A Multilevel Analysis of the Relationship Between Institutional and Individual Racial Discrimination and Health Status

Overview

Journal Am J Public Health

Specialty Public Health

Date 2002 Mar 29

PMID 11919062

Citations 159

Authors

Gilbert C Gee

Affiliations

Soon will be listed here.

Abstract

Objectives: This study examined whether individual (self-perceived) and institutional (segregation and redlining) racial discrimination was associated with poor health status among members of an ethnic group.

Methods: Adult respondents (n = 1503) in the cross-sectional Chinese American Psychiatric Epidemiologic Study were geocoded to the 1990 census and the 1995 Home Mortgage Disclosure Act database. Hierarchical linear modeling assessed the relationship between discrimination and scores on the Medical Outcomes Study Short-Form 36 and revised Symptom Checklist 90 health status measures.

Results: Individual and institutional measures of racial discrimination were associated with health status after control for acculturation, sex, age, social support, income, health insurance, employment status, education, neighborhood poverty, and housing value.

Conclusions: The data support the hypothesis that discrimination at multiple levels influences the health of minority group members.

Citing Articles

The long-run effect of historical redlining practices on social vulnerability in U.S. cities.

Lu Y, Lin Y, Howard N, Brown C, Gong X Cities. 2025; 157.

PMID: 39867654 PMC: 11759317. DOI: 10.1016/j.cities.2024.105590.

Assessing Structural Racism Measures on Health Outcomes of Asian Americans, Native Hawaiians, and Pacific Islanders: A Scoping Review.

Raman P, Chu C, Chong S, Mukherjea A, Kue J J Racial Ethn Health Disparities. 2024; .

PMID: 38539020 DOI: 10.1007/s40615-024-01987-1.

Lessons Learned from Immigrant Health Cohorts: A Review of the Evidence and Implications for Policy and Practice in Addressing Health Inequities among Asian Americans, Native Hawaiians, and Pacific Islanders.

Guan A, Talingdan A, Tanjasiri S, Kanaya A, Gomez S Annu Rev Public Health. 2023; 45(1):401-424.

PMID: 38109517 PMC: 11332134. DOI: 10.1146/annurev-publhealth-060922-040413.

The Health Implications of Perceived Anti-Muslim Discrimination Among South Asian Muslim Americans.

Ahmed N, Islam N AJPM Focus. 2023; 2(4):100139.

PMID: 37928060 PMC: 10624581. DOI: 10.1016/j.focus.2023.100139.

Interpersonal Discrimination, Neighborhood Inequities, and Children's Body Mass Index: A Descriptive, Cross-Sectional Analysis.

Kunin-Batson A, Carr C, Tate A, Trofholz A, Troy M, Hardeman R Fam Community Health. 2023; 46(Suppl 1):S30-S40.

PMID: 37696014 PMC: 10503111. DOI: 10.1097/FCH.0000000000000372.

References

Siefert K, Bowman P, Heflin C, DANZIGER S, Williams D . Social and environmental predictors of maternal depression in current and recent welfare recipients. Am J Orthopsychiatry. 2000; 70(4):510-22. DOI: 10.1037/h0087688. View

Halpern D, Nazroo J . The ethnic density effect: results from a national community survey of England and Wales. Int J Soc Psychiatry. 2003; 46(1):34-46. DOI: 10.1177/002076400004600105. View

Krieger N, Sidney S . Racial discrimination and blood pressure: the CARDIA Study of young black and white adults. Am J Public Health. 1996; 86(10):1370-8. PMC: 1380646. DOI: 10.2105/ajph.86.10.1370. View

Geronimus A . The weathering hypothesis and the health of African-American women and infants: evidence and speculations. Ethn Dis. 1992; 2(3):207-21. View

Susser M . The logic in ecological: II. The logic of design. Am J Public Health. 1994; 84(5):830-5. PMC: 1615022. DOI: 10.2105/ajph.84.5.830. View

Halpern D . Minorities and mental health. Soc Sci Med. 1993; 36(5):597-607. DOI: 10.1016/0277-9536(93)90056-a. View

Geronimus A . Black/white differences in the relationship of maternal age to birthweight: a population-based test of the weathering hypothesis. Soc Sci Med. 1996; 42(4):589-97. DOI: 10.1016/0277-9536(95)00159-x. View

Diez-Roux A, Nieto F, Caulfield L, Tyroler H, Watson R, Szklo M . Neighbourhood differences in diet: the Atherosclerosis Risk in Communities (ARIC) Study. J Epidemiol Community Health. 1999; 53(1):55-63. PMC: 1756776. DOI: 10.1136/jech.53.1.55. View

Kawachi I, Kennedy B, Glass R . Social capital and self-rated health: a contextual analysis. Am J Public Health. 1999; 89(8):1187-93. PMC: 1508687. DOI: 10.2105/ajph.89.8.1187. View

10.

Takeuchi D, Chung R, Lin K, Shen H, Kurasaki K, Chun C . Lifetime and twelve-month prevalence rates of major depressive episodes and dysthymia among Chinese Americans in Los Angeles. Am J Psychiatry. 1998; 155(10):1407-14. DOI: 10.1176/ajp.155.10.1407. View

11.

OCampo P, Gielen A, Faden R, Xue X, Kass N, Wang M . Violence by male partners against women during the childbearing year: a contextual analysis. Am J Public Health. 1995; 85(8 Pt 1):1092-7. PMC: 1615813. DOI: 10.2105/ajph.85.8_pt_1.1092. View

12.

Zambrana R, Scrimshaw S, Collins N, Dunkel-Schetter C . Prenatal health behaviors and psychosocial risk factors in pregnant women of Mexican origin: the role of acculturation. Am J Public Health. 1997; 87(6):1022-6. PMC: 1380943. DOI: 10.2105/ajph.87.6.1022. View

13.

Williams D, Yu Y, Jackson J, Anderson N . Racial Differences in Physical and Mental Health: Socio-economic Status, Stress and Discrimination. J Health Psychol. 2011; 2(3):335-51. DOI: 10.1177/135910539700200305. View

14.

Jackson J, Brown T, Williams D, Torres M, Sellers S, Brown K . Racism and the physical and mental health status of African Americans: a thirteen year national panel study. Ethn Dis. 1996; 6(1-2):132-47. View

15.

Krieger N, Rowley D, Herman A, Avery B, PHILLIPS M . Racism, sexism, and social class: implications for studies of health, disease, and well-being. Am J Prev Med. 1993; 9(6 Suppl):82-122. View

16.

Diez-Roux A, Nieto F, Muntaner C, Tyroler H, Comstock G, Shahar E . Neighborhood environments and coronary heart disease: a multilevel analysis. Am J Epidemiol. 1997; 146(1):48-63. DOI: 10.1093/oxfordjournals.aje.a009191. View

17.

Takeuchi D, Chung R, Shen H . Health insurance coverage among Chinese Americans in Los Angeles County. Am J Public Health. 1998; 88(3):451-3. PMC: 1508335. DOI: 10.2105/ajph.88.3.451. View

18.

Robert S . Community-level socioeconomic status effects on adult health. J Health Soc Behav. 1998; 39(1):18-37. View

19.

Burnam M, Hough R, Karno M, Escobar J, Telles C . Acculturation and lifetime prevalence of psychiatric disorders among Mexican Americans in Los Angeles. J Health Soc Behav. 1987; 28(1):89-102. View

20.

Ross C . Walking, exercising, and smoking: does neighborhood matter?. Soc Sci Med. 2000; 51(2):265-74. DOI: 10.1016/s0277-9536(99)00451-7. View