Racial and ethnic health disparities: evidence of discrimination's effects across the SEP spectrum

DʼAnna, Laura Hoyt; Ponce, Ninez A.; Siegel, Judith M.

doi:10.1080/13557850903490298

Cited by 59 publications

(57 citation statements)

References 77 publications

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“…Although the associations between these psychosocial factors and poor mental health [27] and socio-economic status [29,47] have been extensively explored, to the authors’ knowledge, these factors have seldom been specifically examined as underpinning socio-economic inequalities in mental health, and never by decomposition analysis. Previous studies have, for example, pointed out that perceived discrimination, one of the strongest contributors to the inequalities in our study, is associated with poor mental health [28] and more frequent among low socio-economic positions [48], and that socio-economic disadvantage partially explains the association between perceived discrimination and psychological distress in Sweden [49]. Similarly, lack of emotional support [50] and exposure to violence [29] are established predictors of poor mental health, and are also more common among those of a lower socio-economic position [51,52].…”

Section: Discussionmentioning

confidence: 75%

Explaining mental health inequalities in Northern Sweden: a decomposition analysis

Amroussia

Gustafsson

Mosquera

2017

Global Health Action

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Background: There has been a substantial increase of income inequalities in Sweden over the last 20 years, which also could be reflected in health inequalities, including mental health inequalities. Despite the growing body of literature focusing on health inequalities in Sweden, income-related inequalities in mental health have received little attention. Particularly scarce are research from Northern Sweden and examinations of the social determinants of health inequalities.Objectives: The present study seeks to provide evidence regarding inequalities in mental health in Northern Sweden. The specific aims were to (1) quantify the income-related inequality in mental health in Northern Sweden, and (2) determine the contribution of social determinants to the inequality.Methods: The study population comprised 25,646 participants of the 2014 Health on Equal Terms survey in the four northernmost counties of Sweden, aged 16 to 84 years old. Income-related inequalities in mental health were quantified by the concentration index and further decomposed by applying Wagstaff-type decomposition analysis.Results: The overall concentration index of mental health in Northern Sweden was−0.15 (95% CI: −0.17 to −0.13), indicating income inequalities in mental health disfavoring the less affluent population. The decomposition analysis results revealed that socio-economic conditions, including employment status (31%), income (22.6%), and cash margin (14%), made the largest contribution to the pro-rich inequalities in mental health. The second-largest contribution came from demographic factors, mainly age (11.3%) and gender (6%). Psychosocial factors were of smaller importance, with perceived discrimination (8%) and emotional support (3.4%) making moderate contributions to the health inequalities. Conclusions: The present study demonstrates substantial income-related mental health inequalities in Northern Sweden, and provides insights into their underpinnings. These findings suggest that addressing the root causes is essential for promoting mental health equity in this region.

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Section: Discussionmentioning

confidence: 75%

Explaining mental health inequalities in Northern Sweden: a decomposition analysis

Amroussia

Gustafsson

Mosquera

2017

Global Health Action

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“…One important factor that may contribute these racial disparities is racial discrimination (D’Anna et al, 2010; Mays et al, 2007; Williams & Mohammed, 2009; Zapolski et al, 2014). Racial discrimination is a psychosocial stressor that involves unfair or negative treatment directed at an individual due to their racial/ethnic background (Landrine & Klonoff, 1996; Williams & Mohammed, 2009).…”

Section: Racial Discrimination and Negative Health Outcomesmentioning

confidence: 99%

Past racial discrimination exacerbates the effects of racial exclusion on negative affect, perceived control, and alcohol-risk cognitions among Black young adults

et al. 2016

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Racial discrimination is associated with alcohol use and risky sex cognitions and behaviors, which are risk factors for negative health outcomes, including human immunodeficiency virus (HIV) infection. The current study investigated the causal impact of racial discrimination on alcohol and sexual-risk cognitions while exploring potential mediators that might help explain this relation: negative affect, perceived control, and meaningful existence. We also examined if past discrimination impacts the strength of (moderates) these effects. Participants were 287 Black/African American young adults aged 18 to 25. They were randomly assigned to be excluded or included by White peers via the game Cyberball. Racial exclusion (vs. inclusion) predicted greater: perceived racial discrimination, negative affect, alcohol use willingness, and reduced perceived control and meaningful existence. Furthermore, excluded participants who experienced more past racial discrimination reported the lowest perceived control, and greatest negative affect and alcohol-risk cognitions. The findings suggest that past racial discrimination exacerbates the harmful health effects of immediate experiences of discrimination.

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“…21 Lower education has been associated with perceptions of discrimination in general, not limited to health care, 21 but experiences within the healthcare system may differ from those in other life domains. Unique health-related factors, such as insurance status 22 and cost-associated access barriers, may be important. This warrants examination of multiple dimensions of SES in relation to perceived racial treatment specifically in the area of health care.…”

Section: Introductionmentioning

confidence: 99%

Perceived Discrimination and Privilege in Health Care: The Role of Socioeconomic Status and Race

Štěpáníková

Oates

2017

American Journal of Preventive Medicine

152

107

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Introduction This study examined how perceived racial privilege and perceived racial discrimination in health care varied with race and socioeconomic status (SES). Methods The sample consisted of white, black, and Native American respondents to the Behavioral Risk Factor Surveillance System (2005–2013) who had sought health care in the past 12 months. Multiple logistic regression models of perceived racial privilege and perceived discrimination were estimated. Analyses were performed in 2016. Results Perceptions of racial privilege were less common among blacks and Native Americans compared with whites, while perceptions of racial discrimination were more common among these minorities. In whites, higher income and education contributed to increased perceptions of privileged treatment and decreased perceptions of discrimination. The pattern was reversed in blacks, who reported more discrimination and less privilege at higher income and education levels. Across racial groups, respondents who reported foregone medical care due to cost had higher risk of perceived racial discrimination. Health insurance contributed to less perceived racial discrimination and more perceived privilege only among whites. Conclusions SES is an important social determinant of perceived privilege and perceived discrimination in health care, but its role varies by indicator and racial group. Whites with low education or no health insurance, well-educated blacks, and individuals who face cost-related barriers to care are at increased risk of perceived discrimination. Policies and interventions to reduce these perceptions should target structural and systemic factors, including society-wide inequalities in income, education, and healthcare access, and should be tailored to account for racially specific healthcare experiences.

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Racial and ethnic health disparities: evidence of discrimination's effects across the SEP spectrum

Cited by 59 publications

References 77 publications

Explaining mental health inequalities in Northern Sweden: a decomposition analysis

Explaining mental health inequalities in Northern Sweden: a decomposition analysis

Past racial discrimination exacerbates the effects of racial exclusion on negative affect, perceived control, and alcohol-risk cognitions among Black young adults

Perceived Discrimination and Privilege in Health Care: The Role of Socioeconomic Status and Race

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