Social status correlates of reporting gender discrimination and racial discrimination among racially diverse women

How do we measure gender discrimination? Proposing a construct of gender discrimination through a systematic scoping review

BACKGROUND

Gender discrimination (GD) has been frequently linked to mental health. The heterogeneity of how GD is defined has led to variation around the analysis of GD. This might affect the study of the association between GD and health outcomes. The main goal of this systematic scoping review is to operationalize the definition of the GD construct.

METHODS

Three search strategies were set in Pubmed, CINAHL and PsycINFO. The first strategy obtained results mainly about women, while the second focused on men. The third strategy focused on the identification of GD questionnaires. The prevalence of GD, factors and consequences associated with GD perception, and forms of discrimination were the principal variables collected. Risk of bias was assessed (PROSPERO:CRD42019120719).

RESULTS

Of the 925 studies obtained, 84 were finally included. 60 GD questionnaires were identified. GD prevalence varied between 3.4 and 67 %. Female gender and a younger age were the factors most frequently related to GD. Poorer mental health was the most frequent consequence. Two components of the GD construct were identified: undervaluation (different recognition, opportunities in access, evaluation standards and expectations) and different treatment (verbal abuse and behaviour).

CONCLUSIONS

Two-component GD definition can add order and precision to the measurement, increase response rates and reported GD.

Race and other sociodemographic categories are differentially linked to multiple dimensions of interpersonal-level discrimination: Implications for intersectional, health research

Objectives

To examine whether intersections of race with other key sociodemographic categories contribute to variations in multiple dimensions of race- and non-race-related, interpersonal-level discrimination and burden in urban-dwelling African Americans and Whites.

Methods

Data from 2,958 participants aged 30–64 in the population-based Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were used to estimate up to four-way interactions of race, age, gender, and poverty status with reports of racial and everyday discrimination, discrimination across multiple social statuses, and related lifetime discrimination burden in multiple regression models.

Results

We observed that: 1) African Americans experienced all forms of discrimination more frequently than Whites, but this finding was qualified by interactions of race with age, gender, and/or poverty status; 2) older African Americans, particularly African American men, and African American men living in poverty reported the greatest lifetime discrimination burden; 3) older African Americans reported greater racial discrimination and greater frequency of multiple social status-based discrimination than younger African Americans; 4) African American men reported greater racial and everyday discrimination and a greater frequency of social status discrimination than African American women; and, 5) White women reported greater frequency of discrimination than White men. All p’s < .05.

Conclusions

Within African Americans, older, male individuals with lower SES experienced greater racial, lifetime, and multiple social status-based discrimination, but this pattern was not observed in Whites. Among Whites, women reported greater frequency of discrimination across multiple social statuses and other factors (i.e., gender, income, appearance, and health status) than men. Efforts to reduce discrimination-related health disparities should concurrently assess dimensions of interpersonal-level discrimination across multiple sociodemographic categories, while simultaneously considering the broader socioecological context shaping these factors.

Is Perceived Discrimination in Pregnancy Prospectively Linked to Postpartum Depression? Exploring the Role of Education

Objectives The role of perceived discrimination in postpartum depression is largely unknown. We investigate whether perceived discrimination reported in pregnancy contributes to postpartum depression, and whether its impact varies by education level. Methods Prospective data are a part of European Longitudinal Study of Pregnancy and Childhood, the Czech Republic. Surveys were collected in mid-pregnancy and at 6 months after delivery. Depression was measured using Edinburgh Postnatal Depression Scale. Generalized linear models were estimated to test the effects of perceived discrimination on postpartum depression. Results Multivariate models revealed that among women with low education, discrimination in pregnancy was prospectively associated with 2.43 times higher odds of postpartum depression (p < .01), after adjusting for antenatal depression, history of earlier depression, and socio-demographic background. In contrast, perceived discrimination was not linked to postpartum depression among women with high education. Conclusions Perceived discrimination is a risk factor for postpartum depression among women with low education. Screening for discrimination and socio-economic disadvantage during pregnancy could benefit women who are at risk for mental health problems.

Perceived Discrimination and Longitudinal Change in Kidney Function Among Urban Adults

OBJECTIVE

Perceived discrimination has been associated with psychosocial distress and adverse health outcomes. We examined associations of perceived discrimination measures with changes in kidney function in a prospective cohort study, the Healthy Aging in Neighborhoods of Diversity across the Life Span.

METHODS

Our study included 1620 participants with preserved baseline kidney function (estimated glomerular filtration rate [eGFR] ≥ 60 mL/min/1.73 m) (662 whites and 958 African Americans, aged 30-64 years). Self-reported perceived racial discrimination and perceived gender discrimination (PGD) and a general measure of experience of discrimination (EOD) ("medium versus low," "high versus low") were examined in relation to baseline, follow-up, and annual rate of change in eGFR using multiple mixed-effects regression (γbase, γrate) and ordinary least square models (γfollow).

RESULTS

Perceived gender discrimination "high versus low PGD" was associated with a lower baseline eGFR in all models (γbase = -3.51 (1.34), p = .009 for total sample). Among white women, high EOD was associated with lower baseline eGFR, an effect that was strengthened in the full model (γbase = -5.86 [2.52], p = .020). Overall, "high versus low" PGD was associated with lower follow-up eGFR (γfollow = -3.03 [1.45], p = .036). Among African American women, both perceived racial discrimination and PGD were linked to lower follow-up kidney function, an effect that was attenuated with covariate adjustment, indicating mediation through health-related, psychosocial, and lifestyle factors. In contrast, EOD was not linked to follow-up eGFR in any of the sex by race groups.

CONCLUSIONS

Perceived racial and gender discrimination are associated with lower kidney function assessed by glomerular filtration rate and the strength of associations differ by sex and race groups. Perceived discrimination deserves further investigation as a psychosocial risk factors for kidney disease.

Social Status, Discrimination, and Minority Individuals' Mental Health: a Secondary Analysis of US National Surveys

OBJECTIVES

Our study measured minority individuals' social status factors and frequency of discrimination experiences, in order to delineate social mechanisms linking race/ethnicity to mental status (specifically, to current mood/anxiety disorder and self-rated mental health).

METHODS

In this nationally representative secondary research, our data analyses drew on the cross-sectional "Collaborative Psychiatric Epidemiology Surveys," dating 2001-2003. The sample for the final model numbered 9368 respondents (2016 Asians, 2676 Latinos, 4676 blacks).

RESULTS

Across races/ethnicities, better mental health was associated with male gender, higher income, marriage, more education, and less-frequent discrimination experiences; discrimination experiences could impair health, especially among blacks. Marriage's strong contribution to Asians' mental health did not hold among blacks; education's contribution to Latinos' mental health did not hold among blacks either. Blacks' mental health was unaffected by immigration status, but Asian and Latino immigrants showed less-robust mental health than native-born counterparts.

CONCLUSIONS

Across the three racial/ethnic groups studied, differences were noted in relationships between self-reported mental health status and the employed social status and discrimination factors.

Place of birth effects on self-reported discrimination: Variations by type of discrimination

Researchers have suggested that perceptions of discrimination may vary depending on place of birth and the length of time spent living in the U.S., variables related to acculturation. However, the existing literature provides a mixed picture, with data suggesting that the effects of acculturation on perceptions of discrimination vary by race and other sociodemographic factors. This study evaluated the role of place of birth (POB: defined as U.S.-born vs. foreign-born), age at immigration, and length of residence in the U.S. on self-reported discrimination in a sample of urban-dwelling Asian and Black adults (n= 1454). Analyses examined POB effects on different types of discrimination including race-related stigmatization, exclusion, threat, and workplace discrimination. Sociodemographic variables (including age, gender, employment status and education level) were tested as potential moderators of the relationship between POB and discrimination. The results revealed a significant main effect for POB on discrimination, with U.S.-born individuals reporting significantly more discrimination than foreign-born individuals, although the effect was reduced when sociodemographic variables were controlled. Across the sample, POB effects were seen only for race-related stigmatization and exclusion, not for threat and workplace discrimination. With the exception of limited effects for gender, sociodemographic variables did not moderate these effects. Younger age at immigration and greater years of residence in the U.S. were also positively associated with higher levels of perceived discrimination. These findings suggest increasing acculturation may shape the experience and perception of racial and ethnic discrimination.

Discrimination and substance use disorders among Latinos: the role of gender, nativity, and ethnicity

OBJECTIVES

We examined the relationship between discrimination and substance use disorders among a diverse sample of Latinos. We also investigated whether the relationship between discrimination and substance use disorders varied by gender, nativity, and ethnicity.

METHODS

Our analyses focused on 6294 Latinos who participated in the National Epidemiologic Survey on Alcohol and Related Conditions from 2004 to 2005. We used multinomial logistic regression to examine the association between discrimination and substance use disorders.

RESULTS

Discrimination was significantly associated with increased odds of alcohol and drug use disorders among Latinos. However, the relationship between discrimination and substance use disorders varied by gender, nativity, and ethnicity. Discrimination was associated with increased odds of alcohol and drug use disorders for certain groups, such as women, US-born Latinos, and Mexicans, but this relationship did not follow the same pattern for other subgroups.

CONCLUSIONS

It is important to determine which subgroups among Latinos may be particularly vulnerable to the negative effects of discrimination to address their needs.

Determinants of perceived sexism and their role on the association of sexism with mental health

The authors of this study sought to compare the socioeconomic factors related to perceived sexism in employed and non-employed Spanish women and to examine whether the relationship of perceived sexism with mental health outcomes is reduced when such factors are taken into account. Data were taken from the 2006 Spanish Health Survey, including women aged 20-64 years (n=10,927). Multivariate logistic regression models were used to analyze the independent relationships between socioeconomic variables and perceived sexism and also between perceived sexism and poor mental health. In this latter case, socioeconomic variables were included by blocks in the logistic models. Perceived sexism was higher among employed women (3.9% vs. 2.8% among non-employed) and mainly among those in a managerial position (11.35%; adjusted OR: 2.71, 95% CI: 1.30-5.67) and having irregular working hours (5.5%; adjusted OR: 1.60, 95% CI: 1.10-2.34). Socioeconomic and family characteristics were associated with perceived sexism among women. Perceived sexism was associated with poor mental health, and this remained the case when different independent variables were taken into account. These results highlight the importance of taking into account gender discrimination in different aspects of our society, such as work and family organization, and in planning mental health interventions.

School-Based Racial and Gender Discrimination among African American Adolescents: Exploring Gender Variation in Frequency and Implications for Adjustment

The present study examined school-based racial and gender discrimination experiences among African American adolescents in Grade 8 (n = 204 girls; n = 209 boys). A primary goal was exploring gender variation in frequency of both types of discrimination and associations of discrimination with academic and psychological functioning among girls and boys. Girls and boys did not vary in reported racial discrimination frequency, but boys reported more gender discrimination experiences. Multiple regression analyses within gender groups indicated that among girls and boys, racial discrimination and gender discrimination predicted higher depressive symptoms and school importance and racial discrimination predicted self-esteem. Racial and gender discrimination were also negatively associated with grade point average among boys but were not significantly associated in girls' analyses. Significant gender discrimination X racial discrimination interactions resulted in the girls' models predicting psychological outcomes and in boys' models predicting academic achievement. Taken together, findings suggest the importance of considering gender- and race-related experiences in understanding academic and psychological adjustment among African American adolescents.

The association between income, education, and experiences of discrimination in older African American and European American patients

OBJECTIVE

Racial/ethnic discrimination has adverse effects on health outcomes, as does low income and education, but the relationship between discrimination, income, and education is not well characterized. In this study, we describe the associations of discrimination with income and education in elderly African Americans (AA) and European Americans (EA).

DESIGN

Cross-sectional observational study involving computer-assisted telephone survey.

SETTING

Southeastern United States.

PARTICIPANTS

AA and EA Medicare managed care enrollees.

MAIN OUTCOME MEASURES

Discrimination was measured with the Experience of Discrimination (EOD) scale (range 0-35). We used zero-inflated negative binomial models to determine the association between self-reported income and education and 1) presence of any discrimination and 2) intensity of discrimination.

RESULTS

Among 1,800 participants (45% AA, 56% female, and mean age 73 years), EA reported less discrimination than AA (4% vs. 47%; P < .001). AA men reported more discrimination and more intense discrimination than AA women (EOD scores 4.35 vs. 2.50; P < .001). Both income and education were directly and linearly associated with both presence of discrimination and intensity of discrimination in AA, so that people with higher incomes and education experienced more discrimination. In adjusted models, predicted EOD scores among AA decreased with increasing age categories (3.42, 3.21, 2.99, 2.53; P < .01) and increased with increasing income (2.36, 3.44, 4.17; P < .001) and education categories (2.31, 3.09, 5.12; P < .001).

CONCLUSIONS

This study suggests future research should focus less on differences between racial/ethnic groups and more on factors within minority populations that may contribute to healthcare disparities.

Effects of gender discrimination and reported stress on drug use among racially/ethnically diverse women in Northern California

PURPOSE

Gender discrimination has been associated with worse health outcomes for U.S. women. Using the stress and coping process framework, we examined whether lifetime gender discrimination was associated with maladaptive coping behaviors, namely, lifetime and recent hard drug use. We also considered whether reported stress from gender discrimination mediated this relationship and whether this process differed across racial/ethnic groups.

METHODS

We used data from a racially/ethnically diverse convenience sample of 754 women attending family planning clinics in Northern California (11% African American, 17% Latina, 10% Asian, and 62% Caucasian). To test our hypotheses, we conducted logistic regression models, controlling for sociodemographic characteristics.

MAIN FINDINGS

Gender discrimination was positively associated with both lifetime and recent hard drug use. We did not find support for the mediation hypothesis, because stress was not associated with either lifetime or recent hard drug use. There was evidence of some race moderation for the Latina sample. Among these respondents, gender discrimination was associated with higher odds of lifetime drug use, whereas stress was associated with lower odds.

CONCLUSION

These results suggest that experiences of gender discrimination may still activate negative coping strategies involving drug use, regardless of the stress they cause. For Latina respondents, more research is needed to better understand the stress and coping process related to gender discrimination.

Racial discrimination and health among Asian Americans: evidence, assessment, and directions for future research

Research shows that racial discrimination is related to illness among diverse racial and ethnic populations. Studies of racial discrimination and health among Asian Americans, however, remain underdeveloped. In this paper, the authors review evidence on racial discrimination and health among Asian Americans, identify gaps in the literature, and provide suggestions for future research. They identified 62 empirical articles assessing the relation between discrimination and health among Asian Americans. The majority of articles focused on mental health problems, followed by physical and behavioral problems. Most studies find that discrimination was associated with poorer health, although the most consistent findings were for mental health problems. This review suggests that future studies should continue to investigate the following: 1) the measurement of discrimination among Asian Americans, whose experiences may be qualitatively different from those of other racial minority groups; 2) the heterogeneity among Asian Americans, including those factors that are particularly salient in this population, such as ethnic ancestry and immigration history; and 3) the health implications of discrimination at multiple ecologic levels, ranging from the individual level to the structural level.