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 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.

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 Eye Examination Recency among African American Older Adults with Chronic Medical Conditions

Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 94
Author(s):  
Mohsen Bazargan ◽  
Tavonia Ekwegh ◽  
Sharon Cobb ◽  
Edward Adinkrah ◽  
Shervin Assari
Keyword(s):  
Older Adults ◽  
African American ◽  
Los Angeles ◽  
Medical Care ◽  
Care Providers ◽  
Middle Aged ◽  
South Los Angeles ◽  
Self Rated Health ◽  
Eye Examination ◽  
African American Older Adults

Background: Pervasive racial and economic inequalities have a disproportionate impact on health care utilization among African Americans. One area where we see such disparities is in the recency of eye examinations among the economically disadvantaged. However, our current understanding of the barriers and facilitators of eye examinations in underserved African-American older adults is limited. Aims: Building on Andersen’s model of health service use and using an exploratory approach; we tested various demographic, social, and health factors that were associated with eye examination among underserved middle-aged and older adults in South Los Angeles. We examined predisposing characteristics, enabling factors, and need-for-care characteristics. Methods: With a cross-sectional design, we conducted this survey on a convenience sample of (n = 740) non-institutionalized African-American older adults who were 55+ years old and residing in South Los Angeles, CA, USA. Data were collected on demographic factors, continuity of care, access to care, self-rated health, chronic medical conditions, and depressive symptoms. The outcome was recency of eye examination. Multivariate regression was used for data analysis. Results: 59% of the participants had received at least one eye examination during the last 12 months. A total of 17% had an eye examination within the last two years. Notably, 26% of diabetic participants did not have an eye examination within the last two years. One out of four participants indicated that, within the last two years, no provider ever recommended that they receive an eye examination. Age, education, continuity of medical care, accessibility of medical care, satisfaction with medical care, providers’ recommendation for eye examination, self-rated health, and a diagnosis of hypertension and diabetes mellitus were predictors of eye examination recency. Overall, our analysis indicates that these enabling factors accounted for most of the variance in the recency of eye examinations. Conclusion: A large proportion of underserved African-American middle-aged and older adults in South Los Angeles do not comply with the recommended annual eye examination. This is, in part, because about one-third of them have not received an eye exam recommendation from their health care providers. However, a wide range of factors such as age, education, continuity of care, satisfaction with access, self-rated health, and a diagnosis of hypertension and diabetes mellitus, also influence whether or not African-American middle-aged and older adults receive an eye examination. Programs should address a wide range of multi-level factors to tackle this health inequality.

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.

The Role of Race in Relations of Social Support to Hippocampal Volumes Among Older Adults

2021 ◽  
pp. 016402752110172
Author(s):  
Desirée C. Bygrave ◽  
Constance S. Gerassimakis ◽  
Denée T. Mwendwa ◽  
Guray Erus ◽  
Christos Davatzikos ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
African American ◽  
Disease Risk ◽  
Total Sample ◽  
Hippocampal Volume ◽  
Brain Pathology ◽  
Resonance Imaging ◽  
African American Older Adults

Evidence suggests social support may buffer brain pathology. However, neither its association with hippocampal volume, a marker of Alzheimer’s disease risk, nor the role of race in this association has been fully investigated. Multiple regression analyses examined relations of total social support to magnetic resonance imaging-assessed gray matter (GM) hippocampal volumes in the total sample ( n = 165; mean age = 68.48 year), and in race-stratified models of African American and White older adults, adjusting for select covariates. Results showed greater social support was associated with greater GM hippocampal volumes among African American older adults only ( p < .01). Our findings suggest greater total social support may play a role in supporting the hippocampus, particularly among African American older adults, who had lower hippocampal volumes than their White counterparts. Further research is needed to test these questions longitudinally and examine which aspects of social support may promote hippocampal integrity, specifically.

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