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: 2.56). 04/2009; 68(9):1676-84. DOI: 10.1016/j.socscimed.2009.02.002
Source: PubMed

ABSTRACT 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 02, 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, socio-demographic 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; biascorrected 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 · 0.87 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: Racism is increasingly recognized as a key determinant of health. A growing body of epidemiological evidence shows strong associations between self-reported racism and poor health outcomes across diverse minority groups in developed countries. While the relationship between racism and health has received increasing attention over the last two decades, a comprehensive meta-analysis focused on the health effects of racism has yet to be conducted. The aim of this review protocol is to provide a structure from which to conduct a systematic review and meta-analysis of studies that assess the relationship between racism and health. This research will consist of a systematic review and meta-analysis. Studies will be considered for review if they are empirical studies reporting quantitative data on the association between racism and health for adults and/or children of all ages from any racial/ethnic/cultural groups. Outcome measures will include general health and well-being, physical health, mental health, healthcare use and health behaviors. Scientific databases (for example, Medline) will be searched using a comprehensive search strategy and reference lists will be manually searched for relevant studies. In addition, use of online search engines (for example, Google Scholar), key websites, and personal contact with experts will also be undertaken. Screening of search results and extraction of data from included studies will be independently conducted by at least two authors, including assessment of inter-rater reliability. Studies included in the review will be appraised for quality using tools tailored to each study design. Summary statistics of study characteristics and findings will be compiled and findings synthesized in a narrative summary as well as a meta-analysis. This review aims to examine associations between reported racism and health outcomes. This comprehensive and systematic review and meta-analysis of empirical research will provide a rigorous and reliable evidence base for future research, policy and practice, including information on the extent of available evidence for a range of racial/ethnic minority groups.
    Systematic Reviews 09/2013; 2(1):85. DOI:10.1186/2046-4053-2-85
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    • "In addition, the possibility of reverse causation in the relationship between social stressors and health has been explicitly tested using longitudinal datasets. Results from these studies suggest that poor health does not predict subsequent reports of discrimination , but that racism, sexism, and other forms of discrimination do lead to later health problems (Gee and Walsemann 2009; Pavalko et al. 2003). While these findings lend confidence to the interpretations provided here, future research in this area should examine these relationships using longitudinal data. "
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    ABSTRACT: In recent decades, sociologists have increasingly adopted an intersectionality framework to explore and explain the complex and interconnected nature of inequalities in the areas of race, class, and gender. Using an inclusion-centered approach and a sample of 204 low-socioeconomic-status (SES) African American women, the authors theorize and explore the role of racial and gender discrimination in the stress process. Analyses examine relationships between social stressors (racial and gender discrimination) and individual stressors occurring in each of six distinct social contexts. Furthermore, the authors evaluate the effects of racial and gender discrimination as compared to individual stressors on three indicators of mental health and well-being. Findings suggest that racial and gender discrimination increases risk for poor health and low well-being, working both directly and indirectly through increased vulnerability to individual stressors. This research demonstrates the value of a more comprehensive study of stressors that influence the health of low-SES African American women and other multiply disadvantaged groups.
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