Publications

2014
Atwoli, L., Nock, M. K., Williams, D. R., & Stein, D. J. (2014). Association between parental psychopathology and suicidal behavior among adult offspring: results from the cross-sectional South African Stress and Health survey. BMC Psychiatry , 14, 65.Abstract

BACKGROUND: Prior studies have demonstrated a link between parental psychopathology and offspring suicidal behavior. However, it remains unclear what aspects of suicidal behavior among adult offspring are predicted by specific parental mental disorders, especially in Africa. This study set out to investigate the association between parental psychopathology and suicidal behavior among their adult offspring in a South African general population sample. METHOD: Parental psychopathology and suicidal behavior in offspring were assessed using structured interviews among 4,315 respondents from across South Africa. The WHO CIDI was used to collect data on suicidal behavior, while the Family History Research Diagnostic Criteria Interview was used to assess prior parental psychopathology. Bivariate and multivariate survival models tested the associations between the type and number parental mental disorders (including suicide) and lifetime suicidal behavior in the offspring. Associations between a range of parental disorders and the onset of subsequent suicidal behavior (suicidal ideation, plans, and attempts) among adult offspring were tested. RESULTS: The presence of parental psychopathology significantly increased the odds of suicidal behavior among their adult offspring. More specifically, parental panic disorder was associated with offspring suicidal ideation, while parental panic disorder, generalized anxiety disorder and suicide were significantly associated with offspring suicide attempts. Among those with suicidal ideation, none of the tested forms of parental psychopathology was associated with having suicide plans or attempts. There was a dose-response relationship between the number of parental disorders and odds of suicidal ideation. CONCLUSIONS: Parental psychopathology increases the odds of suicidal behavior among their adult offspring in the South African context, replicating results found in other regions. Specific parental disorders predicted the onset and persistence of suicidal ideation or attempts in their offspring. Further research into these associations is recommended in order to determine the mechanisms through which parent psychopathology increases the odds of suicidal behavior among offspring.

2014i.pdf
Garnett, B. R., Masyn, K. E., Austin, B. S., Miller, M., Williams, D. R., & Viswanath, K. (2014). The intersectionality of discrimination attributes and bullying among youth: an applied latent class analysis. J Youth Adolesc , 43 (8), 1225-39.Abstract

Discrimination is commonly experienced among adolescents. However, little is known about the intersection of multiple attributes of discrimination and bullying. We used a latent class analysis (LCA) to illustrate the intersections of discrimination attributes and bullying, and to assess the associations of LCA membership to depressive symptoms, deliberate self harm and suicidal ideation among a sample of ethnically diverse adolescents. The data come from the 2006 Boston Youth Survey where students were asked whether they had experienced discrimination based on four attributes: race/ethnicity, immigration status, perceived sexual orientation and weight. They were also asked whether they had been bullied or assaulted for these attributes. A total of 965 (78%) students contributed to the LCA analytic sample (45% Non-Hispanic Black, 29% Hispanic, 58% Female). The LCA revealed that a 4-class solution had adequate relative and absolute fit. The 4-classes were characterized as: low discrimination (51%); racial discrimination (33%); sexual orientation discrimination (7%); racial and weight discrimination with high bullying (intersectional class) (7%). In multivariate models, compared to the low discrimination class, individuals in the sexual orientation discrimination class and the intersectional class had higher odds of engaging in deliberate self-harm. Students in the intersectional class also had higher odds of suicidal ideation. All three discrimination latent classes had significantly higher depressive symptoms compared to the low discrimination class. Multiple attributes of discrimination and bullying co-occur among adolescents. Research should consider the co-occurrence of bullying and discrimination.

2014m.pdf
LaVeist, T. A., Thorpe, R. J., Pierre, G., Mance, G. S. A., & Williams, D. R. (2014). THE RELATIONSHIPS AMONG VIGILANT COPING STYLE, RACE, AND DEPRESSION. J Soc Issues , 70 (2), 241-255.Abstract

Although Black-white differences in depression are well documented, vigilant coping style as an explanation for the observed inequalities in depression is less understood. Using data from 718 adults in the Exploring Health Disparities in Integrated Communities (EHDIC) Study, we estimated logistic regression models to examine the cross sectional relationship between race, vigilant coping style, and depression. After controlling for demographic variables, white adults were more likely to report depression than Black adults. Moreover, when accounting for coping style, the Black-white difference in depression widened. This association persisted even with the addition of the covariates. While high rates of depression among whites compared with Blacks are well documented, the degree of the differences appears to be greater than previously reported once vigilance is accounted for. This finding suggests that if it were not for the high prevalence of vigilant coping in blacks, the well-documented black advantage regarding depression compared to whites would likely be even greater.

2014k.pdf
Duncan, D. T., Kawachi, I., Subramanian, S. V., Aldstadt, J., Melly, S. J., & Williams, D. R. (2014). Examination of How Neighborhood Definition Influences Measurements of Youths’ Access to Tobacco Retailers: A Methodological Note on Spatial Misclassification. Am J Epidemiol , 179 (3), 373-381. duncan_et_al._neighborhood_definition_youth_access_to_tobacco_am_j_epi_2014.pdf
Slopen, N., & Williams, D. R. (2014). Discrimination, other psychosocial stressors, and self-reported sleep duration and difficulties. Sleep , 37 (1), 147-56.Abstract

OBJECTIVES: To advance understanding of the relationship between discrimination and sleep duration and difficulties, with consideration of multiple dimensions of discrimination, and attention to concurrent stressors; and to examine the contribution of discrimination and other stressors to racial/ ethnic differences in these outcomes. DESIGN: Cross-sectional probability sample. SETTING: Chicago, IL. PARTICIPANTS: There were 2,983 black, Hispanic, and white adults. MEASUREMENTS AND RESULTS: Outcomes included self-reported sleep duration and difficulties. Discrimination, including racial and nonracial everyday and major experiences of discrimination, workplace harassment and incivilities, and other stressors were assessed via questionnaire. In models adjusted for sociodemographic characteristics, greater exposure to racial (β = -0.14)) and nonracial (β = -0.08) everyday discrimination, major experiences of discrimination attributed to race/ethnicity (β = -0.17), and workplace harassment and incivilities (β = -0.14) were associated with shorter sleep (P < 0.05). The association between major experiences of discrimination attributed to race/ethnicity and sleep duration (β = -0.09, P < 0.05) was independent of concurrent stressors (i.e., acute events, childhood adversity, and financial, community, employment, and relationship stressors). Racial (β = 0.04) and non-racial (β = 0.05) everyday discrimination and racial (β = 0.04) and nonracial (β = 0.04) major experiences of discrimination, and workplace harassment and incivilities (β = 0.04) were also associated with more (log) sleep difficulties, and associations between racial and nonracial everyday discrimination and sleep difficulties remained after adjustment for other stressors (P < 0.05). Racial/ethnic differences in sleep duration and difficulties were not significant after adjustment for discrimination (P > 0.05). CONCLUSIONS: Discrimination was associated with shorter sleep and more sleep difficulties, independent of socioeconomic status and other stressors, and may account for some of the racial/ethnic differences in sleep.

2014c.pdf
Dutra, L. M., Williams, D. R., Gupta, J., Kawachi, I., & Okechukwu, C. A. (2014). Human rights violations and smoking status among South African adults enrolled in the South Africa Stress and Health (SASH) study. Soc Sci Med , 105, 103-11.Abstract

Despite South Africa's history of violent political conflict, and the link between stressful experiences and smoking in the literature, no public health study has examined South Africans' experiences of human rights violations and smoking. Using data from participants in the nationally representative cross-sectional South Africa Stress and Health study (SASH), this analysis examined the association between respondent smoking status and both human rights violations experienced by the respondent and violations experienced by the respondents' close friends and family members. SAS-Callable SUDAAN was used to construct separate log-binomial models by political affiliation during apartheid (government or liberation supporters). In comparison to those who reported no violations, in adjusted analyses, government supporters who reported violations of themselves but not others (RR = 1.76, 95% CI: 1.25-2.46) had a significantly higher smoking prevalence. In comparison to liberation supporters who reported no violations, those who reported violations of self only (RR = 1.56, 95%CI: 1.07-2.29), close others only (RR = 1.97, 95%CI: 1.12-3.47), or violations of self and close others due to close others' political beliefs and the respondent's political beliefs (RR = 2.86, 95%CI: 1.70-4.82) had a significantly higher prevalence of smoking. The results of this analysis suggest that a relationship may exist between human rights violations and smoking among South Africa adults. Future research should use longitudinal data to assess causality, test the generalizability of these findings, and consider how to apply these findings to smoking cessation interventions.

2014g.pdf
Toomey, R. B., Umaña-Taylor, A. J., Williams, D. R., Harvey-Mendoza, E., Jahromi, L. B., & Updegraff, K. A. (2014). Impact of Arizona's SB 1070 immigration law on utilization of health care and public assistance among Mexican-origin adolescent mothers and their mother figures. Am J Public Health , 104 Suppl 1, S28-34.Abstract

OBJECTIVES: We examined the impact of Arizona's "Supporting Our Law Enforcement and Safe Neighborhoods Act" (SB 1070, enacted July 29, 2010) on the utilization of preventive health care and public assistance among Mexican-origin families. METHODS: Data came from 142 adolescent mothers and 137 mother figures who participated in a quasi-experimental, ongoing longitudinal study of the health and development of Mexican-origin adolescent mothers and their infants (4 waves; March 2007-December 2011). We used general estimating equations to determine whether utilization of preventive health care and public assistance differed before versus after SB 1070's enactment. RESULTS: Adolescents reported declines in use of public assistance and were less likely to take their baby to the doctor; compared with older adolescents, younger adolescents were less likely to use preventive health care after SB 1070. Mother figures were less likely to use public assistance after SB 1070 if they were born in the United States and if their post-SB 1070 interview was closer to the law's enactment. CONCLUSIONS: Findings suggest that immigration policies such as SB 1070 may contribute to decreases in use of preventive health care and public assistance among high-risk populations.

2014a.pdf
Hicken, M. T., Lee, H., Morenoff, J., House, J. S., & Williams, D. R. (2014). Racial/ethnic disparities in hypertension prevalence: reconsidering the role of chronic stress. Am J Public Health , 104 (1), 117-23.Abstract

OBJECTIVES: We investigated the association between anticipatory stress, also known as racism-related vigilance, and hypertension prevalence in Black, Hispanic, and White adults. METHODS: We used data from the Chicago Community Adult Health Study, a population-representative sample of adults (n = 3105) surveyed in 2001 to 2003, to regress hypertension prevalence on the interaction between race/ethnicity and vigilance in logit models. RESULTS: Blacks reported the highest vigilance levels. For Blacks, each unit increase in vigilance (range = 0-12) was associated with a 4% increase in the odds of hypertension (odds ratio [OR] = 1.04; 95% confidence interval [CI] = 1.00, 1.09). Hispanics showed a similar but nonsignificant association (OR = 1.05; 95% CI = 0.99, 1.12), and Whites showed no association (OR = 0.95; 95% CI = 0.87, 1.03). CONCLUSIONS: Vigilance may represent an important and unique source of chronic stress that contributes to the well-documented higher prevalence of hypertension among Blacks than Whites; it is a possible contributor to hypertension among Hispanics but not Whites.

2014b.pdf
Lewis, T. T., Williams, D. R., Tamene, M., & Clark, C. R. (2014). Self-Reported Experiences of Discrimination and Cardiovascular Disease. Curr Cardiovasc Risk Rep , 8 (1), 365.Abstract

Researchers have long speculated that exposure to discrimination may increase cardiovascular disease (CVD) risk but compared to other psychosocial risk factors, large-scale epidemiologic and community based studies examining associations between reports of discrimination and CVD risk have only emerged fairly recently. This review summarizes findings from studies of self-reported experiences of discrimination and CVD risk published between 2011-2013. We document the innovative advances in recent work, the notable heterogeneity in these studies, and the considerable need for additional work with objective clinical endpoints other than blood pressure. Implications for the study of racial disparities in CVD and clinical practice are also discussed.

2014d.pdf
Dean, L., Subramanian, S. V., Williams, D. R., Armstrong, K., Charles, C. Z., & Kawachi, I. (2014). The role of social capital in African-American women's use of mammography. Soc Sci Med , 104, 148-56.Abstract

Black/African-American women are more likely to get breast cancer at a young age and/or be diagnosed at a late disease stage, pointing to a greater need to promote mammography for Black women at earlier ages than are currently recommended. This study explores how perceived neighborhood social capital, that is, perceptions of how tight-knit a neighborhood is and what power that confers to neighborhood members, relates to use of mammography for Black women in Philadelphia. Living in a community with tight social ties (social cohesion) or that have a collective motivation for community change (collective efficacy) may increase the likelihood that an individual woman in that community will hear health messages from other community members and neighbors (diffusion of information) and will have access to health-related resources that allow them to engage in healthy behaviors. No prior studies have explored the role of social capital in decisions for mammography use. Using multilevel logistic regression, we analyzed self-report of mammography in the past year for 2586, Black women over age 40 across 381 Philadelphia, Pennsylvania USA census tracts. Our study included individual demographic and aggregates of individual-level social capital data from the Public Health Management Corporation's 2004, 2006, and 2008 Community Health Database waves, and 2000 US Census sociodemographic characteristics. Individual perceptions that a Black woman's neighborhood had high social capital, specifically collective efficacy, had a positive and statistically significant association with mammography use (OR = 1.40, CI: 1.05, 1.85). Our findings suggest that an individual woman's perception of greater neighborhood social capital may be related to increased mammography use. Although this analysis could not determine the direction of causality, it suggests that social capital may play a role in cancer preventive screening for African-American women in Philadelphia, which warrants further study.

2014h.pdf
2013
Williams, D. R., & Mohammed, S. A. (2013). Racism and Health II: A Needed Research Agenda for Effective Interventions. American Behavioral Scientist , 57 (8), 1200–1226. 2013c.pdf
Fuller-Rowell, T. E., Williams, D. R., Love, G. D., McKinley, P. S., Sloan, R. P., & Ryff, C. D. (2013). Race differences in age-trends of autonomic nervous system functioning. J Aging Health , 25 (5), 839-62.Abstract
OBJECTIVE: The objective of this study was to consider race differences in age-trends of autonomic nervous system functioning, using a national data set with a broad age range. METHODS: Measures of baseline heart rate variability (HRV) and HRV reactivity were derived from electrocardiograph (ECG) recordings taken at rest and during cognitive stress tasks. Age-trends in HRV and HRV reactivity were compared among 204 African Americans and 833 Whites ages 34 to 83 years (M = 53.7, SD = 11.4), before and after controlling for socioeconomic status (SES). RESULTS: For HRV-reactivity, age-trends were steeper among African Americans and lower SES participants than Whites and higher SES participants. For baseline HRV, age-trends varied by SES but not race. DISCUSSION: Results relating to HRV-reactivity (but not baseline HRV) were consistent with hypotheses suggesting that African Americans are exposed to higher levels of stress and experience accelerated declines in health across the life span. The relevance of the findings to research on social stress and health disparities is discussed.
autonomic_nerv_system_race_j_ag_hlth_2013_fuller-rowell_39-62.pdf
Lund, C., Myer, L., Stein, D. J., Williams, D. R., & Flisher, A. J. (2013). Mental illness and lost income among adult South Africans. Soc Psychiatry Psychiatr Epidemiol , 48 (5), 845-51. 2013t.pdf
Brewer, L. C., Carson, K. A., Williams, D. R., Allen, A., Jones, C. P., & Cooper, L. A. (2013). Association of Race Consciousness With the Patient-Physician Relationship, Medication Adherence, and Blood Pressure in Urban Primary Care Patients. Am J Hypertens.Abstract

BACKGROUND: Race consciousness (the frequency with which one thinks about his or her own race) is a measure that may be useful in assessing whether racial discrimination negatively impacts blood pressure (BP). However, the relation between race consciousness and BP has yet to be empirically tested, especially within the context of the patient-physician relationship and medication adherence. METHODS: Race-stratified generalized estimating equations were used to assess the relationship of race consciousness on BP, measures of the patient-physician relationship, and self-reported medication adherence, controlling for patients being nested within physicians and for patient age and sex. RESULTS: The mean age of the patients was 61.3 years, 62% were black, and 65% were women. Black patients were more likely to ever think about race than were white patients (49% vs. 21%; P < 0.001). Race-conscious blacks had significantly higher diastolic BP (79.4 vs. 74.5mm Hg; P = 0.004) and somewhat higher systolic BP (138.8 vs. 134.7mm Hg; P = 0.13) than blacks who were not race conscious. Race-conscious whites were more likely to perceive respect from their physician (57.1% vs. 25.8%; P = 0.01) but had lower medication adherence (62.4% vs. 82.9%; P = 0.05) than whites who were not race-conscious. CONCLUSIONS: Among blacks, race consciousness was associated with higher diastolic BP. In contrast, among whites, there was no association between race consciousness and BP, but race consciousness was associated with poor ratings of adherence, despite more favorable ratings of the patient-physician relationship. Future work should explore disparities in race consciousness and its impact on health and health-care disparities.

2013v.pdf
Viruell-Fuentes, E. A., Morenoff, J. D., Williams, D. R., & House, J. S. (2013). Contextualizing nativity status, Latino social ties, and ethnic enclaves: an examination of the 'immigrant social ties hypothesis'. Ethn Health , 18 (6), 586-609. 2013s.pdf
Wosu, A. C., Valdimarsdóttir, U., Shields, A. E., Williams, D. R., & Williams, M. A. (2013). Correlates of cortisol in human hair: implications for epidemiologic studies on health effects of chronic stress. Ann Epidemiol , 23 (12), 797-811.e2. 2013q.pdf
Albert, M., Slopen, N., & Williams, D. R. (2013). Cumulative Psychological Stress and Cardiovascular Disease Risk: A Focused Review with Consideration of Black-White Disparities. Current Cardiovascular Risk Reports , 7 (5), 318-325. 2013u.pdf
Duncan, D. T., Kawachi, I., Subramanian, S. V., Aldstadt, J., Melly, S. J., & Williams, D. R. (2013). Examination of how neighborhood definition influences measurements of youths' access to tobacco retailers: a methodological note on spatial misclassification. Am J Epidemiol , 179 (3), 373-81.Abstract

Measurements of neighborhood exposures likely vary depending on the definition of "neighborhood" selected. This study examined the extent to which neighborhood definition influences findings regarding spatial accessibility to tobacco retailers among youth. We defined spatial accessibility to tobacco retailers (i.e., tobacco retail density, closest tobacco retailer, and average distance to the closest 5 tobacco retailers) on the basis of circular and network buffers of 400 m and 800 m, census block groups, and census tracts by using residential addresses from the 2008 Boston Youth Survey Geospatial Dataset (n = 1,292). Friedman tests (to compare overall differences in neighborhood definitions) were applied. There were differences in measurements of youths' access to tobacco retailers according to the selected neighborhood definitions, and these were marked for the 2 spatial proximity measures (both P < 0.01 for all differences). For example, the median average distance to the closest 5 tobacco retailers was 381.50 m when using specific home addresses, 414.00 m when using census block groups, and 482.50 m when using census tracts, illustrating how neighborhood definition influences the measurement of spatial accessibility to tobacco retailers. These analyses suggest that, whenever possible, egocentric neighborhood definitions should be used. The use of larger administrative neighborhood definitions can bias exposure estimates for proximity measures.

2013w.pdf
John, D. A., & Williams, D. R. (2013). Mental health service use from a religious or spiritual advisor among Asian Americans. Asian J Psychiatr , 6 (6), 599-605. 2013p.pdf
Krieger, N., Waterman, P. D., Kosheleva, A., Chen, J. T., Smith, K. S., Carney, D. R., Bennett, G., et al. (2013). Racial discrimination & cardiovascular disease risk: My Body My Story study of 1005 US-born black and white community health center participants (US). PLoS ONE , 8 (10), e77174. 2013n.pdf

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