Objectives-This study examines religious fatalism as a potential barrier to good health and healthy behavior.Methods-As part of Nashville's REACH 2010 project, residents (n=1,273) were randomly selected to participate in a telephone survey examining health variables. This survey included the Helpless Inevitability sub-scale of the Religious Health Fatalism Questionnaire.Results-Results indicate significant racial/ethnicity differences, however associations of fatalism with health outcomes and behaviors were only partially confirmed.Conclusions-Fatalism may be primarily a coping response to illness rather than an inhibitory belief.

To better understand how neighborhood environments contribute to health outcomes by encouraging or discouraging healthy lifestyles, we studied the clustering of health outcomes, health behaviors, and environmental characteristics in Nashville, Tenn. Data from 2 large telephone surveys (N = 7606) were geocoded and linked to the long-form census data at the census-tract level. Cluster analysis was used to create 12 scales that measured neighborhood characteristics using census variables. A geographic information system was used to map patterns of health, health behavior, and neighborhood characteristics at the census-tract level. Pearson correlations across the 129 census tracts were in the 0.20 to 0.60 range and provided evidence for spatial clustering of health outcomes, health behaviors, and neighborhood characteristics.

Depression and psychological distress often go unrecognized and untreated in primary care settings. The association between depression, socioeconomic status, and chronic disease underscore the importance of incorporating mental health education and screening into community-based health initiatives. This is particularly critical for African Americans who bear a disproportionate burden of poverty and chronic disease. This descriptive study assessed associations between symptoms of depression, socioeconomic status, healthcare utilization, physical and mental health functioning, and reactions to race among a sample of low-income African Americans. Consistent with the findings of previous research, respondents with symptoms of depression reported lower levels of physical and mental health functioning, and perceived that they had been treated worse by others at work, and had worse healthcare experiences than those of other races. Community-based programs for reducing disparities in physical illness may need to address the burden of undiagnosed and untreated depression in order to become optimally effective.