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Guerrero N, Yu X, Raphael J, O'Connor T. Racial Discrimination in Late Adolescence and Mental Health Outcomes Among Participants in the Panel Study of Income Dynamics. J Adolesc Health 2023:S1054-139X(23)00124-6. [PMID: 37140520 DOI: 10.1016/j.jadohealth.2023.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 02/22/2023] [Accepted: 02/22/2023] [Indexed: 05/05/2023]
Abstract
PURPOSE To assess whether racial discrimination experienced at ages 18-21 years is associated with psychological distress and well-being, and investigate potential moderators of this relationship. METHODS We used panel data collected from 2005 to 2017 from 661 participants in the Transition into Adulthood Supplement of the Panel Study of Income Dynamics. The Everyday Discrimination Scale measured racial discrimination. The Kessler six and Mental Health Continuum Short Form assessed psychological distress and well-being, respectively. Generalized linear mixed modeling was used to model outcomes and test potential moderating variables. RESULTS Approximately 25% of participants experienced high levels of racial discrimination. In analyses of panel data, these participants had significantly worse psychological distress (odds ratio = 6.04, 95% confidence interval: 3.41, 8.67) and lower levels of emotional well-being (odds ratio = 4.61, 95% confidence interval: 1.87, 7.36) compared to those who did not. Race and ethnicity moderated the relationship. DISCUSSION Exposure to racial discrimination in late adolescence was associated with worse mental health outcomes. This study has important implications for interventions addressing the need for mental health support that is critical for adolescents who experience racial discrimination.
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Affiliation(s)
- Natalie Guerrero
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
| | - Xian Yu
- Center for Innovation in Quality, Effectiveness and Safety (IQuESt), Houston, Texas
| | - Jean Raphael
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Teresia O'Connor
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
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Eick SM, Barr DB, Brennan PA, Taibl KR, Tan Y, Robinson M, Kannan K, Panuwet P, Yakimavets V, Ryan PB, Liang D, Dunlop AL. Per- and polyfluoroalkyl substances and psychosocial stressors have a joint effect on adverse pregnancy outcomes in the Atlanta African American Maternal-Child cohort. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159450. [PMID: 36252672 PMCID: PMC9884463 DOI: 10.1016/j.scitotenv.2022.159450] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/11/2022] [Accepted: 10/11/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND African Americans (AAs) experience high rates of adverse pregnancy outcomes relative to Whites. Differential in utero exposure to environmental chemicals and psychosocial stressors may explain some of the observed health disparities, as exposures to per- and polyfluoroalkyl substances (PFAS) and experiences of discrimination have been linked to adverse birth outcomes. Few studies have examined chemicals and non-chemical stressors together as an exposure mixture, which may better reflect real-life exposure patterns. Here, we adapted methods designed for the analysis of exposure mixtures to examine joint effects of PFAS and psychosocial stress on birth outcomes among AAs. METHODS 348 participants from the Atlanta African American Maternal-Child cohort were included in this study. Four PFAS were measured in first trimester serum samples. Self-report questionnaires were administered during the first trimester and were used to assess psychosocial stress (perceived stress, depression, anxiety, gendered racial stress). Quantile g-computation and Bayesian kernel machine regression (BKMR) were used to estimate the joint effects between PFAS and psychosocial stressors on gestational age at delivery and birthweight for gestational age z-scores. All models were adjusted for maternal education, maternal age, parity, and any alcohol, tobacco and marijuana use. RESULTS Our analytic sample included a socioeconomically diverse group of pregnant women, with 79 % receiving public health insurance. In quantile g-computation models, a simultaneous one-quartile increase in all PFAS, perceived stress, depression, anxiety, and gendered racial stress was associated with a reduction in birthweight z-scores (mean %change per quartile increase = -0.24, 95 % confidence interval = -0.43, -0.06). BKMR similarly showed that increasing all exposures in the mixture was associated with a modest decrease in birthweight z-scores, but not a reduced length of gestation. DISCUSSION Using methods designed for analyzing exposure mixtures, we found that a simultaneous increase in in utero PFAS and psychosocial stressors was associated with reduced birthweight for gestational age z-scores.
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Affiliation(s)
- Stephanie M Eick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Dana Boyd Barr
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Kaitlin R Taibl
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Youran Tan
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Morgan Robinson
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Parinya Panuwet
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Volha Yakimavets
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - P Barry Ryan
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Anne L Dunlop
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, GA, USA
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Racial Discrimination, Mental Health and Behavioral Health During the COVID-19 Pandemic: a National Survey in the United States. J Gen Intern Med 2022; 37:2496-2504. [PMID: 35411530 PMCID: PMC8999987 DOI: 10.1007/s11606-022-07540-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/29/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND While hate crimes rose during the COVID-19 pandemic, few studies examined whether this pandemic-time racial discrimination has led to negative health consequences at the population level. OBJECTIVE We examined whether experienced and perceived racial discrimination were associated with mental or behavioral health outcomes during the pandemic. DESIGN In October 2020, we conducted a national survey with minorities oversampled that covered respondents' sociodemographic background and health-related information. PARTICIPANTS A total of 2709 participants responded to the survey (response rate: 4.2%). MAIN MEASURES The exposure variables included (1) experienced and encountered racial discrimination, (2) experienced racial and ethnic cyberbullying, and (3) perceived racial bias. Mental health outcomes were measured by psychological distress and self-rated happiness. Measures for behavioral health included sleep quality, change in cigarette smoking, and change in alcohol consumption. Weighted logistic regressions were performed to estimate the associations between the exposure variables and the outcomes, controlling for age, gender, race and ethnicity, educational attainment, household income, eligibility to vote, political party, COVID-19 infection, and geographic region. Separate regressions were performed in the six racial and ethnic subgroups: non-Hispanic White, non-Hispanic Black, Hispanic, East Asian, South Asian, and Southeast Asian respondents. KEY RESULTS Experienced racial discrimination was associated with higher likelihood of psychological distress (adjusted odds ratio [AOR] = 2.18, 95% confidence interval [95% CI]: 1.34-3.55). Experienced racial discrimination (AOR = 2.31, 95% CI: 1.34-3.99) and perceived racial bias (AOR = 1.05, 95% CI: 1.00-1.09) were both associated with increased cigarette smoking. The associations between racial discrimination and mental distress and substance use were most salient among Black, East Asian, South Asian, and Hispanic respondents. CONCLUSIONS Racial discrimination may be associated with higher likelihood of distress, and cigarette smoking among racial and ethnic minorities. Addressing racial discrimination is important for mitigating negative mental and behavioral health ramifications of the pandemic.
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Performance-based alternatives to race-norms in neuropsychological assessment. Cortex 2021; 148:231-238. [DOI: 10.1016/j.cortex.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/13/2021] [Accepted: 12/16/2021] [Indexed: 11/20/2022]
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Beatty Moody DL, Waldstein SR, Leibel DK, Hoggard LS, Gee GC, Ashe JJ, Brondolo E, Al-Najjar E, Evans MK, Zonderman AB. Race and other sociodemographic categories are differentially linked to multiple dimensions of interpersonal-level discrimination: Implications for intersectional, health research. PLoS One 2021; 16:e0251174. [PMID: 34010303 PMCID: PMC8133471 DOI: 10.1371/journal.pone.0251174] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 04/21/2021] [Indexed: 01/15/2023] Open
Abstract
Objectives To examine whether intersections of race with other key sociodemographic categories contribute to variations in multiple dimensions of race- and non-race-related, interpersonal-level discrimination and burden in urban-dwelling African Americans and Whites. Methods Data from 2,958 participants aged 30–64 in the population-based Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were used to estimate up to four-way interactions of race, age, gender, and poverty status with reports of racial and everyday discrimination, discrimination across multiple social statuses, and related lifetime discrimination burden in multiple regression models. Results We observed that: 1) African Americans experienced all forms of discrimination more frequently than Whites, but this finding was qualified by interactions of race with age, gender, and/or poverty status; 2) older African Americans, particularly African American men, and African American men living in poverty reported the greatest lifetime discrimination burden; 3) older African Americans reported greater racial discrimination and greater frequency of multiple social status-based discrimination than younger African Americans; 4) African American men reported greater racial and everyday discrimination and a greater frequency of social status discrimination than African American women; and, 5) White women reported greater frequency of discrimination than White men. All p’s < .05. Conclusions Within African Americans, older, male individuals with lower SES experienced greater racial, lifetime, and multiple social status-based discrimination, but this pattern was not observed in Whites. Among Whites, women reported greater frequency of discrimination across multiple social statuses and other factors (i.e., gender, income, appearance, and health status) than men. Efforts to reduce discrimination-related health disparities should concurrently assess dimensions of interpersonal-level discrimination across multiple sociodemographic categories, while simultaneously considering the broader socioecological context shaping these factors.
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Affiliation(s)
- Danielle L. Beatty Moody
- Department of Human Services Psychology, University of Maryland, Baltimore, Maryland, United States of America
- * E-mail:
| | - Shari R. Waldstein
- Department of Human Services Psychology, University of Maryland, Baltimore, Maryland, United States of America
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
- Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, Baltimore, Maryland, United States of America
| | - Daniel K. Leibel
- Department of Human Services Psychology, University of Maryland, Baltimore, Maryland, United States of America
| | - Lori S. Hoggard
- Department of Psychology, Rutgers University, New Brunswick, New Jersey, United States of America
| | - Gilbert C. Gee
- Department of Community Health Sciences, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Jason J. Ashe
- Department of Human Services Psychology, University of Maryland, Baltimore, Maryland, United States of America
| | - Elizabeth Brondolo
- Department of Psychology, St. John’s University, Queens, New York, New York, United States of America
| | - Elias Al-Najjar
- Department of Mathematics and Statistics, University of Maryland, Baltimore County, Baltimore, Maryland, United States of America
| | - Michele K. Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, United States of America
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, United States of America
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Luo L, Buxton OM, Gamaldo AA, Almeida DM, Xiao Q. Opposite educational gradients in sleep duration between Black and White adults, 2004-2018. Sleep Health 2021; 7:3-9. [PMID: 33358437 PMCID: PMC8783663 DOI: 10.1016/j.sleh.2020.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate the heterogeneous effects of education on sleep duration for Black and White adults and how the education effects changed between 2004 and 2018. METHODS A total of 251,994 adult participants in the 2004 to 2018 National Health Interview Survey were included in pooled cross-sectional data analyses. Separately for Black and White men and women, we calculated prevalence ratio and average marginal probability of short sleep (<7 hours) for each education level over the study period based on weighted logistic regression models. RESULTS Opposite educational gradients in short sleep were observed between Black and White adults. Greater educational attainment was associated with lower likelihood of short sleep among White adults but higher likelihood of short sleep among Black adults. Such heterogeneous educational gradients were robust after accounting for a set of socioeconomic, family, and health factors and persisted between 2004 and 2018. CONCLUSIONS The health implications of education are not uniform in the US population, and heterogeneous education effects on sleep duration persisted over the past decade. More scholarly attention is needed to identify challenges and barriers that may be unique for race, sex, and education subpopulations to maintain healthy sleep.
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Affiliation(s)
- Liying Luo
- Pennsylvania State Unviersity, University Park, Pennsylvania, USA.
| | - Orfeu M Buxton
- Pennsylvania State Unviersity, University Park, Pennsylvania, USA
| | - Alyssa A Gamaldo
- Pennsylvania State Unviersity, University Park, Pennsylvania, USA
| | - David M Almeida
- Pennsylvania State Unviersity, University Park, Pennsylvania, USA
| | - Qian Xiao
- The University of Texas Health Science Center at Houston, Houston Texas, USA
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Saadi A, Ponce NA. Worse Mental Health Among More-Acculturated and Younger Immigrants Experiencing Discrimination: California Health Interview Survey, 2015-2016. J Gen Intern Med 2020; 35:1419-1426. [PMID: 31677103 PMCID: PMC7210364 DOI: 10.1007/s11606-019-05412-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 09/20/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Experiences of discrimination harm mental and physical health, with the strongest penalty on mental health. Among immigrants, it remains unclear how acculturation-the process by which immigrants acquire the beliefs and practices of a host culture-influences the mental health burden of navigating discrimination. On the one hand, acculturation can be associated with upward social mobility. Conversely, the acculturative process may increase exposure to, and recognition of, discrimination. OBJECTIVES We examined the relationship between discrimination and mental illness across racial/ethnic groups, and pathways by which acculturation and age relate to the discrimination-mental health relationship. DESIGN A secondary data analysis using population data from the 2015-2016 California Health Interview Survey. MAIN MEASURES The Kessler 6-item Psychological Distress Scale (K6) assessed symptoms of psychological distress, with K6 score ≥ 13 associated with severe mental illness. Discrimination was measured using a self-reported measure of lifetime experience of unfair treatment in getting medical care. We used a 5-point acculturation index (constructed by measures of nativity, years living in the USA, and home language use). A weighted logistic regression model predicted mental illness as a function of discrimination. We ran mediational analysis using the Karlson-Holm-Breen method and used predictive margins to present predicted probabilities of mental illness for people reporting discrimination at different acculturation and age levels. KEY RESULTS There were independent effects on mental illness associated with increased discrimination (OR 3.85, 95% CI = 2.46, 6.03, p < 0.001) and increased acculturation (OR 1.72, 95% CI = 1.24, 2.38, p = 0.001), including when stratified across racial/ethnic groups. Higher levels of acculturation led to a significant increase in discrimination's association with mental illness. There was a higher probability of mental illness in younger age groups than in older age groups. CONCLUSIONS While discrimination is associated with poor mental health, a stronger link between discrimination and mental illness exists among younger immigrants and immigrants with increased acculturation. Health practitioners should not overlook the mental health needs of younger immigrants and immigrants who may seem more integrated into US society.
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Affiliation(s)
- Altaf Saadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, WACC #720, Boston, MA, 02120, USA.
| | - Ninez A Ponce
- UCLA Center for Health Policy Research, Los Angeles, CA, USA.,UCLA Fielding School of Public Health, Los Angeles, CA, USA
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Carter RT, Roberson K, Johnson VE. Race‐Based Stress in White Adults: Exploring the Role of White Racial Identity Status Attitudes and Type of Racial Events. JOURNAL OF MULTICULTURAL COUNSELING AND DEVELOPMENT 2020. [DOI: 10.1002/jmcd.12168] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Robert T. Carter
- Department of Counseling and Clinical Psychology, Teachers CollegeColumbia University
| | - Katheryn Roberson
- Department of Educational and Counseling PsychologyUniversity at Albany, State University of New York
| | - Veronica E. Johnson
- Department of Psychology, John Jay College of Criminal JusticeCity University of New York
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Gabriel AC, Bell CN, Bowie JV, LaVeist TA, Thorpe RJ. The Role of Social Support in Moderating the Relationship between Race and Hypertension in a Low-Income, Urban, Racially Integrated Community. J Urban Health 2020; 97:250-259. [PMID: 31997139 PMCID: PMC7101450 DOI: 10.1007/s11524-020-00421-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
In the US, African Americans have a higher prevalence of hypertension than Whites. Previous studies show that social support contributes to the racial differences in hypertension but are limited in accounting for the social and environmental effects of racial residential segregation. We examined whether the association between race and hypertension varies by the level of social support among African Americans and Whites living in similar social and environmental conditions, specifically an urban, low-income, racially integrated community. Using data from the Exploring Health Disparities in Integrated Communities-Southwest Baltimore (EHDIC-SWB) sample, we hypothesized that social support moderates the relationship between race and hypertension and the racial difference in hypertension is smaller as the level of social support increases. Hypertension was defined as having systolic blood pressure greater than 140 mmHg and/or diastolic blood pressure greater than 90 mmHg, or the participant reports of taking antihypertensive medication(s). The study only included participants that self-reported as "Black/African American" or "White." Social support was measured as functional social support and marital status. After adjusting for demographics and health-related characteristics, we found no interaction between social support and race (DUFSS score, prevalence ratio 1.00; 95% confidence interval 0.99, 1.01; marital status, prevalence ratio 1.02; 95% confidence interval 0.86, 1.21); thus the hypothesis was not supported. A plausible explanation is that the buffering factor of social support cannot overcome the social and environmental conditions which the participants live in. Further, these findings emphasize social and environmental conditions of participants in EHDIC-SWB may equally impact race and hypertension.
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Affiliation(s)
- Angel C Gabriel
- Hopkins Center for Health Disparities Solutions, Johns Hopkins School of Public Health, Baltimore, MD, USA.
| | | | - Janice V Bowie
- Hopkins Center for Health Disparities Solutions, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Thomas A LaVeist
- Tulane School of Tropical Medicine and Public Health, New Orleans, LA, USA
| | - Roland J Thorpe
- Hopkins Center for Health Disparities Solutions, Johns Hopkins School of Public Health, Baltimore, MD, USA
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Gabriel AC, Bell CN, Bowie JV, Hines AL, LaVeist TA, Thorpe RJ. The Association Between Perceived Racial Discrimination and Hypertension in a Low-Income, Racially Integrated Urban Community. FAMILY & COMMUNITY HEALTH 2020; 43:93-99. [PMID: 32079965 DOI: 10.1097/fch.0000000000000254] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We examined the association between perceived racial discrimination and hypertension among African Americans and whites who live in a low-income, racially integrated, urban community. Hypertension was defined as having a systolic blood pressure 140 mm Hg or more, a diastolic blood pressure 90 mm Hg or more, or taking antihypertensive medication(s). Perceived racial discrimination was based on self-reported responses of experiencing racial discrimination in various settings. Using modified Poisson multivariable regression models, we found no association between perceived racial discrimination and hypertension (prevalence ratio: 0.96, 95% confidence interval: 0.90-1.04). Findings suggest that social context may play a role in the relationship between perceived racial discrimination and hypertension.
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Affiliation(s)
- Angel C Gabriel
- Hopkins Center for Health Disparities Solutions, Johns Hopkins School of Public Health, Baltimore, Maryland (Ms Gabriel and Drs Bowie and Thorpe); University of Maryland, College Park (Dr Bell); Johns Hopkins School of Medicine, Baltimore, Maryland (Dr Hines); and Tulane School of Tropical Medicine and Public Health, New Orleans, Louisiana (Dr LaVeist)
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Vilsaint CL, NeMoyer A, Fillbrunn M, Sadikova E, Kessler RC, Sampson NA, Alvarez K, Green JG, McLaughlin KA, Chen R, Williams DR, Jackson JS, Alegría M. Racial/ethnic differences in 12-month prevalence and persistence of mood, anxiety, and substance use disorders: Variation by nativity and socioeconomic status. Compr Psychiatry 2019; 89:52-60. [PMID: 30594752 PMCID: PMC6421861 DOI: 10.1016/j.comppsych.2018.12.008] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/20/2018] [Accepted: 12/15/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Despite equivalent or lower lifetime and past-year prevalence of mental disorder among racial/ethnic minorities compared to non-Latino Whites in the United States, evidence suggests that mental disorders are more persistent among minorities than non-Latino Whites. But, it is unclear how nativity and socioeconomic status contribute to observed racial/ethnic differences in prevalence and persistence of mood, anxiety, and substance disorders. METHOD Data were examined from a coordinated series of four national surveys that together assessed 21,024 Asian, non-Latino Black, Latino, and non-Latino White adults between 2001 and 2003. Common DSM-IV mood, anxiety, and substance disorders were assessed using the Composite International Diagnostic Interview. Logistic regression analyses examined how several predictors (e.g., race/ethnicity, nativity, education, income) and the interactions between those predictors were associated with both 12-month disorder prevalence and 12-month prevalence among lifetime cases. For the second series of analyses, age of onset and time since onset were used as additional control variables to indirectly estimate disorder persistence. RESULTS Non-Latino Whites demonstrated the highest unadjusted 12-month prevalence of all disorder types (p < 0.001), though differences were also observed across minority groups. In contrast, Asian, Latino, and Black adults demonstrated higher 12-month prevalence of mood disorders among lifetime cases than Whites (p < 0.001) prior to adjustments Once we introduced nativity and other relevant controls (e.g., age, sex, urbanicity), US-born Whites with at least one US-born parent demonstrated higher 12-month mood disorder prevalence than foreign-born Whites or US-born Whites with two foreign parents (OR = 0.51, 95% CI = [0.36, 0.73]); this group also demonstrated higher odds of past-year mood disorder than Asian (OR = 0.59, 95% CI = [0.42, 0.82]) and Black (OR = 0.70, 95% CI = [0.58, 0.83]) adults, but not Latino adults (OR = 0.89, 95% CI = [0.74, 1.06]). Racial/ethnic differences in 12-month mood and substance disorder prevalence were moderated by educational attainment, especially among adults without a college education. Additionally, racial/ethnic minority groups with no more than a high school education demonstrated more persistent mood and substance disorders than non-Latino Whites; these relationships reversed or disappeared at higher education levels. CONCLUSION Nativity may be a particularly relevant consideration for diagnosing mood disorder among non-Latino Whites; additionally, lower education appears to be associated with increased relative risk of persistent mood and substance use disorders among racial/ethnic minorities compared to non-Latino Whites.
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Affiliation(s)
- Corrie L Vilsaint
- Recovery Research Institute, Center for Addiction Medicine, Massachusetts General Hospital, 151 Merrimac Street 6th Floor, Boston, MA 02114, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, United States.
| | - Amanda NeMoyer
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA 02114, United States; Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States.
| | - Mirko Fillbrunn
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA 02114, United States; Department of Medicine, Harvard Medical School, 55 Fruit Street Boston, MA 02114, United States.
| | - Ekaterina Sadikova
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States.
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States.
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States.
| | - Kiara Alvarez
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, United States; Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA 02114, United States; Department of Medicine, Harvard Medical School, 55 Fruit Street Boston, MA 02114, United States.
| | - Jennifer Greif Green
- Boston University, Wheelock College of Educaion & Human Development, Two Silber Way, Boston, MA 02215, United States..
| | - Katie A McLaughlin
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA 02138, United States.
| | - Ruijia Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building Room 615, Boston, MA 02115, United States.
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building Room 615, Boston, MA 02115, United States; Department of African and African American Studies, Harvard University, Barker Center, 12 Quincy St., Cambridge, MA 02138, United States.
| | - James S Jackson
- Institute for Social Research, 5057 ISR, 426 Thompson St., Ann Arbor, MI 48104, United States.
| | - Margarita Alegría
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, United States; Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA 02114, United States; Department of Medicine, Harvard Medical School, 55 Fruit Street Boston, MA 02114, United States.
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Weeks MR, Sullivan AL. Discrimination Matters: Relations of Perceived Discrimination to Student Mental Health. SCHOOL MENTAL HEALTH 2019. [DOI: 10.1007/s12310-019-09309-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hosler AS, Kammer JR, Cong X. Everyday Discrimination Experience and Depressive Symptoms in Urban Black, Guyanese, Hispanic, and White Adults. J Am Psychiatr Nurses Assoc 2019; 25:445-452. [PMID: 30569835 DOI: 10.1177/1078390318814620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Discrimination experience is a stressor that may disproportionately affect the mental health of minority populations. AIMS: We examined the association between discrimination experience and depressive symptoms among four urban racial/ethnic groups. METHOD: Cross-sectional community-based health survey data for Black (n = 434), Guyanese (n = 180), Hispanic (n = 173), and White (n = 809) adults aged ⩾18 years were collected in Schenectady, New York, in 2013. Discrimination experience was measured with the Everyday Discrimination Scale (EDS), and depressive symptoms were measured with the Center for Epidemiologic Studies-Depression (CES-D) scale. Logistic regression models for the association between EDS and major depressive symptoms (CES-D ⩾ 16) were fitted for each racial/ethnic group. The final model adjusted for age, sex, education, income, smoking, alcohol binge drinking, emotional/social support, and perceived stress. RESULTS: The mean EDS scores varied significantly across groups (p < .001), with 2.6 in Hispanics, 2.2 in Whites, 2.0 in Blacks, and 1.1 in the Guyanese. There was a consistent and significant independent association between EDS and major depressive symptoms in the crude model and at each step of covariate adjustment in each group. Fully adjusted odds ratios were 1.28 (95% confidence interval [CI; 1.16, 1.41]) in Blacks, 1.83 in the Guyanese [1.36, 2.47], 1.23 in Hispanics [1.07, 1.41], and 1.24 [1.16, 1.33] in Whites. The presence of covariates did not significantly modify the main effect in each group. CONCLUSIONS: This study suggests that discrimination experience can be one of the fundamental social causes of depression. It may be feasible to assess discrimination experience as a risk factor of depression in individuals of all racial/ethnic backgrounds.
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Affiliation(s)
- Akiko S Hosler
- Akiko S. Hosler, PhD, University at Albany School of Public Health, Rensselaer, NY, USA
| | - Jamie R Kammer
- Jamie R. Kammer, PhD, New York State Office of Mental Health, Albany, NY, USA
| | - Xiao Cong
- Xiao Cong, MPH, University at Albany School of Public Health, Rensselaer, NY, USA
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Baron-Epel O, Berardi V, Bellettiere J, Shalata W. The Relation Between Discrimination, Sense of Coherence and Health Varies According to Ethnicity: A Study Among Three Distinct Populations in Israel. J Immigr Minor Health 2018; 19:1386-1396. [PMID: 27325224 DOI: 10.1007/s10903-016-0449-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Self-reported experiences of discrimination and sense of coherence (SOC) have been found to be associated with health. A face-to-face survey of Long Term Jewish Residents (LTJR), Arabs and former Soviet Union (fSU) immigrants in Israel was performed. Respondents reported their physical and mental health, self-reported experiences of discrimination, SOC and socioeconomic status. Multivariable logistic regressions and bootstrapping path analyses were performed. Discrimination was associated with health after adjusting for all other variables. SOC was also associated with health. SOC did not mediate the strong association between discrimination and health among Israeli LTJR, but was a significant mediator among Arabs and fSU immigrants. Discrimination seems to have a direct effect on health only among the majority and not among minority populations. High levels of SOC may reduce the negative effects of discrimination on health by serving as a coping resource, however only among minorities.
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Affiliation(s)
- Orna Baron-Epel
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Haifa, 31905, Israel.
| | - Vincent Berardi
- Computational Sciences Research Center, San Diego State University, San Diego, CA, USA
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - John Bellettiere
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Waleed Shalata
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Haifa, 31905, Israel
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Yang TC, Chen IC, Kim S, Choi SW. Differential investments and opportunities: How do neighborhood conditions moderate the relationship between perceived housing discrimination and social capital? SOCIAL SCIENCE RESEARCH 2018; 72:69-83. [PMID: 29609746 PMCID: PMC5886033 DOI: 10.1016/j.ssresearch.2018.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 12/27/2017] [Accepted: 01/29/2018] [Indexed: 06/08/2023]
Abstract
Though the adverse consequences of perceived housing discrimination have been documented, little is known about whether such experience undermines one's social capital in a neighborhood and even less is about whether and how this relationship is altered by neighborhood features. We proposed a framework that simultaneously considers within-individual and between-neighborhood processes. We applied multilevel structural equation models to data from Philadelphia (n = 9987) and found that (a) perceived housing discrimination was negatively associated with one's social capital even after other confounders were considered, (b) this negative association could be partly explained by the proliferated daily stress and anxiety mechanisms, (c) differential exposures to neighborhood social disadvantage accounted for the variation in social capital across neighborhoods, and (d) the adverse association between perceived housing discrimination and social capital could be attenuated by neighborhood stability. The findings suggested that appropriate interventions should buffer the negative association of perceived housing discrimination with social capital.
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Affiliation(s)
- Tse-Chuan Yang
- University at Albany, State University of New York, United States.
| | | | - Seulki Kim
- University at Albany, State University of New York, United States
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Garrett BA, Livingston BJ, Livingston MD, Komro KA. The Effects of Perceived Racial/Ethnic Discrimination on Substance Use Among Youths Living in the Cherokee Nation. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2017; 26:242-249. [PMID: 29225452 DOI: 10.1080/1067828x.2017.1299656] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We examined frequency and intensity of racial/ethnic discrimination and the longitudinal relationship to substance use. The sample included (N = 1,421) American Indian, American Indian and White, and White adolescents. A high frequency of perceived racial discrimination was associated with an increased risk for heavy alcohol use, prescription drug misuse, and other illicit drug use. Experiences of perceived racial discrimination high in intensity were associated with further increased risk of prescription drug misuse and other illicit drug use. Race/ethnicity did not moderate the relationship between perceived racial discrimination and substance use. Interventions targeting the deleterious effects of racial discrimination may need to be designed to account for both the environment and the individual.
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Havranek EP, Mujahid MS, Barr DA, Blair IV, Cohen MS, Cruz-Flores S, Davey-Smith G, Dennison-Himmelfarb CR, Lauer MS, Lockwood DW, Rosal M, Yancy CW. Social Determinants of Risk and Outcomes for Cardiovascular Disease. Circulation 2015; 132:873-98. [DOI: 10.1161/cir.0000000000000228] [Citation(s) in RCA: 738] [Impact Index Per Article: 82.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Dawson AZ, Walker RJ, Campbell JA, Egede LE. Effect of perceived racial discrimination on self-care behaviors, glycemic control, and quality of life in adults with type 2 diabetes. Endocrine 2015; 49:422-8. [PMID: 25414069 PMCID: PMC4440842 DOI: 10.1007/s12020-014-0482-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 11/12/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study used a large sample size of black and white patients with type 2 diabetes to investigate the influence of perceived racial discrimination on biologic measures (glycemic control, blood pressure, and LDL cholesterol), the mental component of quality of life (MCS), and health behaviors known to improve diabetes outcomes. METHODS 602 patients were recruited from two adult primary care clinics in the southeastern United States. Linear regression models were used to assess the associations between perceived racial discrimination, self-care, clinical outcomes, MCS, adjusting for relevant covariates. Race-stratified models were conducted to examine differential associations by race. RESULTS The mean age was 61 years, with 64.9 % non-Hispanic black, and 41.6 % earning less than $20,000 annually. Perceived discrimination was significantly negatively associated with MCS (β = -0.56, 95 % CI -0.90, 0.23), general diet (β = -0.37, CI -0.65, -0.08), and specific diet (β = -0.25, CI -0.47, -0.03). In African Americans, perceived discrimination was significantly associated with higher systolic blood pressure (β = 10.17, CI 1.13, -19.22). In Whites, perceived discrimination was significantly associated with lower MCS (β = -0.51, CI -0.89, -0.14), general diet (β = -0.40, CI -0.69, -0.99), specific diet (β = -0.25, CI -0.47, -0.03), and blood glucose testing (β = -0.43, CI -0.80, -0.06). CONCLUSIONS While no association was found with biologic measures, perceived discrimination was associated with health behaviors and the MCS. In addition, results showed a difference in influence of perceived discrimination by race.
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Affiliation(s)
- Aprill Z. Dawson
- Center for Health Disparities Research, Medical University of South Carolina, Charleston, SC
| | - Rebekah J. Walker
- Center for Health Disparities Research, Medical University of South Carolina, Charleston, SC
- Health Equity and Rural Outreach Innovation Center (HEROIC), Charleston VA HSR&D COIN, Ralph H. Johnson VAMC, Charleston, SC
| | - Jennifer A. Campbell
- Center for Health Disparities Research, Medical University of South Carolina, Charleston, SC
| | - Leonard E. Egede
- Center for Health Disparities Research, Medical University of South Carolina, Charleston, SC
- Health Equity and Rural Outreach Innovation Center (HEROIC), Charleston VA HSR&D COIN, Ralph H. Johnson VAMC, Charleston, SC
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, SC
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