Social Determinants of Health and Depression Among African American Adults: A Scoping Review of Current Research

Depression in the United States (US) is increasing across all races and ethnicities and is attributed to multiple social determinants of health (SDOH). For members of historically marginalized races and ethnicities, depression is often underreported and undertreated, and can present as more severe. Limited research explores multiple SDOH and depression among African American adults in the US. Guided by Healthy People (HP) 2030, and using cross-disciplinary mental health terminology, we conducted a comprehensive search to capture studies specific to African American adults in the US published after 2016. We applied known scoping review methodology and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. From 12,315 initial results, 60 studies were included in our final sample. Most studies explored the HP 2030 Social and Community Context domain, with a heavy focus on discrimination and social support; no studies examined Health Care Access and Quality. Researchers typically utilized cross-sectional, secondary datasets; no qualitative studies were included. We recommend research that comprehensively examines mental health risk and protective factors over the life course within, not just between, populations to inform tailored health promotion and public policy interventions for improving SDOH and reducing racial and ethnic health disparities

Understanding Lyme disease: Illness experience, prevention, and the health belief model

Lyme disease is the most common vector-borne disease in the United States and is endemic in the Northeast. The aims of this research were to examine how people living in an area endemic for Lyme disease attempt to prevent catching the disease, and why they choose certain prevention measures over others. This dissertation research had three goals. The first was to examine what people who live in Storrs/Mansfield Connecticut and Block Island, Rhode Island knew about the disease, what kinds of illness experiences they have had, what types of prevention measures they used, and what they thought of prevention measures in terms of effectiveness and practicality. The second goal was to see whether variables in the Health Belief Model (perceived severity of disease, perceived susceptibility to disease, benefits to prevention and barriers to prevention) could predict level of prevention effort. The third goal was to examine whether experiences with the disease influenced levels of perceived severity and susceptibility. Overall, the participants in the study were very aware of Lyme disease, though they knew more about early onset symptoms than late stage complications. Perceived susceptibility and perceived severity levels were high. Informants recognized risky environments and almost universally took some type of precaution. The most common precaution was checking for ticks. Conversely, use of chemical bug sprays was infrequent, and many informants were concerned about the health risks of insecticide. Most, if not all, of the participants either knew someone who had been with ill Lyme disease, or had suffered from it personally. Knowing someone who suffered from Lyme, or having contracted it oneself were significant predictors of perceived susceptibility. Knowing someone who had suffered from a severe case of Lyme, or having suffered oneself were significant predictors of perceived severity. Perceived severity, seeing barriers to prevention and questioning the effectiveness of prevention were significant predictors of prevention effort. The use of tick checks, DEET sprays and wearing long pants and socks when outdoors were associated with high perceived effectiveness and low perceived barriers for these methods.

Understanding Lyme disease: Illness experience, prevention, and the health belief model

Lyme disease is the most common vector-borne disease in the United States and is endemic in the Northeast. The aims of this research were to examine how people living in an area endemic for Lyme disease attempt to prevent catching the disease, and why they choose certain prevention measures over others. This dissertation research had three goals. The first was to examine what people who live in Storrs/Mansfield Connecticut and Block Island, Rhode Island knew about the disease, what kinds of illness experiences they have had, what types of prevention measures they used, and what they thought of prevention measures in terms of effectiveness and practicality. The second goal was to see whether variables in the Health Belief Model (perceived severity of disease, perceived susceptibility to disease, benefits to prevention and barriers to prevention) could predict level of prevention effort. The third goal was to examine whether experiences with the disease influenced levels of perceived severity and susceptibility. Overall, the participants in the study were very aware of Lyme disease, though they knew more about early onset symptoms than late stage complications. Perceived susceptibility and perceived severity levels were high. Informants recognized risky environments and almost universally took some type of precaution. The most common precaution was checking for ticks. Conversely, use of chemical bug sprays was infrequent, and many informants were concerned about the health risks of insecticide. Most, if not all, of the participants either knew someone who had been with ill Lyme disease, or had suffered from it personally. Knowing someone who suffered from Lyme, or having contracted it oneself were significant predictors of perceived susceptibility. Knowing someone who had suffered from a severe case of Lyme, or having suffered oneself were significant predictors of perceived severity. Perceived severity, seeing barriers to prevention and questioning the effectiveness of prevention were significant predictors of prevention effort. The use of tick checks, DEET sprays and wearing long pants and socks when outdoors were associated with high perceived effectiveness and low perceived barriers for these methods.

Social Determinants of Health and Depression among African American Adults: A Scoping Review of Current Research

Depression in the United States (US) is increasing across all races and ethnicities and is attributed to multiple social determinants of health (SDOH). For members of historically marginalized races and ethnicities, depression is often underreported and undertreated, and can present as more severe. Limited research explores multiple SDOH and depression among African American adults in the US. Guided by Healthy People (HP) 2030, and using cross-disciplinary mental health terminology, we conducted a comprehensive search to capture studies specific to African American adults in the US published after 2016. We applied known scoping review methodology and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. From 12,315 initial results, 60 studies were included in our final sample. Most studies explored the HP 2030 Social and Community Context domain, with a heavy focus on discrimination and social support; no studies examined Health Care Access and Quality. Researchers typically utilized cross-sectional, secondary datasets; no qualitative studies were included. We recommend research that comprehensively examines mental health risk and protective factors over the life course within, not just between, populations to inform tailored health promotion and public policy interventions for improving SDOH and reducing racial and ethnic health disparities

Policy-relevant context of waterpipe tobacco smoking among university students in six countries across the Eastern Mediterranean region: A qualitative study

Background: Waterpipe tobacco smoking rates in the Eastern Mediterranean region are some of the highest worldwide, especially among young people. This study aimed to improve our knowledge of the policy-relevant context of waterpipe smoking among six countries in the Eastern Mediterranean region. Methods: In-depth interviews were conducted in Bahrain, Egypt, Jordan, Lebanon, Palestine, and the United Arab Emirates. Participants were young adult university students (18-29 years) from both genders who had ever smoked the waterpipe, recruited from universities participating in this study. Directed content analysis was used to analyze the transcripts. Results: A total of 53 in-depth interviews were conducted in Arabic in 2016. Findings were organized around 5 themes: waterpipe product characteristics; patterns of waterpipe smoking; the waterpipe café setting; perceived health consequences; and health warning labels. Waterpipe smoking was commonly perceived as a safe alternative to cigarettes. Waterpipe tobacco was reported to be widely accessible and affordable to young participants. There is a lack of knowledge among waterpipe smokers about the associated health effects. Warning labels are effective at communicating health risks associated with waterpipe smoking. Conclusions: Regulatory frameworks for waterpipe tobacco smoking should be developed and enforced, including waterpipe-specific health warning labels that elucidate the harmful effects of waterpipe smoking