Is unity durable among people of color? Two large experiments stress-testing solidarity between Black and Latino Americans

Stroke is the fifth leading cause of death and a leading cause of long-term disability in the United States (1). Although stroke death rates have declined since the 1950s, age-adjusted rates remained higher among non-Hispanic Black or African American (Black) adults than among non-Hispanic White (White) adults (1,2). Despite intervention efforts to reduce racial disparities in stroke prevention and treatment through reducing stroke risk factors, increasing awareness of stroke symptoms, and improving access to treatment and care for stroke (1,3), Black adults were 45% more likely than were White adults to die from stroke in 2018.* In 2019, age-adjusted stroke death rates (AASDRs) (stroke deaths per 100,000 population) were 101.6 among Black adults and 69.1 among White adults aged ≥35 years. Stroke deaths increased during the early phase of the COVID-19 pandemic (March-August 2020), and minority populations experienced a disproportionate increase (4). The current study examined disparities in stroke mortality between Black and White adults before and during the COVID-19 pandemic. Analysts used National Vital Statistics System (NVSS) mortality data accessed via CDC WONDER† to calculate AASDRs among Black and White adults aged ≥35 years prepandemic (2015-2019) and during the pandemic (2020-2021). Compared with that during the prepandemic period, the absolute difference in AASDR between Black and White adults during the pandemic was 21.7% higher (31.3 per 100,000 versus 38.0). During the pandemic period, an estimated 3,835 excess stroke deaths occurred among Black adults (9.4% more than expected) and 15,125 among White adults (6.9% more than expected). These findings underscore the importance of identifying the major factors contributing to the widened disparities; implementing prevention efforts, including the management and control of hypertension, high blood cholesterol, and diabetes; and developing tailored interventions to reduce disparities and advance health equity in stroke mortality between Black and White adults. Stroke is a serious medical condition that requires emergency care. Warning signs of a stroke include sudden face drooping, arm weakness, and speech difficulty. Immediate notification of Emergency Medical Services by calling 9-1-1 is critical upon recognition of stroke signs and symptoms.

Mental health care among marginalized populations in the United States

Background: Social determinants of health (SDOH) impact the burden of cardiovascular disease (CVD) among Black adults, but limited information is available on how various SDOH dimensions are linked to CVD risk factors for Black ethnic subgroups and White adults. The study aimed to examine differences in the association between SDOH dimensions and CVD risk factors among Black ethnic subgroups including Black Americans (BAs), Afro-Caribbeans (ACs), African immigrants (AIs), and White adults. We hypothesized differences in the SDOH indices and CVD risk factors with stronger associations for the U.S born adults. Methodology: Using the National Health Interview Surveys 2013-2018, we categorized 143,459 participants based on race and birthplace. A principal component analysis was used to reduce fourteen variables to four indices. Multivariable-adjusted logistic regression models were utilized to assess the associations between these SDOH indices and self-reported CVD risk factors, including hypertension, high cholesterol, and diabetes. Results: The sample included 24, 830 Black (90% BAs, 5% ACs, 5% AIs) and 118, 979 White adults. Significant differences were observed in several social determinant factors among Black subgroups and White adults (Table 1). For AIs, there was no association between SDOH indices and CVD risk factors, except for diabetes and poor neighborhood cohesion (Table 2). Among ACs, only socioeconomic disadvantage was associated with lower odds of hypertension (OR= 0.74, 95% CI: 0.59-0.94), and all SDOH indices were associated with diabetes except for poor neighborhood cohesion. Among BAs and White adults, all SDOH indices were associated with diabetes and hypertension, except for socioeconomic disadvantage. Socioeconomic disadvantage and low healthcare access were significantly associated with high cholesterol (OR= 0.93, 95% CI: 0.89-0.98) and (OR= 1.12, 95% CI:1.04-1,19) in BAs. Among White adults, all SDOH indices were associated with high cholesterol apart from poor neighborhood cohesion (OR= 0.98, 95% CI: 0.97-1.00). Conclusions: The relationship between CVD risk factors and SDOH indices varied across Black ethnic subgroups and White adults with more significant associations among BAs and White adults. These findings suggest that nativity may play a role in the association between SDOH and CVD risk factors.

Mounting U.S. research suggests many non-White individuals feel solidarity with, and identify as, people of color (PoC). Yet measurement limitations prevent scholars from testing whether these constructs are empirically different. We explain why these concepts diverge and evaluate our claims with an expanded battery of measures across U.S. Asian, Black, Latino, and Multiracial adults (N = 3402). Using multi-group confirmatory factor analysis, we show these items capture related but distinct concepts among PoC (configural invariance). We then establish that these items uniformly measure each construct across PoC groups (metric invariance), with mean level differences validly reflecting actual heterogeneity between groups, rather than measurement artifacts (scalar invariance). Finally, consistent with our conceptualization, we show that solidarity among PoC mediates the association between PoC identification and support for policies that implicate various communities of color. We end with practical advice for using these items in surveys of racially diverse populations.

BackgroundOlder African American and Black adults are twice as likely to develop Alzheimer disease and related dementias (ADRD) and have the lowest level of ADRD health literacy compared to any other ethnic group in the United States. Low health literacy concerning ADRD negatively impacts African American and Black people in accessing adequate health care.ObjectiveThis study explored how 3 technological modalities—voice assistants, chatbots, and mobile apps—can assist older African American and Black adults in accessing ADRD information to improve ADRD health literacy. By testing each modality independently, the focus could be kept on understanding the unique needs and challenges of this population concerning the use of each modality when accessing ADRD-related information.MethodsUsing the Wizard of Oz usability testing method, we assessed the 3 modalities with a sample of 15 older African American and Black adults aged >55 years. The 15 participants were asked to interact with the 3 modalities to search for information on local events happening in their geographical area and search for ADRD-related health information.ResultsOur findings revealed that, across the 3 modalities, the content should avoid convoluted and complex language and give the possibility to save, store, and share it to be fully accessible by this population. In addition, content should come from credible sources, including information tailored to the participants’ cultural values, as it has to be culturally relevant for African American and Black communities. Finally, the interaction with the tool must be time efficient, and it should be adapted to the user’s needs to foster a sense of control and representation.ConclusionsWe conclude that, when designing ADRD-related interventions for African American and Black older adults, it proves to be crucial to tailor the content provided by the technology to the community’s values and construct an interaction with the technology that is built on African American and Black communities’ needs and demands.

POLICE REFORM IN DIVIDED TIMES

Acute beetroot juice reduces blood pressure in young Black and White males but not females

The current study examined race differences in how childhood socioeconomic status (SES) predicted midlife inflammation. It also tested psychological resources (purpose in life, optimism, and conscientiousness) as moderators of the association between childhood SES and inflammation among Black and White adults. Data came from the biomarker subsamples of the Midlife in the United States Core and Refresher studies (n = 1,578 White and n = 395 Black participants). Childhood SES was operationalized as a composite of parental education, perceived financial status, and welfare status. Outcomes included circulating IL-6 and CRP. Childhood SES did not predict IL-6 or CRP among Black or White adults in fully adjusted models. Among Black adults with low optimism, lower childhood SES predicted higher IL-6 and CRP. Among Black adults with low purpose in life, lower childhood SES predicted higher CRP (but not IL-6). Conscientiousness did not moderate childhood SES-inflammation associations among Black adults. Among White adults with low conscientiousness or low optimism, lower childhood SES predicted higher IL-6 (but not CRP). Purpose in life did not moderate associations among White adults. Effect sizes were small (≤1% variance explained) and comparable to effects of clinical risk factors in this sample (e.g., age, chronic conditions). Race differences in the childhood SES and inflammation association were not apparent. Childhood SES was linked to inflammation more strongly among those with fewer psychological resources across both racial groups. Psychological resources may be important moderators of inflammation in the context of early life SES disadvantage. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Background: Black, Latino, and Asian Americans experience higher diabetes incidence rates compared to White adults. According to self-determination theory, psychosocial factors such as autonomous motivation, self-efficacy, perceived social support and patient activation influence the likelihood of initiating and engaging in health behaviors that prevent diabetes. Whether these psychosocial factors differ by race/ethnicity among adults with prediabetes and if these may contribute to observed racial/ethnic disparities in diabetes incidence is unknown. Methods: Using baseline survey data from a diabetes prevention intervention study at Kaiser Permanente Northern California and Michigan Medicine, we measured autonomous motivation and self-efficacy on a 1-7 scale, perceived social support on a 12-72 scale, and activation on a 0-100 scale. Multivariable linear regression models estimated mean racial/ethnic differences, adjusting for age, sex and clinic. Results: Of 296 prediabetic adults, 40% were White, 37% Black, 10% Latino, and 6% Asian American. Mean autonomous motivation was high (6.6/7) and did not differ by race/ethnicity (all p-values >0.05). Self-efficacy was higher for Black vs. White adults (6.1 vs. 5.7; p-value < 0.05). Black and Latino adults had higher values of perceived social support compared to White adults, and Asian American adults had the lowest (all p-values < 0.05). Mean activation was higher in Asian American and Latino compared to White adults, but lower in Black adults (p-values < 0.05). Conclusion: Autonomous motivation was high in adults with prediabetes, underscoring the opportunity to address diabetes prevention efforts at the population level. However, Asian American adults reporter lower social support and Black adults reported lower patient activation than other groups. Differences in these psychosocial factors should be considered when tailoring diabetes prevention efforts and outreach. Disclosure L. A. Rodriguez: None. T. Thomas: None. H. Finertie: None. C. D. Turner: None. M. Heisler: None. J. Schmittdiel: None. Funding Permanente Medical Group; National Institute of Diabetes and Digestive and Kidney Diseases (T32DK11668401)

High rates of physical inactivity persist in the United States, with higher rates among non-Hispanic Black adults than among their White peers. However, a comparison of physical activity engagement across nativity among Black adults in the United States has yet to be fully documented. The purpose of this cross-sectional study was to examine physical activity engagement rates among African immigrant and Afro-Caribbean immigrant adults compared with native-born African American adults using data from the 2010 to 2018 National Health Interview Survey. Using data from the 2010 to 2018 National Health Interview Survey, we used generalized linear models to compare levels of physical activity (meeting the moderate-to-vigorous physical activity [MVPA] recommendations) by ethnic subgroups of Black adults, sequentially adjusting for sociodemographic and health-related risk factors. Data from 38,037 adults (58.8% female, 21% college/graduate degree, and 41.4% with obesity) were included. Only 41.9% of all participants met the MVPA recommendations. In the fully adjusted models across the 9 years, higher levels of MVPA were seen among African Americans (42%) than among African immigrants (38%) and Afro-Caribbean immigrants (41%). Compared with African Americans, African immigrants were less likely to engage in physical activity that met the MVPA guidelines (prevalence ratio: 0.90; 95% confidence interval: 0.85, 0.96), whereas there were no differences in meeting the guidelines between Afro-Caribbean immigrants (prevalence ratio: 0.96; 95% confidence interval:0.90, 1.02) and African Americans. Culturally tailored interventions addressing socioenvironmental barriers and facilitators of physical activity may have important impacts on physical activity promotion and long-term disease burden among Black adults across nativity.

The current study examined whether knowledge, understanding and support of the Black Lives Matter movement were positively linked to self-reported physical health among a representative sample of Black American adults. The 2016 Collaborative Multiracial Post-election Survey (CMPS) examined attitudes about the 2016 US election, immigration, policing, racial equality, and racial discrimination among Asian American, Black American, Latinx, and White adults. The current study used the Black American sample, which included 3102 individuals (69% female) older than 18years of age. We used a set of logistic regression models to assess the associations of knowledge, support, and understanding of Black Lives Matter with overall physical health. Although knowledge of Black Lives Matter was not a significant predictor for physical health, understanding and supporting Black Lives Matter significantly predicted positive physical health among Black American adults. Black American adults who understand and support Black Lives Matter reported more positive overall physical health.

Mounting research finds that shared discrimination boosts solidarity between people of color (PoC), with downstream increases in support for pro-outgroup policies. However, these experiments measure the proposed mediator (solidarity), rather than manipulate it, which raises reasonable doubts about its causal impact. We report two pre-registered experiments (N = 2,692) that reassess solidarity’s causal influence by “blocking” its downstream effects. We conducted these studies with Black adults – the prototypical person of color who define this mega-group’s norms and values. Both studies focus on Black-Latino relations and reveal that manipulating shared discrimination between these groups heartily boosts Black solidarity with PoC (d∼.40). Critically, after solidarity’s activation, manipulating differences in the bases of discrimination against Black and Latino people (i.e., slavery versus immigration) modestly reduces its downstream effect on Black support for pro-Latino policies. A pre-registered internal meta-analysis finds this “blockage” effect is modest but statistically reliable (d∼.10), leading us to conclude that solidarity’s mediating influence is likely causal and resistant to this divisive threat. We discuss our results’ implications for inter-minority politics.

Sermons to Address Obesity in Partnership With African American and Latino Churches

Black individuals are disproportionately exposed to gun violence in the US. Suicide rates among Black US individuals have increased in recent years. To evaluate whether gun violence exposures (GVEs) are associated with suicidal ideation and behaviors among Black adults. This cross-sectional study used survey data collected from a nationally representative sample of self-identified Black or African American (hereafter, Black) adults in the US from April 12, 2023, through May 4, 2023. Ever being shot, being threatened with a gun, knowing someone who has been shot, and witnessing or hearing about a shooting. Outcome variables were derived from the Self-Injurious Thoughts and Behaviors Interview, including suicidal ideation, suicide attempt preparation, and suicide attempt. A subsample of those exhibiting suicidal ideation was used to assess for suicidal behaviors. The study sample included 3015 Black adults (1646 [55%] female; mean [SD] age, 46.34 [0.44] years [range, 18-94 years]). Most respondents were exposed to at least 1 type of gun violence (1693 [56%]), and 300 (12%) were exposed to at least 3 types of gun violence. Being threatened with a gun (odds ratio [OR], 1.44; 95% CI, 1.01-2.05) or knowing someone who has been shot (OR, 1.44; 95% CI, 1.05-1.97) was associated with reporting lifetime suicidal ideation. Being shot was associated with reporting ever planning a suicide (OR, 3.73; 95% CI, 1.10-12.64). Being threatened (OR, 2.41; 95% CI, 2.41-5.09) or knowing someone who has been shot (OR, 2.86; 95% CI, 1.42-5.74) was associated with reporting lifetime suicide attempts. Cumulative GVE was associated with reporting lifetime suicidal ideation (1 type: OR, 1.69 [95% CI, 1.19-2.39]; 2 types: OR, 1.69 [95% CI, 1.17-2.44]; ≥3 types: OR, 2.27 [95% CI, 1.48-3.48]), suicide attempt preparation (≥3 types; OR, 2.37; 95% CI, 2.37-5.63), and attempting suicide (2 types: OR, 4.78 [95% CI, 1.80-12.71]; ≥3 types: OR, 4.01 [95% CI, 1.41-11.44]). In this cross-sectional study, GVE among Black adults in the US was significantly associated with lifetime suicidal ideation and behavior. Public health efforts to substantially reduce interpersonal gun violence may yield additional benefits by decreasing suicide among Black individuals in the US.

BackgroundLittle research has investigated predictors of specialty substance use treatment gaps among Black adults. This study examined differential odds of experiencing self-reported, past-year treatment gaps among Black adults with respect to sexual minority status and health insurance coverage, accounting for social cofactors.MethodThis cross-sectional study comprised 36,098 Black Americans aged 18 and older who completed the 2015–2019 National Survey on Drug Use and Health (NSDUH) and provided responses for all selected survey items. Design-based multivariable logistic regression models were used to examine predictors of drug and alcohol treatment gaps.ResultsSexual minority Black adults reported greater odds of experiencing treatment gaps to specialty treatment (i.e., inpatient hospital, inpatient/outpatient rehabilitation facility, or mental health center) compared to Black heterosexuals in adjusted models (Gay or lesbian: AOR = 2.01, 95% CI = 1.39–2.89; Bisexual: AOR = 2.35, 95% CI = 1.77–3.12), with bisexual Black women experiencing the greatest odds (AOR = 3.10, 95% CI = 2.33–4.14). Black adults with no health insurance were significantly more likely to report substance use treatment gaps relative to their peers with health insurance coverage (AOR = 50, 95% CI = 1.26–1.78).ConclusionThe results suggest a critical need for more investigations into patterns of specialty substance use treatment gaps within Black populations and for developing sexual identity-affirming mechanisms for closing the disparity gap, particularly for Black sexual minorities and those who lack health insurance coverage.