"We've Always Been Kind of Kicked to the Curb": A Mixed-Methods Assessment of Discrimination Experiences among College Students.

Background: Experiences of discrimination are prevalent among minority populations, although often empirical evidence does not provide depth into the source and types of discrimination, such as racial/ethnic, gender-based, age, etc. The goal of this study was to assess the unique patterns, types, and sources of discrimination experiences that college students face and explore the role these experiences play in their mental health. Methods: An explanatory sequential mixed-methods study was utilized. Quantitative assessment of college students from a Hispanic and minority-serving institution was conducted to evaluate experiences of discrimination and its association to physical health and mental health (including psychological distress), as well as food insecurity, a marker for poverty. Next, qualitative data were thematically analyzed to further provide an in depth understanding on the sources of such experiences, types of discriminations, as well as the impact on mental health. Results: Results of the quantitative assessment highlight that discrimination was prevalent among the population with a higher everyday discrimination score significantly associated with serious psychological distress, low mental health status, low physical health status, and being food insecure. Further, most of the participants reported that they felt discriminated due to their appearance, with race/ethnicity and skin color as next most commonly cited reasons. Qualitative assessment further demonstrates distinct types of discrimination experiences from a variety of sources. Within a family, colorism and having an American accent while speaking a native language was a predominant source, while among peers, having a non-American accent was a primary source of discrimination experiences. Such experiences based on elitism, gender, and age (being younger) from the workplace were prevalent among the target population. Finally, feelings of isolation, not belonging, as well as negative impact on self-efficacy and self-worth were noted. Conclusion: Experiences of discrimination are prevalent among college students, including from within family and peers. To improve mental health outcomes of such a population, campus-based measures are needed to promote resiliency and social support, as well as community-based initiatives to promote workplace training to create inclusive environments for younger generations entering the workforce.

Sex-Specific Association between Environmental Tobacco Smoke Exposure and Asthma Severity among Adults with Current Asthma.

BACKGROUND: Tobacco smoke has been associated with negative health outcomes, including those with chronic respiratory illnesses, such as asthma. This study aimed to assess the relationship between exposure to environmental tobacco smoke (ETS), as well as tobacco use (cigarette and electronic cigarettes), on asthma severity among adults with current asthma, with stratification by sex to understand potential biological sex differences. METHODS: The study population consisted of Californian adults 18 years or older with self-reported physician/health care diagnosis of asthma and still having current asthma from 2020 California Health Interview Survey. All descriptive statistics and analyses were sex-stratified and survey-weighted. Crosstabulations were used to understand the association between asthma attack and ETS or firsthand smoke exposure, while binary logistic regression models were used to assess the effect of ETS exposure, current smoking status, and control variables on asthma attack in the past 12 months, with a sub-analysis among non-smoking adults with asthma. RESULTS: Among the primary variable of interest, 35% of males and 30% of females reported ETS exposure in the past 12 months, while 13% of males and 6% of females reported being a current smoker. Past year asthma attack was reported among 43% and 55% of males and females, respectively. Among males, after adjusting for all control variables, asthma attack was significantly higher among those with ETS exposure (OR: 1.75, 95% CI: 1.01-3.02) and among current smokers (OR: 3.82, 95% CI: 1.49, 9.81). Male non-smokers with ETS exposure had a 109% higher odds of asthma attack, compared to non-exposure individuals. CONCLUSION: Using a population-based survey, our results highlight the ongoing burden of tobacco use and exposure particularly among males with current asthma, further corroborate the literature on the relationship between tobacco and asthma, and highlight putative sex-specific outcomes.

Low Health Literacy among Immigrant Hispanics.

Low health literacy is a significant barrier to healthcare access and service utilization; however, there are few studies that have evaluated the factors associated with having low health literacy, especially among immigrant minority populations. This exploratory study aimed to assess the key determinants of low health literacy among immigrant Hispanic adults in California using the California Health Interview Survey, the largest population-based state health survey in the United States. Analysis accounted for complex survey design, allowing generalizations to the entire state of California. Low health literacy was associated with living in poverty (OR = 1.63), lacking consistent health insurance (OR = 1.40), and limited English language proficiency (OR = 3.22), while women were less likely than men (OR = 0.59) to report low health literacy. The results of this study demonstrate that language proficiency, in addition to other key sociodemographic variables, can significantly posit limitations to health literacy. Future efforts should address providing linguistically competent health literacy interventions in order to improve associated health outcomes.

Racial and ethnic differences in asthma and mental health among US adults: results from the National Survey on Drug Use and Health.

OBJECTIVE: Evaluate the racial and ethnic differences in asthma and mental health comorbidity. METHODS: A secondary analysis of 2008-2013 National Survey on Drug Use and Health was conducted, resulting in a total of 206 993 civilian adult respondents to evaluate the association between asthma and mental health (past year serious psychological distress [SPD] and doctor diagnosis of depression). Both survey weighted bivariate (chi-square) and multivariable (binary logistic) regression analyses, after accounting for control variables, were conducted to evaluate the asthma/mental health nexus. A p value of less than 0.05 was used to denote significance. RESULTS: Current asthma was significantly associated with past year SPD for non-Hispanic Whites (adjusted odds ratio [aOR] = 1.45), Hispanics (aOR = 1.68), and Black/African Americans (aOR = 1.47). A similar association was noted for current asthma and past year doctor diagnosis of depression (non-Hispanic White aOR = 1.74; Hispanics aOR = 1.77; Black/African American aOR = 1.62). Among those with lifetime asthma, higher odds of SPD were reported for non-Hispanic Whites (aOR = 1.42), Hispanics (aOR = 1.64), and Black/African Americans (aOR = 1.50). Lifetime asthma also significantly associated with past year doctor diagnosis of depression for non-Hispanic Whites (aOR = 1.42), Hispanics (aOR = 1.41), and Black/African Americans (aOR = 1.46). CONCLUSION: Our results demonstrate the significant burden of asthma and mental health comorbidity among diverse racial and ethnic groups. Improved public health efforts through promotion of integrated care for early screening and preventive measures are needed to alleviate the burden for at-risk groups.

Sociodemographic Correlates of Dietary Practices among Asian-Americans: Results from the California Health Interview Survey.

OBJECTIVE: Studies show that Asian-American subgroups do not always meet dietary recommendations and are at high risk of cardiovascular diseases. The purpose of our research is to illustrate the various sociodemographic correlates of dietary habits for six subgroups of Asian-Americans in California. DESIGN: The 2005 California Health Interview Survey (CHIS) was utilized. A total of 3772 Asian-Americans were included in this study, with the largest subgroup being Chinese (n = 1280; N = 913,798). The outcome variable for this study was dietary behavior defined as consuming five or more fruits and vegetables per day (5-a-day), provided by CHIS. Univariate and multivariable regression analyses were conducted accounting for complex survey design. RESULTS: Being a female (Chinese, Filipina, Korean, and Vietnamese), not being married (Chinese), not being a college graduate (Chinese), living in poverty (South Asian), and speaking only English language at home (Chinese and Japanese) were associated with higher odds of not meeting a 5-a-day requirement. CONCLUSION: Results highlighted several sociodemographic correlates to not meeting 5-a-day requirement among six Asian-American subgroups. Targeted health promotion measures for such at-risk groups should be implemented to improve dietary practices.