The Influence of Social Dynamics on Biological Aging and the Health of Historically Marginalized Populations: A Biopsychosocial Model for Health Disparities

Historically marginalized populations are susceptible to social isolation resulting from their unique social dynamics; thus, they incur a higher risk of developing chronic diseases across the course of life. Research has suggested that the cumulative effect of aging trajectories per se, across the lifespan, determines later-in-life disease risks. Emerging evidence has shown the biopsychosocial effects of social stress and social support on one's wellbeing in terms of inflammation. Built upon previous multidisciplinary findings, here, we provide an overarching model that explains how the social dynamics of marginalized populations shape their rate of biological aging through the inflammatory process. Under the framework of social stress and social support theories, this model aims to facilitate our understanding of the biopsychosocial impacts of social dynamics on the wellbeing of historically marginalized individuals, with a special emphasis on biological aging. We leverage this model to advance our mechanistic understanding of the health disparity observed in historically marginalized populations and inform future remediation strategies.

The impact of the COVID-19 pandemic experiences on college drinking via mental distress: Cross-sectional mediation moderated by race

BACKGROUND

The COVID-19 pandemic has been linked to stress, anxiety, and depression among college students, with heightened distress tied to greater drinking for some individuals. Emerging research suggests that these associations may differ across race, but few studies use adequate samples to examine this, particularly among college students, an at-risk population for both heavy drinking and mental distress. Specifically, pandemic-related stressors and mental distress may be higher among Black students than White students. The current study examined: (1) whether mental distress cross-sectionally mediates the association between pandemic-specific stressors and drinking and (2) whether race (Black or White) moderates these associations.

METHODS

A cross-sectional online survey of 400 college drinkers (43% White, 28% Black) in fall 2020 assessed pandemic-related stressors (e.g., losing a job, contracting COVID-19, changed living situation), mental distress (stress, anxiety, depression), and drinking (past-month drinking, perceived changes since the start of the pandemic).

RESULTS

Cross-sectional mediation models indicated that financial stressors and social distancing were linked to greater quantity and frequency of past-month drinking through greater mental distress. For perceived changes in drinking, only financial stressors were linked to drinking greater quantities and drinking more often (compared to pre-pandemic levels) via mental distress. Moderated mediation models among students identifying as White or Black revealed that changed living situation was a robust stressor across race. Financial stressors and social distancing were linked with greater distress only among White students, whereas essential worker status was a protective factor against distress only among Black students.

CONCLUSIONS

Select stressors were linked to increased drinking through greater mental distress, with differential risks across Black versus White students. Findings suggest campus administrators should focus on connecting students with resources (e.g., counseling centers and health promotion offices) during times of distress.

Examining Emailed Feedback as Boosters After a College Drinking Intervention Among Fraternities and Sororities: Rationale and Protocol for a Remote Controlled Trial (Project Greek)

Background

College students involved in Greek life (ie, members of fraternities and sororities) tend to engage in more high-risk alcohol use and experience more negative consequences than those not involved in Greek life. Web-based alcohol interventions, such as Alcohol eCHECKUP TO GO, have been successful in reducing alcohol use and consequences among the general college student population, but interventions targeting alcohol reduction among those involved in Greek life have had limited success. Booster emails including personalized feedback regarding descriptive norms and protective behavioral strategies have shown potential in increasing the effectiveness of web-based interventions among college drinkers. Studies are needed to determine the efficacy of these boosters among those involved in Greek life.

Objective

The primary objective of this study is to assess the efficacy of booster emails sent to Greek life students who complete Alcohol eCHECKUP TO GO. Specifically, we expect that participants who receive the booster emails will reduce their alcohol consumption and related problems (primary aim 1), reduce perceived peer drinking, and increase the number of protective behavioral strategies they use over time (primary aim 2) relative to those who do not receive boosters. Contingent upon finding the emailed booster efficacious and sufficient enrollment of members from each organization, an exploratory aim is to examine social mechanisms of change (ie, through selection vs socialization).

Methods

This study is a remote, controlled intervention trial following participants for up to 6 months. Participants must be aged at least 18 years, undergraduate students, and members of a participating fraternity or sorority. Eligible participants complete a web-based baseline survey to assess their alcohol consumption behaviors and beliefs, including norms and protective behavioral strategies, and information about their social networks. After completing the baseline survey, they participate in the web-based intervention. Follow-up surveys are sent 1, 3, and 6 months after the intervention. Those in the booster condition also receive emails containing personalized feedback at 2 weeks and 14 weeks after the intervention. Latent growth models and R-Simulation Investigation for Empirical Network Analysis will be used to analyze the data.

Results

As of September 2022, we have enrolled 18 participants from 2 fraternities and 2 sororities, and they have completed the baseline survey. Overall, 72% (13/18) of participants have completed the 1-month follow-up. Enrollment will continue through December 2022.

Conclusions

This study aims to examine the effectiveness of personalized feedback booster emails sent after an alcohol intervention among members of college Greek life. A secondary, exploratory aim is to provide information about social mechanisms of change (if possible). The current methodology targets whole network recruitment, with chapter presidents serving as gatekeepers and facilitators. Unique challenges of recruiting whole networks and working with campus administrators are discussed.

Trial Registration

ClinicalTrials.gov NCT05107284; https://clinicaltrials.gov/ct2/show/NCT05107284

International Registered Report Identifier (IRRID)

DERR1-10.2196/42535

Religiosity and Physical Health of Middle–Old Aged African Americans: The Linking Role of Self-Control

Objective: This study examined a psychological process (i.e., sense of control) that links religiosity to self-reported physical health in older African Americans. Methods: Two waves of data from 231 middle–old aged African Americans (AAs) were used to test two specific hypotheses: (a) religiosity influences changes in sense of control middle–old aged AAs, and (b) sense of control influences changes in global physical health in middle–old aged AAs. The analysis used two modeling approaches: (a) an autoregressive cross-lagged modeland (b) a parallel growth/change model. Results: The results of both types of models showed that religiosity positively influenced changes in sense of control and that sense of control positively influenced changes in physical health in middle–old aged AAs over time. Discussion: These findings provide evidence that sense of control links religiosity to physical health in older African Americans. The theoretical and practical implications of the findings are discussed.

Lower Life Satisfaction and Inflammation in African American Adults: Body Adiposity Mediation and Sex Moderation

Both lower life satisfaction (LLS) and chronic inflammation are underlying conditions for numerous diseases. We investigated their associations in African American adults, within the context of three hypotheses: (a) perceived LLS will be positively associated with inflammation measured by serum C-reactive protein (CRP); (b) this association will be mediated by body adiposity; and (c) these associations will be moderated by sex. Participants (n = 83; >45 years; 59% women) were a subsample of a larger church-based intervention to reduce cardiovascular risks and were assessed at baseline and after 6 months. Body adiposity (BMI/hip/waist circumferences) was measured by standardized methods and CRP with ELISA. LLS was self-reported. The analyses were conducted in the structural equation modeling (SEM) framework. The direct relationship between LLS and CRP was significant for all participants but was mediated by BMI/hip/waist circumferences. Multi-group SEM analysis provided evidence for sex moderation by showing that the mediating pathway from LLS to CRP through BMI, and to a lesser extent through hip/waist circumferences, was significant only in women. In conclusion, perceived LLS was positively associated with the level of inflammation mediated by BMI/hip/waist circumference, with the association between LLS and CRP being stronger in women. These findings contribute to the current literature untangling mediation/moderation processes in which perceived LLS may contribute to adiposity-related inflammation. They also add to precision medicine development, suggesting that stress and inflammation-reducing interventions should focus on African Americans, particularly women.

Initial impact of the COVID-19 pandemic on college student mental health: A longitudinal examination of risk and protective factors

The spread of the novel coronavirus has led to unprecedented changes in daily living. College students (N = 205) completed a battery of questionnaires in April of 2020, after having completed similar measures 8, 5, and 2 months prior as part of a larger study. A repeated measures ANOVA suggested significantly greater depression and anxiety symptom severity during the pandemic than any other time during the 2019-2020 academic year. Two-thirds reported a level of distress above clinical cutoffs on the PHQ-9 and GAD-7. Pre-existing depression and anxiety symptom severity was associated with greater psychological distress during the pandemic. One quarter of students reported using substances to cope with the pandemic. Static and modifiable factors associated with psychological distress and controlling for pre-existing psychological distress were examined. Cognitive and behavioral avoidance, online social engagement, and problematic Internet use were associated with greater risk. Women and Latinx participants were more likely to experience elevated distress during the pandemic, even when controlling for distress prior to the pandemic.

Factors Related to the Behavior of People Who Have Never Used the Internet for Voluntary Reasons: Cross-Sectional Survey Study

BACKGROUND

If there are people who do not want to use the internet despite having the circumstances and conditions for using it, another policy consideration will be needed.

OBJECTIVE

The purpose of this study was to explore the factors related to the behavior of people who do not voluntarily use the internet.

METHODS

A cross-sectional survey was conducted in 2018. It used a proportional quota random sampling design to select a representative sample of Koreans. Accordingly, 6150 participants were included in the study. Multiple logistic regression methods were used to explore the predicting factors of the act of voluntarily not using the internet.

RESULTS

Age, education level, bonding and bridging social capitals, and daily life satisfaction for health status were found to be factors related to the behavior of not voluntarily using the internet. However, gender, household income, occupation, family size, and community type were not related to voluntary nonuse of the internet.

CONCLUSIONS

It was found that sociodemographic factors, such as age and education level, which are difficult to modify, along with psychosocial factors located deeper than the visible living conditions, such as social capital and life satisfaction, are involved in voluntary internet nonuse. These results also suggest that it is not desirable to proceed with policies related to information and communications technology on a separate track, but rather that they should be comprehensively approached with other social policies that design various social interventions in order to enhance equity within the society.

Antioxidant intake in relation to serum C-reactive protein in mid-life and older African Americans

Objective: African Americans (AAs) experience greater prevalence of cardiovascular disease (CVD) compared to other ethnic/racial groups. Low-grade chronic inflammation (often quantified by serum C-reactive protein CRP) is a well-documented risk factor for CVD. A healthy diet is plentiful in antioxidant nutrients and is associated with a lower inflammatory status and CVD risk. Our objective was to examine the relationship between dietary intake of antioxidants (carotenoids, vitamins A, C, E, and selenium) and serum CRP concentrations in mid-life and older AAs, while controlling for confounders. Methods: Data were from the baseline phase of a longitudinal church-based intervention study to reduce CVD risk in AAs. Anthropometrics were measured in a standard manner. Fasting serum samples were analyzed with ELISA for CRP. Multiple-pass 24-hour dietary recalls were used to assess intake; self-reported questionnaires were used to collect demographics. Statistical analyses were performed using SPSS Statistics 21 with the level of significance set at p < 0.05. Results: A total of n = 73 participants (n = 51 females) were included in the analyses. The females and males, respectively were 58.9 ± 10.3 and 59.4 ± 9.7 years old, with BMI of 34.6 ± 8.3 and 35.6 ± 9.3 kg/m² (Mean ± SD). The mean serum CRP was above 0.6 mg/dL, although slightly lower in males. Males consumed more energy (kcal) and met RDA for selenium, whereas females met RDA for vitamin C. Both groups met RDA for vitamin A. All other dietary variables fell below the RDA or had no RDA established. Results from the binary logistic regression did not show significant association between dietary antioxidants and serum CRP in males or females. However, among females, for every unit increase in BMI, there was a 15% increase in serum CRP (OR = 1.15, p = 0.04). Conclusions: Our study does not support the inverse relationship between antioxidants intake and CRP, but does support the evidence for obesity-induced inflammation and suggests the association can be applied to AA women.

Lower life satisfaction, active coping and cardiovascular disease risk factors in older African Americans: outcomes of a longitudinal church-based intervention

This study examined lower life satisfaction, active coping and cardiovascular disease risk factors (diastolic and systolic blood pressure, body mass index, and circumferences) in older African Americans over the phases of an 18-month church-based intervention, using a quasi-experimental design. Participants (n = 89) were 45 years of age and older from six churches (three treatment, three comparison) in North Florida. Lower life satisfaction had a persistent unfavorable effect on weight variables. Active coping showed a direct beneficial effect on selected weight variables. However, active coping was adversely associated with blood pressure, and did not moderate the association between lower life satisfaction and cardiovascular risk factors. The intervention had a beneficial moderating influence on the association between lower life satisfaction and weight variables and on the association between active coping and these variables. Yet, this pattern did not hold for the association between active coping and blood pressure. The relationship of lower life satisfaction and selected cardiovascular risk factors and the positive effect of active coping were established, but findings regarding blood pressure suggest further study is needed.

Health insurance status, psychological processes, and older African Americans' use of preventive care

The current study examined the influence of health insurance, psychological processes (i.e. psychological competency and vulnerability), and the interaction of these two constructs on older African Americans' utilization of five preventive care services (e.g. cholesterol screening and mammogram/prostate examination) using data from 211 older African Americans (median age = 60). In addition to direct effects, the influence of health insurance sometimes varied depending on respondents' psychological competency and/or vulnerability. Policies and interventions to increase older African Americans' use of preventive health services should consider structural (e.g. health insurance) and psychological (e.g. psychological competency and vulnerability) factors along with the interaction between these factors.