Shervin Assari | Charles R. Drew University of Medicine and Science (original) (raw)
Papers by Shervin Assari
Journal of Racial and Ethnic Health Disparities
Background COVID-19 pandemic has immensely impacted the social and personal lives of individu... more Background COVID-19 pandemic has immensely impacted the social and personal lives of individuals around the globe. Marginalized-related diminished returns (MDRs) theory suggests that educational attainment shows a weaker protective effect for health and behavioral outcomes for Black individuals compared to White individuals. Previous studies conducted before the COVID-19 pandemic demonstrated diminished returns of educational attainment for Black individuals compared to White individuals. Objectives The study has three objectives: First, to test the association between educational attainment and cigarette smoking, e-cigarette vaping, presence of chronic medical conditions (CMC), self-rated health (SRH), depressive symptoms, and obesity; second, to explore racial differences in these associations in the USA during the COVID-19 pandemic; and third, to compare the interaction of race and return of educational attainment pre- and post-COVID-19 pandemic. Methods This study utilized d...
International Journal of Environmental Research and Public Health, 2021
Chronic low back pain is one of the most common, poorly understood, and potentially disabling chr... more Chronic low back pain is one of the most common, poorly understood, and potentially disabling chronic pain conditions from which older adults suffer. The existing low back pain research has relied almost exclusively on White/Caucasian participant samples. This study examines the correlates of chronic low back pain among a sample of underserved urban African American and Latino older adults. Controlling for age, gender, race/ethnicity, education, living arrangement, and number of major chronic conditions, associations between low back pain and the following outcome variables are examined: (1) healthcare utilization, (2) health-related quality of life (HR-QoL) and self-rated quality of health; and (3) physical and mental health outcomes. Methods: We recruited nine hundred and five (905) African American and Latino older adults from the South Los Angeles community using convenience and snowball sampling. In addition to standard items that measure demographic variables, our survey inclu...
Journal of health economics and development, 2019
Background Although socioeconomic position (SEP) is associated with better health, the protective... more Background Although socioeconomic position (SEP) is associated with better health, the protective effects of high SEP may be smaller for racial and ethnic minorities than Whites, as explained by Minorities' Diminished Returns theory. It is still unknown whether the association between SEP and systolic blood pressure (SBP) differs for racial and ethnic groups. The current study racial and ethnic variation in the association between SEP (education attainment and household income) and SBP among American adults. Methods The National Health and Nutrition Examination Survey (NHANES; 2005-2006) included 4773 adults 20 years or older. Education attainment and household income were the predictor variables, SBP was the outcome variable, age and gender were the covariates, and race/ethnicity was the effect modifier. Multiple linear regression models were used in the pooled sample and each race/ethnicity. Results In the pooled sample, higher education attainment and household income were as...
Background As suggested by the Minorities' Diminished Returns (MDR) theory, socioeconomic sta... more Background As suggested by the Minorities' Diminished Returns (MDR) theory, socioeconomic status (SES) systemically results in smaller outcomes for non-Whites compared to Whites. We still know very little about diminished trans-generational returns of SES resources such as parental educational attainment (PEA). Purpose This cross-sectional study explored racial variation in the effect of PEA on the college students' grade point average (GPA) in the US. Methods The Healthy Mind Study (HMS, 2016-2017) is a national telephone of college students in the US. The total sample was 18,072 domestic undergraduate college students who were either non-Hispanic Whites (n = 16,718; %92.50) or non-Hispanic Blacks (n = 1,354; %7.50). The independent variable was PEA. The main outcome was GPA measured using self-reported data. Age, gender, sexual orientation, transgender status, and financial difficulty were covariates. Race/ethnicity was the effect modifier. Linear regression models were us...
This paper presents three design products referred to as delightful companions that are intended ... more This paper presents three design products referred to as delightful companions that are intended to help people engage in well-being practices. It also introduces the approach utilized to guide the design decisions during their creation. Design delight is the name of this approach, which comprises six experiential qualities that are regarded as antecedents of delight. The objective of this paper is to introduce the approach and the companions and state the two paths that have defined the future steps of this research.
Journal of Mental Health & Clinical Psychology
Background: Education, employment, and marital status are among the main socioeconomic status (SE... more Background: Education, employment, and marital status are among the main socioeconomic status (SES) indicators that are associated with subjective health and happiness. The effects of these SES indicators may, however, be different for various demographic groups. Aims: To understand if SES indicators differently impact men and women, we tested gender differences in the effects of education, employment, and marital status on the subjective health and happiness of American adults. Methods: This cross-sectional study used data of the General Social Survey (GSS), a series of nationally representative surveys between 1972 and 2018 in the US. Our analytical sample included 65,814 adults. The main independent variables were education attainment, marital status, and employment. Outcomes were self-rated health (SRH) and happiness measured using single items. Age and year of the study were covariates. Gender was the moderator. Results: Overall, high education, being employed, and being married were associated with better SRH and happiness. We, however, found significant interactions between gender and educational attainment, marital status, and employment on the outcomes, which suggested that the effect of high education and marital status were stronger for women. In comparison, the effect of employment was stronger for men. Some inconsistencies in the results were observed for SRH compared to happiness. Conclusions: In the United States, while education, employment, and marital status are critical social determinants of subjective health and happiness, these effects vary between women and men. Men's outcomes seem to be more strongly shaped by employment, while women's outcomes are more strongly shaped by education and marital status. Background The topic of well-being, that includes subjective health and happiness, has attracted the attention of governments, sociologists, psychologists, and economists 1,2. There is ample evidence showing a robust relationship between well-being and subjective health 1,2. At the national level, gross domestic product (GDP) is a robust measure of economic wellbeing. However, it is not ideal because it does not provide a tool to compare other aspects of well-being of demographic subgroups within a single country. In addition, this measure does not reflect inequalities in subjective health and happiness due to differences in socioeconomic resources such as education, employment, and marital status. As a result, it is essential to consider subjective components of well-being 2. Hence, selfreported happiness and health, are now being recognized as two
Brain Sciences
Background. Although psychosocial and health factors impact insomnia symptoms, less is known abou... more Background. Although psychosocial and health factors impact insomnia symptoms, less is known about these effects in economically disadvantaged African-American older adults. Aims. This study investigated social and health determinants of insomnia symptoms among economically disadvantaged African-American older adults. Methods. This survey enrolled 398 African-American older adults (age ≥ 65 years) from economically disadvantaged areas of South Los Angeles. Gender, age, educational attainment, financial difficulty, number of chronic diseases, self-rated health, pain intensity, and depression were covariates. Total insomnia, insomnia symptoms, and insomnia impact were our outcomes. Linear regression was applied for data analysis. Results. Based on linear regression, higher financial difficulty (B = 0.48, 95% CI = 0.35–0.61), smoking status (B = 1.64, 95% CI = 0.13–3.16), higher pain intensity (B = 0.39, 95% CI = 0.11–0.67), higher number of chronic diseases (B = 0.34, 95% CI = 0.05–0....
Brain Sciences
Purpose: This study explored demographic, social, behavioral, and health factors associated with ... more Purpose: This study explored demographic, social, behavioral, and health factors associated with current marijuana use (MU) among African American older adults who were residing in economically challenged areas of south Los Angeles. Methods: This community-based study recruited a consecutive sample of African American older adults (n = 340), age ≥ 55 years, residing in economically challenged areas of South Los Angeles. Interviews were conducted to collect data. Demographics (age and gender), socioeconomic status (educational attainment, income, and financial strain), marital status, living alone, health behaviors (alcohol drinking and cigarette smoking), health status (number of chronic medical conditions, body mass index, depression, and chronic pain), and current MU were collected. Logistic regression was used to analyze the data. Results: Thirty (9.1%) participants reported current MU. Age, educational attainment, chronic medical conditions, and obesity were negatively associate...
Health Equity
According to the Minorities' Diminished Return (MDR) theory, socioeconomic status (SES) indicator... more According to the Minorities' Diminished Return (MDR) theory, socioeconomic status (SES) indicators such as employment status produce smaller tangible outcomes for racial and ethnic minority groups, however, very limited information exists on such diminished returns for Hispanics. To test whether MDR also holds for the social patterning of smoking behaviors among white adults, this study explored ethnic differences in the association between employment status and ever smoking in a representative sample of adults in Los Angeles. Methods: Los Angeles Family and Neighborhood Survey 2001 included 907 non-Hispanic white and 2117 Hispanic white adults (ages 18 or older). Ethnicity, gender, age, employment status, marital status, immigration status, and ever smoking were measured. Logistic regression models were used for data analysis. Results: In the pooled sample that included both non-Hispanic whites and Hispanic whites, being employed was associated with lower odds of ever smoking, net of covariates. A significant interaction was found between ethnicity and employment status on odds of ever smoking, suggesting a stronger inverse association between employment status and ever smoking for non-Hispanic whites than Hispanic whites. Ethnic specific models showed an inverse association between being employed and ever smoking status for non-Hispanic whites, but not for Hispanic whites. Conclusion: Even among whites, whether or not employment reduces the risk of ever smoking may depend on ethnicity, with Hispanics being at a disadvantage relative to non-Hispanic whites in terms of lower odds of ever smoking from their employment status.
International Journal of Environmental Research and Public Health
Objectives: Using the Andersen’s Behavioral Model of Health Services Use, we explored social, beh... more Objectives: Using the Andersen’s Behavioral Model of Health Services Use, we explored social, behavioral, and health factors that are associated with emergency department (ED) utilization among underserved African American (AA) older adults in one of the most economically disadvantaged urban areas in South Los Angeles, California. Methods: This cross-sectional study recruited a convenience sample of 609 non-institutionalized AA older adults (age ≥ 65 years) from South Los Angeles, California. Participants were interviewed for demographic factors, self-rated health, chronic medication conditions (CMCs), pain, depressive symptoms, access to care, and continuity of care. Outcomes included 1 or 2+ ED visits in the last 12 months. Polynomial regression was used for data analysis. Results: Almost 41% of participants were treated at an ED during the last 12 months. In all, 27% of participants attended an ED once and 14% two or more times. Half of those with 6+ chronic conditions reported b...
The journal of Tehran Heart Center, 2017
The association between coronary angiographic findings and the level of anxiety symptoms among pa... more The association between coronary angiographic findings and the level of anxiety symptoms among patients who undergo coronary angiography is not known. The aim of this study was to investigate the association between the extent of coronary stenosis and anxiety symptoms in patients who undergo coronary angiography. In a cross-sectional study, 106 patients who underwent coronary angiography and had varying degrees of coronary artery disease were enrolled. Demographic characteristics (i.e., age and gender), socioeconomic status (i.e., educational attainment, income, and marital status), and traditional risk factors (i.e., hypertension, diabetes mellitus, hyperlipidemia, and smoking) were measured. The independent variable was the extent of coronary stenosis shown by coronary angiography, coded as single-vessel disease (n = 19), 2-vessel disease (n = 28), or 3-vessel disease (n = 59). The main outcome was symptoms of anxiety measured using the Hospital Anxiety Depression Scale (HADS). Th...
Brain Sciences
Background: Sociological and epidemiological literature have both shown that socioeconomic status... more Background: Sociological and epidemiological literature have both shown that socioeconomic status (SES) protects populations and individuals against health problems. Recent research, however, has shown that African Americans gain less from their SES and African Americans of high SES, particularly males, may be vulnerable to perceived discrimination, as explained by the Minorities’ Diminished Returns theory. One potential mechanism for this phenomenon is that high SES African Americans have a higher tendency to work in predominantly White workplaces, which increases their perceived discrimination. It is, however, unknown if the links between SES, working in predominantly White work groups and perceived discrimination differ for male and female African Americans. Aim: To test the associations between SES, workplace racial composition and perceived discrimination in a nationally representative sample of male and female African American adults. Methods. This study included a total numbe...
Behavioral Sciences
Background. Socioeconomic status (SES) has smaller protective effects on the health of African Am... more Background. Socioeconomic status (SES) has smaller protective effects on the health of African Americans, and the differential association between social mobility and stress may explain the diminished returns of SES for African Americans. Aim. This study tested the race/ethnic differences in the association between upward and downward social mobility and stress in a nationally representative sample of African American and White American adults. Methods. This study included 3570 African Americans and 891 non-Hispanic White Americans from the National Survey of American Life (NSAL), 2003. Race/ethnicity, gender, age, upward and downward social mobility (independent variable, defined as difference between parent and respondent education), and stressful life events (SLE, dependent variable) were measured. Linear regression models were used for data analysis. Results. In the pooled sample that included both races, upward and downward social mobility were both associated with SLE, the net...
Brain Sciences
Background: Recent research has shown smaller health effects of socioeconomic status (SES) indica... more Background: Recent research has shown smaller health effects of socioeconomic status (SES) indicators such as education attainment for African Americans as compared to whites. However, less is known about diminished returns based on gender within African Americans. Aim: To test whether among African American men are at a relative disadvantage compared to women in terms of having improved mental health as a result of their education attainment. This study thus explored gender differences in the association between education attainment and mental health, using a representative sample of American adults. Methods: The National Survey of American Life (NSAL; 2003) recruited 3570 African American adults (2299 females and 1271 males). The dependent variables were depressive symptoms and psychological distress. The independent variable was education attainment. Race was the focal moderator. Age, employment status, and marital status were covariates. Linear regressions were used for data ana...
Suicide and Life-Threatening Behavior
This is the author manuscript accepted for publication and has undergone full peer review but has... more This is the author manuscript accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as
Cultural diversity & ethnic minority psychology, Jan 30, 2018
Believing in justice can protect health. Among marginalized racial minorities however, both endor... more Believing in justice can protect health. Among marginalized racial minorities however, both endorsing and rejecting beliefs about justice might be critical. The current research examined links between African Americans' beliefs about justice for self and for others and telomere length (TL)-an indicator of biological aging that is increasingly implicated in racial health disparities, with shorter telomeres indicating poorer health. Healthy African Americans (N = 118; 30% male; M age = 31.63 years) completed individual differences measures of justice beliefs for self and others and then provided dried blood spot samples that were assayed for TL. We expected that a belief in justice for self would be positively associated with TL, whereas a belief in justice for others would be negatively associated. A significant 3-way interaction with chronological age confirmed this hypothesis-among older African Americans, TL was positively associated with believing in justice for self, but onl...
Bipolar disorders, Jan 12, 2018
Health disparities between individuals of African and European ancestry are well documented. The ... more Health disparities between individuals of African and European ancestry are well documented. The disparities in bipolar disorder may be driven by racial bias superimposed on established factors contributing to misdiagnosis, including: evolving empirically based diagnostic criteria (International Classification of Diseases [ICD], Research Diagnostic Criteria [RDC] and Diagnostic and Statistical Manual [DSM]), multiple symptom domains (i.e. mania, depression and psychosis), and multimodal medical and additional psychiatric comorbidity. For this paper, we reviewed the phenomenological differences between bipolar individuals of African and European ancestry in the context of diagnostic criteria and clinical factors that may contribute to a potential racial bias. Published data show that bipolar persons of African ancestry, compared with bipolar persons of non-African ancestry, are more often misdiagnosed with a disease other than bipolar disorder (i.e. schizophrenia). Additionally, stud...
International journal of epidemiology, Feb 2, 2017
The American Journal of Geriatric Psychiatry
OBJECTIVE To understand unmet depression needs of older adults, the current study investigates de... more OBJECTIVE To understand unmet depression needs of older adults, the current study investigates depressive symptoms, psychiatric treatment, and home- and community-based service (HCBS) use in a nationally representative sample of older adults in the United States. METHODS Participants included 5,582 adults aged 60 and over from the 2010-2012 waves of the nationally representative Health and Retirement Study. Weighted bivariate analyses were used to examine the frequency of depressive symptoms (Center for Epidemiologic Studies Depression Scale) and psychiatric treatment among HCBS recipients compared with non-HCBS recipients. Weighted logistic regression models were used to evaluate the effect of depressive symptoms on HCBS use. RESULTS HCBS recipients had a higher frequency of depressive symptoms compared with nonrecipients (27.5% versus 10.4%, respectively). In particular, transportation service recipients had the highest frequency of depressive symptoms (37.5%). HCBS recipients with depressive symptoms were no more likely than nonrecipients to receive psychiatric services. Depressive symptoms were associated with HCBS use, above and beyond sociodemographic and health risk factors. CONCLUSION Depressive symptoms are more frequent among HCBS recipients compared with nonrecipients; however, depressed HCBS recipients are no more likely to receive psychiatric services, suggesting unmet depression needs. HCBS may be a key setting for depression detection and delivery of mental health interventions.
Journal of Behavioral Medicine
Journal of Racial and Ethnic Health Disparities
Background COVID-19 pandemic has immensely impacted the social and personal lives of individu... more Background COVID-19 pandemic has immensely impacted the social and personal lives of individuals around the globe. Marginalized-related diminished returns (MDRs) theory suggests that educational attainment shows a weaker protective effect for health and behavioral outcomes for Black individuals compared to White individuals. Previous studies conducted before the COVID-19 pandemic demonstrated diminished returns of educational attainment for Black individuals compared to White individuals. Objectives The study has three objectives: First, to test the association between educational attainment and cigarette smoking, e-cigarette vaping, presence of chronic medical conditions (CMC), self-rated health (SRH), depressive symptoms, and obesity; second, to explore racial differences in these associations in the USA during the COVID-19 pandemic; and third, to compare the interaction of race and return of educational attainment pre- and post-COVID-19 pandemic. Methods This study utilized d...
International Journal of Environmental Research and Public Health, 2021
Chronic low back pain is one of the most common, poorly understood, and potentially disabling chr... more Chronic low back pain is one of the most common, poorly understood, and potentially disabling chronic pain conditions from which older adults suffer. The existing low back pain research has relied almost exclusively on White/Caucasian participant samples. This study examines the correlates of chronic low back pain among a sample of underserved urban African American and Latino older adults. Controlling for age, gender, race/ethnicity, education, living arrangement, and number of major chronic conditions, associations between low back pain and the following outcome variables are examined: (1) healthcare utilization, (2) health-related quality of life (HR-QoL) and self-rated quality of health; and (3) physical and mental health outcomes. Methods: We recruited nine hundred and five (905) African American and Latino older adults from the South Los Angeles community using convenience and snowball sampling. In addition to standard items that measure demographic variables, our survey inclu...
Journal of health economics and development, 2019
Background Although socioeconomic position (SEP) is associated with better health, the protective... more Background Although socioeconomic position (SEP) is associated with better health, the protective effects of high SEP may be smaller for racial and ethnic minorities than Whites, as explained by Minorities' Diminished Returns theory. It is still unknown whether the association between SEP and systolic blood pressure (SBP) differs for racial and ethnic groups. The current study racial and ethnic variation in the association between SEP (education attainment and household income) and SBP among American adults. Methods The National Health and Nutrition Examination Survey (NHANES; 2005-2006) included 4773 adults 20 years or older. Education attainment and household income were the predictor variables, SBP was the outcome variable, age and gender were the covariates, and race/ethnicity was the effect modifier. Multiple linear regression models were used in the pooled sample and each race/ethnicity. Results In the pooled sample, higher education attainment and household income were as...
Background As suggested by the Minorities' Diminished Returns (MDR) theory, socioeconomic sta... more Background As suggested by the Minorities' Diminished Returns (MDR) theory, socioeconomic status (SES) systemically results in smaller outcomes for non-Whites compared to Whites. We still know very little about diminished trans-generational returns of SES resources such as parental educational attainment (PEA). Purpose This cross-sectional study explored racial variation in the effect of PEA on the college students' grade point average (GPA) in the US. Methods The Healthy Mind Study (HMS, 2016-2017) is a national telephone of college students in the US. The total sample was 18,072 domestic undergraduate college students who were either non-Hispanic Whites (n = 16,718; %92.50) or non-Hispanic Blacks (n = 1,354; %7.50). The independent variable was PEA. The main outcome was GPA measured using self-reported data. Age, gender, sexual orientation, transgender status, and financial difficulty were covariates. Race/ethnicity was the effect modifier. Linear regression models were us...
This paper presents three design products referred to as delightful companions that are intended ... more This paper presents three design products referred to as delightful companions that are intended to help people engage in well-being practices. It also introduces the approach utilized to guide the design decisions during their creation. Design delight is the name of this approach, which comprises six experiential qualities that are regarded as antecedents of delight. The objective of this paper is to introduce the approach and the companions and state the two paths that have defined the future steps of this research.
Journal of Mental Health & Clinical Psychology
Background: Education, employment, and marital status are among the main socioeconomic status (SE... more Background: Education, employment, and marital status are among the main socioeconomic status (SES) indicators that are associated with subjective health and happiness. The effects of these SES indicators may, however, be different for various demographic groups. Aims: To understand if SES indicators differently impact men and women, we tested gender differences in the effects of education, employment, and marital status on the subjective health and happiness of American adults. Methods: This cross-sectional study used data of the General Social Survey (GSS), a series of nationally representative surveys between 1972 and 2018 in the US. Our analytical sample included 65,814 adults. The main independent variables were education attainment, marital status, and employment. Outcomes were self-rated health (SRH) and happiness measured using single items. Age and year of the study were covariates. Gender was the moderator. Results: Overall, high education, being employed, and being married were associated with better SRH and happiness. We, however, found significant interactions between gender and educational attainment, marital status, and employment on the outcomes, which suggested that the effect of high education and marital status were stronger for women. In comparison, the effect of employment was stronger for men. Some inconsistencies in the results were observed for SRH compared to happiness. Conclusions: In the United States, while education, employment, and marital status are critical social determinants of subjective health and happiness, these effects vary between women and men. Men's outcomes seem to be more strongly shaped by employment, while women's outcomes are more strongly shaped by education and marital status. Background The topic of well-being, that includes subjective health and happiness, has attracted the attention of governments, sociologists, psychologists, and economists 1,2. There is ample evidence showing a robust relationship between well-being and subjective health 1,2. At the national level, gross domestic product (GDP) is a robust measure of economic wellbeing. However, it is not ideal because it does not provide a tool to compare other aspects of well-being of demographic subgroups within a single country. In addition, this measure does not reflect inequalities in subjective health and happiness due to differences in socioeconomic resources such as education, employment, and marital status. As a result, it is essential to consider subjective components of well-being 2. Hence, selfreported happiness and health, are now being recognized as two
Brain Sciences
Background. Although psychosocial and health factors impact insomnia symptoms, less is known abou... more Background. Although psychosocial and health factors impact insomnia symptoms, less is known about these effects in economically disadvantaged African-American older adults. Aims. This study investigated social and health determinants of insomnia symptoms among economically disadvantaged African-American older adults. Methods. This survey enrolled 398 African-American older adults (age ≥ 65 years) from economically disadvantaged areas of South Los Angeles. Gender, age, educational attainment, financial difficulty, number of chronic diseases, self-rated health, pain intensity, and depression were covariates. Total insomnia, insomnia symptoms, and insomnia impact were our outcomes. Linear regression was applied for data analysis. Results. Based on linear regression, higher financial difficulty (B = 0.48, 95% CI = 0.35–0.61), smoking status (B = 1.64, 95% CI = 0.13–3.16), higher pain intensity (B = 0.39, 95% CI = 0.11–0.67), higher number of chronic diseases (B = 0.34, 95% CI = 0.05–0....
Brain Sciences
Purpose: This study explored demographic, social, behavioral, and health factors associated with ... more Purpose: This study explored demographic, social, behavioral, and health factors associated with current marijuana use (MU) among African American older adults who were residing in economically challenged areas of south Los Angeles. Methods: This community-based study recruited a consecutive sample of African American older adults (n = 340), age ≥ 55 years, residing in economically challenged areas of South Los Angeles. Interviews were conducted to collect data. Demographics (age and gender), socioeconomic status (educational attainment, income, and financial strain), marital status, living alone, health behaviors (alcohol drinking and cigarette smoking), health status (number of chronic medical conditions, body mass index, depression, and chronic pain), and current MU were collected. Logistic regression was used to analyze the data. Results: Thirty (9.1%) participants reported current MU. Age, educational attainment, chronic medical conditions, and obesity were negatively associate...
Health Equity
According to the Minorities' Diminished Return (MDR) theory, socioeconomic status (SES) indicator... more According to the Minorities' Diminished Return (MDR) theory, socioeconomic status (SES) indicators such as employment status produce smaller tangible outcomes for racial and ethnic minority groups, however, very limited information exists on such diminished returns for Hispanics. To test whether MDR also holds for the social patterning of smoking behaviors among white adults, this study explored ethnic differences in the association between employment status and ever smoking in a representative sample of adults in Los Angeles. Methods: Los Angeles Family and Neighborhood Survey 2001 included 907 non-Hispanic white and 2117 Hispanic white adults (ages 18 or older). Ethnicity, gender, age, employment status, marital status, immigration status, and ever smoking were measured. Logistic regression models were used for data analysis. Results: In the pooled sample that included both non-Hispanic whites and Hispanic whites, being employed was associated with lower odds of ever smoking, net of covariates. A significant interaction was found between ethnicity and employment status on odds of ever smoking, suggesting a stronger inverse association between employment status and ever smoking for non-Hispanic whites than Hispanic whites. Ethnic specific models showed an inverse association between being employed and ever smoking status for non-Hispanic whites, but not for Hispanic whites. Conclusion: Even among whites, whether or not employment reduces the risk of ever smoking may depend on ethnicity, with Hispanics being at a disadvantage relative to non-Hispanic whites in terms of lower odds of ever smoking from their employment status.
International Journal of Environmental Research and Public Health
Objectives: Using the Andersen’s Behavioral Model of Health Services Use, we explored social, beh... more Objectives: Using the Andersen’s Behavioral Model of Health Services Use, we explored social, behavioral, and health factors that are associated with emergency department (ED) utilization among underserved African American (AA) older adults in one of the most economically disadvantaged urban areas in South Los Angeles, California. Methods: This cross-sectional study recruited a convenience sample of 609 non-institutionalized AA older adults (age ≥ 65 years) from South Los Angeles, California. Participants were interviewed for demographic factors, self-rated health, chronic medication conditions (CMCs), pain, depressive symptoms, access to care, and continuity of care. Outcomes included 1 or 2+ ED visits in the last 12 months. Polynomial regression was used for data analysis. Results: Almost 41% of participants were treated at an ED during the last 12 months. In all, 27% of participants attended an ED once and 14% two or more times. Half of those with 6+ chronic conditions reported b...
The journal of Tehran Heart Center, 2017
The association between coronary angiographic findings and the level of anxiety symptoms among pa... more The association between coronary angiographic findings and the level of anxiety symptoms among patients who undergo coronary angiography is not known. The aim of this study was to investigate the association between the extent of coronary stenosis and anxiety symptoms in patients who undergo coronary angiography. In a cross-sectional study, 106 patients who underwent coronary angiography and had varying degrees of coronary artery disease were enrolled. Demographic characteristics (i.e., age and gender), socioeconomic status (i.e., educational attainment, income, and marital status), and traditional risk factors (i.e., hypertension, diabetes mellitus, hyperlipidemia, and smoking) were measured. The independent variable was the extent of coronary stenosis shown by coronary angiography, coded as single-vessel disease (n = 19), 2-vessel disease (n = 28), or 3-vessel disease (n = 59). The main outcome was symptoms of anxiety measured using the Hospital Anxiety Depression Scale (HADS). Th...
Brain Sciences
Background: Sociological and epidemiological literature have both shown that socioeconomic status... more Background: Sociological and epidemiological literature have both shown that socioeconomic status (SES) protects populations and individuals against health problems. Recent research, however, has shown that African Americans gain less from their SES and African Americans of high SES, particularly males, may be vulnerable to perceived discrimination, as explained by the Minorities’ Diminished Returns theory. One potential mechanism for this phenomenon is that high SES African Americans have a higher tendency to work in predominantly White workplaces, which increases their perceived discrimination. It is, however, unknown if the links between SES, working in predominantly White work groups and perceived discrimination differ for male and female African Americans. Aim: To test the associations between SES, workplace racial composition and perceived discrimination in a nationally representative sample of male and female African American adults. Methods. This study included a total numbe...
Behavioral Sciences
Background. Socioeconomic status (SES) has smaller protective effects on the health of African Am... more Background. Socioeconomic status (SES) has smaller protective effects on the health of African Americans, and the differential association between social mobility and stress may explain the diminished returns of SES for African Americans. Aim. This study tested the race/ethnic differences in the association between upward and downward social mobility and stress in a nationally representative sample of African American and White American adults. Methods. This study included 3570 African Americans and 891 non-Hispanic White Americans from the National Survey of American Life (NSAL), 2003. Race/ethnicity, gender, age, upward and downward social mobility (independent variable, defined as difference between parent and respondent education), and stressful life events (SLE, dependent variable) were measured. Linear regression models were used for data analysis. Results. In the pooled sample that included both races, upward and downward social mobility were both associated with SLE, the net...
Brain Sciences
Background: Recent research has shown smaller health effects of socioeconomic status (SES) indica... more Background: Recent research has shown smaller health effects of socioeconomic status (SES) indicators such as education attainment for African Americans as compared to whites. However, less is known about diminished returns based on gender within African Americans. Aim: To test whether among African American men are at a relative disadvantage compared to women in terms of having improved mental health as a result of their education attainment. This study thus explored gender differences in the association between education attainment and mental health, using a representative sample of American adults. Methods: The National Survey of American Life (NSAL; 2003) recruited 3570 African American adults (2299 females and 1271 males). The dependent variables were depressive symptoms and psychological distress. The independent variable was education attainment. Race was the focal moderator. Age, employment status, and marital status were covariates. Linear regressions were used for data ana...
Suicide and Life-Threatening Behavior
This is the author manuscript accepted for publication and has undergone full peer review but has... more This is the author manuscript accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as
Cultural diversity & ethnic minority psychology, Jan 30, 2018
Believing in justice can protect health. Among marginalized racial minorities however, both endor... more Believing in justice can protect health. Among marginalized racial minorities however, both endorsing and rejecting beliefs about justice might be critical. The current research examined links between African Americans' beliefs about justice for self and for others and telomere length (TL)-an indicator of biological aging that is increasingly implicated in racial health disparities, with shorter telomeres indicating poorer health. Healthy African Americans (N = 118; 30% male; M age = 31.63 years) completed individual differences measures of justice beliefs for self and others and then provided dried blood spot samples that were assayed for TL. We expected that a belief in justice for self would be positively associated with TL, whereas a belief in justice for others would be negatively associated. A significant 3-way interaction with chronological age confirmed this hypothesis-among older African Americans, TL was positively associated with believing in justice for self, but onl...
Bipolar disorders, Jan 12, 2018
Health disparities between individuals of African and European ancestry are well documented. The ... more Health disparities between individuals of African and European ancestry are well documented. The disparities in bipolar disorder may be driven by racial bias superimposed on established factors contributing to misdiagnosis, including: evolving empirically based diagnostic criteria (International Classification of Diseases [ICD], Research Diagnostic Criteria [RDC] and Diagnostic and Statistical Manual [DSM]), multiple symptom domains (i.e. mania, depression and psychosis), and multimodal medical and additional psychiatric comorbidity. For this paper, we reviewed the phenomenological differences between bipolar individuals of African and European ancestry in the context of diagnostic criteria and clinical factors that may contribute to a potential racial bias. Published data show that bipolar persons of African ancestry, compared with bipolar persons of non-African ancestry, are more often misdiagnosed with a disease other than bipolar disorder (i.e. schizophrenia). Additionally, stud...
International journal of epidemiology, Feb 2, 2017
The American Journal of Geriatric Psychiatry
OBJECTIVE To understand unmet depression needs of older adults, the current study investigates de... more OBJECTIVE To understand unmet depression needs of older adults, the current study investigates depressive symptoms, psychiatric treatment, and home- and community-based service (HCBS) use in a nationally representative sample of older adults in the United States. METHODS Participants included 5,582 adults aged 60 and over from the 2010-2012 waves of the nationally representative Health and Retirement Study. Weighted bivariate analyses were used to examine the frequency of depressive symptoms (Center for Epidemiologic Studies Depression Scale) and psychiatric treatment among HCBS recipients compared with non-HCBS recipients. Weighted logistic regression models were used to evaluate the effect of depressive symptoms on HCBS use. RESULTS HCBS recipients had a higher frequency of depressive symptoms compared with nonrecipients (27.5% versus 10.4%, respectively). In particular, transportation service recipients had the highest frequency of depressive symptoms (37.5%). HCBS recipients with depressive symptoms were no more likely than nonrecipients to receive psychiatric services. Depressive symptoms were associated with HCBS use, above and beyond sociodemographic and health risk factors. CONCLUSION Depressive symptoms are more frequent among HCBS recipients compared with nonrecipients; however, depressed HCBS recipients are no more likely to receive psychiatric services, suggesting unmet depression needs. HCBS may be a key setting for depression detection and delivery of mental health interventions.
Journal of Behavioral Medicine