title: Prevalence and correlates of perceived societal racism in older African-American adults with type 2 diabetes mellitus.
abstract: Although experiences of racism in day-to-day life may affect minority patients' interaction with the health system and may influence health outcomes, little is known about these experiences in patients with chronic diseases. The goal of this study was to explore the frequency and correlates of perceived societal racism in 42 African Americans aged 50 and older with type 2 diabetes mellitus. Twenty-seven items of the McNeilly Perceived Racism Scale were used to assess exposure to racist incidents in employment and public domains and emotional and coping responses to perceived racism in general. Mean age was 62, 71% were women, and more than half rated their health as fair/poor (55%). Overall, 95.2% of the participants reported at least some exposure to perceived societal racism. Higher mean lifetime exposure to societal racism, based on summary scores on the perceived racism scale, was reported by men (35.0+/-19.1) than women (19.7+/-14.4) (P<.01) and by those with higher household income (30.7+/-17.3) than those with lower household income (18.6+/-15.1) (P<.05). Greater passive coping (e.g., "avoiding it," "ignoring it") was associated with being female and having lower household income and fair/poor self-rated health. The findings that perception of racism and a range of emotional and coping responses were common in older African-American patients attending two diabetes clinics suggest that physicians and other healthcare providers may need to be more aware of patients' day-to-day experiences of societal racism and the influence these experiences may have on patient trust in the medical system and their adherence to medical advice or engagement in self-management of their chronic conditions.
authors.affiliation: San Francisco Veterans Affairs Medical Center, San Francisco, California 94121, USA. sandra.moody@med.va.gov
authors.forename: Sandra Y
authors.initials: SY
authors.lastname: Moody-Ayers
authors.forename: Anita L
authors.initials: AL
authors.lastname: Stewart
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Covinsky
authors.forename: Sharon K
authors.initials: SK
authors.lastname: Inouye
mesh_terms: D000223:Adaptation, Psychological; D001741:Black or African American / Q000523:psychology; D000368:Aged; D003237:Connecticut / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011287:Prejudice; D015995:Prevalence; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology