title: The association between income, education, and experiences of discrimination in older African American and European American patients.
abstract: OBJECTIVE
  Racial/ethnic discrimination has adverse effects on health outcomes, as does low income and education, but the relationship between discrimination, income, and education is not well characterized. In this study, we describe the associations of discrimination with income and education in elderly African Americans (AA) and European Americans (EA).
  
  
  METHODS
  Cross-sectional observational study involving computer-assisted telephone survey.
  
  
  METHODS
  Southeastern United States.
  
  
  METHODS
  AA and EA Medicare managed care enrollees.
  
  
  METHODS
  Discrimination was measured with the Experience of Discrimination (EOD) scale (range 0-35). We used zero-inflated negative binomial models to determine the association between self-reported income and education and 1) presence of any discrimination and 2) intensity of discrimination.
  
  
  RESULTS
  Among 1,800 participants (45% AA, 56% female, and mean age 73 years), EA reported less discrimination than AA (4% vs. 47%; P < .001). AA men reported more discrimination and more intense discrimination than AA women (EOD scores 4.35 vs. 2.50; P < .001). Both income and education were directly and linearly associated with both presence of discrimination and intensity of discrimination in AA, so that people with higher incomes and education experienced more discrimination. In adjusted models, predicted EOD scores among AA decreased with increasing age categories (3.42, 3.21, 2.99, 2.53; P < .01) and increased with increasing income (2.36, 3.44, 4.17; P < .001) and education categories (2.31, 3.09, 5.12; P < .001).
  
  
  CONCLUSIONS
  This study suggests future research should focus less on differences between racial/ethnic groups and more on factors within minority populations that may contribute to healthcare disparities.
authors: Department of Medicine, University of Alabama at Birmingham, USA. jhalanych@uab.edu
authors: Jewell H
authors: JH
authors: Halanych
authors: Monika M
authors: MM
authors: Safford
authors: James M
authors: JM
authors: Shikany
authors: Yendelela
authors: Y
authors: Cuffee
authors: Sharina D
authors: SD
authors: Person
authors: Isabel C
authors: IC
authors: Scarinci
authors: Catarina I
authors: CI
authors: Kiefe
authors: Jeroan J
authors: JJ
authors: Allison
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011287:Prejudice; D015144:Southeastern United States; D044465:White People