Untangling Inequalities: Gender,Race, and Socioeconomic Differences in Depression1

In their important paper, Link and Phelan (1995) argue that socioeconomic status is a fundamental cause of variation in well‐being and that the social resources associated with socioeconomic status constitute the fundamental cause of variation in well‐being. In this article, I elaborate on the fundamental cause perspective in three respects: by suggesting an expansion of the definition of resources, by examining how race and gender influence variation in the relationship between resources and mental health, and by developing a model of the relationship between social class, race, and gender that takes account of the potential asymmetry in the influence of resources across race and gender. Using the 2003 National Health Interview Survey and ordinary least squares regression, I find that black and white men are significantly less depressed than black and white women. However, women accrue greater mental health advantage from marriage, home ownership, and education. African‐American men experience less depression as a result of being unmarried and non‐Hispanic white women experience less benefit from full‐time employment, relative to African‐American women and men. Results are discussed in terms of implications for future research on race, class, and gender differences in health.     

Racialized Labour Market Incorporation? African Immigrants and the Role of Education‐Occupation Mismatch in Earnings

U.S. immigration policy debates increasingly center on attracting highly‐skilled immigrants. African immigrants, in particular, exhibit high levels of over‐education. But questions remain about whether African immigrants’ skills are appropriately utilized in the U.S. labour market. This paper uses U.S. Census and American Community Survey data to determine whether Africans’ over‐education leads to a corresponding wage disadvantage. I also investigate whether search and match, imperfect transferability, or queuing theory describes African immigrants’ wage outcomes. I find that, while African and Asian immigrants have similarly high rates of college education and over‐education, Africans experience significantly larger wage disadvantages due to over‐education. African immigrants’ low wages are closer to that of U.S. and Caribbean‐born blacks indicating that queuing theory describes their wage disadvantage. These findings suggest the need for policy addressing racial disparities in the labour market rather than new immigration policy.     

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.     

A gender-based approach to developing a healthy lifestyle and healthy weight intervention for diverse Utah women

Utah women from some cultural minority groups have higher overweight/obesity rates than the overall population. We utilized a gender-based mixed methods approach to learn about the underlying social, cultural and gender issues that contribute to the increased obesity risk among these women and to inform intervention development. A literature review and analysis of Utah's Behavioral Risk Factor Surveillance System data informed the development of a focus group guide. Focus groups were conducted with five groups of women: African immigrants from Burundi and Rwanda, African Americans, American Indians/Alaskan Natives, Hispanics/Latinas, and Pacific Islanders. Six common themes emerged: (1) health is multidimensional and interventions must address health in this manner; (2) limited resources and time influence health behaviors; (3) norms about healthy weight vary, with certain communities showing more preference to heavier women; (4) women and men have important but different influences on healthy lifestyle practices within households; (5) women have an influential role on the health of families; and (6) opportunities exist within each group to improve health. Seeking insights from these five groups of women helped to identify common and distinct cultural and gender themes related to obesity, which can be used to help elucidate core obesity determinants.     

Food insufficiency and physical and mental health in a longitudinal survey of welfare recipients

Food insufficiency is a significant problem in the United States, and poor African American women with children are at especially high risk. An inadequate household food supply can potentially affect the well-being of household members, but it is difficult to distinguish the effects of food insufficiency from risk factors for poor health that are also common among the food insufficient, such as poverty. We examined food insufficiency and physical and mental health among African American and white women (n = 676) who were welfare recipients in 1997. Controlling for common risk factors, women who reported food insufficiency in both 1997 and 1998 were more likely to report fair or poor health at the later date. Food insufficiency in 1998 was significantly associated with meeting the diagnostic screening criteria for recent major depression. Food insufficiency at both times and in 1998 only was related to women's sense of mastery. These findings add to growing evidence that household food insufficiency is associated with poor physical and mental health.     

Comparing Offers and Take‐ups of Employee Health Insurance across Race,Gender, and Decade*

How often do U.S. employees receive health insurance offers from employers? When offered, how often do they take up their employer‐based health insurance? This article uses the 1992 and 2002 waves of the National Study of the Changing Workforce (NSCW) to investigate changes in access to (offers) and employees electing to accept, take, or purchase their employers’ health insurance plans (take‐ups) among wage and salaried workers. Although much research has studied employee health benefits, little has examined the intersection of gender and race regarding both offers and take‐ups of such benefits. Logistic regression results indicate that offers and take‐ups of personal health benefits declined from 1992 to 2002, net of salient controls. Further analyses demonstrate that these declines did not affect all workers identically. Offers declined somewhat for both women and men among whites and African Americans, but declined more among Hispanic women and men. Among other ethnoracial groups, offers declined the most among men, but increased among comparable women. Take‐ups declined among white men and Hispanic workers. However, white and African American women's take‐ups did not change and among African American men take‐ups increased. We discuss the need to examine gender and race simultaneously and urge researchers to more closely examine changes in health benefit offers and take‐ups.     

Social isolation from extended family members and friends among African Americans: Findings from a national survey

This study investigated the correlates of objective social isolation from extended family members and friends among a national sample of African Americans. The analysis is based upon the African American subsample (n = 3,570) of the National Survey of American Life. The dependent variable examines four categories of respondents: 1) socially isolated from both family and friends, 2) socially isolated from friends only, 3) socially isolated from family only, and 4) not socially isolated. Overall, 23% of respondents indicated some degree of objective social isolation from family, friends or both groups, while the complementary 77% of the sample were not isolated from family or friends. Only 4% of respondents indicated being isolated from both family and friends. Multinomial logistic regression analysis revealed several gender, education, marital status and region differences. In particular, African American women were less likely to be socially isolated from family members than African American men. This finding was sustained even when controlling for differences in subjective isolation from family members, underscoring the protective effect of female gender. Study findings are discussed in relation to previous research on social isolation, as well as prior research on African American social support networks.     

Race,Class, and Support for the Welfare State*

Two competing approaches to the study of African Americans—the race and class perspectives—have dominated attempts to explain their views on contemporary issues. To examine the race versus class debate, this study uses African Americans' views on government spending for five social welfare concerns: (1) improving and protecting the nation's health, (2) solving the problems of big cities, (3) halting rising crime rates, (4) dealing with drug addiction, and (5) improving the nation's education system. Data from the 1972–1990 General Social Surveys are used to compare middle-class blacks with both working-class blacks and whites and middle-class whites in terms of their support for government spending for those five social welfare issues. Examining group means, we found no significant difference between the two black classes but a significant difference between the black middle class and the white middle class on support for government spending in all areas except halting the rising crime rates (where there were no significant differences among the four groups). Similarly, using logistic regression analysis we found that race continued to have a significant effect on support for spending even after controlling for class, year, age, gender, education, income, and occupational prestige. In respect to social welfare spending, the results indicate support for the race, as opposed to the class, perspective; that is, race is better than class for predicting African American attitudes on government spending.     

“We Have Closed Our Eyes and Sealed Our Lips”: Black Women’s Accounts of Discussing Suicide within the Black Community

Conversing about suicide with an at-risk individual can be enough to save a life. Given the rise of suicidal behavior among African American subgroups (i.e., youth and male), advocates are urging blacks to have candid conversations about the issue. The current study highlights black women’s experiences discussing suicide. Findings suggest that widespread beliefs that suicide is an insignificant issue among blacks make conversing about suicide especially challenging. These findings reveal problematic implications for African Americans contemplating suicide in their communities. Suicide may be a phenomenon for which communal support is less prevalent.     

DESPAIR, DISTRUST AND DISSATISFACTION AMONG BLACKS AND WOMEN, 1973–1987

Discontent among American blacks and women is examined with indicators of the anomia of despair and distrust, and of job and financial dissatisfaction. Nine years of General Social Survey data covering 1973 through 1987 show that blacks' discontent exceeds whites' in most instances examined; and black women more frequently show significantly higher discontent than other race/gender groups. Also, blacks' discontent more often exceeds whites' among persons high in SES than among those low in SES. But gender main effects are almost nonexistent; and white women almost never show more discontent than other race/gender groups. This unexpected finding may be related to white women's greater identification with race than gender and their perception of general but not personal discrimination. Failure of the gender/discontent relationships to differ with the American president in office may have a similar explanation. But, as expected, racial differences in discontent tended to be higher during the Nixon/Ford and Reagan administrations than Carter's.     

Perceptions of Equal Opportunity among Women and Minority Army Personnel

Equal opportunity (EO) is recognized by the Department of Defense (DoD) as being crucial to maintaining a high state of military readiness. In the last two and a half decades, a number of EO initiatives have been employed by the DoD and each of the military services in an effort to promote fair treatment of minorities and women. Social science literature suggests that the integration of racial minorities, particularly African American males, is a military success story. Some social scientists argue convincingly that the military has far surpassed civilian organizations in integrating African Americans. While the U.S. military has had a long history of addressing racial issues, problems concerning gender have only recently been addressed on a large scale. Some scholars assert that the military is the last male bastion in the United States. It lags behind the civilian sector in integrating women. This study examines the perceptions of active‐duty men and women in the U.S. Army to determine whether minority men are more satisfied with the equal opportunity climate than women and whether minority women are less satisfied with the equal opportunity climate than non‐minority (White) women. The purpose of this study is twofold: One objective is to examine differences within the gender category, i.e., African American, Hispanic, and White women. The other objective is to explore differences across gender. Degree of satisfaction is measured by responses to items on the Military Equal Opportunity Climate Survey (MEOCS). The data were stratified by rank level, officer and enlisted, and a General Linear Model (GLM) was performed with race, gender, and the interaction of race and gender as independent variables. In the final analysis, the data were stratified by paygrade, and a GLM was performed on each part separately. Among the findings, race is a more powerful predictor of the attitudes of active‐duty men and women toward the EO climate in their units than either gender or the interaction of race and gender. While gender is significant in most of the statistical models, and the interaction of gender and race is sometimes significant, these variables explain less than one percent of the variance. Although African American men are generally more satisfied with the EO climate than African American women, they are less satisfied than White and, in some cases, Hispanic men and women.     

Race-Ethnicity and Health Trajectories: Tests of Three Hypotheses across Multiple Groups and Health Outcomes

Racial-ethnic disparities in static levels of health are well documented. Less is known about racial-ethnic differences in age trajectories of health. The few studies on this topic have examined only single health outcomes and focused on black-white disparities. This study extends prior research by using a life course perspective, panel data from the Health and Retirement Study, and multilevel growth curve models to investigate racial-ethnic differences in the trajectories of serious conditions and functional limitations among blacks, Mexican Americans, and whites. We test three hypotheses on the nature of racial-ethnic disparities in health across the life course (aging-as-leveler, persistent inequality, and cumulative disadvantage). Results controlling for mortality selection reveal that support for the hypotheses varies by health outcome, racial-ethnic group, and life stage. Controlling for childhood socioeconomic status, adult social and economic resources, and health behaviors reduces but does not eliminate racial-ethnic disparities in health trajectories.     

A qualitative study to examine how differences in motivation can inform the development of targeted physical activity interventions for African American women

Self-Determination Theory proposes that some people are motivated to initiate physical activity by externally-controlled reasons (e.g., physical appearance, approval from others), whereas others feel compelled by more autonomous sources of motivation (e.g., enjoyment, personal importance). This study used qualitative methods to examine whether individual differences in autonomous motivation offers a useful framework for developing targeted intervention programs for African American women. Focus groups (k = 6) were conducted to examine how different levels of autonomous motivation for physical activity related to differences in physical activity barriers and facilitators among African American women (N = 31). Sessions were audiotaped, transcribed, and coded by independent raters (r = 0.70). QSR NVivo 11 was used to analyze data, and themes were identified separately for women with low, medium, or high autonomous motivation. Those with high autonomous motivation focused on themes of wanting novelty, excitement, and competition, whereas those with low autonomous motivation focused on themes of wanting instrumental support and financial incentives for increasing engagement in physical activity. Implications for developing physical activity intervention programs for African American women that are targeted toward differences in autonomous motivation are discussed.     

Lifting the Veil: African American Images and the European American Gaze

Patricia Hill Collins presents and discusses gender and gender role norms, behaviors, and ideologies among African Americans in an interdisciplinary diagnostic endeavor that calls attention to health, economic, behavioral, and psychosocial patterns related to social injustice and inequality. Collins presents several popular culture, mass media, and social science literature topics that call for a progressive Black sexual politics necessary for African American empowerment. A most crucial and apparent point of Collins's discussion is that improvement in the lives of African Americans requires inspection and analysis of gender and sexuality related intragroup variation and diversity. I situate this discussion primarily within a post-civil rights ideological revolution related to the European American “gaze,” multiculturalism, and European American emotional ambivalence toward the Black body. It is proposed that Collins's analysis of the intersectionality of race, gender, and sexuality among African Americans occurs within an American context that reciprocally impacts African American intragroup dynamics.     

Gender Role Identity and Stress in African American Women

Abstract

Womanism is a feminist perspective that has recently been appropriated for social work practice with African American women (Littlefleld, in press). It emphasizes the centrality of gender role in African American women's psychosocial adaptation, and asserts that the archetypal gender role for this group incorporates both nurturing and economic providing functions. This gender role fluidity has been characterized both as a source of strength (Billingsley, 1992; Hill, 1999) and strain (Lewis, 1989; McAdoo, 1985). The present study empirically investigated the relationship between gender role identity and stress in African American women to clarify its adaptive value. The Bem Sex Role Inventory was used to classify subjects into groups based on the degree to which they identified themselves with stereotypically masculine and feminine traits. Women who endorsed high levels of both masculine and feminine traits experienced lower levels of stress than did other women. The findings indicate that gender role identity is a factor in African American women's psychosocial well-being, and that mainstream gender role norms may not be adequate for analyzing the experiences of this group.     

Violence and trauma: predicting the impact on the well-being of African American women with severe mental illness

Exposure to violence and trauma has become a major mental health and public health problem in the United States. This study assesses the rates of exposure to traumatic events of 55 adult African American women receiving treatment in an urban community mental health clinic. The study examined three research questions. First, what is the rate of exposure to violence and trauma among African American women in an urban community mental health clinic? Second, what effect does violence and trauma exposure have on mental health? Finally, does exposure to violence and trauma have an effect on well-being as measured with the Medical Outcomes Survey (MOS/SF-36)? A significant negative relationship between diagnostic burden and well-being was found. A negative nonsignificant relationship was found between Posttraumatic Diagnostic Scale (PDS) and wellbeing. Study findings suggest that use of a screening and assessment tool for violence and trauma exposure may have important clinical implications in providing appropriate mental health services to African American women.     

African American and European American Women's Marital Well‐Being

Using a sample of 247 African American and European American women in their 3rd year of marriage, this study compared the predictors of marital well‐being for each group by focusing on the influences of individual, interpersonal, and social and economic resources. Regression analyses revealed that emotional health (individual), trusting one's spouse (interpersonal), and feeling underbenefited in the relationship (interpersonal) were significant predictors of marital well‐being for both groups of women. Physical health (individual) and in‐law relations (social and economic), however, affected the marital well‐being of only African American women. Findings from this study suggest the need to examine marital well‐being within the context of race.     

Does an Immigrant Background Ameliorate Racial Disadvantage? The Socioeconomic Attainments of Second‐Generation African Americans1

Although there is a growing literature on the socioeconomic circumstances of the second generation, this issue has not been systematically considered for African Americans. To help fill this research gap, we investigate the extent to which the socioeconomic attainments of second‐generation African Americans differ from mainstream (i.e., third and higher generation) African Americans. Using data from the Current Population Survey and the 2000 Census, our results indicate that the schooling and wages of second‐generation African Americans consistently exceed those of third‐ and higher generation African Americans. Our findings also reveal that second‐generation African Americans do at least as well as whites in terms of years of schooling, but wage differentials differ significantly by gender. Second‐generation African‐American women earn wages that are at least as high as comparable white women, but second‐generation African‐American men earn wages that are, on average, about 16% less than measurably comparable white men. While no one theoretical perspective can account for all these results, they nonetheless indicate the continuing significance of racial disadvantage for African‐American men, including those with an immigrant background.     

Physical and mental health outcomes of women in nonviolent, unilaterally violent, and mutually violent relationships

Despite equivocal findings on whether men or women are more violent, the negative impact of violence is greatest for women. To determine how gender asymmetry in perpetration affects women's health status, we conducted a study in two phases with 835 African American, Euro-American, and Mexican American low-income women in Project HOW: Health Outcomes of Women. In Phase 1, we used severity and frequency of women's and male partners' violence to create six groups: nonviolent (NV), uni-directional male (UM) perpetrator, uni-directional female (UF) perpetrator and, when both partners were violent, symmetrical (SYM), male primary perpetrator (MPP), and female primary perpetrator (FPP). The MPP group sustained the most threats, violence, sexual aggression, and psychological abuse. They also reported the most fear. Injury was highest in the MPP and FPP groups. In Phase 2, we examined group differences in women's health status over time for 535 participants, who completed five annual interviews. Surprisingly, women's health in the MPP and FPP violence groups was similar and generally worse than if violence was uni-directional.     

Economic Resources and Woman Abuse

Abstract

Secondary data analyses of the 1999 National Crime Victimization Survey (NCVS) were conducted to examine relationships between economic resources and woman abuse among subsamples of African American, Hispanic and White women. Logistic analyses indicated that associations vary, not only along racial and ethnic lines, but also by type of woman abuse. None of the economic resources were associated with woman abuse for the Hispanic women. Employment status and education attainment were the strongest predictors of abuse among the African American and White women. Adding marital status and age into the models had significant impact on the previous associations.