Intergenerational Mobility and Goal-Striving Stress Among Black Americans: The Roles of Ethnicity and Nativity Status.

Goal-striving stress refers to the psychological consequences of seeking but failing to reach upward mobility and is more common among low-income and people of color. Intergenerational mobility-or improved socioeconomic standing relative to one's parents-may be an important predictor of goal-striving stress for Blacks. We used the National Survey of American Life to investigate the association between intergenerational mobility and goal-striving stress among U.S.-born African Americans, U.S.-born Caribbean Blacks, and foreign-born Caribbean Blacks. Intergenerational mobility was associated with lower goal-striving stress and U.S.-born African Americans and Caribbean Blacks reported lower goal-striving stress than foreign-born Caribbean Blacks. Goal-striving stress was relatively high among foreign-born Blacks, regardless of level of intergenerational mobility attained. Goal-striving is an important stressor for foreign-born Caribbean Blacks, regardless of their level of educational success. Given increasing Black migration, future studies should disaggregate the Black racial category based on ethnicity and nativity.

Chronic adolescent marijuana use as a risk factor for physical and mental health problems in young adult men.

Some evidence suggests that youth who use marijuana heavily during adolescence may be particularly prone to health problems in later adulthood (e.g., respiratory illnesses, psychotic symptoms). However, relatively few longitudinal studies have prospectively examined the long-term physical and mental health consequences associated with chronic adolescent marijuana use. The present study used data from a longitudinal sample of Black and White young men to determine whether different developmental patterns of marijuana use, assessed annually from early adolescence to the mid-20s, were associated with adverse physical (e.g., asthma, high blood pressure) and mental (e.g., psychosis, anxiety disorders) health outcomes in the mid-30s. Analyses also examined whether chronic marijuana use was more strongly associated with later health problems in Black men relative to White men. Findings from latent class growth curve analysis identified 4 distinct subgroups of marijuana users: early onset chronic users, late increasing users, adolescence-limited users, and low/nonusers. Results indicated that the 4 marijuana use trajectory groups were not significantly different in terms of their physical and mental health problems assessed in the mid-30s. The associations between marijuana group membership and later health problems did not vary significantly by race. Findings are discussed in the context of a larger body of work investigating the potential long-term health consequences of early onset chronic marijuana use, as well as the complications inherent in studying the possible link between marijuana use and health effects.

Parental eligibility and enrollment in state children's health insurance program: the roles of parental health, employment, and family structure.

We examined eligibility and enrollment among parents of children in New Jersey's State Children's Health Insurance Program following expansion of parental eligibility for NJ FamilyCare coverage. Data were from the 2003 NJ FamilyCare Family Health Survey (n = 416 families). Parental eligibility was higher in households without a full-time employed parent (odds ratio [OR] = 5.50; 95% confidence interval [CI] = 2.72, 11.14) and lower among single parents (OR = 0.38; 95% CI = 0.23, 0.61). Enrollment was higher among single parents (OR = 2.24; 95% CI = 1.17, 4.31). Roughly one third of eligible parents did not enroll, suggesting the need to increase awareness of parental eligibility and reduce barriers to enrollment.

Is there differential retention of children with special health care needs in the State Children's Health Insurance Program?

OBJECTIVE: The purpose of this work was to determine whether children with special health care needs in New Jersey's State Children's Health Insurance Program are less likely to become uninsured than children without special health care needs. PATIENTS AND METHODS: We used the 2003 New Jersey FamilyCare Supplement to the New Jersey Family Health Survey. Children were randomly selected from the universe of children enrolled in New Jersey FamilyCare as of May 2002, and their families were surveyed during 2003 (N = 675). The Children With Special Health Care Needs Screener was used to identify 5 types of special health care needs. We estimated multinomial logistic regression models of final enrollment status according to the presence of > or = 1 special health care need, controlling for demographic characteristics. RESULTS: Roughly 1 of every 5 children in New Jersey FamilyCare had > or = 1 special health care need. Older children and boys had greater odds of having special health care needs than others. Children with special health care needs had only one fourth the odds of becoming disenrolled and uninsured compared with children without special health care needs, even when controlling for age, gender, race/ethnicity, and insurance plan level. There was no difference in likelihood of finding other health insurance according to children with special health care needs status. CONCLUSIONS: Children with special health care needs were more likely than children without such needs to be covered by health insurance at the time of the survey, either by retaining State Children's Health Insurance Program coverage or by finding other insurance. The higher retention of children with special health care needs in New Jersey FamilyCare is good news for families of these children and their advocates. However, higher health care costs for these children should be considered in federal and state budget planning for the State Children's Health Insurance Program.

Postpartum depression and social support in adolescents.

OBJECTIVE: The purpose of the study was to determine the effectiveness of a social support intervention delivered to pregnant adolescent girls between 32 and 36 weeks of gestation in preventing symptoms of depression at 6 weeks postpartum. DESIGN: The study used a repeated measures design. SETTING: Data were collected at a teenage parenting program, an educational option of the public school system. PARTICIPANTS: Participants (n = 128) were pregnant and postpartum adolescents. MAIN OUTCOME MEASURE: Symptoms of depression at 6 weeks postpartum. INTERVENTION: Participants completed the Postpartum Support Questionnaire, Rosenberg's Self-Esteem instrument, and the Center for Epidemiological Studies of Depression instrument at baseline, then were randomly assigned to one of three intervention groups (pamphlet, video, or pamphlet plus video) or the control group. The content of the intervention was based on a synthesis of the literature describing social support needed and desired by postpartum adolescents. RESULTS: No significant differences were found in Center for Epidemiological Studies of Depression instrument scores among the groups at 6 weeks postpartum. Using path analysis, the authors found that predictors of symptoms of depression at 6 weeks postpartum were (a) receiving more support from friends, family, and others and (b) having low self-esteem. CONCLUSION: These findings differ from earlier studies, and both research and clinical implications are discussed.

Prediction of postpartum social support and symptoms of depression in pregnant adolescents: a pilot study.

Many pregnant adolescents remain in school, creating unique challenges for professionals to meet their educational and health needs. In this descriptive pilot study of pregnant adolescents (n = 26), 68% demonstrated symptoms of depression as measured by the Center for Epidemiologic Studies Depression Scale (CES-D). In addition, there was an expectation by the pregnant adolescent that postpartum social support received, as measured by the Postpartum Support Questionnaire, would be different from what is important to her. As an important part of the team, school nurses are uniquely positioned to screen pregnant adolescents for depression and to assist them in learning how to negotiate for the social support that is important to them.