Low Socioeconomic Status African Americans Research Articles

Testing the John Henryism Hypothesis on Cardiometabolic Health Among Older African Americans

In the context of racism, the John Henryism Hypothesis posits that prolonged high-effort coping, which is referred to as John Henryism, may take a toll on physical health among individuals from low socioeconomic status (SES) backgrounds, particularly low SES African Americans. This study aimed to test the John Henryism Hypothesis among older African Americans by examining the combined effect of John Henryism and childhood SES on cardiometabolic health indexed by metabolic syndrome and systemic inflammation. Data were drawn from a sample of 170 urban older African Americans (Mage = 67.4 years, 75.9% female), who completed questionnaires assessing John Henryism and childhood SES (i.e., parental education). Blood pressure, waist circumference, and fasting blood were also collected to assess metabolic syndrome and systemic inflammation. Results indicated that John Henryism was significantly associated with elevated metabolic syndrome symptoms among older African Americans reporting low childhood SES (b = 0.42, 95%CI = [0.02, 0.83]), but not among those with high childhood SES (b = -0.33, 95%CI = [-0.78, 0.13]). This result was robust to a variety of demographic variables, lifestyle behavioral factors, and health conditions that are known to be associated with metabolic syndrome. A similar pattern of results, however, did not emerge for systemic inflammation. Our findings highlight the importance of considering the joint impact of early childhood socioeconomic backgrounds and individual psychological proclivities in explaining the elevated cardiovascular disease risk among older African Americans.

Abstract 639: Dietary polyunsaturated fatty acids intake and pancreatic cancer risk in understudied populations

Abstract Background: Pancreatic cancer (PC) is one of the deadliest malignancies. Lab based research suggests that two types of polyunsaturated fatty acids (PUFA), n-3 and n-6 PUFA, may have opposing effects on PC carcinogenesis. However, human evidence on the role of dietary PUFA intake in PC risk is inconsistent. Previous epidemiological studies on this topic were conducted primarily among Whites and included few individuals from low socioeconomic status (SES). The exposure patterns of n-3 and n-6 PUFA differ across racial groups, with African Americans (AAs) in the high end and Asians in the low end of range. To better characterize the associations of PUFA with PC risk, we conducted a nested case-control study focusing on understudied Asians and low SES AAs and Whites. Methods: We performed a nested case-control study within three population-based prospective cohort studies: the Shanghai Women’s Health Study (SWHS), Shanghai Men’s Health Study (SMHS), and Southern Community Cohort Study (SCCS). Dietary PUFA intakes and other variables were collected from the baseline dietary and other questionnaires. Participants were followed up through annual linkage to cancer registries. Controls were matched to cases on age, sex, and blood sample availability in SWHS/SMHS, and age, sex, race, and enrollment location in SCCS, using incidence density sampling (case-to-control ratio:1:4). Included in the study are 244 cases and 973 controls of Asian females in SWHS, 189 cases and 755 controls of Asian males in SMHS, and 307 cases and 1,228 controls in SCCS (including 219 cases and 876 controls of AAs). The PUFA intake was adjusted for total energy intake using the residual method. Conditional logistic regression analyses were performed to estimate the association of PC risk with dietary PUFA consumption after adjusting for potential covariates. Results: The average dietary intake (mean ± SD; g/day) of n-3 and n-6 PUFA were 1.0 ± 0.5 and 6.3 ± 3.1, 1.1 ± 0.5 and 7.2 ± 3.0, and 2.0 ± 1.2 and 19.3 ± 11.7 in the controls of SWHS, SMHS and SCCS, respectively. We observed that in Chinese men, high intakes of certain n-3 PUFA were significantly associated with increased PC risk. The adjusted odds ratio (OR) (95% confidence interval (CI)) comparing the highest versus lowest quartile of docosapentaenoic acid (DPA) was 1.79 (1.10-2.93), with a p for trend across quartiles of 0.02. For docosahexaenoic acid (DHA), the OR 4th vs. 1st quartile (95% CI) = 1.71 (1.06-2.78) (p for trend = 0.04). For marine n-3 PUFA, the OR 4th vs. 1st quartile (95% CI) = 1.69 (1.03-2.76) (p for trend = 0.04). There was no significant association for n-6 PUFA. No significant association was observed for n-3 or n-6 PUFA with PC risk in SWHS or SCCS. Conclusions: In a nested case-control study, we observed that in Chinese men, the dietary intake of overall marine n-3 PUFA, DPA, and DHA were positively associated with PC risk. Such associations were not observed in Chinese women or low SES AAs/Whites. Citation Format: Lang Wu, Wei Zheng, William J. Blot, Mark D. Steinwandel, Wanqing Wen, Yong-Bing Xiang, Yu-Tang Gao, Hong-Lan Li, Rachael Stolzenberg-Solomon, Harvey J. Murff, Xiao-Ou Shu. Dietary polyunsaturated fatty acids intake and pancreatic cancer risk in understudied populations [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 639.

Distributions of Subclinical Cardiovascular Disease in a Socioeconomically and Racially Diverse Sample.

Differential subgroup vulnerability to subclinical cardiovascular disease is likely, and yet few, if any, studies have addressed interactive relations of age, sex, race, and socioeconomic status (SES) to these conditions to examine nuances of known health disparities. We examined distributions of carotid atherosclerosis and arterial stiffness in a socioeconomically diverse, biracial, urban sample. Participants (n=2270) in the population-based HANDLS study (Healthy Aging in Neighborhoods of Diversity Across the Life Span; 30-64 years old, 44% men, 57% African American, 39% with household income <125% federal poverty threshold) underwent carotid intimal medial thickness (IMT) and pulse wave velocity assessment. In cross-sectional hierarchical regression analyses, interactive race×SES effects were identified for IMT and pulse wave velocity, such that high SES African Americans had significantly thicker IMTs and faster pulse wave velocities than all other subgroups (ie, low SES African Americans, low SES whites, and high SES whites). A race×sex effect was also identified for IMT, such that the IMT discrepancy between white men and women was more pronounced than the discrepancy between African American men and women. Finally, an SES×sex effect indicated that while IMTs of high SES and low SES men did not significantly differ, high SES women had marginally thicker IMTs than low SES women. High SES African Americans may be particularly vulnerable to subclinical cardiovascular diseases, placing them at enhanced risk for clinical cardiovascular diseases, including stroke. These findings suggest that male sex, low SES, and African American ancestry may represent imprecise generalizations as risk factors for subclinical cardiovascular disease.

Cumulative burden of lifetime adversities: Trauma and mental health in low-SES African Americans and Latino/as.

This study examined the utility of a lifetime cumulative adversities and trauma model in predicting the severity of mental health symptoms of depression, anxiety, and posttraumatic stress disorder. We also tested whether ethnicity and gender moderate the effects of this stress exposure construct on mental health using multigroup structural equation modeling. A sample of 500 low-socioeconomic status African American and Latino men and women with histories of adversities and trauma were recruited and assessed with a standard battery of self-report measures of stress and mental health. Multiple-group structural equation models indicated good overall model fit. As hypothesized, experiences of discrimination, childhood family adversities, childhood sexual abuse, other childhood trauma, and chronic stresses all loaded on the latent cumulative burden of adversities and trauma construct (CBAT). The CBAT stress exposure index in turn predicted the mental health status latent variable. Although there were several significant univariate ethnic and gender differences, and ethnic and gender differences were observed on several paths, there were no significant ethnic differences in the final model fit of the data. These findings highlight the deleterious consequences of cumulative stress and trauma for mental health and underscore a need to assess these constructs in selecting appropriate clinical interventions for reducing mental health disparities and improving human health.

Sociopolitical development, work salience, and vocational expectations among low socioeconomic status African American, Latin American, and Asian American youth.

Structural barriers constrain marginalized youths' development of work salience and vocational expectations. Sociopolitical development (SPD), the consciousness of, and motivation to reduce, sociopolitical inequality, may facilitate the negotiation of structural constraints. A structural model of SPD's impact on work salience and vocational expectations was proposed and its generalizability tested among samples of low-socioeconomic-status African American, Latin American, and Asian American youth, with Educational Longitudinal Study data. Measurement and temporal invariance of these constructs was first established before testing the proposed model across the samples. Across the three samples, 10th-grade SPD had significant effects on 10th-grade work salience and vocational expectations; 12th-grade SPD had a significant effect on 12th-grade work salience. Tenth-grade SPD had significant indirect effects on 12th-grade work salience and on 12th-grade vocational expectations for all three samples. These results suggest that SPD facilitates the agentic negotiation of constraints on the development of work salience and vocational expectations. Given the impact of adolescent career development on adult occupational attainment, SPD may also foster social mobility among youth constrained by an inequitable opportunity structure.

Literacy-based normative data for low socioeconomic status African Americans

Clinical neuropsychology relies on the use of appropriate test norms. Normative studies frequently stratify based on age, education, sex, and race. None to date has reported norms based on literacy, despite the substantial evidence that literacy impacts cognitive functioning. Some researchers have suggested that literacy is a more accurate reflection of academic achievement and quality of education than years of education, particularly for African Americans. The current study provides literacy-based normative data for multiple neuropsychological measures based on a sample of predominantly low socioeconomic status African Americans. These normative data should improve the diagnostic accuracy of performances by African-American clients with similar demographic backgrounds.

Absence of racial predilection for aggressive tumor phenotype among low socio-economic status women with breast cancer

10554 Background: Survival disparity for African-American (AA) women with breast cancer has been associated with more frequent aggressive tumor phenotype, manifested as higher stage, high grade and negative estrogen/progesterone receptor (ER/PR) status. However, AAs more often have low socioeconomic status (SES), and other studies suggest that low SES, not simply race, is associated with these prognostic features. We hypothesized that low SES AAs and non-AAs with breast cancer would demonstrate similar aggressive tumor phenotype and prognosis. Methods: Variables were analyzed for 538 consecutive low SES women treated between 1/00–12/05. Comparison between racial groups was done with independent t-test &amp; Chi-square test. Associations were examined with logistic-regression, and compared as odds ratios (OR) &amp; 95% confidence intervals (CI). Survival was computed using Log-rank test &amp; Kaplan-Meier method. Results: At median follow-up of 32 months, there were 335 AAs &amp; 203 non-AAs. No significant differences occurred between racial groups for tumor size &amp; grade, node status, stage, ER/PR status, and frequency of survival events. HER2+ status was more frequent in non-AAs (25.1% vs. 17.9% AAs; p=0.048). No significant differences occurred between races for treatment with surgery, chemo &amp; endocrine therapy, however radiation was more common in non-AAs (73.4% vs. 62.2% AAs; p=0.012) but AAs were significantly older (p=0.0001) and had more comorbid disease (p=0.0001). See Table for prevalence of aggressive tumor features. Age-adjusted logistic-regression showed no racial predilection for negative ER/PR, high grade and higher stage, but AAs were less likely to be HER2+ (OR=0.644; 95% CI=0.415–1.00; p=0.05). Log-rank tests showed no differences between racial groups for age &amp; stage-specific disease-free &amp; overall survival. Conclusions: These results confirm that among similar low SES women with breast cancer, there is no racial predilection for aggressive tumor phenotype and poor prognosis. [Table: see text] No significant financial relationships to disclose.

Influence of medical conditions on executive and memory functions in low socioeconomic status African Americans

We examined the association of total comorbid score and specific chronic conditions including cardiovascular diseases, musculoskeletal conditions, diabetes mellitus, stroke, hypertension, and cancer with several cognitive domains across four different age groups: young adults (ages 18–34), young middle-aged adults (ages 35–50), middle-aged adults (ages 51–64), and older adults (ages >64). Cognitive tests measuring global ability, executive function, memory function, and perceptual speed ability were administered to 384 African Americans. Total comorbid score was computed by summing up the number of chronic conditions. Results showed an inverse association between total comorbid scores and executive and memory functions in the total sample. With the exception of the youngest group, stroke was the only prominent predictor of poor performance for all age groups, but the impact was greater in the younger age groups compared with older adults. These results suggest that the impact of medical conditions on domain specific tasks may be modified by age.

Factorial invariance of the CES-D in low socioeconomic status African Americans compared with a nationally representative sample

This study examined the factor structure of the Center for Epidemiologic Studies Depression Scale (CES-D) in low socioeconomic status African Americans ( n=426). Confirmatory factor analysis indicated that the four factors—(1) depressed affect, (2) positive affect, (3) somatic complaints, and (4) interpersonal problems—of the CES-D scale previously found in the general population were supported in this sample. These results were cross-validated in other nationally representative samples of African-American participants ( n=988) and Caucasians ( n=666), and the four-factor structure of the CES-D scale replicated in all three groups in this study. An alternative model was also tested with the factors depressed affect and somatic complaints combined as a single factor, a finding often reported in minority groups. Results indicated a significantly poorer fit for the three-factor model compared with the four-factor model for all three groups. In addition, higher loading differences were significantly evident between African-American and Caucasian groups, while higher loading similarities were found between the two African-American groups. These findings provide further evidence of measurement equivalency of the CES-D scale in samples with differential characteristics including race and socioeconomic status.

OP-ED Constructing a liberatory pedagogy in science: Dilemmas and contradictions

Two summers ago the group of second grade girls I taught in science camp seemed to come from a large number of different backgrounds- Korean daughters of graduate students; white middle class children with parents who were musicians and who went river rafting in Colorado on vacations; white working-class girls of fundamentalist religious background; some from blended marriages; two low socio-economic status African Americans on scholarship. Jennifer, a child of intense religious views, chose not to participate in the questioning I was leading the girls through as they compared their experiences with kite flying. She did not participate in the 'science' side of anything we did. She led the class in turning our 'science' into arts and crafts; turning the empirical testing of kite tail design into a workshop on braiding. She polarized the group; her friends were torn between friendship for her and their interest in the group's inquiry. I responded by changing the curriculum to accommodate: I provided many different materials for braiding and then crafts; I asked questions about the qualities of materials in light of what the children wanted to do with them. I asked the children repeatedly to think and articulate ways they thought what we were doing was science. The science became hidden beneath the 'crafts' but it was still there as we examined the properties of materials, testing and assessing them. We designed things and tried to realize them. Such an evolution in the science we were doing happened by responding to the children's wishes rather than forcing them to choose science or their own desires. from the journal of Margery Osborne

Characteristics of social support networks of low socioeconomic status African American, Anglo American, and Mexican American mothers of full‐term and preterm infants

This study examined the relation of ethnicity to two aspects of mothers' social support: structure (friends vs. family) and quality (satisfaction vs. aggravation) for mothers from low socioeconomic (SES) backgrounds in three ethnic groups—Anglo American (n = 53), African American (n = 50), and Mexican American (n = 42). Mothers of both preterm (n = 81) and full-term infants (n = 64) were included. Mothers from Mexican American backgrounds had fewer friends in their networks when compared with mothers in the African American and Anglo American groups. While there were no significant effects for ethnicity on support satisfaction, mothers overall reported more satisfaction with support received from friends rather than family. African American mothers reported significantly more aggravation in their support systems than the other two groups. This was not due to differences for these mothers in their SES or marital status, and are discussed in relation to community differences that appear to be present for this ethnic group. The clinical importance of considering ethnic backgrounds when serving mothers with young children are discussed. © 1998 John Wiley & Sons, Inc.

Characteristics of social support networks of low socioeconomic status African American, Anglo American, and Mexican American mothers of full-term and preterm infants

Characteristics of social support networks of low socioeconomic status African American, Anglo American, and Mexican American mothers of full-term and preterm infants

Characteristics of social support networks of low socioeconomic status African American, Anglo American, and Mexican American mothers of full‐term and preterm infants

This study examined the relation of ethnicity to two aspects of mothers' social support: structure (friends vs. family) and quality (satisfaction vs. aggravation) for mothers from low socioeconomic (SES) backgrounds in three ethnic groups—Anglo American (n = 53), African American (n = 50), and Mexican American (n = 42). Mothers of both preterm (n = 81) and full-term infants (n = 64) were included. Mothers from Mexican American backgrounds had fewer friends in their networks when compared with mothers in the African American and Anglo American groups. While there were no significant effects for ethnicity on support satisfaction, mothers overall reported more satisfaction with support received from friends rather than family. African American mothers reported significantly more aggravation in their support systems than the other two groups. This was not due to differences for these mothers in their SES or marital status, and are discussed in relation to community differences that appear to be present for this ethnic group. The clinical importance of considering ethnic backgrounds when serving mothers with young children are discussed. © 1998 John Wiley & Sons, Inc.

Developing cancer pamphlets for economically disadvantaged African Americans.

Cancer is the second leading cause of death in African Americans. The relatively poor cancer survival prognosis in this population is a consequence of a group which is more likely to be less well educated and which composes one-fourth of the unemployed and one-third of the socioeconomically disadvantaged. While this paper describes the procedures used to create culturally appropriate cancer pamphlets specifically designed for low socioeconomic status African Americans, the same process could be used by health educators interested in developing pamphlets for less well educated populations on a myriad of other topics. Guidelines for collecting relevant educational information, deciding which information to include, formatting issues (e.g., readability and basic design principles), and distribution are discussed.