Skin condition

Kevin Lewis

February 27, 2014

Discrimination, Racial Bias, and Telomere Length in African-American Men

David Chae et al.
American Journal of Preventive Medicine, February 2014, Pages 103–111

Background: Leukocyte telomere length (LTL) is an indicator of general systemic aging, with shorter LTL being associated with several chronic diseases of aging and earlier mortality. Identifying factors related to LTL among African Americans may yield insights into mechanisms underlying racial disparities in health.

Purpose: To test whether the combination of more frequent reports of racial discrimination and holding a greater implicit anti-black racial bias is associated with shorter LTL among African- American men.

Methods: Cross-sectional study of a community sample of 92 African-American men aged between 30 and 50 years. Participants were recruited from February to May 2010. Ordinary least squares regressions were used to examine LTL in kilobase pairs in relation to racial discrimination and implicit racial bias. Data analysis was completed in July 2013.

Results: After controlling for chronologic age and socioeconomic and health-related characteristics, the interaction between racial discrimination and implicit racial bias was significantly associated with LTL (b=−0.10, SE=0.04, p=0.02). Those demonstrating a stronger implicit anti-black bias and reporting higher levels of racial discrimination had the shortest LTL. Household income-to-poverty threshold ratio was also associated with LTL (b=0.05, SE=0.02, p<0.01).

Conclusions: Results suggest that multiple levels of racism, including interpersonal experiences of racial discrimination and the internalization of negative racial bias, operate jointly to accelerate biological aging among African-American men. Societal efforts to address racial discrimination in concert with efforts to promote positive in-group racial attitudes may protect against premature biological aging in this population.


Does the Hispanic Paradox in U.S. Adult Mortality Extend to Disability?

Mark Hayward et al.
Population Research and Policy Review, February 2014, Pages 81-96

Studies consistently document a Hispanic paradox in U.S. adult mortality, whereby Hispanics have similar or lower mortality rates than non-Hispanic whites despite lower socioeconomic status. This study extends this line of inquiry to disability, especially among foreign-born Hispanics, since their advantaged mortality seemingly should be paired with health advantages more generally. We also assess whether the paradox extends to U.S.-born Hispanics to evaluate the effect of nativity. We calculate multistate life tables of life expectancy with disability to assess whether racial/ethnic and nativity differences in the length of disability-free life parallel differences in overall life expectancy. Our results document a Hispanic paradox in mortality for foreign-born and U.S.-born Hispanics. However, Hispanics’ low mortality rates are not matched by low disability rates. Their disability rates are substantially higher than those of non-Hispanic whites and generally similar to those of non-Hispanic blacks. The result is a protracted period of disabled life expectancy for Hispanics, both foreign- and U.S.-born.


Black/White dating online: Interracial courtship in the 21st century

Gerald Mendelsohn et al.
Psychology of Popular Media Culture, January 2014, Pages 2-18

We analyzed personal profiles and records of communication for more than a million nationwide users of a major online dating site. White more than Black, women more than men, and old more than young users stated a preference for a same-race partner. Overall, Blacks, especially Black men, proved more open to cross-race dating than did Whites. More than 80% of the contacts initiated by Whites were to Whites, with only 3% to Blacks. This sharp difference held for men and women and even for those who stated no racial or ethnic preference in their profiles. Blacks were 10 times more likely to contact Whites than Whites were to contact Blacks. Reciprocations to messages showed the same trends, but more moderately.


Digital Discrimination: The Case of

Benjamin Edelman & Michael Luca
Harvard Working Paper, January 2014

Online marketplaces often contain information not only about products, but also about the people selling the products. In an effort to facilitate trust, many platforms encourage sellers to provide personal profiles and even to post pictures of themselves. However, these features may also facilitate discrimination based on sellers’ race, gender, age, or other aspects of appearance. In this paper, we test for racial discrimination against landlords in the online rental marketplace Airbnb. Using a new data set combining pictures of all New York City landlords on Airbnb with their rental prices and information about quality of the rentals, we show that non-black hosts charge approximately 12% more than black hosts for the equivalent rental. These effects are robust when controlling for all information visible in the Airbnb marketplace. These findings highlight the prevalence of discrimination in online marketplaces, suggesting an important unintended consequence of a seemingly-routine mechanism for building trust.


Structural racism and myocardial infarction in the United States

Alicia Lukachko, Mark Hatzenbuehler & Katherine Keyes
Social Science & Medicine, February 2014, Pages 42–50

There is a growing research literature suggesting that racism is an important risk factor undermining the health of Blacks in the United States. Racism can take many forms, ranging from interpersonal interactions to institutional/structural conditions and practices. Existing research, however, tends to focus on individual forms of racial discrimination using self-report measures. Far less attention has been paid to whether structural racism may disadvantage the health of Blacks in the United States. The current study addresses gaps in the existing research by using novel measures of structural racism and by explicitly testing the hypothesis that structural racism is a risk factor for myocardial infarction among Blacks in the United States. State-level indicators of structural racism included four domains: (1) political participation; (2) employment and job status; (3) educational attainment; and (4) judicial treatment. State-level racial disparities across these domains were proposed to represent the systematic exclusion of Blacks from resources and mobility in society. Data on past-year myocardial infarction were obtained from the National Epidemiologic Survey on Alcohol and Related Conditions (non-Hispanic Black: N = 8245; non-Hispanic White: N = 24,507), a nationally representative survey of the U.S. civilian, non-institutionalized population aged 18 and older. Models were adjusted for individual-level confounders (age, sex, education, household income, medical insurance) as well as for state-level disparities in poverty. Results indicated that Blacks living in states with high levels of structural racism were generally more likely to report past-year myocardial infarction than Blacks living in low-structural racism states. Conversely, Whites living in high structural racism states experienced null or lower odds of myocardial infarction compared to Whites living in low-structural racism states. These results raise the provocative possibility that structural racism may not only harm the targets of stigma but also benefit those who wield the power to enact stigma and discrimination.


Effects of perceived racial discrimination on health status and health behavior: A differential mediation hypothesis

Frederick Gibbons et al.
Health Psychology, January 2014, Pages 11-19

Objective: Prospective data tested a “differential mediation” hypothesis: The relations (found in previous research) between perceived racial discrimination and physical health status versus health-impairing behavior (problematic substance use) are mediated by two different types of affective reactions, internalizing and externalizing.

Method: The sample included 680 African American women from the Family and Community Health Study (M age = 37 years at Time 1; 45 years at Time 4). Four waves of data were analyzed. Perceived discrimination was assessed, along with anxiety and depression (internalizing) and hostility/anger (externalizing) as mediators, and physical health status and problematic substance use (drinking) as outcomes.

Results: Structural equation modeling indicated that discrimination predicted increases in both externalizing and internalizing reactions. These affective responses, in turn, predicted subsequent problematic substance use and physical health status, respectively, also controlling for earlier reports. In each case, the indirect effects from discrimination through the affective mediator to the specific health outcome were significant and consistent with the differential mediation hypothesis.

Conclusions: Perceived racial discrimination is associated with increases in internalizing and externalizing reactions among Black women, but these reactions are related to different health outcomes. Changes in internalizing are associated with self-reported changes in physical health status, whereas changes in externalizing are associated with changes in substance use problems. Discussion focuses on the processes whereby discrimination affects health behavior and physical health status.


Race of Interviewer Effect on Disclosures of Suicidal Low-Income African American Women

Tara Samples et al.
Journal of Black Psychology, February 2014, Pages 27-46

Few studies have investigated the impact of interviewer race on the results gleaned through psychological assessment. African American and European American clinical evaluators conducted face-to-face interviews with 161 low-income African American women seeking services at an inner-city hospital following a suicide attempt. Participants were administered measures related to various current life stressors, including the Survey for Recent Life Events, which assesses various forms of daily hassles, and the Index of Spouse Abuse, which taps both physical and nonphysical intimate partner violence (IPV). Multivariate analyses of variance revealed a significant difference on the participants’ reports of daily hassles and IPV to African American and European American evaluators. With regard to overall life stress, African American women reported higher levels of total life stress, time pressure stress, social acceptability stress, and social victimization to African American than in European American–led interviews. They also endorsed higher levels of both physical and nonphysical IPV to interviewers of the same race as themselves as compared with interviewers from a different racial background. There were no group differences in terms of work stress, sociocultural differences, and finances. The findings underscore the saliency of interviewer race as a source of nonrandom measurement error capable of influencing statistical results. Implications of ignoring race of interviewer effects in analysis are explored and suggestions are offered in terms of culturally responsive assessment processes.


Perceived Discrimination Among African American Adolescents and Allostatic Load: A Longitudinal Analysis With Buffering Effects

Gene Brody et al.
Child Development, forthcoming

This study was designed to examine the prospective relations of perceived racial discrimination with allostatic load (AL), along with a possible buffer of the association. A sample of 331 African Americans in the rural South provided assessments of perceived discrimination from ages 16 to 18 years. When youth were 18 years, caregivers reported parental emotional support and youth assessed peer emotional support. AL and potential confounder variables were assessed when youth were 20. Latent growth mixture modeling identified two perceived discrimination classes: high and stable, and low and increasing. Adolescents in the high and stable class evinced heightened AL even with confounder variables controlled. The racial discrimination to AL link was not significant for young adults who received high emotional support.


Provider-Patient Communication About Adherence to Anti-retroviral Regimens Differs by Patient Race and Ethnicity

Barton Laws et al.
AIDS and Behavior, forthcoming

Disparities in HIV care and outcomes negatively affect Black and Hispanic patients. Features of clinical communication may be a factor. This study is based on coding transcripts of 404 routine outpatient visits by people with HIV at four sites, using a validated system. In models adjusting for site and patient characteristics, with provider as a random effect, providers were more “verbally dominant” with Black patients than with others. There was more discussion about ARV adherence with both Black and Hispanic patients, but no more discussion about strategies to improve adherence. Providers made more directive utterances discussing ARV treatment with Hispanic patients. Possible interpretations of these findings are that providers are less confident in Black and Hispanic patients to be adherent; that they place too much confidence in their White, non-Hispanic patients; or that patients differentially want such discussion. The lack of specific problem solving and high provider directiveness suggests areas for improvement.


The Changing Character of the Black–White Infant Mortality Gap, 1983–2004

Todd Elder et al.
American Journal of Public Health, February 2014, Pages S105-S111

Objectives: We examined how changes in demographic, geographic, and childbearing risk factors were related to changes in the Black–White infant mortality rate (IMR) gap over 2 decades.

Methods: Using 1983–2004 Vital Statistics, we applied inverse probability weighting methods to examine the relationship between risk factors and 3 outcomes: the overall IMR gap, its birth weight component, and its conditional (on birth weight) IMR component.

Results: The unexplained IMR gap (the part not related to observed risk factors) was stable, changing from 5.0 to 5.3 deaths per 1000 live births. By contrast, the explained gap declined from 4.6 to 1.9. The decline in the explained gap was driven by the changing relationship between risk factors and IMR. Further analysis revealed that most of the unexplained gap occurred among infants weighing less than 1000 grams at birth, whereas most of the explained gap occurred among infants weighing more than 1000 grams.

Conclusions: The unexplained gap was stable over the last 2 decades, but the explained gap declined markedly. If the stability of the unexplained gap continues, even complete convergence of risk factors would reduce the Black–White IMR gap by only one quarter.


Soaking Up the Sun: The Complicated Role of Sunshine in the Production of Infant Health

Jennifer Trudeau, Karen Smith Conway & Andrea Kutinova Menclova
University of New Hampshire Working Paper, October 2013

This research explores the role of sunshine in birth outcomes production. Its most obvious role is through Vitamin D absorption, which could explain racial disparities because skin pigmentation inhibits this process. However, the effects of sunshine are complex and closely connected to environmental factors (e.g., air pollution and temperature), season of birth, and policies like Medicaid. Combining daily weather data with 1989-2004 birth outcomes from the Natality Detail Files, we estimate sunshine’s effects in a range of models that disentangle these confounding factors and find they differ by race and explain a nontrivial portion of racial differences in birth weight.


The pathways from perceived discrimination to self-rated health: An investigation of the roles of distrust, social capital, and health behaviors

Danhong Chen & Tse-Chuan Yang
Social Science & Medicine, March 2014, Pages 64–73

Although there has been extensive research on the adverse impacts of perceived discrimination on health, it remains unclear how perceived discrimination gets under the skin. This paper develops a comprehensive structural equation model (SEM) by incorporating both the direct effects of perceived discrimination on self-rated health (SRH), a powerful predictor for many health outcomes, and the indirect effects of perceived discrimination on SRH through health care system distrust, neighborhood social capital, and health behaviors and health conditions. Applying SEM to 9,880 adults (aged between 18 and 100) in the 2008 Southeastern Pennsylvania Household Health Survey, we not only confirmed the positive and direct association between discrimination and poor or fair SRH, but also verified two underlying mechanisms: 1) perceived discrimination is associated with lower neighborhood social capital, which further contributes to poor or fair SRH; and 2) perceived discrimination is related to risky behaviors (e.g., reduced physical activity and sleep quality, and intensified smoking) that lead to worse health conditions, and then result in poor or fair SRH. Moreover, we found that perceived discrimination is negatively associated with health care system distrust, but did not find a significant relationship between distrust and poor or fair SRH.


The Contribution of Health Care and Other Interventions to Black–White Disparities in Life Expectancy, 1980–2007

Irma Elo, Hiram Beltrán-Sánchez & James Macinko
Population Research and Policy Review, February 2014, Pages 97-126

Black–white mortality disparities remain sizable in the United States. In this study, we use the concept of avoidable/amenable mortality to estimate cause-of-death contributions to the difference in life expectancy between whites and blacks by gender in the United States in 1980, 1993, and 2007. We begin with a review of the concept of “avoidable mortality” and results of prior studies using this cause-of-death classification. We then present the results of our empirical analyses. We classified causes of death as amenable to medical care, sensitive to public health policies and health behaviors, ischemic heart disease, suicide, HIV/AIDS, and all other causes combined. We used vital statistics data on deaths and Census Bureau population estimates and standard demographic decomposition techniques. In 2007, causes of death amenable to medical care continued to account for close to 2 years of the racial difference in life expectancy among men (2.08) and women (1.85). Causes amenable to public health interventions made a larger contribution to the racial difference in life expectancy among men (1.17 years) than women (0.08 years). The contribution of HIV/AIDS substantially widened the racial difference among both men (1.08 years) and women (0.42 years) in 1993, but its contribution declined over time. Despite progress observed over the time period studied, a substantial portion of black–white disparities in mortality could be reduced given more equitable access to medical care and health interventions.


The Impact of Education and Intergroup Friendship on the Development of Ethnocentrism. A Latent Growth Curve Model Analysis of a Five-Year Panel Study among Belgian Late Adolescents

Marc Hooghe, Cecil Meeusen & Ellen Quintelier
European Sociological Review, December 2013, Pages 1109-1121

In this article, we investigate individual-level changes in ethnocentrism during adolescence and pre-adulthood. We use structural equation modelling for longitudinal designs on data from the Belgian Political Panel Survey (BPPS, 2006–2011). In this panel, 2,428 Belgian adolescents were questioned at three points in time: at the ages of 16, 18 and 21 years. Individual change is analysed by using Latent Growth Curve Modelling. Individual variability was explained using two important predictors of ethnocentrism: education and intergroup friendship. Adolescents in lower educational tracks have higher initial levels of ethnocentrism, and their levels of ethnocentrism continue to rise during the observation period. Adolescents who change to lower education tracks between 2006 and 2008 increase more in ethnocentrism than adolescents who stay in the same track. While intergroup friendship had an effect on initial levels of ethnocentrism, this contact did not have an effect on subsequent changes in the level of ethnocentrism.


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