“Discrimination” versus “Unfair Treatment”: Measuring Differential Treatment and its Association with Health

There is consistent evidence of the health‐harming effects of discrimination. However, it remains unclear whether discrimination contributes to persistent racial and ethnic health disparities. One hindrance to documenting the association between discrimination and health disparities is ongoing methodological issues, particularly the role of question wording in assessing self‐reports of discrimination. Using two nationally representative surveys, we investigate whether the prevalence, distribution, and mental and physical health consequences of differential treatment vary by question wording—”discrimination” versus “unfair treatment.” We find that “unfair treatment” yields greater reports of everyday forms of differential treatment relative to reports of “discrimination,” while the latter yields greater reports of major forms of differential treatment. In addition, the negative effect of “unfair treatment” on mental health is stronger than that of “discrimination,” while the latter has a stronger negative effect on physical health. However, the effect of question wording on reports of differential treatment and its association with health is largely unique to non‐Hispanic whites. We conclude that unfair treatment and discrimination reflect distinct concepts that should not be used interchangeably.     

Everyday Racial Discrimination,Everyday Non-Racial Discrimination,and Physical Health Among African-Americans

ABSTRACT

Past research has identified a link between discrimination and health outcomes among people of color. Perceptions of the cause of discrimination (racial versus other) seem to be important for mental health; however, this relationship has not been fully examined for physical health. Using data from the National Survey of American Life, we find that, among African-Americans, racial discrimination and overall discrimination regardless of attribution are associated with negative health outcomes while non-racial discrimination is not. The results suggest that racial discrimination has a unique adverse effect on physical health for African-Americans that practitioners need to better understand.     

Perceived discrimination,socioeconomic status,and mental health among Latino adolescents in US immigrant families

The association between interpersonal discrimination and mental health among Latino adolescents has been relatively well studied. Less is known about perceived societal discrimination or how discrimination may differentially impact Latino adolescents with recent immigration histories. Further, while personal and family characteristics have often been posited to influence the association between discrimination and health outcomes, little attention has been paid to potentially moderating influences of social status. Using data from the first two rounds of the Children of Immigrants Longitudinal Study (CILS) study, we estimate a series of logit regression models to investigate the association between discrimination (societal and interpersonal) and mental health (depressive symptoms and self-esteem) among Latino adolescents with recent immigration histories, and test how this association differs by parental socioeconomic status (SES). Results show a negative association between perceived societal and interpersonal discrimination and mental health, inconsistent associations between SES and mental health, and some evidence of a moderating role of parental SES. Specifically, higher SES appears to attenuate the detrimental effect of discrimination on depressive symptoms, particularly in contexts of interpersonal discrimination. Our findings support increased attention to measuring the impact of perceived societal discrimination on mental health outcomes as well as further examination of the intervening role of social status.     

The prevalence, distribution, and mental health correlates of perceived discrimination in the United States.

The survey data presented here are on the national prevalences of major life-time perceived discrimination and day-to-day perceived discrimination; the associations between perceived discrimination and mental health; and the extent to which differential exposure and differential emotional reactivity to perceived discrimination account for the well-known associations between disadvantaged social status and mental health. Although more prevalent among people with disadvantaged social status, results show that perceived discrimination is common in the total population, with 33.5 percent of respondents in the total sample reporting exposure to major lifetime discrimination and 60.9 percent reporting exposure to day-to-day discrimination. The associations of perceived discrimination with mental health are comparable in magnitude to those of other more commonly studied stressors, and these associations do not vary consistently across subsamples defined on the basis of social status. Even though perceived discrimination explains only a small part of the observed associations between disadvantaged social status and mental health, given its high prevalence, wide distribution, and strong associations with mental health, perceived discrimination needs to be treated much more seriously than in the past in future studies of stress and mental health.     

Multiple forms of perceived discrimination and health among adolescents and young adults

Research on perceived discrimination has overwhelmingly focused on one form of discrimination, especially race discrimination, in isolation from other forms. The present article uses data from the Black Youth Culture Survey, a nationally representative, racially and ethnically diverse sample of 1,052 adolescents and young adults to investigate the prevalence, distribution, and mental and physical health consequences of multiple forms of perceived discrimination. The findings suggest that disadvantaged groups, especially multiply disadvantaged youth, face greater exposure to multiple forms of discrimination than their more privileged counterparts. The experience of multiple forms of discrimination is associated with worse mental and physical health above the effect of only one form and contributes to the relationship between multiple disadvantaged statuses and health. These findings suggest that past research may misspecify the discrimination-health relationship and fails to account for the disproportionate exposure to discrimination faced by multiply disadvantaged individuals.     

Does perceived discrimination affect health? Longitudinal relationships between work discrimination and women's physical and emotional health

This study uses longitudinal data to examine the causal relationships between perceived work discrimination and women's physical and emotional health. Using data on 1,778 employed women in the National Longitudinal Survey of Mature Women, we investigate the structural and individual characteristics that predict later perceptions of discrimination and the effects of those perceptions on subsequent health. We find that perceptions of discrimination are influenced by job attitudes, prior experiences of discrimination, and work contexts, but prior health is not related to later perceptions. However, perceptions of discrimination do impact subsequent health, and these effects remain significant after controlling for prior emotional health, physical health limitations, discrimination, and job characteristics. Overall, the results provide even stronger support for the health impact of workplace discrimination and suggest a need for further longitudinal analyses of causes and consequences of perceived discrimination.     

Brief report: the relationship between multiple forms of oppression and subjective health among Black lesbian and bisexual women

This study was designed to explore the relationships between multiple forms of oppression and subjective physical health among a community sample of 85 Black lesbian and bisexual women. Self-report surveys assessing health behaviors, physical and mental health status, and experiences with discrimination were administered during a weekend retreat of a community-based organization serving this population. Structural equation modeling showed there were significant, but different, relationships between subjective health and two types of oppression, heterosexism and weight-based discrimination. Further research on the independent and intersectional effects of multiple forms of oppression on health is needed.     

Modeling the impact of social discrimination on the physical and mental health of Portuguese gay,lesbian and bisexual people

Background: Despite growing acceptance of same-sex sexuality in Portugal, identity development of lesbian, gay and bisexual (LGB) individuals is still restricted by negative societal attitudes, which maintain the experience of stigmatization and discrimination. The purpose of this study is to document the frequency of discriminatory events experienced by sexual minorities and their association with indicators of physical and mental health in Portugal. Methods: A total of 610 LGB participants completed an online survey (mean age?=?34.48, SD?=?11.54). Most participants were single and self-identified as gay (73.8%). The survey included five categories of survey items: demographic information, social support, physical health, mental health, and discrimination experiences. Results: Physical and mental health results revealed that bisexual people were more likely to report higher levels of psychological distress than gay men. Overall, between one-fifth and one-fourth of the participants in this sample frequently felt the need to hide their sexual orientation to prevent discrimination experiences across the different settings. Regarding actual discrimination experiences, close to 20% reported having suffered from verbal abuse, followed by close to 10% who suffered from written threats, harassment, and physical threats. A hierarchical multiple regression analysis was performed to assess the effects of anticipated and actual discrimination on mental health. Possible confounding variables were added in the first block – age, sexual orientation, being in a relationship, body mass index, and HIV status. Anticipated and actual discrimination experiences were added in the second block. The first block of the analysis explained 6% of the overall variance, while the second block – discrimination experiences – explained an additional 17%. Conclusion: Portuguese culture and stigma/discrimination create discriminatory experiences which impact LGB people's health. Unless policies are changed to allow for the acceptance of LGB people, they will continue to experience violence and discrimination as a result of homophobia.     

Beyond Good Intentions. Making Anti-discrimination Strategies Work

This article seeks to explore some key questions about effectiveness in anti-discrimination work: what do we know of what works to reduce discrimination faced by disabled people? It takes, as its key focus, current work to reduce discrimination experienced by people who use mental health services, in Britain and internationally. It also looks at initiatives in wider disability communities. It argues on the basis of available evidence (see, particularly, Link &; Phelan, 2001) that initiatives are most likely to succeed if they effectively challenge the power that underpins discrimination, aim to transform beliefs amongst those with the power to discriminate, intervene carefully in the different components of 'discrimination', drawing on evidence of effectiveness and work within a comprehensive framework for ongoing anti-discrimination work. This means targeting anti-discrimination work at different levels and different sectors, working with a range of different organisations and groups, rather than dispersing resources through ad hoc , one-off mini-initiatives. There is no single solution to discrimination, but different elements of potential 'solutions' exist. What is needed is to bring different strands of work together. In particular, it would be helpful to forge a stronger synthesis between, on the one hand, securing legislative improve ment and enforcement, and on the other, promoting the universal benefits of a more inclusive society. Each complements the other.     

Structural Influences on Racial and Ethnic Disparities in Women's Health Care

This paper summarizes recent research about several structural influences on racial and ethnic disparities in women's health care. While disparities in women's health care access and quality emanate from a number of sources, this paper focuses on the intersection between race/ethnicity and several structural factors (access to insurance coverage, discrimination, neighborhood characteristics, and social isolation). We identify gaps in the literature and suggest directions for future research. Particularly needed are gender studies of the impact of race/ethnicity that transcend the black–white dichotomy, that attend to location, that examine variation in social networks, and that clarify the impact of discrimination on women's health care.     

Latino Immigrants,Discrimination and Reception in Columbus,Ohio

Columbus, Ohio has witnessed rapid growth in its Latino population as immigrants settle in the city to access jobs and a generally low cost of living. Immigrants also face discrimination as they settle in Columbus and interact with the city's citizens. In this paper, we note how discrimination plays out in social and economic isolation; a lack of programmes to support the incorporation of Latinos in the city; and state laws that target immigrants. We present results of ongoing ethnographic work with the Latino community in Columbus.     

The Transgenerational Consequences of Discrimination on African‐American Health Outcomes

Disparities in African American health remain pervasive and persist ransgenerationally. There is a growing consensus that both structural and interpersonal racial discrimination are key mechanisms affecting African American health. The Biopsychosocial Model of Racism as a Stressor posits that the persistent stress of experiencing discrimination take a physical toll on the health of African Americans and is ultimately manifested in the onset of illness. However, the degree to which the health consequences of racism and discrimination can be passed down from one generation to the next is an important avenue of exploration. In this review, we discuss and link literature across disciplines demonstrating the harmful impact of racism on African American physical health and the health of their offspring.     

Participatory action research with asylum seekers and refugees experiencing stigma and discrimination: the experience from Scotland

Using evidence from a participatory action research process with over 100 asylum seekers and refugees in Scotland, this study explores participants’ views on mental health problems, stigma and discrimination. The study found that migration can have adverse effects on mental health and well-being, due to racism and the asylum process, and this is worsened by stigma and discrimination. This stigma is influenced by both social and cultural causal factors, including fear, past trauma, isolation, racism and the stress of the asylum process coupled with negative cultural beliefs about mental health problems. The paper considers the international relevance of this approach and the value of a model grounded in principles of community development and grassroots action.     

Preference for same-race health care providers and perceptions of interpersonal discrimination in health care

This article examines black Americans' preference for black health care providers. Using data from a national survey, we assess how blacks 'perceptions of discrimination are related to preference for same-race health care providers. Overall, the belief that discrimination is frequent in different-race doctor-patient dyads is associated with greater preference for a same-race provider However; the belief that discrimination occurs regardless of a doctor's race reduces preference for a same-race provider Finally, general perceptions of discrimination are distinct from concerns about personally being treated unfairly, and low personal concern about unfair treatment reduces preference for a same-race provider among those who believe that interpersonal discrimination occurs frequently. These results suggest a complex picture of how perceptions of discrimination influence preferred race of health care provider among blacks in the United States.     

Examining Associations Between Discrimination,Social Cohesion,and Health among White LGBT versus POC LGBT Chicagoans

Consistent with the minority stress perspective, lesbian/gay, bisexual, and transgender (LGBT) individuals on average report worse health than heterosexual individuals in several domains, for example, general health, mental health, physical health, and healthcare access. Intersectionality-based research shows that LGBT people of color (POC) are, on average, at even greater risk for adverse health outcomes. Discrimination and social cohesion may be two mechanisms underlying these between- and within-group disparities, given that both constructs are frequently reported within marginalized populations, and that both broadly relate to health. This study used data from the Chicago Department of Public Health to examine broad health differences between White LGBT and LGBT POC, and to test specific models in which social cohesion mediated links between discrimination and health. LGBT POC reported experiencing worse general health, lower access to health care, more experiences of discrimination, and lower feelings of social cohesion than did White LGBT individuals. No mediation effects emerged; however, there was a direct effect of experiencing discrimination on mental health distress. Discrimination exposure inversely related to the feelings of social cohesion.     

"We are not aliens, we're people, and we have rights." Canadian human rights discourse and high school climate for LGBTQ students

Canadian law protects people from discrimination on the grounds of sexual orientation, but our public schools do not fulfill their ethical and legal obligations where sexual and gender minority youth are concerned. This article reports on a national survey study on homophobia and transphobia in Canadian high schools. Participants (n = 3,607) were questioned about school climate, harassment, school attachment, and institutional interventions. We found that schools were neither safe nor respectful for sexual and gender minority students, and we argue that ongoing exposure to this situation undermines students' respect for the Charter of Rights and their faith in adults.     

Denied Citizens of Turkey: Experiences of Discrimination Among LGBT Individuals in Employment,Housing and Health Care

The purpose of this article is to explore experiences of discrimination against lesbian, gay, bisexual and trans (LGBT) individuals in three domains of social policies: employment, housing and health care — domains in which LGBT individuals are not openly recognized as equal citizens and anti‐discrimination legislation is absent in Turkey. Drawing on qualitative content analysis of the data collected from 14 focus group interviews with 139 LGBT individuals conducted in ten provinces of Turkey in the first half of 2014, this article sheds light on diverse forms of discrimination facing LGBT individuals in employment, housing and health care in a largely under‐researched country. The article concludes that the contemporary understanding of Turkish citizenship and its practice are rooted in heterosexist universalism that does not recognize LGBTs as equal citizens, which, in turn, leads to systematic breaches of LGBTs' social rights in employment, housing and health care. The article shows that even strong and universalistic social policies fail to serve LGBTs on an equal footing with other citizens unless equal citizenship rights of LGBTs and anti‐discrimination principles are recognized and realized.     

Perceived Discrimination and Its Associations With Mental Health and Substance Use Among Asian American and Pacific Islander Undergraduate and Graduate Students

Abstract

Objectives: Racial discrimination experiences can negatively affect health. This study examined perceived discrimination and its relationship with mental health and substance use among Asian American and Pacific Islander (API) undergraduate and graduate students. Participants: A total of 113 API students aged 18–35 completed the study during February–June, 2011. Methods: The authors conducted a cross-sectional, anonymous survey online. Dependent variables included mental health (depressive, anxiety, and somatic symptoms) and substance use (alcohol problems, use of tobacco, marijuana or hashish, and other illegal drugs). Results: Students’ perceived discrimination were significantly, positively associated with depressive, anxiety, and somatic symptoms, but not with substance use. Ethnic identity moderated the relationship between perceived discrimination and somatic symptoms, but not depressive or anxiety symptoms. Conclusions: These findings suggested the negative effect of racial discrimination on API students’ mental health. The buffering effect of ethnic identity may increase resilience in these students when they face racial discrimination.     

CULTURAL DIVERSITY, DISCRIMINATION, AND ECONOMIC OUTCOMES: AN EXPERIMENTAL ANALYSIS

Does cultural diversity affect economic outcomes? We develop an experimental framework that complements ongoing research on this question. We vary the ethnic mix of bargaining sessions to study intercultural interactions among members of U.S. Hispanic and Navajo cultures. We control for demographic differences in our subject pools and elicit beliefs directly in order to differentiate between statistical discrimination and preference‐based discrimination. Hispanic and Navajo subjects behave differently, and their behavior is affected by the ethnic composition of the experimental session. Our experimental framework can shed light on economic behavior and outcomes in societies of mixed ethnicity, race, and religion. (JEL C78, C90, Z10)     

The (In)Significance of Race and Discrimination among Latino Youth: The Case of Depressive Symptoms

Abstract

Despite the growing population of Latinos in the United States, there is little research that explores how discrimination affects the mental health of Latino youth along racial lines. In this paper we ask two closely related questions. First, do black Latino youth have higher or lower symptoms of depression than nonblack Latinos? Second, is the relationship between race and depression among Latino youth buffered by discrimination stress? Results from the Transitions Study show that black Latino youth have significantly higher symptoms of depression than nonblack Latinos. The relationship between race and depression depends on daily—but not on lifetime—experiences of discrimination. The combined effect of race and discrimination holds in the face of a wide range of measures of stress, including major lifetime events, recent life events, and chronic stressors. These findings encourage future research that considers the mental health effects of racial variation among Latinos.