There has been a great deal of state-level legislative activity focused on immigration and immigrants over the past decade in the United States. Some policies aim to improve access to education, ...transportation, benefits, and additional services while others constrain such access. From a social determinants of health perspective, social and economic policies are intrinsically health policies, but research on the relationship between state-level immigration-related policies and Latino health remains scarce. This paper summarizes the existing evidence about the range of state-level immigration policies that affect Latino health, indicates conceptually plausible but under-explored relationships between policy domains and Latino health, traces the mechanisms through which immigration policies might shape Latino health, and points to key areas for future research. We examined peer-reviewed publications from 1986 to 2016 and assessed 838 based on inclusion criteria; 40 were included for final review. These 40 articles identified four pathways through which state-level immigration policies may influence Latino health: through stress related to structural racism; by affecting access to beneficial social institutions, particularly education; by affecting access to healthcare and related services; and through constraining access to material conditions such as food, wages, working conditions, and housing. Our review demonstrates that the field of immigration policy and health is currently dominated by a “one-policy, one-level, one-outcome” approach. We argue that pursuing multi-sectoral, multi-level, and multi-outcome research will strengthen and advance the existing evidence base on immigration policy and Latino health.
•State-level immigration and immigrant-focused policies influence Latino health.•Policies aimed at undocumented immigrants ‘spill over’ and affect all Latinos.•State-level immigration policies shape Latino health through four pathways.•Pathways include racism and access to institutions, healthcare, and material goods.
We examined whether sexual minority students living in states and cities with more protective school climates were at lower risk of suicidal thoughts, plans, and attempts.
Data on sexual orientation ...and past-year suicidal thoughts, plans, and attempts were from the pooled 2005 and 2007 Youth Risk Behavior Surveillance Surveys from 8 states and cities. We derived data on school climates that protected sexual minority students (e.g., percentage of schools with safe spaces and Gay-Straight Alliances) from the 2010 School Health Profile Survey, compiled by the Centers for Disease Control and Prevention.
Lesbian, gay, and bisexual students living in states and cities with more protective school climates reported fewer past-year suicidal thoughts than those living in states and cities with less protective climates (lesbians and gays: odds ratio OR = 0.68; 95% confidence interval CI = 0.47, 0.99; bisexuals: OR = 0.81; 95% CI = 0.66, 0.99). Results were robust to adjustment for potential state-level confounders. Sexual orientation disparities in suicidal thoughts were nearly eliminated in states and cities with the most protective school climates.
School climates that protect sexual minority students may reduce their risk of suicidal thoughts.
Background
Exposure to stress is potentially important in the pathway to alcohol use and alcohol use disorders. Stressors occur at multiple time points across the life course, with varying degrees of ...chronicity and severity.
Method
We review evidence from epidemiologic studies on the relationship between four different stressors (fateful/catastrophic events, child maltreatment, common adult stressful life events in interpersonal, occupational, financial, and legal domains, and minority stress) and alcohol consumption and alcohol use disorders.
Results
Studies generally demonstrate an increase in alcohol consumption in response to exposure to terrorism or other disasters. Research has demonstrated little increase in incident alcohol use disorders, but individuals with a history of alcohol use disorders are more likely to report drinking to cope with the traumatic event. Childhood maltreatment is a consistent risk factor for early onset of drinking in adolescence and adult alcohol use disorders, and accumulating evidence suggests that specific polymorphisms may interact with child maltreatment to increase risk for alcohol consumption and disorder. Stressful life events such as divorce and job loss increase the risk of alcohol disorders, but epidemiologic consensus on the specificity of these associations across gender has not been reached. Finally, both perceptions of discrimination and objective indicators of discrimination are associated with alcohol use and alcohol use disorders among racial/ethnic and sexual minorities.
Conclusion
Taken together, these literatures demonstrate that exposure to stress is an important component in individual differences in risk for alcohol consumption and alcohol use disorders. However, many areas of this research remain to be studied, including greater attention to the role of various stressors in the course of alcohol use disorders and potential risk moderators when individuals are exposed to stressors.
Emotion regulation deficits have been consistently linked to psychopathology in cross-sectional studies. However, the direction of the relationship between emotion regulation and psychopathology is ...unclear. This study examined the longitudinal and reciprocal relationships between emotion regulation deficits and psychopathology in adolescents.
Emotion dysregulation and symptomatology (depression, anxiety, aggressive behavior, and eating pathology) were assessed in a large, diverse sample of adolescents (N=1065) at two time points separated by seven months. Structural equation modeling was used to examine the longitudinal and reciprocal relationships between emotion dysregulation and symptoms of psychopathology.
The three distinct emotion processes examined here (emotional understanding, dysregulated expression of sadness and anger, and ruminative responses to distress) formed a unitary latent emotion dysregulation factor. Emotion dysregulation predicted increases in anxiety symptoms, aggressive behavior, and eating pathology after controlling for baseline symptoms but did not predict depressive symptoms. In contrast, none of the four types of psychopathology predicted increases in emotion dysregulation after controlling for baseline emotion dysregulation.
Emotion dysregulation appears to be an important transdiagnostic factor that increases risk for a wide range of psychopathology outcomes in adolescence. These results suggest targets for preventive interventions during this developmental period of risk.
► Emotion dysregulation predicts adolescent anxiety, aggression, and eating pathology. ► Emotion dysregulation is not associated with increases in depression. ► The presence of psychopathology does not predict increases in emotion dysregulation. ► Poor emotional understanding, expressive dysregulation, and rumination forma single latent factor. ► Emotion dysregulation is a risk factor for adolescent psychopathology.
There is a growing research literature suggesting that racism is an important risk factor undermining the health of Blacks in the United States. Racism can take many forms, ranging from interpersonal ...interactions to institutional/structural conditions and practices. Existing research, however, tends to focus on individual forms of racial discrimination using self-report measures. Far less attention has been paid to whether structural racism may disadvantage the health of Blacks in the United States. The current study addresses gaps in the existing research by using novel measures of structural racism and by explicitly testing the hypothesis that structural racism is a risk factor for myocardial infarction among Blacks in the United States. State-level indicators of structural racism included four domains: (1) political participation; (2) employment and job status; (3) educational attainment; and (4) judicial treatment. State-level racial disparities across these domains were proposed to represent the systematic exclusion of Blacks from resources and mobility in society. Data on past-year myocardial infarction were obtained from the National Epidemiologic Survey on Alcohol and Related Conditions (non-Hispanic Black: N = 8245; non-Hispanic White: N = 24,507), a nationally representative survey of the U.S. civilian, non-institutionalized population aged 18 and older. Models were adjusted for individual-level confounders (age, sex, education, household income, medical insurance) as well as for state-level disparities in poverty. Results indicated that Blacks living in states with high levels of structural racism were generally more likely to report past-year myocardial infarction than Blacks living in low-structural racism states. Conversely, Whites living in high structural racism states experienced null or lower odds of myocardial infarction compared to Whites living in low-structural racism states. These results raise the provocative possibility that structural racism may not only harm the targets of stigma but also benefit those who wield the power to enact stigma and discrimination.
•This study examined effects of structural racism on myocardial infarction (MI).•Among Blacks, high structural racism was associated with increased odds of MI.•Among Whites, high structural racism had null or inverse effects on MI.•Structural racism may harm its targets while benefiting those who enact it.
Macrostructural characteristics, such as cost of living and state-level anti-poverty programs relate to the magnitude of socioeconomic disparities in brain development and mental health. In this ...study we leveraged data from the Adolescent Brain and Cognitive Development (ABCD) study from 10,633 9-11 year old youth (5115 female) across 17 states. Lower income was associated with smaller hippocampal volume and higher internalizing psychopathology. These associations were stronger in states with higher cost of living. However, in high cost of living states that provide more generous cash benefits for low-income families, socioeconomic disparities in hippocampal volume were reduced by 34%, such that the association of family income with hippocampal volume resembled that in the lowest cost of living states. We observed similar patterns for internalizing psychopathology. State-level anti-poverty programs and cost of living may be confounded with other factors related to neurodevelopment and mental health. However, the patterns were robust to controls for numerous state-level social, economic, and political characteristics. These findings suggest that state-level macrostructural characteristics, including the generosity of anti-poverty policies, are potentially relevant for addressing the relationship of low income with brain development and mental health.
Stimulated by the pioneering work of Goffman (1963), research into the causes and consequences of stigma has proliferated over the past five decades. Progress has been made in the construction of new ...concepts, measures, and methodological approaches that have illuminated how stigma works to the disadvantage of those targeted by it. The culmination of this intense scrutiny has created the capacity to more deeply understand this powerful human phenomenon, opening the possibility to address its unwanted effects. At the same time, in the midst of this growth and advancement, the stigma concept has been criticized on several fronts. One of the most consistent criticisms has been that stigma research is too individually focused (Link & Phelan, 2001; Parker & Aggleton, 2003). According to Oliver (1992), the central thrust of stigma research has been focused on the perceptions of individuals and the consequences of such perceptions for micro-level interactions, rather than on structural issues underlying stigma. In part to address this criticism, researchers have recently expanded the stigma construct to consider how broader, macro-social forms of stigma -- termed structural stigma -- may also disadvantage the stigmatized. Copyright Elsevier Ltd.
Background Emerging evidence from general population studies suggests that lesbian, gay, and bisexual (LGB) adults are more likely to experience adverse cardiovascular outcomes relative to ...heterosexuals. No studies have examined whether sexual orientation disparities exist in biomarkers of early cardiovascular disease risk. Purpose To determine whether sexual orientation disparities in biomarkers of early cardiovascular risk are present among young adults. Methods Data come from Wave IV (2008–2009) of the National Longitudinal Study for Adolescent Health (N=12,451), a prospective nationally representative study of U.S. adolescents followed into young adulthood (mean age=28.9 years). A total of 520 respondents identified as lesbian, gay, or bisexual. Biomarkers included C-reactive protein, glycosylated hemoglobin, systolic and diastolic blood pressure, and pulse rate. Analyses were conducted in 2012. Results In gender-stratified models adjusted for demographics (age, race/ethnicity); SES (income, education); health behaviors (smoking, regular physical activity, alcohol consumption); and BMI, gay and bisexual men had significant elevations in C-reactive protein, diastolic blood pressure, and pulse rate, compared to heterosexual men. Despite having more risk factors for cardiovascular disease, including smoking, heavy alcohol consumption, and higher BMI, lesbians and bisexual women had lower levels of C-reactive protein than heterosexual women in fully adjusted models. Conclusions Evidence was found for sexual orientation disparities in biomarkers of cardiovascular risk among young adults, particularly in gay and bisexual men. These findings, if confirmed in other studies, suggest that disruptions in core physiologic processes that ultimately confer risk for cardiovascular disease may occur early in the life course for sexual-minority men.
Stigma processes play an underrecognized role in the distribution of life chances, influencing health through the production of disadvantage and the induction of stress. Policies enact stigma ...processes, mitigate them, or ignore them. If each of these two statements is correct, the intersection of stigma and policy demands our attention. We propose a change of perspective from an approach that considers one stigmatized status and one outcome at a time to a perspective that considers the full range of stigmatized statuses and outcomes so as to reveal stigma's full impact. Concerning the second statement, literature addressing “structural stigma” provides compelling evidence that policy enacts stigma and harms health in some circumstances and mitigates stigma and improves health in others. In addition to the effects of active policies, we also bring attention to policy inattention—doing nothing. A core feature of stigma is a discounting—a mattering less—that allows and even fosters policy inattention toward the concerns of stigmatized groups. We end by engaging David Mechanic and Linda H. Aiken's ideas concerning how social science influences policy by changing how people think about problems and hope that our consideration of stigma and policy might ultimately have such a consequence.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
The purpose of this study was to examine rates of substance use between transgender and nontransgender youth using a representative population-based sample and to examine mediating risk factors.
A ...statewide cross-sectional sample of California middle and high schools collected between 2013 and 2015. This representative sample of students in California included 335 transgender and 31,737 nontransgender youth. Using multivariate linear and logistic regression, we assessed differences between transgender and nontransgender youth in substance use behaviors related to alcohol, cigarette, marijuana, other illicit drugs, polysubstance use, and heavy episodic drinking. Substance use was assessed with lifetime use, age of onset, and past 30-day use for alcohol, cigarettes, and marijuana. Past 30-day use was also assessed for other illicit drugs and polysubstance use. Models were adjusted for demographics and risk factors including victimization, depressive symptoms, and perceived risk of substance use.
The prevalence of substance use was 2.5–4 times higher for transgender youth compared with their nontransgender peers (depending on the substance). Transgender youth were also at greater risk for early age of onset and recent substance use than nontransgender youth. In addition, psychosocial risk factors related to victimization, depressive symptoms, and perceived risk of substance use partially mediated the relationship between gender identity and substance use.
Using data from the first representative study of youth to include a measure of gender identity, we show that transgender youth are at heightened risk for substance use compared with nontransgender peers. Future research is needed to identify the structural and psychosocial mechanisms that drive these disparities.
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