scholarly journals Cigarette Smoking among Economically Disadvantaged African-American Older Adults in South Los Angeles: Gender Differences

2019 ◽  
Vol 16 (7) ◽  
pp. 1208 ◽  
Author(s):  
Shervin Assari ◽  
James Smith ◽  
Marc Zimmerman ◽  
Mohsen Bazargan
Keyword(s):  
Older Adults ◽  
Gender Differences ◽  
Smoking Cessation ◽  
Depressive Symptoms ◽  
Los Angeles ◽  
Cigarette Smoking ◽  
Urban Areas ◽  
Economically Disadvantaged ◽  
Financial Difficulty ◽  
Current Smoking

The current study aims to explore gender differences in the risk of cigarette smoking among African-American (AA) older adults who live in economically disadvantaged urban areas of southern Los Angeles. This cross-sectional study enrolled 576 older AA adults (age range between 65 and 96 years) who were residing in Service Planning Area 6 (SPA 6), one of the most economically challenged areas in southern Los Angeles. All participants had cardiometabolic disease (CMD). Data were collected using structured face-to-face interviews. Demographic factors (age and gender), socioeconomic status (educational attainment and financial difficulty), health (number of comorbid medical conditions and depressive symptoms), and health behaviors (current alcohol drinking and current smoking) were measured. Logistic regressions were used to analyze the data without and with interaction terms between gender and current drinking, depressive symptoms, and financial difficulty. AA men reported more smoking than AA women (25.3% versus 9.3%; p < 0.05). Drinking showed a stronger association with smoking for AA men than AA women. Depressive symptoms, however, showed stronger effects on smoking for AA women than AA men. Gender did not interact with financial difficulty with regard to current smoking. As AA older men and women differ in psychological and behavioral determinants of cigarette smoking, gender-specific smoking cessation interventions for AA older adults who live in economically deprived urban areas may be more successful than interventions and programs that do not consider gender differences in determinants of smoking. Gender-tailored smoking cessation programs that address drinking for AA men and depression for AA women may help reduce the burden of smoking in AA older adults in economically disadvantaged urban areas. Given the non-random sampling, there is a need for replication of these findings in future studies.

scholarly journals Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women

2019 ◽  
Vol 16 (10) ◽  
pp. 1670 ◽  
Author(s):  
Shervin Assari ◽  
James Smith ◽  
Mohsen Bazargan
Keyword(s):  
Older Adults ◽  
Gender Differences ◽  
Los Angeles ◽  
Social Relations ◽  
Low Income ◽  
Economically Disadvantaged ◽  
African American Men ◽  
Equation Modeling ◽  
Men And Women ◽  
Self Rated Health

Background. Although chronic medical conditions (CMCs), depression, and self-rated health (SRH) are associated, their associations may depend on race, ethnicity, gender, and their intersections. In predominantly White samples, SRH is shown to better reflect the risk of mortality and multimorbidity for men than it is for women, which suggests that poor SRH among women may be caused not only by CMCs, but also by conditions like depression and social relations—a phenomenon known as “the sponge hypothesis.” However, little is known about gender differences in the links between multimorbidity, depression, and SRH among African Americans (AAs). Objective. To study whether depression differently mediates the association between multimorbidity and SRH for economically disadvantaged AA men and women. Methods. This survey was conducted in South Los Angeles between 2015 to 2018. A total number of 740 AA older adults (age ≥ 55 years) were enrolled in this study, of which 266 were AA men and 474 were AA women. The independent variable was the number of CMCs. The dependent variable was SRH. Age and socioeconomic status (educational attainment and marital status) were covariates. Depression was the mediator. Gender was the moderator. Structural Equation Modeling (SEM) was used to analyze the data. Results. In the pooled sample that included both genders, depression partially mediated the effect of multimorbidity on SRH. In gender specific models, depression fully mediated the effects of multimorbidity on SRH for AA men but not AA women. For AA women but not AA men, social isolation was associated with depression. Conclusion. Gender differences exist in the role of depression as an underlying mechanism behind the effect of multimorbidity on the SRH of economically disadvantaged AA older adults. For AA men, depression may be the reason people with multimorbidity report worse SRH. For AA women, depression is only one of the many reasons individuals with multiple CMCs report poor SRH. Prevention of depression may differently influence the SRH of low-income AA men and women with multimorbidity.

scholarly journals Pain Intensity among Community-Dwelling African American Older Adults in an Economically Disadvantaged Area of Los Angeles: Social, Behavioral, and Health Determinants

2019 ◽  
Vol 16 (20) ◽  
pp. 3894 ◽  
Author(s):  
Meghan C. Evans ◽  
Mohsen Bazargan ◽  
Sharon Cobb ◽  
Shervin Assari
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Los Angeles ◽  
Pain Intensity ◽  
Economically Disadvantaged ◽  
Community Dwelling ◽  
Chronic Medical Conditions ◽  
Medical Conditions ◽  
Disadvantaged Area ◽  
Financial Difficulties

Background. Although social, behavioral, and health factors influence prevalence and intensity of pain, very few studies have investigated correlates of pain among economically disadvantaged older African American (AA) adults. Objective. This study explored social, behavioral, and health correlates of pain intensity among community-dwelling AA older adults in an economically disadvantaged area of Los Angeles. Methods. A cross-sectional study on 740 AA older adults (age ≥ 55 years) was conducted in South Los Angeles between 2015 and 2018. Exploratory variables were age, gender, educational attainment, financial difficulties, living alone, marital status, smoking, drinking, pain-related chronic medical conditions (CMCs), and depressive symptoms. Dependent variable was pain intensity. Linear regression was used for data analysis. Results. Age, financial difficulties, living alone, smoking, pain-related chronic medical conditions, and depressive symptoms were associated with pain intensity. Individuals with lower age, higher financial difficulties, those who lived alone, those with a higher number of pain-related chronic medical conditions, more depressive symptoms, and nonsmokers reported more pain intensity. Gender, educational attainment, marital status, and drinking were not associated with pain intensity. Conclusion. The results may help with the health promotion of economically disadvantaged AA older adults in urban areas.

scholarly journals Insomnia Symptoms among African-American Older Adults in Economically Disadvantaged Areas of South Los Angeles

2019 ◽  
Vol 9 (11) ◽  
pp. 306 ◽  
Author(s):  
Mohsen Bazargan ◽  
Nadia Mian ◽  
Sharon Cobb ◽  
Roberto Vargas ◽  
Shervin Assari
Keyword(s):  
Older Adults ◽  
African American ◽  
Los Angeles ◽  
Linear Regression ◽  
Pain Intensity ◽  
Economically Disadvantaged ◽  
Financial Difficulty ◽  
South Los Angeles ◽  
Insomnia Symptoms ◽  
African American Older Adults

Background. Although psychosocial and health factors impact insomnia symptoms, less is known about these effects in economically disadvantaged African-American older adults. Aims. This study investigated social and health determinants of insomnia symptoms among economically disadvantaged African-American older adults. Methods. This survey enrolled 398 African-American older adults (age ≥ 65 years) from economically disadvantaged areas of South Los Angeles. Gender, age, educational attainment, financial difficulty, number of chronic diseases, self-rated health, pain intensity, and depression were covariates. Total insomnia, insomnia symptoms, and insomnia impact were our outcomes. Linear regression was applied for data analysis. Results. Based on linear regression, higher financial difficulty (B = 0.48, 95% CI = 0.35–0.61), smoking status (B = 1.64, 95% CI = 0.13–3.16), higher pain intensity (B = 0.39, 95% CI = 0.11–0.67), higher number of chronic diseases (B = 0.34, 95% CI = 0.05–0.64), and more depressive symptoms (B = 0.35, 95% CI = 0.12–0.57) were associated with a higher frequency of insomnia symptoms. Based on a logistic regression model, lower age (B = 0.91, 95% CI = 0.91–1.00) and high financial difficulty (OR = 1.15, 95% CI = 1.08–1.24), pain (OR = 2.08, 95% CI = 1.14–3.80), chronic disease (OR = 1.27, 95% CI = 1.07–1.51) and depression (OR = 2.38, 95% CI = 1.22–4.65) were associated with higher odds of possible clinical insomnia. We also found specific predictors for insomnia symptoms and insomnia impact. Conclusions. Among African-American older adults in economically disadvantaged areas of South Los Angeles, insomnia symptoms co-occur with other economic, physical, and mental health challenges such as financial difficulty, smoking, multimorbidity, pain, and depression. There is a need to address sleep as a component of care of economically disadvantaged African-American older adults who have multiple social and health challenges.

scholarly journals Chronic Respiratory Disease and Health-Related Quality of Life of African American Older Adults in an Economically Disadvantaged Area of Los Angeles

2019 ◽  
Vol 16 (10) ◽  
pp. 1756 ◽  
Author(s):  
Mohsen Bazargan ◽  
James L. Smith ◽  
Paul Robinson ◽  
John Uyanne ◽  
Ruqayyah Abdulrahoof ◽  
...  
Keyword(s):  
Older Adults ◽  
African American ◽  
Los Angeles ◽  
Urban Areas ◽  
Economically Disadvantaged ◽  
Disadvantaged Area ◽  
Related Quality ◽  
Health Related ◽  
African American Older Adults

Background. Most of the attention of policy makers, program planners, clinicians, and researchers in the area of physical health disparities among African American older adults has been traditionally focused on cardiometabolic disease and cancer. Among a long list of chronic medical conditions, chronic respiratory conditions (CRCs), such as asthma, chronic bronchitis, and emphysema, have received less attention. Purpose. This study investigated whether CRCs contribute to physical and mental health-related quality of life (HRQoL) of African American older adults who live in economically disadvantaged urban areas, and whether these effects are due to demographic factors, socioeconomic status (SES), health behaviors, and comorbid medical and mental conditions. Methods. This community-based study recruited 617 African American older adults (age ≥ 65 years) from Service Planning Areas (SPA) 6, an economically disadvantaged area in South Los Angeles. Structured face-to-face interviews were used to collect data on demographic factors (age and gender), SES (educational attainment and financial difficulty), living arrangements, marital status, health behaviors (cigarette smoking and alcohol drinking), health (CRC, number of comorbid medical conditions, depressive symptoms, and pain intensity), and physical and mental HRQoL (Physical and Mental Component Summary Scores; PCS and MCS; SF-12). Linear regressions were used to analyze the data. Results. The presence of CRCs was associated with lower PCS and MCS in bivariate analysis. The association between CRCs and PCS remained significant above and beyond all confounders. However, the association between CRCs and MCS disappeared after controlling for confounders. Conclusion. For African American older adults living in economically disadvantaged urban areas, CRCs contribute to poor physical HRQoL. Evaluation and treatment of CRCs in African American older adults may be a strategy for reduction of disparities in HRQoL in this population. As smoking is the major modifiable risk factor for CRCs, there is a need to increase accessibility of smoking cessation programs in economically disadvantaged urban areas. More research is needed on the types, management, and prognosis of CRCs such as asthma, chronic bronchitis, and emphysema in African American older adults who reside in low-income and resource limited urban areas.

scholarly journals Depressive Symptoms among Economically Disadvantaged African American Older Adults in South Los Angeles

2019 ◽  
Vol 9 (10) ◽  
pp. 246 ◽  
Author(s):  
Meghan C. Evans ◽  
Sharon Cobb ◽  
James Smith ◽  
Mohsen Bazargan ◽  
Shervin Assari
Keyword(s):  
Older Adults ◽  
African American ◽  
Depressive Symptoms ◽  
Los Angeles ◽  
Educational Attainment ◽  
Marital Status ◽  
Pain Intensity ◽  
Economically Disadvantaged ◽  
South Los Angeles ◽  
Financial Difficulties

Background: Although social, behavioral, and health factors correlate with depressive symptoms, less is known about these links among economically disadvantaged African American (AA) older adults. Objective: To study social, behavioral, and health correlates of depressive symptoms among economically disadvantaged AA older adults. Methods: This survey was conducted in South Los Angeles between 2015 and 2018. A total number of 740 AA older adults (age ≥55 years) were entered to this study. Independent variables were gender, age, educational attainment, financial difficulties, living alone, marital status, smoking, drinking, chronic medical conditions (CMCs), and pain intensity. The dependent variable was depressive symptoms. Linear regression model was used to analyze the data. Results: Age, financial difficulties, smoking, CMCs, and pain intensity were associated with depressive symptoms. Gender, educational attainment, living arrangement, marital status, and drinking were not associated with depressive symptoms. Conclusion: Factors such as age, financial difficulties, smoking, CMCs, and pain may inform programs that wish to screen high risk economically disadvantaged AA older adults for depressive symptoms.

scholarly journals Rural–Urban Differences in the Factors Affecting Depressive Symptoms among Older Adults of Two Regions in Myanmar

2021 ◽  
Vol 18 (6) ◽  
pp. 2818
Author(s):  
Yuri Sasaki ◽  
Yugo Shobugawa ◽  
Ikuma Nozaki ◽  
Daisuke Takagi ◽  
Yuiko Nagamine ◽  
...  
Keyword(s):  
Older Adults ◽  
Middle School ◽  
Depressive Symptoms ◽  
Rural Areas ◽  
Urban Areas ◽  
Depression Scale ◽  
Wealth Index ◽  
School Level ◽  
Cross Sectional ◽  
Middle School Level

The aim of the study was to investigate rural–urban differences in depressive symptoms in terms of the risk factors among older adults of two regions in Myanmar to provide appropriate intervention for depression depending on local characteristics. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from the two regions, for face-to-face interviews. Depressive symptoms were assessed using the 15-item version of the Geriatric Depression Scale (GDS). Depressive symptoms were positively associated with living in rural areas (B = 0.42; 95% confidence interval (CI): 0.12,0.72), female (B = 0.55; 95% CI: 0.31,0.79), illness during the preceding year (B = 0.68; 95% CI: 0.45,0.91) and non-Buddhist religion (B = 0.57; 95% CI: 0.001,1.15) and protectively associated with education to middle school level or higher (B = −0.61; 95% CI: −0.94, −0.28) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.30, −0.10). In women in urban areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.78; 95% CI: 0.36, 1.20) and protectively associated with education to middle school level or higher (B = −0.67; 95% CI: −1.23, −0.11), middle or high wealth index (B = −0.92; 95% CI: −1.59, −0.25) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.38, −0.03). In men in rural areas, illness during the preceding year was positively associated with depressive symptoms (B = 0.87; 95% CI: 0.33, 1.42). In women in rural areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.83; 95% CI: 0.36, 1.30) and protectively associated with primary education (B = −0.62; 95% CI: −1.12, −0.12) and the frequency of visits to religious facilities (B = −0.44; 95% CI: −0.68, −0.21). Religion and wealth could have different levels of association with depression between older adults in the urban and rural areas and men and women. Interventions for depression in older adults should consider regional and gender differences in the roles of religion and wealth in Myanmar.

scholarly journals Health-Related Quality of Life of Economically Disadvantaged African American Older Adults: Age and Gender Differences

2019 ◽  
Vol 16 (9) ◽  
pp. 1522 ◽  
Author(s):  
Shervin Assari ◽  
James Smith ◽  
Mohsen Bazargan
Keyword(s):  
Older Adults ◽  
Gender Differences ◽  
Economically Disadvantaged ◽  
Older Age ◽  
Related Quality ◽  
Health Related ◽  
Physical Hrqol ◽  
Effect Of Age ◽  
Pooled Sample

Background: The association between age and health-related quality of life (HRQoL) is still under debate. While some research shows older age is associated with better HRQoL, other studies show no or negative association between age and HRQoL. In addition, while the association between age and HRQoL may depend on race, ethnicity, gender, and their intersections, most previous research on this link has been performed in predominantly White Middle Class. Objective: To explore gender differences in the association between age and mental and physical HRQoL in a sample of economically disadvantaged African American (AA) older adults. Methods: This cross-sectional survey was conducted in South Los Angeles between 2015 to 2018. A total number of 740 economically disadvantaged AA older adults (age ≥ 55 years) were enrolled in this study, using non-random sampling. This includes 266 AA men and 474 AA women. The independent variable of interest was age. Dependent variables of interest were physical component scores (PCS) and mental component scores (MCS), two main summary scores of the HRQoL, measured using Short Form-12 (SF-12). Gender was the moderator. Socioeconomic status (educational attainment and financial difficulty) were covariates. Linear regression models were used to analyze the data. Results: AA women reported worse PCS; however, gender did not impact MCS. In the pooled sample, high age was associated with better PCS and MCS. In the pooled sample, a significant interaction was found between gender and age on PCS, suggesting a stronger effect of age on PCS for AA men than AA women. In gender-stratified models, older age was associated with better PCS for AA men but not AA women. Older age was similarly and positively associated with better MCS for AA men and women. Conclusions: There may be some gender differences in the implications of ageing for the physical HRQoL of AA older adults. It is unclear how old age may have a boosting effect on physical HRQoL for AA men but not AA women. Future research should test gender differences in the effect of age on physical health indicators such as chronic disease as well as cognitive processes involved in the evaluation of own’s health in AA men and women.

scholarly journals Substance Use among Economically Disadvantaged African American Older Adults; Objective and Subjective Socioeconomic Status

2019 ◽  
Vol 16 (10) ◽  
pp. 1826 ◽  
Author(s):  
Shervin Assari ◽  
James Smith ◽  
Ritesh Mistry ◽  
Mehdi Farokhnia ◽  
Mohsen Bazargan
Keyword(s):  
Older Adults ◽  
African American ◽  
Cigarette Smoking ◽  
Educational Attainment ◽  
Alcohol Drinking ◽  
Economically Disadvantaged ◽  
Health Risk Behaviors ◽  
Subjective Socioeconomic Status ◽  
Financial Difficulties ◽  
African American Older Adults

Purpose. This study investigated the effects of objective and subjective socioeconomic status (SES) indicators on two health behaviors, cigarette smoking and alcohol drinking, among African American older adults. Methods. This community-based study recruited 619 economically disadvantaged African American older adults (age ≥ 65 years) residing in South Los Angeles. Structured face-to-face interviews were conducted to collect data. Data on demographic factors (age and gender), subjective SES (financial difficulties), objective SES (educational attainment), living arrangement, marital status, healthcare access (insurance), and health (number of chronic medical conditions, self-rated health, sick days, depression, and chronic pain) and health behaviors (cigarette smoking and alcohol drinking) were collected from participants. Logistic regressions were used to analyze the data. Results. High financial difficulties were associated with higher odds of smoking cigarettes and drinking alcohol, independent of covariates. Educational attainment did not correlate with our outcomes. Similar patterns emerged for cigarette smoking and alcohol drinking. Conclusion. Subjective SES indicators such as financial difficulties may be more relevant than objective SES indicators such as educational attainment to health risk behaviors such as cigarette smoking and alcohol drinking among African American older adults in economically constrain urban environments. Smoking and drinking may serve as coping mechanisms with financial difficulty, especially among African American older adults. In line with the minorities’ diminished returns (MDR) theory, and probably due to discrimination against racial minorities, educational attainment has a smaller protective effect among economically disadvantaged African American individuals against health risk behaviors.

scholarly journals Binge Drinking among Economically Disadvantaged African American Older Adults with Diabetes

2019 ◽  
Vol 9 (9) ◽  
pp. 97 ◽  
Author(s):  
Shervin Assari ◽  
James L. Smith ◽  
Mohammed Saqib ◽  
Mohsen Bazargan
Keyword(s):  
Older Adults ◽  
African American ◽  
African Americans ◽  
Los Angeles ◽  
Binge Drinking ◽  
Economically Disadvantaged ◽  
Living Arrangement ◽  
Urban Environments ◽  
Health Determinants ◽  
African American Older Adults

Purpose. This study investigated the effect of demographic, socioeconomic, and psychological factors as well as the role of health determinants on alcohol consumption and binge drinking among economically disadvantaged African American older adults with type 2 diabetes mellites (T2DM). Methods. This survey recruited 231 African Americans who were older adults (age 65+ years) and had T2DM. Participants were selected from economically disadvantaged areas of South Los Angeles. A structured face-to-face interview was conducted to collect data on demographic factors, objective and subjective socioeconomic status (SES) including education and financial difficulty, living arrangement, marital status, health, and drinking behaviors (drinking and binge drinking). Results. Age, gender, living alone, pain, comorbid conditions, and smoking were associated with drinking/binge drinking. Male gender, pain, and being a smoker were associated with higher odds of drinking/binge drinking, while individuals with more comorbid medical conditions had lower odds of binge drinking. Conclusion. In economically constrained urban environments, gender, pain, and smoking but not age, SES, depression, and health may predict binge drinking for African American older adults with T2DM. African Americans older adult men with T2DM with comorbid pain should be screened for binge drinking.

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