David R. Williams

David R. Williams
  • Harvard University

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772
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91,626
Citations
Current institution
Harvard University

Publications

Publications (772)
Article
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Background: Data from the World Mental Health (WMH) surveys on the coverage cascade has underscored the importance of perceived need for seeking treatment of mental disorders. However, little research has focused on treatment contact after adjusting for perceived need. We do so here in analysis of WMH data. Methods: The WMH data considered here...
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Background High unmet need for treatment of mental disorders exists throughout the world. An understanding of barriers to treatment is needed to develop effective programs to address this problem. Methods Data on barriers were obtained from face-to-face interviews in 22 community surveys across 19 countries (n = 102,812 respondents aged ≥ 18 years...
Article
Importance Accurate baseline information about the proportion of people with mental disorders who receive effective treatment is required to assess the success of treatment quality improvement initiatives. Objective To examine the proportion of mental and substance use disorders receiving guideline-consistent treatment in multiple countries. Desi...
Chapter
This second edition of the Oxford Textbook of Community Mental Health addresses recent changes and achievements, current controversies, and future challenges while emphasizing areas of convergence, where social values, health, medical sciences, and policy formation converge and meet. This edition also features a new section on global mental health,...
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This survey study uses 3 nationally representative US surveys to evaluate the prevalence of poor mental health overall and by age, sex, and race and ethnicity.
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Background Religiousness has been consistently linked to positive health outcomes and flourishing, yet the underlying mechanisms are complex and not well-understood. The forgiveness and relational spirituality model offers a framework to explore the moderated mediation among religious commitment, health, and forgiveness by God. Understanding these...
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Background Discrimination may contribute to sleep health disparities among women, yet limited research has investigated the association between discrimination and insomnia with short sleep. Methods and Results Among a racially and ethnically diverse sample of women (N=25 920; mean age, 72.2±6.1 years), we investigated the relationship of discrimin...
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Recent studies have suggested that high levels of social support can encourage better health behaviours and result in improved cardiovascular health. In this study we evaluated the association between social support and ideal cardiovascular health among urban Jamaicans. We conducted a cross-sectional study among urban residents in Jamaica’s south-e...
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Introduction Anti‐transgender stigma presents threats of discrimination to transgender and nonbinary (TGNB) individuals, prompting them to stay vigilant. Using a longitudinal data of 285 South Korean TGNB adults, we examined vigilance and its associations with suicidal ideation and suicide attempt and explored the protective role of connectedness t...
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This JAMA Insights in the Women’s Health series discusses the incidence, diagnosis, and treatment of uterine fibroids.
Article
Importance Identifying factors contributing to sustained physical functioning is critical for the health and well-being of the aging population, especially as physical functioning may precede and predict subsequent health outcomes. Prior work suggests optimism may protect health, but less is known about the association between optimism and objectiv...
Article
Importance Adolescent suicide in the US is a major public health problem, yet temporal trends in suicide methods by demographics are understudied. Objective To examine national trends in suicide mortality by method (firearm, poisoning, hanging and asphyxiation, and all other means) from 1999 to 2020 by demographic characteristics. Design, Setting...
Article
Objectives Purpose in life has been associated with diverse health outcomes, however, few studies have examined its associations with progressive motor decline in older adults. We tested if higher purpose would be associated with lower likelihood of incident parkinsonism as well as with lower levels and slower rates of increase in parkinsonian sign...
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BACKGROUND AND OBJECTIVES The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) prevents food insecurity and supports nutrition for more than 3 million low-income young children. Our objectives were to determine the cost-effectiveness of changes to WIC’s nutrition standards in 2009 for preventing obesity and to estimate...
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Introduction Research is beginning to examine the health outcomes of migrators of the Great Migration, a movement of up to eight million African Americans from the South to the North and West during the twentieth century. However, sparse evidence exists studying the health outcomes of the descendants of Great Migration movers. The aim for this stud...
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During the COVID-19 pandemic, the American Heart Association created a new 2024 Impact Goal with health equity at its core, in recognition of the increasing health disparities in our country and the overwhelming evidence of the damaging effect of structural racism on cardiovascular and stroke health. Concurrent with the announcement of the new Impa...
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Objective To quantify the association between attributional ambiguity–the uncertainty of whether an experience is discrimination–and mental health. Methods Using a nationally representative sample of U.S. adults recruited through an online survey by Ipsos (April 23 and May 3, 2021), attributional ambiguity was quantified by asking participants if...
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Evidence linking maternal subjective wellbeing (SWB) to early childhood development (ECD) is scarce. Subjective wellbeing measures an individual’s negative and positive affect, life satisfaction, and optimism for the future. During ECD, growth occurs in family niches where a mother’s physical, emotional, and mental wellbeing affects her child throu...
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South Africa is experiencing a rapidly growing diabetes epidemic that threatens its healthcare system. Research on the determinants of diabetes in South Africa receives considerable attention due to the lifestyle changes accompanying South Africa’s rapid urbanization since the fall of Apartheid. However, few studies have investigated how segments o...
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This study investigates associations between religious involvement and identity and attitudes related to domestic violence using nationally representative cross‐sectional data from n = 1287 Australian adults in the 2018 Australian Survey of Social Attitudes (AuSSA). Linear regression models were used to analyse the association between religious inv...
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The Liberian civil wars led to widespread destruction and devastation for its individuals, communities, and economy. However, individuals’ subjective trauma experiences and long-term psychological impact remain relatively understudied. This study aims to explore context-specific traumatic events and examine how risk and protective factors combine w...
Preprint
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Recent studies suggest that high levels of social support can encourage better health behaviours and result in improved cardiovascular health. In this paper, we evaluated the association between social support and ideal cardiovascular health among urban Jamaicans. We conducted a cross-sectional study among urban residents in Jamaica's southeast hea...
Article
The Great Migration was a movement of roughly eight million Black Southerners relocating to the North and West from 1910 to 1980. Despite being one of the most significant mass internal migrations during the twentieth century, little is known about the health outcomes resulting from migration and whether migrators’ destination choices were potentia...
Article
Introduction: Amid the successes of local sugar-sweetened beverage (SSB) taxes, interest in state-wide policies has grown. This study evaluated the cost-effectiveness of a hypothetical 2-cent-per-ounce excise tax in California (CA) and implications for population health and health equity. Methods: Using the CHOICES microsimulation model, tax imp...
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Introduction: Calorie labeling of standard menu items has been implemented at large restaurant chains across the United States since 2018. The objective of this study was to evaluate the cost-effectiveness of calorie labeling at large U.S. fast-food chains. Methods: This study evaluated the national implementation of calorie labeling at large fa...
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Background Despite the high cost of low birth weight and the persistent challenge of racial inequities affecting the Arab American community, there has been limited research to identify and examine risk factors for these inequities with validated data on Arab American ethnicity and recent population stressors. Objectives This study examined whethe...
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Racial inequities in blood pressure levels have been extensively documented. Experiences of racial discrimination could explain some of this disparity, although findings from previous studies have been inconsistent. To address limitations of prior literature, including measurement error, we implemented instrumental variable analysis (IV) to assess...
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Summary Background Information on the frequency and timing of mental disorder onsets across the lifespan is of fundamental importance for public health planning. Broad, cross-national estimates of this information from coordinated general population surveys were last updated in 2007. We aimed to provide updated and improved estimates of age-of-o...
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Background Despite limited data on neighborhood factors and health risk in Caribbean populations, previous analyses from Jamaica have shown that neighborhood and home disorder were associated with lower physical activity and higher cumulative biological risk among women, while poorer neighborhood infrastructure was associated with higher overweight...
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Importance: Understanding the association of civil violence with mental disorders is important for developing effective postconflict recovery policies. Objective: To estimate the association between exposure to civil violence and the subsequent onset and persistence of common mental disorders (in the Diagnostic and Statistical Manual of Mental D...
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Objective: The Great Migration was a mass movement in the United States during the twentieth century of roughly eight million Black Southerners to the Northeast, Midwest, and West. Despite its significance, little is known about the health outcomes associated with this internal migration. This study assessed the relationship between migration and...
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James S. Jackson (1944–2020) is remembered as a groundbreaking social psychologist whose career contributions in scholarship, research, and service were fundamental to the field of psychology. This article briefly outlines his career-long work and contributions. A strong believer in interdisciplinary work, his research spanned other related social...
Preprint
Full-text available
Introduction: Research is beginning to examine the health outcomes of migrators of the Great Migration, a movement of up to eight million African Americans from the South to the North and West during the 20th century. However, sparse evidence exists studying the health outcomes of the children of Great Migration movers. The aims for this study were...
Article
Fees and fines collected through courts and law enforcement can comprise a considerable proportion of revenue for local governments. Law enforcement, as agents of revenue generation, change policing behavior to increase revenue, at times targeting Black and brown neighborhoods to bolster municipal budgets. This structural racism in revenue generati...
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Background Although investigations have begun to differentiate biological and neurobiological responses to a variety of adversities, studies considering both endocrine and immune function in the same datasets are limited. Methods Associations between proximal (family functioning, caregiver depression, and anxiety) and distal (SES-D; socioeconomic...
Chapter
Large racial inequalities exist in the onset, course, and outcomes of illness in the United States and certain other race-conscious countries. Despite our extensive knowledge of the magnitude, trends, and determinants of these social inequalities in health, there is still much that we need to learn about the forces that drive them. This chapter pro...
Article
Background: International and population-specific evidence identifies elevated psychological distress prevalence among those experiencing interpersonal discrimination. We aim to quantify the potential whole-of-population contribution of interpersonal discrimination to psychological distress prevalence and Indigenous-non-Indigenous gaps in Australi...
Article
Research on discrimination and risks for violence and mental health issues under the pandemic is notably absent. We examined the relative effects of perceived everyday discrimination (e.g., poorer service, disrespectful treatment in a typical week) and major experiences of race-based discrimination (e.g., racial/ethnic discrimination in housing or...
Article
Introduction: Discrimination may contribute to sleep disparities, and subsequent adverse cardiovascular health. Despite the higher prevalence of insomnia among women, particularly historically minoritized women compared to men, limited studies examine the association between discrimination and insomnia and sleep duration. Methods: Among 26,616 wome...
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Background Many studies have evaluated the stress-cognition association, but few have captured the cumulative nature of stress or distinguished the influences of stressors occurring in childhood versus adulthood. Using a lifecourse approach, we investigated whether cumulative stress exposures are associated with poorer cognitive function and faster...
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We examined the associations between a sense of purpose and all-cause mortality by gender and race/ethnicity groups. Data were from the Health and Retirement Study, a nationally representative cohort study of U.S. adults aged >50 (n = 13,159). Sense of purpose was self-reported at baseline (2006/2008), and risk of all-cause mortality was assessed o...
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Purpose Lesbian, gay, and bisexual (LGB) individuals, and LB women specifically, have an increased risk for psychiatric morbidity, theorized to result from stigma-based discrimination. To date, no study has investigated the mental health disparities between LGB and heterosexual AQ1individuals in a large cross-national population-based comparison. T...
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Aim Exposure to traumatic events (TEs) is associated with substance use disorders (SUDs). However, most studies focus on a single TE, and are limited to single countries, rather than across countries with variation in economic, social and cultural characteristics. We used cross-national data to examine associations of diverse TEs with SUD onset, an...
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Patient‐reported helpfulness of treatment is an important indicator of quality in patient‐centered care. We examined its pathways and predictors among respondents to household surveys who reported ever receiving treatment for major depression, generalized anxiety disorder, social phobia, specific phobia, post‐traumatic stress disorder, bipolar diso...
Article
As the science of adversity and resilience advances, and public awareness of the health consequences of stress grows, primary care providers are being increasingly asked to address the effects of adverse experiences on child wellbeing. Given limited tools for assessing these effects early in life, the authors explore how enhanced capacity to measur...
Article
Psychotic disorders (e.g., schizophrenia, schizoaffective disorder) are a leading cause of morbidity and premature mortality and an overlooked health inequity in the United States. European data indicate inequities in incidence, severity, and treatment of psychotic disorders, particularly for Black communities, that appear to be primarily attributa...
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Importance: Prior studies found a higher risk of acute cardiovascular disease (CVD) around population-wide psychosocial or environmental stressors. Less is known about acute CVD risk in relation to political events. Objective: To examine acute CVD hospitalizations following the 2020 presidential election. Design, setting, and participants: Thi...
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Discrimination has consistently been associated with multiple adverse health outcomes. Like other psychosocial stressors, discrimination is thought to impact health through stress-related physiologic pathways including hypothalamic-pituitary-adrenal (HPA) axis activation, dysregulation of inflammation responses, and accelerated cellular aging. Give...
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Life course-informed theories of development suggest it is important to integrate information about positive and negative aspects of the social environment into studies of child and parental wellbeing, including both stressors that compromise health and resources that promote well-being. We recruited a sample of 169 pairs of caregivers and young ch...
Article
The objective of this paper is to examine associations between multiple measures of discrimination (i.e., everyday, lifetime, and appraised burden) and components of allostatic load (AL). We drew on pooled cross-sectional data from the Biomarker Project of the Midlife in the United States study (n = 2118). Ages ranged from 25 to 84 years and includ...
Article
Background: Prior studies demonstrated a higher risk of acute cardiovascular disease (CVD) around population-wide psychosocial or environmental stressors. Less is known about the impact of sociopolitical events. The objective of the current study was to examine acute CVD hospitalizations following the 2020 presidential election. Methods: We examine...
Article
Research related to racism and health has evolved in recent decades, with a growing appreciation of the centrality of the social determinants of health, life-course approaches and structural racism, and other upstream factors as drivers of health inequities. Examining how race, class, and structural racism relate to each other and combine over the...
Article
Background: Studies from armed conflict settings, including South Sudan, have revealed the deleterious mental health impact of exposure to war atrocities. However, there is little consensus on what is meant by war trauma, how it should be measured, and how levels of trauma vary across biological sex. Methods: We used psychometric analyses to mea...
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While racial/ethnic oral health inequities have been documented for many years in the United States, the potential role of racism has not been examined until recently. In fact, the common practice has been to attribute racial/ethnic disparities in oral health to low socioeconomic position and/or the lack of access to care. In contrast, racism is co...
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Background Foreign-born Black and Latina women on average have higher birthweight infants than their US-born counterparts, despite generally worse socioeconomic indicators and prenatal care access, i.e., “immigrant birthweight paradox” (IBP). Residence in immigrant enclaves and associated social-cultural and economic benefits may be drivers of IBP....
Article
Aim We examined prevalence and factors associated with receiving perceived helpful alcohol use disorder (AUD) treatment, and persistence in help-seeking after earlier unhelpful treatment. Methods Data came from 27 community epidemiologic surveys of adults in 24 countries using the World Health Organization World Mental Health surveys (n = 93,843)....
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Background: Hypertension is the leading cardiovascular disease in Africa. It is increasing in prevalence due partly to the epidemiological transition that African countries, including South Africa, are undergoing. This epidemiological transition is characterised by a nutrition transition andurbanisation; resulting in behavioural, environmental and...
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Purpose South Africa has long endured a high prevalence of mental disorders at the national level, and its unique social and historical context could be a contributor to an increased risk of mental health problems. Our current understanding is limited regarding the relative importance of various social determinants to mental health challenges in So...
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Objectives: To examine the association of perceived discrimination with participant retention and diabetes risk among American Indians and Alaska Natives. Methods: Data were drawn from the Special Diabetes Program for Indians–Diabetes Prevention Demonstration Project (N = 2553). Results: Perceived discrimination was significantly and negatively ass...
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Background: Treatment guidelines for generalized anxiety disorder (GAD) are based on a relatively small number of randomized controlled trials and do not consider patient-centered perceptions of treatment helpfulness. We investigated the prevalence and predictors of patient-reported treatment helpfulness for DSM-5 GAD and its two main treatment pa...
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Methods for calculating health indicators profoundly influence understanding of and action on population health and inequities. Age-standardization can be useful and is commonly applied to account for differences in age structures when comparing health indicators across groups. Age-standardized rates have well-acknowledged limitations, including th...
Article
Racial/ethnic discrimination may contribute to type 2 diabetes mellitus (T2DM) risk, but few studies have prospectively examined this relationship among racially/ethnically diverse populations. We analyzed prospective data from 33,833 eligible Sister Study participants enrolled from 2003 to 2009. In a follow-up questionnaire (2008-2012), participan...
Article
Study objectives: African-Americans have a high burden of poor sleep, yet, psychosocial determinants (e.g., discrimination) are understudied. We investigated longitudinal associations between everyday discrimination and sleep quality and duration among African-Americans (N=3404) in the Jackson Heart Study. Methods: At Exam 1 (2000-2004) and Exam...
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Discrimination is a fundamental determinant of health and health inequities. However, despite the high prevalence of discrimination exposure, there is limited evidence specific to Indigenous populations on the link between discrimination and health. This study employs a validated measure to quantify experiences of everyday discrimination in a natio...
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Sexually transmitted diseases (STDs) are high in populations of color compared to Whites. High-risk sexual behaviors are widely viewed as the key contributors to the levels of STDs, especially in adolescents and young adults. This article situates the sexual risk behaviors of Black, Indigenous, and other young people of color within the framework o...
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Background: Psychosocial stressors, such as perceived discrimination and depressive symptoms, may shorten telomeres and exacerbate aging-related illnesses. Methods: Participants from the Jackson Heart Study at visit 1 (2000-2004) with LTL data and Center for Epidemiological Studies-Depression (CES-D) scores (n = 580 men, n = 910 women) were util...
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There is not much evidence on the effects of south–south migration and its consequences on physical and mental health. Our objective was to examine the mediating role of Acculturative Stress in the association between ethnic discrimination and racial discrimination with physical and mental health. This research is a non-experimental, analytical, cr...
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Excessive home cage aggression often results in severe injury and subsequent premature euthanasia of male laboratory mice. Aggression can be reduced by transferring used nesting material during cage cleaning, which is thought to contain aggression appeasing odors from the plantar sweat glands. However, neither the composition of plantar sweat nor t...
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The health status of children in the United States varies by racial and ethnic, shaped by an interrelated set of systems that disadvantage children of color in the United States. In this article, we argue for a broad view of resilience, in both research and policy, that views resilience not just as a property of individuals but also as a characteri...
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Introduction Having a higher purpose in life has been linked to favorable health outcomes. However, little research has examined whether the purpose–health association persists across different levels of SES. This study assesses whether the association between higher purpose in life and lower mortality is similar across the levels of SES. Methods...
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Background Racial disparities in cognitive function are well documented, but factors driving these disparities remain underexplored. This study aims to quantify the extent to which cumulative stress exposures across the life course explain Black–White disparities in executive function and episodic memory in middle-aged and older adults. Methods Da...
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This study assessed whether race moderates the association between flourishing and all-cause mortality. We used panel data from the Midlife in the United States Study (MIDUS) (1995–2016) (n = 2851). Approximately 19% of White respondents and 23% of Black respondents of the baseline sample died over the course of the 21-year study period (n = 564)....
Article
Background: Perceived discrimination is associated with worse mental health. Few studies have assessed whether perceived discrimination (i) is associated with the risk of psychotic disorders and (ii) contributes to an increased risk among minority ethnic groups relative to the ethnic majority. Methods: We used data from the European Network of N...
Article
Racial disparities in health-care access, quality and outcomes are pervasive and persistent. Racism is a fundamental driver of racial disparities. Individuals and institutions in the health-care system must prioritize addressing racism as their professional responsibility through training, support and inclusion. Racial disparities in health-care ac...
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Stress is a common belief among breast cancer patients and the public to explain variation in breast cancer incidence. Epidemiological studies interrogating the relationship between stress and cancer have reported mixed results. The impact of the topic and the lack of consensus has sparked this review of the literature to investigate gaps in knowle...
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Evidence of an association between psychosocial stress and mortality continues to accumulate. However, despite repeated calls in the literature for further examination into the physiological and behavioral pathways though which stress affects health and mortality, research on this topic remains limited. This study addresses this gap by employing a...
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Although socioeconomic status partly explains ethnic disparities seen with covid-19, cultural and structural racism also adversely affect health, argue Mohammad Razai and colleagues © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to.
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Background Awareness of burnout and its implications within the medical field has been growing. However, an understanding of the prevalence and consequences of burnout among underrepresented minority (URM), specifically underrepresented minority in medicine (UiM) populations, is not readily available.Objective To examine literature investigating bu...
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Background: It is well established that racism is a fundamental contributor to poor health and inequities. There is consistent evidence of high exposure to discrimination among Aboriginal and Torres Strait Islander (Indigenous Australian) peoples, but impacts have not been fully quantified, in part due to limited measurement tools. We aim to valid...
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Significance Genetic factors can concurrently influence perceptions of threatening and stressful events, like discriminatory experiences, and increase liability for anxiety and negative affect. The question has remained unsettled as to whether genetic susceptibility to anxiety and negative affect confounds the relationship between discrimination ex...
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Background: The ability to resist adverse outcomes, or demonstrate resilience after exposure to trauma is a thriving field of study. Yet ongoing debate persists regarding definitions of resilience, generalizability of the extant literature, neurobiological correlates, and a consensus research agenda. Objectives: To address these pressing questions,...
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Objective Ideal cardiovascular health (ICH) is associated with greater longevity and reduced morbidity, but no research on ICH has been conducted in Jamaica. We aimed to estimate the prevalence of ICH in urban Jamaica and to evaluate associations between ICH and community, household, and individual socioeconomic status (SES). Design Cross-sectiona...
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Significance Previous studies have shown a transiently higher risk of acute cardiovascular disease (CVD) events within minutes to hours after behavioral, psychosocial, and environmental triggers. Research is limited examining acute CVD surrounding sociopolitical events. We compared hospitalization rates for acute CVD before and immediately after th...
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Purpose: The purpose was to use Twitter to conduct online surveillance of negative sentiment towards Mexicans and Hispanics during the 2016 United States presidential election, and to examine its relationship with mental well-being in this targeted group at the population level. Methods: Tweets containing the terms Mexican(s) and Hispanic(s) wer...
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Background and Objectives Perceived discrimination is a risk factor for poor mental health. However, most studies measure discrimination at one time point, which does not account for heterogeneity in the cumulative patterning of exposure to discrimination. To address this gap, we examine the association between discrimination trajectories and depre...

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