title: Racial discrimination, psychological distress, and self-rated health among US-born and foreign-born Black Americans.
abstract: OBJECTIVE
  We investigated associations among racial discrimination, psychological distress, and self-rated health among US-born and immigrant Black Americans.
  
  
  METHODS
  We conducted a cross-sectional analysis of a cohort of employed working-class Black Americans (193 US-born, 275 foreign-born).
  
  
  RESULTS
  Both US-born and foreign-born Black participants had high levels of exposure to poverty (51% and 57%, respectively) and racial discrimination (76% and 60%) and reported high levels of severe psychological distress (14% and 16% had a Kessler 6 [K6] score of 13 or greater); 17% and 7% reported fair or poor health. After controlling for relevant covariates, their risk parameters for racial discrimination (high vs no exposure) were 4.0 (95% confidence interval [CI] = 2.3, 5.6) and 3.3 (95% CI = 2.1, 4.5), respectively, for continuous K6 score; corresponding odds ratios for severe psychological distress were 6.9 (95% CI = 1.4, 35.7) and 6.8 (95% CI = 2.5, 18.3). No associations existed between racial discrimination and self-reported health, suggesting that an underlying propensity to report adversity does not account for our psychological distress findings.
  
  
  CONCLUSIONS
  Our results attest to the salience of racial discrimination, nativity, and socioeconomic position in understanding the experiences and psychological health of Black Americans.
authors.affiliation: Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA 02115, USA. nkrieger@hsph.harvard.edu
authors.forename: Nancy
authors.initials: N
authors.lastname: Krieger
authors.forename: Anna
authors.initials: A
authors.lastname: Kosheleva
authors.forename: Pamela D
authors.initials: PD
authors.lastname: Waterman
authors.forename: Jarvis T
authors.initials: JT
authors.lastname: Chen
authors.forename: Karestan
authors.initials: K
authors.lastname: Koenen
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D054624:Health Status Disparities; D006801:Humans; D007750:Labor Unions / Q000706:statistics & numerical data; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011287:Prejudice; D057566:Self Report; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000208:ethnology* / Q000209:etiology*