Mechanisms of Black–White disparities in health among older adults: Examining discrimination and personality

Abstract

We tested whether personality traits help explain the association between discrimination and racial health disparities in a sample of 1033 Black and White older adults. Participants completed measures of discrimination, personality, and self-reported physical and mental health. Elevated discrimination among Black participants was indirectly linked to worse physical and mental health outcomes through elevated neuroticism and lower agreeableness, controlling income, education, and gender. The specific facets of depression, impulsiveness, and trust were the most robust intervening personality factors. Interventions that target cognitive, emotional, and behavioral sequelae of discrimination may lessen its impact on health disparities.

Do trait psychological characteristics moderate sympathetic arousal to racial discrimination exposure in a natural setting?

“…These different forms of discrimination‐related experiences can repeatedly initiate sympathetic nervous system arousal (fight‐or‐flight) so that what appears discrete at short timescales is chronic when viewed over longer durations, triggering systemic wear and tear on the body (i.e., allostatic load) through cardiometabolic and inflammatory pathways linked to diseases of aging such as cardiovascular disease and hypertension (McEwen, 2005). Many studies provide evidence that lifetime discrimination exposure predicts worse health outcomes and higher allostatic load burdens, and is generally accepted as a major contributor to population‐level racial health disparities observed in the United States (Brondolo et al., 2011; Kessler et al., 1999; Lewis et al., 2015; Mays et al., 2007; McClendon et al., 2019; Williams & Mohammed, 2009). Due to data and methodological challenges, few studies have been able to couple racism‐related experiences with the immediate stress response, however.…”

“…Researchers have identified various individual‐level factors that moderate the association between discrimination and health, including coping resources (Brondolo et al., 2009; Polanco‐Roman et al., 2019), family and peer influences (Jelsma & Varner, 2020; Roberts et al., 2012), racial identity (Banks & Kohn‐Wood, 2007; Brody et al., 2015; Chae et al., 2016; Lucas et al., 2017; Sellers & Shelton, 2003), racial socialization (Brown & Tylka, 2011; Neblett et al., 2008), resilience (Spence et al., 2016), vigilance (Hicken et al., 2013; Himmelstein et al., 2015; LaVeist et al., 2014), and psychological traits such as anger (Pittman, 2011). In this study, we emphasize psychological traits known to moderate how one appraises and reacts to stress (Burns, 1995; Burns & Katkin, 1993; Lilienfeld, 2017; McClendon et al., 2019). For example, physiological stress reactivity is exacerbated by psychological traits associated with chronic depression such as worry, anticipatory stress, and loneliness (Brosschot et al., 2006; Doane & Adam, 2010; Jaremka et al., 2013).…”

“…Although negative emotions and psychological traits are known to moderate reactivity to general social stressors (Tellegen & Waller, 2008), very few studies have included these individual difference factors as moderators of discrimination‐health associations. In a sample of 1,033 Black and White older adults, McClendon and colleagues (2019) found that discrimination exposure was linked to worse health through elevated negative emotions and lower agreeableness across the life span for Black participants. Whereas this study was able to link major experiences of discrimination across one's lifetime (e.g., housing and employment discrimination) to self‐reported physical and mental health in adulthood, it is still unclear how real‐world experiences of racial discrimination influence immediate physiological responding and how this responding is moderated by psychological factors.…”

Racial Discrimination Predicts Mental Health Outcomes Beyond the Role of Personality Traits in a Community Sample of African Americans

“…In support of the idea that racial discrimination is associated with negative emotionality, Pearson et al (2014) found that neuroticism was associated with more negative psychological responses to a racist incident (e.g., intrusive thoughts, lack of forgiveness) in a large sample of African American students. Likewise, McClendon, Bogdan, Jackson, and Oltmanns (2019) recently found that racial discrimination may be indirectly associated with mental health outcomes through elevated neuroticism. However, research examining whether neuroticism accounts for associations between racial discrimination and mental health outcomes has received relatively little empirical support.…”

Cumulative Disadvantage and Disparities in Depression and Pain Among Veterans With Osteoarthritis: The Role of Perceived Discrimination

“…Discrimination thus contributes to the burden of stress experienced by individuals from marginalized groups and may contribute to the effects of allostatic load (i.e., biologic adaptation in response to chronic stress) on dysfunctions in hormonal, metabolic, and immunologic systems that influence symptoms of depression (e.g., activation of the hypothalamic-pituitary-adrenal axis) and pain severity (e.g., inflammation) (43,44). Ongoing experiences of discrimination also have direct psychological effects on individuals, such as increasing unpleasant emotions (e.g., sadness, worthlessness) and negative cognitive schemas related to the self, others and the world, which can further exacerbate or make manifest symptoms of depression (45). Our findings suggest that the daily indignities experienced by people from multiple marginalized groups have a significant negative association with their mental and physical health.…”