Experiences Of Everyday Discrimination Research Articles

Identifying pathways from childhood adversity to suicidal thoughts and behaviors among sexual minority adults: An exploratory mediation analysis

BackgroundThe current study uses a nationally representative longitudinal dataset of sexual minority adults in the US to investigate the pathways from adverse childhood experiences (ACEs) to adulthood suicidal thoughts and behaviors. MethodsACEs were measured at year one, potential mediators at year two, and suicidal thoughts and behaviors (suicidal ideation, intent, plan, and attempt) at year three. We conducted an exploratory mediation analysis to identify potential mediating factors linking ACEs to suicidal thoughts and behaviors. Ten candidate mediators were examined: social well-being, felt stigma, experiences of everyday discrimination, social support, psychological distress, alcohol and drug use, importance of sexual identity, community connection, and internalized homophobia. ResultsParticipants were 1518 adults who identified as lesbian or gay (n = 833; 55 %), bisexual (n = 493; 33 %), or with other sexual minority identities (n = 181; 12 %) and were on average 36.48 years (SD = 14.7) of age. Psychological distress served as a common mediator between ACEs and suicidal ideation, intent, plan, and attempt. Additionally, experiences of everyday discrimination emerged as a specific mediator leading to suicidal intent, whereas social support uniquely mediated the relation between ACEs and suicide plan. LimitationsPotential recall bias due to retrospective reporting of ACEs may be a limitation. Future studies should broaden the measurement scope of ACEs and implement intersectional methods. ConclusionThe current findings underscore the urgent need for targeted interventions that address the specific mental health needs of sexual minority individuals, particularly focusing on mitigating psychological distress, combating systemic discrimination, and enhancing social support.

Perceived discrimination and type 2 diabetes incidence: Findings from the Health and Retirement Study.

To examine the prospective association between perceived everyday discrimination and Type 2 diabetes incidence in a large population-based sample. Data were from the Health and Retirement Study of 14,900 individuals aged ≥ 50 years without a diabetes diagnosis. Participants self-reported experiences of everyday discrimination and diabetes status. Associations between baseline perceived everyday discrimination (one time point) and incident diabetes in the following 10 years were modeled using Cox regression, adjusting for potential confounders. Exploratory analyses assessed the association between repeated reports of perceived everyday discrimination (reports of everyday discrimination at more than one time point) and later diabetes onset. A total of 917 (6.15%) of the 14,900 participants developed Type 2 diabetes over a maximum 10-year follow-up (Mdn = 6). Baseline perceived everyday discrimination was prospectively associated with an increased risk of diabetes (hazard ratio = 1.37, 95% confidence interval [1.15, 1.63], p < .001) independent of age, sex, wealth, race and ethnicity, and education. This association was robust to further adjustment for body mass index, hypertension, physical activity, smoking, alcohol consumption, and depression. In exploratory analyses, repeated reports of everyday discrimination were not significantly associated with incident diabetes. Individuals who perceive everyday discrimination are more likely to develop Type 2 diabetes than those who do not perceive everyday discrimination. Further research is needed to investigate the potential pathways linking discrimination and diabetes onset. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Reintroducing the “Tough Black Man” and Its Socio-Demographic, Race-Related, and Psychological Correlates

The “tough Black man” is expected to be physically strong, emotionally restrictive, resilient, and self-reliant. However, to date, limited research has examined the correlates of endorsing beliefs about the “tough Black man” among Black U.S. American men. To address this gap, this research examines the sociodemographic (i.e., age, sexual identity, income, education, and relationship status), race-related (i.e., racial identity, internalized racism, everyday discrimination, and race stigma consciousness), and psychological (i.e., self-esteem, locus of control, resilience, and depression symptoms) correlates of endorsing “tough Black man” beliefs in an internet-obtained sample of 329 Black U.S. American men (Mean age = 37.22). Multiple regression analysis showed that a more positive racial identity, greater internalized racism, and higher race stigma consciousness—but not everyday discrimination experiences—were associated with greater endorsement of “tough Black man” beliefs. Multivariate regression results showed that greater endorsement of “tough Black man” beliefs was associated with greater resilience, greater internal locus of control, and more depression symptoms, but not self-esteem. Last, exploratory findings showed that endorsing beliefs about the “tough Black man” did not vary by age, income, education, relationship status, or sexual identity. This study has implications for understanding Black masculinities, along with the psycho-social and psychological correlates of internalizing intersecting race and gender stereotypes among Black U.S. American men. Together, our research provides the opportunity to expand knowledge about how internalized stigma processes, beliefs about Black manhood, and the social-structural factors that might explain it, contribute to poor health among Black U.S. American men.

Perceived discrimination, political efficacy, and political participation in American Indian adults

IntroductionPsychological factors linked to political participation are largely understudied in American Indians. Prior work notes relatively low levels of participation compared to other racial and ethnic groups and suggests that identification with being American Indian is linked to overall levels of civic engagement in part through perceptions of group discrimination.MethodsIn the current work, in a sample of 727 American Indian adults, we created two groups: Group 1 (N = 398) reported perceived discrimination related to race, and Group 2 (N = 329) reported perceived discrimination not related to race or ethnicity. We investigated the relationships between individual experiences of everyday discrimination related to race, levels of political efficacy, and political participation (Group 1), and individual experiences of everyday discrimination not related to race or ethnicity, political efficacy, and political participation (Group 2).ResultsWe found that greater experiences of everyday discrimination related to race was associated with higher levels of political participation through increased levels of internal and collective efficacy. In contrast, greater experiences of everyday discrimination related to race was associated with higher levels of political participation through lower external political efficacy. For Group 2, we found that greater experiences of everyday discrimination not related to race or ethnicity was not directly associated with political participation, but mediation analyses revealed a relationship with lower levels of political participation through decreased internal and collective efficacy. The indirect effect through external political efficacy was not significant.DiscussionGiven low levels of American Indian political participation, political efficacy could be a target for interventions aiming to increase participation in the political system.

Education, Income, Wealth, and Discrimination in Black-White Allostatic Load Disparities

IntroductionAllostatic load (AL) is a significant marker of aging, associated with disease and mortality. Research has elucidated the impact of education and income on AL. However, the roles of wealth and discrimination in contributing to AL and shaping AL disparities remain underexplored. This study aimed to investigate the association between wealth and AL, while also examining the independent contributions of education, income, wealth, and everyday discrimination in shaping AL disparities. MethodsUsing 2016 data from the nationally representative Health and Retirement Study (N=3,866), this study employed multilinear regression analysis to quantify the association between education and income, wealth (calculated as assets minus debts), and everyday discrimination with AL. Oaxaca-Blinder decomposition analysis was conducted to determine the proportion of AL disparities between Black and White participants attributed to education and income, wealth, and everyday discrimination. Analyses were performed in 2023. ResultsHaving a college degree or more (b = -0.32; 95% CI: -0.46, -0.17), higher income (b = -0.06; 95% CI: -0.11, -0.01), and greater wealth (b = -0.11; 95% CI: -0.16, -0.07) were linked to reduced AL. Conversely, increased experiences of everyday discrimination were associated with heightened AL (b = 0.07; 95% CI: 0.01, 0.16). Collectively, differences in possessing a college degree or more, wealth, and exposure to discrimination accounted for about 18% of the observed Black-White AL disparities. ConclusionsEducation, income, wealth, and experiences of discrimination may independently contribute to AL and partially explain Black-White disparities in AL. There is a need to elucidate the underlying mechanisms governing these relationships, particularly wealth, and extend the research to additional social determinants of racial health disparities.

Examining Factors Associated with Cannabis Use Among Sexual and Gender Minority and Cisgender Heterosexual Emerging Adults in California.

Purpose: We explored correlates of cannabis risk and examined differences between sexual and gender minority (SGM) and cisgender heterosexual emerging adults (ages 18-29) in California. Methods: We recruited 1491 participants aged 18-29 years for a cross-sectional online survey. Ordinal logistic regressions assessed associations between minority stress (discrimination and internalized homophobia [IH]), social support (perceived social support and lesbian, gay, bisexual, transgender, and queer+ [LGBTQ+] community connectedness), and cannabis risk scores (low, medium, and high risk of developing problems related to their cannabis use). We also explored differences in cannabis risk scores by sexual orientation and gender identity (SOGI). Results: Higher everyday discrimination scores were associated with increased odds of self-scoring in a higher cannabis risk range (adjusted odds ratio = 1.53, 95% confidence interval [CI] = 1.31-1.79). We found no significant associations for IH, LGBTQ+ community connectedness, or social support on cannabis risk scores. There were also no statistically significant differences by SOGI groups; however, SOGI did moderate the relationship between IH and cannabis risk score such that the slope for IH was 0.43 units higher for cisgender sexual minority women compared to cisgender sexual minority men (95% CI = 0.05-0.81). Conclusion: Our findings suggest that experiences of everyday discrimination are important contributors to developing cannabis-related problems and IH may have more pronounced effects for sexual minority women compared to sexual minority men. More research is needed to better understand risk and protective factors of cannabis risk to inform the development of culturally tailored interventions for SGM emerging adults.

Acceptability and Feasibility of a Smartphone-Based Real-Time Assessment of Suicide Among Black Men: Mixed Methods Pilot Study.

Suicide rates in the United States have increased recently among Black men. To address this public health crisis, smartphone-based ecological momentary assessment (EMA) platforms are a promising way to collect dynamic, real-time data that can help improve suicide prevention efforts. Despite the promise of this methodology, little is known about its suitability in detecting experiences related to suicidal thoughts and behavior (STB) among Black men. This study aims to clarify the acceptability and feasibility of using smartphone-based EMA through a pilot study that assesses the user experience among Black men. We recruited Black men aged 18 years and older using the MyChart patient portal messaging (the patient-facing side of the Epic electronic medical record system) or outpatient provider referrals. Eligible participants self-identified as Black men with a previous history of STB and ownership of an Android or iOS smartphone. Eligible participants completed a 7-day smartphone-based EMA study. They received a prompt 4 times per day to complete a brief survey detailing their STB, as well as proximal risk factors, such as depression, social isolation, and feeling like a burden to others. At the conclusion of each day, participants also received a daily diary survey detailing their sleep quality and their daily experiences of everyday discrimination. Participants completed a semistructured exit interview of 60-90 minutes at the study's conclusion. In total, 10 participants completed 166 EMA surveys and 39 daily diary entries. A total of 4 of the 10 participants completed 75% (21/28) or more of the EMA surveys, while 9 (90%) out of 10 completed 25% (7/28) or more. The average completion rate of all surveys was 58% (20.3/35), with a minimum of 17% (6/35) and maximum of 100% (35/35). A total of 4 (40%) out of 10 participants completed daily diary entries for the full pilot study. No safety-related incidents were reported. On average, participants took 2.08 minutes to complete EMA prompts and 2.72 minutes for daily diary surveys. Our qualitative results generally affirm the acceptability and feasibility of the study procedures, but the participants noted difficulties with the technology and the redundancy of the survey questions. Emerging themes also addressed issues such as reduced EMA survey compliance and diminished mood related to deficit-framed questions related to suicide. Findings from this study will be used to clarify the suitability of EMA for Black men. Overall, our EMA pilot study demonstrated mixed feasibility and acceptability when delivered through smartphone-based apps to Black men. Specific recommendations are provided for managing safety within these study designs and for refinements in future intervention and implementation science research. RR2-10.2196/31241.

Everyday discrimination, co-ethnic social support and mood changes in young adult immigrants in Germany–Evidence from an ecological momentary assessment study

ObjectiveIn the context of international migration flows, Germany is the second largest receiving country of migrants in the world. The aim of this study is to investigate the momentary mood effects of discrimination experiences for young adult immigrants and which social resources can buffer negative effects. A distinction is made between the importance of inter and intra-ethnic interaction partners in processing stressors. MethodUsing an ecological momentary assessment design, first-generation migrants in Germany who had recently migrated from Poland, Turkey or Syria were interviewed three times a day over seven days in June 2021 (N individuals = 976; N observations = 11,470). The timing of the short surveys was chosen at random using a signal contingent sampling method. Participants reported their momentary mood and instances of discrimination, along with information on social support perception and interaction partners during the preceding hour in the context of their everyday lives. Hybrid mixed-effects regression models were estimated and the research questions were tested with three-way interactions. ResultsThe results indicate that perceived social support only moderately buffers the negative effect of everyday discrimination experiences on mood. A positive main effect on mood is observed for situational variations in perceived social support as well as for support from interaction partners. ConclusionThe findings illustrate that being embedded in supportive relationships is important in everyday life, regardless of the occurrence of stressors. Furthermore, the study suggests that the level of perceived support is more important for first-generation migrants than the ethnic origin of the support provider.

BIOPSYCHOSOCIAL DETERMINANTS OF COGNITIVE FUNCTION AMONG BLACK OLDER ADULTS

Abstract Black older adults in the United States have twice the risk of being diagnosed with Alzheimer’s disease and related dementias than their white counterparts. However, there remains a gap in knowledge of which factors may contribute to this disparity as well as mechanisms that either increase or decrease risk for poor cognitive outcomes, specifically in older Black adults. This presentation will highlight recent interdisciplinary population health research on the biopsychosocial determinants of cognitive function among Black adults 65 years and older in the Health and Retirement Study. Using within-group regression analyses, studies examine associations between multiple measures across neighborhood, psychosocial, and biomarker domains with cognitive function, measured by Telephone Interview for Cognitive Status scores (range: 0-35) which captures memory and overall mental status. We find that high neighborhood disorder and low social cohesion were associated with worse cognitive function, especially for more highly educated Black older adults and those living in urban communities. Greater frequency of experiences of everyday discrimination among Black older adults was also related to lower cognitive function. Volunteering and having a high sense of purpose in life were associated with better cognitive function for older Black men and women, while being physical active was associated with increased cognitive function for older Black women. C-reactive protein, a measure of systemic inflammation, was positively associated with cognitive function. Overall, this body of work demonstrates the need to further critically assess both risk and resilience processes underlying cognitive function among older Black adults towards reducing current cognitive health inequities.

Psychometric evaluation of the Everyday Discrimination Scale in KHANDLE

AbstractBackgroundStructural racism manifests in differential experiences of everyday discrimination for racialized and minoritized groups. The Everyday Discrimination Scale (EDS) assesses subjective experiences of unfair treatment in everyday social situations. The goal of this study is to evaluate the psychometric performance of the EDS within racialized groups and specifically to evaluate if the EDS measures a unidimensional construct.MethodData was from a diverse sample of community‐dwelling older adults in Northern California (N = 1,590 participants) from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study (Non‐Hispanic (NH) Black = 411; NH Asian = 380; NH white = 477; LatinX = 322). The EDS is a 9‐item scale with six response categories that range from “almost everyday” to “never”. The EDS was administered to each participant at baseline. We used confirmatory factor analysis to evaluate unidimensionality in the combined sample and in the 4 racialized subgroups. We identified model modifications that improved fit in a random 50% subsample of each group and tested fit of the modified model in the other random 50%.ResultLoadings for all items on the main factor were &gt; 0.50 for each racialized group and for the full sample. There were issues with model fit with the full sample, which were improved when residual correlations were set between items “courtesy” and “respect” and between “insult” and “threat”. Cross‐validated model fit was improved after adding these parameters to the model and was best in groups racialized as Black and LatinX (Table 1).ConclusionThe EDS is a commonly used assessment in aging studies purporting to capture effects of discrimination on a variety of health and psychosocial outcomes. Our study show that all EDS items are strongly associated with underlying construct of discrimination in all groups, though differentially. Further work is needed to determine if the identified residual correlations point to additional factors that are important to measure. Model fit suggests the EDS is better suited to capture discrimination in groups racialized as Black and LatinX groups, which is consistent with the development of the scale. This study expands the literature by carefully examining the measurement properties of the EDS among four racialized groups.

Experiences of everyday discrimination and use of online resources in a population-based sample of breast cancer survivors.

318 Background: For many cancer survivors, clinical spaces may not feel safe for support and information seeking. Individuals experiencing more discrimination in their daily lives may be more likely to seek resources online. Given the varying quality of online resources, understanding this relationship is important as it may exacerbate existing breast cancer survivorship disparities. Methods: The iCanCare study is a longitudinal study of women diagnosed with breast cancer in 2014-15 identified in the Los Angeles and Georgia Surveillance, Epidemiology and End Results registries. Women were surveyed during initial treatment and again 6 years later in survivorship (2021-22) (Expected final N=1430, 60% current response rate). Respondents were asked about the frequency of 5 types of perceived discrimination in the past 12 months using the short Everyday Discrimination scale. Responses were averaged to generate a mean discrimination frequency (range: 0 (never) - 5 (almost every day)). Respondents were also asked, in the past 12 months 1) how often they had looked online for medical information related to their breast cancer follow-up care and 2) how often they had used social medial to offer or receive support for breast cancer related issues. Responses were categorized into never vs. any. The associations between everyday discrimination and dependent variables 1) online information seeking and 2) online support seeking were evaluated using multivariable-adjusted logistic regression models adjusted for demographics and socioeconomic status. Results: In this sample of 1,058 women with complete responses, 42.2% reported seeking medical information related to survivorship care online and 22.0% reported seeking online support related to their breast cancer. Being treated with less respect than other people (24.3%) and people acting as if they think you are not smart (20.2%) were the most experienced types of discrimination, but “never” was the most common frequency for each type of discrimination. The mean discrimination frequency across the sample was 0.25 (range: 0 (never)-4.2 (once a week)). Mean discrimination frequency was highest in black women (mean=0.35), Latina women (mean=0.31), and people with no insurance (mean=0.49) (P&lt;0.01). In the adjusted model, a one-unit increase in average discrimination frequency was associated with 50% higher odds of online information seeking (OR 1.52 CI 1.16, 1.99) and twice the odds of using social media for breast cancer support (OR 2.15 CI 1.31, 3.52). Conclusions: In this sample of early-stage breast cancer survivors, more frequent experiences of discrimination were associated with higher likelihood of online information and support seeking for breast cancer. Future work delineating the validity of information sources for patients is needed to prevent worsening disparities.

Caring Self-Efficacy of Personal Care Attendants From English-Speaking and Non-English-Speaking Countries Working in Australian Residential Aged Care Settings.

Objectives: This study compared the caring self-efficacy between personal care attendants (PCAs) from English-speaking and non-English-speaking countries, controlling for potential sociodemographic and work-related covariates. PCAs' perceptions of their caring self-efficacy were further explored. Methods: An independent samples t-test was used to determine the mean difference in the caring self-efficacy score between the two groups. A multivariate analysis was conducted to adjust for covariates. Thematic analysis was conducted on open-ended responses. Results: The results showed that caring self-efficacy was significantly influenced by whether participants primarily spoke English at home rather than where they were born. Younger age and everyday discrimination experiences were negatively associated with caring self-efficacy. Both groups perceived that inadequate resources and experiencing bullying and discrimination reduced their caring self-efficacy. Discussion: Access to organisational resources and training opportunities and addressing workplace bullying and discrimination against PCAs, particularly younger PCAs and those from non-English-speaking backgrounds, could improve their caring self-efficacy.

Examining characteristics and experiences of Black firearm owners.

The present study sought to better understand the characteristics of those who own firearms in the Black community; and to understand how Black firearm owners differ from nonfirearm owning Black individuals on a variety of variables related to safety, threat concerns, and suicide risk. Two samples were utilized in this study. The first was a subsample of those who identified as Black from a nationally representative sample (N = 502) seeking to understand firearm ownership within the United States. The second used a subsample of those who identified as Black (N = 1086) from a representative sample from New Jersey, Minnesota, and Mississippi. Variables related to safety and threat concerns were included in the second sample. In both samples, multiple demographic variables, such as being a woman and having higher education, predicted firearm ownership. In the second sample, experiences of everyday discrimination and crime experiences were associated with firearm ownership. Additionally, Black firearm owners reported significantly more suicidal ideation than Black nonfirearm owners. The findings demonstrate the unique characteristics and experiences of Black firearm owners and show that firearm ownership is associated with increased suicide risk factors for Black adults. Findings should be used to advocate for the creation of more culturally relevant suicide prevention and firearm means safety strategies.

Discrimination and cognitive failures in Singapore and the US: An investigation of between- and within-persons associations through multilevel modelling

Experiencing everyday discrimination can have a significant negative impact on an individual’s wellbeing. While much attention has been paid to the physical and mental health consequences of discrimination, less is known about how discrimination can affect cognitive health, and most existing work has been conducted in laboratory settings where participants recall discrimination retrospectively. Given the artificial environment and susceptibility to recall bias in such procedures, the current study utilised two daily diary studies, consisting of young adults in Singapore (Study 1; N = 484) and midlife adults from the US (Study 2; N = 3577), to examine the association between discrimination and cognitive failures in daily life. Multilevel modelling revealed consistent evidence that experiencing discrimination was associated with poorer cognitive health at both the within- and between-person levels. These associations between discrimination and cognitive health remained robust even after controlling for demographic covariates previously found to affect cognitive health, as well as daily stressor exposure. These findings suggest that the experiences of everyday discrimination may lead to poorer daily cognitive functioning regardless of whether discrimination was experienced in a daily context or across the lifespan, and indicate importance of raising awareness on the harmful cognitive consequences of discrimination.

Racism-Related Experiences and Adiposity: Findings From the Black Women's Experiences Living With Lupus (BeWELL) Study.

Studies suggest that higher rates of excess adiposity in Black women may in part be driven by experiences of racism. Racial microaggressions, which include unintentional and subtle slights and insults, and responses to racism such as racism-related vigilance, may contribute to adiposity in this population. This study examined these understudied racism-related facets as well as interpersonal racial discrimination in relation to adiposity in a cohort of Black women with systemic lupus erythematosus. Data are from the Black Women's Experiences Living with Lupus (BeWELL) Study (2015-2017; n=432). Linear regression was used to examine adiposity measures (body mass index [BMI], percent body fat, and waist-to-hip ratio), measured during a physical examination, in relation to self-reported measures of racial microaggressions, racism-related vigilance, and interpersonal racial discrimination. Compared with infrequent microaggressions, very frequent experiences of microaggressions were associated with 2.9kg/m2 higher BMI (95% confidence [CI], 0.63-5.21) and 2.6% higher body fat (95% CI, 0.32-4.80) after adjusting for covariates. Racism-related vigilance, measured continuously, was positively associated with BMI (b=0.84; 95% CI-0.08, 1.61) and percent body fat (b=0.89; 95% CI, 0.14-1.64). Very frequent experiences of everyday discrimination were associated with a higher BMI (b=2.70; 95% CI, 0.58-4.83) and waist-to-hip ratio (b=0.32; 95% CI, 0.09-0.55) compared with less frequent everyday discrimination. Our results suggest that various dimensions of racism are associated with excess adiposity. Efforts to address obesity among Black women with systemic lupus erythematosus should consider these multiple aspects to decrease racial inequities in adiposity.

Health outcomes and female genital mutilation/cutting: how much is due to the cutting itself?

While Female Genital Mutilation/Cutting (FGM/C) continues to garner global attention, FGM/C-affected migrant communities, who are often racialized minorities in the U.S., face additional challenges which may impact their physical and mental health and well-being. It has been proposed that an overly narrow focus on the female genitalia or FGM/C status alone, while ignoring the wider social experiences and perceptions of affected migrant women, will result in incomplete or misleading conclusions about the relationship between FGM/C and migrant women’s health. A cross-sectional study was conducted across two waves of Somali and Somali Bantu women living in the United States, (n = 879 [wave 1], n = 654 [wave 2]). Socio-demographics, self-reported FGM/C status, perceived psychological distress, and self-reported FGM/C-related health morbidity was examined against self-reported experiences of everyday discrimination and perceived psychosocial support. In statistical models including age and educational attainment as potentially confounding socio-demographic variables, as well as self-reported FGM/C status, self-reported discrimination, and perceived psychosocial support, self-reported discrimination was the variable most strongly associated with poor physical health and psychological distress (i.e., FGM/C-related health morbidity and psychological distress), with greater perceived psychosocial support negatively associated with psychological distress, when controlling for all the other variables in the model. FGM/C status was not significantly associated with either outcome. Discrimination, more frequently reported among ‘No FGM/C’ (i.e., genitally intact or unmodified) women, was most frequently perceived as linked to religion and ethnicity. Our findings are consistent with views that discrimination drives negative outcomes. In this population, discrimination may include the ‘quadruple jeopardy’ of intersecting relationships among gender, race, religion, and migration status. We find that self-reported experiences of discrimination—and not FGM/C status per se—is associated with adverse physical and mental health consequences in our sample drawn from Somali migrant communities living in the United States, and that social support may help to mitigate these consequences. Our findings thus reinforce calls to better contextualize the relationship between FGM/C and measures of health and well-being among Somali women in the United States (regardless of their FGM/C status), taking psychosocial factors more centrally into account.Clinical Trials.Gov ID no. NCT03249649, Study ID no. 5252. Public website: https://clinicaltrials.gov/ct2/show/NCT03249649

TOXIC STRESS, RESILIENCY RESOURCES, AND TIME TO DEMENTIA DIAGNOSIS AMONG AMERICANS AGED ≥50 YEARS IN THE HRS 2006–2016

Abstract Toxic stress (TS), resiliency-promoting factors (RPFs) and their interactions were investigated in relationship to incident dementia in a sample (n = 6516) of US adults ≥50 years old enrolled in the HRS between 2006-2016. TS included experiences of everyday discrimination and RPF included personal mastery. Race/ethnicity was self-reported as African American (AA), Caucasian, or Other. Multivariable Cox proportional hazards regression models estimated TS-, RPF- and race-associated hazard ratios (HR) for dementia diagnosis and 95% confidence intervals (CIs) with adjustment for comorbidity and socio-demographic factors. Discrimination-associated risk of dementia diagnosis on average increased with education level [discrimination x education, p = 0.032; HR = 1.75 (95% CI: 1.01–3.03) if &amp;lt; high school, HR = 5.67 (95% CI: 2.94–10.94) if high school completed and HR = 2.48 (95% CI: 1.53–4.00) if ≥some college education]. Likewise, AA vs. Caucasian race disparity in new-onset dementia was evident (HR = 2.12, 95% CI: 1.42–3.17) among adults with high-mastery while absent (HR = 1.35, 95% CI: 0.75–2.41) among adults with low mastery (Mastery x Race, p = 0.01). TS is a contextual driver of incident dementia that seemingly operates in a race and RPF-dependent manner. Heterogeneity pattern suggests that TS may overwhelm the cognitive reserve benefit of RPF particularly in status-inconsistent contexts including persons subjected to discrimination despite high education and in AA individuals despite high mastery. Policies that reduce discrimination and promote equitable treatment by race/ethnicity may support cognitive resiliency and reduce the risk of dementia diagnosis in adult Americans.

FINDING THE MINDS OF OUR ELDERS: TESTING THE MINORITY STRESS AND COGNITION MODEL WITH INDIGENOUS OLDER ADULTS

Abstract This study used data from the Health and Retirement Study (HRS) data to investigate how an understudied group of Indigenous Older Adults (IOAs) in the United States fared over a 14-year period (2006-2020) in the domain of global cognitive function. The number of IOAs, defined here as Native American and Alaska Natives, will more than double in the next 30 years. Concurrently, the number of IOAs living with cognitive impairments will also increase. Guided by the Minority Stress and Cognition Model, we tested the hypothesis that discriminatory stress increases the risk of cognitive impairment in later life. Using a robust set of psychosocial (e.g. educational quality, perceived everyday discrimination experiences), behavioral (e.g. substance use, exercise), and physiological (e.g. diabetes, hypertension, obesity) risk factors, we modeled the cognition trajectories 186 IOAs using mixed growth curves. We found that one third of these IOAs reported experiencing everyday discrimination at least once per month, the highest of any ethnic group. They also reported high rates of other risk factors for cognitive impairment like low education, SES, and physical activity, and high rates of depression and chronic health conditions. Our analysis found that everyday discrimination was negatively associated with total cognition among IOAs but that this relationship was mediated by allostatic loads. On average, the total cognition scores of IOAs declined significantly faster than those of Whites. This study has important implications for the integration of stress as a mechanism for cognitive decline and the health equity of Indigenous older adults.

Body image disturbance and associated eating disorder and body dysmorphic disorder pathology in gay and heterosexual men: A systematic analyses of cognitive, affective, behavioral und perceptual aspects.

This study contributes to the quantitatively large, yet narrow in scope research on body image in gay men by assessing whether gay and heterosexual men systematically differ on various dimensions of body image disturbance and associated pathology, i.e., eating disorder and body dysmorphic disorder symptoms. Moreover, we examined the influence of general everyday discrimination experiences and involvement with the gay community on body image. N = 216 men (n = 112 gay men, n = 104 heterosexual men) participated in an online survey measuring the discrepancy between self-rated current and ideal body fat/ muscularity; drive for leanness, muscularity, and thinness; body satisfaction; body-related avoidance and checking; appearance fixing; overall body image disturbance; eating disorder and body dysmorphic disorder pathology; general everyday discrimination experiences; and involvement with the gay community. Gay men showed a greater discrepancy between self-rated current and ideal body fat; higher drive for thinness, body-related avoidance, appearance fixing, overall body image disturbance, eating disorder and body dysmorphic disorder pathology; and lower body appreciation than heterosexual men (all p ≤ .05). Contrary to expectation, everyday discrimination experiences were more strongly associated with body image disturbance and eating disorder/ body dysmorphic disorder pathology in heterosexual men than in gay men (all p ≤ .05). Gay community involvement was not associated with any body image disturbance-, ED-, or BDD aspect in gay men (all p ≥ .20). The results suggest greater body image disturbance in gay men than in heterosexual men regarding cognitions, emotions, behaviors, and perception as well as higher eating disorder and body dysmorphic disorder pathology. The results also suggest the dilemma of a thin, yet muscular body ideal in gay men. Surprisingly, discrimination experiences and involvement with the gay community did not explain differences in body image disturbance. Gay men may have become resilient to discrimination over time, and body ideals might differ across gay sub-communities.

Contextualising measures of everyday discrimination experienced by Aboriginal peoples: A place-based analysis from central Australia

Everyday discrimination is a deeply personal experience, which is influenced by the wider community, as well as complex social and historical contexts. In Australia, the most recent national data for Aboriginal and Torres Strait Islander peoples reports the highest prevalence of everyday discrimination among those living in remote regions compared with urban and regional areas. Given the diversity in settlement types in remote Australia, a place-based analysis can inform the extent of discrimination experienced and the impact on communities. This study used a mixed method approach to identify Indigenous community member understandings of discrimination and quantify everyday discrimination in Central Australia by settlement. Drawing on workshop data from community members, we defined two research questions: Do experiences of everyday discrimination vary according to where people live? What role does community cohesion have on experiences of discrimination? We used data from the Mayi Kuwayu Study to explore these questions. The studyfound a high prevalence of everyday discrimination, with 70.6% (n/N = 369/523) of Mayi Kuwayu participants in Central Australia experiencing any discrimination which triangulated with people's experience of overt racism. Discrimination varied by settlement type, with higher prevalence of experiencing any discrimination among participants in Town Camps (unadjusted PR 1.33, 95%CI 1.18–1.50) and suburbs (1.19, 1.05–1.35) compared to participants from remote communities. High community cohesion attenuates the prevalence of the discrimination (0.87, 0.77–0.97). If health and social outcomes are to improve among Aboriginal people in remote areas, societal responses must acknowledge the high prevalence of discrimination in places where race and social inequalities are stark, act to confront interpersonal and systemic prejudices, and build cohesive communities.