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A multilevel analysis of the relationship between institutional and individual racial discrimination and health status.

Training Program in Identity, Self, Role, and Mental Health, Department of Sociology, Indiana University, Ballantine Hall 744, 1020 E Kirkwood Avenue, Bloomington, IN 47405-7103, USA.
American Journal of Public Health (Impact Factor: 4.23). 05/2002; 92(4):615-23. DOI: 10.2105/AJPH.92.4.615
Source: PubMed

ABSTRACT This study examined whether individual (self-perceived) and institutional (segregation and redlining) racial discrimination was associated with poor health status among members of an ethnic group.
Adult respondents (n = 1503) in the cross-sectional Chinese American Psychiatric Epidemiologic Study were geocoded to the 1990 census and the 1995 Home Mortgage Disclosure Act database. Hierarchical linear modeling assessed the relationship between discrimination and scores on the Medical Outcomes Study Short-Form 36 and revised Symptom Checklist 90 health status measures.
Individual and institutional measures of racial discrimination were associated with health status after control for acculturation, sex, age, social support, income, health insurance, employment status, education, neighborhood poverty, and housing value.
The data support the hypothesis that discrimination at multiple levels influences the health of minority group members.

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Available from: Gilbert Gee, Jul 08, 2015
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    • "There is only limited work employing MLM in house prices research, while most applications are in education (Harris, Johnston, & Burgess, 2007; Goldstein, 1999; Haurin & Brasington, 1996; Aitkin & Longford, 1986); public health (Gee 2008; Diez-roux 2000) and epidemiology (Merlo et al., 2006; Congdon, 2003; Bryk & Raudenbush, 1992). Jones (1991) is the first paper to employ a multilevel approach to house price research. "
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    DESCRIPTION: Two advanced modelling approaches, Multi-Level Models and Artificial Neural Networks are employed to model house prices. These approaches and the standard Hedonic Price Model are compared in terms of predictive accuracy, capability to capture location information, and their explanatory power. These models are applied to 2001-2013 house prices in the Greater Bristol area, using secondary data from the Land Registry, the Population Census and Neighbourhood Statistics so that these models could be applied nationally. The results indicate that MLM offers good predictive accuracy with high explanatory power, especially if neighbourhood effects are explored at multiple spatial scales.
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    • "For example, investigations using data from the National Latino and Asian American Study find that perceived racial/ethnic discrimination and everyday discrimination are associated with higher levels of psychological distress and mental disorders among Asian Americans (Gee et al. 2007; Hahm et al. 2010; Yip et al. 2008; Zhang et al. 2012). Similarly, studies analyzing data from the Chinese American Psychiatric Epidemiologic Study and the Filipino American Community Epidemiological Study show that these types of discrimination are linked with elevated levels of psychological distress (Gee 2002; Mossakowski 2003, 2007). The relationship between perceived discrimination and distress is also evident in research involving smaller samples of Asian groups (for reviews, see Gee et al. 2009; Lee and Ahn 2011). "
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    ABSTRACT: Using the stress process paradigm and data from the first national epidemiological survey of Asian Americans, we investigate whether social support from family and friends buffers the stress of discrimination to protect psychological well-being. Results suggest that perceived emotional support from family for a serious problem buffers the stress of high levels of everyday discrimination, controlling for sociodemographics, acculturation, and community factors. Contrary to our expectations, perceived emotional support from family about worries and received social support from regularly talking on the phone and getting together with family are not statistically significant stress buffers. Moreover, perceived and received social support from friends do not buffer the stress of any level of discrimination. Overall, our study has broader implications for research on the influence of social relationships on mental health and advances our knowledge of the social psychological process of coping with discrimination in the United States.
    Social Psychology Quarterly 08/2014; 77(3):273-295. DOI:10.1177/0190272514534271 · 1.89 Impact Factor
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    • "There is some evidence that structural and individual discrimination affect stigmatized persons independently. Investigating health consequences of racial discrimination, Gee (2008) found that self-perceived individual discrimination had no significant relationship to general health, whereas structural racial discrimination (segregation, redlining) did. The author concluded that structural discrimination may influence health even in the absence of individual recognition of discrimination. "
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    ABSTRACT: Public attitudes and beliefs are relevant to both individual and structural discrimination. They are a reflection of cultural conceptions of mental illness that form a reality that people must take into account when they enact behavior and policy makers must confront when making decisions. Understanding and keeping track of these attitudes is critical to understanding individual and structural discrimination. Theories of stigma posit that both forms of discrimination are distinct phenomena. Practically nothing is known about how attitudes regarding individual and structural discrimination relate. Our study addresses this gap by examining how attitudes toward allocating financial resources to the care of people with depression (structural discrimination) have developed over the last decade in Germany, compared to the public's desire for social distance from these people (individual discrimination). Previous studies have shown the public being more ready to accept cutbacks for the care for mentally ill persons than for medically ill persons. These preferences could have changed with regard to depression, since there is a growing awareness among the German public of an "epidemic of depression". The idea of a high prevalence of depression may have led to a heightened perception of personal susceptibility for this disorder, making the public become more reluctant to accept cutbacks for the care of people with depression. On the other hand, there is reason to assume that the growing awareness of high prevalence of depression among the general public has not affected individual discrimination of persons suffering from this disorder. The two assumptions were tested comparing data from population surveys conducted in Germany in 2001 and 2011. Within ten years, the proportion of respondents who opposed cutting money from depression treatment tripled from 6% to 21%. In contrast, the public's desire for social distance from persons with depression remained unchanged. Moreover, both trends proved to be independent from each other. Our findings suggest that attitudes relevant to structural and individual discrimination are not necessarily linked together and may lead to divergent results. This means that a comprehensive understanding of stigma must consider both forms of discriminating attitudes together. Studying both simultaneously may deepen our understanding of each and point to novel ways to produce change.
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