Home and Neighborhood Context of Falls Among Black and White Older Americans.
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ABSTRACT:
SUBMITTER: Okoye SM
PROVIDER: S-EPMC8416780 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Does anti-Black racism harm White Americans? We advance hypotheses that address this question within the neighborhood context. Hypotheses are tested with neighborhood and survey data from a probability sample of White residents of Nashville, Tennessee. We find that regardless of neighborhood crime rates or socioeconomic compositions, Whites report heightened perceptions of crime and danger in their neighborhoods as the proportion of Black residents increases. Perceived neighborhood danger, in turn, predicts increased symptoms of psychophysiological distress. When stratified by socioeconomic status (SES), however, low-SES Whites also report perceptions of higher status when living near more Black neighbors, which entirely offsets their distress. We conclude that although anti-Black racism can ironically harm the health of White Americans, compensatory racist ideologies can also offset these harms, particularly for lower-status Whites. We situate our findings within broader discussions of anti-Black racism, residential segregation, and psychiatric disorders commonly observed among White Americans.
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Project description:Racial difference of religiosity in a heterogeneous older population had long been a focal point of gerontological research. However, most religiosity measures were developed from homogenous sample, few underwent rigorous psychometric validation, and studies on racial difference of religiosity had been obstructed. This cross-sectional study adapted a religiosity measure originally designed for blacks only to a heterogeneous older population of blacks and whites, validated its psychometric properties, and examined racial difference of religiosity. Based on qualitative research of concepts, intensive literature review, and abundant experiences in this field, we adapted the original measure. Then, using the data collected from a survey of 196 black and white Americans 55 years and older in Charlotte, North Carolina, we investigated full-scale psychometric properties of the adapted measure at the item-, domain-, and measure- level. These psychometric validations included item analysis, item-scale correlations, correlation matrix among items, confirmatory factor analysis (CFA) to determine if the original factor structure held after adaptation, and reliability analysis using Cronbach's alpha. Finally, using Multiple Indicators and MultIple Causes (MIMIC) models, we examined racial difference of religiosity through regression with latent variables, while potential measurement bias by race through differential item functioning (DIF) was adjusted in the MIMIC models. In result, we successfully adapted the original 12-item religiosity measure for blacks into an 8-item version for blacks and whites. Although sacrificed few reliability for brevity, the adapted measure demonstrated sound psychometric properties, and retained the original factor structure. We also found racial differences of religiosity in all three domains of the measure, even after adjustment of the detected measurement biases in two domains. In conclusion, the original measure can be adapted to and validated for a heterogeneous older population of blacks and whites. Although the adapted measure can be used to measure the three domains of religiosity in blacks and whites, the observed racial differences of religiosity need to be adjusted for measurement biases before meaningful comparisons.
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Project description:Examine the relationship between frailty and falls.A total of 847 Mexican Americans from the Hispanic Established Population for the Epidemiological Study of the Elderly were evaluated. The outcome variable was fall occurrence. Some predictor variables included were frailty, sociodemographic variables, functional and health status, and prior falls.Those who fell were more likely to be women, not married, had prior falls, more functional problems and poorer health. The incidence rate ratio (IRR) for falls was 1.9 for nonfrail individuals and 3.2 for frail individuals. Prefrail individuals had 1.36 higher odds of falls (95% CI [1.11, 1.67]), individuals with prior falls had 1.26 higher odds of falls (95% CI [1.15, 1.37]), and those with poor balance had 1.49 higher odds of falls (95% CI [1.15, 1.95]) over the 2 years (p<.01).Frailty increases the odds of falls in older Mexican Americans. Interventions tailored to reduce fall incidence and improve health care quality for older Mexican Americans are needed.
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Project description:Although the association between high blood pressure (BP), particularly in midlife, and late-life dementia is known, less is known about variations by race and sex. In a prospective national study of 22 164 blacks and whites ≥45 years without baseline cognitive impairment or stroke from the REGARDS cohort study (Reasons for Geographic and Racial Differences in Stroke), enrolled 2003 to 2007 and followed through September 2015, we measured changes in cognition associated with baseline systolic and diastolic BP (SBP and DBP), as well as pulse pressure (PP) and mean arterial pressure, and we tested whether age, race, and sex modified the effects. Outcomes were global cognition (Six-Item Screener; primary outcome), new learning (Word List Learning), verbal memory (Word List Delayed Recall), and executive function (Animal Fluency Test). Median follow-up was 8.1 years. Significantly faster declines in global cognition were associated with higher SBP, lower DBP, and higher PP with increasing age ( P<0.001 for age×SBP×follow-up-time, age×DBP×follow-up-time, and age×PP×follow-up-time interaction). Declines in global cognition were not associated with mean arterial pressure after adjusting for PP. Blacks, compared with whites, had faster declines in global cognition associated with SBP ( P=0.02) and mean arterial pressure ( P=0.04). Men, compared with women, had faster declines in new learning associated with SBP ( P=0.04). BP was not associated with decline of verbal memory and executive function, after controlling for the effect of age on cognitive trajectories. Significantly faster declines in global cognition over 8 years were associated with higher SBP, lower DBP, and higher PP with increasing age. SBP-related cognitive declines were greater in blacks and men.
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Project description:At all levels of socioeconomic status, Black Americans can expect to live shorter and sicker lives than their White counterparts. This study advances the perspective that anti-Black stigma from Whites precludes Blacks from reaping the full health rewards of higher status, particularly within the context of neighborhoods. To test this hypothesis, I merge census data with rich survey and biomarker data from the Nashville Stress and Health Study, a representative sample of Black and White adults from Davidson County, Tennessee (n = 1,252). Initially, I find that Blacks who reside in higher-status and mostly White communities exhibit lower levels of neuroendocrine stress hormones, relative to their peers living in disadvantaged Black neighborhoods. But Blacks in higher-status areas also report more perceived discrimination. In turn, perceived discrimination is associated with chronic bodily pain, as well as elevated stress hormones and blood pressure tied to high goal-striving stress, or fears of being blocked from reaching life goals. After accounting for racism-related stressors, Blacks exhibit comparable levels of physiological distress regardless of neighborhood context. The inverse is true for Whites, who report fewer stressors in higher-status neighborhoods, and less physiological distress than Blacks overall. Findings are discussed within the context of social evolutionary theories of the human brain and are dovetailed with broader racial health disparities in the United States.
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Project description:BACKGROUND:Low levels of total 25-hydroxyvitamin D are common among black Americans. Vitamin D-binding protein has not been considered in the assessment of vitamin D deficiency. METHODS:In the Healthy Aging in Neighborhoods of Diversity across the Life Span cohort of blacks and whites (2085 participants), we measured levels of total 25-hydroxyvitamin D, vitamin D-binding protein, and parathyroid hormone as well as bone mineral density (BMD). We genotyped study participants for two common polymorphisms in the vitamin D-binding protein gene (rs7041 and rs4588). We estimated levels of bioavailable 25-hydroxyvitamin D in homozygous participants. RESULTS:Mean (±SE) levels of both total 25-hydroxyvitamin D and vitamin D-binding protein were lower in blacks than in whites (total 25-hydroxyvitamin D, 15.6±0.2 ng per milliliter vs. 25.8±0.4 ng per milliliter, P<0.001; vitamin D-binding protein, 168±3 ?g per milliliter vs. 337±5 ?g per milliliter, P<0.001). Genetic polymorphisms independently appeared to explain 79.4% and 9.9% of the variation in levels of vitamin D-binding protein and total 25-hydroxyvitamin D, respectively. BMD was higher in blacks than in whites (1.05±0.01 g per square centimeter vs. 0.94±0.01 g per square centimeter, P<0.001). Levels of parathyroid hormone increased with decreasing levels of total or bioavailable 25-hydroxyvitamin D (P<0.001 for both relationships), yet within each quintile of parathyroid hormone concentration, blacks had significantly lower levels of total 25-hydroxyvitamin D than whites. Among homozygous participants, blacks and whites had similar levels of bioavailable 25-hydroxyvitamin D overall (2.9±0.1 ng per milliliter and 3.1±0.1 ng per milliliter, respectively; P=0.71) and within quintiles of parathyroid hormone concentration. CONCLUSIONS:Community-dwelling black Americans, as compared with whites, had low levels of total 25-hydroxyvitamin D and vitamin D-binding protein, resulting in similar concentrations of estimated bioavailable 25-hydroxyvitamin D. Racial differences in the prevalence of common genetic polymorphisms provide a likely explanation for this observation. (Funded by the National Institute on Aging and others.).
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Project description:ObjectiveAlthough early-life insults may affect health, few studies use objective physical measures of adult health. This study investigated whether experiencing misfortune during childhood is associated with handgrip strength (HGS) in later life.MethodData on childhood misfortune and adult characteristics from the Health and Retirement Study were used to predict baseline and longitudinal change in HGS among White, Black, and Hispanic American men and women.ResultsRegression analyses revealed that multiple indicators of childhood misfortune were related to HGS at baseline, but the relationships were distinct for men and women. Over the study, having one childhood impairment predicted steeper declines in HGS for men, but childhood misfortune was unrelated to HGS change among women. Hispanic Americans had lower baseline HGS than their non-Hispanic counterparts and manifested steeper declines in HGS.DiscussionThe relationship between childhood exposures and adult HGS varied by the type of misfortune, but there was no evidence that the relationship varied by race/ethnicity. The significant and enduring Hispanic disadvantage in HGS warrants greater attention in gerontology.
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Project description:BackgroundThere is very limited comprehensive information on disparate outcomes of black and white patients with COVID-19 infection. Reports from cities and states have suggested a discordant impact on black Americans, but no nationwide study has yet been performed. We sought to understand the differential outcomes for black and white Americans infected with COVID-19.MethodsWe obtained case-level data from the Centers for Disease Control and Prevention on 76,442 white and 48,338 non-Hispanic Black patients diagnosed with COVID-19, ages 0 to >80+, outlining information on hospitalization, ICU admission, ventilation, and death outcomes. Multivariate Poisson regressions were used to estimate the association of race, treating white as the reference group, controlling for sex, age group, and the presence of comorbidities.ResultsBlack patients were generally younger than white, were more often female, and had larger numbers of comorbidities. Compared to white patients with COVID-19, black patients had 1.4 times the risk of hospitalization (RR 1.42, p < 0.001), and almost twice the risk of requiring ICU care (RR 1.68, p < 0.001) or ventilatory support (RR 1.81, p < 0.001) after adjusting for covariates. Black patients saw a 1.36 times increased risk of death (RR 1.36, p < 0.001) compared to white. Disparities between black and white outcomes increased with advanced age.ConclusionDespite the initial descriptions of COVID-19 being a disease that affects all individuals, regardless of station, our data demonstrate the differential racial effects in the United States. This current pandemic reinforces the need to assess the unequal effects of crises on disadvantaged populations to promote population health.
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Project description:Multiple studies (n = 1065 parents, 625 females, 437 males, 3 nonbinary, 99.06% White; n = 80, 5 to 7-year-old children, 35 girls, 45 boys, 87.50% White; data collection September 2017-January 2021) investigated White U.S. parents' thinking about White children's Black-White racial biases. In Studies 1-3, parents reported that their own and other children would not express racial biases. When predicting children's social preferences for Black and White children (Study 2), parents underestimated their own and other children's racial biases. Reading an article about the nature, prevalence, and consequences of White children's racial biases (Study 3) increased parents' awareness of, concern about, and motivation to address children's biases (relative to a control condition). The findings have implications for engaging White parents to address their children's racial biases.
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