Prevalence and correlates of everyday discrimination among black Caribbeans in the United States: the impact of nativity and country of origin

The mental health toll of the Great Migration: a comparison of mental health outcomes among descendants of African American migrators

INTRODUCTION

Research is beginning to examine the health outcomes of migrators of the Great Migration, a movement of up to eight million African Americans from the South to the North and West during the twentieth century. However, sparse evidence exists studying the health outcomes of the descendants of Great Migration movers. The aim for this study was to compare the lifetime prevalence of mental health disorders by migration status.

METHODS

We used a sample of 3183 African American adults from the National Survey of American Life (2001-2003). Using birthplaces of participants and their mothers, we classified adults as (1) Southern stayers, (2) migrators to the South, (3) migrators to the North or (4) Northern stayers. The outcomes were lifetime prevalence of any mental health, mood, anxiety, and substance use disorders. We used weighted log-Poisson regression models and adjusted for demographic characteristics and socioeconomic status.

RESULTS

Migrators to the North and Northern stayers had higher risks of any lifetime mental health, mood, anxiety, and substance use disorders compared to Southern stayers in the adjusted models. Migrators to the North and Northern stayers were more likely to report perceived discrimination.

CONCLUSION

This study suggests that migrating families to the North may have experienced mental health adversities.

The social patterning of vicarious discrimination: Implications for health equity

BACKGROUND

Most research on discrimination and health operationalizes discrimination as direct individual experiences. Here, we examine the social patterning of vicarious discrimination, an important but largely overlooked dimension of discrimination.

METHODS

Drawing on community-based participatory research with a multi-stage probability sample (n = 178) of African Americans in Tallahassee, Florida, we measured vicarious discrimination, or exposure to discrimination through one's family and friends. We used chi-square tests to examine gender differences in the social domains and relational sources of vicarious discrimination. Negative binomial regression models were fit to identify predictors of exposure to vicarious discrimination.

RESULTS

Vicarious discrimination is more prevalent than direct experiences of discrimination (73 versus 61%) and more than 20% of participants report vicarious discrimination in the absence of direct discrimination. For women, vicarious discrimination most often involved the workplace; for men, police. However, gender differences are smaller for vicarious versus direct discrimination. Close friends and children were top relational sources of vicarious discrimination for men and women, respectively. Middle-aged participants reported the most vicarious discrimination.

CONCLUSIONS

Overall, our data show that vicarious discrimination is more common than widely understood and associated with individual-level sociodemographic characteristics that index one's position in broader social systems. The prevalence of vicarious discrimination in the absence of direct discrimination suggests that standard approaches, which measure individual exposures in isolation, are subject to misclassification bias. Our results imply that existing research on discrimination and health, which already demonstrates substantial harm, underestimates African Americans' true exposures to salient aspects of discrimination.

Discrimination, resilience, and HIV testing frequency among black women seeking services from STD clinics

RATIONALE

In the United States, Black women are disproportionately affected by HIV, accounting for most new HIV infections diagnosed among women. Socio-structural barriers to HIV testing include stigma and discrimination but may be mitigated by resilience.

OBJECTIVE

We aimed to examine the effect of discrimination and resilience on HIV testing behaviors among Black women.

METHODS

Between 2016 and 2018, we conducted The ESSENCE Project, a retrospective cohort study on the role of physiological and environmental factors on the association between sexual assault and HIV risk among Black women in Baltimore, Maryland, USA. Black women aged 18-44 were recruited from public health STD clinics and completed an audio-computer-assisted self-interview survey. Hierarchical multiple negative binomial regression models were used to examine the associations of everyday discrimination (subtle and overt) and resilience on HIV testing frequency; resilience and its subscales (relational maintenance, personal fortitude, positive coping, independence and insight) were also examined as moderators.

RESULTS

Among 236 Black women reporting HIV testing history, the median number of lifetime HIV tests was 4 (IQR = 2, 6). Mean everyday discrimination was 2.3 (SD = 1.2). Mean resilience was 5.3 (SD = 0.8). Everyday discrimination and its subscales (overt and subtle) were negatively associated with lifetime HIV testing frequency, while overall resilience was not associated with lifetime HIV testing frequency. Accounting for demographics, overall resilience moderated the association of subtle discrimination and lifetime HIV testing frequency. For the resilience subscales, more specifically: (1) associations of subtle discrimination and HIV testing frequency were significant at the lowest relational maintenance and lowest positive coping resilience; and (2) the association of subtle discrimination and HIV testing frequency was significant at the highest resilience for all four subscales.

CONCLUSIONS

These findings highlight the need for provider- and community-level interventions addressing the deleterious effects of everyday discrimination and more specifically subtle everyday discrimination to encourage HIV testing.

Juvenile justice-involved Haitian families' experiences of structural racism and socioethnic discrimination

Objective

This article examines how Haitian families with youth interfacing with the juvenile justice system cope with structural racism and socioethnic discrimination (RSD).

Background

Haitian families' experiences of discrimination based on their histories, immigrant status, and positionality illustrates the need for more scientific scrutiny of the experiences of RSD among Black immigrant groups. This National Institute on Drug Abuse (NIDA)-funded study details the narratives of and responses to RSD experienced by Haitian families interfacing with the juvenile justice system.

Method

Data are drawn from psychosocial assessment tools, therapeutic sessions, and ethnographic interviews conducted with Haitian families participating in a family-based therapeutic intervention. Using critical race theory, we foreground the voices of those negatively impacted and use Bourdieu's theory of practice to examine the intersectionality of race and ethnicity in this population's experiences of RSD.

Results

The different experiences of and responses to RSD among youth and caregivers of Haitian descent are both a variation of the complex continuum of structural racism in the United States and unique to their immigrant experience of marginalization and cultural invalidation by public institutions, community members, and peers.

Conclusion

Professionals working with this population must be sensitive to the ways these experiences impact young people's identity development processes, their health, and well-being. Haitian caregivers should be encouraged to protect their children by engaging in racial and socioethnic socialization that validates their RSD experiences.

Implications

Understanding the intergenerational experiences of RSD among Black, immigrant groups and encouraging family dialogue and adolescent support will strengthen family cohesion during this period of racial reckoning.

Prevalence and Effects of Daily and Major Experiences of Racial Discrimination and Microaggressions among Black Individuals in Canada

The prevalence and correlates of different forms of racial discrimination among Black Canadians are unknown. This article aims to examine the prevalence of different forms of racial discrimination (daily, major and microaggressions) and their association with self-esteem and satisfaction with life among Black Canadians. A convenience sample of 845 Black Canadians aged 15-40 was recruited. We assessed frequencies of everyday and major racial discrimination, and racial microaggressions against Black Canadians and their association with self-esteem and satisfaction with life, controlling for gender, age, job status, education, and matrimonial status. At least 4 out of 10 participants declared having being victims of everyday racial discrimination at least once per week. Between 46.3% and 64.2% of participants declared having been victims of major racial discrimination in various situations including education, job hiring, job dismissal, health services, housing, bank and loans, and police encounters. Significant gender differences were observed for everyday and major racial discrimination with higher frequencies among female participants. A total of 50.2% to 93.8% of participants declared having been victims of at least one episode of racial microaggressions. Results showed a significant negative association between racial discrimination and satisfaction with life (b = -0.26, p = .003), and self-esteem (b = -0.23, p = .009). This study highlights the need to stop colorblind policies in different sectors in Canada, and for a public commitment to combat racism at the municipal, provincial and federal levels. Implications are discussed for prevention, research and public health.

Racial and Ethnic Differences in Major and Everyday Discrimination Among Older Adults: African Americans, Black Caribbeans, and Non-Latino Whites

OBJECTIVES

This study examined differences in major and everyday discrimination between African Americans, Black Caribbeans, and non-Latino White older adults.

METHODS

Data are taken from the National Survey of American Life. Measures of major (e.g., unfairly fired and harassed by police) and everyday (e.g., treated with less courtesy, insulted, and followed in stores) discrimination were examined.

RESULTS

Both African Americans and Black Caribbeans reported more major and everyday discrimination than non-Latino Whites. However, there were no significant differences between African Americans and Whites with regards to being fired, neighbors making life difficult and receiving poor service. There were no significant differences between African Americans and Black Caribbeans in major or everyday discrimination.

DISCUSSION

The discussion notes the importance of examining racial as well as within group ethnic differences within the Black American population in the types of discrimination. It also notes the importance of examining indicators of both major and everyday discrimination.

Everyday discrimination as a predictor of maladaptive and adaptive eating: Findings from EAT 2018

Various types of stressors are associated with maladaptive eating, but how the stressor of everyday discrimination (e.g., less respect, poorer service) relates to maladaptive eating and adaptive eating remains unclear. We examined everyday discrimination as a predictor of maladaptive and adaptive eating. Data were collected in a population-based study, Eating and Activity over Time (N = 1410, ages 18-30). Everyday discrimination was categorized as none, low, moderate, or high. Outcomes included maladaptive eating (i.e., overeating and binge eating) and adaptive eating (i.e., intuitive eating and mindful eating). Modified Poisson regressions estimated the prevalence ratios (PRs) for overeating and binge eating associated with everyday discrimination. Linear regressions estimated associations between everyday discrimination and intuitive and mindful eating scores. After adjustment for age, ethnicity/race, gender, and socioeconomic status, moderate and high levels of discriminatory experiences were each associated with a significantly greater prevalence of binge eating (PR = 2.2, [95% CI = 1.3-3.7] and PR = 3.1, [95% CI = 2.0-4.7], respectively) and lower intuitive (β = -0.4, [95% CI = -0.7, -0.2] and β = -0.5 [95% CI = -0.8, -0.3], respectively), and mindful eating scores (β = -0.3, [95% CI = -0.6, -0.1] and β = -0.5 [95% CI = -0.8, -0.3], respectively) compared to young adults with no discriminatory experience. Public health efforts to prevent maladaptive eating and encourage the adoption of adaptive eating should consider the potential contribution of everyday discrimination and the need to advocate for equity and inclusion.

The effect of stress exposure on depressive symptoms and major depressive episode among US Afro-Caribbean women

PURPOSE

This study examines whether stress exposures experienced within and across various life domains (e.g., interpersonal, financial) are predictors of depression among Afro-Caribbean women, an understudied ethnic group within the US Black female population.

METHODS

A sample of Afro-Caribbean women (N = 878) was drawn from the National Survey of American Life (NSAL), the first nationally representative psychiatric epidemiology survey focused on the mental health of the US Afro-Caribbean and African American populations. Negative binomial regression analysis was conducted for depressive symptoms, and binary logistic regression results are presented for past-year and lifetime major depressive episode. Analyses examined the relative effect of five stress exposures on depression: major discrimination, everyday discrimination, past-month chronic stress, financial strain, and negative interactions with family.

RESULTS

Of the five stress exposures, chronic stress and financial strain were associated with increased risk for both recent (e.g., past week) and more distal (i.e., past-year and lifetime) experiences of depression. Though experiences with discrimination were associated with depression, its effects were attenuated when other stressors were taken into account.

CONCLUSIONS

Mental health prevention and intervention programs must address stress concerns that are chronic in nature and stressors that reflect financial instability for Afro-Caribbean women.

Secular Trends in Physical Activity Among Immigrants in the United States, 2009-2018

BACKGROUND

The objective of this study was to evaluate secular trends in domain-specific physical activity in the immigrant population in the US between 2009 and 2018.

METHOD

A secondary data analysis from the 2009-2018 National Health and Nutrition Examination Survey; a total of 7282 immigrants in the US were included in this analysis. All domain-specific physical activity was assessed by a self-reported questionnaire. Tests for linear trends were performed to examine the trends of each physical activity time using orthogonal polynomial coefficients. Physical activity trends were assessed by the whole group and the various subgroups.

RESULTS

Total physical activity showed an upward linear trend in female (Ptrend = .04) and young adult (Ptrend = .009) immigrants. Work-related physical activity showed an upward linear trend in young adult immigrants (Ptrend = .01). Recreational physical activity showed an upward linear trend in young adult (Ptrend = .03) and Mexican American (Ptrend < .001) immigrants and in immigrants living in the US for 15-29 years (Ptrend = .02). In contrast, we observed downward linear trends in transit-related physical activity for immigrants across male (Ptrend = .04), middle-aged adult (Ptrend = .01), and non-Hispanic black groups (Ptrend = .004) and in immigrants living in the US for 15-29 years (Ptrend = .03).

CONCLUSION

There were no significant linear trends in the 4 domains of physical activity in the overall US immigrant population; however, trends in domain-specific physical activity in the US immigrant population differed by gender, age, race/ethnicity, and length of residence. These findings may inform physical activity promotion strategies targeting US immigrant populations with diverse sociocultural backgrounds.

Associations in physical activity and sedentary behaviour among the immigrant and non-immigrant US population

BACKGROUND

Immigrants are at a higher risk of poor mental and physical health. Regular participation in physical activity (PA) and low levels of sedentary time are beneficial for both these aspects of health. The aim was to investigate levels and trends in domain-specific PA and sedentary behaviour in the US. immigrant compared with non-immigrant populations.

METHODS

From the 2007-2016 National Health and Nutrition Examination Survey (NHANES), a total of 25 142 adults (≥18 years) were included in this analysis. PA and sedentary behaviour time were assessed by a questionnaire.

RESULTS

Transit-related PA showed downward linear trends in young immigrant adults (p _trend=0.006) and middle-aged non-immigrant adults (p _trend=0.009). We found significant upward linear trends in sedentary behaviour for both immigrants and non-immigrants across all age groups. For sitting watching TV or videos ≥2 hours/day, there was a downward linear trend in young immigrant adults (p _trend=0.009). For computer use ≥1 hours/day, an upward linear trend in older non-immigrants was found (p _trend=0.024). Young immigrants spent 37.5 (95% CI -55.4 to -19.6) min less than non-immigrants on recreational PA per week. Also, older immigrants spent 23.5 (95% CI 1.5 to 45.6) and 22.5 (95% CI 5.9 to 39.0) min/week more than non-immigrants on recreational PA and transit-related PA, respectively. Last, young and middle-aged immigrants spent 37.6 (95% CI -68.2 to -7.0) and 37.6 (95% CI -99.7 to -9.7) min/day less than non-immigrants on sedentary behaviour, respectively.

CONCLUSION

Overall, levels of recreational PA were stable, yet the transit-related PA declined coupled with an increase in sedentary behaviour. US. immigrants exhibit higher levels of transit-PA, lower levels of leisure-time PA and lower levels of sedentary behaviour, in some age groups.

Leading by limitation? Language and communication within the workplace

Purpose

Language and how it is communicated within organisations is a complex situation. The purpose of this paper is to provide a perspective on the practice of issuing style guides and restrictive word lists as highlighted in the recent media through the case of Leader of the House of Commons, Mr Rees-Mogg.

Design/methodology/approach

A key focus is the question whether the approach of limiting language and guiding communication through such a directive is effective in developing understanding amongst work-based learners and facilitating both consistency and quality of communications. The paper looks to draw upon both educational and psychological perspectives to underpin the discussion of how such an approach has been implemented and the resulting impact upon those working with such rules of guidance.

Findings

Conclusions drawn highlight that professionals learning at work may fail to understand the rationale for why guidelines have been issued to them. Subsequently, the work-based learner may feel othered by the process thus effecting motivation and well-being.

Originality/value

The paper offers a perspective on an approach utilised by a leader within the UK Government, exploring it through the lens of education and English Language development to discuss the potential impact upon employees within the workplace.

Everyday discrimination among formerly homeless persons in permanent supportive housing

Experiences of discrimination are associated with poor health and are particularly common among persons experiencing homelessness. Permanent supportive housing (PSH) provides a foundation for improved well-being among persons with homelessness histories, but research on discrimination among this population is lacking. We examined changes in experiences of, and perceived reasons for, everyday discrimination when persons moved into PSH. 421 adults in Los Angeles County completed baseline (pre-housing), 3-, 6- or 12-month post-housing structured interviews. Generalized linear mixed models (GLMM) examined change in discrimination outcomes, controlling for demographic characteristics. Everyday discrimination experiences decreased significantly when persons moved from homelessness into PSH, and remained consistently lower across the first year in PSH. Reports of homelessness/poverty, race/ethnicity, and neighborhood as reasons for discrimination also decreased from baseline levels. PSH may offer respite from everyday discrimination, but the persistence of discrimination and particularly racism in society requires structural solutions addressing implicit bias and systemic inequities.

The Relationships Between Perceived Discrimination and Utilization of Mental Health Services Among African Americans and Caribbean Blacks

Although all ethnic/racial groups underutilize mental health services, only about one-third of African Americans and Caribbean Blacks in need utilize mental health services. An extensive literature review led us to examine if an association between perceived discrimination and mental health utilization exists. The National Survey of American Life 2001-2003 nationally representative dataset was analyzed. Variables including utilization of mental health services, perceived discrimination, and socio-demographic variables were assessed for their relationships. The study found that each of the following predictors statistically significant: being male, being employed, having household income higher than 100,000, perceiving no discrimination, being African American, or being Caribbean Black are less likely to utilize mental health services than their counterparts. This study contributes to the emerging body of evidence demonstrating that perceived discrimination has a strong connection with the utilization of mental health services.

A systematic review and meta-analysis of the incidence of psychotic disorders: the distribution of rates and the influence of gender, urbanicity, immigration and socio-economic level

BACKGROUND

Considering existing knowledge on the relationship between certain environmental factors and incidence rates of psychosis, we carried out a systematic review to provide a broad and updated picture of the incidences of different psychotic disorder subgroups worldwide and how some environmental factors influence these rates.

METHODS

Studies with original data related to the incidence of psychosis (published between 2000 and 2015) were identified via searching electronic databases (CINAHL, MEDLINE, PSYCINFO, PUBMED, and SCOPUS). Data on the following risk factors were extracted: gender, urbanicity, immigration and socio-economic level. Descriptive appraisals of variation in incidence rates (IR) and incidence rate ratios (IRR), with a 95% confidence interval were calculated. In addition, a meta-analysis was performed to calculate IR pooled by diagnosis group and IRR pooled by diagnosis and gender, urbanity, immigration and socio-economic level, using a random effects model.

RESULTS

We identified 33 reports to analyse. Overall IR per 100 000 persons for non-affective psychoses (IR pooled = 22.53 (16.51-28.54)) were higher than affective psychoses (IR pooled = 7.12 (5.03-9.22)). There was an increase in rates of psychosis in men v. women (IRR pooled = 1.54 (1.37-1.72)), in urban v. rural areas (IRR pooled = 1.64 (1.38-1.95)), in immigrants v. natives (IRR pooled = 3.09 (2.74-3.49)), and in lower socio-economic level areas (IRR pooled = 1.78 (1.43-2.22)).

CONCLUSIONS

IR among different psychotic disorders was found to vary depending on gender, urbanicity, and immigration (as most of the previous literature focuses on non-affective psychosis or schizophrenia).

Beck Depression Inventory-II: Factor Analyses with Three Groups of Midlife Women of African Descent in the Midwest, the South, and the U.S. Virgin Islands

This research encompasses a factor analysis of the Beck Depression Inventory-II (BDI-II), which involves three groups of midlife women of African descent who reside in the Midwest, the South, and the U.S. Virgin Islands. The purpose of the study was to determine the factor structure of the BDI-II when administered to a sample of women aged 40-65 of African descent who reside in the three distinct geographical regions of the United States. A correlational, descriptive design was used, and 536 women of African descent were invited to participate in face-to-face interviews that transpired in community settings. Results of the factor analysis revealed a two-factor explanation. Factor one included symptoms such as punishment feelings and pessimism (cognitive), and the second factor included symptoms such as tiredness and loss of energy (somatic-affective). The application of the Beck Depression Inventory-II among the three groups of women generated specific information about each group and common findings across the groups. Knowledge gained from the research could help to guide specific intervention programs for the three groups of women, and explicate the common approaches that could be used for the three groups.