Perceived Discrimination, Experiential Avoidance, and Mental Health among Hispanic Adults in Primary Care

The Hispanic population is the largest minority group in the United States and frequently experiences racial discrimination and mental health difficulties. Prior work suggests that perceived racial discrimination is a significant risk factor for poorer mental health among Hispanic in the United States. However, little work has investigated how perceived racial discrimination relates to anxiety and depression among Hispanic adults. Thus, the current study evaluated the explanatory role of experiential avoidance in the relation between perceived racial discrimination and anxiety/depressive symptoms and disorders among Hispanic adults in primary care. Participants included 202 Spanish-speaking adults ( Mage = 38.99, SD = 12.43, 86.1% female) attending a community-based Federally Qualified Health Center. Results were consistent with the hypothesis that perceived racial discrimination had a significant indirect effect on depression, social anxiety, and anxious arousal symptoms as well as the number of mood and anxiety disorders through experiential avoidance. These findings suggest future work should continue to explore experiential avoidance in the association between perceived racial discrimination and other psychiatric and medical problems among the Hispanic population.

The Effects of the COVID-19 Pandemic on the Work and Financial Outcomes of Older Black and Hispanic Adults

This study investigates how older Black and Hispanic adults’ work engagement is impacted by the effects of COVID-19. Using intersectionality and cumulative (dis)advantage as complementing theoretical frameworks, data from the Health and Retirement Study, and series of logistic regression models, we measure work engagement changes pre- and post- COVID-19. Preliminary findings suggest that net of other controls, there were no substantial or significant reductions in resilience as the result of COVID-19 itself for any racial/ethnic group. White older adults, and to some degree Hispanics older adults, experienced erosion in resilience related to financial hardships, but the resilience of Black older adults remained stable in the face of increased hardship. Future work in this area will improve our limited understanding of older Black and Hispanic adults’ experiences of managing and coping with COVID-19- related work and financial risks– information that will be critical for planning intervention and support services.

Life Course Stressors and Functional Limitations in Later Life Among White, Black, and Hispanic Adults

Although striking racial and ethnic disparities in health are manifest during later life, they may be rooted in early-life exposures. Drawing from cumulative inequality theory, we investigate whether experiencing life course stressors increases the risk of later-life functional limitations and whether this relationship differs by race and ethnicity. This study utilizes longitudinal data from the Health and Retirement Study to test whether six indicators of child stressors and eleven indicators of adult stressors predict trajectories of the onset and severity of functional limitations in later life among a diverse sample of adults. We find that child and adult stressors are associated with earlier onset and greater severity of functional limitations during later life. Mediation analyses reveal the indirect influence of child stressors via adult stressors on onset and severity of functional limitations; however, the indirect effects are slightly stronger for Black and Hispanic adults than their White counterparts (i.e., moderated mediation). In sum, child stressors, in and of themselves, do not increase functional limitations among Black and Hispanic people but are associated with greater adult stress exposure, leading to more functional limitations in later life. Disparities in functional limitations are also partly due to lower education and less wealth among Black and Hispanic adults.

Age-Related Ethnic Differences in Self-Reported Hand Function

Racial/ethnic differences in the prevalence of disability based on self-reported activities of daily living (ADLs) exist in older Americans, particularly in Hispanic adults. Such studies have relied on large data sets in which disability is measured across a broad range of functional tasks. While useful in generating a global measure of disability, it precludes an ability to differentiate, for example, deficits in upper versus lower extremity function which can provide useful information in targeting therapeutic interventions. Despite known age-related declines in hand function and concomitant ADLs, racial/ethnic differences in hand-related ADL limitations have not been addressed. Using 2011-2018 data from the National Health and Nutrition Examination Survey (NHANES), we identified 3,189 non-Hispanic White and Hispanic adults aged 65 and older, and classified responses based on perceived difficulty to five self-reported tasks requiring hand dexterity. Compared to non-Hispanic Whites, Hispanic males reported 2.2 times higher rates of difficulty for dressing tasks (p<0.01) and 3.3 times higher rates for difficulties preparing meals (p<0.01). Similar rates of difficulty were also observed in females. Additionally, Hispanic females reported 4.6 times higher rates of difficulty in tasks requiring grasping small objects (p<0.01). Deficits in hand function are often under-reported in older adults despite the role of dexterity in maintaining functional independence. The results presented here indicate that difficulties in hand-related ADLs are more prevalent in the Hispanic population and warrant greater attention in health care settings. Future work will include identifying factors contributing to these observed differences in self-reported difficulties in hand-related ADLs.

Racial and Ethnic Differences in Blood Pressure Among US Adults, 1999–2018

Racial and ethnic differences in blood pressure (BP), regardless of antihypertensive medication use, contribute to cardiovascular disease disparities. We analyzed systolic BP (SBP) data from US adults in the National Health and Nutrition Examination Survey from 1999 to 2002 through 2015 to 2018 (n=51 743) to determine if racial and ethnicity disparities have changed over time. Among US adults not taking antihypertensive medication, the mean age-adjusted SBP (95% CI), mm Hg, in 1999 to 2002 and 2015 to 2018 was 119.6 (118.7–120.5) and 119.4 (118.7–120.1) for non-Hispanic White adults, 124.7 (123.7–125.7) and 124.9 (123.8–125.9) for non-Hispanic Black adults and 120.4 (118.6–122.2) and 120.4 (119.7–121.2) for Hispanic adults. The mean multivariable-adjusted SBP was 4.1 mm Hg (2.7–5.4) higher in 1999 to 2002 and 3.8 mm Hg (2.6–5.0) higher in 2015 to 2018 among non-Hispanic Black adults compared with non-Hispanic White adults, while there was no evidence of a difference between Hispanic adults and non-Hispanic White adults in 1999 to 2002 (−0.2 mm Hg [95% CI, −1.9 to 1.5]) or 2015 to 2018 (−0.8 mm Hg [95% CI, −1.8 to 0.1]). Among US adults taking antihypertensive medication, the mean age-adjusted SBP (95% CI), mm Hg, in 1999 to 2002 and 2015 to 2018 was 129.6 (126.7–132.4) and 127.1 (125.6–128.6) for non-Hispanic White adults, 136.9 (133.8–140.0) and 135.3 (132.5–138.1) for non-Hispanic Black adults and 133.9 (128.0–139.7) and 131.8 (127.6–136.0) for Hispanic adults. After multivariable adjustment, in 1999 to 2002 and 2015 to 2018, mean SBP was 4.8 mm Hg (1.8–7.8) and 6.5 mm Hg (4.5–8.4) higher, respectively, among non-Hispanic Black adults versus White adults, and 2.4 mm Hg (−2.6 to 7.3) and 3.6 mm Hg (0.8 to 6.4) higher, respectively, among Hispanic adults versus non-Hispanic White adults. In the United States, non-Hispanic Black adults continue to have higher SBP levels compared with non-Hispanic White adults.

Challenges with social distancing during the COVID-19 pandemic among Hispanics in New York City: a qualitative study

Background Hispanics in the United States are disproportionately affected by the novel coronavirus (COVID-19). While social distancing and quarantining are effective methods to reduce its spread, Hispanics, who are more likely to be essential workers and live in multigenerational homes than non-Hispanics, may face challenges that limit their ability to carry out these preventative efforts. We elicited the experiences of Hispanic adults with social distancing and self-quarantining during the COVID-19 pandemic in New York. Methods In this qualitative study, Hispanic adults receiving care at a federally qualified community health center in East Harlem, New York, were recruited for remote one-on-one semi-structured interviews from 5/15/2020 to 11/17/2020. Interviews were conducted by a bilingual interviewer in Spanish or English, using a semi-structured topic guide informed by the Health Belief Model. Audio-recordings were professionally transcribed. We used thematic analysis to iteratively code the data. Each transcript was independently coded by two research team members, then reconciled by a third. Major themes and subthemes were identified. Results Among 20 participants, four major themes emerged; Hispanics were: (1) fearful of contracting and transmitting COVID-19, (2) engaging in practices to reduce transmission of COVID-19, (3) experiencing barriers to social distancing and quarantining, and (4) facing an enduring psychological and physical toll from COVID-19. Conclusions Despite understanding the risks for contracting COVID-19 and taking appropriate precautions, Hispanics faced numerous challenges to social distancing and quarantining, such as living in crowded, multi-generational households, working as essential workers, and providing unpaid care to family members. Such challenges took a toll on their physical, emotional, and financial well-being. Our findings suggest that a tailored approach to public health messaging and interventions for pandemic planning are warranted among members of this community. Further research is needed to understand and mitigate the long term physical and psychological consequences of the pandemic among Hispanics.