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Gitelman J, Smith B, Warren CM, Andreacchi AT, Pabayo R, Hobin E. Sexual Identity and Heavy Drinking Among Adults in Canada by Racially Minoritized Status and Income, 2015-2020. LGBT Health 2024. [PMID: 38968343 DOI: 10.1089/lgbt.2023.0187] [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: 07/07/2024] Open
Abstract
Purpose: Our objective was to estimate inequities in heavy drinking between heterosexual, gay or lesbian, and bisexual or pansexual individuals, by sex/gender, and to determine whether this association is heterogeneous across racially minoritized status and income groups in Canadians aged 15 and older. Methods: We pooled three Canadian Community Health Survey cycles (2015-2020) and used separate modified Poisson regressions to explore the sex/gender-specific association between sexual identity and heavy drinking prevalence by racially minoritized status, and income, adjusted for survey cycle, age, marital status, and region. Results: With racially minoritized status, and income categories collapsed, heavy drinking was 1.3 times higher (95% confidence interval [CI] = 1.0-1.7) among bisexual or pansexual women compared with heterosexual women, with no differences among men. Among racially minoritized women, heavy drinking was 2.9 (95% CI = 1.3-6.4) times higher among bisexual or pansexual women and 1.9 (95% CI = 0.7-5.2) times higher among gay or lesbian women compared with heterosexual women. Among racially minoritized men, heavy drinking was 1.9 (95% CI = 0.9-4.0) times higher among gay men compared with heterosexual men. No differences were observed across sexual identity in White men or women. Bisexual or pansexual women reported increased heavy drinking relative to heterosexual women across income quintiles. Conclusion: Heavy drinking is distributed heterogeneously across sexual identity, sex/gender, racially minoritized status, and income. These results encourage equity-focused interventions to reduce heavy drinking among intersecting sociodemographic groups experiencing a greater burden of heavy drinking.
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Affiliation(s)
- Julian Gitelman
- Public Health and Preventive Medicine Residency Program, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Brendan Smith
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| | - Christine M Warren
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| | | | - Roman Pabayo
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Erin Hobin
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
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Kim K, Au-Yeung A, Dagher D, Jacobs N, Martin-Hill D, Wekerle C. Exploring the relevance of a psychology-based resilience app (JoyPop™) for Indigenous youth. CHILD ABUSE & NEGLECT 2024; 148:106343. [PMID: 37451896 DOI: 10.1016/j.chiabu.2023.106343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 04/15/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Despite facing challenges to mental wellness from ongoing multifold trauma, Indigenous youth continue to galvanize their resilience. One pathway undertaken is embracing technology. The JoyPop™ youth resilience mobile application (app) was invited by Six Nations of the Grand River (SN) leadership to consider its use with their reserve youth. OBJECTIVE This study explored the feasibility of JoyPop™ research from the SN community adult perspective for appropriateness and relevance to SN youth, as a precursor to a user-experience study with community youth. METHODS Semi-structured, online interviews with 19 adult community members (26 % male) about JoyPop™ were conducted with nominated stakeholders from SN. Based on a standard presentation of the app, comments were solicited about app features, design, and relevance to Haudenosaunee culture. Interviews were transcribed, coded in a double-blind fashion, and analyzed for themes. RESULTS Most offered positive feedback, with some level of support for each feature of JoyPop™. Themes were identified (Need for Indigenous Design, Incorporation of Indigenous Culture, Appreciation of Ease, Flexibility and Personalization), stemming from comments of appraisal and suggestions for adaptations (e.g., incorporating more cultural elements, localized resources, simplification of app). CONCLUSIONS The JoyPop™ app was viewed as positive and relevant, based on feedback from adults within SN. Adaptations were identified by adults to better fit SN youth needs, and research with SN youth is pending before implementation of adaptations. Research with other communities is encouraged to expand the reach of technology interventions, to holistically support Indigenous youth mental health in a culturally relevant way.
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Affiliation(s)
- Katherine Kim
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - Allison Au-Yeung
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Danielle Dagher
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Norma Jacobs
- Department of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Dawn Martin-Hill
- Department of Anthropology, Indigenous Studies Program, McMaster University, Hamilton, Ontario, Canada
| | - Christine Wekerle
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; Optentia Research Unit, North-West University, South Africa; Department of Psychiatry and Behavioral Neuroscience, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
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Mattingly DT, Mezuk B, Elliott MR, Fleischer NL. Discrimination and Tobacco Use Outcomes Among US Adults: Effect Modification by Race/Ethnicity. J Racial Ethn Health Disparities 2024; 11:395-405. [PMID: 36696079 PMCID: PMC11186478 DOI: 10.1007/s40615-023-01527-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/17/2023] [Accepted: 01/17/2023] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Racial/ethnic discrimination (hereafter, discrimination) is associated with tobacco use. However, little is known about the relationship between discrimination and dual/polytobacco use and tobacco use disorder (TUD), including how these relationships vary by race/ethnicity. METHODS Data on adults 18 and older come from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 35,881). Past-year discrimination was measured using the Experiences of Discrimination scale. Past 30-day exclusive, dual, and polytobacco use was measured as the mutually exclusive use of any combination of four types of tobacco products: cigarettes, electronic nicotine delivery systems, other combustibles (i.e., cigars and pipe), and smokeless tobacco. Past-year TUD was defined according to DSM-5 criteria. Associations between discrimination and exclusive, dual, and polytobacco use and discrimination and TUD were estimated using multinomial logistic regression and logistic regression, respectively. Models were stratified by race/ethnicity (i.e., Hispanic, non-Hispanic (NH) White, NH Black, another race/ethnicity) to assess effect modification. RESULTS Adults who used tobacco and who had TUD was 24.2% and 19.2%, respectively. More discrimination was associated with higher odds of exclusive, dual, and polytobacco use as well as TUD. Models stratified by race/ethnicity suggest that discrimination was associated with dual/polytobacco use among NH Black adults (OR: 1.05, 95% CI: 1.002-1.11) and NH White adults (OR: 1.18, 95% CI: 1.13-1.22). While more discrimination was associated with TUD among all racial/ethnic groups, the relationship was the strongest for NH White adults. CONCLUSIONS Discrimination was associated with more severe tobacco use outcomes among multiple racial/ethnic groups, but associations were the strongest for NH White adults.
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Affiliation(s)
- Delvon T Mattingly
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA.
| | - Briana Mezuk
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
| | - Michael R Elliott
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, 48104, USA
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
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Dong TS, Gee GC, Beltran-Sanchez H, Wang M, Osadchiy V, Kilpatrick LA, Chen Z, Subramanyam V, Zhang Y, Guo Y, Labus JS, Naliboff B, Cole S, Zhang X, Mayer EA, Gupta A. How Discrimination Gets Under the Skin: Biological Determinants of Discrimination Associated With Dysregulation of the Brain-Gut Microbiome System and Psychological Symptoms. Biol Psychiatry 2023; 94:203-214. [PMID: 36754687 PMCID: PMC10684253 DOI: 10.1016/j.biopsych.2022.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Discrimination is associated with negative health outcomes as mediated in part by chronic stress, but a full understanding of the biological pathways is lacking. Here we investigate the effects of discrimination involved in dysregulating the brain-gut microbiome (BGM) system. METHODS A total of 154 participants underwent brain magnetic resonance imaging to measure functional connectivity. Fecal samples were obtained for 16S ribosomal RNA profiling and fecal metabolites and serum for inflammatory markers, along with questionnaires. The Everyday Discrimination Scale was administered to measure chronic and routine experiences of unfair treatment. A sparse partial least squares-discriminant analysis was conducted to predict BGM alterations as a function of discrimination, controlling for sex, age, body mass index, and diet. Associations between discrimination-related BGM alterations and psychological variables were assessed using a tripartite analysis. RESULTS Discrimination was associated with anxiety, depression, and visceral sensitivity. Discrimination was associated with alterations of brain networks related to emotion, cognition and self-perception, and structural and functional changes in the gut microbiome. BGM discrimination-related associations varied by race/ethnicity. Among Black and Hispanic individuals, discrimination led to brain network changes consistent with psychological coping and increased systemic inflammation. For White individuals, discrimination was related to anxiety but not inflammation, while for Asian individuals, the patterns suggest possible somatization and behavioral (e.g., dietary) responses to discrimination. CONCLUSIONS Discrimination is attributed to changes in the BGM system more skewed toward inflammation, threat response, emotional arousal, and psychological symptoms. By integrating diverse lines of research, our results demonstrate evidence that may explain how discrimination contributes to health inequalities.
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Affiliation(s)
- Tien S Dong
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; UCLA Microbiome Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, Los Angeles, California; Division of Gastroenterology, Hepatology and Parenteral Nutrition, VA Greater Los Angeles Healthcare System, Los Angeles, California.
| | - Gilbert C Gee
- Department of Community Health Sciences Fielding School of Public Health, Los Angeles, California; California Center for Population Research, University of California, Los Angeles, Los Angeles, California
| | - Hiram Beltran-Sanchez
- Department of Community Health Sciences Fielding School of Public Health, Los Angeles, California; California Center for Population Research, University of California, Los Angeles, Los Angeles, California
| | - May Wang
- Department of Community Health Sciences Fielding School of Public Health, Los Angeles, California
| | - Vadim Osadchiy
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Lisa A Kilpatrick
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, Los Angeles, California
| | - Zixi Chen
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California
| | - Vishvak Subramanyam
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California
| | - Yurui Zhang
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California
| | - Yinming Guo
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California
| | - Jennifer S Labus
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; UCLA Microbiome Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, Los Angeles, California
| | - Bruce Naliboff
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; UCLA Microbiome Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, Los Angeles, California
| | - Steve Cole
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; Department of Psychiatry & Biobehavioral Sciences and Medicine, University of California, Los Angeles, Los Angeles, California
| | - Xiaobei Zhang
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, Los Angeles, California
| | - Emeran A Mayer
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; UCLA Microbiome Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, Los Angeles, California
| | - Arpana Gupta
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; UCLA Microbiome Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, Los Angeles, California.
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Li R, Liu S, Huang C, Darabi D, Zhao M, Heinzel S. The influence of perceived stress and income on mental health in China and Germany. Heliyon 2023; 9:e17344. [PMID: 37408921 PMCID: PMC10318459 DOI: 10.1016/j.heliyon.2023.e17344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 06/05/2023] [Accepted: 06/14/2023] [Indexed: 07/07/2023] Open
Abstract
Background Mental health issues affect rich and poor, young and old, and are widespread in Asia as well as in Europe. However, few studies have investigated the influence of perceived stress and income on mental health among general population in China and in Germany. Methods We conducted an online survey from December 2021 to February 2022 to investigate how perceived stress and income affect mental health among the general population in China (N = 1123) and in Germany (N = 1018). Accordingly, we used the 10-item Perceived Stress Scale (PSS-10) and the 12-item General Health Questionnaire (GHQ-12). We ran a multiple linear regression model to investigate the relationship between perceived stress, income, and mental health. Results Overall, we found that 53.4% participants reported mental health issues (GHQ-12 score ≥12). The proportion of our sample who reported mental health issues was higher in Germany (60.3%) than in China (44.8%). The regression model revealed that a higher perceived stress score was associated with more mental health issues in both countries (b = 0.60, p < 0.01). Individuals with a low income reported poorer mental health in Germany than those in China. Interestingly, the situation was reversed when incomes were high: individuals with a high income reported worse mental health in China than in Germany (b = -0.40, p < 0.01). Conclusion Perceived stress has a negative impact on mental health, while income has differential effects. Mental health promotion programmes may involve teaching stress management, while considering differences in mental health outcomes in developed and developing countries.
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Affiliation(s)
- Ruihua Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shandong Mental Health Center, Shandong University, Jinan, China
| | - Shuyan Liu
- Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin (Campus Charité Mitte), Berlin, Germany
| | - Chuanning Huang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Debora Darabi
- Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin (Campus Charité Mitte), Berlin, Germany
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
- CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, China
| | - Stephan Heinzel
- Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
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Mattingly DT, Neighbors HW, Mezuk B, Elliott MR, Fleischer NL. Racial/ethnic discrimination and tobacco and cannabis use outcomes among US adults. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 148:208958. [PMID: 37102192 PMCID: PMC11184515 DOI: 10.1016/j.josat.2023.208958] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 10/11/2022] [Accepted: 01/09/2023] [Indexed: 04/28/2023]
Abstract
INTRODUCTION Racial/ethnic discrimination (hereafter, discrimination) is associated with use of individual tobacco and cannabis products. However, we know little about how discrimination affects dual/polytobacco and cannabis use and associated use disorders. METHODS We used cross-sectional data on adults (18+) from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 35,744). We defined past-year discrimination as a summary scale (range: 0-24) based on six scenarios. We created a mutually exclusive six-category use variable: noncurrent, individual tobacco and noncannabis, individual tobacco and cannabis, individual cannabis and nontobacco, dual/polytobacco and noncannabis, and dual/polytobacco and cannabis based on past 30-day tobacco use of four products (i.e., cigarettes, electronic nicotine delivery systems, other combustibles (cigars, pipe), smokeless tobacco) and cannabis use. We also examined past-year tobacco use disorder (TUD) and cannabis use disorder (CUD) as a four-level variable: no disorders, TUD only, CUD only, and TUD and CUD. We estimated associations between discrimination and each outcome using adjusted multinomial logistic regression and assessed effect modification by stratifying adjusted models by race/ethnicity (i.e., Hispanic, non-Hispanic (NH) White, NH Black, and another race/ethnicity). RESULTS Experiencing more discrimination was associated with each outcome but was most strongly associated with dual/polytobacco and cannabis use (OR: 1.13, 95 % CI: 1.07-1.19) and joint TUD and CUD (OR: 1.16, 95 % CI: 1.12-1.20). Models stratified by race/ethnicity showed that discrimination was associated with dual/polytobacco and cannabis only among NH White adults, and with joint TUD and CUD only among NH Black and NH White adults. CONCLUSIONS Discrimination was associated with tobacco and cannabis use outcomes among multiple adult racial/ethnic populations, but associations were more profound for NH White and NH Black adults than adults from other racial/ethnic populations.
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Affiliation(s)
- Delvon T Mattingly
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
| | - Harold W Neighbors
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| | - Briana Mezuk
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Michael R Elliott
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
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Mao W, Wu B, Chi I, Yang W, Dong X. Experiences of discrimination and oral health-related quality of life among foreign-born older Chinese Americans: Does resilience play a mediating role? Community Dent Oral Epidemiol 2023; 51:187-193. [PMID: 34958135 DOI: 10.1111/cdoe.12723] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES It is well-established that racial discrimination influences quality of life, but there is scarce evidence about how racial discrimination affects oral health-related quality of life (OHRQoL). Furthermore, the pathways linking racial discrimination and OHRQoL remain unknown. Guided by the integrative framework of immigration, ageing, and oral health, psychosocial stressors and resources exert influences on OHRQoL. In addition, according to the compensatory model of resilience, resilient resources could counteract risk exposures to stressors given specific outcomes. Hence, this study examined the relationship between experiences of discrimination and OHRQoL and investigated resilience as a mediator in such a relationship among older Chinese immigrants. METHODS Data came from the Population Study of Chinese Elderly in Chicago collected between 2017 and 2019. The working sample included 3054 foreign-born older Chinese Americans aged 60 years or older. OHRQoL was measured by seven items from the Geriatric Oral Health Assessment Index. Experiences of discrimination (yes or no) were measured by the 9-item Experiences of Discrimination instrument. Resilience was measured by the 10-item Connor Davidson Resilience Scale. Mediation analysis was conducted to examine the direct and indirect pathways towards OHRQoL. RESULTS Experiences of discrimination were directly associated with poorer OHRQoL (b = -0.98, P < .05). Resilience partially mediated the relationship between discrimination experiences and OHRQoL. Specifically, discrimination experiences were associated with weaker resilience (b = -1.58, P < .05), and weaker resilience was associated with poorer OHRQoL (b = 0.06, P < .05). CONCLUSIONS Findings illustrate the importance of studying racial discrimination and resilience in OHRQoL. Interventions need to consider individuals' discrimination experiences and stress coping abilities to promote OHRQoL.
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Affiliation(s)
- Weiyu Mao
- School of Social Work, University of Nevada, Reno, Reno, Nevada, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Iris Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Wei Yang
- School of Public Health, University of Nevada, Reno, Reno, Nevada, USA
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey, USA
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Vaswani M, Sutter A, Lapshina N, Esses VM. Discrimination Experienced by Immigrants, Racialized Individuals, and Indigenous Peoples in Small- and Mid-Sized Communities in Southwestern Ontario. CANADIAN REVIEW OF SOCIOLOGY = REVUE CANADIENNE DE SOCIOLOGIE 2023; 60:92-113. [PMID: 36718975 DOI: 10.1111/cars.12413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
We investigate discrimination experiences of (1) immigrants and racialized individuals, (2) Indigenous peoples, and (3) comparison White non-immigrants in nine regions of Southwestern Ontario containing small- and mid-sized communities. For each region, representative samples of the three groups were recruited to complete online surveys. In most regions, over 80 percent of Indigenous peoples reported experiencing discrimination in the past 3 years, and in more than half of the regions, over 60 percent of immigrants and racialized individuals did so. Indigenous peoples, immigrants and racialized individuals were most likely to experience discrimination in employment settings and in a variety of public settings, and were most likely to attribute this discrimination to racial and ethnocultural factors, and for Indigenous peoples also their Indigenous identity. Immigrants and racialized individuals who had experienced discrimination generally reported a lower sense of belonging and welcome in their communities. This association was weaker for Indigenous peoples. The findings provide new insight into discrimination experienced by Indigenous peoples, immigrants and racialized individuals in small and mid-sized Canadian communities, and are critical to creating and implementing effective anti-racism and anti-discrimination strategies.
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Affiliation(s)
- Mamta Vaswani
- Network for Economic and Social Trends (NEST), Western University, London, Ontario, Canada
| | - Alina Sutter
- Network for Economic and Social Trends (NEST), Western University, London, Ontario, Canada
| | - Natalia Lapshina
- Network for Economic and Social Trends (NEST), Western University, London, Ontario, Canada
| | - Victoria M Esses
- Network for Economic and Social Trends (NEST), Western University, London, Ontario, Canada
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Obaoye JO, Dawson AZ, Thakkar M, Williams JS, Egede LE. Understanding the relationship between perceived discrimination and mortality in United States adults. Aging Ment Health 2023; 27:445-451. [PMID: 35118927 PMCID: PMC9349476 DOI: 10.1080/13607863.2022.2032593] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 01/18/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To understand the relationship between mortality and three types of perceived discrimination (lifetime, daily, chronic job) using a nationally representative sample of U.S. adults. METHODS Data from 4562 adults in the Midlife in the United States (MIDUS) between 2004 and 2006 (MIDUS II and MIDUS African American sample) were analyzed. Unadjusted associations between primary independent discrimination variables (lifetime, chronic job, daily) and mortality were analyzed using univariate Cox's proportional hazards regression models. Covariates were added to the models by group: predisposing (sex, age, race/ethnicity, education, marital status); enabling (household income, employment status, insurance status); and need factors (body mass index, diabetes, hypertension, stroke, cancer) to estimate hazard ratios. RESULTS After adjusting for all covariates, hazard ratios for lifetime discrimination (HR: 1.09, p = 0.034) and daily discrimination (HR: 1.03, p = 0.030) were statistically significant. There was no relationship between mortality and chronic job discrimination (HR:1.03, p = 0.15). CONCLUSIONS Adults experiencing lifetime and daily discrimination had significantly increased risk of mortality after adjusting for predisposing, enabling, and need factors. The findings highlight the importance of screening patients during clinical encounters for experiences of discrimination and providing appropriate resources to mitigate the negative impact of discriminatory events on mortality. Future research should work to fully understand the mechanism by which discrimination increases risk of mortality. These future findings should be used to develop targets for interventions designed to decrease mortality among adults who have experienced discrimination.
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Affiliation(s)
- Joanna O. Obaoye
- Department of Medicine, Medical School, Medical College of Wisconsin, CLCC – 5 Floor, 9200 W Wisconsin Ave., Milwaukee, WI 53226
| | - Aprill Z. Dawson
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226
- Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226
| | - Madhuli Thakkar
- Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226
| | - Joni S. Williams
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226
- Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226
| | - Leonard E. Egede
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226
- Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226
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Selvarajah S, Corona Maioli S, Deivanayagam TA, de Morais Sato P, Devakumar D, Kim SS, Wells JC, Yoseph M, Abubakar I, Paradies Y. Racism, xenophobia, and discrimination: mapping pathways to health outcomes. Lancet 2022; 400:2109-2124. [PMID: 36502849 DOI: 10.1016/s0140-6736(22)02484-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 10/06/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022]
Abstract
Despite being globally pervasive, racism, xenophobia, and discrimination are not universally recognised determinants of health. We challenge widespread beliefs related to the inevitability of increased mortality and morbidity associated with particular ethnicities and minoritised groups. In refuting that racial categories have a genetic basis and acknowledging that socioeconomic factors offer incomplete explanations in understanding these health disparities, we examine the pathways by which discrimination based on caste, ethnicity, Indigeneity, migratory status, race, religion, and skin colour affect health. Discrimination based on these categories, although having many unique historical and cultural contexts, operates in the same way, with overlapping pathways and health effects. We synthesise how such discrimination affects health systems, spatial determination, and communities, and how these processes manifest at the individual level, across the life course, and intergenerationally. We explore how individuals respond to and internalise these complex mechanisms psychologically, behaviourally, and physiologically. The evidence shows that racism, xenophobia, and discrimination affect a range of health outcomes across all ages around the world, and remain embedded within the universal challenges we face, from COVID-19 to the climate emergency.
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Affiliation(s)
- Sujitha Selvarajah
- Institute for Global Health, University College London, London, UK; St George's Hospital NHS Foundation Trust, London, UK.
| | | | - Thilagawathi Abi Deivanayagam
- Institute for Global Health, University College London, London, UK; Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | | | - Delan Devakumar
- Institute for Global Health, University College London, London, UK
| | - Seung-Sup Kim
- Department of Environmental Health Sciences, Seoul National University, Seoul, South Korea
| | - Jonathan C Wells
- University College London Great Ormond Street Institute of Child Health, London, UK
| | - Marcella Yoseph
- Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK; Sir Ketumile Masire Teaching Hospital, University of Botswana, Gaborone, Botswana
| | - Ibrahim Abubakar
- Institute for Global Health, University College London, London, UK
| | - Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Melbourne VIC, Australia
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11
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Grasser LR, Jovanovic T. Neural Impacts of Stigma, Racism, and Discrimination. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:1225-1234. [PMID: 35811064 DOI: 10.1016/j.bpsc.2022.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/28/2022] [Accepted: 06/28/2022] [Indexed: 12/13/2022]
Abstract
Racism is a chronic stressor fueled by stigma that can result in significant distress and dysfunction as well as negatively affect emotions, behavior, quality of life, and brain health. The effects of stigma and discrimination emerge early in life and have long-term consequences. In this review, we sought to use neuroscience research to describe how stigma, racism, and discrimination can impact brain and mental health. Societal stigmas may be encoded by associative fear learning and pattern completion networks, and experiences of racial discrimination may similarly affect threat-responsive regions and circuits. Race-related differences in brain function and structure supporting threat circuitry are largely attenuated when negative life experiences and discrimination are taken into account. Downstream, chronic activation of the hypothalamic-pituitary-adrenal axis and the sympathetic-adrenal-medullary axis in the context of discrimination and stigma can contribute to physical health disparities in minoritized and marginalized groups. Finally, we discuss models that provide a framework for interventions and societal-level strategies across ecologic systems to build resilience and foster posttraumatic growth.
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Affiliation(s)
- Lana Ruvolo Grasser
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan.
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12
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Cénat JM, Kouamou LN, Moshirian Farahi SMM, Darius WP, Dalexis RD, Charles M, Kogan CS. Perceived racial discrimination, psychosomatic symptoms, and resilience among Black individuals in Canada: A moderated mediation model. J Psychosom Res 2022; 163:111053. [PMID: 36244137 DOI: 10.1016/j.jpsychores.2022.111053] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 10/02/2022] [Accepted: 10/02/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Although no study has explored psychosomatic symptoms in Black communities in Canada, several studies in the United States showed that psychological distress is often express as physical pain among African Americans. Using a cross-sectional design, the present study documents the frequency of psychosomatic symptoms and its association to racial discrimination, and resilience among Black individuals aged 15 to 40 in Canada. METHOD A total of 860 participants (Mage = 25.0 years, SD = 6.3), predominantly born in Canada (79.1%) and women (75.6%), completed the Symptom Checklist-90-Revised (somatization subscale), the Everyday Discrimination Scale, and the Resilience Scale-14. RESULTS Findings revealed that 81.7% of participants experienced psychosomatic symptoms, with higher prevalence among women (84.2%) compared to men (70.7%;), ꭓ2 = 21.5, p < .001; participants aged 25 to 40 years old (93.7%) compared to those aged 15-24 years old (75.2%) (ꭓ2 = 45.0, p < .001). Participants reporting greater racial discrimination had more psychosomatic symptoms (89.4%) compared to others (72.9%), ꭓ2 = 39.2, p < .001). A moderated mediation model showed that everyday racial discrimination was positively associated with psychosomatic symptoms (B = 0.1, SE = 0.01, p < .001). The model showed that the association between racial discrimination and psychosomatic symptoms was partially mediated by resilience (B = -0.01, SE = 0.0, p < .01), and negatively moderated by gender (B = -0.04, SE = 0.01, p < .01). In other words, being a woman is associated with higher levels of psychosomatic symptoms among those who have experienced racial discrimination. CONCLUSION By highlighting the association between racial discrimination and psychosomatic symptoms and the role of resilience and gender in this relation, this article reveals important factors to integrate to improve healthcare services, prevention, and interventions among Black individuals with psychosomatic symptoms.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, University of Ottawa, Ottawa, Ontario, Canada.
| | | | | | | | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
| | - Michée Charles
- Department of Sociology, Université Toulouse Jean Jaurès, Toulouse, France
| | - Cary S Kogan
- School of Psychology, University of Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ontario, Canada
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13
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Guo R, He Y. Narrative resilience in the cross-regional support of healthcare workers during the COVID-19 outbreak: The Chinese experiences of cultural input. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2022; 82:103376. [PMID: 36267110 PMCID: PMC9562614 DOI: 10.1016/j.ijdrr.2022.103376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 10/08/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
The healthcare staff who supported Wuhan's rescue work were the first batch of cross-regional supporters during the outbreak of the COVID-19 pandemic. To determine the cultural factors that affected their mental health and resilience, as well as the processes that organizations and individuals underwent to transform cultural resources into benefits. This study collected narrative materials in the form of national and individual statements and used Social Ecology of Resilience theory to analyse them. It identified and analysed the cultural factors of resilience in macrosystems, mesosystems, and microsystems according to four themes, namely: cognition, emotion, will, and behaviour. Altogether, it was found that the national voice adopted an optimistic narrative tone reminiscent of that used during the context of war and that the personal or public voice approved of it. The study revealed that the party and government's use of moral narration derived from its heritage culture and its belief in its continuity in new China's culture served as a mechanism of cultural resilience and mobilisation. The above is the experience of the operation of living culture (LC) and cultural heritage (CH) mentioned in Culture Based Development (CBD). In light of this, it was concluded that the predominant form of cultural input during China's national public health crisis has been storytelling with narrative resilience.
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Affiliation(s)
- Ruitong Guo
- School of Education, Yunnan Minzu University, Kunming, China
| | - Yiqing He
- School of Education, Guangzhou University, Guangzhou, China
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14
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James D. An initial framework for the study of internalized racism and health: Internalized racism as a racism‐induced identity threat response. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2022. [DOI: 10.1111/spc3.12712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Drexler James
- Department of Psychology University of Minnesota Minneapolis Minnesota USA
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15
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Tanner B, George N, Brubacher LJ, Morton Ninomiya ME, Peach L, Bernards S, Linklater R, George J, Wells S. Navigating Paths to Wellness: A Strengths-Based Photovoice Study Conducted with One First Nation in Southern Ontario, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10979. [PMID: 36078690 PMCID: PMC9518375 DOI: 10.3390/ijerph191710979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
Research on substance use challenges in First Nations communities is often deficit-focused and can reinforce paternalistic stereotypes that lead to further discrimination. In this article, we report on findings of a strengths-based Photovoice project done in collaboration with a First Nations' community in southern Ontario, Canada to better understand experiences with substance use challenges in the community. We analyzed interview data collected with seventeen individuals who have lived experience or are supporting a loved one with lived experience with a substance use challenge. Participants described sources of strength that characterized their path to wellness, including strong family and social connections, cultural practices, identity, spirituality, day-to-day activities, and helpful supports and services. Furthermore, participants made several suggestions for improving services, including the need for integrated and flexible systems of care and trustful client-provider relationships. At its core, nurturing wellness involved a transformative process involving social and/or cultural connections. The stories shared by participants demonstrate the unique and varied strengths drawn from by individuals dealing with a substance use challenge.
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Affiliation(s)
- Bryan Tanner
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle Suite 200, London, ON N6G 4X8, Canada
| | | | - Laura Jane Brubacher
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle Suite 200, London, ON N6G 4X8, Canada
- Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Melody E. Morton Ninomiya
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle Suite 200, London, ON N6G 4X8, Canada
- Health Sciences, Wilfrid Laurier University, Waterloo, ON N2L 3C5, Canada
| | - Laura Peach
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Sharon Bernards
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle Suite 200, London, ON N6G 4X8, Canada
| | - Renee Linklater
- Shkaabe Makwa, Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada
| | - Julie George
- Mental Health, Addiction and Violence Support Program, Kettle & Stony Point Health Services, Kettle & Stony Point First Nation, Lambton Shores, ON N0N 1J1, Canada
| | - Samantha Wells
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle Suite 200, London, ON N6G 4X8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 3B2, Canada
- Department of Epidemiology and Biostatistics, Western University, London, ON N6A 3K7, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 3B2, Canada
- School of Psychology, Deakin University, Melbourne, VIC 3217, Australia
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16
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Gonzalez MB, Sittner KJ, Walls ML. Cultural efficacy as a novel component of understanding linkages between culture and mental health in Indigenous communities. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 70:191-201. [PMID: 35285956 PMCID: PMC9452443 DOI: 10.1002/ajcp.12594] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 05/22/2023]
Abstract
We used a novel measure of cultural efficacy to examine empirical pathways between enculturation, efficacy, and two wellbeing outcomes. Cultural factors are not consistently linked to better wellbeing in the academic literature despite widespread understanding of these processes in Indigenous communities. Healing pathways is a community-based participatory study with eight reservations/reserves in the upper Midwest and Canada. This study uses data collected in 2017-2018 (n = 453, 58.1% women, mean age = 26.3 years) and structural equation modeling to test the relationships between enculturation, cultural efficacy, and mental health. The direct effect of enculturation on anxiety was positive. The indirect effect of enculturation via cultural efficacy was negatively associated with anxiety and positively associated with positive mental health. Cultural efficacy is an important linking variable through which the protective effects of culture manifest. The complex nature of culture must be met with innovative measures and deep understanding of Indigenous peoples to fully capture the protective role of culture.
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Affiliation(s)
- Miigis B. Gonzalez
- Johns Hopkins Bloomberg School of Public Health, Center for American Indian Health, Great Lakes HubDuluthMinnesotaUSA
| | - Kelley J. Sittner
- Department of SociologyOklahoma State UniversityStillwaterOklahomaUSA
| | - Melissa L. Walls
- Johns Hopkins Bloomberg School of Public Health, Center for American Indian Health, Great Lakes HubDuluthMinnesotaUSA
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17
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Wang C, Yan S, Jiang H, Guo Y, Gan Y, Lv C, Lu Z. Socio-demographic characteristics, lifestyles, social support quality and mental health in college students: a cross-sectional study. BMC Public Health 2022; 22:1583. [PMID: 35987998 PMCID: PMC9392273 DOI: 10.1186/s12889-022-14002-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Mental health problems are important public health issues among college students and are associated with various social factors. However, these influencing factors were scarcely summarized in Chinese college students comprehensively. This study aims to assess the associations between socio-demographic characteristics, lifestyles, social support quality (SSQ) and mental health among Chinese college students .
Methods
A cross-sectional study was conducted in Wuhan, China, from October 2017 to February 2018. College students from 18 colleges or universities were randomly recruited using multi-stage cluster sampling method. The Multidimensional Scale of Perceived Social Support scale and 12-items General Health Questionnaire were used to estimate students’ SSQ and mental health statuses, respectively. Logistic regression analysis was used to evaluate the associations between socio-demographic characteristics, lifestyles, SSQ and mental health problems.
Results
A total of 10,676 college students were included. Among them, 21.4% were identified as having possible mental health problems. Students being a female, aged 18–22 years old, whose mother held college degrees and above, and drinking alcohol were more likely to have mental health problems (P < 0.05). Contrarily, having general or higher household economic levels, work-rest regularly, and sleeping ≥ 7 h were preventive factors (P < 0.05). Especially, a decreasing trend in the risk of having mental health problems with the improvement of SSQ was identified.
Conclusion
Besides socio-demographic and lifestyle factors, social support is a critical factor for mental health among college students. Improving SSQ, especially which from the family, could be an effective method to prevent mental health problems among college students.
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18
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Kogan CS, Noorishad PG, Ndengeyingoma A, Guerrier M, Cénat JM. Prevalence and correlates of anxiety symptoms among Black people in Canada: A significant role for everyday racial discrimination and racial microaggressions. J Affect Disord 2022; 308:545-553. [PMID: 35460740 DOI: 10.1016/j.jad.2022.04.110] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/29/2022] [Accepted: 04/14/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Anxiety disorders are highly prevalent worldwide but vary significantly by country and ethnoracial background. Minimal published data exist on the prevalence of clinically significant anxiety among Black people in Canada and none using validated measures. Therefore, this study sought to establish the frequency of clinically significant anxiety symptoms among a sample of Black people living in Canada as well as examine the association with two forms of racism (racial discrimination and racial microaggressions). METHODS Data collected from the Black Community Mental Health project in Canada was analyzed. Participants provided (N= 845) sociodemographic information and completed measures assessing anxiety symptomology (GAD-7), everyday racial discrimination, racial microaggressions, and resilience. Prevalence of anxiety symptomatology was determined across sociodemographic variables as well as categories of everyday racial discrimination and racial microaggressions. Two regression models were conducted to examine the relationship between anxiety symptoms and the two forms of racism controlling for sociodemographic factors. RESULTS Overall, nearly a third of participants endorsed clinically significant levels of anxiety symptoms, with higher rates observed among men, unemployed people, those with higher education, people who are separated, and those with no reported family history of mental health problems. Logistic regression models demonstrated that, except for those reporting the greatest frequency of racial discrimination, there is a general linear trend such that those experiencing higher levels of racial discrimination or racial microaggressions are increasingly more likely to present with anxiety symptoms when compared to those reporting low levels of discrimination or microaggressions. Psychological resilience afforded nominal protection but only against exposure to racial microaggressions. CONCLUSIONS Rates of clinically significant anxiety are higher among Black people in Canada than reported previously. Both racial discrimination and racial microaggressions predicted higher rates of anxiety symptoms. The results are discussed in relation to previous findings from the US that report similar findings.
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Affiliation(s)
- Cary S Kogan
- School of Psychology, University of Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ontario, Canada.
| | | | | | | | - Jude Mary Cénat
- School of Psychology, University of Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ontario, Canada.
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19
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Graham S, Blaxland M, Bolt R, Beadman M, Gardner K, Martin K, Doyle M, Beetson K, Murphy D, Bell S, Newman CE, Bryant J. Aboriginal peoples' perspectives about COVID-19 vaccines and motivations to seek vaccination: a qualitative study. BMJ Glob Health 2022; 7:e008815. [PMID: 35858705 PMCID: PMC9304971 DOI: 10.1136/bmjgh-2022-008815] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/07/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Aboriginal and Torres Strait Islander (Aboriginal) people compared with non-Aboriginal people in Australia have higher rates of chronic conditions. These conditions increase the risk of poorer health outcomes if infected with COVID-19, highlighting the importance of COVID-19 vaccination. This study examined what Aboriginal people think about COVID-19 vaccines, reasons why they were vaccinated or not vaccinated and factors involved in receiving COVID-19 vaccination. METHODS We used a participatory peer researcher method to interview 35 Aboriginal people aged 15-80 years living in Western Sydney, Australia. Local Aboriginal people who had ties with the community conducted the interviews. The questions and analyses were framed using the WHO's Behavioural and Social Drivers of COVID-19 model. Interviews occurred between February 2021 and March 2021. Peer researchers were paid for their time in training and to conduct the interviews and each participant received $50. RESULTS Reasons why participants would seek vaccination included: to protect themselves from infection and severe illness, to protect others in their community, to travel again and to return to 'normal life'. Reasons why some participants were hesitant about being vaccinated included: fear of vaccine side effects; negative stories on social media; and distrust in Australian governments and medical institutions. Aboriginal people preferred to access COVID-19 vaccination through their local Aboriginal Health Service or a general practitioner they already knew. CONCLUSION Achieving high vaccination rates in Aboriginal communities is possible if vaccination programmes are delivered through trusted general practitioners or Aboriginal Health Services.
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Affiliation(s)
- Simon Graham
- Department of Infectious Diseases, The Peter Doherty Institute for Infection and Immunity, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - Megan Blaxland
- Social Policy Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Reuben Bolt
- Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Mitchell Beadman
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Kristy Gardner
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Kacey Martin
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Michael Doyle
- NHMRC Centre for Research Excellence in Indigenous Health and Alcohol, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Karen Beetson
- Department of Aboriginal Health, South Western Sydney Local Health District, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Dean Murphy
- The Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, New South Wales, Australia
| | - Stephen Bell
- Social Policy Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
- UQ Poche Centre for Indigenous Health, The University of Queensland, Saint Lucia, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Christy E Newman
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Joanne Bryant
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
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20
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Galvao TF, Baldin Tiguman GM, Antonio BVR, de Alencar RRFR, Garcia LP, Silva MT. Perceived discrimination in health services and associated factors in Manaus Metropolitan Region, Brazil: a cross-sectional population-based study. ETHNICITY & HEALTH 2022; 27:847-857. [PMID: 32909824 DOI: 10.1080/13557858.2020.1817341] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/23/2020] [Indexed: 06/11/2023]
Abstract
Objectives: Discrimination is the differentiated treatment of individuals due to prejudgments. Discriminatory practices in health care result in negative effects on patients' health. In Brazil, skin color represents the main form of racial discrimination, which may have an impact on the accessibility and quality of health care. The Brazilian Amazon lacks investigations on this topic at the population level. This study aims to estimate the prevalence of perceived discrimination in health services and associated factors in the Manaus Metropolitan Region, state of Amazonas, Brazil.Design: A population-based cross-sectional study was conducted with a probabilistic sample of adults interviewed in 2015. The associated factors were investigated by calculating the prevalence ratio (PR) using Poisson regression with robust variance.Results: A total of 4,001 participants were included. The overall prevalence of perceived discrimination was 12.9% (95% confidence interval [CI]: 11.8-13.9%). When compared to the reference categories, women (PR = 1.43; 95%CI: 1.20-1.70), individuals with brown skin color (Brazilian mixed race; PR = 1.33; 95%CI: 1.04-1.71), people who suffer from hypertension (PR = 1.27;95%CI: 1.03-1.57), and people who frequently used health services (p≤0.03) experienced more discrimination from health professionals.Conclusions: The prevalence of perceived discrimination in health services in Manaus Metropolitan Region is frequent and is associated with ethnic, social and health-related factors. Investments in inclusive public health policies and a better quality of health assistance are required to tackle this problem.
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Affiliation(s)
- Tais Freire Galvao
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, Brazil
| | | | | | | | - Leila Posenato Garcia
- Board Directory of Studies and Social Policies, Institute of Applied Economic Research, Brasília, Brazil
| | - Marcus Tolentino Silva
- Post-Graduate Program of Pharmaceutical Sciences, Universidade de Sorocaba, Sorocaba, Brazil
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21
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Williams MT, Khanna Roy A, MacIntyre MP, Faber S. The Traumatizing Impact of Racism in Canadians of Colour. CURRENT TRAUMA REPORTS 2022; 8:17-34. [PMID: 35345606 PMCID: PMC8943361 DOI: 10.1007/s40719-022-00225-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2022] [Indexed: 01/27/2023]
Abstract
Purpose of Review While research has identified racial trauma in other contexts, it is often overlooked amongst Canadian society. Racial trauma occurs as a result of an event of racism or cumulative events over time whereby an individual experiences stress and consequent mental health sequelae. Given that the BIPOC (Black, Indigenous, and/or Person of Colour) population in Canada is increasing, it is imperative to identify racial discrimination and the subsequent stress and trauma associated with being racialized in Canada, which subjects BIPOC Canadians to various forms of racism, including microaggressions. Recent Findings This paper reviews the published literature on racism and racial discrimination that identifies or infers racial trauma as the source of the mental health implications for various groups (e.g., Indigenous people, Black Canadians, Asian Canadians, immigrants, and refugees). In addition, intersectionality of racialized persons is prominent to their psychological well-being as their psychosocial and socioeconomic position are complex. Therefore, this paper both provides insight into the Canadian experience as a person of colour and signifies the need for further research on racial trauma in a Canadian context. Summary Despite Canada’s emphasis on multiculturalism, racialized individuals are at risk for racial trauma due to prejudice and discrimination. The politicization of multiculturalism has permitted Canada to deny claims of racism, yet the historical basis of established institutions results in irrefutable systemic and systematic barriers for Canadian people of colour.
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Affiliation(s)
- Monnica T Williams
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, ON K1N 6N5 Canada.,Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON Canada
| | | | - Marie-Paule MacIntyre
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, ON K1N 6N5 Canada
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22
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Fernandez JR, Richmond J, Nápoles AM, Kruglanski AW, Forde AT. Everyday discrimination and cancer metaphor preferences: The mediating effects of needs for personal significance and cognitive closure. SSM Popul Health 2022; 17:100991. [PMID: 35005182 PMCID: PMC8715368 DOI: 10.1016/j.ssmph.2021.100991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 11/20/2022] Open
Abstract
Metaphors are often used to describe cancer experiences (e.g., battle, journey). Few studies explore how social threats (e.g., discrimination) shape metaphor preferences. We examined the relationship between discrimination and preferences for cancer battle metaphors (i.e., concrete, action-based) versus journey metaphors (i.e., open-ended, reflective) and mediating effects of needs for personal significance and cognitive closure. We also stratified the analysis when discrimination was/was not attributed to race and by racial/ethnic group. Four-hundred twenty-seven U.S. participants completed an online survey. Items included everyday discrimination, need for personal significance, need for cognitive closure, and preference for cancer scenarios using battle or journey metaphors. Multigroup structural equation modeling examined: serial mediation (i.e., discrimination predicting metaphor preference via needs for personal significance and cognitive closure) stratified by discrimination attribution; and single mediation (i.e., discrimination predicting need for cognitive closure via need for personal significance) stratified by racial/ethnic group. Discrimination was associated with battle metaphor preferences through serial mediation when discrimination was not attributed to race (β = 0.02, 95% CI [0.01,0.05]). Discrimination was directly associated with journey metaphor preferences (β = -0.20, 95% CI [-0.37,-0.06]) and the serial mediation was nonsignificant when discrimination was attributed to race. The single mediation model varied across racial/ethnic groups and was strongest for Non-Hispanic White participants (β = 0.17, 95% CI [0.07,0.30]). Discrimination may shape cancer metaphor preferences through needs for personal significance and cognitive closure, yet these relationships differ based on whether discrimination is attributed to race and racial/ethnic group. Given that the U.S. health system often focuses on battle metaphors when framing cancer treatment and screenings, individuals who prefer journey metaphors (i.e., those who experienced more frequent racial discrimination in the present study) may experience a systematic disadvantage in cancer communication. A more careful consideration of cultural, racial, and ethnic differences in metaphor use may be a crucial step towards reducing cancer disparities.
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Affiliation(s)
- Jessica R. Fernandez
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Jennifer Richmond
- Department of Medicine, Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Anna M. Nápoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Arie W. Kruglanski
- Department of Psychology, University of Maryland, College Park, College Park, MD, USA
| | - Allana T. Forde
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
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Tanner B, Plain S, George T, George J, Mushquash CJ, Bernards S, Morton Ninomiya M, Wells S. Understanding Social Determinants of First Nations Health Using a Four-Domain Model of Health and Wellness Based on the Medicine Wheel: Findings from a Community Survey in One First Nation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2836. [PMID: 35270529 PMCID: PMC8910369 DOI: 10.3390/ijerph19052836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 02/01/2023]
Abstract
We examined the explanatory roles of social determinants of health (SDOH) for First Nations people using a four-domain model of health and wellness based on the Medicine Wheel (i.e., physical, mental, emotional, and spiritual health), including colonial-linked stressors (i.e., historical trauma, childhood adversities, racial discrimination) and cultural resilience factors (i.e., cultural strengths, traditional healing practices, social support). Data were collected in partnership with a First Nation in Ontario, Canada in 2013 through a community survey (n = 194). For each outcome (physical, mental, emotional, and spiritual health), a modified Poisson regression model estimated prevalence ratios for the SDOH, adjusting for age, sex, education, and marital status. Negative associations were found for historical trauma with physical, mental, emotional, and spiritual health; for childhood adversities with mental health; and for racial discrimination with physical, mental, and emotional health. Positive associations were found for cultural strengths with physical, mental, and emotional health and for social support with physical, mental, emotional, and spiritual health. We observed negative associations between use of traditional healing practices and mental and emotional health. Our findings suggest that these SDOH may play important roles in relation to wellness through associations with the domains of health modelled by the Medicine Wheel.
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Affiliation(s)
- Bryan Tanner
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle, London, ON N6G 4X8, Canada; (S.B.); (M.M.N.); (S.W.)
| | - Sara Plain
- E’Mino Bmaad-Zijig Health Centre, Aamjiwnaang First Nation, 1300 Tashmoo Ave, Sarnia, ON N7T 7H5, Canada; (S.P.); (T.G.)
| | - Tracey George
- E’Mino Bmaad-Zijig Health Centre, Aamjiwnaang First Nation, 1300 Tashmoo Ave, Sarnia, ON N7T 7H5, Canada; (S.P.); (T.G.)
| | - Julie George
- Mental Health, Addiction and Violence Support Program, Kettle & Stony Point Health Services, A-6275 Indian Lane, Kettle & Stony Point First Nation, Lambton Shores, ON N0N 1J1, Canada;
| | - Christopher J. Mushquash
- Department of Psychology, Lakehead University, 955 Oliver Rd, Thunder Bay, ON P7B 5E1, Canada;
- Northern Ontario School of Medicine, Lakehead University, 955 Oliver Rd, Thunder Bay, ON P7B 5E1, Canada
- Dilico Anishinabek Family Care, 200 Anemki Pl, Fort William First Nation, ON P7J 1L6, Canada
- Centre for Rural and Northern Health Research, Thunder Bay, ON P7B 5E1, Canada
- Thunder Bay Regional Health Sciences Centre, 980 Oliver Rd, Thunder Bay, ON P7B 6V4, Canada
- Thunder Bay Regional Health Research Institute, 1040 Oliver Rd, Thunder Bay, ON P7B 7A5, Canada
| | - Sharon Bernards
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle, London, ON N6G 4X8, Canada; (S.B.); (M.M.N.); (S.W.)
| | - Melody Morton Ninomiya
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle, London, ON N6G 4X8, Canada; (S.B.); (M.M.N.); (S.W.)
- Health Sciences, Wilfrid Laurier University, 75 University Ave W, Waterloo, ON N2L 3C5, Canada
| | - Samantha Wells
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle, London, ON N6G 4X8, Canada; (S.B.); (M.M.N.); (S.W.)
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Russel Street, Toronto, ON M5S 3M1, Canada
- Dalla Lana School of Public Health, University of Toronto, 150 College St, Toronto, ON M5T 3M7, Canada
- Department of Epidemiology and Biostatistics, Western University, 1151 Richmond St., London, ON N6A 3K7, Canada
- Department of Psychiatry, University of Toronto, 27 King’s College Circle, Toronto, ON M5S 1A1, Canada
- School of Psychology, Deakin University, 664 Collins Street, Melbourne, VIC 3217, Australia
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Marks C, Pearson JL, Zúñiga ML, Martin N, Werb D, Smith LR. Articulating the Trauma-Informed Theory of Individual Health Behavior. Stress Health 2022; 38:154-162. [PMID: 34009751 PMCID: PMC9035290 DOI: 10.1002/smi.3068] [Citation(s) in RCA: 6] [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] [Received: 01/10/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 02/03/2023]
Abstract
Exposure to trauma increases the risk of engaging in detrimental health behaviours such as tobacco and substance use. In response, the United States Substance Abuse and Mental Health Services Administration developed Trauma-Informed Care (TIC), an organisational framework for improving the provision of behavioural health care to account for the role exposure to trauma plays in patients' lives. We adapt TIC to introduce a novel theory of behaviour change, the Trauma-Informed Theory of Individual Health Behavior (TTB). TTB posits that individual capacity to undertake intentional health-promoting behaviour change is dependent on three factors: (1) the forms and severity of trauma they have been and are exposed to, (2) how this trauma physiologically manifests (i.e., the trauma response) and (3) resilience to undertake behaviour change despite this trauma response. We define each of these factors and their relationships to one another. We anticipate that the introduction of TTB will provide a foundation for developing theory-driven research, interventions, and policies that improve behavioural health outcomes in trauma-affected populations.
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Affiliation(s)
- Charles Marks
- Joint Doctoral Program in Interdisciplinary Research on Substance Use, San Diego State University and University of California, San Diego, US
- School of Social Work, San Diego State University, San Diego, California
- Division of Infectious Diseases and Global Public Health, University of California San Diego
| | - Jennifer L. Pearson
- Division of Social and Behavioral Health/Health Administration and Policy, University of Nevada, Reno
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior, and Society
| | - María Luisa Zúñiga
- Joint Doctoral Program in Interdisciplinary Research on Substance Use, San Diego State University and University of California, San Diego, US
- School of Social Work, San Diego State University, San Diego, California
| | - Natasha Martin
- Division of Infectious Diseases and Global Public Health, University of California San Diego
- Population Health Sciences, University of Bristol, UK
| | - Dan Werb
- Division of Infectious Diseases and Global Public Health, University of California San Diego
- Centre on Drug Policy Evaluation, St. Michael’s Hospital, Toronto, ON, Canada
| | - Laramie R. Smith
- Joint Doctoral Program in Interdisciplinary Research on Substance Use, San Diego State University and University of California, San Diego, US
- Division of Infectious Diseases and Global Public Health, University of California San Diego
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Abstract
PURPOSE OF REVIEW Both social and genetic factors are associated with health outcomes in systemic lupus erythematosus (SLE), thus playing a role in its health disparities. Despite the growing list of social and genetic factors associated with SLE outcomes, studies integrating sociocultural and individual determinants of health to understand health disparities in SLE are lacking. We review the contributions of different social and genetic factors to the disparities in SLE, and propose a socioecological model to integrate and examine the complex interactions between individual and social factors in SLE outcomes. RECENT FINDINGS Multiple studies collecting comprehensive social data and biospecimens from diverse populations are underway, which will contribute to the elucidation of the interplay and underlying mechanisms by which positive and negative social determinants of health influence epigenomic variation, and how the resulting biological changes may contribute to the lupus health disparities. SUMMARY There is growing awareness of the need to integrate genomic and health disparities research to understand how social exposures affect disease outcomes. Understanding the contributions of these factors to the SLE health disparity will inform the development of interventions to eliminate risk exposures and close the health disparity gap.
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Han SD, Lamar M, Fleischman D, Kim N, Bennett DA, Lewis TT, Arfanakis K, Barnes LL. Self-reported experiences of discrimination in older black adults are associated with insula functional connectivity. Brain Imaging Behav 2021; 15:1718-1727. [PMID: 32720182 PMCID: PMC7854830 DOI: 10.1007/s11682-020-00365-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Self-reported experiences of discrimination are associated with a number of negative health outcomes. However, the neurobiological correlates of discrimination remain elusive. Recent neuroimaging work suggests that the amygdala is sensitive to forms of social adversity and the insula is involved in assessments of trust. We hypothesized that functional connectivity (FC) of these brain regions may be associated with discrimination in older Black adults. One-hundred and twenty-four nondemented older Black adults participating in the Minority Aging Research Study or the Clinical Core study of the Rush Alzheimer's Disease Center completed a measure of self-reported experiences of discrimination and a 3T MRI brain scan including structural T1 and resting-state fMRI EPIBOLD sequences. The right and left amygdala and insula regions were anatomically delineated as ROIs according to the Harvard-Oxford Brain Atlas and whole-brain voxelwise FC analyses were conducted using default parameters in the CONN toolbox. In regression analyses controlling for demographics and global cognition, self-reported experiences of discrimination were associated with greater FC between the left insula and the bilateral intracalcarine cortex, weaker FC between the left insula and the left dorsolateral prefrontal cortex, and weaker FC between the right insula and the left supplementary motor area. Amygdala analyses yielded no significant findings. Greater self-reported experiences of discrimination are associated with differential insula functional connectivity in older adults. More specifically, results suggest that discrimination is associated with differential connectivity of a key region (the insula) involved in trust perception.
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Affiliation(s)
- S Duke Han
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, 90089, USA.
- Department of Neurology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, 90089, USA.
- Department of Psychology, University of Southern California, Los Angeles, CA, 90089, USA.
- School of Gerontology, University of Southern California, Los Angeles, CA, 90089, USA.
| | - Melissa Lamar
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, 60612, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Debra Fleischman
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, 60612, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Namhee Kim
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, 60612, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, 60616, USA
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Lisa L Barnes
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, 60612, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, 60612, USA
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Gameon JA, Skewes MC. Historical trauma and substance use among American Indian people with current substance use problems. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 35:295-309. [PMID: 33829816 PMCID: PMC8084991 DOI: 10.1037/adb0000729] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE In the United States, American Indian and Alaska Native (AI/AN) people suffer health inequities associated with alcohol and other drug use and also experience historical trauma symptoms resulting from colonization. Research suggests that historical trauma may be associated with substance use among AI/ANs. METHOD As part of a Community-Based Participatory Research project with tribal partners from a rural AI reservation, our team collected cross-sectional survey data from 198 tribal members who self-identified as having substance use problems. We examined associations between historical trauma thoughts, historical trauma symptoms, and substance use outcomes. We also examined historical trauma symptoms, current trauma symptoms, awareness of systemic discrimination, and ethnic identity as moderators of the associations between historical trauma thoughts and substance use variables. RESULTS Historical trauma thoughts, controlling for symptoms, were associated with greater abstinent days, fewer heavy alcohol use days, fewer drinks per drinking day, and fewer drug use days; historical trauma symptoms, controlling for thoughts, were associated only with fewer abstinent days. Moderation analyses showed that historical trauma thoughts were associated with better substance use outcomes when historical trauma symptoms were low, current trauma symptoms were low, awareness of systemic discrimination was high, and ethnic identity was high. CONCLUSION When distressing trauma symptoms are low, historical trauma thoughts may act as a protective factor or as a marker for other factors associated with better substance use outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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28
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Balabanski AH, Dos Santos A, Woods JA, Thrift AG, Kleinig TJ, Suchy-Dicey A, Siri SR, Boden-Albala B, Krishnamurthi R, Feigin VL, Buchwald D, Ranta A, Mienna CS, Zavaleta C, Churilov L, Burchill L, Zion D, Longstreth WT, Tirschwell DL, Anand S, Parsons MW, Brown A, Warne DK, Harwood M, Katzenellenbogen JM. The Incidence of Stroke in Indigenous Populations of Countries With a Very High Human Development Index: A Systematic Review Protocol. Front Neurol 2021; 12:661570. [PMID: 33967945 PMCID: PMC8100239 DOI: 10.3389/fneur.2021.661570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 03/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Aims: Despite known Indigenous health and socioeconomic disadvantage in countries with a Very High Human Development Index, data on the incidence of stroke in these populations are sparse. With oversight from an Indigenous Advisory Board, we will undertake a systematic review of the incidence of stroke in Indigenous populations of developed countries or regions, with comparisons between Indigenous and non-Indigenous populations of the same region, though not between different Indigenous populations. Methods: Using PubMed, OVID-EMBASE, and Global Health databases, we will examine population-based incidence studies of stroke in Indigenous adult populations of developed countries published 1990-current, without language restriction. Non-peer-reviewed sources, studies including <10 Indigenous People, or with insufficient data to determine incidence, will be excluded. Two reviewers will independently validate the search strategies, screen titles and abstracts, and record reasons for rejection. Relevant articles will undergo full-text screening, with standard data extracted for all studies included. Quality assessment will include Sudlow and Warlow's criteria for population-based stroke incidence studies, the Newcastle-Ottawa Scale for risk of bias, and the CONSIDER checklist for Indigenous research. Results: Primary outcomes include crude, age-specific and/or age-standardized incidence of stroke. Secondary outcomes include overall stroke rates, incidence rate ratio and case-fatality. Results will be synthesized in figures and tables, describing data sources, populations, methodology, and findings. Within-population meta-analysis will be performed if, and where, methodologically sound and comparable studies allow this. Conclusion: We will undertake the first systematic review assessing disparities in stroke incidence in Indigenous populations of developed countries. Data outputs will be disseminated to relevant Indigenous stakeholders to inform public health and policy research.
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Affiliation(s)
- Anna H. Balabanski
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash Universit, Melbourne, VIC, Australia,Department of Medicine and Neurology, Melbourne Brain Centre at Royal Melbourne, Melbourne, VIC, Australia,*Correspondence: Anna H. Balabanski
| | - Angela Dos Santos
- Department of Medicine and Neurology, Melbourne Brain Centre at Royal Melbourne, Melbourne, VIC, Australia
| | - John A. Woods
- Western Australian Centre for Rural Health, School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Amanda G. Thrift
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash Universit, Melbourne, VIC, Australia
| | - Timothy J. Kleinig
- Department of Neurology, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Astrid Suchy-Dicey
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Susanna Ragnhild Siri
- Department of Community Medicine, Faculty of Health Sciences, Centre for Sami Health Research, UiT the Arctic University of Norway, Tromso, Norway
| | - Bernadette Boden-Albala
- Department of Population Health and Disease Prevention, Department of Epidemiology, University of California, Irvine, Irvine, CA, United States
| | - Rita Krishnamurthi
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Valery L. Feigin
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Dedra Buchwald
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, United States
| | - Annemarei Ranta
- Department of Medicine, University of Otago, Wellington, New Zealand
| | | | - Carol Zavaleta
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Leonid Churilov
- Department of Medicine and Neurology, Melbourne Brain Centre at Royal Melbourne, Melbourne, VIC, Australia
| | - Luke Burchill
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Deborah Zion
- Human Research Ethics Committee, Victoria University, Melbourne, VIC, Australia
| | - W. T. Longstreth
- Departments of Neurology and Epidemiology, University of Washington, Seattle, WA, United States
| | - David L. Tirschwell
- Departments of Neurology and Epidemiology, University of Washington, Seattle, WA, United States
| | - Sonia Anand
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Mark W. Parsons
- Department of Medicine and Neurology, Melbourne Brain Centre at Royal Melbourne, Melbourne, VIC, Australia,University of New South Wales (UNSW) South Western Sydney Clinical School, Liverpool, NSW, Australia
| | - Alex Brown
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Donald K. Warne
- School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States
| | - Matire Harwood
- Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Jelsma EB, Goosby BJ, Cheadle JE. Do trait psychological characteristics moderate sympathetic arousal to racial discrimination exposure in a natural setting? Psychophysiology 2021; 58:e13763. [PMID: 33462861 PMCID: PMC10624514 DOI: 10.1111/psyp.13763] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 12/12/2020] [Accepted: 12/14/2020] [Indexed: 11/28/2022]
Abstract
Personality and psychological traits are known to influence how individuals react to and cope with stress, and thus, have downstream health and aging consequences. However, research considering psychological health traits as individual-level difference factors moderating the links been racism-related stress and health for racial and ethnic minorities in the United States is rare. Using intensive daily diaries and a wearable sensor that continuously recorded sympathetic nervous system arousal in a sample of racial and ethnic minority college students (80% African American, first-generation Black, or African; 20% Latinx), we linked arousal to racism-related experiences dynamically throughout the day as participants naturally went about their lives. Findings suggest that multiple traits are associated with increased arousal in real time when interpersonal discrimination is perceived, but that only anger and anxiety also predicted increased arousal during moments of rumination and reflection on race-related inequities. Vicarious discrimination exposure moments were also linked to suppressed arousal in general, but particularly for more anxious individuals. We use a stress appraisal and coping framework to elucidate the ways in which individual psychological differences may inform physiological responses to race-related stress. The biopsychosocial pathways by which cognitive appraisal and interpersonal race-related stress contribute to racial health disparities are also discussed.
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Affiliation(s)
- Elizabeth B Jelsma
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, TX, USA
- Population Research Center, University of Texas at Austin, Austin, TX, USA
| | - Bridget J Goosby
- Population Research Center, University of Texas at Austin, Austin, TX, USA
- Department of Sociology, University of Texas at Austin, Austin, TX, USA
| | - Jacob E Cheadle
- Population Research Center, University of Texas at Austin, Austin, TX, USA
- Department of Sociology, University of Texas at Austin, Austin, TX, USA
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30
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Westerman T, Sheridan L. Whole of community suicide prevention forums for Aboriginal Australians. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1111/ap.12470] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Tracy Westerman
- Indigenous Psychological Services, Perth, Western Australia, Australia,
- School of Psychology, Curtin University, Perth, Western Australia, Australia,
| | - Lorraine Sheridan
- Indigenous Psychological Services, Perth, Western Australia, Australia,
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Towards health equity for people experiencing chronic pain and social marginalization. Int J Equity Health 2021; 20:53. [PMID: 33531018 PMCID: PMC7852178 DOI: 10.1186/s12939-021-01394-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 01/24/2021] [Indexed: 12/31/2022] Open
Abstract
Objective For people who experience social inequities and structural violence, pain and related care are inexorably linked to experiences of injustice and stigma. The purpose of this study was to examine in greater depth the experiences of pain and discrimination and stigma across diverse marginalized communities in order to recommend equity-oriented healthcare approaches. Methods This community-based qualitative study reports on four focus groups that included 36 people living with pain. All participants identified with one of three groups known to experience high levels of inequities and structural violence including an Indigenous group, a LGBTQ2S group, and two newcomer and refugee groups. Results Pain was entangled with and shaped by: social locations and identities, experiences of violence, trauma and related mental health issues, experiences of discrimination, stigma and dismissal, experiences of inadequate and ineffective health care, and the impacts of these intersecting experiences. Conclusions Equity-oriented responses to chronic pain would recognize pain not only as a biomedical issue but as a social justice issue. The EQUIP Framework is an approach to integrating trauma- and violence-informed care; culturally-safe care; and harm reduction in health care that may hold promise for being tailored to people experiencing pain and social marginalization.
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32
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Hostinar CE, Miller GE. Protective factors for youth confronting economic hardship: Current challenges and future avenues in resilience research. ACTA ACUST UNITED AC 2020; 74:641-652. [PMID: 31545638 DOI: 10.1037/amp0000520] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Economic hardship during childhood is associated with worse mental and physical health across the life span. Over the past decade, interdisciplinary research has started to elucidate the behavioral and biological pathways that underlie these disparities and identify protective factors that mitigate against their occurrence. In this integrative review we describe these advances, highlight remaining gaps in knowledge, and outline a research agenda for psychologists. This article has 3 aims. First, we consider the evolving psychobiological literature on protective factors and conclude that supportive relationships can mitigate against the physical health problems often associated with economic hardship. Second, we discuss recent empirical developments in health psychology, public health, and the biological sciences, which reveal trade-offs associated with adaptation and challenge the conception of what it means to be resilient. Finally, we outline a research agenda that attempts to integrate existing knowledge on health disparities with these newer challenges to inform both policy and practice for youth experiencing economic hardship. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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33
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Mann FD, Krueger RF, Clouston S, Cole S. Demographic correlates of inflammatory and antiviral gene expression in the study of Midlife in the United States (MIDUS). BIODEMOGRAPHY AND SOCIAL BIOLOGY 2020; 66:236-249. [PMID: 34622724 PMCID: PMC8702472 DOI: 10.1080/19485565.2021.1983761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The present study examined the demographic correlates of gene expression in a sample of adults (n = 543) from the Study of Midlife in the United States (MIDUS). Inflammatory and antiviral gene sets were operationalized using a priori composite scores and empirically derived co-regulatory gene sets. For both composite scores and co-regulatory gene sets, White/European Americans showed lower while Black/African Americans showed higher expression of genes involved in interferon responses and antibody synthesis. The effects of chronological age on gene expression varied by sex, such that pro-inflammatory gene expression increased with age more rapidly for females than males. The difference between the average expression of inflammatory and antiviral genes also increased with age for females but not males. Results shed light on differential gene expression as a potential physiological correlate for race/ethnicity, age, and sex-related health disparities in adulthood.
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Affiliation(s)
- Frank D. Mann
- Program in Public Health and the Department of Family, Population, and Preventive Medicine, Stony Brook University
| | | | - Sean Clouston
- Program in Public Health and the Department of Family, Population, and Preventive Medicine, Stony Brook University
| | - Steven Cole
- Department of Psychiatry & Biobehavioral Sciences and Medicine, University of California, Los Angeles
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Breathett K, Sims M, Gross M, Jackson EA, Jones EJ, Navas-Acien A, Taylor H, Thomas KL, Howard BV. Cardiovascular Health in American Indians and Alaska Natives: A Scientific Statement From the American Heart Association. Circulation 2020; 141:e948-e959. [PMID: 32460555 PMCID: PMC7351358 DOI: 10.1161/cir.0000000000000773] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death among American Indians and Alaska Natives. Over the past 50 years, the prevalence of CVD has been rising among American Indians and Alaska Natives. The objective of this statement is to summarize population-level risk factors and management techniques tailored for the American Indian and Alaska Native populations. METHODS PubMed/MEDLINE, the Centers for Disease Control and Prevention, and the annual Heart Disease and Stroke Statistics report from the American Heart Association were used to identify risk factors and interventions specific to American Indians and Alaska Natives. RESULTS Diabetes mellitus is a major contributor to disproportionately higher rates of coronary heart disease among American Indians and Alaska Natives compared with other racial and ethnic groups. Additional risk factors for CVD include low-density lipoprotein cholesterol levels, hypertension, renal disease, age, and sex. Smoking and exposure to toxic metals are risk factors for some subpopulations. A quarter of American Indians live below the federal poverty line, and thus, low socioeconomic status is an important social determinant of cardiovascular health. Community-based interventions have reduced CVD risk in American Indians and Alaska Natives. Underreporting of American Indian and Alaska Native race could underestimate the extent of CVD in this population. CONCLUSIONS Prevention and treatment of CVD in American Indians and Alaska Natives should focus on control of risk factors and community-based interventions that address social determinants of health, particularly among individuals with diabetes mellitus. Accurate reporting of race/ethnicity is encouraged to address race-specific risk factors.
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Kawika Allen GE, Wang KT, Richards PS, Ming M, Suh HN. Religious Discrimination Scale: Development and Initial Psychometric Evaluation. JOURNAL OF RELIGION AND HEALTH 2020; 59:700-713. [PMID: 29705827 DOI: 10.1007/s10943-018-0617-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study presents the development and initial psychometric evaluation of the Religious Discrimination Scale (RDS). This 11-item instrument identified three dimensions based on perceived discrimination experiences of members of The Church of Jesus Christ of Latter-day Saints (LDS): Perceived Prejudice, Closet Symptoms, and Negative Labels. The psychometric evaluations of the RDS indicated a strong and clear factor structure as well as good internal consistency reliability. The test of measurement and structural invariance across gender also suggested that the RDS scale is equally appropriate to be used with both men and women. Implications for practice and research as well as future directions are discussed.
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Affiliation(s)
- G E Kawika Allen
- Department of Counseling Psychology and Special Education, McKay School of Education, 273 MCKB, Brigham Young University, Provo, UT, 84602, USA.
| | - Kenneth T Wang
- Department of Clinical Psychology, Fuller Theological Seminary, 180 N. Oakland Ave, Pasadena, CA, 91101, USA
| | - P Scott Richards
- Department of Counseling Psychology and Special Education, McKay School of Education, 340 MCKB, Brigham Young University, Provo, UT, 84602, USA
| | - Mason Ming
- Department of Counseling Psychology and Special Education, McKay School of Education, 340 MCKB, Brigham Young University, Provo, UT, 84602, USA
| | - Han Na Suh
- Department of Educational, School and Counseling Psychology, University of Missouri, Columbia, USA
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Morton Ninomiya M, George N(P, George J, Linklater R, Bull J, Plain S, Graham K, Bernards S, Peach L, Stergiopoulos V, Kurdyak P, McKinley G, Donnelly P, Wells S. A community-driven and evidence-based approach to developing mental wellness strategies in First Nations: a program protocol. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:5. [PMID: 32082614 PMCID: PMC7017570 DOI: 10.1186/s40900-020-0176-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 01/03/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Mental health, substance use/addiction and violence (MSV) are important issues affecting the well-being of Indigenous People in Canada. This paper outlines the protocol for a research-to-action program called the Mental Wellness Program (MWP). The MWP aims to increase community capacity, promote relationship-building among communities, and close gaps in services through processes that place value on and supports Indigenous communities' rights to self-determination and control. The MWP involves collecting and using local data to develop and implement community-specific mental wellness strategies in five First Nations in Ontario. METHODS The MWP has four key phases. Phase 1 (data collection) includes a community-wide survey to understand MSV issues, service needs and community strengths; in-depth interviews with individuals with lived experiences with MSV issues to understand, health system strengths, service gaps and challenges, as well as individual and community resilience factors; and focus groups with service providers to improve understanding of system weaknesses and strengths in addressing MSV. Phase 2 (review and synthesis) involves analysis of results from these local data sources and knowledge-sharing events to identify a priority area for strategic development based on local strengths and need. Phase 3 (participatory action research approach) involves community members, including persons with lived experience, working with the community and local service providers to develop, implement, and evaluate the MWP to address the selected priority area. Phase 4 (share) is focused on developing and implementing effective knowledge-sharing initiatives. Guidelines and models for building the MWP are shared regionally and provincially through forums, webinars, and social media, as well as cross-community mentoring. DISCUSSION MWP uses local community data to address MSV challenges by building on community supports and resilience factors. Drawing on local data and each community's system of formal and informal supports, the program includes sharing exemplary knowledge-to-action models and wellness strategies developed by and for First Nations people that can be used by other First Nations to identify shared wellness priorities in each community, and determine and execute next steps in addressing areas of main concern.
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Affiliation(s)
- Melody Morton Ninomiya
- Centre for Addiction and Mental Health, Toronto and London, Ontario Canada
- Health Sciences, Wilfrid Laurier University, Waterloo, Ontario Canada
| | | | - Julie George
- Centre for Addiction and Mental Health, Toronto and London, Ontario Canada
- Kettle & Stony Point Health Centre, Kettle & Stony Point First Nation, Toronto, Ontario Canada
| | - Renee Linklater
- Centre for Addiction and Mental Health, Toronto and London, Ontario Canada
| | - Julie Bull
- Centre for Addiction and Mental Health, Toronto and London, Ontario Canada
| | - Sara Plain
- E’Mino Bmaad-Zijig Gamig, Aamjiwnaang First Nation Health Centre, Aamjiwnaang First Nation, Toronto, Ontario Canada
| | - Kathryn Graham
- Centre for Addiction and Mental Health, Toronto and London, Ontario Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Victoria Australia
- National Drug Research Institute, Curtin University, Perth, Western Australia Australia
| | - Sharon Bernards
- Centre for Addiction and Mental Health, Toronto and London, Ontario Canada
| | - Laura Peach
- Centre for Addiction and Mental Health, Toronto and London, Ontario Canada
| | - Vicky Stergiopoulos
- Centre for Addiction and Mental Health, Toronto and London, Ontario Canada
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario Canada
| | - Paul Kurdyak
- Centre for Addiction and Mental Health, Toronto and London, Ontario Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario Canada
- Institute for Clinical Evaluative Science, Toronto, Ontario Canada
| | | | - Peter Donnelly
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| | - Samantha Wells
- Centre for Addiction and Mental Health, Toronto and London, Ontario Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Victoria Australia
- University of Western Ontario, London, Ontario Canada
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Nguemo JD, Iroanyah N, Husbands W, Nelson LE, Maina G, Njoroge I, Owino M, Kahan M, Miller D, Wong J. Substance use disorders among African, Caribbean and Black (ACB) people in Canada: a scoping review protocol. BMJ Open 2019; 9:e028985. [PMID: 31296511 PMCID: PMC6624103 DOI: 10.1136/bmjopen-2019-028985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Previous research demonstrated that substance use continues to be one of the most complex and prevalent problems among African, Caribbean and Black (ACB) people. A number of studies were conducted to characterise substance use patterns in this population. To our knowledge, this is the first known review in Canada characterising substance use disorders on ACB people.This scoping review seeks to answer the following research questions: What characterises substance use disorders among ACB people in Canada? What are the different types and prevalence of substance use among ACB people in Canada? Do ACB people in Canada use more than one substance? What factors are associated with substance use among ACB people in Canada? What are the health and social impacts of substance use in ACB people in Canada? METHODS AND ANALYSES This study will use the methodological framework for scoping reviews developed by Arksey and O'Malley. We will search electronic bibliographic databases including Ovid MEDLINE, PsycINFO and CINAHL. We will limit our search to English articles published between 2000and2019. In addition, we will conduct a grey literature search. Two investigators will independently screen citations and full-text articles. Our findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for scoping reviews guidelines. We will provide a descriptive summary of the studies and summarise the findings with respect to the outcomes and report any gaps that might require further investigation. ETHICS AND DISSEMINATION Our proposed study does not involve human participants; therefore, research ethics approval is not required. This study will provide evidence that will inform the development of strategies for appropriate interventions, as well as policy and further research. The results will be disseminated through publications in open access peer-reviewed journals, presentations at scientific meetings and to the lay public.
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Affiliation(s)
- Joseph D Nguemo
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Ngozi Iroanyah
- School of health policy and management, York University, Toronto, Ontario, Canada
| | | | - LaRon E Nelson
- Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
| | - Geoffrey Maina
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Irene Njoroge
- Rapid Access Addiction Medicine Clinic, Women's College Hospital, Toronto, Ontario, Canada
| | - Maureen Owino
- Committee for Accessible AIDS Treatment, Regent Park Community Health Centre, Toronto, Ontario, Canada
| | - Meldon Kahan
- Rapid Access Addiction Medicine Clinic, Women's College Hospital, Toronto, Ontario, Canada
| | - Desmond Miller
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Josephine Wong
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
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Gesink D, Whiskeyjack L, Guimond T. Perspectives on restoring health shared by Cree women, Alberta, Canada. Health Promot Int 2019; 34:454-461. [PMID: 29309576 DOI: 10.1093/heapro/dax099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The purpose of this study was to explore nehiyaw iskwêwak (Cree women's) perceptions and beliefs about how to restore balance to health. Fifteen indigenous women from Northern Alberta, Canada, participated in a 3-day cultural retreat on beauty and art in British Columbia, Canada, in May 2015. At the end of the retreat, these women were invited to participate in a talking circle and asked, 'What does restoring balance look like?' A constructivist grounded theory approach was used to explore individual and collective perspectives on restoring health. Nehiyaw iskwêwak provided a vision of health using metaphors from the natural environment. Starting points and core characteristics of health were grounded in relationship with self, others, place and the land, suggesting interventions grounded in land-based pedagogy and focused on restoring relationship and secure attachment might be effective for this population. Nehiyaw iskwêwak also said interventions should start at the individual level; as the individual restores balance mentally, emotionally, physically and spiritually, a long-term ripple effect can be initiated through the generations and community when these women in turn support the strengthening and nurturing of relations (e.g. parents, siblings, friends, children, grandchildren) for the next seven generations.
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Affiliation(s)
- Dionne Gesink
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7, Canada
| | - Lana Whiskeyjack
- University nuhelot'įne thaiyots'į nistameyimâkanak Blue Quills, St. Paul, Alberta, T0A 3A0, Canada
| | - Tim Guimond
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7, Canada.,Department of Psychiatry, St. Michael's Hospital, Toronto, ON, M5B 1W8, Canada
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Santiago PHR, Roberts R, Smithers LG, Jamieson L. Stress beyond coping? A Rasch analysis of the Perceived Stress Scale (PSS-14) in an Aboriginal population. PLoS One 2019; 14:e0216333. [PMID: 31050685 PMCID: PMC6499425 DOI: 10.1371/journal.pone.0216333] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 04/18/2019] [Indexed: 11/23/2022] Open
Abstract
The history of colonization contributed to Aboriginal and Torres Strait Islanders becoming one of the most disadvantaged groups in Australia. The multiple social inequalities, and therefore the constant insecurities for many about low income, poor living conditions, unemployment, and discrimination, generate chronic stress in this population. In the Baby Teeth Talk Study, an oral-health randomized controlled trial, the Perceived Stress Scale (PSS-14) was administered to 367 pregnant Aboriginal women at baseline. The aim of the present study was to evaluate the validity and reliability of the PSS-14 in an Aboriginal population. The study analysed: (a) model fit; (b) dimensionality; (c) local dependence; (d) differential item functioning; (e) threshold ordering and item fit; (f) targeting; (g) reliability; and (h) criterion validity. The dimensionality analysis indicated a two-factor structure, with negatively and positively worded items clustering together and 21.7% (95% Agresti-Coull C.I. [17.8%, 26.2%]) statistically significant t-tests between the persons' estimates. After the creation of composite items, the revised Perceived Distress (χ2 (21) = 11.74, p = 0.946) and Perceived Coping (χ2 (28) = 17.63, p = 0.935) subscales fitted the Rasch model. Reliability was modest (PersonSeparationIndexdistress = 0.72; PersonSeparationIndexcoping = 0.76). The latent correlation between the Perceived Distress and Perceived Coping subscales was r = 0.14. It is hypothesized that the social inequalities experienced by the Aboriginal population are so pronounced that even Aboriginal pregnant women that perceived themselves as coping well with life challenges ended up endorsing items regarding high levels of stress. The present research showed that a revised PSS-14 is a culturally valid and modestly reliable psychological instrument to measure stress in a population of pregnant Aboriginal women in Australia.
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Affiliation(s)
- Pedro Henrique Ribeiro Santiago
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Rachel Roberts
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Lisa Gaye Smithers
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
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An examination of genes, stress and suicidal behavior in two First Nations communities: The role of the brain-derived neurotropic factor gene. Psychiatry Res 2019; 275:247-252. [PMID: 30933702 DOI: 10.1016/j.psychres.2019.02.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 02/14/2019] [Accepted: 02/15/2019] [Indexed: 12/14/2022]
Abstract
Suicide claims over 800,000 lives each year worldwide. Suicide rates in indigenous populations in Canada are about double that of the national average, making it a serious public health issue. Numerous factors are involved in suicide risk, including genetic factors, as well as various psychosocial stressors, such as historical experience with the Indian Residential School system for Indigenous populations, as well as protective variables such as social support. Here, we report the first genetic study of suicidal behaviors that includes multiple measures of stress and social supports. We investigated the role of the functional Val66Met marker (rs6265) in the Brain-Derived Neurotropic Factor (BDNF) gene in suicidal ideation and suicide attempt in a First Nations community sample (N = 278). We did not find a significant association between the BDNF rs6265 marker and suicidal behaviors. We found childhood adversities, recent life stress, chronic stress, perceived stress, difficulties, and hazardous alcohol use to be associated with both suicidal ideation and suicide attempt. Thus, while additional studies with larger samples are required to elucidate the genetic component of suicide, addressing environmental stressors may be important for suicide prevention.
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Arpaia J, Andersen JP. The Unease Modulation Model: An Experiential Model of Stress With Implications for Health, Stress Management, and Public Policy. Front Psychiatry 2019; 10:379. [PMID: 31231255 PMCID: PMC6567485 DOI: 10.3389/fpsyt.2019.00379] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 05/14/2019] [Indexed: 12/17/2022] Open
Abstract
Stress has a pervasive, global, and negative influence on individual health. Stress also has negative effects on families, organizations, and communities. Current models of stress are either too general or too detailed to guide effective interventions across the spectrum of medical and social conditions that are stress-related. A new model is needed that explains how stress can have such varied effects and describes how to reduce its harm. The model must also capture both the dynamic nature of stress and its ability to persist and cause chronic effects. The model must guide those who use it in selecting effective interventions and in developing more effective interventions. Ideally, the model will be helpful to people who are experiencing stress and do not have access to professional help. The authors propose a model in an attempt to address the above concerns. The proposed model is called the Unease Modulation Model (UM Model). Briefly, the UM Model separates stress into several elements common to people's experience. The model describes how these elements interact and how those interactions lead to recurring states that are associated with health or illness. Finally, the model enables the person under stress to identify the elements where they will have the most leverage to evoke change and apply specific, effective techniques for that purpose. While the model is experiential, it is also based on mathematical theories of perception, nonlinear dynamics, neurophysiology, and cognitive psychology. In spite of this underlying sophistication, it can be used by those without a medical education. The proposed model has been taught successfully to patients in a clinical setting. The model is now being used in an international training program with police officers to address the long-term stress associated with the career and reduce decision-making errors regarding use of force. This article introduces the model by defining components based on patient descriptions of stress and integrating those into a formal structure. We then demonstrate how the model can be applied to a number of medical and psychiatric conditions. The article concludes by briefly discussing the model's application to family and societal stress-related difficulties.
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Affiliation(s)
- Joseph Arpaia
- Private Practitioner, Psychiatry and Behavioral Medicine, Joseph P. Arpaia, MD, LLC, Eugene, OR, United States.,Department of Couples and Family Therapy, University of Oregon, Eugene, OR, United States
| | - Judith P Andersen
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada
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Janzen B, Karunanayake C, Rennie D, Katapally T, Dyck R, McMullin K, Fenton M, Jimmy L, MacDonald J, Ramsden VR, Dosman J, Abonyi S, Pahwa P. Racial discrimination and depression among on-reserve First Nations people in rural Saskatchewan. Canadian Journal of Public Health 2018; 108:e482-e487. [PMID: 29356653 DOI: 10.17269/cjph.108.6151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 09/25/2017] [Accepted: 07/01/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine among rural-dwelling on-reserve Saskatchewan First Nations people whether racial discrimination is associated with depression, and in turn, if this relationship is moderated by gender. METHODS As a component of a community-based participatory research project, a cross-sectional, interviewer-administered survey of 874 adults living on 2 Cree First Nation reserves in rural north-central Saskatchewan was conducted during May-August in 2012 and 2013. Self-reported, health-provider diagnosis of depression was the dependent variable and experiences of interpersonal racial discrimination was the primary exposure. Chi-square and multiple logistic regression were the main analytic techniques. Generalized estimating equations were applied to account for clustering within households. RESULTS Overall, 64% of participants reported being treated unfairly in 1 or more situations because of their ethnicity; 38% indicated discrimination occurring in 3 or more situations. Nineteen percent reported a diagnosis of depression. Adjusted analyses indicated that compared to those with no experience of racial discrimination, those reporting 1-2 and 3 or more situations were 1.77 times (95% CI: 1.06-2.95) and 1.91 times (95% CI: 1.19-3.04) more likely to have diagnosed depression respectively. The relationship between racial discrimination and depression was not modified by gender, although women were 1.85 times (95% CI: 1.24-2.76) more likely to report depression than men. CONCLUSION Interpersonal racial discrimination was associated with depression among First Nations women and men in rural Saskatchewan. Research directed at identifying the most efficacious interventions, programs and policies to combat racism is required to advance the goal of health equity.
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Affiliation(s)
- Bonnie Janzen
- Department of Community Health & Epidemiology, University of Saskatchewan, Saskatoon, SK.
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Vujanovic AA, Dutcher CD, Berenz EC. Multimodal examination of distress tolerance and posttraumatic stress disorder symptoms in acute-care psychiatric inpatients. J Anxiety Disord 2017; 48:45-53. [PMID: 27605231 DOI: 10.1016/j.janxdis.2016.08.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/30/2016] [Accepted: 08/30/2016] [Indexed: 10/21/2022]
Abstract
Distress tolerance (DT), the actual or perceived capacity to withstand negative internal states, has received increasing scholarly attention due to its theoretical and clinical relevance to posttraumatic stress disorder (PTSD). Past studies have indicated that lower self-reported - but not behaviorally observed - DT is associated with greater PTSD symptoms; however, studies in racially and socioeconomically diverse clinical samples are lacking. The current study evaluated associations between multiple measures of DT (self-report and behavioral) and PTSD symptoms in an urban, racially and socioeconomically diverse, acute-care psychiatric inpatient sample. It was hypothesized that lower self-reported DT (Distress Tolerance Scale [DTS]), but not behavioral DT (breath-holding task [BH]; mirror-tracing persistence task [MT]), would be associated with greater PTSD symptoms, above and beyond the variance contributed by trauma load, substance use, gender, race/ethnicity, and subjective social status. Participants were 103 (41.7% women, Mage=33.5) acute-care psychiatric inpatients who endorsed exposure to potentially traumatic events consistent with DSM-5 PTSD Criterion A. Results of hierarchical regression analyses indicated that DTS was negatively associated with PTSD symptom severity (PCL-5 Total) as well as with each of the four DSM-5 PTSD symptom clusters (p's<0.001), contributing between 5.0%-11.1% of unique variance in PTSD symptoms across models. BH duration was positively associated with PTSD arousal symptom severity (p<0.05). Covariates contributed between 21.3%-40.0% of significant variance to the models. Associations between DT and PTSD in this sample of acute-care psychiatric inpatients are largely consistent with those observed in community samples.
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Nelson SE, Wilson K. The mental health of Indigenous peoples in Canada: A critical review of research. Soc Sci Med 2017; 176:93-112. [PMID: 28135694 DOI: 10.1016/j.socscimed.2017.01.021] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 12/06/2016] [Accepted: 01/16/2017] [Indexed: 01/18/2023]
Abstract
Many scholars assert that Indigenous peoples across the globe suffer a disproportionate burden of mental illness. Research indicates that colonialism and its associated processes are important determinants of Indigenous peoples' health internationally. In Canada, despite an abundance of health research documenting inequalities in morbidity and mortality rates for Indigenous peoples, relatively little research has focused on mental health. This paper provides a critical scoping review of the literature related to Indigenous mental health in Canada. We searched eleven databases and two Indigenous health-focused journals for research related to mental health, Indigenous peoples, and Canada, for the years 2006-2016. Over two hundred papers are included in the review and coded according to research theme, population group, and geography. Results demonstrate that the literature is overwhelmingly concerned with issues related to colonialism in mental health services and the prevalence and causes of mental illness among Indigenous peoples in Canada, but with several significant gaps. Mental health research related to Indigenous peoples in Canada overemphasizes suicide and problematic substance use; a more critical use of the concepts of colonialism and historical trauma is advised; and several population groups are underrepresented in research, including Métis peoples and urban or off-reserve Indigenous peoples. The findings are useful in an international context by providing a starting point for discussions, dialogue, and further study regarding mental health research for Indigenous peoples around the world.
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Affiliation(s)
- Sarah E Nelson
- University of Toronto Mississauga, Department of Geography, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada.
| | - Kathi Wilson
- University of Toronto Mississauga, Department of Geography, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada
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Misra R, Hunte H. Perceived discrimination and health outcomes among Asian Indians in the United States. BMC Health Serv Res 2016; 16:567. [PMID: 27729045 PMCID: PMC5059992 DOI: 10.1186/s12913-016-1821-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 10/06/2016] [Indexed: 12/13/2022] Open
Abstract
Background Perceived interpersonal discrimination while seeking healthcare services is associated with poor physical and mental health. Yet, there is a paucity of research among Asian Americans or its subgroups. This study examined the correlates of reported interpersonal discrimination when seeking health care among a large sample of Asian Indians, the 3rd largest Asian American subgroup in the US, and identify predictors of adverse self-rated physical health, a well-accepted measure of overall health status. Methods Cross-sectional survey. Participants comprised of 1824 Asian Indian adults in six states with higher concentration of Asian Indians. Results Mean age and years lived in the US was 45.7 ± 12.8 and 16.6 ± 11.1 years respectively. The majority of the respondents was male, immigrants, college graduates, and had access to care. Perceived interpersonal discrimination when seeking health care was reported by a relatively small proportion of the population (7.2 %). However, Asian Indians who reported poor self-rated health were approximately twice as likely to perceived discrimination when seeking care as compared to those in good or excellent health status (OR 1.88; 95 % CI 1.12–3.14). Poor self-rated health was associated with perceived health care discrimination after controlling for all of the respondent characteristics (OR 1.93; 95 % CI: 1.17–3.19). In addition, Asian Indians who lived for more than 10 years in the U.S. (OR 3.28; 95 % CI: 1.73–6.22) and had chronic illnesses (OR 1.39; 95 % CI: 1.17–1.64) (p < 0.05) were more likely to perceive discrimination when seeking health care. However, older Asian Indians, over the age of 55 years, were less likely to perceive discrimination than those aged 18–34 years Indian American. Conclusion Results offers initial support for the hypothesis that Asian Indians experience interpersonal discrimination when seeking health care services and that these experiences may be related to poor self-rated health status.
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Affiliation(s)
- Ranjita Misra
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia Univeristy, 1 Medical Center Drive, PO Box 9190, Morgantown, WV, 26506-9190, USA.
| | - Haslyn Hunte
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia Univeristy, 1 Medical Center Drive, PO Box 9190, Morgantown, WV, 26506-9190, USA
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