1
|
Amano T, Jia Y, Redding A. The dynamic and reciprocal relationship between perceived everyday discrimination and cognitive function in later life. Aging Ment Health 2024:1-11. [PMID: 38590239 DOI: 10.1080/13607863.2024.2338196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/25/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVES This study, based on socioemotional selectivity theory and cognitive theory, investigates the dynamic and reciprocal relationship between perceived discrimination and cognitive function in later life. METHODS Data were drawn from four waves of the Health and Retirement Study (HRS 2006, 2010, 2014, and 2018). A total of 4,125 people who were 51 and older were included. Cognitive function was measured by the telephone interview for cognitive status (TICS-27). Perceived discrimination was measured using scores of the perceived everyday discrimination scale. Random intercept cross-lagged panel model (RI-CLPM) was utilized. The model was adjusted for a range of covariates. Subgroup analysis by ethnoracial groups was conducted. RESULTS Cross-sectionally, while lower cognitive function was associated with higher perceived discrimination, this relationship was unidirectional. Longitudinally, higher perceived discrimination predicted lower cognitive function in later waves only among non-Hispanic White individuals. CONCLUSION Results suggested that a decline in cognitive function may precede and contribute to the worsening of perceived discrimination, which may result in further decline in cognitive function. Lifetime experience of discrimination was discussed as a possible source of the racial/ethnic variations in the relationship. Further study is needed to examine whether this relationship holds among people with cognitive impairment and dementia.
Collapse
Affiliation(s)
- Takashi Amano
- Department of Social Work, School of Arts and Sciences, Rutgers University, Newark, New Jersey, USA
| | - Yuane Jia
- Department of Interdisciplinary Studies, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA
| | - Audrey Redding
- Department of Social Work, School of Arts and Sciences, Rutgers University, Newark, New Jersey, USA
| |
Collapse
|
2
|
Chai L. Food insecurity and its association with multiple health outcomes among Indigenous peoples in Canada: the buffering role of culture-based resources. ETHNICITY & HEALTH 2024; 29:371-394. [PMID: 38297918 DOI: 10.1080/13557858.2024.2311419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 01/23/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVES Despite growing interest in the health disparities associated with food insecurity, research focusing on Indigenous peoples has been limited, especially in studies using nationally representative samples. This study investigates the association between food insecurity and various health outcomes - self-rated general and mental health, chronic health conditions, suicidal ideation, and obesity - among Indigenous peoples in Canada. It also explores the potential moderating effects of culture-based resources, which include cultural identity affect, cultural group belonging, cultural engagement, and cultural exploration. DESIGN The study utilized data from the 2017 Aboriginal Peoples Survey, a nationally representative sample of First Nations individuals living off-reserve, Métis, and Inuit across Canada (N = 15,533). Logistic regression models were used to analyze the data. RESULTS Food insecurity was negatively associated with all examined health outcomes. Culture-based resources demonstrated a mixture of anticipated and unexpected effects on these relationships. Consistent with the stress process model, cultural group belonging mitigated the negative impact of food insecurity on all health outcomes. A similar pattern was observed for cultural engagement. However, contrary to expectations from the stress-buffering perspective, little evidence was found to support the moderating effects of cultural identity affect and cultural exploration. CONCLUSION The results underscore the detrimental effects of food insecurity on the health of Indigenous peoples in Canada and suggest that culture-based resources, particularly cultural group belonging, play a crucial role in mitigating health disparities.
Collapse
Affiliation(s)
- Lei Chai
- Department of Sociology, University of Toronto, Toronto, Canada
| |
Collapse
|
3
|
McLaurin N, Tabibi D, Wang T, Alhalimi T, Lehrer HM, Harrison L, Tanaka H, Steinhardt MA. Coping With Discrimination Among African Americans With Type 2 Diabetes: Factor Structure and Associations With Diabetes Control, Mental Distress, and Psychosocial Resources. Prev Chronic Dis 2024; 21:E06. [PMID: 38271491 PMCID: PMC10833829 DOI: 10.5888/pcd21.230189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
Introduction Type 2 diabetes undermines diabetes-related health outcomes among African Americans, who have a disproportionately high incidence of the disease. Experiences of discrimination are common among African Americans and compound diabetes-related stress, exacerbating poor health outcomes. Appropriate use of coping strategies may mitigate the detrimental effect of discrimination on diabetes-related outcomes, but examining associations between coping strategies and health outcomes is needed to inform potential interventions. This study assessed the factor structure of the Coping with Discrimination Scale (CDS) among African American adults with type 2 diabetes and examined associations of CDS subscales with measures of diabetes control, mental distress, and psychosocial resources. Methods The CDS was administered primarily through churches to African Americans with type 2 diabetes residing in Austin, Texas, and surrounding areas. Data were collected from August 2020 through April 2023. We conducted principal axis factor analysis of the CDS and determined internal consistency for each factor. We computed bivariate and partial correlations between CDS subscales and indicators of diabetes control (hemoglobin A1c, diabetes self-management), mental distress (diabetes distress, perceived stress, depressive symptoms), and psychosocial resources (resilience, social support, self-efficacy). Results The 284 African American adults (204 women, 80 men) ranged in age from 23 to 86 years (mean [SD] = 62 [11] y). We identified 4 factors: education/advocacy, internalization, strong response, and detachment. Scores were highest for education/advocacy items and lowest for strong response items. Education/advocacy was associated with higher scores on psychosocial resources, whereas detachment was associated with lower scores. Internalization and strong response were associated with higher mental distress. Strong response was associated with higher hemoglobin A1c, and education/advocacy was associated with enhanced diabetes self-management. Conclusion We suggest health care professionals create culturally tailored interventions that aid individuals in educating others, advocating for themselves, or recognizing situations outside one's control and detaching from responsibility, rather than internalizing experiences of discrimination or engaging in strong responses that upon reflection are detrimental to one's health.
Collapse
Affiliation(s)
- Natalie McLaurin
- Department of Kinesiology and Health Education, The University of Texas at Austin
| | - Doonya Tabibi
- Department of Kinesiology and Health Education, The University of Texas at Austin
| | - Tianyu Wang
- Department of Kinesiology and Health Education, The University of Texas at Austin
| | - Taha Alhalimi
- Department of Kinesiology and Health Education, The University of Texas at Austin
| | - H Matthew Lehrer
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pennsylvania
| | - Louis Harrison
- Department of Kinesiology and Health Education, The University of Texas at Austin
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin
| | - Mary A Steinhardt
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd, D3700, Austin, TX 78712
| |
Collapse
|
4
|
Wang Y, Liao J, Chen H, Tao L, Liu J. Association of perceived discrimination with the risk of depression among US older adults: A prospective population-based cohort study. Heliyon 2024; 10:e23843. [PMID: 38226276 PMCID: PMC10788503 DOI: 10.1016/j.heliyon.2023.e23843] [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: 08/17/2023] [Revised: 11/22/2023] [Accepted: 12/13/2023] [Indexed: 01/17/2024] Open
Abstract
Aims Association between perceived discrimination and depression has been demonstrated in some sources of discrimination, such as age, sex, and race. However, the effects of perceived discrimination both in any domain and each domain on development of depression are still unclear. We aimed to estimate the association of any and each domain of perceived discrimination with the risk of depression among US older adults. Methods We did a population-based cohort study using eight waves (from 2006 to 2020) of data from the Health and Retirement Study (HRS), a nationally representative study of US older adults aged 51 years and above. Perceived discrimination was measured by the shortened 5-item version of Williams' discrimination scale, including five domains (less courtesy, service setting, not smart, threatened or harassed, and medical setting). Depressive symptoms were assessed with shortened 8-item version of the Center for Epidemiological Depression scale (8-item CES-D). Cox proportional hazards models were used to estimate the crude and adjusted hazards ratio (HRs) and their 95 % confidence intervals (CIs) between perceived discrimination and risk of depression, after controlling for potential confounders. Results A total of 18502 participants were included in our final analyses. 42.8 % of them had any perceived discrimination at baseline, and the most prevalent perceived discrimination was feeling less courtesy, which was observed in 5893 people (31.6 %). During a median of 9.8 years follow-up, 44.7 % of participants developed depression. The risk of depression was 46 % (adjusted HR: 1.46, 95 % CI: 1.39-1.52) higher among people with perceived discrimination than those without. The associations between perceived discrimination in each domain and risk of depression were all prominent. Conclusions Both any and each domain of perceived discrimination were associated with an increased risk of depression. Considering the high prevalence of perceived discrimination and the following poor health outcomes, our findings suggested the integrated measures of providing public education and diversified communication to reduce discrimination, as well as accessible emotional supports to prevent depression are urgently needed.
Collapse
Affiliation(s)
- Yaping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jiaojiao Liao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, No. 49, Huayuan North Road, Haidian District, Beijing, 100191, China
| | - Hongguang Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), No.35, Xueyuan Road, Haidian District, Beijing, 100191, China
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No.35, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Liyuan Tao
- Department of Epidemiology, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, No.5, Yiheyuan Road, Haidian District, Beijing, 100871, China
- Department of Global Health and Population, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| |
Collapse
|
5
|
Hunter EA, Meyer JM, Brown GM, Hanks MA. Stress indicators in minorities with multiple sclerosis. Mult Scler Relat Disord 2023; 78:104914. [PMID: 37499341 DOI: 10.1016/j.msard.2023.104914] [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: 02/16/2023] [Revised: 06/12/2023] [Accepted: 07/23/2023] [Indexed: 07/29/2023]
Abstract
Black Americans with multiple sclerosis (MS) experience higher levels of disease-related disability compared to White Americans (Marrie et al., 2006). Comorbidities such as depression and anxiety, which are underdiagnosed and undertreated in this population, negatively impact quality of life and treatment outcomes for people living with multiple sclerosis (plwMS) (D'Alisa et al., 2006; Marrie et al., 2009; Stepleman et al., 2014). Acts of discrimination toward Black Americans is associated with stress, which is a contributing factor for depression (Carter, 2017; Nadimpalli, 2015; Williams and Mohammed, 2009). This study compared the severity of multiple sclerosis symptoms amongst Black Americans and White Americans, and whether worsened MS symptoms in Black Americans are associated with increased experiences of discrimination. Data was analyzed from 143 plwMS in the Stress Indicators in Minorities with Multiple Sclerosis (SiMMS) study. Using the Mann-Whitney U test, significant differences were found on the NIH Emotional Distress - Anxiety measure (U = 1466.500, p = 0.045) and NIH Sleep Disturbance measure (U = 1467.000, p = 0.044) between the Black participant and the White participant groups. Discrimination was significantly correlated with both NIH Emotional Distress - Anxiety (r = 0.677, p < .001) and NIH Sleep Disturbance (r = 0.446, p = .007) in Black MS individuals. Additionally, several physiological condition and psychological outcome measures were correlated with the NIH Emotional Distress - Anxiety and NIH Sleep Disturbance measures. This study contributes to literature highlighting the negative impacts of discrimination and race related stress on the physical and mental health of Black Americans.
Collapse
Affiliation(s)
- Evelyn A Hunter
- Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, United States.
| | - J M Meyer
- Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, United States
| | - G M Brown
- Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, United States
| | - M A Hanks
- Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, United States
| |
Collapse
|
6
|
Xiao Z, Zeng L, Pan PL, Lee J, Wu A. Racism, self-rated general health status, and health-related quality of life among Black and Asian Americans. Health Mark Q 2023; 40:458-481. [PMID: 37494547 DOI: 10.1080/07359683.2023.2238161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Race is a consequential sociocultural cue in healthcare contexts. Racism is associated with health disparities. Extant research shows significant health inequities between white and Black people. However, little is known about health gaps between or among other racial groups. This study investigated how Blacks and Asian Americans perceive and experience racism in healthcare settings and in general daily life situations, and how these factors relate to their self-rated general health status and health-related quality of life. Findings from an online survey suggest strong similarities and subtle differences between the two racial groups and within the Asian subgroups.
Collapse
Affiliation(s)
- Zhiwen Xiao
- Valenti School of Communication, University of Houston, Houston, TX, USA
| | - Li Zeng
- School of Media and Journalism, Arkansas State University, Jonesboro, AR, USA
| | - Po-Lin Pan
- Communication, Arkansas State University, Jonesboro, AR, USA
| | - Jae Lee
- Valenti School of Communication, University of Houston, Houston, TX, USA
| | - Allen Wu
- Woodside Priory School, Portola Valley, CA, USA
| |
Collapse
|
7
|
Nillni YI, Horenstein A, McClendon J, Duke CC, Sawdy M, Galovski TE. The impact of perceived everyday discrimination and income on racial and ethnic disparities in PTSD, depression, and anxiety among veterans. PLoS One 2023; 18:e0291965. [PMID: 37751447 PMCID: PMC10521990 DOI: 10.1371/journal.pone.0291965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 09/05/2023] [Indexed: 09/28/2023] Open
Abstract
OBJECTIVES Black and Hispanic/Latinx individuals experience a greater burden of mental health symptoms as compared to White individuals in the general population. Examination of ethnoracial disparities and mechanisms explaining these disparities among veterans is still in its nascence. The current study examined perceived everyday discrimination and income as parallel mediators of the association between race/ethnicity and PTSD, depression, and general anxiety symptoms in a sample of White, Black, and Hispanic/Latinx veterans stratified by gender. METHODS A random sample of 3,060 veterans living across the U.S. (oversampled for veterans living in high crime communities) completed a mail-based survey. Veterans completed self-report measures of perceived discrimination via the Everyday Discrimination Scale, PTSD symptoms via the Posttraumatic Stress Disorder Checklist-5, depressive symptoms via the Patient Health Questionnaire, and anxiety symptoms via the Generalized Anxiety Disorder Questionnaire. RESULTS Models comparing Black vs. White veterans found that the significant effect of race on PTSD, depression, and anxiety symptoms was mediated by both perceived discrimination and income for both male and female veterans. Results were less consistent in models comparing Hispanic/Latinx vs. White veterans. Income, but not perceived discrimination, mediated the relationship between ethnicity/race and depression and anxiety symptoms, but only among women. CONCLUSIONS Results suggest that discrimination and socioeconomic status are important mechanisms through which marginalized social status negatively impacts mental health.
Collapse
Affiliation(s)
- Yael I. Nillni
- National Center for PTSD, Women’s Health Sciences Division at VA Boston Healthcare System, Boston, MA, United States of America
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States of America
| | | | - Juliette McClendon
- National Center for PTSD, Women’s Health Sciences Division at VA Boston Healthcare System, Boston, MA, United States of America
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States of America
| | | | - Molly Sawdy
- Suffolk University, Boston, MA, United States of America
| | - Tara E. Galovski
- National Center for PTSD, Women’s Health Sciences Division at VA Boston Healthcare System, Boston, MA, United States of America
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States of America
| |
Collapse
|
8
|
Ouayogodé MH, Salas SS. Experienced Racism and Discrimination and Psychological Distress amid Different Phases of the COVID-19 Pandemic: Evidence from Wisconsin. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01782-4. [PMID: 37737937 PMCID: PMC11104563 DOI: 10.1007/s40615-023-01782-4] [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: 06/20/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/23/2023]
Abstract
The SARS-COV-2 pandemic created an unprecedented crisis and raised concerns about racial discrimination and psychological distress. We assessed trends in COVID-19-related racism and discrimination irrespective of infection status and changes in emotional health and mental well-being outcomes due to experienced racism and discrimination. Using three waves of the Wisconsin COVID-19 Community Impact Survey (2020-2021), we compared demographics of respondents categorized by two mutually exclusive groups: reporting vs. not reporting COVID-19-related racism and discrimination. Using longitudinal logistic-multivariable regressions, we modeled changes in racism and discrimination-induced stress and 4-item patient health questionnaire screening for anxiety and depression (PHQ-4) associated with experiencing racism and discrimination. Prevalence of reported experiencing COVID-19-related racism and discrimination increased among adult Wisconsinites between 2020 and 2021: 6.28% in Wave 1, 11.13% in Wave 2 (Pearson's chi-square Wave 1 vs 2=16.96, p<.001) vs. 10.87% in Wave 3 (chi-square, Wave 1 vs 3=14.99, p<.001). Experiencing COVID-19-related racism and discrimination was associated with a higher likelihood stress (OR=3.15, 95% CI 2.32-4.29) and a higher PHQ-4 score (coeff=0.63, 95% CI 0.32-0.94). Relative to White respondents, racial/ethnic minorities had a higher likelihood of feeling stress: Black OR=7.13, 95% CI 4.68-10.85; Hispanics OR=3.81, 95% CI 2.11-6.89; and other races OR=2.61, 95% CI 1.51-4.53. Estimated associations varied across racial/ethnic groups, age groups, and survey waves. Our study showed that experienced COVID-19-related racism and discrimination increased during the first 2 years of the pandemic and was associated with greater psychological distress among Wisconsinites of all racial/ethnic groups. Public health policies promoting inclusiveness should be implemented to reduce (COVID-19-related) racism and discrimination and its long-term effects on mental health and well-being.
Collapse
Affiliation(s)
- Mariétou H Ouayogodé
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut St, WARF, Madison, WI, 53726, USA.
| | - Sarah S Salas
- Department of Sociology, Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA
| |
Collapse
|
9
|
Hale ME, Morrow KE, George AM, Gayer A, Caughy MO, Suveg C. Maternal negative affect moderates behavioral and physiological synchrony in Latinx and Black mother-child dyads. Dev Psychobiol 2023; 65:e22394. [PMID: 37338257 DOI: 10.1002/dev.22394] [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: 07/01/2022] [Revised: 01/12/2023] [Accepted: 03/24/2023] [Indexed: 06/21/2023]
Abstract
Positive behavioral synchrony (PBS) between mothers and children involves the bidirectional exchange of verbal and nonverbal communication. Respiratory sinus arrhythmia (RSA) synchrony reflects the concordance between mother-child physiological states. Both PBS and RSA synchrony can be undermined by psychopathology symptoms. Latinx and Black families may experience contextual stressors that contribute to heightened symptoms of psychopathology, yet minimal research has examined relations between psychopathology symptoms with PBS and RSA synchrony in these families. The present study assessed associations between maternal depressive and child internalizing symptoms, mother and child negative affect (NA), and PBS and RSA synchrony in a sample of 100 Latina and Black mothers (Mage = 34.48 years, SD = 6.39 years) and their children (Mage = 6.83 years, SD = 1.50 years). Dyads engaged in a video-recorded stress task where RSA was collected continuously. Videos were later coded for PBS and mother and child NA. Mothers reported on their depressive and child's internalizing symptoms. Maternal NA was associated with weak PBS and negative RSA synchrony. Neither depressive and internalizing symptoms nor child NA were associated with PBS or RSA synchrony. Results highlight the potency of maternal NA on behavioral and physiological synchrony in Latinx and Black families.
Collapse
Affiliation(s)
- Molly E Hale
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Kayley E Morrow
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Andrea M George
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Amy Gayer
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Margaret O Caughy
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia, USA
| | - Cynthia Suveg
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| |
Collapse
|
10
|
Jones AL, Rafferty J, Cochran SD, Abelson J, Hanna MR, Mays VM. Prevalence, Severity and Burden of Post-Traumatic Stress Disorder in Black Men and Women Across the Adult Life span. J Aging Health 2022; 34:401-412. [PMID: 35510479 PMCID: PMC9175561 DOI: 10.1177/08982643221086071] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: To examine post-traumatic stress disorder (PTSD) among Black adults in younger, middle, and older ages. Methods: Using nationally representative data from the National Survey of American Life, we estimated lifetime and 12-month prevalence of PTSD in Black men and women ages 18-34, 35-49, and 50+. We determined PTSD persistence and severity by age group, then associations of PTSD with socio-economic status, chronic stress, and racial discrimination in middle age. Results: The lifetime prevalence of PTSD was higher in Black women/men ages 18-34 (prevalence=14.0%/6.3%) and 35-49 (12.8%/4.6%) versus 50 and older (8.7%/5.1%). Those ages 35-49 were more likely than younger/older Black adults to have severe interference in work, relationships, and activities domains. In middle age, PTSD was associated with unemployment, lower education, poverty, and stress in Black men, and unemployment, divorce, poverty, stress, and discrimination in Black women. Discussion: Black women experience a disproportionate burden of PTSD in middle age.
Collapse
Affiliation(s)
- Audrey L Jones
- Informatics, Decision-Enhancement and Analytic Sciences Center, 20122Veteran Affairs Salt Lake City Health Care System, Salt Lake City, UT, USA
- Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Jane Rafferty
- Program for Research on Black Americans, 51331Institute of Social Research, Ann Arbor, MI, USA
- School of Social Work, 143265University of Michigan, Ann Arbor, MI, USA
| | - Susan D Cochran
- Departments of Epidemiology and Statistics, Fielding School of Public Health, 25808University of California, Los Angeles, CA, USA
- UCLA BRITE Center for Science, Research & Policy, Los Angeles, CA, USA
| | - Jamie Abelson
- Program for Research on Black Americans, 51331Institute of Social Research, Ann Arbor, MI, USA
- School of Social Work, 143265University of Michigan, Ann Arbor, MI, USA
| | - Matthew R Hanna
- Department of Psychology, 5926The New School for Social Research, New York, NY, USA
| | - Vickie M Mays
- UCLA BRITE Center for Science, Research & Policy, Los Angeles, CA, USA
- Departments of Psychology and Health Policy and Management, Fielding School of Public Health, 8783University of California, Los Angeles, CA, USA
| |
Collapse
|
11
|
Cheng P, Casement MD, Cuellar R, Johnson DA, Kalmbach D, Cuamatzi Castelan A, Drake CL. Sleepless in COVID-19: racial disparities during the pandemic as a consequence of structural inequity. Sleep 2022; 45:zsab242. [PMID: 34788453 PMCID: PMC8689929 DOI: 10.1093/sleep/zsab242] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/03/2021] [Indexed: 12/23/2022] Open
Abstract
STUDY OBJECTIVES Insomnia has been on the rise during the 2019 coronavirus disease (COVID-19) pandemic, which may disproportionately affect racial minorities. This study characterized racial disparities in insomnia during the pandemic and evaluated mechanisms for such disparities. METHODS Participants included 196 adults (48 Black) from a 2016-2017 clinical trial of insomnia treatment who were reevaluated in April 2020. Race was evaluated as a predictor of change in insomnia, impact of COVID-19, and COVID-19 stress. Mediation models using the PRODCLIN method evaluated the extent to which: (1) COVID-19 impact accounted for Black-White disparities in change in insomnia, and (2) COVID-19 stress accounted for associations between discrimination and change in insomnia. RESULTS Increases in insomnia symptoms during COVID-19 were greater in Black compared to White participants, with 4.3 times the odds of severe insomnia (Insomnia Severity Index ≥ 22). Symptom severity was associated with pre-pandemic experiences of discrimination. Black participants were also disproportionately impacted by COVID-19, with twice the odds of irreparable loss of income/employment and four times the rate of COVID-19 diagnoses in their sociofamilial network compared to White participants. The disproportionate impact of COVID-19 accounted for 69.2% of the relationship between race and change in insomnia severity, and COVID-19 related stress accounted for 66.5% of the relationship between prior history of racial discrimination and change in insomnia severity. CONCLUSIONS Black-White disparities in insomnia severity during COVID-19 may be driven by structural inequities resulting in the disproportionate impact of COVID-19 on Black Americans. Results lend support for the minority stress model in the context of sleep health. CLINICAL TRIAL REGISTRATION Sleep to Prevent Evolving Affecting Disorders (SPREAD). NCT number: NCT02988375. https://clinicaltrials.gov/ct2/show/NCT02988375.
Collapse
Affiliation(s)
- Philip Cheng
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA
| | | | - Ruby Cuellar
- Department of Psychology, University of Oregon, Eugene, OR, USA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - David Kalmbach
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA
| | | | - Christopher L Drake
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA
| |
Collapse
|