Gaynell M. Simpson

What Factors Hinder Women of Color From Obtaining Preventive Health Care

This commentary examines how women of color fare on the use of preventive care. Logistic regression models of womens use of preventive care were computed with data from the 1994 Commonwealth Fund Minority Health Survey. It was found that having a regular doctor was the most consistent predictor of the use of preventive care, irrespective of the womens racial/ethnic background, socioeconomic circumstances, or place of residence. These findings reinforce the importance of physicians in the delivery of preventive care. Suggestions for improving the use of preventive services by women of color are provided.

Responsibility Without Community Resources: Informal Kinship Care Among Low-Income, African American Grandmother Caregivers

Given the importance of community resources in the lives of African American grandmother caregivers, it is imperative to examine and gain a deeper understanding of how grandmothers perceive the availability and accessibility of community resources to meet their caregiving needs. A study using qualitative research methods resulted in three themes: (a) status of traditional helping resources, (b) inappropriate and unresponsiveness of human service agencies, and (c) limited options and alternatives to grandmother caregivers. Each of these themes provides some evidence of what is needed to shape programs and services targeted toward urban grandmother caregivers.

African American College Students: Literacy of Depression and Help Seeking

Depression is a serious public health concern in the United States affecting almost 18.8 million adults (Office of Disease Prevention and Health Promotion, 2003). It is a common mental disorder in college students (ArehartTreichel, 2002; Song et al., 2008), with estimates of 1 in 4 “experiencing an episode by age 24” (American Psychiatric Assocation [APA], 2007). African American college students are at an elevated risk for depression due to racism, stress, sleep deprivation, and lack of academic and social support (Dzokoto, Hicks, & Miller, 2007; Kelly, Kelly, Brown, & Kelly, 1999). Even though 11.4% of African American students self-reported a psychiatric diagnosis of depression they did not report a history of utilizing campus counseling and/ or community mental health services (Soet & Sevig, 2006). Nationwide 24% of Americans will receive treatment whereas only 16% of African Americans will seek services from specialty mental health clinics (Schnittker, 2003). African Americans often view depression as a personal weakness (Dzokoto et al., 2007) that is best addressed by faith and prayer not counseling and pharmacology (Dzokoto et al.; Shellman, Mokel, & Wright, 2007). Stigmatization, cost of treatment, lack of availability of services, and failing to recognize depressive symptoms are well known barriers to mental health utilization (Brown & Palenchar, 2004; Cooper et al., 2003). However, to date, little research addresses African American college students’ mental health literacy regarding depression. This systematic and empirical knowledge gap regarding African American college students’ recognition of depressive symptoms and perspectives on treatment options for depression must be addressed to avoid complications leading to other problems such as self-medication with drugs and alcohol (Shellman et al.). Therefore, the purpose of this research was to examine African American college students’ mental health literacy regarding depression. Previous studies using this approach have found that individuals who are mental health literate are likely to seek help for themselves, and/or recommend professional assistance to family and friends experiencing symptoms of depression (Jorm, Kitchener, O’Kearney, & Dear, 2004).

Racial/Ethnic Differences in Emotional Health: A Longitudinal Study of Immigrants’ Adolescent Children

First, discrimination was conceptualized as a major source of stress for immigrants’ adolescent children. Next, such children’s emotional health (indicated by measures of self-esteem and depression) was examined for possible associations with discrimination, psychosocial supports, and social structure; additionally, race/ethnicity’s possible moderating role in such associations was evaluated. Data from the first 2 waves of the Children of Immigrants Longitudinal Study (1991–2006) were employed, focusing on 3 groups: Asians, Hispanics, and Whites. Linear regression analyses were used to weigh how discrimination, psychosocial supports, and social structure measured at Wave 1 and Wave 2 related to self-esteem and depression measured at Wave 2. Asians exhibited the highest level of depression and were most likely to perceive discrimination; Asians’ self-esteem was also low, compared to other groups’. Discrimination and psychosocial supports appeared to operate differentially in explaining the 3 groups’ emotional health.

A Call to Action: Dementia Screening of Alzheimer’s Disease in Older African Americans

In the current chapter, we discuss racial disparities with respect to the detection of dementia. We also discuss reasons for the disparities including cultural bias with respect to dementia screening instruments. Topics include the impact of health and educational disparities on test performance, and how these disparities need to be considered when assessing members of minority groups. Special emphasis is given to the fact that accurate detection of dementia is important. Individuals suffer needlessly when falsely diagnosed with dementia. Thus, it is important that clinicians make a concerted effort to minimize false positive diagnoses. On the other hand, it is important that dementia be detected early. If dementia has progressed before an accurate diagnosis is made, individuals will have missed the opportunity to delay the progression of the disease through medication and other cognitive interventions.

Support groups for Alzheimer’s caregivers: Creating our own space in uncertain times

ABSTRACT Older men are often excluded from family caregiving research despite the steady increase in the number of husbands assuming primary caregiving roles. We explored perceptions of older, male caregivers’ experiences with caring for a wife with Alzheimer’s Disease (AD) and examined what aspects of the support group were beneficial. Our qualitative research methods invited six caregivers ranging in age from 74 to 85 years to narratively construct their perspectives on caring for their wives with Alzheimer’s Disease and benefits of participation in an all-male support group. Thematic analyses revealed caregivers faced several transitions. “Losses related to their personal relationships with their wife, family, and self,” captured as loss of golden years. The second area, benefits and improvements of support groups, were captured in the following theme: “creating our own space,” which included two sub-themes: “releasing our frustration” and “developing coping strategies.” There was also “Gendered experience of caregiving.” This study revealed that male caregivers benefited from the support and company of other men in similar caregiving situations. Results from this study have implications for health care professionals for the development of psychosocial educational groups aimed at providing support to male caregivers.

Social Support and Self-Rated Health of African American Women Informal Caregivers: Urban and Rural Differences

ABSTRACT In this study, we examined how geographic location might differently influence social support and self-rated health for rural and urban African American women caregivers. We used cross-sectional data from 253 urban and 263 rural women primary caregivers. Controlling for key demographic factors, we regressed caregivers’ self-rated health on social engagement, structural, and functional aspects of social support for urban and rural caregivers separately. The perception of family functioning was positively associated with urban and rural caregivers’ self-rated health. Urban caregivers reported having significantly more contact with their family and more informal helpers compared to rural caregivers. Furthermore, church attendance, a measure of social engagement, was significant for urban caregivers’ self-rated health, but not rural caregivers. Our findings affirmed the importance of foregrounding context and disaggregating social support, and point to the need for interventions targeting family functioning and paying attention to geographic location.

Informal support experiences of older African-American gay men living with HIV/AIDS

ABSTRACT In lesbian, gay, bisexual, and transgender (LGBT) scholarship, there is paucity in empirical literature documenting the specific ways in which HIV-positive African-American gay men and lesbian women seek social support from caregivers, family, friends, and intimate partners. We know minimal information about how older African-American HIV-positive gay men negotiate intersections of race, age, and sexuality to gain access to informal social support. The purpose of this study was to explore and understand the informal social support experiences among African-American gay men that are 50 years old and older living with HIV/AIDS. A qualitative hermeneutic phenomenology data collection process included the in-depth, face-to-face interviews of 12 African-American males, ages 50 and over, diagnosed with HIV/AIDS from agencies that provided services to HIV/AIDS populations. Upon completion of data collection and transcription, the data were extracted, organized, and analyzed. Due to their multiple positions in society, older African-American gay men living with HIV/AIDS had fashioned a fragile system of support captured a loss of informal social support and relied mostly on formal social supports. From a macro implications perspective, interdisciplinary teams can help build an inclusive systematic environment for older African-American gay men living with HIV/AIDS.

Diabetes, Depression, and Cognition: a Recursive Cycle of Cognitive Dysfunction and Glycemic Dysregulation

Purpose of ReviewThe study aims to examine the effects of diabetes and depression on executive functioning (EF) and to review the effects of EF deficits on diabetes management.Recent FindingsBoth type 2 diabetes and depression influence EF, and in turn, EF has an impact on diabetes management.SummaryIndividuals with both comorbidities (i.e., diabetes and depression) experience greater deficits in EF than individuals with just one of the morbidities (i.e., depression or diabetes). The disruption in EF results in poor diabetes management and poor emotion regulation which ultimately increases the probability of a recursive cycle of depression and hyperglycemia. This recursive cycle can ultimately lead to diabetes-related complications.

Community engagement with African American clergy: faith-based model for culturally competent practice

ABSTRACT Objective: The intent of this exploratory qualitative study was to examine African American Baptist clergys pastoral care to older congregants with mental disorders. Critical Race Theory was the guiding framework in this study. Method: A purposive sample of 18 African American clergy participated in one-on-one interviews. Results: Collectively, all participants were active in the provision of mental health to older congregants with mental disorders. The primary emergent theme ‘shepherding the flock’ the central phenomenon uncovered in the data, was used to organize a model of pastoral care, which is presented in this paper. Findings from this study supported results from previous studies on the integral role of the Church and clergy in the African American community. Conclusion: Moreover, this study highlights the importance of internal ministries in the Church and the need for further study and potential partnership opportunity.