Research That Matters (January 17 - 20, 2008)

Purpose: Social work and social science have had growing interest in examining the potential links between experiences of racial discrimination and health outcomes. The stress induced by discrimination may be an important mechanism through which structural systems of dominance and oppression can affect individual and population health. Equally important are the ways in which potential risk and protective factors at the individual and community level (e.g. social networks, poverty, or neighborhood crime) might moderate the negative effects of discrimination on health. Although a number of individual-level moderators have been recently identified, there is a need for additional research to examine potential community-level risk and protective factors. The current study analyzed the relationship between self-reported experiences of racial discrimination and mental health among African-Americans in a midsize Midwestern county, as well as individual-level and community-level moderators. We applied Ecosocial theory to conceptualize the relationship between self-reported experiences of discrimination and mental health, which posits that social experiences are incorporated biologically and expressed through population patterns of health and well-being. Structural inequalities in exposure to pathogenic insults experienced across the life course manifest in disparate trajectories of biological and social development for different social groups, and so the effects of discrimination are cumulative.

Methods: Two sources of data were merged to complete the analysis: 1) a community telephone survey conducted in 2005 in a midsize Midwestern county through a university-community partnership, and 2) the 2000 U.S. Census. We examined a subsample of African-Americans respondents (n=412) representative of all census tracts in the county. The outcome measure, mental health, was derived from an average of six items. The measure of racial discrimination was a scale of five items that asked respondents to report how often they experienced unfair treatment because of their race (i.e. being provided with inadequate service at a restaurant). We used multilevel methods to model the relationship between perceived discrimination and mental health, in addition to both individual and community level moderators of the relationship.

Results: Self-reported experiences of racial discrimination were significantly associated with poorer mental health, controlling for age, gender, education, marital status and employment. Experiences of racial discrimination had greater effects on reported mental health for respondents who lived in high poverty neighborhoods. Neighborhood safety had an independent relationship with mental health; respondents living in safer neighborhoods had better reported mental health, controlling for neighborhood poverty. Individual-level social support (i.e. supportive relationships with friends and family) was a strong protective factor, mitigating the harmful effects of discrimination on mental health. However, neighborhood-level social support (i.e. trust and social interactions with neighbors) did not serve as a protective factor.

Implications: The results of this study add to the growing evidence that experiences of racial discrimination are an important mechanism through which structural inequalities influence individual health outcomes. Racial inequalities in exposure to psychosocial risk factors are multidimensional, and this study contributes to current knowledge by examining the moderating effects of sociostructural characteristics of neighborhoods on the relationship between individual-level experiences of everyday discrimination and mental health outcomes.