Interpersonal discrimination and depressive symptomatology: examination of several personality-related characteristics as potential confounders in a racial/ethnic heterogeneous adult sample

Abstract Background Research suggests that reports of interpersonal discrimination result in poor mental health. Because personality characteristics may either confound or mediate the link between these reports and mental health, there is a need to disentangle its role in order to better understand the nature of discrimination-mental health association. We examined whether hostility, anger repression and expression, pessimism, optimism, and self-esteem served as confounders in the association between perceived interpersonal discrimination and CESD-based depressive symptoms in a race/ethnic heterogeneous probability-based sample of community-dwelling adults. Methods We employed a series of ordinary least squares regression analyses to examine the potential confounding effect of hostility, anger repression and expression, pessimism, optimism, and self-esteem between interpersonal discrimination and depressive symptoms. Results Hostility, anger repression, pessimism and self-esteem were significant as possible confounders of the relationship between interpersonal discrimination and depressive symptoms, together accounting for approximately 38% of the total association (beta: 0.1892, p < 0.001). However, interpersonal discrimination remained a positive predictor of depressive symptoms (beta: 0.1176, p < 0.001). Conclusion As one of the first empirical attempts to examine the potential confounding role of personality characteristics in the association between reports of interpersonal discrimination and mental health, our results suggest that personality-related characteristics may serve as potential confounders. Nevertheless, our results also suggest that, net of these characteristics, reports of interpersonal discrimination are associated with poor mental health.http://deepblue.lib.umich.edu/bitstream/2027.42/112604/1/12889_2013_Article_6001.pd

Interpersonal discrimination and depressive symptomatology: examination of several personality-related characteristics as potential confounders in a racial/ethnic heterogeneous adult sample

Background Research suggests that reports of interpersonal discrimination result in poor mental health. Because personality characteristics may either confound or mediate the link between these reports and mental health, there is a need to disentangle its role in order to better understand the nature of discrimination-mental health association. We examined whether hostility, anger repression and expression, pessimism, optimism, and self-esteem served as confounders in the association between perceived interpersonal discrimination and CESD-based depressive symptoms in a race/ethnic heterogeneous probability-based sample of community-dwelling adults. Methods We employed a series of ordinary least squares regression analyses to examine the potential confounding effect of hostility, anger repression and expression, pessimism, optimism, and self-esteem between interpersonal discrimination and depressive symptoms. Results Hostility, anger repression, pessimism and self-esteem were significant as possible confounders of the relationship between interpersonal discrimination and depressive symptoms, together accounting for approximately 38% of the total association (beta: 0.1892, p \u3c 0.001). However, interpersonal discrimination remained a positive predictor of depressive symptoms (beta: 0.1176, p \u3c 0.001). Conclusion As one of the first empirical attempts to examine the potential confounding role of personality characteristics in the association between reports of interpersonal discrimination and mental health, our results suggest that personality-related characteristics may serve as potential confounders. Nevertheless, our results also suggest that, net of these characteristics, reports of interpersonal discrimination are associated with poor mental health

Alcohol use and mental health conditions among Black college males: Do those attending postsecondary minority institutions fare better than those at primarily White institutions?

While there is a sizeable body of research examining the association between alcohol use and mental health conditions among college students, there are sparse investigations specifically focusing on these associations among Black college students. This is concerning given Black college students face different stressors compared with their non-Black peers. Black males appear especially at risk, exhibiting increased susceptibility to mental health issues and drinking in greater quantities and more frequently than Black females. This investigation examined the association between alcohol consumption and mental health conditions among Black men attending institutions of higher education in the United States and sought to determine differences between Black men attending predominantly White institutions (PWIs) compared with those attending postsecondary minority institutions. Final sample included 416 Black men, 323 of which attended a PWI. Data were from the National College Health Assessment. Black men attending a PWI reported significantly greater levels of alcohol consumption and significantly more mental health conditions. Attendance at a minority-serving institution was associated with fewer mental health conditions among Black men. Future studies should seek to replicate these findings and conduct culturally sensitive and gender-specific research examining why Black men at PWIs report greater alcohol consumption and more mental health conditions than their peers attending postsecondary minority institutions.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163991/1/Barry et al_Alcohol Use and Mental Health.pdfDescription of Barry et al_Alcohol Use and Mental Health.pdf : Main articl

The social and behavioral influences (SBI) study: study design and rationale for studying the effects of race and activation on cancer pain management

Background Racial disparities exist in the care provided to advanced cancer patients. This article describes an investigation designed to advance the science of healthcare disparities by isolating the effects of patient race and patient activation on physician behavior using novel standardized patient (SP) methodology. Methods/design The Social and Behavioral Influences (SBI) Study is a National Cancer Institute sponsored trial conducted in Western New York State, Northern/Central Indiana, and lower Michigan. The trial uses an incomplete randomized block design, randomizing physicians to see patients who are either black or white and who are “typical” or “activated” (e.g., ask questions, express opinions, ask for clarification, etc.). The study will enroll 91 physicians. Discussion The SBI study addresses important gaps in our knowledge about racial disparities and methods to reduce them in patients with advanced cancer by using standardized patient methodology. This study is innovative in aims, design, and methodology and will point the way to interventions that can reduce racial disparities and discrimination and draw links between implicit attitudes and physician behaviors

Perceived Discrimination and Health Outcomes Among Asian Indians in the United States

Background: Perceived interpersonal discrimination while seeking healthcare services is associated with poor physical and mental health. Yet, there is a paucity of research among Asian Americans or its subgroups. This study examined the correlates of reported interpersonal discrimination when seeking health care among a large sample of Asian Indians, the 3rd largest Asian American subgroup in the US, and identify predictors of adverse self-rated physical health, a well-accepted measure of overall health status. Methods: Cross-sectional survey. Participants comprised of 1824 Asian Indian adults in six states with higher concentration of Asian Indians. Results: Mean age and years lived in the US was 45.7 ± 12.8 and 16.6 ± 11.1 years respectively. The majority of the respondents was male, immigrants, college graduates, and had access to care. Perceived interpersonal discrimination when seeking health care was reported by a relatively small proportion of the population (7.2 %). However, Asian Indians who reported poor self-rated health were approximately twice as likely to perceived discrimination when seeking care as compared to those in good or excellent health status (OR 1.88; 95 % CI 1.12–3. 14). Poor self-rated health was associated with perceived health care discrimination after controlling for all of the respondent characteristics (OR 1.93; 95 % CI: 1.17–3.19). In addition, Asian Indians who lived for more than 10 years in the U.S. (OR 3.28; 95 % CI: 1.73–6.22) and had chronic illnesses (OR 1.39; 95 % CI: 1.17–1.64) (p \u3c 0.05) were more likely to perceive discrimination when seeking health care. However, older Asian Indians, over the age of 55 years, were less likely to perceive discrimination than those aged 18–34 years Indian American. Conclusion: Results offers initial support for the hypothesis that Asian Indians experience interpersonal discrimination when seeking health care services and that these experiences may be related to poor self-rated health status

The role of perceived discrimination on racial/ethnic differences in health risk behaviors and outcomes.

Racial/ethnic minorities in the United States have persistently experienced inequalities in health risk behaviors and health outcomes. To date, no study completely explains these racial/ethnic differences in health behaviors and health outcomes, despite the vast amount of research that has been devoted to the study of racial/ethnic inequalities in health. However, over the last two decades, a small number of published studies have hypothesized that experiences of racial/ethnic discrimination are assumed to be associated with some of the unexplained observed racial/ethnic differences in health behavior and health outcomes. Using a probability-based sample of adult Hispanic, Black and White adults living in Chicago, Illinois, this study examines the role of perceived discrimination on within and between racial/ethnic differences in cigarette and alcohol use, BMI and blood pressure. Although perceptions of experiences of racial/ethnic discrimination were strongly associated with some of the health outcomes/behaviors among some of the racial/ethnic groups, interestingly enough, these perceptions contribute little to understanding the racial/ethnic differences in the health outcomes/behaviors, except for cigarette use. Approximately 20--25% of the differences in cigarette use between Blacks and Whites were explained by experiences of racial/ethnic discrimination and approximately 15 percent of the difference between Hispanic and White heavy smokers were explained. In terms of the within racial/ethnic differences in the health behaviors/outcomes, perceptions of racial/ethnic discrimination were associated with the average number of alcoholic drinks consumed per month among Blacks; on the other hand, only after controlling for sociodemographic variables, perceived discrimination was associated with heavy smoking status among Whites. Furthermore, perceived experiences of racial/ethnic discrimination were also associated with BMI among Hispanics and Whites, but no among Blacks. However, blood pressure was associated with perceived experiences of racial/ethnic discrimination only among Blacks. Taken together, the results of this study were mixed; however, the overall study does provide some interesting findings related to racial/ethnic discrimination affecting health outcomes/behaviors.Ph.D.Health and Environmental SciencesPublic healthUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/126174/2/3237978.pd

Discrimination in Health Care: Correlates of Health Care Discrimination Among Black Males

Using data from the Indiana Black Men’s Health Study (N = 455), a community-based sample of adult Black men, the primary aim of this study was to explore factors of health care discrimination, and to examine if such reports differed by age and the frequency of race thoughts. Approximately one in four men reported experiencing discrimination in the health care setting. Results from the multivariable logistic regression models suggested that frequent race thoughts (odds ratio [OR]: 1.89, p \u3c .05), not having health insurance (OR: 1.80, p \u3c .05), and increased depressive symptomology (OR: 1.06, p \u3c .01) were positively associated with reports of health care discrimination. A multiplicative interaction coefficient of age and frequency of race thoughts was included to determine if health care discrimination differed by age and frequency of race thoughts (OR: 1.03, p = .08). Results from the predicted probability plot suggested that the likelihood of experiencing health care discrimination decreases with age (OR: 0.97, p \u3c .05). In particular, results suggested that between the ages of 33 and 53 years, Black men who experienced frequent race thoughts were more likely to report experiences of discrimination in the health care setting than men of the same age that did not experience frequent race thoughts. These results highlight the need for empirical work to better understand the experiences of Black men, a group less likely to utilize health care services than most adult groups within the health care setting

Alcohol Use and Mental Health Conditions Among Black College Males: Do Those Attending Postsecondary Minority Institutions Fare Better Than Those at Primarily White Institutions?

While there is a sizeable body of research examining the association between alcohol use and mental health conditions among college students, there are sparse investigations specifically focusing on these associations among Black college students. This is concerning given Black college students face different stressors compared with their non-Black peers. Black males appear especially at risk, exhibiting increased susceptibility to mental health issues and drinking in greater quantities and more frequently than Black females. This investigation examined the association between alcohol consumption and mental health conditions among Black men attending institutions of higher education in the United States and sought to determine differences between Black men attending predominantly White institutions (PWIs) compared with those attending postsecondary minority institutions. Final sample included 416 Black men, 323 of which attended a PWI. Data were from the National College Health Assessment. Black men attending a PWI reported significantly greater levels of alcohol consumption and significantly more mental health conditions. Attendance at a minority-serving institution was associated with fewer mental health conditions among Black men. Future studies should seek to replicate these findings and conduct culturally sensitive and gender-specific research examining why Black men at PWIs report greater alcohol consumption and more mental health conditions than their peers attending postsecondary minority institutions

Understanding social disparities in hypertension prevalence, awareness, treatment, and control: The role of neighborhood context

The spatial segregation of the US population by socioeconomic position and especially race/ethnicity suggests that the social contexts or "neighborhoods" in which people live may substantially contribute to social disparities in hypertension. The Chicago Community Adult Health Study did face-to-face interviews, including direct measurement of blood pressure, with a representative probability sample of adults in Chicago. These data were used to estimate socioeconomic and racial-ethnic disparities in the prevalence, awareness, treatment, and control of hypertension, and to analyze how these disparities are related to the areas in which people live. Hypertension was significantly negatively associated with neighborhood affluence/gentrification, and adjustments for context eliminated the highly significant disparity between blacks/African-Americans and whites, and reduced the significant educational disparity by 10-15% to borderline statistical significance. Awareness of hypertension was significantly higher in more disadvantaged neighborhoods and in places with higher concentrations of blacks (and lower concentrations of Hispanics and immigrants). Adjustment for context completely eliminated blacks' greater awareness, but slightly accentuated the lesser awareness of Hispanics and the greater levels of awareness among the less educated. There was no consistent evidence of either social disparities in or contextual associations with treatment of hypertension, given awareness. Among those on medication, blacks were only 40-50% as likely as whites to have their hypertension controlled, but context played little or no role in either the level of or disparities in control of hypertension. In sum, residential contexts potentially play a large role in accounting for racial/ethnic and, to a lesser degree, socioeconomic disparities in hypertension prevalence and, in a different way, awareness, but not in treatment or control of diagnosed hypertension.Neighborhoods Social disparities Multi-level modeling Health inequalities Hypertension Blood pressure