Racial discrimination and cortisol in African American emerging adults: The role of neighborhood racial composition

Developmental life history transitions can be shaped by structural inequities: Insights from the sociology of race

Life history emerges as developmental processes play out over the lifespan of an organism, and the concept of life history intersects with evolutionary biology, ecology, demographics and sociology. Here, we briefly outline the interdisciplinary concept of life history, surveying some of the diversity in life history transitions across animal species, and exploring these transitions as genetically and hormonally-regulated developmental processes. We review some of the data suggesting that social structures are capable of shifting the timing of human life history transitions, with implications for lifetime health outcomes. Social and structural inequity in contemporary society tends to accelerate developmental life history processes, which can create temporal and physiological pressures that intersect with and amplify disadvantage. Focusing specifically on the experiences of Black women in the U.S., we examine the impacts of inequity on the timing of four developmental life history transitions: birth, puberty, first reproduction and menopause. We identify some of the important overlaps between developmental biology, sociology and public health, arguing that these disciplinary intersections can be introduced in many developmental biology classrooms. We propose some pedagogical frameworks designed to help students grow an awareness of how developmental processes can be affected by social inequities, with the ultimate goal of stimulating more cross-disciplinary conversations about life histories and their intersections with social structures.

Hair Cortisol Concentrations in the Prediction of Early Substance Use Engagement in Youth

OBJECTIVE

Understanding factors associated with early onset of substance use is critical as using alcohol or drugs at a young age is a strong predictor of later substance dependency. Experiencing stressful life events is associated with increased risk for early substance use in youth. Hair cortisol concentration (HCC) is considered a biomarker of psychological stress experienced over longer periods of time. We examined whether HCC could predict early substance use engagement in youth followed over 5 years.

METHODS

Participants were 395 young adolescents (50% female, age range 10-15 years, Mage = 12.3, SD = 1.1 at baseline). Demographic data, socioeconomic factors, and substance use habits were collected at four waves between 2015 and 2021. HCC was assayed from hair collected at a home visit between Wave 1 and Wave 2. Analytic models tested a) HCC in relation to latent class membership of substance use and b) whether HCC moderated the relation between self-reports of stress and substance use.

RESULTS

HCC did not add to the prediction of early substance use engagement in any of the models, while self-reports of stressful life events and everyday discrimination predicted early substance use engagement in the models comparing 'Early' vs 'Late/No' substance use class membership.

CONCLUSION

We found no evidence of HCC to be associated with early substance use engagement in youth. Nevertheless, our results do confirm that self-reports of stressful everyday life experiences predict earlier substance use engagement, underscoring the role of psychosocial stressors as significant predictors of substance use engagement in youth.

Unlocking Population-Specific Treatments to Render Equitable Approaches and Management in Cardiovascular Disease: Development of a Situation-Specific Theory for African American Emerging Adults

BACKGROUND

Emerging adulthood (18-25 years old) is a distinct developmental period in which multiple life transitions pose barriers to engaging in healthy lifestyle behaviors that reduce cardiovascular disease risk. There is limited theory-based research on African American emerging adults.

OBJECTIVE

This article introduces a synthesized empirically testable situation-specific theory for cardiovascular disease prevention in African American emerging adults.

METHODOLOGY

Im and Meleis' integrative approach was used to develop the situation-specific theory.

RESULTS

Unlocking Population-Specific Treatments to Render Equitable Approach and Management in Cardiovascular Disease is a situation-specific theory developed based on theoretical and empirical evidence and theorists' research and clinical practice experiences.

DISCUSSION

African American emerging adults have multifaceted factors that influence health behaviors and healthcare needs. Unlocking Population-Specific Treatments to Render Equitable Approaches and Management in Cardiovascular Disease has the potential to inform theory-guided clinical practice and nursing research. Recommendations for integration in nursing practice, research, and policy advocacy are presented. Further critique and testing of the theory are required.

Per- and polyfluoroalkyl substances (PFAS), perceived stress, and depressive symptoms in a prospective cohort study of black women

BACKGROUND

Per- and polyfluoroalkyl substances (PFAS) are endocrine-disrupting chemicals with neurotoxic properties. PFAS have been associated with depressive symptoms among women in some studies, but little research has evaluated the effects of PFAS mixtures. Further, no study has investigated interactions of PFAS-depression associations by perceived stress, which has been shown to modify the effects of PFAS on other health outcomes.

OBJECTIVE

In a prospective cohort study of reproductive-aged Black women, we investigated associations between PFAS and depressive symptoms and the extent to which perceived stress modified these associations.

METHODS

We analyzed data from 1499 participants (23-35 years) in the Study of Environment, Lifestyle, and Fibroids. We quantified concentrations of nine PFAS in baseline plasma samples using online solid-phase extraction-liquid chromatography-isotope dilution tandem mass spectrometry. Participants reported perceived stress via the Perceived Stress Scale (PSS-4; range = 0-16) at baseline and depressive symptoms via the Center for Epidemiologic Studies Depression Scale (CESD; range = 0-44) at the 20-month follow-up visit. We used Bayesian Kernel Machine Regression to estimate associations between PFAS concentrations, individually and as a mixture, and depressive symptoms, and to assess effect modification by PSS-4 scores, adjusting for confounders.

RESULTS

Baseline perfluorodecanoic acid concentrations were associated with greater depressive symptoms at the 20-month follow-up, but associations for other PFAS were null. The PFAS were not associated with depressive symptoms when evaluated as a mixture. The association between the 90th percentile (vs. 50th percentile) of the PFAS mixture with CES-D scores was null at the 10th (β = 0.03; 95 % CrI = 0.20, 0.25), 50th (β = 0.02; 95 % CrI = -0.16, 0.19), and 90th (β = 0.01; 95 % CrI = 0.18, 0.20) percentiles of PSS-4 scores, suggesting perceived stress did not modify the PFAS mixture.

CONCLUSION

In this prospective cohort study, PFAS concentrations-assessed individually or as a mixture-were not appreciably associated with depressive symptoms, and there was no evidence of effect modification by perceived stress.

Short-term cortisol adaption to discrimination and Mexican-origin adolescents' mental and sleep health

Discrimination experiences are a salient contributor to the health disparities facing Latina/x/o youth. The biopsychosocial model of minority health posits that discrimination influences health through wear and tear on the biological stress responses, including the hypothalamic-pituitary-adrenal (HPA) axis, which is a primary stress response system in the body. Emerging evidence suggests that discrimination alters the secretion of cortisol, the end product of the HPA axis, yet, whether the daily processes between discrimination and diurnal cortisol response influence mental and sleep health remains unanswered. This study integrated daily diary and post-diary survey data to examine whether daily diurnal cortisol responses to discrimination influence adolescents' mental (depressive symptoms, anxiety) and sleep (sleep quality, duration) health in a sample of Mexican-origin youth (N = 282; M age = 17.10; 55% female). Results showed that adolescents who experienced more discrimination across the four-day diary period exhibited steeper diurnal cortisol slopes and lower evening cortisol; however, such physiological responses tended to be associated with poorer adolescents' mental and sleep health. The current study underscores the potential adaptation cost associated with short-term cortisol adaptation in the face of discrimination.

Stress Biomarkers in Black Youth: Exploring Psychological, Behavioral, and Socio-Ecological Correlates

Exposure to chronic stress is a major public health concern. Black youth are vulnerable to chronic stress exposure given their overrepresentation in urban neighborhoods characterized by socio-ecological stressors. We contribute to this emerging body of knowledge by (1) investigating stress-induced variability in cortisol response patterns among Black youth, and (2) examining risk and protective factors associated with physiological stress responses. Salivary cortisol was collected from a community sample of 123 low-income Black youth ages 13 to 21. Latent class analysis (LCA) and logistic regression were utilized to identify discrete groups based on cortisol reactivity, and psychological, behavioral, and socio-ecological correlates of class membership. LCA supported a 2-class model of cortisol reactivity. Youth in class one were indicative of a normative stress response with mean cortisol awakening response of 0.38 μg/dL (SD = 0.19), 0.48 μg/dL (SD = 0.20) at time 2, and 0.44 μg/dL (SD = 0.20) at time 3. Youth in class two exhibited a blunted stress response with mean cortisol awakening response of 0.20 μg/dL (SD = 0.11), 0.21 μg/dL (SD = 0.09) at time 2, and 0.18 μg/dL (SD = 0.08) at time 3. Delinquent peer exposure and post-traumatic stress symptoms were negatively associated with blunted stress responses, while greater depressive symptoms were positively associated with blunted stress responses. Black youth displayed distinct physiological stress reactivity patterns. Interventions are needed to assist youth in coping with stress while transforming the upstream factors that give rise to adverse community conditions.

Exploring Health Care Disparities in Maternal-Child Simulation-Based Education

AIM

The purpose of this study was to explore student experiences within a health care disparity simulation, embedded in maternal-child content.

BACKGROUND

Health care disparities related to race and ethnicity in the maternal-child population are daunting among African American and Hispanic women.

METHOD

Participants completed the Simulation Effectiveness Tool-Modified, a rapid-fire huddle questionnaire, and a demographic instrument. All students participated in structured debriefing.

RESULTS

Student responses ( n = 69) demonstrated effectiveness in learning via this scenario.

CONCLUSION

The rapid-fire huddle and debriefing are important elements when health care disparities are introduced into nursing curricula.

School Prejudice and Substance Use from Adolescence to Emerging Adulthood in the United States: Variation across Race and Ethnicity

BACKGROUND

Racial and ethnic disparities in health outcomes have been consistently documented in the health literature. Until recently, many studies have evidenced associations between prejudice and health behaviors using cross-sectional data. However, studies assessing the link between school prejudice and health behaviors from adolescence to adulthood are limited.

METHODS

To address this gap, we use data from Waves I, II, and III of the National Longitudinal Study of Adolescent to Adult Health (1994-2002) to examine how perceptions of school prejudice over time influence cigarette smoking, alcohol use, and marijuana use from adolescence to emerging adulthood. We also examine variation across race and ethnicity.

RESULTS

Results indicate that school prejudice in adolescence (Wave I) is associated with higher cigarette use, alcohol use, and marijuana use in later adolescence (Wave II). White and Asian adolescents who perceived school prejudice were more likely to use alcohol, while Hispanic adolescents were more likely to use marijuana.

CONCLUSIONS

Efforts to reduce school prejudice among adolescents may have implications in reducing substance use.

Discrimination in Context: Examining Neighborhood-Level Variation in the Incidence and Adverse Effects of Perceived Racial and Ethnic Discrimination Among Chicago Youth

A growing body of research links interpersonal racial and ethnic discrimination to adverse youth outcomes. Yet, studies examining the relevance of neighborhood context for discrimination are sparse. This study examines neighborhood-level variation in the incidence and impact of perceived racial and ethnic discrimination on depressive symptoms, suicidal behavior, violent behavior, and substance use. Hierarchical regression models on a sample of 1333 African American and Hispanic youth (52.44% female; x̄ = 13.03 years, SD = 3.25 at wave 1) residing in 238 Chicago neighborhoods from the Project on Human Development in Chicago Neighborhoods indicated little to no neighborhood-level variation in the incidence and impact of discrimination. Findings suggest that the experience of discrimination among youth of color is ubiquitous.

Perceived Neighborhood Crime Safety Moderates the Association Between Racial Discrimination Stress and Chronic Health Conditions Among Hispanic/Latino Adults

Background: Little is known about the link between perceived neighborhood walkability and prevalence of chronic disease. Even less is known regarding this association among Hispanic/Latino adults, despite exhibiting high rates of chronic diseases. Stress due to racial discrimination is a harmful social determinant of health in Hispanics/Latinos. Having both low perceived neighborhood walkability and high racial discrimination stress may exacerbate the chronic disease status of Hispanics/Latinos. Among a U.S. national sample of Hispanic/Latino adults, this cross-sectional study aims to examine (1) the associations among overall perceived neighborhood walkability, racial discrimination stress, and having a chronic health condition; and (2) whether overall perceived neighborhood walkability moderates the hypothesized association between racial discrimination stress and having a chronic health condition. Methods: In January 2018, 798 Hispanic/Latino adults (M age = 39.7 years, SD = 15.1; 58.6% female; 70.0% U.S. born; 52.0% Mexican/Mexican American) responded to a survey via Qualtrics Panels. Surveys included the Neighborhood Environment Walkability Scale-Abbreviated, Hispanic Stress Inventory-2, and self-reported presence/absence of chronic health conditions (e.g., hypertension, heart disease). A logistic regression was conducted testing for the moderation of the main effect of racial discrimination stress on the presence of a chronic health condition by overall perceived neighborhood walkability. Results: After controlling for age, body mass index, and income, racial discrimination stress was inversely associated with overall perceived neighborhood walkability (b = -0.18, p < 0.001) and positively associated with having a chronic health condition (OR = 1.02; 95% CI [1.00, 1.03]). While overall perceived neighborhood walkability was not associated with having a chronic health condition, perceived crime safety was inversely associated with having a chronic health condition (OR = 0.94; 95% CI [0.89, 0.99]). Perceived crime safety moderated the positive association between discrimination stress and having a chronic health condition, such that the association was only significant among those who perceived their neighborhood to be less safe (β = -0.004, 95% CI [-0.01, -0.00]). Conclusions: Overall perceived neighborhood walkability was inversely associated with racial discrimination stress, but not associated with having a chronic health condition. Perceived neighborhood crime safety, but not infrastructure or aesthetics, matters when it comes to the link between racial discrimination stress and having a chronic health condition among Hispanics/Latinos.

Racial discrimination trajectories predicting psychological well-being: From emerging adulthood to adulthood

Perceived racial discrimination (PRD) has been documented as a risk factor for worse psychological well-being among African Americans. Yet, most researchers have not examined how trajectories of PRD during emerging adulthood shape psychological well-being in adulthood. Moreover, less is known about whether demographic factors and components of racial identity shape PRD over time. We identified trajectories of PRD among 605 African American emerging adults and examined whether PRD trajectories were associated with depressive symptoms, anxiety symptoms, and perceived lack of control in adulthood. Four trajectories of PRD were identified (i.e., high-stable, moderate-declining, low-rising, and low-stable), and demographic factors and racial identity indicators influenced the likelihood of trajectory classification. In addition, members of the moderate-declining trajectory exhibited higher levels of depressive symptoms, anxiety symptoms, and perceived lack of control than members in the low-stable trajectory. Our findings suggest that changes in PRD in emerging adulthood can extend our understanding of psychological well-being in adulthood. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Sex Differences in the Impact of Racial Discrimination on Mental Health Among Black Americans

PURPOSE OF REVIEW

Greater racial discrimination is associated with poorer mental health among Black Americans; yet, there remains an incomplete understanding of sex differences in exposure to racial discrimination, and further, of how sex differences in coping with racial discrimination may heighten or diminish risk for poorer mental health.

RECENT FINDINGS

Black men may experience greater exposure to both structural and communal forms of racial discrimination, whereas Black women may face both a wider range of potential sources, as well as encounter greater variability in the subjective experience of racial discrimination. For both Black women and men, racial discrimination may be similarly associated with maladaptive coping strategies (i.e., emotional eating, rumination) that also are linked to poorer mental health; however, emerging findings suggest that mindfulness may partially buffer these deleterious effects. Overall, the recent literature reveals mixed findings with respect to sex differences in the experience and negative mental health impact of racial discrimination. Despite this heterogeneity, evidence documents sex differences in the settings, type, and qualitative experience of racial discrimination among Black Americans. Additionally, growing evidence indicating that racial discrimination is associated with physiological markers of stress reactivity and psychopathology risk further bolsters its characterization as a unique form of chronic stress among Black Americans and other minority groups in the USA.