Browsing by Subject "depressive symptoms"
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Item Discrimination and Depressive Symptom Trajectories of Middle-aged and Older Adults with Chronic Diseases(2021-07) Yoon, Young JiDepression is a serious health concern for adults who have been diagnosed with cancer or diabetes. In addition to the challenges associated with chronic disease management, perceived discrimination has been identified as a factor that increases the risk of depressive symptoms. However, empirical evidence using longitudinal data to test the association between perceived discrimination and depressive symptoms of those with cancer or diabetes is limited. Using Andersen’s Behavioral Model and the Theory of Fundamental Causes as guiding frameworks, this three-paper dissertation study presents a scoping review (Study 1) and two quantitative studies (Studies 2 and 3) to investigate the association between perceived discrimination and depressive symptoms among middle-aged and older adults with a cancer history or diabetes. In Study 1, an assessment of 23 peer-reviewed journal articles provides strong empirical evidence for statistically significant direct or indirect relationships between discrimination/stigma and depressive symptoms. In Studies 2 and 3, latent growth modeling using data from the Health and Retirement Study indicates that cancer survivors had an increasing linear trajectory of depressive symptoms and people with diabetes had a decreasing linear trajectory of depressive symptoms over a 4-year period (Study 2: 2010–2014, Study 3: 2014-2018). Findings from these studies support the need for social workers and other members of the health care team to offer tailored assessment and treatment approaches to address depressive symptoms for cancer survivors and people with diabetes, especially those who may perceive discrimination based on their race, ethnicity, socioeconomic status, culture, language, and having a medical diagnosis. Implications for future investigations are discussed.Item Structural racism and its role in propagating racial health inequities through systems of higher education and public health surveillance(2022-07) Thyden, NaomiHealth inequities by race are ubiquitous and persistent in the U.S., and structural racism is understood to be the cause. However, there has been relatively little research on structural racism as an exposure. This dissertation will describe three ways to conceptualize and measure structural racism with the end goal of intervening to reduce health inequities. First, it will examine structural racism in surveillance data. The Sudden Unexpected Infant Death (SUID) Case Registry is a public health surveillance system created to prevent SUIDs. This study assesses the quality of data collection by rurality and by race to examine bias within the surveillance system. Second, it will discuss exposure distributions and structural racism. Research about causes of racial health inequities often favor using an interaction term with race rather than also considering unequal distributions of exposures by race. This study provides the first estimates for Hispanic Americans, Asian Americans, and Native Americans on an understudied exposure – death of a sibling or a parent – and its effect on attaining a Bachelor’s degree. Third, it will delve into education policy and structural racism. Historically Black Colleges or Universities (HBCUs) were founded on anti-racism while predominantly white institutions (PWIs) were often founded on white supremacy. This contrast provides an opportunity to study effects of structural racism on the health of Black students who attended college in the U.S. This study measures the long-term effect of attending an HBCU on depressive symptoms among Black people compared to Black people who attended PWIs.