Socioeconomic Status, Ecologically Assessed Social Activities, and Daily Cortisol Among Older Urban African Americans

Objectives: Higher socioeconomic status (SES) individuals report more social activities than their lower SES counterparts. Yet, SES and racial health disparities are often confounded. Here, we tested whether the frequency of engagement in social activities contributed to the association between SES and daily cortisol secretion among urban African American older adults. Methods: Ninety-two community-dwelling African Americans aged 55 years and older reported what they were doing at regular intervals across the day on an Android smartphone for seven consecutive days. They also provided four saliva samples at four time points a day during the same period. Results: Higher SES older adults engaged in proportionally more social activities than their lower SES counterparts. A greater relative frequency of weekly social activities was associated with a steeper diurnal cortisol decline. Higher SES was indirectly linked to a steeper cortisol decline via increased relative frequency of weekly social activities. Discussion: Our findings suggest that engagement in weekly social activities represents a behavioral intermediary for SES health disparities in endocrine function among older urban African American adults.

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Neighborhood Characteristics Are Associated with Racial and Gender Variation Among Walking in Older Adults: the Cardiovascular Health Study

Ethnicity & Disease ◽

10.18865/ed.26.1.17 ◽

2016 ◽

Vol 26 (1) ◽

pp. 17

Author(s):

Tingjian Yan ◽

Li-Jung Liang ◽

Stefanie Vassar ◽

Monica Cheung Katz ◽

Jose J. Escarce ◽

...

Keyword(s):

Older Adults ◽

Socioeconomic Status ◽

African Americans ◽

Cardiovascular Health ◽

Statistical Significance ◽

Community Dwelling ◽

Health Study ◽

Cardiovascular Health Study ◽

Neighborhood Socioeconomic Status ◽

And Gender

Objective: To examine variation by race and gender in the association between neighborhood socioeconomic status and walking among community-dwelling older adults.Design: Cross-sectional.Setting: Cardiovascular Health Study, a longitudinal population-based cohort.Participants: 4,849 adults aged >65 years.Measurements: Participants reported number of city blocks walked in the prior week. Neighborhood socioeconomic status (NSES) measured at the level of the census tract. Negative binominal regression models were constructed to test the association between NSES and blocks walked. In the fully adjusted models, we included two-way and three-way interaction terms among race, gender, and NSES. Results: In adjusted analyses, among White residents in the lowest NSES quartile (most disadvantaged), men walked 64% more than women (P<.001), while in the highest NSES (most advantaged), men walked 43% more than women (P<.001). Among African American residents in the lowest NSES quartile, men walked 196% more blocks than women (P<.001), while in the highest NSES, men walked 43% more blocks than women, but this did not reach statistical significance (P=.06). Conclusions: Female gender is more strongly associated with walking for African Americans than for Whites in low SES neighborhoods but had a similar association with walking for both African Americans and Whites in high SES neighborhoods. Ethn Dis. 2016;26(1):17-26; doi:10.18665/ed.26.1.17

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Socioeconomic status is linked to daily cortisol through social activities in older African–American adults

Psychoneuroendocrinology ◽

10.1016/j.psyneuen.2019.07.108 ◽

2019 ◽

Vol 107 ◽

pp. 38-39

Author(s):

Samuele Zilioli ◽

Heather Fritz ◽

Wassim Tarraf ◽

Susan Lawrence ◽

Malcolm Cutchin

Keyword(s):

Socioeconomic Status ◽

African American ◽

Social Activities ◽

African American Adults

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Workplace Racial Composition Explains High Perceived Discrimination of High Socioeconomic Status African American Men

Brain Sciences ◽

10.3390/brainsci8080139 ◽

2018 ◽

Vol 8 (8) ◽

pp. 139 ◽

Cited By ~ 31

Author(s):

Shervin Assari ◽

Maryam Moghani Lankarani

Keyword(s):

Socioeconomic Status ◽

African American ◽

African Americans ◽

Predominantly White ◽

Household Income ◽

Perceived Discrimination ◽

Equation Modeling ◽

Racial Composition ◽

Male And Female ◽

African American Adults

Background: Sociological and epidemiological literature have both shown that socioeconomic status (SES) protects populations and individuals against health problems. Recent research, however, has shown that African Americans gain less from their SES and African Americans of high SES, particularly males, may be vulnerable to perceived discrimination, as explained by the Minorities’ Diminished Returns theory. One potential mechanism for this phenomenon is that high SES African Americans have a higher tendency to work in predominantly White workplaces, which increases their perceived discrimination. It is, however, unknown if the links between SES, working in predominantly White work groups and perceived discrimination differ for male and female African Americans. Aim: To test the associations between SES, workplace racial composition and perceived discrimination in a nationally representative sample of male and female African American adults. Methods. This study included a total number of 1775 employed African American adults who were either male (n = 676) or female (n = 1099), all enrolled from the National Survey of American Life (NSAL). The study measured gender, age, SES (educational attainment and household income), workplace racial composition and perceived discrimination. Structural Equation Modeling (SEM) was applied in the overall sample and also by gender. Results: In the pooled sample that included both genders, high education and household income were associated with working in a predominantly White work group, which was in turn associated with more perceived discrimination. We did not find gender differences in the associations between SES, workplace racial composition and perceived discrimination. Conclusion: Although racial composition of workplace may be a mechanism by which high SES increases discriminatory experiences for African Americans, males and females may not differ in this regard. Policies are needed to reduce discrimination in racially diverse workplaces. This is particularly the case for African Americans who work in predominantly White work environments.

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Polypharmacy and Psychological Distress May Be Associated in African American Adults

Pharmacy ◽

10.3390/pharmacy7010014 ◽

2019 ◽

Vol 7 (1) ◽

pp. 14 ◽

Cited By ~ 6

Author(s):

Shervin Assari ◽

Mohsen Bazargan

Keyword(s):

Socioeconomic Status ◽

African American ◽

Psychological Distress ◽

Health Status ◽

African Americans ◽

Health Care Access ◽

Comprehensive Evaluation ◽

National Sample ◽

Multiple Chronic Conditions ◽

African American Adults

Background: Compared to Whites, African Americans are at a higher risk of multiple chronic conditions, which places them at a higher risk of polypharmacy. Few national studies, however, have tested whether polypharmacy is associated with psychological distress—the net of socioeconomic status, health status, and stress—in African Americans. Aims: In a national sample of African Americans in the US, this study investigated the association between polypharmacy and psychological distress. Methods: The National Survey of American Life (NSAL, 2003) included 3570 African American adults who were 18 years or over. This number was composed of 2299 women and 1271 men. Polypharmacy (using ≥ 5 medications) and hyper-polypharmacy (using ≥ 10 medications) were the independent variables. Psychological distress was the dependent variable. Age, gender, socioeconomic status (education attainment, income, employment, and marital status), health care access (insurance status and usual place of care), and health status (multimorbidity and psychiatric disorders) were the covariates. Linear multivariable regression was applied to perform the data analysis. Results: Both polypharmacy and hyper-polypharmacy were associated with psychological distress. This association was significant after controlling for all the covariates. Conclusions: African Americans with polypharmacy, particularly those with hyper-polypharmacy, are experiencing higher levels of psychological distress, which itself is a known risk factor for poor adherence to medications. There is a need for a comprehensive evaluation of medications as well as screening for psychopathology in African Americans with multiple medical conditions.

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Educational Attainment Better Protects African American Women than African American Men Against Depressive Symptoms and Psychological Distress

Brain Sciences ◽

10.3390/brainsci8100182 ◽

2018 ◽

Vol 8 (10) ◽

pp. 182 ◽

Cited By ~ 18

Author(s):

Shervin Assari

Keyword(s):

Mental Health ◽

Socioeconomic Status ◽

African American ◽

Psychological Distress ◽

Depressive Symptoms ◽

High Education ◽

African Americans ◽

African American Men ◽

Education Attainment ◽

African American Adults

Background: Recent research has shown smaller health effects of socioeconomic status (SES) indicators such as education attainment for African Americans as compared to whites. However, less is known about diminished returns based on gender within African Americans. Aim: To test whether among African American men are at a relative disadvantage compared to women in terms of having improved mental health as a result of their education attainment. This study thus explored gender differences in the association between education attainment and mental health, using a representative sample of American adults. Methods: The National Survey of American Life (NSAL; 2003) recruited 3570 African American adults (2299 females and 1271 males). The dependent variables were depressive symptoms and psychological distress. The independent variable was education attainment. Race was the focal moderator. Age, employment status, and marital status were covariates. Linear regressions were used for data analysis. Results: In the pooled sample that included both male and female African American adults, high education attainment was associated with lower depressive symptoms and psychological distress, net of covariates. Significant interactions were found between gender and education attainment with effects on depressive symptoms and psychological distress, suggesting stronger protective effects of high education attainment against depressive symptoms and psychological distress for female as compared to male African Americans. Conclusion: A smaller gain in mental health with respect to educational attainment for male African American males as compared to African American females is in line with studies showing high risk of depression in African American men of high-socioeconomic status. High-SES African American men need screening for depression and psychological distress.

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Perceptions from Latino and African American Older Adults about Biological Markers in Research

Ethnicity & Disease ◽

10.18865/ed.25.3.355 ◽

2015 ◽

Vol 25 (3) ◽

pp. 355 ◽

Cited By ~ 3

Author(s):

Gerardo Moreno, MD, MSHS ◽

Carol M. Mangione, MD, MSPH ◽

Carlos E. Meza, BS ◽

Ivy Kwon, MPH ◽

Teresa Seeman, PhD ◽

...

Keyword(s):

Older Adults ◽

African American ◽

African Americans ◽

Focus Group ◽

Biological Markers ◽

Community Dwelling ◽

Barriers And Facilitators ◽

Research Approach ◽

Structured Interviews ◽

And Storage

Although older adult minorities face disparities in health and health care, they continue to be underrepresented in health research. Studies with biological markers of health often lack representation of older minority adults. The purpose of this study was to describe perceptions of biomarkers among ethnic minority seniors who might participate in studies of biological markers of health and to document barriers and facilitators to acceptance of biomarkers. Six focus groups (3 of Spanish-speaking Latinos and 3 of African Americans) were conducted in three community senior service organizations (two senior centers and one church). Ten semi-structured interviews were conducted to support and augment focus group data. Seventy-two community-dwelling minority older adults aged 62 years and older and 10 community stakeholders participated. A community-based partnered research approach was used and two community partners participated in the analysis and interpretation of results. Standard qualitative content-analysis methods were used to identify and organize themes in domains. Focus group participants were 49% Latino and 51% African American. Results included barriers: 1) mistrust, 2) fear of specimen collection/storage, 3) perceived harms, 4) competing demands, and 5) costs. Older Latinos cited issues of language as barriers to awareness and acceptance of biomarkers. African Americans had concerns over perceived harms of biomarkers. Facilitators to acceptance of biomarkers were community engagement through church and community leaders. Older Latino and African Americans identified many barriers and facilitators to the collection and storage of biomarkers. Participants identified community-partnered recommendations to overcome barriers to the acceptance, collection, and storage of biomarkers. Ethn Dis.2015;25(3):355-362.

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Symptoms of depression among community-dwelling elderly African-American and White older adults

Psychological Medicine ◽

10.1017/s0033291798007648 ◽

1998 ◽

Vol 28 (6) ◽

pp. 1311-1320 ◽

Cited By ~ 154

Author(s):

D. G. BLAZER ◽

L. R. LANDERMAN ◽

J. C. HAYS ◽

E. M. SIMONSICK ◽

W. B. SAUNDERS

Keyword(s):

Older Adults ◽

African American ◽

African Americans ◽

Racial Differences ◽

Interpersonal Relations ◽

Depressive Symptomatology ◽

Community Sample ◽

The Elderly ◽

Community Dwelling ◽

Bivariate Analysis

Background. Few studies have explored the variance in individual symptoms by race in older adults.Methods. Data were analysed from the Duke site of the Established Populations for Epidemiologic Studies of the Elderly (EPESE), a community sample of persons 65 years-of-age and older, 54% of whom were African-Americans. Of the 3401 subjects with adequate data on depressive symptomatology, confirmatory factor analysis and LISREL were first used to confirm the presence of the factor structure previously reported for the CES-D. Next, bivariate analysis was performed to determine the prevalence of individual symptoms by race. Finally, LISREL analysis was performed to control for potential confounding variables.Results. When bivariate comparisons of specific symptoms by race were explored, African-Americans were more likely to report less hope about the future, poor appetite, difficulty concentrating, requiring more effort for usual activities, less talking, feeling people were unfriendly, feeling disliked by others and being more ‘bothered’ than usual. When LISREL analyses were applied to these data (controlling for education, income, cognitive impairment, chronic health problems and disability and other factors) racial differences in somatic complaints and life satisfaction disappeared, yet differences in interpersonal relations persisted.Conclusions. This study confirms earlier findings of minimal overall differences in symptom frequency between African-American and non-African-American community-dwelling older adults in controlled studies.

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Toward Identifying Mild Cognitive Impairment in Hispanic and African American Adults

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp2.sig2.110 ◽

2017 ◽

Vol 2 (2) ◽

pp. 110-116

Author(s):

Valarie B. Fleming ◽

Joyce L. Harris

Keyword(s):

Older Adults ◽

African American ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Healthcare Access ◽

Communication Disorders ◽

Healthcare Systems ◽

Prevention Education ◽

Education Management ◽

African American Adults

Across the breadth of acquired neurogenic communication disorders, mild cognitive impairment (MCI) may go undetected, underreported, and untreated. In addition to stigma and distrust of healthcare systems, other barriers contribute to decreased identification, healthcare access, and service utilization for Hispanic and African American adults with MCI. Speech-language pathologists (SLPs) have significant roles in prevention, education, management, and support of older adults, the population must susceptible to MCI.

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The Health and Well-Being of African-American Older Adults With a History of Incarceration

Innovation in Aging ◽

10.1093/geroni/igaa057.1633 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 506-506

Author(s):

Rodlescia Sneed

Keyword(s):

Older Adults ◽

African American ◽

African Americans ◽

Well Being ◽

Formerly Incarcerated ◽

Older Prisoners ◽

Health Related ◽

History Of ◽

Health And Well Being ◽

African American Older Adults

Abstract African-Americans are overrepresented in the criminal justice system. Longer prison stays and release programs for older prisoners may result in an increased number of community-dwelling older adults with a history of incarceration. In recent years, there has been a substantial increase in research on health-related outcomes for currently incarcerated older adults; however, there has been little inquiry into outcomes for formerly incarcerated African-American older adults following community re-entry. In this study, we used secondary data from the Health and Retirement Study to describe employment, economic, and health-related outcomes in this population. Twelve percent of the 2238 African-Americans in our sample had been previously incarcerated. Those who had been previously incarcerated had higher rates of lung disease, arthritis, back problems, mobility problems, and mental health issues than their counterparts. They also had higher rates of hospitalization and lower use of dental health services. Further, while they did not experience lower employment rates than those with no criminal history, those who had been incarcerated had more physically demanding jobs and reported greater economic strain. Given the disproportionate incarceration rates among African-Americans, the aging of the prison population, and the increase in community re-entry for older prisoners, research that explores factors that impact the health and well-being of formerly incarcerated individuals has broad impact. Future work should focus on addressing the needs of this vulnerable population of African-American older adults.

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Medical and Social Determinants of Brain Health and Dementia in a Multicultural Community Cohort of Older Adults

Journal of Alzheimer s Disease ◽

10.3233/jad-215020 ◽

2021 ◽

pp. 1-14

Author(s):

James E. Galvin ◽

Stephanie Chrisphonte ◽

Lun-Ching Chang

Keyword(s):

Older Adults ◽

Health Disparities ◽

African Americans ◽

Health Outcomes ◽

Sex Education ◽

Screening Program ◽

Healthcare Services ◽

Social Dimension ◽

Medical Comorbidities ◽

Race Ethnicity

Background: Socioeconomic status (SES), race, ethnicity, and medical comorbidities may contribute to Alzheimer’s disease and related disorders (ADRD) health disparities. Objective: Analyze effects of social and medical determinants on cognition in 374 multicultural older adults participating in a community-based dementia screening program. Methods: We used the Montreal Cognitive Assessment (MoCA) and AD8 as measures of cognition, and a 3-way race/ethnicity variable (White, African American, Hispanic) and SES (Hollingshead index) as predictors. Potential contributors to health disparities included: age, sex, education, total medical comorbidities, health self-ratings, and depression. We applied K-means cluster analyses to study medical and social dimension effects on cognitive outcomes. Results: African Americans and Hispanics had lower SES status and cognitive performance compared with similarly aged Whites. We defined three clusters based on age and SES. Cluster #1 and #3 differed by SES but not age, while cluster #2 was younger with midlevel. Cluster #1 experienced the worse health outcomes while cluster #3 had the best health outcomes. Within each cluster, White participants had higher SES and better health outcomes, African Americans had the worst physical performance, and Hispanics had the most depressive symptoms. In cross-cluster comparisons, higher SES led to better health outcomes for all participants. Conclusion: SES may contribute to disparities in access to healthcare services, while race and ethnicity may contribute to disparities in the quality and extent of services received. Our study highlights the need to critically address potential interactions between race, ethnicity, and SES which may better explain disparities in ADRD health outcomes.

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