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Robinson TD. Black Male Veterans' Mental Health: Exploring Their Lived Experiences. SOCIAL WORK IN PUBLIC HEALTH 2024:1-12. [PMID: 38769819 DOI: 10.1080/19371918.2024.2357084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
This study delves into the mental health experiences of Black male veterans, bridging their military service with the historical context of Black men's mental health. Amid limited literature on this demographic, qualitative methods, including focus groups, are utilized to gather nuanced insights. Themes such as mental health awareness gaps, diverse therapy encounters, familial and social stigmatization, and lacking support networks emerge. The study underscores the urgent need for heightened attention to this overlooked population within social work research, education, and practice. It advocates for an inclusive, culturally sensitive approach in social work, offering implications for practitioners, educators, and curriculum development tailored to the unique needs of Black male veterans. Despite constraints, this research provides vital perspectives, urging further inquiry and support initiatives to better comprehend and aid the mental well-being of Black male veterans.
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Affiliation(s)
- Tay D Robinson
- U.S. Department of Veteran Affairs, Indianapolis Vet Center, Indianapolis, Indiana, USA
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2
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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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3
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Galán CA, Meza JI, Ridenour TA, Shaw DS. Racial Discrimination Experienced by Black Parents: Enduring Mental Health Consequences for Adolescent Youth. J Am Acad Child Adolesc Psychiatry 2022; 61:1251-1261. [PMID: 35513191 DOI: 10.1016/j.jaac.2022.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 12/19/2021] [Accepted: 04/25/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Despite evidence linking experiences of racial discrimination by Black parents and problem behaviors in youth, little is known about the mechanisms that explain this link. To elucidate these developmental pathways, a serial mediation model was tested, in which Black parents' experiences of racial discrimination were hypothesized to predict increased parental depression and parent-child conflict in early adolescence, which in turn would be associated with youth depression, anxiety, and conduct problems in early to mid-adolescence. METHOD Participants were 252 Black parent-child dyads. Youth (56% female) were on average 11.98 years old at study entry (wave 1). Parents and youth completed questionnaires during a home-based assessment at wave 1 and were assessed again 1 and 2 years later (waves 2 and 3). RESULTS Black parents' experiences of racial discrimination at wave 1 were linked to higher levels of parent-child conflict at wave 2 (0.20; 95% CI [0.05, 0.33]), which in turn predicted greater youth-reported depression at wave 3 (0.30; 95% CI [0.15, 0.47]). There was a significant indirect effect of racial discrimination on youth-reported depression via parent-child conflict (indirect effect: 0.06, 95% CI [0.02, 0.10]). Findings were replicated across multiple outcomes (ie, depression, anxiety, conduct problems) and multiple informants (ie, youth report, parent report). There was no evidence to support a serial mediation model via parental depression and then parent-child conflict. CONCLUSION This study identified a developmental pathway from Black parents' experiences of racial discrimination to adolescent problem behaviors via parent-child conflict. Findings may inform interventions aimed at promoting resilience in parents and youth faced with pervasive racism. CLINICAL TRIAL REGISTRATION INFORMATION Substance Use Screening and Prevention for Adolescents in Pediatric Primary Care (SKY); https://clinicaltrials.gov/; NCT03074877.
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4
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Brownlow BN. How Racism "Gets Under the Skin": An Examination of the Physical- and Mental-Health Costs of Culturally Compelled Coping. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2022; 18:576-596. [PMID: 36179058 DOI: 10.1177/17456916221113762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Historically and contemporarily, Black Americans have been compelled to use effortful coping styles characterized by high behavioral and emotional restraint in the face of systematic racism. Lynch and colleagues have previously conceptualized a class of regulatory strategies-overcontrolled coping-characterized by emotional suppression, hypervigilance for threat, and high distress tolerance, which bear close analogy to coping styles frequently used among individuals facing chronic racial stress. However, given the inherent culture of racism in the United States, engaging in highly controlled coping strategies is often necessitated and adaptive, at least in the short term. Thus, for Black Americans this class of coping strategies is conceptualized as culturally compelled coping rather than overcontrolled coping. In the current article, I offer a critical examination of the literature and introduce a novel theoretical model-culturally compelled coping-that culturally translates selected components of Lynch's model. Cultural translation refers to considering how the meaning, function, and consequences of using overcontrolled coping strategies changes when considering how Black Americans exist and cope within a culture of systematic racism. Importantly, this model may offer broad implications for future research and treatment by contextualizing emotion regulation as a central mechanism, partially answering how racism "gets under the skin" and affects the health of Black Americans.
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5
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Tobin CST, Gutiérrez Á, Erving CL, Norris KC, Thorpe RJ. When Resilience Becomes Risk: A Latent Class Analysis of Psychosocial Resources and Allostatic Load Among African American Men. Am J Mens Health 2022; 16:15579883221104272. [PMID: 35758236 PMCID: PMC9244943 DOI: 10.1177/15579883221104272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
There is a well-established link between psychosocial risks and psychological health among African American (AA) men. Yet, the psychosocial sources and physical health consequences of resilience (i.e., the ability to maintain good health despite adversity) remain underexplored. Using data from 283 AA men in the Nashville Stress and Health Study, the present study investigated the links between psychosocial resilience and allostatic load (AL), a biological indicator of physiological dysregulation. Latent class analysis (LCA) identified distinct resilience profiles comprising eight psychosocial resources across four categories: coping strategies, sense of control, racial identity, and social support. Analysis of variance (ANOVA) tests determined significant class differences in men’s AL scores. LCA results confirm a four-class model was the best fit: Class 1 (high resources, 32%), Class 2 (high coping but low control, 13%), Class 3 (low resources but high racial identity, 20%), and Class 4 (low resources but high mastery, 34%). Results reveal lower AL (better health) among Classes 1 (m = 0.35) and 4 (m = 0.31) and higher AL (worse health) among Classes 2 (m = 0.44) and 3 (m = 0.44). Findings indicate that the “quality” rather than the “quantity” of psychosocial resources matters for physical health among AA men, as positive health outcomes were observed among both low- and high-resource classes. Results suggest different resource combinations produce distinct patterns of resilience among AA men and underscore the need to further elucidate complex resilience processes among this population.
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Affiliation(s)
- Courtney S Thomas Tobin
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ángela Gutiérrez
- Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
| | - Christy L Erving
- Department of Sociology, University of Texas at Austin, Austin, TX, USA
| | - Keith C Norris
- Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Roland J Thorpe
- Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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6
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King KM, Key-Hagan M, Desai A, Mundy T, Shittu AK, Roberts LR, Montgomery S, Clarke M, Idoate R, Michaud TL, Ramos AK, Strong S, Thorpe RJ, Montgomery SB. Stress Correlates Related to Depressive Symptoms Among Young Black Men in Southern California. Am J Mens Health 2022; 16:15579883221097801. [PMID: 35549937 PMCID: PMC9112424 DOI: 10.1177/15579883221097801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Black men experience higher levels of chronic stress, life stressors, and discrimination due to oppressive social and economic conditions. Black men are at greater risk of depression, but most published research on stress and depression has focused on Black people in general, Black women, or older Black men. We sought to determine whether discrimination, perceived stress, major life stress, daily hassles, and social capital were associated with depressive symptoms in young Black men. Survey data were collected from April 2010 to March 2012 in Southern California from a convenience sample of Black men (N = 201). We used two-sample t tests and one-way analysis of variance (ANOVA) to examine the association of stress correlates with depressive symptoms. Logistic regression was conducted to estimate the likelihood of reporting depressive symptoms for each significant correlate. Over half of the sample reported depressive symptoms. Health status, perceived discrimination, urban hassles, perceived stress, and neighborhood trust and safety were significantly related to depressive symptoms. Those who reported higher perceived stress had higher odds of reporting depressive symptoms, whereas lower everyday discrimination experiences were associated with lower odds of depressive symptoms. Future studies should consider examining the effectiveness of embedding coping mechanisms for stress, including perceived discrimination, in health interventions for young Black men to prevent or reduce depression.
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Affiliation(s)
- Keyonna M King
- Loma Linda University, Loma Linda, CA, USA.,University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Avni Desai
- Loma Linda University, Loma Linda, CA, USA
| | | | | | | | | | | | - Regina Idoate
- University of Nebraska Medical Center, Omaha, NE, USA
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7
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Fernandez CC, Benner AD. Psychological Resources as a Buffer Between Racial/Ethnic and SES-based Discrimination and Adolescents' Academic Well-being. J Youth Adolesc 2022; 51:599-613. [PMID: 35084688 PMCID: PMC9206839 DOI: 10.1007/s10964-022-01570-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/01/2022] [Indexed: 01/14/2023]
Abstract
While the detrimental consequences of racial/ethnic discrimination for adolescent well-being are well-established, less is known about the impact of SES-based discrimination and the potential protective benefits of adolescents' intraindividual assets. The current study addressed these gaps by investigating the longitudinal associations between racial/ethnic and SES-based educator-perpetrated discrimination and adolescents' academic well-being and assessed whether psychological resources moderated these pathways. To do so, the study used longitudinal data from a diverse sample of 750 9th grade students (54% female; 41% White, 34% Latina/o/x, 8% Asian American, 6% African American, 11% biracial/other race/ethnicity; 43% had parents with an associate's degree or less) in the Southwestern U.S. who were subsequently surveyed one year later. Educator-perpetrated racial/ethnic discrimination was negatively associated with students' school engagement, and both psychological resilience and self-efficacy emerged as protective for students' educational expectations in the face of racial/ethnic and SES-based discrimination, respectively. The results of the current study highlight the role of discriminatory treatment in educational disparities and provide insights on effective coping strategies to combat the negative impacts of discrimination in academics.
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Affiliation(s)
- Celeste C Fernandez
- The University of Texas at Austin, 108 E. Dean Keeton St., Stop A2702, Austin, TX, 78712, USA.
| | - Aprile D Benner
- The University of Texas at Austin, 108 E. Dean Keeton St., Stop A2702, Austin, TX, 78712, USA
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8
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Abstract
We reviewed research that examines racism as an independent variable and one or more health outcomes as dependent variables in Black American adults aged 50 years and older in the USA. Of the 43 studies we reviewed, most measured perceived interpersonal racism, perceived institutional racism, or residential segregation. The only two measures of structural racism were birth and residence in a "Jim Crow state." Fourteen studies found associations between racism and mental health outcomes, five with cardiovascular outcomes, seven with cognition, two with physical function, two with telomere length, and five with general health/other health outcomes. Ten studies found no significant associations in older Black adults. All but six of the studies were cross-sectional. Research to understand the extent of structural and multilevel racism as a social determinant of health and the impact on older adults specifically is needed. Improved measurement tools could help address this gap in science.
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9
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del Río-González AM, Mbaba M, Johnson C, Teti M, Massie JS, Bowleg L. Strengths despite stress: Social-structural stressors and psychosocial buffers of depressive symptoms among U.S. Black men. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2021; 92:133-143. [PMID: 34928641 PMCID: PMC9946130 DOI: 10.1037/ort0000595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
We examined the association between social-structural stressors-racial discrimination, incarceration, and unemployment-and depressive symptoms among 578 predominantly low-income urban Black men, ages 18-45. We also examined the extent to which two protective factors-social support and problem-solving coping-moderated the relationship between social-structural stressors and depressive symptoms. Results showed that more everyday racial discrimination and incarceration, but not unemployment, significantly predicted more depressive symptoms. The links between discrimination, incarceration, and depressive symptoms were stronger for men who reported lower levels of problem-solving coping and social support than those with higher levels. Our study suggests that interventions emphasizing protective factors may help Black men cope with some of the deleterious effects of racial discrimination and incarceration. It also underscores a need for structural interventions that reduce racial discrimination and incarceration. Depression among Black men is not simply a biomedical or psychological condition, but also a critical health equity issue. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | - Mary Mbaba
- Department of Psychological and Brain Sciences, The George Washington University
| | | | | | - Jenné S. Massie
- Department of Psychological and Brain Sciences, The George Washington University
| | - Lisa Bowleg
- Department of Psychological and Brain Sciences, The George Washington University
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10
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Goodwill JR, Taylor RJ, Watkins DC. Everyday Discrimination, Depressive Symptoms, and Suicide Ideation Among African American Men. Arch Suicide Res 2021; 25:74-93. [PMID: 31597538 DOI: 10.1080/13811118.2019.1660287] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Suicide has remained a leading cause of death among African American males, yet empirical investigations that focus on the experiences of this group are limited. Therefore, we aim to interrogate the impact of everyday discrimination as a risk factor for depressive symptoms and suicide ideation among African American men. Data were drawn from the African American male subsample of the National Survey of American Life (n = 1,271). Path analysis and tests for indirect effects were used to examine relationships between everyday discrimination, depressive symptoms, and suicide ideation. Three sources of everyday discrimination were examined (any everyday discrimination, race-based everyday discrimination, and other everyday discrimination). Study findings revealed that race-based everyday discrimination was the only type of discrimination that was significantly associated with both increased rates of depressive symptoms and suicide ideation. Further, the indirect effect from race-based everyday discrimination to suicide ideation via depressive symptoms was also statistically significant. Thus, the impact of daily encounters with discrimination extends beyond depressive symptoms and is related to higher rates of suicide ideation. Moreover, experiences with discrimination do not have to be overt to be harmful toward African American men's mental health. Culturally relevant suicide prevention interventions are needed to account for the role of discrimination in the lives of African American men.
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11
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Unemployment and Psychological Distress among Young People during the COVID-19 Pandemic: Psychological Resources and Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197163. [PMID: 33007892 PMCID: PMC7579061 DOI: 10.3390/ijerph17197163] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/23/2020] [Accepted: 09/27/2020] [Indexed: 12/24/2022]
Abstract
In the wake of COVID-19, unemployment and its potential deleterious consequences have attracted renewed interest. We examined (1) the association between unemployment, occurring upon the coronavirus outbreak, and psychological distress among Israeli young people (20–35-years-old); (2) the associations between various psychological resources/risk factors and psychological distress; and (3) whether these resources and risk factors were moderators in the unemployment-psychological distress link. A real-time survey based on snowball sampling was conducted during the month of April 2020 (N = 390). We employed hierarchical linear models to explore associations between unemployment, psychological resources, risk factors, and psychological distress. Unemployment was independently associated with greater psychological distress. Perceived trust, optimism, and sense of mastery decreased psychological distress, whereas financial strain and loneliness during the crisis increased this distress. The effect of unemployment on psychological distress did not depend on participants’ resource and risk factor levels. Policymakers must develop and extend health initiatives aimed at alleviating the mental health consequences of COVID-19-related unemployment and promote labor market interventions to help young job seekers integrate into employment. These measures, which are in line with the UN sustainable development goals, should be seen as an important route to promote public health.
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12
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Goodwill JR, Johnson NC, Watkins DC. Adherence to Masculine Norms and Depressive Symptoms in Young Black Men. SOCIAL WORK 2020; 65:235-244. [PMID: 32710114 DOI: 10.1093/sw/swaa029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/18/2019] [Accepted: 08/01/2019] [Indexed: 06/11/2023]
Abstract
Recent reports have highlighted disparities in representation of Black men within research, calling for more work to be done with this group. The authors take up this call by exploring whether adherence to masculine norms influences mental health outcomes among young Black men. The sample included survey responses from 18- to 30-year-old Black men (N = 273) enrolled at five colleges and universities in the midwestern United States. Two theoretically relevant subscales from the Conformity to Masculine Norms Inventory (that is, self-reliance and emotional control) were used to measure adherence to masculine norms, and depressive symptoms were measured using the Patient Health Questionnaire. Confirmatory factor analysis results indicate that the model fit the data well. Furthermore, self-reliance was associated with higher rates of depressive symptoms (β = .358, p < .001), but emotional control was not (β = .137, p = .099). Study findings suggest that depression treatment interventions should be tailored to incorporate aspects of masculinity that are most salient to young Black men. In addition, social work researchers, clinicians, and service providers are uniquely positioned to contribute to the promotion of mental wellness among this underserved population and should be prepared to attend to young Black men's mental health needs.
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Affiliation(s)
- Janelle R Goodwill
- are PhD candidates in social work and psychology, and is professor of social work, University of Michigan, Ann Arbor
| | - Natasha C Johnson
- are PhD candidates in social work and psychology, and is professor of social work, University of Michigan, Ann Arbor
| | - Daphne C Watkins
- are PhD candidates in social work and psychology, and is professor of social work, University of Michigan, Ann Arbor
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13
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Xu YE, Chopik WJ. Identifying Moderators in the Link Between Workplace Discrimination and Health/Well-Being. Front Psychol 2020; 11:458. [PMID: 32256433 PMCID: PMC7092632 DOI: 10.3389/fpsyg.2020.00458] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 02/27/2020] [Indexed: 12/18/2022] Open
Abstract
The stress that arises from workplace discrimination can have a large impact on an employee's work attitude, their work and life satisfaction, and oftentimes whether or not they stay in a job. Workplace discrimination can also have a considerable influence on employees' short- and long-term health. However, less is known about the factors that might mitigate or exacerbate the effects of discrimination on health. The current study focused not only on the links between workplace discrimination and health, and but also on the effects of potential moderators of the discrimination-health link (i.e., perceived control, Big Five personality traits, optimism, and coworker/supervisor support). People with high neuroticism, high extraversion and high agreeableness were more negatively affected by workplace discrimination than those low on neuroticism, extraversion, and agreeableness. Perceived control was found to be a protective factor, such that those high in perceived control had fewer chronic illnesses in the context of high levels of workplace discrimination.
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Affiliation(s)
| | - William J. Chopik
- Department of Psychology, Michigan State University, East Lansing, MI, United States
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14
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Hudson D, Sacks T, Irani K, Asher A. The Price of the Ticket: Health Costs of Upward Mobility among African Americans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1179. [PMID: 32069785 PMCID: PMC7068450 DOI: 10.3390/ijerph17041179] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 01/16/2020] [Accepted: 02/03/2020] [Indexed: 01/09/2023]
Abstract
There is a growing literature that has documented diminishing health returns on upward social mobility among Black Americans. Due to historical policies and practices, upward social mobility is often an arduous, isolating process for Black Americans, especially as they navigate predominately white educational and workplace settings. This paper advances the literature in several meaningful and innovative ways. The goal of this paper is to provide a qualitative account of the health costs of upward social mobility and describe how these costs could diminish health returns despite greater levels of socioeconomic resources. Focus groups and surveys were the data collection methods for the study. Inclusion criteria for the study were that respondents identified as African American or Black, were 24 years or older and had completed college. The total sample was 32 college-educated Black men (n = 12) and women (n = 20). The mean age for men was 39 (range = 26-50) and 33 years of age (range = 24-59) for women. Key findings highlighted in this paper include (1) hypervisibility and subsequent vigilance; (2) uplift stress; and (3) health costs associated with social mobility. The sum of these stressors is posited to affect multiple health outcomes and elucidate the mechanisms through which socioeconomic returns on health are diminished.
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Affiliation(s)
- Darrell Hudson
- Brown School of Social Work, Washington University, St. Louis, MO 63130, USA;
| | - Tina Sacks
- School of Social Welfare, University of California at Berkeley, Berkeley, CA 94720, USA;
| | - Katie Irani
- Brown School of Social Work, Washington University, St. Louis, MO 63130, USA;
| | - Antonia Asher
- School of Public Health, Tulane University, New Orleans, LA 70112, USA;
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15
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Bauer AG, Christensen K, Bowe-Thompson C, Lister S, Aduloju-Ajijola N, Berkley-Patton J. "We Are Our Own Counselor": Resilience, Risk Behaviors, and Mental Health Service Utilization among Young African American Men. Behav Med 2020; 46:278-289. [PMID: 32787722 PMCID: PMC7430196 DOI: 10.1080/08964289.2020.1729087] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Despite risk for trauma, subsequent mental health concerns, and poor health outcomes, young Black/African American men (YBM) are less likely to receive mental health services than other racial/ethnic groups. Despite the growing literature on resilience, there is less information on relationships between resilience, risk behaviors, and use of mental health services. This study sought to examine resilience, trauma-related risk behaviors, and receipt of mental health services among a sample of YBM who experienced trauma. Focus groups and a brief survey were conducted with YBM (N = 55) who had been exposed to at least one traumatic event (e.g., witnessing violence, experienced serious injury or illness) and were recruited from urban community settings (e.g., colleges/universities, barbershops, churches). Participants were an average age of 23 years (SD = 3.9; range 18-30) and experienced an average of 2 to 3 traumatic events (SD = 2.2). Trauma exposure was a significant predictor of risk factors (β = .513, p < .01). However, resilience did not significantly moderate this relationship. Resilience also did not predict receipt of mental health services. Culturally relevant qualitative themes found to be related to resilience included maintaining resilience autonomously, preferred coping methods (e.g., friends, music), and habituating to adversity. This study has potential to inform the development of culturally tailored, relevant interventions to promote engagement in mental health services among YBM who've experienced trauma.
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Affiliation(s)
- Alexandria G. Bauer
- Department of Psychology, University of Missouri-Kansas City, Kansas City, USA,Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, USA
| | - Kelsey Christensen
- Department of Psychology, University of Missouri-Kansas City, Kansas City, USA,Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, USA
| | - Carole Bowe-Thompson
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, USA
| | - Sheila Lister
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, USA
| | - Natasha Aduloju-Ajijola
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, USA
| | - Jannette Berkley-Patton
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, USA
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16
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Brownlow BN, Sosoo EE, Long RN, Hoggard LS, Burford TI, Hill LK. Sex Differences in the Impact of Racial Discrimination on Mental Health Among Black Americans. Curr Psychiatry Rep 2019; 21:112. [PMID: 31686220 DOI: 10.1007/s11920-019-1098-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
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.
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Affiliation(s)
- Briana N Brownlow
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Effua E Sosoo
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Risa N Long
- Department of Family Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Lori S Hoggard
- Department of Psychology, Rutgers-The State University of New Jersey, New Brunswick, NJ, USA
| | - Tanisha I Burford
- Department of Psychology, North Carolina Central University, Durham, NC, USA
| | - LaBarron K Hill
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Box 3119, Durham, NC, 27710, USA.
- Center for Biobehavioral Health Disparities Research, Duke University-Social Science Research Institute, Durham, NC, USA.
- Center for the Study of Aging and Human Development, Duke University Medical Center, Box 3119, Durham, NC, 27710, USA.
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Watkins DC. Improving the Living, Learning, and Thriving of Young Black Men: A Conceptual Framework for Reflection and Projection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081331. [PMID: 31013882 PMCID: PMC6518212 DOI: 10.3390/ijerph16081331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/09/2019] [Accepted: 04/10/2019] [Indexed: 11/16/2022]
Abstract
Black men experience disproportionate mental health challenges due to their exposure to severe psychosocial stressors. Yet, the mental health challenges of Black men have largely been left out of national conversations. Strong theoretical frameworks are important when generating dialogue about the mental health of Black men, as it helps to validate the work on a larger scale while also grounding the work for more practical use. This paper presents the conceptual framework for a five-year initiative aimed at improving the living, learning, and thriving of young Black men through a social media intervention that improves their mental health, expands their definitions of manhood, and helps them to engage in social support. The Young, Black Men, Masculinities, and Mental Health (YBMen) project is a social media-based, health promotion program that targets mental health (e.g., depressive symptoms), masculine norms (e.g., definitions of manhood), and social support for young Black men using culturally-sensitive, age-appropriate, and gender-specific popular culture. The YBMen project has been successfully implemented with over 150+ Black men since 2014; findings demonstrate improved mental health outcomes, progressive definitions of manhood, and stronger social relationships. Reflections from the past and projections for the future are discussed.
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Affiliation(s)
- Daphne C Watkins
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA.
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18
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Yoon E, Coburn C, Spence SA. Perceived discrimination and mental health among older African Americans: the role of psychological well-being. Aging Ment Health 2019; 23:461-469. [PMID: 29334233 DOI: 10.1080/13607863.2017.1423034] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Examine the effect of perceived discrimination (both racial and non-racial) on the mental health of older African Americans and explore the buffering role of psychological well-being (purpose in life and self-acceptance). METHODS Using an older African American subsample from the National Health Measurement Study (n = 397), multiple regression model by gender was used to estimate the effects of two types of discrimination (every day and lifetime) on SF-36 mental component and mediating role of two concepts of psychological well-being. RESULTS With no gender difference on the everyday discrimination, older men experienced more lifetime discrimination than older women. The older men's model found that the depressive symptomology was significantly explained by only everyday discrimination and mediated by self-acceptance. The older women's model was significant, with everyday discrimination and both self-acceptance and purpose in life emerging as mediating variables. DISCUSSION The prevalence of institutional lifetime discrimination for older African American men is consistent with previous research. Inconsistency with past research indicated that only everyday discrimination is statistically associated with depressive symptoms. Considering the buffering role of psychological well-being served for mental health problems, practitioners need to emphasize these factors when providing services to older African Americans. Equally important, they must address racial discrimination in mental health care settings.
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Affiliation(s)
- Eunkyung Yoon
- a School of Social Work , Jackson State University , Jackson , MS , USA
| | - Corvell Coburn
- a School of Social Work , Jackson State University , Jackson , MS , USA
| | - Susie A Spence
- b School of Social Work and Health Science , Jackson State University , Jackson , MS , USA
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Steers MLN, Chen TA, Neisler J, Obasi EM, McNeill LH, Reitzel LR. The buffering effect of social support on the relationship between discrimination and psychological distress among church-going African-American adults. Behav Res Ther 2019; 115:121-128. [PMID: 30415761 PMCID: PMC6409102 DOI: 10.1016/j.brat.2018.10.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/19/2018] [Accepted: 10/24/2018] [Indexed: 10/28/2022]
Abstract
Discrimination is a pervasive stressor among African-American adults. Social support is an important protective factor for psychological distress, especially among minority populations. Although a number of studies have examined social support in relation to discrimination, little research has examined how social support may serve as an important protective factor against both physical and psychological symptoms related to overall psychological distress within this group. The current study examined social support as a moderator of the relationship between discrimination and overall psychological distress as measured by the Brief Symptom Inventory among a community sample of 122 African-American church-going adults. Results indicated that social support buffered the associations of discrimination and overall psychological distress (p < 0.0001) in expected directions. Findings highlight the importance of cultivating strong social relationships to attenuate the effects of this social determinant on mental health disparities among this group.
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Affiliation(s)
- Mai-Ly N Steers
- The University of Houston, College of Liberal Arts and Social Sciences, Department of Psychology, 126 Heyne Building, Suite 104, Houston, TX, 77204, USA
| | - Tzu-An Chen
- The University of Houston, HEALTH Research Institute, 4849 Calhoun Road, Houston, TX, 77204, USA
| | - Julie Neisler
- University of Houston, Department of Psychological, Health, and Learning Sciences, 491 Farish Hall, Houston, TX, 77204-5029, USA
| | - Ezemenari M Obasi
- The University of Houston, HEALTH Research Institute, 4849 Calhoun Road, Houston, TX, 77204, USA; University of Houston, Department of Psychological, Health, and Learning Sciences, 491 Farish Hall, Houston, TX, 77204-5029, USA
| | - Lorna H McNeill
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Unit 1440, P.O. Box 301402, Houston, TX, 77230-1402, USA
| | - Lorraine R Reitzel
- The University of Houston, HEALTH Research Institute, 4849 Calhoun Road, Houston, TX, 77204, USA; University of Houston, Department of Psychological, Health, and Learning Sciences, 491 Farish Hall, Houston, TX, 77204-5029, USA.
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20
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Gayman MD, Lennox Kail B, Spring A, Greenidge GR. Risk and Protective Factors for Depressive Symptoms Among African American Men: An Application of the Stress Process Model. J Gerontol B Psychol Sci Soc Sci 2019; 73:219-229. [PMID: 29340702 DOI: 10.1093/geronb/gbx076] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives This study employs the stress process model (SPM) to identify risk/protective factors for mental health among adult African American men. Method Using a community-based sample of Miami, FL residents linked to neighborhood Census data, this study identifies risk/protective factors for depressive symptomatology using a sample of 248 adult African American men. Results The stress process variables independently associated with depressive symptoms were family support, mastery, self-esteem, chronic stressors, and daily discrimination. While mastery and self-esteem mediated the relationship between neighborhood income and depressive symptoms, perceived family support served as a buffer for stress exposure. Collectively, the SPM explains nearly half of the variability in depressive symptoms among African American men. Discussion The SPM is a useful conceptual framework for identifying psychosocial risk/protective factors and directing health initiatives and policies aimed at improving the psychological health of African American men.
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Affiliation(s)
| | | | - Amy Spring
- Department of Sociology, Georgia State University, Atlanta
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Nguyen AW, Chatters LM, Taylor RJ, Aranda MP, Lincoln KD, Thomas CS. Discrimination, Serious Psychological Distress, and Church-Based Emotional Support Among African American Men Across the Life Span. J Gerontol B Psychol Sci Soc Sci 2019; 73:198-207. [PMID: 29106656 DOI: 10.1093/geronb/gbx083] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 05/31/2017] [Indexed: 11/15/2022] Open
Abstract
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.
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Affiliation(s)
- Ann W Nguyen
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio
| | | | | | - María P Aranda
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles
| | - Karen D Lincoln
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles
| | - Courtney S Thomas
- Fielding School of Public Health, University of California, Los Angeles
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22
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Assari S. Education Attainment and Obesity:Differential Returns Based on Sexual Orientation. Behav Sci (Basel) 2019; 9:E16. [PMID: 30699932 PMCID: PMC6406256 DOI: 10.3390/bs9020016] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 02/06/2023] Open
Abstract
Background: Although high educational attainment is linked to better health and lower health risk behaviors, this effect may be systemically smaller for racial and ethnic minority groups compared to Whites. However, it is still unknown whether these diminished returns also apply to marginalization based on sexual orientation. Aims: In a national sample of adults which was composed of people of color, we compared straight and homosexual people for the association between education attainment and obesity. Methods: The Social Justice Sexuality Project (SJS-2010) is a cross-sectional national survey of health and wellbeing of predominantly people of color who identify as homosexual. The current analysis included 2884 adults (age 24 or more) who were either heterosexual (n = 260) or homosexual (n = 2624). The predictor variable was education attainment, and the outcome variable was obesity status (body mass index larger than 30 kg/m² [kilograms per meter squared]). Demographic factors (age and gender), household income, nativity (US born vs. immigrant), and health (self-rated health and current smoking) were the covariates. Sexual orientation was the moderator. Results: In the pooled sample, high education attainment was protective against obesity status. Sexual orientation interacted with education attainment on odds of obesity, which was suggestive of stronger protective effects of high education attainment against obesity for heterosexual than homosexual individuals. Conclusion: High education attainment better protects heterosexual than homosexual people against obesity, a pattern similar to what has been observed for comparison of Whites and non-Whites. Smaller protective effects of education attainment on health behaviors of marginalized people are possibly, due to prejudice and discrimination that they experience. Discrimination may minimize stigmatized individuals' abilities to mobilize their economic and human resources and translate them to tangible outcomes. This finding extends the Minorities' Diminished Returns theory, suggesting that it is not just race/ethnicity but possibly any marginalizing and stigmatizing social identity that results in diminished returns of socioeconomic status resources.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109-2700, USA.
- Center for Research on Ethnicity, Culture, and Health (CRECH), University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
- Department of Psychology, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA.
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23
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Matsuzaka S, Knapp M. Anti-racism and substance use treatment: Addiction does not discriminate, but do we? J Ethn Subst Abuse 2019; 19:567-593. [DOI: 10.1080/15332640.2018.1548323] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Sara Matsuzaka
- Fordham University Graduate School of Social Service, New York, New York
| | - Margaret Knapp
- Fordham University Graduate School of Social Service, New York, New York
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Interpersonal and institutional ethnic discrimination, and mental health in a random sample of Palestinian minority men smokers in Israel. Soc Psychiatry Psychiatr Epidemiol 2018; 53:1111-1122. [PMID: 29774378 DOI: 10.1007/s00127-018-1531-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/09/2018] [Indexed: 10/16/2022]
Abstract
PURPOSE We sought to extend research into the health effects of discrimination to a non-Western context. We examined the associations between interpersonal and institutional ethnic discrimination, and anxiety and depression among Palestinian-Arab minority men citizens of Israel. METHODS We used data from a nationwide stratified random sample of 964 Arab men in Israel, current or former smokers (age 18-64), who were interviewed as part of a 2012-2013 study on cessation. The questionnaire included an adapted Arabic version of the Experiences of Discrimination scale and a new scale on perceived institutional group discrimination. Logistic regression models estimated the effects of both forms of discrimination on depressive symptoms (Center for Epidemiological Studies Depression Scale) and anxiety (State-Trait Anxiety Inventory), while adjusting for socio-demographic and economic factors. RESULTS The prevalence of depressive symptoms was 24.7% and anxiety 45.5%. Approximately 42% of men reported experiencing interpersonal discrimination, and 50.8% reported perceived institutional group discrimination. Controlling for covariates, experiencing interpersonal discrimination was associated with higher odds for depressive symptoms [OR = 2.36, 95% confidence intervals (CI) = 1.69-1.57] and anxiety (OR = 1.92, 95% CI = 1.45-2.55). Perceived institutional group discrimination was associated only with anxiety (OR = 1.76, 95% CI = 1.32-2.35). Introducing both forms of discrimination into the same model slightly attenuated these associations. CONCLUSIONS Interpersonal and institutional forms of ethnic discrimination are independently associated with poorer mental health among Arab minority men current and former smokers in Israel. Future research is warranted into both forms of discrimination in the general Arab population in Israel, including women.
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Oh H, Noh H, Sims OT, Guo Y, Sawyer P. A comparison of urban and non-urban African American older adults on health-related characteristics. SOCIAL WORK IN HEALTH CARE 2018; 57:762-773. [PMID: 30118652 DOI: 10.1080/00981389.2018.1497748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Although residential geographic health disparities have been noted in the previous literature, studies are specifically lacking on intra-group health comparisons of African American older adults by residential geography. The purpose of this study was to determine if health-related characteristics of African American older adults varied by residential geography. Socioeconomic demographics, medical conditions, primary care use, and self-ratings of general health, social activity, and physical activity were compared in a community-dwelling sample of 327 urban and non-urban African American older adults. Urban and non-urban African American older adults were compared on health-related factors. Compared to urban African American older adults, those in non-urban areas had lower incomes, lower self-ratings of general health, social activity, and physical activity, and a higher frequency of arthritis and gastroenterological and urological conditions. Despite poorer general health and medical conditions, non-urban African American older adults were less likely to visit the doctor when needed. Study findings suggest residential geography may be an underappreciated underlying contributing factor to inter-group health disparities between African American and white older adults and not race alone. Therefore, social workers in public health, health care, and clinical settings should be aware of the interaction between race and residential geography.
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Affiliation(s)
- Hyejung Oh
- a Department of Social Work , California State University Bakersfield , Bakersfield , CA , USA
| | - Hyunjin Noh
- b School of Social Work , The University of Alabama , Tuscaloosa , AL , USA
| | - Omar T Sims
- c Department of Social Work , The University of Alabama at Birmingham , Birmingham , AL , USA
- d Department of Health Behavior , The University of Alabama at Birmingham , Birmingham , AL , USA
- e Comprehensive Center for Healthy Aging , The University of Alabama at Birmingham , Birmingham , AL , USA
- f Center for AIDS Research , The University of Alabama at Birmingham , Birmingham , AL , USA
| | - Yuqi Guo
- b School of Social Work , The University of Alabama , Tuscaloosa , AL , USA
| | - Patricia Sawyer
- g Division of Gerontology, Geriatrics, and Palliative Care , The University of Alabama at Birmingham , Birmingham , AL , USA
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Mays VM, Jones AL, Cochran SD, Taylor RJ, Rafferty J, Jackson JS. Chronicity and Mental Health Service Utilization for Anxiety, Mood, and Substance Use Disorders among Black Men in the United States; Ethnicity and Nativity Differences. Healthcare (Basel) 2018; 6:E53. [PMID: 29882853 PMCID: PMC6023328 DOI: 10.3390/healthcare6020053] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 05/14/2018] [Accepted: 05/14/2018] [Indexed: 11/16/2022] Open
Abstract
This study investigated ethnic and nativity differences in the chronicity and treatment of psychiatric disorders of African American and Caribbean Black men in the U.S. Data were analyzed from the National Survey of American Life, a population-based study which included 1859 self-identified Black men (1222 African American, 176 Caribbean Black men born within the U.S., and 461 Caribbean Black men born outside the U.S.). Lifetime and twelve-month prevalence of DSM-IV mood, anxiety, and substance use disorders (including Bipolar I and Dysthmia), disorder chronicity, and rate of mental health services use among those meeting criteria for a lifetime psychiatric disorder were examined. Logistic regression models were employed to determine ethnic differences in chronicity, and treatment utilization for disorders. While rates of DSM-IV disorders were generally low in this community sample of Black men, their disorders were chronic and remained untreated. Caribbean Black men born in the U.S. had higher prevalence of Post-Traumatic Stress Disorder, Major Depressive Disorder, and Alcohol Abuse Disorder compared with African American men. Foreign born Caribbean Black men experienced greater chronicity in Social Phobia and Generalized Anxiety Disorder compared to other Black Men. Utilization of mental health service was low for all groups of Black Men, but lowest for the foreign born Caribbean Black men. Results underscore the large unmet needs of both African American and Caribbean Black men in the United States. Results also highlight the role of ethnicity and nativity in mental disorder chronicity and mental health service utilization patterns of Black men.
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Affiliation(s)
- Vickie M Mays
- Departments of Psychology and Health Policy and Management, University of California, Los Angeles Fielding School of Public Health, Los Angeles, CA 90095, USA.
- UCLA Center for Bridging Research Innovation, Training and Education for Minority Health Disparities Solutions, Los Angeles, CA 90095, USA.
| | - Audrey L Jones
- Informatics, Decision-Enhancement and Analytic Sciences Center (IDEAS 2.0), Veteran Affairs Salt Lake City Health Care System, Salt Lake City, UT 84148, USA.
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA.
| | - Susan D Cochran
- UCLA Center for Bridging Research Innovation, Training and Education for Minority Health Disparities Solutions, Los Angeles, CA 90095, USA.
- Departments of Epidemiology and Statistics, University of California, Los Angele Fielding School of Public Health, Los Angeles, CA 90095, USA.
| | - Robert Joseph Taylor
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA.
- Program for Research on Black Americans, Institute of Social Research, Ann Arbor, MI 48106, USA.
| | - Jane Rafferty
- Program for Research on Black Americans, Institute of Social Research, Ann Arbor, MI 48106, USA.
| | - James S Jackson
- Program for Research on Black Americans, Institute of Social Research, Ann Arbor, MI 48106, USA.
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA.
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Assari S, Miller RJ, Taylor RJ, Mouzon D, Keith V, Chatters LM. Discrimination Fully Mediates the Effects of Incarceration History on Depressive Symptoms and Psychological Distress Among African American Men. J Racial Ethn Health Disparities 2018; 5:243-252. [PMID: 28405962 PMCID: PMC6556396 DOI: 10.1007/s40615-017-0364-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/21/2017] [Accepted: 03/23/2017] [Indexed: 10/19/2022]
Abstract
AIM Using a nationally representative sample of African American men, this study investigated the associations between lifetime history of incarceration, discrimination, and mental health (e.g., depressive symptoms and psychological distress). We hypothesized that discrimination would fully mediate the association between incarceration history and mental health outcomes among African American men. METHODS Using a cross-sectional design, our analysis included 1271 African American men who participated in the National Survey of American Life (NSAL), 2001-2003. Incarceration history was the main independent variable. Depressive symptoms and psychological distress were the dependent variables. Everyday discrimination was the mediator. Age, education, and income were covariates. Structural equation models (SEMs) were used for data analysis. RESULTS Among African American men, incarceration history was positively associated with perceived discrimination, depressive symptoms, and psychological distress. Everyday discrimination fully mediated the associations between incarceration history and both depressive symptoms and psychological distress. CONCLUSION Discrimination may play an important role in the mental health problems of African American men with a history of incarceration. These findings have public policy implications as well as clinical implications for mental health promotion of African American men. Policies that reduce preventable incarceration or at least reduce subsequent discrimination for those who have been incarcerated may enhance mental health of previously incarcerated African American men.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, 4250 Plymouth Road, SPC 5763, Ann Arbor, MI, 48109-2700, USA.
| | | | - Robert Joseph Taylor
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
- Program for Research on Black Americans, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Dawne Mouzon
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA
| | - Verna Keith
- Race and Ethnic Studies Institute, Texas A&M University, College Station, TX, USA
| | - Linda M Chatters
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
- Program for Research on Black Americans, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Watkins DC, Johnson NC. Age and Gender Differences in Psychological Distress among African Americans and Whites: Findings from the 2016 National Health Interview Survey. Healthcare (Basel) 2018; 6:E6. [PMID: 29342081 PMCID: PMC5872213 DOI: 10.3390/healthcare6010006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/10/2018] [Accepted: 01/11/2018] [Indexed: 01/12/2023] Open
Abstract
Previous studies report a race and mental health paradox: Whites score higher on measures of major depression compared to African Americans, but the opposite is true for psychological distress (i.e., African Americans score higher on distress measures compared to Whites). Independently, race, age, and gender outcomes for psychological distress are well documented in the literature. However, there is relatively little research on how psychological distress interferes with the lives of African Americans and Whites at the intersection of their various race, age, and gender identities. This study uses data from the 2016 National Health Interview Survey to examine age and gender differences in psychological distress and how much psychological distress interferes with the lives of African Americans and Whites. Our study findings are contrary to the paradox such that young White women (M = 3.36, SD = 1.14) and middle-aged White men (M = 2.55, SD = 3.97) experienced higher psychological distress than all other race, age, and gender groups. Psychological distress interference was relatively high among the high distress groups, except for older African American men (M = 1.73, SD = 1.05) and young African American women (M = 1.93, SD = 0.95). Implications for studies that consider cultural experiences of psychological distress, and how it impacts different demographic groups are discussed.
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Affiliation(s)
- Daphne C Watkins
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Natasha C Johnson
- School of Social Work and Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA.
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Wheaton FV, Thomas CS, Roman C, Abdou CM. Discrimination and Depressive Symptoms Among African American Men Across the Adult Lifecourse. J Gerontol B Psychol Sci Soc Sci 2018; 73:208-218. [PMID: 28977662 PMCID: PMC5927120 DOI: 10.1093/geronb/gbx077] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Indexed: 11/14/2022] Open
Abstract
Objectives A lifecourse framework was used to examine the association between major and everyday measures of perceived discrimination and depressive symptoms among African American men and to evaluate whether these relationships differed for young, middle-aged, and older men. Method The association between both major and everyday discrimination and depressive symptoms, as measured by the Center for Epidemiologic Studies Depression (CES-D) scale, was assessed among 296 African American men in the 2011-2014 Nashville Stress and Health Study (NSAHS) using ordinary least squares regression. Interactive associations between major and everyday discrimination and age patterns in the discrimination-depressive symptoms relationship were also investigated. Results Everyday, but not major discrimination was associated with depressive symptoms among African American men. This relationship was stronger among middle-aged men and diminished among older men. However, major discrimination, but not everyday discrimination, was associated with depressive symptoms of older men (age 55+), with greatest depressive symptomatology among those reporting both forms of discrimination. Discussion Everyday discrimination is a more consistent predictor, relative to major discrimination, of depressive symptoms among African American men across the lifecourse, although there were age and/or cohort differences. Findings also demonstrate the synergistic, or additive, impact of multiple forms of discrimination on mental health.
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Affiliation(s)
| | | | - Carly Roman
- Davis School of Gerontology, University of Southern California
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Watkins DC, Wharton T, Mitchell JA, Matusko N, Kales H. Perceptions and receptivity of non-spousal family support: A mixed methods study of psychological distress among older, church-going African American men. JOURNAL OF MIXED METHODS RESEARCH 2017; 11:487-509. [PMID: 28943829 PMCID: PMC5606206 DOI: 10.1177/1558689815622707] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The purpose of this study was to explore the role of non-spousal family support on mental health among older, church-going African American men. The mixed methods objective was to employ a design that used existing qualitative and quantitative data to explore the interpretive context within which social and cultural experiences occur. Qualitative data (n=21) were used to build a conceptual model that was tested using quantitative data (n= 401). Confirmatory factor analysis indicated an inverse association between non-spousal family support and distress. The comparative fit index, Tucker-Lewis fit index, and root mean square error of approximation indicated good model fit. This study offers unique methodological approaches to using existing, complementary data sources to understand the health of African American men.
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Mitchell JA, Watkins DC, Shires D, Chapman RA, Burnett J. Clues to the Blues: Predictors of Self-Reported Mental and Emotional Health Among Older African American Men. Am J Mens Health 2017; 11:1366-1375. [PMID: 26345400 PMCID: PMC5675209 DOI: 10.1177/1557988315600064] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The mental health needs of aging African American men have been overlooked and few studies have distinguished between more severe clinically diagnosable mental health challenges and less severe emotional states for this population. African American men may not identify with or internalize the terminology of "depression" despite exhibiting the symptom criteria. This exploratory cross-sectional study examined correlates of "downheartedness" as an alternative indicator of emotional health. The authors examined the self-reported responses of 1,666 older African American men on a baseline questionnaire from a larger longitudinal study. Demographic, physical, mental and emotional health, and health system factors were examined as possible correlates of downheartedness. The mean age of participants was 73.6 years and 74.8% of men described themselves as "downhearted and blue" most or all of the time while only 18.5% of them reported feeling moderate to severe anxiety or depression. When other factors were controlled, mobility problems (odds ratio [ OR] = 2.36), problems getting health care ( OR = 2.69), having a doctor who never listens ( OR = 2.18), physical or mental problems that interfere with social activities ( OR = 1.34), accomplishing less due to physical health ( OR = 1.35), and accomplishing less due to mental/emotional health ( OR = 1.57) were all associated with greater odds of being downhearted. The current findings indicate that this sample more closely identified with language accurately describing their emotional health state (i.e., downhearted) and not with clinical mental health terminology (i.e., depression) that may be culturally stigmatized.
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Rose T, Lindsey MA, Xiao Y, Finigan-Carr NM, Joe S. Mental Health and Educational Experiences Among Black Youth: A Latent Class Analysis. J Youth Adolesc 2017; 46:2321-2340. [PMID: 28755250 DOI: 10.1007/s10964-017-0723-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 07/14/2017] [Indexed: 11/30/2022]
Abstract
Disproportionately lower educational achievement, coupled with higher grade retention, suspensions, expulsions, and lower school bonding make educational success among Black adolescents a major public health concern. Mental health is a key developmental factor related to educational outcomes among adolescents; however, traditional models of mental health focus on absence of dysfunction as a way to conceptualize mental health. The dual-factor model of mental health incorporates indicators of both subjective wellbeing and psychopathology, supporting more recent research that both are needed to comprehensively assess mental health. This study applied the dual-factor model to measure mental health using the National Survey of American Life-Adolescent Supplement (NSAL-A), a representative cross-sectional survey. The sample included 1170 Black adolescents (52% female; mean age 15). Latent class analysis was conducted with positive indicators of subjective wellbeing (emotional, psychological, and social) as well as measures of psychopathology. Four mental health groups were identified, based on having high or low subjective wellbeing and high or low psychopathology. Accordingly, associations between mental health groups and educational outcomes were investigated. Significant associations were observed in school bonding, suspensions, and grade retention, with the positive mental health group (high subjective wellbeing, low psychopathology) experiencing more beneficial outcomes. The results support a strong association between school bonding and better mental health and have implications for a more comprehensive view of mental health in interventions targeting improved educational experiences and mental health among Black adolescents.
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Affiliation(s)
- Theda Rose
- School of Social Work, University of Maryland, 525W Redwood Street, Baltimore, MD, 21201, USA.
| | - Michael A Lindsey
- Silver School of Social Work, New York University, Ehrenkranz Center 1 Washington Square North, New York, NY, 10003, USA
| | - Yunyu Xiao
- Silver School of Social Work, New York University, Ehrenkranz Center 1 Washington Square North, New York, NY, 10003, USA
| | - Nadine M Finigan-Carr
- School of Social Work, University of Maryland, 525W Redwood Street, Baltimore, MD, 21201, USA
| | - Sean Joe
- George Warren Brown School of Social Work, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
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Latham-Mintus K, Vowels A, Huskins K. Healthy Aging Among Older Black and White Men: What Is the Role of Mastery? J Gerontol B Psychol Sci Soc Sci 2017; 73:248-257. [DOI: 10.1093/geronb/gbx105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 07/11/2017] [Indexed: 01/04/2023] Open
Affiliation(s)
- Kenzie Latham-Mintus
- Department of Sociology, Indiana University-Purdue University Indianapolis, Indianapolis, IN
| | - Ashley Vowels
- Department of Sociology, Indiana University-Purdue University Indianapolis, Indianapolis, IN
| | - Kyle Huskins
- Department of Sociology, Indiana University-Purdue University Indianapolis, Indianapolis, IN
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Keith VM, Nguyen AW, Taylor RJ, Mouzon DM, Chatters LM. Microaggressions, Discrimination, and Phenotype among African Americans: A Latent Class Analysis of the Impact of Skin Tone and BMI. SOCIOLOGICAL INQUIRY 2017; 87:233-255. [PMID: 28603300 PMCID: PMC5464745 DOI: 10.1111/soin.12168] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Data from the 2001-2003National Survey of American Life are used to investigate the effects of phenotype on everyday experiences with discrimination among African Americans (N=3343). Latent class analysis is used to identify four classes of discriminatory treatment: 1) low levels of discrimination, 2) disrespect and condescension, 3) character-based discrimination, and 4) high levels of discrimination. We then employ latent class multinomial logistic regression to evaluate the association between skin tone and body weight and these four classes of discrimination. Designating the low level discrimination class as the reference group, findings revealed that respondents with darker skin were more likely to be classified into the disrespect/condescension and the high level microaggression types. BMI was unrelated to the discrimination type, although there was a significant interaction effect between gender and BMI. BMI was strongly and positively associated with membership in the disrespect and condescension type among men but not among women. These findings indicate that skin tone and body weight are two phenotypic characteristics that influence the type and frequency of discrimination experienced by African Americans.
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Affiliation(s)
- Verna M Keith
- Department of Sociology, Race and Ethnic Studies Institute, 4351 TAMU, Texas A & M University, College Station, TX 77843-4351,
| | - Ann W Nguyen
- Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA 90015,
| | - Robert Joseph Taylor
- School of Social Work, Institute for Social Research, University of Michigan, Ann Arbor, MI 48109,
| | - Dawne M Mouzon
- Edward J. Bloustein School of Planning and Public Policy, Institute for Health, Health Care Policy, and Aging Research Rutgers, The State University of New Jersey, New Brunswick, NJ 08901,
| | - Linda M Chatters
- School of Public Health, School of Social Work, Institute for Social Research, University of Michigan Ann, Arbor MI 48109,
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English D, Bowleg L, Del Río-González AM, Tschann JM, Agans RP, Malebranche DJ. Measuring Black men's police-based discrimination experiences: Development and validation of the Police and Law Enforcement (PLE) Scale. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2017; 23:185-199. [PMID: 28080104 PMCID: PMC5783293 DOI: 10.1037/cdp0000137] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVES Although social science research has examined police and law enforcement-perpetrated discrimination against Black men using policing statistics and implicit bias studies, there is little quantitative evidence detailing this phenomenon from the perspective of Black men. Consequently, there is a dearth of research detailing how Black men's perspectives on police and law enforcement-related stress predict negative physiological and psychological health outcomes. This study addresses these gaps with the qualitative development and quantitative test of the Police and Law Enforcement (PLE) Scale. METHOD In Study 1, we used thematic analysis on transcripts of individual qualitative interviews with 90 Black men to assess key themes and concepts and develop quantitative items. In Study 2, we used 2 focus groups comprised of 5 Black men each (n = 10), intensive cognitive interviewing with a separate sample of Black men (n = 15), and piloting with another sample of Black men (n = 13) to assess the ecological validity of the quantitative items. For Study 3, we analyzed data from a sample of 633 Black men between the ages of 18 and 65 to test the factor structure of the PLE, as we all as its concurrent validity and convergent/discriminant validity. RESULTS Qualitative analyses and confirmatory factor analyses suggested that a 5-item, 1-factor measure appropriately represented respondents' experiences of police/law enforcement discrimination. As hypothesized, the PLE was positively associated with measures of racial discrimination and depressive symptoms. CONCLUSIONS Preliminary evidence suggests that the PLE is a reliable and valid measure of Black men's experiences of discrimination with police/law enforcement. (PsycINFO Database Record
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Affiliation(s)
- Devin English
- Department of Psychology, The George Washington University
| | - Lisa Bowleg
- Department of Psychology, The George Washington University
| | | | - Jeanne M Tschann
- Department of Psychiatry, University of California San Francisco School of Medicine
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Chae DH, Powell WA, Nuru-Jeter AM, Smith-Bynum MA, Seaton EK, Forman TA, Turpin R, Sellers R. The Role of Racial Identity and Implicit Racial Bias in Self-Reported Racial Discrimination: Implications for Depression Among African American Men. JOURNAL OF BLACK PSYCHOLOGY 2017; 43:789-812. [PMID: 29386696 PMCID: PMC5788304 DOI: 10.1177/0095798417690055] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Racial discrimination is conceptualized as a psychosocial stressor that has negative implications for mental health. However, factors related to racial identity may influence whether negative experiences are interpreted as instances of racial discrimination and subsequently reported as such in survey instruments, particularly given the ambiguous nature of contemporary racism. Along these lines, dimensions of racial identity may moderate associations between racial discrimination and mental health outcomes. This study examined relationships between racial discrimination, racial identity, implicit racial bias, and depressive symptoms among African American men between 30 and 50 years of age (n = 95). Higher racial centrality was associated with greater reports of racial discrimination, while greater implicit anti-Black bias was associated with lower reports of racial discrimination. In models predicting elevated depressive symptoms, holding greater implicit anti-Black bias in tandem with reporting lower racial discrimination was associated with the highest risk. Results suggest that unconscious as well as conscious processes related to racial identity are important to consider in measuring racial discrimination, and should be integrated in studies of racial discrimination and mental health.
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Assari S, Sonnega A, Pepin R, Leggett A. Residual Effects of Restless Sleep over Depressive Symptoms on Chronic Medical Conditions: Race by Gender Differences. J Racial Ethn Health Disparities 2017; 4:59-69. [PMID: 26823066 PMCID: PMC4965357 DOI: 10.1007/s40615-015-0202-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 12/07/2015] [Accepted: 12/29/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND Sleep and depression are comorbid problems that contribute to the development of chronic medical conditions (CMC) over time. Although racial and gender differences in the bidirectional associations between sleep, depression, and CMC are known, very limited information exists on heterogeneity of the residual effects of sleep problems over depressive symptoms on CMC across race by gender groups. AIM Using a life-course perspective, the present study compared race by gender groups for residual effects of restless sleep over depressive symptoms on CMC. METHODS We used data from waves 1 (year 1986), 4 (year 2001), and 5 (year 2011) of the Americans' Changing Lives Study (ACL). The study followed 294 White men, 108 Black men, 490 White women, and 237 Black women for 25 years. Restless sleep, depressive symptoms (Center for Epidemiological Studies-Depression scale [CES-D]), and number of chronic medical conditions (hypertension, diabetes, chronic lung disease, heart disease, stroke, cancer, and arthritis) were measured in 1986, 2001, and 2011. We employed multi-group cross-lagged modeling, with chronic medical conditions as the outcome and race by gender as the groups. RESULTS Major group differences were found in the residual effect of restless sleep on CMC over depressive symptoms across race by gender groups. Restless sleep in 2001 predicted CMC 10 years later in 2011 among Black women (standardized adjusted B = .135, P < .05) and White men (standardized adjusted = .145, P < .01) and White women (standardized adjusted B = .171, P < .001) but not Black men (standardized adjusted B = .001, P > .05). CONCLUSION Race by gender heterogeneity in the residual effect of restless sleep over depressive symptoms on CMC over 25 years suggests that comorbid poor sleep and depressive symptoms differently contribute to development of multi-morbidity among subpopulations based on the intersection of race and gender. Thus, interventions that try to prevent comorbid sleep problems and depression as a strategy to prevent medical conditions may benefit from tailoring based on the intersection of race and gender.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, SPC 5763, Ann Arbor, MI, 48109-2700, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Amanda Sonnega
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Renee Pepin
- Dartmouth Centers for Health and Aging, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
| | - Amanda Leggett
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, SPC 5763, Ann Arbor, MI, 48109-2700, USA
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Mouzon DM, McLean JS. Internalized racism and mental health among African-Americans, US-born Caribbean Blacks, and foreign-born Caribbean Blacks. ETHNICITY & HEALTH 2017; 22:36-48. [PMID: 27354264 DOI: 10.1080/13557858.2016.1196652] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVES The tripartite model of racism includes personally mediated racism, institutionalized racism, and the less-oft studied internalized racism. Internalized racism - or negative beliefs about one's racial group - results from cultural racism that is endemic in American society. In this project, we studied whether these negative stereotypes are associated with mental health among African-Americans and Caribbean Blacks. DESIGN Using secondary data from the National Survey of American Life, we investigated the association between internalized racism and mental health (measured by depressive symptoms and serious psychological distress (SPD)) among these two groups. We also explored whether ethnicity/nativity and mastery moderate the association between internalized racism and mental health among African-Americans and Caribbean Blacks. RESULTS Internalized racism was positively associated with depressive symptoms and SPD among all Black subgroups. However, internalized racism was a weaker predictor of SPD among foreign-born Caribbean Blacks than US-born Caribbean Blacks and US-born African-Americans. Additionally, higher mastery was protective against distress associated with internalized racism. CONCLUSION Internalized racism is an important yet understudied determinant of mental health among Blacks. Future studies should take into account additional heterogeneity within the Black population (e.g. African-born individuals) and other potential protective mechanisms in addition to mastery (e.g. self-esteem and racial identity).
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Affiliation(s)
- Dawne M Mouzon
- a Edward J. Bloustein School of Planning and Public Policy , Rutgers, The State University of New Jersey , New Brunswick , NJ , USA
- b Institute for Health, Health Care Policy, and Aging Research , Rutgers, The State University of New Jersey , New Brunswick , NJ , USA
| | - Jamila S McLean
- a Edward J. Bloustein School of Planning and Public Policy , Rutgers, The State University of New Jersey , New Brunswick , NJ , USA
- b Institute for Health, Health Care Policy, and Aging Research , Rutgers, The State University of New Jersey , New Brunswick , NJ , USA
- c Rutgers School of Public Health , Piscataway Township , NJ , USA
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Hankerson SH, Suite D, Bailey RK. Treatment disparities among African American men with depression: implications for clinical practice. J Health Care Poor Underserved 2016; 26:21-34. [PMID: 25702724 DOI: 10.1353/hpu.2015.0012] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A decade has passed since the National Institute of Mental Health initiated its landmark Real Men Real Depression public education campaign. Despite increased awareness, depressed African American men continue to underutilize mental health treatment and have the highest all-cause mortality rates of any racial/ethnic group in the United States. We review a complex array of socio-cultural factors, including racism and discrimination, cultural mistrust, misdiagnosis and clinician bias, and informal support networks that contribute to treatment disparities. We identify clinical and community entry points to engage African American men. We provide specific recommendations for frontline mental health workers to increase depression treatment utilization for African American men. Providers who present treatment options within a frame of holistic health promotion may enhance treatment adherence. We encourage the use of multidisciplinary, community-based participatory research approaches to test our hypotheses and engage African American men in clinical research.
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Powell W, Banks KH, Mattis JS. Buried hatchets, marked locations: Forgiveness, everyday racial discrimination, and African American men's depressive symptomatology. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2016; 87:646-662. [PMID: 27786503 PMCID: PMC5408301 DOI: 10.1037/ort0000210] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Everyday racial discrimination (ERD) is linked to pronounced depressive symptomatology among African American men. Yet, many African American men do not experience depressive symptoms following ERD exposure often because they use positive coping strategies that offset its effects. Granting forgiveness is 1 coping strategy associated with less depression. However, extant findings about the mental health benefits of forgiveness are somewhat mixed and pay scarce attention to offenses which are fleeting, historically rooted, and committed outside of close personal relationships. Evidence further suggest age-related differences in forgiveness, ERD exposure, and depressive symptoms. We explore the extent to which 3 strategies of granting forgiveness of ERD-letting go of negative emotion (negative release), embracing positive emotion (positive embrace), or combining both (combined)-are associated with less depressive symptomatology in 674 African American men (ages 18 through 79). Building on past findings, we also test whether these forgiveness strategies moderate the ERD-depressive symptoms relationship for men in different age groups (18 through 25, 26 through 39, and 40). Higher combined and negative release forgiveness were directly related to lower depressive symptoms among 18 through 25 year olds. We also detected a less pronounced positive relationship between ERD and depressive symptoms among men reporting high levels of combined (18 through 25 and 26 through 39 groups) and negative release (26 through 39 and 40+ groups) forgiveness. We observed a more pronounced positive ERD-depressive symptoms relationship among 18 through 25 and 26 through 39 year olds reporting lower forgiveness. When faced with frequent ERD, younger African American men may have the most difficult time burying hatchets without marking their location but experience more positive mental health benefits when they do. (PsycINFO Database Record
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Affiliation(s)
- Wizdom Powell
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | | | - Jacqueline S Mattis
- Department of Personality and Social Contexts, University of Michigan-Ann Arbor
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Assari S, Lankarani MM. Chronic Medical Conditions and Negative Affect; Racial Variation in Reciprocal Associations Over Time. Front Psychiatry 2016; 7:140. [PMID: 27605913 PMCID: PMC4996069 DOI: 10.3389/fpsyt.2016.00140] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 07/29/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The Black-White health paradox can be defined as lower frequency of depression despite higher prevalence of economic and social adversities as well as chronic medical conditions (CMC) among American Blacks compared to American Whites. Based on this paradox, the CMC - depressive symptoms link is expected to be weaker among Blacks than Whites. We conducted a 10-year longitudinal study to compare Blacks and Whites for bidirectional associations between number of CMC and negative affect over time. METHODS We used data from the MIDUS (Midlife in the United States), a nationally representative longitudinal study of American adults. A total number of 7,108 individuals with an age range of 25-75 years (N = 7,108) were followed for 10 years from 1995 to 2004. Age, gender, and socioeconomic status (education and income) were measured at baseline. Negative affect and CMC were measured at baseline (1995) and end of follow up (2004). Race was the moderator. Linear regression was used to test the moderating effect of race on the reciprocal associations between CMC and negative affect, net of covariates. RESULTS In the pooled sample, while baseline CMC was predictive of an increase in negative affect over time, baseline negative affect was also predictive of an increase in CMC. We found interactions between race and baseline CMC on change in depressive symptoms, as well as race with negative affect on CMC change, suggesting that the associations between CMC and negative affect are stronger for Whites in comparison to Blacks. CONCLUSION Blacks and Whites differ in reciprocal links between CMC and negative affect over time. This finding replicates recent studies on differential links between psychosocial factors and physical health based on race. Findings may help us better understand how Black-White health paradox develops across mid and later life.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Powell W, Adams LB, Cole-Lewis Y, Agyemang A, Upton RD. Masculinity and Race-Related Factors as Barriers to Health Help-Seeking Among African American Men. Behav Med 2016; 42:150-63. [PMID: 27337619 PMCID: PMC4979354 DOI: 10.1080/08964289.2016.1165174] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Men's tendency to delay health help-seeking is largely attributed to masculinity, but findings scarcely focus on African American men who face additional race-related, help-seeking barriers. Building principally on reactance theory, we test a hypothesized model situating racial discrimination, masculinity norms salience (MNS), everyday racism (ERD), racial identity, sense of control (SOC), and depressive symptomatology as key barriers to African American men's health help-seeking. A total of 458 African American men were recruited primarily from US barbershops in the Western and Southern regions. The primary outcome was Barriers to Help-Seeking Scale (BHSS) scores. The hypothesized model was investigated with confirmatory factor and path analysis with tests for measurement invariance. Our model fit was excellent [Formula: see text] CFI = 0.99; TLI = 1.00; RMSEA = 0.00, and 90% CI [0.00, 0.07] and operated equivalently across different age, income, and education strata. Frequent ERD and higher MNS contributed to higher BHHS scores. The relationship between ERD exposure and BHHS scores was partially mediated by diminished SOC and greater depressive symptomatology. Interventions aimed at addressing African American men's health help-seeking should not only address masculinity norms but also threats to sense of control, and negative psychological sequelae induced by everyday racism.
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Hudson DL, Neighbors HW, Geronimus AT, Jackson JS. Racial Discrimination, John Henryism, and Depression Among African Americans. JOURNAL OF BLACK PSYCHOLOGY 2016. [PMID: 27529626 DOI: 10.1177/00957984145677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Evidence from previous studies indicates that racial discrimination is significantly associated with depression and that African Americans with higher levels of socioeconomic status (SES) report greater exposure to racial discrimination compared to those with lower SES levels. Coping strategies could alter the relationship between racial discrimination and depression among African Americans. This study first examined whether greater levels of SES were associated with increased reports of racial discrimination and ratings of John Henryism, a measure of high-effort coping, among African Americans. Second, we examined whether high-effort coping moderated the relationship between racial discrimination and depression. Data were drawn from the National Survey of American Life Reinterview (n = 2,137). Analyses indicated that greater levels of education were positively associated with racial discrimination (p < .001) and increased levels of racial discrimination were positively related to depression (p < .001), controlling for all sociodemographic factors. Greater levels of John Henryism were associated with increased odds of depression but there was no evidence to suggest that the relationship between discrimination and depression was altered by the effects of John Henryism.
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Hudson DL, Neighbors HW, Geronimus AT, Jackson JS. Racial Discrimination, John Henryism, and Depression Among African Americans. JOURNAL OF BLACK PSYCHOLOGY 2016; 42:221-243. [PMID: 27529626 DOI: 10.1177/0095798414567757] [Citation(s) in RCA: 172] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Evidence from previous studies indicates that racial discrimination is significantly associated with depression and that African Americans with higher levels of socioeconomic status (SES) report greater exposure to racial discrimination compared to those with lower SES levels. Coping strategies could alter the relationship between racial discrimination and depression among African Americans. This study first examined whether greater levels of SES were associated with increased reports of racial discrimination and ratings of John Henryism, a measure of high-effort coping, among African Americans. Second, we examined whether high-effort coping moderated the relationship between racial discrimination and depression. Data were drawn from the National Survey of American Life Reinterview (n = 2,137). Analyses indicated that greater levels of education were positively associated with racial discrimination (p < .001) and increased levels of racial discrimination were positively related to depression (p < .001), controlling for all sociodemographic factors. Greater levels of John Henryism were associated with increased odds of depression but there was no evidence to suggest that the relationship between discrimination and depression was altered by the effects of John Henryism.
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Hudson DL, Eaton J, Lewis P, Grant P, Sewell W, Gilbert K. "Racism?!?… Just Look at Our Neighborhoods": Views on Racial Discrimination and Coping Among African American Men in Saint Louis. ACTA ACUST UNITED AC 2016; 24:130-150. [PMID: 33100801 DOI: 10.1177/1060826516641103] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Recent events in Ferguson underscore the need to better understand the unique challenges, stressors, and coping mechanisms of African American men. To this end, a focus group study was conducted in Saint Louis, a few miles from Ferguson. Although numerous stress-related themes were discussed, racial discrimination and structural racism emerged as pervasive stressors among these men. Participants described experiences of discrimination in multiple settings including workplace, school, and residential, and within the criminal justice system. Coping strategies included not only drinking and smoking but also religiosity and familial support. Men also mentioned that they found relief in simply discussing their stressors in a group setting. One implication of this study is to develop and implement group support models for this population.
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46
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Bowleg L, English D, Del Rio-Gonzalez AM, Burkholder GJ, Teti M, Tschann JM. 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). PSYCHOLOGY OF MEN & MASCULINITY 2016; 17:177-188. [PMID: 27087786 PMCID: PMC4827438 DOI: 10.1037/men0000026] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
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.
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Britt-Spells AM, Slebodnik M, Sands LP, Rollock D. Effects of Perceived Discrimination on Depressive Symptoms Among Black Men Residing in the United States: A Meta-Analysis. Am J Mens Health 2016; 12:52-63. [PMID: 26742988 DOI: 10.1177/1557988315624509] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Research reports that perceived discrimination is positively associated with depressive symptoms. The literature is limited when examining this relationship among Black men. This meta-analysis systematically examines the current literature and investigates the relationship of perceived discrimination on depressive symptoms among Black men residing in the United States. Using a random-effects model, study findings indicate a positive association between perceived discrimination and depressive symptoms among Black men ( r = .29). Several potential moderators were also examined in this study; however, there were no significant moderation effects detected. Recommendations and implications for future research and practice are discussed.
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Nadimpalli SB, James BD, Yu L, Cothran F, Barnes LL. The association between discrimination and depressive symptoms among older African Americans: the role of psychological and social factors. Exp Aging Res 2015; 41:1-24. [PMID: 25494668 DOI: 10.1080/0361073x.2015.978201] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
UNLABELLED BACKGROUND/STUDY CONTEXT: Several studies have demonstrated a link between perceived discrimination and depression in ethnic minority groups, yet most have focused on younger or middle-aged African Americans and little is known about factors that may moderate the relationship. METHODS Participants were 487 older African Americans (60-98 years old) enrolled in the Minority Aging Research Study. Discrimination, depressive symptoms, and psychological and social resources were assessed via interview using validated measures. Ordinal logistic regression models were used to assess (1) the main relationship between discrimination and depression and (2) resilience, purpose in life, social isolation, and social networks as potential moderators of this relationship. RESULTS In models adjusted for age, sex, education, and income, perceived discrimination was positively associated with depressive symptoms (odds ratio [OR]: 1.20, 95% confidence interval [CI]: 1.10-1.31; p < .001). However, there was no evidence of effect modification by resilience, purpose in life, social isolation, or social networks (all ps ≤ .05). CONCLUSION Findings provide support for accumulating evidence on the adverse mental health effects of discrimination among older African Americans. Because the association was not modified by psychological or social factors, these findings do not support a role for a buffering effect of resources on discrimination and depressive symptoms. Further studies are needed to examine a wider range of coping resources among older adults.
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Rudman LA, McLean MC. The role of appearance stigma in implicit racial ingroup bias. GROUP PROCESSES & INTERGROUP RELATIONS 2015. [DOI: 10.1177/1368430215583152] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Minority groups who show implicit outgroup preference (African Americans, the elderly, and the overweight) are also likely to suffer from appearance stigma (for deviating from cultural aesthetic norms; Goffman, 1963). Three studies showed that people who automatically preferred Whites using the attitude Implicit Association Test (IAT) also associated Whites more than Blacks with attractiveness using the aesthetic IAT. In Study 1, the aesthetic IAT covaried with Black American’s preference for Black women with chemically treated versus natural hair, and rating products that purchase “racial capital” (e.g., skin whiteners) as important and useful. In Study 2, Black American’s pro-White bias was only eliminated when the attitude IAT represented their group as more attractive than Whites (i.e., when appearance stigma was reversed). Further, the aesthetic IAT predicted the attitude IAT more uniquely than outgroup contact. In concert, the findings suggest that appearance stigma is an overlooked factor influencing racial asymmetries in automatic ingroup esteem.
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Assari S, Burgard S, Zivin K. Long-Term Reciprocal Associations Between Depressive Symptoms and Number of Chronic Medical Conditions: Longitudinal Support for Black–White Health Paradox. J Racial Ethn Health Disparities 2015; 2:589-97. [DOI: 10.1007/s40615-015-0116-9] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 04/15/2015] [Accepted: 04/23/2015] [Indexed: 12/01/2022]
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