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 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 Marijuana Use among African American Older Adults in Economically Challenged Areas of South Los Angeles

2019 ◽  
Vol 9 (7) ◽  
pp. 166 ◽  
Author(s):  
Sharon Cobb ◽  
Mohsen Bazargan ◽  
James Smith ◽  
Homero E. del Pino ◽  
Kimberly Dorrah ◽  
...  
Keyword(s):  
Older Adults ◽  
African American ◽  
Los Angeles ◽  
Cigarette Smoking ◽  
Alcohol Drinking ◽  
Living Alone ◽  
Financial Strain ◽  
Chronic Medical Conditions ◽  
South Los Angeles ◽  
African American Older Adults

Purpose: This study explored demographic, social, behavioral, and health factors associated with current marijuana use (MU) among African American older adults who were residing in economically challenged areas of south Los Angeles. Methods: This community-based study recruited a consecutive sample of African American older adults (n = 340), age ≥ 55 years, residing in economically challenged areas of South Los Angeles. Interviews were conducted to collect data. Demographics (age and gender), socioeconomic status (educational attainment, income, and financial strain), marital status, living alone, health behaviors (alcohol drinking and cigarette smoking), health status (number of chronic medical conditions, body mass index, depression, and chronic pain), and current MU were collected. Logistic regression was used to analyze the data. Results: Thirty (9.1%) participants reported current MU. Age, educational attainment, chronic medical conditions, and obesity were negatively associated with current MU. Gender, income, financial strain, living alone, marital status, smoking cigarettes, drinking alcohol, depression, and pain did not correlate with MU. Conclusion: Current MU is more common in younger, healthier, less obese, less educated African American older adults. It does not seem that African American older adults use marijuana for the self-medication of chronic disease, pain, or depression. For African American older adults, MU also does not co-occur with cigarette smoking and alcohol drinking. These results may help clinicians who provide services for older African Americans in economically challenged urban areas.

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.

scholarly journals Depression Treatment Status of Economically Disadvantaged African American Older Adults

2020 ◽  
Vol 10 (3) ◽  
pp. 154
Author(s):  
Sharon Cobb ◽  
Mohsen Bazargan ◽  
Jessica Castro Sandoval ◽  
Cheryl Wisseh ◽  
Meghan C. Evans ◽  
...  
Keyword(s):  
Older Adults ◽  
African American ◽  
High Risk ◽  
Educational Attainment ◽  
Pain Intensity ◽  
Economically Disadvantaged ◽  
Polynomial Regression ◽  
Chronic Medical Conditions ◽  
Medical Conditions ◽  
Treatment Status

Background: It is known that depression remains largely untreated in underserved communities. Hence, it is desirable to gain more knowledge on the prevalence and correlates of untreated depression among African-American (AA) older adults in economically disadvantaged areas. This knowledge may have the public health benefit of improving detection of AA older adults with depression who are at high risk of not receiving treatment, thereby reducing this health disparity. Objective: To study health and social correlates of untreated depression among AA older adults in economically disadvantaged areas. Methods: Between 2015 and 2018, this cross-sectional survey was conducted in South Los Angeles. Overall, 740 AA older adults who were 55+ years old entered this study. Independent variables were age, gender, living arrangement, insurance type, educational attainment, financial strain, chronic medical conditions, and pain intensity. Untreated depression was the dependent variable. Logistic and polynomial regression models were used to analyze these data. Results: According to the polynomial regression model, factors such as number of chronic medical conditions and pain intensity were higher in individuals with depression, regardless of treatment status. As our binary logistic regression showed, age, education, and number of providers were predictive of receiving treatment for depression. Conclusion: Age, educational attainment, number of providers (as a proxy of access to and use of care) may be useful to detect AA older adults with depression who are at high risk of not receiving treatment. Future research may focus on decomposition of the role of individual-level characteristics and health system-level characteristics that operate as barriers and facilitators to AA older adults receiving treatment for depression.

scholarly journals Psychotropic and Opioid-Based Medication Use among Economically Disadvantaged African-American Older Adults

Pharmacy ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 74
Author(s):  
Mohsen Bazargan ◽  
Sharon Cobb ◽  
Cheryl Wisseh ◽  
Shervin Assari
Keyword(s):  
Older Adults ◽  
African American ◽  
Back Pain ◽  
Psychotropic Medication ◽  
Economically Disadvantaged ◽  
Severe Pain ◽  
Medication Use ◽  
Psychotropic Medications ◽  
Self Rated Health ◽  
African American Older Adults

African-American older adults, particularly those who live in economically deprived areas, are less likely to receive pain and psychotropic medications, compared to Whites. This study explored the link between social, behavioral, and health correlates of pain and psychotropic medication use in a sample of economically disadvantaged African-American older adults. This community-based study recruited 740 African-American older adults who were 55+ yeas-old in economically disadvantaged areas of South Los Angeles. Opioid-based and psychotropic medications were the outcome variables. Gender, age, living arrangement, socioeconomic status (educational attainment and financial strain), continuity of medical care, health management organization membership, sleeping disorder/insomnia, arthritis, back pain, pain severity, self-rated health, depressive symptoms, and major chronic conditions were the explanatory variables. Logistic regression was used for data analyses. Arthritis, back pain, severe pain, and poor self-rated health were associated with opioid-based medications. Pain severity and depressive symptoms were correlated with psychotropic medication. Among African-American older adults, arthritis, back pain, poor self-rated health, and severe pain increase the chance of opioid-based and psychotropic medication. Future research should test factors that can reduce inappropriate and appropriate use and prescription of opioid-based and psychotropic medication among economically disadvantaged African-American older adults.

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 Music Is Healing: Developing a Music Module for a Pain Management Intervention for African American Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 815-815
Author(s):  
Mary Janevic ◽  
Sheria Robinson-Lane ◽  
Afton Hassett ◽  
Rebecca Courser
Keyword(s):  
Older Adults ◽  
African American ◽  
Pain Management ◽  
Health Workers ◽  
New Music ◽  
Participant Engagement ◽  
Management Intervention ◽  
Phone Calls ◽  
Positive Memories ◽  
African American Older Adults

Abstract Music has a known analgesic effect. Our multidisciplinary team is developing a music-focused module for Positive STEPS, a pain self-management intervention based on principles of positive psychology. The priority population is African American older adults with disabling chronic pain. Positive STEPS is delivered via website and phone calls from community health workers. To inform program design, we conducted two focus groups with older adults in Detroit (n=16; 100% female and African American; 75% age 70+). All participants said they would enjoy using music to cope with pain. Content analysis revealed the following themes regarding music for pain management: it elicits positive memories, reduces stress, motivates exercise and daily activities, and promotes relaxation. Participants offered ideas for music-focused activities, including learning about unfamiliar genres and using music for meditation/relaxation. Findings will inform the design of a new music module, to be pilot-tested for its effect on participant engagement and pain-related outcomes.

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

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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