The Moderation Effects of Migration-Related Factors on the Association between Discrimination and Allostatic Load Among Puerto Ricans

Background and Purpose

A cumulative body of evidence consistently documents that discrimination is an important social stressor that creates and perpetuates health disparities. Previous studies established a relationship between discrimination and as allostatic load, a preclinical indicator of disease. Though Puerto Ricans display multiple disparities in the chronic diseases compared to other racial/ethnic groups, studies that test the deleterious influence of discrimination among this ethnic group is at the early stage. Research also shows that the impact of stress on health outcomes varies by migration-related factors among Latinos and non-Hispanic Whites. However, whether the migration-related factors moderate the association between discrimination and allostatic load remains underexplored, especially among Puerto Ricans. Therefore, the purpose of this present study is to examine the moderation effects of migration-related factors, more specifically age of migration, psychological acculturation, and language acculturation, on the association between discrimination and allostatic load.

 

Methods

Data were drawn from the 2015 Boston Puerto Rican Health Study, a population-based study of older Puerto Ricans in the Boston, MA metro area. The sample consists of 523 Puerto Rican older adults between the ages of 45 and 75 years. The dependent variable is allostatic load, measured by 11 biomarkers associated with neuroendocrine, cardiovascular, immune, and metabolic systems. The key independent variable is perceived discrimination, measured by the Everyday Discrimination Scale. The moderators include age at arrival and bidimensional language and psychological acculturation. Ordinary Least Squares regression analyses were conducted to examine the moderating effect of these migration-related factors on the relationship between discrimination and allostatic load.

Results

Age at arrival has a statistically significant moderating effect on the association between discrimination and allostatic load. Compared to those arrived in the U.S. mainland in their infancy or pre-school (0-5 years), participants arrived in their middle childhood (6-11 years) and adolescence (12-18 years) have weaker associations between discrimination and allostatic load, but not for those arrived later. Language and psychological acculturation do not statistically moderate the association between discrimination and allostatic load.

Conclusions and Implications

            The present study highlights that the relationship between discrimination and allostatic load is influenced by developmental contexts of migration. We found that those who arrived during infancy are most vulnerable to the health burden of unfair treatment compared to other age-at-arrival groups. Our result is different from a previous finding that these two groups display higher allostatic load in response to generic stressful life events, indicating that discrimination is a unique social stressor that has a distinct health implication. Overall, our findings suggest that age at arrival is an important explanatory factor to disentangle the health effects of discrimination for Puerto Ricans in the United States.