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Reaction paper DEP Choose a recently published research article related to adult development and aging and write a 1-2 page summary of the article. a

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Reaction paper DEP
Choose a recently published research article related to adult development and aging and write a 1-2 page summary of the article. a. The research article: 1) must come from a peer-reviewed journal and 2) must be published on or after the year 2000. b. I recommend you choose a topic that is of most interest to you. You may use the power point slides to find topics.
2. What should be included in the summary: a. Summary of the introduction of the article, taking into consideration:i. The purpose of the studyii. The importance of the studyiii. Did the authors have any hypotheses? If so, what were they?
b. Summarize the methods and results section. i. Identify the sample size, participants, and measures used.ii. What were the findings of the study? iii. Did the findings confirm the study hypotheses?
c. Summarize the discussion section, particularly focusing on:i. Limitations of the studyii. Suggestions made by the authors for future research
d. Finally, discuss what you found most interesting in the study; what did you learn?
Additional Information:
It is very important that you follow APA style when writing your summary. You will not receive full credit if you do not. The APA publication manual (6th edition) is available in the library. The body of your paper should be 1-2 pages (not including the title page).

Material Hardship and Self-Rated Mental Health
among Older Black Americans in the National

Survey of American Life
Gillian L. Marshall, Roland J. Thorpe Jr., and Sarah L. Szanton

This article examines the association between material hardships and self-rated mental
health (SRMH) among older black Americans and determines whether the effect varies by
race and ethnicity. Using data from the National Survey of American Life, multiple logistic
regression models were specified on a sample of older white Americans (n = 289), African
Americans (n = 1,135), and black Caribbean Americans (n = 377). Material hardship was
measured as an index of seven items that occurred within the past year. Material hardship
(odds ratio = 0.48; 95 percent confidence interval = 0.290.79) was associated with SRMH
for both groups. None of the interactions were significant. The study concludes that mater-
ial hardship may contribute to poorer SRMH among older African Americans and black
Caribbean Americans. Future studies should examine these associations by using longitu-
dinal designs, which may be better designed to confirm these results.

KEY WORDS: African Americans; black Caribbean Americans; material hardship; mental health

Although federal agencies such as theNational Institutes of Health [NIH], theNational Academy of Medicine [NAM]
(formerly the Institute of Medicine), and the Admin-
istration on Aging (AoA) have goals of reducing or
eliminating mental health disparities across the life
course (AoA, 2001; U.S. Department of Health and
Human Services [HHS], AoA, 2008), significant
racial, ethnic, and economic disparities in mental
health persist. This is particularly true among older
adults (AoA, 2001). One of the goals set out by NIH
and NAM has been to better understand and reduce
socioeconomic and racial health disparities.

Earlier work suggests that socioeconomic status
(SES), in part, is one mechanism by which health dis-
parities exist (Williams & Collins, 1995; Williams, Yu,
Jackson, & Anderson, 1997). The impact of SES as a
risk factor resulting in poor health outcomes has been
well documented (Braveman, Cubbin, Egerter, Wil-
liams, & Pamuk, 2010; Farmer & Ferraro, 2005; Lantz,
House, Mero, & Williams, 2005). Although the con-
tribution of SES is important in that it has been a ma-
jor source for understanding health disparities, it still
does not fully explain the gap in health that remains or
the pathway by which low income affects health
(Whitfield, Thorpe, & Szanton, 2011). SES indicators
other than education, income, and occupation may

be worth exploring. Some evidence suggests that
the differences in the relationship between low SES
and poor health outcomes may be attributed to eco-
nomic hardships (Kahn & Pearlin, 2006; Krause, 1987;
Szanton et al., 2008; Szanton, Thorpe, & Whitfield,
2010; Thorpe, Szanton, Bell, & Whitfield, 2013).
Material hardship, for example, complements mea-
sures of SES in an attempt to capture hardships ex-
perienced related to unfavorable economic situations
and vulnerabilities due to limited resources (Beverly,
2001; Mayer, 1997; Mayer & Jencks, 1989; Ouellette,
Burstein, Long, & Beecroft, 2004).

With the rapid growth of the older adult popula-
tion (AoA, 2001; U.S. Census Bureau, 2004), it is
expected that the diversity already in this demo-
graphic will become even more obvious as the
numbers increase within each subgroup. It is esti-
mated that between 2007 and 2030, the number of
white Americans 65 years and older will increase by
68 percent, compared with African Americans (184
percent); Latinos (244 percent); American Indians,
Eskimos, and Aleuts (126 percent); and Asian and
Pacific Islanders (213 percent) (HHS, 2008). This
suggests that the number of older adults of color will
surpass that of the older white population. There-
fore, to avoid obscuring potential differences in
health within a racial group, ethnic group affiliation

doi: 10.1093/hsw/hlx008 2017 National Association of Social Workers 87

should be considered with a national sample (Jackson,
Torres, et al., 2004).

African Americans and black Caribbean Americans
have long been assumed to belong to the same racial
group (black); in fact, they are ethnically distinct and
display considerable heterogeneity when compared
with respect to history, culture, life experience, con-
text, status dimensions, beliefs, and cultural norms.
The term African American refers to people who
are U.S.-born black people from the African diaspora
who self-identify as Negro, black, Afro-American,
or African American. Black Caribbean Americans are
those who self-identify as people who trace their
ethnic heritage to a Caribbean country but who
now reside in the United States. The term black
is often used to describe groups of black people
who are either U.S.-born citizens or foreign-born

Although African Americans and black Caribbean
Americans share commonalities such as phenotype,
vulnerability to discrimination, and a history of
enslavement by white people, black Caribbean
Americans also share similarities with Europeans
in their experience of migration and maintaining
ties with their country of origin (Rogers, 2006).

These distinct differences have been largely ig-
nored (Bryant, 2003; Lincoln, Chatters, Taylor, &
Jackson, 2007; Lyons, 1997; Thorpe et al., 2013;
Whitfield, Allaire, Belue, & Edwards, 2008; Williams
et al., 2007). In spite of the growing numbers of
both older African Americans and older black
Caribbean Americans in the United States, the
empirical research regarding the similarities and dif-
ferences in mental health status between these
groups is lacking (Williams et al., 2007). Therefore,
it is worth considering that these factors may have a
bearing on how members of each group perceive
material hardship and rate their mental health status.

Prior work in this area has demonstrated that eco-
nomic measures are an important predictor of men-
tal well-being and strongly associated with mental
health outcomes (Alley & Kahn, 2012; Lee &
Brown, 2007; Savoy et al., 2014). Yet few studies
have used a national sample of older black Americans
to investigate the effects of material hardship on self-
rated mental health (SRMH) among all older black
Americans (African Americans and black Caribbean
Americans). Despite the growing interest in the

mental well-being of adults in late life, little is
known about how material hardship affects well-
being. Furthermore, it is not known whether differ-
ences in ethnicity within race can serve as a potential
explanation for why there is variation in SRMH.

Using a nationally representative sample of older
white Americans, African Americans, and black
Caribbean Americans, this study examines the
association between material hardship and SRMH
status, while controlling for key covariates such as
age, income, marital status, and education and de-
termines whether this relationship varies by ethnic
group. We hypothesize that after adjusting for cov-
ariates, material hardship will be positively asso-
ciated with SRMH and that this relationship will
vary by ethnic group.

Study Sample
Data for these analyses were obtained from the
National Survey of American Life: Coping with
Strain in the 21st Century (NSAL). This is a cross-
sectional survey study of inter- and intragroup
racial and ethnic differences with respect to mental
disorders, psychological strain, help seeking, and
the use of informal and formal health services
(Jackson, Neighbors, Nesse, Trierweiler, & Torres,
2004). Face-to-face interviews were conducted
with a total of 6,082 adults in the United States,
age 18 years and older, consisting of 3,750 African
Americans, 1,621 black Americans of Caribbean
descent, and 892 non-Hispanic white Americans.

This is a nationally representative, probability
complex sample for which primary data were col-
lected from 2001 through 2003 (Jackson, Neigh-
bors, et al., 2004) by the University of Michigans
Institute for Social Research Survey Center, which
is part of the National Institute of Mental Health
Collaborative Psychiatric Epidemiology Surveys
initiative. People ineligible for the study were those
institutionalized in prison or jail, psychiatric facil-
ities, nursing homes, and other long-term medical
or dependent care facilities. Also excluded were
those who had been homeless or were in the

The analytic sample for this study was composed
of 1,801 men and women age 50 years and older
who self-identified as African American (n = 1,135),
black Caribbean American (n = 377), or white
American (n = 289).

88 Health & Social Work Volume 42, Number 2 May 2017

Dependent Variable. SRMH was assessed using a
single item in which participants were asked, How
would you rate your overall mental health? at the
present time. There were five possible response op-
tions: 1 = poor, 2 = fair, 3 = good, 4 = very good,
and 5 = excellent. This variable was dichotomized
into two categories: 0 = fair/poor and 1 = good/
very good/excellent mental health.

Independent Variables. Material hardship con-
sisted of a seven-item scale asking, In the past 12
months was there a time when you (1) didnt meet
basic expenses; (2) didnt pay full rent or mortgage;
(3) were evicted for non-payment; (4) didnt pay
full gas, electric, or oil; (5) had gas or oil discon-
nected; (6) had telephone disconnected; (7) couldnt
afford leisure activities. Responses were either no
(0) or yes (1). All responses were summed for a total
composite score; higher scores reflected greater
material hardship. This approach is similar to that of
previous investigators (Hughes, Kiecolt, & Keith,

Covariates. Covariates included age (50 to 94
years, as a continuous measure), gender (0 = male;
1 = female), race and ethnicity (African Americans,
black Caribbean Americans, and white Americans
as the reference group), education (<12 years, 12 years, >12 years), and annual household income
(<$10,000; $10,000$19,999; $20,000$39,999; $40,000$59,999; $60,000). Statistical Analysis Descriptive statistics included percentages and p values for categorical variables and mean and standard variations for continuous variables for the total sample and by material hardship. Logis- tic regression models were used to determine the associations between SRMH and material hard- ship and other covariates. Interaction terms were created for material hardship ethnic group to determine whether material hardship varies by ethnic group. We reported results as odds ratios with 95 percent confidence intervals (CIs). NSAL data are weighted by using sampling weights adjust- ing for disproportionate sampling, nonresponse, and population representation across various sociode- mographic characteristics across the United States (Heeringa et al., 2004, 2006). Results with p values less than .05 were considered statistically significant. We used Stata (Version 11) to conduct statistical procedures (StataCorp, 2009). RESULTS Table 1 presents demographic information about the characteristics of the total NSAL sample (N = 1,801) by material hardship. The mean age among those with material hardship and those without was 60 years (SD = 9.5) and 64 years (SD = 9.4), respect- ively. Compared with 19 percent of white Amer- icans, 29 percent of African Americans and 26 percent of black Caribbean Americans were likely to experience material hardship. We found that a lower proportion of those who were married or partnered reported material hardship. With regard to SES indi- cators, 32 percent of those with less than 12 years of education were likely to experience material hard- ship. Across all income levels, only a small percent- age measured having material hardship. Among those without material hardship, 80 percent reported experiencing good to excellent health; 35 percent of those with material hardship reported poor to fair health status. Table 2 presents the association between material hardship and SRMH. Specifically, model 1 tested for the direct effect between material hardship and SRMH. People who experienced material hardship had 48 percent higher odds of reporting fair or poor mental health than those without material hardship (95 percent CI = 0.29, 0.79). When we exam- ined the association between material hardship and SRMH controlling for race (model 2), we found that those who did report material hardship had 49 percent higher odds of reporting poor mental health compared with those who did not have material hardship (95 percent CI = 0.031, 0.77). Model 3 examined the association between material hardship and SRMH by controlling for all demographics fac- tors. We found that people with material hardship (95 percent CI = 0.39, 0.79) had 56 percent greater odds of reporting poor or fair mental health. For model 4, we added one interaction term to test whether material hardship varied by ethic group (African American material hardship; black Carib- bean Americans material hardship). When the interaction term was added to the model, we found that material hardship lost its significance. In add- ition, the interaction in model 4 was not significant. DISCUSSION By using data from a nationally representative sam- ple of older African American and black Caribbean Americans, we examined the relationship between material hardship and SRMH. Results indicate that 89Marshall, Thorpe, and Szanton / Material Hardship and Self-Rated Mental Health those who experienced material hardship were more likely to report fair or poor mental health. Our study differs from previous work in that it examined within-group differences among older black Amer- icans. In addition, the current study extended the lit- erature by examining material hardship and its association to SRMH in late life. Older African Americans and black Caribbean Americans who had material hardship had higher odds of reporting fair or poor mental health. As sta- ted earlier, material hardship measures comple- ment measures of SES by measuring specific concrete bills (for example, gas, light, power) in an attempt to capture hardship related to unfavorable economic situations and vulnerabilities due to lim- ited resources (Szanton et al., 2008). These are actionable by policy that may provide additional information regarding an older persons economic well-being. This finding is novel in that it contributes to the literature on hardship related to material hardship and SRMH as few studies, if any, have. This is especially significant because the study used this measure with a national sample of older African Americans and black Caribbean Americans. These findings suggest that material hardship directly in- fluences black adults reports of their mental health status in later life. Studies using other measures of economic hardship have found similar results (Lin- coln & Chae, 2010; Szanton et al., 2010). These findings should be interpreted with caution as this study has limitations. First, this was a cross- sectional study, which limits our ability to make in- ferences about the causal direction of the relation- ships. In addition, longitudinal studies that examine the impact of material hardship and change in SRMH are needed. Second, this study examined only two English-speaking black ethnic groups: Table 1: Demographic Characteristics of Older Adults 50 and over, by Material Hardship Characteristic Material Hardship p Total (N = 1,801) With Material Hardship (n = 520) Without Material Hardship (n = 1,381) Age (years): mean (SD) 62.9 (9.5) 60.3 (9.5) 63.7 (9.4) <.001 Race and ethnicity African American 59.7 28.7 71.3 .004 Black Caribbean 19.8 25.5 74.5 .653 White 20.5 18.6 81.4 .004 Gender .23 Male 47.1 21.2 78.8 Female 52.9 24.8 75.2 Marital status <.001 Single/divorced/ widowed 47.4 28.0 72.0 Married/partnered 52.6 17.2 82.8 Education level .003 Less than 12 years 28.1 32.4 67.6 12 years (ref) 33.4 21.9 78.1 More than 12 years 38.5 17.4 82.6 Income <.001 $200$9,999 12.1 42.5 57.5 $10,000$19,999 22.8 29.0 71.0 $20,000$39,999 27.1 22.8 77.2 $40,000$59,999 14.4 19.0 81.0 $60,000+ 23.6 10.4 89.6 Self-rated mental health status .002 Poor/fair 11.9 35.0 65.0 Good/very good/ excellent 88.1 20.5 79.5 Notes: All values are percentages, unless otherwise indicated; ref = reference category. 90 Health & Social Work Volume 42, Number 2 May 2017 African American and black Caribbean Americans. Black Caribbean Americans consist of people from several islands that are diverse in culture, language, and experience. The island-specific subgroups were too small to provide stable estimates; hence, one limitation is that the Caribbean American sample was examined as if it represented one homoge- neous group. A third potential limitation might be the use of a single-item measure of SRMH as a dependent variable. The single-item assessment of SRMH has received some attention to date in its association with psychological symptoms and mental disorders (Kim et al., 2010). However, in spite of the reported validity of the SRMH vari- able, some have argued that the degree to which SRMH may be used as a proxy for other mea- sures of mental health is unclear (Fleishman & Zuvekas, 2007). Perhaps a more robust measure of mental health might have more variability and therefore be better able to detect any changes. Despite these limitations, however, the findings are important in that they showed that material hardship plays a significant role in the lives of older African Americans and black Caribbean Americans who rated their mental health status as being either fair or poor. This study is one of the first to investigate the association between material hardship and SRMH in a national sample of older African Americans and black Caribbean Americans in the United States. This study also extends the aging and mental health literature by examining the differences and similarities in the association of hardship and depres- sive symptoms among older African Americans and black Caribbean Americans. SOCIAL WORK PRACTICE IMPLICATIONS The aim of this study was to assess the association between material hardship and SRMH status and determine whether this relationship varied by ethnic group. Our results are consistent with those of simi- lar studies examining the relationship of hardship Table 2: Logistic Regression for Self-Rated Mental Health, by Material Hardship, Demographic Characteristics, and Interaction Terms Variable Model 1 Model 2 Model 3 Model 4 OR 95% CI OR 95% CI OR 95% CI OR 95% CI Material hardship 0.48** 0.29, 0.79 0.49** 0.31, 0.77 0.56** 0.39, 0.79 0.73 0.38, 1.40 Race and ethnicity White (ref) African American 0.87 0.52, 1.45 0.91 0.60, 1.38 1.07 0.64, 1.78 Black Caribbean 0.67 0.28, 1.60 0.54 0.24, 1.23 0.59 0.22, 1.60 Age: mean (SD) 0.99 0.97, 1.02 0.99 0.97, 1.02 Gender Male (ref) Female 0.76 0.41, 1.39 0.77 0.42, 1.41 Marital status Single/widowed/divorced (ref) Married/partnered 1.32 0.68, 2.57 1.32 0.68, 2.57 Education 12 years (ref) Less than 12 years 0.56* 0.31, 1.01 0.56 0.31, 1.00 More than 12 years 0.59 0.26, 1.31 0.59 0.26, 1.32 Income $200$9,999 (ref) $10,000$19,999 1.40 0.26, 1.31 1.40 0.89, 2.20 $20,000$39,999 1.81** 0.89, 2.19 1.84** 1.07, 3.15 $40,000$59,999 3.24** 1.23, 8.56 3.27** 1.23, 8.68 $60,000+ 5.84*** 2.71, 12.57 6.01*** 2.79, 12.93 Ethnicity material hardship African American 0.62 0.26, 1.45 Black Caribbean 0.79 0.20, 2.94 Notes: CI = confidence interval; ref = reference category. *p < .05. **p < .01. ***p < .001. 91Marshall, Thorpe, and Szanton / Material Hardship and Self-Rated Mental Health and poor mental health outcomes in older African Americans (Savoy et al., 2014; Szanton et al., 2010). However, few studies to date have examined material hardship within-group differences specifically. Frequently neglected in the literature is a discus- sion regarding hardships in later life. Older adults, often vulnerable and underserved, may also have increasing needs and experience hardships as they age, potentially leading to poor mental health out- comes in late life (Lee & Brown, 2007; Szanton et al., 2008). With the growth in the older adult population and increased life expectancy, older adults will need to manage their financial resources over a longer or extended period of time (Hill, Kellard, Middleton, Cox, & Pound, 2007). Older adult clients face hardships, such as possessing lim- ited financial resources or lacking knowledge about finances; this may be why they come into contact with social workers for assistance. Social workers are often faced with the task of helping their clients address stressful life situations. Stress related to hardships in the form of debt is one such stressful life situation that has been often over- looked in social work practice, especially among the older adult population. The National Association of Social Workers (2015) has identified enhancing the capacity of people to address their own needs as one of social works top priorities. One such need is assistance with financial matters. Although social workers have the opportunity to help individuals and families with their financial problems in a variety of practice settings (Sherraden, Laux, & Kaufman, 2007), a cursory review of social work curricula suggests that the skills to do so are not being taught. Social work graduates are rarely provided with the expertise and formal training on how to help individuals and fam- ilies manage household finances and financial decision making (Despard & Chowa, 2013; Frey et al., 2015; Gillen & Loeffler, 2012; Sherraden et al., 2007). Although social workers are not given this formal training, many are already doing work in household finance areas and have some of the necessary skills and knowledge on financial matters to practice well. However, many other social work professionals are not prepared to assist families with financial concerns and are at a disadvantage when working with clients, especially those who borrow from fringe economy enterprises (payday lenders, pawn shops, rent-to- own shops) (Karger, 2015). Despite this challenge, working in this area provides an opportunity for social workers to intervene to help clients better address their financial circumstances. Social workers interested in improving clients financial well-being have used intervention methods such as financial counseling or financial education as potential prac- tice approaches (Despard & Chowa, 2013). Newer fields of study, such as financial capabil- ity, have emerged to address the specific financial needs of the clients social workers serve. Financial capability incorporates aspects of financial literacy and financial stability. A recent pre- and poststudy conducted by Frey et al. (2015) examined the knowl- edge, attitudes, and behaviors of social workers before taking a financial capability training program and then assessed them again after the training. Frey et al. found that although many clients who sought out social work services had financial problems, social workers reported not having any formal training in this area. Posttest assessments revealed that social workers increased their financial knowledge and behaviors. Another emerging field of study specific to the older population is financial gerontologya multidis- ciplinary approach drawing from various disci- plines, such as biology, psychology, sociology, and demography, and using a life span framework to advance understanding of lifelong wealth span is- sues and aspirations of older adults and their fam- ilies (American Institute of Financial Gerontology, 2007). Evidence from practitioners using interven- tions such as financial capability and gerontology, financial counseling, or financial education is prom- ising, but additional research and evaluations of these models are needed. HSW REFERENCES Administration on Aging. (2001). Older adults and mental health: Issues and opportunities. In Mental health: A report of the surgeon general (pp. 336381). Rockville, MD: Author. Alley, D., & Kahn, J. R. (2012). Demographic and psycho- social predictors of financial strain in older adults. 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Whitfield, K. E., Thorpe, R. Jr., & Szanton, S. (2011).
Health disparities, so


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