Adults Of Color Research Articles

Intersecting Inequities for Older LGBTQ+ Adults of Color in the Advent of Medicare Access: A Structural Vulnerability Framework

Intersecting Inequities for Older LGBTQ+ Adults of Color in the Advent of Medicare Access: A Structural Vulnerability Framework

Promise Parent Leadership Academy (PPLA) and Clemente Veterans’ Initiative (CVI) Newark

Urban and metropolitan colleges and universities can play an important role in innovative, equitable community revitalization. This is especially true for universities that also function as anchor institutions; there is both a challenge and an opportunity for such urban anchors to conduct their work in a manner that engages the community proximate to campus and improves the lives of its residents. This paper presents the Promise Parent Leadership Academy (PPLA) and Clemente Veterans’ Initiative (CVI) Newark as two examples of how an urban, postsecondary anchor institution can establish and nurture hyperlocal initiatives to improve outcomes for underserved residents. PPLA and CVI Newark, established in 2017 and 2019, respectively, have emerged as novel, impactful, and scalable initiatives that move beyond the typical one-way flow of intellectual capital generated within the confines of a university. Instead, PPLA and CVI Newark actively engage community members in meaningful, intellectually rigorous work that adds value to the institution, program participants, and greater Newark. Data from program evaluations indicate that participants of both programs—most of whom are adults of color from low-income households—gain personal and professional skills that bolster their confidence, critical thinking, and quality of life.

"I just check 'other'": Evidence to support expanding the measurement inclusivity and equity of ethnicity/race and cultural identifications of U.S. adolescents.

In nationally funded research in the U.S., ethnicity and race are measured with checkbox questions, the limited categories of which may yield significant missing data and low salience to available categories, particularly among adults of color. How adolescent-generated data compare to these limited categories, and how adolescents, not just those of color, describe their culture are understudied. In our sample, we asked the following: (a) how do adolescents' ethnicity/race and culture identifications compare?, (b) how do adolescents' open-ended ethnicity/race and checkbox ethnicity/race labels compare?, and (c) how do adolescents' ethnicity/race labels compare to available categories for identification on the National Institutes of Health's (NIH's) demographic form? Data from 76 adolescents (64.5% female, Mage = 15.78 years) were qualitatively and quantitatively analyzed. White adolescents were as likely as adolescents of color to identify with cultural labels, and most adolescents described culture differently than race/ethnicity. White adolescents' open-ended and checkbox labels overlapped more (38.8%) than adolescents of colors' (22.5%). Only 17% of adolescents' open-ended race/ethnicity identification labels and 54% of their checkbox identifications were available on the NIH's demographic form. As measurement of demographic data is reduced to few options that favor privileged identities, innovative methods to measure individuals' identities are warranted. Using tools that do not reflect individuals' identity labels may increase error and reflects structural problems of research inequity. Our findings provide initial evidence of this methodological issue in a sample of adolescents. Building inclusive demographic tools from individuals' self-descriptors that remain feasible and practical for use can diminish inequity associated with describing "diverse" populations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Blueprint for Genetic Determinism

A Blueprint for Genetic Determinism

Relational Factors Associated With Posttraumatic Stress Among Emerging Adults of Color Exposed to Community Violence.

The relationship between trauma exposure and posttraumatic stress symptoms (PTSS) is well-documented, but less is known about factors that contribute to the expression of PTSS following community violence exposure, particularly among emerging adults of color. Utilizing the Person-Environment Interaction model (Slaug et al., 2018), this study examined the role of relational factors, specifically ethnic identity, community cohesion, and social support, associated with PTSS following exposure to community violence. Participants included 243 emerging adult university students of color (Mage = 20.27, SD = 1.95, 83.5% female). Linear regression analyses indicated that less frequent trauma exposure and greater perceived social support were related to lower PTSS. A significant interaction was also found between social support and exposure to community violence, such that at low levels of social support, individuals with more community violence exposure had the highest levels of PTSS. Regression and moderation analyses indicated that ethnic identity and community cohesion were not significantly associated with PTSS in this sample. Findings highlight the importance of incorporating social support strategies in treatments for PTSS following community violence exposure.

2020 Editor's Choice Articles From JGMS: Focus on Vulnerable Populations

This symposium will present four 2020 “Editor’s Choice” articles from the Journal of Gerontology Medical Sciences that focus on issues relevant to vulnerable older populations. Justin Golub and colleagues, in their article “Audiometric Age-Related Hearing Loss and Cognition in the Hispanic Community Health Study”, broaden the scope of age-related studies on audiometric hearing loss by using a large Hispanic cohort, a community largely excluded from previous hearing loss studies. By examining audiometrically-defined hearing loss and cognitive measures, Golub found links between hearing loss and lower neurocognition. Janice Atkins and colleagues, in “Preexisting Comorbidities Predicting COVID-19 and Mortality in the UK Biobank Community Cohort”, challenge the practice of simple age-based targeting of older adults to prevent severe COVID-19 infections, and show that specific high-risk comorbidities are better indicators of hospitalization and mortality. “Comparison of Recruitment Strategies for Engaging Older Minority Adults: Results from Take Heart”, by Jessica Ramsay and colleagues, examines methods used to recruit older adults of color from primarily low socio-economic households for behavioral and clinical health research. Ryon Cobb and coauthors, in their article “Self-reported Instances of Major Discrimination, Race/Ethnicity, and Inflammation among Older Adults: Evidence from the Health and Retirement Study”, investigate whether self-reported lifetime discrimination is a psychosocial factor influencing inflammation in older adults. Tamara Baker, the discussant, will highlight commonalities and lessons learned from these studies, including links between racial, socio-economic, or disease-related vulnerabilities of older adults and their health status, as well as best practices to account for these factors in future clinical trials.

Conducting Community-Based Qualitative Research With LGBTQ Older Adults of Color During COVID-19

COVID-19 continues to transform the way scientists conduct research with study participants, particularly older adults who are at high risk of becoming seriously ill from the virus. For older adults who may be negatively affected by the digital divide, inclusive data collection practices become even more nuanced. Qualitative researchers moving their research into digital spaces must think critically about their use of technology, and how it affects the quality of data as well as the participant experience. This presentation highlights ethical and methodological considerations from a completely digital, community-based, qualitative research study conducted alongside LGBTQ older adults of color during COVID-19. Strategies to build and strengthen community partnerships are discussed along with challenges and opportunities for collecting data in the current digital landscape. Publicly available records are identified as a potential data source to understand the lives of LGBTQ older adults of color when in-person research is not feasible.

Just Another Storm: Conceptualizing Older Adults’ Perceptions of the COVID-19 Pandemic

Older adults of color who experience health disparities are especially vulnerable to health and economic adversity related to COVID-19. This study focuses on nine zip codes wherein 70.2% of residents are of African-American descent and an estimated 31.5% of residents live in poverty. To understand the lived experience of the COVID-19 pandemic, perceived challenges of COVID-19, and the dissemination of information related to COVID-19, we collected interview and focus group data in Spring 2020 from fifteen community members, leaders, or advocates. Analyses reveal that older individuals approach the COVID-19 pandemic with familiar disaster mitigation strategies. Other persons perceive the pandemic as another community challenge that African-Americans must confront. Older adults report generational differences in perceptions of the risk of COVID-19 and compliance with health guidelines. Overall, analyses reveal a deeply cultural context for intergenerational responses associated with COVID-19 and a sense of agency among older community leaders as health advocates.

Counseling Older LGBTQ+ Adults of Color: Relational-Cultural Theory in Practice

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) communities have faced a history of discriminatory incidents with deleterious effects on mental health and wellness. Compounded with other historically marginalized identities, LGBTQ+ people of color continue to experience disenfranchisement, inequities, and invisibility, leading to complex experiences of oppression and resilience. Moving into later stages of life span development, older adults of color in LGBTQ+ communities navigate unique nuances within their transitions. The article addresses the following goals to connect relational–cultural theory (RCT) as a relevant theoretical framework for counseling with older LGBTQ+ adults of color: (a) explication of conceptual and empirical research related to older LGBTQ+ adults of color; (b) outline of key principles involved in the RCT approach; and (c) RCT applications in practice and research for older LGBTQ+ adults of color.

Introduction to the Special Issue: Disproportionate trauma, stress, and adversities as a pathway to health disparities among disenfranchised groups globally.

Globally, individuals and communities that are marginalized based on their identities are at heightened risk for exposure to traumatic stress and socioeconomic hardship. Marginalization and disproportionate risk for many types of adversities correspond with disparities in physical health, mental health, and overall well-being. Together, the 12 empirical studies, one systematic review, and commentary in this special issue of the Journal of Traumatic Stress highlight the impact of discrimination and disproportionate adversity among groups marginalized based on race, ethnicity, nativity, caste, gender identity, sexual orientation, economic status, and medical status. Although most studies in this issue focus on the United States, the articles that focus on disparities and risk factors in India, El Salvador, Uganda, and Burundi provides a multicontinent global perspective. The global perspective, including the impact of the global pandemic, invites further examination of how disproportionate exposure to traumatic stress and adversity are associated with inequitable burden and health disparities worldwide. This special issue further highlights the developmental and multigenerational burden of systemic marginalization by including studies of children, young adults, adults, and parent-child dyads. Pathways for change and intervention are illustrated through a liberatory consciousness perspective, with one study utilizing liberatory media skills (e.g., positive media images and messages) to mitigate the adverse effects of trauma exposure on at-risk young adults of color. Worldwide, research on the effects of trauma, stress, and adversities must examine contextual factors (e.g., economic hardship), marginalization (e.g., discrimination, identity factors), and the differential impact on health among individuals and communities.

Equity for People of Color With Intellectual and Developmental Disabilities

Equity for People of Color With Intellectual and Developmental Disabilities

Emerging Retirement Crisis: When Social Security Is Not Enough

Evidence suggests a growing retirement crisis in the United States among older adults placing many of them at risk of falling into poverty. While Social Security provides income assistance to retirees, the average monthly benefit is $1,300. Among older adults nearing or in retirement, the use of public assistance programs is increasing. Using data collected by the Associated Press-NORC Center for Public Affairs Research we examine retirement preparedness, borrowing from retirement plans, and use of social welfare programs. Findings indicate increased borrowing from retirement plans due to debt, significant differences in racial and gender groups accessing and receiving services among those 75 and older. Increasing rates of unpreparedness for retirement exist among older Americans, particularly among adults of color. An increase in the use of safety net services among older adults is occurring concurrently with severe funding reductions in social welfare programming.

Experiences of Racial Discrimination Among Community-Dwelling Older Adults of Color and Nursing Home Staff of Color

This symposium will present results of three qualitative studies that explored experiences of racial discrimination among older adults and their professional caregivers. Our first study reports on interviews conducted with older community-dwelling African American adults about their perceptions of and experiences with structural racial discrimination. Participants reported exposure that has accumulated over the life course and across contexts, including through limited access to educational and employment opportunities and disproportionate exposure to neighborhood violence and unhealthy products. Our second study reports findings from interviews conducted with older community-dwelling African immigrants about their experiences with acculturation and racial discrimination. Older African immigrants reported several types of discrimination, had developed unique strategies to cope with perceived discrimination and described how it impacted domains of health and wellbeing. Our third study reports on experiences with discrimination among U.S-born and immigrant staff of color caring for residents in high minority proportion nursing homes. Findings indicate that although staff of color are valued for the diversity they contribute to the workforce, they are also exposed to discriminatory events. In addition, tensions exist between U.S. and non-U.S born staff of color. In this symposium, we will discuss differences in experiences between U.S.-born and immigrant participants, levels of discrimination experienced (interpersonal, institutional, structural), and discrimination across contexts. We will also discuss intersectionality of race, ethnicity, immigrant status, language, gender, age, and class in relation to experiences of discrimination. We will reflect on the clinical and policy implications of our findings.

In the Red: Debt, Financial Well-Being, and Retirement Preparedness Among Older Adults

Over the past twenty years, total debt for Americans ages 70 and over has increased more relative to all other ages group- by 543% according to the Federal Reserve Bank of New York (2019). Higher rates of debt among older adults have been attributed to a range of factors including expanded access to consumer credit, the capability for people to borrow from 401(k) plans, increases in costs of living, and limited financial literacy, among others. Related research of adults nearing retirement age who carry debt points to delayed retirement timing, lower levels of retirement savings, and higher risk and rates of bankruptcy. This symposium introduces timely investigations of retirement planning and economic security among older adults with debt. The first presentation will provide an overview of the impact of financial hardship on health among older adults in the United States over a recent ten-year period. The second presentation will focus on over-indebtedness among pre-retirees. The third presentation will examine the role of safety net services and borrowing from retirement plans among older adults with debt, particularly among older adults of color. The fourth and final presentation will focus on student loan debt as a hurdle to near-term and long-term financial security for older women in particular. A discussant will comment on how, together, the aforementioned papers contribute to our understanding of economic wellbeing and retirement preparedness in this era of increasing longevity. The session will integrate policy and programming implications for gerontological professionals.

Advancing Alzheimer’s Disease Care and Services Among Racial and Ethnic Minorities

Research shows consistent and adverse disparities among racial and ethnic minorities compared to non-Hispanic Whites in the prevalence and incidence of Alzheimer’s disease, mortality, participation in clinical trials, use of medications and other interventions, health care expenditures, and quality-of-life outcomes. The literature suggests numerous underlying causes, including factors related to measurement of the disease, genetics, socioeconomic factors, cultural differences, lack of culturally competent interventions, and discrimination in services and care. Although these disparities are well known, little is known about the effectiveness of various strategies to address these differences within the context of Alzheimer’s disease services and care. This symposium aims to contribute to this knowledge. The first presentation examines the role of race with marital status and risk for dementia using data from the Health and Retirement Study. Results suggest differences for unmarried White and unmarried older adults of color, which can inform dementia care services. The second presentation highlights the opportunities and challenges of facilitating cognitive impairment screenings among African American congregations. The third presentation introduces attitudes about brain donation among African American research participants and suggestions to increase involvement. The symposium concludes with a presentation on hearing care disparities in dementia with practical recommendations on how to close this gap in hearing care. The findings from these papers contribute significantly to the impact of ethnoracial differences in dementia and the need to include more diverse populations in ADRD research to promote equity. Alzheimer’s Disease Research Interest Group Sponsored Symposium.

“That is when I changed and my whole life changed”: Turning points in health perceptions among LGBTQ adults of color

ABSTRACT This study explored turning points in health perceptions among lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults of color living in a major US city. Turning points in health perceptions were elicited from 38 participants through in-depth interviews and were examined using interpretive phenomenological analysis. Findings revealed three key themes: (a) diagnosis and disease; (b) death or illness of family and friends; and (c) changes in environmental context and body. The positive impacts of turning points are discussed, including the development of active coping skills, engagement in health-promoting behaviors, and increased community connectedness. Implications for future research are also suggested.

SOCIAL ISOLATION AMONG LGBT OLDER ADULTS: LESSONS LEARNED FROM A PILOT FRIENDLY-CALLER PROGRAM

Lesbian, gay, bisexual, and transgender (LGBT) older adults face heightened risks of social isolation, given decades of discrimination. Research on telephone buddy programs with non-LGBT participants have proved predominantly unsuccessful at addressing social isolation and have found the greatest success with same-age matches. However, evidence suggests that LGBT adults may actually benefit from telephone buddy programs and in ways uniquely different from other groups. This article shares lessons learned from 30 participants across a 12-month pilot program that matched LGBT older adults to both LGBT and non-LGBT volunteer callers of various ages. One-third of participants identified as African American or Black. This project employed community-based participatory action research to identify, execute, and evaluate the program. Data includes information from questionnaires and telephone interviews prior to and during the program. In contrast to other research, data here revealed strong support for intergenerational matches. LGBT older adults of color especially benefited from program referrals and matches with/from LGBT adults of color, regardless of age. While the project aimed to capture two groups (LGBT older adults experiencing isolation and volunteer callers), the project revealed a third group: LGBT adults at risk of social isolation. This third group usually emerged among the “volunteer” callers but also identified concerns and risk factors for social isolation. The program also revealed unexpected benefits to both LGBT and non-LGBT volunteers, including less loneliness and a stronger sense of community. This article concludes with recommendations for developing similar programs to reduce social isolation in the LGBT community.

MEDICAID FINANCING IN ASSISTED LIVING AND CHARACTERISTICS OF MEDICARE DUAL-ELIGIBLE RESIDENTS

An increasing number of assisted living (AL) residents rely on Medicaid waivers or state plans to pay for personal care and other supportive services. States may finance services for duals residing in AL through Medicaid waivers and state plans, but the availability of coverage varies – some states offer little to no Medicaid coverage for services in AL, and others offer multiple pathways to receiving assistance. Little is known about duals in AL, including how many have access to AL and the quality of care they receive there. The present study compares the characteristics of Medicare beneficiaries residing in large AL settings, by dual-eligibility status, and investigates the variability in the share of duals in AL among states. We identified 586,397 Medicare beneficiaries residing in AL in 2014. Medicare claims were used to measure health characteristics and health care utilization. Duals represented 16% of AL residents in our cohort. Compared to non-duals, duals were more often older adults of color (24 vs 4%), and more likely to qualify for Medicare due to disability (46 vs 7%). Duals had higher rates of hospitalizations (24 vs 21%) and skilled nursing facility use while in AL (11 vs 10%), and more chronic conditions than non-duals. States varied in the share of AL residents who are duals, ranging from 6% in New Hampshire to 41% in New York. State policies that may contribute to variation in the prevalence of duals in AL and implications of these findings for policy-makers and residents will be discussed.

RECASTing racial stress and trauma: Theorizing the healing potential of racial socialization in families.

For youth and adults of color, prolonged exposure to racial discrimination may result in debilitating psychological, behavioral, and health outcomes. Research has suggested that race-based traumatic stress can manifest from direct and vicarious discriminatory racial encounters (DREs) that impact individuals during and after an event. To help their children prepare for and prevent the deleterious consequences of DREs, many parents of color utilize racial socialization (RS), or communication about racialized experiences. Although RS research has illuminated associations between RS and youth well-being indicators (i.e., psychosocial, physiological, academic, and identity-related), findings have mainly focused on RS frequency and endorsement in retrospective accounts and not on how RS is transmitted and received, used during in-the-moment encounters, or applied to reduce racial stress and trauma through clinical processes. This article explores how systemic and interpersonal DREs require literate, active, and bidirectional RS to repair from race-based traumatic stress often overlooked by traditional stress and coping models and clinical services. A novel theory (Racial Encounter Coping Appraisal and Socialization Theory [RECAST]), wherein RS moderates the relationship between racial stress and self-efficacy in a path to coping and well-being, is advanced. Greater RS competency is proposed as achievable through intentional and mindful practice. Given heightened awareness to DREs plaguing youth, better understanding of how RS processes and skills development can help youth and parents heal from the effects of past, current, and future racial trauma is important. A description of proposed measures and RECAST's use within trauma-focused clinical practices and interventions for family led healing is also provided. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Linking Racial Identity, Ethnic Identity, and Racial-Ethnic Socialization: A Tale of Three Race-Ethnicities

The relationship between racial and ethnic identity, as well as that between racial-ethnic socialization and racial and ethnic identity development, has become increasingly important to researchers as the proportion of children and young adults of color grows in the U.S. population. Parents’ racial-ethnic socialization messages are important for the ways in which children and young adults develop a sense of self as members of their racial or ethnic group. This article examined the racial identity, ethnic identity, and racial-ethnic socialization of 90 African American, 224 Asian American, and 216 Latino American college students. There were many strong associations between the measures of racial identity and ethnic identity as well as between racial-ethnic socialization and each measure of identity. Different patterns of relationships emerged among the three groups depending on whether the outcome variable was racial identity or ethnic identity. In the majority of instances where the three groups were not the same, Latino and Asian Americans were more similar to each other than to African Americans. In a few instances, the three groups exhibited different patterns of relationship among the constructs. Findings are discussed in terms of the sociocultural histories of the three groups.