Men and Their Father Figures: Exploring Racial and Ethnic Differences in Mental Health Outcomes

Though gender, racial, and ethnic disparities in health in the United States are well documented, it is less clear how these factors intersect to produce patterns of mental health outcomes among men. This study examined the presence of father figures in the lives of African American, Caribbean black and non-Hispanic white American males until the age of 16; assessed the current socio-demographic factors of these men as adults; and explored whether these factors lead to variations in mental health outcomes. Regression models were used to examine the correlates of socio-demographic, psychosocial, and retrospective father figure measures for depressive symptoms and non-specific psychological distress among African American (n = 999), Caribbean black (n = 506), and non-Hispanic white men (n = 193) from the National Survey of American Life. Findings revealed racial and ethnic group differences by age, employment status, education, and household income on depressive symptoms (measured using the CES-D scale) and non-specific psychological distress (using the Kessler-6 scale). Findings suggested that being raised by a grandfather placed both African American and Caribbean black men at greater risk for depressive symptoms and non-specific psychological distress under certain socio-demographic conditions. This study is unique in that it considers the influence of father figures on the mental health outcomes of adult males across three racial and ethnic groups. We conclude with a discussion of the implications for future mental health research and practice with men of color.     

Low Social Status Markers: Do They Predict Depressive Symptoms in Adolescence?

Some markers of social disadvantage are associated robustly with depressive symptoms among adolescents: female gender and lower socioeconomic status (SES), respectively. Others are associated equivocally, notably black v. white race/ethnicity. Few studies examine whether markers of social disadvantage by gender, SES, and race/ethnicity jointly predict self-reported depressive symptoms during adolescence; this was our goal. Secondary analyses were conducted on data from a socioeconomically diverse community-based cohort study of non-Hispanic black and white adolescents (N = 1,263, 50.4% female). Multivariable general linear models tested whether female gender, black race/ethnicity, and lower SES (assessed by parent education and household income) and their interactions predicted greater depressive symptoms reported on the Center for Epidemiological Studies Depression Scale. Models adjusted for age and pubertal status. Univariate analyses revealed more depressive symptoms in females, blacks, and participants with lower SES. Multivariable models showed females across both racial/ethnic groups reported greater depressive symptoms; blacks demonstrated more depressive symptoms than did whites, but when SES was included this association disappeared. Exploratory analyses suggested blacks gained less mental health benefit from increased SES. However, there were no statistically significant interactions among gender, race/ethnicity, or SES. Taken together, we conclude that complex patterning among low social status domains within gender, race/ethnicity, and SES predicts depressive symptoms among adolescents.     

Race and Ethnic Self-Identification Influences on Physical and Mental Health Statuses Among Blacks

We examine if commonly used distress measures, rates of psychiatric disorders, and chronic health conditions are affected by alternate measures of race-ethnicity for African Americans and Caribbean blacks. We examined two alternative self-identification measures to investigate if their influence might differ. A study on national household probability sample of non-institutionalized African Americans (n = 3,570) and blacks from Caribbean countries, who now live in the United States (n = 1,621), was conducted between February 2001 and June 2003, using a slightly modified version of the Composite International Diagnostic Interview. The method used to measure black race and ethnicity has influence on physical and mental health outcomes. The distributions of depressive symptoms are not affected, while the distributions of DSM IV disorders and chronic health conditions vary by race and ethnic self-identifications among the African American and Caribbean black populations. There are serious implications of using alternate measures of race-ethnicity on the distribution of physical and mental health morbidity among African Americans and Caribbean blacks. The conceptualization and assessment of race-ethnicity should be carefully considered when studying mental and physical health statuses and service needs in the American black population.     

Goal-Striving Stress and Racial Differences in Mental Health

This study investigated the associations among goal-striving stress, racial related stressors, and mental health. Goal-striving stress was defined as the discrepancy between aspiration for and achievement of a better way of life, weighted by the subjective probability of success, and the level of disappointment experienced if those life goals were not realized. Data are from the National Survey of American Life’s African American (N = 3,570) and non-Hispanic white (N = 891) adult samples. Regression analysis was used to assess the relationship between goal-striving stress and five mental health outcomes: happiness, life satisfaction, self-esteem, psychological distress, and depressive symptoms. After controlling for socio-demographic factors, a personal problems checklist, and racial discrimination, goal-striving stress was significantly related to all mental health measures such that as goal-striving stress increased, mental health worsened. Additionally, the relationship of goal-striving stress to mental health was found to be conditional upon race. Specifically, goal-striving stress had a stronger effect among white Americans than African Americans. Goal-striving stress was associated differentially with lower levels of mental health for black and white Americans. Racial differences in the impact of goal-striving stress suggest a need for analyses exploring resilience and coping in relation to the impact of goal-striving stress on black–white differences in mental health.     

Job Strain, Workplace Discrimination, and Hypertension Among Older Workers: The Health and Retirement Study

Job strain has been associated with hypertension among younger workers; however, whether this relationship persists among older workers, particularly older racial/ethnic minorities, is unresolved. This study evaluated whether job strain and workplace discrimination are associated with hypertension and poor blood pressure control among older workers and whether these relationships vary by gender and race/ethnicity. Data were drawn from the Health and Retirement Study, and analysis was restricted to employed participants with complete information on job strain and blood pressure (N = 3,794). In adjusted models, high job strain was associated with lower likelihood of hypertension (odds ratio (OR): 0.75, 95% confidence interval (CI): 0.63, 0.89) relative to low job strain. Stratified analyses indicated this association was only significant among white (OR: 0.71, 95% CI: 0.58, 0.86) and male (OR: 0.61, 95% CI: 0.47, 0.79) workers. High job strain was not significantly associated with hypertension among African American (OR: 1.14, 95% CI: 0.63, 2.07) or Hispanic (OR: 0.56, 95% CI: 0.29, 1.09) workers. Workplace discrimination was not associated with hypertension among any group. Neither job strain nor discrimination was associated with poor blood pressure control. These findings suggest that persistence in work characterized by high job strain in later life may signal resilience to the influence of work-related stressors on health. Future research efforts should examine the factors that contribute to gender and racial differences in these relationships.     

Perceived Racial Discrimination in Health Care and Race Differences in Physician Trust

Racial discrimination in health care is more often perceived by racial minority patients than by whites. In this study, we explored whether two types of perceived racial discrimination, perceptions that the healthcare system is racially biased in general (perceived institutional racial discrimination) and perceptions that one has personally encountered racial discrimination while seeking health care (perceived interpersonal racial discrimination), mediated racial differences in patients’ trust in physicians. We examined this in a sample of black (N = 127) and white (N = 303) patients being treated in two Veterans Affairs orthopedic clinics for advanced osteoarthritis. Patients completed measures of perceived institutional and interpersonal racial discrimination in health care before meeting with an orthopedic surgeon and a measure of physician trust after the visit. Using a multiple mediator bootstrapping procedure, we tested whether perceived institutional and/or interpersonal racial discrimination mediated the association between race and trust. Compared to whites, blacks reported lower physician trust (M = 4.00 vs. 4.17, β = ?0.15, 95 % CI = ?0.25, ?0.05), more perceived institutional racial discrimination (M = 3.13 vs. 2.60, β = 0.43, 95 % CI = 0.25, 0.61), and more perceived interpersonal racial discrimination (M = 1.94 vs. 1.21, β = 0.60, 95 % CI = 0.47, 0.74). Perceived interpersonal, but not institutional, racial discrimination mediated the race difference in physician trust and accounted for 55 % of the variance. Our finding that lower physician trust among black patients than white patients was explained by perceptions of interpersonal racial discrimination in health care suggests that issues of racial discrimination may need to be addressed in order to foster minority patients’ trust in physicians.     

Hardship Among Older Adults in the HRS: Exploring Measurement Differences Across Socio-Demographic Characteristics

Measures of hardship have been proffered as better indicators of economic well-being than traditional measures of socioeconomic status (SES). However, there is a dearth of research on latent factor structures and measurement bias in items assessing hardship across socio-demographic characteristics, especially among older adults. As such, the purpose of this study was to determine the factor structure of items measuring hardship in the Health and Retirement Study (HRS) and to determine measurement bias across socio-demographic groups (i.e., race/ethnicity, gender, and age). The participants were HRS subjects who completed an additional psychosocial survey (N = 3074). The results revealed a single latent factor for hardship (comparative fit index = 0.99, root mean square error of approximation = 0.02) using confirmatory factor analysis on eight items in the HRS. The multiple indicator, multiple causes (MIMIC) model was used to determine measurement bias in the items due to socio-demographic characteristics. Compared to white respondents, black respondents were more likely to endorse items of financial dissatisfaction (Odds Ratio (OR) = 2.19, 95 % Confidence Interval (CI) = 1.43, 3.35), while Latino respondents were more likely to endorse food insecurity (OR = 2.78, 95 % CI = 1.60, 4.83); and older individuals (age 65 and older) were less likely to endorse having moved to a worse residence/neighborhood (OR = 0.32, CI = 0.18, 0.57) and being unemployed (OR = 0.28, CI = 0.20, 0.38). These results indicate that there is differential item functioning for specific measures of hardship suggesting that there are differences observed for the measurement of hardship for these items across racial/ethnic and age groups.     

Race,SES, and Obesity Among Men

Over the last decade, obesity has increased significantly among men but few national studies have empirically examined racial and socioeconomic differences in obesity among men. In this paper, we utilized logistic regression to evaluate the potential associations that race and socioeconomic status may have with obesity among men in the National Survey of American Life: an in-person household survey of non-institutionalized U.S. blacks and whites who lived in communities where at least 10% of the community residents were black Americans. A greater proportion of black men were likely to be obese than white men, but no interaction among race, SES, and obesity was detected when potential confounding variables were included. There was not a relationship between SES and obesity for white men, but there was an apparent positive relationship between SES and obesity for black men that did not remain significant in adjusted models. No relationship was found between age and obesity among black men, though white men who were 55 and older were more likely than those 18–34 to be obese in confounder adjusted models. Among white men, no relationships were found between obesity and education, household income, or marital status. Black men in the lowest income category were less likely to be obese than those in the highest income category, in bivariate but not adjusted models. These findings suggest that the way racial, economic, stress and behavioral factors combine to affect obesity in black and white men may be different.     

Differentiating Contemporary Racial Prejudice from Old-Fashioned Racial Prejudice

The present study addresses the distinction between contemporary and old-fashioned prejudice using survey data from a national sample (n = 600) of self-identified whites living in the United States and interviewed by telephone in 2001. First, we examine associations among indicators of contemporary and old-fashioned prejudice. Consistent with the literature, contemporary and old-fashioned prejudice indicators represent two distinct but correlated common factors. Second, we examine whether belief in genetic race differences uniformly predicts both types of prejudice. As might be expected, belief in genetic race differences predicts old-fashioned prejudice but contrary to recent theorizing, it also predicts contemporary prejudice.     

Immigrant Group Differences in Job Satisfaction

Despite the large number of immigrants in Canada’s labor force, studies of immigrants to Canada have devoted insufficient attention to how country of birth and race are related to job satisfaction. Using data from a general population telephone survey of English-speaking workers in Toronto (n = 659), we investigate job satisfaction differences between white Canadian-born workers and immigrants born in the Caribbean, the Philippines, South Asia, China, Portugal, the United States, and the UK. Each of the immigrant groups is racially homogenous, and most of the groups are composed of (non-white) visible minorities. We find that the contrasts between Canadian-born whites and workers born in the Philippines and China remain substantial, and statistically significant under one-tailed tests, after age, gender, job type, income, job demands, job control, job support, workplace discrimination, job-related stress, and perceived unfairness at work are all controlled. We argue that social comparison theory offers the most compelling explanation for the persistence of group differences in job satisfaction after controls.     

Effect of School Racial Composition on Trajectories of Depressive Symptoms from Adolescence Through Early Adulthood

We investigate the effect of high school racial composition, measured as percent of non-Hispanic white students, on trajectories of depressive symptoms from adolescence to early adulthood. We also explore whether the effect of school racial composition varies by respondent race/ethnicity and whether adult socioeconomic status mediates this relationship. We analyzed four waves of data from the National Longitudinal Study of Adolescent Health using 3-level linear growth models. We restricted our sample to respondents enrolled in grades 9–12 in 1994/5 who were interviewed at a minimum in Waves I and IV. This resulted in 10,350 respondents enrolled in 80 high schools in 1994/5 (5,561 whites, 2,030 blacks, 1,834 Hispanics, 738 Asians, and 187 of other race). As the percentage of white students increased at the high school respondents attended in 1994/5, blacks reported more depressive symptoms. This effect did not vary by age. In comparison, Asian and Hispanic respondents who attended predominantly white high schools had lower levels of depressive symptoms than their counterparts who attended predominantly minority schools, but they also experienced a slower decline in depressive symptoms through early adulthood. Adult SES mediated the relationship between high school racial composition and depressive symptoms for black, but not for Asian or Hispanic respondents. Our results suggest that high school racial composition is associated with trajectories of depressive symptoms through early adulthood, but the effect differs by respondents’ race/ethnicity. Racial/ethnic disparities in depressive symptoms during early adulthood may have their origins in adolescence.     

Adolescent-Rated Health and Intention to Attend College: Variation by Race/Ethnicity and Levels of Health Status

Quantify the relationships between adolescent self-reported health and college intention in a diverse sample including Asians. Data were used from 3,737 adolescents ages 12–17 who completed the 2003 California Health Interview Survey. Self-reported intention to attend college/university was compared to other plans. Multivariate logistic models predicting college intention by health status (poor/fair, good, or very good/excellent) were performed with the entire sample and for each race/ethnicity separately. Age, poverty, gender, rural residence, and parental college education were controlled. Participants were 44 % white, 36 % Hispanic, 11 % Asian, and 9 % black. Overall, 10 % reported poor/fair health, 30 % good health, and 60 % very good/excellent health. Whites were the most likely to report very good/excellent health and Hispanics least likely (χ²(6) = 11.85; p < 0.01). Eighty-one percent had college plans, which also varied by race/ethnicity with Asians most likely to report college intentions and Hispanics least likely (χ²(3) = 3.97; p < 0.05). In the overall multivariate model, adolescents in poor/fair health (OR: 0.53; 95 % CI: 0.34–0.83) and good health (OR: 0.59; 95 % CI: 0.45–0.78) were significantly less likely to plan on college compared to those in very good/excellent health. Variation was seen by racial/ethnic group. For whites and blacks, only good health significantly predicted less college intention (compared to very good/excellent health) while only poor/fair health significantly predicted less college intention for Hispanics and Asians. Very good/excellent health in adolescence was associated with greater college intention compared to both fair/poor health and good health, but this relationship varied by race/ethnicity.     

Predictors of Posttraumatic Stress and Growth Among Black and White Survivors of Hurricane Katrina: Does Perceived Quality of the Governmental Response Matter?

Data from the Baseline Survey of the Hurricane Katrina Community Advisory Group Study (Kessler 2009) were used to explore the predictors of posttraumatic growth and posttraumatic stress among black (n?=?265) and white (n?=?715) adult survivors of Hurricane Katrina. We focus on the perceived quality of the governmental response and cognitive processing related to the response on posttraumatic outcomes, and whether there were racial group differences. We also consider the impact of demographic factors and severity of stress. Results of hierarchical linear regression showed that being black, older, having lower educational attainment, and experiencing greater perceived stress and loss during Katrina positively predicted greater posttraumatic growth. Being female, living below the poverty line, and experiencing greater perceived stress and loss positively predicted posttraumatic stress symptoms. More positive views of the governmental response were associated with greater posttraumatic growth and more negative views with greater posttraumatic stress symptomology. Moreover, it was found that race significantly moderated the effect between perceived quality of the response and posttraumatic stress. Subgroup analysis corroborated the interaction effect and showed that while perceived quality of the governmental response significantly predicted posttraumatic stress for black survivors, it was not a significant predictor for white survivors. This study sheds light on some of the factors and conditions under which positive and negative post-trauma outcomes occurred after Katrina. We propose that racial group differences in the impact of perceived quality of the response on posttraumatic stress may be related to views among some black survivors that the emergency response was discriminatory.     

School-Based Racial and Gender Discrimination among African American Adolescents: Exploring Gender Variation in Frequency and Implications for Adjustment

The present study examined school-based racial and gender discrimination experiences among African American adolescents in Grade 8 (n = 204 girls; n = 209 boys). A primary goal was exploring gender variation in frequency of both types of discrimination and associations of discrimination with academic and psychological functioning among girls and boys. Girls and boys did not vary in reported racial discrimination frequency, but boys reported more gender discrimination experiences. Multiple regression analyses within gender groups indicated that among girls and boys, racial discrimination and gender discrimination predicted higher depressive symptoms and school importance and racial discrimination predicted self-esteem. Racial and gender discrimination were also negatively associated with grade point average among boys but were not significantly associated in girls’ analyses. Significant gender discrimination X racial discrimination interactions resulted in the girls’ models predicting psychological outcomes and in boys’ models predicting academic achievement. Taken together, findings suggest the importance of considering gender- and race-related experiences in understanding academic and psychological adjustment among African American adolescents.     

Racial Disproportionality in Juvenile Justice: The Interaction of Race and Geography in Pretrial Detention for Violent and Serious Offenses

Youth of color, particularly black youth, are overrepresented at every stage of processing in the juvenile justice system. This paper presents an analysis of racial differentials at an early stage—pretrial detention among youth charged with violent and serious offenses. It contributes to work in this area by exploring police decision making, which has been understudied in comparison with decision making by court actors. Contrary to prior studies suggesting that race differences in police treatment are found primarily in the handling of youth suspected of minor offenses, we find that black youth are three times as likely as white youth to be detained, controlling for other demographic and legal factors, including offense type and severity. This paper also contributes to efforts to understand how racial disproportionality occurs, by including an analysis of how geography affects detention decisions differentially by race. Using data from an urban county in Michigan, we find that geography and race interact, such that white youth from the suburbs are much less likely to be detained than white youth from the city and black youth from the city or suburbs.     

Understanding Racial and Ethnic Disparities in Arrest: The Role of Individual,Home, School,and Community Characteristics

Contact with the justice system can lead to a range of poor health and social outcomes. While persons of color are disproportionately represented in both the juvenile and criminal justice systems, reasons for these patters remain unclear. This study sought to examine the extent and sources of differences in arrests during adolescence and young adulthood among blacks, whites, and Hispanics in the USA. Multilevel cross-sectional logistic regression analyses were conducted using data from waves I and IV of the National Longitudinal Study of Adolescent to Adult Health (n = 12,752 respondents). Results showed significantly higher likelihood of having ever been arrested among blacks, when compared to whites, even after controlling for a range of delinquent behaviors (odds ratio = 1.58, 95 % confidence interval = 1.27, 1.95). These black–white disparities were no longer present after accounting for racial composition of the neighborhood, supporting the growing body of research demonstrating the importance of contextual variables in driving disproportionate minority contact with the justice system.     

Understanding Differences in College Enrollment: Race,Class and Cultural Capital

Scholarship on race and class differences in educational outcomes has identified cultural capital, or cultural resources that can be utilized to increase educational success, as important mechanisms of educational inequality. However, despite substantial interest, the role of cultural capital in producing inequalities among American students remains unclear. In this research, we use nationally representative data from the Educational Longitudinal Study to clarify the relationships among race, social class, cultural capital and 4-year college enrollment. Using a theoretically based approach to operationalizing social class and measures of both cultural capital possession and activation, this research finds that while black students tend to possess fewer resources than their white counterparts at any class level, they activate cultural capital to a greater degree than white students. Results also show that while cultural capital can explain differences between low-income and middle-income students, a persistent middle-class advantage remains for both black and white students. Additionally, results indicate that at any class level, black students are more likely than their white counterparts to attend a 4-year university. Finally, results show that measures of cultural capital possession and activation have generally independent effects on college enrollment.     

A test of racial conceptualization between African Americans and indigenous Africans

Studies were conducted to assess the significance of the concept of race in interpersonal attraction and self-identification comparing African Americans and native Ghanaians. An adaptation of the Bogardus Scale (1926) was used to measure interpersonal attraction. A self-identification questionnaire developed by the principal author was used to measure self-identification. The samples consisted of 366 native Ghanaians residing in Ghana and 113 African Americans residing in Northern New Jersey. The results show that when making judgments about interpersonal attraction to different ethnic and racial groups as well as in self-identification, African American respondents attributed more psychological significance to the concept of race than Ghanaian respondents did. Racial group membership and cultural kinships were strongly related to interpersonal attraction and self-identification for African American respondents. They attributed more significance to racial group membership in judging self-identification and interpersonal attraction toward other African Americans compared with other groups. On the other hand, in judging interpersonal attraction toward other groups, African American respondents attributed more significance to cultural reference factors than racial group membership. Ghanaians perceived nationality and cultural kinships as more significant than racial group membership in their reported interpersonal attraction to groups represented in this work Ghanaian respondents did not perceive racial group membership as a significant factor in making judgments about interpersonal attraction and self-identification.     

Sounding Like Your Race in the Employment Process: An Experiment on Speaker Voice,Race Identification,and Stereotyping

Research has shown that listeners can identify black and white speakers with high accuracy rates from voice alone, but few studies have investigated whether individuals can identify Asian American native English speakers. In a three-part hypothetical employment process experiment, recordings of white, black, and US-born Asian American voices are used to test participants’ (N = 49) race identification of unseen speakers, evaluations of speakers’ employability, and accuracy of race identification with the introduction of headshots. Key findings show the following: judges demonstrate high accuracy rates of identifying white and black speakers based on voice alone, judges rated the black speaker at least eight times less likely to be hired than the white and Asian American speakers, and accuracy rates of race identification for the Asian American speaker rose dramatically with the introduction of headshots. The study contributes to research on Asian American English speech and extends work on stereotyping and employment discrimination.     

Race and Gender Concordance: Strategy to Reduce Healthcare Disparities or Red Herring? Evidence from a Qualitative Study

Healthcare treatment differences persist for African Americans even after controlling for socioeconomic status (van Ryn and Burke 2000). Although blacks represent a sizable percentage of the middle class, most disparities research does not address class heterogeneity. Furthermore, research indicates patient–provider race concordance may mitigate racial disparities in health care (Laveist and Neru-jeter in J Health Soc Behav 43(3):296–306, 2002; IOM in Unequal treatment: confronting racial and ethnic disparities in health care. National Academies Press, Washington, 2002). This study explores race and gender preference for black middle-class women in healthcare settings. The study uses in-depth interviews and focus groups to explore the experiences of thirty African American women between 38 and 67 in a large urban area. The majority of respondents expressed a strong preference for a female OB/GYN (of any race) while 9 preferred a female primary care provider (of any race). Although the women did not express an explicit race preference, they had a strong affinity for black female providers. Importantly, respondents complicated the idea of provider-level race preference by noting that other site-level factors like wait times and the site’s racial composition affected their racial preferences. Although increasing racial diversity among providers is generally positive, respondents suggest that alone will not ameliorate racial disparities. The complexities of the healthcare encounter, including time pressure, clinical uncertainty, and the patient’s desire for expertise regardless of race or gender, all impinge on respondents’ race preferences. Lastly, women noted that site-level factors may be conflated with the race of provider such that having a black provider does not necessarily lead to better care or protect women from discrimination or bias.