abstract: Identifying modifiable causes of chronic disease is essential to prepare for the needs of an aging population. Cognitive decline is a precursor to the development of Alzheimer's and other dementing diseases, representing some of the most prevalent and least understood sources of morbidity and mortality associated with aging. To contribute to the literature on cognitive aging, this work focuses on the role of vascular and physical health in the development of cognitive trajectories while accounting for the socioeconomic context where health disparities are developed. The Assets and Health Dynamics among the Oldest-Old study provided a nationally-representative sample of non-institutionalized adults age 65 and over in 1998, with biennial follow-up continuing until 2008. Latent growth models with adjustment for non-random missing data were used to assess vascular, physical, and social predictors of cognitive change. A core aim of this project was examining socioeconomic and racial/ethnic variation in vascular predictors of cognitive trajectories. Results indicated that diabetes and heart problems were directly related to an increased rate of memory decline in whites, where these risk factors were only associated with baseline word-recall for blacks when conditioned on gender and household assets. These results support the vascular hypotheses of cognitive aging and attest to the significance of socioeconomic and racial/ethnic variation in vascular influences on cognitive health. The second substantive portion of this dissertation used parallel process latent growth models to examine the co-development of cognitive and functional health. Initial word-recall scores were consistently associated with later functional limitations, but baseline functional limitations were not consistently associated with later word-recall scores. Gender and household income moderated this relationship, and indicators of lifecourse SES were better equipped to explain variation in initial cognitive and functional status than change in these measures over time. Overall, this work suggests that research examining associations between cognitive decline, chronic disease, and disability must account for the social context where individuals and their health develop. Also, these findings advocate that reducing socioeconomic and racial/ethnic disparities in cognitive health among the aging requires interventions early in the lifecourse, as disparities in cognitive trajectories were solidified prior to late old age. / Dissertation/Thesis / Ph.D. Sociology 2011

The ethnic-racial relations in Brazil are contained in unequal contexts that reflect the ways in which the country was formed from enslavement. Thus the country was marked by racism and especially the exclusion of blacks. Thus, social institutions, especially the school is not exempt from this reality, since the racial conflicts are present in society due to the inheritance of a past forged by our shared values and habits in a process that favors a single racial segment. Therefore, the school is a space in which they live subjects of different ethnicities, genders and subjectivities. In this perspective we can observe the importance of checking the relationship of students from a public school in order to analyze how they relate to other subjects in the school environment, given the racial differences, since through coexistence develop actions in this space. Thus, the purpose of this work is to investigate the ethnic-racial relations experienced in the daily life of a classroom of 5th year of elementary school of a state school in Maceio, in order to analyze the relationships between black students in the everyday classroom in order to identify racist and prejudiced manifestations. The results indicate that black students are daily oppressed in school, discrimination and racism manifest through name calling, teasing and depreciation. / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / As relações étnico-raciais no Brasil estão contidas em contextos de desigualdades que refletem as formas pelas quais o país se constituiu desde a escravização. Diante disso, o país ficou marcado pelo racismo e, especialmente, pela exclusão dos negros. Desse modo, as instituições sociais, especialmente a escola não está isenta desta realidade, visto que os conflitos raciais estão presentes na sociedade devido à herança de um passado forjado por hábitos e valores pautados em um processo que privilegia um único segmento racial. Logo, a escola constitui um espaço no qual estão inseridos sujeitos de diferentes etnias, gêneros e subjetividades. Nesta perspectiva, observa-se a importância de verificar as relações dos alunos, de uma escola pública estadual com o intuito de analisar como estes se relacionam com os outros sujeitos do ambiente escolar, diante das diferenças raciais, já que, por meio da convivência, desenvolvem ações neste espaço. Dessa forma, a finalidade desta dissertação é investigar as relações étnico-raciais vivenciadas no cotidiano de uma sala de aula do 5º ano do ensino fundamental I, em uma escola pública estadual de Maceió, com o propósito de analisar as relações dos alunos negros no cotidiano da sala de aula, a fim de identificarmos manifestações racistas e preconceituosas. Os resultados obtidos apontam que os alunos negros são oprimidos cotidianamente na escola, a discriminação e o racismo se manifestam por meio de xingamentos, gozações e depreciações.

Suicidality rates are far higher among gender minority individuals than in the general population. This study sought to determine if intersecting identities and social support play a role in these rates. There were no differences in suicidality among gender minorities with an intersecting sexual minority identity. For intersecting racial/ethnic identities, it was found that White individuals were more likely to report past suicidal ideation than racial/ethnic minority individuals. Family support was independently associated with less suicidal ideation, whereas gender minority friend support was independently associated with an increase in suicidal ideation.

Introduction: The purpose of this study is to examine how nursing home (NH) characteristics, specifically racial composition of nursing homes residents, influences the use of physical restraints. As the population ages and becomes more diverse, it is essential to mitigate/eliminate racial/ethnic disparities in quality care. Methods: This is cross-sectional study using a 2010 national data set from Brown University Center for Gerontology and Healthcare Research. This study employs Donabedian's Structure-Process-Outcome (SPO) conceptual framework. Statistical analysis includes univariate, bivariate, and a logistic regression model. It is hypothesized that nursing homes with higher proportions of black residents, more Medicaid residents, and for-profit ownership status will be associated with higher prevalence of physical restraint use. Results: Findings show that nursing homes with high proportions of blacks have a lower likelihood of high physical restraint use. Nursing homes with a higher proportion of Medicaid-reliant residents have a higher likelihood of restraint use, as does for-profit nursing homes. Discussion: The findings indicate that there are no racial/ethnic disparities present in the use of physical restraints in nursing homes. There is indication of socio-economic disparities, since nursing homes with higher Medicaid-reliant residents are associated with greater restraint. There are policy implications associated with these findings, including raising Medicaid per diem or implementing a quality performance payment incentive. Further research will be needed to determine ways to reduce racial/ethnic disparities in nursing homes. This research, adds to the nursing home literature focused on socio-economic disparities.

Victims of racial discrimination often experience negative consequences that extend into all aspects of well-being (e.g., psychological, subjective, social). Racial microaggressions describe a series of verbal and non-verbal behaviors that cause harm, perpetuate negative stereotypes, and negate the experience of racial/ethnic minorities. Research has found a negative relationship between experiencing racial discrimination and psychological well-being, as well as a potential buffering effect of racial/ethnic identity. However, less information is available about the existence of these relationships with social well-being. The purpose of this dissertation is to fill a gap in the literature in regard to racial microaggressions, racial/ethnic identity, and social well-being in 453 racially diverse undergraduate students. Quantitative results indicated that African Americans reported higher levels of racial microaggressions and racial/ethnic identity than other groups, racial microaggressions were negatively associated with sense of belonging, racial/ethnic identity was positively associated with sense of belonging, and the association between racial microaggressions and sense of belonging was not moderated by racial/ethnic identity. Qualitative analyses using the conventional content analysis revealed two clusters of facilitative behavioral expressions of university/community inclusion: (a) interpersonal expressions of inclusion and (b) systemic expression of inclusion. I conclude by discussing limitations, areas for future research, and implications for counseling.

The purpose of this phenomenological study was to explore how individuals from different multiracial/multiethnic groups experience and process the phenomenon of parental racial ethnic socialization (RES). Critical multiracial race theory, critical race theory, and bioecological systems theory offered a conceptual framework to how RES is often presented and processed. This study was guided by two research questions: (1) What are the experiences of RES among multiracial individuals? and (2) How do multiracial individuals process the parental racial ethnic socialization they were offered? Nine qualitative, one-on-one, semistructured interviews were conducted with individuals from three different multiracial/multiethnic groups. Results revealed that experiences of RES varied along with how participants processed RES. Three subthemes and one theme emerged related to the RES experiences of participants. For some participants lack of conversations were evident in their RES, which meant that conversations surrounding multiraciality and other racialized topics were not present. Other participants disclosed the subtheme of preparedness as part of their RES experience, while others mentioned the importance of environment to their RES experience. Additionally, the theme of changes over time arose, demonstrating how different life events can impact RES experiences. As for how multiracial/multiethnic individuals process RES experiences, the main theme of identity arose with three subthemes. Participants felt that the lack of awareness/knowledge parents had about potential multiracial experiences left them feeling confused about how to navigate their multiple heritages.

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<p dir="ltr">Recent years have brought significant advances in interventions for developmental disabilities, emphasizing family-centered strategies and highlighting the importance of sociocultural context and family structures for providing context-specific interventions. Despite these advances, many families continue to struggle with understanding or accepting developmental disabilities, complicating intervention progress. This complexity is exacerbated for racially and ethnically diverse caregivers adapting to a new culture, as cultural differences influence how disabilities are perceived and managed.</p><p dir="ltr">This dissertation investigates the role of culture in the experiences of diverse caregivers of children with developmental disabilities. Guided by Bronfenbrenner’s bioecological systems theory and Berry’s acculturation theory, it examines how cultural adaptation impacts caregiving. Study 1 captures caregivers' lived experiences, revealing the dual challenges of stigma and negative community attitudes. Despite these obstacles, their resilience shines through, supported by culturally sensitive coaches. Study 2 examines the relationship between caregivers' acculturation strategies and parenting stress, finding that marginalization and separation increase stress, while integration and assimilation do not significantly impact it. Notably, longer residency in the U.S. correlates with lower satisfaction with interventions, regardless of acculturation strategies.</p><p dir="ltr">These findings underscore the urgent need for culturally sensitive support systems and the establishment of trustful relationships between service providers and caregivers. Recommendations include the involvement of translators, educators, and community resources to deliver holistic, culturally attuned support. Policymakers are urged to design flexible programs that cater to the unique needs of diverse families, enhancing their interaction with healthcare services and interventions.</p><p dir="ltr">In essence, this dissertation underscores the critical role of cultural context in shaping caregiving experiences. It passionately argues for a comprehensive support approach that embraces the rich diversity and distinct challenges faced by caregivers, paving the way for more effective and empathetic care strategies.</p><p><br></p>

<p dir="ltr">Background: Racial discrimination has been consistently associated with risk for alcohol use outcomes among racial/ethnic minority groups. This is particularly concerning given that engagement in alcohol use during adolescence has significant downstream effects on an individual's health into adulthood. Understanding factors that influence the relationship between racial discrimination and alcohol outcomes are needed to better understand the risk pathway and to identify malleable targets for interventions to reduce alcohol use among racial/ethnic minority adolescents. One potential candidate is emotion regulation as there is evidence that exposure to discrimination is associated with emotion regulation difficulties, and that emotion regulation difficulties are associated with alcohol outcomes. It is also plausible that emotion regulation is an external factor that strengthens or weakens to direct association between racial discrimination and alcohol use. Thus, the current study examined difficulties in emotion regulation (as measured by the State Difficulties in Emotion Regulation, S-DERS) as a mediator and moderator separately on the relationship between racial discrimination related stress (RDRS) and alcohol outcomes (i.e., use, quantity, frequency, alcohol use disorder, binge drinking, high intensity alcohol use) and risk for problems associated with substance use. To better understand the nuances within the emotion regulation construct, this study also examined the four subscales of the S-DERS (e.g., difficulties in nonacceptance, modulation, lack of awareness, lack of clarity) in a parallel mediation and moderation model to account for each domain’s unique effect on the racial discrimination-alcohol pathway. Methods: 714 self-identifying racial/ethnic minority adolescents aged 10-19 years old (62.9% male, mean age 16.21 years old, 58.1% African American/Black, 19% American, 9.9% Hispanic/Latino, 9.7% Asian American/Pacific Islander, 1.3% Middle Eastern/North African) completed an online questionnaire that included measures assessing experiences of racial discrimination related stress, state difficulties in emotion regulation, and alcohol outcomes. Results: Findings indicated a significant indirect effect of RDRS on alcohol outcomes through total state difficulties in emotion regulation (past year use b = 0.002, p <0.001; frequency b = 0.005, p <0.001; quantity b = 0.003, p <0.001; alcohol use disorder b = 0.056, p <0.001; binge drinking b = 0.004, p <0.001; high intensity alcohol use b = 0.003, p <0.001; risk for problems associated with substance use b = 0.007, p <0.001). When examining the subscales of emotion regulation, a significant indirect effect was found for difficulties in modulation within the relationship between RDRS and past year use, quantity, frequency, alcohol use disorder, binge drinking, and high-intensity alcohol use, but not for risk for problems associated with substance use. There were no significant indirect effects observed for the other subscales of emotion regulation. Additionally, when examining whether S-DERS or the S-DERS subscales moderated the relationship between RDRS and alcohol outcomes, no significant effects were found. Conclusion: These findings expand our understanding on potential mechanisms that underlie the racial discrimination-alcohol risk pathway among racial/ethnic minority adolescents, which may in turn help clarify the multifaceted nature of emotion regulation. As such, findings suggest that a unique effect was found for difficulties in modulation of emotions when accounting for the other domains of emotion regulation when examining the RDRS and alcohol outcomes relationship. Given that this study was cross-sectional, additional research utilizing a prospective study design can build off the current findings to confirm the proposed temporal pathway between RDRS, emotion regulation, and alcohol use outcomes. Moreover, findings suggest that difficulties in modulation and emotion regulation may be important constructs to include within treatments aimed at reducing alcohol use and prevention efforts among racial/ethnic minority adolescents experiencing racial discrimination related distress.</p>