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Racial and ethnic health disparities: evidence of discrimination's effects across the SEP spectrum.

机译:种族和种族健康差异:歧视在整个SEP频谱中的影响的证据。

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OBJECTIVES: Perceived discrimination is a psychosocial stressor that plays a role in explaining racial/ethnic disparities in self-reported physical and mental health. The purpose of this paper is: (1) to investigate the association between perceived discrimination in receiving healthcare and racial/ethnic disparities in self-rated health status, physical, and emotional functional limitations among a diverse sample of California adults; (2) to assess whether discrimination effects vary by racial/ethnic group and gender; and (3) to evaluate how the effects of discrimination on health are manifest across the socioeconomic position (SEP) spectrum. DESIGN: Data were drawn from the 2001 California Health Interview Survey adult file (n=55,428). The analytic approach employed multivariate linear and logistic regressions. Discrimination is qualitatively identified into two types: (1) discrimination due to race/ethnicity, language, or accent, and (2) other discrimination. RESULTS: Findings show that both types of discrimination negatively influenced self-rated health, and were associated with a two to three-fold odds of limitations in physical and emotional health. Further, these effects varied by racial/ethnic group and gender, and the effects were mixed. Most notably, for emotional health, racial/ethnic discrimination penalized Latinas more than non-Latina Whites, but for physical health, other discrimination was less detrimental to Latinas than it was to non-Latina Whites. At higher levels of SEP, the effects of racial/ethnic discrimination on self-rated health and other discriminations' effects on physical health were attenuated. DISCUSSION: Higher SEP may serve as an important mitigator, particularly when comparing the medium to the low SEP categories. It is also possible that SEP effects cannot be extracted from the relationships of interest in that SEP is an expression of social discrimination. In fact, negative health effects associated with discrimination are evident across the SEP spectrum. This study highlights the complexity of the relationships between discrimination and racial/ethnic identity, gender, and SEP.
机译:目的:感知到的歧视是一种社会心理压力源,在解释自我报告的身心健康中的种族/种族差异方面发挥作用。本文的目的是:(1)研究加州成年人的样本中接受医疗保健的歧视与自我评价的健康状况,身体和情绪功能限制方面的种族/种族差异之间的关系; (2)评估歧视效果是否因种族/族裔群体和性别而异; (3)评价歧视对健康的影响如何在整个社会经济地位(SEP)范围内体现出来。设计:数据来自2001年加州健康访问调查成人档案(n = 55,428)。分析方法采用多元线性和逻辑回归。定性地将歧视分为两种类型:(1)由于种族/民族,语言或口音而引起的歧视,以及(2)其他歧视。结果:研究结果表明,两种类型的歧视都会对自我评价的健康产生负面影响,并且与身体和情绪健康方面的限制可能性相差两到三倍。此外,这些影响因种族/族裔群体和性别而异,并且影响混合。最值得注意的是,对于情绪健康,种族/族裔歧视对拉丁裔的处罚要比非拉丁裔白人高,但对于身体健康,其他歧视对拉丁裔的危害要小于对非拉丁裔白人的不利。在较高的SEP水平下,种族/族裔歧视对自我评价健康的影响以及其他歧视对身体健康的影响被减弱。讨论:较高的SEP可能是一个重要的缓解因素,尤其是在将中型和低SEP类别进行比较时。由于SEP是社会歧视的一种表达,因此也有可能无法从利益关系中提取SEP效果。实际上,与歧视相关的负面健康影响在整个SEP频谱中都很明显。这项研究突显了歧视与种族/族裔认同,性别和SEP之间关系的复杂性。

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