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Everyday discrimination and chronic health conditions among Latinos: the moderating role of socioeconomic position

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Abstract

Emerging research has revealed that everyday discrimination and socioeconomic position may have synergistic effects on the health of racial/ethnic minorities. The present study examined the association between self-reported everyday discrimination and count of chronic health conditions, and explored the moderating role of objective and subjective socioeconomic position on the discrimination–health relation. We utilized nationally representative data of Latino adults (N = 2,554) from the National Latino and Asian American Study. Weighted negative binomial regression modeling was used to estimate the association between self-reported everyday discrimination and count of chronic health conditions, and to test whether this relation was modified by markers of socioeconomic position. Binomial regressions revealed that everyday discrimination was associated with a greater count of chronic conditions. However, moderation analyses indicated that household income moderated the discrimination–health relation, controlling for sociodemographic variables. More specifically, the adverse effects of discrimination were stronger for Latinos in middle-income tertiles compared to their lower income counterparts, such that as frequency of discrimination increased, Latinos with medium levels of household income were predicted to have greater counts of chronic conditions. This was only marginally significant among those in the high-income tertile. Our findings suggest that identifying segments of the Latino population that may be at greatest (and lowest) risk of ill health in the context of perceiving being discriminated against may prove useful for understanding Latino health “paradoxes,” and may have implications for tailoring prevention and intervention efforts to particular segments of the Latino population.

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References

  • Acevedo-Garcia, D., & Bates, L. M. (2008). Latino health paradoxes: Empirical evidence, explanations, future research, and implications. In H. Rodriguez, R. Saenz, & C. Menjívar (Eds.), Latinas/os in the United States: Changing the face of América (pp. 101–113). New York: Springer.

    Google Scholar 

  • Adler, N. E., Boyce, T., Chesney, M. A., Cohen, S., Folkman, S., Kahn, R. L., et al. (1994). Socioeconomic status and health: The challenge of the gradient. American Psychologist, 49, 15–24.

    Article  CAS  PubMed  Google Scholar 

  • Adler, N. E., Epel, E. S., Castellazo, G., & Ickovics, J. R. (2000). Relationship of subjective and objective social status with psychological and physiological functioning: Preliminary data in healthy White Women. Health Psychology, 19, 586–592.

    Article  CAS  PubMed  Google Scholar 

  • Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Alegría, M., Pérez, D. J., & Williams, S. (2003). The role of public policies in reducing mental health status disparities for people of color. Health Affairs, 22, 51–64.

    Article  PubMed  Google Scholar 

  • Alegría, M., Takeuchi, D., Canino, G., Duan, H., Shrout, P., Meng, X., et al. (2004). Considering context, place and culture: The National Latino and Asian American Study. International Journal of Methods in Psychiatric Research, 13, 208–220.

    Article  PubMed Central  PubMed  Google Scholar 

  • Boltri, J. M., Okosun, I. S., Davis-Smith, M., & Vogel, R. L. (2005). Hemoglobin A1c levels in diagnosed and undiagnosed Black, Hispanic, and White persons with diabetes: Results from NHANES 1999–2000. Ethnicity and Disease, 15, 562–567.

    PubMed  Google Scholar 

  • Bostean, G. (2010). An examination of the relationship between family and U.S. Latinos’ physical health. Field Actions Science Report. http://factreports.revenues.org/473

  • Braveman, P. A., Cubbin, C., Egerter, S., Chideya, S., Marchi, K. S., Metzler, M., et al. (2005). Socioeconomic status in health research: One size does not fit all. Journal of American Medical Association, 294, 2879–2888.

    Article  CAS  Google Scholar 

  • Braveman, P. A., Cubbin, C., Egerter, S., Williams, D. R., & Pamuk, E. (2010). Socioeconomic disparities in health in the United States: What the patterns tell us. American Journal of Public Health, 100(S1), S186–S196.

    Google Scholar 

  • Brondolo, E., Hausmann, L. R. M., Jhalani, J., Pencille, M., Atencio-Bacayon, J., Kumar, A., et al. (2011). Dimensions of perceived racism and self-reported health: Examination of racial/ethnic differences and potential mediators. Annals of Behavioral Medicine, 42, 14–28.

    Article  PubMed  Google Scholar 

  • Bui, Q., Doescher, M., Takeuchi, D., & Taylor, V. (2011). Immigration, acculturation and chronic back and neck problems among Latino-Americans. Journal of Immigrant and Minority Health, 13, 194–201.

    Article  PubMed Central  PubMed  Google Scholar 

  • Chen, E. (2012). Protective factors for health among low-socioeconomic status individuals. Current Directions in Psychological Science, 21, 189–193.

    Article  Google Scholar 

  • Chen, E., & Miller, G. E. (2012). “Shift-and-persist” strategies: Why low socioeconomic status isn’t always bad for health. Perspectives on Psychological Science, 7, 135–158.

    Article  PubMed Central  PubMed  Google Scholar 

  • Clark, R., Anderson, N. B., Clark, V. R., & Williams, D. R. (1999). Racism as a stressor for African Americans: A biopsychosocial model. American Psychologist, 54, 805–816.

    Article  CAS  PubMed  Google Scholar 

  • Cohen, S., Frank, E., Doyle, W. J., Skoner, D. R., Rabin, B. S., & Gwaltney, J. M. (1998). Types of stressors that increase susceptibility to the common cold in health adults. Health Psychology, 17, 214–223.

    Article  CAS  PubMed  Google Scholar 

  • Cole, E. R., & Omari, S. R. (2003). Race, class and the dilemmas of upward mobility for African Americans. Journal of Social Issues, 59, 785–802.

    Article  Google Scholar 

  • Crocker, J., Major, B., & Steele, C. (1998). Social stigma. In D. Gilbert, S. T. Fiske, & G. Lindzey (Eds.), The handbook of social psychology (4th ed., Vol. 2, pp. 504–553). New York: McGraw Hill.

    Google Scholar 

  • Crowne, D. P., & Marlowe, D. (1960). A new scale of social desirability independent of psychopathology. Journal of Consulting Psychology, 24, 349–354.

    Article  CAS  PubMed  Google Scholar 

  • Dougall, A. L., & Baum, A. (2012). Stress, health, and illness. In A. Baumm, T. Revenson, & J. Singer (Eds.), Handbook of health psychology (2nd ed., pp. 53–78). New York, NY: Taylor & Francis Group.

    Google Scholar 

  • Dressler, W. W. (1996). Hypertension in the African American community: Social, cultural, and psychological factors. Seminars in Nephrology, 16(2), 71–82.

  • Essed, P. (1991). Understanding everyday racism: An interdisciplinary theory. Newbury Park, CA: Sage.

    Google Scholar 

  • Farmer, M. M., & Ferraro, K. F. (2005). Are racial disparities in health conditional on socioeconomic status? Social Science and Medicine, 60, 191–204.

    Article  PubMed  Google Scholar 

  • Finch, B. K., Hummer, R. A., Kolody, B., & Vega, W. A. (2001). The role of discrimination and acculturative stress in the physical health of Mexican-origin adults. Hispanic Journal of Behavioral Sciences, 23, 399–429.

    Article  Google Scholar 

  • Finch, B. K., & Vega, W. A. (2003). Acculturation stress, social support, and self-rated health among Latinos in California. Journal of Immigrant Health, 5(3), 109–117.

    Google Scholar 

  • Fiske, S. T. (2010). Interpersonal stratification: Status, power, and subordination. In S. T. Fiske, D. T. Gilbert, & G. Lindzey (Eds.), Handbook of social psychology (5th ed., pp. 941–982). New York, NY: Wiley.

    Chapter  Google Scholar 

  • Flores, E., Tschann, J. M., Diman, J. M., Bachen, E. A., Pasch, L. A., & de Groat, C. L. (2008). Perceived discrimination, perceived stress, and mental and physical health among Mexican-origin adults. Hispanic Journal of Behavioral Sciences, 20, 401–424.

    Article  Google Scholar 

  • Forman, T. A., Goar, C., & Lewis, A. (2002). Neither black nor white? An empirical test of the Latin Americanization thesis. Race and Society, 5, 65–84.

    Article  Google Scholar 

  • Franzini, L., & Fernandez-Esquer, M. (2006). The association of subjective social status and health in low-income Mexican-origin individuals in Texas. Social Science and Medicine, 63, 788–804.

    Article  PubMed  Google Scholar 

  • Gee, G. C., Spencer, M. S., Chen, J., & Takeuchi, D. (2007). A nationwide study of discrimination and chronic health conditions among Asian Americans. American Journal of Public Health, 97, 1275–1282.

    Article  PubMed Central  PubMed  Google Scholar 

  • Harrell, J. P. (2000). A multidimensional conceptualization of racism-related stress: Implications for the well-being of people of color. American Journal of Orthopsychiatry, 70, 42–57.

    Article  CAS  PubMed  Google Scholar 

  • Harrell, C. J. P., Hall, S., & Taliaferro, J. (2003). Physiological responses to racism and discrimination: An assessment of the evidence. American Journal of Public Health, 93, 243–248.

    Article  PubMed Central  PubMed  Google Scholar 

  • Heckhausen, J., & Schulz, R. (1995). A life-span theory of control. Psychological Review, 102, 284–304.

    Article  CAS  PubMed  Google Scholar 

  • Heeringa, S. G., Wagner, J., Torres, M., Duan, N., Adams, T., & Berglund, P. (2004). Sample designs and sampling methods for the Collaborative Psychiatric Epidemiology Studies (CPES). International Journal of Methods in Psychiatric Research, 13, 221–240.

    Article  PubMed  Google Scholar 

  • Hudson, D. L., Bullard, K. M., Neighbors, H. W., Geronimus, A. T., Yang, J., & Jackson, J. S. (2012). Are benefits conferred with greater socioeconomic position undermined by racial discrimination among African American men? Journal of Men’s Health, 9, 127–136.

    Article  PubMed Central  PubMed  Google Scholar 

  • Karlsen, S., & Nazroo, J. Y. (2002). Relation between racial discrimination, social class, and health among ethnic minority groups. American Journal of Public Health, 92, 624–631.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kimbro, R. T., Bzotek, S., Goldman, N., & Rodriguez, G. (2008). Race, ethnicity, and the education gradient in health. Health Affairs, 27, 361–372.

    Article  PubMed  Google Scholar 

  • Krieger, N., Smith, K., Naidshadham, D., Hartman, C., & Barbeau, E. M. (2005). Experiences of discrimination: Validity and reliability of a self-report measure of population health research on racism and health. Social Science and Medicine, 61, 1576–1596.

    Article  PubMed  Google Scholar 

  • Krieger, N., Williams, D. R., & Moss, N. E. (1997). Measuring social class in U.S. public health research: Concepts, methodologies, and guidelines. Annual Review of Public Health, 18, 341–378.

    Article  CAS  PubMed  Google Scholar 

  • Lee, D. L., & Ahn, S. (2012). Discrimination against Latinos: A meta-analysis of individual-level resources and outcomes. Counseling Psychologist, 40, 28–65.

    Article  Google Scholar 

  • Lee, M., & Ferraro, K. F. (2009). Perceived discrimination and health among Puerto Rican and Mexican Americans: Buffering effect of the Lazo matrimonial? Social Science and Medicine, 68, 1966–1974.

    Article  PubMed  Google Scholar 

  • Marotta, S. A., & Garcia, J. G. (2003). Latinos in the United States in 2000. Hispanic Journal of Behavioral Sciences, 25, 13–34.

    Article  Google Scholar 

  • Martin, L. M., Leff, M., Calonge, N., Garrett, C., & Nelson, D. E. (2000). Validation of self-reported chronic conditions and health services in a managed care population. American Journal of Preventive Medicine, 18, 215–218.

    Article  CAS  PubMed  Google Scholar 

  • McEwen, B. S. (1998). Stress, adaptation, and disease: Allostasis and allostatic load. Annals of the New York Academy of Sciences, 840, 33–44.

    Article  CAS  PubMed  Google Scholar 

  • Miller, G., Chen, E., & Cole, S. W. (2009). Health psychology: Developing biologically plausible models linking the social world and physical health. Annual Review of Psychology, 60, 501–524.

    Article  PubMed  Google Scholar 

  • Molina, K. M. (2011). A multiple-group path analysis of social marginality on self-rated physical health among U.S. Latina/o adults: An intersectional perspective. Unpublished dissertation, University of Michigan, Ann Arbor, MI.

  • Molina, K. M., & Alcántara, C. (2013). Household structure, family ties, and psychological distress among U.S.-born and immigrant Latino women. Journal of Family Psychology, 27, 147–158.

    Article  PubMed Central  PubMed  Google Scholar 

  • Molina, K. M., Alegria, M., & Mahalingam, R. (2013). A multiple-group path analysis of the role of everyday discrimination on self-rated physical health among Latina/os in the U.S. Annals of Behavioral Medicine, 45, 33–44.

    Article  PubMed Central  PubMed  Google Scholar 

  • Motel, S. (2012). Statistical portrait of Hispanics in the United States, 2010. Pew Hispanic Center. Accessed at http://www.pewhispanic.org/2012/02/21/statistical-portrait-of-hispanics-in-the-united-states-2010/

  • Ostrove, J. M., Adler, N. E., Kuppermann, M., & Eugene, W. A. (2000). Objective and subjective assessments of socioeconomic status and their relationship to self-rated health in an ethnically diverse sample of pregnant women. Health Psychology, 19, 613–618.

    Article  CAS  PubMed  Google Scholar 

  • Otiniano, A. D., & Gee, G. C. (2012). Self-reported discrimination and health-related quality of life among Whites, Blacks, Mexicans and Central Americans. Journal of Immigrant and Minority Health, 14, 189–197.

    Article  PubMed  Google Scholar 

  • Paradies, Y. A. (2006). A systematic review of empirical research on self-reported racism and health. International Journal of Epidemiology, 35, 888–901.

    Article  PubMed  Google Scholar 

  • Park-Taylor, J., Ng, V., Ventura, A. B., Kang, A. E., Morris, C. R., Gilbert, T., et al. (2008). What it means to be and feel like a true American: Perceptions and experiences of second-generation Americans. Cultural Diversity and Ethnic Minority Psychology, 14, 128–137.

    Article  PubMed  Google Scholar 

  • Pasco, E. A., & Smart Richman, L. (2009). Perceived discrimination and health: A meta-analytic review. Psychological Bulletin, 135, 531–554.

    Article  Google Scholar 

  • Passel, J. S., D’Vera, C., & Lopez, H. (2011). Hispanics account for more than half of nation‘s growth in past decade. Pew Hispanic Center http://pewhispanic.org/files/reports/140.pdf

  • Pavalko, E. K., Mossakowski, K. N., & Hamilton, V. J. (2003). Does perceived discrimination affect health? Longitudinal relationships between work discrimination and women’s physical and emotional health. Journal of Health and Social Behavior, 43, 18–33.

    Google Scholar 

  • Pérez, D. J., Fortuna, L., & Alegría, M. (2008). Prevalence and correlates of everyday discrimination among U.S. Latinos. Journal of Community Psychology, 36, 421–433.

    Article  PubMed Central  PubMed  Google Scholar 

  • Reeve, B., Willis, G., Shariff-Marco, S., Bree, N., Williams, D., Gee, G., et al. (2011). Comparing cognitive interviewing and psychometric methods to evaluate a racial/ethnic discrimination scale. Field Methods, 23, 397–419.

    Article  Google Scholar 

  • Ruggiero, K. M., & Taylor, D. M. (1995). Coping with discrimination: How disadvantaged group members perceive the discrimination that confronts them. Journal of Personality and Social Psychology, 68, 826–838.

    Article  Google Scholar 

  • Ryan, A. M., Gee, G. C., & Laflamme, D. F. (2006). The association between self-reported discrimination, physical health and blood pressure: Findings from African Americans, Black immigrants, and Latino immigrants in New Hampshire. Journal of Health Care for the Poor and Underserved, 17, 116–132.

    Article  PubMed  Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Boston, MA: Allyn and Bacon.

    Google Scholar 

  • Tomaskovic-Devey, D., Thomas, M., & Johnson, K. (2005). Race and the accumulation of human capital across the career: A theoretical model and fixed effects application. American Journal of Sociology, 111, 58–89.

    Article  Google Scholar 

  • Williams, D. R. (1999). Race, socioeconomic status, and health: The added effects of racism and discrimination. The Annals of the New York Academy of Sciences, 896, 173–188.

    Article  CAS  Google Scholar 

  • Williams, D. R., & Collins, C. (1995). Socioeconomic and racial differences in health: Patterns and explanations. Annual Review of Sociology, 21, 349–386.

    Article  Google Scholar 

  • Williams, D. R., & Mohammed, S. A. (2009). Discrimination and racial disparities in health: Evidence and needed research. Journal of Behavioral Medicine, 32, 20–47.

    Article  PubMed Central  PubMed  Google Scholar 

  • Williams, D. R., Yu, Y., Jackson, J., & Anderson, N. (1997). Racial differences in physical and mental health: Socioeconomic status, stress, and discrimination. Journal of Health Psychology, 2, 335–351.

    Article  CAS  PubMed  Google Scholar 

  • Zhang, W., & Hong, S. (2012). Perceived discrimination and psychological distress among Asian Americans: Does education matter? Journal of Immigrant and Minority Health. doi:10.1007/s10903-012-9676-5

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Acknowledgments

Kristine M. Molina was partially supported by Grant #T32HL007426 from the National Heart, Lung and Blood Institute and by the NIH Loan Repayment Award (National Institute on Minority Health and Health Disparities Grant # L60MD007288). Yenisleidy Simon was supported by a Praxis Summer Internship grant provided through Smith College’s Lazarus Center for Career Development. We are grateful to Jeanne Miranda, Ph.D. for her helpful comments on a previous draft.

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The authors have no conflict of interest to disclose.

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  1. Community and Prevention Research Division, Department of Psychology, University of Illinois at Chicago, 1007 W. Harrison Street, Behavioral Sciences Building, Room 1050A, Chicago, IL, 60607, USA

    Kristine M. Molina

  2. Psychology Department, Smith College, Northampton, MA, USA

    Yenisleidy Simon

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  1. Kristine M. Molina
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Correspondence to Kristine M. Molina.

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Molina, K.M., Simon, Y. Everyday discrimination and chronic health conditions among Latinos: the moderating role of socioeconomic position. J Behav Med 37, 868–880 (2014). https://doi.org/10.1007/s10865-013-9547-0

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