Perceived Racial/Ethnic Discrimination and Mental Health: a Review and Future Directions for Social Epidemiology

Abstract

Purpose of review Recent literature on racial or ethnic discrimination and mental health was reviewed to assess the current science and identify key areas of emphasis for social epidemiology. Objectives of this review were to: 1) Determine whether there have been advancements in the measurement and analysis of perceived discrimination; 2) Identify the use of theories and/or frameworks in perceived discrimination and mental health research; and 3) Assess the extent to which stress buffers are being considered and evaluated in the existing literature. Recent findings Metrics and analytic approaches used to assess discrimination remain largely unchanged. Theory and/or frameworks such as the stress and coping framework continue to be underused in majority of the studies. Adolescents and young adults experiencing racial/ethnic discrimination were at greater risk of adverse mental health outcomes, and the accumulation of stressors over the life course may have an aggregate impact on mental health. Some growth seems evident in studies examining the mediation and moderation of stress buffers and other key factors with the findings suggesting a reduction in the effects of discrimination on mental health. Summary Discrimination scales should consider the multiple social identities of a person, the context where the exposure occurs, how the stressor manifests specifically in adolescents, the historical traumas, and cumulative exposure. Life course theory and intersectionality may help guide future work. Despite existing research, gaps remain in in elucidating the effects of racial and ethnic discrimination on mental health, signaling an opportunity and a call to social epidemiologists to engage in interdisciplinary research to speed research progress.

Understanding how discrimination can affect health

“…Across diverse ethnic populations, positive associations were found between ethnic discrimination and emotional distress, as well as inverse associations with positive markers of well‐being, such as self‐esteem and self‐efficacy . Several recent reviews continue to document an inverse association between discrimination and good mental health . For example, a 2014 review reported the results of two meta‐analyses focused on the association between discrimination and well‐being .…”

“…20 Several recent reviews continue to document an inverse association between discrimination and good mental health. [21][22][23][24][25][26][27] For example, a 2014 review reported the results of two meta-analyses focused on the association between discrimination and well-being. 28 Discrimination, in the first meta-analysis, was associated with poorer well-being (self-esteem, depressive and anxiety symptoms, psychological distress, and life satisfaction), with the association being somewhat weaker for positive outcomes than negative ones.…”

Diminished Returns of Parental Education in Terms of Youth School Performance: Ruling out Regression toward the Mean

“…Black children and youth commonly experience discrimination [29,30]. Such discrimination increases the risk of problems across domains [24,25,31]. Discrimination may result in MDRs of education [32,33].…”

Perceived Discrimination as a Mediator of ACEs and Psychological Distress

“…Studies on different types of discrimination document the impact of being treated "less than" on psychological and interpersonal functioning (Pascoe & Smart Richman, 2009). When this treatment is pervasive and frequent, such as with everyday experiences of discrimination, individuals often experience a range of negative psychological outcomes (Schmitt et al, 2014;Vines et al, 2017). While in this study, we noted greater perceived discrimination and psychological distress in some marginalized groups, our finding of a significant indirect effect even after accounting for these differences indicates the importance of inquiring about perceived discrimination in individuals with adversity in childhood.…”