The Effects of Perceived Discriminations on Disparities in Chronic Health Conditions: Findings from the National Health Measurement Study

Introduction

 As the experience of discrimination varies so does the effects of health. Chronic health effects of gender, age, social status, or racial motivated discrimination may be different from the association of subtler everyday discrimination. For most of the 15 leading causes of death including heart disease, cancer, stroke, diabetes, kidney disease, and hypertension, African Americans have higher death rates than whites. Limited studies have noted the interplay between perceptions of discriminatory experiences and other contextual factors, such as socioeconomic status, gender, and age. Prior studies demonstrated that self-perceived discrimination is associated with chronic health conditions such as obesity and heart conditions

Purposes:

 The purposes of this study are 1) to explore the prevalence of self-reported discriminatory experiences and obesity and 2) to examine the relation between discrimination and chronic health conditions

 Methods:

This study selected the African American (n = 1,063, 30%) and White (n=2,492, 70%) sample with age ranged from 35 ~ 89 from the National Health Measurement Study.  The selected sample included women (n=1,536, 43.2%), married or with partner (51.4%), and more aged group over 65 (1,572, 44.2%). Two different scales of self-perceived discrimination, everyday discrimination and lifetime discrimination were analyzed as independent variables. The self-reported 4 chronic health conditions were measured by dichotomous variables. The obesity is calculated with BMI excluding the underweighted group.  T or F tests was used to examine the effects of race, gender, age category (35-44, 45-64, and 65-89), and SES on study variables. The Chi-square tests and logistic regression models were conducted to examine the effects of socio-demographic factors to obesity and chronic health conditions.

 

Results: 

African Americans reported more race-related discrimination (32.3%) and some other reason (28.7%) and Whites experienced discimations by unspecified reasons (48.6%) with age (7.3%) and gender (6.5%) rated factors. Middle-aged (35 ~ 54), African Americans, males, persons in lower SES were found to be the most vulnerable groups in the levels of both lifetime and everyday discriminatory experiences. The lowest SES groups are significantly associated with BMI (39.6% as obese), CHD (22%), Diabetes (32.4%), Stroke (10.0%), and Depression (19.9%). There were significant race disparities in Diabetes (27.8% Blacks) and Depression (15.3% Whites), but not differences in CHD & Stroke. Further, BMI is found to be significantly predicting overall conditions (r=.202, p <.01), CHD, Diabetes, and Depression, but not Stroke.  The binary logistic regression models showed that race (Wald = 15.23), income (Wald = 47.18), everyday discrimination (Wald = 17.15), and BMI (Wald = 17.30) were significant predictors to Cardiovascular disease (R² =.068) in particular.

 

Discussion:

The study findings provided partial evidences to prove existing disparities in chronic health conditions depending on level of discriminatory experiences based on race, gender, and social economic status. These findings revealed potential pathways linking perceived discrimination to negative chronic physical (obesity, diabetes, and heart) and psychological outcomes (e.g., depression). The study findings suggest why social workers should address different types of institutional and everyday discrimination when working with socially and economically vulnerable individuals would experience in their schools, employments, and communities.