Racial/ethnic disparities in health: the interplay between discrimination and socioeconomic status.
In the past decade, racial/ethnic discrepancy in health status has drawn increased attention from academicians, policy makers and planners, service providers, and community advocates. While the field has witnessed a growth in research projects and intervention programs, the gap in health status among racial/ethnic groups persists, which suggests that future research should incorporate a focus on one neglected area, ie, the health implications of discrimination. Using the National Survey of Functional Health (N=1,659), a nationally representative sample of English-speaking persons 18 years of age and older living in non-institutional arrangements within the United States, we analyzed how self-perceived unfairness (discrimination due to racial identity or to low socioeconomic status [SES]) was linked to self-assessed health status. The study found that racial and class discrimination were rather pervasive in the United States. Experiences of discrimination tended to have a strong negative association with health and accounted for some racial/ethnic differences in health status. The study also revealed a complex relationship between experiences of discrimination and social class, suggesting that future research should focus on specifying the social distribution of discrimination and assessing its subsequent association with health.
Center for Health Quality, Outcomes, and Economic Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts 01730, USA. xsren@bu.edu
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D000328:Adult; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology*; D016009:Chi-Square Distribution; D003863:Depression / Q000208:ethnology; D005260:Female; D006304:Health Status; D006801:Humans; D016018:Least-Squares Analysis; D008297:Male; D008875:Middle Aged; D011287:Prejudice; D012044:Regression Analysis; D012923:Social Class; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology