Race/Ethnic Variations in Predictors of Health Consciousness Within the Cancer Prevention Context

Exploring direct and indirect predictors of heart disease information seeking

BACKGROUND

Based on the integrative model of behavioral prediction, we examined predictors of heart disease information seeking. We also examined demographic and individual factors associated with seeking-related perceived norms, attitudes, and perceived behavioral control.

METHODS

Non-Hispanic White and Black participants, aged 45 and older, completed a cross sectional online survey (N = 383). Stepwise logistic and multiple linear regression models were tested to assess study hypotheses, as well as tests of indirect effects.

RESULTS

Perceived norms, attitudes and perceived behavioral control were positively associated with heart disease information seeking, but when controlling for distal variables only the perceived norm-behavior association remained significant (p <.05). Indirect effects of distal variables (race, heart disease risk, perceived heart disease susceptibility and information engagement orientation) on information seeking were also detected via perceived norms.

CONCLUSIONS

Our results provide support for the integrative model as a framework for predicting information seeking, but further highlight the important role of distal predictors and perceived norms on heart disease seeking intentions. When communicating to promote heart disease information acquisition, communicators should pay particular attention to promoting information seeking as a normative behavior, particularly among those who perceive a lower risk of heart disease and who may be less engaged with health information more generally.

Geographic heterogeneity in Black-white infant mortality disparities

Despite recent decreases in Black infant mortality, racial disparities persist, motivating continued research into factors related to these inequalities. While the inverse association between education and infant mortality has been documented across races, less is known about its geographic heterogeneity. Using vital statistics from the National Center for Health Statistics, this study considers Black-white disparities in infant mortality for births occurring between 2011 and 2015 across regions and metropolitan status of maternal residence. With logistic regressions, we investigate heterogeneity in maternal educational gradients of infant mortality by geographic residence both within and between races. Beyond confirming the well-known relationship between education and infant mortality, our findings document a slight metropolitan advantage for infants born to white mothers as well as lower returns to education for infants born to Black mothers residing in nonmetropolitan counties. We observe a metropolitan advantage for infants born to Black mothers with at least a bachelor's degree, but a metropolitan disadvantage for infants born to Black mothers with less than a high school degree. The South is driving this divergence, pointing to particular mechanisms limiting returns to education for Southern Black mothers in nonmetropolitan areas. This paper's geographic perspective emphasizes that racial infant health disparities are not uniform across the country and cannot be fully understood through individual and household characteristics.

Racism and Cancer Screening among Low-Income, African American Women: A Multilevel, Longitudinal Analysis of 2-1-1 Texas Callers

Although racism is increasingly being studied as an important contributor to racial health disparities, its relation to cancer-related outcomes among African Americans remains unclear. The purpose of this study was to help clarify the relation between two indicators of racism-perceived racial discrimination and racial residential segregation-and cancer screening. We conducted a multilevel, longitudinal study among a medically underserved population of African Americans in Texas. We assessed discrimination using the Experiences of Discrimination Scale and segregation using the Location Quotient for Racial Residential Segregation. The outcome examined was "any cancer screening completion" (Pap test, mammography, and/or colorectal cancer screening) at follow-up (3-10 months post-baseline). We tested hypothesized relations using multilevel logistic regression. We also conducted interaction and stratified analyses to explore whether discrimination modified the relation between segregation and screening completion. We found a significant positive relation between discrimination and screening and a non-significant negative relation between segregation and screening. Preliminary evidence suggests that discrimination modifies the relation between segregation and screening. Racism has a nuanced association with cancer screening among African Americans. Perceived racial discrimination and racial residential segregation should be considered jointly, rather than independently, to better understand their influence on cancer screening behavior.