The chronic load carried by minority status, including anti-Muslim prejudice.
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451 to 475 of 599The Boston Puerto Rican Health Study, a longitudinal cohort study on health disparities in Puerto Rican adults: challenges and opportunities.
Background: The Boston Puerto Rican Health Study is an ongoing longitudinal cohort study designed to examine the role of psychosocial stress on presence and development of allostatic load and health outcomes in Puerto Ricans, and potential modification by nutritional status, genetic variation, and social support.
Methods: Self-identified Puerto Ricans, aged 45-75 years and residing in the Boston, MA metro area, were recruited through door-to-door enumeration and community approaches. Participants completed a comprehensive set of questionnaires and tests. Blood, urine and salivary samples were extracted for biomarker and genetic analysis. Measurements are repeated at a two-year follow-up.
Results: A total of 1500 eligible participants completed baseline measurements, with nearly 80% two-year follow-up retention. The majority of the cohort is female (70%), and many have less than 8th grade…
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Transgender female youth and sex work: HIV risk and a comparison of life factors related to engagement in sex work.
This study examined the HIV risk behaviors and life experiences of 151 transgender female youth, ages 15-24, in Los Angeles and Chicago. Descriptive analyses and logistic regression modeling were used to identify life factors associated with ever having engaged in sex work. Sixty-seven percent of participants had ever engaged in sex work and 19% self-reported being HIV positive. Many factors were significantly associated with sex work for this sample population. A final multivariate logistic regression model found that lower education status, homelessness, use of street drugs, and perceived social support remained significantly associated with sex work when controlling for other factors. Findings highlight the complex HIV risk environment and suggest a need for sex work initiation research for transgender female youth. HIV prevention efforts for this population need to include broad-base…
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Enhancing pathways into care (EPIC): community development working with the Pakistani community to improve patient pathways within a crisis resolution and home treatment service.
Black and Minority Ethnic (BME) communities receive different pathways into mental health care with BME service users often presenting in crisis. This is associated with both an over representation of such groups in psychiatric wards and people avoiding mainstream services altogether. The Sheffield Crisis Resolution Home Treatment (CRHT) created the Enhancing Pathways Into Care (EPIC) project, which initially focused on engagement with the Pakistani community (the largest BME group in Sheffield). The project aimed to empower the Pakistani community to seek mental health support earlier within their own community, build up trust in mainstream services and enhance the clinical pathways within services to provide more culturally appropriate care. CRHT joined with the local Pakistani Muslim Centre (PMC) to work in partnership. The PMC had existing links with the Pakistani community and provi…
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Ethnic stereotypes and the underachievement of UK medical students from ethnic minorities: qualitative study.
Objective: To explore ethnic stereotypes of UK medical students in the context of academic underachievement of medical students from ethnic minorities.
Design: Qualitative study using semistructured one to one interviews and focus groups.
Setting: A London medical school.
Participants: 27 year 3 medical students and 25 clinical teachers, purposively sampled for ethnicity and sex.
Methods: Data were analysed using the theory of stereotype threat (a psychological phenomenon thought to negatively affect the performance of people from ethnic minorities in educational contexts) and the constant comparative method.
Results: Participants believed the student-teacher relationship was vital for clinical learning. Teachers had strong perceptions about "good" clinical students (interactive, keen, respectful), and some described being aggressive towards students whom they perceived as quiet, unmotiv…
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Ethnicity and registration as a kidney donor: the significance of identity and belonging.
Studies of attitudes towards cadaveric organ donation have failed to adequately explain the disproportionately low rates of cadaveric organ donation among ethnic minorities. This may reflect an unhelpfully static and narrow definition of 'culture' entailing a collection of predefined cognitive 'beliefs' and 'attitudes.' This paper takes a more integrative approach and considers how ethnicity shapes perceptions of identity and belonging that underpin organ donation discourse among a section of Black British Caribbean people, one of largest migrant groups in the UK. The study is based on 14 in-depth interviews with men and women of Caribbean descent living in south London. Respondents' accounts identified their Caribbean heritage and racial identity as producing a divided sense of loyalty and belonging accompanied by perceptions of discrimination and exclusion from the mainstream society t…
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"You've gotta know the community": minority women make recommendations about community-focused health research.
Objectives: To determine what ethnic and racial minority women recommend as the best approaches to participatory health research in their communities. To achieve this goal, this study focused on HIV prevention research.
Methods: In 2003, Seven African American and seven Latina women (ages 33 to 52), all members of an HIV Prevention Collaborative Board, participated in individual interviews, lasting about 90 minutes each. Participants discussed their involvement in participatory research, and made recommendations as to how health researchers might better engage their communities. Data were coded independently by two coders following standard procedure for content analysis.
Results: Women's voices and expertise can help guide health-related research. This study shows that: (1) participatory HIV prevention research should be founded on trust and commitment, leading to social support; (2) re…
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The stress moderating role of benefit finding on psychological distress and well-being among women living with HIV/AIDS.
This study examines whether the perception of having experienced growth as a result of a stressful event, often termed benefit finding, moderates the effects of stress (both physical symptomatology and social conflict) on psychological distress and well-being. For this cross-sectional study, an ethnically diverse sample (N = 138) of women living with HIV/AIDS completed a series of self-report measures. Hierarchical regression analysis demonstrated that physical symptoms, social conflict, and benefit finding were associated with psychological distress and positive affect, even after controlling for social support, locus of control, and demographic confounds. Significant interactions revealed that among women with a high number of HIV-related physical symptoms, benefit finding moderated the negative effects of physical symptoms on both depressive and anxious symptoms. Benefit finding was n…
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Prevalence, recognition, and treatment of attention-deficit/hyperactivity disorder in a national sample of US children.
Objective: To determine the US national prevalence of attention-deficit/hyperactivity disorder (ADHD) and whether prevalence, recognition, and treatment vary by socioeconomic group.
Design: Cross-sectional survey.
Setting: Nationally representative sample of the US population from 2001 to 2004.
Participants: Eight- to 15-year-old children (N = 3082) in the National Health and Nutrition Examination Survey.
Main outcome measures: The Diagnostic Interview Schedule for Children (caregiver module) was used to ascertain the presence of ADHD in the past year based on Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) criteria. Prior diagnosis of ADHD by a health professional and ADHD medication use were assessed by caregiver report.
Results: Of the children, 8.7% met DSM-IV criteria for ADHD. The poorest children (lowest quintile) were more likely than the wealthies…
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Remennick L (2006)MEDLINE-indexed journal, not yet read by usThe breast journal70 citations The challenge of early breast cancer detection among immigrant and minority women in multicultural societies.
A sociological view of the barriers experienced by women from traditional cultures, both in their native countries and as immigrants and minorities in multicultural western societies, in preventive health care generally and in breast screening specifically, is essential not only to understand patterns of late-stage diagnosis, but also to design successful interventions and programs. Breast cancer is a unique disease, as its name ties together a multisymbolic organ of the female anatomy and a potentially fatal affliction, the treatment of which commonly is a body-mutilating procedure (mastectomy). Because of its special nature, breast cancer is shrouded in fears, myths, and connotations reaching far beyond the objective clinical understanding of the disease. Many women do not use available breast-screening services and present with advanced symptoms. To help women detect and treat breast …
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The role of faith-based institutions in addressing health disparities: a case study of an initiative in the southwest Bronx.
Although many public health initiatives have been implemented through collaborations with faith-based institutions, little is known about best practices for developing such programs. Using a community-based participatory approach, this case study examines the implementation of an initiative in the Bronx, New York, that is designed to educate community members about health promotion and disease management and to mobilize church members to seek equal access to health care services. The study used qualitative methods, including the collaborative development of a logic model for the initiative, focus groups, interviews, analysis of program reports, and participant observation. The paper examines three key aspects of the initiative's implementation: (1) the engagement of the church leadership; (2) the use of church structures as venues for education and intervention; and (3) changes in church…
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Evaluation of a community-based health promotion program for the elderly: lessons from Seniors CAN.
Purpose: To evaluate the effects of a community-based educational program designed to promote health by enhancing older adults' mastery while decreasing loneliness and stress.
Methods: Between 1999 and 2004, 339 older adults who participated in Seniors CAN completed standardized assessments of mastery, loneliness, and stress, prior to and upon completion of the 4-month intervention. Participants'scores were compared using paired t-tests to measure changes from preintervention to postintervention. Change scores were then subjected to three-way ANOVA to assess the relative effectiveness based upon participants' sociodemographic characteristics.
Results: Participants demonstrated significant improvements from preintervention to postintervention for mastery, loneliness, and stress. Additional analysis revealed that improvement in loneliness was significantly greater among low-income ethnic m…
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Early infant feeding decisions in low-income Latinas.
Breastfeeding rates remain low, especially among low-income minority women. The objective of this qualitative study was to assess barriers to breastfeeding and reasons for combination feeding among low-income Latina women and their families. Meetings were held with key informants to inform the sampling plan and develop questions for focus groups. Data were collected from eight qualitative focus groups with primiparous mothers postpartum, mothers breastfeeding at 4 to 6 months, mothers formula feeding at 4 to 6 months, grandmothers and fathers, and 29 individual interviews with formula- and combination-feeding mothers. Transcripts of focus groups and interviews were content coded and analyzed for thematic domains and then compared for concurrence and differences. Four main domains with 15 categories were identified: (a) Best of both: Mothers desire to ensure their babies get both the heal…
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Sexual Anal Pain in Gay and Bisexual Men: In Search of Explanatory Factors.
Background: Sexual anal pain-or anodyspareunia-in gay and bisexual men is a scientifically and clinically neglected topic. More understanding of its origins and correlates is needed.
Aim: To search for correlates of painful anal intercourse with the inclusion of minority stress processes.
Methods: The analysis is based on data collected in an Internet study on the sexuality of Polish gay, bisexual, and straight men. Multiple ordinal regression analysis was used to search for the correlates of painful receptive anal intercourse in a group of 1,443 nonheterosexual men who declared practicing this type of intercourse within the last 12 months. The investigated correlates included demographics, sexual patterns and experiences, experiencing minority stress, sexual problems, and mental and physical health. To assess the level of minority stress, we used the Sexual Minority Stress Scale based o…
matched on minority stress (text), Bisexuality (mesh)
The effects of general and homophobic victimization on adolescents' psychosocial and educational concerns: the importance of intersecting identities and parent support.
Many adolescents experience peer victimization, which often can be homophobic. Applying the minority stress model with attention to intersecting social identities, this study tested the effects of general and homophobic victimization on several educational outcomes through suicidality and school belonging among 15,923 adolescents in Grades 7 through 12 on account of their sexual orientation and race/ethnicity. Parent support also was tested as a moderator of these effects. Homophobic victimization had different effects on suicidality across groups, indicating the importance of considering individuals' multiple social identities. However, homophobic victimization had universal negative effects on school belonging for all groups. Nearly all indirect effects of general and homophobic victimization on reported grades, truancy, and importance of graduating were significant through suicidality…
matched on minority stress (text), Bisexuality (mesh)
Racial Discrimination during Adolescence Predicts Mental Health Deterioration in Adulthood: Gender Differences among Blacks.
Background: Despite the existing knowledge regarding the negative mental health consequences of perceived racial discrimination, very few researchers have used a longitudinal design with long-term follow-up periods to explore gender differences in this association over time.
Objective: The current longitudinal study aimed to investigate gender differences in predictive role of an increase in perceived racial discrimination during adolescence for mental health deterioration a decade later when they are transitioning to young adulthood.
Methods: Current study followed 681 Black youths for 18 years from 1994 (mean age 15) to 2012 (mean age 32). All participants spent their adolescence and transition to young adulthood in an economically disadvantaged urban area in the Midwest of the United States. Independent variable was perceived racial discrimination measured in 1999 and 2002. Outcomes w…
matched on perceived discrimination (text), racial discrimination (text)
Perceived discrimination and mental health symptoms among Black men with HIV.
People living with HIV (PLWH) exhibit more severe mental health symptoms, including depression and posttraumatic stress disorder (PTSD) symptoms, than do members of the general public. We examined whether perceived discrimination, which has been associated with poor mental health in prior research, contributes to greater depression and PTSD symptoms among HIV-positive Black men who have sex with men (MSM), who are at high risk for discrimination from multiple stigmatized characteristics (HIV-serostatus, race/ethnicity, sexual orientation). A total of 181 Black MSM living with HIV completed audio computer-assisted self-interviews (ACASI) that included measures of mental health symptoms (depression, PTSD) and scales assessing perceived discrimination due to HIV-serostatus, race/ethnicity, and sexual orientation. In bivariate tests, all three perceived discrimination scales were significant…
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Littman L (2021)MEDLINE-indexed journal, not yet read by usArchives of sexual behavior96 citations Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners.
The study's purpose was to describe a population of individuals who experienced gender dysphoria, chose to undergo medical and/or surgical transition and then detransitioned by discontinuing medications, having surgery to reverse the effects of transition, or both. Recruitment information with a link to an anonymous survey was shared on social media, professional listservs, and via snowball sampling. Sixty-nine percent of the 100 participants were natal female and 31.0% were natal male. Reasons for detransitioning were varied and included: experiencing discrimination (23.0%); becoming more comfortable identifying as their natal sex (60.0%); having concerns about potential medical complications from transitioning (49.0%); and coming to the view that their gender dysphoria was caused by something specific such as trauma, abuse, or a mental health condition (38.0%). Homophobia or difficulty…
matched on Bisexuality (mesh), Homosexuality, Female (mesh)
Religious-Based Sexual Stigma and Psychological Health: Roles of Internalization, Religious Struggle, and Religiosity.
The current study examined potential mediators (i.e., internalized heterosexism and religious struggle), moderators (i.e., religiosity), and moderated mediation of the links between experiences of enacted religious-based sexual stigma and both psychological distress and wellbeing. Participants were 193 lesbian, gay, and bisexual (LGB) persons who were currently affiliated with a faith/religion and who completed an online survey. Participants were recruited through paid Facebook advertisements and research announcements sent to a variety of LGB-related Listservs, organizations, and Internet resources. Results from the mediation analyses revealed that religious-based sexual stigma was indirectly related to more psychological distress and less wellbeing via more internalized heterosexism and greater religious struggle. Findings from the moderated-mediation analyses revealed a significant co…
matched on Bisexuality (mesh), Homosexuality, Female (mesh)
Health, Homelessness Severity, and Substance Use among Sexual Minority Youth Experiencing Homelessness: A Comparison of Bisexual Versus Gay and Lesbian Youth.
Lesbian, gay, bisexual, and questioning (LGBQ) youth are overrepresented among youth experiencing homelessness (YEH), and health disparities among LGBQ youth are well-documented. LGBQ youth are typically aggregated as a single sexual minority group; however, research suggests that bisexual youth may have greater mental health, substance use, and physical health risks relative to their gay and lesbian peers. In a probability sample of LGBQ YEH in Los Angeles County (n = 183), we examined subgroup differences in homelessness severity, depression, physical health, and substance use, focusing on differences between bisexual and gay/lesbian youth due to the small subsample of questioning youth. Indicators of homelessness severity were standalone outcomes, and also were integrated as control variables with gender, age, race/ethnicity, and education in multivariable models. Bisexual youth were …
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Kaestle CE (2019)MEDLINE-indexed journal, not yet read by usJournal of sex research32 citations Sexual Orientation Trajectories Based on Sexual Attractions, Partners, and Identity: A Longitudinal Investigation From Adolescence Through Young Adulthood Using a U.S. Representative Sample.
Defining sexual minority status longitudinally over critical developmental periods is essential for understanding the roots of health disparities. Theory supports multidimensional continuums, but current research often examines single measures of sexual activity, sexual attractions, or self-labeled identity separately. Here, a new typology of longitudinal latent classes describes dynamic multidimensional processes continuing from late adolescence (ages 16 to 18) through the late 20s. Using Add Health data (N = 6,864), longitudinal latent class analysis (LLCA), a person-centered approach, showed significant differences between the orientation experiences of males and females (invariance tests led to stratification by sex). The male LLCA model predicted four classes: straight males (87.4%), minimal sexual expression males (6.5%), mostly straight and bi males (3.8%), and emerging gay males …
matched on Bisexuality (mesh), Homosexuality, Female (mesh)
Bisexuality, Union Status, and Gender Composition of the Couple: Reexamining Marital Advantage in Health.
It has long been documented that married individuals have better health outcomes than unmarried individuals. However, this marital advantage paradigm has been developed primarily based on heterosexual populations. No studies to date have examined the health effects of marriage among bisexuals, one of the most disadvantaged but understudied sexual minority groups, although a few have shown mixed results for gays and lesbians. Similarly, no research has examined how the gender composition of a couple may shape bisexuals' health outcomes above and beyond the effects of sexual orientation. We analyzed pooled data from the 2013-2017 National Health Interview Survey (n = 154,485) and found that the health advantage of marriage applied only to heterosexuals and, to a lesser extent, gays and lesbians. Married bisexuals, however, exhibited poorer health than unmarried bisexuals when socioeconomic…
matched on Bisexuality (mesh), Homosexuality, Female (mesh)
Chronic Physiologic Effects of Stress Among Lesbian, Gay, and Bisexual Adults: Results From the National Health and Nutrition Examination Survey.
Objective: Social disadvantage is associated with markers of physiological dysregulation, which is linked to disease trajectories. Chronic experiences with discrimination are thought to result in the accumulation of physiological "wear and tear" known as allostatic load (AL) among socially marginalized populations such as sexual minorities. Using a nationally representative US sample, we examined whether (1) people who self-identified as homosexual or bisexual display higher levels of AL than heterosexual individuals and (2) subgroups of sexual identity would further differ from each other as a consequence of distinct experiences of marginalization.
Methods: We use data from the 2001-2010 National Health and Nutrition Examination Survey. Employing multivariate regression methods with sex-specific analyses, we examined AL score differences among lesbian/gay (n = 211), bisexual (n = 307), …
matched on Bisexuality (mesh), Homosexuality, Female (mesh)
Predictors of Sexual Minority Youth's Reported Suicide Attempts and Mental Health.
Lesbian, gay, and bisexual youth (LGBY) report higher rates of mental health concerns compared to heterosexual youth due to minority stressors. This study examined the interpersonal and intrapersonal variables that predict psychological distress and self-reported suicide attempts in a sample of 61 LGBY in the Mid-South, which is a highly overlooked regional area for LGBY research. Youth who lost friends when coming out were 29 times more likely to report suicide attempts, and those who experienced psychological maltreatment from caregivers were 9.5 times more likely to report a suicide attempt. Internalized heterosexism, feelings of guilt or shame, and psychological maltreatment from caregivers were significant predictors of depression and anxiety symptoms. This study highlights the importance of creating affirming spaces for LGBY, particularly in areas of the country that experience gre…
matched on Bisexuality (mesh), Homosexuality, Female (mesh)
Stereotypes, Emotions, and Behaviors Toward Lesbians, Gay Men, Bisexual Women, and Bisexual Men.
The utility of the Stereotype Content Model (Fiske, Cuddy, Glick, & Xu, 2002) and the Behaviors from Intergroup Affect and Stereotypes map (Cuddy, Fiske, & Glick, 2007) were examined in the context of heterosexuals' attitudes toward sexual minorities. Heterosexual adults completed a survey measuring stereotypes, emotions, and behavioral tendencies toward lesbians, gay men, bisexual women, and bisexual men. Stereotype content differed across groups and showed "gendered" and "valenced" effects on emotions and behavioral tendencies. Competence predicted behaviors for men, whereas warmth and competence predicted behaviors for women, and, for the most part, more was better. Admiration and contempt mediated most of these relationships across most subgroups, but pity and envy played smaller roles for some subgroups. Across all groups, competence played a more predictive role than warmth.
matched on Bisexuality (mesh), Homosexuality, Female (mesh)
Living Arrangement and Loneliness Among Lesbian, Gay, and Bisexual Older Adults.
Purpose of the study: Loneliness is a key health risk for older adults. Utilizing the loneliness model, we examine the relationship between living arrangement and loneliness among lesbian, gay, and bisexual (LGB) older adults, taking into consideration potential correlates including social resources and personal constraints.
Design and methods: We use data from a national survey of LGB adults aged 50 and older (N = 2,444). Types of living arrangement include living with a partner or spouse, living alone, and living with someone other than a partner or spouse.
Results: Compared with LGB older adults living with a partner or spouse, both those living alone and living with others reported higher degrees of loneliness, even after controlling for other correlates. The results of a multivariate regression analysis reveal that social support, social network size, and internalized stigma partial…
matched on Bisexuality (mesh), Homosexuality, Female (mesh)