Antonius D. Skipper

Background: This study examined whether religious coping modified the longitudinal associations between lifetime discrimination and subclinical atherosclerotic cardiovascular disease risk among Black individuals, and if these effects differed by sex. Methods: Data were collected from 753 Black adult participants (44.5% men; mean age=49.3 years) in the Healthy Aging in Neighborhoods of Diversity across the Life Span study. Carotid intima‐media thickness (CIMT) was measured using ultrasonography at baseline (Wave 1: 2004–2009) and a subsequent follow‐up visit (Wave 4: 2013–2017). Abnormal CIMT was defined as ≥1.0 mm of plaque buildup. Religious coping, racial discrimination, and burden of lifetime discrimination were self‐reported at baseline. Results: Mixed‐effects multivariable logistic regression analyses estimated the longitudinal associations between a 3‐way interaction term (discrimination, religious coping, and sex) and abnormal CIMT in models adjusted for age and socioeconomic status. For Black men, those who engaged in religious coping the least had higher odds of abnormal CIMT for both racial (OR=1.22, 95% CI [1.02–1.48], P =0.03) and burden of lifetime discrimination (OR=1.75, 95% CI [1.14–2.69], P =0.01). The associations were attenuated at higher levels of religious coping. No associations were found among women. Conclusions: The effects of discrimination on abnormal CIMT lessened as religious coping increased for Black men. Future research is needed to disentangle how aspects of religious coping might yield benefits linked with atherosclerotic cardiovascular disease risk for this group and identify alternative psychosocial resources effective in mitigating discrimination effects on health for Black women.

Older African Americans experienced disproportionately high rates of morbidity and mortality during the COVID-19 pandemic. Yet, scientists and researchers made little effort to understand the factors contributing to COVID-19 vaccine hesitancy among these individuals. Research finds that older African Americans are generally highly religious and often use religion to inform their health decisions. Using the Religious Coping Theory, the purpose of this study was to analyze the interview data of 22 older African Americans to examine religious justification as a contributor to COVID-19 vaccine hesitancy. A semi-structured interview protocol was used to collect data from vaccine hesitant older African Americans in the USA. Data were analyzed using thematic analysis and inductive coding. Salient themes included: (1) I Have not Been Led, (2) God’s Medicine, and (3) The Pandemic is Divine Punishment. Findings suggest that religious beliefs can influence the health decisions of older African Americans, despite COVID-19 vaccine recommendations. Some forms of vaccine hesitancy may be overcome through partnerships with religious leaders and accurate information on the COVID-19 vaccine.

Direct care workers (DCWs) experience job quality challenges such as heavy workload, low pay, and few benefits. Layered risks such as the COVID-19 pandemic and systemic racism have impacted DCWs, made them more vulnerable, and increased turnover and the precarity of the long-term care system and residents’ care. Drawing from qualitative interviews collected from 25 direct care workers, this study seeks to understand and describe the DCWs’ experiences of trauma during COVID-19 and how these experiences affect their ability to provide care. Findings suggest that DCWs are often crippled with challenges stemming from the impact of COVID-19, work-related factors, and personal factors. Understanding the intersection of trauma provides a detailed contextual description of care work, which is important for developing practical coping strategies, either at the personal or organizational levels, and developing more refined trauma-informed initiatives to build resilience and support DCWs.

Despite the significance of romantic relationships in later life, relatively little research has focused on older African Americans, a population highly engaged in religious behaviors. Forgiveness often mediates the relationship between relational sanctification and various positive relational outcomes. This study examined forgiveness as a mediator between relational sanctification and family functioning among older African American couples. It used dyadic data from 194 African American couples aged 50 to 86. The relationships between men’s relational sanctification and men’s reports of family functioning were partially mediated by men’s self-reported ability to forgive their partner ( B = .045) and the sum of all men’s and women’s reported abilities to forgive and perceive forgiveness ( B = .124). However, these associations were not statistically significant for women. These findings highlight the growing yet underrecognized need to understand the religiosity of older African American men relative to positive relational outcomes.

As interventionists and policymakers aim to strengthen marriages and families, research on the nuances of romantic relationships, particularly among historically disadvantaged populations, grows more important. In its simplest form, the dynamics of a marriage consist of a combination of emotional highs and lows. Spousal support is generally a relational boon, capable of contributing to stability and happiness. On the other hand, negative interactions (e.g., criticism, unmet demands) can damage relationships and lead to instability or divorce. Although research has studied various correlates of spousal support and negative interactions, relatively little knowledge exists on these constructs among African Americans in long‐term marriages. To understand the correlates of spousal support and negative interactions among African Americans in long‐term (≥20 years) marriages, this study used data ( n = 200) from The National Survey of American Life Adult Reinterview (NSAL‐RIW). Our emphasis on long‐term marriages contributed to a sample that consists largely of older adults. Data analyses revealed that African Americans in long‐term marriages report high levels of emotional and instrumental spousal support and relatively low levels of negative interactions with their spouses. Gender, education, family income, and length of marriage were significantly associated with emotional and instrumental spousal support. Spousal negative interactions were associated with gender, family income, and marriage duration. Grounding policies and interventions in research that considers what strong couples have done well is an important first step toward building more strong, healthy relationships in underserved communities.

Objective: This cross-sectional study examined whether religious coping buffered the associations between racial discrimination and several modifiable cardiovascular disease (CVD) risk factors—systolic and diastolic blood pressure (BP), glycated hemoglobin (HbA1c), body mass index (BMI), and cholesterol—in a sample of African American women and men. Methods: Participant data were taken from the Healthy Aging in Neighborhoods of Diversity Across the Life Span study (N = 815; 55.2% women; 30–64 years old). Racial discrimination and religious coping were self-reported. CVD risk factors were clinically assessed. Results: In sex-stratified hierarchical regression analyses adjusted for age, socioeconomic status, and medication use, findings revealed several significant interactive associations and opposite effects by sex. Among men who experienced racial discrimination, religious coping was negatively related to systolic BP and HbA1c. However, in men reporting no prior discrimination, religious coping was positively related to most risk factors. Among women who had experienced racial discrimination, greater religious coping was associated with higher HbA1c and BMI. The lowest levels of CVD risk were observed among women who seldom used religious coping but experienced discrimination. Conclusion: Religious coping might mitigate the effects of racial discrimination on CVD risk for African American men but not women. Additional work is needed to understand whether reinforcing these coping strategies only benefits those who have experienced discrimination. It is also possible that religion may not buffer the effects of other psychosocial stressors linked with elevated CVD risk.

Despite the common use of religious buffers, African Americans are disproportionately affected by depressive symptoms. Communal coping may serve as one factor in helping religious African American couples alleviate the symptoms of depression. This study examines the association between relational sanctification and depressive symptoms as mediated by the communal coping of 467 African American married and cohabiting couples. Data from the sampled couples were analyzed using a common fate model, and analyses revealed higher scores on the measure of sanctification were associated with more communal coping; more communal coping was associated with fewer depressive symptoms among women and men, and communal coping acted as a mediator between relational sanctification and depressive symptoms in both partners. Findings from this study underscore the importance of considering how the religiosity and cooperative action of African American couples relate to depressive symptoms.

Objectives: Assisted living (AL), a popular long-term care setting for older Americans, increasingly is a site for end-of-life care. Although most residents prefer AL to be their final home, relatively little is known about end-of-life preferences and advance care planning, especially among African American residents. Our research addresses this knowledge gap.Methods: Informed by grounded theory, we present an analysis of qualitative data collected over 2 years in a 100-bed AL community catering to African American residents. Data consisted of field notes from participant observation conducted during 310 site visits and 818 observation hours, in-depth interviews with 25 residents, and a review of their AL records.Results: Residents varied in their end-of-life preferences and advance care planning, but united in the belief that God was in control. We identified “Turning it over to God” as an explanatory framework for understanding how this group negotiated end-of-life preferences and advance care planning. Individual-level resident factors (e.g., age, pain, and function) and factors reflecting broader cultural and societal influences, including health literacy and care experiences, were influential.Discussion: Contradictions arose from turning it over to God, including those between care preferences, planning, and anticipated or actual end-of-life outcomes.

Relatively few studies have examined the strengths of the African American family, while several have highlighted social issues that have affected the African American family such as divorce, single-parent households, and absentee fathers. This focus on deficit and dysfunction contributes to a research-based gap in understanding the African American marital dyad. Given that religion influences the lives of many African American couples, it is important to understand the impact that religious coping can have on marital stability in the African American community. The purpose of this study is to explore the underlying processes of religious coping for those African American couples that identify as highly religious and happily married. Specifically, this study seeks to answer the two following questions: 1) How do highly religious, happily married African American couples use religion as a coping resource for common stressors that impact the marriage?, and 2) How are the three approaches to religious coping, identified as self-directed, deferred, and collaborative, used to contribute to the marital stability of highly religious, happily married African American couples? In-depth, qualitative interviews were conducted with 35 African American couples, married for at least 7-years and highly involved with an Abrahamic (Christian, Jewish, Mormon, and Muslim) faith. Grounded theory methods and a Numeric Content Analysis were used to analyze the narrative data. Three a priori themes related to the variations of religious coping were presented: 1) Often, We Can Manage Our Stress, 2) I’ve Laid My Burdens Down, and 3) Dear God, Help Us to Help Us. Emergent subthemes related to each of these a priori topics were also presented. Implications, related to theory, policy, and practice, that consider the intersections of religion and marriage for African American families are also discussed.

Objective: This study examined racial and ethnic differences in the receipt and provision of instrumental family support.Background: Extended families provide significant levels of emotional and instrumental support across the life course. Despite their importance, extended family relationships and the assistance they provide are largely neglected in the literature. Further, questions remain concerning cultural variation in family support relationships and inconsistent findings on racial differences in family support in prior investigations.Method: This study relied on data from the National Survey of American Life‐Reinterview (n = 3483) to investigate the provision and receipt of instrumental support from extended family among African Americans, Black Caribbeans, and non‐Latino Whites and within high‐ and low‐income categories for each group. Eight key measures of instrumental family support are examined: receiving and providing transportation, help with chores, financial assistance, and help during an illness.Results: African Americans and Black Caribbeans share similar profiles of providing and receiving instrumental family support. Both populations receive and provide assistance more frequently than do non‐Latino Whites. Similarly, analyses stratified by income indicated that for low‐income and high‐income groups, African American and Black Caribbeans are similar to one another, and at each income category, both groups received and provided support more frequently than non‐Latino Whites.Conclusion: Study findings are discussed in relation to conceptual and methodological differences in assessing Black–White differences across studies of family support. Attention to these issues and the specific contexts for receiving/providing family support (emergency vs. routine; intergenerational vs. extended) will help clarify inconsistent findings across studies.