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Background: Racism and discrimination are psychosocial stressors that affect the health of minority populations. While discrimination has been associated with poor mental health, little is known about the relationship between discrimination and mental health outcomes in youth nationally. Furthermore, mental and behavioral health consequences of discrimination may differ in different minority groups., Objective: The goal of this study is to determine (1) how common perceptions of discrimination are in a nationally representative sample of African-American (AA) and Afro-Caribbean (AC) teens, (2) the relationship between discrimination and mental health conditions, and (3) whether discrimination has different associations with mental health in AA and AC youth., Design: Cross-sectional comparison study SETTING: National Survey of American Life-Adolescent Supplement, a nationwide sample of African-American and Afro-Caribbean youth drawn from a nationally representative household survey of AA and AC population PARTICIPANTS: One thousand, one hundred and seventy AA and AC youth between 13 and 17 years EXPOSURE: Experiences with discrimination (Everyday Discrimination Scale) MAIN OUTCOMES: Lifetime and past 12-month major depression and anxiety RESULTS: Ninety percent of AA and 87% of AC youth experienced discrimination. Discrimination was significantly associated with lifetime and 12-month major depression and lifetime and 12-month anxiety. There were no differences in the associations between discrimination and mental health between AA and AC youth except for lifetime anxiety: as discrimination increased, the likelihood of lifetime anxiety disorder increased at a higher rate among AC youth compared to AA., Conclusions: Discrimination is a common psychosocial stressor in African-American and Afro-Caribbean youth. It is associated with poor mental health outcomes. There was no difference in the occurrence of discrimination between African-American and Afro-Caribbean youth or in its mental health consequences.

Little is known about the epidemiology of Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM–IV ) intermittent explosive disorder (IED) in adolescents, and no information is currently available regarding the relationship between race/ethnicity and IED among Black youth in the United States. Using the World Health Organization World Mental Health Composite International Diagnostic Interview (Adolescent Version), we estimated the prevalence, severity, and disability of IED in a national, probability sample of African American and Caribbean Black youth (ages 13–17) from the National Survey of American Life, Adolescent Supplement. Face-to-face surveys of 810 African American and 360 Caribbean Black youth were conducted between 2001 and 2003. We calculated lifetime and 12-month diagnoses of IED using diagnostic algorithms based on DSM–IV and assessed IED disability using a modified Sheehan Disability Scale. Overall findings indicated lifetime and 12-month IED prevalence rates of 9.2% and 7.0%, respectively. Lifetime prevalence rates of IED were 9.0% for African American and 12.4% for Caribbean Black teens. Within the past 12 months, 6.7% of African American and 11.5% of Caribbean Black adolescents met diagnostic criteria for IED. Lifetime and 12-month IED were associated with anxiety disorders. In addition, few teens with lifetime IED received any treatment. Findings are consistent with recent evidence that intermittent explosive disorder may be more common than previously considered, especially among adolescents. Significant acts of aggression and impairment are associated with IED, and low treatment rates indicate that more research on this disorder and intervention options is warranted., (PsycINFO Database Record (c) 2016 APA, all rights reserved)

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 women's health, findings that inform intervention and clinical services tailored to meet the needs of Black women from diverse ethnic and cultural backgrounds., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

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.

Background: It is generally accepted that obesity and depression are positively related in women. Very little prior research, however, has examined potential variation in this relationship across different racial/ethnic groups. This paper examines the association between obesity and depression in non-Hispanic White, non-Hispanic Black, and Mexican American women., Methods: The sample included women aged 20 years and older in the 2005-2008 National Health and Nutrition Examination Surveys (n=3666). Logistic regression was used to assess the relationship between obesity and depression syndrome (assessed using the Patient Health Questionnaire-9), after adjusting for covariates. We then investigated whether this association varied by race/ethnicity., Results: Overall, obese women showed a 73% greater odds of depression (odds ratio [OR]=1.73; 95% confidence interval [CI]=1.19, 2.53) compared with normal weight women. This association varied significantly, however, by race/ethnicity. The obesity-depression associations for both Black and Mexican American women were different from the positive association found for White women (ORBlack*obese=0.24; 95% CI=0.10,0.54; ORMexican American*obese=0.42; 95% CI=1.04). Among White women, obesity was associated with significantly greater likelihood of depression (OR=2.37; 95% CI=1.41, 4.00) compared to normal weight. Among Black women, although not statistically significant, results are suggestive that obesity was inversely associated with depression (OR=0.56; 95% CI=0.28, 1.12) relative to normal weight. Among Mexican American women, obesity was not associated with depression (OR=1.01; 95% CI=0.59, 1.72)., Conclusions: The results reveal that the association between obesity and depression varies by racial/ethnic categorization. White, but not Black or Mexican American women showed a positive association. Next research steps could include examination of factors that vary by race/ethnicity that may link obesity to depression.

Objective: To assess classification adjustments and examine correlates of eating disorders among Blacks., Methods: The National Survey of American Life (NSAL) was conducted from 2001-2003 and consisted of adults (n=5,191) and adolescents (n=1,170). The World Mental Health Composite International Diagnostic Interview (WMH-CIDI-World Health Organization 2004-modified) and DSM-IV-TR eating disorder criteria were used., Results: Sixty-six percent of African American and 59% Caribbean Black adults were overweight or obese, while 30% and 29% of adolescents were overweight or obese. Although lifetime rates of anorexia nervosa and bulimia nervosa were low, binge eating disorder was high for both ethnic groups among adults and adolescents. Eliminating certain classification criteria resulted in higher rates of eating disorders for all groups., Conclusion: Culturally sensitive criteria should be incorporated into future versions of Diagnostic Statistical Manual (DSM) classifications for eating disorders that consider within-group ethnic variations.

Objective: To contribute to the growing understanding of U.S. black-white health disparities by examining psychosocial stress as an important contributor to physical health problems., Methods: Data are from the National Survey of American Life, an integrated national household probability sample of White Americans, African Americans, and Caribbean blacks. Regression analysis was used to assess associations between goal-striving stress and hypertension, BMI, physical health problems, and self-rated health., Results: After accounting for sociodemographic factors and three additional stressors--personal problems, lifetime racial discrimination, and everyday racial discrimination-goal-striving stress was a significant predictor of hypertension, physical health problems, and diminished self-rated health. Ethnicity moderated the relationship; the negative association between goal-striving stress and physical health problems was strongest for Caribbean blacks., Conclusions: This study extends the research on goal-striving stress and adds to a growing literature documenting relationships between social processes and disease.

There have been few empirical studies of ethnic differences in health within the American Black population. Logistic regressions were used to examine the relationships among ethnicity, nativity, depressive symptoms, and physical health in the two largest ethnic groups of American Blacks, African Americans and Caribbean Blacks. The data were from the National Survey of American Life, a national household survey representative of the non-institutionalized U.S. Black population. We found that African Americans, U.S.-born Caribbean Blacks, and Caribbean-born Blacks had significantly different self-ratings of their health and self-reports of being diagnosed with a chronic physical health condition: Caribbean-born Blacks had the best health outcomes and U.S.-born Caribbean Blacks had the worst. This finding remained significant even after considering self-reported depressive symptoms. This study highlights the importance of considering ethnic diversity, nativity and immigration as independent sources of variation in health status within the American Black population.

Prevalence of depression is associated inversely with some indicators of socioeconomic position, and the stress of social disadvantage is hypothesized to mediate this relation. Relative to whites, blacks have a higher burden of most physical health conditions but, unexpectedly, a lower burden of depression. This study evaluated an etiologic model that integrates mental and physical health to account for this counterintuitive patterning. The Baltimore Epidemiologic Catchment Area Study (Maryland, 1993-2004) was used to evaluate the interaction between stress and poor health behaviors (smoking, alcohol use, poor diet, and obesity) and risk of depression 12 years later for 341 blacks and 601 whites. At baseline, blacks engaged in more poor health behaviors and had a lower prevalence of depression compared with whites (5.9% vs. 9.2%). The interaction between health behaviors and stress was nonsignificant for whites (odds ratio (OR = 1.04, 95% confidence interval: 0.98, 1.11); for blacks, the interaction term was significant and negative (β: -0.18, P < 0.014). For blacks, the association between median stress and depression was stronger for those who engaged in zero (OR = 1.34) relative to 1 (OR = 1.12) and ≥2 (OR = 0.94) poor health behaviors. Findings are consistent with the proposed model of mental and physical health disparities.

The present study examined whether combinations of ethnicity, gender, and age moderated the association between perceived discrimination and psychological well-being indicators (depressive symptoms, self-esteem, and life satisfaction) in a nationally representative sample of Black youth. The data were from the National Survey of American Life, which includes 810 African American and 360 Caribbean Black adolescents. The results indicated main effects such that perceived discrimination was linked to increased depressive symptoms and decreased self-esteem and life satisfaction. Additionally, there were significant interactions for ethnicity, gender, and race. Specifically, older Caribbean Black female adolescents exhibited higher depressive symptoms and lower life satisfaction in the context of high levels of perceived discrimination compared with older African American male adolescents.

Background: This study examined whether there were associations between individual measures of socio-economic status (SES) and the 12-month prevalence of major depressive disorder (MDD) in representative samples of Blacks, Latinos, Asians and Whites in the USA., Method: The data used were from the Collaborative Psychiatric Epidemiology Studies (CPES)., Results: There was an association between household income and MDD among Whites. However, the association was not statistically significant. Statistically significant associations were present between educational attainment and MDD among Whites. Among both Whites and Latinos, being out of the labor force was significantly associated with MDD. In analyses by nativity, being out of the labor force was significantly associated with MDD among US-born and foreign-born Latinos., Conclusions: Significant associations between various measures of SES and MDD were consistently observed among White and, in some cases, Latino populations. Future studies should continue to examine sociopsychological factors related to SES that increase the risk of MDD among people from racial-ethnic communities.

Objective: Provide nationally representative data on the prevalence and psychiatric correlates of suicidal ideation and attempts among African American and Caribbean black adolescents in the United States., Method: Data on nonfatal suicidal behavior among 1,170 African American and Caribbean black adolescents aged 13 to 17 years are from the National Survey of American Life-Adolescent, a nationally representative household survey of adults with an attached adolescent sample conducted between February 2001 and June 2003., Results: Nationwide black adolescents reported having a lifetime prevalence of 7.5% for suicidal ideation and 2.7% for attempts. The 12-month prevalence of suicidal ideation and attempt was 3.2% and 1.4%, respectively. Among all respondents, 4% of black American adolescents and 7% of female subjects were projected to attempt suicide by age 17 years. African American adolescents were approximately five times more likely than Caribbean black adolescents to attempt suicide. Almost half of the National Survey of American Life-Adolescent respondents who reported a suicide attempt had never met criteria for any of the DSM-IV disorders by the time of their attempts., Conclusions: Clinicians should be trained to screen for suicidal behavior, even among those without DSM-IV disorders, when treating black adolescents, particularly female subjects. In addition, preventive efforts should consider ethnic differences in suicide risk and targeting nonclinical settings.

The present study examined ethnic, gender, and age differences in perceived discrimination and the association between perceived discrimination and psychological well-being in a nationally representative sample of Black adolescents. Data are from the National Survey of African Life (NSAL), which includes 810 African American and 360 Caribbean Black youth. Results indicate that the majority of Black youth perceived at least 1 discriminatory incident in the previous year. Adolescents at later stages of development perceived more discrimination than those at earlier stages, and African American and Caribbean Black males perceived more discrimination than their female counterparts. Perceptions of discrimination were positively linked to depressive symptoms and were negatively linked to self-esteem and life satisfaction, regardless of ethnicity. However, Caribbean Black youth appear to be more vulnerable when they perceive high levels of discrimination.

Objectives: We sought to estimate the prevalence of substance disorders for African Americans and Caribbean Blacks in the United States using data from the National Survey of American Life., Methods: A national household probability sample of noninstitutionalized African Americans (n=3570) and Caribbean Blacks (n=1621) was obtained between February 2001 and June 2003 using a slightly modified version of the Composite International Diagnostic Interview., Results: Overall differences in prevalence of substance disorders between the ethnic groups were not significant. Prevalence rates of substance disorders among African Americans exceeded that of Caribbean Blacks among women, those aged 45 to 59 years, and those who were divorced. African Americans in major metropolitan areas had higher prevalence rates, and those in the South had lower ones, compared with those living in other areas. Overall, first-generation Caribbean Blacks were significantly less likely, but second-generation more likely, than were African Americans to meet criteria for overall substance disorders., Conclusions: Failure to distinguish between African Americans and Caribbean Blacks masks important differences in substance use patterns among the Black population in the United States.

Background: There is limited research regarding the nature and prevalence of obsessive-compulsive disorder (OCD) among various racial and ethnic subpopulations within the United States, including African Americans and blacks of Caribbean descent. Although heterogeneity within the black population in the United States has largely been ignored, notable differences exist between blacks of Caribbean descent and African Americans with respect to ethnicity, national heritage, and living circumstances. This is the first comprehensive examination of OCD among African Americans and blacks of Caribbean descent., Methods: Data from the National Survey of American Life, a national household probability sample of African Americans and Caribbean blacks in the United States, were used to examine rates of OCD among these groups., Results: Lifetime and 12-month OCD prevalence estimates were very similar for African Americans and Caribbean blacks. Persistence of OCD and rates of co-occurring psychiatric disorders were very high and also similar between African American and Caribbean black respondents. Both groups had high levels of overall mental illness severity and functional impairment. Use of services was low for both groups, particularly in specialty mental health settings. Use of anti-obsessional medications was also rare, especially among the Caribbean black OCD population., Conclusions: OCD among African Americans and Caribbean blacks is very persistent, often accompanied by other psychiatric disorders, and is associated with high overall mental illness severity and functional impairment. It is also likely that very few blacks in the United States with OCD are receiving evidence-based treatment and thus considerable effort is needed to bring treatment to these groups.

Objective: The purpose of this study was to estimate lifetime and 12-month prevalence of 13 psychiatric disorders for older African Americans., Methods: Data are from the older African American subsample of the National Survey of American Life. Selected measures of lifetime and 12-month Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) psychiatric disorders were examined (i.e., panic disorder, agoraphobia, social phobia, generalized anxiety disorder, obsessive compulsive disorder, posttraumatic stress disorder (PTSD), major depressive disorder, dysthymia, bipolar I and II disorders, alcohol abuse/dependence, and drug abuse/dependence)., Results: Twenty-three percent of older African Americans reported at least one lifetime disorder and 8.54% reported at least one 12-month disorder. Alcohol abuse, PTSD, and major depression were the most prevalent lifetime disorders. The most prevalent 12-month disorders were PTSD, major depression, and social phobia. Age, sex, education, and region were significantly associated with the odds of having a lifetime disorder., Conclusion: This is the first study of prevalence rates of serious mental disorders for older African Americans based on a national sample. Demographic correlates of the prevalence of disorders are discussed with an emphasis on age and regional differences.

Objectives: The purpose of this study was to examine similarities and differences in religious involvement among three groups of older adults-African Americans, Caribbean Blacks, and non-Hispanic Whites., Methods: We used data from the National Survey of American Life, a nationally representative household study of African Americans and Caribbean Blacks with a national sample of non-Hispanic Whites who reside in areas (census tracks and block groups) at least 10% African American. We examined demographic correlates of 16 measures of organizational, nonorganizational, subjective religiosity, as well as religious coping and spirituality., Results: The findings indicated that older African Americans and Caribbean Blacks reported higher levels of religious participation, religious coping, and spirituality than older Whites. We observed few significant differences between older African Americans and older Caribbean Blacks. Gender, age, marital status, income, education, marital status, and region all exhibited significant influences on religious participation and spirituality., Discussion: Racial groups within the older population present distinctive profiles of religious participation and spirituality. The demographic correlates of religious involvement and spirituality are consistent across a variety of diverse dimensions and measures.

Objective: The purpose of this study was to examine the correlates of religious participation among older Black Caribbeans., Methods: Data from the older Black Caribbean subsample of the National Survey of American Life were used to examine selected measures of organizational, nonorganizational, and subjective religious participation., Result: The findings indicated important demographic differences in the correlates of religious participation among older Black Caribbeans. In particular, gender, marital status, income, immigration status, and denomination were associated with religious participation., Discussion: We discuss study findings in relation to available ethnographic data on Black Caribbeans and prior survey research on religious participation among older African Americans. Although there were several similarities to the research on older African Americans and religious involvement (e.g., marital status, gender, denomination), noted departures from prior research findings (e.g., income effects) may indicate the influence of ethnic group membership and the importance of the immigration experience in shaping distinctive life experiences for older Black Caribbeans.

Normative neuropsychological data for U.S. racial/ethnic minorities are limited. Extant norms are based on small, regional groups that may not be nationally representative. The objectives of this study were to (1) provide norms for a modified Symbol Digit Modalities Test (M-SDMT) based on a nationally representative sample of African Americans, Caribbean Blacks, and non-Latino Whites (NLW) living in areas with large populations of Blacks; and (2) determine significant correlates of M-SDMT performance. The M-SDMT was administered to a subset of respondents from the National Survey of American Life in standard face-to-face interviews. M-SDMT performance was influenced by race/ethnicity, age, education, and gender. African Americans and NLW groups had similar M-SDMT performances, which differed from Caribbean Blacks. The Black ethnic differences in M-SDMT were not explained by the sociodemographic factors considered in this study. Unlike previous work, this study supports the consideration of Black ethnicity when evaluating Black neuropsychological test performance.

Context: Little is known about differences in the unmet need for mental health service use between African Americans and Caribbean blacks., Objective: To extend the National Survey of Black Americans by examining 12-month mental health service use for African Americans and Caribbean blacks from the recently completed National Survey of American Life., Design and Setting: National household probability samples of noninstitutionalized African Americans and Caribbean blacks (blacks from Caribbean area countries now living in the United States) conducted between February 2001 and June 2003, using a slightly modified World Mental Health version of the World Health Organization's Composite International Diagnostic Interview., Participants: A total of 3570 African Americans and 1621 Caribbean blacks 18 years and older (N = 5191)., Main Outcome Measures: Proportion of respondents with 12-month DSM-IV disorders who sought help in the specialty mental health, general medical, human service, and complementary-alternative medicine treatment sectors. The percentage receiving minimally adequate treatment was also assessed., Results: Overall, 10.1% of respondents used some form of mental heath care services in the past year. Use of services was much higher among those who met criteria for a 12-month DSM-IV disorder (31.9%) than among those who did not (5.4%). Forty-nine percent of respondents with serious mental illness used services, whereas 39.3% had contact with mental health care specialists. The youngest and oldest age groups were least likely to obtain any services. Among African Americans, women were more likely than men to use general medical care and services from any sector. Respondents with the most years of education showed the highest use of services., Conclusions: The underuse of mental health services among black Americans remains a serious concern. Educational interventions that focus on both consumers and mental health care professionals are needed.

Context: Little is known about the relationship between race/ethnicity and depression among US blacks., Objective: To estimate the prevalence, persistence, treatment, and disability of depression in African Americans, Caribbean blacks, and non-Hispanic whites in the National Survey of American Life., Design: A slightly modified adaptation of the World Health Organization World Mental Health version of the Composite International Diagnostic Interview., Setting: National household probability samples of noninstitutionalized African Americans, Caribbean blacks, and non-Hispanic whites in the United States conducted between February 2, 2001, and June 30, 2003., Participants: A total of 3570 African Americans, 1621 Caribbean blacks, and 891 non-Hispanic whites aged 18 years and older (N = 6082)., Main Outcome Measures: Lifetime and 12-month diagnoses of DSM-IV major depressive disorder (MDD), 12-month mental health services use, and MDD disability as quantified using the Sheehan Disability Scale and the World Health Organization's Disability Assessment Schedule II., Results: Lifetime MDD prevalence estimates were highest for whites (17.9%), followed by Caribbean blacks (12.9%) and African Americans (10.4%); however, 12-month MDD estimates across groups were similar. The chronicity of MDD was higher for both black groups (56.5% for African Americans and 56.0% for Caribbean blacks) than for whites (38.6%). Fewer than half of the African Americans (45.0%) and fewer than a quarter (24.3%) of the Caribbean blacks who met the criteria received any form of MDD therapy. In addition, relative to whites, both black groups were more likely to rate their MDD as severe or very severe and more disabling., Conclusions: When MDD affects African Americans and Caribbean blacks, it is usually untreated and is more severe and disabling compared with that in non-Hispanic whites. The burden of mental disorders, especially depressive disorders, may be higher among US blacks than in US whites.

Context: Lack of data on the lifetime prevalence and age at onset of suicide ideation, plans, and attempts among blacks in the United States limits the creation and evaluation of interventions to reduce suicide among black Americans., Objective: To examine the prevalence and correlates of suicide ideation, planning, and attempts across 2 ethnic classifications of blacks in a nationally representative sample., Design, Setting, and Participants: Data are from the National Survey of American Life, a national household probability sample of 5181 black respondents aged 18 years and older, conducted between February 2001 and June 2003, using a slightly modified adaptation of the World Health Organization World Mental Health version of the Composite International Diagnostic Interview. Bivariate and survival analyses were used to delineate patterns and correlates of nonfatal suicidal behavior., Main Outcome Measures: Self-reports of lifetime suicide ideation, planning, and attempts., Results: Survey respondents, categorized as African Americans and Caribbean Americans, reported lifetime prevalence of 11.7% for suicide ideation and 4.1% for attempts. Among the respondents who reported ideation, 34.6% transitioned to making a plan and only 21% made an unplanned attempt. Among 4 ethnic-sex groups, the 7.5% lifetime prevalence for attempts among Caribbean black men was the highest among black Americans. The greatest risk of progressing to suicide planning or attempt among ideators occurred within the first year after ideation onset. Blacks at higher risk for suicide attempts were in younger birth cohorts, less educated, Midwest residents, and had 1 or more Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition disorders., Conclusions: This study documents the burden of nonfatal suicidality among US blacks, notably Caribbean black men, and individuals making planned attempts. Advancing research on the transition from suicide planning to attempt is vital to the efficacy of health care professionals' ability to screen blacks at risk for suicide.

This commentary considers the implications of the assessment of racial/ethnic status for monitoring the health of African Americans and other Black populations in the United States. It argues that because racial disparities in health and other social indicators persist undiminished, the continued assessment of race is essential. However, efforts must be made to ensure that racial data are of the highest quality. This will require uniform assessment of racial status that includes identifiers for subgroups of the Black population. Research also indicates that the health of multiracial persons varies by maternal race. Thus, efforts to monitor multiracial status should assess the race of both parents. More attention should also be given to analysis and interpretation of racial data and to the collection of additional data that capture characteristics linked to race (such as socioeconomic factors and racism) that may adversely affect health.

The extraordinarily high rate of hypertension in blacks remains a significant public health issue in most industrialized societies. Research has focused on the investigation of racial differences in biological, nutritional, behavioural and psychological, and social factors in an effort to identify the causes of this high morbidity rate. Thus far, research suggests important racial differences in renal functioning, particularly in sodium metabolism and plasma renin activity, as well as potassium intake and sodium:potassium ratio. Behavioral factors such as anger-coping style and John Henryism, and social factors such as socioeconomic status, socioecological stress, social support, urban-rural residence, and family interaction patterns have also been identified as potential contributors. Finally, emerging research paradigms such as laboratory stress reactivity and 24-h ambulatory monitoring of blood pressure may provide promising leads about the interaction between these effects and hypertension in black populations.

Objective: To provide information on the characteristics of eating disorders based on nationally representative samples of African American and Caribbean Black adults and adolescents. Method: Conducted between 2001 and 2003 the National Survey of American Life (NSAL) interviewed adults (n = 5,191) and adolescents (n = 1,170) in their homes. Professionally trained interviewers used the WMH Composite International Diagnostic Interview (WMH-CIDI-WHO Organization 2004-modified) to assess DSM-IV TR eating disorders. Results: Anorexia was the rarest eating disorder among African American adults and adolescents, with age of onset for adults in mid adolescence. No 12-month case of anorexia was found among Caribbean Black adults. Binge eating was the most prevalent eating disorder among adults and adolescents. Persistence of disorders was lowest for anorexia and highest for binge eating disorder among adults. Conclusion: Prevalence of eating disorders within the U.S. Black population varies by type of disorder, age cohort, gender, and ethnic group among adults, and by type of disorder among adolescents. Clinicians need preparation and training to recognize and treat eating disorders in ethnically-diverse patient populations. Int J Eat Disord 2007 © 2007 by Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]