The Association between Multiple Domains of Discrimination and Self‐assessed Health: A Multilevel Analysis of Latinos and Blacks in Four Low‐Income New York City Neighborhoods

Abstract

Objective. This study examines the association between discrimination due to race and other attributes (e.g., sex, age) and self-assessed mental and physical health among Latinos and blacks. Data Source. Latino and black adult participants (n 5 873) identified by random digit dialing were interviewed by telephone in four low-income neighborhoods in New York City: the South Bronx, East Harlem, Central Harlem, and Bedford-Stuyvesant. Study Design. In this cross-sectional study, generalized estimating equations were used to fit multilevel multivariable models to test the association between discrimination and poor mental and physical health while controlling for socioeconomic status, access to health care, social support, smoking, and the racial and ethnic composition of each neighborhood. Principal Findings. Discrimination due to race and discrimination due to other attributes were associated with poor self-assessed mental but not physical health in separate multivariable models. Persons who experienced multiple domains of discrimination had a greater probability of reporting poor mental health than persons who experienced no discrimination. Conclusions. Discrimination due to race and other attributes was a significant correlate of mental health among Latinos and blacks independent of other accepted determinants of health.

Social Adversity, Stress, and Alcohol Problems: Are Racial/Ethnic Minorities and the Poor More Vulnerable?

“…In what contexts do they perceive that they are racially stigmatized, and on what basis do they feel they are treated unfairly? Unfair treatment may be attributed to various social status categories (e.g., race, SES, gender) and personal characteristics (e.g., criminal history, religious affi liation) (Stuber et al, 2003). Future research is also needed to understand what factors might mitigate the harmful effects of social adversity experienced by Blacks and Hispanics and thus help to explain why they do not appear to be affected more severely than Whites.…”

Social Disadvantage, Stress, and Alcohol Use Among Black, Hispanic, and White Americans: Findings From the 2005 U.S. National Alcohol Survey

“…It should also be noted that our use of a single-item measure of unfair treatment might underestimate its prevalence (Martin et al, 2003;Williams and Williams-Morris, 2000) and offer less reliability than multi-item measures (Krieger et al, 2005). Future work should attempt to capture experiences of discrimination attributable to race and other dimensions of difference by employing multi-item measures that allow respondents to indicate multiple attributions for unfair treatment (e.g., see Stuber et al, 2003).…”

“…Although we expect that racial/ethnic minorities have greater exposure to social disadvantage, it is unclear whether the adverse effects of disadvantage are limited to minorities. Much of the public health research on social disadvantage, particularly racial discrimination, has logically focused on people of color, but we recognize that poverty and unfair treatment might negatively affect whites as well as minorities, as nonracial forms of discrimination have been shown to be highly salient to persons of low socioeconomic position, including low-income blacks (Stuber et al, 2003). The current study thus aims to contribute new information by (1) examining both economic and social hardship as sources of stress; (2) examining their associations with alcohol use and problems; and (3) assessing the mediating role of psychological distress in each case for the three largest U.S. racial/ethnic groups-white, Hispanic, and black Americans.…”

Racism, Health Status, and Birth Outcomes: Results of a Participatory Community-Based Intervention and Health Survey

“…[21][22][23] Perceived discrimination has been associated with low selfrated mental and physical health, [24][25][26] low birth weight, [27][28][29] and preterm delivery 30,31 among African Americans. Perceived discrimination has also been associated with hypertension 32,33 and smoking, 34 which are risk factors during pregnancy.…”