Racial Differences in Arthritis-Related Stress, Chronic Life Stress, and Depressive Symptoms Among Women With Arthritis: A Contextual Perspective

School of Aging Studies, University of South Florida, 4202 East Fowler Avenue, MHC1318, Tampa, FL 33620, USA.
The Journals of Gerontology Series B Psychological Sciences and Social Sciences (Impact Factor: 3.21). 10/2008; 63(5):S320-7. DOI: 10.1093/geronb/63.5.S320
Source: PubMed


This study examined the effects of arthritis-related stress and chronic life stress on depressive symptoms among African Americans and Whites with arthritis.
Participants included 175 African American and White women (aged 45-90) who completed structured questionnaires assessing arthritis-related stress (i.e., pain, functional impairment, perceived stress), chronic life stress (i.e., discrimination, financial stress, life stressors), and well-being (i.e., depressive symptoms).
African Americans reported more functional impairment and lower perceived arthritis stress, but more life stressors, financial stress, and discrimination, than Whites. Arthritis-related stress accounted for similar proportions of variance in depressive symptoms across African Americans (DeltaR2=.16, p<.001) and Whites (DeltaR2=.24, p<.001). However, chronic life stressors explained significantly more variance among African Americans (DeltaR2=.20, p<.001, vs DeltaR2=.06, p<.05).
Findings demonstrate the importance of considering contextual factors influencing women's health and well-being, particularly for those women with a chronic illness, including arthritis. Although arthritis-related stressors may be the predominant factors affecting well-being for Whites with arthritis, well-being in African Americans with arthritis is also closely tied to broader life stressors. Results suggest the importance of looking beyond illness-specific stressors when studying aging and health.

4 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study examined factors underlying racial differences in pain and function among patients with hip and/or knee osteoarthritis (OA). Participants were n=491 African Americans and Caucasians enrolled in a clinical trial of telephone-based OA self-management. Arthritis Impact Measurement Scales-2 (AIMS2) pain and function subscales were obtained at baseline. Potential explanatory variables included arthritis self-efficacy, AIMS2 affect subscale, problem- and emotion-focused pain coping, demographic characteristics, body mass index, self-reported health, joint(s) with OA, symptom duration, pain medication use, current exercise, and AIMS2 pain subscale (in models of function). Variables associated with both race and pain or function, and which reduced the association of race with pain or function by >or=10%, were included in final multivariable models. In simple linear regression models, African Americans had worse scores than Caucasians on AIMS2 pain (B=0.65, P=0.001) and function (B=0.59, P<0.001) subscales. In multivariable models race was no longer associated with pain (B=0.03, P=0.874) or function (B=0.07, P=0.509), indicating these associations were accounted for by other covariates. Variables associated with worse AIMS2 pain and function were: worse AIMS2 affect scores, greater emotion-focused coping, lower arthritis self-efficacy, and fair or poor self-reported health. AIMS2 pain scores were also significantly associated with AIMS2 function. Factors explaining racial differences in pain and function were largely psychological, including arthritis self-efficacy, affect, and use of emotion-focused coping. Self-management and psychological interventions can influence these factors, and greater dissemination among African Americans may be a key step toward reducing racial disparities in pain and function.
    Osteoarthritis and Cartilage 10/2009; 18(2):160-7. DOI:10.1016/j.joca.2009.09.010 · 4.17 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We examined the extent to which experiences of racial discrimination are associated with bodily pain reported by African American men. The study sample consisted of 393 African American male veterans who responded to a national survey of patients aged 50-75 who received care from the Veterans Health Administration (VHA). Veterans were surveyed by mail, with a telephone follow-up. The response rate for African Americans in the sample was 60.5%. Pain (assessed using the bodily pain subscale of the 36-item short-form health survey), experiences of discrimination, employment, education, and income were obtained through the survey. Age, race, and mental health comorbidities were obtained from VA administrative data. Multiple regression analysis adjusting for item non-response (via imputation) and unit non-response (via propensity scores and weighting) was used to assess the association between racial discrimination and likelihood of experiencing moderate or severe pain over the past 4 weeks. Experiences of racial discrimination were associated with greater bodily pain (beta = -0.25, P < 0.0001), even after controlling for socioeconomic and health-related characteristics. Perceived racial discrimination was associated with greater pain among a sample of older African American male patients in the VA. Additional research is needed to replicate this finding among other populations of African Americans.
    Pain Medicine 11/2009; 10(8):1341-52. DOI:10.1111/j.1526-4637.2009.00742.x · 2.30 Impact Factor

  • Annual review of gerontology & geriatrics 11/2009; 29(1):181-202. DOI:10.1891/0198-8794.29.181
Show more


4 Reads
Available from