The Association Between Discrimination and Falling. A National Sample of Older Adults

Abstract

Objective To assess the relationship between discrimination and falling among older people. Methods A cross-sectional nationwide population-based face-to-face survey, 2015. The SABE ( Salud, Bienestar y Envejecimiento) Colombia Study, 19,004 community-dwelling adults aged ≥60 years. Recurrent falling was defined as ≥2 falls during the prior year. Main independent variable was discrimination. Results Multivariate logistic regression models showed that recurrent falling was significantly associated with a number of reasons for experiences of everyday discrimination (due to racial, socioeconomic status, gender, age, religion, sexual orientation, or disability) (OR = 1.27, 95% CI 1.21–1.33), childhood discrimination score (never = 0 to many times = 3) (OR = 1.23, 95% CI 1.13–1.33), and number of situations for discrimination during the last 5 years due to skin color (group activities, public places, inside the family, or health centers) (OR = 1.12, 95% CI 1.08–1.17). Discussion Discrimination experiences were associated with higher odds of recurrent falling.

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

“…Concerning clinical practice, younger patients prone to experiencing discrimination should be referred to counselors or therapists who can help them mitigate the stress they may experience after being exposed to racial discrimination. This therapy may reduce long-term negative health consequences such as depression, poor self-rated health, recurrent falling, and multimorbidity ( 5 , 6 , 8 , 28 , 29 , 32 ).…”

“…In the SABE Colombia study, this variable was specifically constructed for racial and skin color discrimination and separated from the section on adverse childhood experiences. Childhood discrimination experiences are a part of lifetime discrimination as a person ages and should be considered an expanded measure of adverse childhood experiences ( 6 ).…”

“…In Latin America, racial discrimination based on skin color is a societal problem deeply rooted in the history of the region, which placed European conquerors and their descendants at the top of a racial and class-based hierarchy and enslaved Africans and subjugated Indigenous peoples at the bottom ( 4 ). Perceived discrimination has been associated with various adverse health outcomes among older adults, such as poor self-reported health, increased symptoms of depression, poor memory, chronic diseases, functional limitations, slow walking, recurrent falling, and shorter telomere length ( 5 , 6 ). One study in Puerto Rico identified a mediating relationship for social class between skin color and blood pressure, so complex sociocultural processes are at work between socially defined racial categories and health status ( 7 ).…”

“…Considering the multiple physical and mental health effects of racial discrimination on the older adult population in Colombia, we hypothesized that racial discrimination (everyday exposure, childhood events, or recent situations) would be independently associated with multimorbidity after adjusting for potential confounding factors. This relationship might be explained because people who have experienced racial discrimination may be frail and have risk factors commonly associated with multimorbidity, such as poor functional status and low physical performance ( 6 ). Moreover, racial and ethnic discrimination interact in a syndemic way with other adversities and social inequalities that increase the possibility of becoming ill or dying ( 12 ).…”

Edentulism and Individual Factors of Active Aging Framework in Colombia

“…The estimated sample size was 24,553 individuals from 244 municipalities across all departments (Colombian administrative units) and 23,694 older adults. 26 - 28 )…”