Racial Discrimination and Multimorbidity Among Older Adults in Colombia: A National Data Analysis

Abstract

Introduction Multimorbidity is a prevalent worldwide problem among older adults. Our objective was to assess the association between life-course racial discrimination and multimorbidity among older adults in Colombia. Methods We used data from the SABE (Salud, Bienestar y Envejecimiento) Colombia Study in 2015 (N = 18,873), a national cross-sectional survey among adults aged 60 years or older. The outcome was multimorbidity, defined as having 2 or more chronic conditions. The main independent variables were 3 racial discrimination measures: 1) everyday racial discrimination (yes or no), 2) childhood racial discrimination score (scored from 0 [never] to 3 [many times]), and 3) situations of racial discrimination in the last 5 years (scored from 0 to 4 as a sum of the number of situations [group activities, public places, inside the family, health centers]). Other variables were sociodemographic characteristics, diseases, economic or health adversity during childhood, and functional status. We used weighted logistic regression analyses to adjust for differences between groups. Results Multivariate logistic regression models showed that multimorbidity was significantly associated with experiencing everyday racial discrimination (OR, 2.21; 95% CI, 1.62–3.02), childhood racial discrimination (OR, 1.27; 95% CI, 1.10–1.47), and the number of situations of racial discrimination (OR= 1.56; 95% CI, 1.22–2.00). Multimorbidity was also independently associated with multimorbidity during childhood. Conclusion Racial discrimination experiences were associated with higher odds of multimorbidity among older adults in Colombia. Strategies to decrease life course experiences of racial discrimination may improve the health of older adults.

Combating Racism Through Research, Training, Practice, and Public Health Policies

“…However, continued expansion and updating of knowledge about how racism affects health, and who it affects, are critical to ensure that health care and public health remain capable of accounting for and mitigating the effects of all its manifestations. Original research by Reyes-Ortiz et al ( 27 ) demonstrates the continued salience of personally mediated racism and interpersonal racial discrimination as an emphasis toward which the performance of core functions must be directed and adapted.…”

“…Experiencing rejection, unfair treatment, or discrimination because of the meanings assigned to race, ethnicity, and skin color affects the odds of experiencing 2 or more chronic conditions concurrently in older adulthood among Colombians ( 27 ). Such experiences may increase or amplify the burden and complexity of multimorbidity patterns with which Columbian health care and public health systems must contend.…”