Racial Identity, Perceived Discrimination and Health Behaviors Among Black Primary Care Patients who Use Substances PDF Download

Author: Leah E. Squires
Publisher:
ISBN:
Category :
Languages : en
Pages : 186

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Book Description
Abstract: Blacks who use substances are at heightened risk for health problems. Although negative health outcomes are influenced by several factors related to drug use, these individuals also experience multiple sources of discrimination that may contribute to poor health. Previous work has identified associations between indices of perceived discrimination and health. However, there has been no research examining the relative influence of multiple sources of perceived discrimination on health risk behaviors of Blacks who use substances. The primary aim of this study was to examine how multiple types of discrimination and racial identity centrality contribute to the health risk behaviors of Blacks who use substances.A sample of 279 (203 Black) primary care patients who endorsed substance use completed measures of discrimination, racial identity and health risk behaviors. Outcomes of interest were hazardous drinking, smoking, unprotected sex and low physical activity. Two models were tested by logistic regression: (1) a direct effects model, which proposes unique predictive effects of racial identity centrality and discrimination indices on health risk behaviors, and (2) a buffering model, which proposes racial identity centrality moderates the association between perceived discrimination and health risk behavior.Analyses provided limited support for either model. Single variable effects were not observed. Two interactions were significant. Among those experiencing racial discrimination in health care settings, high centrality was protective against low physical activity. In contrast, among those reporting everyday discrimination, high centrality increased the likelihood of unprotected sex.The current study provided limited support for the hypothesis that perceived discrimination contributes to health risk behaviors among Blacks who use substances. Limited variability in discrimination ratings and health risk outcomes may have obscured the ability to detect main effects of discrimination. Given the number of other factors that contribute to health risk behaviors in this population, the perceived discrimination variables assessed may not have a significant impact on health risk behaviors. Examining these models among Black patients who are not substance users may yield different results. Future work on the influence of discrimination on health may benefit from exploring additional factors, such as stress, in multivariable models.

Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309439124
Category : Social Science
Languages : en
Pages : 171

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Book Description
Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309452961
Category : Medical
Languages : en
Pages : 583

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Book Description
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Author: Brenda Major
Publisher: Oxford University Press
ISBN: 0190243473
Category : Medical
Languages : en
Pages : 577

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Book Description
Stigma leads to poorer health. In The Oxford Handbook of Stigma, Discrimination, and Health, leading scholars identify stigma mechanisms that operate at multiple levels to erode the health of stigmatized individuals and, collectively, produce health disparities. This book provides unique insights concerning the link between stigma and health across various types of stigma and groups.

Author: Jamilia Raki Sly
Publisher:
ISBN:
Category : Electronic dissertations
Languages : en
Pages : 96

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Book Description
Racial identity is an important factor in predicting health behaviors, especially among African Americans. The history of African Americans in the United States makes racial identity an important concept to study. Racial identity can be described as the degree to which a person feels connected to or shares commonalities with an ethnic racial group (Helms, 1990). African Americans fare much worse than other racial and ethnic minorities in the United States in many areas of health. The purpose of this project was to investigate the relationship between racial identity and health behaviors of African American adults aged 18-25 years old. Two hundred African American emerging adults (18-28 years old) (50% female) were recruited from a university campus and community arts festival to participate in the study. Results yielded three distinct identity profiles (multicultural, integrationist and marginalized). Race was a defining feature of identity for the integrationist cluster. The multicultural profile embraced blending with mainstream culture and other minority groups and the marginalized profile did not identify with any group or ideology. The three profiles were assessed for differences in health behaviors (i.e. substance use, mental health, exercise, number of sexual partners). The marginalized profile displayed lower positive affect, more cigarette smoking and more sexual partners in the past year than the other two profiles. Racial identity may be one way of assessing how participants view the world. The information about why they identify with a certain racial identity profile might help researchers tailor preventive interventions to reducing health disparities. Our findings, however, have shown that racial identity alone is not sufficient in explaining how or why people choose to engage in unhealthy behaviors.

Author: Lisa F. Berkman
Publisher: Oxford University Press
ISBN: 9780195083316
Category : Medical
Languages : en
Pages : 428

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Book Description
This book shows the important links between social conditions and health and begins to describe the processes through which these health inequalities may be generated. It reviews a range of methodologies that could be used by health researchers in this field and proposes innovative future research directions.

Author: Yonette F. Thomas
Publisher: Springer
ISBN: 9401774919
Category : Social Science
Languages : en
Pages : 459

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Book Description
This volume examines trajectories of drug use among ethnic minority youth in the United States with a focus on African Americans and Hispanics. It also highlights what research designs have been employed to address these differences as well as suggests strategies for moving this discourse forward by identifying potential targets for prevention and intervention with minority youth. This book features essays by leading experts in the field who have grappled with this issue for decades. Inside, readers will find an insightful dialogue that addresses such questions as: Why are African American and Hispanic youth more likely than their White peers to abstain from drug use during adolescence but are more likely to become problem users later in life? What impact does the stress caused by discrimination have on potential drug use? To what extent does religiosity protect minority youth from drug use as past research suggests that it protects White youth? What is the influence of neighborhood context on exposure to and use of substances among urban African American children? Taken together, the essays in this book identify underexplored risk and protective factors and gaps in the current state of knowledge that can be used to develop effective, culturally specific drug abuse prevention strategies. This book is for anyone with an interest in the initiation and escalation of drug use among African Americans and Hispanics/Latinos and factors that influence these patterns over the life course. It will also be an ideal resource for those interested in better understanding the mechanisms by which risk and protective factors are related to the development of drug use and addiction, particularly the ways in which such factors contribute to health differences and have disproportionately more negative consequences for ethnic minorities.

Author: National Research Council
Publisher: National Academies Press
ISBN: 0309092116
Category : Social Science
Languages : en
Pages : 753

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Book Description
In their later years, Americans of different racial and ethnic backgrounds are not in equally good-or equally poor-health. There is wide variation, but on average older Whites are healthier than older Blacks and tend to outlive them. But Whites tend to be in poorer health than Hispanics and Asian Americans. This volume documents the differentials and considers possible explanations. Selection processes play a role: selective migration, for instance, or selective survival to advanced ages. Health differentials originate early in life, possibly even before birth, and are affected by events and experiences throughout the life course. Differences in socioeconomic status, risk behavior, social relations, and health care all play a role. Separate chapters consider the contribution of such factors and the biopsychosocial mechanisms that link them to health. This volume provides the empirical evidence for the research agenda provided in the separate report of the Panel on Race, Ethnicity, and Health in Later Life.

Author: Sara N. Sayre
Publisher:
ISBN:
Category : African Americans
Languages : en
Pages : 149

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Book Description
Disparities in healthcare are a significant social problem affecting millions of racial and ethnic minorities in the United States. The sources of health disparities are many and range from institutional barriers, provider influences, and even patient factors (Smedley, et al., 2003). In comparison to research on provider contributions to health disparities, there is far less research on patient factors (Bird & Bogart, 2001; Smedley et al., 2003). The purpose of this study was to further examine patient-level factors which may be related to disparities in health care. Specifically, this study focused on how medical mistrust, perceived racial discrimination, and perceived health care specific discrimination were related to African Americans' intentions to seek medical help. A primary purpose of this study was to better understand how medical mistrust relates to intentions to seek help. African Americans' health care behavior was examined within the theoretical framework of the Behavioral Model for Vulnerable Populations (BVMP), in which, medical mistrust functions as a predisposing factor in the process of health services use (Gelberg, Andersen, & Leake, 2000). In addition to using the structure of the BMVP to examine the variables of interest, multiple additional explanatory models were utilized to gain a better understanding how these variables of interest relate to one another, and to determine if medical mistrust may function as a mediator between experiences of discrimination and intentions to seek medical help. The sample included 322 participants who identified as Black/African American. Participants completed an anonymous survey which included demographic questions and 46-items assessing the constructs of perceived racial discrimination, perceived health specific racial discrimination, mistrust of the medical system, and intentions to seek medical help. Consistent with hypotheses, perceived racial discrimination, perceived health care specific racial discrimination, and medical mistrust were significantly negatively related to intentions to seek medical care. Hierarchical regression and path analysis were used to test four explanatory models of relationships among the primary variables of interest. Results indicated support for the Partially Mediated Model where medical mistrust functions as a mediator between discrimination, both within and outside the health care system, and intentions to seek medical help.

Author: David F. Musto
Publisher: Oxford University Press, USA
ISBN: 0195125096
Category : Medical
Languages : en
Pages : 431

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Book Description
The American Disease is a classic study of the development of drug laws in the United States. Supporting the theory that Americans' attitudes toward drugs have followed a cyclic pattern of tolerance and restraint, author David F. Musto examines the relationz between public outcry and the creation of prohibitive drug laws from the end of the Civil War up to the present. Originally published in 1973, and then in an expanded edition in 1987, this third edition contains a new chapter and preface that both address the renewed debate on policy and drug legislation from the end of the Reagan administration to the current Clinton administration. Here, Musto thoroughly investigates how our nation has dealt with such issues as the controversies over prevention programs and mandatory minimum sentencing, the catastrophe of the crack epidemic, the fear of a heroin revival, and the continued debate over the legalization of marijuana.