Race, social pain minimization, and mental health

People often believe Black individuals experience less social pain and require less social support to cope with distress than White individuals (e.g., Deska, Kunstman, Lloyd, et al., 2020). However, researchers have not tested whether biases in third-person pain judgments translate to first-person experiences with social pain minimization. For example, do Black individuals feel their social pain is underrecognized to a greater extent than White individuals? The current work tested whether Black individuals felt their social pain was minimized more than White individuals and if the experience of social pain minimization was related to worse mental health and greater life stress. Data from two cross-sectional, correlational studies provide initial support for these predictions ( Ntotal = 1,501). Black participants felt their social pain was minimized more than White participants and this race difference in social pain minimization was associated with worse mental health and greater life stress. These results suggest that Black individuals feel their pain is underrecognized and this experience of social pain minimization is related to worse mental health outcomes.

COVID-19 associated mortality and cardiovascular disease outcomes among US women veterans

The burden of COVID-19 has been noted to be disproportionately greater in minority women, a population that is nevertheless still understudied in COVID-19 research. We conducted an observational study to examine COVID-19-associated mortality and cardiovascular disease outcomes after testing (henceforth index) among a racially diverse adult women veteran population. We assembled a retrospective cohort from a Veterans Affairs (VA) national COVID-19 shared data repository, collected between February and August 2020. A case was defined as a woman veteran who tested positive for SARS-COV-2, and a control as a woman veteran who tested negative. We used Kaplan–Meier curves and the Cox proportional hazards model to examine the distribution of time to death and the effects of baseline predictors on mortality risk. We used generalized linear models to examine 60-day cardiovascular disease outcomes. Covariates studied included age, body mass index (BMI), and active smoking status at index, and pre-existing conditions of diabetes, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), and a history of treatment with antiplatelet or anti-thrombotic drug at any time in the 2 years prior to the index date. Women veterans who tested positive for SARS-CoV-2 had 4 times higher mortality risk than women veterans who tested negative (Hazard Ratio 3.8, 95% Confidence Interval CI 2.92 to 4.89) but had lower risk of cardiovascular events (Odds Ratio OR 0.78, 95% CI 0.66 to 0.92) and developing new heart disease conditions within 60 days (OR 0.67, 95% CI 0.58 to 0.77). Older age, obesity (BMI > 30), and prior CVD and COPD conditions were positively associated with increased mortality in 60 days. Despite a higher infection rate among minority women veterans, there was no significant race difference in mortality, cardiovascular events, or onset of heart disease. SARS-CoV-2 infection increased short-term mortality risk among women veterans similarly across race groups. However, there was no evidence of increased cardiovascular disease incidence in 60 days. A longer follow-up of women veterans who tested positive is warranted.

COVID-19 Associated Mortality and Cardiovascular Disease Outcomes Among U.S. Women Veterans

BackgroundThe burden of COVID-19 has been noted to be disproportionately greater in minority women, a population that is nevertheless still understudied in COVID-19 research. MethodsWe conducted a case-control cohort study to examine COVID-19-associated mortality and cardiovascular disease outcomes after testing (henceforth index) among a racially diverse adult women veteran population. We drew data from a Veterans Affairs (VA) national COVID-19 shared data repository, collected between February and August 2020. Kaplan-Meier curves and the Cox proportional hazards model were employed to examine the distribution of time to death and the effects of baseline predictors on mortality risk. Generalized linear models were used to examine 60-day cardiovascular disease outcomes. Covariates studied included age, body mass index (BMI), and active smoking status at index, and pre-existing conditions of diabetes, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), and a history of treatment with antiplatelet or anti-thrombotic drug at any time in the 2 years prior to the index date.ResultsWomen veterans who tested positive for SARS-CoV-2 had 4 times higher mortality risk than women veterans who tested negative (Hazard Ratio 3.8, 95% Confidence Interval CI 2.92 to 4.89) but had lower risk of cardiovascular events (Odds Ratio OR 0.78, 95% CI 0.66 to 0.92) and developing new heart disease conditions within 60 days (OR 0.67, 95% CI 0.58 to 0.77). Older age, obesity (BMI > 30), and prior CVD and COPD conditions were positively associated with increased mortality in 60 days. Despite a higher infection rate among minority women veterans, there was no significant race difference in mortality, cardiovascular events, or onset of heart disease. Conclusions and RelevanceSARS-CoV-2 infection increased short-term mortality risk among women veterans similarly across race groups. However, there was no evidence of increased cardiovascular disease incidence in 60 days. A longer follow-up of women veterans who tested positive is warranted.

Race Differences and Depressive Symptoms Among Community-Dwelling Older Americans

Using data from the Wave 3 National Social Life, Health and Aging Project, this study examines cognition, stress and social support factors associated with depressive symptomatology among older White (n=2356) and Black/African Americans (n=473) living in the community. Bivariate analyses suggest that Whites were slightly older than Blacks [(M(SD) = 73 .24(8.18) and 72.52(8.69); 71)]; and had higher unmarried status (66.58% vs. 43.76%). In terms of cognitive functioning, Whites scored significantly higher than Blacks [Mean (SD) of MoCA Short Form were 10.44(3.06) and 7.75.0(3.33)]. There was race difference in depressive symptoms experienced (CESD Short Form: M(SD) = 20.99(4.01) for Whites; M(SD) = 21.35(4.33) for Blacks). In order to identify predictors of depression, multiple hierarchical regressions were performed. Results showed that race had significant independent effect and multiplicative effect with IADL impairment in explaining depression scores. To identify predicators for each racial group, parallel regression analyses were conducted and two models were significant. Findings show that unmarried status and IADL impairment were common predictors of depressive symptoms for the two groups, and the impact of both variables were stronger for Blacks (for unmarried status; b =-1.42 vs. -.52; for IADL impairment b = .23 vs. .13). For Whites, other unique predictors of depression were male gender, lower income, more ADL impairment, higher stress, less socialization and poor friendship quality. For Blacks, the only unique predictor of depressive symptoms was being younger age. The different correlates of depression for White and Black elders provide new insight into the design of race-sensitive interventions.

Introduction

The main intervention of this special section is to identify and reposition race and colonial law as (conspicuously) absent referents in widely accepted genealogies of the state of exception—most notably, that of Giorgio Agamben—and to offer methodological pathways, based on historical and contemporary examples, of how colonial legal histories might be “written back” into this history. Collectively, these essays attempt to show how race thinking and exception each operate as the other's alibi: exception instantiating and substantiating race difference, and race difference justifying exception and ushering its expansion and normalization in steadily more realms of law and life. In so doing, this special section proposes at least three possible avenues of further inquiry, each of which builds on and into the other: First, by virtue of their geographic and temporal scope, these essays signal a way of approaching sovereignty and exception not as totalizing and synthetic, but rather as multivalent, recursive, and regenerative. Second, the designation of “partial personhood” or “disabled citizenship” is offered as a way of conceptually traversing trans-Mediterranean and trans-Atlantic historical experiences and legal traditions. Third, these essays signal the need for more sustained exploration at the nexus of law, labor, and violence.

The Unique and Interactive Effects of Patient Race, Patient Socioeconomic Status, and Provider Attitudes on Chronic Pain Care Decisions

Background Compared to White and high socioeconomic status (SES) patients, Black and low SES patients receive less adequate pain care. Providers may contribute to these disparities by making biased decisions that are driven, in part, by their attitudes about race and SES. Purpose We examined the effects of patient race and SES on providers’ chronic pain decisions and the extent to which providers’ implicit and explicit attitudes about race and SES were related to these decisions. Methods Physician residents/fellows (n = 436) made pain care decisions for 12 computer-simulated patients with chronic back pain that varied by race (Black/White) and SES (low/high). Physicians also completed measures assessing implicit and explicit attitudes about race and SES. Results There were three significant race-by-SES interactions: (a) For high SES patients, Black (vs. White) patients were rated as having more pain interference; the opposite race difference emerged for low SES patients. (b) For high SES patients, Black (vs. White) patients were rated as being in greater distress; no race difference emerged for low SES patients. (c) For low SES patients, White (vs. Black) patients were more likely to be recommended workplace accommodations; no race difference emerged for high SES patients. Additionally, providers were more likely to recommend opioids to Black (vs. White) and low (vs. high) SES patients, and were more likely to use opioid contracts with low (vs. high) SES patients. Providers’ implicit and explicit attitudes predicted some, but not all, of their pain-related ratings. Conclusion These results highlight the need to further examine the effects of patient race and SES simultaneously in the context of pain care.

Abstract WP475: Pro-neurotensin/neuromedin N is Associated With Incident Cognitive Impairment in Women

Introduction: Neurotensin (NT) is a neuropeptide implicated in cardiovascular and metabolic disease. As such, it is a candidate risk factor for cognitive impairment. We are not aware of studies reporting the relationship of NT and incident cognitive impairment (ICI). NT can be estimated in plasma by measuring its stable equimolar precursor, pro-neurotensin/neuromedin N (pro-NT/NMN). Hypothesis: Higher fasting plasma pro-NT/NMN is associated with risk of ICI. Methods: Prospective nested case-control study in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. REGARDS enrolled 30,239 Black and White adults aged ≥45 from 2003-2007. Baseline pro-NT/NMN was measured by immunoassay in 497 controls and 399 cases of ICI over 3.5 years follow up. ICI was identified using a 3-test cognitive battery biannually. Multivariable logistic regression was used to calculate odds ratios (OR) of ICI by pro-NT/NMN quartiles. Race and sex differences were studied with stratified models and interaction testing (with p <0.10 significant). Results: There was no association of 4 th vs. 1 st -quartile proNT/NMN with ICI in the overall group (see table), nor significant associations of the 2 nd and 3 rd quartiles with ICI in any group The OR differed significantly by sex; women had a 90% increased odds in the demographic-adjusted model, only slightly attenuated by risk factor adjustment. There was no race difference in associations. Conclusions: Higher circulating pro-NT/NMN was associated with ICI in women but not men. This could be due to cerebral vasoconstrictive effects of NT and estrogen-mediated differences in transcription. Confirmatory study is required.

Family matters in racial logics: Tracing intimacies, inequalities, and ideologies

This article seeks to advance our understanding of how intimate relations and racial logics are co-constituted and matter – subjectively, culturally, materially, and politically – in our colonial present of economic inequalities, nationalist populisms, anti-migrant discourses and xenophobic hostilities. Addressing these crisis conditions is urgent, yet critical interventions indicate that prevailing accounts inadequately address the scale, complexity, and fluidity of racisms operating today. This article proposes to think racial logics ‘otherwise’ by drawing on interdisciplinary scholarship and intersectional analytics to produce a genealogy of state/nation formation processes, imperial encounters, and legitimating ideologies that illuminates how ‘intimacy builds worlds’.1 A deep history of political centralisation reveals that regulation of intimate, familial relations is a constitutive feature of successful state-making and crucial for understanding how modernity's ‘race difference’ is produced and how the racialisation of ‘Other’ (‘non-European’, undesirable) sexual/familial practices figures in contemporary crises. Locating intimate relations – ‘family’ – in (birthright) citizenship, immigration regimes, and political-economic frames helps clarify the amplification of global inequalities and the power of stigmatisations to fuel nationalist attachments and anti-migrant hostilities. Foregrounding intimacy and integrating typically disparate lines of inquiry advances our analyses of today's often opaque yet intense racisms and their globally problematic effects.

Sex and race differences in J-Tend, J-Tpeak, and Tpeak-Tend intervals

To facilitate the precision of clinical electrocardiographic studies of J-to-Tpeak (JTp) and Tpeak-to-Tend (Tpe) intervals, the study investigated their differences between healthy females and males, and between subjects of African and Caucasian origin. In 523 healthy subjects (254 females; 236 subjects of African origin), repeated Holter recordings were used to measure QT, JT, JTp, and Tpe intervals preceded by both stable and variable heart rates. Subject-specific curvilinear regression models were used to obtain individual QTc, JTc, JTpc and Tpec intervals. Rate hysteresis, i.e., the speed with which the intervals adapted after heart rate changes, was also investigated. In all sex-race groups, Tpe intervals were not systematically heart rate dependent. Similar to QTc intervals, women had JTc, and JTpc intervals longer than males (difference 20–30 ms, p < 0.001). However, women had Tpec intervals (and rate uncorrected Tpe intervals) shorter by approximately 10 ms compared to males (p < 0.001). Subjects of African origin had significantly shorter QTc intervals than Caucasians (p < 0.001). Gradually diminishing race-difference was found for JTc, JTpc and Tpec intervals. JTc and JTpc were moderately increasing with age but Tpe/Tpec were not. Rate hysteresis of JTp was approximately 10% longer compared to that of JT (p < 0.001). In future clinical studies, Tpe interval should not be systematically corrected for heart rate and similar to the QT interval, the differences in JT, JTp and Tpe intervals should be corrected for sex. The differences in QT and JT, and JTp intervals should also be corrected for race.