Perceived discrimination in middle-aged and older adults: Comparison between England and the United States

Abstract

ObjectivesThis study examined differences in perceived discrimination across multiple characteristics in England and the United States (US), in middle- and older-aged adults.MethodsUsing data from the English Longitudinal Study of Aging (N = 8,671) and the US-based Health and Retirement Study (N = 7,927), we assessed cross-national differences in perceived discrimination attributed to disability, financial status, sex, race, sexual orientation, and weight. We also compared how perceived discrimination varied with socioeconomic position (SEP) based on wealth.ResultsPerceived discrimination due to financial status was more common in England (6.65%) than in the US (2.14%) adjusting for age, sex, and wealth [Odds Ratio (OR) = 1.09, 95% CI (1.07; 1.10)]. This affected people of low but not high SEP. Sexual orientation discrimination was more common in England [0.72 vs. 0.15%, OR = 4.61, 95% CI (2.48; 8.57)]. Sex-based perceived discrimination was more prevalent in the US (12.42%) than England (9.07%) adjusting for age and wealth [OR = 0.87, 95% CI (0.86; 0.89)]. Cross-national differences in sex discrimination did not vary with SEP. Racism was the most common type of perceived discrimination reported in both samples (England: 17.84%, US: 19.80%), with no significant cross-national differences after adjustment for sex.DiscussionPerceived discrimination attributed to financial status and sexual orientation were more prevalent in England, while more women perceived sex discrimination in the US. This study suggests that country-specific and socioeconomic factors affect the prevalence of perceived discrimination. This may be relevant when targeting interventions aimed at reducing perceived discrimination.

The role of stress and health behaviour in linking weight discrimination and health: a secondary data analysis in England

“…Further, we observed an inverse association between perceived weight discrimination and wealth, suggesting that those of lower socioeconomic position could be more vulnerable to the deleterious effects of weight discrimination. This inverse association is in line with previous reports in ELSA, but not other studies 47. Therefore, the role of socioeconomic position in the associations between weight discrimination, health and well-being, warrants further attention.…”

“…The discrimination questions asked about five broad discriminatory situations and were not tailored for weight discrimination. This may have helped avoid bias or priming, as participants were able to attribute multiple reasons for their experience of discrimination 31–34 47. However, other measures with more specific items on experiences weight discrimination, for example, having to pay more on public transport for occupying two passenger seats or being viewed unfavourably as a potential romantic partner, may have garnered different results.…”

The relationship between gender discrimination and wellbeing in middle-aged and older women

“…We selected our covariates in advance due to associations with discrimination and wellbeing reported in earlier research [ 24 , 31 , 32 , 44 , 45 ]. All covariates (except BMI) were assessed at baseline (wave 5, 2010–11) and were self-reported.…”

“…As the data were skewed, with most women 'never' reporting discrimination, we dichotomised responses to indicate whether or not they perceived discrimination in the past year (a few times or more a year vs less than once a year or never), with the exception of the fifth item which was dichotomised to indicate whether or not respondents had ever experienced discrimination from doctors or hospitals (never vs all other options) as most individuals never reported discrimination in this setting. In line with previous work in ELSA, responses were combined to create an overall discrimination binary score (yes/no) if participants reported any of these experiences [24,[31][32][33][34][35]. If participants reported discrimination in any of the situations, a follow-up question asked participants to indicate the characteristic(s) they attributed their experience to, with a choice from a list of options including age, race, sex, sexual orientation, and weight.…”

“…For middle-aged and older women in the United Kingdom (UK), the right to equal pay [ 21 ] and the recognition of sex as protected characteristic under equality law [ 22 ] was secured during their lifetimes. However, this legal equality has not fully translated into equal experiences as a ‘gender pay gap’ still exists [ 23 ] and gender-based discrimination is perceived to be common [ 13 , 24 ].…”