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1.
PLoS One ; 19(5): e0300455, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38771867

RESUMO

The number of Americans with multiple jobs is increasing and multiple jobholders work more hours per week. However, the associations between multiple jobholding and hypertension are unknown. The aim of this study was to examine the associations of multiple jobholding with hypertension and determine whether weekly working hours moderated this association. Data from the 2015 National Health Interview Survey on adults (age ≥18 years) were used and included participants who self-identified as non-Hispanic Asian, non-Hispanic Black, Hispanic, or non-Hispanic White in the U.S. (n = 16,926), The associations of multiple jobholding with self-reported hypertension by sex were assessed using modified Poisson regressions. Both the number of working hours per week and race/ethnicity were assessed as moderators using multiplicative interaction terms. Multiple jobholding was not associated with hypertension among women. However, there was a significant three-way interaction such that multiple jobholding was associated with hypertension among non-Hispanic Black men who worked ≥55 hours per week (relative risk = 1.02, 95% confidence interval = 1.01-1.05). The results suggest that the associations between multiple jobholding, number of working hours, and hypertension should be examined at the intersection of race/ethnicity and sex. Future studies should further characterize multiple jobholding and hypertension among non-Hispanic Black men.


Assuntos
Hipertensão , Humanos , Masculino , Hipertensão/epidemiologia , Hipertensão/etnologia , Feminino , Adulto , Pessoa de Meia-Idade , Emprego/estatística & dados numéricos , Estados Unidos/epidemiologia , Fatores Sexuais , Etnicidade/estatística & dados numéricos , Adulto Jovem , Hispânico ou Latino/estatística & dados numéricos , Negro ou Afro-Americano/estatística & dados numéricos , Adolescente , Idoso , População Branca/estatística & dados numéricos
2.
Health Place ; 83: 103089, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37557002

RESUMO

This scoping review summarized findings and key measures from U.S.-based studies that 1) examined associations between geographic indicators of structural racism (e.g., redlining, racial segregation) and access to food retailers (e.g., supermarkets, convenience stores) or 2) documented disparities in access by neighborhood racial/ethnic composition. In 2022, relevant scientific literature was reviewed using Covidence software. Independent reviewers examined 13,069 citations; 163 citations advanced to the full-text review stage and 70 were selected for inclusion. Twenty-one studies (30%) linked one or more indicator of structural racism to food retailer access while 49 (70%) solely examined differences in access by neighborhood racial/ethnic composition. All studies featuring indicators of structural racism reported significant findings; however, indicators varied across studies making it difficult to make direct comparisons. Key indicators of structural racism in the food access literature included redlining (n = 3), gentrification (n = 3), and racial segregation (n = 4). Many U.S.-based studies have evaluated food retailer access by neighborhood racial/ethnic composition. Moving forward, studies should model indicators of structural racism and determine their influence on geographic access to large and small food retailers.


Assuntos
Racismo , Segregação Social , Estados Unidos , Humanos , Racismo Sistêmico , Alimentos , Segregação Residencial
3.
Artigo em Inglês | MEDLINE | ID: mdl-37507635

RESUMO

Black adults are more likely to consume meals from fast-food restaurants than other racial/ethnic groups with implications for disparities in dietary quality and obesity outcomes. Family and economic characteristics are associated with fast-food consumption. The aim of this study was to determine the association between household composition, income, and fast-food consumption among Black women and men. A cross-sectional, secondary analysis of nationally representative data from the 2011-2018 National Health and Nutrition Examination Survey using multiplicative interaction terms and negative binomial regressions were used to assess whether household income moderated associations between number of children or older adults in the household and number of weekly fast-food meals consumed. Household composition was not associated with fast-food consumption among Black women overall. Yet, demonstrated by a significant interaction (incidence rate ratio (IRR) = 3.41, 95% confidence interval (CI) = 1.59-7.32), Black women with higher household income (≥ $75,000) and multiple young children consumed more fast-food compared to women with no children in the household. In contrast, Black men with one school-aged child in the home consumed fewer weekly fast-food meals than men with no school-aged children in the home (IRR = 0.69, 95% CI = 0.51-0.93). A significant interaction between number of older adults in the household and household income ≥ $75,000 (IRR = 3.56, 95% CI = 1.59-8.01) indicated that Black men with lower incomes and at least one older adult in the household consumed fewer weekly fast-food meals. These findings demonstrate that household composition and household income interact on fast-food consumption among Black women and men. Future studies should interrogate these differences, while programs and policies can be informed by the results of this study.

4.
Am J Med Sci ; 366(3): 199-208, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37244637

RESUMO

BACKGROUND: Church-based interventions have been shown to reduce cardiovascular disease (CVD) risk factors and could reduce health disparities in groups with a high burden of CVD. We aim to conduct a systematic review and meta-analysis to determine the effectiveness of church-based interventions for CVD risk factor improvement and to examine the types of interventions that are effective. METHODS: Systematic searches of MEDLINE, Embase, and manual reference searches were conducted through November 2021. Study inclusion criteria were church-based interventions delivered in the United States to address CVD risk factors. Interventions targeted barriers to improving blood pressure, weight, diabetes, physical activity, cholesterol, diet, or smoking. Two investigators independently extracted study data. Random effects meta-analyses were conducted. RESULTS: A total of 81 studies with 17,275 participants were included. The most common interventions included increasing physical activity (n = 69), improving diet (n = 67), stress management (n = 20), medication adherence (n = 9), and smoking cessation (n = 7). Commonly used approaches for implementation included cultural tailoring of the intervention, health coaching, group education sessions, inclusion of spiritual components in the intervention, and home health monitoring. Church-based interventions were associated with significant reductions in body weight (-3.1 lb, [95% CI, -5.8, -1.2], N = 15), waist circumference (-0.8 in, [CI, -1.4, -0.1], N = 6), and systolic blood pressure (-2.3 mm Hg, [CI, -4.3, -0.3], N = 13). CONCLUSIONS: Church-based interventions targeting CVD risk factors are effective for reducing CVD risk factors, particularly in populations with health disparities. These findings can be used to design future church-based studies and programs to improve cardiovascular health.


Assuntos
Doenças Cardiovasculares , Humanos , Doenças Cardiovasculares/prevenção & controle , Dieta , Promoção da Saúde , Exercício Físico/fisiologia , Fatores de Risco de Doenças Cardíacas
5.
Prev Med ; 173: 107554, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37217035

RESUMO

Work-life interference has detrimental impacts on health outcomes. However, there are potential differences in these associations at the intersection of race/ethnicity and sex. The aim of this study was to examine whether race/ethnicity moderates the associations of work-life interference with health outcomes among women and men. Using data from the 2015 National Health Interview Survey on adults (age ≥ 18 years) who self-identified as non-Hispanic Asian, non-Hispanic Black, Hispanic, or non-Hispanic White in the U.S. (n = 17,492), the associations of work-life interference with self-rated health, psychological distress, and body mass index (BMI) were assessed using multiplicative interaction terms. Work-life interference was associated with higher log-odds of worse self-rated health (log-odds = 0.17, standard error (s.e.) = 0.06) and more psychological distress (ß = 1.32, s.e. = 0.13) in men. Work-life interference was similarly positively associated with worse self-rated health (log-odds = 0.27, s.e. = 0.06) and psychological distress (ß = 1.39, s.e. = 0.16) among women as well. A stronger association between work-life interference and psychological distress was observed among non-Hispanic Asian women compared to non-Hispanic White women (ß = 1.42, s.e. = 0.52) and a stronger association between work-life interference and BMI was observed among non-Hispanic Black women compared to non-Hispanic White women (ß = 3.97, s.e. = 1.93). The results suggest detrimental impacts of work-life interference on self-rated health and psychological distress. Yet, the variation in the associations of work-life interference with psychological distress and BMI among women suggest that an intersectional lens should be applied. Efforts to understand and address the negative effects of work-life interference on health should consider potentially unique associations across race/ethnicity and sex.


Assuntos
Saúde , Equilíbrio Trabalho-Vida , Adolescente , Adulto , Feminino , Humanos , Masculino , Negro ou Afro-Americano , Etnicidade , Hispânico ou Latino , Estados Unidos/epidemiologia , Brancos , Equilíbrio Trabalho-Vida/estatística & dados numéricos , Fatores Sexuais , Fatores Raciais , Adulto Jovem , Asiático , Angústia Psicológica , Autoavaliação (Psicologia) , Saúde/etnologia , Saúde/estatística & dados numéricos , Índice de Massa Corporal
6.
Artigo em Inglês | MEDLINE | ID: mdl-36674349

RESUMO

The Black-White racial employment disparity and its link to mortality have demonstrated the health benefits obtained from employment. Further, racial/ethnic mortality disparities existing among men with different employment statuses have been previously documented. The purpose of this study was to examine the association between employment status and all-cause mortality among Black men. Data for the study was obtained from the National Health and Nutrition Examination Survey (NHANES) III 1988-1994 linked to the NHANES III Linked Mortality File. Cox proportional hazard models were specified to examine the association between health behaviors and mortality in Black men by employment status. Among those who were assumed alive (n = 1354), 41.9% were unemployed. In the fully adjusted model, unemployed Black men had an increased risk of all-cause mortality (Hazard Ratio [HR] 1.60, 95% confidence interval or CI [1.33, 1.92]) compared to Black men who were employed. These results highlight the impact of employment on all-cause mortality among unemployed Black men and underscore the need to address employment inequalities to reduce the mortality disparities among Black men.


Assuntos
Emprego , Desemprego , Masculino , Humanos , Inquéritos Nutricionais , Grupos Raciais , População Negra
7.
J Public Health Manag Pract ; 29(Suppl 1): S98-S106, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36223514

RESUMO

OBJECTIVE: In response to calls to achieve racial equity, racism has been declared as a public health crisis. Diversity, equity, and inclusion (DEI) is an approach public health organizations are pursuing to address racial inequities in health. However, public health workforce perceptions about organizational commitment to DEI have not yet been assessed. Using a nationally representative survey of public health practitioners, we examine how perceptions about supervisors' and managers' commitment to DEI and their ability to support a diverse workforce relate to perceptions of organizational culture around DEI. METHODS: Data from the 2021 Public Health Workforce Interests and Needs Survey (PH WINS) to examine the relationship between public health employees' perceptions about their organization's commitment to DEI and factors related to those perceptions. PH WINS received 44 732 responses (35% response rate). We calculated descriptive statistics and constructed a logistic regression model to assess these relationships. RESULTS: Findings show that most public health employees perceive that their organizations are committed to DEI; however, perceptions about commitment to DEI vary by race, ethnicity, gender identity, and organizational setting. Across all settings, White respondents were more likely to agree with the statement, "My organization prioritizes diversity, equity, and inclusion" (range, 70%-75%), than Black/African American (range, 55%-65%) and Hispanic/Latino respondents (range, 62.5%-72.5%). Perception that supervisors worked well with individuals with diverse backgrounds had an adjusted odds ratio (AOR) of 5.37 ( P < .001); organizational satisfaction had an AOR of 4.45 ( P < .001). Compared with White staff, all other racial and ethnic groups had lower AOR of reporting their organizations prioritized DEI, with Black/African American staff being the lowest (AOR = 0.55), followed by Hispanic/Latino staff (AOR = 0.71) and all other staff (AOR = 0.82). CONCLUSIONS: These differences suggest that there are opportunities for organizational DEI commitment to marginalized public health staff to further support DEI and racial equity efforts. Building a diverse public health workforce pipeline will not be sufficient to achieve health equity if staff perceive that their organization does not prioritize DEI.


Assuntos
Mão de Obra em Saúde , Saúde Pública , Humanos , Feminino , Masculino , Saúde Pública/métodos , Identidade de Gênero , Recursos Humanos , Inquéritos e Questionários
8.
J Racial Ethn Health Disparities ; 10(5): 2207-2217, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-36068481

RESUMO

There is a large literature on work-related characteristics and hypertension, but studies on self-employment, longer working hours, and hypertension are mixed. Assessments of self-employment should be extended to account for people with part-time self-employment (i.e., employees also earning income from self-employment). The aim of this study was to determine the association of different types of self-employment with hypertension among adults by race/ethnicity and to assess whether longer working hours moderated these associations. Using data from the 2007-2018 National Health and Nutrition Examination Survey, measured hypertension (blood pressure ≥ 140/90 mm Hg) was assessed and employment categories included employees, part-time self-employment (i.e., employee with self-employment income), or full-time self-employment. Modified Poisson regressions and multiplicative interaction terms were used. Having full-time self-employment was associated with lower relative risk (RR) of hypertension compared to employees among Black (RR = 0.77, 95% confidence interval (CI) = 0.61-0.96) and White men (RR = 0.77, 0.65-0.93) compared to employees. Full-time self-employment was associated with higher risk of hypertension (RR = 1.36, 95% CI = 1.01-1.82) compared to employees among Hispanic women, while part-time self-employment was associated with lower risk (RR = 0.69, 95% CI = 0.48-0.98). Among White women, part-time self-employment was associated with higher relative risk of hypertension (RR = 1.27, 95% CI = 1.05-1.53) compared to employees. There were significant interactions between employment categories and longer working hours among Hispanic women as well as Black women and men. The results suggest that self-employment categories and longer working hours impact hypertension by race/ethnicity and sex. Because the number of full-time and part-time self-employed adults has increased, the health of this particular subgroup of workers should be further addressed.


Assuntos
Etnicidade , Hipertensão , Adulto , Masculino , Humanos , Feminino , Estados Unidos/epidemiologia , Inquéritos Nutricionais , Emprego , Ocupações , Hipertensão/epidemiologia
9.
Am J Health Behav ; 46(5): 515-527, 2022 10 17.
Artigo em Inglês | MEDLINE | ID: mdl-36333832

RESUMO

OBJECTIVES: Unequal access to healthy food environments is often implicated in racial inequities in health and behaviors that are largest among college graduates. The aim of this study was to determine associations between perceived proximity to food sources and dietary behaviors between black and white college graduates. METHODS: In a cross-sectional online survey of dietary behaviors between black and white adults who have a ≥ 4-year bachelor's degree, respondents were asked how long it typically takes for them to get to grocery stores and fast-food restaurants from home. We used ordinal logit regression models to assess associations between perceived proximity to food sources and dietary behaviors. RESULTS: Among black men, perceiving that a grocery store was ≥ 10 minutes from their home was associated with lower fruit consumption (beta=-0.94, SE=0.48). Perceiving that a grocery store was ≥ 10 minutes from their home was associated with more frequent fast-food consumption among black men (beta=1.21, SE=0.39), Black women (beta=0.98, SE=0.34), and white men (beta=0.74, SE=0.30). CONCLUSIONS: The associations between perceived proximity to food sources and dietary behaviors differ by race and sex among college graduates with important implications for racial disparities in diet quality and obesity across SES.


Assuntos
Fast Foods , Restaurantes , Adulto , Masculino , Feminino , Humanos , Estudos Transversais , Frutas , Dieta
10.
Sci Rep ; 12(1): 16535, 2022 10 03.
Artigo em Inglês | MEDLINE | ID: mdl-36192415

RESUMO

A shift in focus towards healthy reproductive outcomes may reveal opportunities for novel interventions and strategies to promote optimal health. Using variables from the National Center for Health Statistics restricted use natality files, we calculated Empirical Bayes smoothed (EBS) rates of optimal birth for the all live births-both overall and by maternal race/ethnicity-by applying the smoothing tool in GeoDa version 1.18.0.10 We defined counties achieving greater racial birth equity as those where the overall EBS optimal birth rate was greater than the national 75th percentile and the absolute difference between maternal racial/ethnic categories was smaller than the national 25th percentile difference. During the study period, 49.80% of overall births could be classified as an optimal birth according to the study definition. Of the 3140 US counties, only 282 (8.98%) appeared to advance White-Black equity in optimal births, and 205 (6.53%) appeared to advance White-Hispanic equity in optimal births. In the effort improve maternal health, we should focus not only on the absence of negative outcomes, but also the occurrence of positive outcomes. Our analytic results suggest that optimal births can be measured and that geographic inequities by race occur.


Assuntos
Hispânico ou Latino , População Branca , Teorema de Bayes , Etnicidade , Feminino , Humanos , Prevalência , Estados Unidos/epidemiologia
11.
Am J Prev Med ; 63(6): 971-978, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35961812

RESUMO

INTRODUCTION: Racial inequities in food insecurity have been documented for the past 2 decades in the U.S., with the prevalence of food insecurity among Black households being 2-3 times higher than that among White households across time. The purpose of this study was to determine the association between socioeconomic indicators of structural racism at the state level and food insecurity among White and Black households in the U.S. METHODS: This study is a secondary analysis of pooled, cross-sectional data from the Current Population Survey and the American Community Survey, 2015-2019 (N=158,551 Black and White households). Data analysis occurred in 2021-2022. The outcome was household food insecurity, and the exposure was structural racism indicators, operationalized as state-level racial inequities in income, earnings, education, unemployment, and home ownership. Individual-, household-, and state-level sociodemographic covariates were included. RESULTS: Among Black households, state-level racial inequities in income, unemployment, and home ownership were associated with 34% (OR=1.34; 95% CI=1.05, 1.70), 14% (OR=1.14; 95% CI=1.02, 1.28), and 11% (OR=1.11; 95% CI=1.05, 1.16) higher odds of food insecurity, respectively. For White households, state-level racial inequities in income, education, unemployment, and home ownership were associated with 21% (OR=0.79; 95% CI=0.63, 0.98), 27% (OR=0.73; 95% CI=0.66, 0.85), 10% (OR=0.90; 95% CI=0.82, 0.98), and 8% (OR=0.92; 95% CI=0.89, 0.95) lower odds of food insecurity, respectively. CONCLUSIONS: Structural racism may be a key driver of food insecurity among Black households and may be protective against food insecurity among White households. Implementing policies addressing state-level racial inequity in socioeconomic indicators could be effective at reducing racial inequities in food insecurity.


Assuntos
Renda , Grupos Raciais , Humanos , Estudos Transversais , Escolaridade , Insegurança Alimentar
12.
Curr Opin Cardiol ; 37(4): 326-333, 2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-35731677

RESUMO

PURPOSE OF REVIEW: Dementia is a life-course condition with modifiable risk factors many from cardiovascular (CV) origin, and disproportionally affects some race/ethnic groups and underserved communities in the USA. Hypertension (HTN) is the most common preventable and treatable condition that increases the risk for dementia and exacerbates dementia pathology. Epidemiological studies beginning in midlife provide strong evidence for this association. This study provides an overview of the differences in the associations across the lifespan, and the role of social determinants of health (SDoH). RECENT FINDINGS: Clinical trials support HTN management in midlife as an avenue to lower the risk for late-life cognitive decline. However, the association between HTN and cognition differs over the life course. SDoH including higher education modify the association between HTN and cognition which may differ by race and ethnicity. The role of blood pressure (BP) variability, interactions among CV risk factors, and cognitive assessment modalities may provide information to better understand the relationship between HTN and cognition. SUMMARY: Adopting a life-course approach that considers SDoH, may help develop tailored interventions to manage HTN and prevent dementia syndromes. Where clinical trials to assess BP management from childhood to late-life are not feasible, observational studies remain the best available evidence.


Assuntos
Demência , Hipertensão , Pressão Sanguínea , Criança , Cognição , Demência/epidemiologia , Demência/etiologia , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Acontecimentos que Mudam a Vida , Fatores de Risco
13.
Am J Mens Health ; 16(2): 15579883221092290, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35466781

RESUMO

Research indicates that income is significantly associated with allostatic load (AL) and that this association may differ between White and Black Americans. Most existing income-AL link work focuses on women and less is known about this association among men. Using data from the National Health and Nutrition Examination Survey (NHANES), we examined whether race moderates the association between income and AL among Black and White men in the United States (n = 5,685). We find that, regardless of income levels, Black men have significantly higher prevalence of being in the high-AL group compared with high-income White men. Our findings suggest that Black men do not receive the same health benefits for increased income relative to their White counterparts.


Assuntos
Alostase , Negro ou Afro-Americano , População Negra , Feminino , Humanos , Masculino , Inquéritos Nutricionais , Estados Unidos , População Branca
14.
Health Aff (Millwood) ; 41(2): 228-236, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35130074

RESUMO

The disproportionate rates of police surveillance and encounters in many communities in the US may be contributing to inequities in health and violence. Frequent policing in communities, which may often also be aggressive policing, has been associated with diminished health and well-being. This study adds to the growing body of research on this issue by examining the relationships between neighborhood police stop-and-frisk encounters and both health outcomes and violence rates in New Orleans, Louisiana, in an ecological, cross-sectional study using local police report, Centers for Disease Control and Prevention, and census data. The average rate of police stop-and-frisk encounters was more than three times higher for Black adults compared with their White counterparts. Even after we accounted for concentrated disadvantage (a high percentage of residents of lower socioeconomic status) and residential racial and income segregation, neighborhoods with higher rates of encounters had significantly higher prevalence rates of smoking, physical inactivity, and poor physical health, and they experienced significantly more violent crime (18.35 more per 1,000) and domestic violence (49.91 more per 1,000) events than neighborhoods with lower levels of police encounters. There is a need for strengthened policy focused on the relationship between frequent policing and health and violence outcomes.


Assuntos
Violência Doméstica , Polícia , Adulto , Estudos Transversais , Humanos , Aplicação da Lei , Características de Residência
15.
J Racial Ethn Health Disparities ; 9(3): 739-747, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35192179

RESUMO

COVID-19 has disproportionately impacted Black adults with high prevalence and mortality rates. Obesity is a central factor in the severity of COVID-19 and related treatment. Behavioral weight loss interventions are an efficacious treatment for obesity, but consistently, Black men and women are minimally represented, and weight loss outcomes are less than clinically significant thresholds. This commentary draws parallels between COVID-19 racial disparities, disparate obesity rates, weight loss treatment outcomes, and underlying systemic racial context. This paper also indicates paths forward to address racialized societal norms in obesity treatment to advance health equity in obesity and reduce acute disease vulnerability. Recommendations for behavioral medicine practice and policy include (1) expanding the research lens to prioritize Black scholars and institutions to generate innovative research questions, (2) creating trustworthy relationships with Black community members to bolster recruitment and retention, (3) employing qualitative methods to facilitate better intervention design and uncover influences of racialized social context, (4) centering Black adults in weight loss interventions, and (5) using multilevel approaches that integrate policy into interventions. Moving forward, this commentary aims to make plain the multilayered form and function of racism, its impact on COVID-19 and obesity, and offer pathways to improve behavioral weight loss interventions that can produce more equitable outcomes.


Assuntos
COVID-19 , Equidade em Saúde , Racismo , Adulto , COVID-19/terapia , Feminino , Humanos , Obesidade/terapia , Redução de Peso
16.
J Racial Ethn Health Disparities ; 9(4): 1488-1499, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-34165703

RESUMO

OBJECTIVE: Disparities in obesity highlight the need for an examination of determinants that may be uniquely experienced by race and sex. An understudied factor is household composition with the potential for variation in its obesogenic impacts. This study examines the association between household composition and body mass index (BMI) among Black, Hispanic, and White adults and determines whether income moderates these associations. METHODS: Using cross-sectional data from the 2011-2018 National Health and Nutrition Examination Survey, the number of children and adults aged ≥ 60 years in the household were reported among non-Hispanic Black and White adults as well as Hispanic adults aged 20-59 years old. Multivariable linear regressions were used to assess the associations between household composition and BMI with income as a potential moderator. RESULTS: Having multiple school-aged children was associated with higher BMI (ß = 1.34, standard error (s.e.) = 0.50) among Hispanic men, while having older adults in the household was associated with lower BMI among Black women (ß = - 3.21, s.e. = 1.42). Income moderated the associations between household composition and BMI among Black women and men. There were no associations between household composition and BMI in White women or men. CONCLUSIONS: Future studies should further explicate the mechanisms of household composition that uniquely impact obesity outcomes among Black women and men by income. Efforts to address higher BMI among those with more young children in the household should target Hispanic men.


Assuntos
Etnicidade , Obesidade , Adulto , Idoso , Índice de Massa Corporal , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Fatores Socioeconômicos , Adulto Jovem
17.
J Racial Ethn Health Disparities ; 9(5): 1850-1860, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-34363186

RESUMO

Racial disparities in obesity are larger between Black and White college graduates compared to disparities among those who did not complete high school. A possible explanation is that Black adults with higher socioeconomic status (SES) experience unique obesogenic determinants. Black adults who have completed a 4-year college degree can report "uplift stress" from providing financial assistance to family members. The aim of this study is to determine whether the association between familial financial assistance and body mass index (BMI) varies among college-educated Black women and men. This study utilized data from an online survey of Qualtrics standing panels including 451 non-Hispanic Black college graduates. Respondents were asked if they had provided or received any monetary gift or financial help from a family member in the past 12 months as well as their height and weight. Using linear regression and multiplicative interaction terms, the association between familial financial assistance and BMI was assessed by sex. Those who reported both giving and receiving familial financial assistance had higher BMI than those who neither gave nor received assistance (ß = 2.80, standard error (s.e.) = 1.16). There was a significant interaction such that this association was observed among women only (ß = 6.67, s.e. = 2.32). Future studies should seek to understand the gendered impact of familial financial assistance on BMI in college-educated Black women.


Assuntos
População Negra , Grupos Raciais , Adulto , Índice de Massa Corporal , Escolaridade , Feminino , Humanos , Masculino , Classe Social
18.
Gerontologist ; 62(5): 721-731, 2022 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-34922345

RESUMO

BACKGROUND AND OBJECTIVES: Prior research documents accelerated physiological aging among African Americans due to their greater lifetime exposure to social and economic adversity. Yet, less is known about the mechanisms through which early life stressors, such as early life racial discrimination (ELRD), and later life psychosocial resources, such as racial centrality (i.e., importance of Black identity to one's sense of self), interact to shape allostatic load (AL) in adulthood. We evaluate the life course processes linking ELRD, adult racial centrality, and adult AL among older African Americans. RESEARCH DESIGN AND METHODS: Data from the Nashville Stress and Health Study included African Americans aged 50 and older (N = 260). Poisson regression models assessed the links between ELRD, adult centrality, and adult AL. Interactions determined whether ELRD conditions the centrality-AL association in adulthood. RESULTS: Adolescent ELRD conferred significantly higher levels of adult centrality and 32% increased risk of high adult AL. Greater adult centrality was linked to high adult AL, but the ELRD-adult AL association was not explained by centrality. However, ELRD and centrality interact to shape adult AL, such that racial centrality was protective against high adult AL for those who experienced racial discrimination as children or adolescents. DISCUSSION AND IMPLICATIONS: Findings highlight the multiple pathways through which racism-related stressors and psychosocial resources interact to shape physiological dysregulation in later life and underscore the health significance of racial identity for older African Americans. Clinicians and public health professionals should assess early life stressors and foster psychosocial resilience to promote healthy aging.


Assuntos
Alostase , Racismo , Adolescente , Adulto , Negro ou Afro-Americano/psicologia , Idoso , Envelhecimento , Alostase/fisiologia , População Negra , Humanos , Pessoa de Meia-Idade , Racismo/psicologia
19.
Front Epidemiol ; 2: 991628, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-38455288

RESUMO

Background: Self-employment is generally associated with better health outcomes and educational attainment can shape self-employment. Yet, Black Americans are less likely to be self-employed and analyses of self-employment and health among Black Americans are few. The aim of this study was to determine how educational attainment moderates the associations between self-employment and hypertension among Black adults. Methods: Using data from the 2007-2018 National Health and Nutrition Examination Survey, participants who self-identified as non-Hispanic Black (n = 2,855) were categorized as (1) employees with no self-employment income, (2) employees with self-employment income, or (3) having full-time self-employment. Modified Poisson regressions and multiplicative interaction terms were used to determine whether educational attainment moderated the associations between self-employment and measured hypertension (i.e., 140/90 mm Hg or anti-hypertensive medication). Results: Most participants were employees with no self-employment income (81.9%), but 11.8% were employees reporting some self-employment income and 6.3% were self-employed full-time. About two in five (40.9%) had hypertension. Having full-time self-employment was associated with lower risk of hypertension compared to those who were employees (risk ratio = 0.82, 95% confidence interval = 0.67-0.98), and educational attainment moderated the associations among Black men such that part-time self-employment was associated with high rates of hypertension among Black men who had not completed high school. Conclusions: These results suggest that full-time self-employment is associated with lower risk of hypertension among Black adults, but that being an employee with some self-employment income may elevate rates of hypertension among Black men depending on educational attainment. Future studies should assess pathways between self-employment and hypertension by educational attainment among Black women and men.

20.
Ethn Dis ; 30(4): 629-636, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32989363

RESUMO

Obesity rates increase as household income increases among Black men, yet only a few studies have sought to understand this unique association. Scholars have posited that gendered stressors like role strain that are work-related could play a role in obesity among Black men. Work-life interference is a concept that captures the conflict between work life and family/personal life. Work-life interference is associated with obesity-related behaviors but has been understudied in Black men. The aim of this study was to determine the interrelationship between work-life interference, income, and obesity among Black men. Using data from the 2015 National Health Interview Survey, the associations between household income and odds of overweight and obesity (measured by body mass index) were assessed using ordinal logit regressions. Multiplicative interaction terms were used to assess the potential moderation of the association between income and log-odds of overweight/obesity by work-life interference. The results of our study demonstrate that work-life interference interacts with income ≥400% federal poverty level (FPL) on the log-odds of overweight/obesity (beta=2.10, standard error [se]=.87). Among those who reported work-life interference, Black men who had household income ≥400% FPL had higher log-odds of overweight/obesity (beta=1.51, se=.74) compared with those with income <100% FPL. There was no association between income and obesity among Black men who did not report work-life interference. The results suggest that work-life interference plays an important role in the positive association between income and obesity in Black men. Future studies should explicate the obesogenic ways in which work and family/personal life combine among high-income Black men.


Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Renda/estatística & dados numéricos , Obesidade/etnologia , Equilíbrio Trabalho-Vida , Adulto , Índice de Massa Corporal , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Sobrepeso/etnologia , Fatores de Risco
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