Combining explicit and implicit measures of racial discrimination in health research.
OBJECTIVE
To improve measurement of discrimination for health research, we sought to address the concern that explicit self-reports of racial discrimination may not capture unconscious cognition.


METHODS
We used 2 assessment tools in our Web-based study: a new application of the Implicit Association Test, a computer-based reaction-time test that measures the strength of association between an individual's self or group and being a victim or perpetrator of racial discrimination, and a validated explicit self-report measure of racial discrimination.


RESULTS
Among the 442 US-born non-Hispanic Black participants, the explicit and implicit measures, as hypothesized, were weakly correlated and tended to be independently associated with risk of hypertension among persons with less than a college degree. Adjustments for both measures eliminated the significantly greater risk for Blacks than for Whites (odds ratio = 1.4), reducing it to 1.1 (95% confidence interval = 0.7, 1.7).


CONCLUSIONS
Our results suggest that the scientific rigor of research on racism and health will be improved by investigating how both unconscious and conscious mental awareness of having experienced discrimination matter for somatic and mental health.
Krieger
Nancy
N
Dept of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA 02115, USA. nkrieger@hsph.harvard.edu
Carney
Dana
D
Lancaster
Katie
K
Waterman
Pamela D
PD
Kosheleva
Anna
A
Banaji
Mahzarin
M
D000328:Adult; D001741:Black or African American / Q000193:education / Q000208:ethnology*; D000704:Analysis of Variance; D001294:Attitude to Health / Q000208:ethnology*; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000379:methods* / Q000592:standards; D004522:Educational Status; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000208:ethnology*; D020407:Internet; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D011287:Prejudice; D011634:Public Health; D012107:Research Design; D012307:Risk Factors; D012959:Socioeconomic Factors; D013997:Time Factors; D014473:Unconscious, Psychology; D014481:United States / Q000453:epidemiology; D044465:White People / Q000208:ethnology; D014936:Word Association Tests / Q000592:standards