Understanding the Impact of Contemporary Racism on the Mental Health of Middle Class Black Americans
Abstract
:1. Introduction
1.1. Racial Residential Segregation
1.2. Diminished Returns
1.3. Study Rationale
2. Materials and Methods
2.1. Data Collection
2.2. Measurement
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Colen, C.G.; Krueger, P.M.; Boettner, B.L. Do rising tides lift all boats? Racial disparities in health across the lifecourse among middle-class African-Americans and Whites. SSM-Popul. Health 2018, 6, 125–135. [Google Scholar] [CrossRef] [PubMed]
- Esposito, M.H. Inequality in Process: Income and Heterogeneous Educational Health Gradients Among Blacks and Whites in the USA. Race Soc. Probl. 2019, 11, 269–281. [Google Scholar] [CrossRef]
- Brown, T.H.; Richardson, L.J.; Hargrove, T.W.; Thomas, C.S. Using Multiple-hierarchy Stratification and Life Course Approaches to Understand Health Inequalities. J. Health Soc. Behav. 2016, 57, 200–222. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Phelan, J.C.; Link, B.G.; Tehranifar, P. Social Conditions as Fundamental Causes of Health Inequalities: Theory, Evidence, and Policy Implications. J. Health Soc. Behav. 2010, 51, S28–S40. [Google Scholar] [CrossRef] [Green Version]
- Ray, R. Black people don’t exercise in my neighborhood: Perceived racial composition and leisure-time physical activity among middle class blacks and whites. Soc. Sci. Res. 2017, 66, 42–57. [Google Scholar] [CrossRef]
- Cole, E.R.; Omari, S.R. Race, class and the dilemmas of upward mobility for African Americans. J. Soc. Issues 2003, 59, 785–802. [Google Scholar] [CrossRef]
- Colen, C.G.; Ramey, D.M.; Cooksey, E.C.; Williams, D.R. Racial disparities in health among nonpoor African Americans and Hispanics: The role of acute and chronic discrimination. Soc. Sci. Med. 2018, 199, 167–180. [Google Scholar] [CrossRef]
- Colen, C.G.; Geronimus, A.T.; Bound, J.; James, S.A. Maternal upward socioeconomic mobility and Black-White disparities in infant birthweight. Am. J. Public Health 2006, 96, 2032–2039. [Google Scholar] [CrossRef]
- Johnson, R.C. Addressing Racial Health Disparities: Looking Back to Point the Way Forward. Ann. Am. Acad. Polit. Soc. Sci. 2018, 680, 132–171. [Google Scholar] [CrossRef] [Green Version]
- Assari, S.; Moghani Lankarani, M. Workplace Racial Composition Explains High Perceived Discrimination of High Socioeconomic Status African American Men. Brain Sci. 2018, 8, 139. [Google Scholar] [CrossRef]
- Bell, C.N.; Sacks, T.K.; Thomas Tobin, C.S.; Thorpe, R.J. Racial Non-equivalence of Socioeconomic Status and Self-rated Health among African Americans and Whites. SSM-Popul. Health 2020, 10, 100561. [Google Scholar] [CrossRef]
- Hudson, D.; Sacks, T.; Irani, K.; Asher, A. The Price of the Ticket: Health Costs of Upward Mobility among African Americans. Int. J. Environ. Res. Public Health 2020, 17, 1179. [Google Scholar] [CrossRef] [Green Version]
- Üstün, T.B.; Ayuso-Mateos, J.L.; Chatterji, S.; Mathers, C.; Murray, C.J.L. Global burden of depressive disorders in the year 2000. Br. J. Psychiatry 2004, 184, 386–392. [Google Scholar] [CrossRef] [Green Version]
- Friedrich, M.J. Depression Is the Leading Cause of Disability Around the World. JAMA 2017, 317, 1517. [Google Scholar] [CrossRef]
- Snowden, L. Explaining Mental Health Treatment Disparities: Ethnic and Cultural Differences in Family Involvement. Cult. Med. Psychiatry 2007, 31, 389–402. [Google Scholar] [CrossRef]
- Snowden, L.R.; Pingitore, D. Frequency and Scope of Mental Health Service Delivery to African Americans in Primary Care. Ment. Health Serv. Res. 2002, 4, 123–130. [Google Scholar] [CrossRef]
- Hudson, D.L.; Eaton, J.; Banks, A.; Sewell, W.; Neighbors, H. “Down in the Sewers”: Perceptions of Depression and Depression Care Among African American Men. Am. J. Men’s Health 2016, 12, 126–137. [Google Scholar] [CrossRef] [Green Version]
- Jackson, J.S.; Torres, M.; Caldwell, C.H.; Neighbors, H.W.; Nesse, R.M.; Taylor, R.J.; Trierweiler, S.J.; Williams, D.R. The National Survey of American Life: A study of racial, ethnic and cultural influences on mental disorders and mental health. Int. J. Methods Psychiatr. Res. 2004, 13, 196–207. [Google Scholar] [CrossRef]
- Thorpe, R.J.; Kelley, E.; Bowie, J.V.; Griffith, D.M.; Bruce, M.; LaVeist, T. Explaining Racial Disparities in Obesity Among Men: Does Place Matter? Am. J. Men’s Health 2015, 9, 464–472. [Google Scholar] [CrossRef] [Green Version]
- Logan, J.R. The Persistence of Segregation in the 21st Century Metropolis. City Community 2013, 12, 160–168. [Google Scholar] [CrossRef]
- Gee, G.C.; Ford, C.L. Structural racism and health inequities: Old issues, New Directions1. Du Bois Rev. Soc. Sci. Res. Race 2011, 8, 115–132. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Williams, D.R.; Collins, C. Racial residential segregation: A fundamental cause of racial disparities in health. Public Health Rep. 2001, 116, 404–416. [Google Scholar] [CrossRef] [PubMed]
- Diangelo, R. White Fragility. J. Crit. Pedag. 2011, 3, 3. [Google Scholar]
- Bonilla-Silva, E.; Baiocchi, G. Anything but racism: How sociologists limit the significance of racism. Race Soc. 2001, 4, 117–131. [Google Scholar] [CrossRef]
- Charles, C.Z. The dynamics of racial residential segregation. Annu. Rev. Sociol. 2003, 29, 167–207. [Google Scholar] [CrossRef] [Green Version]
- Krysan, M.; Couper, M.P.; Farley, R.; Forman, T.A. Does race matter in neighborhood preferences? Results from a video experiment. AJS Am. J. Sociol. 2009, 115, 527–559. [Google Scholar] [CrossRef] [Green Version]
- Hicken, M.T.; Lee, H.; Hing, A.K. The weight of racism: Vigilance and racial inequalities in weight-related measures. Soc. Sci. Med. 2018, 199, 157–166. [Google Scholar] [CrossRef] [Green Version]
- Geronimus, A.T.; James, S.A.; Destin, M.; Graham, L.A.; Hatzenbuehler, M.; Murphy, M.; Pearson, J.A.; Omari, A.; Thompson, J.P. Jedi public health: Co-creating an identity-safe culture to promote health equity. SSM-Popul. Health 2016, 2, 105–116. [Google Scholar] [CrossRef] [Green Version]
- Higginbotham, E. Too Much to Ask: Black Women in the Era of Integration; University of North Carolina Press: Chapel Hill, NC, USA, 2001; ISBN 0-8078-2662-6. [Google Scholar]
- Lacy, K.R. Black spaces, Black places: Identity construction in middle-class suburbia. Ethn. Racial Stud. 2004, 27, 908–930. [Google Scholar] [CrossRef]
- Hudson, D.L.; Bullard, K.M.; Neighbors, H.W.; Geronimus, A.T.; Yang, J.; Jackson, J.S. Are Benefits Conferred with Greater Socioeconomic Position Undermined by Racial Discrimination among African American Men? J. Men’s Health 2012, 9, 127–136. [Google Scholar] [CrossRef] [Green Version]
- Ford, C.L.; Airhihenbuwa, C.O. Critical Race Theory, race equity, and public health: Toward antiracism praxis. Am. J. Public Health 2010, 100 (Suppl. 1), S30–S35. [Google Scholar] [CrossRef]
- Bonilla-Silva, E. Racism without Racists: Color-Blind Racism and the Persistence of Racial Inequality in America; Rowman and Littlefield: New York, NY, USA, 2014. [Google Scholar]
- Lacy, K.R. Blue-Chip Black: Race, Class, and Status in the New Black Middle Class; University of California Press: Berkeley, CA, USA, 2007. [Google Scholar]
- Anderson, E. The White Space. Sociol. Race Ethnic 2015, 1, 10–21. [Google Scholar] [CrossRef] [Green Version]
- Sacks, T.K. Performing Black womanhood: A qualitative study of stereotypes and the healthcare encounter. Crit. Public Health 2018, 28, 59–69. [Google Scholar] [CrossRef]
- Kroenke, K.; Spitzer, R.L.; Williams, J.B.W. The PHQ-9. J. Gen. Intern. Med. 2001, 16, 606–613. [Google Scholar] [CrossRef]
- Huang, F.Y.; Chung, H.; Kroenke, K.; Delucchi, K.L.; Spitzer, R.L. Using the Patient Health Questionnaire-9 to Measure Depression among Racially and Ethnically Diverse Primary Care Patients. J. Gen. Intern. Med. 2006, 21, 547–552. [Google Scholar] [CrossRef] [Green Version]
- Kroenke, K.; Spitzer, R.L.; Williams, J.B.W. The Patient Health Questionnaire-2: Validity of a Two-Item Depression Screener. Med. Care 2003, 41, 1284–1292. [Google Scholar] [CrossRef]
- Huang, F.Y.; Chung, H.; Kroenke, K.; Spitzer, R.L. Racial and Ethnic Differences in the Relationship Between Depression Severity and Functional Status. Psychiatr. Serv. 2006, 57, 498–503. [Google Scholar] [CrossRef]
- Blazer, D.G.; Landerman, L.R.; Hays, J.C.; Simonsick, E.M.; Saunders, W.B. Symptoms of depression among community-dwelling elderly African-American and White older adults. Psychol. Med. 1998, 28, 1311–1320. [Google Scholar] [CrossRef]
- Hybels, C.F.; Blazer, D.G.; Pieper, C.F. Toward a Threshold for Subthreshold Depression. Gerontologist 2001, 41, 357–365. [Google Scholar] [CrossRef] [Green Version]
- Williams, D.R.; Mohammed, S.A. Racism and Health I: Pathways and Scientific Evidence. Am. Behav. Sci. 2013, 57, 1152–1173. [Google Scholar] [CrossRef] [Green Version]
- Shariff-marco, S.; Reeve, B.B.; Krieger, N.; Gee, G.C.; Williams, D.R.; Mays, V.M.; Johnson, T.P. Measuring Everyday Racial/Ethnic Discrimination in Health Surveys How Best to Ask the Questions, in One or Two Stages, Across Multiple Racial/Ethnic Groups? Am. Behav. Sci. 2011, 1, 159–177. [Google Scholar]
- Assari, S.; Lankarani, M.; Caldwell, C. Does Discrimination Explain High Risk of Depression among High-Income African American Men? Behav. Sci. 2018, 8, 40. [Google Scholar] [CrossRef] [PubMed]
- Hudson, D.L.; Puterman, E.; Bibbins-Domingo, K.; Matthews, K.A.; Adler, N.E. Race, life course socioeconomic position, racial discrimination, depressive symptoms and self-rated health. Soc. Sci. Med. 2013, 97, 7–14. [Google Scholar] [CrossRef] [PubMed]
- Anderson, R.E.; McKenny, M.C.; Stevenson, H.C. EMBRace: Developing a Racial Socialization Intervention to Reduce Racial Stress and Enhance Racial Coping among Black Parents and Adolescents. Fam. Process. 2019, 58, 53–67. [Google Scholar] [CrossRef] [Green Version]
- Anderson, R.E.; Stevenson, H.C. RECASTing racial stress and trauma: Theorizing the healing potential of racial socialization in families. Am. Psychol. 2019, 74, 63–75. [Google Scholar] [CrossRef]
- Buhrmester, M.; Kwang, T.; Gosling, S.D. Amazon’s Mechanical Turk. Perspect. Psychol. Sci. 2011, 6, 3–5. [Google Scholar] [CrossRef]
- Beymer, M.R.; Holloway, I.W.; Grov, C. Comparing Self-Reported Demographic and Sexual Behavioral Factors Among Men Who Have Sex with Men Recruited Through Mechanical Turk, Qualtrics, and a HIV/STI Clinic-Based Sample: Implications for Researchers and Providers. Arch. Sex. Behav. 2018, 47, 133–142. [Google Scholar] [CrossRef]
- Heen, M.S.J.; Lieberman, J.D.; Miethe, T.D. A Comparison of Different Online Sampling Approaches for Generating National Samples; University of Nevada, Las Vegas Center for Crime and Justice Policy: Las Vegas, NV, USA, 2014; pp. 1–8. [Google Scholar]
- Bowleg, L. The problem with the phrase women and minorities: Intersectionality-an important theoretical framework for public health. Am. J. Public Health 2012, 102, 1267–1273. [Google Scholar] [CrossRef]
- Mullings, L. Resistance and resilience: The sojourner syndrome and the social context of reproduction in central harlem. Transform. Anthropol. 1984, 13, 79–91. [Google Scholar] [CrossRef]
M or % | SD or N | Range (If Applicable) | |
---|---|---|---|
Age | 38.9 | 12.5 | 18–66 |
Gender (ref Male) | 48.8 | 258 | 1–3 |
Education | |||
Bachelor’s Degree * | 64.5 | 341 | |
Professional/Graduate degree | 35.4 | 187 | |
Relationship Status | |||
Married/Partnered * | 39.6 | 209 | |
Divorced/separated/widowed or never married | 60.4 | 319 | |
Annual income | |||
Less than $10,000 * | 4.3 | 23 | |
$10,000–$25,999 | 9.2 | 49 | |
$26,000–$39,999 | 10.9 | 58 | |
$40,000–$64,999 | 21.4 | 113 | |
$65,000–$79,999 | 17.6 | 93 | |
More than $80,000 | 33.5 | 177 | |
Assets | |||
Less than $10,000 * | 25.5 | 135 | |
More than $10,000 | 67.2 | 355 | |
Home Ownership | |||
Rent * | 32.7 | 173 | |
Own | 59.4 | 314 | |
Live rent-free | 4.5 | 24 | |
Depression Diagnosis (ref No) | 84.4 | 446 | |
Severity of depressive symptoms | |||
None/Mild * | 60.0 | 317 | |
Moderate | 19.1 | 101 | |
Moderately Severe | 13.6 | 72 | |
Severe | 7.2 | 38 | |
Patient Health Questionnaire (PHQ-9) | 8.3 | 7.0 | 0–27 |
Everyday Discrimination | 19.9 | 12.9 | 0–50 |
Major Discrimination | 2.1 | 1.9 | 0–9 |
Coefficient (95% CI) | ||||||
---|---|---|---|---|---|---|
Moderate | Moderately Severe | Severe | ||||
Age | −0.06 * | (−0.07–−0.43) | −0.05 * | (−0.07–−0.03) | −0.04 * | (−0.06–−0.02) |
Gender | −0.08 | (−0.43–0.26) | −0.14 | (−0.52–0.22) | 0.06 | (−0.36–0.49) |
Education | 0.12 | (−0.25–0.50) | −0.06 | (−0.48–0.34) | 0.12 | (−0.03–0.58) |
Relationship Status | −0.02 | (−0.12–0.06) | 0.04 | (−0.06–0.15) | 0.00 | (−0.11–0.12) |
Annual income | −0.01 | (−0.02–0.00) | −0.00 | (−0.01–0.10) | −0.02 | (−0.06–0.01) |
Assets | 0.00 | (−0.00–0.00) | −0.01 | (−0.02–0.00) | 0.00 | (−0.00–0.01) |
Home ownership | 0.00 | (−0.01–0.01) | 0.00 | (−0.00–0.02) | 0.00 | (−0.01–0.02) |
Discrimination | ||||||
Everyday Discrimination | 0.06 * | (0.05–0.08) | 0.05 * | (0.03–0.06) | 0.66 * | (0.04–0.08) |
Major Discrimination | 0.12 * | (0.03–0.20) | 0.07 | (−0.01–0.17) | 0.12 * | (0.01–0.22) |
Coefficient (95% CI) | ||||||
---|---|---|---|---|---|---|
Moderate | Moderately Severe | Severe | ||||
Age | −0.06 * | (−0.07–−0.04) | −0.05 * | (−0.07–−0.03) | −0.05 * | (−0.07–−0.02) |
Gender | −0.07 | (−0.43–0.27) | −0.13 | (−0.51–0.23) | 0.03 | (−0.40–0.48) |
Education | 0.09 | (−0.28–0.47) | −0.09 | (−0.51–0.31) | 0.01 | (−0.46–0.49) |
Relationship Status | −0.03 | (−0.13–0.06) | 0.04 | (−0.06–0.14) | 0.00 | (−0.12–0.12) |
Annual income | −0.01 | (−0.02–0.00) | −0.00 | (−0.01–0.10) | −0.02 | (−0.06–0.01) |
Assets | 0.00 | (−0.00–0.00) | −0.01 * | (−0.02–−0.00) | 0.00 | (−0.00–0.01) |
Home ownership | 0.00 | (−0.00–0.01) | 0.01 | (−0.00–0.02) | 0.01 | (−0.00–0.02) |
Hypervigilance | 0.03 | (−0.00–0.07) | 0.03 | (−0.00–0.07) | 0.10 * | (0.05–0.15) |
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Hudson, D.; Collins-Anderson, A.; Hutson, W. Understanding the Impact of Contemporary Racism on the Mental Health of Middle Class Black Americans. Int. J. Environ. Res. Public Health 2023, 20, 1660. https://doi.org/10.3390/ijerph20031660
Hudson D, Collins-Anderson A, Hutson W. Understanding the Impact of Contemporary Racism on the Mental Health of Middle Class Black Americans. International Journal of Environmental Research and Public Health. 2023; 20(3):1660. https://doi.org/10.3390/ijerph20031660
Chicago/Turabian StyleHudson, Darrell, Akilah Collins-Anderson, and William Hutson. 2023. "Understanding the Impact of Contemporary Racism on the Mental Health of Middle Class Black Americans" International Journal of Environmental Research and Public Health 20, no. 3: 1660. https://doi.org/10.3390/ijerph20031660