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Ransome Y, Valido AD, Espelage DL, Clements GL, Harrell C, Eckel C, Price N, Nassau R, Nyhan K, Taggart TL. A systematic review of how social connectedness influences associations between racism and discrimination on health outcomes. Epidemiol Rev 2023; 45:44-62. [PMID: 37477041 DOI: 10.1093/epirev/mxad009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 06/12/2023] [Accepted: 07/10/2023] [Indexed: 07/22/2023] Open
Abstract
Racial discrimination is a well-known risk factor of racial disparities in health. Although progress has been made in identifying multiple levels through which racism and racial discrimination influences health, less is known about social factors that may buffer racism's associations with health. We conducted a systematic review of the literature with a specific focus on social connectedness, racism, and health, retrieving studies conducted in the United States and published between January 1, 2012, and July 30, 2022, in peer-reviewed journals. Of the 787 articles screened, 32 were selected for full-text synthesis. Most studies (72%) were at the individual level, cross-sectional, and among community/neighborhood, school, or university samples. Studies had good methodological rigor and low risk of bias. Measures of racism and racial discrimination varied. Discrimination scales included unfair treatment because of race, schedule of racist events, experiences of lifetime discrimination, and everyday discrimination. Measures of social connectedness (or disconnectedness) varied. Social-connectedness constructs included social isolation, loneliness, and social support. Mental health was the most frequently examined outcome (75%). Effect modification was used in 56% of studies and mediation in 34% of studies. In 81% of studies, at least 1 aspect of social connectedness significantly buffered or mediated the associations between racism and health. Negative health associations were often weaker among people with higher social connectedness. Social connectedness is an important buffering mechanism to mitigate the associations between racial discrimination and health. In future studies, harmonizing metrics of social connectedness and racial discrimination can strengthen causal claims to inform interventions.
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Affiliation(s)
- Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06510, United States
| | - Alberto D Valido
- School of Education, Applied Developmental Sciences and Special Education, Human Development and Family Science, School Psychology, University of North Carolina Chapel Hill, Chapel Hill, NC 27514, United States
| | - Dorothy L Espelage
- School of Education, Applied Developmental Sciences and Special Education, Human Development and Family Science, School Psychology, University of North Carolina Chapel Hill, Chapel Hill, NC 27514, United States
| | - Graceson L Clements
- School of Education, Applied Developmental Sciences and Special Education, Human Development and Family Science, School Psychology, University of North Carolina Chapel Hill, Chapel Hill, NC 27514, United States
| | - Crystal Harrell
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06510, United States
| | - Caroline Eckel
- Department of Sociology, University of California, Davis, Davis, CA 95616, United States
| | - Natalie Price
- Milken Institute School of Public Health, Department of Prevention and Community Health, The George Washington University, Washington, DC 20037, United States
| | - Rachel Nassau
- The George Washington School of Medicine and Health Sciences, Washington, DC 20052, United States
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale School of Public Health, New Haven, CT 06510, United States
| | - Tamara L Taggart
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06510, United States
- Milken Institute School of Public Health, Department of Prevention and Community Health, The George Washington University, Washington, DC 20037, United States
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Everyday Discrimination and Depressive Symptoms among Gujarati Adults: Gender Difference in the Role of Social Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148674. [PMID: 35886527 PMCID: PMC9320648 DOI: 10.3390/ijerph19148674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/07/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022]
Abstract
Discrimination against Asians in the USA and its impact on their mental health are urgent public health concerns. Most research on discrimination against Asians has used aggregated Asian group samples. Focusing on Gujaratis, a specific subgroup of Asian Indians, the second-largest Asian group in the USA, this study examined the relationships between everyday discrimination and psychological distress and how they vary by gender. Data were collected via computer-assisted telephone interviews with a representative sample of 553 Gujaratis aged 18 to 65 years residing in a Midwestern state. Negative binomial regression analyses were conducted to examine how exposure to unfair treatment and three types of social support, respectively, was associated with depressive symptoms. For both women and men, unfair treatment was positively associated with depressive symptoms, controlling for sociodemographic characteristics. For women, but not for men, the incidence rate ratio became non-significant when adding social support measures to the model. All three social support measures for women, and only satisfaction with social support for men, were significantly associated with lower depressive symptoms. The findings highlight the need for further research on the role of different types of social support and gender differences, which can inform gender- and socioculturally-relevant intervention efforts.
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