Perceived interpersonal discrimination and older women’s mental health: accumulation across domains, attributions, and time

Experiencing discrimination is associated with poor mental health, but how cumulative experiences of perceived interpersonal discrimination across attributes, domains, and time are associated with mental disorders is still unknown. Using data from the Study of Women’s Health Across the Nation (1996–2008), we applied latent class analysis and generalized linear models to estimate the association between cumulative exposure to perceived interpersonal discrimination and older women’s mental health. We found 4 classes of perceived interpersonal discrimination, ranging from cumulative exposure to discrimination over attributes, domains, and time to none or minimal reports of discrimination. Women who experienced cumulative perceived interpersonal discrimination over time and across attributes and domains had the highest risk of depression (Center for Epidemiologic Studies Depression Scale score ≥16) compared with women in all other classes. This was true for all women regardless of race/ethnicity, although the type and severity of perceived discrimination differed across racial/ethnic groups. Cumulative exposure to perceived interpersonal discrimination across attributes, domains, and time has an incremental negative long-term association with mental health. Studies that examine exposure to perceived discrimination due to a single attribute in 1 domain or at 1 point in time underestimate the magnitude and complexity of discrimination and its association with health

Islamophobia, racism and health

Racism has been argued to be a focal element of ethnic inequalities in health (Williams 1999, Krieger 2003, Nazroo 2003, Paradies et al. 2015), impacting on the health of ethnic minority people through differential exposure to socioeconomic, environmental, psychosocial and healthcare-related pathways. In this chapter we explore the implications of this for the health of Muslim people in the UK, with the intention of illustrating how Islamophobia, racism targeted towards Islam or Muslims, harms the health of Muslim people. The evidence we draw on is mainly from studies of racism and health, so the primary focus is on ethnic minority people in general, with discussion of a range of health outcomes. Nevertheless, the conclusions from this evidence are clear on the harm of Islamophobia to health

Inequalities in mental health, self-rated health, and social support among sexual minority young adults during the COVID-19 pandemic: analyses from the UK Millennium Cohort Study

PURPOSE: Young adults who self-identify as a sexual minority may have been particularly harmed by the consequences of lockdown, closure of educational institutions, and social distancing measures as they are likely to have been confined in households that may not be supportive of their sexual orientation. We examine inequalities in the mental health and self-rated health of sexual minority young adults, compared to their heterosexual peers, at the height of lockdown restrictions in the UK. METHODS: We analysed data from singletons who participated in waves 6, 7, and the wave 1 COVID-19 survey (n = 2211) of the Millennium Cohort Study, a nationally representative longitudinal study of infants born in the UK between September 2000 and January 2002. Regression models compared the mental health, self-rated health, and social support of sexual minority young adults to that of their heterosexual peers. RESULTS: One in four young adults self-identified with a sexual orientation or attraction other than completely heterosexual. Sexual minority young adults had significantly lower levels of social support (β =  - 0.38, SE 0.08), poorer self-rated health (OR 3.91, 95% CI 2.41-6.34), and higher levels of psychological distress (β = 2.26, SE 0.34), anxiety (β = 0.40, SE 0.15), and loneliness (β = 0.66, SE 0.18) when compared to heterosexual young adults. CONCLUSIONS: Sexual minority young adults in the UK have been detrimentally impacted by the coronavirus pandemic, experiencing inequalities in mental health, self-rated health, and social support when compared to heterosexual young adults. Implications for policy and practice include a stronger provision of safe spaces in the community and in institutions, and policies that address marginalisation and harassment

Exploring household dynamics: the reciprocal effects of parent and child characteristics

A burgeoning line of literature has shown there are strong effects of maternal mental health on child socio-emotional development (Cummings & Davies, 1994; Downey & Coyne, 1990; Mensah & Kiernan, 2010; Smith, 2004). This literature is often based on the examination of dyadic relationships, where maternal mental health is hypothesised to have an effect on child development and well-being, and the mother-child relationship is examined in isolation of other household relationships. This may also be true in clinical practice: while family dynamics are often considered when treating children for behavioural problems or other psychological symptoms, this is often not the case when the parents are treated. However, household dynamics are complex, and other household members may have an effect both on the well-being of the mother and the child. Furthermore, children’s characteristics can also have a feedback effect on their parents’ outcomes. While the literature often concentrates on the effects of parents’ characteristics on child outcomes, the reverse might also occur. In this paper, we employ a structural equation model with crossed lagged effects, to understand the reciprocal relationships between the mother’s mental health, the child socio-emotional development, and the quality of the parental relationship. Analyses were conducted using longitudinal data from the Millennium Cohort Study, a prospective national birth cohort of children born in the UK in 2000-2001. The Millennium Cohort Study has a wealth of information on the socio-economic background of the household, and has collected data on the mother’s mental health, the quality of the parents’ relationship, and the children’s socio-emotional development. In this work we look at data relating to the pre-school age, a crucial developmental age which has often been missing from the literature

Bi-directional relationships between body mass index and height from three to seven years of age: an analysis of children in the United Kingdom Millennium Cohort Study

Adiposity and height are known to correlate in childhood but it is less clear whether height and weight gain occur in synergy. We investigate the bidirectional relationships between measures of height and body mass index (BMI) – an indicator of adiposity – and their rates of change. The sample comprises singleton children in the Millennium Cohort Study (N = 11,357). Child anthropometrics measured by trained interviewers at ages three, five and seven years (2003-2009) were transformed to standardised scores based on 1990 British Growth Reference data from which piecewise linear models for height and BMI were jointly fitted. At three years of age, zHeight was positively related to subsequent zBMI velocities, whereas zBMI at three years was positively related to zHeight velocity to age five but inversely related to zHeight velocity from five to seven years of age. Age three zBMI predicted zHeight velocity from three to five years more strongly than age three zHeight predicted zBMI velocity over the same period. The rate of change in zHeight was positively correlated with subsequent zBMI velocity and vice versa. This new evidence on the bidirectional relationships between height and BMI velocities sheds light on the early childhood origins of obesity in adulthood and the need to monitor growth as well as weight gain

Parental migration, intergenerational obligations and the paradox for left-behind boys in rural China

Drawing on in-depth interviews with caregivers of left-behind children (LBC) in rural China, this article seeks to explore their understanding of migration motives and the social process of taking on care-giving roles for LBC. The authors argue that there are underlying socio-cultural explanations pertaining to economic motives for migration; such as, making contributions to social events (weddings and funerals) in village life, and fulfilling social obligations for left-behind sons’ futures. Parents migrate to save for sons’, but not daughters’, adult lives. Grandparents, particularly on the paternal side, are expected to fulfil social obligations to care for left-behind grandchildren, even without immediate financial returns. These suggest that left-behind boys, and in particular boys cared for by paternal grandparents, may be at greater risk than other LBC, as they may receive even fewer resources in the form of remittances from migrant parents in their early childhood

Evidence for ethnic inequalities in mortality related to COVID-19 infections: findings from an ecological analysis of England

Objectives In the absence of robust direct data on ethnic inequalities in COVID-19-related mortality in the UK, we examine the relationship between ethnic composition of an area and rate of mortality in the area. Design Ecological analysis of COVID-19-related mortality rates occurring by 24 April 2020 and ethnic composition of the population. Account is taken of age, population density, area deprivation and pollution. Setting Local authorities in England. Results For every 1% rise in proportion of the population who are ethnic minority, COVID-19-related deaths increased by 5·12, 95% CI (4·00 to 6·24), per million. This rise is present for each ethnic minority category examined, including the white minority group. The size of this increase is a little reduced in an adjusted model to 4·42, 95% CI (2·24 to 6·60), suggesting that some of the association results from ethnic minority people living in more densely populated, more polluted and more deprived areas. This estimate suggests that the average England COVID-19-related death rate would rise by 25% in a local authority with two times the average number of ethnic minority people. Conclusions We find clear evidence that rates of COVID-19-related mortality within a local authority increases as the proportion of the population who are ethnic minority increases. We suggest that this is a consequence of social and economic inequalities driven by entrenched structural and institutional racism and racial discrimination. We argue that these factors should be central to any investigation of ethnic inequalities in COVID-19 outcomes

Ethnic density effects for adult mental health: systematic review and meta-analysis of international studies

Background Despite increased ethnic diversity in more economically developed countries it is unclear whether residential concentration of ethnic minority people (ethnic density) is detrimental or protective for mental health. This is the first systematic review and meta-analysis covering the international literature, assessing ethnic density associations with mental health outcomes. Methods We systematically searched Medline, PsychINFO, Sociological Abstracts, Web of Science from inception to 31 March 2016. We obtained additional data from study authors. We conducted random-effects meta-analysis taking into account clustering of estimates within datasets. Meta-regression assessed heterogeneity in studies due to ethnicity, country, generation, and area-level deprivation. Our main exposure was ethnic density, defined as the residential concentration of own racial/ethnic minority group. Outcomes included depression, anxiety and the common mental disorders (CMD), suicide, suicidality, psychotic experiences, and psychosis. Results We included 41 studies in the review, with meta-analysis of 12 studies. In the meta-analyses, we found a large reduction in relative odds of psychotic experiences [odds ratio (OR) 0.82 (95% confidence interval (CI) 0.76–0.89)] and suicidal ideation [OR 0.88 (95% CI 0.79–0.98)] for each 10 percentage-point increase in own ethnic density. For CMD, depression, and anxiety, associations were indicative of protective effects of own ethnic density; however, results were not statistically significant. Findings from narrative review were consistent with those of the meta-analysis. Conclusions The findings support consistent protective ethnic density associations across countries and racial/ethnic minority populations as well as mental health outcomes. This may suggest the importance of the social environment in patterning detrimental mental health outcomes in marginalized and excluded population groups

Neighbourhood ethnic density and psychosis — is there a difference according to generation?

Background For different migrant groups living in an area with few people from the same ethnic background is associated with increased psychosis incidence (the ethnic density effect). We set out to answer the question: are there generational differences in this effect? Methods Analysis of a population based cohort (2.2 million) comprising all those born 1st January 1965, or later, living in Denmark on their 15th birthday. This included 90,476 migrants from Africa, Europe (excluding Scandinavia) and the Middle East, with 55% first generation and the rest second-generation migrants. Neighbourhood co-ethnic density was determined at age 15 and we adjusted for age, gender, calendar period, parental psychiatric history and parental income. Results For first-generation migrants from Africa, there was no statistically significant difference (p = 0.30) in psychosis rates when comparing lowest with highest ethnic density quintiles, whereas the second generation showed a 3.87-fold (95% CI 1.77–8.48) increase. Similarly, for migrants from the Middle East, the first generation showed no evidence of an ethnic density effect (p = 0.94) while the second showed a clear increase in psychosis when comparing lowest with highest quintiles, incidence rate ratio (IRR) 2.43 (95% CI, 1.18–5.00). For European migrants, there was some limited evidence of an effect in the first generation, (IRR) 1.69 (95% CI, 1.19–2.40), with this slightly raised in the second: IRR 1.80 (95% CI, 1.27–2.56). Conclusions We found strong evidence for an ethnic density effect on psychosis incidence for second-generation migrants but this was either weak or absent for the first generation

Ethnic density effects on psychological distress among Latino ethnic groups: an examination of hypothesized pathways

Studies among US Latinos provide the most consistent evidence of ethnic density effects. However, most studies conducted to date have focused on Mexican Americans, and it is not clear whether ethnic density effects differ across Latino sub-groups, generational status, or measures of ethnic density. In addition, the mechanisms behind ethnic density are not well understood. This study uses a multi-group structural equation modeling approach to analyze the Latino sample from the National Latino and Asian-American Study (n¼1940) and examine ethnic density effects on psychological distress among Latino sub-groups, and explore two hypothesized mechanisms: increased neighborhood cohesion and reduced exposure to interpersonal racism. Results of the main effects between ethnic density and health, and of the hypothesized mechanisms, show clear differences across Latino ethnic groups, generational categories and measures of ethnic density. Findings highlight that ethnic density effects and their mechanisms depend on the current and historical context of Latino sub-groups, including reasons for migration and rights upon arrival