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Objectives: The John Henryism (JH) hypothesis suggests that, under adverse social and economic conditions, high-effort coping styles that reflect hard work and determination may contribute to elevated blood pressure. Results from tests of this hypothesis have been mixed, with variations by region, urban versus rural areas, race, gender, and age. The majority of studies reporting that socioeconomic position modifies associations between JH and blood pressure have been for non-Latino Blacks in rural communities. In contrast, most studies conducted in urban areas report little support for the JH hypothesis. Few studies have been conducted in samples that include Latinos. We extend previous research by testing the JH hypothesis in a multi-ethnic, low-to-moderate income urban community., Design: We used multivariate linear regression to test the hypothesis that associations between JH and blood pressure were modified by income, education, or labor force status in a multi-ethnic (non-Latino Black, Latino, non-Latino White) sample (N=703) in Detroit, Michigan. The outcome measures were systolic (SBP) and diastolic blood pressure (DBP)., Results: John Henryism was associated with higher SBP (β=3.92, P=.05), but not DBP (β=1.85, P=.13). These associations did not differ by income, education, or labor force status. Results did not differ by race or ethnicity., Conclusions: John Henryism is positively associated with SBP in this multi-ethnic, low-to-moderate income sample. This association did not differ by income, education, or labor force status. Results are consistent with studies conducted in urban communities, finding limited evidence that associations between JH and blood pressure vary by socioeconomic position.

This study examines how Mexican-origin women construct and navigate racialized identities in a postindustrial northern border community during a period of prolonged restrictive immigration and immigrant policies, and it considers mechanisms by which responses to racialization may shape health. This grounded theory analysis involves interviews with 48 Mexican-origin women in Detroit, Michigan, who identified as being in the first, 1.5, or second immigrant generation. In response to institutions and institutional agents using racializing markers to assess their legal status and policing access to health-promoting resources, women engaged in a range of strategies to resist being constructed as an "other." Women used the same racializing markers or symbols of (il)legality that had been used against them as a malleable set of resources to resist processes of racialization and to form, preserve, and affirm their identities. These responses include constructing an authorized immigrant identity, engaging in immigration advocacy, and resisting stigmatizing labels. These strategies may have different implications for health over time. Findings indicate the importance of addressing policies that promulgate or exacerbate racialization of Mexican-origin communities and other communities who experience growth through migration. Such policies include creating pathways to legalization and access to resources that have been invoked in racialization processes, such as state-issued driver's licenses. [ABSTRACT FROM AUTHOR]

Policy PointsDespite 30 years of attention to eliminating population health inequity, it remains entrenched, calling for new approaches.Targeted universalism, wellness‐based local development, and Jedi Public Health approaches that are community informed, evidence based, and focused on improving everyday settings and diverse lived experiences are important policy directions.State and federal revenue transfers are necessary to mitigate the harms of austerity and assure greater equity in fiscal and population health in places like Detroit, Michigan. Context: US population health inequity remains entrenched, despite mandates to eliminate it. To promote a public health approach of consequence in this domain, stakeholders call for moving from risk‐factor epidemiology toward consideration of dynamic local variations in the physiological impacts of structured lived experience. Methods: Using a community‐based, participatory research approach, we collected and analyzed a unique data set of 239 black, white, and Mexican adults from a stratified, multistage probability sample of three Detroit, Michigan, neighborhoods. We drew venous blood, collected saliva, took anthropometric measurements, and assayed specimens to measure allostatic load (AL), an indicator of stress‐mediated biological dysregulation, linking participants' AL scores and survey responses. In a series of nested Poisson models, we regressed AL on socioeconomic, psychosocial, neighborhood, and behavioral stressors to test the hypothesis that race/ethnicity and poverty‐to‐income ratio (PIR) are conceptually fluctuating variables whose impacts on AL are sensitive to structured lived experience. Findings: White and Mexican Detroit participants with PIR < 1 have higher AL than counterparts nationally; black participants in Detroit and nationwide had comparable AL. Within Detroit, disparities by PIR were higher in whites than blacks, with no significant difference by PIR in Mexicans. The size of estimated effects of having PIR < 1 for whites is 58 percentage points greater than that of Mexicans and twice that of blacks. Conclusions: Structurally rooted unobserved heterogeneity bias threatens the validity of independent main effects interpretations of associations between race/ethnicity, socioeconomic characteristics, or place and health. One‐size‐fits‐all analytic or policy models developed from the perspective of the dominant social group insufficiently address the experiences of diverse populations in specific settings and historical moments; nor do they recognize culturally mediated protective resources residents may have developed against material and psychosocial hardship. [ABSTRACT FROM AUTHOR]

Objectives: The 21st century has seen a rise in racism and xenophobia in the United States. Few studies have examined the health implications of heightened institutional and interpersonal racism. This study examines changes in reported discrimination and associations with blood pressure over time among non-Latino Blacks (NLBs), Latinos, and non-Latino Whites (NLWs) in an urban area, and variations by nativity among Latinos. Design: Data from a probability sample of NLB, Latino, and NLW Detroit, Michigan residents were collected in 2002–2003, with follow-up at the same addresses in 2007–2008. Surveys were completed at 80% of eligible housing units in 2008 (n = 460). Of those, 219 participants were interviewed at both time points and were thus included in this analysis. Discrimination patterns across racial/ethnic groups and associations with blood pressure were examined using generalized estimating equations. Results: From 2002 to 2008, NLBs and Latinos reported heightened interpersonal and institutional discrimination, respectively, compared with NLWs. There were no differences in associations between interpersonal discrimination and blood pressure. Increased institutional discrimination was associated with stronger increases in systolic and diastolic blood pressure for NLBs than NLWs, with no differences between Latinos and NLWs. Latino immigrants experienced greater increases in blood pressure with increased interpersonal and institutional discrimination compared to US-born Latinos. Conclusions: Together, these findings suggest that NLBs and Latinos experienced heightened discrimination from 2002 to 2008, and that increases in institutional discrimination were more strongly associated with blood pressure elevation among NLBs and Latino immigrants compared to NLWs and US-born Latinos, respectively. These findings suggest recent increases in discrimination experienced by NLBs and Latinos, and that these increases may exacerbate racial/ethnic health inequities. [ABSTRACT FROM AUTHOR]

The purpose of this study is to identify the social and economic correlates of reported experiences of interpersonal ethnoracial discrimination among Latino adults in Detroit. We examine whether the correlates of interpersonal ethnoracial discrimination vary according to the domain of discrimination and compare findings for individual domains of discrimination to a composite measure of experiences of discrimination. This study suggests that the frequency of reported discrimination is moderately high, and relatively common among Latinos with diabetes who live in Detroit. The findings demonstrate that immigration and ethnicity-related factors, such as greater comfort speaking Spanish and being born in the United States, were persistent correlates of more frequent encounters of interpersonal ethnoracial discrimination. Implications for social work research and practice are presented. [ABSTRACT FROM AUTHOR]

In light of the social/ethnic disparity in preterm delivery (PTD) rates, the Pregnancy Outcomes and Community Health (POUCH) Study takes a broad view of the determinants of PTD by attempting to link underlying biological and psychosocial factors. The relationships between placental pathology, maternal biomarkers, and antecedent psychosocial factors are evaluated in three hypothesised pathways of PTD – one characterised primarily by infection, one by maternal vascular disease, and one by premature elevations in corticotropin releasing hormone in the absence of histological evidence of placental pathology. Within each pathway, an emphasis is placed on understanding the roles of stress and of maternal serum alpha-fetoprotein, an early biomarker associated with PTD. The POUCH Study enrols pregnant women from five Michigan communities. Information about these women and their environments is gathered through detailed interviews and collection of biological samples including hair, urine, saliva, blood, vaginal fluid, and vaginal smear at 15–26 weeks of gestation. We have chosen to focus on the second trimester – a time when pathological processes may have evolved to a detectable stage, but generally before the onset of biological changes that accompany labour. This focus is consistent with the long-range goal of early detection/intervention and prevention of PTD. [ABSTRACT FROM AUTHOR]

This investigation focuses on the relationship between racial discrimination and health. Many studies have shown a link between race and differential health outcomes, but few have actually measured racial discrimination. Such studies leave unanswered the question of exactly how the experience of racial discrimination might affect health. Racial discrimination is argued to act in the same fashion as other chronic stressors by increasing blood pressure. However, racial discrimination may also give rise to the sense of thwarted aspirations, itself a stressor, and make the active coping style of "John Henryism" more likely. In these data, we measure perceived racial discrimination for a sample of African Americans and find that experiencing racially-based discriminatory treatment does not impact health. There is no relationship between doctor-diagnosed hypertension and cardiovascular disease, and being the victim of racially biased treatment. We discuss possible reasons for this, and argue that greater conceptualization about the postulated link between discrimination and health is necessary, as well as explicitly designed studies for the purpose of examining this postulated relationship.