsylvania State University, University Park, Pennsylvania; and Department of Psychology (Yip), Fordham University, Bronx, New York
| | | | | | | | | |
Collapse
|
3
|
Bridson L, Robinson E, Putra IGNE. Financial-related discrimination and socioeconomic inequalities in psychological well-being related measures: a longitudinal study. BMC Public Health 2024; 24:1008. [PMID: 38605335 PMCID: PMC11010292 DOI: 10.1186/s12889-024-18417-w] [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: 01/16/2024] [Accepted: 03/22/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND This study examined the prospective association between financial-related discrimination and psychological well-being related measures and assessed the role of financial-related discrimination in explaining socioeconomic inequalities in psychological well-being related measures. METHODS Data of UK older adults (≥ 50 years) from the English Longitudinal Study of Ageing were used (baseline: Wave 5, 2010/2011; n = 8,988). The baseline total non-pension wealth (in tertiles: poorest, middle, richest) was used as a socioeconomic status (SES) measure. Financial-related discrimination at baseline was defined as participants who reported they had been discriminated against due to their financial status. Five psychological well-being related measures (depressive symptoms, enjoyment of life, eudemonic well-being, life satisfaction and loneliness) were examined prospectively across different follow-up periods (Waves 6, 2012/2013, 2-year follow-up; and 7, 2014/2015, 4-year follow-up). Regression models assessed associations between wealth, financial-related discrimination, and follow-up psychological measures, controlling for sociodemographic covariates and baseline psychological measures (for longitudinal associations). Mediation analysis informed how much (%) the association between wealth and psychological well-being related measures was explained by financial-related discrimination. RESULTS Participants from the poorest, but not middle, (vs. richest) wealth groups were more likely to experience financial-related discrimination (OR = 1.97; 95%CI = 1.49, 2.59). The poorest (vs. richest) wealth was also longitudinally associated with increased depressive symptoms and decreased enjoyment of life, eudemonic well-being and life satisfaction in both 2-year and 4-year follow-ups, and increased loneliness at 4-year follow-up. Experiencing financial-related discrimination was longitudinally associated with greater depressive symptoms and loneliness, and lower enjoyment of life across follow-up periods. Findings from mediation analysis indicated that financial-related discrimination explained 3-8% of the longitudinal associations between wealth (poorest vs. richest) and psychological well-being related measures. CONCLUSIONS Financial-related discrimination is associated with worse psychological well-being and explains a small proportion of socioeconomic inequalities in psychological well-being.
Collapse
Affiliation(s)
- Lucy Bridson
- Department of Psychology, Institute of Population Health, University of Liverpool, Bedford Street South, L69 7ZA, Liverpool, UK
| | - Eric Robinson
- Department of Psychology, Institute of Population Health, University of Liverpool, Bedford Street South, L69 7ZA, Liverpool, UK
| | - I Gusti Ngurah Edi Putra
- Department of Psychology, Institute of Population Health, University of Liverpool, Bedford Street South, L69 7ZA, Liverpool, UK.
| |
Collapse
|
4
|
Figueroa DG, Parker JE, Hunger JM, Kraus MW, Muscatell KA, Tomiyama AJ. Social class stigma and poorer health behaviors: Evidence from the eating in America study. Soc Sci Med 2024; 347:116765. [PMID: 38492265 DOI: 10.1016/j.socscimed.2024.116765] [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: 06/22/2023] [Revised: 02/19/2024] [Accepted: 03/05/2024] [Indexed: 03/18/2024]
Abstract
Although the association between objective markers of low socioeconomic status (SES) and poor health is well established, one underexamined possibility is that over and above objective SES, social class stigma-experiences and anticipation of discrimination based on social class-might undermine people's ability to engage in healthy behaviors. Participants (N = 2022) were recruited between December 2019 and January 2020 via a national Qualtrics panel that was census-matched to the U.S. population in age, gender, income, race/ethnicity, and census region. Participants completed measures of class stigma, alcohol use, disordered eating, comfort eating, sleep disturbance, physical activity, and demographics. Controlling for objective SES and demographics, generalized linear regression models indicated that class stigma was associated with significantly greater alcohol use, disordered eating, greater comfort eating, and sleep disturbance but not less physical activity. Class stigma was not associated with health behaviors after full adjustment for weight/racial discrimination and psychological factors. Results from this investigation suggest that beyond one's objective SES, the stigma associated with having low class may also contribute to poorer health behaviors.
Collapse
Affiliation(s)
- David G Figueroa
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Jordan E Parker
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | | | | | - Keely A Muscatell
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - A Janet Tomiyama
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA.
| |
Collapse
|
5
|
Lai D, Mao Y. How is physical attractiveness associated with depression in China: A moderated mediation analysis. J Affect Disord 2023; 340:506-515. [PMID: 37572706 DOI: 10.1016/j.jad.2023.08.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 08/14/2023]
Abstract
Rewarding beauty has never fallen out of vogue in human history. Attractive people enjoy many social and economic advantages. This study aims to investigate the relationship between physical attractiveness and depression and its potential mechanism among Chinese residents. A population-based data including 12,172 Chinese adults from 3 waves of CFPS (2012, 2016, 2020) were used. Moderated-mediation models were utilized to assess the mediation effect of unfair experiences and the moderation effect of socioeconomic-status (SES), in the linkage between physical attractiveness and depression. Firstly, our results demonstrated that physical attractiveness is negatively associated with depression. Secondly, the effect of unfair experiences as a mediator between physical attractiveness and depression is statistically significant. Lastly, socioeconomic status (SES) performs a crucial moderating role. Among Chinese residents, the mitigating effect of physical attractiveness on unfair experiences and depression would be stronger among those with a lower SES compared to those with a higher SES.
Collapse
Affiliation(s)
- Dongpeng Lai
- School of Sociology and Anthropology, Xiamen University, China
| | - Yunyun Mao
- School of Sociology and Anthropology, Xiamen University, China.
| |
Collapse
|
6
|
Fuller-Rowell TE, Saini EK, El-Sheikh M. Social class discrimination during adolescence as a mediator of socioeconomic disparities in actigraphy-assessed and self-reported sleep. Sleep Med 2023; 108:61-70. [PMID: 37331131 PMCID: PMC10395515 DOI: 10.1016/j.sleep.2023.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/04/2023] [Accepted: 05/22/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE To examine social class discrimination as a mediator of socioeconomic disparities in sleep outcomes in an adolescent sample. METHODS Sleep was assessed from established actigraphy (efficiency, long wake episodes, duration) and self-report (sleep/wake problems, daytime sleepiness) measures among 272 high school students in the Southeastern region of the United States (35% low income; 59% White, 41% Black, 49% female, Mean age = 17.3, SD = 0.8). Social class discrimination was assessed using a new measure, the Social Class Discrimination Scale (SCDS; 22-items), and an established measure, the Experiences of Discrimination Scale (EODS; 7-items). Socioeconomic disadvantage (SED) was measured as an aggregate of six indicators. RESULTS The SCDS was associated with sleep efficiency, long wake episodes, sleep/wake problems and daytime sleepiness (but not sleep duration), and significantly mediated the socioeconomic gradient in each sleep outcome. Black males experienced higher levels of social class discrimination than Black females, White males, or White females. A race by gender moderation effect was evident for two of the five sleep outcomes (sleep efficiency and long wake episodes) suggesting a stronger association between social class discrimination and sleep problems for Black females than White females but no clear race differences among males. The EODS was not associated with objective sleep outcomes or SED but was associated with self-reported sleep and showed a similar pattern of moderation effects. CONCLUSIONS Findings suggest that social class discrimination may contribute to socioeconomic disparities in sleep problems, with some variability across measures and demographic groups. Results are discussed in light of evolving trends in socioeconomic health disparities.
Collapse
Affiliation(s)
| | - Ekjyot K Saini
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
| | - Mona El-Sheikh
- Department of Human Development and Family Science, Auburn University, Auburn, AL, USA
| |
Collapse
|
7
|
Njoroge A, Shariff MA, Khan HW, Gordillo V, Eclarinal B, Vargas J, Faiz M, Kasubhai M, Jackson T. Assessment of Adverse Childhood Experiences in the South Bronx on the Risk of Developing Chronic Disease as Adults. Cureus 2023; 15:e43078. [PMID: 37680403 PMCID: PMC10482123 DOI: 10.7759/cureus.43078] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 09/09/2023] Open
Abstract
Background Adverse childhood experiences (ACEs) have a negative impact on health outcomes. Using a cross-sectional study design, our objective was to identify the prevalence of ACEs among residents of South Bronx and the increased relationship between such childhood stressors and the prevalence of both chronic disease and modifiable high-risk behavior in adulthood. Methods We recruited patients from a hospital-based, adult primary care clinic in the metropolitan area of the South Bronx. A prospectively designed, observational study recruited patients in a consecutive fashion to conduct a cross-sectional survey between September 2017 and January 2018. The demographic representation comprises a low socioeconomic sector of urban New York City, with low education and immigrant population. A modified ACE questionnaire that included nine ACE categories (Physical Abuse, Sexual Abuse, Household Substance Abuse, Separation from Parents, Incarcerated Household Member, Parental Separation/Divorce, and Bullying) in addition to questions on demographics, high-risk behavior, and diagnosis of chronic disease. Our primary objective was to gather the incidence of ACEs organized by domains. Secondary objectives were to demonstrate any expected increase (as odds ratios (ORs)) in chronic disease or maladaptive social habits when compared to patients with no ACEs within the cohort. The OR for the associations was calculated with logistic regression. Individual logistic regression models for each chronic disease, high-risk behavior, and demographics were used to measure the exposure response of the nine ACE categories. Results A total of 454 patients completed the survey. The average age was 53.1±14.2 years, and females were 49% of the sample. Hispanics were at 61% followed by Blacks at 34%. Participants reported high-risk behavior at 24%, had a high prevalence of chronic illness (82%), and had ACE events at 70%. We found a significant relationship between ACE events and having a chronic disease diagnosis and engagement in high-risk behavior with higher odds of reporting chronic illnesses among participants with exposure to childhood stressors (OR 1.26, 95% confidence interval 1.1-1.5, p=0.002). Of the nine ACE categories, many were independently associated with one or more chronic diseases in adulthood. Conclusion According to our survey data, ACE events in our patient population were more prevalent (30% with four or more exposures), higher than the proposed average of one out of six Americans with four or more exposures nationally according to national statistics. These childhood stressors appeared to have a strong association with the development of high-risk behavior and chronic illnesses.
Collapse
Affiliation(s)
- Alexander Njoroge
- Department of Internal Medicine, NYC HHC (New York City Health and Hospitals Corporation) Lincoln, Bronx, USA
| | - Masood A Shariff
- Department of Internal Medicine, NYC HHC (New York City Health and Hospitals Corporation) Lincoln, Bronx, USA
| | - Hira W Khan
- Department of Internal Medicine, NYC HHC (New York City Health and Hospitals Corporation) Lincoln, Bronx, USA
| | - Victor Gordillo
- Department of Internal Medicine, NYC HHC (New York City Health and Hospitals Corporation) Lincoln, Bronx, USA
| | - Brian Eclarinal
- Department of Internal Medicine, NYC HHC (New York City Health and Hospitals Corporation) Lincoln, Bronx, USA
| | - Jose Vargas
- Department of Internal Medicine, NYC HHC (New York City Health and Hospitals Corporation) Lincoln, Bronx, USA
| | - Mohammad Faiz
- Department of Internal Medicine, NYC HHC (New York City Health and Hospitals Corporation) Lincoln, Bronx, USA
| | - Moiz Kasubhai
- Department of Internal Medicine, NYC HHC (New York City Health and Hospitals Corporation) Lincoln, Bronx, USA
| | - Tranice Jackson
- Department of Internal Medicine, NYC HHC (New York City Health and Hospitals Corporation) Lincoln, Bronx, USA
| |
Collapse
|
8
|
Siddiq H, Darvishi M, Najand B. Self-Rated Health of US Older Adults in the General Social Survey (GSS) 1972-2021: Complexity of the Associations of Education and Immigration. Healthcare (Basel) 2023; 11:463. [PMID: 36832997 PMCID: PMC9956057 DOI: 10.3390/healthcare11040463] [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: 01/05/2023] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Multiple studies have shown a link between high education and better self-rated health (SRH). However, recent studies have suggested that immigrants may experience a weaker association between education and SRH than native-born individuals. AIM Using a national sample of US older adults, this investigation studied whether there is an inverse association between education and SRH and whether immigration status moderates this association. METHODS This study is based on marginalized diminished returns (MDRs) that argues socioeconomic status (SES) resources, such as education, may generate less favorable health outcomes for marginalized groups. Data were from the General Social Survey (GSS) 1972-2021, a cross-sectional survey in the US. A total of 7999 participants who were 65+ years old were included. The independent variable was education, measured as years of schooling and treated as a continuous variable. The dependent variable was poor/fair (poor) SRH. Immigration status was the moderator. Age, sex, and race were control variables. Logistic regressions were used for data analysis. RESULTS We found that higher levels of education were protective against poor SRH. However, this effect was weaker for immigrants than for US-born individuals. CONCLUSIONS This study found that native-born US older individuals are more likely to experience the protective effect of their education against poor SRH compared to their immigrants. Eliminating health inequality between immigrant and US-born individuals needs policies that go beyond socioeconomic status (SES) equality and address barriers that hinder highly-educated immigrants.
Collapse
Affiliation(s)
- Hafifa Siddiq
- School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Mona Darvishi
- Marginalization-Related Diminished Returns, Los Angeles, CA 90059, USA
| | - Babak Najand
- Marginalization-Related Diminished Returns, Los Angeles, CA 90059, USA
| |
Collapse
|
9
|
The Relationship Between Subjective Social Status, Mental Health Disparities, and the Mediating Role of Discrimination Among Latinx Populations. J Racial Ethn Health Disparities 2023; 10:350-356. [PMID: 35040105 DOI: 10.1007/s40615-021-01226-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: 09/30/2021] [Revised: 12/27/2021] [Accepted: 12/30/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Subjec tive social status (SSS) has consistently been linked to health outcomes among Latinx populations, but less is known about how discrimination explains the relationship between SSS and health disparities. While SSS, an individual's perception of her socioeconomic standing, is a robust predictor of health disparities in many societies, discriminatory experiences may impact the relationship between SSS and mental health and health outcomes. Subjective social status can negatively contribute to health disparities through several pathways including the stigma associated with lower social status and poverty. Experiencing discrimination can contribute to feelings of marginalization and therefore decrease individuals' perception of their social status. This study tested discrimination as a mediator of SSS and health disparities among Latinx populations. DESIGN Using the National Latino and Asian American Study (NLAAS), we identified 2554 Latinx participants to be included in the sample. Participants reported ratings of mental and physical health and exposure to everyday discrimination. Mediation models were used to analyze everyday discrimination as a mediator of SSS and health outcomes. RESULTS The present results support that SSS is directly associated with ratings of mental and physical health in Latinx individuals. Discrimination was also found to mediate the relationship between SSS and health outcomes. CONCLUSIONS These findings have practice implications for health disparities among Latinx populations. In particular, discrimination may be a major contributing factor to the role of SSS on health outcomes.
Collapse
|
10
|
Siddiq H, Maharlouei N, Najand B, Rahmani A, Zare H. Immigration Status, Educational Level, and Perceived Discrimination in Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2222. [PMID: 36767588 PMCID: PMC9915095 DOI: 10.3390/ijerph20032222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/10/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Multiple studies have been conducted to test the moderating effect of immigration on the positive health results yielded through educational attainment. However, no study has been conducted to examine the role of immigration as a moderator in the association between educational level and perceived discrimination in Europe. AIM We aimed to study whether an inverse association exists between educational level and perceived discrimination in European countries and whether immigration status moderates the association between educational level and perceived discrimination. METHODS Data from the 10th round of the cross-sectional European Social Survey (ESS) were used in this cross-sectional study. A total of 17,596 participants between 15-90 years old who lived in European countries were included. The independent variable was educational level, a categorical variable, and the dependent variable was perceived discrimination. Immigration status was the moderator, and age and sex were confounders. RESULTS Of 17,596 participants, 16,632 (94.5%) were native-born and 964 were immigrants (5.5%). We found that higher levels of educational level were protective against perceived discrimination, which was also found in immigrant participants; however, the effect was weaker. CONCLUSIONS This study found that educational level was a protective factor against perceived discrimination. This effect, however, was more robust in the native-born participants than in their immigrant counterparts.
Collapse
Affiliation(s)
- Hafifa Siddiq
- School of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Najmeh Maharlouei
- Marginalization-Related Diminished Returns, Los Angeles, CA 90059, USA
| | - Babak Najand
- Marginalization-Related Diminished Returns, Los Angeles, CA 90059, USA
| | - Arash Rahmani
- Marginalization-Related Diminished Returns, Los Angeles, CA 90059, USA
| | - Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- School of Business, University of Maryland Global Campus (UMGC), Adelphi, MD 20783, USA
| |
Collapse
|
11
|
Jokela M, Fuller‐Rowell TE. Changing associations between socioeconomic status and self-reported discrimination from the 1990s to the 2010s in the United States. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2022; 57:760-765. [PMID: 35535557 PMCID: PMC9790514 DOI: 10.1002/ijop.12853] [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: 10/26/2021] [Accepted: 04/11/2022] [Indexed: 12/30/2022]
Abstract
We examined whether prevalence of social class discrimination-and its association with psychological distress-has changed between 1990s and 2010s in the United States. Data were from the original Midlife in the United States (MIDUS) study with data collections in 1995-1996 (n = 2931) and 2004-2005 (n = 1708), and the new MIDUS Refresher sample from 2011 to 2014 (n = 2543). Socioeconomic status (SES) became more strongly associated with self-rated discrimination over time, with individuals with the lowest SES experiencing more discrimination (B = 0.75, p < .001) and those with the highest SES less discrimination (B = 0.36, p < .001) over time: at baseline, the difference in self-rated discrimination between the highest and lowest SES groups was 15.3% versus 10.8% (4.7% point difference). This difference increased to 20.0% versus 7.4% in the last study wave (12.6% point difference). Association between self-reported discrimination and psychological distress strengthened over time, but the associations between socioeconomic indicators and distress did not change. The results suggest that people with low SES had higher risk of encountering unfair and disrespectful treatment in the 2010s compared to the 1990s.
Collapse
Affiliation(s)
- Markus Jokela
- Department of Psychology and Logopedics, MedicumUniversity of HelsinkiHelsinkiFinland
| | | |
Collapse
|
12
|
Muñoz E, Robins RW, Sutin AR. Perceived ethnic discrimination and cognitive function: A 12-year longitudinal study of Mexican-origin adults. Soc Sci Med 2022; 311:115296. [PMID: 36088721 DOI: 10.1016/j.socscimed.2022.115296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 07/12/2022] [Accepted: 08/12/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Hispanic/Latinx adults are at increased risk for cognitive impairment, and it is critically important to identify modifiable risk factors for cognitive impairment in this population. We addressed two key questions: (1) How does perceived discrimination change across middle adulthood? And, (2) how are discrimination and the trajectory of discrimination associated with cognitive function? METHODS We used data from 1,110 Mexican-origin adults between 26 and 62 years old (63% female; 85% born in Mexico). Participants completed a perceived ethnic discrimination scale five times across 12 years and completed cognitive assessments in the last wave, which were composited into a measure of overall cognitive function. We used latent growth curve models to estimate the longitudinal trajectory of perceived ethnic discrimination and growth mixture models to identify sub-groups of change trajectories. We evaluated whether patterns of perceived discrimination trajectories, baseline, intermediary, and concurrent discrimination predicted cognitive function at the last wave. RESULTS Perceived ethnic discrimination decreased over time on average. Significant individual differences in within-person change revealed two change trajectory classes: Stable Low and High Declining. The Stable Low class had better cognitive performance compared to the High Declining class, but this effect was not robust to educational attainment. Perceived discrimination at the last wave was associated with worse cognitive function, and this effect remained after accounting for covariates. CONCLUSIONS This study is among the first to evaluate changes in perceived ethnic discrimination in a sample of Mexican-origin adults and their associations with cognitive function. The results highlight the need for more research to better understand the role of discrimination and other social stressors on cognitive health outcomes.
Collapse
Affiliation(s)
- Elizabeth Muñoz
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, TX, USA.
| | - Richard W Robins
- Department of Psychology, University of California, Davis, CA, USA
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA
| |
Collapse
|
13
|
Murray PM, Sepulveda A, Baird J. Longitudinal impact of a poverty simulation on healthcare practitioners' attitudes towards poverty. J Pediatr Nurs 2022; 64:24-30. [PMID: 35131716 DOI: 10.1016/j.pedn.2022.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Many clinicians have limited knowledge about the challenges of living in poverty, leading to stigma and differential treatment in healthcare settings. A poverty simulation event may help clinicians gain empathy and knowledge about the ways that poverty impacts health and well-being. PURPOSE This study evaluated the impact of a poverty simulation and the effect of personal characteristics on clinicians' attitudes towards poverty. METHODS Using a prospective longitudinal mixed-methods study design, a convenience sampling of clinicians from a freestanding children's hospital was recruited to participate in a poverty simulation event. The 21-item Attitudes Towards Poverty (ATP) tool was administered pre- and post-simulation and at 3 follow-up time points. Multiple linear regression analysis and linear mixed effects models were used to analyze ATP data. Qualitative data were analyzed to identify broad themes. RESULTS Mean scores in the ATP domains of stigma and structural perspective increased post-simulation, but only stigma scores demonstrated sustained improvement. Scores in the personal deficiency domain remained unchanged. Being male, White, and having Liberal political views were associated with lower ATP scores in our data. Qualitative data show participants felt the simulation generated feelings of compassion and empathy. DISCUSSION Simulation participation improved ATP scores in two domains immediately post-event, suggesting the simulation positively impacted clinicians' attitudes towards poverty. Follow-up data suggest the impact of the simulation may be temporary. TRANSLATION TO HEALTH EDUCATION PRACTICE Experiential learning activities, like poverty simulations, help foster awareness and empathy among clinicians but may not have long-term impact. Ongoing education is needed to create a workforce sensitized and equipped to care for families from all backgrounds.
Collapse
Affiliation(s)
- Paula M Murray
- Institute for Nursing and Interprofessional Research, Children's Hospital Los Angeles, Los Angeles, USA
| | - Aviril Sepulveda
- Division of Rehabilitation Medicine, Children's Hospital Los Angeles, Los Angeles, USA
| | - Jennifer Baird
- Institute for Nursing and Interprofessional Research, Children's Hospital Los Angeles, Los Angeles, USA.
| |
Collapse
|
14
|
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.
Collapse
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: )
| | | | | | | | | | | |
Collapse
|
15
|
Van Dyke ME, Crawford ND, Lewis TT. Van Dyke et al. Respond to "Methodological Considerations in Investigating Discrimination". Am J Epidemiol 2022; 191:384-385. [PMID: 34431496 DOI: 10.1093/aje/kwab224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/01/2021] [Accepted: 08/18/2021] [Indexed: 11/14/2022] Open
|
16
|
Novrinda H, Han DH. Oral health inequality among Indonesian workers in South Korea: role of health insurance and discrimination factors. BMC Oral Health 2022; 22:22. [PMID: 35090443 PMCID: PMC8799411 DOI: 10.1186/s12903-022-02050-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 01/14/2022] [Indexed: 11/26/2022] Open
Abstract
Background The health of migrant workers is becoming an important public health issue. Although there are an increasing number of migrant workers in Korea, the health status in migrant populations remains unknown. The aims of this study were (1) to evaluate the association between income and self-rated oral health (SROH), and (2) to assess the role of health insurance and self-perceived discrimination in the association between income and SROH among Indonesian migrant workers in Korea. Methods Information about self-reported income, SROH, coverage/utilization of health insurance (HI), living difficulties related to oral health (LDROH), oral health literacy (OHL), and discrimination were obtained from Indonesian migrant workers in Korea (n = 248). The main explanatory variable was income, and SROH was an outcome variable. Logistic regression analyses were performed controlling for age, gender, HI, LDROH, OHL, and discrimination. The paths from income to SROH were analyzed using the Partial Least Square-Structural Equation Model (PLS-SEM). Results Among Indonesian migrant workers, the lower income group had the highest probability of a poor SROH compared to the higher income group. The variables showing a high explanatory power were discrimination among the low income group and HI among the middle income group. In PLS-SEM, the variables such as HI, LDROH, OHL, and discrimination contributed 11% to explaining the association between income and SROH. Conclusion A monotonic gradient was revealed among migrant workers according to the association between income and SROH. Discrimination and HI contributed to oral health inequalities.
Collapse
|
17
|
Wedel AV, Goodhines PA, Zaso MJ, Park A. Prospective Associations of Discrimination, Race, and Sexual Orientation with Substance Use in Adolescents. Subst Use Misuse 2022; 57:263-272. [PMID: 34809528 PMCID: PMC9132580 DOI: 10.1080/10826084.2021.2002904] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objective: Adolescents are at high risk for alcohol and cannabis use. Emerging evidence suggests that discrimination exposure is prospectively associated with risk for alcohol use among adolescents of marginalized race, sexual orientation, or gender identity. However, it is unknown whether prospective discrimination-substance use associations among marginalized adolescents are also present for cannabis use. This study examined prospective associations of race, sexual orientation, and discrimination exposure with alcohol and cannabis use over one year. Methods: Data were drawn from a two-wave longitudinal health survey study of 9-11th graders (n = 350 for the current analyses; Year 1 Mage=15.95 [SD = 1.07, range = 13-19]; 44% male; 44% Black, 22% White, 18% Asian, 16% Multiracial; 16% LGB; 10% Hispanic/Latinx ethnicity) at an urban high school. Two multinomial logistic regressions examined associations of Year 1 race, sexual orientation, and discrimination experiences with Year 2 alcohol and cannabis consumption separately. Results: Year 1 Discrimination exposure was associated with increased risk for Year 2 past-year alcohol use among Asian (OR = 1.34) and past-month alcohol use among Multiracial (OR = 1.30) adolescents, but not Black or LGB adolescents. Discrimination exposure was not associated with any cannabis use pattern in any group. Independent of discrimination, LGB adolescents were at greater risk for monthly alcohol (OR = 3.48) and cannabis use (OR = 4.07) at Year 2. Conclusions: Discrimination exposure is prospectively associated with risk for alcohol use among adolescents of understudied (Asian, Multiracial) racial backgrounds, and should be considered in alcohol prevention and intervention strategies. Risk factors for alcohol and cannabis use among LGB adolescents should continue to be explored.
Collapse
Affiliation(s)
- Amelia V Wedel
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | | | - Michelle J Zaso
- Clinical and Research Institute on Addictions, University at Buffalo - The State University of New York, Buffalo, New York, USA
| | - Aesoon Park
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| |
Collapse
|
18
|
Lindert J, Paul KC, Lachman Margie E, Ritz B, Seeman T. Social stress and risk of declining cognition: a longitudinal study of men and women in the United States. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1875-1884. [PMID: 33864472 PMCID: PMC8522181 DOI: 10.1007/s00127-021-02089-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 04/07/2021] [Indexed: 12/16/2022]
Abstract
Limited research is available on the relationship between social stress and risk of declining cognition. We sought to examine whether social stress has adverse effects on risk of declining episodic memory and executive functioning in aging individuals. We used data from the MIDUS study, a national probability sample of non-institutionalized, English speaking respondents aged 25-74 living in the 48 contiguous states of the United States. The initial wave (1995) included 4963 non-institutionalized adults aged 32-84 (M = 55, SD = 12.4). We used an analytic sample from MIDUS-II (1996/1997) and MIDUS-III (2013) (n = 1821). The dependent variables are episodic memory and executive functioning, which were assessed with the Brief Test for Cognition (BTACT). The independent variables were social stress variables (subjective social status, family and marital stress, work stress and discrimination). To evaluate episodic memory and executive functioning changes over a time period of 10 years, we estimated adjusted linear regression models. Women report significantly lower subjective social status and more discrimination stress than men across all age groups. Controlling for education and income, age, and baseline episodic memory and executive functioning, lower subjective social status had additional adverse effects on declines in episodic memory in men and women. Marital risk had adverse effects on episodic memory in men but not in women. Daily discrimination had adverse effects on executive functioning on all individuals. Public health strategies should focus on reducing social stress in a socio-ecological perspective. Especially, subjective social status and discrimination stress might be a target for prevention efforts.
Collapse
Affiliation(s)
- Jutta Lindert
- Department of Health and Social Work, University of Applied Sciences Emden/Leer, Constantiaplatz 4, 22687, Emden, Germany. .,Women's Research Center at Brandeis University, 415 South St., Waltham, MA, 02453, USA.
| | - Kimberley C. Paul
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California At Los Angeles, 650 Charles E. Young Dr. S, Los Angeles, CA 90095 USA
| | - E. Lachman Margie
- The Heller School for Social Policy and Management, Brandeis University, 415 South St., Waltham, MA 02453 USA
| | - Beate Ritz
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California At Los Angeles, 650 Charles E. Young Dr. S, Los Angeles, CA 90095 USA
| | - Teresa Seeman
- Division of Geriatrics, David Geffen School of Medicine, 10833 Le Conte Ave, Los Angeles, CA 90095 USA
| |
Collapse
|
19
|
Fuller-Rowell TE, Nichols OI, Jokela M, Kim ES, Yildirim ED, Ryff CD. A Changing Landscape of Health Opportunity in the United States: Increases in the Strength of Association Between Childhood Socioeconomic Disadvantage and Adult Health Between the 1990s and the 2010s. Am J Epidemiol 2021; 190:2284-2293. [PMID: 33710274 DOI: 10.1093/aje/kwab060] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 02/18/2021] [Accepted: 03/09/2021] [Indexed: 12/12/2022] Open
Abstract
Understanding the changing health consequences of childhood socioeconomic disadvantage (SED) is highly relevant to policy debates on inequality and national and state goals to improve population health. However, changes in the strength of association between childhood SED and adult health over historic time are largely unexamined in the United States. The present study begins to address this knowledge gap. Data were from 2 national samples of adults collected in 1995 (n = 7,108) and 2012 (n = 3,577) as part of the Midlife in the United States study. Three measures of childhood SED (parents' occupational prestige, childhood poverty exposure, and parents' education) were combined into an aggregate index and examined separately. The association between childhood SED (aggregate index) and 5 health outcomes (body mass index, waist circumference, chronic conditions, functional limitations, and self-rated health) was stronger in the 2012 sample than the 1995 sample, with the magnitude of associations being approximately twice as large in the more recent sample. Results persisted after adjusting for age, sex, race, marital status, and number of children, and were similar across all 3 measures of childhood SED. The findings suggest that the socioeconomic circumstances of childhood might have become a stronger predictor of adult health in recent decades.
Collapse
|
20
|
Miyamoto Y, Ryff CD. Culture and Health: Recent Developments and Future Directions
1. JAPANESE PSYCHOLOGICAL RESEARCH 2021; 64:90-108. [PMID: 35509718 PMCID: PMC9060271 DOI: 10.1111/jpr.12378] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Evidence of cultural differences in relationships and emotions has accumulated over the past few decades. As findings on cultural differences in psychological processes have accumulated, there has been growing interest in investigating whether they have implications for other phenomena such as health. Using scientific advances from the MIDUS and MIDJA studies, both publicly available, we examine links between culture and health. We first briefly review the accumulated evidence on cultural influences on health correlates of psychosocial factors. We then feature two recent developments - a more micro-level perspective on biological factors that may be involved in the culture and health linkage, and a more macro-level view of socioeconomic inequality, which also matters for health. Both perspectives inform the pathways through which health effects occur. Finally, we conclude our review by highlighting the changing historical contexts surrounding these cross-cultural investigations. Specifically, we draw attention to widening of economic inequality across cultures and the world-wide COVID-19 pandemic. These happenings bring notable implications for future research on health across cultural contexts.
Collapse
|
21
|
Assari S, Cochran SD, Mays VM. Money Protects White but Not African American Men against Discrimination: Comparison of African American and White Men in the Same Geographic Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052706. [PMID: 33800177 PMCID: PMC7967423 DOI: 10.3390/ijerph18052706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 11/16/2022]
Abstract
To compare African American (AA) and non-Hispanic White men living in same residential areas for the associations between educational attainment and household income with perceived discrimination (PD). The National Survey of American Life (NSAL), a nationally representative study, included 1643 men who were either African American (n = 1271) or non-Hispanic White (n = 372). We compared the associations between the two race groups using linear regression. In the total sample, high household income was significantly associated with lower levels of PD. There were interactions between race and household income, suggesting that the association between household income and PD significantly differs for African American and non-Hispanic White men. For non-Hispanic White men, household income was inversely associated with PD. For African American men, however, household income was not related to PD. While higher income offers greater protection for non-Hispanic White men against PD, African American men perceive higher levels of discrimination compared to White males, regardless of income levels. Understanding the role this similar but unequal experience plays in the physical and mental health of African American men is worth exploring. Additionally, developing an enhanced understanding of the drivers for high-income African American men’s cognitive appraisal of discrimination may be useful in anticipating and addressing the health impacts of that discrimination. Equally important to discerning how social determinants work in high-income African American men’s physical and mental health may be investigating the impact of the mental health and wellbeing of deferment based on perceived discrimination of dreams and aspirations associated with achieving high levels of education and income attainment of Black men.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles Drew University, Los Angeles, CA 90059, USA;
- UCLA BRITE Center for Science, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, CA 90095-1563, USA;
| | - Susan D. Cochran
- UCLA BRITE Center for Science, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, CA 90095-1563, USA;
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA 90095-1772, USA
- Department of Statistics, University of California, Los Angeles (UCLA), Los Angeles, CA 90095-1554, USA
| | - Vickie M. Mays
- UCLA BRITE Center for Science, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, CA 90095-1563, USA;
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA 90095-1772, USA
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095-1563, USA
- Correspondence: ; Tel.: +1-310-206-5159
| |
Collapse
|
22
|
Assari S, Ayoubian A, Caldwell CH. Comparison of European, African, Asian, and Other/Mixed Race American Children for the Association Between Household Income and Perceived Discrimination. INTERNATIONAL JOURNAL OF TRAVEL MEDICINE AND GLOBAL HEALTH 2020; 9:31-38. [PMID: 34307699 DOI: 10.34172/ijtmgh.2021.06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Introduction Perceived discrimination is one of the reasons behind racial/ethnic health disparities. However, less is known about racial and ethnic groups differ in social determinants of discrimination. This study aimed to compare the association between household income and perceived discrimination among American children of different racial/ethnic groups. Methods The Adolescent Brain Cognitive Development (ABCD) study, a national longitudinal study, followed 4383 children 9-10 years old who were either European American, African American, Asian American, or mixed/other race for one year. We compared racial and ethnic groups for the association between baseline household income and perceived discrimination at the end of one year follow up. We used ANOVA and linear regression for data analysis. The outcome was perceived discrimination. The predictor was household income. Covariates were age, gender, and parental marital status. The moderator was race/ethnicity. Results In the total sample, high household income was associated with less perceived discrimination. There was an interaction between race and household income, suggesting a difference in the association between household income and perceived discrimination between African American and European American children. The inverse association between household income and perceived discrimination was weaker for African American than European American children. Conclusion High-income African American children are not well protected against perceived discrimination. High exposure to perceived discrimination may explain the worse expected health and development of middle-class African American children. As discrimination is a major social determinant of health, the results have considerable implications for public and health policy.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA.,Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Ali Ayoubian
- National Center for Health Insurance Research, Iran Health Insurance Organization, Tehran, Iran
| | - Cleopatra H Caldwell
- Department of Health Behavior and Health Education, University of Michigan, University of Michigan, Ann Arbor, MI 48109, USA.,Center for Research on Ethnicity, Culture, and Health, University of Michigan, University of Michigan, Ann Arbor, MI 48109, USA
| |
Collapse
|
23
|
Chang Q, Peng C, Guo Y, Cai Z, Yip PS. Mechanisms connecting objective and subjective poverty to mental health: Serial mediation roles of negative life events and social support. Soc Sci Med 2020; 265:113308. [DOI: 10.1016/j.socscimed.2020.113308] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/04/2020] [Accepted: 08/16/2020] [Indexed: 01/02/2023]
|
24
|
Assari S. Social Epidemiology of Perceived Discrimination in the United States: Role of Race, Educational Attainment, and Income. INTERNATIONAL JOURNAL OF EPIDEMIOLOGIC RESEARCH 2020; 7:136-141. [PMID: 33094165 DOI: 10.34172/ijer.2020.24] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background and aims This study aimed to compare non-Hispanic Black (NHB) and non-Hispanic White (NHW) American adults for the associations of educational attainment and household income with perceived racial discrimination. Methods The 2010 National Alcohol Survey (NAS N12), a nationally representative study, included 2635 adults who were either NHB (n = 273) or NHW (n = 2362). We compared NHBs and NHWs for the associations between education, income, and perceived racial discrimination. We used linear regression for data analysis. Outcome was perceived racial discrimination; the predictors were educational attainment and household income; covariates were age and gender; and moderator was race. Results In the total sample, high income was associated with lower levels of perceived racial discrimination, while educational attainment was not significantly associated with perceived racial discrimination. There was also an interaction between race and education but not household income, suggesting a difference in the association between educational attainment and perceived racial discrimination between NHB and NHW individuals. For NHW individuals, household income was inversely associated with perceived racial discrimination. For NHB individuals, however, household income was not related to perceived racial discrimination. For NHB but not NHW individuals, educational attainment was correlated with more not less perceived racial discrimination. Conclusion High income protects NHW but not NHB individuals against perceived racial discrimination, and NHB individuals with high education levels report more not less perceived racial discrimination.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.,Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| |
Collapse
|
25
|
Alen NV, Sloan RP, Seeman TE, Hostinar CE. Childhood Parental Warmth and Heart Rate Variability in Midlife: Implications for Health. PERSONAL RELATIONSHIPS 2020; 27:506-525. [PMID: 33244293 PMCID: PMC7685289 DOI: 10.1111/pere.12329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The current study investigated high-frequency heart rate variability (HF-HRV) as a potential mediator between childhood parental warmth and later health and mortality outcomes. Participants were 1,255 adults (56.9% female). Childhood parental warmth was reported retrospectively at mean age 46; resting HF-HRV was measured at mean age 57; cardiovascular health and self-evaluated health were assessed at mean age 57 and 63, and mortality records extracted at mean age 63. Results revealed a positive association between childhood parental warmth and resting HF-HRV, as well as associations between higher HF-HRV and reduced risk of having a later cardiovascular health problem and of mortality by age 63. Mediation analyses revealed a small significant indirect effect of parental warmth, through HF-HRV, on cardiovascular health.
Collapse
|
26
|
Goodhines PA, Desalu JM, Zaso MJ, Gellis LA, Park A. Sleep Problems and Drinking Frequency among Urban Multiracial and Monoracial Adolescents: Role of Discrimination Experiences and Negative Mood. J Youth Adolesc 2020; 49:2109-2123. [PMID: 32860577 PMCID: PMC7487034 DOI: 10.1007/s10964-020-01310-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/20/2020] [Indexed: 12/13/2022]
Abstract
Mounting evidence suggests that multiracial adolescents may be at greater risk than their monoracial peers for both sleep problems and alcohol use. However, mechanisms underlying these uniquely-heightened risky health behaviors among multiracial adolescents remain a gap in the literature. This cross-sectional study examined a risk pathway involving discrimination experiences and negative mood underlying racial disparities in concurrent sleep problems and drinking frequency. Students at an urban, socioeconomically-disadvantaged high school (N=414; grades 9–11, Mage=16.00 [SD=1.08]; 57% female; 17% multiracial, 41% Black, 22% White, 18% Asian, 2% Other; 12% Hispanic/Latinx) completed a survey. Path analysis demonstrated that associations of multiracial status with sleep problems (insomnia symptom severity and insufficient weekday sleep duration), but not drinking frequencies (past-year drinking or past-2-week binge-drinking frequencies), were explained by discrimination experiences and, in turn, negative mood. In ancillary analysis excluding White students, the serial indirect risk pathway was significant for both insomnia symptom severity and past-year drinking frequency outcomes. Discrimination experiences and negative mood may function as intermediate factors contributing to racial disparities in adolescent sleep problems, although longitudinal replication is needed.
Collapse
Affiliation(s)
| | - Jessica M Desalu
- Department of Psychology, Syracuse University, Syracuse, NY, 13244, USA
| | - Michelle J Zaso
- Department of Psychology, Syracuse University, Syracuse, NY, 13244, USA
- Clinical and Research Institute on Addictions, University at Buffalo, Buffalo, NY, 14203, USA
| | - Les A Gellis
- Department of Psychology, Syracuse University, Syracuse, NY, 13244, USA
| | - Aesoon Park
- Department of Psychology, Syracuse University, Syracuse, NY, 13244, USA.
| |
Collapse
|
27
|
Philbrook LE, Saini EK, Fuller-Rowell TE, Buckhalt JA, El-Sheikh M. Socioeconomic status and sleep in adolescence: The role of family chaos. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2020; 34:577-586. [PMID: 32011158 PMCID: PMC7374040 DOI: 10.1037/fam0000636] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Low socioeconomic status (SES) has been associated with poor sleep in youth, yet mechanisms underlying this association are not well-understood. The present study examined greater chaos as a mediator of associations between low SES and 2 indices of poor sleep. Two hundred fifty-two adolescents (53% girls; 66% White/European American, 34% Black/African American) participated in the 3-wave longitudinal study. The sample was socioeconomically diverse. At age 16, parents reported on 2 indices of SES: family income and perceived economic well-being. Adolescents reported on chaos within their family at age 17 and on 2 key sleep-wake processes-sleep quality and daytime sleepiness-at age 18. Family chaos functioned as a mediating or intervening variable in longitudinal associations between lower SES and both poorer sleep quality and greater daytime sleepiness. The findings suggest the potential utility of targeting family level processes that exemplify chaos, such as unpredictability, noise, and interruptions, to improve sleep among adolescents. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
|
28
|
Hayes L, Pössel P, Roane SJ. Perceived Everyday Discrimination and Depressive Symptoms: Does Cognitive Style Mediate? JOURNAL OF COUNSELING AND DEVELOPMENT 2019. [DOI: 10.1002/jcad.12291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Lauren Hayes
- Department of Counseling and Human Development, University of Louisville
- Now at Department of Counseling, Educational Psychology, and Research, University of Memphis
| | - Patrick Pössel
- Department of Counseling and Human Development, University of Louisville
| | - Sarah J. Roane
- Department of Counseling and Human Development, University of Louisville
- Now at Dartmouth–Hitchcock Medical Center, Dartmouth Geisel School of Medicine, Dartmouth College
| |
Collapse
|
29
|
Namkung EH, Carr D. Perceived interpersonal and institutional discrimination among persons with disability in the U.S.: Do patterns differ by age? Soc Sci Med 2019; 239:112521. [PMID: 31518845 DOI: 10.1016/j.socscimed.2019.112521] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 08/05/2019] [Accepted: 08/24/2019] [Indexed: 02/07/2023]
Abstract
RATIONALE One-third of U.S. adults have an activity-limiting health condition and this proportion increases with age. However, it is unclear whether functional limitation renders one vulnerable to institutional and interpersonal discrimination, and whether this vulnerability differs over the life course. Stigma theories suggest disability would be more discrediting to younger persons relative to older adults, as it violates cultural norms and expectations regarding able-bodied working-age adults. OBJECTIVE We evaluate whether U.S. adults with functional impairment report higher levels of perceived interpersonal mistreatment and institutional discrimination relative to persons without impairment, and whether these patterns differ across age groups. METHOD We use data from the second wave of the National Survey of Midlife Development in the United States (MIDUS II), collected between 2004 and 2006 (n = 3931). We estimate OLS and logistic regression models to predict interpersonal and institutional discrimination, respectively. RESULTS Persons with impairment report more frequent encounters of disrespectful treatment, insults, and being treated as if they have a character flaw, and elevated odds of workplace- and service-related discrimination, net of sociodemographic, and physical and mental health characteristics. Effects are significantly larger among early (age 40-49) and late (age 50-64) midlife versus older (age 65+) adults. CONCLUSIONS We discuss implications for policy and practice, and underscore that stigmatization processes may further amplify health and socioeconomic disparities between those with versus without functional limitations.
Collapse
Affiliation(s)
- Eun Ha Namkung
- Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, USA.
| | - Deborah Carr
- Department of Sociology, Boston University, USA.
| |
Collapse
|
30
|
Inglis G, McHardy F, Sosu E, McAteer J, Biggs H. Health inequality implications from a qualitative study of experiences of poverty stigma in Scotland. Soc Sci Med 2019; 232:43-49. [PMID: 31054403 PMCID: PMC6597943 DOI: 10.1016/j.socscimed.2019.04.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/15/2019] [Accepted: 04/21/2019] [Indexed: 11/28/2022]
Abstract
Rationale Individuals living in Scotland's most deprived communities experience a higher burden of morbidity and early mortality than those living in more affluent areas. Experiences of poverty-based stigma may be one psychosocial mechanism through which socioeconomic position influences health, although there is little available data on this issue from a Scottish perspective. Objective The aim of this study was to identify which aspects of poverty stigma are particularly salient to individuals with lived experience of poverty, and may therefore contribute to health inequalities. Methods Five focus groups were conducted with 39 individuals with experience of living on low incomes in Scotland in order to explore their experiences and perceptions of poverty stigma. Results Five main themes were identified, reflecting aspects of poverty stigma operating at various structural, public and individual levels: media representations of poverty; negative encounters with social security systems; perceived public attitudes regarding poverty in Scotland; lowered self-esteem and internalisation of negative attitudes, and; emotional responses to stigma. Conclusion These dimensions of stigma potentially influence public health and health inequalities in Scotland, although future research will be necessary to quantify these and estimate their relationships with health outcomes. Relatively little is currently known about poverty-based stigma in Scotland. People with experience of poverty discussed this issue in five focus groups. Participants' accounts reflected several forms of poverty stigma. Poverty stigma operates at various structural, social, and individual levels. Poverty stigma is a potentially important determinant of health inequalities.
Collapse
Affiliation(s)
- Greig Inglis
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, 20 West Richmond Street, Edinburgh, EH8 9DX, UK.
| | | | | | - John McAteer
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, 20 West Richmond Street, Edinburgh, EH8 9DX, UK.
| | - Hannah Biggs
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, 20 West Richmond Street, Edinburgh, EH8 9DX, UK.
| |
Collapse
|
31
|
Zhu J, Chen Y, Zhang W. Association between family economic hardship and university students' risky alcohol use: Mediating and moderating roles of perceived discrimination and impulsivity. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2018.12.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
32
|
Cundiff JM, Jennings JR, Matthews KA. Social Stratification and Risk for Cardiovascular Disease: Examination of Emotional Suppression as a Pathway to Risk. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2018; 45:1202-1215. [PMID: 30526318 DOI: 10.1177/0146167218808504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article examines whether emotional suppression is associated with socioeconomic position (SEP) in a community sample of Black and White men, and whether emotional suppression may help explain the aggregation of multiple biopsychosocial risk factors for cardiovascular disease at lower SEP (social support, depression, cardiovascular stress reactivity). Aim 1 tests whether multiple indicators of SEP show a consistent graded association with self-reported trait suppression, and whether suppression mediates associations between SEP and perceived social support and depressive affect. Aim 2 tests whether suppression during a laboratory anger recall task mediates associations between SEP and cardiovascular reactivity to the task. All measures of higher SEP were associated with lower suppression. Findings in this racially diverse sample of adult men suggest that socioeconomic disparities in emotional suppression may be more likely to confer cardiovascular risk through disruption of affect and social relationships, than through direct and immediate physiological pathways.
Collapse
|
33
|
Assari S. Race, Intergenerational Social Mobility and Stressful Life Events. Behav Sci (Basel) 2018; 8:E86. [PMID: 30241335 PMCID: PMC6211020 DOI: 10.3390/bs8100086] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/11/2018] [Accepted: 09/17/2018] [Indexed: 12/12/2022] Open
Abstract
Background. Socioeconomic status (SES) has smaller protective effects on the health of African Americans, and the differential association between social mobility and stress may explain the diminished returns of SES for African Americans. Aim. This study tested the race/ethnic differences in the association between upward and downward social mobility and stress in a nationally representative sample of African American and White American adults. Methods. This study included 3570 African Americans and 891 non-Hispanic White Americans from the National Survey of American Life (NSAL), 2003. Race/ethnicity, gender, age, upward and downward social mobility (independent variable, defined as difference between parent and respondent education), and stressful life events (SLE, dependent variable) were measured. Linear regression models were used for data analysis. Results. In the pooled sample that included both races, upward and downward social mobility were both associated with SLE, the net of all covariates. Significant interactions were found between race/ethnicity and social mobility, suggesting a stronger association between social mobility and stress for White Americans than for African Americans. According to race-stratified models, upward and downward social mobility were associated with higher SLE for White Americans but not African Americans. Conclusion. Although upwardly and downwardly mobile White Americans experience more stress than the socially stable White Americans, African Americans do not experience a change in SLE related to their intergenerational social mobility.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- BRITE Center for Science, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109-2700, USA.
| |
Collapse
|
34
|
Assari S, Moghani Lankarani M. Workplace Racial Composition Explains High Perceived Discrimination of High Socioeconomic Status African American Men. Brain Sci 2018; 8:E139. [PMID: 30060492 PMCID: PMC6120025 DOI: 10.3390/brainsci8080139] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/13/2018] [Accepted: 07/13/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Sociological and epidemiological literature have both shown that socioeconomic status (SES) protects populations and individuals against health problems. Recent research, however, has shown that African Americans gain less from their SES and African Americans of high SES, particularly males, may be vulnerable to perceived discrimination, as explained by the Minorities' Diminished Returns theory. One potential mechanism for this phenomenon is that high SES African Americans have a higher tendency to work in predominantly White workplaces, which increases their perceived discrimination. It is, however, unknown if the links between SES, working in predominantly White work groups and perceived discrimination differ for male and female African Americans. AIM To test the associations between SES, workplace racial composition and perceived discrimination in a nationally representative sample of male and female African American adults. METHODS This study included a total number of 1775 employed African American adults who were either male (n = 676) or female (n = 1099), all enrolled from the National Survey of American Life (NSAL). The study measured gender, age, SES (educational attainment and household income), workplace racial composition and perceived discrimination. Structural Equation Modeling (SEM) was applied in the overall sample and also by gender. RESULTS In the pooled sample that included both genders, high education and household income were associated with working in a predominantly White work group, which was in turn associated with more perceived discrimination. We did not find gender differences in the associations between SES, workplace racial composition and perceived discrimination. CONCLUSION Although racial composition of workplace may be a mechanism by which high SES increases discriminatory experiences for African Americans, males and females may not differ in this regard. Policies are needed to reduce discrimination in racially diverse workplaces. This is particularly the case for African Americans who work in predominantly White work environments.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109-2700, USA.
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- BRITE Center for Science, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- Center for Research on Ethnicity, Culture and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
| | - Maryam Moghani Lankarani
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109-2700, USA.
| |
Collapse
|
35
|
Assari S, Gibbons FX, Simons R. Depression among Black Youth; Interaction of Class and Place. Brain Sci 2018; 8:E108. [PMID: 29895752 PMCID: PMC6025590 DOI: 10.3390/brainsci8060108] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/04/2018] [Accepted: 06/10/2018] [Indexed: 12/12/2022] Open
Abstract
Although high socioeconomic status (SES) is traditionally conceptualized as a health protective factor, recent literature has documented positive associations between SES (e.g., income) and depression among Blacks, including Black youth. To extend the results of this recent literature, the current study used the Family and Community Health Study (FACHS) data to examine the multiplicative effects of gender, place, and SES on average depressive symptoms of Black youth over a long period of time. FACHS, 1997⁻2017, followed 889 Black children aged 10⁻12 years old for up to 18 years. Depressive symptoms were measured in seven waves. The main predictors of interest were two SES indicators, parent education and family income measured at baseline (1997). Main outcome of interest was average depressive symptoms over the 18 year follow up period. Place of residence and gender were the focal moderators. Linear regression models were used for data analysis. In the pooled sample, living in a predominantly White area was associated with higher average depressive symptoms over time, however, this association was fully explained by higher perceived racial discrimination in the predominantly White areas. We found an interaction between income and place of residence on average depressive symptoms, suggesting that higher income is associated with more depressive symptoms in predominantly White compared to predominantly Black areas. Place did not interact with parent education on average depressive symptoms. Gender also did not interact with education or income on depressive symptoms. Findings suggest that place and SES may interact on depressive symptoms of Black youth, with high income becoming a risk factor for depressive symptoms in predominantly White areas. How SES indicators, such as income, protect or become a risk factor depend on other contextual factors, such as place of residence. There is a need to reduce discrimination experienced by Blacks, especially in predominantly White areas. Meanwhile, Black youth who live in predominantly White areas may require additional help that enhances their coping.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- BRITE Center for Science, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Frederick X Gibbons
- Department of Psychological Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Ronald Simons
- Department of Sociology, University of Georgia, Athens, GA 30602, USA.
| |
Collapse
|