Conceptualizing and Measuring Ethnic Discrimination in Health Research

  • Hope Landrine
  • Elizabeth A. Klonoff
  • Irma Corral
  • Senaida Fernandez
  • Scott Roesch
Original Article

This paper presents the General Ethnic Discrimination Scale, an 18-item measure of perceived ethnic discrimination that can be used in health research with any ethnic group. The 1569 participants (half college students, half community adults) completed the General Ethnic Discrimination scale and measures of cigarette smoking and of psychiatric symptoms. Results revealed that the General Ethnic Discrimination subscales model the latent construct of perceived ethnic discrimination equally well for Blacks, Latinos, Asians, and Whites. Discrimination was strongly related to psychiatric symptoms and to current cigarette smoking for ethnic minorities and Whites alike, but such relationships were stronger for ethnic minorities. Minorities who experienced frequent discrimination were 2.3 times more likely than their low-discrimination counterparts to be smokers. This 5th grade reading-level scale takes 10 min to complete and has sufficient, initial psychometric integrity for use in clinical and community health studies.

KEY WORDS:

ethnic discrimination scale minorities health smoking. 

REFERENCES

  1. Andersen, B. L., Kiecolt-Glaser, J. K., and Glaser, R. (1994). A biobehavioral model of cancer stress and disease course. Am. Psychol. 49: 389–404.CrossRefPubMedGoogle Scholar
  2. Barret, L. F., and Swim, J. K. (1998). Appraisals of prejudice and discrimination. In Swim, J. K., and Stangor, C. (Eds.), Prejudice, Academic Press, San Diego, CA, pp. 11–35.Google Scholar
  3. Barry, D. T., and Grilo, C. M. (2003). Cultural, self-esteem, and demographic correlates of perception of personal and group discrimination among East Asian immigrants. Am. J. Orthopsychiatry 73: 223–229.CrossRefPubMedGoogle Scholar
  4. Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychol. Bull. 107: 238–246.CrossRefPubMedGoogle Scholar
  5. Bird, S. T., and Bogart, L. M. (2001). Perceived race-based and socioeconomic status-based discrimination in interactions with health care providers. Ethn. Dis. 11: 554–563.PubMedGoogle Scholar
  6. Branscombe, N. R., Schmitt, M. T., and Harvey, R. D. (1999). Perceiving pervasive discrimination among African-Americans. J. Pers. Soc. Psychol. 77: 135–149.CrossRefGoogle Scholar
  7. Broman, C. L., Mavaddat, R., and Hsu, S. (2000). The experience and consequences of perceived racial discrimination. J. Black Psychol. 26: 165–180.CrossRefGoogle Scholar
  8. Brondolo, E., Kelly, K. P., Coakley, V., Gordon, T., Thompson, S., Levy, E., et al. (2005). The perceived ethnic discrimination questionnaire. J. Appl. Soc. Psychol. 35(2): 335–365.CrossRefGoogle Scholar
  9. Brondolo, E., Rieppi, R., Kelly, K. P., and Gerin, W. (2003). Perceived racism and blood pressure. Ann. Behav. Med. 25: 55–65.CrossRefPubMedGoogle Scholar
  10. Cacioppo, J. (1994). Social neuroscience: Autonomic, neuroendocrine, and immune responses to stress. Psychophysiology 31: 113–128.PubMedCrossRefGoogle Scholar
  11. Choi, I., Nisbett, R. E., and Norenzayan, A. (1999). Causal attribution across cultures. Psychol. Bull. 125: 47–63.CrossRefGoogle Scholar
  12. Clark, R., Anderson, N. B., Clark, C. R., and Williams, D. R. (1999). Racism as a stressor for African Americans: A biopsychosocial model. Am. Psychol. 54: 805–816.CrossRefPubMedGoogle Scholar
  13. Cohen, S. (1986). Contrasting the Hassles scale and the Perceived Stress Scale. Am. Psychol. 41: 716–718.CrossRefGoogle Scholar
  14. Cohen, S., Kamarck, T., and Mermelstein, R. (1983). A global measure of perceived stress. J. Health Soc. Behav. 24: 385–396.PubMedCrossRefGoogle Scholar
  15. Collins, J. W., David, R. J., Symons, R., Handler, A., Wall, S. N., and Dwyer, L. (2000). Low-income African-American mothers’ perception of exposure to racial discrimination and infant birth weight. Epidemiology 11: 337–339.CrossRefPubMedGoogle Scholar
  16. Contrada, R. J., Ashmore, R. D., Gary, M. L., Coups, E., Egeth, J. D., Sewell, A., et al. (2001). Measures of ethnicity-related stress. J. Appl. Soc. Psychol. 31: 1775–1820.CrossRefGoogle Scholar
  17. Crocker, J., Major, B., and Steele, C. (1998). Social stigma. In Gilbert, D., Fiske, S. T., and Lindzey, G. (Eds.), Handbook of Social Psychology, McGraw-Hill, Boston, pp. 504–553.Google Scholar
  18. Crocker, J., and Quinn, D. (1998). Racism and self-esteem. In Eberhardt, J. L., and Fiske, S. T. (Eds.), Confronting Racism: The Problem and the Response, Sage, Thousand Oaks, CA, pp. 169–187.Google Scholar
  19. Darity, W. A. (2003). Employment discrimination, segregation, and health. Am. J. Public Health 93: 226–231.PubMedGoogle Scholar
  20. Derogatis, L. R., Lipman, R. S., Covi, L., and Rickels, K. (1971). Neurotic symptom dimensions. Arch. Gen. Psychiatry 24: 454–464.PubMedGoogle Scholar
  21. Derogatis, L. R., Lipman, R. S., Rickles, K., Ulenhuth, E., and Covi, L. (1994). The Hopkins Symptom Checklist: A self-report symptom inventory. Behav. Sci. 19: 1–15.CrossRefGoogle Scholar
  22. Dion, K. L. (2002). The social psychology of perceived prejudice and discrimination. Can. Psychol. 43: 1–10.Google Scholar
  23. Dion, K. L., Dion, K. K., and Pappas, G. (1992). Personality based hardiness as a buffer for discrimination-related stress in members of Toronto's Chinese community. Can. J. Behav. Sci. 24: 517–536.CrossRefGoogle Scholar
  24. Dohrenwend, B. P. (1998). Adversity, Stress, and Psychopathology, Oxford University Press, NY.Google Scholar
  25. Dohrenwend, B. S., and Dohrenwend, B. P. (1974). Stressful Life Events, Wiley, New York.Google Scholar
  26. Dohrenwend, B. S., and Dohrenwend, B. P. (1981). Life Stress and Illness. Prodist, New York.Google Scholar
  27. Dohrenwend, B. S., Krasnoff, L., Askenasy, A., and Dohrenwend, B. P. (1978). Exemplification of a method for scaling life events. J. Health Soc. Behav. 19: 205–229.PubMedCrossRefGoogle Scholar
  28. Essed, P. (1991). Everyday Racism, Hunter House, Claremont, CA.Google Scholar
  29. Finch, B. K., Kolody, B., and Vega, W. A. (2000). Perceived discrimination and depression among Mexican origin adults in California. J. Health Soc. Behav. 41: 295–313.PubMedCrossRefGoogle Scholar
  30. Flesch, R. (1948). A new readability yardstick. J. Appl. Psychol. 32: 221–233.CrossRefPubMedGoogle Scholar
  31. Flesch, R. (1974). The Art of Readable Writing, Harper and Row, New York.Google Scholar
  32. Gallo, L. C., and Matthews, K. A. (2003). Understanding the association between socioeconomic status and physical health: Do negative emotions play a role? Psychol. Bull. 129: 10–51.CrossRefPubMedGoogle Scholar
  33. Garfinkel, L. (1997). Trends in cigarette smoking in the United States. Prev. Med. 26: 447–450.CrossRefPubMedGoogle Scholar
  34. Gee, G. C. (2002). A multilevel analysis of the relationship between institutional and individual racial discrimination and health status. Am. J. Public Health 92: 615–623.PubMedGoogle Scholar
  35. Harrell, J. P., Hall, S., and Taliaferro, J. (2003). Physiological responses to racism and discrimination. Am. J. Public Health 93: 243–248.PubMedGoogle Scholar
  36. Herbert, T. B., and Cohen, S. (1993). Stress and immunity in humans: A meta-analytic review. Psychosom. Med. 55: 364–379.PubMedGoogle Scholar
  37. Hoyle, R. H. (2000). Confirmatory factor analysis. In Tinsley, H. E. A., and Brown, S. D. (Eds.), Handbook of Applied Multivariate Statistics and Mathematical Modeling, Academic Press, San Diego, CA, pp. 465–497.Google Scholar
  38. Hu, L. T., and Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct. Equat. Model. 6: 1–55.CrossRefGoogle Scholar
  39. Jackson, J. S., Brown, T. N., Williams, D. R., Torres, M., Sellers, S. L., and Brown, K. (1996). Racism and the physical and mental health status of African Americans. Ethn. Dis. 6: 32–47.Google Scholar
  40. Kanner, A. D., Coyne, J. C., Schaeffer, C., and Lazarus, R. S. (1981). Comparison of two modes of stress measurement. J. Behav. Med. 4: 1–39.CrossRefPubMedGoogle Scholar
  41. Karlsen, S., and Nazroo, J. Y. (2002). Relation between racial discrimination, social class, and health among ethnic minority groups. Am. J. Public Health 92: 624–631.PubMedGoogle Scholar
  42. Kiecolt-Glaser, J. K., and Glaser, R. (1995). Psychoneuroimmunology and health consequences: Data and shared mechanisms. Psychosom. Med. 57: 269–274.PubMedGoogle Scholar
  43. Klonoff, E. A., and Landrine, H. (1996). Acculturation and cigarette smoking among African-American adults. J. Behav. Med. 19(5): 501–514.CrossRefPubMedGoogle Scholar
  44. Klonoff, E. A., and Landrine, H. (1999a). Cross-validation of the schedule of racist events. J. Black Psychol. 25: 231–254.CrossRefGoogle Scholar
  45. Klonoff, E. A., and Landrine, H. (1999b). Acculturation and cigarette smoking among African Americans: Replication and implications for prevention and cessation programs. J. Behav. Med. 22(2): 195–204.CrossRefPubMedGoogle Scholar
  46. Klonoff, E. A., and Landrine, H. (2000). Is skin color is a marker for racial discrimination? Explaining the skin color-hypertension relationship. J. Behav. Med. 23: 329–338.CrossRefPubMedGoogle Scholar
  47. Klonoff, E. A., and Landrine, H. (2001). Depressive symptoms and smoking among Black adults: Absence of a relationship? J. Health Psychol. 6(6): 645–649.Google Scholar
  48. Klonoff, E. A., Landrine, H., and Campbell, R. R. (2000). Sexist discrimination may account for wellknown gender differences in psychiatric symptoms. Psychol. Women Q. 24(1): 92–98.CrossRefGoogle Scholar
  49. Klonoff, E. A., Landrine, H., and Ullman, J. B. (1999). Racial discrimination and psychiatric symptoms among Blacks. Cult. Divers. Ethn. Minor. Psychol. 5: 329–339.CrossRefGoogle Scholar
  50. Krieger, N. (1990). Racial and gender discrimination: Risk factors for high blood pressure? Soc. Sci. Med. 30: 1273–1281.CrossRefPubMedGoogle Scholar
  51. Krieger, N., and Sidney, S. (1996). Racial discrimination and blood pressure: The CARDIA study. Am. J. Public Health 86: 1370–1378.PubMedGoogle Scholar
  52. Krieger, N., Sidney, S., and Coakley, E. (1998). Racial discrimination and skin color in the CARDIA study. Am. J. Public Health 88: 1308–1313.PubMedCrossRefGoogle Scholar
  53. Landrine, H., and Klonoff, E. A. (1996a). The schedule of racist events. J. Black Psychol. 22: 144–168.CrossRefGoogle Scholar
  54. Landrine, H., and Klonoff, E. A. (1996b). African-American Acculturation: Deconstructing “Race” and Reviving Culture, Sage, Thousand Oaks, CA.Google Scholar
  55. Landrine, H., and Klonoff, E. A. (1997). Discrimination Against Women: Prevalence, Consequences, Remedies, Sage, Thousand Oaks, CA.Google Scholar
  56. Landrine, H., and Klonoff, E. A. (2000). Racial discrimination and smoking among Blacks: Findings from two studies. Ethn. Dis. 10: 195–202.PubMedGoogle Scholar
  57. LaVeist, T. A., and Wallace, J. M. (2000). Health risk and inequitable distribution of liquor stores in African American neighborhoods. Soc. Sci. Med. 51: 613–617.CrossRefPubMedGoogle Scholar
  58. Lazarus, R. S., and Folkman, S. (1984). Stress, Appraisal, and Coping, Springer, New York.Google Scholar
  59. LeClere, F. B., Rogers, R. G., and Peters, K. D. (1997). Ethnicity and mortality in the United States: Individual and community correlates. Soc. Forces 76: 169–198.CrossRefGoogle Scholar
  60. Lee, R. E., and Cubbin, C. (2002). Neighborhood context and youth cardiovascular health behaviors. Am. J. Public Health 92: 428–436.PubMedCrossRefGoogle Scholar
  61. Lee, R. M. (2003). Do ethnic identity and other-group orientation protect against discrimination for Asian Americans? J. Couns. Psychol. 50: 133–141.CrossRefGoogle Scholar
  62. Lepore, S. J. (1995). Measurement of chronic stressors. In Cohen, S. C., Kessler, R. C., and Gordon, L. U. (Eds.), Measuring Stress, Oxford University Press, New York, pp. 102–120.Google Scholar
  63. Loo, C. M., Fairbank, J. A., Scurfield, R. M., Ruch, L. O., King, D. W., Adams, L. J., and Chemtob, C. M. (2001). Measuring exposure to racism: Development and validation of a Race-Related Stressor Scale for Asian American Vietnam veterans. Psychol. Assess. 13: 503–520.CrossRefPubMedGoogle Scholar
  64. Major, B., Gramzow, R. H., McCoy, S. K., Levin, S., Schmader, T., and Sidanius, J. (2002). Perceiving personal discrimination. J. Pers. Soc. Psychol. 82: 269–282.CrossRefPubMedGoogle Scholar
  65. Mattsson, N. B., Williams, H. V., Rickles, K., Lipman, R. S., and Uhlenhuth, E. H. (1969). Dimensions of symptom distress in anxious neurotic outpatients. Psychopharmacol. Bull. 5: 19–32.PubMedGoogle Scholar
  66. McCoy, S. K., and Major, B. (2003). Group identification moderates emotional responses to perceived prejudice. Pers. Soc. Psychol. Bull. 29: 1005–1017.CrossRefPubMedGoogle Scholar
  67. Morris, M. W., Nisbett, R. E., and Peng, K. (1995). Causal understanding across domains and cultures. In Sperber, D., Premack, D., and Premack, A. J. (Eds.), Causal Cognition, Oxford University Press, Oxford, pp. 577–612.Google Scholar
  68. Myer, I. H. (2003). Prejudice as stress: Conceptual and measurement problems. Am. J. Public Health 93: 262–265.PubMedGoogle Scholar
  69. Nazroo, J. Y. (2003). The structuring of ethnic inequalities in health: Economic position, racial discrimination, and racism. Am. J. Public Health 93: 277–284.PubMedGoogle Scholar
  70. Noh, S., Beiser, M., Kaspar, V., Hou, F., and Rummens, J. (1999). Perceived racial discrimination, depression and coping: A study of Southeast Asian refugees in Canada. J. Health Soc. Behav. 40: 208–230.PubMedCrossRefGoogle Scholar
  71. Noh, S., and Kaspar, V. (2003). Perceived discrimination and depression: Moderating effects of coping, acculturation, and ethnic support. Am. J. Public Health 93: 232–238.PubMedGoogle Scholar
  72. Polednak, A. P. (1996). Segregation, discrimination and mortality in U.S. Blacks. Ethn. Dis. 6: 99–108.PubMedGoogle Scholar
  73. Ruggiero, K. M., and Taylor, D. M. (1997). Why minority group members perceive or do not perceive the discrimination that confronts them: The role of self-esteem and perceived control. J. Pers. Soc. Psychol. 72: 373–389.CrossRefPubMedGoogle Scholar
  74. Satorra, A., and Bentler, P. M. (1988). Scaling corrections for chi-square statistics in covariance structure analysis. Proc. Am. Stat. Assoc. 308–313.Google Scholar
  75. Steiger, J. S. (1999). Structural model evaluation and modification: An interval estimation approach. Multivar. Behav. Res. 25: 173–180.CrossRefGoogle Scholar
  76. Szalacha, L. A., Erkut, S., Coll, C. G., Alarcon, O., Fields, J. P., and Ceder, I. (2003). Discrimination and Puerto Rican children's and adolescents’ mental health. Cult. Divers. Ethn. Minor. Psychol. 9: 141–155.CrossRefGoogle Scholar
  77. Tanaka, J. S. (1993). Multifaceted conceptions of fit in structural equation models. In Bollen, K. A., and Long, J. S. (Eds.), Testing Structural Equation Models, Sage Press, Newbury Park, CA, pp. 10–39.Google Scholar
  78. Thompson, V. L. S. (1996). Perceived experiences of racism as stressful life events. Community Ment. Health J. 32: 223–233.CrossRefPubMedGoogle Scholar
  79. Ullman, J. B. (2001). Structural equation modeling. In Tabachnick, B. G., and Fidell, L. S. (Eds.), Using Multivariate Statistics, Harper Collins, New York, pp. 709–811.Google Scholar
  80. U.S. Dept. of Health and Human Services (1998). Tobacco Use Among U.S. Racial/ethnic Minority Groups—African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, and Hispanics: A Report of the Surgeon General, DHHS, Centers for Disease Control & Prevention, Office on Smoking and Health.Google Scholar
  81. Utsey, S. O. (1998). Assessing the stressful effects of racism: A review of instrumentation. J. Black Psychol. 24: 269–288.CrossRefGoogle Scholar
  82. Utsey, S. O., and Ponterotto, J. G. (1996). Development and validation of the Index of Race-Related Stress. J. Couns. Psychol. 43: 490–501.CrossRefGoogle Scholar
  83. Vines, A. I., McNeilly, M. D., Stevens, J., Hertz-Picciotto, I., Bohlig, M., and Baird, D. S. (2001). Development and reliability of a Telephone-Administered Perceived Racism Scale (TPRS). Ethn. Dis. 11: 251–262.PubMedGoogle Scholar
  84. Williams, D. R., Neighbors, H. W., and Jackson, J. S. (2003). Racial/ethnic discrimination and health. Am. J. Public Health 93: 200–208.PubMedGoogle Scholar
  85. Williams, D. R., Spencer, M. S., and Jackson, J. S. (1999). Race, stress, and physical health. In Contrada, R. J., and Ashmore, R. D. (Eds.), Self, Social Identity, and Physical Health: Interdisciplinary Explorations, Oxford University Press, New York, pp. 71–100.Google Scholar
  86. Williams, D. R., Yu, Y., Jackson, J. S., and Anderson, N. B. (1997). Racial differences in physical and mental health. J. Health Psychol. 2: 335–351.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  • Hope Landrine
    • 1
    • 4
  • Elizabeth A. Klonoff
    • 1
  • Irma Corral
    • 1
  • Senaida Fernandez
    • 2
  • Scott Roesch
    • 3
  1. 1.Joint Doctoral Program in Clinical Psychology and Behavioral Health InstituteSan Diego State UniversitySan DiegoU.S.A.
  2. 2.Columbia University Medical CenterNew YarkU.S.A.
  3. 3.Psychology DepartmentSan Diego State UniversitySan DiegoU.S.A.
  4. 4.Joint Doctoral Program in Clinical Psychology and Behavioral Health InstituteSan Diego State University, 6363 Alvarado CourtSan DiegoU.S.A.

Personalised recommendations