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Perceived discrimination and health-related quality-of-life: gender differences among older African Americans

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Abstract

Purpose

Emerging data suggest that African-American women may fare worse than African-American men in health-related quality-of-life (HRQOL). Perceived discrimination is an important contributor to poor health overall among African Americans, but few studies examined the intersecting effects of perceived discrimination and gender in explaining HRQOL disparities. We investigated gender differences in HRQOL and tested whether perceived discrimination accounted for these differences.

Methods

We examined data from the Chicago Health and Aging Project in which 5652 African-American adults aged 65 and older completed structured questionnaires about demographic and socioeconomic characteristics, HRQOL, perceived discrimination, and health-related variables. Logistic regression models were used to identify associations between perceived discrimination and gender differences in poor HRQOL outcomes (defined as 14+ unhealthy days in overall, physical, or mental health over the past 30 days) when controlling for the other variables.

Results

More women reported poor overall HRQOL than men (24 vs. 16% respectively). Higher perceived discrimination was significantly associated with worse overall HRQOL (OR 1.11; 95% CI 1.08, 1.15), with stronger effects for women in overall and mental HRQOL. These gender disparities remained significant until controlling for potentially confounding variables. Perceived discrimination did not account for gender differences in poor physical HRQOL.

Conclusions

Perceived discrimination is associated with poor HRQOL in older African Americans, with this association appearing stronger in women than men for mental HRQOL. These findings warrant further investigation of effects of perceived discrimination in gender disparities in overall health, and such research can inform and guide efforts for reducing these disparities.

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Acknowledgements

The authors thank the Chicago Health and Aging Project research team and the study participants for their contributions to the overall study. This research was supported by awards from the National Institute on Aging (AG11101, AG22018, AG 032247 and AG033172), National Institute on Environmental Health Sciences (ES10902), National Institute of Child Health and Human Development (T32HD049302), University of Wisconsin Health Innovation Program, School of Medicine and Public Health from The Wisconsin Partnership Program, and the Community-Academic Partnerships core of the University of Wisconsin Institute for Clinical and Translational Research through the National Center for Advancing Translational Sciences, Grant UL1TR000427. The authors have no conflicts of interest in the study design, analyses, interpretation of findings, writing, nor submission of this manuscript. The responsibility of this content rests solely on the authors and does not necessarily reflect the official views of the National Institutes of Health.

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Authors and Affiliations

  1. University of Wisconsin Madison, Madison, WI, USA

    Sheryl L. Coley, Earlise C. Ward & Elizabeth A. Jacobs

  2. University of Michigan, Ann Arbor, MI, USA

    Carlos F. Mendes de Leon

  3. Rush University Medical Center, Chicago, IL, USA

    Lisa L. Barnes

  4. Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Kimberly A. Skarupski

  5. School of Medicine and Public Health, University of Wisconsin Madison, WARF Building, 610 Walnut St, 9th Floor, Suite 957, Madison, WI, 53726, USA

    Sheryl L. Coley

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  1. Sheryl L. Coley
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  2. Carlos F. Mendes de Leon
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  3. Earlise C. Ward
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  4. Lisa L. Barnes
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  5. Kimberly A. Skarupski
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Correspondence to Sheryl L. Coley.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of retrospective study, formal consent is not required.

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Coley, S.L., Mendes de Leon, C.F., Ward, E.C. et al. Perceived discrimination and health-related quality-of-life: gender differences among older African Americans. Qual Life Res 26, 3449–3458 (2017). https://doi.org/10.1007/s11136-017-1663-9

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