Krim K. Lacey

The Impact of Different Types of Intimate Partner Violence on the Mental and Physical Health of Women in Different Ethnic Groups

Intimate partner violence, including threats, stalking, emotional, physical, and sexual assault by a spouse or partner, has significant influences on the well-being of women of all racial and social backgrounds. This study of a nationally representative sample of women from varying racial and ethnic groups examined specific types of violent acts on health and well-being. An association between intimate partner violence and poor physical and mental health was found. Types of partner violence also had different associations with the well-being of women of different racial and ethnic backgrounds. Social and demographic factors played an important role in moderating women’s outcomes. Suggestions for future studies are discussed.

A Comparison of Women of Color and Non-Hispanic White Women on Factors Related to Leaving a Violent Relationship

This study compares women of color and non-Hispanic White women regarding the influence of socioeconomic status, family investment, and psychological abuse on leaving a violent relationship. It was found that most women who left stayed away for less than a month. Women of color and non-Hispanic White women did not differ in their length or rate of leaving, although women of color left more frequently when they did leave. Factors associated with leaving for both groups were threat with a weapon, psychological abuse, being single, and having fewer adults in the household. Women of color with higher socioeconomic status were less likely to leave, which was not the case for non-Hispanic White women. Non-Hispanic White women were more likely to leave if they had lived with their partners less than 5 years and had children at home.

When Is It Enough for Me to Leave?:Black and Hispanic Women’s Response to Violent Relationships

Based upon a subsample from the National Violence Against Women Survey (NVAWS) this article examines the role of socioeconomic status, relationship investment and psychological abuse in Black and Hispanic women’s decisions to leave or stay in violent relationships. Racial and ethnic differences and similarities were found in the factors related to staying or leaving violent relationships. Black women stayed in violent relationships at a slightly higher rate than Hispanic women. Marital status, presence of other adults in the household, and psychological abuse influenced Black women’s staying/leaving decision. Household income and psychological abuse were factors in whether Hispanic women remained in or exited violent relationships. Recommendations for possible interventions are discussed.

Substance use, mental disorders and physical health of Caribbeans at-home compared to those residing in the United States.

This study compares the health conditions of domestic Caribbeans with those living in the United States to explore how national context and migration experiences might influence substance use (i.e., alcohol or drug) and other mental and physical health conditions. The study is based upon probability samples of non-institutionalized Caribbeans living in the United States (1621), Jamaica (1216) and Guyana (2068) 18 years of age and over. Employing descriptive statistics and multivariate analytic procedures, the results revealed that substance use and other physical health conditions and major depressive disorder and mania vary by national context, with higher rates among Caribbeans living in the United States. Context and generation status influenced health outcomes. Among first generation black Caribbeans, residing in the United States for a longer length of time is linked to poorer health outcomes. There were different socio-demographic correlates of health among at-home and abroad Caribbeans. The results of this study support the need for additional research to explain how national context, migratory experiences and generation status contribute to understanding substance use and mental disorders and physical health outcomes among Caribbean first generation and descendants within the United States, compared to those remaining in the Caribbean region.

The mental health of US Black women: the roles of social context and severe intimate partner violence

Objective Black women continue to have rates of mental health conditions that can be negative for their well-being. This study examined the contribution of social and contextual factors and severe physical intimate partner violence on the mental health of US Black women (African-American and Caribbean Black). Setting Data were largely collected via in-person community interviews at participants’ homes. Participants We studied 3277 African-American and Black Caribbean women from the 2001–2003 National Survey of American Life (NSAL), the largest and most complete sample of Blacks residing in the USA. Primary and secondary outcomes Key outcomes included an array of psychiatric disorders based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Results Bivariate results revealed noticeably high rates of any anxiety disorder, post-traumatic stress disorder, any substance disorder, alcohol abuse disorder, suicide ideation and attempts, and any overall mental disorder among African-American women relative to Caribbean Black women. Multiple social and contextual factors were associated with various mental disorders among both sets of Black women in multivariate models, with the most consistent associations found for severe physical intimate partner violence. Everyday discrimination was associated with anxiety disorders (95% AOR=2.08 CI 1.23 to 3.51), eating disorders (95% AOR=2.69 CI 1.38 to 5.22), and any disorder (95% AOR=2.18 CI 1.40 to 3.40), while neighbourhood drug problems contributed to mood (95% AOR=1.19 CI 1.04 to 1.36), substance disorders (95% AOR=1.37 CI 1.11 to 1.69) and any disorder (95% AOR=1.18 CI 1.03 to 1.34). Conclusions Severe physical intimate partner violence, discrimination, and to a lesser extent, neighbourhood problems are important predictors of Black womens health, findings that inform intervention and clinical services tailored to meet the needs of Black women from diverse ethnic and cultural backgrounds.

Prevalence and factors associated with severe physical intimate partner violence among U.S. Black women: a comparison of African American and Caribbean Blacks

This study explored prevalence rates and factors associated with lifetime severe physical intimate partner violence among U.S. Black women. Data from the National Survey of American Life were examined. Rates of severe physical intimate partner violence were higher among African American women compared with U.S. Caribbean Black women. Risk factors associated with reported abuse were similar to those found in earlier studies but differed by ethnic backgrounds. Demographic, resource, and situational factors were associated with severe physical intimate partner violence among U.S. Black women in general but made unique contributions by ethnic group. Implications and suggestions for future studies were discussed.

Substance Abuse Among Blacks Across the Diaspora

ABSTRACT Background: Lower rates of substance abuse are found among Black Americans compared to Whites, but little is known about differences in substance abuse across ethnic groups within the black population. Objectives: We examined prevalence rates of substance abuse among Blacks across three geographic regions (US, Jamaica, Guyana). The study also sought to ascertain whether length of time, national context and major depressive episodes (MDE) were associated with substance abuse. Methods: We utilized three different data sources based upon probability samples collected in three different countries. The samples included 3,570 African Americans and 1,621 US Caribbean Black adults from the 2001–2003 National Survey of American Life (NSAL). An additional 1,142 Guyanese Blacks and 1,176 Jamaican Blacks living in the Caribbean region were included from the 2005 NSAL replication extension study, Family Connections Across Generations and Nations (FCGN). Mental disorders were based upon DSM-IV criteria. For the analysis, we used descriptive statistics, chi-square, and multivariate logistic regression analytic procedures. Results: Prevalence of substance abuse varied by national context, with higher rates among Blacks within the United States compared to the Caribbean region. Rates of substance abuse were lower overall for women, but differ across cohorts by nativity and length of time in the United States, and in association with major depressive episode. Conclusions: The study highlights the need for further examination of how substance abuse disparities between US-based and Caribbean-based populations may become manifested.

Relationship of social and economic factors to mental disorders among population-based samples of Jamaicans and Guyanese

Background There have been growing concerns about increasing mental health problems in the Caribbean region. This study explores rates and factors associated with selected mental health disorders within 2 Caribbean countries: Jamaica and Guyana. Methods Probability samples of 1218 Jamaicans and 2068 Guyanese participants were used. A modified version of the WHO Composite International Diagnostic Interview (WHO CIDI) defined by the Diagnostic Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) was administered in order to assess lifetime mental disorders. Descriptive statistics, χ2 and hierarchical regression analytic procedures were used to examine rates and factors associated with mental disorders. Results Rates of mental health conditions were different across contexts and were generally higher for Guyanese compared with Jamaicans for alcohol abuse (3.6% vs 2.2%), drug abuse (1.4% vs 1.3%), substance abuse (4.7% vs 2.7%) and mania (0.4% vs 0.1%). The rate of depression, however, was higher among Jamaicans than Guyanese (7.4% vs 4.1%). There were also noticeable differences in rates in both countries, due to social and economic factors, with social factors playing a larger contributory role in the mental health status of individuals across countries. Conclusions The results of this study suggest the need for more indepth analyses of factors contributing to mental health conditions of peoples within the Caribbean region, including the influence of additional sources of stress, quality of care and help-seeking behaviours of individuals.

Racial and Ethnic Influences on Mental Health and Substance Use Disorders: The Case of Caribbean Blacks

The scientific literature supports that differences in socioeconomic status and poor living arrangements influence health outcomes. The fact that the nature of health inequalities differ by their sources raises important questions about causal factors related to substance abuse disorders. Prior studies have generally grouped respondents of African American and Caribbean black ethnicities into one global category of “Black” or African American. This aggregation may obscure important differences in substance use patterns. This study examines in- and out-of country Caribbean Blacks, in comparison to African Americans, at the population and individual levels and how processes of migration might influence substance use disorders. The study is based upon national household probability samples of non-institutionalized African Americans and Blacks from Caribbean countries living in the U.S., conducted between February 2001 and June 2003, with a slightly modified version of the World Mental Health version of the World Health Organization’s Composite International Diagnostic Interview. A total of 3570 African Americans and 1623 Caribbean Blacks, aged 18 and over were interviewed in the United States and an additional 2068 adults in Guyana and 1216 in Jamaica. In this study we found that prevalence of substance disorders vary by national context, with higher rates within the U.S. Rates of substance misuse were lower overall for women, but differ across cohorts by other socio-demographic factors. Nativity and length of time in the U.S. were also associated with mental health disorders. The needs and directions for future research are discussed.