HOW IS MENTAL HEALTH IN LATE LIFE SHAPED BY STRUCTURAL RACISM?

Abstract Less than one percent of studies on the link between race and health have focused on structural racism. Empirical research on how structural racism affects health in later life is especially rare. Moreover, the conceptualization of structural racism in the race theory literature has often differed from the measurement strategies used in aging and health research. This study advances the field by 1) utilizing a novel, theory-informed latent measure of structural racism in states across multiple domains, including political participation, education, economics, housing, and the judicial system, 2) mapping structural racism across states, and 3) quantifying the association between structural racism and mental health outcomes (depressive symptoms and frequency of poor mental health days) among Black and White older adults. We use administrative data measuring state-level racial stratification linked to geocoded individual-level demographic and health data from the HRS (N=9,126) and the BRFSS (N=308,029). Results show that, whereas structural racism is consistently associated with worse mental health for Black people, it is either unrelated to health or predictive of better health among Whites. Findings highlight the utility of rigorously conceptualizing and measuring structural racism and its impact on health among older adults.

adaptation and wellbeing. Despite recognizing the dynamic nature of ethnic identity development, extant research has predominantly focused on adolescence, overlooking the development and impact of ethnic identity in adulthood, when individuals' experiences are continuously shaped by critical life events (e.g., moving to a new country). Additionally, there is a lack of longitudinal research on mid-late adulthood. Filling these gaps, this study utilized a three-wave longitudinal dataset of 595 Mexican-origin female adults (Mage.wave1 = 38.39) to examine their initial levels and trajectories of ethnic identity development (i.e., exploration, centrality, and resolution) and understand how these individuals' initial levels and trajectories of ethnic identity are associated with their wellbeing (i.e., life meaning, resilience, and depressive symptoms) at Wave 3. Using latent growth curve modeling, unconditional models revealed that initial levels of ethnic identity in Mexican-origin female adults were moderately high, and that their centrality and resolution of ethnic identity remained stable while their exploration of heritage identity increased over time. The conditional model also showed that Mexican-origin female adults' higher initial levels of centrality and resolution were associated with a greater sense of life meaning (and resiliency, only true for resolution levels) but not with depressive symptoms. These findings suggest that ethnic heritage is associated with more positive perception in life and may inform interventions on developing a positive ethnic identity that is related to better wellbeing.

LIMITED ENGLISH PROFICIENCY AND HEALTH LITERACY IN KOREAN OLDER ADULTS: MEDIATING EFFECT OF ACCULTURATION
Hae Sagong, and Pao-Feng Tsai, Auburn University, Auburn, Alabama, United States Language proficiency and comprehension in the culture and health systems of the host country are imperative factors enabling appropriate health literacy (HL) for non-English speaking immigrants. Older immigrants with limited English proficiency have fewer opportunities and limited abilities to improve their English skills. Increasing individuals' acculturation levels can be an effective strategy for older immigrants than solely educating English language skills. The purpose of this study is to investigate the mediating effect of acculturation between English proficiency and HL in older Korean immigrants. From June to October of 2020, a total of 244 older Korean immigrants aged 50 years or older residing in the Southern US were recruited. English proficiency was categorized into limited (very limited to fair) and fluent (fluent to very fluent). HL and acculturation were measured using the Health Literacy Survey-12 Questionnaires (HLS-Q12), and the East Asian Acculturation Measure (EAAM), respectively. Covariates were gender, age, monthly income, education, and length of residency in the U.S. The statistically significant differences were shown in age, gender, education, perceived health, and length of residency in the US by the level of English proficiency The limited English proficiency was negatively associated with HL (β= -.192, p=.002) and acculturation had a mediating effect between English proficiency and HL (β= -.133, p=.001). To alleviate the language barrier that causes low HL in older Korean immigrants, enhancing their understanding of the host country's culture as well as improving organizational HL should be considered. Health literacy, which is defined as being able to understand and utilize information related to one's health, is an essential part of the health care process as it is related to health outcomes. However, little is known about health literacy in Black Belt communities in Alabama although this rural area has shown very high rates of health concerns such as diabetes, cardiovascular disease, stroke, and cancer (CDC Interactive Atlas, 2022). Study participants were recruited from the Black Belt areas of Alabama. A total of 180 African-American participants with a mean age of 57.5 completed a survey. A regression analysis was conducted to understand if sociodemographic and other relevant factors would predict health literacy. Lower education, gender, age, perceived racism, and perception that race impacts health care quality predicted health literacy. Interestingly, those with less internet access had significantly lower health literacy. Access to internet and smart phones was a reported concern for over a third of the participants. Only a quarter of participants reported use of the internet to assist with lifestyle modifications while almost half reported internet use to obtain health information; suggesting this as a potential means to improve health literacy and even potential lifestyle modification in health behaviors. Recommendations are made for interventions to improve health literacy in minority populations of this underserved region.

HOW IS MENTAL HEALTH IN LATE LIFE SHAPED BY STRUCTURAL RACISM?
Reed DeAngelis 1 , Patricia Homan 2 , and Tyson Brown 3 , 1. University of North Carolina at Chapel Hill,Chapel Hill,North Carolina,United States,2. Florida State University,Tallahassee,Florida,United States,3. Duke University,Durham,North Carolina,United States Less than one percent of studies on the link between race and health have focused on structural racism. Empirical research on how structural racism affects health in later life is especially rare. Moreover, the conceptualization of structural racism in the race theory literature has often differed from the measurement strategies used in aging and health research. This study advances the field by 1) utilizing a novel, theory-informed latent measure of structural racism in states across multiple domains, including political participation, education, economics, housing, and the judicial system, 2) mapping structural racism across states, and 3) quantifying the association between structural racism and mental health outcomes (depressive symptoms and frequency of poor mental health days) among Black and White older adults. We use administrative data measuring state-level racial stratification linked to geocoded individual-level demographic and health data from the HRS (N=9,126) and the BRFSS (N=308,029). Results show that, whereas structural racism is consistently associated with worse mental health for Black people, it is either unrelated to health or predictive of better health among Whites. Findings highlight the utility of rigorously conceptualizing and measuring structural racism and its impact on health among older adults. Between 2010 and 2017, South Asians were the fastestgrowing major ethnic minority group in the US, growing at a rate of 40% over the previous decade (SAALT, 2019). This exponential growth, along with a rapidly aging US population, implies that a significant proportion of the South Asian American population will be 65 years or older in the coming years; yet research on the lived experiences/needs of older South Asian Americans is limited. To address this gap, this qualitative study explored barriers and facilitators to healthy or positive aging in a sample of community-dwelling South Asian Americans 50 years and older. In-depth, semistructured interviews were conducted with 32 South Asian American older adults (18 women and 14 men). Thematic analysis of the interview data showed that level of acculturation, proficiency in English, cultural beliefs/practices, awareness about available health and social services, degree of religiosity, and the density of social networks were key determinants of healthy aging. Compared to those who were US-born or had immigrated earlier in life, participants who had immigrated later in life (post-retirement) appeared more financially and/or emotionally dependent on their adult children and expressed ambivalence vis-à-vis future caregiving arrangements and intergenerational co-residence. Nearly all participants shared that helping their adult children with childcare, cooking, or other household chores gave them a sense of purpose and made them feel valued. Study findings suggest that along with culturally appropriate programs and policies to support healthy aging, increased volunteering opportunities may enhance subjective well-being in South Asian American older adults.

HETERONORMATIVE DEFINITIONS OF SEX: IMPLICATIONS FOR LGBT+ WOMEN'S PREVENTIVE HEALTHCARE Jessica Noblitt, and Anne Barrett, Florida State University, Tallahassee, Florida, United States
The dominant cultural definitions of sex, which is heteronormative, has implications for preventive health screening among LGB+ women. Medical recommendations for women's screening exclude some same-sex behaviors from this definition, and they center on reproduction -both of which can discourage LGB+ women's preventive health screening. Qualitative studies have found that sexual minority women, as well as their doctors, are less likely to see sexual health exams as important for sexual minority women's healthcare because many are not engaging in penilevaginal intercourse. However, we are aware of no study that has used a large, nationally representative dataset to examine potential differences in health screening by sexual identity. We used data from the National Health Interview Survey (2018; n=1394) to examine differences by sexual identity in having Pap tests and mammograms. We found that sexual minority women were about 40% less likely than heterosexual women to have ever had a Pap test. Moreover, among sexual minority women, lesbian women were about 50% less likely than bisexual women to have ever had one. Sexual minority women also were 22% less likely than heterosexual women to have had a Pap test in the last 12 months. Differences by sexual identity in receiving mammograms were less striking. We found, however, that bisexuals were 25% less likely than lesbians to have ever had a mammogram. In addition, these differences in health screening were more pronounced in younger than older women.

SEXUAL ACTIVITY OF OLDER ADULTS: WE'RE ASKING THE WRONG QUESTIONS Janie Steckenrider, Loyola Marymount University, Los Angeles, California, United States
Sexual activity of older adults is an under researched area as most surveys on sexual behavior end at age 60 reflecting the myth that older adults are not sexually active. Only recently has survey data asked specifically about sexual activity of those ages 60 to 95. Their consensus is over half of males and a third of females over 70 are sexually active. Most striking is the current body of research almost exclusively defines sexual activity measured as partnered sexual behaviors of intercourse, fondling, kissing, touching. Given the reality for many older adults lacking an active sex partner due to death, sexual dysfunction, or serious illness, the aim of this study was to determine if the right survey questions are being asked for older adults. Seven major surveys, underlying most current research, were analyzed regarding solitary sex (masturbation) compared to partnered sex. Results of this study found extensive questioning about aspects of partnered sex including pleasure, satisfaction, pain, relationship status, sexual functioning, anxiety, individual sexual acts, etc. compared to only two questions about masturbation, both only about frequency. The psychological and physiological benefits of sexual activity, both partnered and solo sex, are well documented and correlate with higher life satisfaction for older adults. Sexual activity needs to be redefined to also include solitary sex and this begins by asking the right questions. This study has implications for the need to bring a broader perspective in promoting a healthy sex life among older adults, defined both as partnered and solitary sex.

CONTEXT-DEPENDENT SEXUAL CHANGES DURING WOMEN'S MIDLIFE TRANSITIONS
Amber Watts, and Sarah Jen, University of Kansas, Lawrence, Kansas, United States For women, midlife represents an important stage of transition, including shifts in physiological, social, and sexual experiences. Prior research demonstrates that women's sexuality is more dynamic and context-dependent than