Publications by authors named "Kristine M Molina"

17 Publications

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Alcohol use, acculturation and socioeconomic status among Hispanic/Latino men and women: The Hispanic Community Health Study/Study of Latinos.

PLoS One 2019 4;14(4):e0214906. Epub 2019 Apr 4.

Southbay Latino Research Center, School of Public Health, San Diego State University, San Diego, California, United States of America.

The objective of this study was to examine the prevalence and patterns of alcohol use among U.S. Hispanic/Latino adults of diverse backgrounds. The population-based Hispanic Community Health Study/ Study of Latinos (HCHS/SOL) enrolled a cohort of Hispanic/Latino adults (N = 16,415) ages 18-74 years at time of recruitment, from four US metropolitan areas between 2008-11. Drinking patterns and socio-demographics questionnaires were administered as part of the baseline examination. The relationship between age, sex, socio-demographics, acculturation, current alcohol use, and alcohol risk disorder, defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) [no risk (i.e., never drinker), low risk (i.e., women<7 drinks/week; men<14 drinks/week), and at-risk (i.e., women>7 drinks/week; men>14 drinks/week)] were assessed in unadjusted and adjusted multinomial logistic regression analyses. Men reported a higher prevalence than women of at-risk drinking. For women, increased odds of at-risk alcohol use was associated with: a younger age, greater education, full-time employment, and acculturation after adjustment. For men, having a lower income (vs. higher income) or a higher income (vs. not reported) and being employed fulltime (vs. retired) was associated with at-risk alcohol use. For both men and women, there were variations in odds of at-risk drinking across Hispanic/Latino heritage backgrounds, after adjustment. Exact values, odds ratios and p-values are reported within the text. Common factors across sex associated with at-risk drinking included being of Mexican background and being employed full-time. Intervention strategies should consider diversity within the Hispanic/Latino community when designing alcohol abuse prevention programs.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0214906PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6449031PMC
January 2020

A Seat at the Table: Strategic Engagement in Service Activities for Early-Career Faculty From Underrepresented Groups in the Academy.

Acad Med 2019 08;94(8):1089-1093

T.L. Carson is assistant professor, Division of Preventive Medicine, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; ORCID: https://orcid.org/0000-0002-8180-4523. A. Aguilera is associate professor, School of Social Welfare, University of California, Berkeley, Berkeley, California, and Department of Psychiatry, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, California; ORCID: https://orcid.org/0000-0003-1773-8768. S.D. Brown is research scientist I, Division of Research, Kaiser Permanente Northern California, Oakland, California; ORCID: https://orcid.org/0000-0002-3920-0945. J. Peña is assistant professor, Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine and New York-Presbyterian Hospital, New York, New York. A. Butler is assistant professor, Department of Pediatrics, Baylor College of Medicine, Houston, Texas. A. Dulin is Manning Assistant Professor, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island. C.R. Jonassaint is assistant professor, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania. I. Riley is medical instructor, Division of Pulmonary & Critical Care Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina. K. Vanderbom is implementation science coordinator, National Center on Health, Physical Activity, and Disability, University of Alabama at Birmingham/Lakeshore Research Collaborative, Birmingham, Alabama; ORCID: https://orcid.org/0000-0002-4799-954X. K.M. Molina is assistant professor, Department of Psychology, University of Illinois at Chicago, Chicago, Illinois; ORCID: https://orcid.org/0000-0001-9127-993X. C.W. Cené is associate professor, Division of General Internal Medicine & Clinical Epidemiology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina.

Many academic institutions strive to promote more diverse and inclusive campuses for faculty, staff, and students. As part of this effort, these institutions seek to include individuals from historically underrepresented groups (URGs)-such as women, people from racial/ethnic minority populations, persons with disabilities-on committees and in other service activities. However, given the low number of faculty members from URGs at many institutions, these faculty members tend to receive more requests to provide service to the institution or department (e.g., serving on committees, mentoring) than their counterparts from majority groups. Faculty members from URGs, especially early-career faculty, thus risk becoming overburdened with providing service at the expense of working on other scholarly activities required for promotion and tenure (i.e., conducting research, publishing). Although many scholars and others have written about this "minority tax" and its implications for early-career faculty from underrepresented racial/ethnic minority groups, fewer have published about how this tax extends beyond racial/ethnic minorities to women and persons with disabilities. Further, the literature provides scant practical advice on how to avoid overburdening early-career faculty from URGs. Here, a group of multidisciplinary early- and mid-career faculty members from URGs seek to provide their peers from URGs with practical strategies for both evaluating the appropriateness of service requests and declining those that are not a good fit. The authors also provide institutional leaders with actionable recommendations to prevent early-career faculty from URGs from becoming overburdened with service.
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http://dx.doi.org/10.1097/ACM.0000000000002603DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6626695PMC
August 2019

Perceived discrimination and physical health-related quality of life: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study.

Soc Sci Med 2019 02 27;222:91-100. Epub 2018 Dec 27.

Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA.

Rationale: The aim of this study was to examine the direct associations of perceived personal and group discrimination with physical health-related quality of life (HRQoL) among Latinx adults. We also tested whether ethnic identity and depression symptoms sequentially mediate these associations.

Method: This population-based study included 5313 Latinx adults, ages 18-74 years, from the Hispanic Community Health Study/Study of Latinos (2008-11) and its Sociocultural Ancillary Study (2010-11). Participants were recruited from the Bronx; NY; Chicago, IL; Miami, FL; and San Diego, CA. Self-reported perceived personal and group discrimination, ethnic identity, depression symptoms, and physical HRQoL were ascertained through interviewer-administered surveys. Survey-weighted path analysis was used to examine direct and indirect effects simultaneously in one analytic model controlling for demographic covariates.

Results: Path analysis indicated that higher perceived personal discrimination was directly associated with poorer physical HRQoL and this association was only mediated by depression symptoms. In contrast, perceived group discrimination was not directly associated with physical HRQoL. However, each of the direct paths linking perceived group discrimination to physical HRQoL were statistically significant: perceived group discrimination was positively associated with ethnic identity, and ethnic identity was negatively associated with depression symptoms, and, in turn, depression symptoms were negatively associated with physical HRQoL. Our model accounted for 18% of the variance of physical HRQoL.

Conclusions: Perceived personal and group discrimination are differently associated with physical HRQoL. Results highlight the importance of considering self-perceptions of different discrimination forms when evaluating its impact on the physical HRQoL of Latinx adults.
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http://dx.doi.org/10.1016/j.socscimed.2018.12.038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377306PMC
February 2019

It Weigh(t)s on You: Everyday Discrimination and Adiposity Among Latinos.

Obesity (Silver Spring) 2018 09 3;26(9):1474-1480. Epub 2018 Sep 3.

Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.

Objective: Evidence suggests discrimination increases the risk of obesity. The biopsychosocial model of racism posits that psychological factors such as depressive symptoms may link experiences of perceived interpersonal discrimination to obesity. This study tested whether self-reported experiences of everyday discrimination were associated with adiposity indicators and whether depressive symptoms explained these associations.

Methods: Cross-sectional survey data of 602 Latino adults living in Lawrence, Massachusetts, from the Latino Health and Well-being Project (2011-2013) were used. Participants completed questionnaires assessing perceived everyday discrimination and depressive symptoms. Anthropometric measures (i.e., BMI and waist circumference [WC]) were obtained by trained staff. Structural equation modeling was employed to test for direct and indirect effects of perceived everyday discrimination on adiposity.

Results: Perceived everyday discrimination was directly and positively associated with higher BMI and WC, independent of sociodemographic factors, physical activity, and stressful life events. Perceived everyday discrimination was not indirectly associated with BMI and WC through depressive symptoms. However, perceived everyday discrimination was associated with higher levels of depressive symptoms.

Conclusions: Self-reported everyday discrimination among Latino adults is associated with adiposity. Day-to-day interpersonal discrimination may be implicated in obesity disparities for Latino adults.
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http://dx.doi.org/10.1002/oby.22248DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159926PMC
September 2018

Religiosity prevalence and its association with depression and anxiety symptoms among Hispanic/Latino adults.

PLoS One 2018 7;13(2):e0185661. Epub 2018 Feb 7.

Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, United States of America.

Objectives: Religion plays an important role in the lives of people in the United States. We examined the prevalence of religiosity among Hispanic/Latinos in four regions of the United States and looked at its correlation to depression and anxiety symptoms.

Design: The population-based Hispanic Community Health Study/ Study of Latinos enrolled a cohort of Hispanic/Latino adults (N = 16,415) ages 18-74 in four US cities from June 2008 to June 2011. Participants with complete data on religiosity (i.e., religious affiliation, frequency of attending religious activities and importance of religion), depression (assessed with the CESD-10), and trait anxiety (assessed with the STAI-10) were included in the present study. Distribution of religiosity is described by sociodemographic characteristics. Associations between religiosity with depression and anxiety were examined with logistic regression models controlling for sex, age group, education, Hispanic/Latino background, clinical center, and nativity.

Results: The majority of the population (89.5%) reported having a religious affiliation. Weekly attendance at religious activities was reported by 41.6% of participants, while 20.6% did not attend any religious activities. Religion was very important to 63.9% and not at all important to 6.7% of the population. The CES-D scores and trait anxiety scores were not significantly related in the overall group to frequency of attending religious activity or perceived importance of religion. However, in age-stratified analyses, among older individuals (65+ years old) reporting "never" participating in religious activities compared to more than once per week was associated with an 80% higher likelihood of having high depressive symptomatology. Similarly, in the older age group, no religious affiliation or reporting that religion is "not at all important" was associated with greater anxiety symptomatology.

Conclusion: Religiosity varied by Hispanic/Latino background. Lack of religiosity was associated with elevated depressive or anxiety symptomology in older adults but not in young or middle-aged adults.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0185661PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5802430PMC
March 2018

Discrimination, internalized racism, and depression: A comparative study of African American and Afro-Caribbean adults in the US.

Group Process Intergroup Relat 2016 Jul 3;19(4):439-461. Epub 2016 May 3.

University of Illinois at Chicago, USA.

Emerging research suggests that both perceptions of discrimination and internalized racism (i.e., endorsement of negative stereotypes of one's racial group) are associated with poor mental health. Yet, no studies to date have examined their effects on mental health with racial/ethnic minorities in the US in a single study. The present study examined: (a) the direct effects of everyday discrimination and internalized racism on risk of DSM-IV criteria of past-year major depressive disorder (MDD); (b) the interactive effects of everyday discrimination and internalized racism on risk of past-year MDD; and (c) the indirect effect of everyday discrimination on risk of past-year MDD via internalized racism. Further, we examined whether these associations differed by ethnic group membership. We utilized nationally representative data of Afro-Caribbean ( = 1,418) and African American ( = 3,570) adults from the National Survey of American Life. Results revealed that experiencing discrimination was associated with increased odds of past-year MDD among the total sample. Moreover, for Afro-Caribbeans, but not African Americans, internalized racism was associated with decreased odds of meeting criteria for past-year MDD. We did not find an interaction effect for everyday discrimination by internalized racism, nor an indirect effect of discrimination on risk of past-year MDD through internalized racism. Collectively, our findings suggest a need to investigate other potential mechanisms by which discrimination impacts mental health, and examine further the underlying factors of internalized racism as a potential self-protective strategy. Lastly, our findings point to the need for research that draws attention to the heterogeneity within the U.S. Black population.
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http://dx.doi.org/10.1177/1368430216641304DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5386401PMC
July 2016

Is there a link between wealth and cardiovascular disease risk factors among Hispanic/Latinos? Results from the HCHS/SOL sociocultural ancillary study.

Ethn Health 2018 11 6;23(8):902-913. Epub 2017 Apr 6.

c Institute for Behavioral and Community Health , Graduate School of Public Health, San Diego State University , San Diego , USA.

Objective: To examine the relationship between wealth and cardiovascular disease risk factors among Hispanic/Latinos of diverse backgrounds.

Design: This cross-sectional study used data from 4971 Hispanic/Latinos, 18-74 years, who participated in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) baseline exam and the HCHS/SOL Sociocultural Ancillary Study. Three objectively measured cardiovascular disease risk factors (hypertension, hypercholesterolemia, and obesity) were included. Wealth was measured using an adapted version of the Home Affluence Scale, which included questions regarding the ownership of a home, cars, computers, and recent vacations.

Results: After adjusting for traditional socioeconomic indicators (income, employment, education), and other covariates, we found that wealth was not associated with hypertension, hypercholesterolemia or obesity. Analyses by sex showed that middle-wealth women were less likely to have hypercholesterolemia or obesity. Analyses by Hispanic/Latino background groups showed that while wealthier Central Americans were less likely to have obesity, wealthier Puerto Ricans were more likely to have obesity.

Conclusion: This is the first study to explore the relationship between wealth and health among Hispanic/Latinos of diverse backgrounds, finding only partial evidence of this association. Future studies should utilize more robust measures of wealth, and address mechanisms by which wealth may impact health status among Hispanic/Latinos of diverse backgrounds in longitudinal designs.
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http://dx.doi.org/10.1080/13557858.2017.1315370DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5796865PMC
November 2018

Prevalence and Correlates of Perceived Ethnic Discrimination in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study.

J Lat Psychol 2015 Aug 8;3(3):160-176. Epub 2015 Jun 8.

Department of Psychology, St John's University.

Empirical studies examining perceived ethnic discrimination in Latinos of diverse background groups are limited. This study examined prevalence and correlates of discrimination in a diverse sample of U.S. Latinos (N=5,291) from the multi-site Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and HCHS/SOL Sociocultural Ancillary Study. The sample permitted an examination of differences across seven groups (Central American, Cuban, Dominican, Mexican, Puerto Rican, South American, and Other/Multiple Background). Most participants (79.5%) reported lifetime discrimination exposure and prevalence rates ranged from 64.9% to 98% across groups. Structural Equation Models (SEM) indicated that after adjusting for sociodemographic covariates most group differences in reports of discrimination were eliminated. However, Cubans reported the lowest levels of discrimination, overall among all groups. Furthermore, regional effects were more important than group effects. Participants from Chicago reported the highest levels of discrimination in comparison to other regions. Group differences among Latinos appear to be primarily a function of sociodemographic differences in education, income, and acculturation. In addition, differences in exposure to discrimination may be tied to variables associated with both immigration patterns and integration to U.S. culture. Results highlight the importance of considering historical context and the intersection of discrimination and immigration when evaluating the mental health of Latinos.
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http://dx.doi.org/10.1037/lat0000040DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610197PMC
August 2015

Discrimination, Racial/Ethnic Identity, and Substance Use Among Latina/os: Are They Gendered?

Ann Behav Med 2016 Feb;50(1):119-29

Background: Prior research suggests that stronger racial/ethnic identification offsets negative effects of discrimination on substance use. Yet research in this area and on whether gender modifies this association is limited for Latina/os.

Purpose: The purpose of the present study is to examine whether different sources of discrimination (everyday and racial/ethnic) are associated with substance use (alcohol use disorder, smoking), if racial/ethnic identity buffers this association, and the potential moderating role of gender among these variables.

Methods: We present cross-sectional, US population-based data from the Latina/o adult sample (1427 females and 1127 males) of the National Latino and Asian American Study. Respondents completed self-reported measures of everyday and racial/ethnic discrimination, racial/ethnic identity, smoking status, and Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) lifetime alcohol use disorder.

Results: Weighted logistic regression analyses showed that before inclusion of three-way interactions and adjusting for covariates, everyday discrimination predicted increased risk for any DSM-IV lifetime alcohol use disorders. Moderation analyses revealed that the effect of everyday discrimination on the risk of being a current smoker was strongest for Latino men with high levels of racial/ethnic identity compared to those with low racial/ethnic identity. No differences were noted among Latino women. There were no main or interaction effects of racial/ethnic discrimination for any substance use outcome.

Conclusions: Findings suggest differential associations for type of discrimination and outcome and that the role of racial/ethnic identity is gender-specific for smoking, appearing particularly detrimental for Latino men reporting high levels of racial/ethnic identity.
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http://dx.doi.org/10.1007/s12160-015-9738-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139622PMC
February 2016

Transnational, social, and neighborhood ties and smoking among Latino immigrants: does gender matter?

Am J Public Health 2015 Apr 14;105(4):741-9. Epub 2014 Aug 14.

Carmela Alcántara is with the Department of Medicine, Columbia University Medical Center, New York, NY. Kristine M. Molina is with the Department of Psychology, University of Illinois at Chicago. Ichiro Kawachi is with the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA.

Objectives: We examined whether transnational ties, social ties, and neighborhood ties were independently associated with current smoking status among Latino immigrants. We also tested interactions to determine whether these associations were moderated by gender.

Methods: We conducted a series of weighted logistic regression analyses (i.e., economic remittances, number of return visits, friend support, family support, and neighborhood cohesion) using the Latino immigrant subsample (n = 1629) of the National Latino and Asian American Study in 2002 and 2003.

Results: The number of past-year return visits to the country-of-origin was positively associated with current smoker status. Gender moderated the association between economic remittances, friend support, and smoking. Remittance behavior had a protective association with smoking, and this association was particularly pronounced for Latino immigrant women. Friendship support lowered the odds of smoking among men, but not women.

Conclusions: Our results underscore the growing importance of transnational networks for understanding Latino immigrant health and the gendered patterns of the associations between social ties, transnational ties, and health risk behaviors.
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http://dx.doi.org/10.2105/AJPH.2014.301964DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4329101PMC
April 2015

Everyday discrimination and chronic health conditions among Latinos: the moderating role of socioeconomic position.

J Behav Med 2014 Oct 12;37(5):868-80. Epub 2013 Nov 12.

Community and Prevention Research Division, Department of Psychology, University of Illinois at Chicago, 1007 W. Harrison Street, Behavioral Sciences Building, Room 1050A, Chicago, IL, 60607, USA,

Emerging research has revealed that everyday discrimination and socioeconomic position may have synergistic effects on the health of racial/ethnic minorities. The present study examined the association between self-reported everyday discrimination and count of chronic health conditions, and explored the moderating role of objective and subjective socioeconomic position on the discrimination-health relation. We utilized nationally representative data of Latino adults (N = 2,554) from the National Latino and Asian American Study. Weighted negative binomial regression modeling was used to estimate the association between self-reported everyday discrimination and count of chronic health conditions, and to test whether this relation was modified by markers of socioeconomic position. Binomial regressions revealed that everyday discrimination was associated with a greater count of chronic conditions. However, moderation analyses indicated that household income moderated the discrimination-health relation, controlling for sociodemographic variables. More specifically, the adverse effects of discrimination were stronger for Latinos in middle-income tertiles compared to their lower income counterparts, such that as frequency of discrimination increased, Latinos with medium levels of household income were predicted to have greater counts of chronic conditions. This was only marginally significant among those in the high-income tertile. Our findings suggest that identifying segments of the Latino population that may be at greatest (and lowest) risk of ill health in the context of perceiving being discriminated against may prove useful for understanding Latino health "paradoxes," and may have implications for tailoring prevention and intervention efforts to particular segments of the Latino population.
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http://dx.doi.org/10.1007/s10865-013-9547-0DOI Listing
October 2014

Neighborhood characteristics and differential risk for depressive and anxiety disorders across racial/ethnic groups in the United States.

Depress Anxiety 2014 Jan 7;31(1):27-37. Epub 2013 Oct 7.

Center for Multicultural Mental Health Research, Cambridge Health Alliance, Somerville, Massachusetts.

Background: The prevalence of psychiatric disorders varies depending on the person's neighborhood context, their racial/ethnic group, and the specific diagnoses being examined. Less is known about specific neighborhood features that represent differential risk for depressive and anxiety disorders (DAD) across racial/ethnic groups in the United States. This study examines whether neighborhood etiologic factors are associated with DAD, above and beyond individual-level characteristics, and whether these associations are moderated by race/ethnicity.

Methods: We utilized nationally representative data (N = 13,837) from the Collaborative Psychiatric Epidemiology Studies (CPES-Geocode file). Separate weighted multilevel logistic regression models were fitted for any past-year depressive and/or anxiety disorder, any depressive disorder only, and any anxiety disorder only.

Results: After adjusting for individual-level characteristics, African Americans living in a neighborhood with greater affluence and Afro-Caribbeans residing in more residentially unstable neighborhoods were at increased risk for any past-year depressive disorder as compared to their non-Latino white counterparts. Further, Latinos residing in neighborhoods with greater levels of Latino/immigrant concentration were at increased risk of any past-year anxiety disorder. Lastly, Asians living in neighborhoods with higher levels of economic disadvantage were at decreased risk of any past-year depressive and/or anxiety disorders compared to non-Latino whites, independent of individual-level factors. Differences across subethnic groups are also evident.

Conclusions: Results suggest neighborhood characteristics operate differently on risk for DAD across racial/ethnic groups. Our findings have important implications for designing and targeting interventions to address DAD risk among racial/ethnic minorities.
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http://dx.doi.org/10.1002/da.22197DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5737710PMC
January 2014

Household structure, family ties, and psychological distress among U.S.-born and immigrant Latino women.

J Fam Psychol 2013 Feb;27(1):147-58

Department of Psychology, Behavioral Medicine Research Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA.

Latino women endorse the highest rates of past-month depressive symptoms relative to Latino men and non-Latino White men and women. Yet, research into the specific domains of family life that reduce or engender psychological distress among Latinas is sparse. We examine the hypothesis that indicators of household structure and family ties will relate to psychological distress among Latinas in the United States, and that these associations will vary by nativity status. We employed nationally representative data of Latina adults (N = 1,427) from the National Latino and Asian American Study. Nativity-stratified regression analyses revealed that strained family ties (i.e., family burden, family cultural conflict) were associated with greater levels of past-month psychological distress for both U.S.-born and immigrant Latinas. Yet, the effect of household structures on psychological distress differed by nativity status. Adjusting for sociodemographic factors, lower levels of household income were associated with greater psychological distress; and having children in the household was associated with lower levels of psychological distress among U.S.-born Latinas. In contrast, for immigrant Latinas, being out of the labor force was associated with greater levels of psychological distress. Results suggest that dynamics of both the household and family context predict differential as well as similar mental-health outcomes across segments of the Latina population in the United States. These findings underscore the need to understand the pathways by which different facets of family life-structural and social domains-relate to mental-health status among subgroups of Latinas. Our results also have implications for the development of tailored interventions to meet the specific needs of Latinas.
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http://dx.doi.org/10.1037/a0031135DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900573PMC
February 2013

A multiple-group path analysis of the role of everyday discrimination on self-rated physical health among Latina/os in the USA.

Ann Behav Med 2013 Feb;45(1):33-44

Department of Psychology, Behavioral Medicine Research Center, University of Miami, Coral Gables, FL, USA.

Background: Few studies have examined the psychosocial mechanisms through which self-reported discrimination may influence the health status of Latinos.

Purpose: This study examined the mediating role of subjective social status in the USA and psychological distress on the relation between everyday discrimination and self-rated physical health, and the moderating role of gender and ethnicity.

Methods: A US population-based sample of Latinos (N = 2,554) was drawn from the National Latino and Asian American Study. Respondents completed measures of everyday discrimination, subjective social status, psychological distress, and self-rated physical health.

Results: Path analysis revealed that among the total sample, subjective social status and psychological distress sequentially mediated the effect of everyday discrimination on self-rated physical health. Psychological distress was a more consistent mediator across Latino subgroups. Gender and ethnicity moderated the mediation model.

Conclusions: This study provides a systematic examination of how psychosocial mechanisms may operate differently or similarly across Latino subgroups.
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http://dx.doi.org/10.1007/s12160-012-9421-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3562407PMC
February 2013

Neighborhood context and substance use disorders: a comparative analysis of racial and ethnic groups in the United States.

Drug Alcohol Depend 2012 Sep 13;125 Suppl 1:S35-43. Epub 2012 Jun 13.

Behavioral Medicine Research Center, University of Miami, Miami, FL 33136, United States.

Background: There is evidence that ethnic/racial minorities are conferred differential risk for substance use problems based on where they live. Despite a burgeoning of research focusing on the role of neighborhood characteristics on health, limited findings are available on substance use. Our study uses nationally representative data (N=13,837) to examine: (1) what neighborhood characteristics are associated with risk of substance use disorders?; (2) do the associations between neighborhood characteristics and substance use disorders remain after adjusting for individual-level factors?; and (3) do neighborhood characteristics associated with substance use disorders differ by race/ethnicity after adjusting for individual-level factors?

Methods: Data were drawn from the Collaborative Psychiatric Epidemiology Studies (CPES-Geocode file) with 836 census tracts. Analyses included African Americans, Asians, Caribbean Blacks, Latinos, and non-Latino whites. Separate logistic regression models were fitted for any past-year substance use disorder, alcohol use disorder, and drug use disorder.

Results: Living in more affluent and residentially unstable census tracts was associated with decreased risk of past-year substance use disorder, even after adjusting for individual-level factors. However, when we investigated the interaction of race/ethnicity and census latent factors with past-year substance use disorders, we found different associations for the different racial/ethnic groups. We also found different associations between neighborhood affluence, residential instability and any past-year substance use and alcohol disorders by nativity.

Conclusions: Characteristics of the environment might represent differential risk for substance disorders depending on a person's ethnicity/race and nativity status.
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http://dx.doi.org/10.1016/j.drugalcdep.2012.05.027DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3488110PMC
September 2012

Prevalence of neurasthenia, comorbidity, and association with impairment among a nationally representative sample of US adults.

Soc Psychiatry Psychiatr Epidemiol 2012 Nov 17;47(11):1733-44. Epub 2012 Feb 17.

Behavioral Medicine Research Center, Miller School of Medicine, University of Miami, Clinical Research Building, #1516, 1120 NW 14th Street, Miami, FL 33136, USA.

Purpose: There are no current psychiatric epidemiological studies examining prevalence estimates of neurasthenia across different racial and ethnic groups in the US. This study compares prevalence rates of International Classification of Diseases (ICD-10) lifetime and 12-month neurasthenia across racial/ethnic groups in the US (Asians, African Americans, Latinos, and non-Latino Whites) and by levels of acculturation. We examine comorbidity of neurasthenia with DSM-IV psychiatric disorders and the association between neurasthenia and impairment.

Methods: We used a pooled sample (N = 10, 118) from two nationally representative household surveys of adults ages 18 years and older: the National Comorbidity Survey-Replication (NCS-R) and the National Latino and Asian American Study (NLAAS).

Results: Among the total sample, the adjusted prevalence rates of lifetime and 12-month neurasthenia with exclusionary criteria were 2.22 and 1.19%. The adjusted prevalence rates for lifetime and 12-month neurasthenia without exclusionary criteria were 4.89 and 2.80%. There were significant racial/ethnic group differences in prevalence for both lifetime and past-year neurasthenia, with Asians reporting significantly lower prevalence of neurasthenia than their non-Latino White counterparts. Less acculturated individuals were at a decreased risk for lifetime and past-year neurasthenia. Lifetime neurasthenia was associated with increased odds of meeting lifetime criteria for any depressive, any anxiety, and any substance use disorder. Respondents with lifetime or past-year neurasthenia had significantly greater levels of impairment compared to those without neurasthenia.

Conclusion: Neurasthenia is a prevalent condition deserving further research attention given its comorbidity with other psychiatric disorders and its association with functional impairment.
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http://dx.doi.org/10.1007/s00127-012-0489-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6241298PMC
November 2012

Understanding depressive symptoms among high-risk, pregnant, African-American women.

Womens Health Issues 2011 Jul-Aug;21(4):293-303. Epub 2011 May 12.

Psychology and Women's Studies Departments, University of Michigan, Ann Arbor, MI, USA.

Purpose: Depression has been shown to be a risk factor of poor pregnancy outcomes among African-American women. The goal of this study was to examine both risk and protective factors of depressive symptoms among urban, high-risk African-American, pregnant women.

Methods: Data were drawn from a larger randomized controlled trial, Health Outcomes of Pregnancy Education that was a part of the National Institutes of Health-DC Initiative to Reduce Infant Mortality in Minority Populations in the District of Columbia. For purposes of the present study, a sample of African-American pregnant women (n = 1,044) were recruited from six urban prenatal care clinics. Baseline depressive symptoms were assessed using the Hopkins Symptom Checklist-Depression Scale.

Results: Forty-four percent of women were confirmed as moderately to severely depressed at baseline. In multivariate linear regression analysis among the total sample, maternal age, intimate partner violence, illicit drug and alcohol use during pregnancy, and reproductive history (no live birth/only loss; no live birth/no loss) were associated with increased depressive symptoms. Being very happy about the pregnancy, having emotional support from others, and reporting more positive expectancies about the ability to regulate negative moods were associated with decreased depressive symptoms.

Conclusion: Results highlight the importance of attending to the context of high-risk, African-American, pregnant women, paying attention to both risk and protective factors of poor psychological well-being. Implications for future research in this area are discussed.
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http://dx.doi.org/10.1016/j.whi.2011.01.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3488109PMC
February 2012