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Large, pervasive, and persistent racial inequalities exist in the onset, courses, and outcomes of illness. A comprehensive understanding of the patterning of racial disparities indicates that racism in both its institutional and individual forms remains an important determinant. There is an urgent need to build the science base that would identify how to trigger the conditions that would facilitate needed societal change and to identify the optimal interventions that would confront and dismantle the societal conditions that create and sustain health inequalities. (Contains 2 tables.)

Repetitive dynamic two-photon imaging of retinoid cycle fluorophores and subcellular details of their location within the retinal pigment epithelium in intact eyes of live mice. Two-photon excitation microscopy can image retinal molecular processes in vivo. Intrinsically fluorescent retinyl esters in subcellular structures called retinosomes are an integral part of the visual chromophore regeneration pathway. Fluorescent condensation products of all-trans-retinal accumulate in the eye with age and are also associated with age-related macular degeneration (AMD). Here, we report repetitive, dynamic imaging of these compounds in live mice through the pupil of the eye. By leveraging advanced adaptive optics, we developed a data acquisition algorithm that permitted the identification of retinosomes and condensation products in the retinal pigment epithelium by their characteristic localization, spectral properties and absence in genetically modified or drug-treated mice. This imaging approach has the potential to detect early molecular changes in retinoid metabolism that trigger light- and AMD-induced retinal defects and to assess the effectiveness of treatments for these conditions., Author(s): Grazyna Palczewska [sup.1] , Zhiqian Dong [sup.1] , Marcin Golczak [sup.2] , Jennifer J Hunter [sup.3] [sup.4] [sup.5] , David R Williams [sup.3] [sup.6] , Nathan S Alexander [sup.2] [...]

This article explores the potential benefits and defined risks associated with prophylactic surgical procedures for astronauts before extended-duration space flight. This includes, but is not limited to, appendectomy and cholecystesctomy. Furthermore, discussion of treatment during space flight, potential impact of an acute illness on a defined mission and the ethical issues surrounding this concept are debated in detail. Cet article explore les avantages possibles et les risques definis associes a des interventions chirurgicales prophylactiques (notamment appendicectomie et cholecystectomie) chez les astronautes devant effectuer des sejours prolonges dans l'espace. Le traitement pendant le sejour dans l'espace, les repercussions eventuelles d'une maladie grave au cours d'une mission particuliere et les enjeux ethiques entourant la question y sont debattus en profondeur., The potential to regularly extend human space flight beyond low-earth orbit is current. In the coming years, the National Aeronautics and Space Administration (NASA) in the United States and similar [...]

We analyze data from the South African Stress and Health Study, a nationally representative in-person psychiatric epidemiologic survey of 4,351 adults conducted as part of the World Mental Health Survey Initiative between January 2002 and June 2004. AII blacks (Africans, Coloreds, and Indians) initially report higher levels of non-specific distress and anger/hostility than whites. Access to socioeconomic resources helps explain differences in non-specific distress between Coloreds and whites and Indians and whites. However, only when social stressors are considered do we find few differences in psychological distress (i.e., non-specific distress and anger/hostility) between Africans and whites. In addition, self-esteem and mastery have independent effects on non-specific distress and anger/hostility, but differences between Coloreds and whites in feelings of anger/hostility are not completely explained by self-esteem and mastery. The findings contribute to the international body of work on social stress theory, challenge underlying assumptions of the minority status perspective, and raise a series of questions regarding mental health disparities among South Africans. Keywords life events, psychological distress, race, South Africa, stress DOI: 10.1177/0022146510386795

Multiphoton excitation fluorescence microscopy (MPM) can image certain molecular processes in vivo. In the eye, fluorescent retinyl esters in subcellular structures called retinosomes mediate regeneration of the visual chromophore, 11-cis-retinal, by the visual cycle. But harmful fluorescent condensation products of retinoids also occur in the retina. We report that in wild-type mice, excitation with a wavelength of ~730 nm identified retinosomes in the retinal pigment epithelium, and excitation with a wavelength of ~910 nm revealed at least one additional retinal fluorophore. The latter fluorescence was absent in eyes of genetically modified mice lacking a functional visual cycle, but accentuated in eyes of older wild-type mice and mice with defective clearance of all-frans-retinal, an intermediate in the visual cycle. MPM, a noninvasive imaging modality that facilitates concurrent monitoring of retinosomes along with potentially harmful products in aging eyes, has the potential to detect early molecular changes due to age-related macular degeneration and other defects in retinoid metabolism., High-resolution noninvasive imaging has become an essential method for understanding complex biological systems in experimental cell lines and is used with increasing frequency in tissues and live animals (1-5). These [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2010.08.015 Byline: Natalie Slopen (a), David R. Williams (a), Soraya Seedat (b), Hashim Moomal (c), Allen Herman (d), Dan J. Stein (e) Abstract: Extensive epidemiologic research from the United States demonstrates that childhood adversities (CAs) are predictive of several psychiatric outcomes, including depression, anxiety, substance abuse, and externalizing disorders. To date, this has not been explored in a national sample of adults in South Africa. The present study examined the joint predictive effects of 11 retrospectively reported CAs on the first onset of DSM-IV disorders in the South Africa Stress and Health Study (SASH), a nationally representative sample of adults. We utilized substantively plausible regression models of joint CA effects that account for the comorbidity between individual CAs; outcomes included DSM-IV anxiety disorders, mood disorders, substance use disorders, and externalizing disorders measured with the WHO Composite International Diagnostic Interview. The results indicated that experiences of CA varied by race, and many CAs were correlated with one another. The best-fitting model for first onset of any disorder included separate indicators for each type of CA, in addition to indicator variables for the number of other CAs reported. Results disaggregated by class of disorder showed that the majority of CAs with significant odds ratios only predicted anxiety disorder. Results disaggregated by life course stage of first onset showed that significant effects of CAs can be observed at each stage of the life course. This study contributes to a growing body of research on the social determinants of mental health in South Africa. Our findings illustrate the importance of utilizing a model that accounts for the clustering and accumulation of CAs, and suggest that a variety of CAs predict onset of mental disorders, particularly anxiety disorders, at several stages of the life course. Author Affiliation: (a) Harvard School of Public Health, Harvard University, 677 Huntington Ave., Boston, MA 02115, United States (b) University of Stellenbosch, Stellenbosch, South Africa (c) University of Witwatersrand, Johannesburg, South Africa (d) National School of Public Health, MEDUNSA, Pretoria, South Africa (e) University of Cape Town, Cape Town, South Africa

We examine several potential mechanisms linking religious involvement to depressive symptoms, major depression, and anxiety. Logistic and OLS regression estimations test five sets of potential psychosocial religion mediators: perceived attitudes toward and motivations for attendance; positive and negative religious coping; religious attitudes, beliefs, and spirituality; congregational support and criticism; and interpersonal and self-forgiveness. Compared to attending services less than once a month or never, attending services once a week but no more is associated with fewer depressive symptoms and anxiety symptoms. Hypothesized mediators, including meaning, interpersonal and self-forgiveness, congregational criticism, social attendance beliefs, and negative coping are independently associated with one or more mental health outcomes. Keywords religion, mental health, religious aspects, religion and health DOI: 10.1177/0022146510378237

Objective: High rates of alcohol use and alcohol-use disorders have been noted in South Africa. Although a number of risk factors for alcohol use and abuse/dependence have been identified, there is a lack of information regarding risk factors for progression through the different stages of alcohol use and alcohol-use disorders. Our aim was to examine sociodemographic predictors of transition across stages of alcohol use, abuse and dependence (according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), and remission in the South African population. Method: A national probability sample of 4,315 adult South Africans was administered Version 3.0 of the World Health Organization Composite International Diagnostic Interview. Results: We found high rates of transition from regular alcohol use to abuse but low rates from alcohol abuse to dependence. All stages of alcohol use and alcohol-use disorders were more common in younger than in older respondents at comparable time points. Younger age (below 50), male gender, lower education, and having been a student were all associated with ever using alcohol, but only male gender was associated with the transition to regular use and abuse. Furthermore, younger age and late age at onset of alcohol abuse were associated with remission from abuse. Conclusions: The importance of socio-demographic predictors appears to vary across stages of alcohol use and could be used to guide the precision of intervention strategies., THE SOUTH AFRICAN Demographic and Health Survey in 1998 found that 45% of men and 17% of women were current drinkers (Parry et al., 2005) and the more recent South [...]

Researchers have established the role of heredity and lifestyle in the occurrence of hypertension, but the potential role of psychosocial factors, especially religiosity, is less understood. This paper analyzes the relationship between multiple dimensions of religiosity and systolic blood pressure, diastolic blood pressure, and hypertension using data taken from the Chicago Community Adult Health Study, a probability sample of adults (N = 3105) aged 18 and over living in the city of Chicago, USA. Of the primary religiosity variables examined here, attendance and public participation were not significantly related to the outcomes. Prayer was associated with an increased likelihood of hypertension, and spirituality was associated with increased diastolic blood pressure. The addition of several other religiosity variables to the models did not appear to affect these findings. However, variables for meaning and forgiveness were associated with lower diastolic blood pressure and a decreased likelihood of hypertension outcomes. These findings emphasize the importance of analyzing religiosity as a multidimensional phenomenon. This study should be regarded as a first step toward systematically analyzing a complex relationship. Keywords: Religion Religiosity Blood pressure Hypertension USA

To assess the levels of perceived acute and chronic racial and non-racial discrimination in South Africa, their association with health, and the extent to which they contribute to racial differences in physical and mental health, data were used from a national probability sample of adults, the South African Stress and Health Study (SASH). All Black groups in South Africa (African, Coloured and Indian) were two to four times more likely than Whites to report acute and chronic experiences of racial discrimination. Africans and Coloureds report higher levels of ill health than Whites, but acute and chronic racial discrimination were unrelated to ill health and unimportant in accounting for racial differences in self-rated health. In contrast, all Black groups had higher levels of psychological distress than Whites, and perceived chronic discrimination was positively associated with distress. Moreover, these experiences accounted for some of the residual racial differences in distress after adjustment for socioeconomic status. Our main findings indicate that, in a historically racialized society, perceived chronic racial and especially non-racial discrimination acts independently of demographic factors, other stressors, psychological factors (social desirability, self-esteem and personal mastery), and multiple SES indicators to adversely affect mental health. Keywords: South Africa Perceived Discrimination Race Mental health Distress South African Stress and Health Study (SASH)

There is substantial evidence from developed countries that lower socioeconomic status (SES) is associated with increased occurrence of mental illness, and growing interest in the role of social support and social capital in mental health. However, there are few data on social determinants of mental health from low- and middle-income nations. We examined the association between psychological distress and SES, social support and bonding social capital in a nationally-representative sample of South African adults. As part of a national survey of mental health, a probability sample of 4351 individuals was interviewed between 2002 and 2004. Non-specific psychological distress was measured using the Kessler K-10 scale. SES was assessed from an aggregate of household income, individual educational and employment status, and household material and financial resources. Social support, bonding social capital and traumatic life events were measured using multi-item scales. The mean age in the sample was 37 years and 76% of participants were black African. Measures of SES and social capital were inversely associated (p < 0.001). Both recent and traumatic life events were more common among individuals with low levels of SES and social support. After adjusting for participant demographic characteristics and life events, high levels of psychological distress were most common among individuals with lower levels of SES and social capital. There was no independent association between levels of social support and psychological distress. The occurrence of recent life events appeared to partially mediate the association between SES and psychological distress (p = 0.035) but not the association involving social capital (p = 0.40). These data demonstrate persistent associations between levels of SES, social capital and psychological distress in South Africa. The increased frequency of recent life events appears to only partially explain higher levels of psychological distress among individuals of lower SES. Additional research is required to understand the temporality of this association as well as mechanisms through which SES and social capital influence mental health in low- and middle-income settings where high levels of poverty and trauma may contribute to excess burden of mental illness. Keywords: Psychological distress; Mental health; Socioeconomic status (SES); Social support; Social capital; South Africa

The spatial segregation of the US population by socioeconomic position and especially race/ethnicity suggests that the social contexts or 'neighborhoods' in which people live may substantially contribute to social disparities in hypertension. The Chicago Community Adult Health Study did face-to-face interviews, including direct measurement of blood pressure, with a representative probability sample of adults in Chicago. These data were used to estimate socioeconomic and racial-ethnic disparities in the prevalence, awareness, treatment, and control of hypertension, and to analyze how these disparities are related to the areas in which people live. Hypertension was significantly negatively associated with neighborhood affluence/gentrification, and adjustments for context eliminated the highly significant disparity between blacks/African-Americans and whites, and reduced the significant educational disparity by 10-15% to borderline statistical significance. Awareness of hypertension was significantly higher in more disadvantaged neighborhoods and in places with higher concentrations of blacks (and lower concentrations of Hispanics and immigrants). Adjustment for context completely eliminated blacks' greater awareness, but slightly accentuated the lesser awareness of Hispanics and the greater levels of awareness among the less educated. There was no consistent evidence of either social disparities in or contextual associations with treatment of hypertension, given awareness. Among those on medication, blacks were only 40-50% as likely as whites to have their hypertension controlled, but context played little or no role in either the level of or disparities in control of hypertension. In sum, residential contexts potentially play a large role in accounting for racial/ethnic and, to a lesser degree, socioeconomic disparities in hypertension prevalence and, in a different way, awareness, but not in treatment or control of diagnosed hypertension. Keywords: Neighborhoods; Social disparities; Multi-level modeling; Health inequalities; Hypertension; Blood pressure

Low-income African American mothers of young children experience high rates of depression, but many of the risk factors that have been identified provide little direction for intervention. The authors examined modifiable risk and protective factors for probable depression (Center for Epidemiological Studies Depression Scale [greater than or equal to] 23) in 824 African American mothers living in the 39 poorest census tracts in Detroit. Household food insufficiency and deteriorated housing significantly increased the odds of likely depression, whereas availability of a loan in a crisis, help with childcare, and transportation were protective. However, more frequent experiences of everyday discrimination greatly increased the odds of elevated depressive symptoms. These findings support the need for interventions that operate across individual and societal levels to address the fundamental causes of poor mental health. Keywords: depression, mothers, African American, socioeconomic status, discrimination

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2006.04.008 Byline: Luisa N. Borrell (a), Catarina I. Kiefe (b), David R. Williams (c), Ana V. Diez-Roux (c), Penny Gordon-Larsen (d) Keywords: Racial discrimination; Racism; Skin color; Physical health; Mental health; African Americans; Gender; USA Abstract: This study investigates the association between self-reported physical and mental health and both perceived racial discrimination and skin color in African American men and women. We used data from the longitudinal coronary artery risk development in young adults study (CARDIA) in African American men and women (n=1722) in the USA. We assessed self-reported mental and physical health status and depressive symptoms at the Year 15 (2000-2001) follow-up examination using the Medical Outcomes Study Short Form (SF-12) and the Center for Epidemiologic Studies Depression scale. Skin color was measured at the Year 7 examination (1992-1993). To assess racial discrimination, we used a summary score (range 0-21) for 7 questions on experiencing racial discrimination: at school, getting a job, getting housing, at work, at home, getting medical care, on the street or in a public setting. Self-reported racial discrimination was more common in men than in women (78.1% versus 73.0%, p Author Affiliation: (a) Columbia University New York, NY, USA (b) University of Alabama, USA (c) University of Michigan, USA (d) University of North Carolina, USA

Household food insufficiency is a significant problem in the United States, and has been associated with poor outcomes on mental health indicators among low-income women. However, it is difficult to disentangle the mental health consequences of household food insufficiency from poverty and other shared risk factors. Drawing on theories of the social production of health and disease, research evidence linking food insufficiency with poor mental health, and high rates of food insufficiency among welfare recipients, we examined whether a change in household food insufficiency is associated with a change in women's self-reported mental health in a sample of current and recent welfare recipients over a 3-year period of time, controlling for common risk factors. Data were obtained from a prospective survey of women who were welfare recipients in an urban Michigan county in February 1997 (n = 753). We estimated fixed effect models for changes in mental health status that make use of information on household food insufficiency gathered in the fall of 1997, 1998, and 1999. The relationship between household food insufficiency and respondents' meeting the diagnostic screening criteria for major depression remained highly significant even when controlling for factors known to confer increased risk of depression and time invariant unobserved heterogeneity. These findings add to growing evidence that household food insufficiency has potentially serious consequences for low-income women's mental health. If confirmed by further research, they suggest that the public health burden of depression in welfare recipients and other low-income women could be reduced by policy-level interventions to reduce their exposure to household food insufficiency. Keywords: Food insufficiency; Food security; Low-income women; Mental health; Depression; USA

This article provides an overview of racial and ethnic disparities in health in the United States. It describes limitations linked to the quality and method of presentation of the available data. It also considers the complex ways in which immigrant status, race, and SES combine to affect health and outlines important directions for research that would enhance our understanding of the ways in which social factors can lead to changes in health status.

It has been hypothesized that exposure to stress and negative life events is related to poor health outcomes, and that differential exposure to stress plays a role in socioeconomic disparities in health. Data from three waves of the Americans' Changing Lives study (n = 3,617) were analyzed to investigate prospectively the relationship among socioeconomic indicators, five measures of stress/negative life events, and the health outcomes of mortality, functional limitations, and self-rated health. The results revealed that (1) life events and other types of stressors are clearly related to socioeconomic position; (2) a count of negative lifetime events was positively associated with mortality; (3) a higher score on financial stress scale was predictive of severe/moderate functional limitations and fair/poor self-rated health at wave 3, and (4) a higher score on a parental stress scale was predictive of fair/poor self-rated health at wave 3. The negative effects of low income on functional limitations attenuated to insignificance when waves 1 and 2 stress/life event measures were controlled for, but other socioeconomic disparities in health change remained sizable and significant when adjusted for exposure to stressors. The results support the hypothesis that differential exposure to stress and negative life events is one of many ways in which socioeconomic inequalities in health are produced in society.

Our objectives were to describe the trajectories of biological risk factors of cardiovascular disease in young adults, and to study the association of socioeconomic status (SES) with aggregate risk scores that summarize longitudinal risk accumulation from multiple risk factors. We used data from a prospective, bi-racial, cohort study of 18 30-year-old adults in the USA, initiated in 1985, with 10-year follow-up. SES was measured by parental education level, financial hardship during the study, and the participant's education level by the end of the study. We studied growth patterns of seven biological risk factors for cardiovascular disease using a semi-parametric, class-mixture model to identify clusters of individuals with distinct growth trajectories. Risk scores that summarize risk from all seven risk factors were created to reflect risk at baseline, longitudinal risk change over 10 years, and total accumulated risk. Multivariable regression was used to study their associations with SES within each race/gender group. We found tracking of all seven risk factors: in each case, the cluster with the highest baseline value maintained its position as the highest-risk cluster over the next 10 years. After adjustment for age, lifestyle, and healthcare access, SES was associated inversely with baseline risk score in women (black and white), with risk change score in all four race/gender groups, and with accumulated risk score in women (black and white) and in white men. Our findings suggest that individuals with high overall cardiovascular risk in midlife can be identified by their relatively higher values of risk lectors in younger ages and that socioeconomic differences in cardiovascular risk start accumulating early in life. Keywords: Socioeconomic status; Cardiovascular risk factors; Longitudinal risk accumulation; Growth trajectories; Tracking; USA

Research and theory increasingly suggest that attendance at religious services is protective against premature mortality. However, prior studies are limited and do not extensively explore potential explanations for the relationship, especially in terms of religious beliefs and behaviors associated with service attendance. This study estimates the impact of service attendance on mortality in a national probability sample and provides the most extensive empirical examination of potential explanations. Individuals who report attending religious services once a month or more (just over 50 percent of the population) have a 30-35 percent reduced risk of death over a 7.5 year follow-up period after adjusting for potential confounding factors. Consistent with prior research, 20-30 percent of this effect may be explained by better health behaviors (especially physical activity) among regular service attendees. Surprisingly, other religious beliefs and behaviors do not explain, and often tend to suppress, the association between service attendance and mortality.

Food insufficiency is a significant problem in the United States, and poor African American women with children are at especially high risk. An inadequate household food supply can potentially affect the well-being of household members, but it is difficult to distinguish the effects of food insufficiency from risk factors for poor health that are also common among the food insufficient, such as poverty. We examined food insufficiency and physical and mental health among African American and white women (n = 676) who were welfare recipients in 1997. Controlling for common risk factors, women who reported food insufficiency in both 1997 and 1998 were more likely to report fair or poor health at the later date. Food insufficiency in 1998 was significantly associated with meeting the diagnostic screening criteria for recent major depression. Food insufficiency at both times and in 1998 only was related to women's sense of mastery. These findings add to growing evidence that household food insufficiency is associated with poor physical and mental health.

The study reported in this article examined the prevalence of mental health disorders and the sociodemographic factors associated with having a mental health disorder in a probability sample of 185 African American and white single mothers. Logistic regression analyses revealed that race (being white) and being on welfare were associated with increased risk of having a mental health disorder, when controlling for other sociodemographic variables. The association of welfare status and psychiatric disorders highlights the need for access to mental health services for this population. Implications for low-income women making the transition from welfare to employment are discussed. Key words: low-income women mental health substance dependence welfare, Welfare mothers experience more psychological distress and psychiatric disturbances than other groups (Bassuk, Buckner, Perloff, & Bassuk, 1998; Berton & Staab, 1996; Tolman & Rosen, 2001). Jayakody, Danziger, and Pollack [...]

Life course-informed theories of development suggest it is important to integrate information about positive and negative aspects of the social environment into studies of child and parental wellbeing, including both stressors that compromise health and resources that promote well-being. We recruited a sample of 169 pairs of caregivers and young children (birth to 5 years) from a community health clinic and administered survey questions to assess stressors and resources. We constructed inventories of stressors and resources and examined the relationships between these inventories and caregivers' depressive symptoms, anxiety symptoms, and sleep problems, and young children's medical diagnoses derived from electronic health records. Cumulative stressors and resources displayed bivariate and adjusted associations with caregivers' depressive symptoms, anxiety symptoms, and sleep problems. For depressive and anxiety symptoms, these associations were evident in models that included stressors and resources together. Caregivers with high stressors and low resources displayed the highest levels of depressive and anxiety symptoms and sleep problems. In terms of children's health outcomes, only modest trends were evident for developmental/mental health outcomes, but not other diagnostic categories. Future studies are needed to examine stressors and resources together in larger samples and in relation to prospectively assessed measures of child well-being. [ABSTRACT FROM AUTHOR]

African Americans in the United States have a higher than average risk of morbidity and mortality, despite declining mortality rates for many causes of death for the general population. This article examines race-based residential segregation as a fundamental cause of racial disparities, shaping differences in exposure to, and experiences of, diseases and risk factors. The spatial distribution of racial groups, specifically the residential segregation of African Americans in aging urban areas, contributes to disparities in health by influencing access to economic, social, and physical resources essential to health. Using the Detroit metropolitan area as a case study, this article looks at the influences of the distribution of African American and white residents on access to these resources and discusses the implications for urban policies to reduce racial disparities in health status.

Depression is highly prevalent in welfare recipients, and is associated with failure to move from welfare to work. This paper examines the relationship between social and environmental factors in a large, community-based sample of mothers who currently or recently received welfare benefits. Specific and modifiable risk factors related to poverty, gender, and race were found to predict major depression beyond traditional risk factors. Research and practice implications are discussed.

The survey data presented here are on the national prevalences of major lifetime perceived discrimination and day-to-day perceived discrimination; the associations between perceived discrimination and mental health; and the extent to which differential exposure and differential emotional reactivity to perceived discrimination account for the well-known associations between disadvantaged social status and mental health. Although more prevalent among people with disadvantaged social status, results show that perceived discrimination is common in the total population, with 33.5 percent of respondents in the total sample reporting exposure to major lifetime discrimination and 60.9 percent reporting exposure to day-to-day discrimination. The associations of perceived discrimination with mental health are comparable in magnitude to those of other more commonly studied stressors, and these associations do not vary consistently across subsamples defined on the basis of social status. Even though perceived discrimination explains only a small part of the observed associations between disadvantaged social status and mental health, given its high prevalence, wide distribution, and strong associations with mental health, perceived discrimination needs to be treated much more seriously than in the past in future studies of stress and mental health.

Despite considerable evidence documenting a strong and persistent relationship between socioeconomic position and mortality, recent research suggests that this association may be weaker among women. In our examination of gender differences in the socioeconomic gradient in mortality, we argue that this inconsistency arises from the failure to consider the ways in which gender is a fundamental constituent of socioeconomic position. The data used are from the Panel Study of Income Dynamics. Respondents, including all household heads and their partners, aged 29 years and older in 1972 (N = 5,665; 56% female), were followed until 1991, death, or attrition. Discrete time event history analysis was used to examine the predictors of death between 1972 and 1991. Of the key socioeconomic predictors, years of education was measured at baseline, while earned income was a time-varying covariate. We find no gender differences in the effect of respondents' own socioeconomic positions on their mortality risk. However, increasing spousal income raises men's odds of dying, while the opposite is true for women. Our results raise questions about the prevailing view that the socioeconomic gradient in mortality is weaker among women. Moreover, gender differences in the effects of spousal earnings on mortality risk suggest that their labor market rewards have fundamentally different meanings for women and men.

This paper examines the association between marital status and psychiatric disorder for Blacks and explores the extent to which these patterns differ from those for Whites. Widowed and separated/divorced Black males and females have higher rates of disorder than the married; never-married Blacks do not have an elevated risk of psychiatric illness. The association between marital status and disorder for White males is similar and stronger than that observed for Blacks. For White women, the separated/divorced have a higher risk of disorder than the married, and unmarried White females have higher rates of the substance abuse disorders, but lower rates of the anxiety disorder than the married. Across all marital status groups, Black males and White males have higher rates of disorder (except for depression), than females. A complex pattern emerges when gender differences in the relative rates of disorder for unmarried Blacks compared to married Blacks are considered. Separated/divorced Black men, widowed Black women, and never-married Black men are worse off than their respective peers. Except for the separated/divorced, opposite patterns are evident for Whites. Directions for further research are outlined.

This paper examones the effect of religious attendance and affiliation on psychological distress in a longitudinal community study of 720 adults. Religious affiliation is unrelated to mental health status. In contrast, although religious attendance does not directly reduce psychological distress, it buffers the deleterious effects of stress on mental health. That is, in the face of stressful events and physical health problems, religious attendance reduces the adverse consequences of these stressors on psychological well-being.

Objective: The present study examined forgiveness of others, self-forgiveness, sleep, and health in a nationally representative sample of United States adults. It was hypothesised that sleep would mediate the associations of forgiveness of others and self-forgiveness with health. Design: A nationally representative survey of 1,423 United States adults. Main Outcome Measures: Measures included forgiveness of others, self-forgiveness, sleep quantity, sleep quality, psychological distress, life satisfaction, and self-rated physical health. Results: Forgiveness of others (β =.20, p <.001) and self-forgiveness (β =.11, p <.01) were associated with sleep and forgiveness of others (β =.24, p <.001) and self-forgiveness (β =.27, p <.001) were associated with health. Sleep was associated with health (β =.45, p <.001) and also acted as a mediator of the associations of forgiveness of others (β =.09, p <.01) and self-forgiveness (β =.05, p <.01) with health. Conclusions: Forgiveness of others and self-forgiveness may attenuate emotions such as anger, regret, and rumination and provide a buffer between one's own and others' offenses occurring during the day and offer a restful mental state that supports sound sleep which, in turn, is associated with better health. [ABSTRACT FROM AUTHOR]

Background: To provide an overview of the empirical research linking self-reports of racial discrimination to health status and health service utilization.Methods: A review of literature reviews and meta-analyses published from January 2013 to 2019 was conducted using PubMed, PsycINFO, Sociological Abstracts, and Web of Science. Articles were considered for inclusion using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) framework.Results: Twenty-nine studies met the criteria for review. Both domestic and international studies find that experiences of discrimination reported by adults are adversely related to mental health and indicators of physical health, including preclinical indicators of disease, health behaviors, utilization of care, and adherence to medical regimens. Emerging evidence also suggests that discrimination can affect the health of children and adolescents and that at least some of its adverse effects may be ameliorated by the presence of psychosocial resources.Conclusions: Increasing evidence indicates that racial discrimination is an emerging risk factor for disease and a contributor to racial disparities in health. Attention is needed to strengthen research gaps and to advance our understanding of the optimal interventions that can reduce the negative effects of discrimination. [ABSTRACT FROM AUTHOR]

This review discusses about the research in space medicine and its impact on the safety of astronauts and cosmonauts and success of future space missions. Research addresses the health effects of adaptaion to microgravity, pharmacodynamics changes, monitoring spacecraft environment and its personnel.

This study investigated the hypothesis that socioeconomic differences in health status change can largely be explained by the higher prevalence of individual health-risk behaviors among those of lower socioeconomic position. Data were from the Americans' Changing Lives study, a longitudinal survey of 3617 adults representative of the US noninstitutionalized population in 1986. The authors examined associations between income and education in 1986, and physical functioning and self-rated health in 1994, adjusted for baseline health status, using a multinomial logistic regression framework that considered mortality and survey nonresponse as competing risks. Covariates included age, sex, race, cigarette smoking, alcohol consumption, physical activity, and Body Mass Index. Both income and education were strong predictors of poor health outcomes. The four health-risk behaviors under study statistically explained only a modest portion of the socioeconomic differences in health at follow-up. For example, after adjustment for baseline health status, those in the lowest income group at baseline had odds of moderate/severe functional impairment in 1994 of 2.11 (95% C.I.: 1.40, 3.20) in an unadjusted model and 1.89 (95% C.I.: 1.23, 2.89) in a model adjusted for health-risk behaviors. The results suggest that the higher prevalence of major health-risk behaviors among those in lower socioeconomic strata is not the dominant mediating mechanism that can explain socioeconomic disparities in health status among US adults. Keywords: Socioeconomic disparities; Poverty; Health status change; Health-risk behaviors; Longitudinal studies; USA

This paper explores the relationships among neighborhood disadvantage, stress, and the likelihood of drug use in a sample of adults (N = 1,101). Using the 1995 Detroit Area Study in conjunction with tract-level data from the 1990 census, we find a positive relationship between neighborhood disadvantage and drug use, and this relationship remains statistically significant net of controls for individual-level socioeconomic status. Neighborhood disadvantage is moderately associated with drug related behaviors, indirectly through increased social stressors and higher levels of psychological distress among residents of disadvantaged neighborhoods. A residual effect of neighborhood disadvantage remains, net ora large number of socially relevant controls. Finally, results from interactive models suggest that the relationship between neighborhood disadvantage and drug use is most pronounced among individuals with lower incomes.

Poor women with children are disproportionately represented among the food insufficient. Recent research has linked food insufficiency with dietary deficiencies, but further research linking this problem to health and mental health problems is needed to inform health and social policy. We analyzed the relationship between food insufficiency and physical and mental health in a random sample of 724 single women who were welfare recipients in February, 1997. Food insufficiency was significantly associated with poor or fair self-rated health and physical limitations, and with respondents' meeting DSM-III-R criteria for recent major depression. Although the cross-sectional design of this study precludes causal inference, these findings add to a growing body of evidence that food insufficiency is associated with serious adverse physical and mental health consequences. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: Website: KEYWORDS. Food insufficiency, women, health status, depression, poverty

Background Sleep benefit ( SB) in Parkinson's disease refers to improved motor symptoms upon waking despite an entire night without medications. Although it was first proposed 30 years ago, this phenomenon proved difficult to investigate, and its true prevalence and underlying mechanisms remain unclear. Objective This study aimed to identify and quantify SB through measurement of motor function using a validated smartphone application and to identify disease characteristics that predicted SB. Methods Ninety-two patients recruited from 2 Movement Disorder Services were clinically assessed at home using a validated smartphone application. Each patient was tested in the on-state, at the end of dose, and on waking (before medications) 3 times. Differences between the 3 states were used to determine the impact of sleep and levodopa on motor function. SB was considered to be a 'measurable improvement in parkinsonism from the end of dose.' Results The morning waking motor function of 20 patients (22%) improved compared with the end-of-dose function, with 9 patients demonstrating superior function compared with their on-state. No clinical features predicted SB. Although all participants subjectively reported motor fluctuations, only 35 patients (38%) demonstrated an objective improvement with levodopa. Patients who had SB more often demonstrated objective motor fluctuations compared with those who did not (65% vs. 31%; P = 0.008). Conclusions SB is a genuine motor phenomenon: 1 in 5 patients have a measurable improvement in motor function on waking. It remains questionable whether this improvement is a direct effect of sleep. Until its underlying mechanism is better understood, it is more appropriate to refer to this phenomenon as simply morning improvement or diurnal fluctuation of motor symptoms. [ABSTRACT FROM AUTHOR]