Black women continue to have rates of mental health
conditions that can be negative for their well-being. This study examined the
contribution of social and contextual factors and severe physical intimate
partner violence on the mental health of US Black women (African-American and
Caribbean Black).
Setting: Data were largely collected via in-person community
interviews at participants' homes.
We studied 3277 African-American and Black Caribbean women
from the 2001-2003 National Survey of American Life (NSAL), the largest and
most complete sample of Blacks residing in the USA.
Key outcomes included an array of psychiatric disorders based
on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).
Bivariate results revealed noticeably high rates of any
anxiety disorder, post-traumatic stress disorder, any substance disorder,
alcohol abuse disorder, suicide ideation and attempts, and any overall mental
disorder among African-American women relative to Caribbean Black women.
Multiple social and contextual factors were associated with various mental
disorders among both sets of Black women in multivariate models, with the most
consistent associations found for severe physical intimate partner violence. Everyday
discrimination was associated with anxiety disorders, eating disorders, and any disorder, while neighbourhood drug problems contributed to
mood, substance disorders and any disorder.
Severe physical intimate partner violence, discrimination,
and to a lesser extent, neighbourhood problems are important predictors of
Black women's health, findings that inform intervention and clinical services
tailored to meet the needs of Black women from diverse ethnic and cultural
backgrounds.
Table 5
Lifetime substance abuse disorder among all Black women by, 2001–2003 NSAL
| Characteristics | Block 1 | Block 2 | Block 3 |
|---|---|---|---|
| Age | |||
| 18–24 | Ref | Ref | Ref |
| 25–34 | 1.30 (0.606 to 2.79) | 1.20 (0.545 to 2.63) | 0.978 (0.464 to 2.06) |
| 35–49 | 2.53 (1.27 to 5.03)** | 2.69 (1.33 to 5.47)** | 2.15 (1.06 to 4.37)* |
| 50–64 | 1.58 (0.657 to 3.80) | 1.63 (0.661 to 4.01) | 1.26 (0.529 to 3.02) |
| >65 | 0.613 (0.167 to 2.25) | 0.708 (0.188 to 2.66) | 0.756 (0.199 to 2.87) |
| Marital status | |||
| Married | Ref | Ref | Ref |
| Partnered | 1.55 (0.672 to 3.59) | 1.26 (0.510 to 3.11) | 1.12 (0.462 to 2.72) |
| Separated-divorced | 1.11 (0.645 to 1.92) | 0.940 (0.523 to 1.69) | 0.775 (0.410 to 1.46) |
| Widowed | 1.13 (0.463 to 2.78) | 1.16 (0.437 to 3.09) | 1.06 (0.388 to 2.87) |
| Never married | 1.66 (0.881 to 3.15) | 1.50 (0.773 to 2.91) | 1.48 (0.759 to 2.88) |
| Education | |||
| Less than high school | Ref | Ref | Ref |
| High school graduate | 0.425 (0.245 to 0.737)** | 0.452 (0.262 to 0.782)* | 0.493 (0.280 to 0.866)* |
| Some college | 0.756 (0.427 to 1.34) | 0.784 (0.434 to 1.42) | 0.820 (0.456 to 1.47) |
| College | 0.383 (0.154 to 0.953)* | 0.428 (0.165 to 1.11) | 0.469 (0.185 to 1.19) |
| Income | |||
| <$25 000 | Ref | Ref | Ref |
| $25 000–$34 999 | 1.22 (0.750 to 2.00) | 1.44 (0.910 to 2.29) | 1.67 (1.05 to 2.66)* |
| $35 000–$49 999 | 0.439 (0.191 to 1.01)* | 0.450 (0.212 to 1.80) | 0.560 (0.225 to 1.39) |
| $50 000–$74 999 | 0.252 (0.105 to 0.605)** | 0.309 (0.127 to 7.53)** | 0.338 (0.135 to 0.846)* |
| >$75 000 | 0.740 (0.349 to 1.57) | 0.893 (0.439 to 1.82) | 1.09 (0.549 to 2.19) |
| Occupational status | |||
| Employed | Ref | Ref | Ref |
| Not employed | 1.08 (0.564 to 2.05) | 0.971 (0.523 to 1.80) | 0.888 (0.465 to 1.70) |
| Not in the labour force | 1.19 (0.654 to 2.18) | 1.12 (0.607 to 2.08) | 1.05 (0.550 to 2.01) |
| Ethnicity | |||
| African-American | Ref | Ref | Ref |
| Caribbean Black | 0.467 (0.265 to 0.820)** | 0.455 (0.246 to 0.842)** | 0.466 (0.255 to 0.851)** |
| Discrimination | |||
| No | Ref | Ref | |
| Yes | 1.54 (0.654 to 3.61) | 1.24 (0.531 to 2.91) | |
| Neighbourhood crime problem | 1.13 (0.954 to 1.34) | 1.10 (0.906 to 1.34) | |
| Neighbourhood drug problem | 1.37 (1.12 to 1.68)** | 1.37 (1.11 to 1.69)** | |
| Severe IPV | |||
| No | Ref | ||
| Yes | 3.52 (2.21 to 5.60)*** | ||
| Model F statistic, p value | F=4.77, p<=0.00 | F=8.24, p<=0.00 | F=15.96, p<=0.00 |
*p<0.05; ** p<0.01; ***p<0.001.
IPV, intimate partner violence; NSAL, National Survey of American Life.
Table 7
Lifetime Suicide Ideation among Black Women by, 2001–2003 NSAL
| Characteristics | Block 1 | Block 2 | Block 3 |
|---|---|---|---|
| Age | |||
| 18–24 | Ref | Ref | Ref |
| 25–34 | 0.873 (0.591 to 1.29) | 0.897 (0.607 to 1.32) | 0.789 (0.520 to 1.20) |
| 35–49 | 0.895 (0.560 to 1.43) | 0.945 (0.597 to 1.50) | 0.830 (0.509 to 1.36) |
| 50–64 | 0.503 (0.282 to 898)* | 0.558 (0.310 to 1.00)* | 0.483 (0.257 to 0.909)* |
| >65 | 0.120 (0.049 to 0.295)*** | 0.153 (0.062 to 0.381)*** | 0.163 (0.065 to 409)*** |
| Marital status | |||
| Married | Ref | Ref | Ref |
| Partnered | 1.34 (0.762 to 2.37) | 1.17 (0.644 to 2.13) | 1.12 (0.593 to 2.13) |
| Separated-divorced | 1.19 (0.723 to 1.95) | 1.10 (0.657 to 1.83) | 0.925 (0.542 to 1.58) |
| Widowed | 1.19 (0.664 to 2.13) | 1.22 (0.653 to 2.29) | 1.15 (0.621 to 2.12) |
| Never married | 1.12 (0.719 to 1.76) | 1.09 (0.680 to 1.74) | 1.09 (0.688 to 1.72) |
| Education | |||
| Less than high school | Ref | Ref | Ref |
| High school graduate | 0.654 (0.452 to 0.946)* | 0.641 (0.452 to 0.909)** | 0.707 (0.498 to 1.00)* |
| Some college | 0.644 (0.421 to 0.986)* | 0.624 (0.414 to 0.941)* | 0.665 (0.431 to 1.03) |
| College | 0.426 (0.235 to 0.773)** | 0.428 (0.242 to 0.757)** | 0.470 (0.263 to 0.841)** |
| Income | |||
| <$25 000 | Ref | Ref | Ref |
| $25 000–$34 999 | 1.21 (0.813 to 1.81) | 1.31 (8.55 to 2.01) | 1.44 (0.922 to 2.25) |
| $35 000–$49 999 | 1.00 (0.686 to 1.47) | 1.09 (0.741 to 1.60) | 1.20 (0.815 to 1.75) |
| $50 000–$74 999 | 0.718 (0.363 to 1.42) | 0.819 (0.388 to 1.73) | 0.871 (0.425 to 1.78) |
| >$75 000 | 1.03 (0.511 to 2.09) | 1.14 (0.546 to 2.39) | 1.27 (0.596 to 2.70) |
| Occupational status | |||
| Employed | Ref | Ref | Ref |
| Not employed | 1.44 (0.988 to 2.11) | 1.48 (0.988 to 2.21) | 1.43 (0.958 to 2.15) |
| Not in the labour force | 1.18 (0.854 to 1.63) | 1.17 (0.837 to 1.63) | 1.15 (0.811 to 1.63) |
| Ethnicity | |||
| African-American | Ref | Ref | Ref |
| Caribbean Black | 0.861 (0.555 to 1.34) | 0.909 (0.581 to 1.42) | 0.933 (0.592 to 1.47) |
| Discrimination | |||
| No | Ref | Ref | |
| Yes | 1.73 (1.01 to 2.96)* | 1.54 (0.887 to 2.67) | |
| Neighbourhood crime problem | 1.02 (0.866 to 1.19 | 0.996 (0.851 to 1.17) | |
| Neighbourhood drug problem | 1.19 (0.968 to 1.47) | 1.19 (0.969 to 1.45) | |
| Severe IPV | |||
| No | Ref | ||
| Yes | 2.65 (1.86 to 3.75)*** | ||
| Model F statistic, p value | F=3.31, p<=0.00 | F=7.78, p<=0.00 | F=14.74, p<=0.00 |
*p<0.05; ** p<0.01; ***p<0.001.
IPV, intimate partner violence; NSAL, National Survey of American Life.
Full article at: http://goo.gl/TjL75K
By:
1University of Michigan, Institute for
Social Research, Program for Research on Black Americans, Ann Arbor, Michigan,
USA
2College of Pharmacy and Health Sciences,
Wayne State University, Detroit, Michigan, USA
3Rutgers, The State University of New
Jersey, Edward J. Bloustein School of Planning and Public Policy &
Institute for Health, Health Care Policy & Aging Research, New Brunswick,
New Jersey, USA
4University of Michigan, Institute for
Social Research, Ann Arbor, Michigan, USA
Correspondence to Krim K Lacey; Email: moc.liamg@yecalmirk
More at: https://twitter.com/hiv_insight
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