Revisiting the relationship between perceived discrimination and health: Evidence from sibling models with multiple health measures |
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| Institution: | 1. Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, the Netherlands;2. Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands;3. School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;4. Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands;5. ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Spain;6. Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom;7. MKPGMS-Uganda Martyrs University, Kampala, Uganda;8. Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany;9. Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universitaet zu Berlin, Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Germany;10. Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa |
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| Abstract: | Perceived discrimination (PD) is known to be significantly related to health outcomes. This link, however, warrants further scrutiny due to the possibility of unobserved family-level confounding. Using the Add Health and sibling fixed-effect approach, we examine whether the relationship between PD and health is confounded by family background characteristics such as genetics, family environment, and childhood social context (school and neighborhood effects). While the naive OLS models exhibit significant associations between PD and both physical and psychological health outcomes, our preferred sibling fixed-effect estimates reveal that the observed associations between PD and physical health outcomes are confounded by shared family background. In contrast, the observed associations for psychological health, self-reported health, and some of health behavior outcomes are robust to adjustment for sibling fixed-effects. Furthermore, we find similar overall patterns in the link between PD and health across races/ethnicities. |
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| Keywords: | Discrimination Mental health Physical health Health seeking behavior Self-rated health Young adult Sibling mode |
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