Race-related stress, quality of life indicators, and life satisfaction among elderly African Americans

Exploring pathways to successful aging among older black lesbians and sexual minority women: A focus on life satisfaction and intersectional factors

PURPOSE

Satisfaction with life is a core aspect of successful aging, which is influenced by a broad range of factors, including health, socioeconomic status, and social relationships. Black lesbians experience various social challenges, including racism, sexism, ageism, and heterosexualism, that may present as deterrents to aging successfully. To develop better policies and programs in support of successful aging among all adults, an understanding of the unique components associated with their intersecting identities must be explored. This study was carried out to gain a better understanding of how Black lesbians and other Black sexual minority women (BSMW) view successful aging within the context of life satisfaction.

METHODS

Inferential statistics were used to determine relationships between satisfaction with life (SWLS-3) and selected independent variables. Backward stepwise regression was conducted to ascertain significant relationships of the study outcome variable.

RESULTS

The respondents were 118 Black lesbians and other BSMW aged 50 and above. Independent t-tests showed that those living with a partner had a significantly higher SWLS-3. Backwards stepwise regression indicated the predictor variables for higher rates of SWLS-3 to be harmony in life, annual household income, and provider sensitivity/cultural competence to their patient being Black.

CONCLUSION

This study provides insight on factors increasing and diminishing satisfaction with life for aging Black lesbians and other BSMW. Future research should replicate this study with a more diverse and nationally representative sample, especially given the study limitations of having recruited a highly educated sample during a global pandemic.

Vicarious Experiences of Major Discrimination and Psychological Distress among Black Men and Women

Racism-related stress frameworks posit that the discriminatory experiences of one's loved ones may threaten one's well-being, but relatively few studies have examined how they may impact mental health beyond childhood and adolescence. Using data from the Nashville Stress and Health Study (N = 1,252), the present study assessed the prevalence of vicarious experiences of discrimination among subsamples of Black men (n = 297) and women (n = 330), examined the association between vicarious experiences of discrimination and psychological distress among Black men and women, and evaluated the impact of vicarious discrimination on psychological distress in the context of other stressors. Results suggest that Black women report more vicarious exposure to specific types of discrimination. Furthermore, vicariously experienced discrimination was associated with higher levels of psychological distress among Black women, but not among Black men. Our findings extend the literature on racism-related stress and offer new insights for interventions aimed at reducing racial disparities in mental health.

Promoting African American Activism: Experiences of Racism-Related Stress and Spirituality

This study investigates how spirituality, psychological orientation to religion, and racism-related stress are associated with African American activism. Measures of Race-Related Stress, Quest Religious Orientation, Fundamentalism Religious Orientation, and Intrinsic Spirituality were used as exogenous variables. African American Activism was the endogenous variable. Results based on a sample of 148 self-identified African American adults revealed that quest religious orientation, intrinsic spirituality, and racism-related stress were positively associated with activism-related behaviors, while fundamentalist religious orientation was negatively but not significantly associated with activism-related behaviors. Paths of a multiple regression model were analyzed using Mplus version 8. Findings shed light on the interplay of spiritual coping resources and the personal impact of racism in mobilizing an activist response to oppression.

Examining Coping Skills as a Mediating Factor in Perceived Stress and Life Satisfaction: A Comparison Between Minority and Nonminority Older Adults

Although stress due to racial and ethnic differences can negatively impact life satisfaction, there is a lack of focus on the differences between minority and nonminority older adults in how stress and coping skills impact life satisfaction. The objectives of this study are to explore (a) the differences between minority and nonminority older adults in their levels of life satisfaction, stress, and coping skills; and (b) the mediating effects of coping skills on the relationship between perceived stress and life satisfaction among both groups. Cross-sectional data from the Well Elderly 2 study (N = 460) were utilized in bivariate and mediation analyses. Minority older adults reported higher levels of stress and prioritized different coping skills. Mediation was not supported for either group. These findings enable practitioners to focus on the coping skills more frequently identified by clients' racial/ethnic grouping, as well as to target the primary stressors identified.

Special Issue: Race and Mental Health Among Older Adults: Do Depressive Symptoms Shape Blacks' Perceptions of Stress Over Time?

Background and Objectives

Previous studies have linked stress to multiple negative mental health outcomes, including depression. This established stress–depression association is typically examined in one direction and cross-sectionally. This study examined the bidirectional relationships between depressive symptoms and changes in perceived stress over time in Blacks.

Research Design and Methods

The present study uses a community-dwelling sample of 450 Black adults, aged 51–96 years old, who participated in the Baltimore Study of Black Aging—Patterns of Cognitive Aging. Perceived stress—measured by the Perceived Stress Scale—and depressive symptoms—measured using the Center for Epidemiologic Studies Depression scale—were both assessed at baseline and follow-up 33 months later. Ordinary least squares regression was used to examine 2 bidirectional longitudinal relationships between (1) stress–depression and (2) depression–stress, and whether these associations are modified by age.

Results

Initial analyses testing the typical stress–depression relationship showed an effect in the expected direction, that is stress leading to more depressive symptoms over time, adjusting for model covariates, but the effect was not statistically significant (b = 0.014, p = .642). After accounting for baseline perceived stress level, age, sex, education, and chronic health conditions, depressive symptoms were positively associated with follow-up stress (b = 0.210, p < .000). The depression–stress association further varied by age group such that the impact of baseline depression on changes in perceived stress was greatest in Blacks in their 60s versus those in their 50s (b = 0.267, p = .001), controlling for model covariates.

Discussion and Implications

Contrary to previous work, the results suggest that an individual’s mental health shapes his/her perception of stressful events and this relationship varies by age group. While the typical finding (stress impacting depression) was not significant, the findings reported here highlight the importance of considering the possible bidirectional nature of the relationships between psychosocial measures of stress and mental health in later life among Blacks.

The role of social support on the effects of stress and depression on African American tobacco and alcohol use

OBJECTIVES

The current study explored whether social support (SS) from family and peers, influences the relationship between depressed mood (DM) and substance use (SU). We hypothesized that SS would have a protective effect on DM, and moderate the association between DM and SU.

PARTICIPANTS AND METHODS

Analyses focused on 703 individuals from the Carolina African American Twin Study on Aging (mean age = 49.78 years, STD = 14.52; 51% female). Participants reported on past year frequency of cigarettes and alcohol consumption, depressed mood, and stressful life events. Social support (SS) was assessed on two domains (i.e., emotional and instrumental), as well as for perceived quality and quantity of each type. Hypotheses were tested using ordinal logistic regression in Mplus while controlling for socioeconomic status, age, and gender.

RESULTS

Quality of emotional support was negatively associated with drinking. Smoking, but not drinking was associated with depressed mood. While individuals with high levels of depressed mood received more support, receiving better quality emotional support was associated with fewer mood and stress symptoms. Individuals who reported receiving better quality emotional support typically smoked fewer cigarettes.

CONCLUSION

Quantity of emotional support was associated with higher levels of negative emotionality, whereas the opposite was found for quality of emotional support. Emotional support may indirectly influence smoking via depressed mood. Effecting the perceived quality of support appears to be the mechanism by which emotional support helps to reduce smoking in adult African Americans.

Black Cultural Strengths and Psychosocial Well-Being: An Empirical Analysis With Black American Adults

Based on historical literature, Black Americans have persisted through centuries of oppression in North America. To survive, they retained Africultural values and adopted group-specific practices. Black cultural values and practices can potentially, if bolstered, increase psychosocial health in this population. In the current study, we examined specific Black values and practices and their collective ability to predict psychosocial health. In a sample 486 Black, middle-class, American adults with a mean age of 31 years, we used structural equation modeling to test a first- and a second-order measurement model, as well as a structural model. We hypothesized that health-promoting aspects of Black racial identity (e.g., racial centrality), racial socialization (e.g., cultural socialization), and racism-related coping (e.g., confrontation), as well as higher levels of communalism and spirituality would indicate one latent factor, Black Cultural Strength. Furthermore, we hypothesized that Black Cultural Strength would be predictive of psychosocial health. After slight model modifications, we found an acceptable fit for the data. Clinical implications and future research directions are discussed.

Is the Brief Multidimensional Student's Life Satisfaction Scale Valid and Reliable for African American Adolescents?

BACKGROUND

Health promotion/education strive to promote healthful conditions that improve quality of life1 based on the perceptions of those whose lives are affected.2-4 Though health promotion/education might have instrumental value in reducing risks for premature morbidity and mortality, their ultimate value lies in contributions to quality of life.1 Life satisfaction (LS) has been defined as an individual's assessment of their quality of life based upon personal criteria5,6 and linked to adolescent health risk behaviors7,8 and developmental assets.9.

PURPOSE

We investigated the psychometrics of the Brief Multidimensional Students' Life Satisfaction Scale [BMSLSS] with an adolescent sample of African Americans (N=1,658) from four mid-sized cities in the United States (US). Reliability and validity of the BMSLSS has not been determined for samples of exclusively African American adolescents.

METHODS

Data analysis included calculating mean ratings, standard deviations and effect sizes (Cohen's d) and inspecting the scale's internal structure, reliability, and relationships to other variables.

RESULTS

Evidence of internal structure, internal consistency reliability, and hypothesized relationships to other variables for participants were determined.

TRANSLATION TO HEALTH EDUCATION PRACTICE

The BMSLSS is a useful indicator of LS for research and health education assessment purposes among African American adolescents where brevity of psychometric measures is imperative.

Discrimination, Serious Psychological Distress, and Church-Based Emotional Support Among African American Men Across the Life Span

Objective

This study tested whether church-based social support buffers the negative effects of discrimination on serious psychological distress (SPD) among three age groups-early, middle, and late adulthood-of African American men.

Methods

Negative binominal regression analyses for discrimination and SPD were performed using data from 1,271 African American men from the National Survey of American Life.

Results

Discrimination was positively associated with SPD for all age groups. An interaction between church-based support and discrimination indicated that under conditions of high levels of support from congregants, discrimination, and SPD were positively correlated. However, discrimination and SPD were unrelated for low levels of church-based support. Further, the interaction was significant for men aged 18-34 and 55 or older but not significant for men aged 35-54.

Discussion

This is the first study to document relationships among discrimination, SPD, and church-based support in a nationally representative sample of African American men. Overall, rather than revealing a stress-buffering function, findings were consistent with the resource mobilization perspective of social support, indicating that higher levels of assistance from church networks are provided when individuals experience high levels of both discrimination and SPD.

HRQOL in Diverse Ethnic Groups with Diabetes: Findings from the 2014 BRFSS

OBJECTIVE

The study's objective is to examine differences in mental and physical health-related quality of life (HRQOL) in non-Hispanic White, non-Hispanic Black, and Hispanic adults with diabetes.

DESIGN

A secondary analysis of 2014 Behavioral Risk Factor Surveillance System (BRFSS) data was conducted. A total of 26 states participated in the 2014 BRFSS core and optional diabetes models (n = 17,923). HRQOL was measured by the number of mentally and physically unhealthy days during the past month, respectively. A series of regression models were developed to assess differences in HRQOL without and with inclusion of demographic (age, marital status, income, gender, and education) and diabetes-related (depression, sleep time, insulin use, complications, age of diabetes diagnosis, BMI, smoking, and exercise) factors.

RESULTS

In the fully adjusted models (inclusion of demographic and diabetes-related factors), non-Hispanic Whites had more mentally (β = 0.88, p = 0.03) and physically (β = 1.35, p = 0.01) unhealthy days per month compared to Hispanics. Non-Hispanic Blacks (β = 1.42, p < 0.01) also had more mentally unhealthy days per month in relation to Hispanics when adjusting for demographic and diabetes-related factors. Depression emerged as a potent predictor of mentally (β = 8.60; p < 0.0001) and physically (β = 4.43; p < 0.0001) unhealthy days in the multivariate models.

CONCLUSION

Non-Hispanic Black and White adults with diabetes may be more vulnerable to poor HRQOL compared to their Hispanic counterparts. Increased, widened application of diabetes interventions targeting depression appears warranted to improve HRQOL outcomes.

Testing a Social Cognitive Model of Well-Being With Women Engineers

The present study tests the utility of the Social Cognitive Model of Well-Being (SCWB) in the context of work, with a sample of 348 women engineers. Using structural equation modeling, we examined the relations of positive affect, self-efficacy, work conditions, goal progress, and environmental supports and barriers that were assumed to account for job satisfaction and life satisfaction of women engineers. Overall, the model provided a good fit to the data, and SCWB predictors accounted for a significant amount of variance in job satisfaction (63%) and life satisfaction (54%) with our sample of women engineers. As expected, most paths of the SCWB model were significant; however, we also found nonsignificant relations among variables in the model. In particular, goal progress did not play a critical role in the present study. In addition, we examined the indirect effects of environmental variables (e.g., supports and barriers) on job satisfaction via sociocognitive variables (e.g., self-efficacy and perceived work conditions) in the engineering work domain. Implications for practice, theory, and future vocational and organizational research in engineering are discussed.

Factors associated with ageist attitudes among college students

AIM

Ageist views have the potential to deleteriously impact large populations of older adults in the USA and worldwide. The high levels of ageism among young adults might originate from their limited interactions with older adults (individuals aged 65 years and older). The present study examined the factors associated with ageist attitudes among college students.

METHODS

Data were analyzed from 641 college students using an internet-delivered questionnaire. Participants were asked to rate their level of agreement with 17 ageist statements about older adults. A general least squares regression analysis was carried out to identify the associations of participants' sex, race/ethnicity and interactions with older adults on self-identified ageist attitudes.

RESULTS

Approximately 37% of participating college students interacted with older adults one or more times per week, 38.3% had resided with an older adult in their lifetime and 78.2% had volunteered/worked with an older adult. Participants who were female (P = 0.035), African American (P = 0.033), those with more frequent interaction with older adults (P = 0.001) and those with experience living with an older adult (P = 0.028) reported significantly lower negative ageist attitudes.

CONCLUSIONS

Findings suggest that increased exposure to and interactions with older adults can reduce ageist views among college students. Practical recommendations are provided to increase students' opportunities for interactions with and exposure to older adults. Geriatr Gerontol Int 2017; 17: 1698-1706.

The expression Of Cultural Sensitivity in the Presence of African Americans

This study explores the motivational factors underlying European American individuals’ tendency to display more culturally sensitive behavior in the presence of African Americans. European American male college students (N = 75) individually viewed and evaluated racially insensitive humor, ostensibly in small groups with two confederates. The confederates’ racialbackgrounds were varied so that they consisted of either (a)two European Americans, (b) one European American and one African American, or (c) two African Americans. Half of the participants in each condition reacted to the humor privately, whereas the other half responded to the humor publicly. It was revealed that the mere perception of the presence of an African American individual prompted participants to display cultural sensitivity, evaluating the anti-African American humor negatively. It was interesting that this tendency was equally prevalent when participants rated the humor publicly and when they rated it privately. Implications for understanding the nature of cultural sensitivity and interracial self disclosure are discussed.

Subjective Stress and Coping Resources Interact to Predict Blood Pressure Reactivity in Black College Students

This study examined the effects of subjective stress and coping resources on blood pressure reactivity. Sixty-nine Black college students (mean age = 23.58 years) completed the Life Experiences and Stress Scale to explore the subjective stressfulness associated with life events, the Coping Orientations to Problems Experienced Scale to measure usual ways of coping, and a standardized serial addition laboratory challenge during which blood pressure was assessed. Multiple regression analyses revealed that the interactive effects of subjective stress and coping resources predicted diastolic blood pressure reactivity (both p < .025) but not systolic blood pressure reactivity (both p > .10). These significant interaction effects indicated that higher levels of problem-focused coping were related to more marked diastolic blood pressure changes under conditions of high subjective stress and that emotion-focused coping was associated with less exaggerated diastolic blood pressure changes under conditions of low subjective stress. These findings highlight the potential contribution of psychosocial factors to blood pressure reactivity in Blacks.

Interethnic Group and Intraethnic Group Racism: Perceptions and Coping in Black University Students

This study explored perceived racism and the usual ways of coping with these perceptions in a sample of 269 Black university students (53% female). Perceptions of inter- and intragroup racism were assessed with the Life Experiences and Stress scale, and coping was measured with the Coping Orientations to Problems Experienced scale. A principal component analysis suggested that inter- and intragroup racism were separable constructs. Correlation analyses revealed that inter- and intragroup racism were negatively associated with self-deception.Relative to females, t-test analyses indicated that males perceived more inter- and intragroup racism. The t-test analyses also revealed that females were more likely than males to use emotion-focused and religious coping responses, when negotiating perceptions of inter- and intragroup racism; and, when negotiating perceptions of intragroup racism, males were more likely than females to use alcohol as a coping response. The limitations of the study and directions for future research are discussed.

Racist Incident–Based Trauma

Racist incidents are potentially traumatizing forms of victimization that may lead to increased psychiatric and psychophysiological symptoms in targets. The magnitude of the problem of racist incidents in the United States is difficult to estimate; however, data from several sources permit the inference that the prevalence of racist incidents, particularly among people of color, is high. This article (a) distinguishes traumatic stress from nontraumatic stress and (b) draws parallels between experiences of racist incidents and experiences that are acknowledged to be traumatic, such as rape or domestic violence. Conceptualizing the symptoms of some survivors of racist incidents as trauma responses may help inform treatment when these individuals are clients in psychotherapy.

Religiosity, Adherence to Traditional Culture, and Psychological Well-Being Among African American Elders

To expand our knowledge on the role of religiosity in African American culture, this study assessed the associations among religiosity, adherence to traditional African American culture, and psychological well-being. Regression models of psychological well-being, indexed with depressive symptoms and life satisfaction, were tested using a representative sample of 255 community-dwelling African American older adults in Hillsborough County, Florida. The direct effect of religiosity was found to be significant for both depressive symptoms and life satisfaction. A significant interaction between religiosity and adherence to African American culture was observed in the prediction of life satisfaction. Further analyses indicated that the positive effect of religiosity on life satisfaction was stronger in the more traditional group compared to that in the less traditional group. The results demonstrate that the benefits of religiosity do not exist uniformly across all African Americans but vary by the level of adherence to traditional culture.

Measuring the Pros and Cons of What It Means to Be a Black Man: Development and Validation of the Black Men's Experiences Scale (BMES)

Although extensive research documents that Black people in the U.S. frequently experience social discrimination, most of this research aggregates these experiences primarily or exclusively by race. Consequently, empirical gaps exist about the psychosocial costs and benefits of Black men's experiences at the intersection of race and gender. Informed by intersectionality, a theoretical framework that highlights how multiple social identities intersect to reflect interlocking social-structural inequality, this study addresses these gaps with the qualitative development and quantitative test of the Black Men's Experiences Scale (BMES). The BMES assesses Black men's negative experiences with overt discrimination and microaggressions, as well their positive evaluations of what it means to be Black men. First, we conducted focus groups and individual interviews with Black men to develop the BMES. Next, we tested the BMES with 578 predominantly low-income urban Black men between the ages of 18 and 44. Exploratory factor analysis suggested a 12-item, 3-factor solution that explained 63.7% of the variance. We labeled the subscales: Overt Discrimination, Microaggressions, and Positives: Black Men. Confirmatory factor analysis supported the three-factor solution. As hypothesized, the BMES's subscales correlated with measures of racial discrimination, depression, resilience, and social class at the neighborhood-level. Preliminary evidence suggests that the BMES is a reliable and valid measure of Black men's experiences at the intersection of race and gender.

Social Cognitive Career Theory, the Theory of Work Adjustment, and Work Satisfaction of Retirement-Age Adults

Despite a recent increase in the number of adults who work past traditional retirement age, existing theories of vocational behavior have not yet received adequate empirical support. In a large sample of adults age 60-87, we evaluated the relationship between theorized predictors of work satisfaction proposed by Social Cognitive Career Theory (SCCT), work satisfaction as a predictor of continued work, as proposed by the Theory of Work adjustment (TWA), as well as the influence of reported experiences of discrimination on these relationships. While the results supported most of the predicted relationships, the effects of discrimination were stronger than the variables proposed by either SCCT or TWA for the present sample.

Vigilance in the discrimination-stress model for Black Americans

OBJECTIVE

Daily events of discrimination are important factors in understanding health disparities. Vigilant coping, or protecting against anticipated discrimination by monitoring and modifying behaviour, is an understudied mechanism that may link discrimination and health outcomes. This study investigates how responding to everyday discrimination with anticipatory vigilance relates to the health of Black men and women.

METHODS

Black adults (N = 221) from the Detroit area completed measures of discrimination, adverse life events, vigilance coping, stress, depressive symptoms and self-reported health.

RESULTS

Vigilance coping strategies mediated the relationship between discrimination and stress. Multi-group path analysis revealed that stress in turn was associated with increased depression in men and women. Self-reported health consequences of stress differed between men and women.

CONCLUSIONS

Vigilance coping mediates the link between discrimination and stress, and stress has consequences for health outcomes resulting from discrimination. More research is needed to understand other underlying contributors to discrimination, stress and poor health outcomes as well as to create potential interventions to ameliorate health outcomes in the face of discrimination-related stress.

Subjective Well-being of Older African Americans with DSM IV Psychiatric Disorders

This study examined demographic and mental health correlates of subjective well-being (i.e., life satisfaction, happiness) using a national sample of older African Americans with psychiatric disorders. We used a subsample of 185 African Americans, 55 and older with at least one of thirteen lifetime psychiatric disorders from The National Survey of American Life: Coping with Stress in the 21st Century (NSAL). The findings indicated that among this population of older adults who had a lifetime psychiatric disorder, having a lifetime suicidal ideation was associated with life satisfaction but not happiness. Further, having a 12-month anxiety disorder or a lifetime suicidal ideation was not associated with happiness. Having a 12-month mood disorder, however, was negatively associated with an individual's level of happiness, as well as their life satisfaction. Additionally, there were two significant interactions. Among men, employment was positively associated with life satisfaction, and marriage was associated with higher levels of happiness among men but not women. The overall pattern of findings reflects both similarities and departures from prior research confirming that well-being evaluations are associated with multiple factors.

Cultural Racism–Related Stress in Black Caribbean Immigrants

Scholars maintain that with greater length of residence, the U.S. context adversely affects Black immigrants (e.g., via racism-related stress). Yet, the psychological mechanisms that account for increases in racism-related stress over time are unclear. Racial identity scholarship provides reason to suspect Black immigrants’ racial identities may partially explain these increases. In this study, Black Americans and Black Caribbean immigrants ( N = 171) responded to measures of cultural racism–related stress and the “identity” (importance of racial group membership to the self-concept) component of racial identity. We expected identity importance to (a) positively predict cultural racism–related stress for both populations and (b) mediate the association between length of residence and cultural racism–related stress in Black Caribbean immigrants. Although no significant mean difference in identity importance existed between groups, identity predicted cultural racism–related stress only in Black Americans. In Black Caribbean immigrants, identity was not a mediator, but length of residence positively predicted cultural racism–related stress. Differences in results across the two populations may indicate important distinctions in racial identity function between Black Caribbean immigrants and Black Americans.

"Their depression is something different . . . it would have to be": findings from a qualitative study of black women's perceptions of depression in black men

This study reports findings from the Black Women's Perceptions of Black Men's Depression (BWP) study, which included eight focus groups with Black women (N = 46) from southeastern Michigan. Four themes illustrated the impressions of Black women from different socioeconomic backgrounds: Black men's depression is a cultured and gendered phenomenon, the role of Black women in Black men's depression, intergenerational differences with how depression is handled by Black men, and the need (and ways) to reach Black men with depression resources. Results underscore not only the importance of understanding the kind of depression in Black men that meets criteria described by the Diagnostic and Statistical Manual of Mental Disorders (DSM) but also the psychological distress that may coexist with (or be separate from) DSM depression. Implications for interventions that educate, diagnose, and treat depression in Black men are discussed.

Theory-guided selection of discrimination measures for racial/ ethnic health disparities research among older adults

OBJECTIVE

Discrimination may contribute to health disparities among older adults. Existing measures of perceived discrimination have provided important insights but may have limitations when used in studies of older adults. This article illustrates the process of assessing the appropriateness of existing measures for theory-based research on perceived discrimination and health.

METHOD

First, we describe three theoretical frameworks that are relevant to the study of perceived discrimination and health-stress-process models, life course models, and the Public Health Critical Race (PHCR) praxis. We then review four widely-used measures of discrimination, comparing their content and describing how well they address key aspects of each framework, and discussing potential areas of modification.

DISCUSSION

Using theory to guide measure selection can help improve understanding of how perceived discrimination may contribute to racial/ethnic health disparities among older adults.

Depression over the adult life course for African American men: toward a framework for research and practice

Rarely are within-group differences among African American men explored in the context of mental health and well-being. Though current conceptual and empirical studies on depression among African American men exists, these studies do not offer a framework that considers how this disorder manifests over the adult life course for African American men. The purpose of this article is to examine the use of an adult life course perspective in understanding the complexity of depression for African American men. The proposed framework underscores six social determinants of depression (socioeconomic status, stressors, racial and masculine identity, kinship and social support, self-esteem and mastery, and access to quality health care) to initiate dialogue about the risk and protective factors that initiate, prolong, and exacerbate depression for African American men. The framework presented here is meant to stimulate discussion about the social determinants that influence depression for African American men to and through adulthood. Implications for the utility and applicability of the framework for researchers and health professionals who work with African American men are discussed.

Discrimination, Mastery, and Depressive Symptoms Among African American Men

PURPOSE

This study examines the influence of discrimination and mastery on depressive symptoms for African American men at young (18-34), middle (35-54), and late (55+) adulthood.

METHOD

Analyses are based on responses from 1,271 African American men from the National Survey of American Life (NSAL).

RESULTS

Discrimination was significantly related to depressive symptoms for men ages 35 to 54 and mastery was found to be protective against depressive symptoms for all men. Compared to African American men in the young and late adult groups, discrimination remained a statistically significant predictor of depressive symptoms for men in the middle group once mastery was included.

IMPLICATIONS

Findings demonstrate the distinct differences in the influence of discrimination on depressive symptoms among adult African American males and the need for future research that explores the correlates of mental health across age groups. Implications for social work research and practice with African American men are discussed.

Impact of Experiences With Racism on African-Descent Persons’ Susceptibility to Stereotype Threat Within the United Kingdom

The present study examines the impact of experiences with individual, institutional, cultural, and collective racism on susceptibility to stereotype among African-descent persons within the United Kingdom ( n = 103). Results of hierarchical multiple regression analysis indicated that (contrary to hypotheses) experiences with individual, institutional, and cultural racism were not significantly or marginally related to susceptibility to stereotype threat when entered together in Model 1. However (consistent with hypotheses), experience with collective racism was a significant positive predictor of susceptibility to stereotype threat after controlling for the effects of experiences with individual, institutional, and cultural racism in Model 2. Moreover (and unexpectedly), once experience with collective racism was added, experience with cultural racism emerged as a marginal negative predictor of susceptibility to stereotype threat. Implications for the continuing relevance of Erving Goffman’s symbolic interactionist theory and construct of stigma, along with Claude Steele’s construct of stereotype threat, to the field of Black psychology is discussed.

Coping Strategies as Moderators of the Relation Between Individual Race-Related Stress and Mental Health Symptoms for African American Women

The purpose of this investigation was to examine coping strategies as moderators of the relationship between individual race-related stress and mental health symptoms among a sample of 128 African American women. Coping strategies refer to efforts used to resolve problems and those used to manage, endure, or alleviate distress. Culture-specific strategies were examined in the current study (i.e., efforts that are commonly used by members of a cultural group). Culture-specific efforts were hypothesized to influence the severity of psychological symptoms associated with individual race-related stress, such that frequent use of culture-specific efforts would lessen the strength of the relationship between race-related stress and psychological symptoms. Moderated hierarchical regression analyses revealed that high use of ritual-centered strategies to address race-related stress was related to severe anxiety and interpersonal sensitivity. No moderating effect of coping strategies was found for depression, obsessive-compulsion, and somatization symptoms. The findings suggest that African American women may inadvertently utilize coping efforts that serve to increase the severity of psychological symptoms related to individual race-related stress. Mental health professionals should explore underlying emotions related to coping efforts utilized to address race-related stress among African American women.

Coping profiles common to older African American cancer survivors: relationships with quality of life

CONTEXT

Cancer survivors use distinct sets of coping behaviors that vary in their associations with psychological health and quality of life. However, existing research has largely focused on Caucasian and middle-class subjects.

OBJECTIVES

This study explores whether clusters with differing coping profiles could be identified among older African American cancer survivors and whether these profiles varied on cultural factors and physical, psychological, and relationship well-being.

METHODS

Four hundred forty-nine older African American cancer survivors recruited from outpatient oncology clinics completed a questionnaire booklet containing the Ways of Helping Questionnaire (WHQ), the Brief Index of Race-Related Stress, the Religious Involvement Scale, Mutuality Scale, and the Short Form-12 Health Survey Questionnaire. A k-means cluster analysis was conducted using the WHQ.

RESULTS

Four distinct coping profiles were identified and labeled as high coping, low encouraging healthy behaviors, low coping, and strong/distracting behaviors. Coping profiles were associated with participant's gender, age, and living-alone status. Controlling for these demographic differences, the coping profiles were associated with religiosity; experiences with racism; and physical, psychological, and relationship well-being.

CONCLUSIONS

The findings from this study lend support for examining coping profiles and health outcomes among African American cancer survivors. This research also suggests that these profiles vary on cultural factors. This information should prove useful to researchers as they develop culturally appropriate interventions for this underserved population.

Resiliency and Optimism: An African American Senior Citizen’s Perspective

A total of 52 African American senior citizens (aged 59-99 years) were asked to participate in a study examining psychological resources (ego resilience and dispositional optimism) and the experience of racial stress as a function of geographical location (north vs. south). This is an understudied population, and African American seniors who remain relatively active within their respected communities may provide useful information regarding these psychological constructs in particular and successful aging in general. Participants completed the ego resilience, optimism, stress, and distress surveys. When collapsed across geographical location, resilience was negatively correlated with distress and positively correlated with optimism. Dispositional optimism was negatively correlated with levels of psychological distress. African American seniors who resided in the north reported significantly less distress than those in the south. Findings support resiliency and optimism as stress buffers for older African Americans.

Examining the Relation Between Racial Identity Attitude Clusters and Psychological Health Outcomes in African American College Students

Using Cross’s expanded Nigrescence theory, this study examined the relation between patterns of racial identity attitudes and mental health outcomes among a sample of 317 Black American college students. Racial identity attitudes were operationalized using the Cross Racial Identity Scale, and the mental health outcomes assessed included subjective well-being, hardiness, and general psychological health. Results from a cluster analysis indicated a five-cluster solution (Low Race Salience, Multiculturalist, Self-Hatred, Immersion, and Afrocentric), which for the most part is consistent with previous research. In addition, differential associations were found between cluster groups and psychological health outcomes, where participants in the Multiculturalist cluster reported greater levels of psychological well-being and those in the Immersion cluster group reported the lowest levels. The implications for these findings with respect to future research are discussed.

Perceived discrimination and health: a meta-analytic review

Perceived discrimination has been studied with regard to its impact on several types of health effects. This meta-analysis provides a comprehensive account of the relationships between multiple forms of perceived discrimination and both mental and physical health outcomes. In addition, this meta-analysis examines potential mechanisms by which perceiving discrimination may affect health, including through psychological and physiological stress responses and health behaviors. Analysis of 134 samples suggests that when weighting each study's contribution by sample size, perceived discrimination has a significant negative effect on both mental and physical health. Perceived discrimination also produces significantly heightened stress responses and is related to participation in unhealthy and nonparticipation in healthy behaviors. These findings suggest potential pathways linking perceived discrimination to negative health outcomes.

Perceived discrimination and health: a meta-analytic review

Perceived discrimination has been studied with regard to its impact on several types of health effects. This meta-analysis provides a comprehensive account of the relationships between multiple forms of perceived discrimination and both mental and physical health outcomes. In addition, this meta-analysis examines potential mechanisms by which perceiving discrimination may affect health, including through psychological and physiological stress responses and health behaviors. Analysis of 134 samples suggests that when weighting each study's contribution by sample size, perceived discrimination has a significant negative effect on both mental and physical health. Perceived discrimination also produces significantly heightened stress responses and is related to participation in unhealthy and nonparticipation in healthy behaviors. These findings suggest potential pathways linking perceived discrimination to negative health outcomes.

Health-related quality of life in low-income older African Americans

This study examined the relationships among comorbid conditions, symptom stress, depression, functional status and health-related quality of life (HRQOL) in low-income older African Americans with chronic diseases. A convenience sample of 83 older African American adults living in subsidized housing for elders participated in the study. Data were collected in face-to-face interviews. Participants reported lower scores on HRQOL than the SF-36 norms for age 60 or older in the general U.S. population. Comorbid conditions, symptom distress, depression, and functional status significantly predicted both the physical (F = 38.92, p < .001) and mental (F = 23.21, p < .001) health components of HRQOL, accounting for 63% of variance in the SF-36 physical health score and 55% of the variance in the SF-36 mental health score. The findings suggested that developing interventions to assist older African Americans to better manage their symptoms and depression are of prime importance for improving HRQOL.

Health care providers' knowledge, attitudes, and self-efficacy for working with patients with spinal cord injury who have diverse sexual orientations

BACKGROUND AND PURPOSE

This study, using an evaluative, cross-sectional design, explored the self-efficacy, knowledge, and attitudes of health care providers who treat people with spinal cord injury (SCI) who may be gay, lesbian, bisexual, or transgender (GLBT). The study also designed and implemented a diversity training program and measured its effect on participants' perceptions of their ability to change their knowledge levels, attitudes, and self-efficacy with regard to sexual orientation diversity.

SUBJECTS AND METHODS

Health care professionals (N=402) participated in a diversity training program that included a pre-briefing questionnaire, a videotape, a post-briefing questionnaire, and discussion. Descriptive and chi-square analyses were performed on all variables of interest.

RESULTS

The majority of the participants reported low levels of knowledge, attitudes of tolerance versus respect, and 0% to 20% confidence levels for providing culturally sensitive services for patients with diverse sexual orientations. Three hundred seventeen participants strongly agreed that watching the videotape increased their confidence levels in providing services for people who may be GLBT.

DISCUSSION AND CONCLUSION

Health care providers who treat people with SCI self-report low levels of knowledge, tolerance versus respect, and low levels of self-efficacy with regard to sexual orientation diversity. If a health care provider has a low level of knowledge, tolerance versus respect, and a low level of diversity self-efficacy toward others, there may be direct physical and mental health consequences for the patient. A limitation of the study was that social desirability bias may have increased the number of participants who reported increased levels of self-efficacy following the videotape. Further research is recommended (1) to determine whether current diversity training for health care professionals includes diversity of sexual orientation and (2) to examine the knowledge levels, attitudes, and self-efficacy of health care professionals with regard to sexual orientation diversity while attempting to control for social desirability bias in participants' responses.

Large arterial elasticity varies as a function of gender and racism-related vigilance in black youth

BACKGROUND

This exploratory study examined the relationship of gender and racism-related vigilance to baseline and task-induced changes in large arterial elasticity (LAE).

METHODS

The convenience sample consisted of 153 black youth (M age = 11.5 years, SD = 1.4) who were normotensive. Large arterial elasticity was measured via pulse wave contour analysis, before, during, and after a sequentially administered digit forward and digit backward task. Racism-related vigilance was reported by participants.

RESULTS

Although findings from general linear models indicated that the independent effects of gender and racism-related vigilance were not significantly related to LAE (baseline, reactivity, or recovery) (all p > .05), these analyses showed that gender and racism-related vigilance interacted to predict baseline LAE (p < .02) and task-induced changes (reactivity only) in LAE (p < .006). Follow-up regression analyses explicating the pattern of these interaction effects indicated that 1) racism-related vigilance was marginally and inversely related to baseline LAE among boys (p < .06) but not in girls (p > .21); and, 2) racism-related vigilance was positively and significantly associated with task-induced changes (reactivity) in LAE among boys (p < .008) but not in girls (p > .30).

CONCLUSIONS

The relationship between racism-related vigilance and LAE varies as a function of gender, and may have longer-term implications for between and within-group disparities in cardiovascular health.

A systematic review of empirical research on self-reported racism and health

This paper reviews 138 empirical quantitative population-based studies of self-reported racism and health. These studies show an association between self-reported racism and ill health for oppressed racial groups after adjustment for a range of confounders. The strongest and most consistent findings are for negative mental health outcomes and health-related behaviours, with weaker associations existing for positive mental health outcomes, self-assessed health status, and physical health outcomes. Most studies in this emerging field have been published in the past 5 years and have been limited by a dearth of cohort studies, a lack of psychometrically validated exposure instruments, poor conceptualization and definition of racism, conflation of racism with stress, and debate about the aetiologically relevant period for self-reported racism. Future research should examine the psychometric validity of racism instruments and include these instruments, along with objectively measured health outcomes, in existing large-scale survey vehicles as well as longitudinal studies and studies involving children. There is also a need to gain a better understanding of the perception, attribution, and reporting of racism, to investigate the pathways via which self-reported racism affects health, the interplay between mental and physical health outcomes, and exposure to intra-racial, internalized, and systemic racism. Ensuring the quality of studies in this field will allow future research to reveal the complex role that racism plays as a determinant of population health.

Prevalence and correlates of perceived societal racism in older African-American adults with type 2 diabetes mellitus

Although experiences of racism in day-to-day life may affect minority patients' interaction with the health system and may influence health outcomes, little is known about these experiences in patients with chronic diseases. The goal of this study was to explore the frequency and correlates of perceived societal racism in 42 African Americans aged 50 and older with type 2 diabetes mellitus. Twenty-seven items of the McNeilly Perceived Racism Scale were used to assess exposure to racist incidents in employment and public domains and emotional and coping responses to perceived racism in general. Mean age was 62, 71% were women, and more than half rated their health as fair/poor (55%). Overall, 95.2% of the participants reported at least some exposure to perceived societal racism. Higher mean lifetime exposure to societal racism, based on summary scores on the perceived racism scale, was reported by men (35.0+/-19.1) than women (19.7+/-14.4) (P<.01) and by those with higher household income (30.7+/-17.3) than those with lower household income (18.6+/-15.1) (P<.05). Greater passive coping (e.g., "avoiding it," "ignoring it") was associated with being female and having lower household income and fair/poor self-rated health. The findings that perception of racism and a range of emotional and coping responses were common in older African-American patients attending two diabetes clinics suggest that physicians and other healthcare providers may need to be more aware of patients' day-to-day experiences of societal racism and the influence these experiences may have on patient trust in the medical system and their adherence to medical advice or engagement in self-management of their chronic conditions.

Examining African self-consciousness and Black racial identity as predictors of Black men's psychological well-being

This study investigated African self-consciousness and Black racial identity as predictors of psychological distress and self-esteem for Black men. One hundred thirty Black men from a college and community sample completed the African Self-Consciousness Scale, the Racial Identity Attitude Scale-B, the Symptom Checklist 90-Revised, and the Coopersmith Self-Esteem Inventory. Canonical correlation analysis found 2 significant roots with the 1st root indicating that Black men whose attitudes reflected Preencounter and Immersion racial identity attitudes and who do not resist against anti-African/Black forces reported greater psychological distress and less esteem. Results from the 2nd root suggested that Black men whose attitudes reflect greater Internalization racial identity attitudes, greater resistance to anti-African/Black forces, and less identification with Blacks reported greater self-esteem.