Democracy Intercepted.

Did platform feeds sow the seeds of deep divisions during the 2020 US presidential election?

Who belongs in America? Latinxs' skin tones, perceived discrimination, and opposition to multicultural policies.

OBJECTIVE: Consequences of colorism are well documented, yet little is known about its relationship with political views of racial/ethnic minorities. Although a very small literature found no evidence that skin tone shapes political attitudes of Latinx Americans, the present study was the first to extend this to immigration and language policy preferences. Because support for public policies is an important mechanism through which inequality is either reduced or reproduced, this filled an important gap in the literature on colorism and political behavior. METHOD: Using binary or ordered logistic regression, skin tone, perceived discrimination, and demographic characteristics were examined as predictors of Latinxs' policy preferences for U.S. border security and/or mandated use of English. Several probability samples were analyzed: one national sample (N = 430), as well as other national (N = 349, mean age 41), regional (N = 256, mean ages 36-40), and nationally representative samples (N = 8,065, mean ages 32-35). RESULTS: Relative to their counterparts, the lightest-skinned Latinx women were more tolerant of restrictive policies-tighter border security and a preference for English as the only official language. Among Latinx men, medium-skinned subgroups reported the most unfavorable opinions about a U.S. border wall policy whereas lighter-skinned men were less opposed to this policy. CONCLUSIONS: Findings suggested that skin tone biases may be tied to men's engagement on border security issues and women's support for language and border policies. Therefore, colorism may be implicated in important processes that shape American politics and Latinx public opinion. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Dark and sick, light and healthy: black women's complexion-based health disparities.

Objective: Although research on skin tone inequalities suggest that darker-skinned Black women should experience worse health outcomes than lighter-skinned women, findings have been mixed. The present study investigates the possibility that the manner that stress and health are measured (i.e. global versus count measures) may explain the conflicting findings. Design: Black American women of different skin tones were investigated in two cross-sectional samples: the National Longitudinal Study of Adolescent to Adult Health (N = 571) and the Detroit Area Study (N = 290). Women's skin tone health disparities were examined using both objective (i.e. directly measured) or count measures (i.e. number of diagnosed chronic health conditions) as well as a global measure of health (i.e. self-rated health - SRH). Additionally, in the Detroit Area Study (DAS), disparities in stress exposure were examined using count and global measures. Results: Skin tone did not predict global measures of health (i.e. SRH) in both samples. In contrast, skin tone predicted objective and count measures of health in both samples, and the disparities between dark- and light-skinned women were starker among higher SES populations. Furthermore, DAS analyses of stress measures indicated that skin tone did not predict a global measure of stress but significantly predicted a count measure of stress (i.e. life events) since dark-skinned women reported worse outcomes. Conclusions: Health disparities research will benefit from accounting for Black women's skin tones as an important social determinant of health. Additionally, use of subjective measurements of health (e.g. SRH) may conceal within-race health disparities across complexions as well as obscure the magnitude of disparities across race.

A comparison of skin tone discrimination among African American men: 1995 and 2003.

This study investigated perceptions of skin tone discrimination among adult African American men. Research suggests that through negative African American stereotypes, out-group members (Whites) perceive light-skinned African Americans favorably and dark-skinned African Americans unfavorably. However, it is unclear how treatment by in-group members (other African Americans) uniquely affects men. Using data from the 1995 Detroit Area Study and the 2003 National Survey of American Life, we investigated these relationships among African American men representing a wide range of socioeconomic groups. We found that African American men's perceptions of out-group and in-group treatment, respectively, were similar across time. Light-skinned men perceived the least out-group discrimination while dark-skinned men perceived the most out-group discrimination. In appraisals of skin tone discrimination from in-group members, medium-skinned men perceived the least discrimination while both light- and dark-skinned men perceived more in-group discrimination. Additionally, men of lower social economic groups were more affected by skin tone bias than others. Future research should explore the influence of these out- and in-group experiences of skin tone discrimination on social and psychological functioning of African American men.

Is ignorance bliss? Depression, antidepressants, and the diagnosis of prediabetes and type 2 diabetes.

OBJECTIVE: To examine the association between clinically identified and undiagnosed prediabetes and Type 2 diabetes with depression and antidepressant medication use. METHODS: Data come from the National Health and Nutrition Examination Study (2005 and 2007), a population-based cross-sectional survey. Analysis is limited to adults aged 30 and older (n = 3,183, Mean age = 52.1 year). Depression syndrome was measured by the Patient Health Questionnaire-9. Participants were categorized using fasting glucose levels as normoglycemic (glucose <100 mg/dL), undiagnosed prediabetes (glucose 100-125.9), clinically identified prediabetes (glucose 100-125.9 plus clinician diagnosis), undiagnosed Type 2 diabetes (glucose >126), and clinically identified Type 2 diabetes (glucose >126 plus clinician diagnosis or use of antidiabetic medications). Health behaviors included smoking, poor diet, excessive alcohol use, and obesity. Health promotion behaviors included efforts to change diet, lose weight, and increase physical activity. RESULTS: Clinically identified diabetes was associated with 4.3-fold greater odds of depression, but undiagnosed diabetes was not significantly associated with depression. This relationship was more pronounced for prediabetes. Clinically identified diabetes was associated with 1.8-fold greater odds of antidepressant use, but undiagnosed diabetes was not significantly associated with antidepressant use. Health behaviors were not consistently related to depression syndrome. CONCLUSION: The relationship between diabetes status and depression and antidepressant use depends on whether the diabetes has been clinically identified. Findings are consistent with the hypothesis that the relationship between diabetes and depression may be attributable to factors related to disease management. Previous reports linking antidepressants and diabetes may be attributable to clinical ascertainment bias.

What does it take to have sustained use of decision aids? A programme evaluation for the Breast Cancer Initiative.

BACKGROUND: The Breast Cancer Initiative (BCI) was started in 2002 to disseminate breast cancer decision aids (PtDAs) to providers. METHODS: We analysed BCI programme data for 195 sites and determined the proportion of sites involved in each of five stages of dissemination and implementation of PtDAs. We conducted cross-sectional mail and telephone surveys of 79 sites with the most interest in implementation. We examined barriers associated with sustained use of the PtDAs. RESULTS: Since 2002 we attempted contact with 195 sites to join the BCI. The majority indicated interest in using PtDAs 172 of 195 (88%), 93 of 195 signed up for the BCI (48%), 57 of 195 reported distributing PtDAs to at least one patient (57%), and 46 of 195 reported sustained use (24%). We analysed data from interviews with 59 of 79 active sites (75% response rate). The majority of providers 49 of 59 (83%) had watched the PtDAs, and 46 of 59 (78%) distributed them to patients. The most common barriers were lack of a reliable way to identify patients before decisions are made (37%), a lack of time to distribute the PtDAs (22%) and having too many educational materials (15%). Sites that indicated a lack of clinician support as a barrier were significantly less likely to have sustained use compared to sites that didn't (33% vs. 74%, P = 0.02). CONCLUSIONS: Community breast cancer providers, both physicians and non-physicians, express a high interest in using PtDAs with their patients. About a quarter of sites report sustained use of the PtDAs in routine care.

Developing instruments to measure the quality of decisions: early results for a set of symptom-driven decisions.

OBJECTIVE: To identify a set of critical facts and key goals and concerns for five common medical conditions, benign prostate disease, hip and knee osteoarthritis, herniated disc and spinal stenosis and examine the validity of the method for identifying these items. METHODS: Investigators identified facts and goals through literature reviews and qualitative work with patients and providers. A cross-sectional survey of patients and providers was conducted to examine the accuracy, importance and completeness of the identified items. RESULTS: 42 facts (6-16 per condition) and 31 goals and concerns (4-13 per condition) were identified. 182 responses were obtained from patients (76.5% response rate) and 113 responses from providers (78% response rate). Overall, the facts were accurate, important and complete across all conditions. For one condition (hip osteoarthritis), the goals did not meet the criteria for completeness. There was more disagreement between patients and providers around the ranking of goals than of facts. CONCLUSIONS: Overall, respondents found the identified facts and goals accurate, important and complete. Significant differences between patients' and providers' rankings highlight the importance of including both perspectives. PRACTICE IMPLICATIONS: Instruments to measure whether or not patients are informed and the extent to which treatments reflect patients' goals must balance patients' and providers' perspectives when selecting items to include.