Alcohol abstinence and binge drinking: the intersections of language and gender among Hispanic adults in a national sample, 2002–2018

Purpose

Prior research examining alcohol use using national data has often overlooked vital heterogeneity among Hispanics, especially that related to language dominance and gender. We examine the prevalence of alcohol abstinence and—given prior research suggesting that many Spanish dominant Hispanics do not drink—examine rates of binge drinking among past-year alcohol users with a focus on the intersections of language and gender among Hispanics, while drawing comparisons with non-Hispanic (NH) White and NH Black adults.

Methods

Drawing from the National Survey on Drug Use and Health—a nationally representative survey between 2002 and 2018—we examine the year-by-year prevalence of alcohol abstinence and binge drinking among adults ages 18 and older in the United States.

Results

A disproportionate number of Spanish-dominant Hispanics abstain from alcohol use (54%), with particularly high levels of alcohol abstinence observed among Spanish dominant women (men: 39%, women: 67%). The prevalence of alcohol abstinence among English-dominant Hispanic men (24%) and women (32%) is far lower, approximating that of NH Whites (men: 23%, women: 32%). Importantly, however, among Spanish-dominant drinkers, the prevalence of binge drinking (men: 52%, women: 33%) is comparable to or greater than NH Whites (men: 42%, women: 32%). Binge drinking levels among English-dominant Hispanic men (50%) and women (37%) are greater than among their NH White counterparts.

Conclusion

Findings paint a complex picture; consistent with prior research, we see that many Hispanics abstain from alcohol, but we also see new evidence underscoring that—among Hispanic drinkers—the prevalence of binge drinking is disconcertingly elevated.

     

Social inequalities contribute to racial/ethnic disparities in depressive symptomology among men who have sex with men

Purpose

Racial/ethnic minorities experience disproportionate rates of depressive symptoms in the United States. The magnitude that underlying factors—such as social inequalities—contribute to these symptoms is unknown. We sought to identify exposures that explain racial/ethnic differences in clinically significant depressive symptomology among men who have sex with men (MSM).

Methods

Data from the Multicenter AIDS Cohort Study (MACS), a prospective cohort study, were used to examine clinically significant symptoms of depression (Center for Epidemiologic Studies Depression Scale score ≥ 20) among non-Latinx White, non-Latinx Black, and Latinx MSM. We included 44,823 person-visits by 1729 MSM seen in the study sites of Baltimore/Washington, DC; Chicago; Pittsburgh/Columbus; and Los Angeles from 2000 to 2017. Regression models estimated the percentage of depressive symptom risk explained by social, treatment, and health-related variables related to race/ethnicity. Machine-learning methods were used to predict the impact of mitigating differences in determinants of depressive symptoms by race/ethnicity.

Results

At the most recent non-missing MACS visit, 16% of non-Latinx White MSM reported clinically significant depressive symptoms, compared to 22% of non-Latinx Black and 25% of Latinx men. We found that income and social-environmental stress were the largest contributors to racial/ethnic disparities in risk for depressive symptoms. Similarly, setting the prevalence of these two exposures to be equal across racial/ethnic groups was estimated to be most effective at reducing levels of clinically significant depressive symptoms.

Conclusion

Results suggested that reducing socioeconomic inequalities and stressful experiences may be effective public health targets to decrease racial/ethnic disparities in depressive symptoms among MSM.

     

Racial disparities in sleep health between Black and White young adults: The role of neighborhood safety in childhood

ObjectivesBlack adults in the United States have shorter sleep durations and poorer sleep efficiency relative to White adults, yet reasons for these disparities are not well explicated. The objective of this study was to examine neighborhood safety in childhood as a mediator of subsequent racial disparities in sleep.MethodsData were from Black and White young adults attending a large, predominantly White university in the Southeastern United States (N = 263; 52% Black, 53% female; Mean age = 19.21 years, SD = 1.01). Sleep parameters were assessed from eight nights of wrist actigraphy (time in bed, sleep duration, and efficiency) and an established self-report measure of daytime sleepiness. Residential histories from birth through age 18 were documented, and retrospective self-reports of neighborhood safety in childhood were assessed.ResultsBlack participants had less time in bed (p < 0.001), shorter sleep duration (p < 0.001), poorer sleep efficiency (p < 0.001), and more daytime sleepiness (p = 0.009) than White participants. Neighborhood safety mediated race differences in time in bed (p = 0.028), sleep duration (p = 0.033), and daytime sleepiness (p = 0.048), but not sleep efficiency. Findings were substantively unchanged after adjustment for family socioeconomic status, BMI, and substance use.ConclusionsFindings support the hypothesis that neighborhood safety in childhood may partially account for race differences in subsequent sleep duration and daytime sleepiness. Addressing racial inequities in childhood neighborhood safety may be an important step toward reducing racial disparities in sleep health.     

Disparities in diagnosis,treatment and survival between Black and White Parkinson patients

IntroductionRacial disparities in diagnosis, treatment and survival in Black patients with Parkinson's disease (PD) compared to White patients have not been well studied, largely due to limited number of studies and information on Black patients in healthcare systems. Studying racial disparities and identifying underlying factors in large populations are important to understand PD and improve care.MethodsWe retrospectively identified PD patients on both races from 1/1/2006 to 10/31/2017 and compared demographics, socioeconomic status (educations, incomes and insurances), comorbidities (all categories, including mood, cognition and psychosis), treatment (medications for parkinsonism and major non-motor symptoms, and frequency and locations of healthcare) and survival, and identified factors associated with medication usage and survival.ResultsWe retrospectively studied 2033 PD patients, of whom 725 were Black. Black patients lacked male predominance, were 4 years older at first diagnosis here, more likely to smoke and live in a low education and income community, and possessed limited insurances compared to White patients. Black patients also had more comorbidities and were more likely to receive care through emergency or inpatient service, but less likely to be on medications for parkinsonism and mood disorders. Race, age, smoking status, insurance type, frequency and locations of healthcare and comorbidities were associated with medication usage. Black race, older age, inpatient admission and malignancy were associated with increased risk of death.ConclusionWe revealed racial disparities in diagnosis, treatment and survival, and factors associated with medication usage and survival in the largest reported Black PD cohort from a single center.     

Sleep-related problems and suicide behavior and ideation among Black and White trauma-exposed psychiatric inpatients

ObjectiveSleep-related problems (SRPs) are associated with increased risk for suicide-related behavior and death. Given that Black adults report greater SRPs as compared to White adults, the purpose of the current study was to examine sleep problems, suicide-related psychiatric admission, and suicide ideation, in Black and White trauma-exposed adults.MethodSuicide-related behavior (i.e., intent, plan, and/or behavior) as reason for hospital admission was obtained via medical records review for 172 Black and White adults who were admitted to an acute-care psychiatric facility; all participants completed validated measures of sleep quality and suicide ideation.ResultsAdjusted logistic regression analyses revealed that sleep-related daytime dysfunction (AOR = 4.32, p < .05) and poor sleep quality (AOR = 3.64, p < .05) were associated with significantly increased odds that Black participants were admitted for suicide-related psychiatric care. Poorer sleep quality (AOR = 2.10, p < .05) was also associated with increased odds of suicide-related admission among White participants. However, shorter sleep duration was marginally associated with suicide ideation in Black participants only.ConclusionsSRPs may be related to suicide-related behavior and ideation differently for vulnerable Black and White adults. More research is needed to understand potential race group differences and mechanisms by which SRPs increase risk for suicide crisis across racial groups.     

Racial/ethnic differences in 12-month prevalence and persistence of mood,anxiety, and substance use disorders: Variation by nativity and socioeconomic status

BackgroundDespite equivalent or lower lifetime and past-year prevalence of mental disorder among racial/ethnic minorities compared to non-Latino Whites in the United States, evidence suggests that mental disorders are more persistent among minorities than non-Latino Whites. But, it is unclear how nativity and socioeconomic status contribute to observed racial/ethnic differences in prevalence and persistence of mood, anxiety, and substance disorders.MethodData were examined from a coordinated series of four national surveys that together assessed 21,024 Asian, non-Latino Black, Latino, and non-Latino White adults between 2001 and 2003. Common DSM-IV mood, anxiety, and substance disorders were assessed using the Composite International Diagnostic Interview. Logistic regression analyses examined how several predictors (e.g., race/ethnicity, nativity, education, income) and the interactions between those predictors were associated with both 12-month disorder prevalence and 12-month prevalence among lifetime cases. For the second series of analyses, age of onset and time since onset were used as additional control variables to indirectly estimate disorder persistence.ResultsNon-Latino Whites demonstrated the highest unadjusted 12-month prevalence of all disorder types (p < 0.001), though differences were also observed across minority groups. In contrast, Asian, Latino, and Black adults demonstrated higher 12-month prevalence of mood disorders among lifetime cases than Whites (p < 0.001) prior to adjustments Once we introduced nativity and other relevant controls (e.g., age, sex, urbanicity), US-born Whites with at least one US-born parent demonstrated higher 12-month mood disorder prevalence than foreign-born Whites or US-born Whites with two foreign parents (OR = 0.51, 95% CI = [0.36, 0.73]); this group also demonstrated higher odds of past-year mood disorder than Asian (OR = 0.59, 95% CI = [0.42, 0.82]) and Black (OR = 0.70, 95% CI = [0.58, 0.83]) adults, but not Latino adults (OR = 0.89, 95% CI = [0.74, 1.06]). Racial/ethnic differences in 12-month mood and substance disorder prevalence were moderated by educational attainment, especially among adults without a college education. Additionally, racial/ethnic minority groups with no more than a high school education demonstrated more persistent mood and substance disorders than non-Latino Whites; these relationships reversed or disappeared at higher education levels.ConclusionNativity may be a particularly relevant consideration for diagnosing mood disorder among non-Latino Whites; additionally, lower education appears to be associated with increased relative risk of persistent mood and substance use disorders among racial/ethnic minorities compared to non-Latino Whites.     

The Impact of Mental Health Intensive Case Management on Functioning and Clinical Outcomes of Older Black and White Veterans With Serious Mental Illness

ObjectivesTo examine differences in service delivery, functioning, and clinical outcomes between older Black and White veterans participating in a national Veterans Health Administration (VHA) program of intensive case management.DesignSecondary analysis of national program evaluation data.SettingVHA Intensive Community Mental Health Recovery (ICMHR) program.ParticipantsBlack (n = 1327) and White (n = 4402) veterans age 55 and older who enrolled in ICMHR between 2000-2013.MeasurementsMeasures evaluated sociodemographic factors, service delivery, functioning, and clinical outcomes. ANOVA and chi-squares were used to evaluate differences in enrollment characteristics and service delivery between Black and White veterans. Regression analyses were used to examine changes in outcomes over 6 months controlling for confounding baseline differences and service delivery. Cohen's d of .20 was used as a threshold for a clinically meaningful effect.ResultsBlack veterans were more likely to be diagnosed with schizophrenia, alcohol use disorder, and drug use disorder. Although case managers spent significantly less time with Black veterans, there was no difference in the frequency of contacts. Medication management and substance use treatment were more often provided to Black veterans. Black veterans experienced substantially greater improvement in anxiety/depression than White veterans with a small effect size (Cohen's d =-0.25). Changes in all other outcome measures did not meet criteria for clinically meaningful differences.ConclusionsBlack veterans experienced meaningfully greater improvements than White veterans on anxiety/depression but not on other measures. Provision of high-intensity services in an equal-access setting may reduce health disparities between Black and White older adults with serious mental illness.     

Ethnic inequalities in clozapine use among people with treatment-resistant schizophrenia: a retrospective cohort study using data from electronic clinical records

Purpose

Clozapine is the most effective intervention for treatment-resistant schizophrenia (TRS). Several studies report ethnic disparities in clozapine treatment. However, few studies restrict analyses to TRS cohorts alone or address confounding by benign ethnic neutropenia. This study investigates ethnic equity in access to clozapine treatment for people with treatment-resistant schizophrenia spectrum disorder.

Methods

A retrospective cohort study, using information from 11 years of clinical records (2007–2017) from the South London and Maudsley NHS Trust. We identified a cohort of service-users with TRS using a validated algorithm. We investigated associations between ethnicity and clozapine treatment, adjusting for sociodemographic factors, psychiatric multi-morbidity, substance misuse, neutropenia, and service-use.

Results

Among 2239 cases of TRS, Black service-users were less likely to be receive clozapine compared with White British service-users after adjusting for confounders (Black African aOR = 0.49, 95% CI [0.33, 0.74], p = 0.001; Black Caribbean aOR = 0.64, 95% CI [0.43, 0.93], p = 0.019; Black British aOR = 0.61, 95% CI [0.41, 0.91], p = 0.016). It was additionally observed that neutropenia was not related to treatment with clozapine. Also, a detention under the Mental Health Act was negatively associated clozapine receipt, suggesting people with TRS who were detained are less likely to be treated with clozapine.

Conclusion

Black service-users with TRS were less likely to receive clozapine than White British service-users. Considering the protective effect of treatment with clozapine, these inequities may place Black service-users at higher risk for hospital admissions and mortality.

     

Intersections of poverty,race/ethnicity,and sex: alcohol consumption and adverse outcomes in the United States

We examine whether intersectionality theory—which formalizes the notion that adverse health outcomes owing to having a marginalized social status, identity, or characteristic, may be magnified for individuals with an additional marginalized social status, identity, or characteristic—can be applied using quantitative methods to describe the differential effects of poverty on alcohol consumption across sex and race/ethnicity. Using the National Epidemiologic Survey on Alcohol and Related Conditions, we analyze longitudinal data from Black, Hispanic, and White drinkers (n?=?21,140) to assess multiplicative interactions between poverty, as defined by the US Census Bureau, sex, and race/ethnicity, on adverse alcohol outcomes. Findings indicated that the effect of poverty on the past-year incidence of heavy episodic drinking was stronger among Black men and Black women in comparison to men and women of other racial/ethnic groups. Poverty reduction programs that are culturally informed may help reduce racial/ethnic disparities in the adverse outcomes of alcohol consumption.     

Racial and Socioeconomic Disparities in Spinal Cord Stimulation Among the Medicare Population

IntroductionSpinal cord stimulation (SCS) is used in the treatment of many chronic pain conditions. This study investigates racial and socioeconomic disparities in SCS among Medicare patients with chronic pain.Materials and MethodsPatients over the age of 18 with a primary diagnosis of postlaminectomy syndrome (ICD-10 M96.1) or chronic pain syndrome (ICD-10 G89.4) were identified in the Center for Medicare and Medicaid Services (CMS) Medicare Claims Limited Data Set. We defined our outcome as SCS therapy by race and socioeconomic status. Multivariable logistic regression was used to determine the variables associated with SCS.ResultsWe identified 1,244,927 patients treated between 2016 and 2019 with a primary diagnosis of postlaminectomy syndrome (PLS) or chronic pain syndrome (CPS). Of these patients, 59,182 (4.8%) received SCS. Multivariable logistic regression analysis revealed that, compared with White patients, Black (OR [95%CI], 0.62 [0.6–0.65], p < 0.001), Asian (0.66 [0.56–0.76], p < 0.001), Hispanic (0.86 [0.8–0.93], p < 0.001), and North American Native (0.62 [0.56–0.69], p < 0.001) patients were significantly less likely to receive SCS. In addition, patients who were dual-eligible for Medicare and Medicaid were significantly less likely to receive SCS than those eligible for Medicare only (OR = 0.38 [95% CI: 0.37–0.39], p < 0.001).ConclusionsThis study suggests that racial and socioeconomic disparities exist in SCS among Medicare and Medicaid patients with PLS and CPS. Further work is required to elucidate the complex etiology underlying these findings.     

Risk of suicide among stroke survivors in the United States

BackgroundStroke is the largest cause of disability and the 5^th leading cause of death in the United States. Suicide is the 12^th leading cause of death in the United States. However, little is known about the risk of suicide among people with a prior stroke.ObjectivesUsing Multiple Cause of Death data (1999-2020) from the Centers for Disease Control and Prevention WONDER database, we examined via cross-sectional analysis the risk of suicide among survivors of stroke as compared to the general U.S. population and among subgroups within the United States.MethodsWe assessed disparities in suicide rate among patients with stroke stratified by sex, race, urbanization levels, and census regions using the CDC WONDER multiple cause of death database. Standardized mortality rates were calculated to compare the suicide rate of stroke patients with the rates among demographic-matched cohorts and the general United States population.ResultsAs compared to the general population, stroke survivors had an elevated risk of suicide. Black stroke survivors had a lower rate of suicide as compared to the general population, while White stroke survivors and those in nonmetropolitan areas had an elevated risk compared to the general population.ConclusionThere was a slightly elevated risk of suicide among people with a prior stroke in the United States. This risk may be elevated among White people and among people living in nonmetropolitan areas.     

The relation between race-related implicit associations and scalp-recorded neural activity evoked by faces from different races

Abstract

The neural correlates of the perception of faces from different races were investigated. White participants performed a gender identification task in which Asian, Black, and White faces were presented while event-related potentials (ERPs) were recorded. Participants also completed an implicit association task for Black (IAT-Black) and Asian (IAT-Asian) faces. ERPs evoked by Black and White faces differed, with Black faces evoking a larger positive ERP that peaked at 168 ms over the frontal scalp, and White faces evoking a larger negative ERP that peaked at 244 ms. These Black/White ERP differences significantly correlated with participants’ scores on the IAT-Black. ERPs also differentiated White from Asian faces and a significant correlation was obtained between the White-Asian ERP difference waves at ~500 ms and the IAT-Asian. A positive ERP at 116 ms over occipital scalp differentiated all three races, but was not correlated with either IAT. In addition, a late positive component (around 592 ms) was greater for the same race compared to either other race faces, suggesting potentially more extended or deeper processing of the same race faces. Taken together, the ERP/IAT correlations observed for both other races indicate the influence of a race-sensitive evaluative process that may include early more automatic and/or implicit processes and relatively later more controlled processes.     

The relationship between childhood trauma and alcohol use initiation in Black and White adolescent girls: considering socioeconomic status and neighborhood factors

Purpose

To assess whether the higher prevalence of childhood trauma exposure but lower prevalence of alcohol use in Black vs. White adolescent girls reflects a lower magnitude of association between trauma and alcohol use initiation in Black girls; and additionally, whether low socioeconomic status (SES) and neighborhood factors account in part for the link between trauma and early alcohol use.

Methods

Data were drawn from annual interviews conducted with an urban sample of girls and their primary caregivers from ages 5–8 (baseline) through age 17 (n?=?2068, 57.7% Black, 42.3% White). Cox proportional hazards regression analyses using race and childhood trauma to predict alcohol use initiation were conducted in two stages, with SES and neighborhood factors added in the second stage.

Results

Childhood trauma was more prevalent (29.0 vs. 17.5%) and alcohol use initiation less prevalent (37.7 vs. 54.4%) in Black vs. White girls, but we found no evidence for differences in liability conferred by trauma. However, significant changes in hazards ratios (HRs) from the unadjusted to adjusted models were observed for Black race (HR?=?0.57, CI 0.50–0.65 to HR?=?0.66, CI 0.54–0.80) and childhood trauma (HR?=?1.70, CI 1.46–1.99 to HR?=?1.34, CI 1.05–1.71).

Conclusions

Findings indicate that childhood trauma is an equally potent risk factor for early drinking onset for Black and White girls; the risk for early alcohol use in Black girls who have experienced traumatic events should not be underestimated. Results further indicate that low SES and neighborhood factors contribute to the associations of childhood trauma and race with alcohol use initiation.

     

Chronic Psychological Stress and Racial Disparities in Body Mass Index Change Between Black and White Girls Aged 10–19

Background

One of the largest health disparities in the USA is in obesity rates between Black and White females.

Purpose

The objective of this study was to test the hypothesis that the stress–obesity link is stronger in Black females than in White females aged 10–19.

Methods

Multilevel modeling captured the dynamic of acute (1 month) and chronic (10 years) stress and body mass index (BMI; weight in kilograms divided by height in meters squared) change in the National Heart, Lung, and Blood Institute Growth and Health Study, which consists of 2,379 Black and White girls across a span of socioeconomic status. The girls were assessed longitudinally from ages 10 to 19.

Results

Higher levels of stress during the 10 years predicted significantly greater increases in BMI over time compared to lower levels of stress. This relationship was significantly stronger for Black compared to White girls.

Conclusion

Psychological stress is a modifiable risk factor that may moderate early racial disparities in BMI.     

Relationships between insomnia and alcohol and cocaine use frequency with aggression among veterans engaged in substance use treatment

BackgroundVeterans with substance use problems have rates of partner and non-partner violence that typically exceed the general population. Sleep problems may exacerbate violence and maintain addictive behaviors in non-veterans, but requires study in veterans. Therefore, we examine the interrelationships between substance use, insomnia, and violence in veterans.MethodsVeterans (N = 762) screened for a randomized controlled trial at veterans affairs mental health and substance use clinics. Participants completed modified Conflict Tactics Scales to quantify past-year violence and the Insomnia Symptom Questionnaire to assess sleep disturbance. We evaluated associations between substance use and sleep in predicting the target of aggression (partner or non-partner) and degree of violence (aggression or injury) using binomial logistic regressions.ResultsHalf of participants endorsed symptoms suggestive of insomnia, 23.2% endorsed physical aggression toward partners (PA-P) and 33.9% non-partners (PA-NP), and 9.7% endorsed physical injury of partners (PI-P) and 17.6% of non-partners (PI-NP). Regressions revealed significant models for PA-P, PA-NP, and PI-NP, whereas the PI-P model was not significant. PA-P was higher among non-Caucasian race and older veterans. PA-NP was more common in those with insomnia and increased with frequency of cocaine use. Insomnia moderated the relationship between cocaine use and PA-NP; there was a weaker relationship between cocaine use and PA-NP in those with insomnia. PI-NP was more common with higher frequency of alcohol and cocaine use, and in those with insomnia.ConclusionsThis study finds sleep disturbances are meaningful predictors of violence among veterans with differential relationships with aggression severity, victims, and substance use concurrence.     

Disparities in sleep characteristics by race/ethnicity in a population-based sample: Chicago Area Sleep Study

BackgroundPrior studies report less favorable sleep characteristics among non-Whites as compared with non-Hispanic Whites. However, few population-based studies have used objective measures of sleep duration, especially in more than two racial/ethnic groups. We tested whether objectively estimated sleep duration and self-reported sleep quality varied by race and whether differences were at least partially explained by the variability in clinical, psychological, and behavioral covariates.MethodsAdults aged 35–64 years who self-identified as White, Black, Asian, or Hispanic were randomly sampled from Chicago, IL, and the surrounding suburbs. Our analytic sample included adults who had an apnea–hypopnea index <15 after one night of screening and who completed seven nights of wrist actigraphy for determination of sleep duration, sleep percentage, minutes of wake after sleep onset, and sleep fragmentation (n = 495). Daytime sleepiness was estimated using the Epworth Sleepiness Scale (ESS), and sleep quality was estimated from the Pittsburgh Sleep Quality Index (PSQI).ResultsFollowing statistical adjustment for age, gender, education, work schedule (ie, day vs. night shift), smoking status, depressive symptoms, body mass index (BMI), hypertension, and diabetes, sleep duration (minutes) was significantly (all p < 0.01) shorter in Black (mean = 399.5), Hispanic (mean = 411.7), and Asian (mean = 409.6) participants than in White participants (mean = 447.4). All remaining sleep characteristics were significantly less favorable among Black participants as compared with White participants. Asian participants also reported significantly more daytime sleepiness than did White participants.ConclusionsDifferences in sleep characteristics by race/ethnicity are apparent in a sample of adults with a low probability of sleep apnea and following adjustment for known confounders.     

Effects of social stressors on cardiovascular reactivity in black and white women

Background: Behavioral scientists have theorized that perceived racism in social interactions may account for some of the observed disparities in coronary heart disease between Black and White Americans.Purpose: The objective was to examine whether racial stress influences cardiovascular reactivity, a risk factor for cardiovascular disease.Methods: We measured cardiovascular responses in Black and White women (n = 80) as they talked about 3 hypothetical scenarios: (a) being accused of shoplifting (racial stressor), (b) experiencing airport delays (nonracial stressor), and (c) giving a campus tour (control).Results: Relative to White women, Black women had significantly greater mean diastolic blood pressure reactivity (3.81 vs. 0.25 mmHg; p < .05) in response to the racial stressor than in response to the nonracial stressor. Black women exhibited significantly lower heart rate during recovery following the racial stressor than during recovery following the nonracial stressor (−0.37 beats/min vs. 0.86 beats/min; p < .001). Among Black women, those who explicitly made race attributions during the racial stressor had greater systolic but not diastolic blood pressure reactivity than those who did not make racial attributions (8.32 mmHg vs. 2.17 mmHg; p < .05).Conclusions: These findings suggest that perceived racism in social interactions may contribute to increased physiological stress for Black women. This work was supported by Grant CA91411 from the National Institutes of Health and a grant from the Professional Staff Congress of City University of New York. We are grateful for the excellent research assistance of Allyson Bunbury, Michael Gold, Mark Vegh, and Alex Libin. Teceta Thomas provided helpful comments on the article.     

Ethnic and racial diversity in eating disorder prevention trials

ABSTRACT

Recruiting diverse samples for prevention trials is challenging, but essential. This paper provides baseline data for four racial/ethnic groups from a randomized controlled trial of a mobile-based prevention intervention and systematically reviews recruitment trends in diversity across technology-based prevention studies. Female emerging adults completed measures of appearance esteem, body image flexibility, appearance comparison, and self-compassion. White participants reported lower body esteem and body image flexibility, and higher appearance comparison compared to Black and Asian participants. Latina participants evidenced higher appearance comparison compared to Black participants. The literature review revealed that while rates of diversity in previous trials vary, the majority of the participants were White. Efforts are needed to increase diversity in prevention trials.     

Does the longitudinal association between neighbourhood cohesion and mental health differ by ethnicity? Results from the UK Household Longitudinal Survey

Purpose

While the association between neighbourhood cohesion and mental health has been widely studied in the general population, the effects of neighbourhood cohesion across ethnic groups are not well understood. Ethnicity is often left out of study design, many studies do not consider effect modification by ethnicity, or they rely on overly simplistic ethnic categories.

Methods

Data from the UK household longitudinal study were used to investigate whether changes in neighbourhood cohesion are independently associated with changes in mental health (measured using the GHQ) over 9 years (2009–2018), and whether the association differed across 17 ethnic groups. The study used a fixed-effect modeling approach that includes within-person estimators that allow each participant to act as their own control.

Results

Compared to British White, the following ethnic groups all saw a similar improvement in GHQ (− 0.76, 95% CI − 0.83 to − 0.70) for each point increase in neighbourhood cohesion: Irish, any other White, White and Asian mixed, Chinese, Caribbean, African, any other Black, Arab, and others. Some ethnic groups saw stronger improvements in mental for each point increase in neighbourhood cohesion, including White and Black Caribbean mixed, any other mixed, Indian, Pakistani, any other Asian, with the strongest effect seen in Bangladeshi participants (− 2.52. 95% CI − 3.48 to − 1.56).

Conclusion

Our study highlights the importance of ethnocultural data in research examining neighbourhood effects on mental health. Future research should evaluate policies to improve neighbourhood cohesion for ethnic minorities to address ethnic mental health disparities.

     

Racial disparities in sleep: the role of neighborhood disadvantage

ObjectiveDisparities in sleep duration and efficiency between Black/African American (AA) and White/European American (EA) adults are well-documented. The objective of this study was to examine neighborhood disadvantage as an explanation for race differences in objectively measured sleep.MethodsData were from 133 AA and 293 EA adults who participated in the sleep assessment protocol of the Midlife in the United States (MIDUS) study (57% female; Mean Age = 56.8 years, SD = 11.4). Sleep minutes, onset latency, and waking after sleep onset (WASO) were assessed over seven nights using wrist actigraphy. Neighborhood characteristics were assessed by linking home addresses to tract-level socioeconomic data from the 2000 US Census. Multilevel models estimated associations between neighborhood disadvantage and sleep, and the degree to which neighborhood disadvantage mediated race differences in sleep controlling for family socioeconomic position and demographic variables.ResultsAAs had shorter sleep duration, greater onset latency, and higher WASO than EAs (ps < 0.001). Neighborhood disadvantage was significantly associated with WASO (B = 3.54, p = 0.028), but not sleep minutes (B = -2.21, p = 0.60) or latency (B = 1.55, p = 0.38). Furthermore, race was indirectly associated with WASO via neighborhood disadvantage (B = 4.63, p = 0.035), which explained 24% of the race difference. When measures of depression, health behaviors, and obesity were added to the model, the association between neighborhood disadvantage and WASO was attenuated by 11% but remained significant.ConclusionFindings suggest that neighborhood disadvantage mediates a portion of race differences in WASO, an important indicator of sleep efficiency.