The Black-White Paradox Revisited: Understanding the Role of Counterbalancing Mechanisms during Adolescence

Latino adolescents' experiences of residential risks on social media and mental health implications

Despite alarms raised that adolescents' social media use can aggravate the harmful impact of residential risks (e.g. local violence) to their mental health, the mechanisms are poorly understood. To better understand potential mechanisms, we interviewed Latino adolescents living in a hypersegregated U.S. city, for whom social media may aggravate existing inequalities in residential risks to their mental health. Through an abductive analysis, we identified two processes suggesting how social media can amplify the deleterious impact of residential risks to their mental health. We refer to the first as additive, whereby social media heightens awareness of residential risks. The second is extension, whereby social media lengthens one's risk awareness, speeds up potential for risk awareness and multiplies who may become aware. We found evidence suggestive of parallel processes yielding diminution, whereby social media can minimise the deleterious effects of residential risks via adding and extending exposure to mental health resources, like collective efficacy. Further, the potential for extension (to both risks and resources) appears limited because social media practices (e.g. reposting, seeking viral attention) can foster indifference. Findings suggest the need to consider how adolescents activate resources via social media to avoid overstating its negative impact on mental health.

How our longitudinal employment patterns might shape our health as we approach middle adulthood-US NLSY79 cohort

Recent labor market transformations brought on by digital and technological advances, together with the rise of the service economy since the 1980s, have subjected more workers to precarious conditions, such as irregular work hours and low or unpredictable wages, threatening their economic well-being and health. This study advances our understanding of the critical role employment plays in our health by examining how employment patterns throughout our working lives, based on work schedules, may shape our health at age 50, paying particular attention to the moderating role of social position. The National Longitudinal Survey of Youth-1979 (NLSY79), which has collected 30+ years of longitudinal information, was used to examine how employment patterns starting at ages 22 (n ≈ 7,336) might be associated with sleep hours and quality, physical and mental functions, and the likelihood of reporting poor health and depressive symptoms at age 50. Sequence analysis found five dominant employment patterns between ages 22 and 49: "mostly not working" (10%), "early standard hours before transitioning into mostly variable hours" (12%), "early standard hours before transitioning into volatile schedules" (early ST-volatile, 17%), "mostly standard hours with some variable hours" (35%), and "stable standard hours" (26%). The multiple regression analyses indicate that having the "early ST-volatile" schedule pattern between ages 22 and 49 was consistently, significantly associated with the poorest health, including the fewest hours of sleep per day, the lowest sleep quality, the lowest physical and mental functions, and the highest likelihood of reporting poor health and depressive symptoms at age 50. In addition, social position plays a significant role in these adverse health consequences. For example, whereas non-Hispanic White women reported the most hours of sleep and non-Hispanic Black men reported the fewest, the opposite was true for sleep quality. In addition, non-Hispanic Black men with less than a high school education had the highest likelihood of reporting poor health at age 50 if they engaged in an employment pattern of "early ST-volatile" between ages 22 and 49. In comparison, non-Hispanic White men with a college degree or above education had the lowest likelihood of reporting poor health if they engaged in an employment pattern of stable standard hours. This analysis underscores the critical role of employment patterns in shaping our daily routines, which matter to sleep and physical and mental health as we approach middle adulthood. Notably, the groups with relatively disadvantaged social positions are also likely to be subject to nonstandard work schedules, including non-Hispanic Blacks and people with low education; hence, they were more likely than others to shoulder the harmful links between nonstandard work schedules and sleep and health, worsening their probability of maintaining and nurturing their health as they approach middle adulthood.

Variation by race/ethnicity-gender in the relationship between arrest history and alcohol use

BACKGROUND

Alcohol use contributes to the national burden of morbidity and mortality in the United States. Arrest, as a unique form of criminal justice system involvement, may be related to alcohol use from adolescence to adulthood. This study investigates the relationship between arrest and alcohol use across race/ethnicity-gender (R/E-G) status (e.g., Black, Latinx, and White men and women) as youth age.

METHODS

Data from 17 waves (1997-2015) of the National Longitudinal Survey of Youth, 1997 cohort (N = 8901) were used to explore how variation in R/E-G moderates the relationship between arrest history and alcohol use trajectories from 13 to 30 years old. Multilevel zero-inflated Poisson and Poisson regression were used to assess R/E-G variation in the relationship between arrest history and days of alcohol consumption, drinks per drinking occasion, and days of binge drinking after accounting for covariates, including incarceration.

RESULTS

The findings indicate that an arrest history is associated with alcohol use, and these results varied by R/E-G status, age, and alcohol use outcome. Those with an arrest history reported more days of drinking than their counterparts without an arrest; yet, the magnitude and direction of average drinks per occasion and binge drinking days varied by R/E-G status and age. Paradoxically, Black men, Black women, and Latinx men with an arrest history reported fewer days of binge drinking as they aged than their counterparts without an arrest.

CONCLUSIONS

A history of arrest is important for alcohol use from adolescence to adulthood and varies by R/E-G status, age, and alcohol use outcome. This work confirms previous scholarship showing that arrest and alcohol use are socially patterned and R/E-G status is an essential consideration in understanding the relationship. Future work should include additional identities and health behaviors and the consequences related to alcohol use outcomes.

Are Interracial Couples at Higher Risk of Multiple Chronic Conditions? Evidence from a Nationally Representative Sample

Interracial relationships are becoming increasingly common in the United States, yet the physical health status of individuals in interracial relationships is not well understood. Using 18 years of pooled data from the National Health Interview Study (2001-2018) (N = 264, 891), we compared the odds of having multiple chronic conditions (MCC) among adults in interracial and same-race unions. We anticipate that individuals in interracial relationships may be at higher risk of MCC than individuals in same-race relationships due to increased exposure to stressors associated with crossing racial boundaries. Findings indicate that the implications of interracial relationships on MCC depended on the racial composition of the couple. We found that White-Black couples had higher odds of MCC than both White-White and Black-Black couples, but Asian-Black and Hispanic-Black couples did not differ from their same-race couple counterparts, indicating a pronounced and unique health disadvantage for White adults paired with Black adults. We also found that Asian-White and Hispanic-White couples had higher odds of MCC relative to their same-race counterparts. In addition, minority-minority couples generally did not differ from their same-race minority couple counterparts in terms of MCC. The results of the study provide new insights into how the racial composition of interracial unions impacts health and how a closer proximity to Whiteness may be a health risk for some minority groups.

Residential segregation and Black-White differences in physical and mental health: Evidence of a health paradox?

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.

Revisiting the Black-White Mental Health Paradox During the Coronavirus Pandemic

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.

Examination of the Relationship Between Daily Perceptions of Collective Efficacy and Marijuana Use Among Black Youth: Does the Location of the Perception Matters?

Neighborhood-level collective efficacy protects Black youth from substance use; however, neighborhood research does not account for the entirety of adolescents' exposure or their perceptions of space which may be critical to understanding the role of context in substance use. To address this limitation, the SPIN Project recruited 65 Black adolescents (M(SD) = 15.32(1.06)) to complete four brief surveys each day for a month describing their perceptions of spaces and marijuana use. Multilevel negative binomial models were estimated to test the relationship between an individual's perceptions of collective efficacy and the marijuana used during a day, and if the location of the observations moderated these relationships. Findings indicated that the perceptions of collective efficacy protected adolescents from marijuana use when occurring within their home neighborhood, but not outside of it; thereby suggesting important variations in adolescents' perceptions based on the location that matter for Black youth marijuana use.

Functional Limitations and Psychological Well-Being Among Older Adults in China: The Critical Role of Hukou as a Stratifying Factor

Based on a stress process perspective, this study examines how the hukou system and gender intersect to shape the relationship between functional limitations and psychological well-being in older adults. Using the China Health and Retirement Longitudinal Study (N = 17,708 at baseline), analyses are carried out with random- and fixed-effects models. Analyses show that an urban hukou benefits the psychological well-being of Chinese older adults by weakening the relationship between functional limitations and depression, and these differences do not vary significantly between men and women. The relationship between functional limitations and life satisfaction does not differ by hukou region. This study shows that China's household registration system provides an important context for the associations between functional limitations and psychological well-being in later life. The hukou system is an important stratifying agent and should be taken into account in the study of stress and aging in a Chinese context.

Vicarious experiences of major discrimination, anxiety symptoms, and mental health care utilization among Black Adults

BACKGROUND

The adverse mental health consequences of discrimination among Black adults, such as anxiety symptoms, are well documented. Prior research establishes anxiety as a risk factor for suboptimal health outcomes among Black adults. Most discrimination and mental health studies, however, have focused on the effects of personal experiences of discrimination. Moreover, of the studies that examine the mental health effects of vicarious exposure to discrimination, few investigate this relationship from a stress and coping perspective beyond the life stages of childhood and adolescence. Thus, the purpose of this study was to assess the effects of vicarious and personal experiences of discrimination on the subjective well-being of Black adults, while observing the potentially moderating effects of utilizing mental health care.

METHODS

A subsample of Black adults (N = 627) between the ages of 22-69 years old were drawn from the Nashville Stress and Health Study and analyzed to assess within-group variation. Multivariate linear regression was employed to examine the association between vicarious experiences of major discrimination and self-reported anxiety symptoms. Additionally, we evaluated the moderating effects of lifetime utilization of mental health services on the relationship between discrimination and symptoms of anxiety.

RESULTS

Findings revealed that vicarious experiences of major discrimination and personal experiences of everyday discrimination were both associated with higher levels of anxiety symptoms among the participants. Additionally, lifetime utilization of mental health care moderated the effects of vicarious and personal experiences of discrimination.

CONCLUSIONS

The secondhand consequences of discrimination must be considered while assessing the racism-related stress experience. Results from this investigation suggest that mental health treatment should be included in programs targeted to reduce the negative effects of discrimination among Black adults. Additionally, culturally-specific strategies should be considered for addressing racism-related adversity.

Anticipation of Racially Motivated Police Brutality and Youth Mental Health

Purpose

Exposure to police brutality is a significant risk to adolescent mental health. This study extends this literature by exploring connections between anticipation of racially motivated police brutality and multiple facets of adolescent mental health.

Methods

Students ages 14 to 18 (n = 151) were recruited from a study administered in Baltimore City public schools. Between December 2020 and July 2021, participants completed a questionnaire assessing anticipatory stress regarding racially motivated police brutality and current mental health. Regression models examined associations between this anticipatory stress and mental health. Latent profile and regression analyses were used to examine whether anticipatory stress was more salient among adolescents with comorbid mental health symptoms, compared to those without comorbid symptoms.

Results

Youth with anticipatory stress stemming from both personal and vicarious police brutality had more symptoms of anxiety, depression, and PTSD, as well as lower hope, compared to youth without anticipatory stress. The association between anticipatory stress and anxiety was stronger for girls than boys.

Conclusions

Findings from this study highlight racialized police brutality as a common anticipated stressor among youth, particularly for girls. Findings have implications for policing interventions, including development of additional trainings for police officers and promoting positive police/youth interactions.

Vicarious Experiences of Major Discrimination and Psychological Distress among Black Men and Women

Racism-related stress frameworks posit that the discriminatory experiences of one's loved ones may threaten one's well-being, but relatively few studies have examined how they may impact mental health beyond childhood and adolescence. Using data from the Nashville Stress and Health Study (N = 1,252), the present study assessed the prevalence of vicarious experiences of discrimination among subsamples of Black men (n = 297) and women (n = 330), examined the association between vicarious experiences of discrimination and psychological distress among Black men and women, and evaluated the impact of vicarious discrimination on psychological distress in the context of other stressors. Results suggest that Black women report more vicarious exposure to specific types of discrimination. Furthermore, vicariously experienced discrimination was associated with higher levels of psychological distress among Black women, but not among Black men. Our findings extend the literature on racism-related stress and offer new insights for interventions aimed at reducing racial disparities in mental health.

Vicarious Discrimination, Psychosocial Resources, and Mental Health among Black Americans

Does hearing about or witnessing someone else experience discrimination harm individuals’ mental health? Using data from the Nashville Stress and Health Study, we answer this question by examining how vicarious discrimination impacts depressive symptoms, anxiety symptoms, and anger among black Americans. We also test whether mastery and self-esteem moderate the association between vicarious discrimination and each mental health outcome. Findings indicate experiencing vicarious discrimination via a family member has a similar impact on mental health to personally experiencing discrimination. While experiencing vicarious discrimination via a close friend also increased mental health problems, it appeared to be less harmful than personally experiencing discrimination. Moreover, self-esteem moderated the association between vicarious discrimination via a family member and via a close friend and mental health, while mastery did not. This study provides new insights into ways vicarious discrimination impacts health as well as the role that psychosocial resources play in shaping this relationship.

Do Racial Differences in Coping Resources Explain the Black-White Paradox in Mental Health? A Test of Multiple Mechanisms

A central paradox in the mental health literature is the tendency for black Americans to report similar or better mental health than white Americans despite experiencing greater stress exposure. However, black Americans' higher levels of certain coping resources may explain this finding. Using data from the Nashville Stress and Health Study (n = 1,186), we examine whether black Americans have higher levels of self-esteem, social support, religious attendance, and divine control than white Americans and whether these resources, in turn, explain the black-white paradox in mental health. In adjusted models, the black-white paradox holds for depressive symptoms and any DSM-IV disorder. Findings indicate that black Americans have higher levels of self-esteem, family social support, and religiosity than white Americans. Causal mediation techniques reveal that self-esteem has the largest effect in explaining black-white differences in depressive symptoms, whereas divine control has the largest effect in explaining differences in disorder.

Racial differences in psychological stress and insulin sensitivity in non-Hispanic Black and White adolescents with overweight/obesity

INTRODUCTION

Racial differences in type 2 diabetes risk persist among non-Hispanic Black and non-Hispanic White adolescents with overweight/obesity; however, the role of psychological stress in this disparity is less clear.

PURPOSE

To examine racial differences in the association between psychological stress, insulin sensitivity (S_i), acute insulin response to glucose (AIR_g), and disposition index (DI) among non-Hispanic Black and non-Hispanic White adolescents with overweight/obesity.

METHODS

Ninety-six adolescents (60% female; 51% non-Hispanic Black; 16.6 ± 1.8 years of age) with overweight/obesity (BMI percentile ≥ 85th percentile) were included in this analysis. Psychological stress was assessed using the 14-item Perceived Stress Scale. Glucose and insulin data from an intravenous glucose tolerance test was modeled to obtain S_i, AIR_g, and DI. Multivariable linear regression models were used to examine the association between race, psychological stress and metabolic outcomes (S_i, AIR_g, and DI).

RESULTS

Race was a significant predictor of log-AIR_g and log-DI (ps < 0.05) independent of all covariates in the main effect models. Lower S_i (p_interaction = 0.014) and DI (p_interaction = 0.012) was also observed among Black adolescents who reported higher stress levels, whereas higher S_i and DI was observed among non-Hispanic White adolescents reporting higher stress in the race interaction models. Race however, did not moderate the association between psychological stress and AIR_g (p > 0.05), nor was stress associated with S_i, AIR_g, or DI ("p" "s" > 0.05) across all other models.

CONCLUSIONS

Psychological stress may play an important and distinct role in shaping racial differences in type 2 diabetes risk among adolescents with overweight/obesity. Additional research is needed to understand the long-term effects of psychological stress on metabolic health among non-Hispanic Black and non-Hispanic White adolescents with overweight/obesity.

THOSE LEFT BEHIND: Socioeconomic Predictors and Social Mediators of Psychological Distress among Working-age African Americans in a Post-industrial City

While the socioeconomic status (SES)-psychological distress gradient is well-documented in the social science literature, less attention has been devoted to how this relationship varies within sociodemographic subgroups. I contribute to this small but growing literature by first examining the relationship between multiple dimensions of SES and two measures of psychological distress (depression and anxiety) among working-aged African Americans. I then test whether three social mediators explain the SES-psychological distress relationship, and whether gender modifies these associations and/or the social mediators that shape them. To address these aims, I analyze two waves of population-representative data from the Detroit Neighborhood Health Study (N=685). Data were collected between 2008 and 2010 in the wake of the Great Recession. I utilize structural equation modeling with latent variables to assess these relationships, and test indirect and conditional effects to detect the presence of mediation and/or moderation, respectively. Findings revealed associations between higher total household income and lower levels of depression/anxiety, as well as unemployment and increased depression/anxiety among working age African Americans. Furthermore, higher educational attainment was associated with reduced anxiety, but not depression, in this population. Gender moderated these findings such that unemployment was associated with higher levels of depression/anxiety among women but not men. I also found that trauma mediated the relationship between unemployment and depression/anxiety as well as educational attainment and anxiety. Gender, however, moderated the association between unemployment and depression/anxiety via traumatic events such that the relationship was stronger among women than men. Collectively, these findings contribute to our limited understanding of African Americans' mental health and underscore the importance of how both socioeconomic forces and life course experiences with traumatic events contribute to poor mental health among this population.

"What Doesn't Kill You, Makes You Stronger": Psychosocial Resources and the Mental Health of Black Older Adults

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.

Race and SES Differences in Psychosocial Resources: Implications for Social Stress Theory

Social stress theory predicts that psychosocial resources shape health inequalities but is less clear about the ways in which the availability of resources differs across racial and socioeconomic groups. Using data from the Nashville Stress and Health Study (N = 1,214), the present study assessed racial and socioeconomic status (SES) differences in mastery, self-esteem, and social support; evaluated the extent to which SES accounts for racial differences in resources; and considered the interactive roles of race and SES in shaping resources among Black and White adults. Results show Blacks have greater access to resources, but SES yields greater psychosocial benefits among Whites. Findings demonstrate that SES and race may jointly and independently shape access to resources. This study contributes to the broader literature on status distinctions in psychosocial resources, providing new insights into the ways in which race and SES shape access to these health-protective resources while also raising several questions for future research.

Status Variation in Anticipatory Stressors and Their Associations with Depressive Symptoms

Members of structurally disadvantaged social groups report more frequent exposure to a variety of negative life events and chronic strains, yet little research has examined whether similar patterns exist for anticipatory stressors, or challenging circumstances that loom as potential threats in the future. This study uses data collected as part of a national survey of college seniors (N = 995) to examine how anticipatory stress regarding economic and residential security, exposure to traumatic events, and experiences of discrimination vary by gender identity, race-ethnicity, sexual orientation, and first-generation college student status. Consistent with stress theory, anticipatory stressors are more commonly reported by members of disadvantaged groups. Notably, variation in anticipatory stressors explains a nontrivial proportion of differences in depressive symptoms found across gender identity and sexual orientation categories. Findings signal the necessity of incorporating anticipatory stressors into research in the stress paradigm to further disentangle the contributions of social stressors to health disparities.

Racial Difference in the Relationship Between Health and Happiness in the United States

Background

Although health is a prerequisite for happiness, the salience of health for maintaining happiness may be diminished for Blacks when compared to Whites, a phenomenon which can be explained by the Black-White mental health paradox and minorities’ diminished returns.

Aim

To understand if Black and White adult Americans differ in the effects of self-rated health (SRH) on happiness.

Methods

This cross-sectional study used data from the General Social Survey (GSS; 1972–2018), a nationally representative survey in the US. Our analytical sample included 42,201 Black and White adults. The independent variable was SRH. Happiness was the dependent variable. Sociodemographic factors were covariates. Race was the moderator. Logistic regression was used to analyze the data without and with interaction terms between race and SRH.

Results

Overall, good SRH was positively associated with happiness, however, there was a significant interaction between race/ethnicity and good SRH on the outcome (i.e. happiness) . This finding suggested that the boosting effect of good SRH on happiness is weaker for Black than White people.

Conclusion

In the United States, due to a weaker concordance between good health and happiness, Blacks who have poor SRH are more likely to report happiness. At the same time, Whites who are healthy report happiness, however, Blacks who are healthy do not necessarily report happiness. Disjointed link between health and happiness may be due to different racial, ethnic, and cultural perceptions of physical health and happiness as well as salience of physical health as a component of happiness. This may be an adaptive response of Blacks to sociopolitical as well as health-related adversities over centuries as a result of the combination of oppression, injustice, and poverty.

Pharmaceutical Side Effects and Mental Health Paradoxes among Racial-Ethnic Minorities

Sociologists have long struggled to explain the minority mental health paradox: that racial-ethnic minorities often report better mental health than non-Hispanic whites despite social environments that seem less conducive to well-being. Using data from the 2008-2013 Medical Expenditure Panel Survey (MEPS), this study provides a partial explanation for the paradox rooted in a very different disparity. Evidence from MEPS indicates that non-Hispanic whites consume more pharmaceuticals than racial-ethnic minorities for a wide variety of medical conditions. Moreover, non-Hispanic whites consume more pharmaceuticals that although effective in treating their focal indication, include depression or suicide as a side effect. In models that adjust for the use of such medications, the minority advantage in significant distress is reduced, in some instances to statistical nonsignificance. Although a significant black and Hispanic advantage in a continuous measure of distress remains, the magnitude of the difference is reduced considerably. The relationship between the use of medications with suicide as a side effect and significant distress is especially large, exceeding, for instance, the relationship between poverty and significant distress. For some minority groups, the less frequent use of such medications is driven by better health (as in the case of Asians), whereas for others, it reflects a treatment disparity (as in the case of blacks), although the consequences for the mental health paradox are the same. The implications of the results are discussed, especially with respect to the neglect of psychological side effects in the treatment of physical disease as well as the problem of multiple morbidities.

Striving While Black: Race and the Psychophysiology of Goal Pursuit

Population health scientists have largely overlooked anticipatory stressors and how different groups of people experience and cope with anticipatory stress. I address these gaps by examining black-white differences in the associations between an important anticipatory stressor-goal-striving stress (GSS)-and several measures of psychophysiology. Hypotheses focusing on racial differences in GSS and psychophysiology are tested using self-report and biomarker data from the Nashville Stress and Health Study (2011-2014), a cross-sectional probability survey of black and white working-age adults from Davidson County, Tennessee (n = 1,252). Compared to their white peers, blacks with higher GSS report greater self-esteem and fewer symptoms of depression and anxiety. However, increased GSS also predicts elevated levels of high-effort coping (i.e., John Henryism), neuroendocrine stress hormones, and blood pressure for blacks but not whites. I discuss the implications of these findings for scholars interested in the stress process and broader black-white health inequalities in the United States.