African-Americans and Latinos with Chronic Fatigue: Examining the Role of Acculturation Status

Article excerpt

Psychosocial variables may influence the experience of chronic fatigue, especially in individuals of color. Overarching psychosocial realities such as the endemic nature of ethnic/racial discrimination and the complexity of the acculturation process may bear on the experience of fatigue. This study evaluated whether the acculturation process was related to chronic fatigue and racism among African Americans and Latinos. While associations among the predicted variables were not statistically significant, distinct divisions among levels of acculturation appeared between African Americans and Latinos. Membership in a community of color likely increases the complexity of the experience of chronic fatigue in a manner that requires further investigation.

Fatigue is one of the more common symptoms that patients have, and for this reason, it is of importance to social and medical scientists (Jason et al., 1999). Research on fatigue, chronic fatigue, and/or chronic fatigue syndrome (CFS) among groups of color suggests that different ethnic groups may differ in their experience of fatigue. For example, Song, Jason, and Taylor (1999) found that mean fatigue severity scores in a community-based sample were significantly higher for Latino females and Latinos of higher SES when compared to African-Americans and European Americans. In addition, Torres-Harding, Mason-Shutter, and Jason (in press) found that, even when controlling for other socio-demographic variables, language status (English- vs. Spanish-speaking) significantly predicted fatigue severity level. Specifically, English-speaking Latinos reported more severe fatigue levels, and were more likely to report both prolonged fatigue (i.e., lasting 1 month or longer) and chronic fatigue (i.e., lasting 6 months or longer). Furthermore, Torres-Harding, Jason, and Taylor (2002) found that, when compared to the African-Americans and European Americans, Latinos with chronic fatigue were more likely to report a higher number of physical symptoms, and were more likely to attribute their symptoms to mixed physical and psychological causes as compared to purely physical causes.

In another study, Njoku, Jason, and Torres-Harding (2005) found that, when compared to European Americans and African-Americans, Latinos with chronic fatigue used different coping styles, and that these different coping styles were differentially related to fatigue levels and functional impairment. The study found that Latinos in particular used denial as a coping mechanism significantly more than did European Americans. In addition, the use of the acceptance coping style among Latinos was related to greater fatigue severity but less physical disability.

Finally, a few studies have examined people of color, not specifying racial group, with CFS. Jason, Taylor, Kennedy, Song, Johnson and Torres (2001) found that people of color with CFS experienced more severe sore throat pain, more severe post-exertional malaise, more severe unrefreshing sleep, poorer general health, and were less likely to be optimistic. Although a small sample size precluded examining individual ethnic groups, these findings suggest that minorities with CFS such as Latinos and African-Americans, may be more severely ill and experience poorer general health when compared to European Americans. These studies (Jason et al., 2001; Njoku et al., 2005; Torres-Harding et al., in press; Torres-Harding et al., 2002; Song et al., 1999) suggest that cultural factors may be important when studying chronic fatigue.

There may be overarching psychosocial variables that uniquely impact people of color and can help illuminate the reasons for differences in health outcomes. Ethnic/racial discrimination and level of acculturation might be integral to understanding psychosocial aspects of health outcomes in people of color. Despite their mutual significance, the interplay of racism and acculturation has not been thoroughly examined in communities of color. …