Neighborhood disorder, exposure to violence, and perceived discrimination in relation to symptoms in midlife women

Does everyday discrimination account for the increased risk of vasomotor symptoms in Black women?: the Study of Women's Health Across the Nation (SWAN)

OBJECTIVES

Vasomotor symptoms (VMS), including hot flashes and night sweats, are hallmark symptoms of the menopause transition. Previous research has documented greater frequency, duration, and severity of VMS in Black women compared with women from other racial/ethnic groups, even after accounting for other factors. This analysis examined the association between discrimination and VMS and the extent to which discrimination accounts for the disproportionate burden of VMS in Black women.

METHODS

Using available discrimination and VMS data from the SWAN cohort study (n = 2,377, 48% White, 32% Black, 6% Japanese, 4% Chinese, and 9% Hispanic women) followed approximately yearly in midlife from premenopause (42-52 y) through postmenopause (~20 y), we assessed concurrent associations between discrimination and VMS frequency in the past 2 weeks using weighted generalized mixed models. We also assessed associations between chronic discrimination across first four visits and VMS trajectories from premenopause to postmenopause using weighted multinomial logistic regression. Models were adjusted for known risk factors for VMS.

RESULTS

Higher levels of discrimination were associated with concurrent reporting of any (odds ratio [OR], 1.57 [1.31-1.89]) and frequent (≥6 d) VMS (OR, 1.55 [1.21-1.99]). After adjustment, associations remained significant for any (OR, 1.30 [1.09-1.54]) but not frequent VMS. For any VMS trajectories, chronic discrimination was associated with "continuously high" (OR, 1.69 [1.03-2.77]) and "high pre-FMP-decline post-FMP" (OR, 1.70 [1.01-2.88]) versus "FMP-onset low" trajectories. After adjusting for discrimination, odds of reporting any, frequent, and of being in the "continuously high" any VMS trajectory remained elevated for Black versus White women.

CONCLUSIONS

Discrimination is associated with greater concurrent risk of any (but not frequent) VMS, and chronic discrimination is associated with a continuously high reporting of any VMS over time, independent of known risk factors. Adjusting for discrimination attenuates but does not eliminate the increased risk of VMS for Black women.

The Influence of Chronic Stress and Emotions on Eating Behavior Patterns and Weight among Young African American Women

This study examines the influence of chronic stress, varied positive and negative emotions on eating behaviors, and weight among 91 community-dwelling African American women 18-40 years old. Study measures include hair cortisol, Differential Emotional Scale IV, Eating Behavior Pattern Questionnaire, demographic form, waist circumference, and Body Mass Index (BMI). Analysis revealed positive emotions of interest (r_s = .27, p = .011) and surprise (r_s = .23, p = .029) were associated with low fat eating. Negative emotions of anger (r_s = .23, p = .035), shyness (r_s = .29, p = .006), and guilt (r_s = .24, p = .022) were positively associated with emotional eating. Mediation analysis suggests that emotional eating mediates anger (indirect effect = 0.136), shyness (0.144), guilt (0.187), and BMI among young African American women. Chronic stress and positive and negative emotions impact eating behaviors and should be considered for successful weight management among African American women.

Exploring the Consequences of Major Lifetime Discrimination, Neighborhood Conditions, Chronic Work, and Everyday Discrimination on Health and Retirement

This study examines the associations of multiple forms of perceived discrimination and negative neighborhood conditions with mental health and retirement age. Respondents aged above 51 years from the Health and Retirement Study were selected in 2006 and surveyed through 2014. Ordinary least squares regression evaluated associations. Bias-corrected bootstrap resampling method tested whether mental health mediated the relationships between disadvantages and retirement age. Major lifetime and work discrimination, as well as neighborhood conditions, were directly associated with earlier retirement. Individuals who did not experience disadvantages retired at age 65, whereas respondents with the highest levels of disadvantage retired earlier (at age 62). Mental health partially mediated relationships between major lifetime discrimination, neighborhood conditions, and work discrimination with retirement age, whereas mental health fully mediated the relationship between everyday discrimination and retirement age. Efforts to promote civil rights, reduce discrimination, and enhance individual resilience may promote mental health and capacity to work longer.