Multiple Forms of Perceived Mistreatment and Mortality Risk Among Older Adults: Evidence from the Health and Retirement Study

Background and Purpose: Perceived discrimination is a common experience among older adults; yet, no study has investigated the joint consequences of multiple dimensions of perceived discrimination on mortality risk.

Methods: This study utilized data from a nationally representative panel study of older adults in the United States (N=12,988). Perceived discrimination is based on responses from the 2006/2008 HRS waves and included everyday discrimination, the number of attributed reasons for everyday discrimination, and major lifetime discrimination. Respondents’ vital status was obtained from the National Death Index and reports from key household informants (spanning 2006–2016). Cox proportional hazard models were used to estimate the risk of mortality.

Results: During the 10-year observation period, 3,494 deaths occurred. All three measures of perceived discrimination were independently associated with an increased the likelihood of death. However, only the number of attributed reasons for discrimination predicted mortality risk when all discrimination measures were estimated in the same model (Hazard Ratio [HR]=1.09; 95%, Confidence Interval [CI]=1.05 - 1.14). This relationship remained significant (HR=1.05, 95% CI=1.01 - 1.09) after further adjustments for health, economic, and personal resources. Our results suggested major lifetime discrimination may have a more harmful influence on likelihood of death among older Whites than Latinos.

Conclusions: Examining the joint consequences of multiple dimensions of perceived discrimination has considerable utility in clarifying their unique contributions to mortality risk; the number of attributed reasons for everyday discrimination is a particularly salient risk factor for mortality in later life.