Racial Trends
Gregory Miller & Edith Chen
Psychological Science, forthcoming
Abstract:
A growing body of evidence indicates that children reared in harsh families are prone to chronic diseases and premature death later in life. To shed light on the mechanisms potentially underlying this phenomenon, we evaluated the hypothesis that harsh families engender a proinflammatory phenotype in children that is marked by exaggerated cytokine responses to bacterial stimuli and resistance to the anti-inflammatory properties of cortisol. We repeatedly measured psychological stress and inflammatory activity in 135 female adolescents on four occasions over 1.5 years. To the extent that they were reared in harsh families, participants displayed an increasingly proinflammatory phenotype during the follow-up analyses. This phenotype was marked by increasingly pronounced cytokine responses to in vitro bacterial challenge and a progressive desensitization of the glucocorticoid receptor, which hampered cortisol's ability to properly regulate inflammatory responses. If sustained, these tendencies may place children from harsh families on a developmental trajectory toward the chronic diseases of aging.
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Why are Mexican American boys so much taller now?
Marcelo Delajara & Melissa Rodríguez Segura
Economics & Human Biology, forthcoming
Abstract:
Using NHANES data we find that the difference in average height between non-Hispanic White and Mexican American boys of ages 2-14 years has decreased 1.7 cm on average during the last quarter of the twentieth century in the United States. Our hypothesis is that the narrowing of the height gap is related to a larger gain in maternal height among Mexican Americans in relation to Whites. We estimate a child's height equation and find that on average about 38 % of the reduction in the gap for boys of ages 2-5 years is attributed to this factor. The evidence of a secular trend for height is weak for the case of girls.
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Arline Geronimus, Margaret Hicken, Jay Pearson, Sarah Seashols, Kelly Brown & Tracey Dawson Cruz
Human Nature, March 2010, Pages 19-38
Abstract:
We hypothesize that black women experience accelerated biological aging in response to repeated or prolonged adaptation to subjective and objective stressors. Drawing on stress physiology and ethnographic, social science, and public health literature, we lay out the rationale for this hypothesis. We also perform a first population-based test of its plausibility, focusing on telomere length, a biomeasure of aging that may be shortened by stressors. Analyzing data from the Study of Women's Health Across the Nation (SWAN), we estimate that at ages 49-55, black women are 7.5 years biologically "older" than white women. Indicators of perceived stress and poverty account for 27% of this difference. Data limitations preclude assessing objective stressors and also result in imprecise estimates, limiting our ability to draw firm inferences. Further investigation of black-white differences in telomere length using large-population-based samples of broad age range and with detailed measures of environmental stressors is merited.
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Heather Mcclure, Charles Martinez, Josh Snodgrass, Mark Eddy, Roberto Jiménez, Laura Isiordia & Thomas Mcdade
Journal of Biosocial Science, July 2010, Pages 433-461
Abstract:
Perceived discrimination has been linked to poor health outcomes among ethnic and racial minorities in the United States, though the relationship of discrimination-related stress to immigrant health is not well understood. This article reports findings from a preliminary study that examined blood pressure and Epstein-Barr virus antibody levels in relation to self-reported indicators of stress, acculturation and social support among 79 adult immigrant Latino farm workers in Oregon, US. Findings show that increases in discrimination-related stress predicted elevated systolic blood pressure (SBP) and Epstein-Barr virus antibody levels among male participants. Though female participants reported similar levels of discrimination stress, this perceived stress was not reflected in biological measures. Among women, greater English language engagement was linked to higher SBP, and more years in the US was associated with higher diastolic blood pressure. Study results suggest that male and female immigrants' physiological responses to stress may be influenced in distinctive ways by processes of adjustment to life in the US. If replicated, the finding that discrimination stress predicts elevated SBP may have clinical and public health implications given that elevated SBP is an established risk factor for cardiovascular disease.
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Mother's educational level and fetal growth: The genesis of health inequalities
Lindsay Silva, Pauline Jansen, Eric Steegers, Vincent Jaddoe, Lidia Arends, Henning Tiemeier, Frank Verhulst, Henriëtte Moll, Albert Hofman, Johan Mackenbach & Hein Raat
International Journal of Epidemiology, forthcoming
Background: Women of low socio-economic status (SES) give birth to lighter babies. It is unknown from which moment during pregnancy socio-economic differences in fetal weight can be observed, whether low SES equally affects different fetal-growth components, or what the effect of low SES is after taking into account mediating factors. Methods: In 3545 pregnant women participating in the Generation R Study, we studied the association of maternal educational level (high, mid-high, mid-low and low) as a measure of SES with fetal weight, head circumference, abdominal circumference and femur length. We did this before and after adjusting for potential mediators, including maternal height, pre-pregnancy body mass index and smoking. Results: In fetuses of low-educated women relative to those of high-educated women, fetal growth was slower, leading to a lower fetal weight that was observable from late pregnancy onwards. In these fetuses, growth of the head [-0.16 mm/week; 95% confidence interval (CI): -0.25 to -0.07; P = 0.0004], abdomen (-0.10 mm/week; 95% CI: -0.21 to 0.01; P = 0.08) and femur (-0.03 mm/week; 95% CI: -0.05 to -0.006; P = 0.01) were all slower; from mid-pregnancy onwards, head circumference was smaller, and from late pregnancy onwards, femur length was also smaller. The negative effect of low education was greatest for head circumference (difference in standard deviation score in late pregnancy: -0.26; 95% CI: -0.36 to -0.15; P < 0.0001). This effect persevered even after adjustment for the potential mediators (adjusted difference: -0.14; 95% CI: -0.25 to -0.03; P = 0.01). Conclusions: Low maternal education is associated with a slower fetal growth and this effect appears stronger for growth of the head than for other body parts.
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Kevin Gorey, Isaac Luginaah, Emma Bartfay, Karen Fung, Eric Holowaty, Frances Wright, Caroline Hamm & Sindu Kanjeekal
American Journal of Public Health, forthcoming
Objectives: We examined the differential effects of socioeconomic status on colon cancer care and survival in Toronto, Ontario, Canada, and San Francisco, California. Methods: We analyzed registry data for colon cancer patients from Ontario (n=930) and California (n=1014), diagnosed between 1996 and 2000 and followed until 2006, on stage, surgery, adjuvant chemotherapy, and survival. We obtained socioeconomic data for individuals' residences from population censuses. Results: Income was directly associated with lymph node evaluation, chemotherapy, and survival in San Francisco but not in Toronto. High-income persons had better survival rates in San Francisco than in Toronto. After adjustment for stage, survival was better for low-income residents of Toronto than for those of San Francisco. Middle- to low-income patients were more likely to receive indicated chemotherapy in Toronto than in San Francisco. Conclusions: Socioeconomic factors appear to mediate colon cancer care in urban areas of the United States but not in Canada. Improvements are needed in screening, diagnostic investigations, and treatment access among low-income Americans.
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Race Disparities in Low Birth Weight in the U.S. South and the Rest of the Nation
Lenna Nepomnyaschy
Social Science & Medicine, March 2010, Pages 684-691
Abstract:
There are well-documented and as yet unexplained disparities in birth outcomes by race in the USA. This paper examines the sources of disparities in low birth weight between blacks and whites in the US, by focusing on differences in disparities between two very distinct geographic areas, the Deep South and the rest of the country. Two findings from prior research drive the analyses: first, health overall is worse in the Deep South states; second, race disparities are smaller in the Deep South than in the rest of the nation. A number of potential explanations for these findings are examined using nationally representative data on approximately 8,000 children born in the US in 2001. Results suggest that, first, almost all of the increased burden of low birth weight in the Deep South states may be explained by differences in race composition and socioeconomic status between the Deep South and rest of the nation. Second, the slightly lower race disparities found in the Deep South states are being driven not by better outcomes for black mothers, but by two other factors: higher returns to socioeconomic status for black mothers and much worse outcomes for poor white mothers in the Deep South compared with the rest of the country.
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Residential Segregation and Birth Weight among Racial and Ethnic Minorities in the United States
Emily Walton
Journal of Health and Social Behavior, December 2009, Pages 427-442
Abstract:
Racial and ethnic minorities are often residentially segregated from whites in urban settings, a fact which has important health consequences. Research on the relationship between residential segregation and health outcomes lacks national-level investigation of racial and ethnic minority groups other than African Americans. I use multilevel analyses to examine the associations of residential isolation and clustering with birth weight among Asian, black, and Latino Americans using data from the National Center for Health Statistics' Natality Files and the U.S. Census. Findings indicate that segregation has a negative effect on the likelihood of having a low birth weight baby among Asian Americans, suggesting a possible concentration of social and structural resources in highly-segregated communities. On the contrary, segregation marginally increases the odds of low birth weight among African Americans, but only in the presence of higher poverty rates. Segregation does not affect birth weight among Latino Americans.
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The Psychological Sting of Stigma: The Costs of Attributing Ostracism to Racism
Stephanie Goodwin, Kipling Williams & Adrienne Carter-Sowell
Journal of Experimental Social Psychology, July 2010, Pages 612-618
Abstract:
Laboratory-based research with university students demonstrates that ostracism is reflexively painful, depletes fundamental needs, and is highly resistant to variations in situational context or individual differences. Employing a representative sample of 614 US White and African American adults, we sought to (1) demonstrate the utility of using Cyberball on a broader non-college sample, and examine (2) whether attributing ostracism to racial prejudice mediates recovery. Participants in an Internet version of Cyberball were either included or ostracized by two other players (both White or both Black), and reported their level of distress before and after making attributions for treatment during the game. Overall, reflexive needs were threatened by ostracism, but more so for Blacks. Whites attributed ostracism to racism when the other players were Black. Blacks attributed ostracism to racism when the other players were White or Black. Within a few minutes, participants reported feeling less distress, but attributing ostracism to racial prejudice impeded their recovery.
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Parker Frisbie, Robert Hummer, Daniel Powers, Seung-Eun Song & Starling Pullum
Population Research and Policy Review, June 2010, Pages 395-422
Abstract:
Using data from the national linked birth/infant death cohort files, we examined race/ethnicity/nativity disparities and changes in infant mortality due to the five leading causes of infant death between 1989 and 2001. Our results indicate substantial decreases in infant mortality from three causes (congenital anomalies, sudden infant death syndrome, and respiratory distress syndrome) for which specific perinatal health innovations emerged or were expanded. However, for these three causes, the relative disparities in infant mortality between infants born to U.S.-born black women as compared to infants of U.S.-born white women increased following the introduction (or expansion) of beneficial interventions. Among infants of U.S.-born Mexican American mothers, the findings differed. In the static comparisons, our results show the often-reported similarity in the risk of death of these babies compared to those born to non-Hispanic white mothers. However, when changes over time were modeled, there was an erosion of the relatively favorable survival chances of Mexican American infants. Our models show little change in the relative risk of death for infants of immigrant women. Regarding the other two causes (disorders relating to short gestation and unspecified low birth weight and maternal complications) for which no efficacious innovations occurred, either little change or actual increases in risks were observed. Future studies and health policy efforts should be geared toward further understanding and aggressively working to close infant mortality gaps, especially for infants of U.S.-born black mothers-an effort that will be facilitated by research focused on cause-specific infant mortality.
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Population Density and Racial Differences in the Performance of Emergency Medical Services
Guy David & Scott Harrington
Journal of Health Economics, forthcoming
Abstract:
This paper analyzes the existence and scope of possible racial differences/disparities in the provision of emergency medical services (EMS) response capability (time from dispatch to arrival at the scene and level of training of the responding team) using data on approximately 120,000 cardiac incidents in the state of Mississippi during 1995-2004. The conceptual framework and empirical analysis focus on the likely effects of population density on the efficient production of EMS as a local public good subject to congestion, and on the need to control adequately for population density to avoid bias in testing for racial differences. Models that control for aggregate population density at the county level indicate "reverse" disparities: faster estimated response times for African-Americans than for whites. When a refined county-level measure of population density is used that incorporates differences in African-American and white population density by Census tract, the reverse disparity in response times disappears. There also is little or no evidence of race-related differences in the certification level of EMS responders. However, there is evidence that, controlling for response time, African-Americans on average were significantly more likely to be deceased than whites upon EMS arrival at the scene. The overall results are germane to the debate over the scope of conditioning variables that should be included when testing for racial disparities in health care.
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Everyday Discrimination and Nocturnal Blood Pressure Dipping in Black and White Americans
Lianne Tomfohr, Denise Cooper, Paul Mills, Richard Nelesen & Joel Dimsdale
Psychosomatic Medicine, April 2010, Pages 266-272
Objective: To investigate whether an association exists between experiences of everyday discrimination and blood pressure (BP) dipping in a biracial sample of black and white adults. Attenuated nocturnal BP dipping is closely linked to cardiovascular morbidity and mortality. Self-reported experiences of everyday discrimination have also been associated with negative cardiovascular health outcomes. Methods: Seventy-eight hypertensive and normotensive women and men (n = 30 black and 48 white) reported on their experiences of everyday discrimination (Everyday Discrimination Scale) and underwent two separate 24-hour ambulatory BP monitoring (ABPM) sessions approximately 1 week apart. Results: Correlation analysis revealed that higher endorsement of everyday discrimination was significantly associated with less diastolic BP (DBP) and systolic BP (SBP) dipping (p < .05). Subsequent hierarchical regression analyses indicated that everyday discrimination explained 8% to 11% of the variance in SBP and DBP dipping above and beyond other demographic and life-style-related factors, including race, age, 24-hour BP, body mass index, and current socioeconomic status . The relationship between discrimination and dipping was significantly stronger on the second night of monitoring. Finally, analyses revealed that everyday discrimination mediated the relationship between race and BP dipping. Conclusions: These findings suggest that experiences of everyday discrimination are associated with less nocturnal SBP and DBP dipping above and beyond the effect of known covariates. The use of multiple ABPM sessions may facilitate the detection of relationships between psychological variables and BP dipping.
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Trends in the association between height and socioeconomic indicators in France, 1970-2003
Archana Singh-Manoux, Julie Gourmelen, Jane Ferrie, Karri Silventoinen, Alice Guéguen, Silvia Stringhini, Hermann Nabi & Mika Kivimaki
Economics & Human Biology, forthcoming
Abstract:
Average physical stature has increased dramatically during the 20th century in many populations across the world with few exceptions. It remains unclear if social inequalities in height persist despite improvements in living standards in the welfare economies of Western Europe. We examined trends in the association between height and socioeconomic indicators in adults over three decades in France. The data were drawn from the French Decennial Health Surveys: a multistage, stratified, random survey of households, representative of the population, conducted in 1970, 1980, 1991, and 2003. We categorised age into 10-year bands, 25-34, 35-44, 45-54 and 55-64 years. Education and income were the two socioeconomic measures used. The slope index of inequality (SII) was used as a summary index of absolute social inequalities in height. The results show that average height increased over this period; men and women aged 25-34 years were 171.9 and 161.2 cm tall in 1970 and 177.0 and 164.0 cm in 2003. However, education-related inequalities in height remained unchanged over this period and in men were 4.48 cm (1970), 4.71 cm (1980), 5.58 cm (1991) and 4.69 cm (2003), the corresponding figures in women were 2.41, 2.37, 3.14 and 2.96 cm. Income-related inequalities in height were smaller and much attenuated after adjustment for education. These results suggest that in France, social inequalities in adult height in absolute terms have remained unchanged across the three decades under examination.
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The Impact of Prenatal WIC Participation on Infant Mortality and Racial Disparities
Intisar Khanani, Jon Elam, Rick Hearn, Camille Jones & Noble Maseru
American Journal of Public Health, April 2010, Pages S204-S209
Objectives: We assessed the value of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) services as a public health intervention seeking to improve birth outcomes and reduce racial disparities. Methods: We compared the infant mortality rate (IMR) per 1000 live births and percentage of preterm births overall and by race for prenatal WIC versus non-WIC participants in Hamilton County, Ohio, from 2005 to 2008. Results: The IMR was lower for WIC participants than for non-WIC participants (8.0 vs 10.6; P = .04). For African Americans, the IMR of WIC participants was much lower than that of non-WIC participants (9.6 vs 21.0; P < .001). For Whites, IMR and preterm birth rates were not improved by WIC participation; however, there was a higher rate of maternal smoking among Whites. The racial disparity in IMR was dramatically reduced in WIC participants (9.6 for African Americans vs 6.7 for Whites; P = .14) as compared with non-WIC participants (21.0 for African Americans vs 7.8 for Whites; P < .001). Conclusions: Prenatal WIC participation is associated with significant improvements in African American IMR. WIC participation reduces racial disparities in IMR between African Americans and Whites.