Background and Objectives Among the multiple factors posited to drive the health inequities that Black men experience, the fundamental role of stress in the production of poor health is a key component. Allostatic load (AL) is considered to be a byproduct of stressors related to cumulative disadvantage. Exposure to chronic stress is associated with poorer mental health including depressive symptoms. Few studies have investigated how AL contribute to depressive symptoms among Black men. The purpose of the cross-sectional study was to examine the association between AL and depressive symptoms among middle to old age Black men. Research Design and Methods This project used the 2010 and 2012 wave of the Health and Retirement Study enhanced face-to-face interview that included a biomarker assessment and psychosocial questionnaire. Depressive symptoms, assessed by the endorsement of 3 or more symptoms on the CES-D 8-item scale, was the outcome variable. The main independent variable, AL, score was calculated by summing the number values that were in the high range for that particular biomarker value scores ranging from 0 to 7. Black men whose AL score was 3 or greater was considered to be in the high AL group. Modified Poisson regression was used to estimate prevalence ratios and corresponding 95% confidence intervals. Results There was a larger proportion of Black men in the high AL group who reported depressive symptoms (30.0% v. 20.0%) compared with Black men in the low AL group. After adjusting for age, education, income, drinking and smoking status, the prevalence of reporting 3 or more depressive symptoms was statistically significant among Black men in the high AL group(PR=1.61 [95% CI: 1.20-2.17]) than Black men in the low AL group. Discussion and Implications Exposure to chronic stress is related to reporting 3 or more depressive symptoms among Black men after controlling for potential confounders. Improving the social and economic conditions for which Black men work, play, and pray is key to reducing stress; thereby potentially leading to the reporting of fewer depressive symptoms.
Findings from five community surveys suggest that the depressive symptom scores of African-Americans are the same as, or lower than, those of Whites. This seems at odds with the minority status hypothesis that predicts higher rates of mental disorders for African-Americans. However, little is known about the role of African-American coping capacity during the life stress process which may shed light on the seeming contradiction. This cross-sectional survey examined the role of spirituality-coping, sense of control, and stress in predicting depressive symptoms among 3570 African-Americans. The findings showed that sense of control mediates the relationship between spirituality, life stressors, and depressive symptoms.
Using a mixed-methods approach, data from 124 MSW students were collected between 2011 and 2015. Students completed a 3-hour course module that focused on harm reduction philosophy and interventions specifically for opioid use disorders. Students completed pre- and posttest of the Harm Reduction Attitude Scale. Students were also engaged in focus groups to gain a better understanding of how and if their knowledge and attitudes changed. Results: Overall, attitudes towards harm reduction approaches for opioid use disorder shifted favorably following the course module. Paired t-test results show a statistically significant difference in the mean scores for pretest attitudes (M = 2.64, SD = 0.16) and posttest attitudes (M = 2.86, SD = 0.12) among social work students. This trend remained consistent despite treatment orientation and having a family history of substance use. Conclusion: Given the increased capacity for social work students to encounter clients with opioid use disorders, it is important to ensure that students are provided with relevant and accurate information related to client-centered approaches such as the harm reduction model to address opioid use disorders. Moreover, given the dearth of social work programs that have and required substance use disorder courses, it is imperative for schools of social work to ensure that students are provided with more than practical information, which is often gained during field placement.
Criminal justice contact-defined as lifetime arrest, parole, or incarceration, seems to exacerbate chronic conditions, and those who are most likely to have had contact with the criminal justice system, such as Black adults, often already have pre-existing disproportionately high rates of stress and chronic conditions due to the social determinants of health that affect underrepresented minorities. Findings from this study suggest that there is a mechanism that links the stressors among Black adults manifested by such factors as family, financial, neighborhood, and personal problems with criminal justice contact to obesity-related health status. Using the National Survey of American Life (NSAL), modified Poisson regression analyses were used to determine the association between criminal justice contact, stressors, and obesity-related health problems among a national sample of Black adults (n = 5008). In the full model, the odds of experiencing obesity-related health problems for Black adults who had criminal justice contact was reduced (PR, 1.23 to 1.14) and not statistically significant. Black adults who reported experiencing family stressors (PR, 1.21; 95% CI, 1.08, 1.36), financial stressors (PR, 1.30; 95% CI, 1.16, 1.47), and personal stressors (PR, 1.16; 95% CI, 1.02, 1.31) were statistically significant and higher than those who reported not experiencing any of these stressors; neighborhood stressors was not statistically significant. The evidence suggests a relationship between the stressors associated with criminal justice contact and obesity-related health status. These findings emphasize the need to further explore the family, financial, and personal stressors for Black adults with criminal justice contact in order to further our understanding of their obesity-related health problems.ᅟ.
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