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.     

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.     

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 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.     

Diagnosing Discrimination: Stress from Perceived Racism and the Mental and Physical Health Effects*

Differences in health between racial groups in the United States are significant and persistent. Many studies have documented these differences as a result of a variety of different social factors. An emerging emphasis is the impact of racism in its various forms on physical and mental health. Social stress theory conceptualizes racism as a social stresssor which can produce negative health consequences for racial minorities. This study uses binary logit and negative binomial regression models of four items from the 2004 Behavioral Risk Factor Surveillance System (BRFSS) to test social stress theory and examine the relationship between stress symptoms from perceived racism and overall health (N = 32,585). The effect of race on the experience of emotional and physical stress symptoms from racism is substantial. Furthermore, experiencing both emotional and physical stress from perceived racist treatment is an important factor in predicting the number of poor mental and physical health days, indicating that the experience of stress from perceived racism is related to overall poorer health.     

Heterosexism,racism, and mental illness discrimination: Experiences of people with mental health conditions and their families

Experiencing discrimination related to race/ethnicity, sexual orientation, or having a mental health condition is associated with negative outcomes. Research comparing types of discrimination or considering intersectionalities is lacking. This study reports findings from interviews with people with mental illnesses (PWMI) or family members of PWMI; all study participants also are of color and/or lesbian, gay, or bisexual. Findings include the following: participants experienced multiple forms of discrimination, mental illness discrimination shares characteristics with racism and heterosexism, and heterosexuals and people of color reported more mental illness discrimination than their counterparts. Implications for change advocates, mental health providers, and researchers are offered.     

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.     

Jeopardy,Consciousness, and Multiple Discrimination: Intersecting Inequalities in Contemporary Western Europe

Theories of intersectionality argue that individuals with multiple minority statuses often face mistreatment that stems from multiple, interlocking systems of inequality. King (1988) refers to this phenomenon as “multiple jeopardy,” and argues that those who experience multiple jeopardy often develop a “multiple consciousness”—an awareness of multiple systems of inequality working with and through one another. This study analyzes recent survey data to assess perceived multiple jeopardy and its relationship to multiple consciousness in the context of contemporary Western Europe. Findings provide support for intersectionality, as individuals who hold multiple minority statuses are more likely than others to perceive having personally experienced multiple forms of discrimination, and are more likely to view multiple discrimination (discrimination based on multiple social statuses) as a widespread social phenomenon. Controlling for other factors, personal experiences with multiple forms of discrimination (“multiple jeopardy”) are associated with greater multiple consciousness. Personal experiences with discrimination based on a single dimension of inequality (“single jeopardy”) also facilitate multiple consciousness, however, though not to the same degree. The conclusion highlights the importance of intersectionality for future research and policy concerning discrimination.     

Perceived discrimination and health: Paradigms and prospects

This article reviews recent research on the effects of perceived discrimination on subsequent mental and physical health. I argue that despite legal reforms banning discrimination since the civil rights era, discrimination persists, posing an ongoing health risk and maintaining social health inequalities. Couched within broader health trends, this covers ongoing challenges and new developments, particularly related to measurement, and promising directions. As the most commonly reported location of individual discrimination is at work, this review concludes by arguing for the significance of the workplace as a unique context ripe for further inquiry for scholars interested in health inequality.     

Program evaluation of trauma-informed yoga for vulnerable populations

BackgroundTrauma is highly prevalent among vulnerable populations, including those who are incarcerated, in treatment for substance use, or seeking mental health services. Trauma-informed yoga seeks to create a safer yoga practice for individuals with a trauma history and may improve emotional and physical wellbeing. Thus, we conducted an evaluation of a trauma-informed yoga program to gain insight into participant experiences.MethodsTrauma-informed yoga classes were led by trained volunteers and held in three sectors that work with vulnerable populations: corrections and reentry, substance use treatment and recovery, and community and mental health. Data were collected via anonymous survey using a retrospective pre-post design. The survey instrument captured reasons for student participation and perceived effects of yoga on emotional and physical wellbeing.ResultsStudents were motivated to participate in yoga classes by expectations of physical, mental, and spiritual benefit. Students reported perceived improvements in emotional and physical wellbeing and greater use of self-regulation skills after starting yoga.ConclusionOur findings suggest trauma-informed yoga is perceived as beneficial by vulnerable individuals, especially those in the correctional system or recovering from substance use. Our results support the value of offering trauma-informed yoga in institutionalized and community settings. Improvements in emotional and physical wellbeing warrant formal study.     

Legal Marriage,Unequal Recognition,and Mental Health Among Same‐Sex Couples

The authors examined whether the perception of unequal relationship recognition ‐ a novel couple‐level minority stressor ‐ has negative consequences for mental health among same‐sex couples. Data were analyzed from a dyadic study of 100 same‐sex couples (200 individuals) in the United States. Being in a legal marriage was associated with lower perceived unequal recognition and better mental health; being in a registered domestic partnership or civil union—but not also legally married—was associated with greater perceived unequal recognition and worse mental health. Actor partner interdependence models tested associations between legal relationship status, unequal relationship recognition, and mental health (nonspecific psychological distress, depressive symptomatology, and problematic drinking), net controls (age, gender, race and ethnicity, education, and income). Unequal recognition was consistently associated with worse mental health, independent of legal relationship status. Legal changes affecting relationship recognition should not be seen as simple remedies for addressing the mental health effects of institutionalized discrimination.     

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.     

Perceived Stigma and Depression among Black Adolescents in Outpatient Treatment

Despite the high prevalence of depression among children and adolescents, most that need mental health treatment do not seek care. This is especially true for ethnic minority adolescents. Prior research has shown that perceived stigma may act as a barrier to the initiation of and adherence to depression treatment, yet few studies have examined the relationship between stigma and depression among Black adolescents. This exploratory study examined the relationship between Black adolescents' depression severity and their current level of perceived stigma in an outpatient sample. Face-to-face interviews were conducted with a clinical sample of adolescents referred for mental health services at a community-based outpatient clinic (n =108), participating in a prospective pilot study on adolescents' patterns of mental health service use. The analyses revealed that greater depression severity was significantly associated with higher perceived stigma (p < .05), particularly among females. The results also suggest that Black adolescents appear to exhibit an appropriate level of self-assessment regarding their need for mental health services. These results are interpreted in relation to previous literature, and limitations and directions for future research are discussed.     

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.     

“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.     

Understanding Gender as a Fundamental Cause of Health: Simultaneous Linear Relationships between Gender,Mental Health,and Physical Health Over Time

Abstract

Responding to calls to move beyond mental or physical health examinations of gender and health, and to systemically understand the relationships between mental health, physical health, and social identity locations, we explored the extent to which gender is a fundamental cause of health by estimating the relationships between gender, mental health, and physical health simultaneously. We analyzed nationally representative longitudinal data from Waves I and III of the American Changing Lives Survey, and estimated general and gender-specific structural equation models to better understand direct and indirect effects of the structural relationships between gender, mental health, and physical health over time. Our findings suggest mental health outcomes drive the likelihood of physical health outcomes in the case of women only, whereas for men, there is no direct nor significant relationship. However, we find persistent effects of anxiety on limited daily activities for men, but not for women. In conclusion, we discuss potential lessons learned from using such analytic methods and the implications of our findings as they relate to gender and health.     

What mental health professionals in Israel know and think about adolescent problem gambling

Mental health professionals are well versed in addressing multiple adolescent risky behaviours and play a primary role in the identification of and referral process and service provision for young people who engage in such behaviours. Given their ‘person-in-environment’ approach, training in multi-sectoral collaboration, and awareness of social policies, social workers are especially equipped to provide needed mental health services to young people. The aim of the current study was to examine Israeli mental health professionals’ awareness of and attitudes towards adolescent high-risk behaviours, including gambling. Child psychologists, social workers and school counsellors (N = 273) completed an online survey addressing concerns related to high-risk behaviours. Findings revealed that social workers perceived gambling as being among one of the least concerning adolescent mental health issues and reported feeling the least confident in their abilities to provide services to young people with gambling problems. The results suggest the importance of youth gambling addictions being incorporated into social work training curricula.     

The Impact of Low Socioeconomic Status and Perceived Discrimination on Parental Perceptions of the Well-Being of Latino Children

This exploratory study examined the impact of low socioeconomic status (SES) and perceived discrimination on Latino parents’ perceptions of their children’s mental health issues. Anti-immigrant policies and negative public discourse lead to perceived discrimination among Latinos, which may impact mental health. Participants (106), surveyed in 2011, were Latino, predominantly female, had a mean of 14 years living in the United States, and less than 9 years of education. The results of multivariate ordinary-least-squares regressions indicated that participants with lower levels of SES had significantly greater (p < .05) perceptions that their children were angry, had separation anxiety from parents, were fearful, and avoided social situations. Higher levels of perceived discrimination were significantly related (p < .05) to participants’ perceptions of fear among their children. Social service providers must assess for possible mental health issues and develop culturally appropriate intervention strategies to effectively address these issues with parents and children.     

Perceived discrimination and depression among Mexican-origin adults in California

We contend that perceived discrimination has an independent effect on depression outcomes among adults of Mexican origin. Using a sample of 3,012 Mexican-origin respondents in Fresno, California in 1995/96 (ages 18-59) we investigate the direct and moderating connections between perceived discrimination, acculturative stress, and mental health (CES-D). We also investigate the social patterning of perceived discrimination. While more highly acculturated immigrant respondents were more likely to experience discrimination than their less acculturated counterparts, more highly acculturated U.S. born respondents were less likely to experience discrimination. Discrimination was directly related to depression, but this effect was moderated through nativity/country of residence, English-language acculturation, sex, and country of education variables. Moderate levels of legal status acculturative stress were especially depressive for native-born U.S. residents.     

The Injurious Relationship Between Racial Microaggressions and Physical Health: Implications for Social Work

ABSTRACT

In recent years, the study of racial microaggressions (or subtle forms of racial discrimination) has increased significantly in the social sciences, particularly highlighting the negative impact of racial microaggressions on individuals’ mental health. Despite this, there is a dearth of literature that has examined the relationship between racial microaggressions and physical and psychological health. Using two self-reported measures—the Racial and Ethnic Microaggressions Scale (REMS) and the RAND 36-Item Short Form Health Survey—with a diverse group of participants (N = 277), results suggest that racial microaggressions are significantly correlated with poorer health conditions. Furthermore, racial microaggressions were found to predict various types of physical health conditions, such as general health problems, pain, lower energy levels, and fatigue. Finally, different types of microaggressions (e.g., microaggressions in school or the workplace, environmental microaggressions) were found to be predictors of specific health issues. Implications for social work are discussed.