Racism as a Stressor for African Americans: A Biopsychosocial Model

American Psychologist

Volumn 54, Issue 10, 1999, Pages 805-816

  Clark, Rodney ^b   Anderson, Norman B ^a   Clark, Vernessa R ^c   Williams, David R ^c  

^a NATIONAL INSTITUTES OF HEALTH   (United States)

^b WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE   (United States)

^c NONE

Author keywords

[No Author keywords available]

Indexed keywords

AFRICAN AMERICAN; ARTICLE; HUMAN; MENTAL STRESS; PERCEPTION; PSYCHOLOGICAL ASPECT; PSYCHOLOGICAL MODEL; SELF CONCEPT; SOCIAL PSYCHOLOGY;

AFRICAN AMERICANS; HUMANS; MODELS, PSYCHOLOGICAL; PERCEPTION; PREJUDICE; SELF CONCEPT; STRESS, PSYCHOLOGICAL;

EID: 0033210179     PISSN: 0003066X     EISSN: None     Source Type: Journal    
DOI: 10.1037/0003-066X.54.10.805     Document Type: Article

References (126)

1. Adams, J. P., & Dressler, W. W. (1988). Perceptions of injustice in a Black community: Dimensions and variations. Human Relations, 41, 753-767.
2. Allan-Claiborne, J. G., & Taylor, J. (1981). The racialistic incidents inventory: Measuring awareness of racialism. In O. A. Barbarin, P. R. Good, O. M. Pharr, & J. A. Siskind (Eds.), Institutional racism and community competence (pp. 172-178). Rockville, MD: U. S. Department of Health and Human Services.
3. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
4. Andersen, B. L., Kiecolt-Glaser, J. K., & Glaser, R. (1994). A biobehavioral model of cancer stress and disease course. American Psychologist, 49, 389-404.
5. Anderson, L. P. (1991). Acculturative stress: A theory of relevance to Black Americans. Clinical Psychology Review, 11, 685-702.
6. Anderson, N. B., & Armstead, C. A. (1995). Toward understanding the association of socioeconomic status and health: A new challenge for the biopsychosocial approach. Psychosomatic Medicine, 57, 213-225.
7. Anderson, N. B., Lane, J. D., Taguchi, F., & Williams, R. B., Jr. (1989). Patterns of cardiovascular responses to stress as a function of race and parental hypertension in men. Health Psychology, 8, 525-540.
8. Anderson, N. B., McNeilly, M., & Myers, H. (1991). Autonomic reactivity and hypertension in Blacks: A review and proposed model. Ethnicity and Disease, 1, 154-170.
9. Anisman, H., Kokkinidis, L., & Sklar, L. S. (1985). Neurochemical consequences of stress: Contributions of adaptive processes. In S. R. Burchfield (Ed.), Stress: Psychological and physiological interactions (pp. 67-98). New York: Hemisphere.
10. Armstead, C. A., Lawler, K. A., Gorden, G., Cross, J., & Gibbons, J. (1989). Relationship of racial stressors to blood pressure responses and anger expression in Black college students. Health Psychology, 8, 541-556.
11. Ayres, I. (1991). Fair driving: Gender and race discrimination in bargaining for a new car. American Economic Review, 85, 304-321.
12. Bandura, A., Taylor, C. B., & Williams, S. L. (1985). Catecholamine secretion as a function of perceived coping self-efficacy. Journal of Consulting and Clinical Psychology, 53, 406-414.
13. Barbarin, O. A. (1996). The IRS: Multidimensional measurement of institutional racism. In R. L. Jones (Ed.), Handbook of tests and measurements for Black populations (Vol. 2, pp. 375-398). Hampton, VA: Cobb and Henry.
14. Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182.
15. Brandenberger, G., Follenius, M., Wittersheim, G., & Salame, P. (1980). Plasma catecholamines and pituitary adrenal hormones related to mental task demand under quiet and noise conditions. Biological Psychology, 10, 239-252.
16. Browman, C. L. (1996). The health consequences of racial discrimination: A study of African Americans. Ethnicity and Disease, 6, 148-153.
17. Bullock, S. C., & Houston, E. (1987). Perceptions of racism by Black medical students attending White medical schools. Journal of the National Medical Association, 79, 601-608.
18. Burchfield, S. R. (1979). The stress response: A new perspective. Psychosomatic Medicine, 41, 661-672.
19. Burchfield, S. R. (1985). Stress: An integrative framework. In S. R. Burchfield (Ed.), Stress: Psychological and physiological interactions (pp. 381-394). New York: Hemisphere.
20. Cacioppo, J. (1994). Social neuroscience: Autonomic, neuroendocrine, and immune responses to stress. Psychophysiology, 31, 113-128.
21. Clark, R., & Armstead, C. A. (in press). Family conflict predicts blood pressure changes in African American adolescents. Journal of Adolescence.
22. Clark, V. R., & Harrell, J. P. (1982). The relationship among Type A behavior, styles used in coping with racism, and blood pressure. Journal of Black Psychology, 8, 89-99.
23. Cohen, F., & Lazarus, R. S. (1979). Coping with the stresses of illness. In G. S. Stone, F. Cohen, & N. E. Adler (Eds.), Health psychology: A handbook (pp. 77-112). San Francisco: Jossey-Bass.
24. Cohen, S., Frank, E., Doyle, W. J., Skoner, D. P., Rabin, B. S., & Gwaltney, J. M., Jr. (1998). Types of stressors that increase susceptibility to the common cold in healthy adults. Health Psychology, 17, 214-223.
25. Cohen, S., & Herbert, T. B. (1996). Health psychology: Psychological factors and physical disease from the perspective of human psychoneuroimmunology. Annual Review of Psychology, 47, 113-142.
26. Cohen, S., Tyrrell, D. A. J., & Smith, A. P. (1991). Psychological stress and susceptibility to the common cold. New England Journal of Medicine, 325, 606-612.
27. Cooper, R. S. (1993). Health and the social status of Blacks in the United States. Annals of Epidemiology, 3, 137-144.
28. Cornell, D. G., Peterson, C. S., & Richards, H. (1999). Anger as a predictor of aggression among incarcerated adolescents. Journal of Consulting and Clinical Psychology, 67, 108-115.
29. Dressler, W. W. (1991). Social class, skin color, and arterial blood pressure in two societies. Ethnicity and Disease, 1, 60-77.
30. Ernst, F. A., Jackson, I., Robertson, R. M., Nevels, H., & Watts, E. (1997). Skin tone, hostility, and blood pressure in young normotensive African Americans. Ethnicity and Disease, 7, 34-40.
31. Essed, P. (1991). Everyday racism. Claremont, CA: Hunter House.
32. Everson, S. A., Goldberg, D. E., Kaplan, G. A., Julkunen, J., & Solonen, J. T. (1998). Anger expression and incident hypertension. Psychosomatic Medicine, 60, 730-735.
33. Farley, J. E. (1988). Orientation: Basic terms and concepts. In Majority-minority relations (2nd ed., pp. 1-11). Englewood Cliffs, NJ: Prentice Hall.
34. Farrell, W. C., Jr., & Jones, C. K. (1988). Recent racial incidents in higher education: A preliminary perspective. The Urban Review, 20, 211-226.
35. Feagin, J. R. (1991). The continuing significance of race: Antiblack discrimination in public places. American Sociological Review, 56, 101-116.
36. Fernando, S. (1984). Racism as a cause of depression. International Journal of Social Psychiatry, 30, 41-49.
37. Forman, T. A., Williams, D. R., & Jackson, J. S. (1997). Race, place, and discrimination. Perspectives on Social Problems, 9, 231-261.
38. Gatewood, W. B., Jr. (1988). Aristocrats of color: South and North, the Black elite, 1880-1920. Journal of Southern History, 54, 3-20.
39. Grier, W. H., & Cobbs, P. M. (1968). Black rage. New York: Basic Books.
40. Harburg, E., Gleiberman, L., Roeper, P., Schork, M. A., & Schull, W. J. (1978). Skin color, ethnicity, and blood pressure in Detroit Blacks. American Journal of Public Health, 68, 1177-1183.
41. Harburg, E., Gleiberman, L., Russell, M., & Cooper, M. L. (1991). Anger-coping styles and blood pressure in Black and White males: Buffalo, New York. Psychosomatic Medicine, 53, 153-164.
42. Harrell, S. P. (1997). The Racism and Life Experiences Scales (RaLES). Unpublished manuscript, California School of Professional Psychology, Los Angeles.
43. Harris, M. B. (1992). Beliefs about how to reduce anger. Psychological Reports, 70, 203-210.
44. Herbert, T. B., & Cohen, S. (1993). Stress and immunity in humans: A meta-analytic review. Psychosomatic Medicine, 55, 364-379.
45. Herd, J. A. (1991). Cardiovascular responses to stress. Physiological Reviews, 71, 305-330.
46. Hohn, A. R., Riopel, D. A., Keil, J. E., Loadholt, C. B., Margolius, H. S., Halushka, P. V., Privitera, P. J., Webb, J. G., Medley, E. S., Schuman, S. H., Rubin, M. I., Pantell, R. H., & Braunstein, M. L. (1983). Childhood familial and racial differences in physiologic and biochemical factors related to hypertension. Hypertension, 5, 56-70.
47. Hughes, M., & Hertel, B. R. (1990). The significance of color remains: A study of life chances, mate selection, and ethnic consciousness among Black Americans. Social Forces, 68, 1105-1120.
48. Jackson, J. S., Brown, T. N., Williams, D. R., Torres, M., Sellers, S. L., & Brown, K. (1996). Racism and the physical and mental health status of African Americans: A thirteen year national panel study. Ethnicity and Disease, 6, 132-147.
49. James, S. A. (1993). Racial and ethnic differences in infant mortality and low birth weight: A psychosocial critique. Annals of Epidemiology, 3, 130-136.
50. James, S. A., Hartnett, S. A., & Kalsbeek, W. D. (1983). John Henryism and blood pressure differences among black men. Journal of Behavioral Medicine, 6, 259-278.
51. James, S. A., Strogatz, D. S., Wing, S. B., & Ramsey, D. L. (1987). Socioeconomic status, John Henryism, and hypertension in Blacks and Whites. American Journal of Epidemiology, 126, 664-673.
52. Jaynes, G. D., & Williams, R. M., Jr. (1989). A common destiny: Blacks and American society. Washington, DC: National Academic Press.
53. Jiang, W., Babyak, M., Krantz, D. S., Waugh, R. A., Coleman, R. E., Hanson, M. M., Frid, D. J., McNulty, S., Morris, J. J., O'Connor, C. M., & Blumenthal, J. A. (1996). Mental stress-induced myocardial ischemia and cardiac events. Journal of the American Medical Association, 275, 1651-1656.
54. Johnson, E. H., & Browman, C. L. (1987). The relationship of anger expression to health problems among Black Americans in a national survey. Journal of Behavioral Medicine, 10, 103-116.
55. Jones, J. M. (1997). Prejudice and racism (2nd ed.). New York: McGraw-Hill.
56. Jorgensen, R. S., Gelling, P. D., & Kliner, L. (1992). Patterns of social desirability and anger in young men with a parental history of hypertension: Association with cardiovascular activity. Health Psychology, 11, 403-412.
57. Jorgensen, R. S., Johnson, B. T., Kolodziej, M. E., & Schreer, G. E. (1996). Elevated blood pressure and personality: A meta-analytic review. Psychological Bulletin, 120, 293-320.
58. Kamarck, T., & Jennings, J. R. (1991). Biobehavioral factors in sudden cardiac death. Psychological Bulletin, 109, 42-75.
59. Keith, V. M., & Herring, C. (1991). Skin tone and stratification in the Black community. American Journal of Sociology, 97, 760-778.
60. Kendler, K. S., Kessler, R. C., Walters, E. E., MacLean, C., Neale, M. C., Heath, A. C., & Eaves, L. J. (1995). Stressful life events, genetic liability, and onset of an episode of major depression in women. American Journal of Psychiatry, 152, 833-842.
61. Kiecolt-Glaser, J. K., Dura, J. R., Speicher, C. E., Trask, O. J., & Glaser, R. (1991). Spousal caregivers of dementia victims: Longitudinal changes in immunity and health. Psychosomatic Medicine, 53, 345-362.
62. Kiecolt-Glaser, J. K., & Glaser, R. (1995). Psychoneuroimmunology and health consequences: Data and shared mechanisms. Psychosomatic Medicine, 57, 269-274.
63. Kiecolt-Glaser, J. K., Malarkey, W. B., Chee, M., Newton, T., Cacioppo, J. T., Mao, H., & Glaser, R. (1993). Negative behavior during marital conflict is associated with immunological down-regulation. Psychosomatic Medicine, 55, 395-409.
64. Kiecolt-Glaser, J. K., Marucha, P. T., Malarkey, W. B., Mercado, A. M., & Glaser, R. (1995, November 4). Slowing of wound healing by psychological stress. Lancet, 346, 1194-1196.
65. Kinder, D. R., & Mendelberg, T. (1995). Cracks in American apartheid: The political impact of prejudice among desegregated whites. Journal of Politics, 57, 402-424.
66. King, G., & Williams, D. R. (1995). Race and health: A multi-dimensional approach to African American health. In B. C. Amick, S. Levine, D. C. Walsh, & A. Tarlov (Eds.), Society and health (pp. 93-130). New York: Oxford University Press.
67. Kirschenman, J., & Neckerman, K. M. (1991). We'd love to hire them, but . . . : The meaning of race for employers. In C. Jenkins & P. E. Peterson (Eds.), The urban underclass (pp. 203-232). Washington, DC: Brookings Institution.
68. Klag, M. J., Whelton, P. K., Coresh, J., Grim, C. E., & Kuller, L. H. (1991). The association of skin color with blood pressure in U.S. Blacks with low socioeconomic status. Journal of the American Medical Association, 265, 599-602.
69. Korol, B., Bergfeld, G. R., & McLaughlin, L. J. (1975). Skin color and autonomie nervous system measures. Physiology and Behavior, 14, 575-578.
70. Krieger, N. (1990). Racial and gender discrimination: Risk factors for high blood pressure? Social Science Medicine, 12, 1273-1281.
71. Krieger, N., Rowley, D. L., Herman, A. A., Avery, B., & Phillips, M. T. (1993). Racism, sexism, and social class: Implications for studies of health, disease, and well-being. American Journal of Preventive Medicine, 9, 82-122.
72. Krieger, N., & Sidney, S. (1996). Racial discrimination and blood pressure: The CARDIA Study of young Black and White adults. American Journal of Public Health, 86, 1370-1378.
73. Landrine, H., & Klonoff, E. A. (1996). The Schedule of Racist Events: A measure of racial discrimination and a study of its negative physical and mental health consequences. Journal of Black Psychology, 22, 144-168.
74. Larkin, K. T., Semenchuk, E. M., Frazer, N. L., Suchday, S., & Taylor, R. L. (1998). Cardiovascular and behavioral response to social confrontation: Measuring real-life stress in the laboratory. Annals of Behavioral Medicine, 20, 294-301.
75. Lawler, K. A., & Allen, M. T. (1981). Risk factors for hypertension in children: Their relationship to psychophysiological responses. Journal of Psychosomatic Research, 23, 199-204.
76. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.
77. Light, K. C., & Obrist, P. A. (1980). Cardiovascular response to stress: Effects of opportunity to avoid shock, shock experience, and performance feedback. Psychophysiology, 17, 243-252.
78. Manuck, S., Kasprowicz, A., & Muldoon, M. (1990). Behaviorally-evoked cardiovascular reactivity and hypertension: Conceptual issues and potential associations. Annals of Behavioral Medicine, 12, 17-29.
79. Matheny, K. B., Aycock, D. W., Pugh, J. L., Curlette, W. L., & Cannella, K. A. S. (1986). Stress coping: A qualitative and quantitative synthesis with implications for treatment. Counseling Psychologist, 14, 499-549.
80. Mays, V. M., Coleman, L. M., & Jackson, J. S. (1996). Perceived race-based discrimination, employment status, and job stress in a national sample of Black women: Implications for health outcomes. Journal of Occupational Health Psychology, 1, 319-329.
81. McCance, K. L. (1990). Stress and disease. In K. L. McCance & S. E. Huether (Eds.), Pathophysiology: The biologic basis for disease in adults and children (pp. 279-293). St. Louis, MO: C. V. Mosby.
82. McConahay, J. B., & Hough, J. C. (1976). Symbolic racism. Journal of Social Issues, 32, 23-45.
83. McNeilly, M. D., Anderson, N. B., Armstead, C. A., Clark, R., Corbett, M. O., Robinson, E. L., Pieper, C. F., & Lipisto, M. (1996). The Perceived Racism Scale: A multidimensional assessment of the perception of White racism among African Americans. Racism and Health, Ethnicity and Disease, 6, 154-166.
84. McNeilly, M., Anderson, N. B., Robinson, E. F., McManus, C. F., Armstead, C. A., Clark, R., Pieper, C. F., Simons, C., & Saulter, T. D. (1996). The convergent, discriminant, and concurrent criterion validity of the perceived racism scale: A multidimensional assessment of White racism among African Americans. In R. L. Jones (Ed.), Handbook of tests and measurements for Black populations (Vol. 2, pp. 359-374). Hampton, VA: Cobb and Henry.
85. Miller, G. E., Dopp, J. M., Myers, H. F., Stevens, S. Y., & Fahey, J. L. (1999). Psychosocial predictors of natural killer cell mobilization during marital conflict. Health Psychology, 18, 262-271.
86. Myers, L. J., Stokes, D. R., & Speight, S. L. (1989). Physiological responses to anxiety and stress: Reactions to oppression, galvanic skin potential, and heart rate. Journal of Black Studies, 20, 80-96.
87. Narsavage, G. L., & Weaver, T. E. (1994). Physiologic status, coping, and hardiness as predictors of outcomes in chronic obstructive pulmonary disease. Nursing Research, 43, 90-94.
88. Neal, A. M., & Wilson, M. L. (1989). The role of skin color and features in the Black community: Implications for Black women and therapy. Clinical Psychology Review, 9, 323-333.
89. Novaco, R. W. (1985). Anger and its therapeutic regulation. In M. A. Chesney & R. Rosenman (Eds.), Anger and hostility in cardiovascular and behavioral disorders (pp. 203-226). New York: Hemisphere/ McGraw-Hill.
90. Okazawa-Rey, M., Robinson, T., & Ward, J. V. (1986). Black women and the politics of skin color and hair. Women's Studies Quarterly, 14, 13-14.
91. Outlaw, F. H. (1993). Stress and coping: The influence of racism on the cognitive appraisal processing of African Americans. Issues in Mental Health Nursing, 14, 399-409.
92. Pappas, G., Queen, S., Hadden, W., & Fisher, G. (1993). The increasing disparity and mortality between socioeconomic groups in the United States, 1960 and 1986. New England Journal of Medicine, 329, 103-109.
93. Pearlin, L. I. (1989). The sociological study of stress. Journal of Health and Social Behavior, 30, 241-256.
94. Peterson, C., Maier, S. F., & Seligman, M. E. P. (1993). Learned helplessness: A theory for the age of personal control. New York: Oxford University Press.
95. Phillip, S. F. (1998). African-American perceptions of leisure, racial discrimination, and life satisfaction. Perceptual and Motor Skills, 87, 1418.
96. Rozanski, A., Blumenthal, J. A., & Kaplan, J. (1999). Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation, 99, 2192-2217.
97. Ruggiero, K. M., & Taylor, D. M. (1997). Why minority group members perceive or do not perceive the discrimination that confronts them: The role of self-esteem and perceived control. Journal of Personality and Social Psychology, 72, 373-389.
98. Rumbaut, R. G. (1994). The crucible within: Ethnic identity, self-esteem, and segmented assimilation among children of immigrants. International Migration Review, 28, 748-794.
99. Schulman, K. A., Berlin, J. A., Harless, W., Kerner, J. F., Sistrunk, S., Gersh, B. J., Dube, R., Taleghani, C. K., Burke, J. E., Williams, S., Eisenberg, J. M., & Escarce, J. J. (1999). The effects of race and sex on physicians' recommendations for cardiac catheterization. New England Journal of Medicine, 340, 618-626.
100. Schuman, H., Singer, E., Donovan, R., & Sellitz, C. (1983). Discriminatory behavior in New York restaurants: 1950 and 1981. Social Indicators Research, 13, 69-83.
101. Schuman, H., Steeh, C., & Bobo, L. (1985). Racial attitudes in America. Cambridge, MA: Harvard University Press.
102. Sears, D. O. (1991). Symbolic racism. In P. A. Katz & D. A. Taylor (Eds.), Eliminating racism: Profiles in controversy (pp. 53-84). New York: Plenum.
103. Seligman, M. E. P. (1975). Helplessness: On depression, development, and death. San Francisco: W. H. Freeman.
104. Selye, H. (1976). The stress of life. New York: McGraw-Hill.
105. Selye, H. (1983). The stress concept: Past, present, and future. In C. L. Cooper (Ed.), Stress research (pp. 1-20). New York: Wiley.
106. Serafica, F. C., Schwebel, A. I., Russell, R. K., Isaac, P. D., & Myers, L. B. (Eds.). (1990). Mental health of ethnic minorities. New York: Praeger.
107. Sigelman, L., & Welch, S. (1991). Black Americans' views of racial inequality: The dream deferred. New York: Cambridge University Press.
108. Sommers-Flanagan, J., & Greenberg, R. P. (1989). Psychosocial variables and hypertension: A new look at an old controversy. Journal of Nervous and Mental Disease, 177, 15-24.
109. Spiegel, D., Bloom, H. C., Kraemer, J. R., & Gottheil, E. (1989, October 14). Effect of psychosocial treatment on survival of patients with metastatic cancer. The Lancet, 2, 888-901.
110. Stone, A. A., Valdimarsdottir, H. B., Katkin, E. S., Burns, J., & Cox, D. S. (1993). Effects of mental stressors on mitogen-induced lymphocyte responses in the laboratory. Psychology and Health, 8, 269-284.
111. Sutherland, M. E., & Harrell, J. P. (1986-1987). Individual differences in physiological responses to fearful, racially noxious, and neutral imagery. Imagination, Cognition and Personality, 6, 133-150.
112. Taylor, D. M., Wright, S. C., & Ruggiero, K. (1991). The personal/group discrimination discrepancy: Responses to experimentally induced personal and group discrimination. Journal of Social Psychology, 131, 847-858.
113. Thompson, C. E., Neville, H., Weathers, P. L., Poston, W. C., & Atkinson, D. R. (1990). Cultural mistrust and racism reaction among African-American students. Journal of College Student Development, 31, 162-168.
114. Thompson, V. L. S. (1996). Perceived experiences of racism as stressful life events. Community Mental Health Journal, 32, 223-233.
115. Tyroler, H. A., & James, S. A. (1978). Blood pressure and skin color. American Journal of Public Health, 68, 1170-1172.
116. Udry, J. R., Bauman, K. E., & Chase, C. (1971). Skin color, status, and mate selection. American Journal of Sociology, 76, 722-733.
117. Ursin, H., Baade, E., & Levine, S. (Eds.). (1978). Psychobiology of stress: A study of coping men. New York: Academic.
118. U.S. Department of Health and Human Services. (1985). Report of the Secretary's task force on Black & minority health. Washington, DC: U.S. Government Printing Office.
119. Utsey, S. O., & Ponterotto, J. G. (1996). Development and validation of the Index of Race-Related Stress (IRRS). Journal of Counseling Psychology, 43, 490-501.
120. Wiebe, D. J., & Williams, P. G. (1992). Hardiness and health: A social psychophysiological perspective on stress and adaptation. Journal of Social and Clinical Psychology, 11, 238-262.
121. Williams, D. R., & Collins, C. (1995). Socioeconomic and racial differences in health. Annual Review of Sociology, 21, 349-386.
122. Williams, D. R., Yu, Y., & Jackson, J. (1997, July). The costs of racism: Discrimination, race, and health. Paper presented at the joint meeting of the Public Health Conference on Records and Statistics and Data User's Conference, Washington, DC.
123. Williams, D. R., Yu, Y., Jackson, J., & Anderson, N. (1997). Racial differences in physical and mental health: Socioeconomic status, stress, and discrimination. Journal of Health Psychology, 2, 335-351.
124. Wu, H., Wang, J., Cacioppo, J. T., Glaser, R., Kiecolt-Glaser, J. K., & Malarkey, W. B. (1999). Chronic stress associated with spousal caregiving of patients with Alzheimer's dementia is associated with down regulation of B-lymphocyte GH mRNA. Journals of Gerontology: Series A, Biological Sciences and Medical Sciences, 54, 212-215.
125. Yetman, N. (1985). Introduction: Definitions and perspectives. In N. Yetman (Ed.), Majority and minority: The dynamics of race and ethnicity in American life (4th ed., pp. 1-20). Boston: Allyn & Bacon.
126. Yinger, J. (1995). Closed doors, opportunities lost: The continuing costs of housing discrimination. New York: Sage.