How old do I look? Aging appearance and experiences of aging among U.S. adults ages 50-80

Appearance is an indicator of age and life stage, which are linked to socially salient stereotypes and prejudices. Older adults' appearance-related perceptions and behaviors may affect their experiences of aging within broader society, which may in turn influence health. This study examined associations between two measures related to aging appearance-assessment of one's aging appearance relative to same-age peers and investing time or effort to look younger-positive and negative experiences of aging, and health using multivariable regression. Cross-sectional data were from a nationally representative sample of 2006 U.S. adults ages 50-80 (Mage = 63, 52% women, 71% White) who completed Wave 6 of the National Poll on Healthy Aging in 2019. The majority (59%) reported appearing relatively younger than peers, while fewer reported appearing the same age (35%) or older (6%). About a third (35%) reported investing in looking younger. Appearing relatively younger was associated with more positive (p < .001) and less negative experiences of aging (p = .019). Appearing relatively older showed the opposite relationships (p values < .001). Investing in looking younger was associated with more positive and more negative experiences of aging (p values < .001). Few sociodemographic variations were detected. More positive and less negative experiences of aging were associated with better physical and mental health (p values < .001). While aging appearance is often the basis for jokes, it may affect the quality of older adults' experiences of aging and associated health outcomes. Nuanced findings caution against framing youthful biases in aging appearance and investments in looking younger as solely negative (or positive). (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Aging Stigma and the Health of US Adults Over 65: What Do We Know?

This narrative review assessed the current state of research on aging stigma and health relevant to US adults ages 65 and older. We adopted a stigma framework to highlight aging stigma as a meaningful social construct and the complex ways in which it may be harmful for health. We identified 29 studies of various types (experimental, intervention, cross-sectional quantitative, longitudinal quantitative, and qualitative) published between 2010 and 2023 that investigated relationships between concepts related to aging stigma and health. Aging stigma was associated with poor short- and long-term health outcomes spanning cognition, psychological wellbeing, physical health, and hospitalizations. The premise that aging stigma is harmful to health was moderately well supported, while evidence that health influenced aging stigma was weak. Collectively, studies provided insight into several mechanisms through which aging stigma may affect the health of older US adults, while also highlighting areas for future research. Potential strategies for addressing aging stigma as a public health hazard were discussed.

Multiple forms of discrimination and inflammation in Black Americans: Are there differences by sex?

RATIONALE

Discrimination is a risk factor and potential pathway through which social determinants such as race and sex contribute to chronic inflammation in Black Americans in middle and later adulthood. Questions remain regarding which forms of discrimination are most salient for inflammatory dysregulation, and whether there are sex-based differences in these pathways.

OBJECTIVE

This exploratory study investigates sex differences in the relationships between four forms of discrimination and inflammatory dysregulation among middle aged and older Black Americans.

METHODS

Using cross-sectionally linked data from participants in the Midlife in the United States (MIDUS II) Survey (2004-2006) and Biomarker Project (2004-2009) (N = 225, ages 37-84, 67% female), this study conducted a series of multivariable regression analyses. Inflammatory burden was measured using a composite indicator comprised of five biomarkers: C-reactive protein (CRP), interleukin-6 (IL-6), fibrinogen, E-selectin, and intercellular adhesion molecule (ICAM). Discrimination measures were lifetime, daily, and chronic job discrimination and perceived inequality at work.

RESULTS

Black men generally reported higher levels of discrimination than Black women (3 out of 4 forms), though only sex differences in job discrimination achieved statistical significance (p < .001). In contrast, Black women exhibited more overall inflammatory burden than Black men (2.09 vs. 1.66, p = .024), particularly elevated levels of fibrinogen (p = .003). Lifetime discrimination and inequality at work were associated with higher levels of inflammatory burden, after adjusting for demographic and health factors (p = .057 and p = .029, respectively). The discrimination-inflammation relationships further varied by sex, such that more lifetime and job discrimination predicted greater inflammatory burden in Black women, but not in Black men.

CONCLUSION

These findings highlight the potentially detrimental impact of discrimination and emphasize the importance of sex-specific research on biological mechanisms of health and health disparities in Black Americans.

Differences and Disparities in Ageism Affecting Older US Adults: A Review

Purpose of Review

This review summarizes findings from quantitative research studies published between 2010 and 2022 providing insight on sociodemographic differences and disparities in ageism among US adults ages 50 and older.

Findings

Across 21 studies, disparities in ageism were more consistently found such that those who were older (57% of studies), with less education (64%), and of lower socioeconomic status (100%) reported more ageism than their counterparts. Amount of ageism did not differ by sex in the majority (71%) of studies. Findings regarding race/ethnicity were mixed. Other possible differences in ageism, assessed in a small number of studies, were patterned by employment characteristics, geographic residence, religiosity, and political affiliation but not by marital or employment status.

Summary

Given that ageism is both common and associated with poor health outcomes, identifying disproportionately affected segments of the older adult population is a necessary prerequisite for developing targeted interventions to reduce negative outcomes linked to ageism and associated health disparities. Evidence within this review suggests that the patterning of ageism may deviate from that typically documented for other social and structural disadvantages. Some groups traditionally considered to be socially marginalized were found to report more ageism while others did not.

THE ROLE OF SYSTEMIC INFLAMMATION IN HEALTH NOW, LATER, AND CHANGE OVER TIME: EVIDENCE FROM MIDUS

Systemic inflammation is theorized to be a biological pathway through which chronic stressors (e.g., discrimination, social marginalization) contribute to adverse health outcomes and disparities among older adults. Cross sectional research documents associations between inflammation and a broad array of health outcomes. Less is known about whether and how inflammation may influence health longitudinally. This study investigated whether a composite measure of inflammatory burden predicted physical health: a) concurrently, b) approximately 7 years later, and c) changes during that time. Data derive the National Survey of Midlife in the United States (MIDUS) participants who provided inflammatory biomarker data (2004-2009 Biomarker study) and health data in MIDUS 2 (2004-2006) and MIDUS 3 (2013-2014) (N=931, Mage 57, 45% male, 91% White). Inflammatory burden reflected the number of inflammatory biomarkers in the highest risk quartile, out of five: C-reactive protein, interleukin-6, fibrinogen, E-selectin, and intracellular adhesion molecule. Three general indicators of physical health were examined: number of commonplace chronic physical health conditions, out of 7; functional limitations; and self-rated physical health. Multivariate regression analyses indicated that inflammatory burden predicted all three concurrent physical health outcomes and the same health outcomes seven years later (p-values &lt;.02). Inflammatory burden was unrelated to changes in these outcomes over time. This study adds to the literature on stress-related biological mechanisms of health and identifies a potential clinical indicator of enduring health problems. It also suggests that while inflammatory burden may demonstrate consistent relationships with physical health over time, other mechanisms may account for health changes and deterioration.

Experiences of Everyday Ageism and the Health of Older US Adults

Importance

Major incidents of ageism have been shown to be associated with poorer health and well-being among older adults. Less is known about routine types of age-based discrimination, prejudice, and stereotyping that older adults encounter in their day-to-day lives, known as everyday ageism.

Objective

To examine the prevalence of everyday ageism, group differences and disparities, and associations of everyday ageism with indicators of poor physical and mental health.

Design, Setting, and Participants

This cross-sectional study was conducted using survey data from the December 2019 National Poll on Healthy Aging among a nationally representative household sample of US adults ages 50 to 80 years. Data were analyzed from November 2021 through April 2022.

Exposures

Experiences of everyday ageism were measured using the newly developed multidimensional Everyday Ageism Scale.

Main Outcomes and Measures

Fair or poor physical health, number of chronic health conditions, fair or poor mental health, and depressive symptoms.

Results

Among 2035 adults ages 50 to 80 years (1047 [54.2%] women; 192 Black [10.9%], 178 Hispanic [11.4%], and 1546 White [71.1%]; mean [SD] age, 62.6 [8.0] years [weighted statistics]), most participants (1915 adults [93.4%]) reported regularly experiencing 1 or more forms of everyday ageism. Internalized ageism was reported by 1664 adults (81.2%), ageist messages by 1394 adults (65.2%), and interpersonal ageism by 941 adults (44.9%). Mean Everyday Ageism Scale scores were higher for several sociodemographic groups, including adults ages 65 to 80 years vs those ages 50 to 64 years (11.23 [95% CI, 10.80-11.66] vs 9.55 [95% CI, 9.26-9.84]) and White (10.43 [95% CI, 10.20-10.67]; P < .001) and Hispanic (10.09 [95% CI, 9.31-10.86]; P = .04) adults vs Black adults (9.23 [95% CI, 8.42-10.03]). Higher levels of everyday ageism were associated with increased risk of all 4 negative physical and mental health outcomes examined in regression analyses (with odds ratios [ORs] per additional scale point as high as 1.20 [95% CI, 1.17-1.23] for depressive symptoms and b = 0.039 [95% CI, 0.029-0.048] for chronic health conditions; P values < .001). Internalized ageism was the category associated with the greatest increase in risk of poor outcomes for all health measures (with ORs per additional scale point as high as 1.62 [95% CI, 1.49-1.76] for depressive symptoms and b = 0.063 [95% CI, 0.034-0.092] for chronic health conditions; P values < .001).

Conclusions and Relevance

This study found everyday ageism to be prevalent among US adults ages 50 to 80 years. These findings suggest that commonplace ageist messages, interactions, and beliefs may be harmful to health and that multilevel and multisector efforts may be required to reduce everyday ageism and promote positive beliefs, practices, and policies related to aging and older adults.

Mechanisms of Cardiometabolic Health Outcomes and Disparities: What Characteristics of Chronic Stressors are Linked to HPA-Axis Dysregulation?

Objectives: Chronic stressors are associated with cardiometabolic health conditions and disparities. Mechanisms linking stressors and health remain poorly understood. Methods: Two cohort studies (Cardiac Rehabilitation And The Experience [CREATE] and Tracking Risk Identification for Adult Diabetes [TRIAD]) with harmonized variables were used to examine relationships between six types of chronic stressors in adulthood and Hypothalamic-Pituitary-Adrenal (HPA) axis dysregulation, as indicated by blunted diurnal cortisol slopes, which are stress-sensitive biomarkers implicated in cardiometabolic health (merged N = 213, mean age 61, 18% Black). A secondary aim was to explore whether these chronic stressors accounted for Black-White disparities in HPA axis regulation. Results: Some chronic stressors were linked to HPA axis dysregulation, with recent stressors most salient (b = 0.00353, SE = 0.00133, p = .008). Black-White disparities in HPA axis regulation persisted after controlling for racial differences in chronic stressors, which reduced the disparity 11.46%. Discussion: Chronic stressors in adulthood may increase risk for HPA axis dysregulation and associated cardiometabolic health outcomes but may not be a key factor in racial disparities.

Promoting sustained diabetes management: Identifying challenges and opportunities in developing an alumni peer support component of the YMCA Diabetes Control Program

OBJECTIVE

To explore the perspectives of coaches and participant alumni of the YMCA Diabetes Control Program (DCP) to inform the development of a peer support component of the DCP for sustained diabetes self-management.

METHODS

Coaches (n = 2) and alumni (n = 38) participated in semi-structured interviews and focus groups regarding their experiences with the DCP and anticipated challenges and strengths of incorporating alumni peer support into the program. Transcripts were analyzed using content analysis to identify topics related to peer support.

RESULTS

Six topics emerged related to strengths and weaknesses of the coach and peer roles, including how those roles influenced motivation and accountability in self-management. Both roles provide encouragement for sustained behavior change, particularly in the face of setbacks. Interest in becoming an alumni peer supporter was strongly related to a sense of reciprocity and potential for mutual benefit, while concerns centered on unclear expectations and a desire for formal training.

CONCLUSION

Program alumni saw value in continued formal contact not only with their coaches, but with fellow peers, as part of their sustained diabetes self-management and anticipated reciprocal benefits.

PRACTICE IMPLICATIONS

Findings illustrate opportunities for, and the value of, incorporating alumni peer support into hierarchical coach-led diabetes self-management programs.

The Everyday Ageism Scale: Development and Evaluation

OBJECTIVES

Older adults regularly encounter age-based discrimination and stereotyping in their day-to-day lives. Whether this type of routine ageism negatively affects their health and well-being is unclear, in part due to the absence of validated scales that comprehensively measure this phenomenon and distinguish it from other sources of everyday discrimination.

METHODS

This study describes the development of a novel scale, the Everyday Ageism Scale, and its psychometric evaluation using a nationally representative sample of US adults age 50-80 from the December 2019 National Poll on Healthy Aging (N = 2012).

RESULTS

Exploratory factor analysis indicated a 3-factor structure comprised of ageist messages, ageism in interpersonal interactions, and internalized ageism. The ten-item scale was psychometrically sound and demonstrated good internal reliability.

DISCUSSION

Everyday ageism is a multidimensional construct. Preliminary evaluation of the Everyday Ageism Scale suggests its utility in future studies examining the prevalence of everyday ageism and its relationships with health.

Positive Attributes of Aging and Connections to Health: Evidence From the National Poll on Healthy Aging

This study explored the prevalence of positive attributes of aging among older adults in a nationally representative sample age 50-80 ((N=2,048, 52% female, 71% White). Nearly 70% of older adults reported that people sought their guidance because of their wisdom and experience. Older adults reported that, as they have gotten older, they have become more comfortable with themselves (88%), have a strong sense of purpose (80%), feel more positively about aging (67%), and have found their life to be better than they had thought it would be (65%). Over half (52%) of those who said their lives were better than they thought reported very good or excellent physical health. Among those who disagreed, only one out of four (25%) reported very good/excellent physical health; similar results were found for mental health (48% vs. 22%). This session will describe positive attributes of aging and their association to physical and mental health.

Mechanisms of Cardiometabolic Disparities: Stressor Characteristics Linked to HPA-Axis Dysregulation

Diurnal cortisol slopes are stress-sensitive HPA-axis biomarkers implicated in cardiometabolic health outcomes and disparities. This study used two longitudinal cohort studies (CREATE and TRIAD) with harmonized variables to comprehensively examine what types of exposure to stressors are most salient for cortisol dysregulation in later life, and whether the characteristics of stressor exposure accounts for Black-White disparities in cortisol dysregulation (merged sample N=209, 65% male, mean age 61, 17% Black). Black participants reported greater stressor exposure than Whites along some dimensions (e.g., # recent major stressors, appraised severity of lifetime stressors, all p&lt;.02) but comparable exposure in others (e.g., # of lifetime stressors and life domains). Stressor exposure measures that captured psychological components (i.e., appraised severity, psychological distress) and pervasiveness (i.e., # life domains with major stressors) were more closely related to cortisol dysregulation than more objective measures (e.g., # of recent /lifetime stressors). Everyday discrimination was associated with racial disparities.

Everyday Ageism and Health: Evidence From the National Poll on Healthy Aging

This study examined the prevalence of everyday ageism, routine types of age-based discrimination, prejudice, and stereotyping that older adults encounter in their daily lives, and its relationships with health in a nationally representative sample age 50-80 (N=2,048, 52% female, 71% White). Nearly all older adults said they sometimes or often experienced everyday ageism (96% age 65-80, 92% age 50-64). The most common types were beliefs that health problems were an inevitable part of getting older (78%), hearing jokes about aging/older people (61%), and seeing material suggesting that older adults were unattractive/undesirable (38%). Those reporting more experiences with everyday ageism (>3 types) were less likely than those reporting fewer types to have excellent/very good physical health (31% vs. 50%); similar results were found for mental health (60% vs. 80%). This poll documented the ubiquity of minor, but not inconsequential, everyday ageism reported by older adults and its potential ramifications for health.

Mechanisms of Racial Health Disparities: Relationships between Coping and Psychological and Physiological Stress Responses

Objective

Psychological distress and physiological dysregulation represent two stress response pathways linked to poor health and are implicated in racial disparities in aging-related health outcomes among US men. Less is known about how coping relates to these stress responses. The purpose of this exploratory study was to examine whether midlife and older men's coping strategies and behaviors accounted, in part, for Black-White disparities in men's psychological and physiological stress responses.

Methods

We examined racial differences in 12 coping strategies (COPE Inventory subscales, religious/spiritual coping, and behaviors such as stress eating and substance use) and their relationships with psychological distress (Negative Affect scale) and physiological dysregulation (blunted diurnal cortisol slopes) using regression models and cross-sectional data from 696 Black and White male participants aged 35-85 years in the National Survey of Midlife Development in the United States (MIDUS) II, 2004-2006.

Results

Black men exhibited more psychological distress and physiological dysregulation than White men. Black and White men reported comparable use of most coping strategies, none of which demonstrated similar relationships with both stress responses. Coping strategies explained variations in psychological distress consistent with conventional protective-harmful categorizations. Coping accounted for racial disparities in men's psychological distress, as Black men reported using harmful strategies more often and were more susceptible to their negative effects. Neither differential use of coping strategies nor differing relationships accounted for racial disparities in physiological dysregulation.

Conclusions

Findings revealed complex relationships between coping and psychological and physiological stress responses and suggest the importance of differing approaches to reducing associated racial health disparities among men.

Cortisol and Racial Health Disparities Affecting Black Men in Later Life: Evidence From MIDUS II

In the United States, Black men have poorer overall health and shorter life spans than most other racial/ethnic groups of men, largely attributable to chronic health conditions. Dysregulated patterns of daily cortisol, an indicator of hypothalamic–pituitary–adrenal (HPA) axis stress–response functioning, are linked to poor health outcomes. Questions remain regarding whether and how cortisol contributes to Black–White differences in men’s health. This exploratory study compared early day changes in cortisol levels (diurnal cortisol slopes from peak to pre-lunch levels) and their associations with medical morbidity (number of chronic medical conditions) and psychological distress (Negative Affect Scale) among 695 Black and White male participants in the National Survey of Midlife in the United States (MIDUS II, 2004–2009). Black men exhibited blunted cortisol slopes relative to White men (−.15 vs. −.21, t = −2.97, p = .004). Cortisol slopes were associated with medical morbidity among Black men (b = .050, t = 3.85, p < .001), but not White men, and were unrelated to psychological distress in both groups. Findings indicate cortisol may contribute to racial health disparities among men through two pathways, including the novel finding that Black men may be more vulnerable to some negative health outcomes linked to cortisol. Further, results suggest that while cortisol may be a mechanism of physical health outcomes and disparities among older men, it may be less important for their emotional health. This study increases understanding of how race and male sex intersect to affect not only men’s lived experiences but also their biological processes to contribute to racial health disparities among men in later life.

An Online Behavioral Health Intervention Promoting Mental Health, Manhood, and Social Support for Young Black Men: The YBMen Project

Conventional definitions of mental health, manhood, and social support create barriers to accessing behavioral health care for Black men ages 18 to 30. Targeted behavioral health interventions sensitive to culture, social norms, and gender that circumvent these barriers are desperately needed to improve access and integrated care for this group. This article reports mixed methods findings from the 2017 iteration of the Young Black Men, Masculinities, and Mental Health (YBMen) project, a social media-based, psychoeducational program that promotes mental health, progressive definitions of manhood, and sustainable social support for Black men. Young Black men (n = 350) across two universities in the Midwest completed baseline surveys on their mental health, definitions of manhood, and social support. Forty of the men participated in the YBMen intervention and at postintervention reported experiencing fewer depressive symptoms on the Patient Health Questionnaire (PHQ-9, Z = -2.05, p < .01) and the Gotland Male Depression Scale (GMDS; Z = -1.76, p < .05). There were also changes on the Conformity to Masculine Norms Inventory (CMNI) for Self-Reliance (Z = -0.34, p = .26) and Heterosexual Self-Presentation (Z = -0.18, p = .59), though these changes were not statistically significant. A qualitative review of postintervention interviews revealed participants' appreciation of the YBMen project and its influence on their mental health, manhood, and social support. Programmatic efforts that support the behavioral health, positive development, and social relationships of Black men translate into positive families, communities, and experiences as they live, learn, love, and work over the life course.

Engaging Underserved Community Members in Diabetes Self-Management: Evidence From the YMCA of Greater Richmond Diabetes Control Program

PURPOSE

The purpose of this study was to identify factors influencing participant engagement in a community-based diabetes self-management program (DSMP), with a focus on the needs of underserved groups (eg, racial/ethnic minorities, low income).

METHODS

Focus groups were conducted with participants (n = 22) from the YMCA of Greater Richmond's Diabetes Control Program, who were recruited using a purposeful sampling frame to capture a range of experiences. In-depth interviews were conducted with lay health coaches (n = 3). The RADaR qualitative analysis technique was used to identify themes related to factors across the continuum of engagement.

RESULTS

Fear affected program enrollment and retention in complex ways. Peers and coaches were important for social support and accountability. The length of the program (12 weeks), accessible information, practical skill building, and emphasis on making small, feasible improvements in pursuit of larger goals were identified as critical for engagement and improving diabetes self-management. Health and outside obligations were the major barriers to program attendance.

CONCLUSIONS

Participant and coach perspectives provide important insight into existing strengths of community-based DSMPs that can be expanded on to promote engagement as well as potential opportunities for improvement. Actionable recommendations for increasing engagement of underserved groups in community-based DSMPs are provided.

Mechanisms of Racial Health Disparities: Evidence on Coping and Cortisol from MIDUS II

OBJECTIVE

Blunted patterns of daily cortisol, an indicator of hypothalamic-pituitary-adrenal (HPA) axis stress response system dysregulation, are implicated in poor health outcomes and racial health disparities. It is unknown how coping-an important, but understudied, component of the stress-health disparities relationship-relates to these biological mechanisms of health.

METHODS

This study investigated relationships, including racial differences, between 12 coping strategies and early-day cortisol changes (diurnal cortisol slopes from peak to before lunch) among 700 35-85-year-old Black and White male participants in the National Survey of Midlife Development in the United States (MIDUS) II. Cognitive-oriented (e.g., positive reinterpretation, denial, religious/spiritual) and behavioral (e.g., stress eating, substance use) coping strategies were examined.

RESULTS

Overall, Black and White men used similar coping strategies. Most coping strategies were not associated with men's cortisol slopes. Religious/spiritual coping was associated with steeper (more robust) cortisol slopes among White (b = - 0.004, t = - 3.28, p = 0.001) but not Black men. Drug use was associated with steeper cortisol slopes among Black (b = - 0.095, t = - 2.87, p = 0.004) but not White men.

CONCLUSIONS

This exploratory study increases our understanding of relationships between coping and stress-related biological mechanisms underlying racial health disparities among men in later life. With some notable exceptions, men's coping strategies were not associated with their diurnal cortisol slopes. This suggests that the coping strategies currently used by older Black and White men may not be important factors, as determinants or intervention targets, in disparities in diurnal cortisol slopes and associated health outcomes among men in this age group.

DETERIORATING HEALTH AMONG OLDER ADULTS AND CORTISOL: LONGITUDINAL EVIDENCE FROM THE MIDUS STUDY

Various mental and physical health conditions common among older adults have been linked to cortisol dysregulation (i.e., blunting of daily cortisol patterns) in predominantly cross-sectional studies. Researchers have suggested that cortisol dysregulation interferes with regulatory functions throughout the body and brain, disrupting multiple biological systems, and contributing to the development or progression of negative health outcomes over time. Prospective studies are needed to investigate the causal direction of cortisol dysregulation and poor health outcomes. This study examined whether diurnal cortisol patterns predicted subsequent health deterioration using longitudinal data from the National Survey of Midlife in the US (MIDUS). Analysis was restricted to 1,336 participants who provided salivary cortisol (4 samples/day for 4 days) and health data in MIDUS II (2004-2009) and updated health data in MIDUS III (2013-2014) (mean age=56, 45% male, 94% White). We simultaneous modeled multiple measures of diurnal cortisol patterns and their relationships to changes in mental (depressive symptomology) and physical (self-rated physical health, functional limitations, and number of new chronic health conditions) health from MIDUS II to III. All indicators of physical health deterioration were associated with cortisol, though not all measures demonstrated relationships in the expected direction. Mental health change over time was unrelated to cortisol. Older age was also associated with increased functional limitations and more new chronic conditions but improvements in mental health over time. Findings suggest that diurnal cortisol patterns contribute to physical health deterioration over time, independent of age-related decline, but not mental health changes in later life.

Identifying subgroups of Black, Hispanic and Asian men at increased risk for comorbid depression and overweight or obesity

Comorbid depression and overweight or obesity increase risk for developing many chronic diseases. Investigating men of color without using a non-Hispanic White male reference group will capture a more nuanced picture of how socio-demographic factors contribute to increased risk for comorbid depression and overweight or obesity among and between men of color. This study used the U.S.-based 2014 National Health Interview Survey (n = 1363) in May 2018 to examine associations between race/ethnicity and comorbid overweight or obesity and depression in men. Men were more likely to be obese or overweight and depressed if they were older (31-54 years old and 55+) [OR = 2.387, 95% CI: 1.526, 3.873, p = 0.000; OR = 2.220, 95% CI: 1.355, 3.635, p = 0.002], Black [OR = 2.745, 95% CI: 1.622, 4.646, p < 0.001], Hispanic [OR = 2.967, 95% CI: 1.762, 4.995, p < 0.001], or earned $35,000-$74,999 [OR = 1.987, 95% CI: 1.255-3.152, p = 0.004]. We identified socio-demographic sub-groups of men at increased risk for comorbid depression and overweight or obesity. Examining intra-group differences among men of color will help clinicians and researchers to address more nuanced socio-demographic characteristics of groups of men who are more at risk for developing a chronic disease.

An exploratory study of stress and coping among Black college men

Research on coping mechanisms among Black Americans is robust, yet there is a dearth of studies that use qualitative approaches to examine coping specifically among young Black men. The current and historical landscape of race relations in the United States calls for additional concern and exploration of this topic. To fill gaps in this area, this study uncovered the ways Black college men cope with various stressors that impact their mental health. Eleven qualitative interviews were conducted with 18- to 25-year-old Black men enrolled at a college in the Midwest who participated in the Young Black Men, Masculinities, and Mental Health (YBMen) project. Data were analyzed using a rigorous and accelerated data reduction technique that involved transferring transcript data onto spreadsheets, reducing the data, and conducting a rigorous content analysis to generate themes and subthemes. Participants reported that Black college men cope with stress by discussing their issues with members of their social support networks, engaging in physical activities, and relying on themselves. Some respondents reported that they intentionally avoided dealing with their mental health, whereas others attempted to make sense of their problems. Substance use, violence, and anger were all identified as markers of unaddressed stressors. Stigma emerged as a barrier to seeking help. Study findings highlight within-group differences among Black college men. Mental health researchers must continue to develop creative ways to examine stress and coping so that resources can become more culturally relevant and readily available both within and outside of the spaces Black men occupy. (PsycINFO Database Record

Strengths and weaknesses of the Young Black Men, Masculinities, and Mental Health (YBMen) Facebook project

The Young Black Men, Masculinities, and Mental Health (YBMen) project is a Facebook-based intervention that provides mental health education and social support to young Black men. The YBMen project was created to better understand and address the pressures and needs of young Black men, particularly with regard to issues related to their conceptualization of masculinity and mental health. Black men from a 2-year liberal arts college in the Midwest (United States) enrolled in the YBMen pilot project. The purpose of this study is to report what participants in the YBMen pilot project liked and disliked about the intervention, along with their suggestions for improvement. Qualitative results from the 8 Black men who actively participated in the YBMen Facebook intervention and completed the postintervention interview are reported. A systematic analysis identified 9 subthemes that described participants' reactions to different components and characteristics of the Facebook intervention. Results indicated that opportunities for relationship building and connectivity, coupled with engaging popular culture references used in the intervention encouraged young Black men to actively participate in the YBMen Facebook intervention. The YBMen project has potential to improve the health and well-being of young Black men by providing nontraditional resources that are easily accessible, culturally sensitive, and gender-specific. Implications of the YBMen project as an effective Internet-based program that promotes mental health and increases social support among young Black men are discussed. (PsycINFO Database Record

Expanding the NCCN guidelines for distress management: a model of barriers to the use of coping resources

Cancer-related distress impacts quality of care, resource use, and patient outcomes. Patients are increasingly screened for distress, yet many do not receive coping resources and psychosocial support services that may help to reduce their distress. Distress screening must be paired with attention to the different phases of the distress and coping process, with emphasis on barriers and facilitators of cancer patients' use of coping resources. This paper offers a conceptual model illustrating key pathways and modifying factors of distress and use of coping resources among cancer patients, and potential roles for cancer care providers and institutions in facilitating effective coping and distress reduction. Building on a review of relevant empirical and theoretical literature, we developed a conceptual model that integrates concepts from Stress and Coping Theory into the National Comprehensive Cancer Network's guidelines for Distress Management. We found that barriers and facilitating factors that may inhibit receipt of coping resources and services to reduce cancer-related distress include health and cancer beliefs, accessibility and acceptability, the role of caregivers in cancer treatment, coordination of care, and the quality of patient-provider relationships. Herein, we highlight largely modifable factors that can infuence the successful uptake of coping resources and services to reduce distress among cancer patients. We conclude with recommendations for how cancer care providers and systems can better identify and address barriers to the use of distress reduction resources and support services.

Ageism as a Risk Factor for Chronic Disease

Ageism is one of the most socially condoned and institutionalized forms of prejudice in the United States. Older adults are discriminated against in employment, health care, and other domains. Exposure to unfavorable stereotypes adversely affects the attitudes, cognitions, and behavior of older adults. Recurrent experiences with negative stereotypes combined with discrimination may make ageism a chronic stressor in the lives of older adults. The way stress influences physical health is gaining increasing support. The weathering hypothesis (Geronimus, A. T. (1992) The weathering hypothesis and the health of African-American women and infants: Evidence and speculations. Ethnicity and Disease, 2, 207-221) posits that the cumulative effects of chronic objective and subjective stressors and high-effort coping cause deterioration of the body, premature aging, and associated health problems such as chronic diseases. Researchers have found empirical support for the weathering hypothesis as well as its theorized contribution to racial and ethnic health disparities. Although ageism is not experienced over the entire life course, as racism typically is, repeated exposure to chronic stressors associated with age stereotypes and discrimination may increase the risk of chronic disease, mortality, and other adverse health outcomes. I conclude with implications for practice in the helping professions and recommendations for future research. Ageism warrants greater recognition, social condemnation, and scientific study as a possible social determinant of chronic disease.

Faith leaders' comfort implementing an HIV prevention curriculum in a faith setting

YOUR Blessed Health (YBH) is a faith-based HIV prevention pilot program designed to increase faith-based organizations' capacity to address HIV/AIDS among African American congregations. Faith leaders (e.g., pastors, pastors' spouses) were trained to deliver youth and adult HIV education sessions. Perceptions of comfort with discussing 11 sexual health topics were assessed after program implementation. Twenty-nine faith leaders self-reported their comfort discussing sexual behaviors, sexual communication, and sexual abuse. Overall, faith leaders were comfortable discussing these sexual health topics; however, denominational and leadership role differences were found. These findings suggest African American faith leaders are willing to lead faith-based HIV prevention efforts, but that consideration of denominational differences and organizational roles in faith-based health promotion programs is critical.

Men on the move: a pilot program to increase physical activity among African American men

Despite the important contribution increasing physical activity levels may play in reducing chronic disease morbidity and mortality, there is a paucity of interventions and research indicating how to improve physical activity levels in African American men. Men on the Move was a pilot study to increase African American men's levels of physical activity by improving access to age and ability-appropriate, male-focused physical activity opportunities and facilitating access to social support from male peers. Forty-one African American men ages 35 to 70 enrolled (mean age = 53.8). Groups of 5 to 10 men met once a week with a certified personal trainer for 10 weeks. Each meeting addressed barriers to physical activity, provided men with community resources, and incorporated activities that promoted flexibility, strength, balance, and conditioning. Improvements (p < .05) were detected for the following outcome measures: perceived self-efficacy to sustain physical activity, endurance, overall health status, and stress level. Physiological and fitness outcome measures improved, although not to significant levels. Whereas 40% of the men met the recommendation of 150 minutes of moderate or vigorous physical activity weekly at baseline, 68% of the men met this recommendation by the end of the project. These positive results attest to the feasibility of successfully engaging middle-aged and older African American men in a physical activity intervention, and our findings demonstrate the initial efficacy of this intervention approach. More research is needed that includes a more intensive intervention and one that helps motivate men to be physically active outside of the structured, small-group sessions.

An intersectional approach to social determinants of stress for African American men: men's and women's perspectives

Stress is a key factor that helps explain racial and gender differences in health, but few studies have examined gendered stressors that affect men. This study uses an intersectional approach to examine the sources of stress in African American men's lives from the perspectives of African American men and important women in their lives. Phenomenological analysis was used to examine data from 18 exploratory focus groups with 150 African American men, ages 30 years and older, and eight groups with 77 African American women. The two primary sources of stress identified were seeking to fulfill socially and culturally important gender roles and being an African American man in a racially stratified society. A central focus of African American men's daily lives was trying to navigate chronic stressors at home and at work and a lack of time to fulfill roles and responsibilities in different life domains that are traditionally the responsibility of men. Health was rarely mentioned by men as a source of stress, though women noted that men's aging and weathering bodies were a source of stress for men. Because of the intersection of racism and economic and social stressors, men and women reported that the stress that African American men experienced was shaped by the intersection of race, ethnicity, age, marital status, and other factors that combined in unique ways. The intersection of these identities and characteristics led to stressors that were perceived to be of greater quantity and qualitatively different than the stress experienced by men of other races.

"She looks out for the meals, period": African American men's perceptions of how their wives influence their eating behavior and dietary health

OBJECTIVE

Women play a critical role in men's dietary health, but how men think about the nature and mechanisms of their wives' influence on their eating behavior is not well understood. This study examined how African American men described the roles their wives played in shaping their eating behavior.

METHODS

Thematic content analysis was used to analyze data from nine exploratory focus groups conducted with a convenience sample of 83 African American men who were middle aged or older and lived in southeast Michigan.

RESULTS

Men perceived having more freedom to choose what they ate while eating out, even when accompanied by their wives, compared with at home. The men indicated their wives influenced what they ate at home more than their own preferences. They described traditional gendered food roles at home and were satisfied that their wives played a dominant role in household food preparation and decision making. Men had mixed feelings about wives' efforts to prepare healthier meals. While they appreciated that their wives cared about their health, the men felt they were rarely consulted on how meals could be healthier and often disliked the healthy changes their wives made. The men prioritized keeping their wives happy, preserving spousal division of roles, and maintaining marital harmony over participating in food decision making or expressing their personal food preferences.

CONCLUSIONS

Interventions to improve married African American men's eating behaviors need to explicitly consider that men may prioritize marital harmony and the preservation of spousal food roles over their tastes, preferences, and desired food decision making roles.

Male peer influence on African American men's motivation for physical activity: men's and women's perspectives

Thematic analysis of data from nine exploratory focus groups conducted with 71 middle-aged and older African American men and eight focus groups with 77 key women in their lives revealed how social norms and modeling of physical activity influenced men's motivation to exercise. Both men and women identified male peers as an important source of ideas, encouragement, and support to initiate and sustain physical activity, yet sedentary peers also could contribute to men being less motivated to be active. The primary difference in men's and women's perspectives was that men attributed their decline in activity levels to difficulties in finding time for physical activity, whereas women attributed sedentary lifestyles to an increase in men's physical illnesses and ailments. Men's participation in team sports and overall activity levels diminished with age. Peer social support can be critical for interventions to help African American men engage in and sustain physical activity.

"I'm ready to eat and grab whatever I can get": Determinants and patterns of African American men's eating practices

This article examines determinants and patterns of African American men's dietary practices. Thematic content analysis was used to analyze data from nine exploratory focus groups conducted with 83 urban, middle-aged and older African American men from southeast Michigan. The men distinguished between healthy and unhealthy foods and "meals" versus other instances of eating. Eating patterns and content differed depending on the meal, work and family schedules, food availability, and whether it was a weekday or weekend. When eating alone or outside the home, men prioritized convenience and preferences for tasty, unhealthy foods. Men often reported skipping breakfast or lunch and grabbing snacks or fast food during the day. They emphasized sharing dinner with their spouses and families-usually a home-cooked, "healthy" meal. On weekends, spouses often cooked less and men snacked and dined out more frequently. Sunday dinners involving favorite, unhealthy comfort foods were the highlight of men's eating practices. African American men tended not to follow healthy eating recommendations because of their busy lives, reliance on spouses to prepare food, and preferences for unhealthy foods. These findings suggest that healthy eating interventions must consider how the contexts of African American men's lives shape their eating practices.

How does health information influence African American men's health behavior?

Few researchers have examined where African American men obtain, process, and use health information. A thematic analysis of data from eighteen exploratory focus groups conducted with 154 urban African American men aged 32 years and older revealed that men received health information from a variety of sources, including health professionals, media, and members of their social networks. At times, information raised their awareness of health issues, but trust in the source of the information influenced how this information was perceived. Medical professionals were the most common source of health information, but family members were the most trusted source of health information. Health problems and social support increased men's motivation to use health information in order to improve their health and healthy behaviors. These findings illustrate that it is critical to identify factors that influence what information men choose to believe and follow or decide to ignore.

Male gender role strain as a barrier to African American men's physical activity

Despite the potential health consequences, African American men tend to treat their roles as providers, fathers, spouses, and community members as more important than engaging in health behaviors such as physical activity. We conducted 14 exploratory focus groups with 105 urban, middle-aged African American men from the Midwest to examine factors that influence their health behaviors. Thematic content analysis revealed three interrelated barriers to physical activity: (a) work, family, and community commitments and priorities limited time and motivation for engaging in physical activity; (b) physical activity was not a normative individual or social activity and contributed to men prioritizing work and family responsibilities over physical activity; and (c) the effort men exerted in seeking to fulfill the provider role limited their motivation and energy to engage in physical activity. These findings highlight the need for physical activity interventions that consider how health fits in the overall context of men's lives.

Involving faith-based organizations in adolescent HIV prevention

BACKGROUND

The rates of sexually transmitted infections (STIs; including HIV/AIDS) among African Americans in Flint, Michigan, are among the highest in the state. In Genesee County, where Flint is located, the incidence of HIV/AIDS cases increased at an average rate of 24% each year from 2003 to 2007 for adolescents between the ages of 13 and 19.

OBJECTIVES

YOUR Blessed Health (YBH) is a multilevel, faith-based HIV prevention program designed to increase HIV awareness and knowledge and reduce HIV risk behaviors among African American congregations. This article describes one of the five components of the intervention--training of faith leaders to implement a sexual health curriculum for adolescents in their congregations.

METHODS

Staff from YOUR Center, a community-based HIV service organization, and researchers from the University of Michigan, School of Public Health, partnered with faith-based organizations (FBOs) to address HIV/AIDS in Flint, Michigan.

RESULTS

Participating FBOs selected faith leaders to be trained by YOUR Center staff to implement the YBH program in their congregations. Using the HIV Outreach, Prevention and Education (HOPE) curriculum, faith leaders from 20 FBOs provided HIV education to 212 adolescents in Flint, Michigan.

CONCLUSION

Study findings demonstrate that faith leaders who participate in specific and ongoing HIV prevention education training can be useful sexual health resources for youth in faith-based settings. Implications for research and practice highlight the advantages of continued partnerships between FBOs and public health professionals in future HIV prevention efforts for adolescents.

Community-based organizational capacity building as a strategy to reduce racial health disparities

One of the biggest challenges facing racial health disparities research is identifying how and where to implement effective, sustainable interventions. Community-based organizations (CBOs) and community-academic partnerships are frequently utilized as vehicles to conduct community health promotion interventions without attending to the viability and sustainability of CBOs or capacity inequities among partners. Utilizing organizational empowerment theory, this paper describes an intervention designed to increase the capacity of CBOs and community-academic partnerships to implement strategies to improve community health. The Capacity Building project illustrates how capacity building interventions can help to identify community health needs, promote community empowerment, and reduce health disparities.

YOUR Blessed Health: a faith-based CBPR approach to addressing HIV/AIDS among African Americans

Despite substantial federal, state, and local efforts to reduce the transmission of HIV/AIDS, African Americans experience higher rates of infection than any other ethnic or racial group in the United States. It is imperative to develop culturally and ecologically sensitive interventions to meet the sexual health needs of this population. Capitalizing on the assets, resources, and strengths of faith-based organizations, YOUR Blessed Health (YBH) is a community-based participatory research project developed to increase HIV/AIDS awareness and reduce HIV-related stigma among the African American faith community in Flint, Michigan. This article describes the historical context and development of YBH, discusses the results of the pilot study, and illustrates how YBH grew into a community mobilization effort led by faith leaders and their congregations to address HIV/AIDS. YBH highlights the importance of developing and testing intervention models that originate from community-based organizations to address complex and sensitive health issues among marginalized populations.

YOUR Blessed Health: an HIV-prevention program bridging faith and public health communities

African American faith-based institutions are not necessarily equipped to balance their moral and spiritual missions and interpretation of religious doctrine with complex health issues such as human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). YOUR Blessed Health (YBH) is a faith-based, six-month pilot project designed to increase the capacity of faith-based institutions and faith leaders to address HIV/AIDS and sexually transmitted infections (STIs) in 11- to 19-year-old African Americans. In addition to increasing the knowledge and skills of young people, the intervention seeks to change churches' norms to provide more open settings where young people can talk with faith leaders about sex, relationships, STIs, and HIV/AIDS. YBH expands the roles of adult faith leaders, particularly pastors' spouses, to include health education as they implement the intervention in their congregations and communities. The intervention includes a flexible menu of activities for faith leaders to select from according to their institutional beliefs, doctrines, and culture.

Organizational empowerment in community mobilization to address youth violence

Community mobilization efforts to address youth violence are often disconnected, uncoordinated, and lacking adequate resources. An organizational empowerment theory for community partnerships provides a useful framework for organizing and evaluating a coalition's community mobilization efforts and benefits for individual organizations, partnerships, and communities. Based on a qualitative analysis of steering committee interviews and other primary data, the results of a case study suggest that the intraorganizational infrastructure; interorganizational membership practices and networking; and extraorganizational research, training, and organizing activities facilitate the community mobilization efforts of the Youth Violence Prevention Center in Flint, Michigan. The organizational empowerment framework, and its focus on organizational structures and processes, illustrates the importance of recognizing and incorporating the organizational systems and structures that provide the foundation on which a community mobilization effort may build. This framework also highlights how organizational structures and processes are central components of multilevel strategies for organizing and mobilizing community efforts to address youth violence.

Emissions of size-segregated aerosols from on-road vehicles in the Caldecott tunnel

Particulate matter emissions from the California in-use vehicle fleet were measured as 37,500 vehicles traveled through two bores of the Caldecott Tunnel located in the San Francisco Bay area. Microorifice cascade impactors and filter-based samplers were used to determine the particle chemical composition as a function of particle size. Ammonia emissions from the vehicle fleet were measured as well. Concentrations of aerosol mass, organic carbon, elemental carbon, sulfate ion, nitrate ion, and ammonium ion, as well as 13 elements are reported. The particle mass distribution peaks in the particle size range 0.1-0.18 microm aerodynamic diameter (Da). Elemental carbon and organic matter were the largest components of particle mass in all the size ranges studied. The Caldecott Tunnel bores studied include one which carries light-duty vehicle traffic and one which carries a mixture of light- and heavy-duty vehicle traffic. From experiments conducted in both bores, estimates are made of the size distribution and chemical composition of particulate matter emissions extrapolated to the 100% light-duty and 100% heavy-duty vehicle fleets. The heavy-duty vehicle fleet emitted 1285 +/- 237 mg of fine particulate matter (Da < 1.9 microm)/kg of C contained in the fuel burned (corresponding to approximately 430 +/- 79 mg/km driven). Light-duty vehicles emitted less than 85 +/- 6 mg/kg of C in the fuel burned (corresponding to less than approximately 5.5 +/- 0.4 mg/km driven). Emissions of gas-phase ammonia in the Caldecott Tunnel were measured to be 194 and 267 mg/L of gasoline-equivalent fuel burned in the tunnel. The ammonia emissions are attributed to automobiles that were equipped with 3-way catalysts and operating fuel rich.

Quantification of ATOFMS data by multivariate methods

Aerosol time-of-flight mass spectrometry (ATOFMS) is capable of measuring the sizes and chemical compositions of individual polydisperse aerosol particles in real time. A qualitative estimate of the particle composition is acquired in the form of a mass spectrum that must be subsequently interpreted in order to draw conclusions regarding atmospheric relevance. The actual problem involves developing a calibration that allows the mass spectral data to be transformed into estimates of the composition of the atmospheric aerosol. A properly calibrated ATOFMS system should be able to quantitatively determine atmospheric concentrations of various species. Ideally, it would be able to accomplish this more rapidly, accurately, with higher size and time resolution, and at a far lower marginal cost than the manual sampling methods that are currently employed. Attempts have already been made at using ATOFMS and similar techniques to extract the bulk chemical species concentration present in an ensemble of particles. This study represents the use of a multivariate calibration method, two-dimensional partial least-squares analysis, for calibrating single-particle mass spectral data. The method presented here is far less labor-intensive than the univariate methods attempted to date and allows for less observer bias. Because of the labor savings, this is also the most comprehensive calibration performed to date, resulting in the quantification of 44 different chemical species.

Direct observation of heterogeneous chemistry in the atmosphere

The heterogeneous replacement of chloride by nitrate in individual sea-salt particles was monitored continuously over time in the troposphere with the use of aerosol time-of-flight mass spectrometry. Modeling calculations show that the observed chloride displacement process is consistent with a heterogeneous chemical reaction between sea-salt particles and gas-phase nitric acid, leading to sodium nitrate production in the particle phase accompanied by liberation of gaseous HCl from the particles. Such single-particle measurements, combined with a single-particle model, make it possible to monitor and explain heterogeneous gas/particle chemistry as it occurs in the atmosphere.

R-type plasmids in mitochondria from a single source of Zea luxurians teosinte

Two linear DNA plasmids resembling the R1 and R2 plasmids that are present in the mitochondria of several South American strains of maize were found in mitochondria from a single source of Zea luxurians collected by L. Mazoti. The Mazoti mtDNA is closely related to mtDNAs of other Z. luxurians, but mitochondria derived from the other Z. luxurians sources lack the plasmids. The larger plasmid from Mazoti mitochondria, M1, was cloned and large portions of it were sequenced. Restriction mapping and sequence comparisons showed that approximately 4.9 kb is similar to the S1 plasmid of maize and an additional 2.6 kb is related to R1 sequences integrated into the main mitochondrial genome of N cytoplasm. Therefore, the M1 plasmid appears to be very similar to the R1 plasmid. The inverted repeats at the ends of the M1 plasmid are not identical. The left end IR is similar to the S-TIRs found at the termini of the S plasmids. The right end IR more closely resembles the integrated R1 sequences, including the "variant" region of the TIR. Whereas the variant region contains 13 bp in the S-TIRs and 15 bp in an integrated version of R1, it is 16 bp long in M1. The region of M1 that has no homology to the S1 plasmid is expressed at very low levels in Mazoti and RU cytoplasms, but at much higher levels in CMS-S mitochondria, where part of it is present in the main mitochondrial genome.