News & Announcements
Black Teens in Public Housing Twice As Likely to Smoke
Posted: August 01, 2012
Black teens living in public housing communities are more than twice as likely to smoke as their peers in other U.S. communities, researchers have found. The findings, published in the August issue of Addictive Behaviors, suggest that early interventions are needed to prevent young people in these communities from lighting up. The study is titled Understanding tobacco use among urban African American adolescents living in public housing communities: A test of problem behavior theory.
"Compared to their same-aged peers, youth living in public housing were more likely to use tobacco and have positive attitudes about using tobacco," researcher Mansoo Yu, an assistant professor of social work and public health in the MU College of Human Environmental Sciences, said in a University of Missouri news release. "As previous research suggests, early use of tobacco increases individuals' chances of using more serious drugs later. In addition, early drug use is related to other serious problems, such as delinquent behaviors, and family and social problems," Yu added.
In conducting the study, Yu and colleagues from the University of Illinois at Chicago, Boston College and the University of South Carolina asked 518 black teenagers living in public housing in three large U.S. cities about their attitudes on tobacco use, symptoms of depression and delinquent behaviors. The study authors found that these teens were 2.3 times more likely to use tobacco than other black teens. The investigators pointed out that teens living in public housing may be more afraid, have poorer social relationships and more psychological strain, which could contribute to the higher rates of smoking.
"Smoking cessation programs for young African-Americans living in public housing communities should focus on reversing their positive attitudes toward tobacco use," Yu said in the news release. "In addition, programs should help address the youths' depressive symptoms and keep them from getting involved in delinquent behaviors." The researchers added that smoking prevention programs in public housing communities should target young children. "Early interventions are critical for these individuals since the likelihood of being exposed to risky behaviors dramatically increases as the children age," explained Yu. "In public housing communities, adolescents may have easier access to drugs and social activities where drugs are used."
To Understand Mental Health Disparities Look to Race, Immigration, Culture & Ethnicity
Posted: August 01, 2012
Accounting for racial disparities in mental health and mental illness involves more than race. “Race matters even if we don’t know what race is,” said James Jackson, Ph.D., a professor of psychology and director of the Institute for Social Research at the University of Michigan, speaking at APA’s 2012 annual meeting in Philadelphia in May. In brief, the issue is not only about “race,” but R.I.C.E.—Race, Immigration, Culture, and Ethnicity, explained Jackson, who received APA’s Solomon Carter Fuller Award at the meeting.
One way to sort out the observed health disparities among racial and ethnic groups is to uncouple race, ethnicity, and immigration status, he said. Afro-Caribbeans make up a useful population for that task, because they share ancestry but not ethnicity with African Americans. Surveys in both the United States and Great Britain indicate that ancestry, gender, timing of immigration, and age at immigration are all factors in rates of mood disorders. For instance, drawing on data from the National Survey of American Life in 2004, Jackson and colleagues found that 19.9 percent of white people recorded a lifetime mood disorder, compared with 12.5 percent of African Americans and 13.7 percent of Afro-Caribbeans.
However, those overall figures masked several complexities. The rate for Afro-Caribbean respondents whose parents had been born in the United States was 24.3 percent, while among respondents who had come to this country 11 to 12 years before was just 6.3 percent. Similar variations dependent on immigration status and timing were observed for any lifetime psychiatric disorders among Afro-Caribbeans over age 55. Age of onset of major depression appeared to be younger for Afro-Caribbean males, who also faced a higher risk for major depressive disorder and a greater chance of its persistence compared with other ethnic-gender subgroups.
Jackson also noted that his research has found that among imprisoned populations, Afro-Caribbean males who met criteria for substance abuse were five times more likely than African-American males who met criteria for substance abuse to also have major depression, which suggests there is something going on with the behaviors of these men who are migrating to the United States. It could be the difficulty of finding work or making an adjustment to life in this country, he suggested.
Finally, important differences appear within nominally similar ethnic groups. Patterns differ among Cubans, Puerto Ricans, and Mexicans, who can’t be lumped together uncritically as “Hispanics.” “There’s no simple story,” Jackson emphasized. “First-generation health protection may not be an adequate explanation, and differences in psychopathology are not reducible in any simplistic way to differences in social and economic statuses among groups.”
Read more on the Psychiatric News website.
Read a related article about Dr. Jackson’s research on the relationship between physical and mental health disparities among minority populations also on Psychiatric News.
Read the full-text of the journal article Race and Unhealthy Behaviors: Chronic Stress, the HPA Axis, and Physical and Mental Health Disparities Over the Life Course.
Rising HIV Infection Rates, Stigma and Discrimination among Gay Men and Transgender People
Posted: July 31, 2012
Men who have sex with men (MSM) remain at substantial risk for HIV infection in almost every nation across the globe. The situation is even more glaring in high–income nations such as the United States, France, the United Kingdom and Canada—where overall HIV trends are declining except among Black MSM. And in many nations, discrimination, stigma, and criminalization laws present significant barriers to creating an AIDS-free generation. These were just a few of the themes at Stigma to Strength: Strategies for MSM, Transgender People and Allies in a Shifting AIDS Landscape, the day-long pre-conference to the 19th International AIDS Conference sponsored by the The Global Forum on MSM & HIV.
The forum opened with a plenary speech by Congresswoman Barbara Lee, the California Democrat and fierce advocate for HIV/AIDS funding. Lee recently introduced landmark anti-HIV criminalization legislation. Perhaps the most compelling research was announced by Kevin Fenton, M.D., Ph.D., director of the Centers for Disease Control and Prevention’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Dr. Fenton reminded the audience that there has been a soaring number of seroconversions among Black American men who have sex with men—and new data show that “globally Black men who have sex with men are 15 times more likely to be HIV-positive.”
The new data was published in the special July 2012 “HIV in Men Who Have Sex with Men” issue of The Lancet. The lead author: White House Office of National AIDS Policy’s Gregorio Millett. Other contributors include Dr. Fenton, Emory University’s David Malebranche, M.D., MPH, and Columbia University’s Patrick A. Wilson, Ph.D. “We see the tremendous variation from Africa to Canada, the Caribbean and elsewhere,” said Dr. Fenton. “The most glaring disparity is in the United States.”
That trend is particularly “alarming” among Black MSM aged 13 to 19, according to CDC. New seroconversions have increased by 48 percent between 2006 and 2009. But the "tide is turning" against the epidemic and there is finally potential that “we can have an AIDS-free generation”—even among Black gay and bisexual men—Dr. Fenton said after the preconference. “That means we have a range of highly effective tools in which we can bring this epidemic to an end. Now the real work begins of implementation, scaling up and targeting different tools to those communities at most risk.”
The MSMGF event also featured more than 20 breakout sessions. One that expanded on Fenton’s plenary was “Strengthening the Response to HIV/AIDS among Ethnic Minority MSM and Transgender People in the Global North.” Dr. Wilson moderated and panelists included Andrea Lamour-Harrington, a transgender black women who represented U.S. Positive Women's Network. Lamour-Harrington was a public face to the "extreme” socioeconomic disparities faced by Black trans women, who are more than likely to be killed, suffer violence or sexual abuse, HIV/AIDS and discrimination.
“There are so many laws on the books that allow police to harass us,” said Lamour-Harrington. “In Philadelphia there is a law called ‘Obstruction of Highway.’ Police can search me or ask for identification if I’m standing on the street. Most of those arrested are Black and Latino trans women. And the only way we can change these laws are through conferences such as these.”
Reducing Mental Health Disparities in Black Californians using Community-defined Practices
Posted: July 30, 2012
African Americans across the state of California have concerns that their mental health assessment and diagnoses are inadequate, according to a state-commissioned report titled Reducing Mental Health Disparities in Black Californians Using Community-defined Practices: “We Ain‟t Crazy”. These inaccurate psychiatric assessments are a “part of the problem that leads to disparate outcomes,” the report said.
Based on 35 focus groups, 45 individual interviews, 635 surveys, and 10 public forums and meetings with residents and mental health professionals from across the state, the report aimed to provide a more complete picture of the African American community’s experience with the state's mental and behavioral health system.
“People felt like they did not have a good assessment (from their provider) to understand what their particular issues are,” said V. Diane Woods, the founding president of the African American Health Institute of San Bernardino County and primary author of the study. “And if you are not getting a good assessment, you are not getting a good plan or care, and it increases the probability that you will be placed on the wrong medication.”
This is an issue of concern for mental health professionals nationwide. “Due to lack of cultural understanding, some clinicians may misdiagnose African American patients,” Annelle Primm, the American Psychiatric Association’s deputy medical director and director of its Office of Minority and National Affairs, wrote in an email. “For instance, it is well documented in the literature that African Americans have been overdiagnosed with schizophrenia and underdiagnosed with illnesses like major depression and bipolar disorder. Expressing 'healthy paranoia,' regarded as a survival skill among African Americans, may prompt an uninformed clinician unfamiliar with African American culture to consider this as a symptom of schizophrenia or psychosis.”
Among the barriers to accessing mental health care described by study participants is a lack of culturally proficient practitioners and providers. Karen D. Lincoln, an associate professor of social work at the University of Southern California, said that this dynamic can contribute to disparities in treatment and diagnosis. “There is a white norm around symptom presentation," Lincoln wrote in an email. "If you aren’t looking for the right symptoms or if the language being used to describe the symptoms is unfamiliar to you, you can have disparities in diagnosis.” Community distrust is another barrier to accessing mental health care, said Thomas A. Parham, a past president of the National Association of Black Psychologists.
Suicide Awareness Voices of Education Releases PSA for Native American Audience
Posted: July 28, 2012
As part of their Native American Public Awareness Campaign, Suicide Awareness Voices of Education (SAVE) has released a radio public service announcement (PSA) promoting suicide awareness and encouraging help-seeking among the American Indian/Alaska Native population. The PSA features male and female voices of youth and adults with the message that although sometimes things may appear to be overwhelming, Native Americans are part of a community that can offer support. The webiste also features television PSAs, Billboard and print advertisements.