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202
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Introduction
Vickie M Mays is a Distinguished Professor at the Departments of Psychology and Health Policy and Management, University of California, Los Angeles. She is a member of the National Committee on Vital and Health Statistics subcommittees on Population Health and Privacy,Security and Confidentiality and a member of the Standards Review Committee for the Affordable Care Act. She is a member of the Board of Public Research in Medicine. She has served on a variety of NAM boards, has served on the Board of Scientific Affairs, Board of Social and Ethical Responsibility and the Board of Professional Affairs for the American Psychological Association. Research:study of racism & discrimination, mental health, suicide, substance abuse, social cognitive neuroscience & racism, big data, technology
Skills and Expertise
Additional affiliations
January 2011 - present
January 1991 - December 2012
Position
- Health Status and Health Behaviors in Racial/Ethnic Minority Populations Social Determinants of Mental Disorders Mental Health Services and Mental Health Policy Research Ethics in Biomedical and Behavioral Research with Racial/Ethnic Minority Populations Abnormal Psychology
Publications
Publications (202)
There is increasing attention to suicides that occur in view of others, as these deaths can cause significant psychological impact on witnesses. This study illuminates characteristics of witnessed suicides and compares characteristics of these deaths to non-witnessed suicides. We develop a codable definition of what constitutes witnessed (vs. non-w...
Objectives. To investigate differences in the documentation of mental health symptomology between male and female suicide decedents in the 2003–2020 US National Violent Death Reporting System (NVDRS).
Methods. Using information on 271 998 suicides in the 2003–2020 NVDRS, we evaluated precoded mental health–related variables and topic model–derived...
Background:
Prescription and illicit drugs are important social environmental variables in many suicides regardless of their role as an immediate cause of death.
Objectives:
To investigate the presence of prescription and illicit drugs, either through mention in the death record or toxicology reports, among suicides attributed to nonpoisonous ca...
Objectives: To examine post-traumatic stress disorder (PTSD) among Black adults in younger, middle, and older ages. Methods: Using nationally representative data from the National Survey of American Life, we estimated lifetime and 12-month prevalence of PTSD in Black men and women ages 18–34, 35–49, and 50+. We determined PTSD persistence and sever...
Objectives: To examine anxiety disorders in aging Black adults. Methods: Using nationally representative data from the National Survey of American Life, we estimated lifetime/12-month prevalence of anxiety disorders in Black men and women, age 50+ (N = 1561). Disorder-specific persistence and severity, functional impairment, and mental health servi...
Significance
We introduce an approach to identify latent topics in large-scale text data. Our approach integrates two prominent methods of computational text analysis: topic modeling and word embedding. We apply our approach to written narratives of violent death (e.g., suicides and homicides) in the National Violent Death Reporting System (NVDRS)....
There is an escalating need for methods to identify latent patterns in text data from many domains. We introduce a new method to identify topics in a corpus and represent documents as topic sequences. Discourse Atom Topic Modeling draws on advances in theoretical machine learning to integrate topic modeling and word embedding, capitalizing on the d...
Objectives. To investigate racial/ethnic differences in legal intervention‒related deaths using state-of-the-art topic modeling of law enforcement and coroner text summaries drawn from the 2003–2017 US National Violent Death Reporting System (NVDRS).
Methods. Employing advanced topic modeling, we identified 8 topics consistent with dangerousness in...
This article reports the outcome of a project to develop and assess a predictive model of vulnerability indicators for COVID-19 infection in Los Angeles County. Multiple data sources were used to construct four indicators for zip code tabulation areas: (1) pre-existing health condition, (2) barriers to accessing health care, (3) built environment r...
Coreference resolution is an important component in analyzing narrative text from administrative data (e.g., clinical or police sources). However, existing coreference models trained on general language corpora suffer from poor transferability due to domain gaps, especially when they are applied to gender-inclusive data with lesbian, gay, bisexual,...
To compare African American (AA) and non-Hispanic White men living in same residential areas for the associations between educational attainment and household income with perceived discrimination (PD). The National Survey of American Life (NSAL), a nationally representative study, included 1643 men who were either African American (n = 1271) or non...
Objective
To develop indicators of vulnerability for coronavirus disease 2019 (covid-19) infection in Los Angeles County (LAC) by race and neighborhood characteristics.
Design
Development of indicators that combines pre-existing medical vulnerabilities with social and built-environment data by zip code tabulation areas (ZCTAs).
Setting
Neighborho...
Objectives
Although lesbian, gay, bisexual, and transgender (LGBT) people have a higher prevalence of reporting a lifetime suicide attempt than non-LGBT people, suicide prevention research on access to lethal means (eg, firearms) among LGBT people is limited. Our study examined (1) the presence of firearms in the home and (2) among respondents with...
There is growing diversity within the Black population in the U.S., but limited understanding of ethnic and nativity differences in the mental health treatment needs of Black women. This study examined differences in the prevalence of psychiatric disorders, their persistence, and unmet treatment needs among Black women in the U.S. Data were from th...
We examined sexual orientation and sex differences in seven methods of suicide among adult suicides reported in the United States National Violent Death Reporting System (2012–2015; N = 59,075). Overall, most sexual minorities (i.e., lesbians, gay men, bisexuals) identified in the dataset used hanging (38%) followed by firearm (30%) and drug or poi...
Violent deaths — such as homicides and suicides — can be a source of "senseless suffering.'' Forensic authorities use narratives to trace events surrounding these deaths both in a search for meaning and a desire to prevent them. We examine these narratives, drawing on summaries from over 300,000 violent deaths in the U.S. Our goal is to capture the...
Objective:
Social disadvantage is associated with markers of physiological dysregulation, which is linked to disease trajectories. Chronic experiences with discrimination are thought to result in the accumulation of physiological "wear and tear" known as allostatic load (AL) among socially marginalized populations such as sexual minorities. Using...
This study investigated ethnic and nativity differences in the chronicity and treatment of psychiatric disorders of African American and Caribbean Black men in the U.S. Data were analyzed from the National Survey of American Life, a population-based study which included 1859 self-identified Black men (1222 African American, 176 Caribbean Black men...
Objective:
To assess the acceptability and feasibility of S2S, a newly adapted behavior intervention to address high-risk sexual behavior.
Design:
Pilot randomized controlled trial.
Setting:
The Internet and text messages with no in-person interactions.
Participants:
Eighty-eight Black women, ages 18 to 24 years, were randomly assigned to th...
Background:
Black and Latino minorities have traditionally had poorer access to primary care than non-Latino Whites, but these patterns could change with the Affordable Care Act (ACA). To guide post-ACA efforts to address mental health service disparities, we used a nationally representative sample to characterize baseline race-, ethnicity-, and n...
Extremely violent deaths among socially marginalized populations are often invisible to society. Furthermore, extrapolating what is known about violent deaths in majority populations to highly intersectionalized populations may be inaccurate and misleading. Indeed, the majority of research on women's experiences to date has focused on heterosexual...
Debate persists about whether parental sexual orientation affects children's well-being. This study utilized information from the 2013 to 2015 U.S., population-based National Health Interview Survey to examine associations between parental sexual orientation and children's well-being. Parents reported their children's (aged 4–17 years old, N = 21,1...
Eager to build an integrated community-based mental health system, in 2004 China started the '686 Programme', whose purpose was to integrate hospital and community services for patients with serious mental illness. In 2015, the National Mental Health Working Plan (2015-2020) proposed an ambitious strategy for implementing this project. The goal of...
Objectives:
The authors investigated sexual orientation differences in risk for mental health morbidity, functional limitations/disability, and mental health services use among adults interviewed in the nationally representative 2013-2014 National Health Interview Survey.
Method:
Respondents were 68,816 adults (67,152 heterosexual and 1,664 lesb...
Racial/ethnic minority populations underutilize mental health services, even relative to psychiatric disorder, and differences in perceived need may contribute to these disparities. Using the Collaborative Psychiatric Epidemiology Surveys, we assessed how the intersections of race/ethnicity, gender, and socioeconomic status affect perceived need. W...
Background:
National heart failure (HF) hospitalization rates have not been appropriately age standardized by sex or race/ethnicity. Reporting hospital utilization trends by subgroup is important for monitoring population health and developing interventions to eliminate disparities.
Methods and results:
The National Inpatient Sample (NIS) was us...
To the Editor In an Original Investigation in a recent issue of JAMA Internal Medicine, Gonzalez et al,¹ using national health surveillance data, observed that lesbian, gay, and bisexual (LGB) adults experience health disparities that warrant clinician attention. These findings were described, incorrectly, as “the first to capture the disparity in...
Purpose:
Cigarette smoking is a preventable risk factor that contributes to unnecessary lung cancer burden among Korean Americans and there is limited research on effective smoking cessation strategies for this population. Smartphone-based smoking cessation apps that leverage just-in-time adaptive interventions (JITAIs) hold promise for smokers at...
Background:
Experiences of discrimination in health care settings may contribute to disparities in mental health outcomes for blacks and Latinos. We investigate whether perceived discrimination in mental health/substance abuse visits contributes to participants' ratings of treatment helpfulness and stopped treatment.
Research methods:
We used da...
Max et al.,1 investigating changes in self-reported tobacco use and household secondhand smoke (SHS) exposure in California, recently found good news: a reduction in SHS exposure over time, although lesbian, gay, and bisexual (LGB) nonsmokers remained at greater risk for SHS exposure than similar heterosexuals. As we reported in 2013,2 SHS exposure...
To determine whether sexual minorities have an earlier mortality than do heterosexuals, we investigated associations between sexual orientation assessed in the 2001 to 2010 National Health and Nutrition Examination Surveys (NHANES) and mortality in the 2011 NHANES-linked mortality file. Mortality follow-up time averaged 69.6 months after NHANES. By...
The Patient Protection and Affordable Care Act (ACA; 2010) is expected to increase access to mental health care through provisions aimed at increasing health coverage among the nation's uninsured, including 10.2 million eligible Latino adults. The ACA will increase health coverage by expanding Medicaid eligibility to individuals living below 138% o...
This investigation explored suicide-related characteristics and help-seeking behavior by sexual orientation. Population-based data are from the California Quality of Life Surveys, which included 1,478 sexual minority (lesbian, gay, bisexual, and homosexually experienced individuals) and 3,465 heterosexual individuals. Bisexual women had a nearly si...
Previous studies have found that sexual orientation concealment affords escape from stigma and discrimination but also creates a psychological toll. While disclosure alleviates the mental burden of concealment, it invites the stress of navigating a new public identity. Population-based samples that include both "in" and "out" sexual minorities prov...
Cross-cultural variability in respondent processing of survey questions may bias results from multiethnic samples. We analyzed behavior codes, which identify difficulties in the interactions of respondents and interviewers, from a discrimination module contained within a field test of the 2007 California Health Interview Survey. In all, 553 (Englis...
The benefits of the patient-centered medical home (PCMH) over and above that of a usual source of medical care have yet to be determined, particularly for adults with mental health disorders.
To examine qualities of a usual provider that align with PCMH goals of access, comprehensiveness, and patient-centered care, and to determine whether PCMH qua...
To identify macro-level trends that are changing the needs of epidemiologic research and practice and to develop and disseminate a set of competencies and recommendations for epidemiologic training that will be responsive to these changing needs.
There were three stages to the project: (1) assembling of a working group of senior epidemiologists fro...
Background: Sexual orientation concealment may afford escape from stigma exposure, but also poses its own psychological toll. Coming out alleviates the mental burden of concealment but also invites the stress of navigating a new public identity. Population-based mental health surveys that include both “in” and “out” sexual minorities provide an ide...
Background: Black women experience higher rates of triple negative cancer, which is one of the most aggressive breast cancers where treatment adherence presents heightened priority. Side effects such as pain, nausea, fatigue, and hot flashes accompany corresponding treatments. Acupuncture has been shown as an effective treatment for such symptoms....
Racial/ethnic disparities in utilization of mental health (MH) services are prominent. Because of its influential role in initiating help-seeking behaviors, we examine racial/ethnic differences in perceived need for MH care and whether its determinants operate differently across race/ethnicity. Data are from the 2001–2003 Collaborative Psychiatric...
Background: Close relationships are protective for mental health reflecting both selective and structural factors (Hughes & Waite, 2009). Population-based studies of lesbian, gay, and bisexual (LGB) individuals commonly find reports of both same-sex (SS) and different-sex (DS) married/cohabiting relationships. Are DS relationships protective for LG...
Including sexual orientation questions in general population surveys has relatively recent origin.(1) But in a short time, their presence has profoundly altered what is known about health disparities affecting lesbians, gay men, bisexuals, and homosexually experienced heterosexuals. Because sexual orientation is a new survey construct, both methodo...
Using the California Quality of Life surveys, we examined suicidal ideation and attempts in 129 lesbian, gay, and bisexual (LGB) veterans and in 315 heterosexual veterans in 2008-2009 and 2012-2013. Although there were no significant differences in the past 12-month suicidal ideation and lifetime attempts, LGB veterans had higher odds of lifetime s...
Objectives:
We investigated the possibility that men who have sex with men (MSM) and women who have sex with women (WSW) may be at higher risk for early mortality associated with suicide and other sexual orientation-associated health risks.
Methods:
We used data from the 1988-2002 General Social Surveys, with respondents followed up for mortalit...
Considering the central role of familismo in Latino culture, it is important to assess the extent to which familismo affects mental health help-seeking. This study examined the role of behavioral familismo, the level of perceived family support, in the use of mental health services of Latinos in the United States. Data come from the National Latino...
Purpose
Disasters expose the general population and responders to a range of potential contaminants and stressors which may harm physical and mental health. This article addresses the role of epidemiology in informing policies after a disaster to mitigate ongoing exposures, provide care and compensation, and improve preparedness for future disaster...
Purpose
This article describes epidemiological evidence concerning risk of gun violence and suicide linked to psychiatric disorders, in contrast to media-fueled public perceptions of the dangerousness of mentally ill individuals, and evaluates effectiveness of policies and laws designed to prevent firearms injury and mortality associated with serio...
Neighborhood characteristics have been shown to impact child well-being. However, it remains unclear how these factors combine with family characteristics to influence child development. The current study helps develop that understanding by investigating how neighborhoods directly impact child and adolescent behavior problems as well as moderate th...
Background: Social disadvantage has been linked to markers of physiological dysregulation, or Allostatic Load (AL). In particular, chronic experiences with discrimination are thought to result in cumulative accumulation of physiological wear and tear at the individual level among socially marginalized persons. Objectives: We use information availab...
Very few theories have generated the kind of interdisciplinary and global engagement that marks the intellectual history of intersectionality. Yet, there has been very little effort to reflect upon precisely how intersectionality has moved across time, disciplines, issues, and geographic and national boundaries. Our failure to attend to intersectio...
Objectives:
We investigated sexual orientation-related differences in tobacco use and secondhand smoke (SHS) exposure in a nationally representative sample of US adults.
Methods:
The 2003-2010 National Health and Nutrition Examination Surveys assessed 11 744 individuals aged 20 to 59 years for sexual orientation, tobacco use, and SHS exposure (c...
RESEARCH Objectives. Recent studies suggest that lesbians and gay men are at higher risk for stress-sensitive psychiatric disorders than are heterosexual persons. We examined the possible role of perceived dis-crimination in generating that risk. Methods. The National Survey of Midlife Development in the United States, a nationally representa-tiv...
Psychological science offers a variety of methods to both understand and intervene when acts of potential racial or ethnic racism, bias or prejudice occur. The Trayvon Martin killing is a reminder of how vulnerable African American men and boys, especially young African American men, are to becoming victims of social inequities in our society. We e...
This chapter focuses on four key topics related to sexual orientation and mental health. First, it highlights several methodological issues that are relevant to understanding research on the associations between sexual orientation and mental health morbidity and its treatment. Second, it reviews findings from primarily population-based or systemati...
Knowledge of the US Public Health Syphilis Study at Tuskegee is sometime cited as a principal reason for the relatively low participation rates seen among racial/ethnic minorities, particularly African Americans, in biomedical research. However, only a few studies have actually explored this possibility. We use data from a random digit dial telepho...
This special issue addresses the legacy of the United States Public Health Service Syphilis Study on health reform, particularly the Affordable Care Act (ACA). The 12 manuscripts cover the history and current practices of ethical abuses affecting American Indians, Latinos, Asian Americans and African Americans in the United States and in one case,...
In 1997 President William Clinton issued an apology to the living male survivors of the U.S. Public Health Syphilis Study at Tuskegee. While the apology became the focus for many, little attention has been paid going forward to two very important recommendations by President Clinton that accompanied the apology. President Clinton pointed out that i...
Background: Individuals with minority sexual orientation are at somewhat elevated risk for common stress-related mental health disorders and are also more likely to seek mental health/substance abuse (MHSA) services than their heterosexual counterparts (Cochran & Mays, 2009). Given concerns about harmful effects of antigay discrimination in health...
Statement of Problem: Coccidioidomycosis (CM) is an infectious disease acquired by inhaling the air born spores of the soil-dwelling fungus Coccidioides immitis or Coccidioides posadasii. Coccidioides species is endemic to the Southwestern United States, Mexico and Central and South America. Even mild symptomatic CM is associated with significant m...
Cross-cultural variability in respondent comprehension of survey questions remains an important factor that may serve as a source of bias in research conducted in multi-ethnic and multilingual settings, including areas of the United States. To examine this we report on data collected as part of a field test nested within the 2009 California Health...
Background: Previous studies have explored the relationship between the legacy of the Tuskegee Syphilis Experiment and reluctance of minorities to participate in HIV/AIDS related treatment or clinical research with mixed results. The purpose of this study was to examine community generated beliefs and conspiracy theories about HIV/AIDS based in the...
Studies indicate that U.S.-born Latino teens exhibit higher rates of alcohol use compared with their foreign-born counterparts. Different hypotheses have been advanced to explain the mechanisms underlying this immigrant paradox, including the erosion of protective cultural factors across generations and increased exposure to risky peer environments...
Illicit drug and heavy alcohol use is more common among sexual minorities compared with heterosexuals. This difference has sometimes been attributed to more tolerant substance use norms within the gay community, although evidence is sparse. The current study investigated the role of perceived drug availability and tolerant injunctive norms in media...
This study describes the physical, psychological and social context of rheumatoid arthritis (RA) pain from the male veterans. A qualitative, descriptive design was employed using a purposive sampling to ensure representation of male veterans. Interviews were conducted with 12 male veterans of the VA Greater Los Angeles Healthcare System. Socio-demo...
Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome surveillance data are critical for monitoring epidemic trends, but they can mask dynamic subepidemics, especially in vulnerable populations that underuse HIV testing. In this case study, we describe community-based epidemiologic data among injection drug users (IDUs) and female s...
Epidemiologists have long contributed to policy efforts to address health disparities. Three examples illustrate how epidemiologists have addressed health disparities in the United States and abroad through a "social determinants of health" lens.
To identify examples of how epidemiologic research has been applied to reduce health disparities, we qu...
This study describes the physical, psychological and social context of rheumatoid arthritis (RA) pain from the male veterans. A qualitative, descriptive design was employed using a purposive sampling to ensure representation of male veterans. Interviews were conducted with 12 male veterans of the VA Greater Los Angeles Healthcare System. Socio-demo...
Lesbians and bisexual women are more likely than other women to evidence a unique mix of common breast cancer risk factors. It is not known if this results in greater breast cancer mortality risk. We investigate possible sexual orientation-related differences in risk for fatal breast cancer in a large representative U.S. sample of married and cohab...
Although recent attention has focused on the likelihood that contemporary sexual minority youth (i.e., gay, lesbian, bisexual [GLB]) are "coming out" at younger ages, few studies have examined whether early sexual orientation identity development is also present in older GLB cohorts. We analyzed retrospective data on the timing of sexual orientatio...
We investigated associations between minority sexual orientation and mortality among US men.
We used data from a retrospective cohort of 5574 men aged 17 to 59 years, first interviewed in the National Health and Nutrition Examination Survey III (NHANES III; 1988-1994) and then followed for mortality status up to 18 years later. We classified men in...