Comparing Veteran and Non-veteran Racial Disparities in Mid-life Health and Well-being

Using National Longitudinal Survey of Youth 1979 data on mid-life physical health, mental health, and self-esteem, I examine inter- and intra-racial disparities in health and well-being among veteran and non-veteran men (N = 2440). After controlling for selectivity into the military via propensity weighting, I find that black veterans have higher self-esteem than white veterans and comparable black non-veterans, but white veterans have similar mid-life self-esteem as their non-veteran counterparts. I find no evidence of disparities in health for depressive symptoms and self-rated health after taking selection into military service into account. The results suggest that aspects of military service may increase blacks’ self-esteem, possibly due to less discrimination and more opportunity.     

Health Outcomes and Volunteering: The Moderating Role of Religiosity

In this paper, we examine whether and what extent public and private forms of religiosity act as moderators of the volunteering and well-being relationship in mid- to later-life. We use data from the second wave of the National Survey of Midlife Development in the United States (n = 1,805). We analyzed the relationships between volunteering and indicators of well-being (self-rated physical and mental health), and tested the moderating effects of public and private religiosity on the volunteering and well-being relationship. Our findings suggest that salubrious effects of volunteering on the self-perceived physical and mental health of middle- aged and older- aged adults varied by their participation in different forms of religiosity. In particular, volunteers who engaged in more public forms of religiosity reported significantly better physical and mental health than non-volunteers who engaged in these forms of religiosity. In other words, individuals who were actively engaged public forms of religious practices and who volunteered, maximized the associated health benefits.     

Disparities in Physical Health Conditions Among Lesbian and Bisexual Women: A Systematic Review of Population-Based Studies

We conducted a systematic review to assess evidence for disparities for lesbian and bisexual women (i.e., sexual minority women [SMW]) in comparison with heterosexual women across a range of nine physical health conditions. Among the k = 11 studies meeting eligibility criteria, almost every comparison (i.e., heterosexual vs. (a) lesbian, (b) bisexual, or (c) both lesbian and bisexual women) was in a direction indicating SMW disparities. Despite limited power due to small samples of SMW, we found evidence of disparities as indicated by a statistically significant adjusted odds ratios for asthma (5 of 7 comparisons), obesity (8 of 12), arthritis (2 of 3), global ratings of physical health (4 of 7), and cardiovascular disease (1 of 1). Evidence was lacking for cancer (1 of 4), diabetes and hypertension (both 1 of 5), and high cholesterol (0 of 3). Future work should confirm findings in more diverse, larger samples and should examine potential explanatory factors.     

On the Predictive Effect of Multidimensional Importance-Weighted Quality of Life Scores on Overall Subjective Well-Being

This study aimed to examine the effectiveness of importance weighting in predicting outcome variables in a hierarchical and multidimensional measurement context. A total of 146 undergraduate students (female = 76; mean age = 20.25) from two universities in Taiwan and China participated in this study. They evaluated their quality of life on 22 facets from the WHOQOL-BREF scale, which covers four domains (i.e., physical health, psychological health, social relationships, and environmental health). They were also asked to rate the importance of these 22 facets and items for three general subjective well-being indices, including overall quality of life, general health, and life satisfaction. A multiplicative formula was used to create importance-weighted scores for each facet, and four domain scores were obtained by averaging facet scores under specific domains. Results of regression analysis revealed that after applying the weighting procedure, the four domain scores did not account for more variances in the three indices for overall subjective well-being, and predictive effects of the four domain scores became less differential. Our findings suggest that importance weighting did not have its expected benefits but instead may negatively impact the predictive effects.     

Racial/Ethnic and Nativity Patterns of U.S. Adolescent and Young Adult Smoking

We document racial/ethnic and nativity differences in U.S. smoking patterns among adolescents and young adults using the 2006 Tobacco Use Supplement to the Current Population Survey (n = 44,202). Stratifying the sample by nativity status within five racial/ethnic groups (Asian American, Mexican–American, other Hispanic, non-Hispanic black, and non-Hispanic white), and further by sex and age, we compare self-reports of lifetime smoking across groups. U.S.-born non-Hispanic whites, particularly men, report smoking more than individuals in other racial/ethnic/nativity groups. Some groups of young women (e.g., foreign-born and U.S.-born Asian Americans, foreign-born and U.S.-born Mexican–Americans, and foreign-born blacks) report extremely low levels of smoking. Foreign-born females in all of the 25–34 year old racial/ethnic groups exhibit greater proportions of never smoking than their U.S.-born counterparts. Heavy/moderate and light/intermittent smoking is generally higher in the older age group among U.S.-born males and females, whereas smoking among the foreign-born of both sexes is low at younger ages and remains low at older ages. Taken together, these findings highlight the importance of considering both race/ethnicity and nativity in assessments of smoking patterns and in strategies to reduce overall U.S. smoking prevalence and smoking-attributable health disparities.     

Asian Americans: growth,change, and diversity

The 1980 US census counted 3.5 million Asian Americans, up from 1.4 million in 1970. Asian Americans made up just 1.5% of the total US population of 226.5 million as of April 1, 1980, but this was the 3rd largest racial or ethnic minority after blacks and Hispanics. Asians increased far more during the 1970s (141%) than blacks (17%) or Hispanics (39%). This Bulletin examines the characteristics of Asian Americans, how their numbers have grown, where they live, how different groups vary in age structure, childbearing, health, and longevity. It reports on the kinds of households Asian Americans form and how they fare with regard to education, occupation, and income. Asian Americans are now often perceived as the model minority. As a whole, they are better educated, occupy higher rungs on the occupational ladder, and earn more than the general US population and even white Americans. This Bulletin presents the 1st comprehensive look at many important facts about Asian Americans and how the groups differ. Special tabulations of data collected in the 1980 census are provided. The 1980 census data are the latest available to give a true picture at the national level of Asian Americans and the various groups among them. The Bulletin examines the current numbers of Asian Americans and how this population is defined. The major Asian American groups are Chinese (21%), Filipinos (20%), Japanese (15%), Vietnamese (21%), Koreans (11%), and Asian Indians (10%). Except for the latest-arrived Vietnamese, the fertility of the 6 groups is lower than the white average. The following areas are also discussed: mortality and health; families and households; education; Asian youth; employment; income and poverty; and future prospects.     

Unraveling Health Disparities Among Sexual and Gender Minorities: A Commentary on the Persistent Impact of Stigma

ABSTRACT

LGBT (lesbian, gay, bisexual, and transgender) populations experience disparities in health outcomes, both physical and mental, compared to their heterosexual and cisgender peers. This commentary confronts the view held by some researchers that the disparate rates of mental health problems reported among LGBT populations are the consequences of pursuing a particular life trajectory, rather than resulting from the corrosive and persistent impact of stigma. Suggesting that mental health disparities among LGBT populations arise internally, de novo, when individuals express non-heterosexual and non-conforming gender identities ignores the vast body of evidence documenting the destructive impact of socially mediated stigma and systemic discrimination on health outcomes for a number of minorities, including sexual and gender minorities. Furthermore, such thinking is antithetical to widely accepted standards of health and wellbeing because it implies that LGBT persons should adopt and live out identities that contradict or deny their innermost feelings of self.     

Demographic and economic correlates of health in old age

In this paper we examine disparities in the ability to function among older Americans. We place special emphasis on two goals: (I) understanding the quantitatively large socioeconomic status-health gradient, and (2) the persistence in health outcomes over long periods. We find that there exist strong contemporaneous and long-run feedbacks from health to economic status. In light of these feedbacks, it is important to distinguish among alternative sources of income and the recipient of income in the household. This research also demonstrates that health outcomes at old age are influenced by health attributes of past, concurrent, and future generations of relatives. Finally, we find that the demographic and economic differences that exist among them explain functional health disparities by race and ethnicity, but not by gender.     

Health Needs and Experiences of a LGBT Population in Georgia and South Carolina

ABSTRACT

The 2016 Municipal Equality Index rated Augusta, the largest city in the Central Savannah River Area (CSRA), as one of the least lesbian, gay, bisexual, and transgender (LGBT) friendly cities in America. To understand the context of our region in relation to LGBT wellness, we conducted the first LGBT health needs assessment of the CSRA, assessing physical and mental health status and health care needs and experiences in the community. Participants (N = 436) were recruited using venue and snowball sampling and completed an anonymous online survey. Overall, the health problems experienced (i.e., obesity, depression) were not uniformly experienced across sexual orientation and gender identity; some groups experienced significantly higher rates of these conditions than others. Similarly, transgender individuals in particular reported higher rates of negative experiences with health care providers. Regional and national dissemination of these findings is critical to reducing health disparities and improving wellness of our local LGBT community.     

Work Disability Among Native-born and Foreign-born Americans: On Origins,Health, and Social Safety Nets

Public debates about both immigration policy and social safety net programs are increasingly contentious. However, little research has explored differences in health within America’s diverse population of foreign-born workers, and the effect of these workers on public benefit programs is not well understood. We investigate differences in work disability by nativity and origins and describe the mix of health problems associated with receiving Social Security Disability Insurance benefits. Our analysis draws on two large national data sources—the American Community Survey and comprehensive administrative records from the Social Security Administration—to determine the prevalence and incidence of work disability between 2001 and 2010. In sharp contrast to prior research, we find that foreign-born adults are substantially less likely than native-born Americans to report work disability, to be insured for work disability benefits, and to apply for those benefits. Overall and across origins, the foreign-born also have a lower incidence of disability benefit award. Persons from Africa, Northern Europe, Canada, and parts of Asia have the lowest work disability benefit prevalence rates among the foreign-born; persons from Southern Europe, Western Europe, the former Soviet Union, and the Caribbean have the highest rates.     

Why Do Pacific People with Multiple Ethnic Affiliations Have Poorer Subjective Wellbeing? Negative Ingroup Affect Mediates the Identity Tension Effect

We argue that multi-ethnic affiliation as a member of both the Pacific and majority (European) group creates tension in psychological wellbeing for Pacific peoples of mixed ancestry. Study 1 showed that multi-ethnic Pacific/non-Pacific people were lower in Pacific Familial Wellbeing relative to mono-ethnic Pacific and multi-ethnic Pacific/Pacific people (n = 586). Study 2 replicated this effect in a New Zealand (NZ) national probability sample using a measure of self-esteem (n = 276). Study 2 also modelled the mechanism driving the identity tension effect, and showed that group differences in negative affect toward Pacific peoples fully mediated the effect of ethnic mixed or mono-ethnic group affiliation on self-esteem. This currently affects the one-third of Pacific people who identify as Pacific/non-Pacific in NZ and occurs because multi-ethnic identification promotes the endorsement of negative societal attitudes toward Pacific peoples. Our model indicates that endorsement of such attitudes produces a more negative self-evaluation and generally corrodes subjective wellbeing and family integration. Population projections indicate that this potentially at-risk Pacific/non-Pacific group may increase dramatically in subsequent generations (upwards of 3.3 % of the population by 2026). Implications for the study of Pacific wellbeing, and avenues for applied research targeting this newly-identified emerging social problem are discussed.     

Solitary Time and Mental Health in the Netherlands

Whereas prior research focused on the beneficial effects of time spent with others, this study investigated the association between solitary time and mental health by hypothesizing about the possible detriments as well as benefits. Additionally, we studied whether the association between solitary time and mental health was nonlinear and moderated by gender and life stage. We hypothesized that whereas solitary time limits individuals’ access to social resources and support (decreasing mental health), it also helps individuals to recharge (enhancing mental health). We used the Dutch Time Use Survey from 2006 (N = 1,487). Results of Tobit models indicated that more solitary time in leisure (but not household labor) was associated with a reduction in mental health. For men, we did find a negative association between alone time in household labor and mental health. There was no evidence for a curvilinear relationship between time alone and mental health, nor did life course stage appeared to moderate this association.     

Health Status and Risk Behaviors of Sexual Minorities Among Chinese Adolescents: A School-Based Survey

This study aimed to examine the association between sexual orientation and health disparities among a stratified random sample of 3776 secondary students in Hong Kong. The prevalence of homosexuality and bisexuality were 1.5% and 2.6% in boys and 1.8% and 3.7% in girls, respectively. A total of 10.7% of boys and 8.8% of girls were unsure of their sexual orientation. Homosexual and bisexual boys reported poorer physical and mental health than their heterosexual peers. Homosexual and bisexual boys were more likely to engage in smoking, frequent drinking, and vaginal sex and be subjected to sexually transmitted disease and sexual victimization. However, lesbian and bisexual girls were less likely to engage in risky health behaviors except for smoking and being subjected to sexual victimization. There is a gender-specific problem that may warrant prevention and intervention programs to address the unique health issues facing homosexual and bisexual adolescents in Hong Kong.     

Mental Health Consequences of International Migration for Vietnamese Americans and the Mediating Effects of Physical Health and Social Networks: Results From a Natural Experiment Approach

Although the existing literature on immigrant mental health is extensive, major substantive and methodological gaps remain. Substantively, there is little population-based research that focuses on the mental health consequences of migration for Vietnamese Americans. More generally, although a wide range of mental health problems among immigrants has been identified, the potential causal or mediating mechanisms underlying these problems remain elusive. This latter substantive shortcoming is related to a key methodological challenge involving the potentially confounding effects of selection on migration-related outcomes. This article addresses these challenges by employing a “natural experiment” design, involving comparisons among three population-based samples of Vietnamese immigrants, never-leavers, and returnees (N  =  709). Data were collected in Ho Chi Minh City and in New Orleans between 2003 and 2005. The study investigates the long-term impact of international migration on Vietnamese mental health, and the potential mediating effects of social networks and physical health on these migration-related outcomes. The results reveal both mental health advantages and disadvantages among Vietnamese immigrants relative to the two groups of Vietnamese nationals. Selection can be ruled out for some of these differences, and both social networks and physical health are found to play important explanatory roles.     

Black masculinity matters in attitudes toward gay males

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

Walking the Dog: The Effect of Pet Ownership on Human Health and Health Behaviors

This analysis explores whether pet owners have better physical health outcomes, and if so, whether the positive physical health benefits are explained by better health behaviors that result from having to take care of the pet’s physical needs. Data come from the National Health and Nutrition Examination Survey, a representative sample of the non-institutionalized United States population. Analyses were limited to persons living alone (n = 2,474) in order to isolate primary pet caretakers from those merely living in a pet household. Results showed that pet owners, particularly dog and cat owners, had more positive physical health outcomes when compared to non pet owners or those owning other types of pets. Surprisingly, the effect of pet ownership was not mediated by health behaviors such as recreational walking. However, the health benefits of pet ownership were largely reduced once sociodemographic variables such as age, socioeconomic status, and residential location were controlled. The positive health effects of pet ownership appear to be primarily the result of selection, not increased physical activity associated with the active caretaking of pets.     

The Relationships Between Sense of Belonging to a Community GLB Youth Group; School,Teacher, and Peer Connectedness; and Depressive Symptoms: Testing of a Path Model

Research indicates belonging to a gay, lesbian, and bisexual (GLB) support group is indirectly associated with fewer depressive symptoms, via higher levels of sense of belonging to the general community. The current study extended this research by testing a path model to determine whether school, teacher, and peer connectedness are influenced by sense of belonging to a community GLB youth group. A sample of 82 Australian GLB adolescents aged 14 to 18 years who currently attend high school completed the Center for Epidemiologic Studies Depression Scale, the Psychological Subscale of the Sense of Belonging Instrument, and the Social Questionnaire for Secondary Students. Results indicated very good model fit. Higher levels of belonging to a community GLB youth group were associated with higher levels of school, teacher, and peer connectedness, but only peer connectedness was directly associated with depressive symptoms. Higher levels of school and teacher connectedness were associated with higher levels of peer connectedness. Interventions aimed at increasing belonging to a community GLB youth group may have indirect benefits for the mental health of GLB adolescents, via higher levels of school, teacher, and peer connectedness.     

Life Course Changes in Smoking by Gender and Education: A Cohort Comparison Across France and the United States

Widening of educational disparities and a narrowing female advantage in mortality stem in good part from disparities in smoking. The changes in smoking and mortality disparities across cohorts and countries have been explained by an epidemic model of cigarette use but are also related to life course changes. To better describe and understand changing disparities over the life course, we compare age patterns of smoking in three cohorts and two nations (France and the US) using smoking history measures from the 2010 French health barometer (N = 20,940) and the 2010 US National Health Interview Survey Sample Adult File (N = 20,444). The results demonstrate statistically significant widening of gender and educational differences from adolescence to early and middle adulthood, thus accentuating the disparities already emerging during adolescence. In addition, the widening disparities over the life course have been changing across cohorts: age differences in educational disparities have grown in recent cohorts (especially in France), while age differences in gender disparities have narrowed. The findings highlight the multiple sources of inequality in smoking and health in high-income nations.     

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

ABSTRACT

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

Will boys’ mental health fare worse under a hotter climate in Australia?

A hotter climate is increasingly found to have negative effects on human health, yet the possible impact on children’s mental health is less understood. Our study explored this potential relationship using a national survey of children aged 6–11 across Australia, during the period 2008–2014 (n?=?14,096). It was hypothesised that the negative effects of hotter weather on children’s mental health can occur both directly (e.g. through heat impacts influencing hyperactivity and restlessness) and indirectly (e.g. through reduced participation in organised physical activities). Mediation analysis controlled for a range of other locational, gender, socio-economic and demographic influences. Results indicate that an increase in annual average daily maximum temperature worsened childhood mental health due to a direct and indirect effect through reduced participation in organised physical activities, as measured by the Strengths and Difficulties Questionnaire (SDQ) total score, but the result is only significant for boys (albeit the magnitude of the effect was small). More specifically, temperature differences are driven through the SDQ mental health sub-scales of hyperactivity and peer problems. Gender disparities are also observed in terms of other environmental or locational influences having a significant impact on boys’ mental health, with no significant impact found for girls. Girls’ mental health is more likely influenced by family and individual socio-economic characteristics. There is also evidence of an increased impact of higher temperature on children’s mental health in poorer households, suggesting the need for more targeted children’s mental health policies.