Neighborhood disorder, exposure to violence, and perceived discrimination in relation to symptoms in midlife women

Abstract

BackgroundSome symptoms at midlife are associated with stress, such as hot flashes, trouble sleeping, headaches, or depressed mood. Hot flashes have been studied in relation to laboratory stressors, physiological biomarkers, and self-reported stress, but less is known about hot flashes in relation to the larger context of women’s lives. This study examined the risk of symptoms in relation to neighborhood disorder, exposure to neighborhood violence, social cohesion and perceived discrimination. We hypothesized that women exposed to more negative neighborhood characteristics and discrimination would be more likely to report hot flashes and other midlife symptoms.MethodsParticipants were black and white women, aged 40 to 60, drawn from a cross-sectional investigation of race/ethnicity, socioeconomic status, and blood pressure in New York City (n = 139). Demographic information, medical history, menopausal status, and symptoms were measured by questionnaire. Likert scales were used to measure neighborhood characteristics, specifically, the Neighborhood Disorder Scale, the Exposure to Violence Scale, the Perceived Violence Subscale, the Neighborhood Social Cohesion and Trust Scale, and the Everyday Discrimination Scale. Ten symptoms were included in analyses: lack of energy, feeling blue/depressed, backaches, headaches, aches/stiffness in joints, shortness of breath, hot flashes, trouble sleeping, nervous tension, and pins/needles in hands/feet. Each scale with each symptom outcome was examined using logistic regression analyses adjusting for significant covariates.ResultsBlack women reported higher scores on all negative neighborhood characteristics and discrimination, and a lower score on the positive Neighborhood Social Cohesion and Trust. Neighborhood Disorder was associated with feeling blue/depressed, aches/stiffness in joints, and hot flashes, and Perceived Violence was associated with aches/stiffness in joints, after controlling for model-specific covariates. There was a lower risk of backaches with increasing Neighborhood Social Cohesion and Trust score. The Everyday Discrimination Scale was associated with lack of energy. Lack of energy, feeling blue/depressed, aches/stiffness in joints, and hot flashes appeared to be most vulnerable to negative neighborhood context and discrimination.ConclusionsThis study adds to the literature linking neighborhood environments to health outcomes. The associations between negative neighborhood contexts and discrimination with diverse symptoms, and the association between social cohesion and back pain, point to the need to expand analyses of stress to multiple physiological systems.

Exploring the Consequences of Major Lifetime Discrimination, Neighborhood Conditions, Chronic Work, and Everyday Discrimination on Health and Retirement

“…Their study revealed that everyday mistreatment was associated with higher allostatic load, above and beyond the independent association of lifetime discrimination. Gerber and Sievert’s (2018) study revealed that neighborhood disorder and social cohesion, as well as everyday discrimination, were associated with a number of adverse physical and mental health outcomes.…”

The Influence of Chronic Stress and Emotions on Eating Behavior Patterns and Weight among Young African American Women

“…African American women face significant socioeconomic, environmental, and relational stressors. Some of these stressors include race/ethnic discrimination that can affect education, employment, and residential opportunities, neighborhood safety, higher levels of bereavement, and disproportionately lower marital relationships compared with other women (Albert, 2019; Gerber & Sievert, 2018; Lewis, Cogburn, & Williams, 2015; Williams, 2018).…”

Does everyday discrimination account for the increased risk of vasomotor symptoms in Black women?: the Study of Women's Health Across the Nation (SWAN)

“…46 Gerber and colleagues 67 assessed the cross-sectional association between everyday discrimination and midlife symptoms of fatigue and hot flashes at one timepoint 52 in a sample of 139 Black and White women aged 40 to 60 years in New York City. 46 In that study, discrimination was associated with lack of energy but, in contrast to our results, not hot flashes. It may be that considering VMS (both hot flashes and night sweats) longitudinally over the course of the menopause transition better captures a woman's experience of VMS than a single measure eliciting information for one 2-week period in a woman's life.…”

“…First, we examined the association between concurrent reports of everyday discrimination and VMS over the menopause transition. Second, given that the one previous study of discrimination and VMS relied on cross-sectional data 46 and the potential for chronic discrimination (discrimination reported at multiple time points) to be more strongly related to health compared with discrimination reported once, 24,47-49 we examined a potential temporal association between chronic discrimination reported at the first four visits and longitudinal trajectories of VMS over the menopausal transition. Finally, we evaluated whether the disproportionate burden of VMS in Black women persisted after accounting for discrimination in midlife and other known risk factors for VMS.…”