Annual Review of Gerontology & Geriatrics

Taylor, Robert Joseph; Skipper, Antonius D.; Ellis, James; Chatters, Linda M.

2022 Annual Review of Gerontology & Geriatrics

doi: 10.1891/0198-8794.41.1

Fictive kin are individuals who are not related biologically or not legal family members but who are conferred all of the expectations, obligations, norms, and behaviors that are typically associated with family members. Early ethnographic and qualitative studies on impoverished African Americans depicted fictive kinship as a strategy of necessity used by urban poor Blacks to share scarce resources. More recent surveys of fictive kin relationships based on nationally representative samples of African Americans establish that fictive kinships occur across a range of social and economic circumstances. However, fictive kin relationships among African American older adults remain an understudied area. The current study explores fictive kinship relationships (i.e., having fictive kin and receiving support from fictive kin) among African American, Black Caribbean, and non-Hispanic White older adults using data from the National Survey of American Life. We examined race/ethnicity and gender differences, as well as demographic and social network correlates. Findings showed that having and receiving support from fictive kin varied across race, ethnicity, and gender. African Americans were more likely to have fictive kin than were non-Hispanic Whites, but there were no overall race/ethnic differences in receiving support from fictive kin. Gender-specific findings showed that Black Caribbean women received fictive kin support more frequently than African American and non-Hispanic White women. Finally, demographic and social network correlates of fictive kin varied by race and ethnicity, and connections with social networks (family, friends, church members) were positively associated with having and receiving support from fictive kin.

Nguyen, Ann W.

2022 Annual Review of Gerontology & Geriatrics

doi: 10.1891/0198-8794.41.33

Insufficient sleep is a major public health problem and is linked to early mortality and chronic and serious morbidities. Although widespread, insufficient sleep disproportionately affects African Americans. The aim of this study was to identify sociodemographic correlates of sleep in a nationally representative sample of older African Americans. A secondary aim of this study was to determine whether particular sociodemographic characteristics function differently in relation to sleep for older African American men and women. The analyses used data from the National Survey of American Life-Reinterview ( N = 459). Sleep variables examined included sleep duration, restless sleep, trouble falling asleep, and sleep satisfaction. Multiple linear, logistic, and multinomial logistic regressions were used to identify correlates of sleep. Gender stratified analyses were used to test for gender differences in sleep correlates. The findings indicated that age, education, family income, material hardship, employment status, marital status, and region of residence were associated with multiple sleep outcomes. Stratified analyses revealed that these associations varied by gender. This study underscores the heterogeneity in sleep outcomes within the older African American population and argues for the importance of focused research in diverse populations using within-group designs. These findings extend the limited research literature on correlates of sleep among older adults and populations of color.

Lincoln, Karen D.; Nguyen, Ann W.

2022 Annual Review of Gerontology & Geriatrics

doi: 10.1891/0198-8794.41.63

Social network diversity has been linked to cognitive status in older adults. While social network diversity is often operationalized by the proportion of social roles represented within one's network, the additive effect of social roles is often unrecognized. Moreover, very few studies examine social relationships and cognitive status among African American older adults—a population with a high risk of cognitive impairment. The current study examined the relationship between social network diversity and cognitive status in a nationally representative sample of middle-aged and older African Americans. Data from the Health and Retirement Study ( N = 2,308) and latent class analysis were used to identify a social network typology using children, extended family members, and friends as social network indicators. Multinomial logistic regression was used to determine the association between social network types and cognitive status. Three social network types were identified—friend-focused, diverse, and restricted network types. African Americans with higher cognitive status were more likely to be assigned to the friend-focused social network type rather than the diverse or restricted network types. Neither the diverse nor restricted social network types were associated with cognitive status. A social network typology accounted for heterogeneity within the social networks of African American middle-aged and older adults and identified a unique social network type that appears to be protective for their cognitive health. Findings have implications for the measurement and operationalization of social networks and cognitive status and the role of social networks in maintaining cognitive functioning in African Americans.

Mouzon, Dawne M.; Brock, Breanna D.

2022 Annual Review of Gerontology & Geriatrics

doi: 10.1891/0198-8794.41.85

Much attention has been directed toward understanding the mental health advantage of African Americans relative to their more privileged White counterparts. One understudied mechanism is the role of coping strategies in the face of psychosocial factors such as racial discrimination. In this chapter, we study how seven distinct coping strategies are associated with depressive symptoms and serious psychological distress among older African Americans, with special emphasis on how the frequency of everyday racial discrimination and gender shape the association between coping and mental health. We find that among African American women aged 55 and older, the combination of blaming oneself and high levels of everyday racial discrimination is especially unfavorable for depressive symptoms, while prayer is protective against psychological distress under conditions of high levels of everyday racial discrimination. For African American men aged 55 and older under high levels of everyday racial discrimination, working harder to prove “them” wrong is detrimental to both mental health outcomes.

Taylor, Harry

2022 Annual Review of Gerontology & Geriatrics

doi: 10.1891/0198-8794.41.123

Social isolation and loneliness are consistently associated with worse health and well-being outcomes among older adults. However, many studies have not examined their concurrent impact on health and well-being, and even fewer studies examine their influence among Black older adults. The 2014 and 2016 waves of the Health and Retirement Study were used to examine the influence of social isolation and loneliness among a nationally representative sample of Black older adults. Social isolation was measured using a social network index based on marital and household status, contact with family members and friends, and participation in social and religious activities. Loneliness was measured by the 3-item loneliness scale. Health outcomes were self-rated physical health and number of chronic health conditions, depressive symptoms, and lifetime occurrence of a psychiatric disorder. Each health outcome was examined using: (a) social isolation, (b) loneliness, and (c) social isolation and loneliness, controlling for sociodemographic covariates. Social isolation was associated with self-rated health and depressive symptoms, while loneliness was associated with all health outcomes. When examined jointly, social isolation was associated with self-rated health, while loneliness was associated with all health outcomes. Study findings suggest that due to its association with multiple physical and mental health measures, loneliness may be a more significant factor for health that should be routinely assessed in working with Black older adults.

Erving, Christy L.

2022 Annual Review of Gerontology & Geriatrics

doi: 10.1891/0198-8794.41.145

Though past research has examined the influence of social stress exposure on the mental health of older African Americans, the tendency is to investigate singular stress exposures (e.g., discrimination). Furthermore, this research rarely assesses whether the psychological effects of specific stress exposures are gender-specific. The current study fills these gaps by ascertaining (a) gendered patterns of stress exposure among older African Americans, and (b) gendered nuances in the individual, collective, and cumulative effects of stress exposure on mental health. Using the National Survey of American of Life ( N = 992; 614 women, 378 men), the study utilizes a sample of African American-identified women and men, 50 years of age and older. Study results revealed that gender patterns of stress exposure were dependent on the stress measure under investigation. In addition, women and men shared some stress predictors of mental health (e.g., everyday discrimination); nevertheless, other stress predictors were specific to women (e.g., health-related mobility challenges) while others were unique to men (e.g., perceived neighborhood crime). Study findings challenge gerontologists to engage how racial and gendered identities intersect to place race-gender groups at distinct risks for stressors that elicit poor mental health. Study results have implications for the development of tailored strategies for improving the psychological health of African American women and men in mid to late life.

Brown, Lauren L.; Zhang, Yuan S.; Mitchell, Uchechi

2022 Annual Review of Gerontology & Geriatrics

doi: 10.1891/0198-8794.41.183

There are persistent disparities in all-cause mortality between Blacks and Whites in the United States. Black Americans also carry the greatest burden of morbidity from different diseases of aging including heart disease, stroke, hypertension, type 2 diabetes, and certain types of cancer. Health disparities research, and particularly race/ethnic comparison studies of physical health and aging, have consistently positioned Black health in frameworks of disadvantage, suggesting that regardless of the outcome, Black people are in worse states of health and well-being relative to Whites. Yet, extensive evidence suggests that there is significant within-group variability in the aging process among Black older adults. The use of biological, physical performance, and genomic data in survey settings offer new tools and insights to interrogate heterogeneity in Black health. This chapter examines indicators of biological, physical performance, and genetic markers of aging among a national sample of Black Americans ages 54+ years with the aim of addressing two questions about heterogeneity among Black older adults: (a) How do these measures vary by age and gender among Black older adults? (b) Which indicators predict health and mortality among Black older adults? The results indicate that biological, physical performance, and genomic measures of health, generally, have more variation than simple yes or no measures of a disease, condition, or diagnosis among Black older adults, providing counternarratives to the disadvantage frameworks that dominate characterizations of Black health and aging. However, bioethical challenges limit the utility of biomarkers, physical performance, and genomics measures for Black populations.

Ellis, Katrina R.

2022 Annual Review of Gerontology & Geriatrics

doi: 10.1891/0198-8794.41.211

The health outcomes of older Black adults with cancer are influenced by individual, familial, and contextual factors that highlight unexplored opportunities to better understand and support this population. Moreover, cancer is often just one of the significant health concerns facing Black families at any one time, adding complexity to caregiving within family systems. In light of this, three main questions guide this chapter. First, what are the experiences and needs of older Black adults across the cancer continuum, from cancer prevention through end-of-life? Second, how do Black families provide care for an older family member and cope with the challenges that cancer brings? Third, how might a family comorbidity lens, that recognizes the presence of concurrent morbidities within the family system, enhance our understanding of concepts and processes that contribute to the well-being of older Blacks with cancer and their family members? Existing research on family support after a cancer diagnosis overwhelmingly focuses on a single (i.e., primary) caregiver and spousal family caregivers. A broader focus on the role of family systems in providing cancer care highlights both the unique strengths and challenges facing Black families who provide care. In addition, a family comorbidity orientation underscores the need to better understand the nature and impact of concurrent health challenges within families and the possibility of new opportunities to address health issues interdependently. Ultimately, a family comorbidity perspective reflects the lived experiences of older Black adults and their families after a cancer diagnosis and has implications for future research and interventions.

Skipper, Antonius D.; Taylor, Robert Joseph

2022 Annual Review of Gerontology & Geriatrics

doi: 10.1891/0198-8794.41.249

There remains a lack of knowledge on marital satisfaction of African Americans in general and this is particularly the case for older African Americans. In addition, only a handful of studies investigate satisfaction among couples who are unmarried. Using data from the National Survey of American Life, this study examined the correlates of romantic and marital satisfaction among older African Americans. Findings reveal that married older African Americans were slightly more satisfied with their relationship than individuals who were either remarried or unmarried but in a romantic relationship. Among older African American married adults, older age was associated with higher marital satisfaction, and men had higher levels of marital satisfaction than women. Also, married older African Americans with lower family incomes reported higher marital satisfaction. Region was the only variable significantly associated with romantic satisfaction indicating higher satisfaction for Southerners as compared to those living in the Northeast. Given the limited research on older African Americans couples, either married or unmarried, this study offers valuable implications for individuals and professionals engaging these couples in practice settings.

Mitchell, Uchechi A.; Nguyen, Ann W.; McBryde-Redzovic, Aminah; Brown, Lauren L.

2022 Annual Review of Gerontology & Geriatrics

doi: 10.1891/0198-8794.41.269

A robust body of research has shown that Black Americans are less likely than Whites to have psychiatric disorders despite the social and economic disadvantage and systemic racism that they face. This mental health paradox has been demonstrated across all ages of the life course, including older adulthood. One of the prevailing explanations for the lower prevalence of psychiatric disorders among Blacks pertains to the influence of psychosocial resources on mental health. Psychosocial resources can directly or indirectly support mental health through physiological and psychological pathways. They can also mitigate the adverse effects of social stressors of discrimination and other stressors on psychological distress and mental illness. Black older adults may particularly benefit from psychosocial resources because they have had a lifetime of experiencing and overcoming adversity. Although this cycle of stress adaptation can wear away at the physical body, it may facilitate mental health resilience. In this chapter, we review research on the relationship between psychosocial resources and mental health. The chapter begins with a brief review of the Black–White mental health paradox and the mechanisms through which psychosocial resources operate to influence mental health. We then review research on intrapersonal, interpersonal, and community-level psychosocial resources that are particularly salient for Black Americans. Throughout the chapter we highlight research specifically focused on Black older adults and discuss the cultural relevance of each resource to their mental health and psychological functioning.

Smith, Imari Z.; Hargrove, Taylor W.; Rose, Daniel J.; Brown, Tyson H.

2022 Annual Review of Gerontology & Geriatrics

doi: 10.1891/0198-8794.41.303

Although older Black women experience disproportionately high rates of morbidity, relatively little is known about the psychosocial mechanisms underlying their health. This study advances the field by drawing on stress processes and intersectionality frameworks to understand the health consequences of psychosocial factors among a nationally representative sample of Black women over the age of 50. We take a broad and systematic approach to analyzing relationships among psychosocial stressors and resources and health among older Black women to address three research questions. First, how do stressors (discrimination, chronic stressors, traumatic events, and financial strains) individually and collectively influence health? Second, are psychosocial resources (social support, mastery, optimism, religiosity, and prayer) protective of health? Third, to what extent do psychosocial resources moderate relationships between stressors and health? To address these questions, we utilize data from the Health and Retirement Survey (HRS) Core Data and Psychosocial Modules ( N = 1,263) and nested multivariate regression analyses. We focus on measures of global health and functional health, which have previously established relationships with stress processes. Results highlight the utility of examining the health consequences of stressors collectively rather than individually in order to avoid biased estimates. Findings also indicate that several of the psychosocial resources examined are protective of older Black women's health; we find no evidence that these resources moderate the impacts of stressors on their self-rated health or functional limitations. We conclude by discussing the theoretical, substantive, and methodological implications of these findings.

Sol, Ketlyne; Hill-Jarrett, Tanisha G.

2022 Annual Review of Gerontology & Geriatrics

doi: 10.1891/0198-8794.41.327

The general population is living longer and growing older. As age is the strongest predictor of cognitive decline and Alzheimer's disease and related dementias (ADRDs), we can anticipate an increase in these conditions over time. However, Black older adults experience cognitive impairment and are diagnosed with dementia in older age at higher rates, compared to other racial and ethnic groups. Research in this area reflects a growing interest in how lived experiences across the life course affect cognitive trajectories, and ultimately cognitive outcomes of older Black adults. Black older adults have unique life experiences stemming from a historical legacy that includes enslavement, legalized segregation, and pervasive systemic racism and discrimination. This history, along with the contextual factors underlying their life experiences, may be contributing factors to observed disparities in cognitive aging. This review chapter explores research on the influence of psychosocial and physical environmental factors on Black cognitive aging with a special emphasis on the neighborhood, which reflects the most natural and intimate context through which a person experiences life.