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Role of Racial Residential Segregation, Political Participation, and Social Capital on the Psychological Distress of Asian Americans in California
Abstracts / Annals of Epidemiology 27 (2017) 504e540
with lower odds as neighborhood SES increased (p¼0.0041). Education was not associated with the odds of depressive symptoms. Conclusions: Although varying patterns of association were observed in SES markers across races/ethnicities and sex, evidence for effect modification was seen only by race/ethnicity on the relationship between neighborhood SES and depressive symptoms. These findings contribute to a nuanced understanding of race/ethnicity and sex differences in SES related to depression.
P118. Cross-sectional Analysis of Driving Resumption among Older Former Drivers
537
marital status, plurality, smoking, and insurance type. Results: There was substantial clustering of mortality across neighborhoods
(intraclass correlation coefficient¼7.7%). After adjustments, odds of death among infants in the most extremely deprived tracts (lowest ICE quartile) were 70% higher compared to infants in the highest ICE quartile (OR¼1.70, 95% CI¼1.10, 2.64). Crudely, NH blacks had double the risk of infant mortality compared to whites (OR¼2.39, 95% 2.02, 2.83). This inequity was significantly reduced, although not eliminated, when adjusted for the ICE and individuallevel covariates (OR¼1.56, 95% CI¼1.22, 2.00). Conclusions: Strong associations between the ICE and infant mortality suggest achieving birth equity may require addressing not only deprivation within cities (as with the poverty level metric) but the distribution of privilege as well.
Kendra Ratnapradipa, Jing Wang, Marla Berg-Weger, Mario Schootman. Saint Louis University, 105 Magnolia Way, United States Purpose: Many older adults stop driving due to functional decline. Driving cessation has been associated with a variety of adverse social and health outcomes. Some former drivers resume driving although factors associated with driving resumption have not been studied. This study seeks to provide evidence of driving resumption, revise definitions of driving status, and provide evidence of factors predicting driving resumption. Methods: Cross-sectional analysis of the National Health and Aging Trends Study public use data (2011-2012). Analysis was limited to communitydwelling self-respondents identified as Round 1 former drivers (had ever driven but not during the preceding month), n¼1,193. Driving resumption (outcome) was defined as former drivers who had driven since the previous interview. Logistic regression models included baseline sociodemographic, health, and transportation variables to calculate adjusted odds ratios (aOR) with confidence intervals (CI) weighted for sample design. Results: In all, 916 former drivers (31.3% males) participated in Round 2, of whom 11.2% (n¼103) resumed driving. Hospitalization in the previous year (aOR 3.61; 95% CI 2.19-5.94), car ownership (aOR 3.58; 95% CI 2.19-5.85), immediate word recall score (aOR 1.35; 95% CI 1.13-1.62), history of stroke (aOR 0.35; 95% CI 0.18-0.68), number of transportation barriers (aOR 1.28; 95% CI 1.01-1.61) and younger age categories were significant predictors of driving resumption. When stratified, word recall, male, and transportation barriers were significant for non-car owners while hospitalization, stroke and recall remained significant for owners. Use of public transportation confounded associations in stratified analysis except for word recall. Conclusions: Driving cessation definitions may need to exclude individuals temporarily unable to drive due to acute health conditions (e.g., hospitalization). Car ownership and use of public transportation differentially impacted driving resumption among former drivers. Non-car owners may resume driving due to transportation barriers. Public transportation and other transportation alternatives may not adequately be meeting their needs.
P119. Privilege and Deprivation: Associations between the Index of Concentration at the Extremes and Birth Equity in Detroit Maeve Wallace, Joia Crear-Perry, Katherine Theall. Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2210, United States Purpose: Increasing spatial social polarization in many US cities has resulted in concentrations of extreme deprivation or privilege. We explored how the Index of Concentration at the Extremes (ICE) e a metric for jointly measuring racial/ethnic and economic segregation across neighborhoods e is associated with infant mortality (death before 1 year of age). Methods: Data on all live births among non-Hispanic (NH) white and non-Hispanic black women in Wayne County, MI from 2010-2013 e including data on whether or not the infant died prior to age 1 e were geocoded into census tracts. Five-year estimates (2009-2013) from the American Community Survey were used to compute the ICE for each census tract, defined as the difference between the number of NH white persons whose household income was greater than or equal to the 80th income percentile and the number of NH black persons in households below the 20 th income percentile, divided by the total population. Hierarchical models estimated the odds ratio and 95% confidence intervals for mortality in neighborhood strata defined by quartiles of the ICE, controlling for tract-level poverty, maternal race, education, age,
P120. Role of Racial Residential Segregation, Political Participation, and Social Capital on the Psychological Distress of Asian Americans in California R. David Rebanal, Mariah Santiago. San Francisco State University, 1600 Holloway Ave, San Francisco, CA 94132, USA Purpose: Racial residential segregation (RRS) negatively affects adult the mental health of minority residents, particularly among African Americans. Few studies have examined the relationship and potential pathways between RRS and health status among Asian Americans (hereafter: Asians), despite evidence that Asians are becoming more residentially segregated. Social capital and racial/ethnic minority political participation are known mechanisms through which residential segregation affects multiple health outcomes, including mental health. We sought to examine the association between RRS and self-reported mental health, and the moderating roles of social capital and political participation, among Asians in California metropolitan areas. Methods: Data are from the 2010 U.C. Census and the California Health Interview Survey, 2011-2014 (n¼8,338). RRS was measured using the Dissimilarity Indexes. Mental health status was measured using the K6 psychological distress scale. Social capital was measured using a fouritem scale. Political participation was measured as Asian American voter registration. Multi-level and ordinary least squares regression was used to examine the association between study variables. Results: Higher RRS was found to significantly increase psychological distress among Asian Americans. Higher levels of voter registration were also associated with higher distress. Conversely, higher levels of social capital resulted in lower distress scores. When examining interaction effects, we found that in highly segregated areas, low social capital was related to lower distress scores. Conclusions: Our findings suggest a positive association between RRS and psychological distress. Social capital and collective political empowerment are both associated with lower psychological distress among Asian Americans. However in highly segregated areas, low social capital is beneficial for mental health status. These results suggest that both the social context (e.g., neighborhood quality) and dimension of social capital (e.g., reciprocity, or enforceable trust) may be important distinguishing features of the relationship between RRS, social capital, political participation and the health status of Asian Americans.
P121. Combining Quantitative and Qualitative Approaches to Improve the health of Immigrant Travelers in an Ethno-culturally Diverse Canadian Region Rachel D. Savage,a Laura C. Rosella,a,b Natasha S. Crowcroft,a,b,c Jasleen Arneja,a Eileen de Villa,d Maureen Horn,d Kamran Khan,e,f Monali Variad. a Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada, b Public Health Ontario, Toronto, Ontario, Canada, c Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada, d Peel Public Health, Mississauga, Ontario, Canada, e Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada, f Department of Medicine, Division of Infectious Diseases, University of Toronto, Toronto, Ontario, Canada
with lower odds as neighborhood SES increased (p¼0.0041). Education was not associated with the odds of depressive symptoms. Conclusions: Although varying patterns of association were observed in SES markers across races/ethnicities and sex, evidence for effect modification was seen only by race/ethnicity on the relationship between neighborhood SES and depressive symptoms. These findings contribute to a nuanced understanding of race/ethnicity and sex differences in SES related to depression.
P118. Cross-sectional Analysis of Driving Resumption among Older Former Drivers
537
marital status, plurality, smoking, and insurance type. Results: There was substantial clustering of mortality across neighborhoods
(intraclass correlation coefficient¼7.7%). After adjustments, odds of death among infants in the most extremely deprived tracts (lowest ICE quartile) were 70% higher compared to infants in the highest ICE quartile (OR¼1.70, 95% CI¼1.10, 2.64). Crudely, NH blacks had double the risk of infant mortality compared to whites (OR¼2.39, 95% 2.02, 2.83). This inequity was significantly reduced, although not eliminated, when adjusted for the ICE and individuallevel covariates (OR¼1.56, 95% CI¼1.22, 2.00). Conclusions: Strong associations between the ICE and infant mortality suggest achieving birth equity may require addressing not only deprivation within cities (as with the poverty level metric) but the distribution of privilege as well.
Kendra Ratnapradipa, Jing Wang, Marla Berg-Weger, Mario Schootman. Saint Louis University, 105 Magnolia Way, United States Purpose: Many older adults stop driving due to functional decline. Driving cessation has been associated with a variety of adverse social and health outcomes. Some former drivers resume driving although factors associated with driving resumption have not been studied. This study seeks to provide evidence of driving resumption, revise definitions of driving status, and provide evidence of factors predicting driving resumption. Methods: Cross-sectional analysis of the National Health and Aging Trends Study public use data (2011-2012). Analysis was limited to communitydwelling self-respondents identified as Round 1 former drivers (had ever driven but not during the preceding month), n¼1,193. Driving resumption (outcome) was defined as former drivers who had driven since the previous interview. Logistic regression models included baseline sociodemographic, health, and transportation variables to calculate adjusted odds ratios (aOR) with confidence intervals (CI) weighted for sample design. Results: In all, 916 former drivers (31.3% males) participated in Round 2, of whom 11.2% (n¼103) resumed driving. Hospitalization in the previous year (aOR 3.61; 95% CI 2.19-5.94), car ownership (aOR 3.58; 95% CI 2.19-5.85), immediate word recall score (aOR 1.35; 95% CI 1.13-1.62), history of stroke (aOR 0.35; 95% CI 0.18-0.68), number of transportation barriers (aOR 1.28; 95% CI 1.01-1.61) and younger age categories were significant predictors of driving resumption. When stratified, word recall, male, and transportation barriers were significant for non-car owners while hospitalization, stroke and recall remained significant for owners. Use of public transportation confounded associations in stratified analysis except for word recall. Conclusions: Driving cessation definitions may need to exclude individuals temporarily unable to drive due to acute health conditions (e.g., hospitalization). Car ownership and use of public transportation differentially impacted driving resumption among former drivers. Non-car owners may resume driving due to transportation barriers. Public transportation and other transportation alternatives may not adequately be meeting their needs.
P119. Privilege and Deprivation: Associations between the Index of Concentration at the Extremes and Birth Equity in Detroit Maeve Wallace, Joia Crear-Perry, Katherine Theall. Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2210, United States Purpose: Increasing spatial social polarization in many US cities has resulted in concentrations of extreme deprivation or privilege. We explored how the Index of Concentration at the Extremes (ICE) e a metric for jointly measuring racial/ethnic and economic segregation across neighborhoods e is associated with infant mortality (death before 1 year of age). Methods: Data on all live births among non-Hispanic (NH) white and non-Hispanic black women in Wayne County, MI from 2010-2013 e including data on whether or not the infant died prior to age 1 e were geocoded into census tracts. Five-year estimates (2009-2013) from the American Community Survey were used to compute the ICE for each census tract, defined as the difference between the number of NH white persons whose household income was greater than or equal to the 80th income percentile and the number of NH black persons in households below the 20 th income percentile, divided by the total population. Hierarchical models estimated the odds ratio and 95% confidence intervals for mortality in neighborhood strata defined by quartiles of the ICE, controlling for tract-level poverty, maternal race, education, age,
P120. Role of Racial Residential Segregation, Political Participation, and Social Capital on the Psychological Distress of Asian Americans in California R. David Rebanal, Mariah Santiago. San Francisco State University, 1600 Holloway Ave, San Francisco, CA 94132, USA Purpose: Racial residential segregation (RRS) negatively affects adult the mental health of minority residents, particularly among African Americans. Few studies have examined the relationship and potential pathways between RRS and health status among Asian Americans (hereafter: Asians), despite evidence that Asians are becoming more residentially segregated. Social capital and racial/ethnic minority political participation are known mechanisms through which residential segregation affects multiple health outcomes, including mental health. We sought to examine the association between RRS and self-reported mental health, and the moderating roles of social capital and political participation, among Asians in California metropolitan areas. Methods: Data are from the 2010 U.C. Census and the California Health Interview Survey, 2011-2014 (n¼8,338). RRS was measured using the Dissimilarity Indexes. Mental health status was measured using the K6 psychological distress scale. Social capital was measured using a fouritem scale. Political participation was measured as Asian American voter registration. Multi-level and ordinary least squares regression was used to examine the association between study variables. Results: Higher RRS was found to significantly increase psychological distress among Asian Americans. Higher levels of voter registration were also associated with higher distress. Conversely, higher levels of social capital resulted in lower distress scores. When examining interaction effects, we found that in highly segregated areas, low social capital was related to lower distress scores. Conclusions: Our findings suggest a positive association between RRS and psychological distress. Social capital and collective political empowerment are both associated with lower psychological distress among Asian Americans. However in highly segregated areas, low social capital is beneficial for mental health status. These results suggest that both the social context (e.g., neighborhood quality) and dimension of social capital (e.g., reciprocity, or enforceable trust) may be important distinguishing features of the relationship between RRS, social capital, political participation and the health status of Asian Americans.
P121. Combining Quantitative and Qualitative Approaches to Improve the health of Immigrant Travelers in an Ethno-culturally Diverse Canadian Region Rachel D. Savage,a Laura C. Rosella,a,b Natasha S. Crowcroft,a,b,c Jasleen Arneja,a Eileen de Villa,d Maureen Horn,d Kamran Khan,e,f Monali Variad. a Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada, b Public Health Ontario, Toronto, Ontario, Canada, c Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada, d Peel Public Health, Mississauga, Ontario, Canada, e Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada, f Department of Medicine, Division of Infectious Diseases, University of Toronto, Toronto, Ontario, Canada