Racial/Ethnic differences in self-reported health problems and herbal use among older women

The purpose of this study was to examine the racial/ethnic differences in self- reported health problems and herbal use as a self-care practice between white American and African-American older women, and between herbal users and nonusers. Two data sets collected in 1998 and 2002 were combined to perform this study. The total sample (143 participants) consisted of 85 white Americans and 58 African-American women > or = 65 years, living independently in the community. While there were statistically significant differences in education (chi-squared = 19.085, p=0.0001) and annual income (chi-squared = 21.905, p=0.0001) between white American and African-American women, no differences were found in the use of herbals between the two groups. There was a significant relationship between the number of herbals used and the number of nonprescribed medications used (gamma = 0.320, p<0.01). No relationship was detected between the number of herbals used and self-reported health problems (gamma = 0.075, p<0.01), and between the number of nonprescribed medications used and self-reported health problems (gamma = 0.047, p<0.01). White American herbal users utilized the highest number of combination products (prescribed, nonprescribed and herbals) of all. African-American herbal users indicated a higher number of combination products than African-American nonusers. Results suggested that herbals were used as a complementary rather than an alternative therapy to manage perceived health concerns in both groups.     

Racial differences in symptoms, comorbidity, and treatment for major depressive disorder among black and white adults

Objective: Racial differences in the clinical nature of major depressive disorder (MDD) could contribute to treatment disparities, but national data with large samples are limited. Our objective was to examine black-white differences in clinical characteristics and treatment for MDD from one of the largest, national community samples of US adults.Methods: Non-Hispanic black and white adults (n = 32752) from the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions produced data on 1866 respondents who met criteria for MDD based on the Diagnosfic and Statistical Manual of Mental Disorders (Fourth Edition) in the preceding 12 months. Outcome measures were depressive symptoms, comorbid psychiatric and medical disorders, disability, and treatment.Results: Blacks with MDD had significantly higher odds of initial insomnia, early-morning awakening, and restlessness than whites. Odds of hypertension (odds ratio [OR], 2.16; 95% confidence interval [CI], 1.48-3.14), obesity (OR, 1.98; 95% CI, 1.45-2.69), and liver disease (OR, 3.68; 95% CI, 1.20-11.30) were higher among blacks than whites. In unadjusted models, blacks had greater impairment than whites in social and physical functioning. However, adjusting for sociode-mographic characteristics eliminated these differences. Blacks were less likely than whites to receive outpatient services (OR, 0.51; 95% CI, 0.36-0.72) and be prescribed medications for MDD, but were more likely to receive emergency room and inpatient treatment.Conclusions: We found few racial differences in depressive symptoms, psychiatric comorbidity, and disability after adjusting for sociodemographic factors. Blacks' lower utilization of ambulatory treatment for MDD and greater medical comorbidity, emergency department use, and hospitalization suggests that management of MDD among blacks should be emphasized in primary care or other settings where treatment is more accessible.     

The association among neighborhood socioeconomic status, race and chronic pain in black and white older adults

The association among race, neighborhood socioeconomic status (SES), and chronic pain has not been well examined in older people. Clinical data was obtained from older adults (>50 years old) presenting to a tertiary care pain center. The relative roles of race and neighborhood SES on the chronic pain experienced in older black and white adults were assessed. Older blacks experienced more affective pain, pain-related disability and mood disorder symptoms than older whites. Confirmatory factor analysis confirmed previously hypothesized factors for the McGill Pain Questionnaire pain dimensions and the Pain Disability Index. Exploratory and confirmatory factor analyses also identified factors in the Brief Symptom Inventory and neighborhood SES. Structural equation modeling showed black race was associated with lower neighborhood SES and also with increased affective pain, obligatory disability and mood disorders mediationally through neighborhood SES. It was indirectly associated with increased sensory and miscellaneous pain, and voluntary disability through low neighborhood SES. Racial interaction examination showed that neighborhood SES had the same relationship to outcomes by race. We found increasing neighborhood SES is associated with decreasing negative chronic pain outcomes for older blacks and whites. Our data provide evidence that both race and neighborhood SES are important factors to consider when examining the chronic pain experience among older Americans.     

Racial differences in health concern

An understanding of racial differences in risk-related affect may help explain racial differences in health behaviors and outcomes and provide additional opportunities for intervention. In phone interviews with a random community sample of 197 whites, 155 blacks and 163 Latinos, we assessed concern that respondents' health would be hurt by their diet, an inability to exercise, an inability to follow a doctor's recommendations and disease. A multivariate analysis of variance with follow-up profile analysis revealed that whites were less concerned than blacks and Latinos about an inability to follow their doctors' recommendations (ps < 0.01). There were no racial differences in the other health concern variables. Interventions to inform blacks and Latinos about their health risks must strike a balance between creating enough health concern to encourage health behavior but not so much that it interferes with health-promoting behaviors.     

Racial/ethnic sexual health disparities among incarcerated women

Rates of sexually transmitted infections (STIs) in women in U.S. corrections facilities are higher than rates in community samples. Research that combines behavioral correlates of STI with STI history by race/ethnicity has not been done in incarcerated women. The purpose of this study was to compare by race/ethnicity self-reported sexual risk behaviors with self-reported history of STI in an incarcerated sample. An interviewer administered a questionnaire to 428 incarcerated women. Blacks were more likely to report consistent condom use in the three months prior to incarceration (47% vs. 28%, p < 0.05), and Hispanics were less likely to report sex work than were whites (16% vs. 39%, p < 0.05). Whites were more likely than blacks to report having had an unplanned pregnancy (88% vs. 67%, p < 0.05). Despite having lower self-reported risk on several measures, Blacks were more likely to report history of STI (65% vs. 40%, p < 0.05). The correctional setting is an opportune place to better understand and address the complex issue of sexual health disparities.     

Stress,psychological distress,psychosocial factors,menopause symptoms and physical health in women

Objectives

Relatively few studies have evaluated relationships between stress, psychological distress, psychosocial factors and menopause symptoms, and none have evaluated emotional intelligence (EI) in relation to menopause. In this study, direct and indirect relationships were evaluated between stress, psychological distress, psychosocial factors (e.g. social support, coping, EI), menopause symptom severity and physical health in middle-aged women.

Methods

One hundred and sixteen women aged 45–55 years were recruited through women's health centres and community organizations. They completed a short questionnaire asking about stress, psychological distress (i.e. anxiety, depression), EI, attitude to menopause, menopause symptoms and physical health.

Results

Low emotional intelligence was found to be related to worse menopause symptoms and physical health, and these associations were partly mediated by high stress, anxiety and depression, a negative attitude to menopause and low proactive coping.

Conclusions

Women with high EI appear to hold more positive attitudes to menopause and experience less severe stress, psychological distress and menopause symptoms and better physical health. These results suggest that women who expect menopause to be a negative experience or are highly stressed or distressed may be more likely to experience a more negative menopause.     

Activity-induced pain as a predictor of physical activity behavior among individuals with chronic pain: the role of physical activity enjoyment

Nearly 70% of adults with chronic pain experience increased pain during activity, and this may reduce enjoyment of physical activity (PA), and subsequent PA intention/behavior. The goal of this study was to examine increased pain during activity as a predictor of PA, via its effects on PA enjoyment. Participants included 178 overweight/obese midlife adults with chronic pain who completed an online prospective survey. Results indicated that greater increases in pain during activity were associated with less PA enjoyment, and, in turn, lower intention to exercise over the next week (p?<?0.05). Activity-induced pain also predicted lower total volume of PA at 1-week follow-up, and this relationship was mediated by PA enjoyment (p?<?0.05). These findings have the potential to inform the refinement of PA promotion interventions for individuals with chronic pain.

     

Racial differences in beliefs about genetic screening among patients at inner-city neighborhood health centers

BACKGROUND: Genetic testing has the potential to identify persons at high risk for disease. Given the history of racial disparities in screening, early detection and accessing treatment, understanding racial differences in beliefs about genetics is essential to preventing disparities in some conditions. METHODS: In 2004, a sample of older adult patients from four inner-city health centers was surveyed to assess beliefs about genetic determinants of disease, genetic testing and religion. Logistic regression determined which beliefs were associated with race. RESULTS: Of the 314 respondents, 50% were African Americans. Most respondents thought that sickle cell disease, cystic fibrosis and diabetes are primarily genetic. African Americans were more likely than Caucasians to believe that genetic testing will lead to racial discrimination (Odds ratio (OR): 3.02, 95% confidence interval (CI): 1.5-6.0) and to think that all pregnant women should have genetic tests (OR=3.8, 95% CI: 1.7-8.6). African Americans were more likely to believe that God's Word is the most important source for moral decisions (OR: 3.6, 95% CI :1.5-8.7). CONCLUSION: African Americans and Caucasians differ in beliefs about genetic testing and the basis for moral decision-making. Acknowledging and understanding these differences may lead to better medical care.     

Spiritual coping,psychosocial adjustment,and physical health in youth with chronic illness: a meta-analytic review

Objective: The current systematic review and meta-analysis aimed to assess the strength of the relationships between religious/spiritual coping strategies and psychosocial adjustment and physical health in youth with chronic illness. Background: Faced with medical stressors and uncertainty about their illness, spiritual beliefs and behaviours are important for youth with chronic illness. Research suggests that some spiritual coping strategies are helpful (positive), while others are not (negative), and these dimensions of spiritual coping are important predictors of functioning among youth with chronic illness. Method: Fourteen studies, published between 1990 and 2015, met inclusion criteria for the meta-analysis and were analysed using both a fixed effects model and random effects model (REM). Results: Findings revealed significant, small to moderate associations between negative spiritual coping and more concurrent internalising problems (REM r?=?.34), lower quality of life (REM r?=??.34), and poorer health (REM r?=??.08). Under the fixed, but not REM, the combined effects showed small to moderate significant relationships between positive spiritual coping and fewer internalising problems (r?=??.19) and better physical health (r?=?.19). Conclusion: The results reveal that spiritual coping is an important coping strategy for paediatric patients. Consistent with findings among adults with chronic illness, negative spiritual coping puts paediatric patients at risk for psychosocial maladjustment and poorer health. Intervention research is needed to determine if targeting spiritual coping improves health and psychosocial well-being.     

Anatomical differences in the psoas muscles in young black and white men

The anatomy of the psoas major muscle (PMA) in young black and white men was studied during routine autopsies. The forensic autopsies included 44 fresh male cadavers (21 black, 23 white) with an age span of 14 to 25 y. The range for weight was 66–76 kg and for height 169–182 cm. The PMA was initially measured in its entire length before measuring the diameter and circumference at each segmental level (L1–S1). At each segmental level, the calculated anatomical cross-sectional area (ACSA) was more than 3 times greater in the black group compared with the white ( P <0.001). The psoas minor muscle (PMI) was absent in 91% of the black subjects, but only in 13% of the white subjects. These data show that the PMA is markedly larger in black than white subjects. The marked race specific difference in the size of the PMA may have implications for hip flexor strength, spine function and race specific incidence in low back pathology, and warrants further investigation.     

Factors associated with elective Norplant removal in black and white women.

Premature removal of contraceptive implants (Norplant [levonorgestrel implants], Wyeth-Ayerst Laboratories, Philadelphia, Pennsylvania) is a cause of a sizable national medical expenditure in the United States. Understanding the factors that influence the decision to remove the implants and being able to predict which users are likely to elect discontinuation prematurely could provide useful information for counseling patients as they are considering contraceptive implants so that potentially enormous long-term savings could be achieved. This study surveyed 98 women who had Norplant inserted and removed between January 1991 and December 1994. Data were collected from chart review, and when necessary, a questionnaire was used to extract information not found in the chart. The chi-squared statistic and t-test were used to compare demographic variables. All but one subject received comprehensive pre-implant counseling. The main reason given for electively removing the Norplant prematurely was irregular menstrual bleeding (60%). Pre-implant counseling did not influence the decision for removal. These results indicate the importance of clarifying patients'' doubts regarding menstrual bleeding irregularities during follow-up visits rather than relying on the information patients received during preimplant counseling.     

Status of dental health in black and white Americans

The status of dental health in the American population has significantly improved during the past 15 years. The prevalence of dental diseases is similar in children when racial comparisons are made. However, the dental treatment needs are greater and much more severe in both black adults and black children. The most recent national dental survey included employed adults only. Therefore, true differences between races may be even more marked when jobless adults are included. This omission is especially significant for blacks, where unemployment rates are twice those of whites, and this subgroup has not been included in the most recent national survey.     

Personality differences among black, white, and Hispanic-American male heroin addicts on MMPI content scales

Used MMPI Content Scale scores (Wiggins, 1966) to assess personality differences among black, white, and Hispanic-American heroin addicts. Ss were 423 male veterans who volunteered for the first time for treatment between 1972 and 1979 to an inpatient Drug Dependence Treatment Program (DDTP) of a Veterans Administration Medical Center. Two hypotheses were tested: First, that minority group heroin addicts (blacks and Hispanics) will show better adjustment than majority group (white) heroin addicts; second, that Hispanic-American heroin addicts will evidence personality characteristics unlike those of either whites or blacks. Both hypotheses were confirmed. Results were interpreted as supporting cultural theories of substance abuse and providing implications for diagnosis and treatment of substance abuse disorders among minority ethnic groups.     

Similarities and differences in black men and women in psychotherapy

A survey of 93 psychiatrists concerning the psychotherapy of black men and women indicated that there were more similarities than differences between the men and women. Black male patients aged 31 to 40 and black women in the age ranges from 26 to 30 and 31 to 40 were most frequently seen for treatment. The patients were usually married and employed in technical or semiprofessional occupations. Both men and women had depression as the most frequent presenting problem, with work-related and family problems the next most frequent presenting problems.     

Racial differences in symptom management approaches among persons with radiographic knee osteoarthritis

ABSTRACT: BACKGROUND: The extent to which racial differences exist in use of treatments for osteoarthritis (OA) is debatable. The purpose of this study was to describe the differences between African Americans (AA) and Caucasian Americans (CA) in using treatment approaches to manage symptoms among individuals with radiographic-confirmed knee OA. METHODS: A cross-sectional study was conducted. Using data from the Osteoarthritis Initiative, we identified 508 AA and 2,075 CA with radiographic tibiofemoral OA in at least one knee. Trained interviewers asked questions relating to current OA treatments including seven CAM therapy categories--alternative medical systems, mind-body interventions, manipulation and body-based methods, energy therapies, and three types of biologically based therapies, as well as conventional medications. We categorized participants as: conventional medication only users, CAM only users, users of both and users of neither. Multinomial logistic regression models adjusting for sociodemographics and clinical/functional factors provided estimates of the association between race and treatment use. RESULTS: Overall, 16.5% of AA and 24.2% of CA exclusively used CAM to treat OA, 25.0% of AA and 23.8% of CA used CAM in conjunction with conventional medications, and 24.8% of AA and 14.6% of CA exclusively used conventional medications. After control for sociodemographic and clinical factors, AA were less likely than CA to use CAM therapies alone (adjusted odds ratio (OR) of using CAM alone relative to no CAM or conventional treatments: 0.68, 95% confidence interval (CI): 0.48-0.96) or with conventional medications (adjusted OR relative to no CAM or conventional treatments: 0.59, 95%CI: 0.42-0.83). However, no differences in use of conventional medications alone were observed after adjustment of covariates. CONCLUSION: CAM use is common among people with knee OA, but is less likely to be used by AA relative to CA. For effective CAM therapies, targeted outreach to underserved populations including education about benefits of various CAM treatments and providing accessible care may attenuate observed disparities in effective CAM use by race. Key words: osteoarthritis, race, pain, complementary and alternative medicine.     

Social support and depression among the black and white elderly

This study of urban elderly persons (age 60+) examines Black/White differences with regard to a set of social support factors, physical health, and ego strength and their relationship t o depression. Data were collected in interviews of community residents of Nashville. The two groups of elderly respondents were very similar relative to age, marital status, education, and income levels. The groups did not differ on the number of medical problems, presence of depression, or social support variables, except for ego strength, in which White respondents had poorer ego strength than did Black respondents. Regression analyses revealed different sets of depression correlates for the groups. Although ego strength was a common correlate of depression for both groups, among Black respondents, lower social support in the areas of reliability, assurance, and guidance was associated with higher levels of depression. Among White respondents, poor social integration, reduction in support network size, and increase in medical problems contributed to higher depression. A discussion of these findings is provided.     

Gender differences in the psychosocial and cognitive correlates of physical activity among taiwanese adolescents: A structural equation modeling approach

This study examined gender differences in the factors related to physical activity in 832 Taiwanese adolescents. Differences in psychosocial and cognitive correlates were noted by gender group. Taiwanese adolescent girls reported lower physical activity self-efficacy and less perceived benefits and more perceived barriers to being active than boys. Girls compared to boys reported significantly more positive social support, modeling, and norms from parents to be active but significantly less social support and norms from their peers. Structural equation modeling was used to test the direct and indirect paths of a model of proposed correlates and physical activity. The results indicated that peer influences had both direct and indirect paths to physical activity for both genders. Among all examined variables, perceived self-efficacy was the strongest correlate of physical activity for these adolescents. The findings of this study provide information relevant to designing physical activity interventions targeted to Taiwanese adolescents.