Objective To examine the association between marital interaction quality during daily life and subclinical cardiovascular disease (CVD). Studies have shown that marital status and quality of marriage are associated with cardiovascular health. However, little is known about the role of marital interaction quality during daily life in contributing to these effects. Methods The sample consisted of 281 healthy, employed middle-aged adults who were married or living with a partner in a marital-like relationship (mean age = 42.0 years, 88% white, 52% men). Marital interaction quality was assessed using hourly real-time Ecological Momentary Assessments (EMAs) for 4 days, with participants rating their current or recent partner interactions on positive and negative characteristics (e.g., agreeableness and conflict). Carotid artery intima medial thickness (IMT) was assessed using ultrasound imaging. Results Adjusting for demographics, positive marital interaction was inversely associated with IMT, [b = −.02 F(1, 275) = 9.18, p = .002], and negative marital interaction was positively associated with IMT, [b = .02 F(1, 275) = 10.29, p = .001]. These associations were not accounted for by behavioral and biological cardiovascular disease (CVD) risk factors and were consistent across age, sex, race, and education. The associations were also independent of marital interaction frequency, nonmarital social interaction quality, and personality factors. Global reports of marital quality, in contrast, were not associated with IMT. Conclusions Marital quality as measured during real-time interactions between partners was associated with subclinical cardiovascular disease in healthy middle-aged adults. This study supports the utility of real-time social interaction assessment for characterizing links between social relationships and cardiovascular health.

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Background Although depression is a highly prevalent condition that occurs in all ethnic groups, the influence of ethnicity on treatment response still remains unclear. Methods A prospective 8-week, open-label clinical trial comparing the efficacy and side-effects of citalopram (CIT) with dose escalation (20–60 mg/day) was performed in African-Americans and Caucasians with non-psychotic major depression. The intent-to-treat sample consisted of 301 participants (169 African Americans and 132 Caucasians). Results Although African-Americans were more socially disadvantaged and had a more severe depression, outcomes between the groups were similar. Remission rates were approximately 50% in both groups and about 2/3 of participants met response criteria. Retention was greater than 75% in both groups, with no differences in drop-out rate. There also were no differences in the number of completers, number of visits made, final dose of CIT, or in side effect profiles. Conclusions These results confirm the growing body of evidence, including recent studies using measurement-based care, that patients from minority groups have outcomes that are similar to those of Caucasians. The provision of measurement-based care and encouragement of patient participation can reduce ethnic differences in response to treatment for depression.

Objective The long-term health impact of acute unemployment and socioeconomic resource deficit has not been shown to be unique from the effects of stable socioeconomic status (SES) and serious life circumstances, such as trauma. This study examined associations between these acute socioeconomic declines and health of hurricane survivors, independent of prehurricane SES and hurricane trauma. Method Participants were 215 African American adults (60% female, mean age = 39 years) living in the Greater New Orleans area at the time of Hurricane Katrina and survey 4 years later. The survey included prehurricane SES measures (i.e., education and neighborhood poverty level); acute unemployment and deficits in access to SES resources following Hurricane Katrina; and posthurricane health events (i.e., cardiometabolic events, chronic pain, posttraumatic stress disorder [PTSD], and major depressive disorder [MDD]). Results Acute unemployment was associated with odds of experiencing a cardiometabolic event (odds ratio [OR] = 5.65, p < .05), MDD (OR = 2.76, p < .05) and chronic pain (OR = 2.76, p < .05), whereas acute socioeconomic resource deficit was associated with odds of chronic pain (OR = 1.93, p < .001) and MDD (OR = 1.19, p < .05). Associations were independent of prehurricane SES, hurricane trauma, potentially chronic SES resource deficits, and current unemployment. Conclusions This study shows that acute socioeconomic decline following a natural disaster can create long-term health disparities beyond those created by prehurricane SES level and traumatic hurricane experiences. Findings suggest that early intervention postdisaster to reduce pervasive socioeconomic disruption may reduce the long-term health impact of disasters.