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Examining the Reciprocity Between Perceived Discrimination and Health: A Longitudinal Perspective

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Abstract

This study aims to fill two interrelated knowledge gaps in the extant literature on the association between perceived discrimination and health. First, potential selection bias associated with pre-existing health conditions has rarely been rigorously tested in empirical studies. Second, whether there is a reciprocal relationship between perceived discrimination and health has been underexplored. Using longitudinal data from the Americans’ Changing Lives data, waves 3 to 5 (N = 1058), we test the reciprocity between perceived discrimination and health with a formal mediation analysis technique. We also use the Heckman correction to adjust for the potential selection bias associated with attrition. Our analysis indicates that perceived discrimination is associated with poor self-rated health and depressive symptoms even when previous health conditions are considered. Furthermore, net of other confounders, there is a reciprocal relationship between perceived discrimination and depressive symptoms. However, this reciprocity does not hold for self-rated health. These findings indicate that there is a vicious circle between perceived discrimination and mental health. That is, poor mental health may lead to perceived discrimination, and heightened perceived discrimination may subsequently increase depressive symptoms. Sensitivity tests suggest that this reciprocity may vary by gender and race.

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Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Code Availability

The code that supports the findings of this study is available from the corresponding author upon reasonable request.

Notes

  1. To put this mediation percentage of 6.16% in context, we find that perceived discrimination plays a more important role in mediating the relationship than income. Specifically, as an experiment, we replicate the KHB analysis using income in wave 5 as the mediator, ceteris paribus, and income mediates 5.54% of the association between CESD in wave 3 and wave 5. It suggests that perceived discrimination outweighs income in terms of the mediation process.

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Acknowledgements

A previous version of the manuscript has been presented at the Population Association of America 2021 Annual Meeting. We acknowledge support from the Center for Social and Demographic Analysis at the University at Albany, which receives funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24-HD044943). We also thank the anonymous reviewers for their constructive suggestions.

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  1. Department of Sociology, University at Albany, SUNY, 1400 Washington Avenue, Albany, NY, 12222, USA

    Han Liu

  2. Department of Preventive Medicine and Population Health, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77551, USA

    Tse-Chuan Yang

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Liu, H., Yang, TC. Examining the Reciprocity Between Perceived Discrimination and Health: A Longitudinal Perspective. Popul Res Policy Rev 41, 1757–1777 (2022). https://doi.org/10.1007/s11113-022-09712-8

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