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 2008 Sep 24

PMID 18687618

Citations 44

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

Increasing Access, Equitability, and Rigor in the Assessment of Neighborhood Mortgage Discrimination.

Moubadder L, Bliss M, Maliniak M, Waddel H, Switchenko J, Chang H J Urban Health. 2024; 101(6):1274-1278.

PMID: 39601956 PMC: 11652444. DOI: 10.1007/s11524-024-00941-0.

Structural Influences on Methamphetamine Use Among Black Sexual Minority Men (HISTORY Study): Protocol for a Longitudinal Cohort Study.

Opara S, Linton S, Weir B, Crawford N, Holland D, Newman Jr A JMIR Res Protoc. 2024; 13:e63761.

PMID: 39481101 PMC: 11565090. DOI: 10.2196/63761.

Contextualizing Inequities in COVID Vaccination Trends Among Project REFOCUS Pilot Sites: Racism-Related Determinants of Health.

Nwankwo E, Le C, Bradford N, Trujillo D, Fletcher A, Ford C Ethn Dis. 2024; 34(1):1-7.

PMID: 38854790 PMC: 11156167. DOI: 10.18865/ed.34.1.1.

Increasing access, equitability, and rigor in the assessment of Neighborhood Mortgage Discrimination.

Moubadder L, Bliss M, Maliniak M, Waddel H, Switchenko J, Chang H Res Sq. 2024; .

PMID: 38826384 PMC: 11142352. DOI: 10.21203/rs.3.rs-4419606/v1.

The effects of contemporary redlining on the mental health of Black residents.

Pearson A, Zhou Y, Buxton R, Horton T, Pfeiffer K, Beyer K SSM Popul Health. 2023; 23:101462.

PMID: 37456619 PMC: 10339054. DOI: 10.1016/j.ssmph.2023.101462.

References

Krieger N . Racial and gender discrimination: risk factors for high blood pressure?. Soc Sci Med. 1990; 30(12):1273-81. DOI: 10.1016/0277-9536(90)90307-e. View

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

Frey W, Farley R . Latino, Asian, and black segregation in U.S. metropolitan areas: are multiethnic metros different?. Demography. 1996; 33(1):35-50. View

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

LaVeist T, Nickerson K, Bowie J . Attitudes about racism, medical mistrust, and satisfaction with care among African American and white cardiac patients. Med Care Res Rev. 2000; 57 Suppl 1:146-61. DOI: 10.1177/1077558700057001S07. View

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

Lillie-Blanton M, Anthony J, Schuster C . Probing the meaning of racial/ethnic group comparisons in crack cocaine smoking. JAMA. 1993; 269(8):993-7. View

Yen I, Ragland D, Greiner B, Fisher J . Workplace discrimination and alcohol consumption: findings from the San Francisco Muni Health and Safety Study. Ethn Dis. 1999; 9(1):70-80. View

Polednak A . Segregation, discrimination and mortality in U.S. blacks. Ethn Dis. 1996; 6(1-2):99-108. View

10.

LaVeist T, Wallace Jr J . Health risk and inequitable distribution of liquor stores in African American neighborhood. Soc Sci Med. 2000; 51(4):613-7. DOI: 10.1016/s0277-9536(00)00004-6. View

11.

La Veist T . Why we should continue to study race...but do a better job: an essay on race, racism and health. Ethn Dis. 1996; 6(1-2):21-9. View

12.

Shiono P, Rauh V, Park M, Lederman S, Zuskar D . Ethnic differences in birthweight: the role of lifestyle and other factors. Am J Public Health. 1997; 87(5):787-93. PMC: 1381051. DOI: 10.2105/ajph.87.5.787. View

13.

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

14.

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

15.

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

16.

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

17.

Kessler R, Mickelson K, Williams D . The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. J Health Soc Behav. 1999; 40(3):208-30. View

18.

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

19.

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

20.

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