Ethnicity & Health最新文献

Objectives: Rates of anxiety and depression have risen among Asian adults in the U.S., and sociodemographic factors such as immigration, financial hardship, and parental education are associated with different health outcomes. However, less is known about mental health by these indicators. While many affective disorders present between young adulthood (ages 18-29), research on this developmental period among Asian adults is scant. Since more than half of all Asian Americans are enrolled in some form of higher education during this age range, colleges and universities are meaningful settings to investigate social factors associated with mental health outcomes among young Asian adults.

Design: Secondary data were analyzed examining a large sample of young Asian students (n = 8,669) who participated in the 2022-2023 Healthy Minds Study (HMS), which is a national survey evaluating mental health among enrollees in higher education. Multivariable logistic regressions were conducted to evaluate differences in anxiety and depression by citizenship status, financial hardship, and highest level of parental education obtained, adjusting for age, ethnic subgroup, sexual orientation, and sex.

Results: The mean age of respondents was 21.3 years (SD = 2.9) and most participants identified as female (70%, n = 6,064). Roughly one quarter of participants (27%, n = 2,365) reported not holding U.S. citizenship. Depression and anxiety were high among the sample overall, with symptoms being greater for those with more financial hardship. Regarding immigrant status, U.S. citizens had higher odds of meeting criteria for both clinical depression and anxiety compared to those without U.S. citizenship. Mixed findings were found regarding parental education and affective symptoms.

Conclusion: Findings support the need to prioritize social determinants of health such as basic needs and financial resources in mental health service delivery for Asian communities in the U.S. More research is also needed to better understand how to assess and promote mental wellbeing among diverse young Asian immigrants.

Drawing on critical multiracial theory, the objective of this study was to describe Multiracial emerging adults' experiences with mental health care. A total of 12 Multiracial emerging adults participated in this phenomenological study that used semi-structured interviews. Participants shared that Multiracial and Black providers were emphatic, but White providers engaged in covert and subtle racism. They further discussed the need for providers to be more culturally competent and the need for more racial and ethnic representation among mental health care providers. Findings suggest that providers need to understand their clients' experiences better, such as participants' experiences with racism when both receiving mental health care and navigating developmental milestones, such as dating. This understanding, in turn, could improve the quality of mental health care. Participants in this study also provided suggestions for improving the quality of mental health care, with recommendations ranging from broaching the topic of race to increased racial representation among providers.

Objectives: Chronic exposure to psychological stress is a well-established social determinant of health, particularly among racial and ethnic minority groups. Repeated stress can lead to persistent activation of the biological stress response, which may become maladaptive and harm both physical and mental health. Latinx immigrants are especially susceptible due to ongoing acculturative stress-challenges associated with adapting to a new culture and environment. Despite these risks, Latinx immigrants also exhibit strong resilience, which can help buffer the negative health effects of acculturative stress. Minimal research has explored associations among measures of acculturative stressors, psychosocial resilience factors, and immunological biomarkers of the physiological stress response. The current study examines these relationships within a Latinx immigrant population.

Design: We conducted a secondary analysis of baseline data collected between June 2018 and January 2020 from a community-engaged research study of Latinx immigrants in the U.S. Southeast aged 18-44 (N = 391). Participants completed self-report measures of acculturative stressors, resilience factors, and health, as well as urine specimens for biomarker analysis using immunoassays. Hypotheses were tested with Spearman's correlations and multivariate linear regressions.

Results: In bivariate correlations, only IL-18, a pro-inflammatory cytokine, and IL-10, an anti-inflammatory cytokine, were associated with acculturative stressors. In our final regression models accounting for acculturative stressors and resilience factors, no moderation effects were observed, and only BMI remained a significant predictor of IL-18. Exploratory mediation analysis demonstrated that BMI partially mediated the relationship between pre-migration stress and IL-18.

Conclusions: The results highlight significant associations among acculturative stressors, inflammatory cytokines, and BMI. Further exploration of these relationships can identify key social determinants and mechanisms underlying health inequities, such as those related to obesity and cardiometabolic health. These findings may contribute to the design of more effective health promotion and disease prevention interventions for Latinx immigrant populations.

Background: The prevalence of diabetes has rapidly increased for East Asian immigrant populations, exceeding rates in East Asian populations in their home countries and the general population of host countries. The increased risk highlights the complex interplay between genetic predisposition and socio-cultural environmental factors associated with migration. Managing diabetes and navigating unfamiliar healthcare systems are challenging for immigrant populations underscoring the need for research on barriers and effective targeted strategies.

Objectives: Identify barriers to best diabetes management practices and effective interventions among East Asian immigrant populations.

Methods: Studies were identified through PUBMED, OVID MEDLINE, CINAHL COMPLETE and SCOPUS databases utilising Arksey and O'Malley's framework. Peer-reviewed, English reports between January 2010 and August 2024 relating to challenges and barriers of best management practices among adult East Asian immigrants and interventions that facilitated management were identified. Studies of people with type 1 or gestational diabetes and those <18 years old were excluded.

Results: Of 576 articles screened, 18 studies meeting the criteria were included in this review. Twelve studies included Chinese immigrants, 13 studies were from the United States, including six among American-Korean immigrants, three were from Australia and two from Canada. Barriers to best diabetes management practices identified from observational studies were themed as relating to (1) 'Cultural Views' (diabetes, diet, medication, traditional remedies, health professional hierarchy and family roles); (2) 'Immigration Challenges' (communication, communication, transport, financial, time constraints, emotional distress and dissatisfaction with Western healthcare systems). Randomised controlled trials (n = 2) and single-group trials (n = 6) reported on effective interventions that improved self-management and/or cardiometabolic risk factors, focusing on self-management (n = 3), nutritional (n = 4) and social media (n = 1) educational programmes.

Conclusion: Barriers to best diabetes management practices included clashes with cultural views, immigration-related challenges and dissatisfaction with Western healthcare systems. Effective interventions were mostly associated with culturally-tailored, didactic and bilingual diabetes education programmes.

Background: Black women are more likely to experience sleep difficulties compared to their White counterparts. This disparity may be fueled by differences in economic opportunities, race - and gender-based discrimination, and other societal factors. Guided by the socio-ecological model, the purpose of this study was to examine the multi-level barriers and facilitators of sleep among Black women in the United States.

Methods: A qualitative description study design was used. Semi-structured interviews were conducted in English among 28 Black women with sleep difficulties. Interviews were audio-recorded and transcribed. Thematic analysis was used to analyze data.

Results: Participants (mean age = 47.3 years) were primarily single (52%) and employed (84%). Through qualitative interviews, four key themes emerged: (a) Individual-level barriers and facilitators, such as chronic health issues, poor sleep hygiene, stress, trauma, financial strain, and coping strategies like prayer and relaxation routines; (b) Interpersonal influences, including caregiving demands, emotional burdens from family dynamics, and social support; (c) Community-level factors, such as neighborhood noise, violence, and safety concerns contributing to hypervigilance; and (d) Societal-level influences, notably the "strong Black woman" schema and experiences of racism and gendered discrimination, which shaped sleep experiences.

Discussion and conclusion: Black women's sleep is impacted by intersecting factors across individual, interpersonal, community, and societal levels. Culturally grounded, trauma-informed, and equity-focused interventions, targeting all socioecological levels, are essential to improve sleep health of Black women.

Objectives: Aligning with past work positioning racial discrimination as invalidation, or a form of interpersonal rejection and devaluation with myriad psychological effects, we aim to examine the role of Strong Black Woman/Superwoman Schema (SBW/SWS) in the relation between racial discrimination and borderline personality disorder (BPD) symptoms among Black women. We predicted that SWS would explain the relation between experiences of racial discrimination and BPD symptoms. We also hypothesized that while SWS would contribute to emotional control and thereby higher BPD symptoms, SWS would also contribute to racial pride and thereby lower BPD symptoms. Exploratorily, we examined whether emotion regulation challenges moderate the relation between SWS and BPD symptoms.

Methods: A national community sample of 81 Black women (M_age = 37.8, SD_age = 12.8) endorsing racial discrimination were recruited through ResearchMatch and reported on SBW/SWS, BPD symptoms, and other emotion-focused assessments. Simple and serial mediation were used to examine the primary hypotheses.

Results: While racial discrimination was not significantly associated with BPD symptoms, SWS did explain this relation. There was further a significant serial effect such that racial discrimination contributed to SWS, which then fueled emotional overcontrol, and higher BPD symptoms. Racial pride did not emerge as a buffer from BPD symptoms. Lastly, the tendency to use interpersonal pathways to enhance positive affect strengthened the relation between SWS and BPD symptoms.

Conclusions: This paper furthers our understanding of how SWS and associated emotion processes link identity-based discrimination to emotional, identity, and interpersonal challenges among Black women.

Background: Culture is important as it influences how survivors navigate micro (e.g. interpersonal relationships, social networks) and macro systems (e.g. healthcare system, society) in their everyday lives. This study applied a sociocultural lens, using the PEN-3 cultural model, to explore experiences of Black and Latinx cancer survivors and their families with the aim of identifying recommendations to improve cancer survivorship experience.

Methods: We used qualitative descriptive design. A total of 17 (4 men and 13 women) cancer survivors 50 years or older (Mean age = 63.9 years) were interviewed using a semi-structured interview guide. Afterwards, we conducted six focus group discussions (three Latinx and three Black groups) with a total of 33 caregivers of cancer survivors (Mean age = 63 years). All interviews were audio recorded, transcribed verbatim, and analyzed using a hybrid of inductive-deductive thematic analysis.

Results: Three themes were identified from the analysis: Two of the themes were labeled using the PEN-3 cultural model categories; (1) relationships and expectations influencing survivorship experience, (2) cultural empowerment and cancer survivorship. The third theme represents the improvement recommendations provided by the participants; (3) recommendations for improving survivorship.

Discussion: The findings of this study will add to a body of knowledge on using a cultural lens to deepen our understanding cancer survivorship inequities and may inform culturally tailored cancer survivorship interventions in Black and Latinx communities.

Understanding how Superwoman Schema (SWS) dimensions cluster may be key to exploring how this phenomenon varies among Black women. In this study, we identified profiles of Superwoman Schema in a sample of 167 Black women (M_age = 22). We also determined if distinct profiles of Superwoman Schema dimensions predicted perceived stress. Using latent profile analysis, we detected a 4-class solution: Guarded Caregivers (high emotional suppression, resistance to vulnerability, and obligation to help others); Authentically Unburdened (lowest average on all SWS dimensions); Reluctant Superwoman (mid-range adherence to SWS dimensions with a strong sense of the obligation to help others); and Resilient Caregivers (high desire to present strength and a strong sense of the obligation to help others). The Guarded Caregiver profile had the highest perceived stress scores compared to all other profiles. There were no significant differences between profile groups and sociodemographics. Findings suggest that Black women who are high in adherence to emotional suppression, resistance to vulnerability, and obligatory helping may be more likely to experience elevated stress. Thus, interventions to reduce stress should promote emotional expression, foster help-seeking behaviors, and challenge the need for self-sacrifice at the expense of personal well-being.

Objectives: Exposure to adverse childhood experiences (ACE) accounts for up to 1.9 million heart disease cases. This study extends research by examining the association between heart disease and four-forms of ACE heterogeneity (i.e. counts, scores, clusters, and individually) among Black men and women.

Design: Data come from the 2019-2022 Behavioral Risk Factor Surveillance System's ACE supplement (n = 30,746). Latent class analysis of eleven ACEs - verbal, physical, or sexual abuse; experiencing divorced parents, rape, or sexual coercion; or living in a household with domestic violence, imprisonment, drug use, alcohol abuse, or mental illness - identified seven-classes. Multiple gender-stratified binary logistic regressions estimated adjusted odds of heart disease based on ACE counts, scores, individual events, and the seven-classes, which reflected: (1) domestic violence and alcohol abuse, (2) sexual violence, (3) abusive parents, (4) universal ACEs, (5) non-sexual ACEs, (6) few ACEs, and (7) household imprisonment/substance abuse.

Results: Odds of heart disease were higher for women and men with more ACE exposures (i.e. counts and universal-ACEs classification), and when exposed specifically to sexual violence, household drug use, and mental illness. Exceeding the threshold of two-plus ACEs increased odds of heart disease for women but not men. Women's and men's odds of heart disease were higher when experiencing physical/verbal abuse and household imprisonment, respectively.

Conclusion: ACE heterogeneity factors into heart disease patterns for Black men and women with important implications for intersectional screening, intervention, and the advancement of health equity.

Background: Effective vaccines for human papillomavirus (HPV) are readily available but culturally and linguistically diverse (CALD) communities experience vaccination disparities. Whilst community engaged (CE) practices are recommended, we know little about this practice in local settings.

Aim: We aim to compare CE practices within HPV vaccination interventions targeting CALD children aged 9-17 years and identify how CE elements are linked to outcomes.

Method: Included interventions targeted vaccine eligible CALD children, their parents/caregivers, or health professionals servicing CALD populations. We searched six databases for studies published between 2006 and April 2024. We critically appraised included studies, and data was synthesised based on a CE health framework.

Results: We screened 3798 articles to identify 22 studies. Interventions were based in the United States (USA) and targeted nine different CALD communities. CE practice varied across interventions. All CE practices improved vaccine knowledge, but only multi-component, peer-led/delivered CE practice improved series completion. We note several confounders and analysis limitations.

Discussion: Most CE approaches were initiated by health services rather than the local community. All interventions were limited by study bias and reporting details. We experienced difficulties linking CE practice to intervention outcomes, highlighting tensions between health service driven CE and community empowered CE practices.