Gender Differences in Longitudinal Links between Neighborhood Fear, Parental Support, and Depression among African American Emerging Adults

Physical and Mental Health Outcomes of Black Emerging Adults with Community Violence Exposure: An Integrative Review

Community violence exposure (CVE) and its health impact is a public health crisis. Violent crime has steadily increased over recent years and has disproportionately affected Black communities. Emerging adulthood (18-29 years old) is a vulnerable period of development and Black emerging adults may be at increased risk for negative physical and mental health consequences from CVE. This integrative review was conducted to evaluate available evidence on health outcomes in Black emerging adults exposed to CVE. This review appraised published studies (2012-2022) addressing physical and mental health outcomes of Black emerging adults with CVE. Articles were identified using structured search terms in several databases (CINAHL, PubMed, PsycInfo, and Web of Science), a gray literature search, and citation mining. A total of 177 studies were identified for screening and 19 studies met inclusion criteria and were included in the review. The majority of studies found a significant positive association between CVE and adverse mental (n = 12) and physical (n = 7) health outcomes. CVE appears to have both mental and physical health consequences for Black emerging adults. Given that violent crime disproportionately increased in Black communities and Black people are more likely to develop chronic health conditions at younger ages, more work is needed to elucidate the relationship between CVE and health outcomes.

School Connectedness and Mental Health Among Black Adolescents

Black students' school experiences are important for their mental health. The current study explored the link between school connectedness in middle childhood and depressive symptoms and aggressive behaviors among Black adolescents. Participants were Black youth (Mage = 9.36 years, SD = 0.38 at time 1), (Mage = 15.59 years, SD = 0.60 at time 2), and 50.2% female. The findings demonstrated a significant association between school connectedness assessed at age nine and reduced depressive symptoms and aggressive behaviors reported at age fifteen. Notably, gender moderated the relationship between school connectedness and depressive symptoms, with a stronger association found for girls. These results offer valuable insights into how early perceptions of school connectedness impact the mental health of Black adolescents as they grow older. These findings also indicate that girls might be more attuned to the social and emotional aspects of their schools. These findings validate the significance of a sense of connection to school with mental health outcomes among Black adolescents and indicate the possibility of school connectedness interventions to enhance their overall well-being.

Where I'm Livin' and How I'm Feelin': Associations among community stress, gender, and mental-emotional health among Black Americans

RATIONALE

Structural racism is a primary avenue for the perpetuation of racial health disparities. For Black Americans, both historically and contemporarily, the neighborhood context serves as one of the most striking examples of structural racism, with stressful neighborhood contexts contributing to the well-documented inequalities in psychological functioning among this population.

OBJECTIVE

Thus, in this study, we adapted an intersectional-ecological framework to investigate the links between community stress and multiple dimensions of mental-emotional health for Black men and women.

METHODS

Drawing on cross-sectional data from 842 Black Americans from the Milwaukee area, we tested both objective (Area Deprivation Index; ADI) and subjective (perceived neighborhood disadvantage; PND) indicators of community stress as simultaneous predictors of negative and positive affect and the odds of psychological disorder (depression, anxiety) in multilevel models, examining gender differences in these linkages.

RESULTS

Results showed greater objective community stress was related to lower levels of negative affect for both men and women and lower odds of psychological disorder for women specifically. Greater subjective community stress was related to higher levels of negative affect and lower levels of positive affect for both men and women and to higher odds of psychological disorder for women specifically.

CONCLUSIONS

Findings highlight the complex intersectional nature of the links between community stress and Black Americans' mental-emotional health. Specifically, findings demonstrate the pernicious psychological effects of perceived community stress and allude to Black Americans', particularly women's, active resistance and resilience to objective disadvantage, potentially through investing in social relationships in their neighborhoods.

Gender, race, and space: A qualitative exploration of young Black women's perceptions of urban neighborhoods

How people think and feel about their neighborhood impacts the way they think of themselves and their futures. These linkages are especially important to understand in the case of urban-residing young Black women. Researchers know very little about what contributes to young Black adults' urban neighborhood perceptions and often rely on "expert" definitions of markers of neighborhood quality. These definitions and subsequent explorations of residents' neighborhood assessment have not adequately considered intersecting oppressive systems that structure urban spaces both physically and socially. Further, within-group diversity of young Black adults based on other social identities, such as gender and class, has gone underexplored in research on residents' neighborhood assessment. We used theory from Black feminist geography and sociology to guide our thematic analysis of interviews with young Black women (N = 9) regarding their urban neighborhood quality. We sought to explore the aspects or features of the neighborhood that young Black women discussed and how social identities may play a role in young Black women's descriptions of their urban neighborhoods. We argue three themes tell an overarching story of young Black women's urban spatial critical analysis: (1) outsiders' perceptions versus our realities, (2) gendered safety, and (3) visibility of young Black women. Young Black women's narratives highlighted communal aspects of neighborhood evaluation and attention to dominant narratives regarding marginalized groups and urban spaces.

Contextualizing black emerging adults' perceptions of neighborhood quality

The ways in which Black emerging adults perceive and evaluate their neighborhoods may be impacted by a host of social and political factors that interplay with their social identities, the social identities of other urban residents, and their time in the area. Early literature on Black emerging adults' perceived neighborhood quality (PNQ) tended to make comparisons to White people and to focus disproportionately on the perceptions of low-income Black people residing in predominately racial/ethnic minority and underresourced communities. Subsequent work on subjective neighborhood assessment has considered specific features of neighborhoods, such as safety or disorder, but a general sense of the quality of one's neighborhood features is still underexplored. The current study adapts Connerly and Marans' (1985) PNQ model to explore the relations between social identities and locations, neighborhood sociostructural features, time in the area, and PNQ among Black urban-residing emerging adults. Block-wise regression results suggest that education and partner status were associated with PNQ. Perceptions of the percentage of Black neighbors and Census Bureau proportions of residents in the zip code who are poor were also associated with PNQ. Length of residence in the neighborhood was marginally associated with PNQ while length of residence in the city/town was not significantly associated with PNQ. For young Black women, combined household income was marginally associated with PNQ, but neighborhood sociostructural features were the strongest contributors to PNQ. In contrast, education was the only significant contributor to PNQ for young Black men. We discuss the ways that the social positions of young Black residents and their neighbors may impact their experiences and evaluations of urban areas.

Love, health, and the 'hood: An examination of romantic relationship adjustment and perceived neighborhood quality as predictors of partnered Black Americans' long-term psychological health

Existing disparities regarding Black Americans' psychological health warrant further investigation of socioecological factors that may be associated with negative and positive dimensions of psychological health in this population. Romantic relationship functioning and neighborhood context are two domains relevant to Black Americans' mental health. However, less is known about how they may serve as independent and interactive prospective predictors of Black Americans' psychological health and potentially in distinctive ways for Black men and women. Using data from 333 partnered Black Americans who participated in the Midlife in the United States study, we investigated relationship adjustment and neighborhood quality as independent and interactive predictors of negative and positive affect 10 years later and examined gender differences in these linkages. Higher neighborhood quality predicted lower levels of negative affect and higher levels of positive affect for both men and women a decade later. Additionally, for Black men, the longitudinal association between relationship adjustment and negative affect differed by neighborhood quality such that better relationship adjustment predicted higher subsequent negative affect only for men in lower quality neighborhoods. Findings demonstrate the connections among romantic relationship functioning, ecological resources, and gender in this population and highlight the importance of incorporating socioecological and intersectional perspectives for predicting Black Americans' long-term psychological health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Racial discrimination, childhood adversity, and depression among Black men: Tests of stress sensitization hypotheses

Racial discrimination has been linked to depression among Black American men. Racial discrimination, however, does not uniformly confer risk for depression. According to the stress sensitization theory, racial discrimination can be particularly harmful for those with histories of adversity in childhood. Existing research on stress sensitization is limited in that it has conceptualized childhood adversity as a unidimensional construct composed of a broad range of stressful experiences. To fill this gap in the literature, the current study investigated stress sensitization hypotheses, focusing on how different dimensions of adverse childhood experiences moderate the association between racial discrimination and depression. Study sample was 504 young Black men (mean age at baseline = 20.3, SD = 1.08) living in rural counties in South Georgia where childhood adversity is disproportionately high. The association between racial discrimination and increased risk for depressive symptoms varied by the degree of childhood experience of deprivation, but not threat. Our findings suggest that no or low levels of childhood deprivation, which is commonly regarded as a protective factor, can elevate the negative effects of discrimination on depression. This finding emphasizes that clinicians should consider developmental risk and protective factors that are unique to Black American men.

Neighborhood Physical and Social Environments and Social Inequalities in Health in Older Adolescents and Young Adults: A Scoping Review

Poor health and well-being are prevalent among young people. Neighborhoods may play a role in promoting good health. Little is known on if and how neighborhood characteristics affect health, and social inequalities therein, among young people. In this scoping review, we asked: (1) what features of the neighborhood physical and social environments have been studied in association with the physical and mental health and well-being of young people 15 to 30 years old; and (2) to what extent have social differentials in these associations been studied, and how? We identified peer-reviewed articles (2000 to 2023) through database and snowball searches. We summarized study characteristics, exposure(s), outcome(s) and main findings, with an eye on social inequalities in health. Out of the 69 articles reviewed, most were quantitative, cross-sectional, conducted among 18-year-olds and younger, and focused on the residential neighborhood. Neighborhood social capital and mental health were the most common exposure and outcome studied, respectively. Almost half of the studies examined social inequalities in health, mostly across sex/gender, socioeconomic status, and ethnicity. Evidence gaps remain, which include exploring settings other than residential neighborhoods, studying the older age stratum of young adulthood, and assessing a broader range of social inequalities. Addressing these gaps can support research and action on designing healthy and equitable neighborhoods for young people.

Mental health disorder symptom prevalence and rates of help-seeking among University-Enrolled, emerging adults

Objective. Examine mental health symptom prevalence and rates of campus services utilization among Black male, White male and Black female college students. Participants. 2500 students from an ongoing, student survey at a public university; launched in 2011. Methods. Measures included data for anxiety and depressive symptoms and utilization of campus health services (counseling center, health services, etc.). Descriptive analyses determined prevalence and utilization rates. Mann Whitney U tests compared prevalence. Chi-squared tests compared utilization rates. Results. Anxiety prevalence: greater than 60% of students from each ethnic group reported symptoms; reporting rates decreased significantly for Black men (49.6%); p < 0.001. Depression prevalence: greater than 80% reported symptoms; there were significant differences in reporting between Black men and Black women (72.7% vs. 87.1%, p < 0.001). Utilization: Black men utilized counseling services less than White men (20.4% vs. 37.8%, p = 0.024). Conclusion. Black men report depressive and anxiety symptoms but underutilize campus health resources.

Longitudinal neighbourhood determinants with cognitive health and dementia disparities: protocol of the Multi-Ethnic Study of Atherosclerosis Neighborhoods and Aging prospective cohort study

INTRODUCTION

The burden of Alzheimer's disease (AD) and AD-related dementias (ADRD) is increasing nationally and globally, with disproportionate impacts on lower-income, lower education and systematically marginalised older adults. Presence of inequalities in neighbourhood factors (eg, social context, physical and built environments) may affect risk of cognitive decline and be key for intervening on AD/ADRD disparities at the population level. However, existing studies are limited by a dearth of longitudinal, detailed neighbourhood measures linked to rich, prospective cohort data. Our main objective is to identify patterns of neighbourhood change related to prevalence of-and disparities in-cognitive decline and dementia.

METHODS AND ANALYSES

We describe the process of collecting, processing and linking extensive neighbourhood data to the Multi-Ethnic Study of Atherosclerosis (MESA), creating a 25+ years dataset. Within the MESA parent study, the MESA Neighborhoods and Aging cohort study will characterise dynamic, longitudinal neighbourhood social and built environment variables relevant to cognition for residential addresses of MESA participants. This includes administering new surveys, expanding residential address histories, calculating new measures derived from spatial data and implementing novel deep learning algorithms on street-level imagery. Applying novel statistical techniques, we will examine associations of neighbourhood environmental characteristics with cognition and clinically relevant AD/ADRD outcomes. We will investigate determinants of disparities in outcomes by socioeconomic position and race/ethnicity and assess the contribution of neighbourhood environments to these disparities. This project will provide new evidence about pathways between neighbourhood environments and cognitive outcomes, with implications for policies to support healthy ageing.

ETHICS AND DISSEMINATION

This project was approved by the University of Washington and Drexel University Institutional Review Boards (protocols #00009029 and #00014523, and #180900605). Data will be distributed through the MESA Coordinating Center. Findings will be disseminated in peer-reviewed scientific journals, briefs, presentations and on the participant website.

Predictors of motives for marijuana use in African American adolescents and emerging adults

African American adolescents use marijuana at higher rates and may be more vulnerable to psychosocial risk factors for marijuana use, including depression, post-traumatic stress, and having substance-using peers, compared to Caucasian adolescents. Little is known about how these factors contribute to African American adolescents' motives for marijuana use. This study examined the roles of depressive and post-traumatic stress symptoms and substance-using peers on marijuana use motives among African American adolescents and emerging adults and whether these motives predicted marijuana use. Findings suggest that identifying motives for marijuana use may help improve approaches to reduce use among this population.

Socioeconomic Disadvantage, Mental Health and Substance Use in Young Men in Emerging Adulthood

Emerging adulthood is a neglected phase of the life course in health research. Health problems and risk behaviors at this time of life can have long-term consequences for health. The 2016 Lancet Commission on Adolescent Health and Wellbeing reported that the influence of socioeconomic factors was under-researched among adolescents and young adults. Moreover, the influence of socioeconomic factors on health has been little researched specifically in emerging adult men. We aimed to investigate associations between socioeconomic disadvantage and mental health, suicidal behavior, and substance use in young adult Australian men. Logistic regression was used to examine the association between Year 12 (high school) completion and area disadvantage on mental health, suicidal behavior, and substance use in 2,281 young men age 18-25 participating in the Australian Longitudinal Study on Male Health (Ten to Men). In unadjusted analysis both Year 12 non-completion and area disadvantage were associated with multiple adverse outcomes. In adjusted analysis Year 12 non-completion, but not area disadvantage, was associated with poorer mental health, increased odds of suicidal behavior, and substance use. Retaining young men in high school and developing health-promotion strategies targeted at those who do exit education early could both improve young men's mental health and reduce suicidal behavior and substance use in emerging adulthood.

Parental Education and Spanking of American Children: Blacks' Diminished Returns

Background

Based on the Minorities' Diminished Returns (MDRs) framework, high socioeconomic status (SES) indicators such as parental education shows weaker protective effects against adverse experiences for Blacks than Whites. For example, Black children with highly educated parents report high levels of depression, anxiety, suicide, smoking, obesity, and chronic disease. Limited knowledge exists on MDRs of parental education on the child's exposure to spanking by the mother.

Aims

Built on the MDRs framework, we tested the hypothesis of whether the effect of parental education on the child's exposure to spanking by the mother differs in Black and White families. We hypothesized that: 1) there is an inverse association between mothers' educational attainment and child spanking, and 2) the effect of mothers' educational attainment on mothers' spanking of the child is weaker for Black than White families.

Methods

We used data from the Fragile Families and Child Well-being Study (FFCWS), a 9-year follow up study of a random sample of births in cities larger than 200,000 population. In this analysis, 2722 Black or White families were followed. The main predictor was parental educational attainment at birth. The outcomes were exposure to spanking at ages 3, 5, and 9. Logistic regression was used for data analysis.

Results

Higher parental educational attainment at birth was inversely associated with the child's exposure to spanking by the mother among Whites, not Blacks. We also found a significant interaction between parental educational attainment at birth and race, suggesting that the associations between parental education and child exposure to spanking by the mother at ages 3, 5, and 9 were weaker for Black than White families.

Conclusions

Diminished returns of parental educational attainment in terms of reducing children's exposure to trauma and stress may be a mechanism that contributes to racial health disparities, particularly poor health of children in highly educated Black families. That is a smaller protective effect of parental education on reducing undesired exposures for Black than White children may be one of the mechanisms that may explain why children develop worse than expected physical, mental, and behavioral health in high SES Black families. Not all health disparities are due to racial differences in SES, but some of them are also secondary to the diminishing returns of socioeconomic status indicators such as parental education for racial minorities. Research should study contextual, structural, family, and behavioral factors that reduce Black families' ability to mobilize their human capital and secure health outcomes for themselves and their children.

Neighborhoods and health during the transition to adulthood: A scoping review

Research suggests that neighborhoods play an important role in shaping health outcomes across the life course, but the neighborhood-health link during the transition to adulthood period (18-29 years) is not well studied. A scoping review of 24 studies used thematic analysis to examine the theoretical and methodological approaches of the neighborhood-health literature during this period. Themes illustrate the varied approaches used in this research, including diversity in how neighborhood is defined, theoretical variation regarding the importance of the transition period and the neighborhood-health link, and the importance of gender and race/ethnicity to this area of study. While the literature on this topic is fragmented, with varied definitions and minimal theoretical coherence, all studies found some degree of support for the relationship between neighborhoods and health during the transition to adulthood. Our analysis suggests that future research should focus on developing a theoretical foundation for these relationships in order to clarify key concepts and advance a science to better understand how and why neighborhoods affect health during this period.

Neighborhood Stress and Life Satisfaction: Is there a Relationship for African American Adolescents?

This study identified associations between perceived neighborhood stress and adolescents' perceptions of life satisfaction. African American adolescents aged 13-18 (n=1,658) from four matched, mid-sized cities in the northeastern and southeastern USA, completed a self-report questionnaire using an audio computer-assisted self-interview (ACASI). Analyses examined relationships between perceived neighborhood stress and perceived life satisfaction, while controlling for socioeconomic status (SES). Life satisfaction was found to be related to neighborhood stress for both males and females, with variability in neighborhood stress characteristics and in the magnitude of associations by gender. Further research should identify the particular characteristics of youth and specific aspects of adolescent life satisfaction associated with perceived neighborhood stress to develop community-based and culturally-sensitive quality of life improvement/health promotion programs.

Gender differences in the interaction effect of cumulative risk and problem-focused coping on depression among adult employees

The adult employees suffer from various pressure and their mental health has been paid more and more attention to. This study has two purposes, namely, (1) to investigate the gender differences in the stressors and utilization frequency of problem-focused coping among adult employees and (2) to explore the gender differences in the interaction effect of cumulative risk and problem-focused coping on depression among adult employees. The cumulative risk of employees was assessed in the following six ways: health pressure, family economic pressure, love and marriage problems, conflicts among family members, work stress and friend support. Problem-focused coping was measured by the three dimensions of active coping, planning, and using instrumental support from the Brief COPE scale, and depression was assessed by the Self-rating Depression Scale. The participants consisted of 406 Chinese employees. The results showed that (1) the cumulative risk of male employees was marginally significantly higher than that of female employees; (2) there was no significant difference in the utilization frequency of problem-focused coping between male and female employees; and (3) problem-focused coping moderated the relationship between cumulative risk and depression for male employees but not for female employees. This study indicates that problem-focused coping has a stronger effect on depression for male employees than for female employees.

Violence Victimization Predicts Body Mass Index One Decade Later among an Urban Sample of African American Young Adults: Sex as a Moderator and Dehydroepiandrosterone as a Mediator

Psychological stressors such as violence victimization are known contributors to obesity. However, moderators and mediators of this association have not been studied, although they might offer pathways for intervention or prevention. Using a sample of African American young adults, this study tested: (1) the moderating effect of sex on the effect of violence victimization on trajectories of body mass index (BMI), and (2) the mediating effect of dehydroepiandrosterone (DHEA) on this association. This 13-year longitudinal study followed 73 male and 80 female African American young adults who lived in an urban area from 1999 to 2012 when the youth were 20-32 years old. The independent variable was violence victimization measured in 1999 and 2000. The dependent variable was BMI measured in 2002 and 2012. The mediator was DHEA measured in 2001 and 2002. Multilevel path analysis was used to test if males and females differed in violence victimization predicting change in BMI (Model I) and the mediating effect of DHEA change on the above association (Model II). The results of Model I suggested that the change in violence victimization from 1999 to 2000 predicted change in BMI from 2002 to 2012 for females, but not males. Based on Model II, the DHEA change from 2000 to 2001 for females fully mediated the association between violence victimization from 1999 to 2000 and increases in BMI from 2002 to 2012. Our findings suggest that violence victimization in urban areas contributes to the development of obesity among African American female young adults and change in DHEA mediates this link. Violence prevention may have important implications for obesity prevention of African American young women who live in unsafe urban areas. This study also suggests that DHEA may be involved in the violence victimization-obesity link for African American women.

Protective Factors Buffer Life Stress and Behavioral Health Outcomes among High-Risk Youth

This study investigated internalizing problems, externalizing problems, and polydrug use among African-American youth residing in high-poverty neighborhoods, and tested the potential protective effects of religiosity, parental monitoring, and neighborhood collective efficacy on life stress and behavioral health outcomes (N = 576; 307 females; Mage = 16 years, SD = 1.44 years). A cumulative risk index reflected the combined effects of past year exposure to stressful life events, racial discrimination, and exposure to violence along with poor neighborhood ecology. Structural equation modeling revealed that cumulative risk significantly predicted internalizing problems, externalizing problems, and polydrug use. Interaction tests showed that the association of cumulative risk with internalizing problems was buffered by adolescent religiosity and neighborhood collective efficacy. The association of cumulative risk with externalizing problems was buffered by parental monitoring and collective efficacy. Adolescent sex further moderated these effects. The findings of the present study collectively highlight potential for protective factors to buffer effects of cumulative risk on behavioral health outcomes among youth residing in high-risk neighborhoods.

Perceived Racial Discrimination and Marijuana Use a Decade Later; Gender Differences Among Black Youth

Background: Researchers have reported gender differences in the association between perceived racial discrimination (PRD) and substance use including marijuana use (MU). A limited number of longitudinal studies, however, have documented the long-term effect of PRD during adolescence on subsequent MU in young adulthood. Objective: In the current longitudinal study, we tested gender differences in the association between baseline PRD during adolescence and subsequent MU during young adulthood within Black population. Methods: A cohort of 595 Black (278 male and 317 female) ninth grade students were followed for 13 years from 1999 (mean age 20) to 2012 (mean age 33). Participants were selected from an economically disadvantaged urban area in the Midwest, United States. The independent variable was PRD measured in 1999. The outcome was average MU between 2000 and 2012 (based on eight measurements). Covariates included age, socio-demographics (family structure, and parental employment), and substance use by friends and parents. Gender was the focal moderator. Linear regression was used for statistical analysis. Results: In the pooled sample, PRD in 1999 was not associated with average MU between 2000 and 2012. We did, however, find an interaction effect between baseline PRD and gender on average MU, suggesting stronger association for males than females. In gender-specific models, baseline PRD predicted average MU between 2000 and 2012 for males, but not for females. Conclusion: Exposure to PRD during late adolescence may have a larger role on MU of male than female Black young adults. Although we found that males are more vulnerable to the effects of PRD on MU, PRD should be prevented regardless of race, gender, and other social identities. While PRD is pervasive among Black Americans, exposure to PRD increase the risk of MU for Black males. Hence, substance use prevention efforts for Black males, in particular, should emphasize coping with PRD.

Gender Differences in Prescription Opioid Misuse Among U.S. Black Adults

BACKGROUND

Prescription opioid misuse (POM) is a significant problem among U.S. adults, including Blacks, as indicated by past research. Despite potential gender differences in POM among Black adults, previous research has yet to examine this possibility.

OBJECTIVES

This study identified the prevalence and unique correlates of POM among both Black men and Black women. Results were compared to those of Whites.

METHODS

We used data from 2015-2016 National Survey on Drug Use and Health (N = 60,133). Weighted logistic regression models stratified by race and gender were estimated. One model was stratified by gender only, with race serving as the primary predictor.

RESULTS

Findings revealed 3.4% of Black women, 4.9% of Black men, 4.1% of White women, and 5.4% of White men reported past-year POM; although, no significant differences were found. Among Black women only, lower socioeconomic status increased odds of POM. Higher educational attainment, residence in rural areas and older age lowered odds of POM. Encounters with drug dealers, illicit drug, marijuana, and tobacco use, other prescription drug misuse, and poor health were associated with increased odds of POM among Black men. In the gender stratified models, White men were more likely to report POM than Black men. However, White women were not more likely to report POM compared to Black women.

CONCLUSIONS

Clear gender differences exist in the prevalence and correlates of POM among Black adults. Prevention and intervention strategies must be cognizant of these differences when developing programs to decrease POM.

Marijuana Use and Depressive Symptoms; Gender Differences in African American Adolescents

Introduction: This study aimed to examine gender differences in the bidirectional associations between marijuana use and depressive symptoms among African American adolescents. The study also tested gender differences in the effects of socioeconomic status, maternal support, and friends' drug use on adolescents' depressive symptoms and marijuana use. Methods: This is a secondary analysis of the Flint Adolescent Study (FAS). Six hundred and eighty one African American adolescents (335 males and 346 females) were followed for 3 years, from 1995 (mean age 16) to 1997 (mean age 19). Depressive symptoms (Brief Symptom Inventory) and marijuana use were measured annually during the follow up. We used multi-group latent growth curve modeling to explore the reciprocal associations between depressive symptoms and marijuana use over time based on gender. Results: Baseline marijuana use was predictive of an increase in depressive symptoms over time among male but not female African American adolescents. Baseline depressive symptoms were not predictive of an increase in marijuana use among male or female adolescents. Conclusion: Study findings suggest that male African American adolescents who use marijuana are at an increased risk of subsequent depressive symptoms. Interventions that combine screening and treatment for marijuana use and depression may be indicated for African American male adolescents.

History of Non-Fatal Physical Assault Is Associated with Premature Mortality for Whites but Not Blacks

Exposure to trauma increases the long-term risk of mortality, and experiencing non-fatal physical assault is not an exception. To better understand population heterogeneity in this link, the current study explored Black–White differences in the association between history of non-fatal physical assault and risk of all-cause mortality over a 25-year period in the United States. Data came from the Americans’ Changing Lives (ACL) study that followed 3617 non-institutionalized respondents for up to 25 years. History of non-fatal physical assault at baseline was the predictor. Outcome was time to death due to all-cause mortality during follow-up from baseline (1986) to follow-up (2011). Confounders included gender, age, and baseline socio-economic status (education and income), health behaviors (smoking and drinking), and health status (chronic medical conditions, self-rated health, and body mass index). Race was the moderator. Cox regressions were used for multi-variable analysis. History of non-fatal physical assault at baseline was associated with an increased risk of mortality, above and beyond baseline socioeconomic status, health behaviors, and health status. Race interacted with history of non-fatal physical assault on mortality, suggesting a stronger effect for Whites compared to Blacks. In race-specific models, history of non-fatal physical assault was associated with risk of mortality for Whites but not Blacks. The current study showed that experiencing non-fatal physical assault increases the risk of premature death above and beyond demographics, socioeconomic status, health behaviors, and health status. Experiencing non-fatal physical assault may have a larger effect on premature mortality among Whites than Blacks. Future research is needed on how Blacks and Whites differ in the health consequences of social adversities.

Adolescent girls in context: Not all patterns may be created equal

Much research exists on the importance of risk factors within individual contexts of parenting, neighborhood, school, and peers for adolescent development. However little exists on whether risks in certain contexts may be more or less likely for risk accumulation across contexts – referred to as the Weighted Risk Phenomenon (WRP). One way to study WRP is to study adolescent patterns of co-existing risk characteristics across domains and over time. The present study focuses on studying information about parenting, neighborhood, school, and peers in order to understand how risk can have different patterns over time. Participants were all girls recruited from junior high schools in rural and metropolitan areas of Sweden. The results illustrate that there are stable structural and individual pathways across four contexts of adolescent girls which may represent risk over time. Structurally, patterns which emerged at grade 7 reappeared again a year later and again a year after that in grade 9. In general, the same individuals seem to re-emerge in the same or similar patterns over time. Those who showed risk accumulation patterns tended to report prior risk factors in the parenting context. Such trends are supported in the literature and give support to the postulation that parenting is one of the strongest risk factors for adolescents. The findings indicate possible underpinnings of WRP.

High Risk of Depression in High-Income African American Boys

BACKGROUND

Despite the well-established literature on the protective effect of socioeconomic status (SES) on physical and mental health, there are a few reports on poor mental health of blacks with high SES. Using a national sample, this study investigated the association between household income and risk of major depressive disorder (MDD) in black youth based on ethnicity, gender, and their intersection.

METHODS

One thousand one hundred seventeen black adolescents (810 African Americans and 360 Caribbean blacks) were included in the current study. Household income was the main predictor. MDD (lifetime, 12-month, and 30-day) was the main outcome. Age was the covariate. Ethnicity and gender were the focal moderators. Logistic regressions were used for data analysis.

RESULTS

In the pooled sample, household income was not associated with risk of MDD (lifetime, 12-month, or 30-day). We found significant interactions between income and gender on lifetime and 12-month MDD, suggesting a stronger protective effect of income on MDD for females than males. We also found significant interaction between income and ethnicity on 30-day MDD, suggesting stronger protective effect of income against MDD for Caribbean blacks than African Americans. In African American males, high household income was associated with higher risk of lifetime, 12-month, and 30-day MDD. For Caribbean black males and females, high household income was associated with lower odds of 30-day MDD.

CONCLUSION

Findings suggest that ethnicity and gender influence how socioeconomic resources such as income are associated with MDD risk among black youth. Higher household income may be associated with higher risk of MDD for African American males.

Perceived Discrimination and Substance Use among Caribbean Black Youth; Gender Differences

Although perceived discrimination in Black youth is a risk factor for a wide range of negative mental health outcomes, recent research has suggested some gender differences in these associations. Gender differences in vulnerability to perceived discrimination among Caribbean Black youth is, however, still unknown. The current cross-sectional study investigated gender variations in the association between perceived discrimination and substance use (SU) in a national sample of Caribbean Black youth. Data came from the National Survey of American Life-Adolescents (NSAL-A), 2003⁻2004. This analysis included 360 Caribbean Black youth (165 males and 195 females) who were between 13 and 17 years old. Sociodemographic factors, perceived discrimination, and SU were measured. Logistic regressions were used for data analysis. Among Caribbean Black youth, a positive association was found between perceived discrimination and SU (odds ratio (OR) = 1.15 (95% confidence interval (CI) = 1.02⁻1.29)). A significant interaction was found between gender and perceived discrimination on smoking (OR = 1.23 (95% CI = 1.07⁻1.41)) suggesting that the association between perceived discrimination and smoking is larger for male than female Caribbean Black youth. The interaction between gender and perceived discrimination on SU was not statistically significant (OR = 1.32 (95% CI = 0.94⁻1.86)). While perceived discrimination increases SU in Caribbean Black youth, this effect is stronger for males than females, especially for smoking. While discrimination should be reduced at all levels and for all populations, clinicians may specifically address discrimination for SU prevention and treatment among male Caribbean Black youth.

Depression among Black Youth; Interaction of Class and Place

Although high socioeconomic status (SES) is traditionally conceptualized as a health protective factor, recent literature has documented positive associations between SES (e.g., income) and depression among Blacks, including Black youth. To extend the results of this recent literature, the current study used the Family and Community Health Study (FACHS) data to examine the multiplicative effects of gender, place, and SES on average depressive symptoms of Black youth over a long period of time. FACHS, 1997⁻2017, followed 889 Black children aged 10⁻12 years old for up to 18 years. Depressive symptoms were measured in seven waves. The main predictors of interest were two SES indicators, parent education and family income measured at baseline (1997). Main outcome of interest was average depressive symptoms over the 18 year follow up period. Place of residence and gender were the focal moderators. Linear regression models were used for data analysis. In the pooled sample, living in a predominantly White area was associated with higher average depressive symptoms over time, however, this association was fully explained by higher perceived racial discrimination in the predominantly White areas. We found an interaction between income and place of residence on average depressive symptoms, suggesting that higher income is associated with more depressive symptoms in predominantly White compared to predominantly Black areas. Place did not interact with parent education on average depressive symptoms. Gender also did not interact with education or income on depressive symptoms. Findings suggest that place and SES may interact on depressive symptoms of Black youth, with high income becoming a risk factor for depressive symptoms in predominantly White areas. How SES indicators, such as income, protect or become a risk factor depend on other contextual factors, such as place of residence. There is a need to reduce discrimination experienced by Blacks, especially in predominantly White areas. Meanwhile, Black youth who live in predominantly White areas may require additional help that enhances their coping.

Homicides, Public Goods, and Population Health in the Context of High Urban Violence Rates in Cali, Colombia

Obesity and frequent mental and physical distress are often associated with major health problems. The characteristics of the urban environment, such as homicide rates and public goods provision, play an important role in influencing participation in physical activity and in overall mental health. This study aimed to determine whether there was a relationship between homicide rates and public goods provision on the health outcomes of the citizens of Cali, Colombia, a city known for its high urban violence rate and low municipal investment in public goods. We used a linear probability model to relate homicide rates and public goods provision (lighted parks, effective public space per inhabitant, and bus stations) at the district level to health outcomes (obesity and frequent mental and physical distress). Individual data were obtained from the 2014 CaliBRANDO survey, and urban context characteristics were obtained from official government statistics. After controlling for individual covariates, results showed that homicide rates were a risk factor in all examined outcomes. An increase in 1.0 m2 of public space per inhabitant reduced the probability of an individual being obese or overweight by 0.2% (95% confidence interval (CI) = - 0.004 to - 0.001) and the probability of frequent physical distress by 0.1% (95% CI = - 0.002 to - 0.001). On average, the presence of one additional bus station increased the probability of being obese or overweight by 1.1%, the probability of frequent mental distress by 0.3% (95% CI = 0.001-0.004), and the probability of frequent physical distress by 0.02% (95% CI = 0.000-0.003). Living in districts with adequate public space and lighted parks lowers the probability of being obese and high homicide rates, which are correlated with poor health outcomes in Cali, Colombia. Investments in public goods provision and urban safety to reduce obesity rates may contribute to a better quality of life for the population.

Perceived Discrimination among Black Youth: An 18-Year Longitudinal Study

Background: Recent research has suggested vulnerability to perceived racial discrimination (PRD) as a mechanism behind high levels of depression seen in high socioeconomic status (SES) Black males. To better understand the effects of gender and SES on shaping experiences of PRD among Black youth in the United States, we used data from the Family and Community Health Study (FACHS) to explore the trajectory of PRD in Black youth by gender, SES, and place. Methods: Data came from FACHS, 1997⁻2017, which followed 889 children aged 10⁻12 years old at Wave 1 (n = 478; 53.8% females and n = 411; 46.2% males) for up to 18 years. Data were collected in seven waves. The main predictors of interest were gender, SES (parent education and annual family income), age, and place of residence. Main outcomes of interest were baseline and slope of PRD. Latent growth curve modeling (LGCM) was used for data analysis. Results: Gender, SES, place, and age were correlated with baseline and change in PRD over time. Male, high family income, and younger Black youth reported lower PRD at baseline but a larger increase in PRD over time. Youth who lived in Iowa (in a predominantly White area) reported higher PRD at baseline and also an increase in PRD over time. High parental education was not associated with baseline or change in PRD. Conclusion: In the United States, Black youth who are male, high income, and live in predominantly White areas experience an increase in PRD over time. Future research is needed on the interactions between gender, SES, and place on exposure and vulnerability of Black youth to PRD. Such research may explain the increased risk of depression in high SES Black males.

Perceived Discrimination and Binge Eating Disorder; Gender Difference in African Americans

Environmental stressors, such as perceived discrimination (PD), are linked to Binge Eating Disorder (BED). The current study investigated the association between PD and BED among African Americans, and the variation in such an association based on gender. Data of the National Survey of American Life (NSAL), 2001⁻2003, with a nationally-representative sample of African American adults, were used (n = 3516). The independent variable in the study was PD. The dependent variable was BED, measured using the Composite International Diagnostic Interview (CIDI). Socio-demographics (age, education, employment, and marital status) were covariates, and gender was the moderator variable. Survey logistic regressions with and without gender × PD interaction terms were used for data analysis. In the pooled sample, PD was associated with higher odds of BED, net of socio-demographic factors. Models also showed a significant gender × PD interaction term suggesting a stronger association between PD and BED for women, compared to men. Gender specific models showed an association between PD and BED among female, but not male, African Americans. Although a link may exist between PD and BED among African Americans, the magnitude of this association depends on gender, with a stronger association among females than males. This finding is in line with the literature that has shown gender-specific consequences of environmental stress for African Americans.

Does Discrimination Explain High Risk of Depression among High-Income African American Men?

Background: Higher socioeconomic status is known to decrease the risk for poor mental health overall. However, African American males of higher socioeconomic status (SES) are at an increased risk for having a major depressive episode (MDE). It is not known whether perceived discrimination (PD) explains this risk. The current study used nationally representative data to explore the role of PD in explaining the association between high-SES and having MDE among African American men. Methods: The National Survey of American Life (NSAL), 2003, included 4461 American adults including 1271 African American men. SES indicators (i.e., household income, educational attainment, employment status, and marital status) were the independent variables. 12-month MDE measured using the Composite International Diagnostic Interview (CIDI) was the outcome. Age, gender, and region were the covariates. PD was the potential mediator. For data analysis, we used logistic regression. Results: Among African American men, household income was positively associated with odds of 12-month MDE. The positive association between household income and odds of MDE remained unchanged after adding PD to the model, suggesting that PD may not explain why high-income African American men are at a higher risk of MDE. Conclusions: Perceived discrimination does not explain the increased risk for depression among African American males of higher SES. Future research should explore the role of other potential mechanisms such as stress, coping, social isolation, and/or negative social interaction that may increase psychological costs of upward social mobility for African American males.

Psychological pathways from racial discrimination to cortisol in African American males and females

The association between racial discrimination (discrimination) and stress-related alterations in the neuroendocrine response-namely, cortisol secretion-is well documented in African Americans (AAs). Dysregulation in production of cortisol has been implicated as a contributor to racial health disparities. Guided by Clark et al. (Am Psychol 54(10):805-816, 1999. doi: 10.1037/0003-066X.54.10.805 ) biopsychosocial model of racism and health, the present study examined the psychological pathways that link discrimination to total cortisol concentrations in AA males and females. In a sample of 312 AA emerging adults (45.5% males; ages 21-23), symptoms of anxiety, but not depression, mediated the relation between discrimination and total concentrations of cortisol. In addition, the results did not reveal sex differences in the direct and indirect pathways. These findings advance our understanding of racial health disparities by suggesting that the psychological consequences of discrimination can uniquely promote physiologic dysregulation in AAs.

Ethnic and Gender Differences in Family Social Support among Black Adolescents

This study examines black adolescents' reports of the most helpful types of social support that they receive from and provide to family members, and whether family support exchanges vary by ethnicity (African American vs. Black Caribbean) and gender. Data for this study are from the National Survey of American Life Adolescent Supplement (NSAL-A), a national, probability sample of African American and Black Caribbean youth (ages 13-17). Overall, youth reported financial support, followed by emotional assistance and practical support as the most helpful types of support that they received. Practical and emotional assistance characterized the most commonly reported types of support that they provided to family members. Black Caribbean adolescents were more likely than African American adolescents to report financial and practical assistance as the most helpful types of support that they received from family members; no ethnic differences were observed in the provision of support to relatives. There were no significant gender differences in the receipt of support, but adolescent girls reported greater involvement in providing emotional support and caregiving than adolescent boys. The results of this paper reveal that African American and Black Caribbean adolescents are involved in a complex pattern of reciprocal support exchanges with their extended family members. Study findings also reinforce the importance of research focused on racial/ethnic and gender differences in family support exchanges in order to develop a more nuanced understanding of family support behaviors within these groups.

Perceived Peer Behavior and Parental Support as Correlates of Marijuana Use: The Role of Age and Gender

INTRODUCTION

Parental support and perceptions of peer behavior on substance use are well-studied, but precisely how their associations vary as a function of age, and how those age-specific patterns vary by gender, remain unknown components of the developmental process underlying substance use.

METHODS

Using data from an 18-year longitudinal study of predominantly African-American students at high-risk for high school dropout in Flint, Michigan (baseline average age = 14.8 years), we examined longitudinal associations between past 30-day marijuana use and three self-reported variables: perceived friend drug use, perceived friend aggression, parental support. We used varying-coefficient regression models to semiparametrically estimate how covariate effects on past 30-day marijuana use vary smoothly as a function of age; gender differences in these age-specific coefficient trajectories were also tested.

RESULTS

In the unadjusted tests, the risk-enhancing effect of perceived friend drug use decreased with age in both genders, but the effect of perceived friend aggression varied only in females; in both cases, gender differences were not significant. In males, parental support had protective effects that decreased with age. The effect of both parental support differed in females, with less protective baseline effects and no evidence of age-variation. Adjusted models simultaneously including both friend and parental variables produced qualitatively similar results.

CONCLUSIONS

Prevention strategies focusing on social exposures may be more effective if they are age- and gender-specific. In particular, interventions focusing on perceived peer behaviors may be more appropriate during adolescence, and those involving parental relationships may be more appropriate for males.

Blacks' Diminished Health Return of Family Structure and Socioeconomic Status; 15 Years of Follow-up of a National Urban Sample of Youth

The protective effect of family structure and socioeconomic status (SES) on physical and mental health is well established. There are reports, however, documenting a smaller return of SES among Blacks compared to Whites, also known as Blacks' diminished return. Using a national sample, this study investigated race by gender differences in the effects of family structure and family SES on subsequent body mass index (BMI) over a 15-year period. This 15-year longitudinal study used data from the Fragile Families and Child Wellbeing Study (FFCWS), in-home survey. This study followed 1781 youth from birth to age 15. The sample was composed of White males (n = 241, 13.5%), White females (n = 224, 12.6%), Black males (n = 667, 37.5%), and Black females (n = 649, 36.4%). Family structure and family SES (maternal education and income to need ratio) at birth were the independent variables. BMI at age 15 was the outcome. Race and gender were the moderators. Linear regression models were run in the pooled sample, in addition to race by gender groups. In the pooled sample, married parents, more maternal education, and income to need ratio were all protective against high BMI of youth at 15 years of age. Race interacted with family structure, maternal education, and income to need ratio on BMI, indicating smaller effects for Blacks compared to Whites. Gender did not interact with SES indicators on BMI. Race by gender stratified regressions showed the most consistent associations between family SES and future BMI for White females followed by White males. Family structure, maternal education, and income to need ratio were not associated with lower BMI in Black males or females. The health gain received from family economic resources over time is smaller for male and female Black youth than for male and female White youth. Equalizing access to economic resources may not be enough to eliminate health disparities in obesity. Policies should address qualitative differences in the lives of Whites and Blacks which result in diminished health returns with similar SES resources. Policies should address structural and societal barriers that hold Blacks against translation of their SES resources to health outcomes.

Darker Skin Tone Increases Perceived Discrimination among Male but Not Female Caribbean Black Youth

Background: Among most minority groups, males seem to report higher levels of exposure and vulnerability to racial discrimination. Although darker skin tone may increase exposure to racial discrimination, it is yet unknown whether skin tone similarly influences perceived discrimination among male and female Caribbean Black youth. Objective: The current cross-sectional study tests the role of gender on the effects of skin tone on perceived discrimination among Caribbean Black youth. Methods: Data came from the National Survey of American Life-Adolescent Supplement (NSAL-A), 2003–2004, which included 360 Caribbean Black youth (ages 13 to 17). Demographic factors (age and gender), socioeconomic status (SES; family income, income to needs ratio, and subjective SES), skin tone, and perceived everyday discrimination were measured. Linear regressions were used for data analysis. Results: In the pooled sample, darker skin tone was associated with higher levels of perceived discrimination among Caribbean Black youth (b = 0.48; 95% Confidence Interval (CI) = 0.07–0.89). A significant interaction was found between gender and skin tone (b = 1.17; 95% CI = 0.49–1.86), suggesting a larger effect of skin tone on perceived discrimination for males than females. In stratified models, darker skin tone was associated with more perceived discrimination for males (b = 1.20; 95% CI = 0.69–0.72) but not females (b = 0.06; 95% CI = −0.42–0.55). Conclusion: Similar to the literature documenting male gender as a vulnerability factor to the effects of racial discrimination, we found that male but not female Caribbean Black youth with darker skin tones perceive more discrimination.

Social Determinants of Depression: The Intersections of Race, Gender, and Socioeconomic Status

Background: Despite the wealth of literature on social determinants of mental health, less is known about the intersection of these determinants. Using a nationally representative sample, this study aimed to study separate, additive, and multiplicative effects of race, gender, and SES on the risk of major depressive episode (MDE) among American adults. Methods: National Survey of American Life (NSAL) included 3570 African Americans and 891 Whites. Race, gender, socioeconomic status (SES, household income, education, employment, and marital status) were independent variables. Twelve-month MDE was measured by the Composite International Diagnostic Interview (CIDI). A series of logistic regressions were used to analyze the data. Results: In the pooled sample, race and household income, but not gender, education, employment, and marital status were associated with 12-month MDE. Gender interacted with the effects of income on MDE, suggesting that the association between household income and MDE is larger for women than men. In race by gender specific models that controlled for other SES indicators, high income was protective for White women, education was protective for African American women, and high income became a risk factor for African American men. High income did not show a risk effect for African American men in the absence of other SES indicators. Conclusions: Findings suggest that race, gender, and class interact on how SES indicators, such as education or income, become a protective or a risk factor for MDE among American Adults. When the outcome is MDE, White women benefit more from income, African American women gain from education, however, the residual effect of high income (above and beyond education, employment, and marital status) may become a risk factor for African American men.

Discrimination Increases Suicidal Ideation in Black Adolescents Regardless of Ethnicity and Gender

BACKGROUND

Discrimination is a common experience for Blacks across various developmental periods. Although much is known about the effect of discrimination on suicidal ideation of adults, less is known about the same association in Black youth.

AIM

We examined the association between discrimination and suicidal ideation in a national sample of Black youth. We also explored gender and ethnic differences in this association.

METHODS

We used data from the National Survey of American Life-Adolescents (NSAL-A), 2003-2004. In total, 1170 Black adolescents entered the study. This number was composed of 810 African American and 360 Caribbean Black youth (aged 13 to 17 years). Demographic and socioeconomic factors were controls, perceived discrimination was the predictor, and lifetime suicidal ideation was the outcome. Logistic regression was used to test the association between perceived discrimination and suicidal ideation in the pooled sample, as well as based on ethnicity and gender.

RESULTS

In the pooled sample of Black youth, higher perceived discrimination was associated with higher odds of suicidal ideation (Odds Ratio (OR) = 1.09; 95% Confidence Interval (CI) = 1.02-1.17). This association was significant net of age, ethnicity, gender, and socioeconomic status. We did not find interactions between perceived discrimination and ethnicity or gender on suicidal ideation. Perceived discrimination was associated with suicidal ideation in African Americans (CI = 1.09; 95% CI = 1.01-1.17) and Caribbean Blacks (CI = 1.16; 95% CI = 1.03-1.32), males (CI = 1.11; 95% CI = 1.00-1.25), and females (CI = 1.08; 95% CI = 1.00-1.16).

CONCLUSION

Discrimination jeopardizes the mental health of Black youth. In a universal pattern, discrimination is associated with suicidal ideation in Black youth. More research is needed on this topic.

Racial Discrimination in Health Care Is Associated with Worse Glycemic Control among Black Men but Not Black Women with Type 2 Diabetes

BACKGROUND

A growing body of research suggests that racial discrimination may affect the health of Black men and Black women differently.

AIMS

This study examined Black patients with diabetes mellitus (DM) in order to test gender differences in (1) levels of perceived racial discrimination in health care and (2) how perceived discrimination relates to glycemic control.

METHODS

A total of 163 Black patients with type 2 DM (78 women and 85 men) provided data on demographics (age and gender), socioeconomic status, perceived racial discrimination in health care, self-rated health, and hemoglobin A1c (HbA1c). Data were analyzed using linear regression.

RESULTS

Black men reported more racial discrimination in health care than Black women. Although racial discrimination in health care was not significantly associated with HbA1c in the pooled sample (b = 0.20, 95% CI = -0.41 -0.80), gender-stratified analysis indicated an association between perceived discrimination and higher HbA1c levels for Black men (b = 0.86, 95% confidence intervals (CI) = 0.01-1.73) but not Black women (b = -0.31, 95% CI = -1.17 to -0.54).

CONCLUSION

Perceived racial discrimination in diabetes care may be more salient for glycemic control of Black men than Black women. Scholars and clinicians should take gender into account when considering the impacts of race-related discrimination experiences on health outcomes. Policies should reduce racial discrimination in the health care.

Racial Discrimination during Adolescence Predicts Mental Health Deterioration in Adulthood: Gender Differences among Blacks

BACKGROUND

Despite the existing knowledge regarding the negative mental health consequences of perceived racial discrimination, very few researchers have used a longitudinal design with long-term follow-up periods to explore gender differences in this association over time.

OBJECTIVE

The current longitudinal study aimed to investigate gender differences in predictive role of an increase in perceived racial discrimination during adolescence for mental health deterioration a decade later when they are transitioning to young adulthood.

METHODS

Current study followed 681 Black youths for 18 years from 1994 (mean age 15) to 2012 (mean age 32). All participants spent their adolescence and transition to young adulthood in an economically disadvantaged urban area in the Midwest of the United States. Independent variable was perceived racial discrimination measured in 1999 and 2002. Outcomes were psychological symptoms (anxiety and depression) measured in 1999 and at end of follow-up (2012). Covariates included sociodemographics (age, family structure, and parental employment) measured in 1994. Gender was used to define groups in a multigroup structural equation model to test moderating effects.

RESULTS

Multigroup structural equation modeling showed that among male Black youth, an increase in perceived racial discrimination from age 20 to 23 was predictive for an increase in symptoms of anxiety and depression from age 20 to 32. Among female Black youth, change in perceived racial discrimination did not predict future change in depressive or anxiety symptoms.

CONCLUSION

While racial discrimination is associated with negative mental health consequences for both genders, male and female Black youth differ in regard to long-term effects of an increase in perceived discrimination on deterioration of psychological symptoms. Black males seem to be more susceptible than Black females to the psychological effects of an increase in racial discrimination over time.

Low Family Support and Risk of Obesity among Black Youth: Role of Gender and Ethnicity

Most studies on the role of family environment in developing risk of obesity among youth have focused on parenting behaviors that are directly involved in energy balance in regional, non-representative White samples. Using a national sample of ethnically diverse Black youth, the current study tested the association between low family support and risk of obesity. We also tested the heterogeneity of this association based on gender, ethnicity, and their intersection. We used data from the National Survey of American Life-Adolescent Supplement (NSAL-A), a national survey of Black adolescents in the United States. The study enrolled 1170 African American and Caribbean Black 13-17 year old youth. Obesity was defined based on the cutoff points of body mass index (BMI) appropriate for age and gender of youth. Family support was measured using a five-item measure that captured emotional and tangible social support. Age, gender, and ethnicity were also measured. Logistic regressions were utilized in the pooled sample, and also based on gender, ethnicity, and their intersection, to test the link between low family support and risk for obesity.

RESULTS

In the pooled sample, low family support was not associated with an increased risk of obesity (OR = 1.35, 95% Confidence Interval (CI) = 0.96-1.89). The association between low family support and risk of obesity was, however, significant among African American females (OR = 1.60, 95% CI = 1.01-2.55). There was no association for African American males (OR = 1.26, 95% CI = 0.82-1.92), Caribbean Black males (OR = 0.68, 95% CI = 0.01-54.85), and Caribbean Black females (OR = 0.78, 95% CI = 0.42-1.44). In conclusion, policies and programs that enable African American families to provide additional family support may prevent obesity among African American female youth. Future research should test the efficacy of promoting family support as a tool for preventing obesity among African American female youth.

Neighborhood Safety and Major Depressive Disorder in a National Sample of Black Youth; Gender by Ethnic Differences

Adolescence is a developmental period marked by increased stress, especially among Black youth. In addition to stress related to their developmental transition, social factors such as a perceived unsafe neighborhood impose additional risks. We examined gender and ethnic differences in the association between perceived neighborhood safety and major depressive disorder (MDD) among a national sample of Black youth. We used data from the National Survey of American Life - Adolescents (NSAL-A), 2003-2004. In total, 1170 Black adolescents entered the study. This number was composed of 810 African American and 360 Caribbean Black youth (age 13 to 17). Demographic factors, perceived neighborhood safety, and MDD (Composite International Diagnostic Interview, CIDI) were measured. Logistic regressions were used to test the association between neighborhood safety and MDD in the pooled sample, as well as based on ethnicity by gender groups. In the pooled sample of Black youth, those who perceived their neighborhoods to be unsafe were at higher risk of MDD (Odds Ratio [OR] = 1.25; 95% Confidence Interval [CI] = 1.02-1.51). The perception that one's neighborhood is unsafe was associated with a higher risk of MDD among African American males (OR=1.41; 95% CI = 1.03-1.93) but not African American females or Caribbean Black males and females. In conclusion, perceived neighborhood safety is not a universal psychological determinant of MDD across ethnic by gender groups of Black youth; however, policies and programs that enhance the sense of neighborhood safety may prevent MDD in male African American youth.

Perceived Neighborhood Safety Better Predicts Risk of Mortality for Whites than Blacks

AIM

The current study had two aims: (1) to investigate whether single-item measures of subjective evaluation of neighborhood (i.e., perceived neighborhood safety and quality) predict long-term risk of mortality and (2) to test whether these associations depend on race and gender.

METHODS

The data came from the Americans' Changing Lives Study (ACL), 1986-2011, a nationally representative longitudinal cohort of 3361 Black and White adults in the USA. The main predictors of interest were perceived neighborhood safety and perceived neighborhood quality, as measured in 1986 using single items and treated as dichotomous variables. Mortality due to all internal and external causes was the main outcome. Confounders included baseline age, socioeconomic status (education, income), health behaviors (smoking, drinking, and exercise), and health (chronic medical conditions, self-rated health, and depressive symptoms). Race and gender were focal effect modifiers. Cox proportional hazard models were ran in the pooled sample and stratified by race and gender.

RESULTS

In the pooled sample, low perceived neighborhood safety and quality predicted increased risk of mortality due to all causes as well as internal causes, net of all covariates. Significant interaction was found between race and perceived neighborhood safety on all-cause mortality, indicating a stronger association for Whites compared to Blacks. Race did not interact with perceived neighborhood quality on mortality. Gender also did not interact with perceived neighborhood safety or quality on mortality. Perceived neighborhood safety and quality were not associated with mortality due to external causes.

CONCLUSION

Findings suggest that single items are appropriate for the measurement of perceived neighborhood safety and quality. Our results also suggest that perceived neighborhood safety better predicts increased risk of mortality over the course of 25 years among Whites than Blacks.

Association Between Self-Esteem and Depressive Symptoms Is Stronger Among Black than White Older Adults

BACKGROUND

Although poor self-esteem is a core component of depression, we still do not know if racial and ethnic groups differ in the magnitude of this link. This study compared Black and White older adults on the association between self-esteem and depressive symptoms.

METHODS

With a cross-sectional design, this study enrolled 1493 older individuals (age 66 or more) from the 2001 Religion, Aging, and Health Survey, a nationally representative study in the United States. Participants were either Blacks (n = 734) or Whites (n = 759). Depressive symptoms and self-esteem were measured using brief measures of the Center for Epidemiological Studies-Depression scale (CES-D) and the Rosenberg Self-Esteem Scale, respectively. Demographics, socioeconomics, and self-rated health (SRH) were covariates and self-identified race was the moderator. Linear regression models were used for data analysis.

RESULTS

Low self-esteem was associated with more depressive symptoms (B = 0.17, 95 % CI 0.15-0.28), above and beyond all covariates. We found a significant and positive interaction between race (Black) and poor self-esteem on depressive symptoms (B = 0.34, 95 % CI 0.17-0.36), suggesting a stronger association between self-esteem and depressive symptoms among Blacks compared to Whites. Although low self-esteem is associated with higher depressive symptoms in both Whites and Blacks (p < 0.05 for both races), the standardized coefficient was 0.25 (95 % CI = 0.20-0.43) for Blacks and 0.16 (95 % CI = 0.09-0.29) for Whites.

CONCLUSIONS

Low self-esteem and high depressive symptoms are more closely associated among Blacks than Whites. It is not clear whether depression leaves a larger scar on self-esteem for Blacks, or Blacks are more vulnerable to the effect of low self-esteem on depression.

Fear of Neighborhood Violence During Adolescence Predicts Development of Obesity a Decade Later: Gender Differences Among African Americans

BACKGROUND

African American youth are more likely than other racial and ethnic groups to be obese. African American youth are also more likely to live in disadvantaged neighborhoods which increase their victimization, observation, and fear of violence.

OBJECTIVES

This study tested if victimization, observation, and fear of violence in the neighborhood during adolescence predict trajectory of body mass index (BMI) in the 3rd decade of life in African Americans.

PATIENTS AND METHODS

Data came from an 18-year community-based cohort. We used multi-group latent growth curve modeling for data analysis, considering neighborhood violence at age 15 (i.e. victimization, observation, and fear) as predictors, and the linear slope for the average change in BMI from age 21 to 32 as the outcome, with age and socioeconomic status (i.e. intact family and parental employment) as covariates.

RESULTS

Fear of neighborhood violence at age 15 was predictive of an increase in BMI from age 21 to 32 among female but not male African Americans. Victimization and observation of violence at age 15 did not predict BMI change from age 21 to 32 among female or male African Americans.

CONCLUSIONS

Fear of neighborhood violence is a contributing factor to increased risk of obesity for female African American youth who live in disadvantaged areas. This finding has implications for prevention of obesity among African American women who are at highest risk for obesity in the United States. Initiatives that enhance neighborhood safety are critical strategies for obesity prevention among African American women.

Depressive Symptoms Are Associated with More Hopelessness among White than Black Older Adults

BACKGROUND

Hopelessness is a core component of depression. Our information is, however, very limited on ethnic variations in the magnitude of the link between depression and hopelessness. Using a national sample of older adults in United States, we compared Blacks and Whites for the magnitude of the association between depressive symptoms and hopelessness.

METHODS

With a cross-sectional design, we used baseline data of the Religion, Aging, and Health Survey, 2001. Linear regression models were used for data analysis. Depressive symptoms (CES-D) and hopelessness were conceptualized as independent and dependent variables in different models, respectively. Demographic factors (age and gender), socioeconomic status (education and marital status), and health (self-rated health) were covariates. Ethnicity was the moderator.

RESULTS

In the pooled sample, higher depressive symptoms were predictive of hopelessness, above and beyond all covariates. We also found significant interactions suggesting that the association between depressive symptoms and hopelessness is weaker among Blacks compared to Whites. In ethnic-specific models, there were significant associations between depressive symptoms and hopelessness among Whites but not Blacks.

CONCLUSION

Depressive symptoms accompany more hopelessness among Whites than Blacks. This finding may explain why Blacks with depression have a lower tendency to commit suicide. Future research should test whether or not Whites with depression better respond to psychotherapies and cognitive behavioral therapies that focus on hope enhancement. This finding may explain differential correlates of depression based on race and ethnicity.

You Do What You See

African American boys are more likely than same-aged counterparts to live in disadvantaged neighborhoods characterized by exposure to physical violence, lower socioeconomic status, poor parent education, and acts of violence. The current study used structural equation modeling to test the associations between witnessing violence, peer and parent expectations, peer behaviors, self-efficacy to avoid violence, and violent behavior as the outcome. Results suggest that African American boys who witnessed physical violence are more likely to engage in violence themselves. Peer and parent violence expectations, peer violence, and adolescent’s self-efficacy to avoid violence mediate this. These findings suggest potential for prevention of violent behaviors through modification of norms of male African American adolescents at risk for witnessing violence in their daily life.

Stressful Life Events and Risk of Depression 25 Years Later: Race and Gender Differences

BACKGROUND

Although stressful life events (SLEs) predict subsequent risk of developing a major depressive episode (MDE), limited information exists on whether or not race and gender alters the predictive role of SLE on risk of MDE over a long-term period. The current study explored race and gender differences in the long-term predictive role of SLE at baseline (1986) on subsequent risk of MDE 25 years later (2011) in a nationally representative cohort in the United States.

METHODS

Using a life course epidemiological approach, this longitudinal study borrowed data from the Americans' Changing Lives (ACL) Study 1986-2011. Main predictor of interest was baseline SLE over the last 3 years measured at 1986. Main outcome was risk of MDE [Composite International Diagnostic Interview (CIDI)] 25 years later (2011). Covariates included demographics, socioeconomics, depressive symptoms [Center for Epidemiological Studies-Depression Scale (CES-D)], chronic medical conditions, and health behaviors measured at baseline (1986). Gender and race were the focal moderators. We employed logistic regressions in the pooled sample, and specific to race and gender, to test whether or not SLE × race and SLE × gender interactions are significant.

RESULTS

In the pooled sample, baseline SLE (1986) predicted risk of MDE 25 years later (2011). We also found a gender by SLE interaction, suggesting a stronger predictive role of SLE for subsequent clinical depression for men compared to women. Race did not modify the predictive role of SLE on subsequent risk of MDE 25 years later.

CONCLUSION

How SLE predicts MDE 25 years later differs for men and women, with a stronger predictive role for men compared to women. More research is needed to better understand the complex links between gender, sex, stress, and depression.