Trends in stress among pregnant and postpartum women during the COVID-19 pandemic (Preprint)

2021 ◽  
Author(s):  
Serwaa Omowale ◽  
Andrea Casas ◽  
Yu-Hsuan Lai ◽  
Sarah Sanders ◽  
Ashley Hill ◽  
...  
Keyword(s):  
Racial Differences ◽  
The United States ◽  
Mean Stress ◽  
Postpartum Health ◽  
Black And White ◽  
Pregnancy And Postpartum ◽  
Significant Difference ◽  
Stress Levels ◽  
Change In Mean ◽  
At Home

BACKGROUND Stress has been associated with adverse birth and postpartum health outcomes. Few studies have explored racial differences in maternal stress in a birthing population longitudinally in the United States (U.S.) during the ongoing COVID-19 pandemic. OBJECTIVE This study aimed to: (1) assess changes in reported stress before, during, and after initial emergency declarations (e.g., stay-at-home orders) were in place due to the COVID-19 pandemic and (2) assess Black-White differences in reported stress in a pregnant and postpartum population from Southwestern Pennsylvania. METHODS We leveraged data from the ongoing Postpartum Mothers Mobile Study (PMOMS) which surveys participants in real-time throughout the pregnancy and postpartum periods via ecological momentary assessment (EMA) and smartphone technology. We analyzed data from a subset of PMOMS participants (n=85) who were either Black or White, and who submitted EMA responses regarding stress between November 1, 2019 and August 31, 2020, the timeframe of this study. Data were divided into four phases based on significant events during the COVID-19 pandemic: a pre-phase (baseline), early-phase (first case of COVID-19 reported in U.S.), during-phase (stay-at-home orders), and post-phase (stay-at-home orders eased). We assessed mean stress levels at each phase using mixed-effects models and post-hoc contrasts based on the models. RESULTS Overall mean stress (min: 0, max: 4 as measured by a modified Cohen Perceived Stress Scale) during the pre-phase was 0.8 for Black and White participants [range for Black participants: 0-3.9, range for White participants: 0-2.8]. There was an increase of 0.26 points (t=5.19, d.f.=5649, p<.0001) in the during-phase as compared with the pre-phase, and an increase of 0.19 points (t=3.09, d.f.=5649, p=0.002) in the post-phase compared with the pre-phase (n=85). No difference was found between Black and White participants in the change in mean stress from the pre-phase to the during-phase (δ ̂= -0.016, p=0.867). There was a significant difference between Black and White participants in the change in mean stress from the during-phase to the post-phase (δ ̂ = -0.39, p<0.0001). CONCLUSIONS There was an overall increase in mean stress levels in this subset of pregnant and postpartum participants during the same time as the emergency declarations/stay-at-home orders in the US. Compared to baseline, mean stress levels remained elevated when stay-at-home orders eased. We found no significant difference in the mean stress levels by race. Given that stress is associated with adverse birth outcomes and postpartum health, stress induced by the ongoing COVID-19 pandemic may have adverse implications for birthing populations in the U.S. INTERNATIONAL REGISTERED REPORT RR2-10.2196/13569

Abstract T P146: Vitamin D Deficiency is Associated With Stroke in Black and White Participants of the REGARDS Study

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Suzanne E Judd ◽  
Virginia J Howard ◽  
Paul Muntner ◽  
Brett M Kissela ◽  
Bhupesh Panwar ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Racial Differences ◽  
Sex Education ◽  
The United States ◽  
Dietary Vitamin ◽  
Equal Distribution ◽  
Black And White ◽  
Increased Risk ◽  
Regards Study

Objective: Black Americans are at greater risk of both stroke and vitamin D deficiency than white Americans. We have previously shown that both higher dietary vitamin D and sunlight exposure are associated with decreased risk of stroke; however, serum 25(OH) is thought to be a better marker of vitamin D status. Methods: Using a case cohort design, we examined the association of plasma 25(OH)D with incident stroke in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, a cohort of black and white participants from across the United States enrolled between 2003 and 2007. Medical records were reviewed by physicians and strokes were classified on the basis of symptoms and neuroimaging. Strokes through July 1, 2011 were included. A stratified cohort sample was selected to ensure approximately equal numbers of black and white participants and an equal distribution across ages. We used Cox proportional hazards models weighted back to the original 30,239 participants, excluding those with history of stroke. Serum 25(OH)D was measured by Immunodetection Systems ELISA. Results: Over mean follow-up of 4.4 years, there were 539 ischemic and 71 hemorrhagic strokes. The stroke-free sub-cohort included 939 participants. After adjustment for age, race, sex, education, diabetes, hypertension, smoking, atrial fibrillation, heart disease, physical activity, kidney function, calcium and phosphorous, 25(OH)D level 30 ng/mL. The direction of association was similar for hemorrhagic stroke though not statistically significant (HR=1.59; 95%CI=0.78, 3.24). Vitamin D deficiency was associated with an increased risk of all stroke (HR=1.54; 95%CI=1.05, 2.23). This effect was greater in blacks (HR=2.09; 95%CI=1.09, 3.99) than whites (HR=1.38; 95%CI=0.78, 2.42). Results were not as strong when we modeled 25(OH)D as a continuous variable (HR=0.99 per 1 ng/ml change in 25(OH)D; 95%CI=0.98, 1.01). Discussion: Similar to low vitamin D intake, vitamin D deficiency is a risk factor for incident stroke. These findings support evidence from cardiovascular and cancer epidemiology that treating low 25(OH)D may prevent strokes.

scholarly journals Evaluation of flow of chorioretinal capillaries in healthy black and white subjects using optical coherence tomography angiography

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nathalie Massamba ◽  
Anna G. Mackin ◽  
Lindsay Y. Chun ◽  
Sarah Rodriguez ◽  
Rose C. Dimitroyannis ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Racial Differences ◽  
Optical Coherence Tomography Angiography ◽  
Capillary Density ◽  
Foveal Avascular Zone ◽  
Optical Coherence ◽  
Flow Area ◽  
Black And White ◽  
Significant Difference ◽  
Retinal Capillary

AbstractThis study compared macular capillary parameters between healthy black and white subjects using optical coherence tomography angiography (OCTA). We measured vessel density (VD) of superficial (SCP), intermediate (ICP), and deep (DCP) capillary plexuses and choriocapillaris blood flow area (BFA) of the fovea, parafovea and total 3 mm-diameter circular area centered on the fovea, as well as the foveal avascular zone (FAZ) parameters, controlling for axial length. Black subjects had lower foveal and parafoveal VD in the SCP (p = 0.043 and p = 0.014) and the ICP (p = 0.014 and p = 0.002). In the DCP, black subjects had a trend toward lower foveal and parafoveal VD. Black subjects had decreased choriocapillaris BFA in the total 3 mm area (p = 0.011) and the parafovea (p = 0.033), larger FAZ area (p = 0.006) and perimeter (p = 0.014), and a higher capillary density in a 300 μm wide region around the FAZ (FD-300) (p = 0.001). There was no significant difference in FAZ acircularity index. To our knowledge, this is the first report analyzing the three distinct retinal capillary plexuses and identifying differing baseline VD, choriocapillaris and FAZ parameters in healthy young black compared to white subjects. Larger studies are needed to validate these findings and better understand racial differences in vulnerability to ocular diseases.

Abstract P011: Serum Adiponectin And Risk Of Incident Hypertension: The REasons For Geographic And Racial Differences In Stroke (REGARDS) Study.

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Aneesh Singal ◽  
Mary Cushman ◽  
Neil A Zakai ◽  
Nels C Olson ◽  
George Howard ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Racial Differences ◽  
The United States ◽  
Demographic Model ◽  
Incident Hypertension ◽  
Black And White ◽  
Hypertension Risk ◽  
Life Years ◽  
Regards Study ◽  
Adjusted Model

Background: Hypertension is a leading cause of disability-adjusted life years lost in the United States. Adiponectin is a cytokine secreted by adipocytes that increases insulin sensitivity, maintains vascular homeostasis, and is inversely associated with adiposity. We sought to determine the risk of incident hypertension by level of adiponectin at baseline. Methods: The REasons for Geographic and Racial Differences in Stroke (REGARDS) study enrolled 30,239 Black and White US adults in 2003-2006, with a second visit ~9 years later. Adiponectin was measured at the baseline visit among a random sample of 4,400 participants who attended the second visit. Modified Poisson regression estimated the relative risk (RR) for incident hypertension by each 1 SD higher of log-transformed adiponectin level adjusting for age, race, and sex in a minimally adjusted model. The fully adjusted model added Southern Diet pattern, dietary ratio of sodium to potassium, BMI, waist circumference, and systolic blood pressure. Restricted cubic splines visualized RR of hypertension by level of adiponectin, relative to the median. Results: After excluding those with prevalent hypertension (threshold 140/90 mm Hg or blood pressure medication use; n=2477) and missing adiponectin (n =129), 1,877 participants remained (mean age 62 years, 49% male, 36% Black, with lower adiponectin in Black participants p<0.001). Incident hypertension occurred in 46% (95% CI 43, 50%) of Black adults and 32% (29, 34%) of White adults. The RR for incident hypertension for each 1-SD higher log adiponectin was 0.91 (0.83, 1.00) in the demographic model and 0.99 (0.89, 1.10) in the fully adjusted model. Hypertension risk was similar across the continuum of adiponectin ( Figure ). Conclusions: In a cohort of Black and White US adults without hypertension, level of adiponectin did not associate with risk of incident hypertension 9 years later after adjusting for other hypertension risk factors.

Racial Differences in Financial Socialization and Financial Behaviors of U.S. College Students

2014 ◽  
pp. 272-292 ◽  
Author(s):  
Michael S. Gutter ◽  
Zeynep Copur ◽  
Amanda Blanco
Keyword(s):  
College Students ◽  
Racial Differences ◽  
Credit Card ◽  
Online Survey ◽  
The United States ◽  
Financial Behavior ◽  
Financial Socialization ◽  
Financial Behaviors ◽  
Black And White ◽  
Important Relationship

This chapter focuses on the effect of race on financial socialization and financial behavior of college students. Data (N = 13,845) were collected from current college students age 18 and over via an online survey throughout the United States during spring and fall of 2008. Results from means comparisons showed significant differences on the financial socialization between Black and White college students. Logistic regression results suggest important relationship exist between race and financial behaviors. Black students were less likely to save and more likely to engage in risky credit card behavior than White students after controlling for the effects of all other variables.

Black and White Self-Identified Latinx Respondents and Perceived Psychological Distress and Impairment

2019 ◽  
Vol 41 (4) ◽  
pp. 504-522
Author(s):  
Jasmine A. Mena ◽  
T. Elizabeth Durden ◽  
Sarah E. Bresette ◽  
Taylor McCready
Keyword(s):  
Psychological Distress ◽  
Racial Differences ◽  
Future Directions ◽  
Level Of Education ◽  
Black And White ◽  
Education And Health ◽  
Significant Difference ◽  
Interview Survey ◽  
Nationally Representative ◽  
Status Level

The influence of racial differences on perceived psychological distress and impairment was examined with a nationally representative sample of Black and White Latinxs. The study sample was selected from multiple years of the National Health Interview Survey and included 30,519 self-identified Black and White Latinxs between the ages of 26 and 64 years. Results indicated that Black Latinxs reported higher levels of psychological distress—a statistically significant difference—compared to White Latinxs after accounting for demographic (age, gender, marital status, and nativity) and socioeconomic status (level of education and health insurance) indicators. Results also indicated that Black and White Latinxs did not differ on impairment associated with perceived psychological distress. The practice of aggregating Black and White Latinxs obscures the racialized experiences reported by Black Latinxs and associated higher levels of psychological distress. Implications and future directions are discussed.

scholarly journals Striving While Black: Race and the Psychophysiology of Goal Pursuit

2020 ◽  
Vol 61 (1) ◽  
pp. 24-42
Author(s):  
Reed T. DeAngelis
Keyword(s):  
Racial Differences ◽  
Stress Hormones ◽  
The United States ◽  
Self Report ◽  
Health Study ◽  
Cross Sectional ◽  
Davidson County ◽  
Black And White ◽  
Symptoms Of Depression ◽  
Working Age

Population health scientists have largely overlooked anticipatory stressors and how different groups of people experience and cope with anticipatory stress. I address these gaps by examining black-white differences in the associations between an important anticipatory stressor—goal-striving stress (GSS)—and several measures of psychophysiology. Hypotheses focusing on racial differences in GSS and psychophysiology are tested using self-report and biomarker data from the Nashville Stress and Health Study (2011–2014), a cross-sectional probability survey of black and white working-age adults from Davidson County, Tennessee (n = 1,252). Compared to their white peers, blacks with higher GSS report greater self-esteem and fewer symptoms of depression and anxiety. However, increased GSS also predicts elevated levels of high-effort coping (i.e., John Henryism), neuroendocrine stress hormones, and blood pressure for blacks but not whites. I discuss the implications of these findings for scholars interested in the stress process and broader black-white health inequalities in the United States.

scholarly journals An Exploratory Study on Determinants of Regular Group Indoor Cycling Participation in Black and White Adults

SAGE Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 215824401986356
Author(s):  
Alvin L. Morton ◽  
Lyndsey M. Hornbuckle ◽  
Miguel Aranda ◽  
Derrick T. Yates ◽  
Courtney L. Anderson
Keyword(s):  
Racial Differences ◽  
Self Regulation ◽  
Autonomous Motivation ◽  
Regular Exercise ◽  
Exercise Motivation ◽  
Regular Group ◽  
Exercise Participation ◽  
Black And White ◽  
Significant Difference ◽  
Intensity Of Exercise

This study investigated factors influencing regular group indoor cycling (GIC) participation in a sample of Black (71%) and White (29%) adults. Seventeen regular GIC participants (≥1 day/week for ≥3 consecutive months) completed surveys that examined motivations for GIC participation. Treatment Self-Regulation Questionnaire (TSRQ), Preference for and Tolerance of Intensity of Exercise Questionnaire (PRETIE-Q), and open-ended survey questions were used. TSRQ showed autonomous motivation was significantly higher than controlled ( p <.001) and amotivation ( p < .001), with no significant difference between controlled and amotivation ( p = .08). There was no significant interaction between motivation and race. There were no significant differences between race groups for PRETIE-Q. Five themes emerged as reasons for GIC participation: music, physical health, social support, studio atmosphere, and enjoyment/fun. Racial differences surfaced in the themes. More research is needed to understand the role of cultural relevance as it relates to exercise motivation and regular exercise participation. This could inform strategies for promoting regular exercise in various populations.

scholarly journals Racial differences in institutional trust and COVID-19 vaccine hesitancy and refusal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anisah B. Bagasra ◽  
Sara Doan ◽  
Christopher T. Allen
Keyword(s):  
Racial Differences ◽  
Scientific Community ◽  
Local Community ◽  
The United States ◽  
Vaccine Hesitancy ◽  
Institutional Trust ◽  
Vaccination Rates ◽  
Alaskan Natives ◽  
Significant Difference ◽  
Nationally Representative

Abstract Background Previous research has indicated that demographic differences affect COVID-19 vaccination rates. Trust, in both the vaccine itself and institutional trust, is one possible factor. The present study examines racial differences in institutional trust and vaccine status among a nationally representative sample of adults in the United States. Methods Data for the current study was collected as part of Wave 8 Omnibus 2000 survey conducted by RAND ALP and consisted of 2080 participants. Responses were collected through the online RAND ALP survey in March 2021. Results Trust in the scientific community was the strongest predictor for already receiving at least one dose of the COVID-19 vaccine at the time of study. Asians had a significantly higher trust in the scientific community compared to all other groups. Results also showed a significant difference in level of trust of the government’s response to the COVID-19 pandemic with Indian/Alaskan Natives reporting lower trust compared to Whites, Blacks and Asians. Asians also had a significantly higher level of trust when compared to those who identified as racial Other. Those who identify as American Indian/Alaskan Natives had the lowest levels of institutional trust. Trust in the government’s response was not indicative of vaccination within the sample. Conclusions Strategies to increase trust of the scientific community can be employed to address vaccine hesitancy through community-based initiatives and building of partnerships between the scientific community and local community stakeholders.

Does Adherence to Mediterranean Diet Mediate the Association Between Food Environment and Obesity Among Non-Hispanic Black and White Older US Adults? A Path Analysis

2020 ◽  
Vol 34 (6) ◽  
pp. 652-658
Author(s):  
Meifang Chen ◽  
Virginia Howard ◽  
Kathy F. Harrington ◽  
Thomas Creger ◽  
Suzanne E. Judd ◽  
...  
Keyword(s):  
United States ◽  
Path Analysis ◽  
Racial Differences ◽  
Mediterranean Diet ◽  
Food Environment ◽  
Household Income ◽  
The United States ◽  
Community Dwelling ◽  
Annual Household Income ◽  
Black And White

Purpose: This study aims to test the hypothesis that in addition to a direct effect of food environment on obesity, food environment is indirectly associated with obesity through consuming Mediterranean diet (MD). Design: Cross-sectional secondary data analysis. Setting: Nationwide community-dwelling residency. Sample: A total of 20 897 non-Hispanic black and white adults aged ≥45 years who participated in the REasons for Geographic and Racial Differences in Stroke study and completed baseline assessment during January 2003 and October 2007. Measures: The Modified Retail Food Environment Index (mRFEI; 0-100) was used as food environment indicator. The MD score (0-9) was calculated to indicate the dietary pattern adherence. Body mass index (BMI; kg/m2) was used to estimate obesity. Analysis: Path analysis was used to quantify the pathways between food environment, MD adherence, and obesity. Proper data transformation was made using Box–Cox power transformation to meet certain analysis assumptions. Results: The participants were from 49 states of the United States, with the majority (64.42%) residing in the South. Most of the participants were retired, female, white, married, having less than college graduate education, having annual household income ≤75 000, and having health insurance. The means of mRFEI was 10.92 (standard deviation [SD] = 10.19), MD score was 4.36 (SD = 1.70), and the BMI was 28.96 kg/m2 (SD = 5.90). Access to healthy food outlets (β = .04, P < .0001) and MD adherence (β = .08, P < .0001) had significant and inverse relationships with BMI, respectively. Mediterranean diet adherence mediated the relationship between food environment and obesity among a subpopulation who had an annual household income of <$75 000 (β = −.02, P = .0391). Conclusion: Population-tailored interventions/policies to modify food environment and promote MD consumption are needed in order to combat the obesity crisis in the United States.

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