Many community-based participatory research (CBPR) partnerships address social determinants of health as a central consideration. However, research studies that explicitly address racism are scarce in the CBPR literature, and there is a dearth of available community-generated data to empirically examine how racism influences health disparities at the local level. In this paper, we provide results of a crosssectional, population-based health survey conducted in the urban areas of Genesee and Saginaw Counties in Michigan to assess how a sustained community intervention to reduce racism and infant mortality influenced knowledge, beliefs, and experiences of racism and to explore how perceived racism is associated with self-rated health and birth outcomes. We used ANOVA and regression models to compare the responses of intervention participants and non-participants as well as African Americans and European Americans (N=629). We found that intervention participants reported greater acknowledgment of the enduring and differential impact of racism in comparison to the non-intervention participants. Moreover, survey analyses revealed that racism was associated with health in the following ways: (1) experiences of racial discrimination predicted self-rated physical health, mental health, and smoking status; (2) perceived racism against one's racial group predicted lower self-rated physical health; and (3) emotional responses to racism-related experiences were marginally associated with lower birth-weight births in the study sample. Our study bolsters the published findings on perceived racism and health outcomes and highlights the usefulness of CBPR and community surveys to empirically investigate racism as a social determinant of health.
The burden of adverse health attributed to Alcohol Use Disorders (AUD) is higher among black compared to white women. We investigated whether socioeconomic status (education and income); healthcare factors (insurance, alcoholism treatment); psychosocial stressors (stressful life events, racial discrimination, alcoholism stigma) could account for black-white disparities in the association between AUD and physical and functional health among current drinker women aged 25 years and older (N = 8,877) in the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). We used generalized linear regression model to test the interaction between race and 12-month DSM-IV AUD in Wave 1 (2001-2002) associated with health in Wave 2 (2004-2005), adjusted for covariates (age group, smoking, alcohol consumption, cardiovascular disease, diabetes, body mass index, and arthritis). Black women with AUD had poorer health compared to white women with AUD (β=−3.18, SE=1.28, p<.05), an association that partially attenuated after adjusting for education and income (β=−2.71, SE=1.27, p<.05), and attenuating further after adjusting for health care and psychosocial factors (β=−2.64, SE=1.27, p<.05). In race-specific analysis, AUD was associated with poorer health for black but not white women. Accounting for black-white differences in AUD and physical and functional health among women requires investigation beyond traditional mechanisms.
The URWs were most effective in the domains related to their standard content. Additional effort is necessary to customize URWs when utilized for activities beyond their original purpose of community mobilization.
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