“Every Shut Eye, Ain’t Sleep”: The Role of Racism-Related Vigilance in Racial/Ethnic Disparities in Sleep Difficulty

Although racial/ethnic disparities in health have been well characterized in biomedical, public health, and social science research, the determinants of these disparities are still not well understood. Chronic psychosocial stress related specifically to the American experience of institutional and interpersonal racial discrimination may be an important determinant of these disparities, as a growing literature in separate scientific disciplines documents the adverse health effects of stress and the greater levels of stress experienced by non-white compared to white Americans. However, the empirical literature on the importance of stress for health and health disparities specifically due to racial discrimination, using population-representative data, is still small and mixed. In this paper, we explore the association between a novel measure of racially salient chronic stress—“racism-related vigilance”—and sleep difficulty. We found that, compared to the white adults in our sample, black (but not Hispanic) adults reported greater levels of vigilance. This vigilance was positively associated with sleep difficulty to similar degrees for all racial/ethnic groups in our sample (white, black, Hispanic). Black adults reported greater levels of sleep difficulty compared to white adults. This disparity was slightly attenuated after adjustment for education and income. However, this disparity was completely attenuated after adjustment for racism-related vigilance. We found similar patterns of results for Hispanic compared to white adults, however, the disparities in sleep difficulty were smaller and not statistically significant. Because of the importance of sleep quality to health, our results suggest that the anticipation of and perseveration about racial discrimination is an important determinant of racial disparities in health.     

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.     

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.     

Are Blacks and Hispanics Disproportionately Incarcerated Relative to Their Arrests? Racial and Ethnic Disproportionality Between Arrest and Incarceration

Do large racial and ethnic disparities in prison populations reflect systematic racial and policy discrimination in the criminal justice system, or do they reflect disproportionate involvement of blacks and Hispanics in “serious” or street crime? Our investigation of this question keys off the approach initiated by Alfred Blumstein is his pioneering studies on the topic. While yielding important findings, there are, however, substantial gaps in the empirical literature on the racial disproportionality issue. We attempt to fill those gaps by (1) using both data on prison admission as well as in-stock prison populations, (2) presenting more recent racially and ethnically disaggregated arrest and incarceration data from Pennsylvania for 2003–2007, and (3) including Hispanic offenders in our racial and ethnic disproportionality comparisons. Our results indicate, first, that the representation of blacks, whites, and Hispanics among offenders admitted to state prison and in the prison population corresponds closely to their representation in arrest statistics. Second, using arrests as a marker of violent offending, the overrepresentation of blacks among offenders admitted to state prisons occurs because they commit a disproportionate number of frequently imprisoned (i.e., violent) crimes. Third, for those offenses where there is a within-race difference between arrest and incarceration representation, Hispanics experience the greatest disadvantage. Fourth, failing to account for Hispanics in white and black estimates tends to inflate white proportions and deflate black proportions of arrests, admissions, and prison population estimates, masking the “true” black and white racial disproportionality. We conclude that while there is a need for continued concern with possible racial discrimination in justice system processing, this concern should not distract attention from what arguably is the more important matter—ameliorating the social environmental conditions that foster disproportionate minority (especially black) involvement in violent crime.     

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.     

Racial and Ethnic Disparities in Leisure-time Physical Activity in California: Patterns and Mechanisms

Evidence has shown that racial/ethnic minorities in the United States are less likely than whites to engage in leisure-time physical activity (LTPA); yet few studies to date have included Asian subgroups in the analyses and mechanisms underlying these disparities are not well known. This study uses data from the 2007 California Health Interview Survey (N = 37,164) to examine racial/ethnic disparities in self-reported adherence to LTPA recommendations and to explore the mediating roles of socioeconomic status (SES), acculturation, and neighborhood perceptions. Nine racial/ethnic groups were included: non-Hispanic whites, non-Hispanic blacks, Mexicans, and six largest Asian subgroups. Results confirm that racial/ethnic minorities are, in general, less likely than whites to meet LTPA recommendations, whereas heterogeneity is also evident across Asian subgroups. No significant disparity is revealed for the Japanese and Filipinos but whites are advantaged compared to all other Asian groups. Educational attainment, percent of lifetime spent in the United States and access to park, playground, or open space are significantly associated with meeting LTPA recommendations. SES and acculturation play differential roles in explaining group disparities for blacks, Mexicans, and some Asian subgroups. Perceived neighborhood environment does not mediate LTPA disparities by race/ethnicity. Net of these mediators, the advantages of whites in meeting LTPA recommendations persist for blacks, Mexicans, the Chinese, and Koreans. Future research should theorize and operationalize additional multilevel pathways linking race/ethnicity and LTPA while assessing measurement errors in the existing constructs.     

Diverging Fortunes: Racial/Ethnic Inequality in Wealth Trajectories in Middle and Late Life

The primary aim of this study is to examine whether racial/ethnic inequality in wealth dissipates or increases between middle and late life, and by how much. To address this aim, this study draws on critical race and life course perspectives as well as 10 waves of panel data from the Health and Retirement Study and growth curve models to understand racial/ethnic inequality in wealth trajectories among whites, blacks, and Mexican Americans (N = 8337). Findings show that, by midlife, significant inequalities in net worth emerge between whites and their black and Mexican American counterparts. On average, white households have amassed a net worth of $105k by midlife, compared to less than $5k and $39k among black and Mexican American families, respectively. Moreover, whites experience much more rapid rates of wealth accumulation during their 50s and 60s than their minority counterparts, resulting in increasing wealth disparities with age, consistent with a process of cumulative disadvantage. At the peak of their wealth trajectory (at age 66), whites have approximately $245k more than blacks and $219k more than Mexican Americans. A wide range of socioeconomic, behavioral, and health factors account for a portion, but not all, of racial/ethnic inequality in wealth, suggesting that unobserved factors such as parental wealth, segregation, and discrimination may play a role in the production and maintenance of wealth inequality.     

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.     

Community Resources in a Diverse City: Supermarket Location and Emerging Racial Hierarchies

Disparities are pronounced along racial/ethnic lines in the USA. Convention draws our attention to blacks and whites, but increased racial/ethnic diversity in the USA requires shifts in that focus. We contribute to studies of racial/ethnic stratification by interrogating the association between racial/ethnic composition and supermarket location in Houston, Texas. First, we assess the benefits of a new approach to defining the racial/ethnic composition of local areas, an approach that acknowledges an increasingly complex racial/ethnic demography. Second, we contribute to our understanding of emerging racial/ethnic stratification hierarchies by examining the position of the racial/ethnic composition categories relative to one another. Our results suggest a persistent link between racial/ethnic composition and supermarket location, which highlights entrenched black disadvantage coupled with malleable middle positions for Hispanic areas. The associated stratification hierarchy is gradual in nature, yet there is evidence supporting arguments that the USA is moving toward a tri-racial system.     

Inequality in the “Cradle of Liberty”: Race/Ethnicity and Wealth in Greater Boston

New data collected for the Boston Metropolitan Statistical Area provide detailed information on financial assets that allow analysis to extend beyond the traditional black–white divide. Targeting US-born blacks, Caribbean blacks, Puerto Ricans, Dominicans, and other Hispanics, findings from the National Asset Scorecard for Communities of Color survey underscore the large racial and ethnic disparities in financial wealth, even after controlling for demographic and socioeconomic status. Further, some notable differences between Boston’s communities of color highlight the importance of detailed analyses for research on the racial wealth gap. In particular, among non-white communities Dominicans report comparatively low asset and high debt amounts, while Caribbean blacks report relatively higher levels of wealth. Altogether, these findings point to the need for wealth building opportunities in communities of color and further investigation of the causes and consequences of financial disparities between groups of color disaggregated by specific ancestral origin.     

Young,Black, and (Still) in the Red: Parental Wealth,Race, and Student Loan Debt

Taking out student loans to assist with the costs of postsecondary schooling in the US has become the norm in recent decades. The debt burden young adults acquire during the higher education process, however, is increasingly stratified with black young adults holding greater debt burden than whites. Using data from the NLSY 1997 cohort, we examine racial differences in student loan debt acquisition and parental net wealth as a predictor contributing to this growing divide. We have four main results. First, confirming prior research, black young adults have substantially more debt than their white counterparts. Second, we find that this difference is partially explained by differences in wealth, family background, postsecondary educational differences, and family contributions to college. Third, young adults’ net worth explain a portion of the black–white disparity in debt, suggesting that both differences in accumulation of debt and ability to repay debt in young adulthood explain racial disparities in debt. Fourth, the black–white disparity in debt is greatest at the highest levels of parents’ net worth. Our findings show that while social and economic experiences can help explain racial disparities in debt, the situation is more precarious for black youth, who are not protected by their parents’ wealth. This suggests that the increasing costs of higher education and corresponding rise in student loan debt are creating a new form of stratification for recent cohorts of young adults, and that student loan debt may be a new mechanism by which racial economic disparities are inherited across generations.     

Cultural Activities,Identities, and Mental Health Among Urban American Indians with Mixed Racial/Ethnic Ancestries

Focus groups were conducted to appreciate the voices of Urban American Indians (UAI) who have mixed ancestries residing in Philadelphia, Pennsylvania. Participants (15 women and 10 men, 19–83 years of age) with a variety of Native ancestries coming from different nations (i.e., blackfeet, blackminkwa, Cherokee, Creek, Delaware, Lakota, Powhatan, Seminole, and Shawnee) reported to also have a Non-Native racial/ethnic ancestry such as African/black, Hispanic, and/or Caucasian/white. Specifically, this study provided evidence about (a) the complexity and challenge of being “mixed” UAI (e.g., “living a culture” as opposed to blood quantum in determining a personal identity) (b) the linkage of cultural identities to mental health (c) contributions of cultural activities to identities and mental health (e.g., therapeutic and healing functions of cultural activities), and (d) very limited urban Native-oriented mental health service (e.g., visions for Native American-centered mental health clinic in an urban setting). Building on those UAI’s voices, this paper provides a context for the need of a culturally respectful transformation of urban mental health system by highlighting the clinical significance of cultural identity and mental health promotion for UAI.     

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.     

Gendered Black Exclusion: The Persistence of Racial Stereotypes Among Daters

Employing questionnaires of 381 college students, this study examines the reasons why Latinos, Asians, and whites choose to include or exclude blacks as potential dates. First, we find that past structural explanations for low rates of interracial intimacy explain current disparities less among young people today. Only 10 % of respondents cited a structural explanation, lack of familiarity, or contact, as the reason they excluded blacks as possible dates. Second, the reasons for black exclusion vary across racial–ethnic–gender groups. Among non-blacks, whites were the most open to dating blacks, followed by Latinos and Asians. Asians and Latinos were more likely to exclude blacks because of social disapproval, and whites were more likely to exclude blacks because of physical attraction. Black women were more highly excluded than black men and more excluded because of their perceived aggressive personalities or behavior and physical attraction. Black men were more excluded because of social disapproval. Thus, persistent racial ideology continues to drive the social distance between blacks and non-blacks, particularly toward black females.     

The Role of Racial Microaggressions,Stress, and Acculturation in Understanding Latino Health Outcomes in the USA

A growing body of literature demonstrates important negative health effects from racial microaggressions for racial/ethnic minorities. However, at present, the bulk of the literature is focused on the case of black Americans with relatively little attention as to how this may play out for other racial/ethnic groups. Here, we examine the association of health and racial microaggressions in the case of Latinos. Furthermore, we disaggregate Latinos by language preference in order to see how acculturation to the USA may moderate the effect of racial microaggressions on health outcomes for the group. In a statistical analysis of the 2004 Behavioral Risk Factor Surveillance System, we examine the association between stress from racial microaggressions and self-rated health for Latinos of different levels of linguistic acculturation. We find that more acculturated Latinos (measured in terms of language preference) are more likely to experience physical stress from perceived racial microaggressions after accounting for social and demographic factors. Further, this stress is linked to overall poorer self-rated health for the group. However, we find no such association for less acculturated, Spanish-preference Latinos.     

‘I’m a different kind of biracial’: how black/white biracial Americans with immigrant parents negotiate race

Increasingly, multiracial families have garnered scholarly attention. However, the roles of ethnicity and immigrant ties are largely absent in bi/multiracial studies. Drawing on 17 in-depth interviews with black/white biracial Americans with at least one immigrant parent, this study analyzes the dynamic interplay of race, ethnicity, and immigrant roots in the bi/multiracial community. Our findings show that participants struggle to articulate the meaning of race, and they assert specific racial/ethnic identities to circumvent stereotypical connotations of whiteness and blackness. We highlight how biracial Americans with immigrant ties – those who we might assume would have a limited understanding of race – voice clear understandings of racial superiority and inferiority, racial relations, and racial stereotypes. Emphasizing their ethnic roots is not only an attempt to accurately describe their ancestry; it also allows them to avoid the social consequences (i.e. stereotypes, discrimination, etc.) of being (half) white or (half) black.     

Convergence and Disadvantage in Poverty Trends (1980–2010): What is Driving the Relative Socioeconomic Position of Hispanics and Whites?

The gap between white and Hispanic poverty has remained stable for decades despite dramatic changes in the size and composition of the two groups. The gap, however, conceals crucial differences within the Hispanic population whereby some leverage education and smaller families to stave off poverty while others facing barriers to citizenship and English language acquisition face particularly high rates. In this paper, we use Decennial Census and American Community Survey data to examine poverty rates between Hispanic and non-Hispanic, white heads of household. We find the usual suspects stratify poverty risks: gender, age, employment, education, marital status, family size, and metro area status. In addition, Hispanic ethnicity has become a weaker indicator of poverty. We then decompose trends in poverty gaps between racial and ethnic groups. Between 1980 and 2010, poverty gaps persisted between whites and Hispanics. We find support for a convergence of advantages hypothesis and only partial support (among Hispanic noncitizens and Hispanics with limited English language proficiency) for a rising disadvantages hypothesis. Poverty-reducing gains in educational attainment alongside smaller families kept white–Hispanic poverty gaps from rising. If educational attainment continues to rise and family size drops further, poverty rates could fall, particularly for Hispanics who still have lower education and larger families, on average. Gains toward citizenship and greater English language proficiency would also serve to reduce the Hispanic–white poverty gap.     

Public Support for Sickle-Cell Disease Funding: Does Race Matter?

Despite the fact that sickle-cell disease (SCD) is perhaps the most “racialized” medical condition in the USA, very little is known about how “race” impacts public support for health policies related to the condition. We embedded an experiment within the 2011 Cooperative Congressional Election Study in order to assess perceptions about SCD among 1250 participants from diverse backgrounds and evaluate the extent to which these perceptions were associated with support for government spending on SCD-related benefits. We manipulated the racial phenotype of SCD advocates who requested additional government funding and asked participants to indicate how much the government should provide. Overall, participants expressed moderately positive attitudes about SCD, and there were no differences in funding support based on the race of the advocate. However, white participants supported less funding compared to nonwhite participants, even after adjusting for a number of demographic and attitudinal covariates. These findings suggest that a complex relationship between racial identification and implicit racism may shape public perceptions about SCD that negatively influences perceivers’ support for SCD-related policy.     

Was <Emphasis Type="Italic">that</Emphasis> Racist? An Experimental Study of Microaggression Ambiguity and Emotional Reactions for Racial–Ethnic Minority and White Individuals

This study examined racial–ethnic minority and white identified participants’ perceptions of racial microaggressions in four video scenarios involving a white professor and a black student. Participants (N = 261) were randomly assigned to observe a one of the four video conditions. The video involved an interaction with no microaggression, a very ambiguous microaggression, an ambiguous microaggression, or an overt microaggression. Participants rated their observations of (a) negative emotions toward the committer (white professor) and receiver (black student) of the microaggression, (b) positive emotions toward the committer and receiver of the microaggression, (c) perceptions on the degree of biasedness of committer, and (d) degree of positive perceptions of the committer. Analysis compared ratings of two groups, including racial–ethnic minority and white observers. We found a significant difference between the overt condition and other three conditions on negative emotions, positive emotions, and attributions of the professor (i.e., cultural biasedness and positive perceptions). However, there were no differences between the no microaggression, very ambiguous, and ambiguous conditions. No significant differences between racial–ethnic minority and white participants’ ratings were detected. Implications for training, practice, and future research are offered in our discussion.     

The Quality of Data on “Race” and “Ethnicity”: Implications for Health Researchers,Policy Makers,and Practitioners

Implicit assumptions about the quality of data on “race” and “ethnicity” underlie the design of much of today’s research on health disparities. Health researchers, policy makers, and practitioners tend to take it for granted that racial/ethnic categories are clearly and consistently defined; that individual race/ethnicity can be easily, validly, and reliably determined; and that categories capture population groups that are so inherently different from each other that any reported racial/ethnic difference can automatically be generalized to the US population as a whole. This article outlines a series of issues that challenge these assumptions about the quality of race/ethnicity data. While race/ethnicity classifications can approximate socially constructed identities for some groups of people under some circumstances, these classifications are inherently too imprecise to allow meaningful statements to be made about underlying biological or genetic differences between groups. Findings of racial/ethnic differences should be reported with appropriate caveats and interpreted with caution. Particular caution should be exercised in hypothesizing genetic differences between groups in the absence of convincing genetic evidence.