Have african american men become less committed to marriage? Explaining the twentieth century racial cross-over in men’s marriage timing

Prior to World War II, the median age at marriage for white men was later than that for African American men. Since World War II, African American men have, on average, married later than white men. A discrete-time hazard model using data from the National Survey of Families and Households was analyzed to explain this racial cross-over in men’s timing of marriage. Dramatic increases in the educational attainment of African American parents and the large movement of African Americans out of the South brought about the racial cross-over in the timing of marriage. Increased enrollment in higher education among African American men also contributed to the racial cross-over in the timing of marriage. Although lack of full-time employment and military service delayed marriage, these factors did not contribute to the racial cross-over.     

Race,Remarital Status,and Infertility in 1910: More Evidence of Multiple Causes

The dominant approach to studying historical race-related fertility differences has been to limit samples to first-married and younger women. We argue that studying historical race-related fertility differences in the context of remarriage is also important: remarriage and fertility patterns are both rooted in the biosocial conditions that produce racial disparities in health. We employ a multiple causes framework that attributes variation in fertility patterns to voluntary limitation and involuntary factors (infecundity/subfecundity). We use data from the 1910 Integrated Public Use Microdata Series and estimate zero-inflated negative binomial models that simultaneously distinguish those who are infecund (vs. fecund) and estimate the number of remarital births among the fecund. Our approach allows us to evaluate historical remarital (in)fertility differences, accounting for marital, socioeconomic, and geographic influences on fecundity and fertility, while empirically accounting for the influence of children “missing” from the household due to mortality and fostering/aging out. Consistent with past studies that emphasized poorer African American health as a major influence on involuntary infertility, we find that African American women were more likely than white women to be in the always-zero (infecund) group and to have fewer remarital births. Supplemental analyses nuance these findings but indicate that these results are robust. Overall, we find support for a multiple-causes perspective: while the findings are consistent with the adoption of deliberate fertility control among urban and higher-status women at higher parities, remarital fertility differences in 1910 also reflected greater infecundity/subfecundity among subgroups of women, especially African American women.     

The Social Environmental Context of Resilience Among Substance-Using African American/Black Men Who Have Sex With Men

ABSTRACT

Resilience theory has been suggested as a framework for research on HIV prevention among men who have sex with men. Among this population, literature indicates that African American/Black men who have sex with men experience additional health disparities including elevated HIV incidence rates, victimization, and poor physical health. Conceptualizing resilience as a part of one’s social environment, this qualitative study investigates resilience processes and HIV transmission risk among a sample of 21 substance-using African American/Black men who have sex with men. Data from in-depth interviews describe the social environmental context in which resilience is exhibited and document the influence of homophobia, expressions of agency, and access to social, economic, and cultural capital on resilience processes. Central to this are expressions of hidden resilience, in which African American/Black men who have sex with men mitigate risk and experience their lives as subjectively successful, whether or not outsiders see it as such.     

Examining Sexual Orientation Disparities in Unmet Medical Needs Among Men and Women

Using the National Longitudinal Study of Adolescent Health (N = 13,810), this study examines disparities in unmet medical needs by sexual orientation identity during young adulthood. We use binary logistic regression and expand Andersen’s health care utilization framework to identify factors that shape disparities in unmet medical needs by sexual orientation. We also investigate whether the well-established gender disparity in health-seeking behaviors among heterosexual persons holds for sexual minorities. The results show that sexual minority women are more likely to report unmet medical needs than heterosexual women, but no differences are found between sexual minority and heterosexual men. Moreover, we find a reversal in the gender disparity between heterosexual and sexual minority populations: heterosexual women are less likely to report unmet medical needs than heterosexual men, whereas sexual minority women are more likely to report unmet medical needs compared to sexual minority men. Finally, this work advances Andersen’s model by articulating the importance of including social psychological factors for reducing disparities in unmet medical needs by sexual orientation for women.     

Smoking and Variation in the Hispanic Paradox: A Comparison of Low Birthweight Across 33 US States

The Hispanic Paradox in birth outcomes is well documented for the US as a whole, but little work has considered geographic variation underlying the national pattern. This inquiry is important given the rapid growth of the Hispanic population and its geographic dispersion. Using birth records data from 2014 through 2016, we document state variation in birthweight differentials between US-born white women and the three Hispanic populations with the largest numbers of births: US-born Mexican women, foreign-born Mexican women, and foreign-born Central and South American women. Our analyses reveal substantial geographic variation in Hispanic immigrant–white low-birthweight disparities. For example, Hispanic immigrants in Southeastern states and in some states from other regions have reduced risk of low birthweight relative to whites, consistent with a “Hispanic Paradox.” A significant portion of Hispanic immigrants’ birthweight advantage in these states is explained by lower rates of smoking relative to whites. However, Hispanic immigrants have higher rates of low birthweight in California and several other Western states. The different state patterns are largely driven by geographic variation in smoking among whites, rather than geographic differences in Hispanic immigrants’ birthweights. In contrast, US-born Mexicans generally have similar or slightly higher odds of low birthweight than whites across the US. Overall, we show that the Hispanic Paradox in birthweight varies quite dramatically by state, driven by geographic variation in low birthweight among whites associated with white smoking disparities across states.     

"Are they still having sex?" STI's and unintended pregnancy among mid-life women

Research has shown that women remain sexually active throughout mid-life and into the post-menopausal years. Recent data reveal that significant numbers of STIs (sexually transmitted infections) and unintended pregnancies occur among mid-life women. Data on STI prevalence indicate several STIs have relatively high rates among women over age 30, including HIV and HSV-2. Racial/ethnic disparities in STI prevalence between mid-life African American, Hispanic, and Caucasian women have also been noted. Data from the 1995 National Survey of Family Growth reveal 51% of pregnancies among women 40 and older are unintended. Both STIs and unintended pregnancy can result in serious health consequences for mid-life women. STIs can result in pelvic inflammatory disease and ectopic pregnancy. Unintended pregnancy can result in increased morbidity and mortality to the woman and the fetus. Mid-life women are also highly likely to go through relationship transitions (e.g., separation, divorce) and the subsequent initiation of new sexual relationships. As a result, these women are at elevated risk of STIs and unintended pregnancy. Despite these realities, there is a lack of programs addressing these two health issues among mid-life women and the unique life circumstances of women at this stage of life. The authors assert there is a compelling need for interventions to reduce STIs and unintended pregnancy in this population of women, review the literature regarding STIs and unintended pregnancy in mid-life women, identify gaps in current resources, and make recommendations for health care practice and future research.     

Black masculinity matters in attitudes toward gay males

Recent work on attitudes toward homosexuals promotes the view that males typically have more negative attitudes than females; and African Americans have more negative attitudes than their white counterparts. However, among African Americans, women are thought to have the greatest negative attitudes because they perceive themselves as competing for a limited pool of black male partners. This study uses the National Black Politics Study to examine African American gender differences in attitudes toward homosexual men. Multivariate findings show that of the variables analyzed: (1) Among African American females, age, income, education, and urban residence are statistically significant; and (2) among African American males, frequency of religious attendance was the only statistically significant variable. It is, therefore, argued that black masculinity explains the gendered differences and that negative attitudes within the African American community toward gay men contribute to debilitating both the physical and mental health of the entire black community.     

Neighborhood context and racial differences in early adolescent sexual activity

Evidence suggests that African American youths initiate sexual activity at earlier ages than do European American or Latino youths. Using data from a multilevel study in Chicago, we developed and tested a neighborhood-based model of the timing of first adolescent intercourse that emphasizes the impact of neighborhood structural disadvantage and collective efficacy on early sexual activity (at ages 11 to 16). In turn, we explored the extent to which neighborhood factors account for racial differences in the timing of first intercourse. The findings indicate that demographic background, family processes, peer influences, and developmental risk factors account for about 30% of the baseline increased likelihood of early sexual onset for African American youths compared with European American youths. However, a significant residual racial difference remained even after we considered a host of micro-level factors. Neighborhood-level concentrated poverty largely explained this residual racial difference. Collective efficacy also independently contributed to the delay of sexual onset. No significant baseline difference in age of sexual initiation was found between Latino and European American youths.     

Black/white differences in women’s reproductive-related health status: evidence from vital statistics

Maternal-age-specific neonatal mortality risk differs by race, with the mid-20s risk low for whites but not blacks. This may be partially due to worsening health for black relative to white women. We analyzed deaths to young women in the aggregate and classified by causes that are also pregnancy risk factors. Over the predominant child-bearing ages, mortality increases for blacks exceeded those for whites, usually by at least 25%. These indicators that black/white health differences widen as women progress through young adulthood suggest that such discrepancies may play a role in the black/white infant mortality differential, which merits further research.     

Who Gets Held Back? An Analysis of Grade Retention Using Stratified Frailty Models

Racial/ethnic disparities in grade retention related to structural inequality are investigated using a quantitative theoretical model from the health literature. Data from the Early Childhood Longitudinal Study-Kindergarten Cohort are linked with segregation indices for dissimilarity and poverty interaction derived from the US Census 2000 data estimate the impact of individual and structural level variables on grade retention. Shared frailty models demonstrate that there are racial/ethnic differences in grade retention, much of which can be explained by structural inequality. Students who are white or African American have lower risk in areas with higher dissimilarity and poverty interaction. Parental involvement mediates the risk of retention.

     

A mixed methods study: Midlife African American women’s knowledge,beliefs, and barriers to well-woman visit,flu vaccine,and mammogram use

ABSTRACT

African American women (AAW) are particularly at risk for deleterious health outcomes that might be mitigated through increased preventive care use. A mixed methods study that examined relationships between knowledge of, beliefs about, and barriers to well-woman visits, flu vaccines, and mammograms was conducted with midlife AAW who participated in an online survey (n = 124) and in-depth interviews (n = 19). Findings showed that greater knowledge of preventive service recommendations and positive patient-provider relationships were associated with greater preventive service use. Flu vaccines were significantly underused. Study implications inform strategies to increase preventive care utilization among AAW and increase capacities to improve health disparities.     

Social Networks and Support,Gender, and Racial/Ethnic Disparities in Hypertension Among Older Adults

Using data from the 2001 NHIS and the 2005–2006 and 2007–2008 NHANES, we examine how self-reporting a previous diagnosis of hypertension among adults aged 65+ differs by race/ethnicity for men and women; we explore the extent to which disparities are driven by group differences in social risk factors, particularly social support and integration; and last, whether these relationships mimic patterns seen for measured hypertension at interview. Findings indicate that rates of ever-diagnosed hypertension in both samples are highest among black seniors and older women and lowest among Mexican-American men, with the gender gap lowest among whites and substantially higher among blacks and Mexican-Americans. However, replication analyses of NHANES models using measured hypertension, instead of a self-report of having ever been diagnosed with hypertension, suggests that reporting bias and measurement error contribute to observed disparities, as racial/ethnic differences in hypertension rates are smaller when measured hypertension is examined, especially among women. Logistic regression models also show that while adjusting for group differences in measures of support and integration mediates some of the disparity in measured hypertension between Mexican-American and white seniors, adjusting for support and integration amplifies black-white disparities in both ever diagnosed and measured hypertension—driven primarily by adjustment for attendance at religious services, which reduces hypertension risk for all older adults but is more commonly reported among black seniors, especially women.     

Race/Ethnicity/Nativity Differentials and Changes in Cause-Specific Infant Deaths in the Context of Declining Infant Mortality in the U.S.: 1989–2001

Using data from the national linked birth/infant death cohort files, we examined race/ethnicity/nativity disparities and changes in infant mortality due to the five leading causes of infant death between 1989 and 2001. Our results indicate substantial decreases in infant mortality from three causes (congenital anomalies, sudden infant death syndrome, and respiratory distress syndrome) for which specific perinatal health innovations emerged or were expanded. However, for these three causes, the relative disparities in infant mortality between infants born to U.S.-born black women as compared to infants of U.S.-born white women increased following the introduction (or expansion) of beneficial interventions. Among infants of U.S.-born Mexican American mothers, the findings differed. In the static comparisons, our results show the often-reported similarity in the risk of death of these babies compared to those born to non-Hispanic white mothers. However, when changes over time were modeled, there was an erosion of the relatively favorable survival chances of Mexican American infants. Our models show little change in the relative risk of death for infants of immigrant women. Regarding the other two causes (disorders relating to short gestation and unspecified low birth weight and maternal complications) for which no efficacious innovations occurred, either little change or actual increases in risks were observed. Future studies and health policy efforts should be geared toward further understanding and aggressively working to close infant mortality gaps, especially for infants of U.S.-born black mothers—an effort that will be facilitated by research focused on cause-specific infant mortality.     

Discrimination,Sleep, and Stress Reactivity: Pathways to African American-White Cardiometabolic Risk Inequities

This review provides a model explicating two related physiologic and behavioral pathways through which the chronic daily stress of the expectation and experience of discrimination exposure can shape life course cardiometabolic risk trajectories: sleep and stress reactivity. We argue that these two pathways work together jointly to shape African American-White disparities in cardiometabolic morbidities. The body’s ongoing anticipation of experiencing racism-related stressors disrupts sleep, a behavior highly responsive to stress reactivity, which is also elevated during stressful conditions. The constant feedback between sleep disruption and the body’s stress response can lead to higher allostatic load and disproportionate exposure to stress-related illness among African Americans earlier in their life course.     

Wearing the Garment of Widowhood: Variations in Time Since Spousal Loss Among Community-Dwelling Older Adults

We examine how the passage of time since spousal loss varies by social and demographic characteristics, using data from the University of Alabama at Birmingham Study of Aging. In multivariate analyses, African American race, female sex, lower income, and higher risk of social isolation had significant and independent associations with variation in time since spousal loss. African American women were at highest risk for long-term widowhood. Accurate characterizations of widowhood among community-dwelling older adults must consider variation in the length of time individuals are living as widowed persons and socioeconomic concomitants of long-term widowhood.     

Educational Attainment by Life Course Sexual Attraction: Prevalence and Correlates in a Nationally Representative Sample of Young Adults

Researchers know relatively little about the educational attainment of sexual minorities, despite the fact that educational attainment is consistently associated with a range of social, economic, and health outcomes. We examined whether sexual attraction in adolescence and early adulthood was associated with educational attainment in early adulthood among a nationally representative sample of US young adults. We analyzed waves I and IV restricted data from the National Longitudinal Study of Adolescent Health (n = 14,111). Sexual orientation was assessed using self-reports of romantic attraction in waves I (adolescence) and IV (adulthood). Multinomial regression models were estimated and all analyses were stratified by gender. Women attracted to the same-sex in adulthood only had lower educational attainment compared to women attracted only to the opposite-sex in adolescence and adulthood. Men attracted to the same-sex in adolescence only had lower educational attainment compared to men attracted only to the opposite-sex in adolescence and adulthood. Adolescent experiences and academic performance attenuated educational disparities among men and women. Adjustment for adolescent experiences also revealed a suppression effect; women attracted to the same-sex in adolescence and adulthood had lower predicted probabilities of having a high school diploma or less compared to women attracted only to the opposite-sex in adolescence and adulthood. Our findings challenge previous research documenting higher educational attainment among sexual minorities in the US. Additional population-based studies documenting the educational attainment of sexual-minority adults are needed.     

Correlates of wellbeing among African American lesbians

Although there is a growing body of knowledge about health among African American women in general, there is a dearth of information on African American lesbians. The primary purpose of this study was to investigate the correlates of health-related quality of life among African American lesbians using a cross-sectional anonymous survey with topics and measures developed by members of the African American lesbian community. Surveys were completed by 123 English speaking adult women who identified as African American lesbians and were attending the Zuna Institute's National Black Lesbian Conference. Overall, we found a very high health-related quality of life, in spite of a high frequency of health impairments. The average body mass index (BMI) for this sample was 32.2 (SD?=?8.0); 13% were morbidly obese, having a BMI of 40 or more and only 15% of the women were in a healthy weight range; advancing age was associated with poorer physical functioning, decreased physical role functioning, and more pain. Health-related quality of life was associated with depression and spirituality, but not religion. This study highlights the need for subjective measures of health-related quality of life as well as checklists of diseases and disorders.     

The influence of remarriage on the racial difference in motheronly families in 1910

Historical demography documents that mother-only families were more common among African Americans than among Euro-Americans early in the twentieth century. We find direct evidence that African American males in both first and higher-order marriages were more likely to have (re)married previously married women and were more likely to have (re)married women with children. This racial difference in (re)marital partner choice reduced the racial difference in the prevalence of mother-only families such that, in the absence of such remarriage choices, the prevalence of mother-only families in the turn-of-the-century African American population would have been even higher than has been reported. Remarriage in this period countered the various demographic, economic, cultural, and social-institutional forces that disproportionately destabilized African American marriages; it must be taken into account more fully by analysts concerned with racial differences in family structure.