Suchergebnisse

<p><strong>Objective: </strong>Racial/ethnic minorities in the United States not only experience discrimination personally but also witness or hear about fellow in-group members experiencing discrimination (ie, group-level discrimination). The objective of our study was to examine whether the effects of group-level discrimination on mental and physical health are different from those of personal level discrimination among Black Americans by drawing upon social psychology research of the Personal/Group Discrimination Discrepancy. <strong></strong></p><p><strong>Design and Setting: </strong>We conducted a secondary analysis of cross-sectional survey data from a larger study. <strong></strong></p><p><strong>Participants: </strong>One hundred and twenty participants, who self-identified as Black/ African Americans during the laboratory sessions (57.5% women, mean age = 48.97, standard deviation = 8.58) in the parent study, were included in our analyses. <strong></strong></p><p><strong>Main Predictor Measures: </strong>Perceived personal- level discrimination was assessed with five items that were taken from two existing measures, and group-level racial discrimination was assessed with three items. <strong></strong></p><p><strong>Main Outcome Measures: </strong>Self-reported physical and mental health were assessed with a modified version of SF-8. <strong></strong></p><p><strong>Results: </strong>Perceived personal-level racial discrimination was associated with worse mental health. In contrast, perceived group-level racial discrimination was associated with better mental as well as physical health. <strong></strong></p><p><strong>Conclusions: </strong>Perceived group-level racial discrimination may serve as one of several health protective factors even when individuals perceive personal-level racial discrimination. The present findings demonstrate the importance of examining both personal- and group-level experiences of racial discrimination as they independently relate to health outcomes for Black Americans. <em>Ethn Dis. </em>2016;26:453-460; doi:10.18865/ ed.26.3.453 </p>

<i>Background:</i> The purpose of this study is to investigate the sociodemographic and health characteristics associated with the willingness to donate a DNA sample, and consent to testing and long-term storage of that sample, among participants in a longitudinal community-based survey. <i>Sample:</i> Eighty-three percent of the 1,071 participants interviewed in 2004/5 agreed to donate a biological specimen (blood or buccal). <i>Results:</i> Age was consistently inversely associated with the willingness to allow genetic testing (OR 0.97; p < 0.05), but was unrelated to the willingness to donate or allow storage.There was no association between race and the consent to donate a specimen, but Blacks were less likely to consent to DNA storage for future research as compared with members of other racial groups (OR 0.50; p < 0.01). Four conditions were listed on the consent form as relevant to the genes targeted for assay. Participants with a family history of 1 or more of these conditions were more likely to donate than those without (OR 1.68; p < 0.01). Participants with a personal history of 1 of the 4 conditions listed were not more or less likely to donate, allow testing or allow storage than respondents without such a history. <i>Conclusions:</i> Sociodemographic characteristics were unrelated to the willingness to donate a biological sample. Age, but not race, sex or education, was related to consent to genetic testing. Race, but not age, sex or education, was related to consent to storage. A family history of health conditions listed as relevant to the assays being requested was related to the willingness to donate. Factors that affect the willingness to donate a biological sample in an epidemiologic study are not the same as those associated with the willingness to allow genetic testing or storage of that sample for unspecified future research.

AbstractThis commentary addresses the increasing public health problem of suicide in later life and presents the case for preventing suicide in residential long-term care settings. We do so by examining this issue from the perspective of three levels of stakeholders – societal, organisational and individual – considering the relevant context, barriers and implications of each. We begin by discussing contemporary societal perspectives of ageing; the potential impact of ageism on prevention of late-life suicide; and the roles of gender and masculinity. This is followed by a historical analysis of the origin of residential long-term care; current organisational challenges; and person-centred care as a suicide prevention strategy. Finally, we consider suicide in long-term care from the perspective of individuals, including the experience of older adults living in residential care settings; the impact of suicide on residential care health professionals and other staff; and the impact of suicide bereavement on family, friends and other residents. We conclude with recommendations for policy reform and future research. This commentary aims to confront the often unspoken bias associated with preventing suicide among older adults, particularly those living with complex medical conditions, and invoke an open dialogue about suicide prevention in this population and setting.

<p class="Pa7">A substantial gap remains between what we know about type 2 diabetes prevention and our ability to apply that knowledge in socially disadvantaged populations at highest risk. This gap results, in part, from a lack of integration between epidemio­logic science and social psychology theory, particularly regarding the intersections of stress, self-regulatory health behaviors, and the biological mechanisms underlying the development of diabetes. In this commen­tary, we describe the utility of a theoretical framework that focuses on the intersection of biological, psychosocial, and environ­mental contexts as they apply to diabetes disparities, and how such a framework could inform a translational research agenda to reorient prevention efforts to address these inequalities. Such reorientation is needed to ensure that the implementation of prevention efforts does not inadvertently widen diabetes disparities.</p><p class="Pa7"><em>Ethn Dis.</em>2017; 27(1):63-68; doi:10.18865/ed.27.1.63.</p>

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. Ethn Dis. 2020;30(4):563-574; doi:10.18865/ed.30.563