Depression and Religiosity in African American and White Community-Dwelling Older Adults

SUMMARY

This research examined the extent to which religiosity was predictive of level of depression, even after controlling for race, gender, social support, income sufficiency, and physical health. Data were collected using in-home interviews conducted from 1999 to 2001 with 1,000 adults age 65 to 106. Subjects were recruited from a stratified, random sample of Medicare beneficiaries age 65 and older in five central Alabama counties (three rural and two urban). The sample was stratified by county, race, and sex and included balanced numbers of African American males and females and White males and females. Highly religious persons had lower levels of depression, even when controlling for other known covariates, β = -.16, t(972) p < .001. Females reported higher levels of depression, β = .07, t(972) p < .05. Although race was unrelated to depression in the model including gender and religiosity only, African Americans reported fewer symptoms of depression than did Whites when social support, income sufficiency, and physical health were added to the model, β= -.08, t(972) p < .01. Results suggest the importance of health and social service professionals' drawing upon older adults' positive spirituality in professional interventions to prevent and treat depression.     

Development of a Spiritual Support Scale for Use with Older Adults

SUMMARY

This study reports the development and empirical test of a measure of spiritual supports used by older adults in managing life challenge. The Spiritual Strategies Scale (SSS) consists of 18 items. Cronbach's coefficient alpha reliability for the measure was .86. The sample, gathered from interviews at four sites, consisted of 79 older adults who were predominantly Jewish European American and African American. Concurrent validity analyses suggest that this measure warrants further testing. This scale also has potential for clinical use in social work practice by counselors for older adults.     

Exploring Physical Health of African Americans: A Social Determinant Model

The objective was to examine the relationships between socioeconomic, structural, community, and individual factors and health outcomes of African Americans in the United States using a modified version of the social determinants of health model in a nationally representative sample of 2,926 non-elderly African American adults. This empirical evidence supports the hypothesis that there is a positive relationship between socioeconomic/structural determinants and health outcomes of African Americans. Results show poor housing and low income contribute to poorer health outcomes; therefore, in order to improve the health outcome, programs are needed that provide their residents with adequate and safe housing and employment. Moreover, local, state, and federal governmental entities need to work together to rebuild and revitalize the housing in African American communities.     

Understanding the African American Research Experience (KAARE)

Summary

Despite recognition that the African American population is underrepresented in studies of health and mental health treatment and prevention efforts, few investigations have systematically examined barriers to African American research participation. Without their participation, treatment and prevention strategies designed to curtail the spread of HIV in their communities will be bound to achieve less than optimal outcomes. Based on the assumption that successful recruitment of African Americans requires knowledge of (a) their beliefs about research, (b) their perceptions of the research process and researchers, (c) their motivations to participate, and (d) the historical and social factors that may be the source of at least some ambivalence, the current study undertook semi-structured interviews with 157 African American, low-income mothers residing in a large urban community where they and their children were at high risk for HIV. Given the sensitive nature of the research topic, members of the community were trained to conduct the interviews. Qualitative and quantitative analyses of the interview content suggest that despite having been consented, many participants (a) are not aware of their rights under informed consent and (b) lack knowledge of how the research will be used. Despite this and the subtle suspicion of White researchers held by some, many decide to participate for altruistic reasons. The implications for recruitment of participants in general and African Americans in particular into HIV prevention studies are discussed as are the implications for service providers directly or indirectly involved in the development and delivery of these interventions.     

The Black Family in the 21st Century and the Church as an Action System: A Macro Perspective

Abstract

The Black church has played a leadership function for African Americans during times of crisis such as slavery and the civil rights movement. This article suggests that the current crisis in the African American community is the disintegration of the African American family because of economic, social and value shifts, as well as misguided social policy. The Black church must again mount a spiritual and political campaign to save African American families, thereby ensuring their prosperity.     

Racial Differences in Exposure and Reactivity to Daily Family Stressors

Using data from the National Study of Daily Experiences, the authors examined racial differences in exposure and reactivity to daily stressors involving family members. Respondents included African American and European American adults age 34 to 84 (N = 1,931) who participated in 8 days of daily interviews during which they reported on daily stressors, affect, and physical health symptoms. The results revealed racial similarities in family stressor exposure. Both races were also emotionally reactive to family arguments and family network events (i.e., events that happen to a family member), whereas African Americans were more physically reactive to family arguments. For African Americans, reactivity to family arguments endured; the increased negative affect and physical symptoms associated with family arguments lasted into the next day. The findings provide evidence for racial similarities and differences, suggesting that family relationships are universally stressful, whereas the negative effects of family stressors are more enduring among African Americans.     

Negotiating Homelessness through the Saliency of Family Ties: The Personal Networking Practices of Latino and African American Men

Abstract

This paper examines the role family networks play in the daily survival of homeless Latino and African American men. Using a qualitative research design and a semi-structured interview technique, I examine how these men initiate, participate in and maintain kin-based social networks and how their networks function. The analysis is carried out comparatively for Latinos and African Americans. Two research questions guide the analysis. First, how do the personal networks of homeless men operate? Second, how do the personal networks of homeless African American men differ from those of homeless Latino men? Key findings suggest differences in provisions for social support available within the respective networks of these men. Overall, participants commonly activated social capital within their personal networks, through the practice of filial fluidity which relaxes expectations of social debt and obligations and thus, facilitates the flow of resources vital to the well-being of these homeless men. These findings support a more empowering view of homeless men as active, rational and competent actors engaged in negotiating their situations of homelessness by maintaining active family-based networks.     

Linking race and well-being within a biopsychosocial framework: variation in subjective sleep quality in two racially diverse older adult samples

Differential life experiences associated with race may critically affect the balance between physical and psychological well-being. This study investigated an age-related and disease-related symptom, restless sleep, among older African American and white members of two sociodemographically matched cohorts, community-dwelling older adults and older adults with chronic renal failure undergoing maintenance dialysis therapy. Sleep behaviors reflect age-dependent and disease-dependent homeostatic and circadian state regulation but are also socioculturally patterned. As hypothesized, restless sleep was significantly more characteristic of the older adults in the chronic disease cohort. With non-renal health conditions, depressed mood, perceived health, medication use, and sociodemographic variables controlled, however, African Americans were significantly less likely than whites in the chronic disease cohort to report restless sleep. African American and white patients differed in their expression of public and private religiousness, which in turn were associated, respectively, with depressed mood and restless sleep complaint. In addition, we suggest that differences for African American and white patients in the environmental exposure of chronic dialysis therapy, including African Americans' greater social integration within the dialysis treatment setting, contributed to their being less at risk than their white peers for subjective perception of sleep decay, a marker of overall well-being.     

Parenthood in the Twenty-First Century: African American Grandparents as Surrogate Parents

African American grandparents serve important roles as surrogate parents. Historically they are honored and recognized for their extraordinary service in augmenting the child welfare system. This article provides a contemporary view of the significant number of African American grandparents who serve as surrogate parents. Their assets and challenges are discussed. Following on the work by Dr. Linda Burton and collaborators in 1995, this article addresses the relationship between temporal context, developmental context, and ethnic/racial context of the life course as it relates to grandparenthood in the twenty-first century. In addition to the discussion of African American grand-parenting trends, challenges and benefits in the twenty-first century, the article presents implications of these contexts for the surrogate parenting by older African Americans relative to social work education, research, and policy.     

Psychological distress among black and white Americans: differential effects of social support, negative interaction and personal control

This study examines the relationships among social support, negative interaction, financial strain, traumatic events, personal control, personality, and psychological distress among African American and white adults. These analyses: (1) test the overall adequacy of various models (i.e., main, mediator, and artifactual effects) of these effects, (2) examine the role of social support and negative interaction within the context of financial strain and traumatic events, and (3) verify possible indirect effects of social interaction on distress by assessing their impact on personal control. Data from The National Comorbidity Survey were used to examine these relationships using structural equation modeling techniques. Findings indicated different models of these relationships for African Americans and whites. Overall, personal control mediated the relationship between negative interaction and psychological distress. For whites, negative interaction was an overall stronger predictor of distress and contributed to the impact of financial strain and traumatic events on psychological distress. Among African Americans, social support was a stronger predictor of distress. The findings suggest that the underlying models of these relationships are different for African Americans and whites.     

Religiousness/Spirituality and Subjective Well-Being Among Rural Elderly Whites,African Americans,and Native Americans

SUMMARY

Little attention has been paid to subjective well-being among non-White elderly in rural areas where medical resources and financial support are deficient. The present study assessed a rural community sample of 215 elderly comprising 85 Caucasians, 75 African Americans, and 55 Native Americans, to examine roles of spirituality/religiousness on their subjective well-being. This study found ethnic differences in the reliance on religiosity/spirituality and a significant association between dimensions of religiousness/spirituality and subjective well-being among all ethnic rural elderly groups. The results of the study suggest that health providers, social workers, and faith communities need to provide rural elderly with religious and spiritual support in order to enhance their life satisfaction and lessen their emotional distress.     

Urban and Indigenous: The Challenges of being a Native American in the City

The United States is home to more than 4 million Native Americans, the majority of whom live in urban areas. Urban Native Americans often experience significant social, health, and economic problems while having access to substantially fewer Native-specific resources than their reservation-based counterparts. They also face challenges with access to tribal services and political processes, as well as identity-sustaining cultural resources. This article describes the urban nature of many contemporary Native American communities. Examples from various urban Native American communities highlight the challenges faced by urban Native people, as well as creative initiatives developed to serve this population. This paper draws on and synthesizes the literature on contemporary urban Native communities, thus providing needed information for service providers and researchers working in these communities.     

Life Balance and Work Addiction Among African Americans

A dearth of counseling literature examines the experiences of people of color, including African American women and men, in relation to work–life balance. The authors, therefore, investigated the association between life‐balance domains and work addiction for African Americans. A multiple regression analysis of 115 African American participants (47 men, 68 women) indicated a significant relationship between life‐balance domains and work addiction. In particular, community support was an important indicator of decreased work addiction. Career counselors and mental health counselors need to develop an understanding of how extended familial and social networks assist African American clients in effectively managing work–life balance.     

Mental Health Recovery

Abstract

Strengths-based approaches that emphasize culturally competent services and naturally occurring community support may be more appropriate than traditional mental health services for African American adults with psychiatric disabilities. An examination of the literature on service utilization and treatment needs for this population highlights the paucity of empirical studies in these areas, while an exploration of the literature related to psychiatric recovery, a prominent strengths-based framework, reveals insufficient application of the approach to the specific interests of African American service recipients. We suggest that recovery is in fact highly compatible with such culturally relevant approaches as the Afrocentric model, and argue that the concept of recovery may therefore provide a resonant and particularly useful framework for practice with this population. Implications for research, practice and policy are discussed.     

Vulnerable African American Seniors: The Challenges of Aging in Place

American Community Survey data are used to develop typologies of the generational dynamics and living arrangements of the estimated 1.6 million African American older adult households who will likely encounter the most difficulty aging in place. Policy recommendations and strategies are offered to address the specific barriers and challenges that must be overcome in order for these older adults to successfully live out their lives in their homes and community.     

Anxiety and Depression: Implications for Older Adults

By the year 2030, it is projected that one in every three Americans will be 55-years-old or older. This age group is by far the fastest growing segment of the population. With the growing number of older adults, the importance of understanding aging and common disorders of later life is essential. In particular, anxiety and depression are among the most common problems in older adults. However, differentiating anxiety and depression at the mood, symptom, and syndromal levels has been a long-standing problem in psychopathology research. In addition to a growing need for research, clinicians will also need to take an active role in the development and implementation of treatment as the population of older adults increases. In particular, mental health service providers must become informed about the economic implications for older adults as the structure of health insurance continues to change.     

Building an Institution Second to None: Dr. Inabel Burns Lindsay—A Social Work Leader in the Academy

ABSTRACT

This article describes Dr. Inabel Burns Lindsay's leadership as the founding dean at Howard University School of Social Work during her 30 years of service from 1937 to 1967. It chronicles her efforts to build the School as well as her efforts to highlight social injustices of the time. Her lifelong efforts promoted the inclusion of African American social workers in the workforce and the need to understand sociocultural factors in working with different ethnic and racial groups. As a female dean, Dr. Lindsay was an avid promoter of social justice and a prolific writer and speaker on the topic. This article introduces the reader to this under-recognized social work pioneer, with emphases on the challenges of her time and her leadership style.     

A Heavenly Collaboration: Social Workers and Churches Working to Increase Advance Directive Completion among African American Elderly

The Patient Self-Determination Act (PSDA) was enacted in 1990 as a guarantee to patients that their wishes surrounding end-of-life care would be honored if they expressed verbally or through advance directives the desired level of care they wished to receive at the end of life. Research shows that African Americans have the lowest percentage of advance directives completed among the major racial groups in the United States despite the PSDA's purpose. African American elderly rely on community supports such as social workers and the church to meet physical and spiritual needs. However, these two entities have yet to collaborate to eradicate the dismal percentages of completed advance directives among African American elderly. This article explores how the religious community and social workers can work toward educating this population on the importance of advance directives and empowering them to take the necessary steps at completion if they choose to do so.     

Gender differences in the experience of violence,discrimination, and stress hormone in African Americans: Implications for public health

Violence is more prevalent in African American communities than in other American communities. This has impacts not only on criminal justice interventions but also on the physical and mental health of these communities including their risk for acquiring life-threatening diseases. While many studies have focused on the effects of violence on African American males, we sought to understand the relative gender effects that violence has on African American females. This is of particular interest given the wide array of scientific literature suggesting maternal health has inter-generational health effects. Understanding gender differences associated with exposure to violence, depression, and immune function is an important step in understanding how young women perceive and internalize societal violence directed toward and around them. We analyzed a cohort of 557 young African American adults aged 18–25 years old from the Washington, DC area. We use sociological, epidemiological, mental health, computational biology, and quantitative genetics approaches to build a predictive portrait of the effects of violence on African American health. This study demonstrates that African American males and females experience different constellations of societal violence, that African American women report greater perception of racial and gender bias, and that cortisol, an indicator of stress response, is correlated to perceived discrimination. This work contributes to current understandings of how violence contributes to negative health outcomes and lays the foundation for a predictive model for sociological, health, and behavior risk that young African Americans encounter.