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纵向考察老年黑人和拉丁裔成年人压力与心理健康的种族悖论。

Longitudinal Examination of an Ethnic Paradox of Stress and Mental Health in Older Black and Latinx Adults.

机构信息

Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA.

College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA.

出版信息

Clin Gerontol. 2023 Jan-Feb;46(1):27-46. doi: 10.1080/07317115.2022.2056102. Epub 2022 Mar 23.

Abstract

OBJECTIVES

To explain the ethnic paradox of mental health in aging, we evaluated whether Black and Latinx older adults experience (1) fewer depressive symptoms (DepSx), but more physical problems, and (2) greater psychological resilience as a result of life stressors than White older adults.

METHODS

DepSx, physical health, and recent stress were obtained biennially from 25,893 older adults (77% White, 15% Black, 9% Latinx) in the U.S. Health and Retirement Study, across 16 years. Psychological resilience, lifetime stress, and discrimination experiences were available for 13,655 individuals. We conducted mixed-effects and linear regression analyses.

RESULTS

For Blacks and Latinxs, experiencing more-than-usual stress events was associated with less increase in DepSx compared to Whites, although on average Blacks and Latinxs experience more DepSx. Black adults showed worse physical health than White adults and weaker effects of stress on psychological resilience despite experiencing more stress of all types. Findings were mixed for Latinxs.

CONCLUSIONS

Studying effects of time-varying stress on changes in health and multiple stressors on psychological resilience by race/ethnicity elucidates mechanisms for later-age health disparities.

CLINICAL IMPLICATIONS

Cross-sectional evaluations of stress and psychological health in a clinical setting may provide incomplete appraisals of health risks for Black and Latinx older Americans.

摘要

目的

为了解释老龄化过程中心理健康的民族悖论,我们评估了黑人和拉丁裔老年群体是否存在以下两种情况:(1)抑郁症状(DepSx)较少,但身体问题更多,以及(2)与白人老年群体相比,生活压力源对他们的心理弹性产生更大的影响。

方法

本研究利用美国健康与退休研究(Health and Retirement Study)在 16 年内对 25893 名老年成年人(77%为白人,15%为黑人,9%为拉丁裔)进行的两年一次的抑郁症状、身体健康和近期压力评估数据,以及对 13655 名个体的心理弹性、终生压力和歧视经历评估数据。我们进行了混合效应和线性回归分析。

结果

对于黑人和拉丁裔群体而言,与白人相比,经历更多异常压力事件与抑郁症状的增加幅度较小相关,尽管平均而言,黑人和拉丁裔群体的抑郁症状更多。尽管黑人群体经历了各种类型的压力,但他们的身体健康状况比白人差,且压力对心理弹性的影响也较弱。拉丁裔群体的结果则较为复杂。

结论

通过研究种族/民族对健康变化的时变压力以及对多种压力源对心理弹性的影响,可以阐明导致老年后期健康差异的机制。

临床意义

在临床环境中对压力和心理健康进行横断面评估可能会对美国黑人和拉丁裔老年人的健康风险评估不完整。

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