Does health predict the reporting of racial discrimination or do reports of discrimination predict health? Findings from the National Longitudinal Study of Youth

UCLA, Community Health Sciences, 650 Charles E. Young Dr. South, Los Angeles, CA 90024, USA.
Social Science [?] Medicine (Impact Factor: 2.89). 04/2009; 68(9):1676-84. DOI: 10.1016/j.socscimed.2009.02.002
Source: PubMed


Racial discrimination may contribute to diminished well-being, possibly through stress and restricted economic advancement. Our study examines whether reports of racial discrimination predict health problems, and whether health problems predict the reporting of racial discrimination. Data come from years 1979 to 1983 of the US National Longitudinal Study of Youth, focusing on respondents of Black (n=1851), Hispanic (n=1170), White (n=3450) and other (n=1387) descent. Our analyses indicate that reports of racial discrimination in seeking employment predict health-related work limitations, although these limitations develop over time, and not immediately. We also find that reports of discrimination at two time-points appear more strongly related to health-related work limitations than reports at one time-point. A key finding is that these limitations do not predict the subsequent reporting of racial discrimination in seeking employment. These findings inform our knowledge of the temporal ordering of racial discrimination in seeking employment and health-related work conditions among young adults. The findings also indicate that future research should carefully attend to the patterns and timing of discrimination.

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Available from: Gilbert Gee, Sep 29, 2015
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    • "The findings of this study must be interpreted in the context of several limitations. The cross-sectional nature of the study design limits definitive conclusions about directions of causality (Gee and Walsemann, 2009). Although evidence from longitudinal studies suggests that racism precedes ill health, the converse cannot be ruled out in this study. "
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    ABSTRACT: Objectives: Despite burgeoning evidence regarding the pathways by which experiences of racism influence health outcomes, little attention has been paid to the relationship between racism and oral health-related behaviours in particular. We hypothesised that self-reported racism was associated with tooth brushing, and that this association was mediated by perceived stress and sense of control and moderated by social support. Methods: Data from 365 pregnant Aboriginal Australian women were used to evaluate tooth brushing behaviour, sociodemographic factors, psychosocial factors, general health, risk behaviours and racism exposure. Bivariate associations were explored and hierarchical logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for tooth brushing. Perceived stress and sense of control were examined as mediators of the association between self-reported racism and tooth brushing using binary mediation with bootstrapping. Results: High levels of self-reported racism persisted as a risk indicator for tooth brushing (OR 0.51, 95%CI 0.27,0.98) after controlling for significant covariates. Perceived stress mediated the relationship between self-reported racism and tooth brushing: the direct effect of racism on tooth brushing was attenuated, and the indirect effect on tooth brushing was significant (beta coefficient -0.09; bias-corrected 95%CI -0.166,-0.028; 48.1% of effect mediated). Sense of control was insignificant as a mediator of the relationship between racism and tooth brushing. Conclusions: High levels of self-reported racism were associated with non-optimal tooth brushing behaviours, and perceived stress mediated this association among this sample of pregnant Aboriginal women.. Limitations and implications are discussed.
    Community dental health 09/2014; 31(3). DOI:10.1922/CDH_3298Ben08 · 0.60 Impact Factor
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    • "The effects of perceived discrimination on adverse health outcomes do not differ gender or between immigrants coming from different countries of origin . Consistent with previous research , we thus do not find evidence of a differential vulnerability to perceived discrimination between different groups ( Gee and Walsemann 2009 ; Kessler , Mickelson , and Williams 1999 ; Krieger and Sidney 1996 ) . However , there is strong evidence for differential exposure ( Kessler , Mickelson , and Williams 1999 ) in our data . "
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    ABSTRACT: Objective: Discrimination is an important determinant of health, and its experience may contribute to the emergence of health inequalities between immigrants and nonimmigrants. We examine pathways between perceived discrimination and health among immigrants in Germany: (1) whether perceptions of discrimination predict self-reported mental and physical health (SF-12), or (2) whether poor mental and physical health predict perceptions of discrimination, and (3) whether discrimination affects physical health via mental health. Design: Data on immigrants come from the German Socio-Economic Panel (SOEP) from the years 2002 to 2010 (N = 8,307), a large national panel survey. Random and fixed effects regression models have been estimated. Results: Perceptions of discrimination affect mental and physical health. The effect of perceived discrimination on physical health is mediated by its effect on mental health. Our analyses do not support the notion that mental and physical health predict the subsequent reporting of discrimination. Different immigrant groups are differentially exposed to perceived discrimination. Conclusion: In spite of anti-discrimination laws, the health of immigrants in Germany is negatively affected by perceived discrimination. Differential exposure to perceived discrimination may be seen as a mechanism contributing to the emergence of health inequalities in Germany.
    Ethnicity and Health 07/2014; DOI:10.1080/13557858.2014.932756 · 1.67 Impact Factor
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    • "Additionally, a focus on longitudinal studies will also explore questions of etiology. Several longitudinal studies have suggested that the association between racism and mental illness appears after a short latency period, whereas the association between racism and physical illness only appears after a longer latency period [21,22]. What this implies is that some of the studies finding null associations between racism and physical health may arise because the studies did not include a long enough etiological period; this further suggests that cross-sectional studies may be biased towards type 2 error in relation to physical outcomes. "
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    ABSTRACT: Despite a growing body of epidemiological evidence in recent years documenting the health impacts of racism, the cumulative evidence base has yet to be synthesized in a comprehensive meta-analysis focused specifically on racism as a determinant of health. This meta-analysis reviewed the literature focusing on the relationship between reported racism and mental and physical health outcomes. Data from 293 studies reported in 333 articles published between 1983 and 2013, and conducted predominately in the U.S., were analysed using random effects models and mean weighted effect sizes. Racism was associated with poorer mental health (negative mental health: r = -.23, 95% CI [-.24,-.21], k = 227; positive mental health: r = -.13, 95% CI [-.16,-.10], k = 113), including depression, anxiety, psychological stress and various other outcomes. Racism was also associated with poorer general health (r = -.13 (95% CI [-.18,-.09], k = 30), and poorer physical health (r = -.09, 95% CI [-.12,-.06], k = 50). Moderation effects were found for some outcomes with regard to study and exposure characteristics. Effect sizes of racism on mental health were stronger in cross-sectional compared with longitudinal data and in non-representative samples compared with representative samples. Age, sex, birthplace and education level did not moderate the effects of racism on health. Ethnicity significantly moderated the effect of racism on negative mental health and physical health: the association between racism and negative mental health was significantly stronger for Asian American and Latino(a) American participants compared with African American participants, and the association between racism and physical health was significantly stronger for Latino(a) American participants compared with African American participants. Protocol PROSPERO registration number: CRD42013005464.
    Systematic Reviews 09/2013; 2(1):85. DOI:10.1186/2046-4053-2-85
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