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Abrams LR, Zhang YS, Munsey AD, Farah MA, Brown LL. Working Through It: Lifetime Experiences of Employment Discrimination Among Older Black Americans and Implications for Labor Force Participation, Job Dissatisfaction, and Mental Health in Older Adulthood. J Aging Health 2024:8982643241259781. [PMID: 38881277 DOI: 10.1177/08982643241259781] [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: 06/18/2024]
Abstract
OBJECTIVES To examine lifetime experiences of employment discrimination and their association with Black older adults' employment status and well-being. METHODS We use data from the Health and Retirement Study's leave-behind questionnaire to characterize lifetime experiences of being unfairly fired, not hired, or not promoted among Black older adults (N = 2948) and test associations with labor force status at age 62, job satisfaction among those working, and depressive symptoms. RESULTS Employment discrimination was commonly reported by Black older adults, especially among men and those with college educations. Employment discrimination was not associated with employment status at age 62 but was associated with job dissatisfaction (OR = 2.00, p = .001) and depressive symptoms (Beta = 0.34, p < .001). DISCUSSION Findings suggest a negative association between employment discrimination at any point in the life course and Black older adults' well-being. Employment discrimination is an obstacle to healthy aging, yet improved discrimination survey items are needed to fully capture its impact on Black Americans.
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Affiliation(s)
- Leah R Abrams
- Department of Community Health, Tufts University, Boston, MA, USA
| | - Yuan S Zhang
- Department of Sociomedical Sciences and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Ayisha D Munsey
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Muna A Farah
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Lauren L Brown
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
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Hynes KC, Russell BS, Tambling RR, Park CL, Fendrich M. Subjective Stress Appraisals Over Time: the Evolving Structure of the COVID-19 Stressor Scale. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024:10.1007/s11121-024-01694-7. [PMID: 38862829 DOI: 10.1007/s11121-024-01694-7] [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] [Accepted: 06/03/2024] [Indexed: 06/13/2024]
Abstract
The COVID-19 Stressors Scale measures individuals' appraisals of stressors related to the pandemic. Measurement of perceptions of stressors is necessary to understand the socioemotional impacts of not only the COVID-19 pandemic, but other disasters. The study examined the factor structure of the scale among adults in the U.S. over six time points. A shortened version was used, and the fit was examined over time. The results of the study show contextual appraisals change over time and offer important implications for the measurement of stressfulness of disasters, a critical step in designing and assessing impacts of social programs aimed to reduce the deleterious effects of disasters.
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Affiliation(s)
- Kevin C Hynes
- Counseling, Rehabilitation, and Human Services, University of Wisconsin-Stout, 221 10th Avenue E, Menomonie, WI, 54751, USA.
| | - Beth S Russell
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269-1058, USA
| | - Rachel R Tambling
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269-1058, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Rd, U-1020, Storrs, CT, 06269-1020, USA
| | - Michael Fendrich
- School of Social Work, University of Connecticut, 38 Prospect Street, Hartford, CT, 06103, USA
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Choi E, Berkman AM, Battle A, Betts AC, Salsman JM, Milam J, Andersen CR, Miller KA, Peterson SK, Lu Q, Cheung CK, Livingston JA, Hildebrandt MAT, Parsons SK, Freyer DR, Roth ME. Psychological distress and mental health care utilization among Black survivors of adolescent and young adult cancer. Cancer 2024. [PMID: 38676935 DOI: 10.1002/cncr.35348] [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: 11/07/2023] [Revised: 02/05/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Survivors of adolescent and young adult (AYA) cancer experience significant psychological distress and encounter barriers to accessing mental health care. Few studies have investigated racial/ethnic disparities in psychological health outcomes among AYA survivors, and none have compared outcomes within a racially minoritized population. METHODS National Health Interview Survey data (2010-2018) were analyzed that identified non-Hispanic Black (hereafter, Black) survivors of AYA cancer and age- and sex-matched Black noncancer controls. Sociodemographic factors, chronic health conditions, modifiable behaviors (smoking and alcohol use), and psychological outcomes were assessed with χ2 tests. Logistic regression models, adjusted for survey weights, were used to evaluate the odds of psychological distress by cancer status after adjusting for covariates. Interactions between variables and cancer status were investigated. RESULTS The study included 334 Black survivors of AYA cancer and 3340 Black controls. Compared to controls, survivors were more likely to report moderate/severe distress (odds ratio [OR], 1.64; p < .001), use mental health care (OR, 1.53; p = .027), report an inability to afford mental health care (OR, 3.82; p < .001), and use medication for anxiety and/or depression (OR, 2.16; p = .001). Forty-one percent of survivors reported moderate/severe distress, and only 15% used mental health care. Among survivors, ages 18-39 years (vs. 40-64 years) and current smoking (vs. never smoking) were associated with the presence of moderate/severe distress. Among survivors with distress, high poverty status was associated with reduced utilization of mental health care. CONCLUSIONS A cancer diagnosis for a Black AYA is associated with greater psychological distress within an already vulnerable population.
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Affiliation(s)
- Eunju Choi
- Department of Nursing, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Amy M Berkman
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Aryce Battle
- McGovern Medical School, University of Texas Health Science Center, Houston, Texas, USA
| | - Andrea C Betts
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Joel Milam
- Department of Epidemiology and Biostatistics, University of California, Irvine, California, USA
| | - Clark R Andersen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kimberly A Miller
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Qian Lu
- Division of Cancer Prevention and Population Sciences, Department of Health Disparities Research, The University of Texas MD Anderson Cancer Institute, Houston, Texas, USA
| | | | - J A Livingston
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michelle A T Hildebrandt
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Susan K Parsons
- Institute for Clinical Research and Health Policy Studies and Division of Hematology/Oncology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - David R Freyer
- Departments of Pediatrics, Medicine, and Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Michael E Roth
- Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Floyd James K, Chen K, Hindra SS, Gray S, Robinson MN, Tobin CST, Choi K, Saint Arnault D. Racism-related stress and mental health among black women living in Los Angeles County, California: A comparison of postpartum mood and anxiety disorder screening scales. Arch Womens Ment Health 2024:10.1007/s00737-024-01458-w. [PMID: 38561564 DOI: 10.1007/s00737-024-01458-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE To assess Black women's exposure to and appraisal of racism-related stress during the postpartum period and to distinguish its impact on three indicators of postpartum mood and anxiety disorders (PMADs) symptoms. METHODS Data from the Black Mothers' Mental Wellness Study (N = 231) and linear regression models estimated the associations between racism-related stress and the PMAD indicators: 3-item Edinburgh Postnatal Depression Scale (EPDS-3), 8-item Patient Health Questionnaire (PHQ-8), and PHQ-15. RESULTS The majority of participants (80.5%, N = 186) experienced racism a few times a year or more, of which 37.1% (N = 69) were bothered somewhat and 19.3% (N = 36) a lot. Racism-related stress, income, level of education, and history of mental health diagnosis explained greater variance in PMAD symptoms as measured by the PHQ-8 score (R2 = 0.58, p = < 0.001) compared to the EPDS-3 (R2 = 0.46, p = < 0.001) or the PHQ-15 (R2 = 0.14, p = 0.035). CONCLUSIONS Racism is a stressor for Black women living in Los Angeles County, California. Racism-related stress and emotional expression of PMAD symptoms were salient to the postpartum mental health of the Black women in this study. Findings from this study suggest that the PHQ-8 should be used to assess how racism impacts Black women's postpartum mental health.
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Affiliation(s)
- Kortney Floyd James
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA.
- RAND Corporation, Santa Monica, CA, USA.
| | - Keren Chen
- David Geffen School of Medicine, Department of Medicine Statistics Core, University of California, Los Angeles, Los Angeles, CA, USA
| | - Sasha S Hindra
- University of California Irvine, Sue & Bill Gross School of Nursing, Irvine, CA, USA
| | | | - Milllicent N Robinson
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Courtney S Thomas Tobin
- Jonathan and Karin Fielding School of Public Health, Department of Community Health Sciences), University of California Los Angeles, Los Angeles, CA, USA
| | - Kristen Choi
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
- Fielding School of Public Health, Department of Health Policy and Management, University of California Los Angeles, Los Angeles, CA, USA
| | - Denise Saint Arnault
- School of Nursing, Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, MI, USA
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Smith NC. Residential segregation and Black-White differences in physical and mental health: Evidence of a health paradox? Soc Sci Med 2024; 340:116417. [PMID: 38007966 DOI: 10.1016/j.socscimed.2023.116417] [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: 08/15/2023] [Revised: 10/30/2023] [Accepted: 11/09/2023] [Indexed: 11/28/2023]
Abstract
Ample research finds that residential segregation is detrimental to Black Americans' physical health and exacerbates Black-White physical health disparities. However, less is known about how residential segregation may influence Black Americans' mental health and Black-White differences in mental health. Drawing on U.S. census data and a state representative study of Indiana residents (N = 2,685), I examine associations between residential segregation and multiple dimensions of physical and mental health. Consistent with past research, I find that residential segregation has an adverse association with physical health among Black respondents. In contrast, I find residential segregation to have a salubrious association with Black respondents' mental health, producing a Black mental health advantage at higher levels of segregation. I conclude by discussing the implications of these findings for research on residential segregation and health and the Black-White mental health paradox.
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Affiliation(s)
- Nicholas C Smith
- University of Maryland, Department of Sociology, 3141 Parren J. Mitchell Art-Sociology Building, RM 3137, College Park, MD, 20742, USA.
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Jardon C, Choi KR. COVID-19 Experiences and Mental Health Among Graduate and Undergraduate Nursing Students in Los Angeles. J Am Psychiatr Nurses Assoc 2024; 30:86-94. [PMID: 35034499 DOI: 10.1177/10783903211072222] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Nurses and nursing students are at risk for negative mental health as a result of significant work stressors from the COVID-19 pandemic. AIMS The purpose of this study was to (1) describe the mental health of nursing students during the COVID-19 pandemic, (2) investigate relationships between stressful COVID-19 experiences and mental health, and (3) examine correlates of mental health service use. METHOD This observational study used a web-based survey to assess COVID-19 experiences, self-reported mental health, and mental health service utilization among nursing students in Los Angeles in spring 2021 (N = 174, 30.1% response rate). The survey used measures of stressful COVID-19 experiences (personal COVID-19 illness, hospitalization of close friends or family, and death of close friends or family), loneliness, resilience, depression, anxiety, COVID-19-related traumatic stress, and utilization of campus and noncampus mental health services. RESULTS Students had high levels of depression (30%), anxiety (38%), and traumatic stress (30%). There was no relationship between stressful COVID-19 experiences and mental health, but loneliness was associated with higher odds of mental health problems and resilience with lower odds. Mental health problems were not associated with use of campus or noncampus mental health services. Students with primary caregiving responsibilities (OR = 0.22, 95% CI [0.05, 0.87]) and students who identified as Asian/Pacific Islander (OR = 0.24, 95% CI [0.09, 0.70]) had lower odds of mental health service utilization. CONCLUSIONS Resilience and loneliness affect nursing student risk for negative mental health as a result of the COVID-19 pandemic. Targeted, accessible mental health support within nursing education programs may be warranted.
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Affiliation(s)
- Cecilia Jardon
- Cecilia Jardon, University of California, Los Angeles, CA, USA
| | - Kristen R Choi
- Kristen R. Choi, PhD, RN, FAAN, University of California, Los Angeles, CA, USA
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Brown MJ, Adkins-Jackson PB, Sayed L, Wang F, Leggett A, Ryan LH. The Worst of Times: Depressive Symptoms Among Racialized Groups Living With Dementia and Cognitive Impairment During the COVID-19 Pandemic. J Aging Health 2023:8982643231223555. [PMID: 38128585 DOI: 10.1177/08982643231223555] [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: 12/23/2023]
Abstract
Objective: To explore differences in depressive symptoms for older adults (Black, Latinx, and White) by cognitive status during the 2020 COVID-19 pandemic. Methods: Data from the Health and Retirement Study identified older adults as cognitively normal, cognitively impaired without dementia (CIND), and persons living with dementia (PLWD). Multiple linear regression analyses examined associations between cognitive status and depressive symptoms among these racialized groups. Results: Compared to the cognitively normal older adults racialized as Black, those with CIND reported higher depressive symptoms during the pandemic (overall and somatic) and PLWD had higher somatic symptoms (p < .01). Older adults racialized as White with CIND reported higher somatic (p < .01) symptoms compared to cognitively normal older adults racialized as White. Discussion: The COVID-19 pandemic was a challenging event among older adults racialized as Black with CIND and PLWD. Future studies should examine if these depressive symptoms persist over time.
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Affiliation(s)
- Monique J Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Paris B Adkins-Jackson
- Departments of Epidemiology and Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Linda Sayed
- James Madison College and College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Fei Wang
- College of Social Work, University of Tennessee, Knoxville, TN, USA
| | - Amanda Leggett
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Lindsay H Ryan
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Morris MC, Goodin BR, Bruehl S, Myers H, Rao U, Karlson C, Huber FA, Nag S, Carter C, Kinney K, Dickens H. Adversity type and timing predict temporal summation of pain in African-American adults. J Behav Med 2023; 46:996-1009. [PMID: 37563499 PMCID: PMC10592130 DOI: 10.1007/s10865-023-00440-8] [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: 09/14/2022] [Accepted: 07/25/2023] [Indexed: 08/12/2023]
Abstract
African Americans are disproportionately exposed to adversity across the lifespan, which includes both stressful and traumatic events. Adversity, in turn, is associated with alterations in pain responsiveness. Racial differences in pain responsiveness among healthy adults are well established. However, the extent to which adversity type and timing are associated with alterations in pain responsiveness among healthy African-American adults is not well understood. The present study included 160 healthy African-American adults (98 women), ages 18 to 45. Outcome measures included pain tolerance and temporal summation of pain to evoked thermal pain. Composite scores were created for early-life adversity (childhood trauma, family adversity) and recent adversity (perceived stress, chronic stress burden). A measure of lifetime racial discrimination was also included. Higher levels of recent adversity were associated with higher temporal summation of pain, controlling for gender, age, and education. Neither early-life adversity nor lifetime racial discrimination were associated with temporal summation of pain. The present findings suggest that heightened temporal summation of pain among healthy African-American adults is associated with exposure to recent adversity events. Improved understanding of how recent adversity contributes to heightened temporal summation of pain in African Americans could help to mitigate racial disparities in pain experiences by identifying at-risk individuals who could benefit from early interventions.
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Affiliation(s)
- Matthew C Morris
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA.
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA.
- , 2525 West End Ave, Nashville, TN, 37206, USA.
| | - Burel R Goodin
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, England
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Stephen Bruehl
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hector Myers
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Uma Rao
- Department of Psychiatry & Human Behavior and Center for the Neurobiology of Learning and Memory, University of California - Irvine, California, CA, USA
- Children's Hospital of Orange County, Orange, CA, USA
| | - Cynthia Karlson
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Pediatrics, Hematology and Oncology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Felicitas A Huber
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - Subodh Nag
- Department of Biochemistry, Cancer Biology, Neuroscience & Pharmacology, Meharry Medical College, Nashville, TN, USA
| | - Chelsea Carter
- Department of Biochemistry, Cancer Biology, Neuroscience & Pharmacology, Meharry Medical College, Nashville, TN, USA
| | - Kerry Kinney
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - Harrison Dickens
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
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LaMotte ME, Elliott M, Mouzon DM. Revisiting the Black-White Mental Health Paradox During the Coronavirus Pandemic. J Racial Ethn Health Disparities 2023; 10:2802-2815. [PMID: 36441494 PMCID: PMC9707209 DOI: 10.1007/s40615-022-01457-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 11/29/2022]
Abstract
Black Americans have lower rates of depression and anxiety than Whites, despite greater exposure to stressors known to negatively impact mental health, characterized as the Black-White mental health paradox. This study revisited the paradox during the coronavirus pandemic. Drawing on stress process theory, minority stress theory, and the rejection-identification model of discrimination, in-group identity, and well-being, we analyzed original survey data from a quota sample of African American and White adults (N = 594). The survey included a range of stressors and coping resources, including those relevant to the pandemic (e.g., COVID-19 illness) and race (e.g., witnessing anti-Black police violence). Results indicate that despite African Americans' greater exposure and vulnerability to racial discrimination, the Black-White mental health paradox holds, owing in part to protective effects of African American's higher self-esteem. Directions for future exploration of the paradox are presented based on this study's findings.
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Affiliation(s)
- Megan E LaMotte
- Interdisciplinary Social Psychology Program, University of Nevada, Reno, 1664 N Virginia St, Reno, NV, 89557, USA.
| | - Marta Elliott
- Department of Sociology, University of Nevada, Reno, Reno, NV, USA
| | - Dawne M Mouzon
- Department of Sociology, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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Horne CE, Abel WM, Crane PB. Fatigue, Stress, and Blood Pressure Medication Adherence by Race After Myocardial Infarction. J Nurse Pract 2023; 19:104757. [PMID: 37810177 PMCID: PMC10552602 DOI: 10.1016/j.nurpra.2023.104757] [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] [Indexed: 10/10/2023]
Abstract
Fatigue and stress may affect medication adherence. This study explored fatigue, stress, and blood pressure (BP) medication adherence in Black and White adults (N= 152) who had experienced a myocardial infarction. Over half of the sample (55%) reported fatigue as moderate to severe. The regression model explained up to 40% of the variance (p < .001) with fatigue and race significantly predicting adherence. Black participants reported fatigue causing distress (r =.40), and White participants reported greater association of fatigue severity-related BP medication adherence (r =.49). Our findings support considering racial differences when evaluating fatigue associated with BP medication adherence.
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Affiliation(s)
- Carolyn E Horne
- School of Nursing, The University of North Carolina, Charlotte, NC
| | - Willie M Abel
- School of Nursing, The University of North Carolina, Charlotte, NC
| | - Patricia B Crane
- School of Nursing, The University of North Carolina, Charlotte, NC
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11
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Gayman MD, Stover S, Tsukerman K, Nielsen K, Wilkin H. Physical Limitations, Health Rumination/Worry, and Depressive Symptoms: Gender Differences among African Americans. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01721-3. [PMID: 37490211 DOI: 10.1007/s40615-023-01721-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 06/23/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023]
Abstract
Although studies have documented the relationships between physical health, health rumination/worry, and mental health, few investigations have assessed these linkages within African American communities. Using a community-based sample of residents in historically lower-income, African American communities (N = 306), this study assesses the mediating role of health rumination/worry in the physical limitation-depressive symptom relationship, and the moderating effect of gender on the relationship between health rumination/worry-depressive symptoms. Findings demonstrate that health rumination/worry explains half of the physical limitation-depressive symptom relationship, and the relationship between health rumination/worry and depressive symptoms is stronger for African American men than women. The findings underscore the importance of intersectional research for policy efforts aimed at reducing mental health morbidities within African American communities.
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Affiliation(s)
- Mathew D Gayman
- Georgia State University, Atlanta, GA, USA.
- Department of Sociology, Georgia State University, P.O. Box 5020, Atlanta, GA, 30302-5020, USA.
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12
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Jester DJ, Kohn JN, Tibiriçá L, Thomas ML, Brown LL, Murphy JD, Jeste DV. Differences in Social Determinants of Health Underlie Racial/Ethnic Disparities in Psychological Health and Well-Being: Study of 11,143 Older Adults. Am J Psychiatry 2023; 180:483-494. [PMID: 37038741 PMCID: PMC10329971 DOI: 10.1176/appi.ajp.20220158] [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] [Indexed: 04/12/2023]
Abstract
OBJECTIVE The authors sought to determine the impact of selected social determinants of health (SDoH) on psychological health and well-being (defined as depression, cognition, and self-rated health) among Black and Hispanic/Latinx adults relative to White adults 51-89 years of age. METHODS Disparities in depressive symptomatology, cognition, and self-rated health were measured among 2,306 non-Hispanic/Latinx Black, 1,593 Hispanic/Latinx, and 7,244 non-Hispanic/Latinx White adults who participated in the Health and Retirement Study (N=11,143). Blinder-Oaxaca decomposition was used to examine whether differences in selected SDoH explained a larger share of the disparities than age, sex, measures of health, health behaviors, and health care utilization. Selected SDoH included education, parental education, number of years worked, marital status, veteran status, geographic residence, nativity status, income, and insurance coverage. RESULTS Black and Hispanic/Latinx adults reported worse depressive symptomatology, cognition, and self-rated health than White adults. Selected SDoH were associated with a larger proportion of the Black-White disparities in depressive symptomatology (51%), cognition (39%), and self-rated health (37%) than were age, sex, measures of health, health behaviors, and health care utilization. SDoH were associated with a larger proportion of the Hispanic/Latinx-White disparity in cognition (76%) and self-rated health (75%), but age and physical health correlated with the disparity in depressive symptomatology (28%). Education, parental education, years worked, income, and insurance parity were SDoH associated with these disparities. CONCLUSIONS Differences in SDoH underlie racial/ethnic disparities in depression, cognition, and self-rated health among older adults. Education, income, number of years worked, and insurance parity are key SDoH.
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Affiliation(s)
- Dylan J. Jester
- Department of Psychiatry, University of California San Diego, La Jolla, CA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - Jordan N. Kohn
- Department of Psychiatry, University of California San Diego, La Jolla, CA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - Lize Tibiriçá
- Department of Psychiatry, University of California San Diego, La Jolla, CA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - Michael L. Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO
| | - Lauren L. Brown
- Divison of Health Management and Policy, School of Public Health, San Diego State University, San Diego, CA
| | - James D. Murphy
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
| | - Dilip V. Jeste
- Department of Psychiatry, University of California San Diego, La Jolla, CA
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Kohn JN, Lobo JD, Troyer EA, Wilson KL, Ang G, Walker AL, Pruitt C, Pung MA, Redwine LS, Hong S. Tai chi or health education for older adults with hypertension: effects on mental health and psychological resilience to COVID-19. Aging Ment Health 2023; 27:496-504. [PMID: 35311437 PMCID: PMC9489818 DOI: 10.1080/13607863.2022.2053836] [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: 12/28/2021] [Accepted: 03/04/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To compare the effectiveness of 12 weeks of community-based, in-person, group Tai Chi (TC) and Health Education (HAP-E) in improving health and wellbeing in older adults with hypertension and in promoting psychological resilience during COVID-19. METHODS A 12-week randomized controlled trial (RCT) in San Diego County, USA. Self-reported depressive symptoms, anxiety, sleep disturbances, gratitude, resilience, mental and physical health were assessed in-person pre- and post-intervention, and by long-term follow-up surveys during COVID-19. Linear mixed-effects models were used to assess study arm differences over time and logistic regression to identify predictors of positive intervention response. RESULTS Of 182 randomized participants (72.6 ± 7.9 yrs; 72% female), 131 completed the intervention. Modest improvements in health and wellbeing occurred post-intervention in both arms (Cohen's d: TC = 0.38, 95% CI: 0.25-0.51; HAP-E = 0.24, 0.11-0.37), though positive intervention responses were more than twice as likely in TC (OR = 2.29, 1.07-4.57). Younger age, higher anxiety, and poorer mental health at baseline predicted greater odds of response. Small declines in health and wellbeing were reported at the first COVID-19 follow-up, with smaller declines in the TC arm (Cohen's d: TC = -0.15, -0.31-0.00; HAP-E = -0.34, -0.49 to -0.19). Health and wellbeing stabilized at the second COVID-19 follow-up. Most participants (>70%) reported that the interventions benefitted their health and wellbeing during COVID-19. CONCLUSION TC and HAP-E improved health and wellbeing, though TC conferred greater odds of an improved mental health response. Declines in health and wellbeing were observed at pandemic follow-up, with smaller declines in the TC arm, suggesting increased resilience.
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Affiliation(s)
- Jordan N. Kohn
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA 92093
| | - Judith D. Lobo
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093
| | - Emily A. Troyer
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093
| | - Kathleen L. Wilson
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA 92093
| | - Gavrila Ang
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093
| | - Amanda L. Walker
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA 92093
| | - Christopher Pruitt
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA 92093
| | - Meredith A. Pung
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA 92093
| | - Laura S. Redwine
- College of Behavioral and Community Sciences, University of South Florida, Tampa, FL
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL
| | - Suzi Hong
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA 92093
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14
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Tran S, Wormley AS, Louie P, Sheehan C. Increasing psychological distress among Californians from 2013 to 2020: Race/ethnic differences. SSM - MENTAL HEALTH 2022; 2:100101. [PMID: 36590986 PMCID: PMC9792130 DOI: 10.1016/j.ssmmh.2022.100101] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/24/2022] [Accepted: 04/19/2022] [Indexed: 01/13/2023] Open
Abstract
The influence of the COVID-19 pandemic on mental health is of mounting concern to population-health researchers. While early reports indicated increases in mental health problems, noticeably absent from these studies is how mental health has changed in 2020 compared to previous years (2013-2019) and whether such trends vary by race/ethnicity. The present study used repeated cross-sectional data from the California Health Interview Survey (n = 168,216) to systematically document trends in psychological distress scores (Kessler-6 scale; K6) and severe psychological distress scores (K6; 13+) from 2013 to 2020 and by race/ethnicity over the same period. Among all Californians we find that the reported average psychological distress scores increased by 22% between 2013 and 2020. Reported severe psychological distress scores increased 61% from 2013 to 2020. These increases were largely concentrated in the years 2017-2020. Increases in psychological distress were also especially pronounced among non-Latino/a White Californians (29% increase in K6 from 2013 to 2020), Latino/a Californians (14% increase in K6 from 2013 to 2020), and Asian Californians (35% increase in K6 from 2013 to 2020). Multiple and logistic regression models that accounted for sociodemographic and behavioral health covariates echoed these findings. Future research should continue to investigate secular trends in mental health that coincided with the COVID-19 pandemic and carefully situate the shifts into broader temporal perspective.
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Affiliation(s)
- Sydney Tran
- Department of Psychology, Arizona State University, USA
| | | | | | - Connor Sheehan
- School of Social and Family Dynamics, Arizona State University, USA,Corresponding author. P.O. Box 873701, Tempe, AZ, 85287-3701, USA
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15
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Lockwood KG, Peddie L, Crosswell AD, Hives BA, Slopen N, Almeida DM, Puterman E. Effects of Chronic Burden Across Multiple Domains and Experiences of Daily Stressors on Negative Affect. Ann Behav Med 2022; 56:1056-1067. [PMID: 35195708 PMCID: PMC9528775 DOI: 10.1093/abm/kaac001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Exposure to chronic psychological stress across multiple life domains (multi-domain chronic burden) is associated with poor health. This may be because multi-domain chronic burden influences daily-level emotional processes, though this hypothesis has not been thoroughly tested. PURPOSE The current study tested whether (a) multi-domain chronic burden is associated with greater exposure to daily stressors and (b) multi-domain chronic burden compounds negative affect on days with stressors compared to stressor-free days. METHODS The MIDUS Study (Wave II) and the National Study of Daily Experiences sub-study were conducted from 2004 to 2006 (N = 2,022). Participants reported on eight life domains of psychological stress used to create a multi-domain chronic burden summary score. For eight consecutive days, participants reported the daily occurrence of stressful events and daily negative affect. RESULTS Participants with greater multi-domain chronic burden were significantly more likely to report daily stressors. There was also a significant interaction between multi-domain chronic burden and daily stressors on negative affect: participants with higher multi-domain chronic burden had greater negative affect on stressor days than stressor-free days compared to those with lower multi-domain chronic burden. CONCLUSION Participants with higher multi-domain chronic burden were more likely to report daily stressors and there was a compounding effect of multi-domain chronic burden and daily stressors on negative affect. These results suggest that experiencing a greater amount of psychological stress across multiple life domains may make daily stressors more toxic for daily affect.
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Affiliation(s)
- Kimberly G Lockwood
- Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Luke Peddie
- School of Kinesiology, University of British Columbia, 210-6081 University Blvd, Vancouver, BC V6T1Z1, Canada
| | - Alexandra D Crosswell
- Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Benjamin A Hives
- School of Kinesiology, University of British Columbia, 210-6081 University Blvd, Vancouver, BC V6T1Z1, Canada
| | - Natalie Slopen
- Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - David M Almeida
- Human Development and Family Studies, Penn State University, University Park, PA,USA
| | - Eli Puterman
- School of Kinesiology, University of British Columbia, 210-6081 University Blvd, Vancouver, BC V6T1Z1, Canada
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16
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Wang K, Marbut AR, Suntai Z, Zheng D, Chen X. Patterns in older adults' perceived chronic stressor types and cognitive functioning trajectories: Are perceived chronic stressors always bad? Soc Sci Med 2022; 311:115297. [PMID: 36063593 DOI: 10.1016/j.socscimed.2022.115297] [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: 08/15/2021] [Revised: 07/15/2022] [Accepted: 08/12/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Previous studies have linked levels of perceived chronic stress to older adults' cognitive functioning, but few have focused on the impact of chronic stressor types. Thus, this study aimed to (1) identify patterns of chronic stressor types and (2) examine the effects of these patterns on cognitive functioning trajectories among older adults. METHODS Two longitudinal studies were conducted separately to test the study aims and ensure replicability across samples and time points. Both used three timepoints (Study 1: 2006, 2008, and 2010, n = 6974; Study 2: 2012, 2014, and 2016, n = 6604) collected from older Americans in the Health and Retirement Study. Participants did not overlap between the two studies. Latent class analyses were conducted to identify chronic stressor-type patterns. Latent growth curve models were used to test the effects of chronic stressor-type patterns on cognitive functioning trajectories. RESULTS Three latent classes of stressor types were identified in both studies: egocentric (4.56%; 5.85%), nonegocentric (8.58%; 10.03%), and low stressor (86.86%; 84.12%). In both studies, compared to the low stressor class, the egocentric stressor class had significantly lower initial cognitive scores (B = -0.72, ρ < 0.001; B = -0.46, ρ < 0.05), while the nonegocentric stressor class did not have significantly different initial scores, with covariates controlled. Additionally, in Study 1, the nonegocentric stressor class had significantly slower cognitive decline rates than the low stressor class (B = 0.11, ρ < 0.05). CONCLUSIONS Findings suggested that nonegocentric stressors are an important stressor source in late adulthood but are less detrimental to cognitive functioning than egocentric stressors. Health management interventions may reduce older adults' cognitive health disparities caused by self-health and financial stressors. More support, including financial subsidies, caregiver stress management training, or support groups, should be provided to older caregivers, especially those with few resources.
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Affiliation(s)
- Kun Wang
- School of Social Work, University of Alabama, Tuscaloosa, AL, USA, 35401; Department of Social Work, Binghamton University, Binghamton, NY, 13902, USA.
| | - Alexander R Marbut
- Department of Management, University of Alabama, Tuscaloosa, AL, USA, 35401
| | - Zainab Suntai
- School of Social Work, University of Alabama, Tuscaloosa, AL, USA, 35401; School of Social Work, Baylor University, Waco, TX, 76706, USA
| | - Dianhan Zheng
- Department of Psychological Science, Kennesaw State University, Kennesaw, GA, USA, 30144
| | - Xiayu Chen
- School of Social Work, University of Illinois Urbana-Champaign, Urbana, IL, USA, 61801
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17
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Lee J, Gao M, Lee C. Gendered racial disparities in health of parents with children with developmental disabilities. Front Psychol 2022; 13:926655. [PMID: 36118507 PMCID: PMC9479760 DOI: 10.3389/fpsyg.2022.926655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/13/2022] [Indexed: 11/18/2022] Open
Abstract
Background There is little information on (1) how adverse experiences in early life are associated with the risk of having a child with health problems and (2) whether the health of racial and gender minority groups would be particularly compromised if they have developmentally disabled (DD) children. Objective By integrating life-course perspectives and the intersectionality framework, we examine (1) the extent to which parents’ early-life adversities (ELAs) are associated with having children with DD or other health issues and (2) whether the association between having DD children and parental (physical and mental) health varies across race–gender groups after accounting for ELAs. Methods Using data from Black and White parents from the Midlife in the US Study (n = 7,425; 18% Black), we employed (1) multinomial logistic regression models to investigate the degree to which ELAs are associated with parenting types (having a child with DD, a child with recent illness, or a child without these health issues) and (2) multiple regression models with a three-way interaction term to investigate whether the gender–parenting type association differs by race. Results With more adversities, the probability of having children with health issues increases for all race–gender groups, but most dramatically for Black women. Having DD children is associated with more chronic illnesses and functional limitations for women than men, with the largest burden for Black women, yet neither gender nor racial differences in depressive symptoms. Our results highlight that while raising children with DD takes a toll on the health of all parents, the strain might be larger for Black mothers. Conclusion The adverse effects of parenting a child with DD is more pronounced for Black women than for other race–gender groups indicating opportunities to promote community-based programs for these parents.
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18
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Brown LL, García C, Reeves AN, Pamplin JR, Mitchell UA. Stress is a Latent Construct: Exploring the Differential Experience of Stress and Discrimination on Depressive Symptoms Among Black Older Adults. J Aging Health 2022; 34:334-346. [PMID: 35418259 PMCID: PMC9379938 DOI: 10.1177/08982643221086333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objectives: While evidence highlights the detrimental mental health consequences of chronic stress exposure, the impact of this stress exposure on older Black Americans' mental health varies by exposure to other types of stressors like discrimination as well as subjective evaluations of stress like chronic stress appraisal. Methods: Using data from the 2010/2012 Health and Retirement Study, we use latent profile analysis (LPA) to describe 2,415 Black older adults experience with chronic stress exposure, appraisal, and discrimination and examine which stress contexts are associated with depressive symptomology. Results: Analyses revealed five stress clusters-demonstrating the diversity in the stress experience for older Black adults. Black older adults with stress profiles that include lower stress appraisal report fewer depressive symptoms regardless of number of stress exposures. Discussion: LPA is as an alternative approach to examining the stress-mental health link that can define stress profiles by both exposure and appraisal-based measures.
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Affiliation(s)
- Lauren L. Brown
- School of Public Health Management and Policy, San Diego State University, San Diego, CA, USA
| | - Catherine García
- Human Development and Family Science, Aging Studies Institute, Center for Aging and Policy Studies, Lerner Center for Public Health Promotion, Syracuse University, Syracuse, NY, USA
| | - Alexis N. Reeves
- Department of Epidemiology and Population Health, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - John R. Pamplin
- Center for Urban Science and Progress, New York University, New York, NY, USA
- Center for Opioid Epidemiology and Policy, Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Uchechi A. Mitchell
- Division of Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL, USA
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19
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Abstract
OBJECTIVES African Americans experience relatively low rates of mental disorder despite being disproportionately exposed to psychosocial stressors. Coping is an understudied area that may help explain the mental health resilience among this population. METHODS Using data from the National Survey of American Life, I use negative binomial logistic regression to investigate the relationships between stress exposure/appraisal, ten coping responses, and mental health among older African American adults. RESULTS Seven of 10 coping responses were predictive of psychological distress. I also found evidence of moderation for six responses. Active coping, instrumental social support, looking for something good in what has happened, and two measures of acceptance were protective against psychological distress associated with high levels of stress. Substance use generally exacerbated the association between stress and psychological distress. DISCUSSION Problem-focused coping and acceptance responses were effective coping strategies for older African Americans under high levels of stress exposure/appraisal.
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Affiliation(s)
- Dawne M Mouzon
- Department of Sociology Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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20
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Yu X, Liu S. Stressful Life Events and Chinese Older People Depression: Moderating Role of Social Support. Front Public Health 2022; 9:768723. [PMID: 34976928 PMCID: PMC8718507 DOI: 10.3389/fpubh.2021.768723] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/29/2021] [Indexed: 01/18/2023] Open
Abstract
Aim: This study analyzes the effects of retrospective stressful life events on current depression among Chinese older people and how these effects are moderated by social support. Stressful life events comprise bereavement, divorce, health adversities, accidents, and financial losses due to fraud. Data and Method: Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS) of the 2015 panel, and responses from 9,619 older people aged over 60 years were used. The least-squares regression method was applied to measure the linear effects. Propensity score matching minimized selection bias and enabled the measurement of the net effects of stressful life events. The bias-corrected matching estimator was also used to correct the inexact matching bias from propensity score matching. Result: Experienced stressful life events and exposure to cumulative stressful life events were found to lead to depression in older people. When older people experienced stressful life events but with more social activities, and higher satisfaction and frequent contact with children, their depressive levels were lower. The results of the propensity score matching showed that stressful life events resulted in depression in older people. Furthermore, individuals with family support were able to moderate stressful life events effects; however, the moderating effects of social activity separately were negligible. In sum, with the moderating role of family support and social activity, the average differences in older people depression caused by stressful life events decreased. Conclusion: Experiencing stressful life events is detrimental to the psychological health of the older people. Social support, including family support and social activity, has buffered detrimental effects on depression caused by stressful life events. Interpretations: The study underscores the need to supply effective interventions for the older people who experienced stressful life events. First, society should improve the capability of community care centers to supply mental health services. Second, family members should pay attention to mental condition of older people, and specific support should concord with the needs of Chinese older people. In addition, support suppliers can move from being confined to kinship relationships to close relationships, such as the community partners and neighbors.
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Affiliation(s)
- Xiao Yu
- Northeast Asian Research Center, Jilin University, Changchun, China.,Northeast Asian Studies College, Jilin University, Changchun, China
| | - Shu Liu
- Northeast Asian Research Center, Jilin University, Changchun, China.,Northeast Asian Studies College, Jilin University, Changchun, China
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21
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Bolina AF, Oliveira NGN, Santos PHFD, Tavares DMDS. Racial inequities and biopsychosocial indicators in older adults. Rev Lat Am Enfermagem 2022; 30:e3514. [PMID: 35319624 PMCID: PMC8966050 DOI: 10.1590/1518-8345.5634.3514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 12/02/2021] [Indexed: 12/02/2022] Open
Abstract
Objective to analyze the association of self-reported skin color/race with biopsychosocial indicators in older adults. Method cross-sectional study conducted with a total of 941 older adults from a health micro-region in Brazil. Data were collected at home with instruments validated for the country. Descriptive analysis and binary, multinomial and linear logistic regression (p<0.05) were performed. Results Most older adults were self-declared white color/race (63.8%). Black color/race was a protective factor for negative (OR=0.40) and regular (OR=0.44) self-rated health perception and for the indicative of depressive symptoms (OR=0.43); and it was associated with the highest social support score (β=3.60) and the lowest number of morbidities (β=-0.78). Conclusion regardless of sociodemographic and economic characteristics, older adults of black color/race had the best outcomes of biopsychosocial indicators.
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Affiliation(s)
| | - Nayara Gomes Nunes Oliveira
- Universidade Federal do Triângulo Mineiro, Departamento de Enfermagem em Educação e Saúde Comunitária, Uberaba, MG, Brasil
| | | | - Darlene Mara Dos Santos Tavares
- Universidade Federal do Triângulo Mineiro, Departamento de Enfermagem em Educação e Saúde Comunitária, Uberaba, MG, Brasil.,Bolsista do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) 1D, Brasil
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22
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Yahirun J, Sheehan C, Mossakowski K. Black-White Differences in the Link Between Offspring College Attainment and Parents' Depressive Symptom Trajectories. Res Aging 2022; 44:123-135. [PMID: 33678079 PMCID: PMC8423861 DOI: 10.1177/0164027521997999] [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: 11/16/2022]
Abstract
This study examines whether the relationship between children's college attainment and their parents' mental health differs for Black and White parents as they age. Data come from the U.S. Health and Retirement Study (HRS) and multilevel growth curve models are used to assess parents' depressive symptom trajectories. Results indicated that parents over age 50 whose children all completed college had significantly lower initial levels of depressive symptoms than those with no college-educated children. The initial benefit was stronger for Blacks than Whites. Results stratified further by parents' education show that Black parents at nearly all levels of schooling experienced stronger returns to their mental health from children's college completion compared to White parents, for whom only those with a high school education showed an inverse association between offspring education and depression symptoms. The findings underscore how offspring education is a potential resource for reducing disparities in health across families.
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Affiliation(s)
- Jenjira Yahirun
- Department of Sociology, 1888Bowling Green State University, Bowling Green, OH, USA
| | - Connor Sheehan
- Sanford School of Social and Family Dynamics, 7864Arizona State University, Phoenix, AZ, USA
| | - Krysia Mossakowski
- Department of Sociology, 3949University of Hawaii at Manoa, Honolulu, HI, USA
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23
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Morris EP, Brown LL, Zaheed AB, Palms JD, Sol K, Martino A, Zahodne LB. Effects of Stress Exposure Versus Appraisal on Episodic Memory Trajectories: Evidence for Risk and Resilience Among Black Older Adults. J Gerontol B Psychol Sci Soc Sci 2021; 77:2148-2155. [PMID: 34871420 PMCID: PMC9683504 DOI: 10.1093/geronb/gbab225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Chronic stressors, experienced disproportionately by Black older adults, are a risk factor for memory impairment. Racially patterned stress exposure may contribute to higher rates of Alzheimer's disease and related dementias (ADRD) among Black older adults compared with Whites, but less is known about the role of stress appraisal. This study examined whether chronic stress exposure mediates racial disparities in memory and whether stress appraisal moderates these associations. METHODS Participants included 16,924 older adults (Mage = 67.39, 21% Black) from the 2010 and 2012 waves of the Health and Retirement Study who completed measures of chronic stress exposure (health, financial, housing, relationships, and caregiving) and appraisal. Latent growth curves modeled longitudinal performance on a word list memory task over 6 years. RESULTS Black older adults reported greater stress exposure than Whites, and greater stress exposure partially mediated Black-White disparities in initial memory (standardized indirect effect = -0.002, p = .009). However, Black older adults appraised stressors as less upsetting than Whites. While stress appraisal did not moderate links between stress exposure and memory, appraising stressors as less upsetting was independently associated with better initial memory. Thus, Black-White disparities in initial memory was partially offset by Black participants' appraisal of stressors as less upsetting (standardized indirect effect = 0.002, p = .016). DISCUSSION Reducing chronic stress exposure may reduce racial disparities in ADRD risk. The counteractive effect of stress appraisal on Black-White disparities in episodic memory highlights resilience factors among Black older adults that should be characterized in future research to move beyond deficit models of ADRD inequality.
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Affiliation(s)
- Emily P Morris
- Address correspondence to: Emily P. Morris, MS, Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109, USA. E-mail:
| | - Lauren L Brown
- Division of Health Management and Policy, San Diego State University School of Public Health, San Diego, California, USA
| | - Afsara B Zaheed
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jordan D Palms
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ketlyne Sol
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Alexa Martino
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Laura B Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
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24
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Wang F, Nguyen AW, Lincoln KD, Qin W, Hamler T. The Moderating Role of Race and Ethnicity in the Relationship Between Negative Family Interactions and Mental Health Among Older Adults. THE GERONTOLOGIST 2021; 62:674-684. [PMID: 34614171 DOI: 10.1093/geront/gnab148] [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] [Received: 05/29/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Studies generally show that negative social interactions are detrimental to mental health for older adults. Further, empirical evidence suggests that negative interactions may function differently in relation to mental health across racial/ethnic groups given their unique life circumstances and social conditions. This study examines whether the association between negative family interactions and mental health outcomes varies by race and ethnicity. RESEARCH DESIGN AND METHODS Samples of older African Americans, Caribbean Blacks, and non-Latino Whites aged 55 and older were drawn from the National Survey of American Life (N=1439). Mental health variables included depressive symptoms, any lifetime DSM-IV disorder, and number of lifetime DSM-IV disorders. Regression models were used to test the study aim. RESULTS Analyses indicated that negative interactions with family were positively associated with all three mental health outcomes. Several racial/ethnic differences emerged. The association between negative family interactions and depressive symptoms was stronger among Whites than African Americans. While negative family interactions were positively associated with number of disorders among Caribbean Blacks, negative interactions were unrelated to number of disorders among African Americans. DISCUSSION AND IMPLICATIONS This study demonstrates the racial and ethnic differences in diverse aging populations and the importance of recognizing the heterogeneity of Black American population in minority research. Clinical practice should focus on reducing negative family interactions, and future research should examine whether psychosocial resources (e.g., stress appraisals, neighborhood social cohesion, and religious practices) can attenuate the association between negative family interactions and mental health for older African Americans.
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Affiliation(s)
- Fei Wang
- Jack, Joseph and Morton Mandel School of Applied Social Sciences Case Western Reserve University, Cleveland, Ohio, USA
| | - Ann W Nguyen
- Jack, Joseph and Morton Mandel School of Applied Social Sciences Case Western Reserve University, Cleveland, Ohio, USA
| | - Karen D Lincoln
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Weidi Qin
- Population Studies Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Tyrone Hamler
- Jack, Joseph and Morton Mandel School of Applied Social Sciences Case Western Reserve University, Cleveland, Ohio, USA
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25
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Abrams LR, Clarke PJ, Mehta NK. Unmet Expectations About Work at Age 62 and Depressive Symptoms. J Gerontol B Psychol Sci Soc Sci 2021; 77:615-625. [PMID: 34173825 DOI: 10.1093/geronb/gbab113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Exiting the labor force earlier or later than planned is common, with predictable economic consequences. However, the mental health ramifications of such off-time events are not known but are important to promoting well-being in retirement. METHODS Using the Health and Retirement Study (1992-2016), we created six groups based on the alignment of expectations about full-time work at age 62 (reported at ages 51-61) with realized labor force status after reaching age 62 (N=10,421). Negative binomial models estimated the adjusted association between unmet expectations about work and depressive symptoms. RESULTS Unexpectedly not working was associated with higher depressive symptoms than working as expected after adjusting for sociodemographic, economic, and health factors at the time of expectations (IRR=1.35, 95% CI:1.17, 1.56). Additionally adjusting for health declines and marriage dissolution between expectations and age 62 partially attenuated the association, but unexpectedly not working remained significantly associated with a 1.16 increase in the incidence rate of depressive symptoms. Unexpectedly working at 62 was not associated with depressive symptoms. Race/ethnicity interacted with expectation alignment (F(15,42)=2.44, p=0.0118) in that Hispanic respondents experienced an increase in depressive symptoms when working after unmet and unsure expectations compared to met expectations, whereas white respondents did not. DISCUSSION Unlike working longer than expected, unexpectedly not working at 62 was associated with depressive symptoms, even after accounting for health declines. Public and employer policies should assist workers in remaining in the labor force as long as planned and offer mental health supports for unexpected work exits.
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Affiliation(s)
- Leah R Abrams
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, MA, USA
| | - Philippa J Clarke
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.,Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Neil K Mehta
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
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Lincoln KD, Nguyen AW. Biopsychosocial Risk Profiles among African American and Non-Hispanic White Adults: Findings from The Health and Retirement Study. J Gerontol A Biol Sci Med Sci 2021; 77:e82-e88. [PMID: 33406248 DOI: 10.1093/gerona/glab003] [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] [Received: 10/20/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Compared to Whites, African Americans have elevated risk for earlier onset fatal and non-fatal chronic conditions and accelerated aging. Despite these persistent race disparities, the causes remain poorly understood. The purpose of this study was to define a biopsychosocial risk typology that might explain accelerated aging in African Americans. METHODS Analyses were based on the African American and White subsample of the Health and Retirement Study (N=8,269). Latent class analysis was used to identify risk types. Chronic health conditions, salivary telomere length (STL), emotional support from family, negative interaction with family, early life adversities, and discrimination were used as class indicators. Latent class multinomial logistic regression was used to identify racial and demographic differences in risk type membership. RESULTS Three distinct risk types were identified: high risk, health risk, and psychosocial risk. African Americans were more likely than Whites to be assigned to the high risk type characterized by chronic health conditions, shorter STL, strained social relationships and high psychosocial stress. African Americans were less likely than Whites to be assigned to the health risk type characterized by chronic health conditions, shorter STL, optimal social relationships and low psychosocial stress. CONCLUSIONS The biopsychosocial risk typology accounted for population heterogeneity, identified high-risk profiles and modifiable factors within risk types that can inform current clinical interventions. The risk types also revealed different patterns of risk and resilience factors and shed light on the interplay between telomere length, stress exposure, chronic disease and accelerated aging in African Americans.
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Mitchell UA, Nguyen AW, McBryde-Redzovic A, Brown LL. "What Doesn't Kill You, Makes You Stronger": Psychosocial Resources and the Mental Health of Black Older Adults. ANNUAL REVIEW OF GERONTOLOGY & GERIATRICS 2021; 41:269-302. [PMID: 36311274 PMCID: PMC9614571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A robust body of research has shown that Black Americans are less likely than Whites to have psychiatric disorders despite the social and economic disadvantage and systemic racism that they face. This mental health paradox has been demonstrated across all ages of the life course, including older adulthood. One of the prevailing explanations for the lower prevalence of psychiatric disorders among Blacks pertains to the influence of psychosocial resources on mental health. Psychosocial resources can directly or indirectly support mental health through physiological and psychological pathways. They can also mitigate the adverse effects of social stressors of discrimination and other stressors on psychological distress and mental illness. Black older adults may particularly benefit from psychosocial resources because they have had a lifetime of experiencing and overcoming adversity. Although this cycle of stress adaptation can wear away at the physical body, it may facilitate mental health resilience. In this chapter, we review research on the relationship between psychosocial resources and mental health. The chapter begins with a brief review of the Black-White mental health paradox and the mechanisms through which psychosocial resources operate to influence mental health. We then review research on intrapersonal, interpersonal, and community-level psychosocial resources that are particularly salient for Black Americans. Throughout the chapter we highlight research specifically focused on Black older adults and discuss the cultural relevance of each resource to their mental health and psychological functioning.
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Affiliation(s)
| | - Ann W Nguyen
- Case Western Reserve University, Jack, Joseph, and Morton Mandel School of Applied Social Sciences
| | | | - Lauren L Brown
- San Diego State University, College of Health and Human Services, School of Public Health
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Taylor RJ. Race and Mental Health Among Older Adults: Within- and Between-Group Comparisons. Innov Aging 2020; 4:igaa056. [PMID: 33367113 PMCID: PMC7739883 DOI: 10.1093/geroni/igaa056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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