TY - JOUR
T1 - Neighborhood socioeconomic status and racial disparities in schizophrenia
T2 - An exploration of domains of functioning
AU - Nagendra, Arundati
AU - Halverson, Tate F.
AU - Pinkham, Amy E.
AU - Harvey, Philip D.
AU - Jarskog, L. Fredrik
AU - Weisman de Mamani, Amy
AU - Penn, David L.
N1 - Funding Information:
This work was supported by the National Institute of Mental Health at the National Institutes of Health ( R01 MH093432 to P.H.D., D.L.P., and A.E.P.).
Funding Information:
The SCOPE study was supported by the National Institute of Mental Health ( R01MH093432 to P.D.H., D.L.P., and A.E.P.). We would also like to thank Philip McDaniel, M.A., from the UNC Chapel Hill Libraries, for his assistance with the geocoding process.
PY - 2020
Y1 - 2020
N2 - Black Americans are disproportionately diagnosed with schizophrenia and experience worse objective functional outcomes (e.g., hospitalizations) than their White counterparts. However, we have a limited understanding of the psychological pathways through which Black Americans with schizophrenia reach worse outcomes. This study assessed race and domains of functioning (e.g., neurocognition, functional capacity) known to be associated with objective outcomes in a sample of 108 non-Hispanic Black and 61 non-Hispanic White individuals with schizophrenia-spectrum disorders from the Social Cognition Psychometric Evaluation (SCOPE) study. Three primary findings emerged: First, Black participants showed lower scores than White participants on measures of neurocognition, social cognition, and everyday living skills, but not social skills or community functioning. Second, neighborhood socioeconomic status (SES) explained 21% of the relationship between race and neurocognitive scores but did not mediate the relationship between race and social cognition or everyday living skills. Finally, prior research has established that NC, SC, social skills, and everyday living skills predict community functioning in individuals with schizophrenia. In our sample, after controlling for neighborhood SES, race did not moderate the relationships of NC, SC, social skills, or everyday living skills to community functioning. This indicates that relationships between these domains are comparably strong across Black and White Americans. These findings show that cognition and everyday living skills may be important areas to explore in regards to racial disparities in schizophrenia. More research, especially incorporating nuanced race- and SES-related variables, is needed to understand how to best intervene and improve real-world outcomes for Black Americans with schizophrenia.
AB - Black Americans are disproportionately diagnosed with schizophrenia and experience worse objective functional outcomes (e.g., hospitalizations) than their White counterparts. However, we have a limited understanding of the psychological pathways through which Black Americans with schizophrenia reach worse outcomes. This study assessed race and domains of functioning (e.g., neurocognition, functional capacity) known to be associated with objective outcomes in a sample of 108 non-Hispanic Black and 61 non-Hispanic White individuals with schizophrenia-spectrum disorders from the Social Cognition Psychometric Evaluation (SCOPE) study. Three primary findings emerged: First, Black participants showed lower scores than White participants on measures of neurocognition, social cognition, and everyday living skills, but not social skills or community functioning. Second, neighborhood socioeconomic status (SES) explained 21% of the relationship between race and neurocognitive scores but did not mediate the relationship between race and social cognition or everyday living skills. Finally, prior research has established that NC, SC, social skills, and everyday living skills predict community functioning in individuals with schizophrenia. In our sample, after controlling for neighborhood SES, race did not moderate the relationships of NC, SC, social skills, or everyday living skills to community functioning. This indicates that relationships between these domains are comparably strong across Black and White Americans. These findings show that cognition and everyday living skills may be important areas to explore in regards to racial disparities in schizophrenia. More research, especially incorporating nuanced race- and SES-related variables, is needed to understand how to best intervene and improve real-world outcomes for Black Americans with schizophrenia.
KW - African Americans
KW - Cognition
KW - Functional outcomes
KW - Race
KW - Schizophrenia
KW - Socioeconomic status
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U2 - 10.1016/j.schres.2020.09.020
DO - 10.1016/j.schres.2020.09.020
M3 - Article
AN - SCOPUS:85093960244
JO - Schizophrenia Research
JF - Schizophrenia Research
SN - 0920-9964
ER -