Despite the recent decline in breast cancer mortality, African American women continue to die from breast cancer at higher rates than do White women. Beyond the fact that breast cancer tends to be a more biologically aggressive disease in African American than in White women, this disparity in breast cancer mortality also reflects social barriers that disproportionately affect African American women. These barriers hinder cancer prevention and control efforts and modify the biological expression of disease. The present review focuses on delineating social, economic, and cultural factors that are potentially responsible for Black-White disparities in breast cancer mortality. This review was guided by the social determinants of health disparities model, a model that identifies barriers associated with poverty, culture, and social injustice as major causes of health disparities. These barriers, in concert with genetic, biological, and environmental factors, can promote differential outcomes for African American and White women along the entire breast cancer continuum, from screening and early detection to treatment and survival. Barriers related to poverty include lack of a primary care physician, inadequate health insurance, and poor access to health care. Barriers related to culture include perceived invulnerability, folk beliefs, and a general mistrust of the health care system. Barriers related to social injustice include racial profiling and discrimination. Many of these barriers are potentially modifiable. Thus, in addition to biomedical advancements, future efforts to reduce disparities in breast cancer mortality should address social barriers that perpetuate disparities among African American and White women in the United States. (Cancer Epidemiol Biomarkers Prev 2008;17(11):2913 -23) During the last two decades, there has been a growing Black-White disparity in breast cancer mortality (1). Although the overall rate of mortality from breast cancer has been decreasing since the early 1980s, this decrease has occurred at a much faster pace for White women than it has for African American women (Fig. 1). This finding is especially noteworthy because the lifetime incidence of breast cancer is actually lower, not higher, among African American women than among their White counterparts (1).What factors might be responsible for this racial disparity in mortality from breast cancer? Poorer outcomes in African American women, in part, reflect the fact that breast cancer tends to be a more biologically aggressive disease in African Americans than in White Americans (2-6). In addition to biological factors, these disparities also reflect social, economic, and cultural barriers that disproportionately affect African American women. Barriers such as poverty and racism both hinder cancer prevention and control efforts and modify the biological expression of disease (7-10). The current review focuses on delineating the social, economic, and cultural factors potentially responsible for Black-White disparities i...
Overall findings highlight the importance of assessing the long-term health impact of volunteering and doing so under diverse social structural contexts.
We use data from the Changing Lives of Older Couples (CLOC) study to investigate the extent to which: (1) five personality traits (agreeableness, conscientiousness, emotional stability/neuroticism, extraversion, and openness) moderate the effect of late-life spousal loss on depressive symptoms; (2) these patterns vary based on the expectedness of the death; and (3) the patterns documented in (1) and (2) are explained by secondary stressors and social support. Widowed persons report significantly more depressive symptoms than married persons, yet the deleterious effects of loss are significantly smaller for highly extraverted and conscientious individuals. The protective effects of personality traits, however, vary based on the expectedness of the death. Extraversion is protective against depression only for persons who had forewarning of the death. Extraverts may be particularly good at marshalling social support during prolonged periods of spousal illness. We discuss the ways that extraversion and conscientiousness may buffer against bereavement-related stressors.
Objectives This study assesses (a) the reciprocity between mental and physical health pre- and postretirement, and (b) the extent to which these associations vary by race. Method Data are from the 1994 to 2008 waves of the Health and Retirement Study. Results Analyses based on structural equation modeling reveal that depression and physical health exert reciprocal effects for Whites pre- and postretirement. For Blacks preretirement, physical limitations predict changes in depression but there is no evidence of the reverse association. Further, the association between physical limitations and changes in depressive symptoms among Blacks is no longer significant after retirement. Discussion The transition into retirement alleviates the translation of physical limitations into depressive symptoms for Blacks only. The findings underscore the relevance of retirement for reciprocity between mental and physical health and suggest that the health implications associated with this life course transition vary by race.
Much of the literature on teaching gerontology derives from experiences in face-to-face settings. There is limited discussion of either the applicability of teaching techniques drawn from the traditional setting to the online environment or the development of novel strategies to engage distance students of aging. We developed and assessed an exercise designed to stimulate an online, asynchronous discussion of ageism in a Web-based social gerontology course. The exercise required students to analyze patterns found in sketches of elders drawn by themselves and their peers. The activity, which was favorably evaluated by our students, provided a springboard for discussion of the origins and consequences of ageism, as well as issues at the intersection of gender and age inequality.
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