The Role of Neighborhood Experiences in Psychological Distress Among African American and White Smokers
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Residential area characteristics and discrimination have been associated with psychological distress. Differences in these relationships across racial groups are not well understood. We examined the relative role of perceived discrimination, neighborhood problems, and neighborhood cohesion/trust in explaining differences in psychological distress (indicated by anxiety and depressive symptoms) between 224 African American and 225 white smokers (income ≤ 400% federal poverty level) in a smoking cessation intervention study. Surveys were linked to US census tract data. We conducted random intercept Poisson multilevel regression models and examined interactions between race and neighborhood experiences. African Americans had greater risk of anxiety and depressive symptoms and greater individual and neighborhood disadvantage than whites. Controlling for objective neighborhood characteristics, when perceived discrimination and perceived neighborhood characteristics were added to the regression models, the association between anxiety symptoms and race were no longer statistically significant; the association between depressive symptoms and race decreased, but remained statistically significant. Lower neighborhood social cohesion/trust and greater neighborhood problems increased depressive symptoms for African Americans, but not for whites. Perceived discrimination and neighborhood social cohesion/trust outweighed the importance of race in explaining anxiety symptoms. These findings underscore the need for multilevel interventions addressing social and environmental contexts.
KeywordsDepressive symptoms Anxiety symptoms Neighborhood socioeconomic contexts Race Neighborhood social cohesion
The clinical trials registration number for the parent study is NCT01836276. This work was supported by the National Institute on Drug Abuse (R01-DA031815 to NLN) and by a Diversity Supplement (R01 DA031815-S1; TSS). Pfizer Global Pharmaceuticals provided the medication for the parent study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health.
National Institute on Drug Abuse (R01-DA031815) and (R01 DA031815-S1).
Compliance with Ethical Standards
Conflict of interest
This work was supported by the NIH, National Institute on Drug Abuse. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. The study sponsor had no role in study design; collection, analysis, or interpretation of data; writing the report; or the decision to submit the report for publication. None of the authors have institutional or corporate affiliations that conflict with this study, and no financial disclosures were reported by the authors of this paper.
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