scholarly journals ADRD Caregiving Experiences and Health by Race, Ethnicity and Care Recipient Geographic Context

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 999-999
Author(s):  
Tiffany Kindratt ◽  
Dominigue Sylvers ◽  
Aya Yoshikawa ◽  
Mónika López Anuarbe ◽  
Noah Webster ◽  
...  
Keyword(s):  
Rural Areas ◽  
Care Recipient ◽  
National Study ◽  
Depression Symptoms ◽  
Care Recipients ◽  
Geographic Context ◽  
Race Ethnicity ◽  
Urban And Rural Areas ◽  
Context Shapes ◽  
Racial Ethnic

Abstract Few studies have examined how the intersectionality of geographic context and race/ethnicity influences Alzheimer’s disease and related dementia (ADRD) caregiving. Our aims were to determine whether 1) caregiver experiences and health differed across urban and rural areas; and 2) these links were moderated by caregiver race/ethnicity. We used data from the 2017 National Health and Aging Trends Study and National Study of Caregiving. The sample included caregivers (n=808) of care recipients ages 65+ with ‘probable’ ADRD (n=482). Geographic context was defined as care recipient’s residence in metro (urban) or non-metro (rural) counties. Outcomes included caregiving experiences (burden, gains, life impacts, service/resource use) and health (self-rated, anxiety, depression symptoms, chronic health conditions). Bivariate analyses indicated that non-metro ADRD caregivers were less racially/ethnically diverse (82.7% white) and more were spouses/partners (20.2%). Among racial/ethnic minority ADRD caregivers, non-metro context was associated with having more chronic conditions (p<.01), providing less care (p<.01), and not co-residing with care recipients (p<.001). Amid white ADRD caregivers, non-metro context was associated with not reporting caregiving was more than they could handle (p<.05) and finding financial assistance for caregiving (p<.05). Multivariate regression analyses demonstrated that non-metro minority ADRD caregivers had 3.09 times higher odds (95% CI=1,02-9.36) of reporting anxiety in comparison to metro minority ADRD caregivers. Geographic context shapes ADRD caregiving experiences and caregiver health differently across racial/ethnic groups. Despite higher rates of ADRD and ADRD-related mortality in non-metro areas, findings suggest both positive and negative aspects of caregiving among White, Black, and Hispanic ADRD caregivers.

scholarly journals Caregiver Well-Being and Burden: Variations by Race/Ethnicity and Care Recipient Nativity Status

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Heehyul E Moon ◽  
William E Haley ◽  
Sunshine M Rote ◽  
Jeanelle S Sears
Keyword(s):  
Well Being ◽  
Care Recipient ◽  
National Study ◽  
Foreign Born ◽  
Psychological Well Being ◽  
Care Burden ◽  
Nativity Status ◽  
Self Rated Health ◽  
Care Recipients ◽  
Race Ethnicity

Abstract Background and Objectives Despite growing diversity among the aging population and extensive previous research on racial/ethnic minority caregivers, little research has been conducted on the potentially unique experiences and outcomes of informal caregivers of foreign-born care recipients. Using nationally representative data and the Stress Process Model, the current study examined the differences in caregiver outcomes (care burden, psychological well-being, and self-rated health) by care recipient nativity status (U.S.-born vs. foreign-born) and the extent to which caregiver outcomes vary by care recipient nativity status and caregiver race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, and Others). Research Design and Methods The current study used Round 5 of the National Health and Aging Trends Study and the National Study of Caregiving (N = 1,436). We conducted ordinary least squares regression to analyze the differences in caregiver’s outcomes by care recipient nativity status and caregiver race/ethnicity and to investigate the impacts of the inclusion of caregiving factors (background factors, primary stressors, secondary stressors, and resources). Results Regression analyses showed that only care burden significantly varied by care recipient nativity status after controlling for covariates. Caregivers of foreign-born care recipients reported a higher burden. However, when interactions of care recipient nativity status × caregiver race/ethnicity were introduced, non-Hispanic black and Hispanic caregivers of foreign-born care recipients were more likely to report better psychological well-being and self-rated health compared to their counterparts. Across caregiver groups, better caregiver–care recipient relationship quality and less caregiver chronic conditions were associated with less burden and better caregiver psychological well-being and self-rated health. Discussion and Implications Care recipient nativity status and caregiver race/ethnicity may have complex effects on caregiving experiences. Given the observed significant interaction effects for caregiver psychological well-being and self-rated health, cultural factors may affect the extent to which these caregivers appraise their caregiving. Future research should delve into the appropriate ways to assess care stress as well as resilience among each caregiver group. Our results indicate the need for research, education, and practice that assess cultural and within-group differences among caregivers and inform needed changes to structural barriers.

scholarly journals PM2.5 polluters disproportionately and systemically affect people of color in the United States

2021 ◽  
Vol 7 (18) ◽  
pp. eabf4491
Author(s):  
Christopher W. Tessum ◽  
David A. Paolella ◽  
Sarah E. Chambliss ◽  
Joshua S. Apte ◽  
Jason D. Hill ◽  
...  
Keyword(s):  
United States ◽  
Rural Areas ◽  
The United States ◽  
People Of Color ◽  
Emission Sources ◽  
Particulate Air Pollution ◽  
Fine Particulate ◽  
Exposure Levels ◽  
Urban And Rural Areas ◽  
Racial Ethnic

Racial-ethnic minorities in the United States are exposed to disproportionately high levels of ambient fine particulate air pollution (PM2.5), the largest environmental cause of human mortality. However, it is unknown which emission sources drive this disparity and whether differences exist by emission sector, geography, or demographics. Quantifying the PM2.5 exposure caused by each emitter type, we show that nearly all major emission categories—consistently across states, urban and rural areas, income levels, and exposure levels—contribute to the systemic PM2.5 exposure disparity experienced by people of color. We identify the most inequitable emission source types by state and city, thereby highlighting potential opportunities for addressing this persistent environmental inequity.

Applying the Health Belief Model to Characterize Racial/Ethnic Differences in Digital Conversations Related to Depression Pre– and Mid–COVID-19 (Preprint)

2021 ◽  
Author(s):  
Ruby Castilla-Puentes ◽  
Jacqueline Pesa ◽  
Caroline Brethenoux ◽  
Patrick Furey ◽  
Liliana Gil Valletta ◽  
...  
Keyword(s):  
Health Belief Model ◽  
Ethnic Groups ◽  
Ethnic Differences ◽  
Health Belief ◽  
Depression Symptoms ◽  
Seeking Help ◽  
Key Drivers ◽  
Race Ethnicity ◽  
Belief Model ◽  
Racial Ethnic

BACKGROUND The prevalence of depression symptoms in the United States is >3 times higher mid–COVID-19 versus pre-pandemic. Racial/ethnic differences in mindsets around depression and the potential impact of the COVID-19 pandemic are not well characterized. OBJECTIVE To describe attitudes, mindsets, key drivers, and barriers related to depression pre– and mid–COVID-19 by race/ethnicity using digital conversations about depression mapped to health belief model (HBM) concepts. METHODS Advanced search, data extraction, and AI-powered tools were used to harvest, mine, and structure open-source digital conversations of US adults who engaged in conversations about depression pre– (February 1, 2019-February 29, 2020) and mid–COVID-19 pandemic (March 1, 2020-November 1, 2020) across the internet. Natural language processing, text analytics, and social data mining were used to categorize conversations that included a self-identifier into racial/ethnic groups. Conversations were mapped to HBM concepts (ie, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy). Results are descriptive in nature. RESULTS Of 2.9 and 1.3 million relevant digital conversations pre– and mid–COVID-19, race/ethnicity was determined among 1.8 million (62%) and 979,000 (75%) conversations pre– and mid–COVID-19, respectively. Pre–COVID-19, 1.3 million conversations about depression occurred among non-Hispanic Whites (NHW), 227,200 among Black Americans (BA), 189,200 among Hispanics, and 86,800 among Asian Americans (AS). Mid–COVID-19, 736,100 conversations about depression occurred among NHW, 131,800 among BA, 78,300 among Hispanics, and 32,800 among AS. Conversations among all racial/ethnic groups had a negative tone, which increased pre– to mid–COVID-19; finding support from others was seen as a benefit among most groups. Hispanics had the highest rate of any racial/ethnic group of conversations showing an avoidant mindset toward their depression. Conversations related to external barriers to seeking treatment (eg, stigma, lack of support, and lack of resources) were generally more prevalent among Hispanics, BA, and AS than among NHW. Being able to benefit others and building a support system were key drivers to seeking help or treatment for all racial/ethnic groups. CONCLUSIONS Applying concepts of the HBM to data on digital conversation about depression allowed organization of the most frequent themes by race/ethnicity. Individuals of all groups came online to discuss their depression. There were considerable racial/ethnic differences in drivers and barriers to seeking help and treatment for depression pre– and mid–COVID-19. Generally, COVID-19 has made conversations about depression more negative, and with frequent discussions of barriers to seeking care. These data highlight opportunities for culturally competent and targeted approaches to address areas amenable to change that might impact the ability of people to ask for or receive mental health help, such as the constructs that comprise the HBM.

scholarly journals Racial/Ethnic Disparities in Mortality: Contributions and Variations by Rurality in the United States, 2012–2015

2019 ◽  
Vol 16 (3) ◽  
pp. 436 ◽  
Author(s):  
Jeffrey Hall ◽  
Ramal Moonesinghe ◽  
Karen Bouye ◽  
Ana Penman-Aguilar
Keyword(s):  
Rural Areas ◽  
Ethnic Disparities ◽  
The United States ◽  
Mortality Rates ◽  
Malignant Neoplasms ◽  
Ethnic Populations ◽  
Asian Pacific Islanders ◽  
Race Ethnicity ◽  
Asian Pacific ◽  
Racial Ethnic

The value of disaggregating non-metropolitan and metropolitan area deaths in illustrating place-based health effects is evident. However, how place interacts with characteristics such as race/ethnicity has been less firmly established. This study compared socioeconomic characteristics and age-adjusted mortality rates by race/ethnicity in six rurality designations and assessed the contributions of mortality rate disparities between non-Hispanic blacks (NHBs) and non-Hispanic whites (NHWs) in each designation to national disparities. Compared to NHWs, age-adjusted mortality rates for: (1) NHBs were higher for all causes (combined), heart disease, malignant neoplasms, and cerebrovascular disease; (2) American Indian and Alaska Natives were significantly higher for all causes in rural areas; (3) Asian Pacific islanders and Hispanics were either lower or not significantly different in all areas for all causes combined and all leading causes of death examined. The largest contribution to the U.S. disparity in mortality rates between NHBs and NHWs originated from large central metropolitan areas. Place-based variations in mortality rates and disparities may reflect resource, and access inequities that are often greater and have greater health consequences for some racial/ethnic populations than others. Tailored, systems level actions may help eliminate mortality disparities existing at intersections between race/ethnicity and place.

scholarly journals IDENTIFYING UNMET NEED IN INFORMAL CAREGIVING: DISPARITIES BY GENDER, EMPLOYMENT STATUS, AND RACE-ETHNICITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S219-S220
Author(s):  
Steven A Cohen ◽  
Furong Xu ◽  
Marissa R Meucci ◽  
Symone Woodham ◽  
Mary L Greaney
Keyword(s):  
Older Adults ◽  
Employment Status ◽  
Informal Caregivers ◽  
Unmet Need ◽  
Informal Caregiving ◽  
Care Recipient ◽  
National Study ◽  
Caregiver Health ◽  
White Caregivers ◽  
Race Ethnicity

Abstract Older adults, including those with dementia and other types of cognitive decline, often report a desire to remain in their homes. Over 50 million informal caregivers in the US provide needed in-home assistance to those in need, and there are well-documented disparities in informal caregiving responsibilities by sociodemographic factors , yet little is known about “unmet need” in informal caregiving. Therefore, the study’s objective is to examine discrepancies in unmet caregiving-related need by race/ethnicity, gender, and employment status. We abstracted data about caregivers from the 2017 National Study of Caregiving and linked these data to participants in the National Health and Aging Trends Study on caregivers of older adults (n=993). Generalized linear models were used to model the discrepancies between the number of activities of daily living for which the care recipient required assistance and the number of tasks caregivers provide, by race/ethnicity, gender, and employment status, accounting for confounders and complex sampling. Care recipients whose primary informal caregivers were employed were 69% more likely than those whose informal caregivers were not employed to experience unmet caregiving need (OR 1.69, 95%CI 1.19-2.41). A similar association between employment and unmet caregiving was observed among White caregivers (OR=1.79, 95% CI 1.16-2.69), while the association was not significant among Black caregivers (p=0.228). These findings suggest potentially addressable disparities in informal caregiving duties between Black and White caregivers, and can be used to inform and develop of policies and programs designed to improve caregiver health and reduce undue strain on caregiver health and wellbeing.

Deplorable or Disposable? The Carceral State and ‘Breaking Bad’ in Rural America

2021 ◽  
pp. 94-132
Author(s):  
Marie Gottschalk
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Mass Incarceration ◽  
War On Drugs ◽  
The United States ◽  
Carceral State ◽  
Breaking Bad ◽  
The Us ◽  
Urban And Rural Areas ◽  
Racial Ethnic

This chapter examines the limitations of viewing the US carceral state primarily through a racial disparities lens centred on differences in incarceration rates between whites and blacks. It surveys important shifts since the 1970s in who is being incarcerated in the United States, including racial, ethnic, gender, and geographic shifts, most notably between urban and rural areas. It deploys three common frameworks used to help explain the rise of mass incarceration and the hyper-incarceration of African Americans—the culture of control, the culture of poverty, and the war on drugs—to analyse the deepening penetration of the carceral state outside of major urban areas and to examine the opioid crisis.

scholarly journals Associations between soil lead concentrations and populations by race/ethnicity and income-to-poverty ratio in urban and rural areas

2012 ◽  
Vol 35 (1) ◽  
pp. 1-12 ◽  
Author(s):  
C. Marjorie Aelion ◽  
Harley T. Davis ◽  
Andrew B. Lawson ◽  
Bo Cai ◽  
Suzanne McDermott
Keyword(s):  
Rural Areas ◽  
Soil Lead ◽  
Race Ethnicity ◽  
Urban And Rural Areas

scholarly journals Association among multimorbidity, physical disability and depression trajectories: a study of urban–rural differences in China

2021 ◽  
Author(s):  
Chaoyang Yan ◽  
Hui Liao ◽  
Ying Ma ◽  
Qin Xiang ◽  
Jing Wang
Keyword(s):  
Activities Of Daily Living ◽  
Rural Areas ◽  
Urban Areas ◽  
Daily Living ◽  
Latent Class ◽  
Multinomial Logistic Regression ◽  
Rural China ◽  
Depression Symptoms ◽  
Depression Symptom ◽  
Urban And Rural Areas

Abstract Purpose The purpose of this study was to analyse the trajectories of depression in urban and rural areas, and to analyse the relationship among multimorbidity, disability and other variables and trajectories. Methods Data from the China Health and Retirement Longitudinal Study were used. A latent class growth model was used to characterise the trajectories of urban and rural depression symptoms. Chi-square test was used to test the differences in respondents’ characteristics among depression trajectories groups within urban and rural areas. The relationships among multimorbidity, disability and depression symptom trajectories were analysed via multinomial logistic regression. Results Urban and rural depression trajectories were divided into three categories. Respondents in urban areas were divided into rising, remaining-low and declining group, and those in rural areas were divided into rising, remaining-low and remaining-high group. The depression scores of respondents with multimorbidity were more likely to rise, and this result was similar for the disabled respondents. Respondents who need help on activities of daily living and instrumental activities of daily living in urban areas were more likely to decline in depression scores. In rural areas, however, the values were consistently high. In urban and rural areas, the relationships among marital status, education and age and depression trajectories were different. Conclusions The depression trajectories are different in urban and rural China. Improving the quality of medical services, promoting the distribution of rural social resources and implementing more recreational activities could be beneficial for the promotion of mental health in rural areas.

scholarly journals Informal Caregivers’ Perceptions of Burdens and Benefits Predict Greater Confidence in Their Abilities

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 802-803
Author(s):  
Cristina de Rosa ◽  
Rebecca Lorenz ◽  
Suzanne Sullivan
Keyword(s):  
Health Care Providers ◽  
Informal Caregivers ◽  
Care Recipient ◽  
National Study ◽  
Future Research ◽  
Care Providers ◽  
Chi Square ◽  
Final Model ◽  
Care Recipients ◽  
Difficult Situations

Abstract Informal caregivers experience both burdens and benefits from caregiving. This analysis aimed to determine whether caregiver perceptions of burdens and benefits predicted feelings of confidence in their abilities. In the National Study of Caregiving (NSOC) Round II (2015), we identified 1,390 caregivers as “primary” for providing the greatest number of care hours in the past month to individuals age 65 and over. Logistic regression was performed to assess the influence of primary caregivers’ gender, age, relationship to their care recipients, and self-reported indications of burdens and benefits on the odds that they would report confidence in their abilities. Caregivers were more likely to report confidence in their abilities when caregiving taught them to deal with difficult situations (OR=5.93, 95% CI [4.67, 7.54]), gave them satisfaction that their care recipient was well cared for (OR=1.97, 95% CI [1.26, 3.04]), and when caregiving brought them closer to their care recipient (OR=2.61, 95% CI [2.02, 3.36]). Caregivers were less likely to feel confident if they reported frequent changes in routine (OR=.78, 95% CI [.64, .96]). The final model predicted confidence (chi-square = 525.383 [4] p < .001) and correctly classified 78.7% of cases. All other variables were non-significant. These findings suggest that confidence in abilities is influenced by caregivers’ perception of learning to handle difficult situations, satisfaction, closeness to the recipient, and burdens associated with changes in routine. Future research should further explore burdens and benefits of caregiving. Health care providers should routinely assess caregivers and provide referrals for additional resources.

scholarly journals Risk Factors Contributing to Racial/Ethnic Disparities in Iron Deficiency in US Women

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 725-725
Author(s):  
Rebecca Campbell ◽  
Heng Wang ◽  
Rashid Ahmed
Keyword(s):  
Risk Factors ◽  
Black Women ◽  
Iron Deficiency ◽  
Healthy Eating ◽  
Ethnic Disparities ◽  
Healthy Eating Index ◽  
Depression Symptoms ◽  
Iron Intake ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract Objectives Iron deficiency (ID) in women of reproductive age can negatively impact women's health, pregnancy outcomes and the health and development of their infants. Disparities in rates of iron deficiency by race and ethnicity in the US are persistent, but their causes are not well understood. This study was conducted to describe risk factors for ID and sources of racial/ethnic disparities in ID burden. Methods Adult women ages 20–49 years (N = 1,069) from the National Health and Nutrition Examination Survey 2015–16 who completed the questionnaire and laboratory examinations were included in the analysis. Risk factors for ID (serum ferritin (SF) < 12 µg/L) were examined in three domains: diet (total iron intake, total vitamin C intake, Healthy Eating Index (HEI) score), sociodemographic and acculturation (race/ethnicity, age, place of birth, interview language), and health (BMI, depression symptoms). Prevalence of ID overall and in subgroups were assessed in mean models accounting for the survey design. Associations of risk factors with ID were examined in logistic regression models using survey commands in SAS. Results In total, 153 women (11.3%) had ID. Prevalence of ID was highest in Mexican American (20.5%, n = 213) and non-Hispanic Black women (19.9%, n = 234) and lower in other Hispanic (13.5%, n = 136) and non-Hispanic, non-Black women (7.7%, n = 486) (p < 0.001). Non-US birth and Spanish language interview were associated with 67% (p = 0.01) and 77% (p = 0.001), respectively, greater risk of ID. Low iron intake and Healthy Eating Index (HEI) were not associated with risk of ID in this sample, while vitamin C intake was inversely associated with risk of ID (β (95% CI): 1.81 (1.0–3.29), p = 0.0. Finally, neither BMI nor depression symptoms was associated with ID in this sample. Stratified and multivariable analyses will be conducted in the 2015–16 and 2017–18 NHANES surveys combined to explore risk factors by race/ethnicity. Conclusions Sociodemographic and lifestyle characteristics are predictive of ID risk in US women. Planned analyses will generate race/ethnicity-specific risk profiles and identify actionable targets for intervention to reduce racial/ethnic disparities in ID prevalence. Funding Sources None.

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