Findings support an association between daily stress and WHR but do not support our hypothesis that passive emotional responses to perceived racism increase abdominal fat. Further study of the stress physiology of perceived racism in African American women is warranted.

Purpose of review Recent literature on racial or ethnic discrimination and mental health was reviewed to assess the current science and identify key areas of emphasis for social epidemiology. Objectives of this review were to: 1) Determine whether there have been advancements in the measurement and analysis of perceived discrimination; 2) Identify the use of theories and/or frameworks in perceived discrimination and mental health research; and 3) Assess the extent to which stress buffers are being considered and evaluated in the existing literature. Recent findings Metrics and analytic approaches used to assess discrimination remain largely unchanged. Theory and/or frameworks such as the stress and coping framework continue to be underused in majority of the studies. Adolescents and young adults experiencing racial/ethnic discrimination were at greater risk of adverse mental health outcomes, and the accumulation of stressors over the life course may have an aggregate impact on mental health. Some growth seems evident in studies examining the mediation and moderation of stress buffers and other key factors with the findings suggesting a reduction in the effects of discrimination on mental health. Summary Discrimination scales should consider the multiple social identities of a person, the context where the exposure occurs, how the stressor manifests specifically in adolescents, the historical traumas, and cumulative exposure. Life course theory and intersectionality may help guide future work. Despite existing research, gaps remain in in elucidating the effects of racial and ethnic discrimination on mental health, signaling an opportunity and a call to social epidemiologists to engage in interdisciplinary research to speed research progress.

Few studies have examined the impact of the frequency of discrimination on hypertension risk. The authors assessed the cross-sectional associations between frequency of perceived racial and nonracial discrimination and hypertension among 1,110 middle-aged African-American men (n = 393) and women (n = 717) participating in the 2001 follow-up of the Pitt County Study (Pitt County, North Carolina). Odds ratios were estimated using gender-specific unconditional weighted logistic regression with adjustment for relevant confounders and the frequency of discrimination. More than half of the men (57%) and women (55%) were hypertensive. The prevalences of perceived racial discrimination, nonracial discrimination, and no discrimination were 57%, 29%, and 13%, respectively, in men and 42%, 43%, and 15%, respectively, in women. Women recounting frequent nonracial discrimination versus those reporting no exposure to discrimination had the highest odds of hypertension (adjusted odds ratio = 2.34, 95% confidence interval: 1.09, 5.02). A nonsignificant inverse odds ratio was evident in men who perceived frequent exposure to racial or nonracial discrimination in comparison with no exposure. A similar association was observed for women reporting perceived racial discrimination. These results indicate that the type and frequency of discrimination perceived by African-American men and women may differentially affect their risk of hypertension.

Introduction-Younger breast cancer survivors often lead extremely busy lives with multiple demands and responsibilities, making them difficult to recruit into clinical trials. African American women are even more difficult to recruit because of additional historical and cultural barriers. In a randomized clinical trial of an intervention, we successfully used culturally informed, population-specific recruitment and retention strategies to engage younger African-American breast cancer survivors.

Background In 2012, the US Preventive Services Task Force (USPSTF) released a hotly-debated recommendation against prostate-specific antigen (PSA) testing for all men. The present research examines African Americans’ beliefs about their susceptibility to prostate cancer (PCa) and the effectiveness of PSA testing in the context of the controversy surrounding this recommendation. Methods This study used a qualitative design to examine perceptions regarding susceptibility along with screening and facilitators of and barriers thereof. Data were collected at a community health center and three predominantly African American churches in North Carolina. Study participants were 46 African American men and women who attended one of four “listening sessions” for pretesting PCa educational materials (average age: 55 years). One-and-a-half-hour listening sessions were conducted to pretest materials; while presenting the materials, researchers probed beliefs and knowledge about PCa screening. The sessions were recorded and transcribed, and the transcripts were qualitatively analyzed using grounded theory. Results The four emergent themes indicated that participants: (1) cited behavioral, psychosocial, and biological reasons why African American men have higher PCa risk compared to others; (2) knew about the controversy and had varying responses and intentions; (3) believed screening could save lives, so it should be utilized regardless of the 2012 recommendation; and (4) felt that women can help men go to the doctor and make screening decisions. Conclusions Health education efforts to help community members understand health controversies, screening options, and how to make informed screening decisions are critical.

Objective: Evidence suggests peer support (PS) is as an effective strategy for enhancing prevention and control of chronic and infectious diseases, including cancer. This systematic scoping review examines the range and variety of interventions on the use of PS across the cancer care continuum. Method: We used a broad definition of PS to capture a wide-range of interventions and characterize the current status of the field. Literature searches were conducted using PubMed, SCOPUS, and CINAHL to identify relevant articles published from January 2011 – June 2016. We screened the title and abstracts of 2087 articles, followed by full-text screening of 420 articles, resulting in a final sample of 242 articles of which the most recent 100 articles were reviewed (published June 2014 – May 2016). Results: A number of the recent intervention studies focused on breast cancer (32%, breast cancer only) or multiple cancer sites (23%). Although the interventions spanned all phases of the cancer care continuum, only 2% targeted end-of-life care. Seventy-six percent focused on clinical outcomes (e.g., screening, treatment adherence) and 72% on reducing health disparities. Interventions were primarily phone-based (44%) or delivered in a clinic setting (44%). Only a few studies (22%) described the impact of providing PS on peer supporters. Conclusion: PS appears to be a widely used approach to address needs across the cancer care continuum, with many opportunities to expand its reach.

In this nation, the unequal burden of disease among People of Color has been well documented. One starting point to eliminating health disparities is recognizing the existence of inequities in health care delivery and identifying the complexities of how institutional racism may operate within the health care system. In this paper, we explore the integration of community-based participatory research (CBPR) principles with an Undoing Racism process to conceptualize, design, apply for, and secure National Institutes of Health (NIH) funding to investigate the complexities of racial equity in the system of breast cancer care. Additionally, we describe the sequence of activities and "necessary conflicts" managed by our Health Disparities Collaborative to design and submit an application for NIH funding. This process of integrating CBPR principles with anti-racist community organizing presented unique challenges that were negotiated only by creating a strong foundation of trusting relationships that viewed conflict as being necessary. The process of developing a successful NIH grant proposal illustrated a variety of important lessons associated with the concepts of cultural humility and cultural safety. For successfully conducting CBPR, major challenges have included: assembling and mobilizing a partnership; the difficulty of establishing a shared vision and purpose for the group; the problem of maintaining trust; and the willingness to address differences in institutional cultures. Expectation, acceptance and negotiation of conflict were essential in the process of developing, preparing and submitting our NIH application. Central to negotiating these and other challenges has been the utilization of a CBPR approach.

Objective Despite growing evidence that discrimination may contribute to poor mental health, few studies have assessed this association among US Latinos. Furthermore, the interaction between discrimination and educational attainment in shaping Latino mental health is virtually unexplored. This study aims to examine the association between perceived discrimination and depressive symptoms and the modifying role of education among a population of Mexican-origin adults. Design We utilized population-based data from 629 Mexican-origin adults (mean age=52.8 years) participating the Niños Lifestyle and Diabetes Study (2013–2014). Perceived discrimination was defined as responding “sometimes” or “often” to at least one item on the 9-item Everyday Discrimination Scale. High depressive symptoms were defined as scoring ≥10 on the CESD-10. We used log-binomial and linear-binomial models to estimate prevalence ratios (PR) and prevalence differences (PD), respectively, of high depressive symptoms for levels of perceived discrimination. Final models were adjusted for age, sex, education, cultural orientation, and nativity. General estimating equations were employed to account for within-family clustering. Results Prevalence of perceived discrimination and high depressive symptoms were 49.5% and 29.2%, respectively. Participants experiencing discrimination had higher depressive symptom prevalence than those never or rarely experiencing discrimination [PR=1.94, 95% confidence interval (CI): 1.46–2.58; PD=0.19, 95% CI: 0.12–0.27]. The strength of this association varied by education level. The association between discrimination and depressive symptoms was stronger among those with >12 years of education (PR=2.69; PD=0.24) compared to those with ≤12 years of education (PR=1.36; PD=0.09). Conclusion US Latinos suffer a high burden of depressive symptoms, and discrimination may be an important driver of this burden. Our results suggest that effortful coping strategies, such as achieving high education despite high perceived discrimination, may magnify discrimination’s adverse effect on Latino mental health.