The chronic load carried by minority status, including anti-Muslim prejudice.
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301 to 325 of 599Alcántara C, Gallo LC, Wen J, Dudley KA, Wallace DM, Mossavar-Rahmani Y, Sotres-Alvarez D, Zee PC, Ramos AR, Petrov ME, Casement MD, Hall MH, Redline S, Patel SR (2019)MEDLINE-indexed journal, not yet read by usSleep33 citations Employment status and the association of sociocultural stress with sleep in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).
Study objectives: We examined the association of sociocultural stress severity (i.e. acculturation stress, ethnic discrimination) and chronic stress burden with multiple dimensions of sleep in a population-based sample of US Hispanics/Latinos. We also explored whether employment status modified stress-sleep associations.
Methods: We conducted survey linear regressions to test the cross-sectional association of sociocultural stress severity and stress burden with sleep dimensions using data collected between 2010 and 2013 from individuals who participated in both the Hispanic Community Health Study/Study of Latinos Sueño and Sociocultural Ancillary studies (N = 1192).
Results: Greater acculturation stress (B = 0.75, standard error [SE] = 0.26, p < .01) and chronic psychosocial stress burden (B = 1.04, SE = 0.18, p < .001) were associated with greater insomnia symptoms but were not associa…
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Challenges to School Success and the Role of Adverse Childhood Experiences.
Objective: To examine the association between adverse childhood experiences (ACEs), by multiple types and counts of ACEs, and challenges to school success.
Methods: A cross-sectional study was conducted using data from the 2016 National Survey of Children's Health using the ACE module and 3 measures of challenges to school success: lack of school engagement, school absenteeism, and repeated grade.
Results: In multivariable analysis adjusting for selected demographic and other characteristics, children with 4 or more ACEs had higher odds of nonengagement in school (adjusted odds ratio [aOR] 2.15; 95% confidence interval [CI], 1.51-3.07), reported school absenteeism (aOR 1.75; 95% CI, 1.12-2.73), and of repeating a grade (aOR 1.71; 95% CI, 1.19-2.47, Table 4) than children with exposure to less than 4 ACEs. Risk factors for all 3 challenges to school success included age of child and speci…
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Dyrbye L, Herrin J, West CP, Wittlin NM, Dovidio JF, Hardeman R, Burke SE, Phelan S, Onyeador IN, Cunningham B, van Ryn M (2019)MEDLINE-indexed journal, not yet read by usJAMA network open101 citations Association of Racial Bias With Burnout Among Resident Physicians.
Importance: Burnout, a syndrome characterized by emotional exhaustion, depersonalization, and a decreased sense of efficacy, is common among resident physicians, and negative emotional states may increase the expression of prejudices, which are associated with racial disparities in health care. Whether racial bias varies by symptoms of burnout among resident physicians is unknown.
Objective: To assess the association between burnout and explicit and implicit racial biases toward black people in resident physicians.
Design, setting, and participants: This cohort study obtained data from surveys completed by first-year medical students and resident physicians in the United States as part of the Cognitive Habits and Growth Evaluation Study. Participants were followed up from enrollment in 2010 to 2011 through 2017. Participants completed questionnaires at year 4 of medical school as well as…
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Alang SM (2019)MEDLINE-indexed journal, not yet read by usHealth services research121 citations Mental health care among blacks in America: Confronting racism and constructing solutions.
Objectives: To describe reasons for unmet need for mental health care among blacks, identify factors associated with causes of unmet need, examine racism as a context of unmet need, and construct ways to improve service use.
Data sources: Data from the 2011-2015 National Survey on Drug Use and Health were pooled to create an analytic sample of black adults with unmet mental health need (N = 1237). Qualitative data came from focus groups (N = 30) recruited through purposive sampling.
Study design: Using sequential mixed methods, reasons for unmet need were regressed on sociodemographic, economic, and health characteristics of respondents. Findings were further explored in focus groups.
Principal findings: Higher education was associated with greater odds of reporting stigma and minimization of symptoms as reasons for unmet need. The fear of discrimination based on race and on mental illne…
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Examining Difference in Immigration Stress, Acculturation Stress and Mental Health Outcomes in Six Hispanic/Latino Nativity and Regional Groups.
Little is known about the specific behavioral health impact of acculturation stressors that affect Hispanic/Latino immigrant sub-groups. These immigration-related stressors and traumatic events may have differential impact on depression depending on country/region of origin. Using a measure of immigration and acculturation stress, the current study sought to determine differences in the impact of stress on six sub-groups of Hispanic immigrants. Data on stress and depression were examined using a large, representative adult immigrant sample (N = 641). Controlling for age, gender and years in the US, factorial analysis of covariance revealed significant differences on total Hispanic Stress Inventory 2 (HSI2) stress appraisal scores based on country/region of origin. Pair wise comparisons between country/region of origin groups revealed that Mexicans had higher levels of stress compared to …
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A model of cumulative racial-ethnic trauma among Americans of Middle Eastern and North African (MENA) descent.
Americans of Middle Eastern and North African (MENA) descent in the United States have been historically understudied, in part due to limitations of racial classification systems that typically include MENA under the broad umbrella of White. As a result, enormous gaps in knowledge about health and mental health disparities exist, with broad public health significance. In particular, there is an urgent need to attend more specifically to MENA Americans' experiences of cumulative racial-ethnic trauma, which occurs at every level of their social ecologies. This article offers a conceptual model of cumulative racial-ethnic trauma to represent the unique experiences of the MENA American population. Traumatic factors at the macrolevel include historical trauma, pervasive institutional discrimination, and a hostile national context. These factors interact with one another and further impact mic…
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Foreign-born physicians' perceptions of discrimination and stress in Finland: a cross-sectional questionnaire study.
Background: Foreign-born physicians fill in the shortage of physicians in many developed countries. Labour market theory and previous studies suggest that foreign-born physicians may be a disadvantaged group with a higher likelihood of discrimination and less prestigious jobs. The present study examines foreign-born physicians' experiences of discrimination (coming from management, colleagues and patients separately) and patient-related stress and integration-related stress, and it examines how gender, age, employment sector, country of birth, years from getting a practicing license in Finland, language problems, cross-cultural training, cross-cultural empathy, team climate and skill discretion were associated with these factors.
Methods: The present study was a cross-sectional questionnaire study among 371 foreign-born physicians in Finland, aged between 26 and 65 (65% women). Analyses …
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Health care experiences of pregnant, birthing and postnatal women of color at risk for preterm birth.
Background: Chronic stress is a known risk factor for preterm birth, yet little is known about how healthcare experiences add to or mitigate perceived stress. In this study, we described the pregnancy-related healthcare experiences of 54 women of color from Fresno, Oakland, and San Francisco, California, with social and/or medical risk factors for preterm birth.
Methods: This study was a secondary analysis of focus group data generated as part of a larger project focused on patient and community involvement in preterm birth research. English and Spanish speaking women, age 18 or greater with social and/or medical risk factors for preterm birth participated in two focus groups, six weeks apart. Data from the first focus groups are included in this analysis.
Results: Five themes emerged from thematic analysis of the transcripts. Participants described disrespect during healthcare encounter…
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Experiences of Racism and Breastfeeding Initiation and Duration Among First-Time Mothers of the Black Women's Health Study.
Background: Breastfeeding rates are lower for black women in the USA compared with other groups. Breastfeeding and lactation are sensitive time points in the life course, centering breastfeeding as a health equity issue. In the USA, experiences of racism have been linked to poor health outcomes but racism relative to breastfeeding has not been extensively investigated.
Aims: This study aims to investigate the association between experiences of racism, neighborhood segregation, and nativity with breastfeeding initiation and duration.
Methods: This is a prospective secondary analysis of the Black Women's Health Study, based on data collected from 1995 through 2005. Daily and institutional (job, housing, police) racism, nativity, and neighborhood segregation in relation to breastfeeding were examined. Odds ratios and 95% confidence intervals were calculated using binomial logistic regressio…
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Ethnic identity in context of ethnic discrimination: When does gender and other-group orientation increase risk for depressive symptoms for immigrant-origin young adults?
Objectives: Ethnic discrimination increases risk for depressive symptoms, but less is known about factors that influence the impact of this cultural challenge on psychological adjustment for immigrant-origin college students. Sociocultural identity development is especially relevant during emerging adulthood. Studies examining exacerbating or buffering impacts of ethnic identity have yielded mixed results. The current study examines conditions under which one aspect of ethnic identity, affirmation/belonging, moderates the impact of perceived ethnic discrimination stress on depressive symptoms. This was expected to vary by other-group orientation and gender, in accordance with rejection sensitivity theory.
Method: A multicultural sample of 290 non-White immigrant-origin emerging adults (aged 18-25) from mixed cultural backgrounds and generational statuses attending a college in the Southe…
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The Psychological Consequences of Pre-Emigration Trauma and Post-Migration Stress in Refugees and Immigrants from Africa.
Over 50 million people have been displaced, some as a result of conflict, which exposure can lead to psychiatric sequelae. The aims of this study were to provide estimates of pre-emigration trauma, post-migration stress, and psychological sequelae of immigrants and refugees from predominantly Sub-Saharan Africa who immigrated to Sweden. We also examined the predictors of the psychiatric sequelae as well as acculturation within the host country. A total of 420 refugees and immigrants were enrolled using stratified quota sampling. A battery of questionnaires including the Harvard Trauma Questionnaire, Post-Migration Living Difficulties Scale, the Cultural Lifestyle Questionnaire; and the Hopkins Checklist were administered. Descriptive statistics, Chi square analyses, Pearson correlations, analysis of variance, and logistic and linear regression were performed to test the aims of the study…
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Liu SY, Kawachi I (2017)MEDLINE-indexed journal, not yet read by usPublic health reports (Washington, D.C. : 1974)46 citations Discrimination and Telomere Length Among Older Adults in the United States.
Objectives: Chronic stress from experiencing discrimination can lead to long-term changes in psychological and physiologic responses, including shorter leukocyte telomere length. We examined the association between leukocyte telomere length and variations in the association by race or type of discrimination.
Methods: Our study consisted of 3868 US-born non-Hispanic black (hereinafter, black) and non-Hispanic white (hereinafter, white) adult participants from the 2008 Health and Retirement Study biomarker sample with complete sociodemographic and discrimination information. We examined major lifetime unfair treatment and everyday discrimination. Coarsened exact matching matched exposed and unexposed participants on several sociodemographic factors. Coarsened exact matching creates analytic weights for the matched data sets. We applied weighted linear regression to the matched data sets. W…
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Individual differences in the impact of vicarious racism: African American students react to the George Zimmerman trial.
Objective: This research focused on how race-based rejection sensitivity (RS-Race) and components of racial identity intensify negative psychological reactions to an incident of vicarious racism. We examined how these individual difference variables directly and/or indirectly predicted African American students' reactions to the trial of George Zimmerman in the killing of the African American teenager, Trayvon Martin.
Method: In Study 1, 471 African American students completed measures of RS-Race, thought intrusions about the Zimmerman trial, and outcome variables (negative affect about the Zimmerman trial and forgiveness for Mr. Zimmerman). In Study 2, 304 African American students completed measures of racial identity (centrality, private regard, and public regard), thought intrusions about the Zimmerman trial, negative affect, and forgiveness.
Results: In Study 1, higher RS-Race was e…
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Senseless Violence Against Central American Unaccompanied Minors: Historical Background and Call for Help.
The southwestern U.S. border has recently seen a significant increase in the number of unaccompanied children from Honduras, Guatemala, and El Salvador illegally crossing the Mexican border into the United States. Many of these children leave home to flee violence, starvation, impoverished living conditions, or other life-threatening situations. The treatment of acute stress, anxiety, and depression associated with traumatic events is crucial in helping these children address these negative psychological events they have experienced so that they can move forward with their lives. Untreated, traumatic events experienced by this population can develop into Post Traumatic Stress Disorder, a potentially life-changing and physically threatening psychological and medical issue. The United States needs to effectively address the serious matter of responding to mental health issues facing refuge…
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Mental health among older refugees: the role of trauma, discrimination, and religiousness.
Objectives: The aim of this study was to examine, first, how past traumatic stress and present acculturation indices, and discrimination are associated with mental health; and, second, whether religiousness can buffer the mental health from negative impacts of war trauma.
Method: Participants were 128 older (50-80 years) Somali refugees living in Finland. They reported experiences of war trauma and childhood adversities, and filled-in questionnaires of perceived ethnic discrimination, religiousness (beliefs, attendance, and observance of Islamic faith), and symptoms of posttraumatic stress disorder (PTSD), depressive (BDI-21), psychological distress (GHQ-12), and somatization (SCL-90).
Results: Symptom-specific regression models showed that newly arrived refugees with non-permanent legal status and severe exposures to war trauma, childhood adversity, and discrimination endorsed greater P…
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Discrimination and common mental disorder among migrant and ethnic groups: findings from a South East London Community sample.
Purpose: Few studies have examined discrimination and mental health in the UK, particularly by migrant status and in urban contexts with greater demographic diversity. This study aims to (1) describe the prevalence of discrimination experiences across multiple life domains; (2) to describe associations between discrimination experiences and common mental disorder (CMD); (3) to determine whether or not the relationship between discrimination and CMD varies by migrant status and ethnicity.
Methods: Data on major, anticipated and everyday discrimination and CMD symptoms were collected from an ethnically diverse prospective sample of 1052 participants followed up from 2008 to 2013 in the South East London Community Health study, a population-based household survey.
Results: With few exceptions, discrimination was most prevalent among those in the Black Caribbean group. However, those in the …
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Challenges Faced by Refugee New Parents from Africa in Canada.
This study examines challenges faced by refugee new parents from Africa in Canada. Refugee new parents from Zimbabwe (n = 36) and Sudan (n = 36) were interviewed individually about challenges of coping concurrently with migration and new parenthood and completed loneliness and trauma/stress measures. Four group interviews with refugee new parents (n = 30) were subsequently conducted. Participants reported isolation, loneliness, and stress linked to migration and new parenthood. New gender roles evoked marital discord. Barriers to health-related services included language. Compounding challenges included discrimination, time restrictions for financial support, prolonged immigration and family reunification processes, uncoordinated government services, and culturally insensitive policies. The results reinforce the need for research on influences of refugees' stressful experiences on parent…
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Perceived ethnic discrimination, acculturation, and psychological distress in women of Turkish origin in Germany.
Purpose: Discrimination is linked to various health problems, including mental disorders like depression and also has a negative effect on the access to mental health care services. Little is known about factors mitigating the association between ethnic discrimination and mental distress.
Methods: The present study examined the extent of the relationship between perceived ethnic discrimination and psychological distress among women of Turkish origin residing in Berlin, and explored whether this association is moderated by acculturation strategies while controlling for known predictors of distress in migrant populations.
Results: A total of 205 women of Turkish origin participated in the study. 55.1% of the participants reported some degree of ethnic discrimination. The degree of reported discrimination varied according to acculturation. The highest level of ethnic discrimination was foun…
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The essence of innocence: consequences of dehumanizing Black children.
The social category "children" defines a group of individuals who are perceived to be distinct, with essential characteristics including innocence and the need for protection (Haslam, Rothschild, & Ernst, 2000). The present research examined whether Black boys are given the protections of childhood equally to their peers. We tested 3 hypotheses: (a) that Black boys are seen as less "childlike" than their White peers, (b) that the characteristics associated with childhood will be applied less when thinking specifically about Black boys relative to White boys, and (c) that these trends would be exacerbated in contexts where Black males are dehumanized by associating them (implicitly) with apes (Goff, Eberhardt, Williams, & Jackson, 2008). We expected, derivative of these 3 principal hypotheses, that individuals would perceive Black boys as being more responsible for their actions and as be…
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Metropolitan racial residential segregation and cardiovascular mortality: exploring pathways.
Racial residential segregation has been associated with an increased risk for heart disease and stroke deaths. However, there has been little research into the role that candidate mediating pathways may play in the relationship between segregation and heart disease or stroke deaths. In this study, we examined the relationship between metropolitan statistical area (MSA)-level segregation and heart disease and stroke mortality rates, by age and race, and also estimated the effects of various educational, economic, social, and health-care indicators (which we refer to as pathways) on this relationship. We used Poisson mixed models to assess the relationship between the isolation index in 265 U.S. MSAs and county-level (heart disease, stroke) mortality rates. All models were stratified by race (non-Hispanic black, non-Hispanic white), age group (35-64 years, ≥ 65 years), and cause of death (…
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Psychosocial and contextual determinants of alcohol and drug use disorders in the National Latino and Asian American Study.
Background: In the U.S., Latino and Asian American immigrants and ethnic minorities may be at increased risk for alcohol and drug use disorders (AUDs/DUDs). The role of psychosocial and contextual characteristics as potential factors underlying this increased risk is unresolved.
Methods: Participants include 4649 adults from the National Latino and Asian American Study. Logistic regression was used to determine the relationship between acculturation, acculturative stress, neighborhood characteristics, family characteristics, and discrimination and AUDs/DUDs. Models were stratified by age of immigration and ethnicity and controlled for demographic and mental health characteristics.
Results: Overall, 9.6% of Latino and 4.1% of Asian participants met criteria for lifetime AUDs/DUDs. Acculturation, family conflict, and discrimination were positively associated with AUDs/DUDs (odds ratios [OR…
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Cultural stressors and mental health symptoms among Mexican Americans: a prospective study examining the impact of the family and neighborhood context.
Studies of stress consistently have linked individuals' experiences of stress to maladjustment, but limited attention has been given to cultural stressors commonly experienced by minority individuals. To address this, the current study examined the links between cultural stressors and prospective changes in mental health symptoms in a sample of 710 (49 % female) Mexican American youth. In addition, the moderating role of both family and neighborhood cohesion was examined. In-home interviews were completed with youth, mothers (required) and fathers (optional) to collect data on youth's experiences of cultural stressors (discrimination and language hassles) and internalizing/externalizing behavior, and mothers' report of family cohesion and mothers' and fathers' report of neighborhood cohesion. Analyses revealed that youth's experiences of discrimination and language hassles at 5th grade w…
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A longitudinal analysis of Hispanic youth acculturation and cigarette smoking: the roles of gender, culture, family, and discrimination.
Introduction: Risk for smoking initiation increases as Hispanic youth acculturate to U.S. society, and this association seems to be stronger for Hispanic girls than boys. To better understand the influence of culture, family, and everyday discrimination on cigarette smoking, we tested a process-oriented model of acculturation and cigarette smoking.
Methods: Data came from Project RED (Reteniendo y Entendiendo Diversidad para Salud), which included 1,436 Hispanic students (54% girls) from Southern California. We used data from 9th to 11th grade (85% were 14 years old, and 86% were U.S. born) to test the influence of acculturation-related experiences on smoking over time.
Results: Multigroup structural equation analysis suggested that acculturation was associated with increased familismo and lower traditional gender roles, and enculturation was linked more with familismo and respeto. Famil…
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A mixed-methods approach to psychological help-seeking in Muslims: Islamophobia, self-stigma, and therapeutic preferences.
Objective: Muslims living in the United States (MLUS) report high mental health stigma. They also underutilize professional psychological help, despite experiencing rising Islamophobia and comparatively poorer mental health. In line with double stigma, we examined whether MLUS who perceived greater Islamophobia also experienced greater self-stigma of seeking help, and whether this was related to negative help-seeking attitudes. We also assessed therapist demographic and treatment modality preferences and explored how they related to risk factors for low help-seeking.
Method: Utilizing a representative sample of 350 MLUS (50% women, 33% immigrants) acquired via a Qualtrics panel aggregate, we assessed a path model of help-seeking attitudes to determine the direct and indirect effects of perceived Islamophobia via self-stigma and psychological distress. Therapist and treatment preferences …
matched on Prejudice (mesh), islamophobia (text)
The Muslimah Project: A Collaborative Inquiry into Discrimination and Muslim Women's Mental Health in a Canadian Context.
Prior research in Europe and North America demonstrates that religious discrimination against Muslim people, commonly known as Islamophobia, results in many negative mental health impacts, including depression, anxiety, isolation, and feelings of exclusion (Awan & Zempi, 2015). In Canada, Muslim women face a unique form of discrimination based on their religious, racial, and gender identities (Helly, 2012; Zine, 2008). Grounded in feminist intersectional theory and practice (Hill Collins & Bilge, 2016), the present manuscript emerges from a community-based project centered on Muslim women's experiences of discrimination and resulting adverse mental health impacts. Through a series of five focus groups (N = 55), the research team engaged with Muslim women from diverse backgrounds in order to gain a more complete understanding of mental health inequities in Canada. Thematic analyses of foc…
matched on Prejudice (mesh), islamophobia (text)