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Purpose: Depressive symptomatology during pregnancy has been associated with negative health outcomes for both the mother and child. This study examines the potential associations between depression and depressive symptoms in poor women and African-American women and their lifelong experiences of discrimination., Methods: Data from 2,731 African-American and White participants in the Pregnancy Outcomes and Community Health Study were analyzed. Multiple regression analyses were used to investigate relations between depressive symptoms and total discrimination, and between depressive symptoms and 3 discrimination types (gender, race, and socioeconomic)., Main Findings: Initial results showed that African-American women had higher levels of depressive symptoms than White women. Self-reported total discrimination and discrimination types were each positively associated with depressive symptomatology in all women. After adjusting for sociodemographic characteristics (maternal age, education, employment status, partner status, and Medicaid status) and examining significant interactions, the race difference in depressive symptomatology was evident only in employed women. The addition of total discrimination to the multicovariate model eliminated race differences in the adjusted mean level of depressive symptoms. When the 3 discrimination types were modeled simultaneously with all other covariates, only gender and economic discrimination remained positively associated with depressive symptoms in African-American and White women., Conclusions: These results should be cautiously interpreted because of 1) the study design--namely, ascertainment of maternal discrimination and depressive symptoms at a single time point; and 2) limitations of the discrimination measure. Despite these limitations, the study points to potential links between lifetime discrimination and depressive symptoms in pregnancy.

This investigation focuses on the relationship between racial discrimination and health. Many studies have shown a link between race and differential health outcomes, but few have actually measured racial discrimination. Such studies leave unanswered the question of exactly how the experience of racial discrimination might affect health. Racial discrimination is argued to act in the same fashion as other chronic stressors by increasing blood pressure. However, racial discrimination may also give rise to the sense of thwarted aspirations, itself a stressor, and make the active coping style of "John Henryism" more likely. In these data, we measure perceived racial discrimination for a sample of African Americans and find that experiencing racially-based discriminatory treatment does not impact health. There is no relationship between doctor-diagnosed hypertension and cardiovascular disease, and being the victim of racially biased treatment. We discuss possible reasons for this, and argue that greater conceptualization about the postulated link between discrimination and health is necessary, as well as explicitly designed studies for the purpose of examining this postulated relationship.

The research on external (social system) and internal (personal) attributions to mental health outcomes for African Americans is reviewed. Although many blacks have aspirations that they are unable to achieve, the motivational and mental health consequences of this situation are unclear. Several researchers have suggested that it is adaptive for African Americans to reduce striving effort and bring personal goals more in line with the objective realities of an unfair opportunity structure. Others have proposed that because an unjust system is to blame, the most appropriate response is to work collectively with other group members to make the system more open to opportunities for advancement. Epidemiologic research on the relationship of internal-external locus of control to mental disorder has generally found that being internal has positive mental health effects; while having an external orientation is detrimental. This paper addresses these issues by demonstrating that the psychiatric-epidemiologic and the race-consciousness literatures lead to opposite predictions about the relationship of external attributions (fatalism and system blame) to mental health. The article concludes with a series of issues that need to be addressed in order to advance knowledge about social and psychological risk factors for psychiatric disorders in African Americans.

A three-wave panel study of auto plant closings focused on the mental health effects of unemployment on blue-collar workers. This paper explores how the impact of long-term unemployment varies across race and gender. We also examine whether other demographic factors can themselves modify the impacts of race and gender. Dependent variables include two measures of distress and two drinking measures. Results showed that the effect of long-term unemployment on distress and drinking was more severe among less educated workers, and responses of blacks were especially sensitive to level of education. In addition, men showed a greater association of long-term unemployment with depression (and to some extent anxiety) than did women. Marriage affected the responses of men but not of women, and of whites but not of blacks. Explanatory variables--the worker's experiences of financial hardship, other negative life events, and lack of a confidant--largely accounted for male-female differences. We conclude by discussing theoretical implications of these effects and address the limitations of the traditional term "vulnerability" in describing them.

Despite the many important benefits of leisure-time physical exercise on health, many Americans do not engage in exercise. This is more the case for the African-American population. This study assesses the impact of efficacy cognitions on leisure-time physical activity (LTPA) in an African-American sample. Our findings show that LTPA is predicted by the sense of efficacy in this African-American sample. Further analyses address significant factors in the prediction of the sense of efficacy. We find that the general sense of mastery predicts efficacy in this African-American sample. This may be especially significant for the African-American population. Also, analysis reveals surprising findings concerning characteristics predictive of efficacy cognitions. The highly educated are least likely to believe in the efficacy of preventive health behavior.

This paper considers the role of social mobility to hypertension among blacks. Using a nationally representative sample of the adult black population, this research finds no effects of intergenerational socioeconomic mobility. Minimal effects are found for geographic mobility; geographic moves bears a small positive relationship to hypertension. The implications for a theory of mobility effects on black health are discussed.

This study examines the relationship between anger expression and life stress in a nationally representative sample of black adults. Recent research of mostly white subjects has shown that anger-hostility, one of the components of the Type A behavioral pattern, is an important predictor of health problems. The findings of the present inquiry indicate that anger-hostility is an important predictor of life stress, and that people with higher levels of anger conflict are more likely to experience negative life events. Moreover, negative life events and anger are shown to be independent predictors of health problems among blacks. The implications of these results for future studies of the health of black Americans are discussed.

Using data from two national surveys, findings from this research indicated that blacks were more likely than whites to seek help from mental health professionals, particularly for economic and physical health problems. Blacks also sought help more often than whites from other sources of professional help, such as teachers, lawyers, social workers and emergency rooms. On the other hand, whites were more likely to seek help from medical sources for all types of problems, and from clergy members.

This study examined the relationship between anger expression, other psychosocial measures, and health problems in a nationally representative, cross-sectional sample of 1277 black adults. Subjects indicating a high level of outwardly expressed anger during a period in which they experienced a severe personal problem had a significantly higher number of health problems than their counterparts who expressed low and moderate levels of anger. Anger expression also significantly interacted with a measure of life strain (employment status) to predict health problems. Blacks who were unemployed were more likely to have a higher number of health problems if anger was expressed outwardly at a high level. The relationship was found to be independent of age, gender, urbanicity, smoking, and drinking problems. The overall pattern of the findings suggests that blacks who are at increased risk for health problems may be identified by how often anger is experienced and expressed during periods of emotional distress.