scholarly journals Polypharmacy in African American Adults: A National Epidemiological Study

Pharmacy ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 33 ◽  
Author(s):  
Shervin Assari ◽  
Hamid Helmi ◽  
Mohsen Bazargan
Keyword(s):  
African American ◽  
African Americans ◽  
Psychiatric Disorders ◽  
National Sample ◽  
Health Determinants ◽  
Multiple Chronic Conditions ◽  
Poverty Index ◽  
African American Adults ◽  
Medical Disease ◽  
Nationally Representative

Background: Despite the association between polypharmacy and undesired health outcomes being well established, very little is known about epidemiology of polypharmacy in the African American community. We are not aware of any nationally representative studies that have described the socioeconomic, behavioral, and health determinants of polypharmacy among African Americans. Aims: We aimed to investigate the socioeconomic and health correlates of polypharmacy in a national sample of African American adults in the US. Methods: The National Survey of American Life (NSAL, 2003–2004) included 3,570 African American adults. Gender, age, socioeconomic status (SES; education attainment, poverty index, and marital status), access to the healthcare system (health insurance and having a usual source of care), and health (self-rated health [SRH], chronic medical disease, and psychiatric disorders) in addition to polypharmacy (5 + medications) as well as hyper-polypharmacy (10 + medications) were measured. Logistic regressions were applied for statistical analysis. Results: that About 9% and 1% of all African American adults had polypharmacy and hyper-polypharmacy, respectively. Overall, higher age, higher SES (education and poverty index), and worse health (poor SRH, more chronic medical disease, and psychiatric disorders) were associated with polypharmacy and hyper-polypharmacy. Individuals with insurance and those with a routine place for healthcare also had higher odds of polypharmacy and hyper-polypharmacy. Conclusions: Given the health risks associated with polypharmacy, there is a need for systemic evaluation of medication use in older African Americans with multiple chronic conditions. Such policies may prevent medication errors and harmful drug interactions, however, they require effective strategies that are tailored to African Americans.

scholarly journals Polypharmacy and Psychological Distress May Be Associated in African American Adults

Pharmacy ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 14 ◽  
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.

scholarly journals An Examination of Demographic and Psychosocial Factors, Barriers to Healthy Eating, and Diet Quality Among African American Adults

Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 519 ◽  
Author(s):  
Ingrid Richards Adams ◽  
Wilson Figueroa ◽  
Irene Hatsu ◽  
James Odei ◽  
Mercedes Sotos-Prieto ◽  
...  
Keyword(s):  
Social Support ◽  
African American ◽  
African Americans ◽  
Psychosocial Factors ◽  
Healthy Eating ◽  
Diet Quality ◽  
Self Efficacy ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
African American Adults

A healthy diet is associated with lower risk of chronic disease. African Americans generally have poor diet quality and experience a higher burden of many chronic diseases. We examined the associations of demographic and psychosocial factors and barriers to diet quality among African American adults. This cross-sectional study included 100 African American adults in a southeastern metropolitan area. Psychosocial factors (social support, self-efficacy), and barriers to healthy eating were assessed with validated measures. Diet quality was assessed using the Healthy Eating Index (HEI-2010). Nested linear regressions were used to examine the association between the variables of interest and HEI scores. Participants reported having social support (M (mean) = 2.0, SD (standard deviation) = 0.6, range 0–3), high levels of self-efficacy (M = 3.1, SD = 0.7, range 1–4), and low barriers (M = 1.4, SD = 0.6, range 0–4) to engage in healthy eating but total mean HEI scores needed improvement (M = 54.8, SD = 10.9, range 27.1–70.0). Participants consumed significantly higher empty calories and lower whole fruits, dairy, and total protein foods than the national average. Barriers to healthy eating (b = −12.13, p = 0.01) and the interaction between age and barriers (b = 0.25, p = 0.02) were most strongly associated with lower HEI scores. Younger African Americans with the highest barriers to healthy eating had the lowest HEI scores. Culturally appropriate interventions targeting empty calories, barriers to healthy eating, and knowledge of the Dietary Guidelines for Americans are needed for African Americans.

Residential segregation, health behavior and overweight/obesity among a national sample of African American adults

2011 ◽  
Vol 17 (3) ◽  
pp. 371-378 ◽  
Author(s):  
Irma Corral ◽  
Hope Landrine ◽  
Yongping Hao ◽  
Luhua Zhao ◽  
Jenelle L. Mellerson ◽  
...  
Keyword(s):  
African American ◽  
Health Behavior ◽  
Residential Segregation ◽  
National Sample ◽  
African American Adults

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.

Probing the Paradoxical Pattern of Cigarette Smoking among African-Americans: Low Teenage Consumption and High Adult Use

1995 ◽  
Vol 25 (4) ◽  
pp. 307-320 ◽  
Author(s):  
William Feigelman ◽  
Julia Lee
Keyword(s):  
African American ◽  
African Americans ◽  
Secondary Analysis ◽  
African American Adolescents ◽  
Past Research ◽  
Use Patterns ◽  
African American Adults ◽  
Gender And Age ◽  
And Gender ◽  
Low Prevalence

Based on secondary analysis of the 1990 California Tobacco Survey, of 24,296 adult and 7,767 adolescent respondents, this study investigates the enigmatic results established by past research, of comparatively low prevalence rates of smoking among African-American adolescents and high use patterns for African-American adults. Findings support the crossover hypothesis claiming that more young adult White smokers successfully relinquish cigarette use than same aged African-Americans. When Whites and Blacks were grouped according to gender and age, findings showed African-American males between ages eighteen to twenty-four and females between ages twenty-five and forty-four were less likely to be among the ranks of former smokers than their same aged and gender White counterparts. The findings suggest that targeting these groups for more antismoking information and for opportunities to participate in smoking cessation programs may be helpful to reduce the higher smoking rates now found among African-American adults.

scholarly journals Housing Insecurity and the Emotional and Physical Health of African Americans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 335-336
Author(s):  
Aarti Bhat ◽  
August Jenkins ◽  
David Almeida
Keyword(s):  
African American ◽  
African Americans ◽  
Negative Affect ◽  
Physical Health ◽  
The United States ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
African American Adults ◽  
The Impact

Abstract Housing insecurity—or limited and/or unreliable access to quality housing— is a potent on-going stressor that can adversely impact individual well-being. This study extends previous research by investigating the impact of housing insecurity on both the emotional and physical health of aging African American adults using the Midlife in the United States (MIDUS) Refresher oversample of African Americans collected from 2012-2013 (N = 508; M age = 43.02; 57% women). Participants reported on their negative affect, number of chronic health conditions experienced in the last year, and experiences of housing insecurity since the 2008 recession (e.g., homelessness, threatened with foreclosure or eviction, lost home). Negative affect and chronic conditions, respectively, were regressed on housing insecurity, and the potential moderating effect of age was tested. Results showed that housing insecurity was associated with more negative affect (B = 0.05, SE = 0.03, p = .002) and chronic health conditions (B = 0.26, SE = 0.03, p < .001). Additionally, the association between housing insecurity and negative affect was moderated by age (B = -0.11, SE = 0.00, p = .019), such that the effect of housing insecurity on negative affect was stronger for younger adults than for older adults. These results suggest that experiences of insecure housing leave African American adults vulnerable to compromised emotional and physical health, however, the negative effects of housing insecurity may attenuate with age.

scholarly journals Psychiatric Disorders Among Older Black Americans: Within- and Between-Group Differences

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Robert Joseph Taylor ◽  
Linda M Chatters
Keyword(s):  
Mental Health ◽  
African American ◽  
Risk Factor ◽  
African Americans ◽  
Literature Review ◽  
Psychiatric Disorders ◽  
Black Americans ◽  
Black American ◽  
American Population ◽  
The Impact

Abstract Psychiatric disorders impose significant personal, social, and financial costs for individuals, families, and the nation. Despite a large amount of research and several journals focused on psychiatric conditions, there is a paucity of research on psychiatric disorders among Black Americans (i.e., African Americans and Black Caribbeans), particularly older Black Americans. The present literature review examines research on psychiatric disorders among older Black Americans and provides a broad overview of research findings that are based on nationally representative studies. Collectively, this research finds: (1) older African Americans have lower rates of psychiatric disorders than younger African Americans; (2) family support is not protective of psychiatric disorders, whereas negative interaction with family members is a risk factor; (3) everyday discrimination is a risk factor for psychiatric disorders; (4) both older African Americans and African American across the adult age range have lower prevalence rates of psychiatric disorders than non-Latino whites; (5) Black Caribbean men have particularly high rates of depression, posttraumatic stress disorder, and suicide attempts; and (6) a significant proportion of African American older adults with mental health disorders do not receive professional help. This literature review also discusses the “Race Paradox” in mental health, the Environmental Affordances Model, and the importance of investigating ethnicity differences among Black Americans. Future research directions address issues that are directly relevant to the Black American population and include the following: (1) understanding the impact of mass incarceration on the psychiatric disorders of prisoners’ family members, (2) assessing the impact of immigration from African countries for ethnic diversity within the Black American population, (3) examining the impact of racial identity and racial socialization as potential protective factors for psychiatric morbidities, and (4) assessing racial diversity in life-course events and their impact on mental health.

Abstract MP58: Racial Residential Segregation is Associated With Worse Cardiovascular Health in African American Adults: The Jackson Heart Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Sharrelle Barber ◽  
Kiarri Kershaw ◽  
Xu Wang ◽  
Mario Sims ◽  
Julianne Nelson ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Residential Segregation ◽  
Cardiovascular Health ◽  
Jackson Heart Study ◽  
Racial Residential Segregation ◽  
African American Adults ◽  
Heart Study ◽  
Neighborhood Environments ◽  
The Impact

Introduction: Racial residential segregation results in increased exposure to adverse neighborhood environments for African Americans; however, the impact of segregation on ideal cardiovascular health (CVH) has not been examined in large, socioeconomically diverse African American samples. Using a novel spatial measure of neighborhood-level racial residential segregation, we examined the association between segregation and ideal CVH in the Jackson Heart Study (JHS). Hypothesis: Racial residential segregation will be associated with worse cardiovascular health among African American adults. Methods: The sample included 4,354 men and women ages 21-93 from the baseline exam of the JHS (2000-2004). Racial residential segregation was assessed at the census-tract level. Data on racial composition (% African American) from the 2000 US Census was used to calculate the local G i * statistic- a spatially-weighted z-score that represents how much a neighborhood’s racial/ethnic composition deviates from the larger metropolitan area. Ideal CVH was assessed using the AHA Life’s Simple Seven (LS7) index which includes 3 behavioral (nutrition, physical activity, and smoking) and 4 biological (systolic BP, glucose, BMI, and cholesterol) metrics of CVH. Multivariable regression models were used to test associations between segregation and the LS7 index continuously (range: 0-14) and categorically (Inadequate: 0-4; Average: 5-9; and Optimal: 10-14). Covariates included age, sex, income, education, and insurance status. Results: The average LS7 summary score was 7.03 (±2.1) and was lowest in the most racially segregated neighborhood environments (High Segregation: 6.88 ±2.1 vs. Low Segregation: 7.55 ±2.1). The prevalence of inadequate CVH was higher in racially segregated neighborhoods (12.3%) compared to neighborhoods that were the least segregated (6.9%). After adjusting for key socio-demographic characteristics, racial residential segregation was inversely associated with ideal CVH (B=-0.041 ±0.02, p=0.0146). Moreover, a 1-SD unit increase in segregation was associated with a 6% increased odds of having inadequate CVH (OR: 1.06, 95% CI: 1.00-1.12, p=0.0461). Conclusion: In conclusion, African Americans in racially segregated neighborhoods are less likely to achieve ideal CVH even after accounting for individual-level factors. Policies aimed at restricting housing segregation/discrimination and/or structural interventions designed to improve neighborhood environments may be viable strategies to improving CVH in this at-risk population.

scholarly journals Parental Education Attainment and Educational Upward Mobility; Role of Race and Gender

2018 ◽  
Vol 8 (11) ◽  
pp. 107 ◽  
Author(s):  
Shervin Assari
Keyword(s):  
African American ◽  
African Americans ◽  
Parental Education ◽  
Upward Mobility ◽  
Well Being ◽  
Education Attainment ◽  
Linear Regression Models ◽  
Racial And Ethnic Differences ◽  
Socioeconomic Resources ◽  
Nationally Representative

Background. The Minorities’ Diminished Return theory suggests that education attainment and other socioeconomic resources have smaller effects on the health and well-being of African Americans and other racial and ethnic minorities compared to Whites. Racial and ethnic differences in the processes involved with educational upward mobility may contribute to the diminished returns of education attainment for African Americans compared to Whites. Aim: This study compared African Americans and non-Hispanic Whites for the effect of parental education attainment on educational upward mobility and explored gender differences in these effects. Methods. The National Survey of American Life (NSAL 2003) is a nationally representative survey of American adults. Participants included 891 non-Hispanic White and 3570 African American adults. Gender, race/ethnicity, age, highest parental education attainment, and respondents’ educational attainment were measured. Data were analyzed using linear regression models. Results. Overall, higher parental education attainment was associated with higher educational upward mobility (b = 0.34, p < 0.001), however, this boosting effect was significantly smaller for African Americans compared to Whites (b = −0.13, p = 0.003). Our further analysis showed that race by parental education attainment can be found for females (b = −0.14, p = 0.013) but not males (p > 0.05). Conclusion. African American females are at a disadvantage compared to White females regarding the effect of parental education attainment on their educational upward mobility, a phenomenon which could not be observed when comparing African American and White males. These results advocate for taking intersectionality frameworks to study the effects of race, gender, and class in the US.

scholarly journals Discrimination and Social Isolation Among African Americans Across the Lifespan

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 581-581
Author(s):  
Ann Nguyen ◽  
Harry Taylor
Keyword(s):  
African Americans ◽  
Social Isolation ◽  
Social Relationships ◽  
Multinomial Logistic Regression ◽  
Systematic Investigation ◽  
Early Mortality ◽  
Regression Analyses ◽  
African American Adults ◽  
Wide Range ◽  
Nationally Representative

Abstract Social isolation is associated with a wide range of health problems, including early mortality. However, little is known about the risk factors for social isolation specifically among African Americans. This study examined 1) the associations between discrimination and objective and subjective social isolation and 2) how these associations vary by age in a nationally representative sample of African American adults from the National Survey of American Life (N=3570). Multinomial logistic regression analyses indicated that discrimination was positively associated with being subjectively isolated from friends only and family only. Discrimination did not predict objective isolation. A significant interaction revealed that the association between discrimination and subjective isolation from friends only varied by age, with older adults being most vulnerable to the effects of discrimination. These findings argue for a more nuanced and systematic investigation of the detrimental effects of discrimination on older African Americans’ social relationships, especially perceptions of relationships.

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