Sex and Gender Differences Between Experiences of Discrimination and Physical Health: A Systematic Review

Economic, social, and traumatic stressors have been shown to impact mental and physical health. Few studies have considered whether different domains of stressors have a differential effect on health outcomes or have considered stressors across the lifecourse. We characterize stress cumulatively (life stress) and across different domains and examine their relation to adult mental and physical health using prospectively collected data from the DISPAR study. At 4 timepoints (birth, age 9, 15, and 50), economic, relational, and traumatic stressors were assessed, and interviews were conducted between 1959 and 2012. Experiences of major discrimination were assessed at age 50. Life stress scores and domain-specific stress scores, (occurring in either childhood or adulthood), were created. The Kessler distress scale, self-reported health, and objective measured allostatic load (AL) were assessed at age 50. Adjusting for race and sex, life stress was associated with all 3 outcomes. Domain-specific analysis showed that only SES stressors impacted all outcomes (poorer self-rated health, higher distress, and higher AL). Relational stress was associated with distress only; experiences of discrimination were associated with poor self-rated health and distress. Stressors across the lifecourse have been proposed to affect wear and tear on multiple bodily systems and to affect multiple health outcomes. Our empirical test supported this hypothesis in a 50-year old cohort and in particular the impact of economic stress across physical and mental health outcomes.

Race, Ethnicity and Experienced Racism Are Associated with Adverse Physical and Mental Health Outcomes Among Cancer Survivors

Culturally informed family interventions can address health disparities among Hispanic adolescents. This literature review presents the current research base for Hispanic parent-adolescent physical and mental health interventions. We performed a multi-database search and included articles that described a Hispanic parent-adolescent dyadic intervention that targeted physical or mental health outcomes. Eighteen studies included interventions such as Familias Unidas, Families Talking Together, and Bridges. Across the trials, physical health outcomes were largely unchanged, mental health outcomes were positively changed, and interventions that targeted substance use and sexual health behavior produced mixed results. Familias Unidas targeted high-risk adolescents and demonstrated the most efficacy regarding mental health and substance use outcomes. Parent-adolescent dyadic interventions show efficacy in improving mental health outcomes and reducing adolescent risk-taking behaviors. However, they have limits regarding physical health outcomes. This supports the need for more interventions that can target both physical and mental health disparities among Hispanic adolescents.

Changing language, changes lives: Learning the lexicon of LGBTQ+ health equity.

The environment an adult resides within is associated with their health behaviours, and their mental and physical health outcomes: a nationwide geospatial study

Purpose: Racial discrimination disproportionately affects Black individuals and is associated with adverse mental and physical health outcomes. Black individuals also exhibit higher levels of systemic inflammation compared to other racial and ethnic groups, which may contribute to disparities in cancer outcomes and comorbid conditions. Despite this, the relationship between racial discrimination and inflammatory biomarkers in cancer survivors remains understudied. This study examines the association between experiences of discrimination and inflammatory biomarker levels in a cohort of Black breast cancer survivors. Methods: We analyzed data from the Women’s Circle of Health Follow-up Study, a population-based longitudinal cohort of Black breast cancer survivors in New Jersey. Self-reported lifetime racial discrimination was assessed during baseline home visits (approximately 12 months post-diagnosis) using the validated “Experiences of Discrimination (EOD)” instrument, which captures experiences of interpersonal and institutional discrimination across nine domains, including work, education, health care, and public settings. Inflammatory biomarkers, including high sensitivity C-reactive protein, Interleukin-6 (IL-6), Tumor Necrosis Factor (TNF)-α, and IL-1β, were assayed in blood samples collected 24-36 months post-diagnosis. Multivariable linear regression models were used to evaluate the associations between EOD (ever vs. none) and biomarker concentrations, adjusting for potential confounders. Results: Among the 156 women included in this analysis, 74% reported experiencing any discrimination. Self-reported EOD was not significantly associated with inflammatory biomarker levels. However, women reporting discrimination had non-significant elevations in TNFα and IL-1β compared to those reporting no EOD. In age-adjusted models, the mean for TNFα among women reporting any EOD was 5.94 pg/mL (95% CI: 5.50, 6.42) compared to 5.57 pg/mL (95% CI: 4.91, 6.32) among those reporting no EOD. Similarly, the age-adjusted mean value for IL-1β was 1.37 pg/mL (95% CI: 1.21, 1.56) for women reporting any EOD versus 1.28 pg/mL (95% CI: 1.03, 1.58) for those reporting none. Fully adjusted models accounting for age at diagnosis, sociodemographic factors (marital status, income), lifestyle factors (smoking, alcohol use, physical activity, body mass index), and chemotherapy yielded comparable results. Conclusion: While we did not observe statistically significant associations, our findings suggest a potential link between EOD and elevated levels of inflammatory biomarkers in Black breast cancer survivors, pointing to a possible biological impact of discrimination-related stress. Future studies with greater statistical power are needed to better understand these relationships and their potential relevance to cancer prognosis and survivorship. Citation Format: Nur Zeinomar, Marley Perlstein, Bo Qin, Hari S. Iyer, Jesse J. Plascak, Tengteng Wang, Kitaw Demissie, Christine B. Ambrosone, Elisa V. Bandera, Chi-Chen Hong. Self-reported experiences of discrimination and inflammatory-related biomarkers among Black breast cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4897.

The negative health consequences of personal experiences of racial discrimination (personal-level discrimination) has been well-documented across developmental stages, including adolescence, in Black individuals. There is also some evidence suggesting perceiving other Black individuals experiencing racial discrimination (group-level discrimination) can protect one's health in Black adults. This study examined the role of personal- and group-level discrimination in Black adolescent health. The study was a secondary analysis of survey data collected from 186 Black adolescents that included reports of discrimination, physical function, anxiety, and depression. Black adolescents who reported greater, as opposed to lower, personal-level discrimination were more likely to experience poorer physical and mental health outcomes. While group-level discrimination was also associated with physical health outcomes, it was not directly associated with mental health outcomes. Importantly, across all three health outcomes, awareness of group-level discrimination mitigated the negative health consequences of personal-level discrimination. Among adolescents who reported low levels of group-level discrimination, personal-level discrimination was associated negatively with physical function and positively with anxiety and depressive symptoms. Among adolescents who reported high levels of group-level discrimination, there was no association between personal-level discrimination and any of the health outcomes. Consistent with prior research with Black adults, awareness of high group-level discrimination may protect Black adolescents from the negative health consequences of personal-level discrimination. The pattern of the results is also consistent with the literature of the personal-group discrimination discrepancy (PGDD) and psychological wellbeing. Future research should investigate the psychological mechanisms implicated in PGDD (e.g., external attribution of discrimination and intragroup comparison) as potential coping strategies for Black adolescents against the negative health consequences of personal-level discrimination.

The number of physically and mentally unhealthy days as a measure of health-related quality of life (HRQOL) is used to examine the different effects of the adverse childhood experiences (ACEs) on physical and mental health outcomes. The data, a cross-sectional state-level survey, is obtained from the Behavioral Risk Factor Surveillance System (BRFSS) collected by the Centers for Disease Control and Prevention (CDC) in 2012. Multiple regression analyses are conducted for the study. The results indicate that all individual ACE categories are inversely associated with both physical and mental health, as respondents who exposed to any adverse childhood experience are likely to have physically- and mentally-related poor HRQOL in adulthood. The estimated coefficients for individual ACEs in magnitude on the mental health outcome are, in overall, greater than the estimated coefficients on the physical health outcome. The regression results with accumulative ACE scores indicate that higher levels of the ACE score would affect higher negative health outcomes, such as the dosage effects that appear again in this study. The estimated coefficients of accumulative ACE scores on the mental health outcome exceed the coefficients of ACE scores on physical health outcome for an ACE score of 2 and above. The gap in the estimated coefficients of ACE scores between physically and mentally unhealthy days increases as the ACE score rises. The estimated coefficient at the score ACE8 for the mentally unhealthy days becomes almost twice as large as the coefficient for the physically unhealthy days. Importantly, the negative effects of ACEs on mental health outcomes are significantly greater than the negative effects on physical health outcomes.

BackgroundDivorce has been linked with poor physical and mental health outcomes among civilians. Given the unique stressors experienced by U.S. service members, including lengthy and/or multiple deployments, this study aimed to examine the associations of recent divorce on health and military outcomes among a cohort of U.S. service members.MethodsMillennium Cohort participants from the first enrollment panel, married at baseline (2001–2003), and married or divorced at follow-up (2004–2006), (N = 29,314). Those divorced were compared to those who remained married for mental, behavioral, physical health, and military outcomes using logistic regression models.ResultsCompared to those who remained married, recently divorced participants were significantly more likely to screen positive for new-onset posttraumatic stress disorder, depression, smoking initiation, binge drinking, alcohol-related problems, and experience moderate weight gain. However, they were also more likely be in the highest 15th percentile of physical functioning, and be able to deploy within the subsequent 3-year period after divorce.ConclusionsRecent divorce among military members was associated with adverse mental health outcomes and risky behaviors, but was also associated with higher odds of subsequent deployment. Attention should be given to those recently divorced regarding mental health and substance abuse treatment and prevention strategies.

Childhood physical and sexual abuse are associated with negative mental and physical health outcomes in adulthood. There may also exist protective factors which attenuate the relationship between childhood abuse and poor health outcomes. Focusing specifically on American Indian and Alaskan Native (AI/AN) adults, a diverse population which has been marginalized and understudied, this study aims to investigate whether the presence of a protective adult in the household may attenuate the association between childhood abuse and poor health outcomes in adulthood. Secondary analyses were conducted on data from the 2021, 2022, and 2023 Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System. An analytic sample of 2,140 adults who self-identified as AI/AN were analyzed using binary logistic regression. The outcomes of interest were key physical and mental health outcomes such as heart disease, stroke, major depressive disorder, and cognitive deficit, among others. The key exposure of interest was childhood abuse (physical abuse alone, sexual abuse with or without co-occurring physical abuse, versus neither form of abuse). Childhood physical and/or sexual abuse was associated with higher odds of negative physical and mental health outcomes. Adjusting for demographic factors and socioeconomic factors partially attenuated this relationship. Adjusting for the presence of a protective adult also attenuated the relationship between abuse and several of the outcomes studied, particularly for respondents who had a protective adult present all of the time. These findings have implications for public health initiatives aimed at strengthening support for AI/AN children and adolescents.

The elderly have a higher risk of experiencing less social support because of role losses and changes associated with aging and chronic disease processes, and there is pressure from third-party payors to reduce the length of home healthcare services. Few studies have examined patients' instrumental social support after discharge from home healthcare. Therefore, this descriptive study examined instrumental social support of discharged home healthcare clients (N = 57) who were older than 65 years old, using a telephone interview and retrospective record review. The purposes were to investigate (1) source and number of sources of received support based on age, gender, marital status, race, and functional ability; (2) whether source of support was associated with physical and mental health outcomes; (3) whether clients' perception of need for more support was associated with physical and mental health outcomes. The results indicated that the number of sources of social support was associated with clients' gender, marital status; and functional status; trends toward improvements in mental and physical health outcomes were associated with support provided by friends and neighbors.

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) people report worse physical and mental health than their heterosexual peers. We review the literature on physical and mental health outcomes among parents and children in LGBTQ-parent families through a family resilience framework. In doing so, we describe research on mechanisms of vulnerability and resilience in families. We found few studies specifically focused on LGBTQ parents and physical health outcomes. Experiences of stigma and peer victimization among LGBTQ parents and children are stressful and associated with psychological distress. However, stressful experiences do not appear to result in significant mental health disparities between children of same-sex and children of different-sex parents. Instability and the ability to mitigate instability appear to be more strongly related to mental health outcomes than family status, parent gender, and family formation method. Clinicians can help mitigate potential negative mental and physical health outcomes by identifying and providing support to families for coping with stress related to stigma, discrimination, and family transitions. School policies and personnel can do more to intervene in bullying based on family status. Additional research on health outcomes, particularly physical health, is needed, including among LGBTQ-parent families of color, bisexual and transgender parent families, and second-generation LGBTQ youth. Overall, there is more to learn about how best to support the health and well-being of these often marginalized families.

Objectives: Person-centered care has been increasingly recognized as an important aspect of health care quality, including in maternity care. Little is known about correlates and outcomes of person-centered care in maternity care in the United States. Materials and Methods: Data were from a prospective cohort of more than 3000 individuals who gave birth to a first baby in a Pennsylvania hospital. Person-centered maternity care was measured via a 13-item rating scale administered 1-month postpartum. Content validity was established through exploratory factor analysis. The resulting scale had scores ranging from 13 to 54, with Cronbach's alpha of 0.86. Using linear and logistic regression models to control for covariates, we examined associations between participants' characteristics and person-centered maternity care and between person-centered maternity care and postpartum outcomes. Results: Participants had a mean total score of 47.80 on the person-centered maternity care scale. Patient factors independently associated with more person-centered maternity care included older age, more positive attitude toward vaginal birth during pregnancy, and spontaneous vaginal birth. In adjusted models, higher person-centered maternity scale scores were strongly associated with many positive physical and mental health outcomes at 1 and 6 months postpartum. Conclusions: Our findings underscore the importance of person-centered maternity not just due to its intrinsic value but also because it may be associated with both mental and physical health outcomes through the postpartum period. Results suggest that policy efforts are necessary to ensure person-centered maternity care, especially for delivery hospitalization experience.

After participating in this CME activity, the psychiatrist should be better able to:• Describe the mental, physical, and social health risks experienced by individuals bereaved by suicide across different kinship groups.• Identify key gaps in the current suicide bereavement research literature and explain their implications for clinical postvention strategies.• Differentiate suicide bereavement-related risks by kinship group (offspring, parents, spouses, siblings) and age at the time of loss.• Recognize populations with the highest suicide bereavement-related vulnerabilities. Suicide bereavement is a global public health problem associated with adverse physical and mental health outcomes. While population-based registry studies offer a promising avenue to understand the impacts of suicide bereavement, there has been no systematic review of results from such studies. This systematic review examines mental, physical, and social health outcomes among suicide-bereaved individuals in global population-based registry studies, with a focus on differences in findings by outcome, kinship, and comparison group. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for studies registered in PubMed and PsycInfo. The review was conducted in April 2025. The initial search revealed 404 unique records. After screening and full-text review, 36 studies published between 2005-2024 were included. Most frequently, studies examined bereaved offspring (n = 20), followed by bereaved parents (n = 8), spouses (n = 5), siblings (n = 5), and unspecified familial relations (n = 5). Overall, suicide loss was frequently associated with adverse health outcomes, including mortality, particularly due to suicide, and mental health (e.g., major depression, self-harm), and some physical health concerns. Associations meaningfully differed by kinship and comparison group. This is the first systematic review on population-based registry research concerning relationships between suicide loss and adverse mental, physical, and social health outcomes. Future studies should examine patterns of disease comorbidity, expand types of kinship examined (e.g., roommates), and probe how risk varies by time since loss.

Acute stress and subsequent health outcomes: A systematic review