Explore the vast range of titles available.

This article provides an overview of research on race-related stressors that can affect the mental health of socially disadvantaged racial and ethnic populations. It begins by reviewing the research on self-reported discrimination and mental health. Although discrimination is the most studied aspect of racism, racism can also affect mental health through structural/institutional mechanisms and racism that is deeply embedded in the larger culture. Key priorities for research include more systematic attention to stress proliferation processes due to institutional racism, the assessment of stressful experiences linked to natural or manmade environmental crises, documenting and understanding the health effects of hostility against immigrants and people of color, cataloguing and quantifying protective resources, and enhancing our understanding of the complex association between physical and mental health.

Objectives Experiences of vicarious racism—hearing about racism directed toward one’s racial group or racist acts committed against other racial group members—and vigilance about racial discrimination have been salient during the COVID-19 pandemic. This study examined vicarious racism and vigilance in relation to symptoms of depression and anxiety among Asian and Black Americans. Methods We used data from a cross-sectional study of 604 Asian American and 844 Black American adults aged ≥18 in the United States recruited from 5 US cities from May 21 through July 15, 2020. Multivariable linear regression models examined levels of depression and anxiety by self-reported vicarious racism and vigilance. Results Controlling for sociodemographic characteristics, among both Asian and Black Americans, greater self-reported vicarious racism was associated with more symptoms of depression (Asian: β = 1.92 [95% CI, 0.97-2.87]; Black: β = 1.72 [95% CI, 0.95-2.49]) and anxiety (Asian: β = 2.40 [95% CI, 1.48-3.32]; Black: β = 1.98 [95% CI, 1.17-2.78]). Vigilance was also positively related to symptoms of depression (Asian: β = 1.54 [95% CI, 0.58-2.50]; Black: β = 0.90 [95% CI, 0.12-1.67]) and anxiety (Asian: β = 1.98 [95% CI, 1.05-2.91]; Black: β = 1.64 [95% CI, 0.82-2.45]). Conclusions Mental health problems are a pressing concern during the COVID-19 pandemic. Results from our study suggest that heightened racist sentiment, harassment, and violence against Asian and Black Americans contribute to increased risk of depression and anxiety via vicarious racism and vigilance. Public health efforts during this period should address endemic racism as well as COVID-19.

The effects of school-based ethnic diversity on student well-being and race-related views were examined during the first year in middle school. To capture the dynamic nature of ethnic exposure, diversity was assessed both at the school-level (n = 26) and based on academic course enrollments of African American, Asian, Latino, and White students (n = 4,302; M = 11.33 years). Across all four pan-ethnic groups, school-level ethnic diversity was associated with lower sense of vulnerability (i.e., feeling safer, less victimized, and less lonely) as well as perceptions of teachers' fair and equal treatment of ethnic groups and lower out-group distance. Underscoring the role of individual experiences, exposure to diversity in academic classes moderated the association between school-level diversity and the two aforementioned race-related views.

Abstract Study Objectives To identify systematic biases across groups in objectively and subjectively measured sleep duration. Methods We investigated concordance of self-reported habitual sleep duration compared with actigraphy- and single-night in-home polysomnography (PSG) across white, black, Hispanic, and Chinese participants in the Multi-Ethnic Study of Atherosclerosis. Results Among 1910 adults, self-reported sleep duration, determined by differences between bed and wake times, was overestimated in all racial groups compared with PSG and actigraphy. Compared with whites (ρ = 0.45), correlations were significantly lower only in blacks (ρ = 0.28). Self-reporting bias for total sleep time compared with wrist actigraphy was 66 min (95% confidence interval [CI]: 61–71) for whites, 58 min (95% CI: 48–69) for blacks, 66 min (95% CI: 57–74) for Hispanics, and 60 min (95% CI: 49–70) for Chinese adults. Compared with PSG, self-reporting bias in whites at 73 min (95% CI: 67–79) was higher than in blacks (54 min [95% CI: 42–65]) and Chinese (49 min [95% CI: 37–61]) but not different from Hispanics (67 min [95% CI: 56–78]). Slight agreement/concordance was observed between self-reported and actigraphy-based total sleep time (kw = 0.14 for whites, 0.10 for blacks, 0.17 for Hispanics, and 0.11 for Chinese) and PSG (kw = 0.08 for whites, 0.04 for blacks, 0.05 for Hispanics, and 0.01 for Chinese) across race/ethnicity. Conclusions Self-reported sleep duration overestimated objectively measured sleep across all races, and compared with PSG, overestimation is significantly greater in whites compared with blacks. Larger reporting bias reduces the ability to identify significant associations between sleep duration and health among blacks compared with whites. Sleep measurement property differences should be considered when comparing sleep indices across racial/ethnic groups.

To identify sources of race/ethnic differences related to post-traumatic stress disorder (PTSD), we compared trauma exposure, risk for PTSD among those exposed to trauma, and treatment-seeking among Whites, Blacks, Hispanics and Asians in the US general population. Data from structured diagnostic interviews with 34 653 adult respondents to the 2004-2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were analysed. The lifetime prevalence of PTSD was highest among Blacks (8.7%), intermediate among Hispanics and Whites (7.0% and 7.4%) and lowest among Asians (4.0%). Differences in risk for trauma varied by type of event. Whites were more likely than the other groups to have any trauma, to learn of a trauma to someone close, and to learn of an unexpected death, but Blacks and Hispanics had higher risk of child maltreatment, chiefly witnessing domestic violence, and Asians, Black men, and Hispanic women had higher risk of war-related events than Whites. Among those exposed to trauma, PTSD risk was slightly higher among Blacks [adjusted odds ratio (aOR) 1.22] and lower among Asians (aOR 0.67) compared with Whites, after adjustment for characteristics of trauma exposure. All minority groups were less likely to seek treatment for PTSD than Whites (aOR range: 0.39-0.61), and fewer than half of minorities with PTSD sought treatment (range: 32.7-42.0%). When PTSD affects US race/ethnic minorities, it is usually untreated. Large disparities in treatment indicate a need for investment in accessible and culturally sensitive treatment options.

Understanding and minimizing coronavirus disease 2019 (COVID‐19) vaccine hesitancy is critical to population health and minimizing health inequities, which continue to be brought into stark relief by the pandemic. We investigate questions regarding vaccine hesitancy in a sample (n = 1205) of Arkansas adults surveyed online in July/August of 2020. We examine relationships among sociodemographics, COVID‐19 health literacy, fear of COVID‐19 infection, general trust in vaccines, and COVID‐19 vaccine hesitancy using bivariate analysis and a full information maximum likelihood (FIML) logistic regression model. One in five people (21,21.86%) reported hesitancy to take a COVID‐19 vaccine. Prevalence of COVID‐19 vaccine hesitancy was highest among Black/African Americans (50.00%), respondents with household income less than $25K (30.68%), some college (32.17%), little to no fear of infection from COVID‐19 (62.50%), and low trust in vaccines in general (55.84%). Odds of COVID‐19 vaccine hesitancy were 2.42 greater for Black/African American respondents compared to White respondents (p < 0.001), 1.67 greater for respondents with some college/technical degree compared to respondents with a 4‐year degree (p < 0.05), 5.48 greater for respondents with no fear of COVID‐19 infection compared to those who fear infection to a great extent (p < 0.001), and 11.32 greater for respondents with low trust in vaccines (p < 0.001). Sociodemographic differences in COVID‐19 vaccine hesitancy raise concerns about the potential of vaccine implementation to widen existing health disparities in COVID‐19 related infections, particularly among Black/African Americans. Fear of infection and general mistrust in vaccines are significantly associated with vaccine hesitancy.

This study was designed to examine the prospective relations of perceived racial discrimination with allostatic load (AL), along with a possible buffer of the association. A sample of 331 African Americans in the rural South provided assessments of perceived discrimination from ages 16 to 18 years. When youth were 18 years, caregivers reported parental emotional support and youth assessed peer emotional support. AL and potential confounder variables were assessed when youth were 20. Latent growth mixture modeling identified two perceived discrimination classes: high and stable, and low and increasing. Adolescents in the high and stable class evinced heightened AL even with confounder variables controlled. The racial discrimination to AL link was not significant for young adults who received high emotional support.

Pre-exposure prophylaxis (PrEP) is an effective biomedical HIV prevention method. PrEP uptake has been persistently low among US women, particularly Black women, who account for 61% of new HIV diagnoses among women. Further understanding of barriers to Black women accessing PrEP is needed. This 2017 cross-sectional survey study explored race-based differences in PrEP interest and intention among women and the indirect association between race and comfort discussing PrEP with a healthcare provider through medical mistrust. The sample consisted of 501 adult women (241 Black; 260 White) who were HIV-negative, PrEP-inexperienced, and heterosexually active. Black women reported greater PrEP interest and intention than White women. However, Black women expressed higher levels of medical mistrust, which, in turn, was associated with lower comfort discussing PrEP with a provider. Medical mistrust may operate as a unique barrier to PrEP access among Black women who are interested in and could benefit from PrEP.

Our country’s long and troubled history of racism has permeated the physician–patient relationship with mistrust. Now, amid an acute public health crisis that is transforming medicine, perhaps we have an opportunity to reset our priorities to face this deeper, more chronic crisis as well.

Objectives. To examine negative police encounters and police avoidance as mediators of incarceration history and depressive symptoms among US Black men and to assess the role of unemployment as a moderator of these associations. Methods. Data were derived from the quantitative phase of Menhood, a 2015–2016 study based in Washington, DC. Participants were 891 Black men, 18 to 44 years of age, who completed computer surveys. We used moderated mediation to test the study’s conceptual model. Results. The results showed significant indirect effects of incarceration history on depressive symptoms via negative police encounters and police avoidance. Unemployment moderated the indirect effect via police avoidance. Participants with a history of incarceration who were unemployed reported significantly higher police avoidance and, in turn, higher depressive symptoms. Moderation of unemployment on the indirect effect via negative police encounters was not significant. Conclusions. There is a critical need to broaden research on the health impact of mass incarceration to include other aspects of criminal justice involvement (e.g., negative police encounters and police avoidance) that negatively affect Black men’s mental health.