Harold W Neighbors

Tulane University | TU · School of Public Health and Tropical Medicine

Background John Henryism (JH) is a behavioral predisposition for high-effort coping with adversity. JH has been associated with hypertension in Black Americans with low socioeconomic status (SES) and is also found to be associated with psychological well-being. Sickle cell disease (SCD), a rare genetic disease largely affecting Black Americans in t...

Mental health problems in emerging adulthood are linked to tobacco and cannabis use, but whether race and ethnicity modifies these associations is unclear. We used data from wave 4 of the Population Assessment of Tobacco and Health Study (youth n = 6898, young adult n = 10,304) to conduct latent class analysis (LCA) of six past 30-day tobacco and c...

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...

Introduction: Racial/ethnic discrimination (hereafter, discrimination) is associated with use of individual tobacco and cannabis products. However, we know little about how discrimination affects dual/polytobacco and cannabis use and associated use disorders. Methods: We used cross-sectional data on adults (18+) from the 2012-2013 National Epide...

Thirty-seven years ago, the Secretary's Task Force on Black and Minority Health called attention to a “national paradox” of persistent Black-White health disparities despite overall health improvements for the nation (HHS, 1985). Subsequent updates to the “Heckler Report” came to the same conclusion; Black Americans continued to exhibit poorer heal...

Caregiving can be both distressing and physically demanding, especially among African Americans. This study uses data from the National Survey of American Life (NSAL) to examine the relationship between religion and spirituality experiences on health ratings among African American caregivers. Logistic regression analyses were performed on a sample...

Background: The minorities’ diminished return theory suggests that socioeconomic position (SEP) generates smaller health gains for racial/ethnic minorities compared to Whites. The current study was a Black–White comparison of the association between household income and self-rated mental health (SRMH). Methods: This cross-sectional study used data...

Objectives: As adults increase in age, the likelihood for using mental health care services decrease. Underutilization, expecially among racial/ethnic minorities such as African American and Caribbean Blacks, can result in a decrease in quality of life, as well as significant costs to families, employers, and health systems. Methods: The study e...

Depression is one of the most common, costly, and debilitating psychiatric disorders in the United States. One of the most persistent mental health disparities is the underutilization of treatment services among African American men with depression. Little is known about appropriateness or acceptability of depression care among African American men...

This study examined the impact of discrimination and legal acculturative stress on Major Depression Episode lifetime among Asian American immigrants. It further examined the role of immigration related-factors (age at immigration, reason for immigration, and years spent in the U.S.) on the relationship of acculturative stress and Major Depression E...

This paper uses the National Survey of American Life (NSAL) to examine within group differences regarding help-seeking for substance disorders among a US sample of African American and Caribbean Black men and women. We examined ethnic and gender differences in the type of providers sought for substance disorder treatment, as well as reasons for avo...

Purpose: Racial and ethnic disparities in periodontal disease exist in the United States. This study examined the prevalence of self-reported periodontal disease, and the extent to which racial/ethnic disparities in the reported disease were reduced or eliminated after controlling for various risk factors in a multi-ethnic study population of olde...

Aim The aim of this study was to explore ethnic differences in the separate and additive effects of anxiety and depression on self-rated mental health (SRMH) of Blacks in the USA. Methods With a cross-sectional design, we used data from a national household probability sample of African Americans (n = 3570) and Caribbean Blacks (n = 1621) who parti...

Background: The purpose of this study was to examine the frequency of gardening/yard work in relation to depressive symptoms in African-Americans while controlling for biological and social factors. Methods: A secondary analysis was performed on the National Survey of American Life (n=2,903) using logistic regression for complex samples. Gardeni...

The high prevalence of co morbid chronic conditions among minorities and underserved individuals is a public health problem that deserves research attention. We used the Design Science Research approach to iteratively build a persuasive mobile phone texting (SMS) based behavior change support intervention (OH-Buddy) that (1) addresses co morbid dia...

Evidence from previous studies indicates that racial discrimination is significantly associated with depression and that African Americans with higher levels of socioeconomic status (SES) report greater exposure to racial discrimination compared to those with lower SES levels. Coping strategies could alter the relationship between racial discrimina...

Although increased frequency of physical activity is associated with fewer depressive symptoms in African-Americans, most studies do not focus on a specific type of activity. Identifying the activity can provide helpful information for designing interventions that focus on depressive symptoms. The objective of this study was to examine the odds of...

Objective: . To examine racial-ethnic differences in the endorsement and attribution of psychotic-like symptoms in a nationally representative sample of African-Americans, Asians, Caribbean Blacks, and Latinos living in the USA. Design: Data were drawn from a total of 979 respondents who endorsed psychotic-like symptoms as part of the National L...

This study used qualitative methods and quantitative statistical analyses to examine whether race and gender are associated with reasons for which adults perceive a situation or object as fearful. The sample consists of 197 African American and White adults (ages 18–85) recruited through a convenience sample and community sources in the Midwest. A...

In Reply The websites for both the American Psychiatric Association and National Institute of Mental Health state that men experience depression differently, but few studies have used a nationally representative sample of Americans to examine the veracity of these assertions.1,2 Our study3 examined the hypothesis that part of the sex difference in...

OBJECTIVE: To study temporal trends and the changing social conditions contributing to socioeconomic and racial disparities in edentulism for adults over time. METHODS: A social demography Age-Period-Cohort (APC) approach was employed to analyze edentulism trends for Blacks and Whites using data from 1982-2010 from the National Health Interview Sur...

Importance: When men are depressed they may experience symptoms that are different than what is included in the current diagnostic criteria. Objective: To explore whether sex disparities in depression rates disappear when alternative symptoms are considered in the place of, or in addition to, more conventional depression symptoms. DESIGN, SETTIN...

Objective: To examine the frequency of leisure-time physical activity (LTPA) in relation to depressive symptoms in a nationally representative sample of African American (AA) women and AA men with guidance by Stokols' Social Ecological Framework. Method: A secondary analysis of AA women (n=1811) and AA men (n=1038) was performed on the National...

Objective: Although antidepressants are an effective treatment for later-life depression, older patients often choose not to initiate or to discontinue medication treatment prematurely. Although racial differences in depression treatment preferences have been reported, little is known about racial differences in antidepressant medication adherence...

To contribute to the growing understanding of U.S. black-white health disparities by examining psychosocial stress as an important contributor to physical health problems. Data are from the National Survey of American Life, an integrated national household probability sample of White Americans, African Americans, and Caribbean blacks. Regression an...

African Americans are disproportionately diagnosed as having schizophrenia, and the factors that contribute to this disparity are poorly understood. This study utilized data from the 1995 MacArthur Violence Risk Assessment Study to examine the impact of racial differences in sociodemographic characteristics, clinical presentation, and perceived hon...

BACKGROUND: conventional wisdom suggests that increased socioeconomic resources should be related to better health. Considering the body of evidence demonstrating the significant association between racial discrimination and depression, we examined whether exposure to racial discrimination could attenuate the positive effects of increased levels of...

Rates of clinical diagnoses of schizophrenia in African American individuals appear to be elevated compared with other ethnic groups in the United States, contradicting population rates derived from epidemiologic surveys. To determine whether African American individuals would continue to exhibit significantly higher rates of clinical diagnoses of...

Over the last decade, obesity has increased significantly among men but few national studies have empirically examined racial and socioeconomic differences in obesity among men. In this paper, we utilized logistic regression to evaluate the potential associations that race and socioeconomic status may have with obesity among men in the National Sur...

Over the last three decades, the increase in the prevalence of obesity across gender, age, socioeconomic status, and racial and ethnic groups has continued to garner attention and concern. Various and inconsistent findings have been reported on differences between BMI and obesity among black and non-black men. These inconsistent findings prompt fur...

The present study examined the relationship between goal-striving stress and well-being in a survey of 399 college-educated Black American men who were members of a Black fraternal organization. Regression analyses revealed that goal-striving stress was associated with decreased psychological well-being, controlling for demographics and various psy...

This study investigated the associations among goal-striving stress, racial related stressors, and mental health. Goal-striving stress was defined as the discrepancy between aspiration for and achievement of a better way of life, weighted by the subjective probability of success, and the level of disappointment experienced if those life goals were...

Findings from previous studies have not revealed significant, inverse relationships between socioeconomic position (SEP) and depression among African Americans. This study examined the relationship between multiple indicators of SEP and Major Depressive Episode (MDE) among African Americans. Data were drawn from the National Survey of American Life...

There have been few empirical studies of ethnic differences in health within the American Black population. Logistic regressions were used to examine the relationships among ethnicity, nativity, depressive symptoms, and physical health in the two largest ethnic groups of American Blacks, African Americans and Caribbean Blacks. The data were from th...

The Aday-Andersen model was used as a framework for investigating the contribution of immigration status (i.e., nativity and acculturation), socioeconomic factors, health care access, health status, and health insurance to usual source of health care (USOC) in a nationally representative sample of African American (n=551) and Caribbean Black men (n...

The educational, employment, and financial status of African Americans differs from that of other US race/ethnic groups, particularly White Americans. For example, in July 2006, it was estimated that 23.8 million Americans aged between 18 and 64 years, or 12.6% of the total US population, were African American. Of the African American noninstitutio...

This study examined use of ministers for assistance with a serious personal problem within a nationally representative sample of African Americans (National Survey of American Life—2001–2003). Different perspectives on the use of ministers—social stratification, religious socialization, and problem-oriented approach—were proposed and tested using l...

This study uses a national probability sample of older adults to examine racial and ethnic differences in the use of professional services and informal support for a stressful personal problem. Using data from the National Survey of American Life, this study focuses on African Americans, Black Caribbean immigrants, and Whites aged 55 years and olde...

We examine if commonly used distress measures, rates of psychiatric disorders, and chronic health conditions are affected by alternate measures of race-ethnicity for African Americans and Caribbean blacks. We examined two alternative self-identification measures to investigate if their influence might differ. A study on national household probabili...

This chapter examines participation in healthcare services among middleclass Black men from a cross-sectional survey of college-educated African American men. The survey was conducted as a series of computer-assisted telephone interviews (CATI) by Michigan State University's Institute for Public Policy and Social Research, Office of Survey Research...

OBJECTIVES: Randomized trials found physical activity (PA) effective in decreasing depressive symptoms. Few studies included Black participants. The purpose of this systematic literature review was to determine the effects of PA on depressive symptoms in Black adults. METHODS: Articles were abstracted by conducting a computer and hand search of eli...

To determine the prevalence and adequacy of depression care among different ethnic and racial groups in the United States. Collaborative Psychiatric Epidemiology Surveys (CPES) data were analyzed to calculate nationally representative estimates of depression care. The 48 coterminous United States. Household residents 18 years and older (N = 15 762)...

Prior research has shown that minority groups experience greater levels of disability associated with psychiatric and substance use conditions due to barriers to treatment. Treatment delays are an important part of the overall problem of service utilization and access to treatment, yet little work has been done to understand the factors associated...

Little information is available about accuracy of diagnoses in clinical care for affective and other major mental disorders experienced by Latino patients. This study addressed two central research questions: Do Latinos have disproportionate rates of clinical diagnoses of major depression based on structured diagnostic interviews? Are diagnostic pa...

Provide nationally representative data on the prevalence and psychiatric correlates of suicidal ideation and attempts among African American and Caribbean black adolescents in the United States. Data on nonfatal suicidal behavior among 1,170 African American and Caribbean black adolescents aged 13 to 17 years are from the National Survey of America...

The objective of this study was to examine mental health services utilization of older African Americans using data from the National Survey of American Life. A subsample of African American respondents aged 55 years or older (N = 837) was used for this study. Thirteen mental disorders, including mood, anxiety, and substance disorders, were assesse...

This study examined the religious correlates of psychiatric disorders. The analysis is based on the National Survey of American Life (NSAL). The African American sample of the NSAL is a national representative sample of households with at least one African American adult 18 years or over. This study uses the older African American subsample (N = 83...

National datasets provide a unique opportunity to examine racial and ethnic disparities in health and mental health. In this article, the authors discuss some of the ways in which national datasets can facilitate our understanding of key pathways and mechanisms that explain racial and ethnic disparities and some of the conceptual and measurement is...

This study investigated the use of professional services and informal support among African Americans and Caribbean blacks with a lifetime mood, anxiety, or substance use disorder. Data were from the National Survey of American Life. Multinomial logistic regression was used to test the utilization of professional services only, informal support onl...

The study objective was to estimate the prevalence and correlates of antidepressant use by black and white Americans. Data from the Collaborative Psychiatric Epidemiology Surveys (CPES) were analyzed to calculate nationally representative estimates of past-year antidepressant use by black and white Americans ages 18 years and older (N=9,723). Among...

Baseline information on the broader health disparities among Native Hawaiian and other Pacific Islanders is lacking. In particular, this gap in our knowledge about obesity disparities and how they may relate to more distal outcomes of cardiovascular disease (CVD), diabetes and cancer in this population does not exist. To fill this gap in our knowle...

We sought to estimate the prevalence of substance disorders for African Americans and Caribbean Blacks in the United States using data from the National Survey of American Life. A national household probability sample of noninstitutionalized African Americans (n=3570) and Caribbean Blacks (n=1621) was obtained between February 2001 and June 2003 us...

Although many scholars have theorized about how responding to the stress of blocked opportunities can affect the well-being of black Americans, few scholars have empirically examined the relationships between striving efforts, personal goals, and mental health among black Americans. This investigation examines the relationship between goal-striving...

This article estimates the prevalence and correlates of antidepressant use by black and white Americans, using data from the Collaborative Psychiatric Epidemiology Surveys. Among individuals with depressive and anxiety disorders in the past year, black respondents (14.6 percent) had significantly lower antidepressant use than white respondents (32....

The purpose of this study was to estimate lifetime and 12-month prevalence of 13 psychiatric disorders for older African Americans. Data are from the older African American subsample of the National Survey of American Life. Selected measures of lifetime and 12-month Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) psyc...

We used data from the adult reinterview portion of the National Survey of American Life (Jackson, Torres, et al., 2004) to investigate the relationships of John Henryism Active Coping Scale (James, Hartnett, & Kalsbeek, 1983), Social Dominance, and Stratification Beliefs to depressive symptoms as measured by the Center for Epi-demiologic Studies De...

Objectives: This paper examines whether historical disparities in periodontal status between African Americans and whites in the United States have increased, decreased, or remained the same over the 15-year period between the First National Health and Nutrition Examination Survey (NHANESI,1971–74) and the Third National Health and Nutrition Examin...

Little is known about differences in the unmet need for mental health service use between African Americans and Caribbean blacks. To extend the National Survey of Black Americans by examining 12-month mental health service use for African Americans and Caribbean blacks from the recently completed National Survey of American Life. National household...

This focus group study examines the use of ministerial support among African American adults with regard to (1) the issues taken to ministers by church members, (2) the issues not taken to ministers by church members, and (3) the factors that inform people's decisions about whether or not to seek ministerial support. Content analysis of narratives...

Little is known about the relationship between race/ethnicity and depression among US blacks. To estimate the prevalence, persistence, treatment, and disability of depression in African Americans, Caribbean blacks, and non-Hispanic whites in the National Survey of American Life. A slightly modified adaptation of the World Health Organization World...

Background: A limited number of studies have examined the knowledge, attitudes, and beliefs of young Black men, particularly with regard to their mental health. This study used focus groups to explore the complexities of the Black male experience and capture young Black men's understanding of and comfort with discussing their mental health. Methods...

We examined the use rates and correlates of formal psychiatric services among the US-born and immigrant Caribbean Black population. We compared overall mental health service use in samples of Caribbean Blacks and African Americans and examined the within-sample ethnic variation among Caribbean Blacks, including for ethnic origin (Spanish Caribbean,...

We examined the prevalence of psychiatric disorders among Black Caribbean immigrant ("Caribbean Black") and African American populations and the correlates of psychiatric disorders among the Caribbean Black population. We conducted descriptive and age-adjusted analyses of the data from the National Survey of American Life--an in-person household me...

This research is an examination of the effects of racial discrimination and health-promoting behaviors on the physical and mental health of a sample of 399 well-educated African American men. One would think that the attainment of higher education would increase health-promoting behaviors and might decrease discriminatory experiences that impact he...

Lack of data on the lifetime prevalence and age at onset of suicide ideation, plans, and attempts among blacks in the United States limits the creation and evaluation of interventions to reduce suicide among black Americans. To examine the prevalence and correlates of suicide ideation, planning, and attempts across 2 ethnic classifications of black...

The authors examined clinician race differences in symptom attribution patterns in diagnosing psychiatric inpatients from a low-income, African American community. Different decision models were applied to patients based on clinician race. African American clinicians diagnosed schizophrenia with higher odds than non-African American clinicians when...

This study investigates whether race/ethnicity, individual income, education, and neighborhood socioeconomic characteristics are independently associated with periodontitis in adults>or=18 years of age who participated in the third National Health and Nutrition Examination Survey (NHANES III). Analyses were limited to participants in NHANES III who...

This research examined clinicians' consideration of situational factors in diagnostic decisions of mood vs. schizophrenia disorders among psychiatric inpatients from a low-income, African American community. Clinicians completed questionnaires describing their diagnostic decisions. Responses reflecting the usage of situational information were inve...

This study examined psychiatrists' contributions to racial and gender disparities in diagnosis and treatment among elderly persons. Psychiatrists who volunteered to participate in the study were randomly assigned to one of four video vignettes depicting an elderly patient with late-life depression. The vignettes differed only in terms of the race o...

To examine primary care physician (PCP) contributions toward racial and sex differences in the diagnosis and treatment of late-life depression. Survey using a computerized instrument incorporating video interviews and text, with volunteer PCPs randomly assigned to one of four standardized video vignettes of an elderly patient depicting late-life de...

The objectives of the National Survey of American Life (NSAL) are to investigate the nature, severity, and impairment of mental disorders among national samples of the black and non-Hispanic white (n = 1,006) populations in the US. Special emphasis in the study is given to the nature of race and ethnicity within the black population by selecting an...

This paper provides an overview of the conceptualization and methods used in the National Survey of American Life (NSAL). The objectives of the NSAL are to investigate the nature, severity, and impairment of mental disorders among national samples of the black and non-Hispanic white (n = 1,006) populations in the US, including African American (N =...

We performed a cross-sectional survey of high-socioeconomic status (SES) African American men and their health to examine the relationship between John Henryism (the strong behavioral predisposition to directly confront barriers to upward social mobility) and self-reported physical health status. We found a positive association between John Henryis...

We assessed the prevalences of periodontitis by education and income levels among US adults with data from the third National Health and Nutrition Examination Survey. The study was limited to non-Hispanic Blacks, Mexican Americans, and non-Hispanic Whites 50 years of age or older with a complete periodontal assessment during the dental examination....

This retrospective study explored the interrelationship among aftercare, length of hospital stay, and rehospitalization within six months of discharge in a sample of psychiatric inpatients. Data were analyzed for 1,481 patients who had received inpatient care at a state psychiatric hospital from November 1991 to July 1994. Logistic regression model...

Schizophrenia is diagnosed more frequently among African Americans while mood disorders are identified more often among whites. Such findings have raised serious questions about the accuracy of clinical judgment. This article analyzes data on 665 African American and white psychiatric inpatients using a semi-structured diagnostic instrument. The pa...

The authors review the available empirical evidence from population-based studies of the association between perceptions of racial/ethnic discrimination and health. This research indicates that discrimination is associated with multiple indicators of poorer physical and, especially, mental health status. However, the extant research does not adequa...

The existence of racial and ethnic health disparities is a major problem for the United States. Whether identified by the construct of “excess deaths” (HHS, US, 1985) or Years of Potential Life Lost (YPLL) (LaVeist, 2000), the differences in morbidity and mortality between US ethnic minority groups and European Americans has been a source of concer...

This paper examines whether historical disparities in periodontal status between African Americans and whites in the United States have increased, decreased, or remained the same over the 15-year period between the First National Health and Nutrition Examination Survey (NHANES I, 1971-74) and the Third National Health and Nutrition Examination Surv...

This study identified and contrasted prevalence and predictors of periodontitis among African Americans, Mexican Americans, and non-Hispanic Whites in the US adult population. Cross-sectional study. This study compared those with and without periodontitis in each racial/ethnic group. This study was limited to records of US African-American, Mexican...

In this article, we examine the National Survey of Black Americans to assess the relationship between perceived racism, self and system blaming attribution and survival. Perceived exposure to racism and other covariates were measured at baseline (1979) with a mortality follow up 13 years later (1992). We test the hypothesis that an external attribu...