Discrimination, symptoms of depression, and self-rated health among african american women in detroit: results from a longitudinal analysis

Unfair treatment, racial/ethnic discrimination, ethnic identification, and smoking among Asian Americans in the National Latino and Asian American Study

OBJECTIVES

We examined the relations of self-report of general unfair treatment and self-report of race/ethnicity-specific discrimination with current smoking among Asian Americans. We investigated whether ethnic identification moderated either association.

METHODS

Weighted logistic regressions were performed among 1977 Asian Americans recruited to the National Latino and Asian American Study (2002-2003).

RESULTS

In weighted multivariate logistic regression models including both general unfair treatment and racial/ethnic discrimination, odds of current smoking were higher among Asian Americans who reported high levels of unfair treatment (odds ratio [OR]=2.80; 95% confidence interval [CI]=1.13, 6.95) and high levels of racial/ethnic discrimination (OR=2.40; 95% CI=0.94, 6.12) compared with those who reported no unfair treatment and discrimination, respectively. High levels of ethnic identification moderated racial/ethnic discrimination (F(3) =3.25; P =.03). High levels of ethnic identification were associated with lower probability of current smoking among participants reporting high levels of racial/ethnic discrimination.

CONCLUSIONS

Our findings suggest that experiences of unfair treatment and racial/ethnic discrimination are risk factors for smoking among Asian Americans. Efforts to promote ethnic identification may be effective in mitigating the influence of racial/ethnic discrimination on smoking in this population.

Workplace discrimination and health among Filipinos in the United States

OBJECTIVES

We examined the association between work discrimination and morbidity among Filipinos in the United States, independent of more-global measures of discrimination.

METHODS

Data were collected from the Filipino American Community Epidemiological Survey. Our analysis focused on 1652 participants who were employed at the time of data collection, and we used negative binomial regression to determine the association between work discrimination and health conditions.

RESULTS

The report of workplace discrimination specific to being Filipino was associated with an increased number of health conditions. This association persisted even after we controlled for everyday discrimination, a general assessment of discrimination; job concerns, a general assessment of unpleasant work circumstances; having immigrated for employment reasons; job category; income; education; gender; and other sociodemographic factors.

CONCLUSIONS

Racial discrimination in the workplace was positively associated with poor health among Filipino Americans after we controlled for reports of everyday discrimination and general concerns about one's job. This finding shows the importance of considering the work setting as a source of discrimination and its effect on morbidity among racial minorities.

Returning to the "homeland": work-related ethnic discrimination and the health of Japanese Brazilians in Japan

OBJECTIVES

We investigated whether self-reported ethnic discrimination in the workplace was associated with well-being among Japanese Brazilians who had returned to Japan. Further, we examined interactions between discrimination and education on well-being.

METHODS

We obtained data from a cross-sectional survey of Japanese Brazilian workers (n = 313) conducted in 2000 and 2001. Outcomes were self-rated health, psychological symptoms as measured by the 12-item General Health Questionnaire (GHQ-12) score, and a checklist of somatic symptoms.

RESULTS

Reports of ethnic discrimination were associated with increased risk of poor self-rated health and psychological symptoms (GHQ-12 score), after we controlled for self-assessed workload, supportive relations at work, physically dangerous working conditions, workplace environmental hazards, shift work, number of working hours, age, gender, marital status, income, education, Japanese lineage, length of residence, and Japanese language proficiency. Further, the relationship between discrimination and self-rated health and somatic symptoms was most robust for those with the least education.

CONCLUSIONS

Ethnic discrimination appears to be a correlate of morbidity among Japanese Brazilian migrants. Future research should investigate how educational and workplace interventions may reduce discrimination and possibly improve health.

Social capital, anticipated ethnic discrimination and self-reported psychological health: a population-based study

This study investigates the association between anticipated ethnic discrimination and self-reported psychological health, taking generalized trust in other people into consideration. The 2004 Public Health Survey in Skåne, Sweden, is a cross-sectional postal questionnaire study including a total of 27,757 respondents aged 18-80 with a 59% response rate. Multivariate analyses of anticipated discrimination and self-reported psychological health were performed using logistic regressions in order to investigate the importance of possible confounders (age, country of origin, education and horizontal trust). Poor psychological health was reported by 13.0% of men and 18.9% of women, and 44.8% and 44.7%, respectively, reported that 50% or more of employers would discriminate according to race, colour of skin, religion, or cultural background. Respondents in younger age groups, born abroad, with high education, low trust and high levels of self-reported anticipated discrimination, had significantly higher levels of poor self-reported psychological health. There was a significant association between anticipated discrimination and low horizontal trust. After multiple adjustments for age, country of origin and education, the addition of trust in the model reduced the odds ratio of poor self-reported psychological health in the "most employers" category from 1.8 (1.4-2.1) to 1.5 (1.3-1.9) among men and from 2.2 (1.8-2.6) to 1.8 (1.5-2.2) among women. Generalized trust in other people may be a confounder of the association between anticipated discrimination and poor psychological health. Anticipated discrimination may have effects on the mental health of not only the affected minorities, but also on the mental health of the general population.

Depressive symptoms among working women in rural North Carolina: a comparison of women in poultry processing and other low-wage jobs

We report on the prevalence of self-reported depressive symptoms and associated factors among women employed in a poultry processing plant and a community comparison group of other employed women in northeastern North Carolina in the southern United States. The rural area is poor and sparsely populated with an African American majority. The largest employer of women in the area is a poultry processing plant. The goals of the analyses were 1) to evaluate whether women employed in poultry processing had a higher prevalence of depressive symptoms than other working women from the same geographic area, and 2) to evaluate factors which might be associated with depression among all of these working women, including specific characteristics of their work environment. Recruitment of participants (n=590) and data collection were by community-based staff who were also African American women. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D). Work organization factors were measured with the Job Content Questionnaire (JCQ). Log-binomial regression was used to calculate crude and adjusted prevalence ratios. The prevalence of depressive symptoms, based on a CES-D measure of sixteen or more, was 47.8% among the poultry workers and 19.7% among the other working women (prevalence ratio=2.3). After adjusting for socioeconomic variables, health-related quality of life and coping style, the prevalence of depressive symptoms remained 80% higher among the poultry workers. The prevalence of symptoms was also higher among those who perceived low social support at work, hazardous work conditions, job insecurity, and high levels of isometric load. These factors were all more common among the women employed in the poultry plant. The concentration of this low-wage industry in economically depressed rural areas illuminates how class exploitation and racial discrimination may influence disparities in health among working women.

Depression: the 'invisible grey fog' influencing the midlife health of African Canadian women

Depression is a topic that is often avoided in discussions among Black women for a myriad of reasons. The purpose of this study was to investigate the midlife health of Black women living in the province of Nova Scotia, Canada. This paper will present one of the key findings of this research; midlife depression. It will examine the factors associated with depression among mid-life African Canadian women and how these women deal with depression. A triangulation of qualitative and quantitative methods guided by the principles of participatory action research (PAR) was used in the study. Data collection methods included 50 in-depth interviews of mid-life African Canadian women aged 40-65, focus groups, and workshops as well as the CES-D structured instrument. Purposive sampling method was the primary recruitment strategy and 113 people participated in the study. Although the women rarely openly discussed depression, they described depression as emotional feelings that range from "feeling blue" to being clinically depressed. Women viewed midlife depression as the consequence of a complex set of circumstances and stressors that they face. At midlife, Black women frequently recognize the importance of greater self-care and the need to pay more attention to their health, but they are reluctant to do so because they have to be "strong" in order to deal with their daily experiences of racism. Racism, among other things, leads to accumulated stress and undermines Black women's ability to cope and make healthy life choices. This signifies the implications of these research findings for clinical practice.

Social determinants of the health of urban populations: methodologic considerations

A full understanding of the role of the urban environment in shaping the health of populations requires consideration of different features of the urban environment that may influence population health. The social environment is key to understanding the way in which cities affect the health of populations. Social determinants of health (SDH) are important, generally, yet can have different effects in different settings from urban to rural, between countries, between cities, and within cities. Failure to acknowledge, and more importantly, to understand the role of SDH in health and access to health and social services will hamper any effort to improve the health of the population. In this paper, we will briefly summarize a few key SDH and their measurement. We will also consider methodologic tools and some methodologic challenges. The concepts presented here are broadly applicable to a variety of settings: developed and developing countries, slum areas, inner cities, middle income neighborhoods, and even higher income neighborhoods. However, our focus will be on some of the more vulnerable urban populations who are most profoundly affected by SDH.

The association between self-reported racial discrimination and 12-month DSM-IV mental disorders among Asian Americans nationwide

Growing research finds that reports of discrimination are associated with mental health. However, many US studies are focused on regional samples and do not control for important confounders such as other stressors and response factors. The present study examines the association between self-reported racial discrimination and DSM-IV defined mental disorders among Asian respondents to the 2002-2003 US National Latino and Asian American Study (n=2047). Logistic regression analyses indicated that self-reported racial discrimination was associated with greater odds of having any DSM-IV disorder, depressive disorder, or anxiety disorder within the past 12 months-controlling for sociodemographic characteristics, acculturative stress, family cohesion, poverty, self-rated health, chronic physical conditions, and social desirability. Further, multinomial logistic regression found that individuals who reported discrimination were at a twofold greater risk of having one disorder within the past 12 months, and a threefold greater risk of having two or more disorders. Thus, self-reported discrimination was associated with increased risk of mental disorders among Asian Americans across the United States and this relationship was not explained by social desirability, physical health, other stressors, and sociodemographic factors. Should these associations ultimately be shown enduring and causal, they suggest that policies designed to reduce discrimination may help improve mental health.

Perceived discrimination and adherence to medical care in a racially integrated community

BACKGROUND

Past research indicates that access to health care and utilization of services varies by sociodemographic characteristics, but little is known about racial differences in health care utilization within racially integrated communities.

OBJECTIVE

To determine whether perceived discrimination was associated with delays in seeking medical care and adherence to medical care recommendations among African Americans and whites living in a socioeconomically homogenous and racially integrated community.

DESIGN

A cross-sectional analysis from the Exploring Health Disparities in Integrated Communities Study.

PARTICIPANTS

Study participants include 1,408 African-American (59.3%) and white (40.7%) adults (> or =18 years) in Baltimore, Md.

MEASUREMENTS

An interviewer-administered questionnaire was used to assess the associations of perceived discrimination with help-seeking behavior for and adherence to medical care.

RESULTS

For both African Americans and whites, a report of 1-2 and >2 discrimination experiences in one's lifetime were associated with more medical care delays and nonadherence compared to those with no experiences after adjustment for need, enabling, and predisposing factors (odds ratio [OR] = 1.8, 2.6; OR = 2.2, 3.3, respectively; all P < .05). Results were similar for perceived discrimination occurring in the past year.

CONCLUSIONS

Experiences with discrimination were associated with delays in seeking medical care and poor adherence to medical care recommendations INDEPENDENT OF NEED, ENABLING, AND PREDISPOSING FACTORS, INCLUDING MEDICAL MISTRUST; however, a prospective study is needed. Further research in this area should include exploration of other potential mechanisms for the association between perceived discrimination and health service utilization.

Engaging Youth in Participatory Research and Evaluation

Although participatory research has been applied by a wide range of disciplines, the engagement of youth as partners in research and evaluation efforts is relatively new. The positive youth development movement has influenced scholars and practitioners to include youth as partners in the design and implementation of research involving issues that affect their lives. Engaging youth in research and evaluation not only generates useful knowledge for communities and individuals but also provides opportunities for the development and empowerment of youth participants, leading to benefits for young people, organizations, the broader community, and the research process. However, there has been little systematic study to establish an evidence base for these effects. This article describes four projects that illustrate active youth participation in research. These examples demonstrate opportunities for positive youth development, create a context for intergenerational partnerships, and generate research findings to inform future interventions and organizational improvements, including community mobilization.