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Brown KL, Bettencourt AF, Hines AL, Cooper LA, Gudzune KA. Association Between Maladaptive Eating Behaviors Among Black Women and Vicarious Racial Discrimination Following a High-Profile Event. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01994-2. [PMID: 38578573 DOI: 10.1007/s40615-024-01994-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE Evidence suggests that racial discrimination causes stress among non-Hispanic Black women, and some Black women may cope with exposure to vicarious racial discrimination by engaging in maladaptive eating behaviors. METHODS We examined eating behaviors among Black women (N = 254) before and after Freddie Gray's death while in police custody. Maladaptive eating behaviors were assessed using the three-factor eating questionnaire. Our independent variables included the following: (1) time period and (2) geographic proximity to the event. Three two-way analysis of covariance tests were conducted to assess potential effects of geographic proximity (close, distant), time period in relation to unrest (before, after unrest), and their interaction on emotional eating, uncontrolled eating, and cognitive restraint controlling for participant age. RESULTS There was a statistically significant main effect of proximity to the unrest on emotional eating, F (1, 252) = 5.64, p = .018, and partial η2 = .022 such that women living in close geographic proximity to the unrest reported higher mean levels of emotional eating as compared to those living more distant to the unrest. There was also a borderline statistically significant interaction between geographic proximity and time period on cognitive restraint, F (1, 252) = 3.89, p = .050, and partial η2 = .015. CONCLUSION Our study found a relationship between vicarious racial discrimination and maladaptive eating behaviors among Black women. Future work should examine stress related to vicarious racial discrimination and maladaptive eating behaviors longitudinally.
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Affiliation(s)
- Kristal Lyn Brown
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
- Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, 19104, USA.
| | - Amie F Bettencourt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Anika L Hines
- Department of Health Policy, Virginia Commonwealth University School of Population Health, Richmond, VA, USA
| | - Lisa A Cooper
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Kimberly A Gudzune
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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2
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Rodriguez VE, Enriquez LE, Ro A, Ayón C. Immigration-Related Discrimination and Mental Health among Latino Undocumented Students and U.S. Citizen Students with Undocumented Parents: A Mixed-Methods Investigation. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2023; 64:593-609. [PMID: 37222500 PMCID: PMC10683331 DOI: 10.1177/00221465231168912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Research has consistently linked discrimination and poorer health; however, fewer studies have focused on immigration-related discrimination and mental health outcomes. Drawing on quantitative surveys (N = 1,131) and qualitative interviews (N = 63) with Latino undergraduate students who are undocumented or U.S. citizens with undocumented parents, we examine the association between perceived immigration-related discrimination and mental health outcomes and the process through which they are linked. Regression analyses identify an association between immigration-related discrimination and increased levels of depression and anxiety; this relationship did not vary by self and parental immigration status. Interview data shed light on this result as immigration-related discrimination manifested as individual discrimination as well as vicarious discrimination through family and community members. We contend that immigration-related discrimination is not limited to individual experiences but rather is shared within the family and community, with negative implications for the mental health of undocumented immigrants and mixed-status family members.
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Affiliation(s)
| | | | - Annie Ro
- University of California, Irvine, Irvine, CA, USA
| | - Cecilia Ayón
- University of California, Riverside, Riverside, CA, USA
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3
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Hennein R, Tiako MJN, Bonumwezi J, Tineo P, Boatright D, Crusto C, Lowe SR. Vicarious Racism, Direct Racism, and Mental Health Among Racialized Minority Healthcare Workers. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01844-7. [PMID: 37935947 DOI: 10.1007/s40615-023-01844-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/03/2023] [Accepted: 10/17/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Racism-related stress is a root cause of racial and ethnic disparities in mental health outcomes. An individual may be exposed to racism directly or vicariously by hearing about or observing people of the same racial and/or ethnic group experience racism. Although the healthcare setting is a venue by which healthcare workers experience both direct and vicarious racism, few studies have assessed the associations between direct and vicarious racism and mental health outcomes among healthcare workers. METHODS In this cross-sectional study, we assessed the relationships between direct and vicarious racism and symptoms of posttraumatic stress, depression, and anxiety among healthcare workers in the USA in 2022. RESULTS Our sample consisted of 259 healthcare workers identifying as a racialized minority, including 68 (26.3%) who identified as mixed-race, 61 (23.6%) East Asian, 36 (13.9%) Black, 33 (12.7%) South Asian, 22 (8.5%) Southeast Asian, 21 (8.1%) Middle Eastern/North African, and 18 (6.9%) another race. The mean age was 37.9 years (SD 10.1). In multivariable linear regression models that adjusted for demographics, work stressors, and social stressors, we found that increased reporting of vicarious racism was associated with greater symptoms of anxiety (B = 0.066, standard error = 0.034, p = .049). We did not identify significant relationships between vicarious and direct racism and symptoms of posttraumatic stress or depression in the fully adjusted models. CONCLUSIONS Our findings should be considered by academic health systems to mitigate the negative impact of racism on healthcare workers' mental health.
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Affiliation(s)
- Rachel Hennein
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College St, New Haven, CT, USA.
- Yale School of Medicine, New Haven, CT, USA.
| | | | - Jessica Bonumwezi
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Petty Tineo
- Department of Psychology, Montclair State University, Montclair, NJ, USA
| | - Dowin Boatright
- Department of Emergency Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Cindy Crusto
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychology, University of Pretoria, Pretoria, South Africa
| | - Sarah R Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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Hennein R, Tiako MJN, Tineo P, Lowe SR. Development and Validation of the Vicarious Racism in Healthcare Workers Scale. J Racial Ethn Health Disparities 2023; 10:2496-2504. [PMID: 36287336 PMCID: PMC9607839 DOI: 10.1007/s40615-022-01430-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 10/31/2022]
Abstract
Vicarious racism occurs when hearing about or observing people of the same racial and/or ethnic group experience racism. Healthcare workers may face unique experiences of vicarious racism through witnessing or hearing about racism that their patients and colleagues face. However, there are no validated measures of vicarious racism for the healthcare worker population. In this study, we developed and conducted an initial evaluation of the Vicarious Racism in Healthcare Workers Scale. We developed the 12-item scale based on a qualitative study exploring the experiences of racism among healthcare workers and existing literature on the topic. We administered the scale to a cohort of 259 healthcare workers identifying as a racialized minority to evaluate its factor structure, internal consistency, and construct validity. Factor analysis yielded two factors: racism in social networks and racism in society at-large. This two-factor solution had good model fit (standardized root mean square residual = 0.061). The internal consistencies of the overall scale, social networks subscale, and society subscale were excellent (α = 0.93, 0.92, and 0.89, respectively). We found evidence in support of convergent validity; scale scores were higher among Black healthcare workers compared with non-Black healthcare workers and those with greater social support needs. Scale scores were positively correlated with directly experienced racism and symptoms of posttraumatic stress, depression, and anxiety. The scale demonstrated discriminant validity; scale scores did not differ based on gender or job. The Vicarious Racism in Healthcare Workers Scale demonstrated favorable psychometric properties and may be used to assess vicarious racism in this population.
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Affiliation(s)
- Rachel Hennein
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College St, New Haven, CT, 06511, USA.
- Yale School of Medicine, 333 Cedar St, New Haven, CT, 06511, USA.
| | | | - Petty Tineo
- Department of Psychology, Montclair State University, 1 Normal Ave, Montclair, NJ, 07043, USA
| | - Sarah R Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College St, New Haven, CT, 06511, USA
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Quinn EB, Ross JD, Boston PQ, Committee HS, Mulligan CJ, Gravlee CC. The social patterning of vicarious discrimination: Implications for health equity. Soc Sci Med 2023; 332:116104. [PMID: 37517313 DOI: 10.1016/j.socscimed.2023.116104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/26/2023] [Accepted: 07/18/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Most research on discrimination and health operationalizes discrimination as direct individual experiences. Here, we examine the social patterning of vicarious discrimination, an important but largely overlooked dimension of discrimination. METHODS Drawing on community-based participatory research with a multi-stage probability sample (n = 178) of African Americans in Tallahassee, Florida, we measured vicarious discrimination, or exposure to discrimination through one's family and friends. We used chi-square tests to examine gender differences in the social domains and relational sources of vicarious discrimination. Negative binomial regression models were fit to identify predictors of exposure to vicarious discrimination. RESULTS Vicarious discrimination is more prevalent than direct experiences of discrimination (73 versus 61%) and more than 20% of participants report vicarious discrimination in the absence of direct discrimination. For women, vicarious discrimination most often involved the workplace; for men, police. However, gender differences are smaller for vicarious versus direct discrimination. Close friends and children were top relational sources of vicarious discrimination for men and women, respectively. Middle-aged participants reported the most vicarious discrimination. CONCLUSIONS Overall, our data show that vicarious discrimination is more common than widely understood and associated with individual-level sociodemographic characteristics that index one's position in broader social systems. The prevalence of vicarious discrimination in the absence of direct discrimination suggests that standard approaches, which measure individual exposures in isolation, are subject to misclassification bias. Our results imply that existing research on discrimination and health, which already demonstrates substantial harm, underestimates African Americans' true exposures to salient aspects of discrimination.
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Affiliation(s)
- Edward B Quinn
- Department of Anthropology, University of Florida, Gainesville, FL 32611, USA; Genetics Institute, University of Florida, Gainesville, FL 32608, USA.
| | - Jessica D Ross
- Department of Biology, University of Florida, Gainesville, FL 32611, USA
| | - P Qasimah Boston
- Tallahassee Food Network, Institute of Public Health, Florida A&M University, Tallahassee, FL 32307, USA
| | | | - Connie J Mulligan
- Department of Anthropology, University of Florida, Gainesville, FL 32611, USA; Genetics Institute, University of Florida, Gainesville, FL 32608, USA
| | - Clarence C Gravlee
- Department of Anthropology, University of Florida, Gainesville, FL 32611, USA; Genetics Institute, University of Florida, Gainesville, FL 32608, USA
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Brantley M. Black feminist theory in maternal health research: A review of concepts and future directions. SOCIOLOGY COMPASS 2023; 17:e13083. [PMID: 37859646 PMCID: PMC10586323 DOI: 10.1111/soc4.13083] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 02/14/2023] [Indexed: 10/21/2023]
Abstract
Black maternal health and well-being has become a necessary focal point for health researchers due to higher rates of maternal mortality and morbidity for Black women. However, what is often absent from this scholarship within medical sociology is Black Feminist Theory as a framework for understanding Black women's health and well-being. Drawing on Black feminist and maternal health scholarship, I argue that integrating Black feminist approaches in maternal health research expands our understandings of what processes and mechanisms are impacting the health and well-being of Black mothers, while also highlighting the importance of maternal health research that solely centers Black women. Specifically, I focus on three concepts of Black Feminist Theory as it relates to Black maternal health research: (1) examining Black women's standpoint as credible, (2) acknowledging the historical context of multiple systems of oppression against Black women, and (3) incorporating a perspective that acknowledges both disadvantages, as well as empowerment, in the lives of Black women. I end this review with a discussion of future directions for sociological research in maternal health, including the importance of acknowledging how Black mothers are both impacted by, and resisting, social structures that may add nuance to our current understandings of Black maternal health and well-being.
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Affiliation(s)
- Mia Brantley
- Department of Sociology, The Ohio State University, Columbus, Ohio
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Moody MD, Browning WR, Hossain M, Clay OJ. Vicarious experiences of major discrimination, anxiety symptoms, and mental health care utilization among Black Adults. Soc Sci Med 2023; 316:114997. [PMID: 35534345 DOI: 10.1016/j.socscimed.2022.114997] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND The adverse mental health consequences of discrimination among Black adults, such as anxiety symptoms, are well documented. Prior research establishes anxiety as a risk factor for suboptimal health outcomes among Black adults. Most discrimination and mental health studies, however, have focused on the effects of personal experiences of discrimination. Moreover, of the studies that examine the mental health effects of vicarious exposure to discrimination, few investigate this relationship from a stress and coping perspective beyond the life stages of childhood and adolescence. Thus, the purpose of this study was to assess the effects of vicarious and personal experiences of discrimination on the subjective well-being of Black adults, while observing the potentially moderating effects of utilizing mental health care. METHODS A subsample of Black adults (N = 627) between the ages of 22-69 years old were drawn from the Nashville Stress and Health Study and analyzed to assess within-group variation. Multivariate linear regression was employed to examine the association between vicarious experiences of major discrimination and self-reported anxiety symptoms. Additionally, we evaluated the moderating effects of lifetime utilization of mental health services on the relationship between discrimination and symptoms of anxiety. RESULTS Findings revealed that vicarious experiences of major discrimination and personal experiences of everyday discrimination were both associated with higher levels of anxiety symptoms among the participants. Additionally, lifetime utilization of mental health care moderated the effects of vicarious and personal experiences of discrimination. CONCLUSIONS The secondhand consequences of discrimination must be considered while assessing the racism-related stress experience. Results from this investigation suggest that mental health treatment should be included in programs targeted to reduce the negative effects of discrimination among Black adults. Additionally, culturally-specific strategies should be considered for addressing racism-related adversity.
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Affiliation(s)
- Myles D Moody
- Department of Sociology, University of Alabama-Birmingham, Heritage Hall, Rm. 460, 1401 University Blvd, Birmingham, AL, 35233, USA.
| | - Wesley R Browning
- Department of Psychology, University of Alabama-Birmingham, Campbell Hall, Rm. 415, 1300 University Blvd, Birmingham, AL, 35233, USA
| | - Monir Hossain
- Department of Sociology, University of Alabama-Birmingham, Heritage Hall, Rm. 460, 1401 University Blvd, Birmingham, AL, 35233, USA
| | - Olivio J Clay
- Department of Psychology, University of Alabama-Birmingham, Campbell Hall, Rm. 415, 1300 University Blvd, Birmingham, AL, 35233, USA
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Volpert-Esmond HI, Landor AM, Bartholow BD. Immediate and delayed effects of everyday racial discrimination on mental health among Black college students: A mixed-methods approach. GROUP PROCESSES & INTERGROUP RELATIONS 2022. [DOI: 10.1177/13684302221131029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Experiences of racial discrimination significantly contribute to both mental and physical health outcomes. In this mixed-methods study, we examine both the immediate and delayed effect of discrimination experienced in daily life. Black students at a predominantly White university reported instances of racial discrimination, affect, anxiety, and depression several times per day over 4 weeks ( N = 114); this was followed by qualitative focus groups ( N = 25). Reporting an instance of discrimination corresponded with an acute decline in psychological wellbeing (higher negative affect, anxiety, and depression), consistent with previous work. However, this effect did not carry forward to later assessments during the same day or the following day as expected. Instead, positive affect temporarily increased in the hours following experiences of discrimination. Qualitative focus groups revealed social support, emotional reflection and processing, and feelings of taking action as important factors contributing to this bump in positive affect.
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Affiliation(s)
| | - Antoinette M. Landor
- Department of Human Development and Family sciences, University of Missouri, USA
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Louie P, Upenieks L. Vicarious Discrimination, Psychosocial Resources, and Mental Health among Black Americans. SOCIAL PSYCHOLOGY QUARTERLY 2022. [DOI: 10.1177/01902725221079279] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Does hearing about or witnessing someone else experience discrimination harm individuals’ mental health? Using data from the Nashville Stress and Health Study, we answer this question by examining how vicarious discrimination impacts depressive symptoms, anxiety symptoms, and anger among black Americans. We also test whether mastery and self-esteem moderate the association between vicarious discrimination and each mental health outcome. Findings indicate experiencing vicarious discrimination via a family member has a similar impact on mental health to personally experiencing discrimination. While experiencing vicarious discrimination via a close friend also increased mental health problems, it appeared to be less harmful than personally experiencing discrimination. Moreover, self-esteem moderated the association between vicarious discrimination via a family member and via a close friend and mental health, while mastery did not. This study provides new insights into ways vicarious discrimination impacts health as well as the role that psychosocial resources play in shaping this relationship.
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