title: Racial and gender discrimination, early life factors, and chronic physical health conditions in midlife.
abstract: OBJECTIVE
  Most studies of perceived discrimination have been cross-sectional and focused primarily on mental rather than physical health conditions. We examined the associations of perceived racial and gender discrimination reported in adulthood with early life factors and self-reported physician diagnosis of chronic physical health conditions.
  
  
  METHODS
  We used data from a racially diverse birth cohort of U.S. women (n = 168; average age, 41 years) with prospectively collected early life data (e.g., parental socioeconomic factors) and adult reported data on perceived discrimination, physical health conditions, and relevant risk factors. We performed modified robust Poisson regression owing to the high prevalence of the outcomes.
  
  
  RESULTS
  Fifty percent of participants reported racial and 39% reported gender discrimination. Early life factors did not have strong associations with perceived discrimination. In adjusted regression models, participants reporting at least three experiences of gender or racial discrimination had a 38% increased risk of having at least one physical health condition (relative risk, 1.38; 95% confidence interval, 1.01-1.87). Using standardized regression coefficients, the magnitude of the association of having physical health condition(s) was larger for perceived discrimination than for being overweight or obese.
  
  
  CONCLUSIONS
  Our results suggest a substantial chronic disease burden associated with perceived discrimination, which may exceed the impact of established risk factors for poor physical health.
authors.affiliation: Department of Epidemiology, Columbia University/Mailman School of Public Health, New York, New York.
authors.forename: Jasmine A
authors.initials: JA
authors.lastname: McDonald
authors.affiliation: Department of Epidemiology, Columbia University/Mailman School of Public Health, New York, New York.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Terry
authors.affiliation: Department of Epidemiology, Columbia University/Mailman School of Public Health, New York, New York. Electronic address: pt140@columbia.edu.
authors.forename: Parisa
authors.initials: P
authors.lastname: Tehranifar
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000208:ethnology* / Q000523:psychology; D004192:Discrimination, Psychological; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D011287:Prejudice; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D057566:Self Report; D012737:Sex Factors; D012938:Social Perception; D012959:Socioeconomic Factors; D055815:Young Adult