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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.
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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.
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Rai A, Held ML, Osborne E, Kapur I. Stress Among Immigrants in the United States. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2024; 21:509-528. [PMID: 38400548 DOI: 10.1080/26408066.2024.2320345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
BACKGROUND Immigrants comprise a sizable proportion (15%) of the population living in the United States (U.S.). Given these proportions, it is imperative that we understand immigrant experiences of well-being and stress toward improved well-being and integration. METHODS To examine the experiences of first- and second-generation immigrants using a comparative approach, we utilized data from two surveys collected under Trump (n = 490) and Biden (n = 306) administrations. Both studies employed non-probability quota and convenience sampling techniques. Questions about experiences of stress (PSS-4), discrimination (Everyday Discrimination Scale), resilience (Brief Resilience Scale), border stress (Border Community and Immigration Stress Scale), immigration policies (general questions) were included in the surveys. Each study sample included diverse racial groups across both immigrant generations. We report frequencies, descriptive statistics, and ANOVAs/post hoc test results. RESULTS Findings highlight that levels of both stress and discrimination among non-White participants under the Trump administration were significantly higher than those of White participants, though neither relationship was significant under the Biden administration. Further, White participants exhibited higher resilience under the Trump administration, but not under the Biden administration. DISCUSSION AND CONCLUSION To our knowledge, this is the first study to comparatively examine immigrant experiences under the two most recent federal administrations. This study is seminal in highlighting discussions and making policy recommendations to limit immigrant exclusion, curtail exclusionary policies regarding travel bans, and improve pathways to citizenship, enhancing immigrant integration in the U.S. Roles of social workers in supporting immigrant communities and pathways for future research with immigrants are discussed.
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Affiliation(s)
- Abha Rai
- School of Social Work, Loyola University Chicago, Chicago, IL, USA
| | - Mary Lehman Held
- College of Social Work, The University of Tennessee Knoxville, Knoxville, TN, USA
| | - Emmalee Osborne
- School of Social Work, Loyola University Chicago, Chicago, IL, USA
| | - Ishita Kapur
- College of Social Work, The University of Tennessee Knoxville, Knoxville, TN, USA
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Dougan MM, Tzuang M, Nam B, Meyer OL, Tsoh JY, Park VMT. Discrimination Experiences among Asian American and Pacific Islander Adults during the COVID-19 Pandemic and Their Association with Mental Health Outcomes: Updated Findings from the COMPASS Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:799. [PMID: 38929045 PMCID: PMC11204087 DOI: 10.3390/ijerph21060799] [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: 04/26/2024] [Revised: 06/08/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Reports of escalated discrimination experiences among Asian American and Native Hawaiian Pacific Islanders (AANHPI) continue. METHODS Using the original and follow-up surveys of the COVID-19 Effects on the Mental and Physical Health of AAPI (Asian American and Pacific Islanders) Survey Study (COMPASS I and COMPASS II) (n = 3177), we examined changes over approximately a 1-year period in discrimination experiences attributable to being AAPI and factors associated with worse mental health outcomes. RESULTS Experiences of discrimination remained high in COMPASS II with 60.6% (of participants (compared to 60.2% among the same people in COMPASS I) reporting one or more discrimination experiences, and 28.6% reporting worse mental health outcomes. Experiences of discrimination were associated with modest but significant increase in the odds of worse mental health: adjusted OR 1.02 (95% CI 1.01-1.04). Being younger, being of Native Hawaiian/Pacific Islander or Hmong descent (relative to Asian Indian), and having spent 50% or less of their lifetime in the US (vs. US born), were significantly associated with worse mental health. CONCLUSIONS The fall-out from the pandemic continues to adversely impact AANHPI communities. These findings may help influence policy initiatives to mitigate its effects and support interventions designed to improve mental health outcomes.
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Affiliation(s)
- Marcelle M. Dougan
- Department of Public Health and Recreation, San José State University, San Jose, CA 95192, USA
| | - Marian Tzuang
- Department of Community Health Systems, School of Nursing, University of California-San Francisco, San Francisco, CA 94143, USA; (M.T.); (B.N.); (V.M.T.P.)
| | - Bora Nam
- Department of Community Health Systems, School of Nursing, University of California-San Francisco, San Francisco, CA 94143, USA; (M.T.); (B.N.); (V.M.T.P.)
| | - Oanh L. Meyer
- Department of Neurology, School of Medicine, University of California, Davis (UCD), Sacramento, CA 95817, USA;
- Asian American Research Center on Health (ARCH), University of California-San Francisco, San Francisco, CA 94143, USA;
| | - Janice Y. Tsoh
- Asian American Research Center on Health (ARCH), University of California-San Francisco, San Francisco, CA 94143, USA;
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California-San Francisco, San Francisco, CA 94143, USA
| | - Van M. Ta Park
- Department of Community Health Systems, School of Nursing, University of California-San Francisco, San Francisco, CA 94143, USA; (M.T.); (B.N.); (V.M.T.P.)
- Asian American Research Center on Health (ARCH), University of California-San Francisco, San Francisco, CA 94143, USA;
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Reeves AN, Lewis TT, Hood MM, Thurston RC, Avis NE, Burnett-Bowie SAM, Cortés YI, Neal-Perry G, Harlow SD. Does everyday discrimination account for the increased risk of vasomotor symptoms in Black women?: the Study of Women's Health Across the Nation (SWAN). Menopause 2024; 31:484-493. [PMID: 38595299 PMCID: PMC11126360 DOI: 10.1097/gme.0000000000002357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVES Vasomotor symptoms (VMS), including hot flashes and night sweats, are hallmark symptoms of the menopause transition. Previous research has documented greater frequency, duration, and severity of VMS in Black women compared with women from other racial/ethnic groups, even after accounting for other factors. This analysis examined the association between discrimination and VMS and the extent to which discrimination accounts for the disproportionate burden of VMS in Black women. METHODS Using available discrimination and VMS data from the SWAN cohort study (n = 2,377, 48% White, 32% Black, 6% Japanese, 4% Chinese, and 9% Hispanic women) followed approximately yearly in midlife from premenopause (42-52 y) through postmenopause (~20 y), we assessed concurrent associations between discrimination and VMS frequency in the past 2 weeks using weighted generalized mixed models. We also assessed associations between chronic discrimination across first four visits and VMS trajectories from premenopause to postmenopause using weighted multinomial logistic regression. Models were adjusted for known risk factors for VMS. RESULTS Higher levels of discrimination were associated with concurrent reporting of any (odds ratio [OR], 1.57 [1.31-1.89]) and frequent (≥6 d) VMS (OR, 1.55 [1.21-1.99]). After adjustment, associations remained significant for any (OR, 1.30 [1.09-1.54]) but not frequent VMS. For any VMS trajectories, chronic discrimination was associated with "continuously high" (OR, 1.69 [1.03-2.77]) and "high pre-FMP-decline post-FMP" (OR, 1.70 [1.01-2.88]) versus "FMP-onset low" trajectories. After adjusting for discrimination, odds of reporting any, frequent, and of being in the "continuously high" any VMS trajectory remained elevated for Black versus White women. CONCLUSIONS Discrimination is associated with greater concurrent risk of any (but not frequent) VMS, and chronic discrimination is associated with a continuously high reporting of any VMS over time, independent of known risk factors. Adjusting for discrimination attenuates but does not eliminate the increased risk of VMS for Black women.
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Affiliation(s)
- Alexis N Reeves
- Department of Epidemiology, School of Public Health, University of Michigan
- Epidemiology and Population Health, School of Medicine, Stanford University
| | - Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Michelle M Hood
- Department of Epidemiology, School of Public Health, University of Michigan
| | - Rebecca C. Thurston
- Department of Psychiatry, University of Pittsburgh School of Medicine
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health
- Department of Psychology, University of Pittsburgh
| | - Nancy E. Avis
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine
| | | | | | - Genevieve Neal-Perry
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina – Chapel Hill
| | - Siobán D. Harlow
- Department of Epidemiology, School of Public Health, University of Michigan
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Schinasi LH, Lawrence JA. Everyday discrimination and satisfaction with nature experiences. FRONTIERS IN EPIDEMIOLOGY 2024; 4:1212114. [PMID: 38872717 PMCID: PMC11169619 DOI: 10.3389/fepid.2024.1212114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/07/2024] [Indexed: 06/15/2024]
Abstract
Introduction There is growing interest in creating public green spaces to promote health. Yet, discussions about these efforts often overlook how experiences of chronic discrimination-which may manifest as racism, sexism, or homophobia, and more-could undermine satisfaction with nature experiences. Methods Using data from the 2018 wave of the National Opinion Research Center (NORC) General Social Survey (GSS), we quantified associations of frequency of everyday discrimination, operationalized using the Everyday Discrimination Scale (EDS, the primary independent variable), with respondents' perceptions of nature experiences and with their reported time spent in nature. Specifically, we quantified associations with the following three variables: (1) dissatisfaction with day-to-day experiences of nature, (2) not spending as much time as they would like in natural environments, and (3) usually spending at least one day per week in nature. We used survey-weighted robust Poisson models to estimate overall associations, and also stratified analyses by racial/ethnic and gender identity categories. Results Of 768 GSS respondents, 14% reported dissatisfaction with nature experiences, 36% reported not spending as much time as they would like in nature, and 33% reported that they did not spend at least one day per week in nature. The median non-standardized EDS, coded such that a higher value indicates greater frequency of discrimination, was 11 (interquartile range: 8, 15). Prevalence of reporting dissatisfaction with day-to-day experiences in nature was 7% higher in association with every one unit increase in EDS score above the median (PR: 1.07, 95% CI: 1.02-1.11). The prevalence of reporting not spending as much time as one would like in nature was 2% higher for every unit increase in higher than median everyday discrimination frequency (PR: 1.02, 95% CI: 1.00-1.05). Higher than median frequency in everyday discrimination was not associated with spending less than one day per week in nature. Race/ethnicity and gender identity did not modify associations. Conclusion Greater frequency of everyday discrimination is associated with less satisfaction with experiences in nature. This relationship could undermine efforts to promote health equity through green interventions.
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Affiliation(s)
- Leah H. Schinasi
- Department of Environmental and Occupational Health, Drexel University, Philadelphia, PA, United States
- Urban Health Collaborative, Drexel University, Philadelphia, PA, United States
| | - Jourdyn A. Lawrence
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA, United States
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Hernandez-Vallant A, Votaw VR, Herron JL, Stein ER, Swan JE, Ulrich DM, Blackwell MA, McCrady BS. A clinical science guide for reviewing the cross-cultural rigor of assessments in an alcohol training clinic. Psychol Serv 2024; 21:305-316. [PMID: 36689373 PMCID: PMC10363250 DOI: 10.1037/ser0000738] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
A standard component of service delivery in alcohol treatment clinics is evidence-based assessment (EBA). Although EBA is essential for selecting appropriate treatment modalities for alcohol use and associated problems, there are limitations in existing EBAs concerning evidence of cultural equivalence and utility among individuals seeking alcohol treatment. However, training in EBA, addictions, and clinical applications with diverse populations all are gaps in clinical training in doctoral programs in clinical psychology. The present work used the clinical science model to review the psychometric properties, cross-cultural utility, and measurement invariance of measures in an assessment battery used in an alcohol treatment training clinic. This article describes the results of that review, recommendations for retaining or replacing common assessment measures used in alcohol treatment clinics, and recommendations for alcohol treatment clinics interested in engaging in similar processes. Findings suggested that more research is needed to evaluate the psychometric properties of EBAs utilized in an alcohol treatment assessment battery, particularly among American Indian and Alaska Native people, and to test measurement invariance across race/ethnicity and other identity groups in alcohol treatment-seeking populations. Overall, routine reviews of cultural relevance are needed in clinical settings to stay current with the emerging literature. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Alexandra Hernandez-Vallant
- Department of Psychology, University of New Mexico
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico
| | - Victoria R. Votaw
- Department of Psychology, University of New Mexico
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico
| | - Jalene L. Herron
- Department of Psychology, University of New Mexico
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico
| | - Elena R. Stein
- Department of Psychology, University of New Mexico
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico
| | - Julia E. Swan
- Department of Psychology, University of New Mexico
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico
| | | | | | - Barbara S. McCrady
- Department of Psychology, University of New Mexico
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico
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Benner AD, Chen S, Fernandez CC, Hayward MD. The Potential for Using a Shortened Version of the Everyday Discrimination Scale in Population Research with Young Adults: A Construct Validation Investigation. SOCIOLOGICAL METHODS & RESEARCH 2024; 53:804-838. [PMID: 38813255 PMCID: PMC11136476 DOI: 10.1177/00491241211067512] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
Discrimination is associated with numerous psychological health outcomes over the life course. The nine-item Everyday Discrimination Scale (EDS) is one of the most widely used measures of discrimination; however, this nine-item measure may not be feasible in large-scale population health surveys where a shortened discrimination measure would be advantageous. The current study examined the construct validity of a combined two-item discrimination measure adapted from the EDS by Add Health (N = 14,839) as compared to the full nine-item EDS and a two-item EDS scale (parallel to the adapted combined measure) used in the National Survey of American Life (NSAL; N = 1,111) and National Latino and Asian American Study (NLAAS) studies (N = 1,055). Results identified convergence among the EDS scales, with high item-total correlations, convergent validity, and criterion validity for psychological outcomes, thus providing evidence for the construct validity of the two-item combined scale. Taken together, the findings provide support for using this reduced scale in studies where the full EDS scale is not available.
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Affiliation(s)
- Aprile D. Benner
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, TX, USA
| | - Shanting Chen
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, TX, USA
| | - Celeste C. Fernandez
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, TX, USA
| | - Mark D. Hayward
- Department of Sociology, University of Texas at Austin, Austin, TX, USA
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Dixon JS, Wang D, Ready RE. Discrimination and Cognition in Midlife Black Women: The Roles of Social Support and Spirituality. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad201. [PMID: 38165061 PMCID: PMC10939168 DOI: 10.1093/geronb/gbad201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVES Black women are at high risk for discrimination and cognitive impairment in late life. It is not known if discrimination is a risk factor for cognitive decline in Black women and if so, what factors are protective against the adverse cognitive effects of discrimination. Using the biopsychosocial model of gendered racism, we determined if discrimination is associated with poorer cognition in midlife Black women and if social support and/or spirituality would protect against the deleterious effects of discrimination on cognition. METHODS Participants were midlife Black women (N = 669) from the Study of Women's Health Across the Nation. Discrimination was measured by the Everyday Discrimination scale. Cognitive outcomes included episodic memory, processing speed, and working memory. Total social support, emotional support, instrumental support, and spirituality were assessed as protective factors. RESULTS Contrary to expectations, structural equation modeling indicated that discrimination was associated with better immediate recall. For women with more emotional support, greater discrimination was associated with better immediate recall than for women with lower emotional support. Spirituality was not a significant moderator in the association between discrimination and cognition. DISCUSSION Discrimination had unexpected positive associations with learning and attention-based cognitive skills for midlife Black women. Discrimination might enhance vigilance, which could be facilitated by higher levels of emotional support. There is an opportunity for clinical and public health interventions for cognitive health and discrimination focused on Black women to better incorporate emotional support as a coping resource.
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Affiliation(s)
- Jasmine S Dixon
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Dongwei Wang
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Rebecca E Ready
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
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Sarullo K, Barch DM, Smyser CD, Rogers C, Warner BB, Miller JP, England SK, Luby J, Swamidass SJ. Disentangling Socioeconomic Status and Race in Infant Brain, Birth Weight, and Gestational Age at Birth: A Neural Network Analysis. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:135-144. [PMID: 38298774 PMCID: PMC10829562 DOI: 10.1016/j.bpsgos.2023.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 02/02/2024] Open
Abstract
Background Race is commonly used as a proxy for multiple features including socioeconomic status. It is critical to dissociate these factors, to identify mechanisms that affect infant outcomes, such as birth weight, gestational age, and brain development, and to direct appropriate interventions and shape public policy. Methods Demographic, socioeconomic, and clinical variables were used to model infant outcomes. There were 351 participants included in the analysis for birth weight and gestational age. For the analysis using brain volumes, 280 participants were included after removing participants with missing magnetic resonance imaging scans and those matching our exclusion criteria. We modeled these three different infant outcomes, including infant brain, birth weight, and gestational age, with both linear and nonlinear models. Results Nonlinear models were better predictors of infant birth weight than linear models (R2 = 0.172 vs. R2 = 0.145, p = .005). In contrast to linear models, nonlinear models ranked income, neighborhood disadvantage, and experiences of discrimination higher in importance than race while modeling birth weight. Race was not an important predictor for either gestational age or structural brain volumes. Conclusions Consistent with the extant social science literature, the findings related to birth weight suggest that race is a linear proxy for nonlinear factors related to structural racism. Methods that can disentangle factors often correlated with race are important for policy in that they may better identify and rank the modifiable factors that influence outcomes.
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Affiliation(s)
- Kathryn Sarullo
- Department of Computer Science and Engineering, McKelvey School of Engineering, Washington University in St. Louis, St. Louis, Missouri
| | - Deanna M. Barch
- Department of Psychological & Brain Sciences, School of Arts & Sciences, Washington University in St. Louis, St. Louis, Missouri
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Christopher D. Smyser
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Cynthia Rogers
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Barbara B. Warner
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - J. Philip Miller
- Division of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Sarah K. England
- Department of Obstetrics & Gynecology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Joan Luby
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - S. Joshua Swamidass
- Department of Computer Science and Engineering, McKelvey School of Engineering, Washington University in St. Louis, St. Louis, Missouri
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
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Bergman AJ, Szanton SL, LaFave SE, Fashaw-Walters SA, Taylor JL, Thorpe RJ, Nkimbeng M. Older Black Americans' Perspectives on Structural Racism-Resilience as a Form of Resistance. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01870-5. [PMID: 38019372 PMCID: PMC11133226 DOI: 10.1007/s40615-023-01870-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/14/2023] [Accepted: 11/12/2023] [Indexed: 11/30/2023]
Abstract
PURPOSE The purpose of this study was to develop a deep understanding of the lived experiences of structural racism and discrimination among older Black Americans' and their perceptions of structural racism across their lives. We also considered individual and community resilience capacity and response in the face of systemic racism. METHODS In-depth interviews were conducted with Black community-dwelling adults aged 55 and older in and around Baltimore City. The interview guide used nine contexts to explore perceptions and experiences with structural racism over the life course. Two researchers used reflexive thematic analysis to code and analyze the data. RESULTS Participants endorsed structural racism to varying degrees across contexts of education, employment, neighborhood, healthcare, and income/wealth. Participants who denied structural racism placed blame for Black underachievement on factors such as personal and community deficiencies, unsafe neighborhoods, and institutional indifference. There was broad agreement about the existence of structural racism within the domains of policing and violence but participants were largely ambivalent about other domains such as environment, media, and civics. Resilience factors that helped individuals to resist and rebound from racism emerged as an unexpected and important theme. CONCLUSIONS We used Public Health Critical Race Praxis and the Cells to Society frameworks to contextualize these findings. Due to the ubiquitous nature of racism, individuals may not fully appreciate the impact of structural racism and its impact on Black well-being. This ordinariness of racism is harmful but may simultaneously contribute to resilience within Baltimore's Black community.
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Affiliation(s)
- Alanna J Bergman
- Johns Hopkins University School of Nursing, Baltimore, MD, USA.
- Center for Infectious Disease and Nursing Innovation - Johns Hopkins University School of Nursing, Baltimore, MD, USA.
| | - Sarah L Szanton
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | | | | | | | - Roland J Thorpe
- Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - Manka Nkimbeng
- University of Minnesota School of Public Health, Minneapolis, MN, USA
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Knorr DA, Fox MM. Maternal grandmothers buffer the effects of ethnic discrimination among pregnant Latina mothers. EVOLUTIONARY HUMAN SCIENCES 2023; 6:e7. [PMID: 38516370 PMCID: PMC10955360 DOI: 10.1017/ehs.2023.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 10/03/2023] [Accepted: 10/04/2023] [Indexed: 03/23/2024] Open
Abstract
Ethnic discrimination during pregnancy is linked to maternal psychological distress, adverse birth outcomes and increased offspring morbidity and mortality. An evolutionary perspective reframes offspring health issues as a risk to maternal fitness. We argue that kin may be evolutionarily motivated to buffer psychosocial stressors for the mother during pregnancy. Previously, we found that the relationship of a pregnant woman with her own mother (fetus' maternal grandmother) had a positive association on maternal prenatal psychology, above and beyond her relationship with her fetus' father. Here, we ask if grandmothers buffer mothers' prenatal psychological distress from ethnic discrimination. Using self-report data collected from 216 pregnant Latina women living in Southern California, we found discrimination to be significantly, positively associated with depression, anxiety, and stress in linear regression models. Maternal grandmother communication attenuated the association of discrimination and all three psychological distress measures, adjusting for the mother's relationship with the father. Maternal grandmother emotional support similarly significantly moderated the relationship of discrimination with depression and anxiety. We did not observe any significant interactions for paternal grandmother relationships. Geographic proximity was not a significant stress buffer. Results suggest the important role maternal grandmothers play in perinatal mental health, and that these benefits exist uncoupled from geographic proximity.
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Affiliation(s)
- Delaney A. Knorr
- Department of Anthropology, University of California, Los Angeles, CA 90095, USA
| | - Molly M. Fox
- Department of Anthropology, University of California, Los Angeles, CA 90095, USA
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
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Kalichman SC, Shkembi B, El-Krab R. Geometric approach to measuring intersectional stigma among black sexual minority men: reliability and validity in an HIV prevention context. Sex Health 2023; 20:441-452. [PMID: 37344210 DOI: 10.1071/sh23021] [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: 02/07/2023] [Accepted: 05/29/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Stigma and discrimination experiences attributable to multiple intersecting facets of the self (e.g. intersectional stigma) pose substantial challenges to accessing health services, including HIV prevention. While there have been theoretical advances in understanding multiple co-occurring stigmas, there are few psychometric instruments available to assess intersectional stigma. We have developed an approach to assessing intersectional stigma that conceptualises an intersection in geometric terms, defined as the line that connects points on two (or more) stigma dimensions and calculates scores derived from the geometric definition of intersecting lines. METHODS Following pilot studies to derive items and response formats, we administered newly developed enacted stigma (24-items) and anticipated stigma (17-items) scales with attributions to race and sexual minority status for stigma experiences to a sample of 422 Black sexual minority men at risk for HIV recruited through social media platforms. RESULTS The enacted and anticipated intersectional stigma scales, including subscales representing discrimination, interpersonal and felt stigma demonstrated evidence for reliability and construct validity. The enacted stigma scales were associated with medical mistrust, whereas the anticipated stigma scales predicted perceived barriers to using pre-exposure prophylaxis for HIV prevention. CONCLUSIONS The intersectional stigma scales offer greater specificity in measuring stigma experiences attributed to race, sexual minority status and the intersection of racial-sexual minority status.
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Affiliation(s)
- Seth C Kalichman
- Institute for Collaboration on Health, Intervention and Policy (InCHIP), University of Connecticut, 2006 Hillside Road, Storrs, CT 06269, USA
| | - Bruno Shkembi
- Institute for Collaboration on Health, Intervention and Policy (InCHIP), University of Connecticut, 2006 Hillside Road, Storrs, CT 06269, USA
| | - Renee El-Krab
- Institute for Collaboration on Health, Intervention and Policy (InCHIP), University of Connecticut, 2006 Hillside Road, Storrs, CT 06269, USA
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Warner BB, Rosa BA, Ndao IM, Tarr PI, Miller JP, England SK, Luby JL, Rogers CE, Hall-Moore C, Bryant RE, Wang JD, Linneman LA, Smyser TA, Smyser CD, Barch DM, Miller GE, Chen E, Martin J, Mitreva M. Social and psychological adversity are associated with distinct mother and infant gut microbiome variations. Nat Commun 2023; 14:5824. [PMID: 37726348 PMCID: PMC10509221 DOI: 10.1038/s41467-023-41421-4] [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: 02/08/2023] [Accepted: 08/29/2023] [Indexed: 09/21/2023] Open
Abstract
Health disparities are driven by underlying social disadvantage and psychosocial stressors. However, how social disadvantage and psychosocial stressors lead to adverse health outcomes is unclear, particularly when exposure begins prenatally. Variations in the gut microbiome and circulating proinflammatory cytokines offer potential mechanistic pathways. Here, we interrogate the gut microbiome of mother-child dyads to compare high-versus-low prenatal social disadvantage, psychosocial stressors and maternal circulating cytokine cohorts (prospective case-control study design using gut microbiomes from 121 dyads profiled with 16 S rRNA sequencing and 89 dyads with shotgun metagenomic sequencing). Gut microbiome characteristics significantly predictive of social disadvantage and psychosocial stressors in the mothers and children indicate that different discriminatory taxa and related pathways are involved, including many species of Bifidobacterium and related pathways across several comparisons. The lowest inter-individual gut microbiome similarity was observed among high-social disadvantage/high-psychosocial stressors mothers, suggesting distinct environmental exposures driving a diverging gut microbiome assembly compared to low-social disadvantage/low-psychosocial stressors controls (P = 3.5 × 10-5 for social disadvantage, P = 2.7 × 10-15 for psychosocial stressors). Children's gut metagenome profiles at 4 months also significantly predicted high/low maternal prenatal IL-6 (P = 0.029), with many bacterial species overlapping those identified by social disadvantage and psychosocial stressors. These differences, based on maternal social and psychological status during a critical developmental window early in life, offer potentially modifiable targets to mitigate health inequities.
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Affiliation(s)
- Barbara B Warner
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA.
| | - Bruce A Rosa
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - I Malick Ndao
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Phillip I Tarr
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
- Department of Molecular Microbiology, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - J Philip Miller
- Institute for Informatics, Data Science and Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Sarah K England
- Department of Obstetrics and Gynecology, Center for Reproductive Health Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Cynthia E Rogers
- Departments of Psychiatry and Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Carla Hall-Moore
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Renay E Bryant
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Jacqueline D Wang
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Laura A Linneman
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Tara A Smyser
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Christopher D Smyser
- Departments of Neurology, Pediatrics and Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Deanna M Barch
- Department of Psychological and Brain Sciences, Psychiatry, & Radiology, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Gregory E Miller
- Institute for Policy Research & Department of Psychology, Northwestern University, Evanston, IL, 60208, USA
| | - Edith Chen
- Institute for Policy Research & Department of Psychology, Northwestern University, Evanston, IL, 60208, USA
| | - John Martin
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Makedonka Mitreva
- Departments of Medicine and Genetics, and McDonnell Genome Institute, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA.
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14
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Krobath DM, Cuevas AG, Allen JD, Chung M, Economos CD, Mistry J. The Influence of Contested Racial Identity and Perceived Everyday Discrimination Exposure on Body Mass Index in US Adults. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01774-4. [PMID: 37668959 DOI: 10.1007/s40615-023-01774-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
Contested racial identity-the discrepancy between one's self-identified race and socially assigned race-is a social determinant of health and may contribute to overweight and obesity. Obesity is associated with a host of short- and long-term health conditions, including cardiovascular disease, a leading cause of death. Individuals racialized as Black, Hispanic, and Latino are at the greatest risk of obesity. Previous research indicates that experiencing interpersonal discrimination is associated with higher body mass index (BMI) in adults, and individuals with a contested racial identity are disproportionately exposed to interpersonal discrimination. However, the association between BMI and contested racial identity is unknown. This cross-sectional study measured the relationship between contested racial identity and perceived everyday discrimination on BMI in a nationally representative sample of US adults. Contested racial identity was measured with a binary variable indicating agreement between participants' self-identified race and socially assigned race. Weighted unadjusted and adjusted multiple linear regression models quantified the associations between BMI and contested racial identity with and without the mean discrimination score. Covariates included nativity status, income, education, racial identity salience, gender, and age. Among 1689 participants, 18.3% had a contested racial identity. Contested identity was associated with significantly higher BMI (β = 1.01, 95% CI = 0.06, 1.92), but the relationship was attenuated when adjusting for interpersonal discrimination, suggesting that individuals with contested identity may face a greater risk of obesity due to their disproportionately high exposure to interpersonal racial discrimination. Further research is needed to elucidate the impact of racism on BMI and obesity risk.
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Affiliation(s)
- Danielle M Krobath
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA.
- Eliot-Pearson Department of Child Study and Human Development, Tufts University, 105 College Ave, Medford, MA, 02155, USA.
| | - Adolfo G Cuevas
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, 708 Broadway, New York, NY, 10003, USA
- Center for Anti-Racism, Social Justice, and Public Health, New York University School of Global Public Health, 708 Broadway, New York, NY, 10003, USA
| | | | - Mei Chung
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA
| | - Christina D Economos
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA
| | - Jayanthi Mistry
- Eliot-Pearson Department of Child Study and Human Development, Tufts University, 105 College Ave, Medford, MA, 02155, USA
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15
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Fredriksen-Goldsen K, Prasad A, Kim HJ, Jung H. Lifetime Violence, Lifetime Discrimination, and Microaggressions in the Lives of LGBT Midlife and Older Adults: Findings from Aging with Pride: National Health, Aging, and Sexuality/Gender Study. LGBT Health 2023; 10:S49-S60. [PMID: 37754926 PMCID: PMC10541934 DOI: 10.1089/lgbt.2023.0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023] Open
Abstract
Purpose: There is a dearth of research on violence and adverse experiences among LGBT midlife and older adults. The goal of this article was to present tailored measures and investigate the relationship between adverse experiences, health, and age. Methods: Based on the Health Equity Promotion Model, we examined lifetime violence, lifetime discrimination, and contemporary microaggressions among LGBT adults, aged 50 and older, utilizing data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study. We examined subgroup differences, the interrelationships between adverse experiences, and the association with health, taking into consideration interactions by age. Results: Distinct aspects of these experiences were effectively captured by tailored measures. Important subgroup differences emerged with high levels of lifetime violence among sexually diverse adults, gay and bisexual men, and transgender adults. Experiences of violence remained a significant predictor across all three health outcomes, after controlling for both lifetime discrimination and microaggressions. Microaggressions had a significant contribution to comorbidity for those with a low level of lifetime violence. The interaction effects suggest that comorbidity increases as the number of lifetime violence experiences increases for those who are younger. As age increased, the lifetime violence effect on comorbidity diminished whereas the microaggressions effect became stronger. Conclusion: Greater attention to the sequelae of lifetime violence and other adverse events among midlife and older adults is needed as well as the development and testing of both downstream and upstream interventions to reduce and mitigate the impact of these experiences on the well-being of LGBT midlife and older adults.
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Affiliation(s)
| | - Anyah Prasad
- Department of Gerontology, John W. McCormack Graduate School of Policy & Global Studies, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Hyun-Jun Kim
- School of Social Work, University of Washington, Seattle, Seattle, Washington, USA
| | - Hailey Jung
- School of Social Work, University of Washington, Seattle, Seattle, Washington, USA
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16
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Ravi M, Mekawi Y, Blevins EJ, Michopoulos V, Stevens J, Carter S, Powers A. Intersections of oppression: Examining the interactive effect of racial discrimination and neighborhood poverty on PTSD symptoms in Black women. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2023; 132:567-576. [PMID: 37079842 PMCID: PMC10293083 DOI: 10.1037/abn0000818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Black Americans living in urban environments are disproportionately impacted by posttraumatic stress disorder (PTSD). Both racial discrimination and neighborhood poverty are factors that contribute to this health disparity. However, studies focused on the intersection of these two oppressive systems on PTSD symptoms are lacking. To address this gap in the literature, we assessed the interactive effects of racial discrimination and neighborhood poverty on PTSD symptoms in an urban sample of trauma-exposed Black women (N = 300). Simple moderation analysis was used to assess the main and interactive effects of racial discrimination and neighborhood poverty on PTSD symptoms. The overall model significantly predicted PTSD symptoms, with a main effect of racial discrimination (B = 1.87, p = .009) and neighborhood poverty rate (B = 0.29, p = .008), independent of prior trauma exposure and percentage of Black residents in the zip code. More frequent experiences of racial discrimination and higher rates of neighborhood poverty both predicted higher PTSD symptoms. There was also a trending interaction of racial discrimination and neighborhood poverty (B = -0.05, p = .054), where the effect of neighborhood poverty on PTSD symptoms was only present for those who reported fewer experiences of racial discrimination. Our results suggest that people who have experienced more instances of racial discrimination show high levels of PTSD symptoms regardless of neighborhood poverty rates and highlight the importance of considering multiple levels of oppression that Black individuals face while diagnosing and treating stress-related psychopathology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Meghna Ravi
- Emory University, Graduate Program in Neuroscience
| | - Yara Mekawi
- University of Louisville, Department of Psychological and Brain Sciences
| | - Emily J. Blevins
- University of Illinois at Urbana-Champaign, Department of Psychology
| | | | - Jennifer Stevens
- Emory University, Department of Psychiatry and Behavioral Sciences
| | | | - Abigail Powers
- Emory University, Department of Psychiatry and Behavioral Sciences
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17
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Anderson AT, Doyle DM, Factor-Litvak P, Cohn B, Link BG. Racial socialization and discrimination-related psychological distress in middle-aged Black men and women. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2023; 93:415-425. [PMID: 37384438 PMCID: PMC10527630 DOI: 10.1037/ort0000687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Our objectives were to evaluate gender-specific associations of racial discrimination with psychological sequelae among middle-aged Blacks and to evaluate the capacity of racial socialization to moderate the association between discrimination and psychological distress, accounting for relevant prospectively assessed childhood factors. We used data from the Child Health and Development Disparities Study that followed a Northern California-based group of Blacks from the prenatal period through midlife (N = 244, 49.6% female). Multiple regression analyses were performed separately by gender to assess (a) the main effects of racial socialization and racial discrimination on adult psychological distress, (b) racial socialization as a moderator of the association between racial discrimination and adult psychological distress, and (c) whether controls for prospectively assessed childhood factors changed conclusions regarding the role of racial socialization. Seventy percent of the middle-aged Blacks in our sample reported having at least one type of major experience of racial discrimination. Increased reports of racial discrimination were positively associated with psychological distress in men, but not in women. Similarly, racial socialization was associated with decreased overall distress for men, but not for women. Discrimination-related distress was attenuated for men who reported higher levels of racial socialization. These findings remained after adjustment for childhood socioeconomic status (SES), childhood internalizing symptoms, parental marital separation, and number of siblings. Findings suggest that racial socialization conferred a protective psychological effect through midlife to Black men who experienced racial discrimination, a commonplace experience in this cohort. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Ashaunta T. Anderson
- Division of Clinical Sciences, University of California, Riverside School of Medicine
| | | | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University
| | | | - Bruce G. Link
- Departments of Sociology and Public Policy, University of California, Riverside
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18
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Ulusoy N, Nienhaus A, Brzoska P. Investigating discrimination in the workplace. Translation and validation of the Everyday Discrimination Scale for nursing staff in Germany. BMC Nurs 2023; 22:196. [PMID: 37291521 DOI: 10.1186/s12912-023-01367-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/01/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND The Everyday Discrimination Scale (EDS) is a frequently used questionnaire in the field of health and social psychology that aims to explore perceptions of discrimination, especially instances of injustice related to various diversity characteristics. No adaptation to health care staff exists. The present study translates and adapts the EDS to nursing staff in Germany and examines its reliability and factorial validity as well as its measurement equivalence between men and women and different age groups. METHODS The study was based on an online survey conducted among health care staff of two hospitals and two inpatient care facilities in Germany. The EDS was translated using a forward-backward translation approach. Direct maximum likelihood confirmatory factor analysis (CFA) was conducted to examine the factorial validity of the adapted EDS. Differential item functioning (DIF) related to age and sex was investigated by means of multiple indicators, multiple causes (MIMIC) models. RESULTS Data on 302 individuals was available, of whom 237 (78.5%) were women. The most commonly employed one-factor, 8-item baseline model of the adapted EDS showed a poor fit (RMSEA = 0.149; CFI = 0.812; TLI = 0.737; SRMR = 0.072). The model fit improved considerably after including three error covariances between items 1 and 2, items 4 and 5, and items 7 and 8 (RMSEA = 0.066; CFI = 0.969; TLI = 0.949; SRMR = 0.036). Item 4 showed DIF related to sex and age, item 6 showed DIF related to age. DIF was moderate in size and did not bias the comparison between men and women or between younger and older employees. CONCLUSIONS The EDS can be considered a valid instrument for the assessment of discrimination experiences among nursing staff. Given that the questionnaire, similar to other EDS adaptations, may be prone to DIF and also considering that some error covariances need to be parameterized, latent variable modelling should be used for the analysis of the questionnaire.
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Affiliation(s)
- Nazan Ulusoy
- Institute for Health Services Research in Dermatology and Nursing (CVcare), University Medical Center Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246, Hamburg, Germany
| | - Albert Nienhaus
- Institute for Health Services Research in Dermatology and Nursing (CVcare), University Medical Center Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246, Hamburg, Germany
- Department of Occupational Medicine, Hazardous Substances and Public Health, German Social Accident Insurance Institution for Health and Welfare Services, 22089, Hamburg, Germany
| | - Patrick Brzoska
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany.
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Majeno A, Molina KM, Frisard CF, Lemon SC, Rosal MC. Discrimination and Sleep: Differential Effects by Type and Coping Strategy. Ann Behav Med 2023; 57:442-452. [PMID: 36534964 PMCID: PMC10205141 DOI: 10.1093/abm/kaac071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Discrimination has been posited as a contributor of sleep disparities for Latinxs. The strategy used to cope with discrimination may reduce or exacerbate its effects on sleep. This study examined whether different types of discrimination (everyday and major lifetime discrimination) were associated with sleep indices (quality, disturbances, efficiency) and whether coping strategy used moderated associations. METHOD Data of Latinx adults (N = 602; 51% women, 65% Dominican, Mage = 46.72 years) come from the Latino Health and Well-being Project, a community-based, cross-sectional study of Latinxs in Lawrence, MA. Multiple linear regressions were estimated separately for each sleep outcome. RESULTS Everyday discrimination was significantly associated with poorer sleep quality and greater disturbances; major lifetime discrimination was significantly associated with worse sleep across the three sleep indices. Coping strategy moderated associations between discrimination and sleep. Compared with Latinxs who used passive coping, those who used passive-active coping strategies had poorer sleep quality the more they experienced everyday discrimination. Latinxs who used any active coping strategy, compared with passive coping, had greater sleep disturbances the more frequently they experienced major lifetime discrimination. CONCLUSIONS Findings show that everyday discrimination and major lifetime discrimination are associated with different dimensions of sleep and suggest that coping with discrimination may require the use of different strategies depending on the type of discrimination experienced.
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Affiliation(s)
- Angelina Majeno
- Department of Psychological Science, University of California–Irvine, Irvine, CA, USA
| | - Kristine M Molina
- Department of Psychological Science, University of California–Irvine, Irvine, CA, USA
| | - Christine F Frisard
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Stephenie C Lemon
- Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Milagros C Rosal
- Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
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20
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Curci SG, Hernández JC, Winstone LK, Perez M, Luecken LJ. Discrimination and Depressive Symptoms Among Mexican American Women: Exploring Multilevel Sociocultural Moderators. Clin Psychol Sci 2023; 11:444-457. [PMID: 37465841 PMCID: PMC10353733 DOI: 10.1177/21677026221129628] [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] [Indexed: 07/20/2023]
Abstract
Relative to empirical studies on risk factors, less research has focused on culturally based protective factors that reduce the impact of discrimination on mental health. The current prospective study evaluated two potential moderators of the effect of discrimination on depressive symptoms among Mexican American women: individually held familism values and neighborhood cultural cohesion. Mexican-origin women in the United States (N = 322; mean age = 27.8 years; 86% born in Mexico) reported on frequency of discrimination, depressive symptoms, familism, and neighborhood cultural cohesion. Independent models evaluated familism and neighborhood cultural cohesion as moderators of the effect of discrimination on subsequent depressive symptoms. More frequent discrimination predicted higher subsequent depressive symptoms. High familism buffered the harmful effect of discrimination on depressive symptoms, such that more frequent discrimination was associated with higher subsequent depressive symptoms only for women who reported average and low familism. Neighborhood cultural cohesion did not buffer the effect of discrimination on depressive symptoms.
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21
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Luby JL, England SK, Barch DM, Warner BB, Rogers C, Smyser CD, Triplett R, Arora J, Smyser TA, Slavich GM, Zhao P, Stout M, Herzog E, Miller JP. Social disadvantage during pregnancy: effects on gestational age and birthweight. J Perinatol 2023; 43:477-483. [PMID: 36914799 PMCID: PMC10079545 DOI: 10.1038/s41372-023-01643-2] [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: 08/31/2022] [Revised: 01/26/2023] [Accepted: 02/24/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE Whether psychosocial adversity during pregnancy impacts fetal health outcomes at birth remains underexplored. This is a critical issue given significant social disadvantage and psychosocial stress faced by pregnant women worldwide. STUDY DESIGN Measures of social disadvantage and psychological factors, and medical/reproductive and nutritional health status in pregnant women were obtained at each trimester. Using Structural Equation Modeling (SEM), we investigated the relationship of forms of adversity to each other and to infant gestational age, and birthweight. RESULTS Among 399 singletons, Social Disadvantage significantly predicted gestational age (p = 0.003), and residual birthweight (p = 0.006). There was a 0.4 week decrease in gestational age and a 3% decrease in birthweight for each standard deviation increase in Social Disadvantage. CONCLUSION Significant negative effects of social adversity on the developing fetus were found. Notably, these effects emerged despite good prenatal care and after accounting for maternal age and medical reproductive risk factors.
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Affiliation(s)
- Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
| | - Sarah K England
- Department of Obstetrics and Gynecology, Center for Reproductive Health Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Barbara B Warner
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Cynthia Rogers
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Christopher D Smyser
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Regina Triplett
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Jyoti Arora
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Tara A Smyser
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Peinan Zhao
- Department of Obstetrics and Gynecology, Center for Reproductive Health Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Molly Stout
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Erik Herzog
- Department of Biology, Washington University in St. Louis, St. Louis, MO, USA
| | - J Philip Miller
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
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Mildrum Chana S, Palenski PE, Hawes ES, Wolford-Clevenger C, Thomas SJ, Gamble KL, Cropsey KL. Discrimination and insomnia: Examining depressive symptoms and nicotine withdrawal through a serial mediation model in a sample of smokers. Addict Behav 2023; 137:107506. [PMID: 36244244 PMCID: PMC10984338 DOI: 10.1016/j.addbeh.2022.107506] [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: 01/16/2022] [Revised: 09/13/2022] [Accepted: 09/16/2022] [Indexed: 11/29/2022]
Abstract
Insomnia is a common sleep disorder associated with poor health outcomes. Individuals from racially underrepresented groups as well as women tend to report more severe insomnia symptoms, and frequent experiences of discrimination have been found to drive such disparities. Smokers commonly experience sleep problems since nicotine can alter the sleep-wake cycle. Discrimination is associated with increased nicotine dependence, and such discrimination may also intensify tobacco withdrawal, specifically mood and cognitive-related aspects of withdrawal. The potential impact of discrimination on withdrawal symptoms and related mood symptoms like depression may lead to increases in insomnia symptoms. However, no studies to date have evaluated the indirect association of discrimination with insomnia severity through nicotine withdrawal and depressive symptoms. Therefore, this cross-sectional survey of n = 110 non-Hispanic Black and White current smokers (48.2 % Black, 69.1 % women) investigated these associations through a serial mediation model. Controlling for race, gender, nicotine dependence levels, and income, multivariate analyses supported a significant indirect effect of discrimination on insomnia severity through depressive symptoms. Analyses supported the hypothesized serial mediation model whereby discrimination is positively associated with depressive symptoms, which in turn are linked to more severe nicotine withdrawal, leading to greater insomnia severity. Smokers encountering frequent experiences of discrimination might be at increased risk of suffering insomnia as a result of their increased depressive and withdrawal symptoms. Future work is necessary to understand the role of depressive symptoms in these associations as well as possible implications for smoking relapse and success of smoking cessation programs.
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Affiliation(s)
- Sofia Mildrum Chana
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Paige E Palenski
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Elizabeth S Hawes
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Caitlin Wolford-Clevenger
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - S Justin Thomas
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Karen L Gamble
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Karen L Cropsey
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA.
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Wilson ME, Hill PL. Sense of Purpose and Experiences of Discrimination During Older Adulthood. GEROPSYCH 2023. [DOI: 10.1024/1662-9647/a000306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Abstract. Experiencing discrimination may hinder purposeful pursuits, but it remains unclear whether experiences continue to hinder sense of purpose into older adulthood. Using the Health and Retirement Study dataset from the United States ( MAge = 65.06; 17% Black, 83% White), the current study examined how everyday and major discrimination relates to sense of purpose and explored whether race and the perceived reason for discrimination moderates these relationships. Results indicate that, while both everyday and major discrimination are negatively associated with sense of purpose, only everyday discrimination remains significant when included in the same model. Additionally, race moderates these associations, whereby Black adults show less negative relationships than White adults. However, there is little evidence that perceiving discrimination as stemming from racism moderates purpose-discrimination associations.
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Affiliation(s)
- Megan E. Wilson
- Psychological and Brain Sciences, Washington University, St. Louis, MO, USA
| | - Patrick L. Hill
- Psychological and Brain Sciences, Washington University, St. Louis, MO, USA
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Carries S, Mkhwanazi Z, Sigwadhi L, Moshabela M, Nyirenda M, Goudge J, Govindasamy D. An economic incentive package to support the wellbeing of caregivers of adolescents living with HIV during the COVID-19 pandemic in South Africa: a feasibility study protocol for a pilot randomised trial. Pilot Feasibility Stud 2023; 9:3. [PMID: 36624520 PMCID: PMC9827020 DOI: 10.1186/s40814-023-01237-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 01/02/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The mental and financial strain linked to unpaid caregiving has been amplified during the COVID-19 pandemic. In sub-Saharan Africa, carers of adolescents living with HIV (ALHIV) are critical for maintenance of optimum HIV treatment outcomes. However, the ability of caregivers to provide quality care to ALHIV is undermined by their ability to maintain their own wellbeing due to multiple factors (viz. poverty, stigma, lack of access to social support services) which have been exacerbated by the COVID-19 pandemic. Economic incentives, such as cash incentives combined with SMS reminders, have been shown to improve wellbeing. However, there is a lack of preliminary evidence on the potential of economic incentives to promote caregiver wellbeing in this setting, particularly in the context of a pandemic. This protocol outlines the design of a parallel-group pilot randomised trial comparing the feasibility and preliminary effectiveness of an economic incentive package versus a control for improving caregiver wellbeing. METHODS Caregivers of ALHIV will be recruited from public-sector HIV clinics in the south of the eThekwini municipality, KwaZulu-Natal, South Africa. Participants will be randomly assigned to one of the following groups: (i) the intervention group (n = 50) will receive three cash payments (of ZAR 350, approximately 23 USD), coupled with a positive wellbeing message over a 3-month period; (ii) the control group (n = 50) will receive a standard message encouraging linkage to health services. Participants will be interviewed at baseline and at endline (12 weeks) to collect socio-demographic, food insecurity, health status, mental health (stigma, depressive symptoms) and wellbeing data. The primary outcome measure, caregiver wellbeing, will be measured using the CarerQoL instrument. A qualitative study will be conducted alongside the main trial to understand participant views on participation in the trial and their feedback on study activities. DISCUSSION This study will provide scientific direction for the design of a larger randomised controlled trial exploring the effects of an economic incentive for improving caregiver wellbeing. The feasibility of conducting study activities and delivering the intervention remotely in the context of a pandemic will also be provided. TRIAL REGISTRATION PACTR202203585402090. Registry name: Pan African Clinical Trials Registry (PACTR); URL: https://pactr.samrc.ac.za/ ; Registration. date: 24 March 2022 (retrospectively registered); Date first participant enrolled: 03 November 2021.
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Affiliation(s)
- Stanley Carries
- grid.415021.30000 0000 9155 0024Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Zibuyisile Mkhwanazi
- grid.415021.30000 0000 9155 0024Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Lovemore Sigwadhi
- grid.11956.3a0000 0001 2214 904XBiostatistics Unit, Stellenbosch University, Stellenbosch, South Africa
| | - Mosa Moshabela
- grid.16463.360000 0001 0723 4123School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Makandwe Nyirenda
- grid.16463.360000 0001 0723 4123School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa ,grid.415021.30000 0000 9155 0024Burden of Disease Unit, South African Medical Research Council, Cape Town, South Africa
| | - Jane Goudge
- grid.11951.3d0000 0004 1937 1135Centre for Health Policy, University of the Witwatersrand, Johannesburg, South Africa
| | - Darshini Govindasamy
- grid.415021.30000 0000 9155 0024Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
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Age and Mental Health Symptoms Among Chinese Persons With HIV: The Mediating and Moderating Role of Perceived Discrimination. J Assoc Nurses AIDS Care 2023; 34:105-112. [PMID: 36656094 DOI: 10.1097/jnc.0000000000000373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
ABSTRACT The association between age and mental health symptoms among persons with HIV (PWH) is inconsistent, and little is known about the mediators and moderators of this association. This study aimed to examine the association between age and mental health symptoms, as well as the mediators and moderators of perceived discrimination. Data were from 1,304 PWH who completed a cross-sectional survey in five areas of China. Multiple linear regressions showed that younger age was significantly associated with more severe mental health symptoms and that perceived discrimination moderated this relationship. The Sobel test showed that perceived discrimination also mediated the association between age and mental health symptoms. Our study indicates that perceived discrimination shapes the association between age and mental health symptoms among PWH and highlights the importance of designing age-tailored mental health intervention strategies for perceived discrimination among young PWH. Interventions addressing discrimination are necessary to help improve mental health, especially for young PWH.
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Fan CA, Hara-Hubbard KK, Barrington WE, Baquero B. The experience of hate incidents across racial and ethnic groups during the COVID-19 pandemic. Front Public Health 2022; 10:982029. [PMID: 36579066 PMCID: PMC9790915 DOI: 10.3389/fpubh.2022.982029] [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: 06/30/2022] [Accepted: 11/25/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction Racism is a root cause of ill health for communities of color, and hate incidents are one manifestation of racism. Marginalized racial and ethnic groups, including but not limited to Asian Americans, have been the target of highly publicized violence, hate, and discrimination which has been amplified during the COVID-19 pandemic. Objectives This paper investigates (1) the prevalence of hate incidents across racial and ethnic groups, and (2) the relationship between race and ethnicity and hate incidents during the first year of the COVID-19 pandemic. We also seek to (3) situate study findings within theories of racism. Methods This study utilizes national data from the Understanding America Study (UAS) COVID-19 Longitudinal Survey from June 10, 2020 to March 30, 2021 (n = 8,436). Hate incidents in six categories were examined: being treated with less courtesy, receiving poorer service, others acting as if they were not smart, others acting as if they were afraid of them, being threatened or harassed, and experiencing any of the previous categories of hate incidents. Main analyses were conducted via population averaged logistic panel regression. Results The majority of members of all six marginalized racial and ethnic groups reported at least one hate incident during the first year of the COVID-19 pandemic. In addition, all marginalized racial or ethnic groups had statistically significant higher odds of experiencing at least two categories of hate incidents compared to white individuals. Asian, AI/AN, Black, and Multiracial groups had significantly higher odds of experiencing each category of hate incident. All marginalized racial and ethnic groups had significantly higher odds of receiving poorer service and others acting as if they were afraid of them. Conclusion All marginalized racial and ethnic groups experienced significant levels of hate incidents within the first year of the COVID-19 pandemic. The public health community must continue to research, monitor, treat, and prevent hate incidents as a public health issue while recognizing the social and historical contexts of structural and interpersonal racism in the US.
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Affiliation(s)
- Carolyn A. Fan
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, United States,*Correspondence: Carolyn A. Fan
| | - KeliAnne K. Hara-Hubbard
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, United States
| | - Wendy E. Barrington
- Center for Anti-Racism and Community Health, Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, United States,Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, WA, United States,Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, United States
| | - Barbara Baquero
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, United States
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Griep RH, Oliveira FEG, de Aguiar OB, Moreno AB, Alves MGDM, Patrão AL, da Fonseca MDJM, Chor D. Cross-cultural adaptation of discrimination and vigilance scales in ELSA-Brasil. Rev Saude Publica 2022; 56:110. [PMID: 36629702 PMCID: PMC9749726 DOI: 10.11606/s1518-8787.2022056004278] [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: 10/06/2021] [Accepted: 01/19/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To describe the process of cross-cultural adaptation for the use in Brazil of the everyday discrimination scale (EDS) and the heightened vigilance scale (HVS) applied in the Longitudinal Study of Adult Health (ELSA-Brasil). METHODS Conceptual, item and semantic equivalence analyses were conducted by a group of four epidemiologists; evaluation of measurement equivalence (factorial analysis of configural, metric and scalar structures, according to sociodemographic characteristics) and reliability. A total of 11,987 participants responded to the discrimination scale, and a subsample of 260 people participated in the test-retest study. In the case of HVS, 8,916 people responded, while 149 individuals did so in the test-retest study. RESULTS The scales presented conceptual, item and semantic equivalence pertinent in the Brazilian context, in addition to adequate correspondence of referential/denotative meaning of terms and also of the general/connotative of the items. The confirmatory factor analysis of EDS revealed a unidimensional structure, with residual correlations between two pairs of items, presenting configural and metric invariance among the four subgroups evaluated. Scalar invariance was identified according to sex and age group, but it was not observed for race/color and education. Heightened vigilance showed low loads and high residuals, with inadequate adjustment indicators. For the items of the discrimination scale the weighted kappa coefficient (Kp) ranged from 0.44 to 0.78, and the intraclass correlation coefficient (ICC) was 0.87. For HVS items, the Kp ranged from 0.47 to 0.59 and the ICC was 0.83. CONCLUSIONS Although there are correlated items, it was concluded that the EDS is a promising scale to evaluate experiences of perceived discrimination in Brazilian daily life. However, the heightened vigilance scale did not present equivalence of measurement in the current format.
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Affiliation(s)
- Rosane Harter Griep
- Fundação Oswaldo CruzInstituto Oswaldo CruzLaboratório de Educação em Ambiente e SaúdeRio de JaneiroRJBrasil Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Educação em Ambiente e Saúde. Rio de Janeiro, RJ, Brasil
| | - Fernanda Esthefane Garrides Oliveira
- Fundação Oswaldo CruzEscola Nacional de Saúde Pública Sérgio AroucaPrograma de Epidemiologia em Saúde PúblicaRio de JaneiroRJBrasil Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Programa de Epidemiologia em Saúde Pública. Rio de Janeiro, RJ, Brasil
| | - Odaleia Barbosa de Aguiar
- Universidade do Estado do Rio de JaneiroInstituto de NutriçãoDepartamento de Nutrição AplicadaRio de JaneiroRJBrasil Universidade do Estado do Rio de Janeiro. Instituto de Nutrição. Departamento de Nutrição Aplicada. Rio de Janeiro, RJ, Brasil
| | - Arlinda B. Moreno
- Fundação Oswaldo CruzEscola Nacional de Saúde Pública Sérgio AroucaDepartamento de Epidemiologia e Métodos QuantitativosRio de JaneiroRJBrasilFundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Departamento de Epidemiologia e Métodos Quantitativos. Rio de Janeiro, RJ, Brasil
| | - Márcia Guimarães de Mello Alves
- Universidade Federal FluminenseInstituto de Saúde ColetivaDepartamento de Planejamento em SaúdeNiteróiRJBrasil Universidade Federal Fluminense. Instituto de Saúde Coletiva. Departamento de Planejamento em Saúde. Niterói, RJ, Brasil
| | - Ana Luisa Patrão
- Universidade do PortoFaculdade de Psicologia e Ciências da EducaçãoCentro de PsicologiaPortoPortugal Universidade do Porto. Faculdade de Psicologia e Ciências da Educação. Centro de Psicologia. Porto, Portugal
| | - Maria de Jesus Mendes da Fonseca
- Fundação Oswaldo CruzEscola Nacional de Saúde Pública Sérgio AroucaDepartamento de Epidemiologia e Métodos QuantitativosRio de JaneiroRJBrasilFundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Departamento de Epidemiologia e Métodos Quantitativos. Rio de Janeiro, RJ, Brasil
| | - Dóra Chor
- Fundação Oswaldo CruzEscola Nacional de Saúde Pública Sérgio AroucaDepartamento de Epidemiologia e Métodos QuantitativosRio de JaneiroRJBrasilFundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Departamento de Epidemiologia e Métodos Quantitativos. Rio de Janeiro, RJ, Brasil
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Slemon A, Susan Dahinten V, Stones C, Bungay V, Varcoe C. Analysis of the social consequences and value implications of the Everyday Discrimination Scale (EDS): implications for measurement of discrimination in health research. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2022; 31:247-261. [PMID: 34416129 DOI: 10.1080/14461242.2021.1969980] [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: 01/22/2021] [Accepted: 08/15/2021] [Indexed: 06/13/2023]
Abstract
The Everyday Discrimination Scale (EDS) is one of the most widely used measures of discrimination in health research, and has been useful for capturing the impact of discrimination on health. However, psychometric analysis of this measure has been predominantly among Black Americans, with limited examination of its effectiveness in capturing discrimination against other social groups. This paper explores the theoretical and historical foundations of the EDS, and draws on the analytic framework of Messick's theory of unified validity to examine the effectiveness of the EDS in capturing diverse experiences of discrimination. Encompassing both social consequences and value implications, Messick's unified validity contends that psychometric evaluation alone is insufficient to justify instrument use or ensure social resonance of findings. We argue that despite the robust psychometric properties and utility in addressing anti-Black race-related discrimination, the theoretical foundations and research use of the EDS have yet to respond to current discrimination theory, particularly intersectionality. This paper concludes with guidance for researchers in using the EDS in health research across diverse populations, including in data collection, analysis, and presentation of findings.
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Affiliation(s)
- Allie Slemon
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - V Susan Dahinten
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Cheyanne Stones
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Vicky Bungay
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Colleen Varcoe
- School of Nursing, University of British Columbia, Vancouver, Canada
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Viazminsky A, Borho A, Morawa E, Schmitt GM, Erim Y. Perceived discrimination among Syrian refugees in Germany and its associations with mental health. Glob Public Health 2022; 17:2854-2867. [PMID: 35042431 DOI: 10.1080/17441692.2022.2026449] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Discrimination is a crucial post migratory stressor but there is little research on perceived discrimination by Syrian refugees. This study aims to assess self-reported discrimination by Syrian refugees with a residence permit in Germany, determine its forms, places, and predictors, and explore its possible relation with mental health. Sociodemographics, migration-specific characteristics, traumatic life events, quality of life, perceived discrimination, depression, generalised anxiety disorder, post-traumatic symptoms, and somatic distress were assessed among 116 participants. More than one-third of the participants perceived discrimination in low frequency, and in general, perceived discrimination was confined to treatment with less courtesy or respect. Unfair treatment was perceived mostly while searching for accommodation and in the neighbourhood. Refugees attributed their experiences to their lack of language skills prior to national, religious, and racial causes. Lower age, higher number of completed years of education, and symptoms of posttraumatic stress disorder were significantly and substantially associated with perceived discrimination. Anxiety symptoms, number of traumatic experiences and gender may also be regarded as relevant predictors of perceived discrimination. Health care professionals must be aware of the links between discrimination and symptoms of mental disorders. Policymakers should address discrimination as a key refugee issue and risk to mental health.
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Affiliation(s)
- Andre Viazminsky
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Andrea Borho
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | | | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
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Zhang L, Cruz-Gonzalez M, Lin Z, Ouyang X, Zhao F, Alegría M. Association of everyday discrimination with health outcomes among Asian and non-Asian US older adults before and during the COVID-19 pandemic. Front Public Health 2022; 10:953155. [PMID: 36339195 PMCID: PMC9627216 DOI: 10.3389/fpubh.2022.953155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/30/2022] [Indexed: 01/24/2023] Open
Abstract
Increases in anti-Asian COVID-19 related discriminatory behaviors have been observed, many of which targeted older adults. Studies demonstrate that racial discrimination is associated with worse health outcomes, including anxiety, depression, and sleep difficulties. No previous studies have examined the impact of day-to-day experiences of discrimination before and during COVID-19 on both Asian and non-Asian older adults within the same sample. We examined whether everyday discrimination was associated with increased anxiety and depression symptoms, decreased levels of functioning, and increased sleep difficulties among Asian and non-Asian US older adults before and during the pandemic. Data came from the Positive Minds-Strong Bodies randomized clinical trial, an evidence-based mental health and disability prevention intervention for racially and ethnically diverse older adults with elevated depression or anxiety symptoms and minor to moderate disability. We conducted secondary data analyses in a cohort of 165 older adults (56 Asian and 109 non-Asian) assessed before COVID-19 (May 2015-May 2018) and during COVID-19 (March 2021-July 2022). Regression models examined whether everyday discrimination impacted health outcomes differently before and during COVID-19, and whether this effect was stronger among Asian compared to non-Asian older adults. Non-Asian older adults reported the same levels of everyday discrimination before and during COVID-19. Consistent with literature suggesting that social distancing has inadvertently kept US Asian populations from experiencing discrimination, Asian older adults reported marginally lower levels of everyday discrimination during the pandemic compared with pre-pandemic. We found that everyday discrimination was not associated with health outcomes before COVID-19. In contrast, during the pandemic, everyday discrimination was associated with worse anxiety and depression symptoms and worse levels of functioning, although only the impact on depression was significantly stronger compared with before the pandemic. This negative impact of everyday discrimination on health outcomes during the pandemic appeared to affect both Asian and non-Asian older adults similarly. Social support and social cohesion buffered against the negative effect of everyday discrimination on depression and level of functioning during the pandemic. Results suggest that public health interventions aimed at reducing everyday discrimination and emphasizing social support and cohesion can potentially improve health outcomes for all US older adult populations. Clinical trial registration www.ClinicalTrials.gov; identifier: NCT02317432.
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Affiliation(s)
- Lulu Zhang
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Mario Cruz-Gonzalez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Ziqiang Lin
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Xinyi Ouyang
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Fengnuan Zhao
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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Freedman RA, Ko NY, Lederman RI, Gagnon H, Fikre T, Gundersen DA, Revette AC, Odai-Afotey A, Kantor O, Hershman DL, Crew KD, Keating NL. Breast cancer knowledge and understanding treatment rationales among diverse breast cancer survivors. Breast Cancer Res Treat 2022; 196:623-633. [PMID: 36220997 PMCID: PMC9552717 DOI: 10.1007/s10549-022-06752-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/18/2022] [Indexed: 12/02/2022]
Abstract
Purpose The degree to which breast cancer survivors know about their tumors and understand treatment rationales is not well understood. We sought to identify information gaps within a diverse sample and explore whether knowledge about breast cancer and treatment may impact care. Methods We conducted a one-time, interviewer-administered survey of women who were diagnosed with breast cancer during 2013–2017 and received care at one of three centers in Boston, MA, and New York, NY. We examined knowledge of breast cancer and treatment rationales, information preferences, and treatment receipt. Results During 2018–2020, we interviewed 313 women (American Association for Public Opinion Research Cooperation Rates 58.4–76.5% across centers) who were 56.9% White, 23.6% Black, 14.1% Hispanic, and 5.4% other. Among the 296 included in analyses, we observed high variability in knowledge of breast cancer and treatment rationales, with a substantial number demonstrating limited knowledge despite feeling highly informed; > 25% actively avoided information. Black and Hispanic (vs. White) women consistently knew less about their cancers. Lack of understanding of treatment rationales for chemotherapy, radiation, and hormonal therapy was common but not consistently different by race and ethnicity. Understanding treatment rationale (but not cancer knowledge) was associated with treatment initiation, but small sample sizes limited in-depth examination. Conclusions Our study highlights the need for enhanced informational support for breast cancer survivors, who are challenged with complex information during the decision-making process and beyond. More research is needed to understand how to further educate and empower diverse populations of patients with breast cancer. Supplementary Information The online version contains supplementary material available at 10.1007/s10549-022-06752-8.
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Affiliation(s)
- Rachel A Freedman
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. .,Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA.
| | - Naomi Y Ko
- Section of Hematology and Medical Oncology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Ruth I Lederman
- Survey and Qualitative Methods Core, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Haley Gagnon
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Tsion Fikre
- Section of Hematology and Medical Oncology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Daniel A Gundersen
- Survey and Qualitative Methods Core, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Anna C Revette
- Survey and Qualitative Methods Core, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Olga Kantor
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA.,Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Dawn L Hershman
- Department of Medicine and Epidemiology, Columbia University Irving Medical Center, Herbert Irving Comprehensive Cancer Center, New York, NY, USA
| | - Katherine D Crew
- Department of Medicine and Epidemiology, Columbia University Irving Medical Center, Herbert Irving Comprehensive Cancer Center, New York, NY, USA
| | - Nancy L Keating
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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Love MF, Brooks AN, Cox SD, Okpala M, Cooksey G, Cohen AS, Sharrief AZ. The effects of racism and resilience on Black stroke- survivor quality of life: Study protocol and rationale for a mixed-methods approach. Front Neurol 2022; 13:885374. [PMID: 36034272 PMCID: PMC9399920 DOI: 10.3389/fneur.2022.885374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Stroke, a life-threatening stressor, often negatively impacts stroke-survivor (SS) quality of life (QoL). Annual age-adjusted incidence and death rates for stroke are significantly higher among Black Americans than among White Americans. Racism, a significant stressor, occurs at structural, cultural, and interpersonal levels and contributes to health disparities for Black SS. Resilience, a dynamic process of positive adaptation to significant stress, is impacted by factors or resources both internal and external to the individual. This study aims to examine the effects of experiences of racism and resilience on Black SS QoL during early stroke recovery. This article presents the study protocol. Methods and analyses This will be a prospective observational mixed-methods study. Black community-dwelling adults who are within 4 weeks of a stroke will be eligible for inclusion. Baseline measures will include the exposure variables of experiences of racism and resilience. Covariates measured at baseline include sociodemographic variables (age, sex, marital status, education, income, health insurance, employment status, number of people in household, residential address), clinical variables (date and type of stroke, inferred Modified Rankin Scale, anxiety and depression screening), and psychosocial variables (COVID-19 stress, perceived stress, mindfulness). The outcome variable (QoL) will be assessed 6-months post-stroke. Multiple-level linear regression models will be used to test the direct effects of experiences of racism, and the direct and indirect effects of resilience, on QoL. Qualitative data will be collected via focus groups and analyzed for themes of racism, resilience, and QoL. Discussion Racism can compound the stress exerted by stroke on Black SS. This study will occur during the COVID-19 pandemic and in the aftermath of calls for social justice for Black Americans. Experiences of racism will be measured with instruments for both “everyday” discrimination and vigilance. Sociodemographic variables will be operationalized to assess specific social determinants of health that intersect with structural racism. Because of the long-standing history of racism in the United States of America (USA), cultural influences and access to resources are central to the consideration of individual-level resilience in Black SS. Study results may inform the development of interventions to support Black SS QoL through enhanced resilience.
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Affiliation(s)
- Mary F. Love
- College of Nursing, University of Houston, Houston, TX, United States
- *Correspondence: Mary F. Love
| | | | - Sonya D. Cox
- College of Nursing, University of Houston, Houston, TX, United States
| | - Munachi Okpala
- Department of Neurology, McGovern Medical School, The University of Texas Health Science Center Houston, Houston, TX, United States
| | - Gail Cooksey
- Department of Neurology, McGovern Medical School, The University of Texas Health Science Center Houston, Houston, TX, United States
| | - Audrey Sarah Cohen
- Department of Neurology, McGovern Medical School, The University of Texas Health Science Center Houston, Houston, TX, United States
| | - Anjail Z. Sharrief
- Department of Neurology, McGovern Medical School, The University of Texas Health Science Center Houston, Houston, TX, United States
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Johnson SN, Forbush KT, Swanson TJ. The impact of discrimination on binge eating in a nationally representative sample of Latine individuals. Int J Eat Disord 2022; 55:1120-1129. [PMID: 35796067 DOI: 10.1002/eat.23773] [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: 04/22/2022] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Latines have higher rates of eating disorders characterized by binge eating compared to their non-Latine white counterparts, yet culturally and socially relevant factors related to binge eating in Latines have been largely understudied. The purpose of the current study was to examine how discrimination and acculturative stress were associated with binge eating in a nationally representative sample of Latines. An additional aim was to test the extent to which family cohesion and social support could buffer against the effects of discrimination and acculturative stress on binge eating. METHOD Participants (56% female, N = 2550) were Latines enrolled in the National Latino and Asian American Study. Structural equation modeling using 1000 re-sampled data sets built from machine learning iterative sampling procedures was used to examine the effects of discrimination, acculturative stress, family cohesion, and social support on binge eating. RESULTS Results indicated that only discrimination was significantly associated with binge eating. Neither the direct effect of acculturative stress, interaction of family cohesion and acculturative stress, interaction of social cohesion and acculturative stress, nor the interaction of social support and discrimination were significantly associated with binge eating. DISCUSSION This study highlights the need for mental-health providers to understand and assess discrimination among Latines presenting with concerns of binge eating. Treatments that effectively provide coping strategies to manage discriminatory experiences and reduce binge eating could improve both effectiveness of treatment and retention rates for Latine individuals with binge eating. PUBLIC SIGNIFICANCE This study examined the association of discrimination, acculturative stress, family cohesion, and social support with binge eating in Latines. Only discrimination was significantly associated with binge eating, highlighting the importance for providers to assess discrimination among Latines with binge-eating concerns and to improve equity, inclusion, and belonging at a societal level. Modifying existing treatments to address coping with discrimination could improve the effectiveness for Latines with binge-eating concerns.
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Affiliation(s)
- Sarah N Johnson
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | - Kelsie T Forbush
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
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A systematic review and meta-analysis of the Everyday Discrimination Scale and biomarker outcomes. Psychoneuroendocrinology 2022; 142:105772. [PMID: 35490482 PMCID: PMC9997446 DOI: 10.1016/j.psyneuen.2022.105772] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 03/01/2022] [Accepted: 04/17/2022] [Indexed: 02/08/2023]
Abstract
Discrimination has consistently been associated with multiple adverse health outcomes. Like other psychosocial stressors, discrimination is thought to impact health through stress-related physiologic pathways including hypothalamic-pituitary-adrenal (HPA) axis activation, dysregulation of inflammation responses, and accelerated cellular aging. Given growing attention to research examining the biological pathways through which discrimination becomes embodied, this systematic review and meta-analysis synthesizes empirical evidence examining relationships between self-reported discrimination and four biomarker outcomes (i.e., cortisol, C-reactive protein (CRP), interleukin-6 (IL-6), and telomere length) among studies that have used the Everyday Discrimination Scale. We conducted a systematic review of studies discussing self-reported, everyday, or chronic discrimination in the context of health by searching Medline / PubMed (National Library of Medicine, NCBI), PsycInfo (APA, Ebsco) and Web of Science Core Collection (Clarivate). Twenty-five articles met the criteria for meta-analysis, with several reporting on multiple outcomes. Discrimination was associated with elevated CRP levels (r = 0.11; 95% CI: 0.01, 0.20, k = 10), though not cortisol (r = 0.05; 95% CI: -0.06, 0.16, k = 9), IL-6 (r = 0.05; 95% CI: -0.32, 0.42, k = 5), or telomere length (r = 0.03; 95% CI: -0.01, 0.07, k = 6). We identify several points of consideration for future research including addressing heterogeneity in assessment of biomarker outcomes and the need for longitudinal assessments of relationships between discrimination and biomarker outcomes.
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Brady RG, Rogers CE, Prochaska T, Kaplan S, Lean RE, Smyser TA, Shimony JS, Slavich GM, Warner BB, Barch DM, Luby JL, Smyser CD. The Effects of Prenatal Exposure to Neighborhood Crime on Neonatal Functional Connectivity. Biol Psychiatry 2022; 92:139-148. [PMID: 35428496 PMCID: PMC9257309 DOI: 10.1016/j.biopsych.2022.01.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/20/2021] [Accepted: 01/29/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Maternal exposure to adversity during pregnancy has been found to affect infant brain development; however, the specific effect of prenatal crime exposure on neonatal brain connectivity remains unclear. Based on existing research, we hypothesized that living in a high-crime neighborhood during pregnancy would affect neonatal frontolimbic connectivity over and above other individual- and neighborhood-level adversity and that these associations would be mediated by maternal psychosocial stress. METHODS Participants included 399 pregnant women, recruited as part of the eLABE (Early Life Adversity, Biological Embedding, and Risk for Developmental Precursors of Mental Disorders) study. In the neonatal period, 319 healthy, nonsedated infants were scanned using resting-state functional magnetic resonance imaging (repetition time = 800 ms; echo time = 37 ms; voxel size = 2.0 × 2.0 × 2.0 mm3; multiband = 8) on a Prisma 3T scanner and had at least 10 minutes of high-quality data. Crime data at the block group level were obtained from Applied Geographic Solution. Linear regressions and mediation models tested associations between crime, frontolimbic connectivity, and psychosocial stress. RESULTS Living in a neighborhood with high property crime during pregnancy was related to weaker neonatal functional connectivity between the thalamus-anterior default mode network (aDMN) (β = -0.15, 95% CI = -0.25 to -0.04, p = .008). Similarly, high neighborhood violent crime was related to weaker functional connectivity between the thalamus-aDMN (β = -0.16, 95% CI = -0.29 to -0.04, p = .01) and amygdala-hippocampus (β = -0.16, 95% CI = -0.29 to -0.03, p = .02), controlling for other types of adversity. Psychosocial stress partially mediated relationships between the thalamus-aDMN and both violent and property crime. CONCLUSIONS These findings suggest that prenatal exposure to crime is associated with weaker neonatal limbic and frontal functional brain connections, providing another reason for targeted public policy interventions to reduce crime.
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Affiliation(s)
- Rebecca G Brady
- Division of Biology and Biomedical Sciences, Washington University School of Medicine, St. Louis, Missouri; Department of Neurology, Washington University School of Medicine, St. Louis, Missouri.
| | - Cynthia E Rogers
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri; Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Trinidi Prochaska
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Sydney Kaplan
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Rachel E Lean
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Tara A Smyser
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Joshua S Shimony
- Mallinckrot Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
| | - Barbara B Warner
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri; Mallinckrot Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri; Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri
| | - Joan L Luby
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri; Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Christopher D Smyser
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri; Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri; Mallinckrot Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
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Ong AD, Urganci B, Burrow AL, DeHart T. The Relational Wear and Tear of Everyday Racism Among African American Couples. Psychol Sci 2022; 33:1187-1198. [PMID: 35772020 DOI: 10.1177/09567976221077041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The wear and tear of adapting to chronic stressors such as racism and discrimination can have detrimental effects on mental and physical health. Here, we investigated the wider implications of everyday racism for relationship quality in an adult sample of 98 heterosexual African American couples. Participants reported on their experiences of racial discrimination and positive and negative affect for 21 consecutive evenings. Using dyadic analyses, we found that independently of age, gender, marital status, income, racial-discrimination frequency, neuroticism, and mean levels of affect, participants' relationship quality was inversely associated with their partner's negative affective reactivity to racial discrimination. Associations did not vary by gender, suggesting that the effects of affective reactivity were similar for men and women. These findings highlight the importance of a dyadic approach and call for further research examining the role of everyday racism as a key source of stress in the lives of African American couples.
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Affiliation(s)
- Anthony D Ong
- Department of Psychology, Cornell University.,Center for Integrative Developmental Science, Cornell University
| | | | - Anthony L Burrow
- Department of Psychology, Cornell University.,Bronfenbrenner Center for Translational Research, Cornell University
| | - Tracy DeHart
- Department of Psychology, Loyola University Chicago
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COVID-19 Mental Health Impacts Among Parents of Color and Parents of Children with Asthma. J Racial Ethn Health Disparities 2022; 10:1259-1269. [PMID: 35505151 PMCID: PMC9063870 DOI: 10.1007/s40615-022-01311-9] [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: 11/16/2021] [Revised: 04/18/2022] [Accepted: 04/21/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVES This study investigated whether select social determinants of health and worries about COVID-19 resource losses mediated the relations between four parent groups: [1) non-Hispanic White (NHW) parents of children with asthma; 2) Black, Indigenous, or other Persons of Color (BIPOC) parents of healthy children; 3) BIPOC parents of children with asthma; and 4) NHW parents of healthy children (referent)] and parent anxiety and depression symptoms during COVID-19. METHODS Parents (N = 321) completed online questionnaires about discrimination, anxiety, depression, and COVID-19 impacts on employment/income and access to food and health care. Mediation analyses were conducting using nonparametric bootstrapping procedures. RESULTS BIPOC parents of children with and without asthma experienced greater anxiety and depression symptoms through greater discrimination compared to NHW parents of healthy children. BIPOC parents of children with asthma experienced greater anxiety symptoms, and both BIPOC groups experienced greater depression symptoms, through greater COVID-19 income losses. NHW parents of children with asthma and both BIPOC groups experienced greater anxiety and depression symptoms through greater worries about COVID-19 resource losses. CONCLUSIONS The suffering of BIPOC parents, especially BIPOC parents of children with asthma, necessitates multi-level COVID-19 responses to address key drivers of health inequities.
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Goldman AW. Everyday discrimination in later life: A social network approach. SOCIAL SCIENCE RESEARCH 2022; 104:102670. [PMID: 35400385 PMCID: PMC9001990 DOI: 10.1016/j.ssresearch.2021.102670] [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: 05/14/2020] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 05/03/2023]
Abstract
What factors shape everyday discrimination among older adults? Existing perspectives focus on individual identities and social group membership (e.g., race/ethnicity, age) as key determinants of perceived discrimination. This paper examines the idea that individuals' broader social contexts - including their personal social networks - also shape perceived discrimination, and in ways that may differ across racial groups. Using data from Round 3 of the National Social Life, Health, and Aging Project (N = 3312), I consider how properties of personal networks are associated with how frequently older adults report everyday discrimination. Results indicate that more kin-centric personal networks protect against more frequent everyday discrimination, but that this protective effect may be stronger among White older adults. I propose why more kin-centric networks may play a different role in the perceived discrimination of White and Black older adults, and close by suggesting that social network composition may be a source of heterogeneity in the link between everyday discrimination and inequality in later life outcomes such as health.
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Affiliation(s)
- Alyssa W Goldman
- Department of Sociology, Boston College, 140 Commonwealth Avenue, 424 McGuinn Hall, Chestnut Hill, MA, 02467, USA.
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Wong-Padoongpatt G, Barrita A, King A. Perceived Everyday Discrimination Explains Internalized Racism during the COVID-19 Pandemic among Asians. Behav Med 2022; 48:109-119. [PMID: 35318901 DOI: 10.1080/08964289.2021.2015277] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The current study examined the impact of the COVID-19 pandemic on perceived everyday discrimination and internalized racism among Asians compared to Latinxs. Recently, researchers have attempted to tackle institutional and interpersonal racism during this pandemic outbreak, however, few studies have addressed the internalized component of the racism. We launched this survey study during the critical months of the national pandemic lockdown (April 2020 to April 2021) with a sample (N = 360) of 170 Asians and 190 Latinxs college students self-reporting their experiences related to everyday discrimination and internalized racism. Findings indicated that Asians experienced more internalized racism and perceived a change in everyday discrimination during the COVID-19 pandemic compared to Latinxs. Furthermore, the perceived everyday discrimination during the COVID-19 pandemic emerged as a mediator for the race effect on internalized racism. That is, Asians perceived a significant change in everyday discrimination frequency during the COVID-19 pandemic compared to Latinxs and this change was related to higher levels of internalized racism. According to our findings, Asians perceived more daily discriminatory and inferiorizing messages, compared to Latinxs, which also explained the reasons for higher levels of internalized racism during the COVID-19 pandemic. Our findings suggest that Asians might be rationalizing their encounters with discrimination and even believing their communities deserve these daily attacks during the COVID-19 pandemic outbreak.
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Affiliation(s)
| | - Aldo Barrita
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Anthony King
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
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Harlow SD, Burnett-Bowie SAM, Greendale GA, Avis NE, Reeves AN, Richards TR, Lewis TT. Disparities in Reproductive Aging and Midlife Health between Black and White women: The Study of Women's Health Across the Nation (SWAN). Womens Midlife Health 2022; 8:3. [PMID: 35130984 PMCID: PMC8822825 DOI: 10.1186/s40695-022-00073-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/03/2022] [Indexed: 01/28/2023] Open
Abstract
This paper reviews differences in the experience of the menopause transition and midlife health outcomes between Black and White women who participated in the Study of Women's Health Across the Nation (SWAN), a 25-year, longitudinal, multi-racial/ethnic cohort study. We identify health disparities, i.e., instances in which Black women's outcomes are less favorable than those of White women, and consider whether structural racism may underlie these disparities. Although SWAN did not explicitly assess structural racism, Black women in SWAN grew up during the Jim Crow era in the United States, during which time racism was legally sanctioned. We consider how we might gain insight into structural racism by examining proxy exposures such as socioeconomic characteristics, reports of everyday discrimination, and a range of life stressors, which likely reflect the longstanding, pervasive and persistent inequities that have roots in systemic racism in the US. Thus, this paper reviews the presence, magnitude, and longitudinal patterns of racial disparities observed in SWAN in six areas of women's health - menopause symptoms, sleep, mental health, health related quality of life, cardio-metabolic health, and physical function -and elucidates the contextual factors that are likely influencing these disparities. We review the strengths and weaknesses of SWAN's design and approach to analysis of racial disparities and use this as a springboard to offer recommendations for future cohort studies.
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Affiliation(s)
- Siobán D Harlow
- Department of Epidemiology, University of Michigan, School of Public Health, United States, 1415 Washington Heights, Ann Arbor, MI, 48104-2029, USA.
| | - Sherri-Ann M Burnett-Bowie
- Endocrine Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Gail A Greendale
- Division of Geriatrics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, USA
| | - Nancy E Avis
- Department of Social Sciences & Health Policy Wake Forest School of Medicine, Winston-Salem, USA
| | - Alexis N Reeves
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, USA
| | - Thomas R Richards
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, USA
| | - Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
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Ta Park VM, Dougan MM, Meyer OL, Nam B, Tzuang M, Park LG, Vuong Q, Bang J, Tsoh JY. Discrimination Experiences during COVID-19 among a National, Multi-Lingual, Community-Based Sample of Asian Americans and Pacific Islanders: COMPASS Findings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:924. [PMID: 35055744 PMCID: PMC8776140 DOI: 10.3390/ijerph19020924] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/03/2022] [Accepted: 01/07/2022] [Indexed: 12/16/2022]
Abstract
Reports of escalated discrimination among Asian Americans and Pacific Islanders (AAPIs) due to COVID-19 are alarming, making this a public health priority. However, there are limited empirical studies on the scope and impact of COVID-19-related discrimination among AAPIs. Using the COVID-19 Effects on the Mental and Physical Health of AAPI Survey Study (COMPASS) data (N = 4971; survey period: October 2020-February 2021), which is a U.S.-wide multi-lingual survey, we examined the prevalence of, and factors associated with discrimination experiences attributable to being an AAPI during the COVID-19 pandemic. Overall, 60.7% reported experiencing discrimination; the group prevalence ranged from 80.0% (Hmong) to 40.5% (Native Hawaiians and Pacific Islanders). Multivariable logistic regression models revealed that COVID-19-related factors were associated with many discrimination experiences: having a shelter-in-place order of ≥1 month, living in areas with perceived similar/higher COVID-19 severity, and negative impact in family income/employment due to COVID-19. Additionally, being Asian American (versus Native Hawaiians and Pacific Islanders), females, non-heterosexuals, younger, more severe effect on family income, living in the non-West, and poorer health were significantly correlated with discrimination experiences. Findings may assist in formulating anti-AAPI-discrimination policies and programs at the local, state, and federal levels. Culturally appropriate programs and policies to combat this are urgently needed.
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Affiliation(s)
- Van M Ta Park
- Department of Community Health Systems, School of Nursing, University of California-San Francisco, San Francisco, CA 94143, USA
- Asian American Research Center on Health (ARCH), University of California-San Francisco, San Francisco, CA 94143, USA
| | - Marcelle M Dougan
- Department of Public Health and Recreation, San Jose State University, San Jose, CA 95192, USA
| | - Oanh L Meyer
- Department of Neurology, School of Medicine, University of California, Davis (UCD), Sacramento, CA 95817, USA
| | - Bora Nam
- Department of Community Health Systems, School of Nursing, University of California-San Francisco, San Francisco, CA 94143, USA
| | - Marian Tzuang
- Department of Community Health Systems, School of Nursing, University of California-San Francisco, San Francisco, CA 94143, USA
| | - Linda G Park
- Department of Community Health Systems, School of Nursing, University of California-San Francisco, San Francisco, CA 94143, USA
| | - Quyen Vuong
- International Children Assistance Network (ICAN), 532 Valley Way, Milpitas, CA 95035, USA
| | - Joon Bang
- Iona Senior Services, 4125 Albemarle Street NW, Washington, DC 20015, USA
| | - Janice Y Tsoh
- Asian American Research Center on Health (ARCH), University of California-San Francisco, San Francisco, CA 94143, USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California-San Francisco, San Francisco, CA 94143, USA
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Kalichman SC, Shkembi B, Eaton LA. Finding the Right Angle: A Geometric Approach to Measuring Intersectional HIV Stigma. AIDS Behav 2022; 26:27-38. [PMID: 34424389 DOI: 10.1007/s10461-021-03437-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2021] [Indexed: 12/31/2022]
Abstract
Intersectionality has emerged as theoretically and practically important to advancing HIV stigma research. However, few psychometric measures capture the intricacies of intersectional stigma. Grounded in the HIV stigma framework and contemporary theories of intersectionality, this paper describes a novel approach to conceptualizing the measurement of intersectional stigma. Taking the notion of an intersection literally, that is the point at which two or more lines meet and form a union, we offer a geometric conceptualization for developing a psychometric instrument to measure intersectional stigma. Ratings of stigmatized attributes, such as stigma ascribed to gender, race, sexual orientation, and HIV status are assessed on independent scales to calculate their intersection using the Pythagorean Theorem, c = [Formula: see text] (a2 + b2) and its extension to multiple stigmatized attributes d = [Formula: see text] (a2 + b2 + c2). Data from a sample of Black /African American women living with HIV were used to test the concept of a geometric approach to measuring intersectional enacted stigma and intersectional anticipated stigma. Findings from the test of concept were encouraging and warrant further scale development research.
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Affiliation(s)
- Seth C Kalichman
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, USA.
| | - Bruno Shkembi
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, USA
| | - Lisa A Eaton
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, USA
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Nketia J, Amso D, Brito NH. Towards a more inclusive and equitable developmental cognitive neuroscience. Dev Cogn Neurosci 2021; 52:101014. [PMID: 34571453 PMCID: PMC8476647 DOI: 10.1016/j.dcn.2021.101014] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 09/07/2021] [Accepted: 09/16/2021] [Indexed: 11/29/2022] Open
Abstract
Brain and cognitive development is a burgeoning area of scientific inquiry, with tremendous potential to better the lives of children. Large scale longitudinal neuroimaging studies offer opportunities for significant scientific advances in our understanding of developing brain structure and function. The proposed manuscript will focus on the scientific potential of the HEALthy Brain and Cognitive Development (HBCD) Study, highlighting what questions these data can and what they cannot answer about child development. Specifically, we caution against the misuse of these data for advancing de-contextualized and scientifically questionable narratives about the development of children from marginalized communities. We will focus on building and organizing a framework for interpreting HBCD data through the lens of sampling, cultural context, measurement, and developmental science theory. Our goal is to thoughtfully offer the scientific community opportunities to use the large scale and collaborative nature of HBCD to collectively revise practices in developmental science that to-date have not carefully considered their own role in perpetuating narratives that support systemic injustice.
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Affiliation(s)
- Jazlyn Nketia
- Department of Cognitive, Linguistic & Psychological Sciences, Brown University, United States; Department of Psychology, Columbia University, United States.
| | - Dima Amso
- Department of Psychology, Columbia University, United States
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Harnois CE. What do we measure when we measure perceptions of everyday discrimination? Soc Sci Med 2021; 292:114609. [PMID: 34894458 DOI: 10.1016/j.socscimed.2021.114609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 08/13/2021] [Accepted: 11/24/2021] [Indexed: 11/16/2022]
Abstract
RATIONALE The Everyday Discrimination Scale forms the backbone of hundreds of studies documenting the health effects of perceived discrimination. Researchers regularly use the scale to examine specific types of discrimination (e.g., racial, ethnic, gender- and age-based) as well as discrimination more generally among the "general population." To date, no study has analyzed the frameworks respondents use to interpret and answer the questions that comprise the scale. As such, what exactly researchers are measuring when they ask about "everyday discrimination" - and how this may vary within and across social groups - remains unknown. OBJECTIVE This study analyzes data from cognitive interviews to assess patterns of interpretation and response to the EDS to assess whether the meaning of the resulting data may vary across diverse social groups. METHODS Researchers conducted structured cognitive interviews with a diverse sample of thirty-eight adults in the Southeastern United States (US). Interview transcripts were qualitatively analyzed using MAXQDA, in a process of reiterative coding. RESULTS Results show that respondents interpret the survey questions in markedly different ways, with some interpreting the scale as asking about negative interactions; others viewing it through a lens of social inequalities; and still others through a lens specifically of racism. Racial/ethnic and gender statuses may structure question interpretation. CONCLUSIONS Pronounced and patterned variation in respondents' interpretation raises questions about its validity. Findings underscore the importance of schemas for assessing the meaning of data generated by the EDS and for measuring the health effects of perceived discrimination and mistreatment.
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Lanaway D, Burlew AK. The Influence of Distressed Coping on the Relationship between Perceived Racial Discrimination and Cannabis Use among Black College Students. J Psychoactive Drugs 2021; 53:404-412. [PMID: 34694206 DOI: 10.1080/02791072.2021.1990443] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Approximately one in five Black students report cannabis use, which is associated with academic challenges, mental health, and interpersonal problems. Understanding motivators to use cannabis among Black students at predominantly White institutions (PWIs) warrants more research. Perceived racial discrimination (PRD), believing one is treated unjustly due to race, is related to substance use and variables associated with poor coping, such as depression and anxiety. Given that research is unavailable for Black college students on the factor structure of the Everyday Discrimination Scale (EDS) using chronicity-based coding, the first aim of the study is to examine the factor structure of the chronicity-based version of the EDS. The second aim is to investigate whether distressed coping is an intervening construct between PRD and cannabis use among Black college students. Participants, recruited from a midwestern PWI (N = 119), completed the EDS, the coping subscale of the Comprehensive Marijuana Motivations Measure, and reported past-year cannabis use. Factor analysis examined the measurement model of the EDS, while path analysis assessed the mediation models. A two-factor model assessing subtle and blatant PRD on the EDS fit the data. The path analysis revealed that distressed coping fully mediated the relationship between subtle PRD and cannabis use. Distressed coping did not mediate the relation between blatant PRD and cannabis use. Institutions might focus on reducing PRD and provide support to Black students to lessen its link to distressed coping and cannabis use.
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Affiliation(s)
- Danni Lanaway
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, 75390, USA
| | - A Kathleen Burlew
- Department of Psychology, University of Cincinnati, Cincinnati, Ohio, USA
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Brown P, Watts V, Hanna M, Rizk M, Tucker E, Saddlemire A, Peteet B. Two Epidemics and a Pandemic: The Collision of Prescription Drug Misuse and Racism during COVID-19. J Psychoactive Drugs 2021; 53:413-421. [PMID: 34694200 DOI: 10.1080/02791072.2021.1992048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The present study investigated the relationship between perceived racial discrimination and prescription drug misuse (PDM) among Asian, Black, and Latinx Americans during the COVID-19 crisis. U.S. racial/ethnic minorities may have been uniquely affected by two national and one global pandemic: the opioid crisis, racism, and COVID-19. Opioid death rates increased among many groups prior to the pandemic. This country witnessed an increase in racialized acts against people of color across the spectrum in the spring and summer months of the world's COVID-19 outbreak. While studies have shown a clear link between perceived racial discrimination and substance abuse outside of the global pandemic, no identified studies have done so against the backdrop of a global health pandemic. Separate hierarchical regressions revealed a significant association between perceived racial discrimination and PDM for Black Americans, Asian Americans, and Latinx individuals. Findings build on the scant literature on PDM in diverse samples and establish a relationship between perceived racial discrimination and PDM, as previously identified for other abused substances. Future post-pandemic substance misuse interventions should consider the influence of perceived racial discrimination as they help individuals recover from the aftermath of this stressful trifecta.
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Affiliation(s)
- P Brown
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - V Watts
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - M Hanna
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - M Rizk
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - E Tucker
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - A Saddlemire
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - B Peteet
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
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47
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Lopez-Vergara HI, Yang M, Weiss NH, Stamates AL, Spillane NS, Feldstein Ewing SW. The cultural equivalence of measurement in substance use research. Exp Clin Psychopharmacol 2021; 29:456-465. [PMID: 34242041 PMCID: PMC8511178 DOI: 10.1037/pha0000512] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Across a wide range of substance use outcomes, ethnic/racial minorities in the U.S. experience a disproportionately higher burden of negative health outcomes and/or lower levels of access to care (relative to non-Latinx White individuals). Various explanations for these substance use-related health disparities have been proposed. This narrative review will not focus on the theoretical content of these explanations but will instead focus on the underlying statistical frameworks that are used to test such theories. Here, we provide a narrative review of psychometric critiques of cross-cultural research, which collectively suggest that (a) research testing similarities and differences among ethnic/racial groups often miss or omit to test statistical assumptions of equal instrument functioning across the ethnic/racial groups being compared; (b) testing the assumptions of equal instrument functioning is feasible using established guidelines from modern measurement theories; and (c) substance use research may need to explicitly incorporate the tests of equal instrument functioning to prevent bias when making inferences across ethnic/racial groups. We provide recommendations for evaluating the cultural equivalence of measurement using structural equation modeling, and advocate that cross-cultural substance use research move toward statistical approaches that are better positioned to test for (and model) bias in measurement. Explicitly testing the cultural equivalence of measurement when making inferences across cultural groups (within a falsifiable psychometric framework) can advance our understanding of similarities and differences among ethnic/racial groups, and hence can provide a more socially just (and statistically robust) scientific base. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Manshu Yang
- Department of Psychology, University of Rhode Island
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Bromfield SG, Sullivan S, Saelee R, Elon L, Lima B, Young A, Uphoff I, Li L, Quyyumi A, Bremner JD, Vaccarino V, Lewis TT. Race and Gender Differences in the Association Between Experiences of Everyday Discrimination and Arterial Stiffness Among Patients With Coronary Heart Disease. Ann Behav Med 2021; 54:761-770. [PMID: 32227162 PMCID: PMC7516092 DOI: 10.1093/abm/kaaa015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Self-reported experiences of discrimination have been linked to indices of cardiovascular disease. However, most studies have focused on healthy populations. Thus, we examined the association between experiences of everyday discrimination and arterial stiffness among patients with a history of myocardial infarction (MI). PURPOSE We hypothesized that higher reports of discrimination would be associated with greater arterial stiffness and that associations would be more pronounced among Black women, in particular, relative to other race-gender groups, using an "intersectionality" perspective. METHODS Data were from 313 participants (49.2% female, mean age: 50.8 years) who were 6 months post-MI in the Myocardial Infarction and Mental Stress 2 study. Data were collected via self-reported questionnaires, medical chart review, and a clinic visit during which arterial stiffness was measured noninvasively using pulse wave velocity. RESULTS Reports of discrimination were highest in Black men and women and arterial stiffness was greatest in Black and White women. After adjustment for demographics and relevant clinical variables, discrimination was not associated with arterial stiffness in the overall study sample. However, discrimination was associated with increased arterial stiffness among Black women but not White women, White men, or Black men. CONCLUSIONS Despite no apparent association between discrimination and arterial stiffness in the overall study sample, further stratification revealed an association among Black women but not other race-gender groups. These data not only support the utility of an intersectionality lens but also suggest the importance of implementing psychosocial interventions and coping strategies focused on discrimination into the care of clinically ill Black women.
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Affiliation(s)
- Samantha G Bromfield
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Samaah Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ryan Saelee
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lisa Elon
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Bruno Lima
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Division of Cardiology, School of Medicine, Emory University, Atlanta, GA, USA
| | - An Young
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Division of Cardiology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Irina Uphoff
- Division of Cardiology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Lian Li
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Arshed Quyyumi
- Division of Cardiology, School of Medicine, Emory University, Atlanta, GA, USA
| | - J Douglas Bremner
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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49
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Srivastav A, Robinson-Ector K, Kipp C, Strompolis M, White K. Who declines to respond to the reactions to race module?: findings from the South Carolina Behavioral Risk Factor Surveillance System, 2016-2017. BMC Public Health 2021; 21:1703. [PMID: 34537021 PMCID: PMC8449882 DOI: 10.1186/s12889-021-11748-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 08/29/2021] [Indexed: 12/03/2022] Open
Abstract
Background The inclusion of self-reported differential treatment by race/ethnicity in population-based public health surveillance and monitoring systems may provide an opportunity to address long-standing health inequalities. While there is a growing trend towards decreasing response rates and selective non-response in health surveys, research examining the magnitude of non-response related to self-reported discrimination warrants greater attention. This study examined the distribution of sociodemographic variables among respondents and non-respondents to the South Carolina Behavioral Risk Factor Surveillance System (SC-BRFSS) Reactions to Race module (6-question optional module capturing reports of race-based treatment). Methods Using data from SC-BRFSS (2016, 2017), we examined patterns of non-response to the Reactions to Race module and individual items in the module. Logistic regression models were employed to examine sociodemographic factors associated with non-response and weighted to account for complex sampling design. Results Among 21,847 respondents, 15.3% were non-responders. Significant differences in RTRM non-response were observed by key sociodemographic variables (e.g., age, race/ethnicity, labor market participation, and health insurance status). Individuals who were younger, Hispanic, homemakers/students, unreported income, and uninsured were over-represented among non-respondents. In adjusted analyses, Hispanics and individuals with unreported income were more likely to be non-responders in RTRM and across item, while retirees were less likely to be non-responders. Heterogeneity in levels of non-responses were observed across RTRM questions, with the highest level of non-response for questions assessing differential treatment in work (54.8%) and healthcare settings (26.9%). Conclusions Non-responders differed from responders according to some key sociodemographic variables, which could contribute to the underestimation of self-reported discrimination and race-related differential treatment and health outcomes. While we advocate for the use of population-based measures of self-reported racial discrimination to monitor and track state-level progress towards health equity, future efforts to estimate, assess, and address non-response variations by sociodemographic factors are warranted to improve understanding of lived experiences impacted by race-based differential treatment. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11748-y.
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Affiliation(s)
| | - Kaitlynn Robinson-Ector
- Department of Health Policy and Management, University of Maryland School of Public Health, College Park, MD, USA
| | - Colby Kipp
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | | | - Kellee White
- Department of Health Policy and Management, University of Maryland School of Public Health, College Park, MD, USA.
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50
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Scheim AI, Bauer GR, Bastos JL, Poteat T. Advancing Intersectional Discrimination Measures for Health Disparities Research: Protocol for a Bilingual Mixed Methods Measurement Study. JMIR Res Protoc 2021; 10:e30987. [PMID: 34459747 PMCID: PMC8438612 DOI: 10.2196/30987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/05/2021] [Indexed: 01/27/2023] Open
Abstract
Background Guided by intersectionality frameworks, researchers have documented health disparities at the intersection of multiple axes of social status and position, particularly race and ethnicity, gender, and sexual orientation. To advance from identifying to intervening in such intersectional health disparities, studies that examine the underlying mechanisms are required. Although much research demonstrates the negative health impacts of perceived discrimination along single axes, quantitative approaches to assessing the role of discrimination in generating intersectional health disparities remain in their infancy. Members of our team recently introduced the Intersectional Discrimination Index (InDI) to address this gap. The InDI comprises three measures of enacted (day-to-day and major) and anticipated discrimination. These attribution-free measures ask about experiences of mistreatment because of who you are. These measures show promise for intersectional health disparities research but require further validation across intersectional groups and languages. In addition, the proposal to remove attributions is controversial, and no direct comparison has ever been conducted. Objective This study aims to cognitively and psychometrically evaluate the InDI in English and Spanish and determine whether attributions should be included. Methods The study will draw on a preliminary validation data set and three original sequentially collected sources of data: qualitative cognitive interviews in English and Spanish with a sample purposively recruited across intersecting social status and position (gender, sexual orientation, race and ethnicity, socioeconomic status, age, and nativity); a Spanish quantitative survey (n=500; 250/500, 50% sexual and gender minorities); and an English quantitative survey (n=3000), with quota sampling by race and ethnicity (Black, Latino/a/x, and White), sexual or gender minority status, and gender. Results The study was funded by the National Institute on Minority Health and Health Disparities in May 2021, and data collection began in July 2021. Conclusions The key deliverables of the study will be bilingual measures of anticipated, day-to-day, and major discrimination validated for multiple health disparity populations using qualitative, quantitative, and mixed methods. International Registered Report Identifier (IRRID) PRR1-10.2196/30987
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Affiliation(s)
- Ayden I Scheim
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Greta R Bauer
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - João L Bastos
- Department of Public Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Tonia Poteat
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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