1
|
Bernardo FR, Bastos JL, Reichenheim ME. Factorial invariance of the abridged version of the Explicit Discrimination Scale among adults living in southern Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2024; 27:e240038. [PMID: 39016389 PMCID: PMC11251642 DOI: 10.1590/1980-549720240038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/08/2024] [Accepted: 04/10/2024] [Indexed: 07/18/2024] Open
Abstract
OBJECTIVE The Explicit Discrimination Scale (EDS) was developed to assess experiences with discrimination in Brazilian epidemiologic surveys. Though previous analyses have demonstrated that the EDS has good configural, metric, and scalar properties, its invariance has not yet been investigated. In this study, we examined the factorial invariance of two abridged versions of the EDS, according to skin color/ethnicity, sex, socioeconomic status, and their intersections. METHODS Data from the EpiFloripa Adult Study were used, which include a representative sample of adults residing in a state capital of southern Brazil (n=1,187). Over half of the respondents were women, and around 90% identified as white; the mean age of the participants was 39 years. Two abridged versions of the EDS were analyzed, with seven and eight items, using Multigroup Confirmatory Analysis and the Alignment method. RESULTS The two versions of the scale may be used to provide estimates of discrimination that are comparable across skin color/ethnicity, sex, socioeconomic status, and their intersections. In the seven-item version of the scale, only one parameter lacked invariance (i.e., threshold of item i13 - called by names you do not like), specifically among black respondents with less than 12 years of formal education. CONCLUSION The EDS may provide researchers with valid, reliable, and comparable estimates of discrimination between different segments of the population, including those at the intersections of skin color/ethnicity, sex, and socioeconomic status. However, future research is needed to determine whether the patterns we identified here are consistent in other population domains.
Collapse
Affiliation(s)
- Fabiula Renilda Bernardo
- Universidade Federal de Santa Catarina, Graduate Program in Public Health – Florianópolis (SC), Brazil
| | - João Luiz Bastos
- Universidade Federal de Santa Catarina, Graduate Program in Public Health – Florianópolis (SC), Brazil
- Simon Fraser University, Faculty of Health Sciences – Burnaby, British Columbia, Canada
| | - Michael Eduardo Reichenheim
- Universidade do Estado do Rio de Janeiro, Hésio Cordeiro Institute of Social Medicine – Rio de Janeiro (RJ), Brazil
| |
Collapse
|
2
|
Freitas L, Torres TS, Hoagland B, Silva MS, Veloso VG, Grinsztejn B, Bastos JL, Luz PM. Discriminatory experiences among gay, bisexual, and other men who have sex with men, and transgender and non-binary individuals: a cross sectional analysis. LANCET REGIONAL HEALTH. AMERICAS 2024; 33:100737. [PMID: 38623451 PMCID: PMC11017276 DOI: 10.1016/j.lana.2024.100737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/17/2024]
Abstract
Background Several systems of oppression combine in complex ways to impact the lives of minority populations. Following an intersectionality framework, we assessed the frequency and perceived reasons for discrimination among gay, bisexual, and other cisgender men who have sex with men (MSM) and transgender and non-binary individuals (TGNB), stratified by race. Methods Online survey among MSM and TGNB ≥18 years living in Brazil, between November/2021 and January/2022. We used the 18-item Explicit Discrimination Scale to assess day-to-day experiences of differential treatment, and perceived discrimination. For each item, participants indicated their perceived reasons for differential treatment using 14 pre-defined options. Negative binomial regression models assessed if race was a significant predictor of discrimination. Subsequent models, stratified by race, examined associations of perceived reasons and number of reasons with perceived discrimination. Findings Of 8464 MSM and TGNB, 4961 (58.6%) were White, 2173 (25.7%) Pardo (Brazil's official term for admixed populations), and 1024 (12.1%) Black. Black participants' scores for perceived discrimination (mean, standard deviation) were higher (10.2, 8.8) [Pardo (6.5, 6.8), White (5.2, 5.7)], and race was both the main reason for and the strongest predictor of perceived discrimination. The number of reasons participants used to interpret their discriminatory experiences was also a predictor of discrimination score among White, Pardo, and Black participants. Interpretation LGBTQIA+phobia was highly prevalent among all participants. Additionally, our results indicated that Black MSM and TGNB participants were more frequently discriminated against than other racial groups, with racial discrimination uniquely contributing these experiences. Funding Fundação Oswaldo Cruz, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro.
Collapse
Affiliation(s)
- Lucilene Freitas
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (Fiocruz), Av. Brasil 4365, Rio de Janeiro, RJ 21040-360, Brazil
| | - Thiago S. Torres
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (Fiocruz), Av. Brasil 4365, Rio de Janeiro, RJ 21040-360, Brazil
| | - Brenda Hoagland
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (Fiocruz), Av. Brasil 4365, Rio de Janeiro, RJ 21040-360, Brazil
| | - Mayara S.T. Silva
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (Fiocruz), Av. Brasil 4365, Rio de Janeiro, RJ 21040-360, Brazil
| | - Valdilea G. Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (Fiocruz), Av. Brasil 4365, Rio de Janeiro, RJ 21040-360, Brazil
| | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (Fiocruz), Av. Brasil 4365, Rio de Janeiro, RJ 21040-360, Brazil
| | - João L. Bastos
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A1S6 Canada
| | - Paula M. Luz
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (Fiocruz), Av. Brasil 4365, Rio de Janeiro, RJ 21040-360, Brazil
| |
Collapse
|
3
|
Sartori LRM, Henzel LT, Chisini LA, de Oliveira LJC, Sabóia VDPA, Correa MB. Discrimination and dental students: What is the reality in Brazilian institutions? EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024; 28:130-141. [PMID: 37315153 DOI: 10.1111/eje.12929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/05/2022] [Accepted: 05/26/2023] [Indexed: 06/16/2023]
Abstract
INTRODUCTION This study aimed to evaluate whether there is discrimination in the dental educational environment, assess the main reasons for the discriminatory events, and if there is an association between discriminatory episodes and sociodemographic characteristics of undergraduate dental students. MATERIALS AND METHODS This observational cross-sectional study was conducted with a self-administered questionnaire to students enrolled in three Brazilian dental schools. Questions included sociodemographic characteristics and the occurrence of discriminatory episodes in the dental academic environment. Descriptive analysis was performed in RStudio 1.3 (R Core Team, RStudio, Inc., Boston, USA) software and the associations were tested using Pearson's chi-square test, considering 95% confidence intervals. RESULTS A total of 732 dental students were included, with a response rate of 70.2%. The vast majority of students were female (66.9%), with white/yellow skin colour (67.9%), and with a mean age of 22.6 (SD 4.1) years. Sixth-eight percent of students reported having experienced some discrimination in the academic environment and most reported feeling uncomfortable with the episode. The main reasons to have been discriminated against raised by students were specific behaviour/habit, have specific moral, ethical, and aesthetic values, gender, and socioeconomic status or social class. The occurrence of discriminatory episodes was associated with female gender (p = .05), non-heterosexual sexual orientation (p < .001), studying in public institutions (p < .001), receiving an institutional scholarship (p = .018), and being in the final undergraduate cycle (p < .001). CONCLUSION The occurrence of discriminatory episodes was common in Brazilian dental higher education. Discriminatory situations generate traumas and psychological marks, causing a loss of diversity within the academic environment that leads to loss of productivity, creativity, and innovation. Thus, strong institutional policies against discrimination are crucial to create a healthy dental academic environment.
Collapse
|
4
|
Sartori LRM, Karam SA, Chisini LA, Corrêa de Oliveira LJ, Aragão Sabóia VDP, Corrêa MB. Discriminatory episodes negatively impact the quality of life of Brazilian dental students: A cross-sectional study. J Dent Educ 2023; 87:1523-1532. [PMID: 37414515 DOI: 10.1002/jdd.13309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/17/2023] [Accepted: 06/27/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE This study aimed to evaluate whether discriminatory episodes occurring in the university environment were associated with dental students' self-perceived overall quality of life and assess the cumulative effect of perceived discriminatory experiences on the overall quality of life. METHODS In this cross-sectional study, all students enrolled in three Brazilian dental schools were invited to participate in a survey between August and October 2019. The outcome was students' self-perceived quality of life, measured through the overall quality of life item of the World Health Organization-Quality of Life Abbreviated Version (WHOQOL-BREF). Descriptive, bivariate, and multivariable logistic regression analyses (95% confidence intervals and α of 5%) were conducted using RStudio software. RESULTS The sample was composed of 732 students (70.2% response rate). The great part was female (66.9%), white or yellow skin color (67.9%), and were children of highly educated mothers. About 68% of the students reported having experienced at least one of the seven discriminatory experiences presented in the questionnaire and 18.1% reported neutral or negative quality of life. In multivariable analyses, it was estimated that students who experienced at least one episode of discrimination were 2.54 times (95% CI: 1.47-4.34) more likely to report worse quality of life than their counterparts who reported no experience of discrimination. There was also a 25% (95% CI: 1.10-1.42) increase in the odds of reporting poorer quality of life for each additional discriminatory experience reported. CONCLUSION Reporting at least one discriminatory situation in the academic environment was associated with worse quality of life among dental students, and a cumulative effect was also noted.
Collapse
Affiliation(s)
- Letícia Regina Morello Sartori
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul State, Pelotas, Rio Grande do Sul, Brazil
| | - Sarah Arangurem Karam
- Dental School, Federal University of Pelotas, Pelotas, Rio Grande do Sul State, Pelotas, Rio Grande do Sul, Brazil
| | - Luiz Alexandre Chisini
- Dental School, Federal University of Pelotas, Pelotas, Rio Grande do Sul State, Pelotas, Rio Grande do Sul, Brazil
| | | | | | - Marcos Britto Corrêa
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| |
Collapse
|
5
|
de Paula W, Pereira JM, Guimarães NS, Godman B, Nascimento RCRMD, Meireles AL. Key characteristics including sex, sexual orientation and internet use associated with worse mental health among university students in Brazil and implications. J Public Health (Oxf) 2022; 44:e487-e498. [PMID: 35037058 DOI: 10.1093/pubmed/fdab406] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/04/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The symptoms of anxiety and depression disorders are multifactorial and can trigger a series of problems especially among university students. The aim of this study was to assess the prevalence and associated factors with anxiety and depression symptoms among first-semester university students at a Federal University in Brazil given the paucity of such data and the first semester is the most stressfultime. METHODS Cross-sectional study with first-semester university students. The questionnaire included socio-demographic variables, lifestyles, health conditions and the Depression Anxiety Stress Scales. Descriptive analysis was performed, followed by bivariate analysis and Poisson regression analysis. RESULTS Three hundred and fifty-six students (65.2%) across a range of courses in their first semester participated. The prevalence of anxiety was 42.5% and depression 33.2%. Regarding symptoms of anxiety and depression disorders, a positive association was observed among females, non-heterosexual, non-white skin color, excessive internet use, lack of physical activity, not attending university parties, having psychological counseling, history of anxiety in first- or second-degree relatives, poor self-rated health and use of psychotropic medicines. CONCLUSIONS Due to the high prevalence of anxiety and depression symptoms, the importance of developing programs to promote mental and physical health of university students is highlighted.
Collapse
Affiliation(s)
- Waléria de Paula
- Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais 35400-000, Brazil
| | - João Marcos Pereira
- School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais 35400-000, Brazil
| | - Nathalia Sernizon Guimarães
- Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais 35400-000, Brazil
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G1 1XQ, UK.,Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0204, South Africa
| | - Renata Cristina Rezende Macedo do Nascimento
- Department of Pharmacy, Postgraduate Program in Pharmaceutical Sciences (CiPharma), School of Pharmacy, Federal University of Ouro Preto, Ouro Preto, Minas Gerais 35400-000, Brazil
| | - Adriana Lúcia Meireles
- Department of Clinical and Social Nutrition, Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais 35400-000, Brazil
| |
Collapse
|
6
|
da Silva Júnior AE, de Lima Macena M, de Oliveira ADS, Praxedes DRS, de Oliveira Maranhão Pureza IR, Bueno NB. Racial Differences in Generalized Anxiety Disorder During the COVID-19 Pandemic among Brazilian University Students: a National Survey. J Racial Ethn Health Disparities 2022; 9:1680-1688. [PMID: 34291439 PMCID: PMC8294286 DOI: 10.1007/s40615-021-01107-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 10/26/2022]
Abstract
There is evidence that during the COVID-19 pandemic, there was an increase in anxiety and depression rates among college students. However, little is known about how generalized anxiety disorder (GAD) developed among individuals of different race/skin color. This study aimed to determine whether there are racial differences in GAD in Brazilian university students during the COVID-19 pandemic. This is a nationwide cross-sectional study, carried out through the application of online questionnaires to university students from 94 Brazilian universities. Self-reported data on age, sex, economic class, race/skin color, anthropometric data, and adherence to social distancing measures were collected. To determine the GAD, the Generalized Anxiety Disorder 7-item scale was applied. A total of 5879 participants were included, with a mean age of 24.1 ± 6.4 years, and the majority were female (n = 4324, 73.5%), most self-declared to be whites (n = 2945, 50.1%), followed by browns (n = 2185, 37.2%) and blacks (n = 749, 12.7%). The prevalence of GAD among black Brazilian university students (47.3% [95% CI 43.7, 50.8]) was significantly higher than that of browns (38.6% [95% CI 36.6, 40.7]) and whites (44.1% [95% CI 42.3, 45.9]), even after multivariable adjustment by other sociodemographic factors. The findings of the present study suggest a possible racial difference in GAD among Brazilian university students, in which those who declared their race/skin color as black showed a greater risk for GAD than those who declared themselves as white or brown.
Collapse
Affiliation(s)
- André Eduardo da Silva Júnior
- Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Mateus de Lima Macena
- Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, 57072-970, Brazil
| | | | | | | | - Nassib Bezerra Bueno
- Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
- Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, 57072-970, Brazil.
| |
Collapse
|
7
|
Dixon AR, Adams LB, Ma T. Perceived healthcare discrimination and well-being among older adults in the United States and Brazil. SSM Popul Health 2022; 18:101113. [PMID: 35664925 PMCID: PMC9160820 DOI: 10.1016/j.ssmph.2022.101113] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/02/2022] [Accepted: 04/29/2022] [Indexed: 11/26/2022] Open
Abstract
Despite well-documented evidence illustrating the relationship between discrimination and health, less is known about the influence of unfair treatment when receiving medical care. Moreover, our current knowledge of cross-national and racial variations in healthcare discrimination is limited in aging populations. This article addresses these gaps using two harmonized data sets of aging populations to clarify the relationship between healthcare discrimination and health in the United States and Brazil. We use nationally representative, harmonized data from the Health and Retirement Study in the United States and the Brazilian Longitudinal Study of Aging to examine and compare perceived discrimination in the healthcare setting and its relationship to self-rated health, depression diagnosis, and depressive symptoms across national contexts. Using Poisson regression models and population attributable risk percent estimates, we found that aging adults reporting healthcare discrimination were at higher risk of poor self-rated health, diagnosed depression, and depressive symptoms. Our results also suggest that reducing perceived healthcare discrimination may contribute to improved self-rated health and mental well-being in later life across racialized societies. In two comparative settings, we highlight the differential impact of healthcare discrimination on self-rated health and depression. We describe the implications of our study's findings for national public health strategies focused on eliminating discrimination in the healthcare setting, particularly among aging countries.
Collapse
Affiliation(s)
| | - Leslie B. Adams
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Maryland, United States
| | - Tszshan Ma
- Gangarosa Department of Environmental Health, Emory University, Georgia
| |
Collapse
|
8
|
Oliveira FD, Bastos JL, Moretti-Pires RO. [Intersectionality, discrimination, and quality of life in the adult population in Florianópolis, Southern Brazil]. CAD SAUDE PUBLICA 2021; 37:e00042320. [PMID: 34877988 DOI: 10.1590/0102-311x00042320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 04/29/2021] [Indexed: 11/22/2022] Open
Abstract
The study investigated how the interaction between axes of marginalization based on race/color, gender, schooling, and interpersonal discrimination affect different dimensions of quality of life in adult individuals. This is a cross-sectional study with data from the second wave of the EpiFloripa Adult Study in Florianópolis, southern Brazil, in 2012. We estimated linear regression models for each domain and for overall quality of life, measured with WHOQOL-Bref. The KHB method was used to estimate the mediating role of perceived discrimination in the associations between the axes of marginalization and quality of life. The analysis showed that schooling and gender operate additivelly, but not intersectionally, on overall quality of life and on the physical domain, with a disadvantage for women and individuals with 11 years of schooling or less. Schooling and race/color were predictors of the environmental domain, with lower mean values for blacks and individuals with 11 years of schooling or less. In the psychological domain, the intersection between gender and schooling resulted in a mean value 2.9 points higher for women with 12 or more years of schooling. Gender and race/color were predictors of quality of life in the social domain, reducing the mean value for black women by 11.3 points. Mediation analyses showed that 29.6% of the effect of the intersection between schooling and gender on the psychological domain and 4.3% of the effect of the intersection between race/color and gender on the social domain were mediated by interpersonal discrimination. These results confirmed the study hypotheses, pointing to the importance and contribution of an intersectional analysis for studying inequities in quality of life.
Collapse
|
9
|
Demographics, Socioeconomic Status, Social Distancing, Psychosocial Factors and Psychological Well-Being among Undergraduate Students during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147215. [PMID: 34299665 PMCID: PMC8306047 DOI: 10.3390/ijerph18147215] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/26/2021] [Accepted: 07/03/2021] [Indexed: 01/04/2023]
Abstract
The COVID-19 pandemic impacted on academic routine because of the social distancing measures. This study examined the relationships of sociodemographic characteristics, social distancing aspects and psychosocial factors on psychosocial well-being among undergraduate students during the social distancing period due to COVID-19. A web-based survey was conducted of undergraduate students at a public university in Brazil (n = 620). Demographics, socioeconomic status (SES), social distancing factors, negative affectivity (DASS-21), sense of coherence (SOC-13), social support and psychosocial well-being (GHQ-12) were measured. The direct and indirect links between was variables was tested using structural equation modelling. The estimated model showed that greater social support, higher sense of coherence and lower negative affectivity were directly associated with better psychological well-being. Female gender, higher SES, not working during the social distancing period and availability of online modules were indirectly associated with psychological well-being through psychosocial factors. Working during the social distancing period and availability of online modules mediated the link of age, gender, SES with psychological well-being. Our findings suggest the need to provide psychological support, online teaching and financial aid to undergraduate students during the social distancing period due to COVID-19 pandemic to improve their psychological well-being.
Collapse
|
10
|
de la Fuente-Núñez V, Cohn-Schwartz E, Roy S, Ayalon L. Scoping Review on Ageism against Younger Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3988. [PMID: 33920114 PMCID: PMC8069403 DOI: 10.3390/ijerph18083988] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 11/17/2022]
Abstract
Systematic efforts have been carried out to study ageism against older populations. Less is known about ageism against younger populations, including how it is defined, how it manifests, its effects, and how it can be addressed. A scoping review was conducted aimed at identifying available evidence on these topics. A comprehensive search strategy was used across thirteen databases, including PubMed, EMBASE, and CINAHL. Records were screened by two independent reviewers. Data extraction was done by one rater and independently reviewed by a second rater. Of the 9270 records identified, 263 were eligible for inclusion. Most of the evidence focused on the manifestation of ageism (86%), followed by a focus on the determinants of ageism (17%), available interventions to address ageism (9%), and the effects of ageism (5%). This study points to the inconsistent terminology used to describe ageism against younger populations and the relatively limited theoretical rationale that guides existing studies. It also highlights key research gaps and points to the strengths of existing research.
Collapse
Affiliation(s)
- Vânia de la Fuente-Núñez
- Demographic Change and Healthy Ageing Unit, Department of Social Determinants of Health, World Health Organization, 1202 Geneva, Switzerland
| | - Ella Cohn-Schwartz
- Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel;
| | - Senjooti Roy
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel; (S.R.); (L.A.)
| | - Liat Ayalon
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel; (S.R.); (L.A.)
| |
Collapse
|
11
|
Ethnic Identity as a Mediator of the Relationship between Discrimination and Psychological Well-Being in South-South Migrant Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052359. [PMID: 33670960 PMCID: PMC7957580 DOI: 10.3390/ijerph18052359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/11/2021] [Accepted: 02/23/2021] [Indexed: 01/30/2023]
Abstract
There is abundant evidence about the negative impact of discrimination on well-being, but less research on factors that can reduce this negative effect, mainly focused on North American samples and with incipient development on South-South migration. The objective of this research was to analyze the effect of ethnic identity on the relationship between the experience of racial and ethnic discrimination and psychological well-being in Colombian immigrants living in Chile. A total of 962 immigrants over the age of 18 from three cities in Chile participated. Of these, 50.7% were women. The average age was 35 years (SD = 10.23). Participants were evaluated using Ryff's Psychological Well-Being Scales, Phinney's adapted version of the Multigroup Ethnic Identity Scale, and Krieger's Discrimination Experience Scale. After the analysis of the measurement models, a mediation model was analyzed using structural equations. The results provide evidence that ethnic and racial discrimination have negative effects on psychological well-being, with the effect of racial discrimination being greater. Likewise, ethnic identity has positive effects on psychological well-being and partially and completely mediates the effects of ethnic and racial discrimination on psychological well-being. The full effect of discrimination on psychological well-being, mediated by ethnic identity, is exercised only by racial discrimination and not by ethnic discrimination.
Collapse
|
12
|
Urzúa A, Henríquez D, Caqueo-Urízar A. Affects as Mediators of the Negative Effects of Discrimination on Psychological Well-Being in the Migrant Population. Front Psychol 2020; 11:602537. [PMID: 33362664 PMCID: PMC7759608 DOI: 10.3389/fpsyg.2020.602537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/13/2020] [Indexed: 12/15/2022] Open
Abstract
There is abundant empirical evidence on the negative effects of discrimination on psychological well-being. However, little research has focused on exploring the factors that can mitigate this effect. Within this framework, the present study examined the mediating role of positive and negative affects in the relationship between ethnic and racial discrimination and psychological well-being in the migrant population. About 919 Colombians, first-generation migrants, residing in Chile (Arica, Antofagasta, and Santiago) were evaluated, of which 50.5% were women, and the participants' average age was 35 years (range: 18-65 years). Krieger's discrimination questionnaires, Watson's Positive and Negative Affect Schedule (PANAS), and Ryff's Psychological Well-Being Scale were applied. The measurement models of each variable were estimated, and then the structural equation models were used. The results of the hypothesized multiple mediation model showed that the main mediator in the relationship between ethnic-racial discrimination and psychological well-being was positive affects over negative ones.
Collapse
Affiliation(s)
- Alfonso Urzúa
- Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
| | - Diego Henríquez
- Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
| | | |
Collapse
|
13
|
Fernandes CSE, Lima MG, Barros MBDA. Emotional problems and the use of psychotropic drugs: investigating racial inequality. CIENCIA & SAUDE COLETIVA 2020; 25:1677-1688. [PMID: 32402020 DOI: 10.1590/1413-81232020255.33362019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 08/07/2019] [Indexed: 01/08/2023] Open
Abstract
The aim of the present study was to investigate the existence of racial inequalities in the prevalence of emotional problems, the search for healthcare services and the use of psychotropic drugs. A population-based, cross-sectional study was conducted with data from the 2014/15 Campinas Health Survey. Sample of 1953 individuals aged 20 years or older was analyzed. We estimated the prevalence of common mental disorders (CMDs), the reporting of emotional problems, insomnia, the search for and the use of healthcare services and the use of psychotropic drugs according to self-reported skin color (white and black/brown). Prevalence ratios were estimated using "Poisson" multiple regression. The prevalence of CMDs was higher among blacks/brown compared to whites but no difference was found regarding the reporting of emotional problems and insomnia. Whites sought healthcare services more due to emotional problems. The use of psychotropic drugs was also higher among whites. The results revealed racial inequalities in the presence of CMDs, the search for healthcare services and the use of psychotropics drugs, highlighting the need for actions to identify and overcome barriers that hinder access to mental health care by different racial segments of the population.
Collapse
Affiliation(s)
| | - Margareth Guimarães Lima
- Departamento de Saúde Coletiva, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil,
| | | |
Collapse
|
14
|
Ruderman A, Pérez LO, Adhikari K, Navarro P, Ramallo V, Gallo C, Poletti G, Bedoya G, Bortolini MC, Acuña-Alonzo V, Canizales-Quinteros S, Rothhammer F, Ruiz-Linares A, González-José R. Obesity, genomic ancestry, and socioeconomic variables in Latin American mestizos. Am J Hum Biol 2019; 31:e23278. [PMID: 31237064 DOI: 10.1002/ajhb.23278] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 03/29/2019] [Accepted: 05/21/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES This article aims to assess the contribution of genomic ancestry and socioeconomic status to obesity in a sample of admixed Latin Americans. METHODS The study comprised 6776 adult volunteers from Brazil, Chile, Colombia, Mexico, and Peru. Each volunteer completed a questionnaire about socioeconomic variables. Anthropometric variables such as weight, height, waist, and hip circumference were measured to calculate body indices: body mass index, waist-to-hip ratio and waist-to-height ratio (WHtR). Genetic data were extracted from blood samples, and ancestry was estimated using chip genotypes. Multiple linear regression was used to evaluate the relationship between the indices and ancestry, educational level, and economic well-being. The body indices were dichotomized to obesity indices by using appropriate thresholds. Odds ratios were calculated for each obesity index. RESULTS The sample showed high percentages of obesity by all measurements. However, indices did not overlap consistently when classifying obesity. WHtR resulted in the highest prevalence of obesity. Overall, women with low education level and men with high economic wellness were more likely to be obese. American ancestry was statistically associated with obesity indices, although to a lesser extent than socioeconomic variables. CONCLUSIONS The proportion of obesity was heavily dependent on the index and the population. Genomic ancestry has a significant influence on the anthropometric measurements, especially on central adiposity. As a whole, we detected a large interpopulation variation that suggests that better approaches to overweight and obesity phenotypes are needed in order to obtain more precise reference values.
Collapse
Affiliation(s)
- Anahí Ruderman
- Instituto Patagónico de Ciencias Sociales y Humanas-CONICET, Puerto Madryn, Chubut, Argentina
| | - Luis O Pérez
- Instituto Patagónico de Ciencias Sociales y Humanas-CONICET, Puerto Madryn, Chubut, Argentina
| | - Kaustubh Adhikari
- School of Mathematics and Statistics, Faculty of Science, Technology, Engineering and Mathematics, The Open University, Milton Keynes, UK.,Department of Genetics, Evolution and Environment, and UCL Genetics Institute, University College London, London, UK
| | - Pablo Navarro
- Instituto Patagónico de Ciencias Sociales y Humanas-CONICET, Puerto Madryn, Chubut, Argentina
| | - Virginia Ramallo
- Instituto Patagónico de Ciencias Sociales y Humanas-CONICET, Puerto Madryn, Chubut, Argentina
| | - Carla Gallo
- Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Giovanni Poletti
- Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Gabriel Bedoya
- Grupo de Genética Molecular (GENMOL), Universidad de Antioquia, Medellín, Colombia
| | - Maria C Bortolini
- Departamento de Genética, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Samuel Canizales-Quinteros
- Unidad de Genomica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM-Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Francisco Rothhammer
- Instituto de Alta Investigación Universidad de Tarapacá, Programa de Genética Humana, ICBM Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Andres Ruiz-Linares
- Department of Genetics, Evolution and Environment, and UCL Genetics Institute, University College London, London, UK.,Ministry of Education Key Laboratory of Contemporary Anthropology and Collaborative Innovation Center of Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China.,Laboratory of Biocultural Anthropology, Law, Ethics, and Health (Centre National de la Recherche Scientifique and Etablissement Français du Sang, UMR-7268), Aix-Marseille University, Marseille, France
| | - Rolando González-José
- Instituto Patagónico de Ciencias Sociales y Humanas-CONICET, Puerto Madryn, Chubut, Argentina
| |
Collapse
|
15
|
Graner KM, Cerqueira ATDAR. [Integrative review: psychological distress among university students and correlated factors]. CIENCIA & SAUDE COLETIVA 2019; 24:1327-1346. [PMID: 31066836 DOI: 10.1590/1413-81232018244.09692017] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 07/28/2017] [Indexed: 11/22/2022] Open
Abstract
This review sought to identify risk factors and protection from psychic distress among university students. Empirical studies were analyzed in the Web of Science, Medline and Scopus databases. A total of 1,375 articles were located, and after the exclusion criteria were applied, 37 articles made up the final sample, most of which were cross-sectional studies published in the last five years, in developed countries and with students in the health area. The most frequently used instruments for psychic distress screening were the General Health Questionnaire and the Self Reporting Questionnaire, which identified a prevalence of between 18.5% and 49.1% and, as risk factors, conditions related to academic life (24) and to health (22). Twelve studies identified as protective factors: given coping strategies, sense of coherence, self-efficacy, vigor, self-esteem, resilience, among other psychological conditions. This review singles out directions for possible interventions that could contribute to the well-being of students and to stimulate more positive experiences in the educational environment.
Collapse
Affiliation(s)
- Karen Mendes Graner
- Departamento de Neurologia e Psiquiatria, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Júlio de Mesquita Filho. Av. Prof. Mário Rubens Guimarães Montenegro s/n, Distrito de Rubião Júnior. 18618-970 Botucatu SP Brasil.
| | - Ana Teresa de Abreu Ramos Cerqueira
- Departamento de Neurologia e Psiquiatria, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Júlio de Mesquita Filho. Av. Prof. Mário Rubens Guimarães Montenegro s/n, Distrito de Rubião Júnior. 18618-970 Botucatu SP Brasil.
| |
Collapse
|
16
|
Allen AM, Thomas MD, Michaels EK, Reeves AN, Okoye U, Price MM, Hasson RE, Syme SL, Chae DH. Racial discrimination, educational attainment, and biological dysregulation among midlife African American women. Psychoneuroendocrinology 2019; 99:225-235. [PMID: 30286445 PMCID: PMC6289261 DOI: 10.1016/j.psyneuen.2018.09.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 08/31/2018] [Accepted: 09/03/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To examine the association between self-reported racial discrimination and allostatic load, and whether the association differs by socioeconomic position. METHODS We recruited a purposive cross-section of midlife (ages 30-50) African American women residing in four San Francisco Bay area counties (n = 208). Racial discrimination was measured using the Experience of Discrimination scale. Allostatic load was measured as a composite of 15 biomarkers assessing cardiometabolic, neuroendocrine, and inflammatory activity. We calculated four composite measures of allostatic load and three system-specific measures of biological dysregulation. Multivariable regression was used to examine associations, while adjusting for relevant confounders. RESULTS In the high education group, reporting low (b = -1.09, P = .02, 95% CI = -1.99, -0.18) and very high (b = -1.88, P = .003, 95% CI = -3.11, -0.65) discrimination was associated with lower allostatic load (reference=moderate). Among those with lower education, reporting low (b = 2.05, P = .008, 95% CI = 0.55,3.56) discrimination was associated with higher allostatic load. Similar but less consistent associations were found for poverty status. Associations were similar for cardiometabolic functioning, but not for neuroendocrine or inflammatory activity. CONCLUSIONS Racial discrimination may be an important predictor of cumulative physiologic dysregulation. Factors associated with educational attainment may mitigate this association for African American women and other groups experiencing chronic social stress.
Collapse
Affiliation(s)
- Amani M Allen
- Divisions of Community Health Sciences and Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA.
| | - Marilyn D Thomas
- Division of Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA.
| | - Eli K Michaels
- Division of Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA.
| | - Alexis N Reeves
- Division of Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA.
| | - Uche Okoye
- Division of Community Health Sciences, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA.
| | - Melisa M Price
- Division of Community Health Sciences, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA.
| | - Rebecca E Hasson
- Schools of Kinesiology and Public Health, University of Michigan, 2110 Observatory Lodge/1402 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
| | - S Leonard Syme
- Divisions of Community Health Sciences and Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA.
| | - David H Chae
- Department of Human Development and Family Studies, College of Human Sciences, Auburn University, 210 Spidle Hall, Auburn, GA, 36849, USA.
| |
Collapse
|
17
|
Urzúa A, Cabrera C, Carvajal CC, Caqueo-Urízar A. The mediating role of self-esteem on the relationship between perceived discrimination and mental health in South American immigrants in Chile. Psychiatry Res 2019; 271:187-194. [PMID: 30500708 DOI: 10.1016/j.psychres.2018.11.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 11/13/2018] [Accepted: 11/14/2018] [Indexed: 11/28/2022]
Abstract
Psychological aspects in South-South migration have been little studied. The following study aimed to describe the effect of individual self-esteem as a mediator in the relationship between perceived discrimination and mental health (understood as the presence of anxious and depressive symptomatology) in South American migrants in Chile. We surveyed 853 people, of Peruvian and Colombian nationality, residing in three cities (Arica, Antofagasta and Santiago). Three ad-hoc scales were applied to evaluate the study variables, analyzing the measurement models for each of them using the Confirmatory Factor Analysis method. Subsequently, the hypothesized mediation model is evaluated through Structural Equations (SEM). The results show that discrimination has a positive and direct relationship with both anxiety and depression, and that the effect of interaction between the variables of discrimination, self-esteem and symptoms associated with depression and anxiety, had a simple partial mediating effect. Discrimination would have a positive and minor effect on anxious and depressive symptoms, as it is mediated by self-esteem.
Collapse
Affiliation(s)
- Alfonso Urzúa
- Universidad Católica del Norte, Escuela de Psicología, Avda. Angamos 0610, Antofagasta, Chile.
| | - Carlos Cabrera
- Universidad Católica del Norte, Escuela de Psicología, Avda. Angamos 0610, Antofagasta, Chile.
| | | | | |
Collapse
|
18
|
Ferrari W, Nascimento M. Práticas sexuais entre homens em tempos de mídias digitais: perspectivas e desafios ao campo da saúde. CAD SAUDE PUBLICA 2019. [DOI: 10.1590/0102-311x00020119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
19
|
Prevalence and correlates of common mental disorders among dental students in Brazil. PLoS One 2018; 13:e0204558. [PMID: 30261025 PMCID: PMC6160106 DOI: 10.1371/journal.pone.0204558] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 09/11/2018] [Indexed: 11/19/2022] Open
Abstract
This study aimed to estimate prevalence of common mental disorders (CMD) and associated factors among dental students. In this cross-sectional study, 230 students answered a questionnaire and instruments to assess CMD (Self Reporting Questionnaire-20), hazardous alcohol consumption (Alcohol Use Disorder Identification Test), social support (Social Support Scale), perceptions of academic life (Dundee Ready Education Environment Measure), coping (Ways of Coping Inventory) and resilience (Resilience Scale). Bivariate analysis was conducted using the Chi-Square and Mann-Whitney tests. Logistic regression included all explanatory variableswith p<0.20 in the bivariate analysis, besides sex and academic year. The explanatory variables were analyzed in five successive blocks (backward-stepwise), until all variables presented statistical significance in the final model (p<0.05). The prevalence of CMD was 45.2% (95%CI: 38.7–51.6), with no significant differences between sexes. Students with no extracurricular activities, who had negatively self- assessed their health status and their academic performance, were about four times more likely to present CMD, followed by receiving psychological or psychiatric treatment during university (AOR: 2.65; 95%CI: 1.1–6.1) and those with high scores for confrontive coping (AOR: 1.20; 95%CI: 1.0–1.4). Resilience was a protective factor for CMD among dental students (AOR: 0.93; 95%CI: 0.9–1.0). Aspects related to academic performance, health status and confrontive coping strategies were risk factors to students’ mental health. Individuals with high levels of resilience showed lower prevalence of CMD. Further prospective studies could contribute to understanding the role of resilience among this population.
Collapse
|
20
|
Smolen JR, Araújo EMD. Race/skin color and mental health disorders in Brazil: a systematic review of the literature. CIENCIA & SAUDE COLETIVA 2018; 22:4021-4030. [PMID: 29267719 DOI: 10.1590/1413-812320172212.19782016] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 09/08/2016] [Indexed: 11/21/2022] Open
Abstract
Mental health disorders contribute a significant burden to society. This systematic literature review aims to summarize the current state of the literature on race/skin color and mental health disorders in Brazil. METHODS PubMed and Lilacs were searched using descriptors for mental health disorders (depression, anxiety, Common Mental Disorders, psychiatric morbidity, etc.) and race to find studies conducted in Brazil. Studies of non-population groups, that did not analyze race/skin color, or for which the mental disorder was not the object of study were excluded. After evaluation of quality, 14 articles were selected for inclusion. There was an overall higher prevalence of mental health disorders in non-Whites. Of the six multivariate analyses that found statistically significant results, five indicated a greater prevalence or odds of mental health disorder in non-Whites compared to Whites (measure of association between 1.18-1.85). This review identified the trend in the literature regarding the association between race and mental health disorders. However, important difficulties complicate the comparability of the studies, principally in function of the differences in the mental health disorders studied, the method of categorizing race/skin color, and the screening tools used in the studies analyzed.
Collapse
Affiliation(s)
- Jenny Rose Smolen
- Núcleo de Pesquisa em Desigualdades em Saúde, Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual de Feira de Santana. Av. Transnordestina s/n, Novo Horizonte. 44036-900 Feira de Santana BA Brasil.
| | - Edna Maria de Araújo
- Núcleo de Pesquisa em Desigualdades em Saúde, Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual de Feira de Santana. Av. Transnordestina s/n, Novo Horizonte. 44036-900 Feira de Santana BA Brasil.
| |
Collapse
|
21
|
Harnois CE, Bastos JL. Discrimination, Harassment, and Gendered Health Inequalities: Do Perceptions of Workplace Mistreatment Contribute to the Gender Gap in Self-reported Health? JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2018; 59:283-299. [PMID: 29608325 DOI: 10.1177/0022146518767407] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study examines the extent to which discrimination and harassment contribute to gendered health disparities. Analyzing data from the 2006, 2010, and 2014 General Social Surveys ( N = 3,724), we ask the following: (1) To what extent are perceptions of workplace gender discrimination and sexual harassment associated with self-reported mental and physical health? (2) How do multiple forms of workplace mistreatment (e.g., racism, ageism, and sexism) combine to structure workers' self-assessed health? and (3) To what extent do perceptions of mistreatment contribute to the gender gap in self-assessed health? Multivariate analyses show that among women, but not men, perceptions of workplace gender discrimination are negatively associated with poor mental health, and perceptions of sexual harassment are associated with poor physical health. Among men and women, perceptions of multiple forms of mistreatment are associated with worse mental health. Gender discrimination partially explains the gender gap in self-reported mental health.
Collapse
Affiliation(s)
| | - João L Bastos
- 2 Federal University of Santa Catarina, Campus Universitário Trindade, Florianópolis, SC, Brazil
| |
Collapse
|
22
|
Bécares L, Zhang N. Perceived Interpersonal Discrimination and Older Women's Mental Health: Accumulation Across Domains, Attributions, and Time. Am J Epidemiol 2018; 187:924-932. [PMID: 29036550 PMCID: PMC5928463 DOI: 10.1093/aje/kwx326] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 09/26/2017] [Indexed: 12/18/2022] Open
Abstract
Experiencing discrimination is associated with poor mental health, but how cumulative experiences of perceived interpersonal discrimination across attributes, domains, and time are associated with mental disorders is still unknown. Using data from the Study of Women’s Health Across the Nation (1996–2008), we applied latent class analysis and generalized linear models to estimate the association between cumulative exposure to perceived interpersonal discrimination and older women’s mental health. We found 4 classes of perceived interpersonal discrimination, ranging from cumulative exposure to discrimination over attributes, domains, and time to none or minimal reports of discrimination. Women who experienced cumulative perceived interpersonal discrimination over time and across attributes and domains had the highest risk of depression (Center for Epidemiologic Studies Depression Scale score ≥16) compared with women in all other classes. This was true for all women regardless of race/ethnicity, although the type and severity of perceived discrimination differed across racial/ethnic groups. Cumulative exposure to perceived interpersonal discrimination across attributes, domains, and time has an incremental negative long-term association with mental health. Studies that examine exposure to perceived discrimination due to a single attribute in 1 domain or at 1 point in time underestimate the magnitude and complexity of discrimination and its association with health.
Collapse
Affiliation(s)
- Laia Bécares
- Cathie Marsh Institute for Social Research, University of Manchester, Manchester, United Kingdom
- Department of Social Statistics, School of Social Sciences, University of Manchester, Manchester, United Kingdom
| | - Nan Zhang
- Cathie Marsh Institute for Social Research, University of Manchester, Manchester, United Kingdom
| |
Collapse
|
23
|
Cormack D, Stanley J, Harris R. Multiple forms of discrimination and relationships with health and wellbeing: findings from national cross-sectional surveys in Aotearoa/New Zealand. Int J Equity Health 2018; 17:26. [PMID: 29454356 PMCID: PMC5816516 DOI: 10.1186/s12939-018-0735-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 01/29/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The complex ways in which experiences of discrimination are patterned in society, including the exposure of communities to multiple overlapping forms of discrimination within social systems of oppression, is increasingly recognised in the health sciences. However, research examining the impacts on health and contribution to racial/ethnic health inequities remains limited. This study aims to contribute to the field by exploring the prevalence and patterning of experience of multiple forms of discrimination in Aotearoa/New Zealand, and associations with health and wellbeing. METHODS The study's conceptual approach is informed by Kaupapa Māori theory, Ecosocial theory, Critical Race Theory and intersectionality. Data are from the 2008, 2010 and 2012 General Social Surveys (GSS), biennial nationally-representative surveys in Aotearoa/New Zealand. We examined patterning of forms of discrimination in the last 12 months and frequency of experiencing multiple forms of discrimination. We also looked at associations between experience of multiple discrimination and self-rated health, mental health (using SF12), and life satisfaction using logistic regression. We used random effects meta-analysis to produce pooled estimates drawing from all three survey instances. RESULTS Māori, and people from Pacific and Asian ethnic groups, reported much higher prevalence of racial discrimination, were more likely to have any experience of discrimination, and were also more likely to experience multiple forms of discrimination, in the last year relative to respondents in the European/Other category. Discrimination was associated with poorer self-rated health, poorer mental health, and greater life dissatisfaction in unadjusted and adjusted estimates. Negative health impacts increased as the number of forms of discrimination experienced increased. CONCLUSIONS Discrimination impacts negatively on the health of indigenous peoples and those from minoritised ethnic groups in Aotearoa/New Zealand through higher exposure to racial discrimination, other forms of discrimination, and a greater likelihood of experiencing multiple forms of discrimination. This supports the need for research and interventions that more fully account for the multiple and interlocking ways in which discrimination impacts on health in racialised social hierarchies to maintain systems of privilege and oppression.
Collapse
Affiliation(s)
- Donna Cormack
- Te Rōpū Rangahau Hauora a Eru Pomare, Department of Public Health, University of Otago Wellington, PO Box 7343, Wellington, 6242 New Zealand
| | - James Stanley
- Biostatistics Group, Dean’s Department, University of Otago Wellington, Wellington, New Zealand
| | - Ricci Harris
- Te Rōpū Rangahau Hauora a Eru Pomare, Department of Public Health, University of Otago Wellington, PO Box 7343, Wellington, 6242 New Zealand
| |
Collapse
|
24
|
Baumgarten A, Bastos JL, Toassi RFC, Hilgert JB, Hugo FN, Celeste RK. Discrimination, gender and self-reported aesthetic problems among Brazilian Adults. Community Dent Oral Epidemiol 2017; 46:24-29. [DOI: 10.1111/cdoe.12324] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 06/22/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Alexandre Baumgarten
- Postgraduate Program in Epidemiology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - João Luiz Bastos
- Postgraduate Program in Community Health; Federal University of Santa Catarina; Florianópolis Brazil
| | | | - Juliana Balbinot Hilgert
- Postgraduate Program in Epidemiology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Postgraduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Fernando Neves Hugo
- Postgraduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Research Centre in Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Roger Keller Celeste
- Postgraduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| |
Collapse
|
25
|
Burgard S, de Pina Castiglione D, Lin KY, Nobre AA, Aquino EML, Pereira AC, Martins Bensenor IJ, Barreto SM, Chor D. Differential reporting of discriminatory experiences in Brazil and the United States. CAD SAUDE PUBLICA 2017; 33Suppl 1:e00110516. [PMID: 28492709 PMCID: PMC10497239 DOI: 10.1590/0102-311x00110516] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 11/07/2016] [Indexed: 11/22/2022] Open
Abstract
There has been little cross-national comparison of perceived discrimination, and few studies have considered how intersectional identities shape perception of discriminatory treatment in different societies. Using data from the ELSA-Brasil, a study of Brazilian civil servants, and the Americans' Changing Lives Study, a nationally-representative sample of U.S. adults, we compare reports of lifetime discrimination among race-by-gender groups in each society. We also consider whether educational attainment explains any group differences, or if differences across groups vary by level of education. Results reveal higher lifetime discrimination experiences among Black respondents in both countries, especially Black men, than among Whites, and lower reports among White women than White men. Brown men and women also reported higher levels than White men in Brazil. For all race-by-gender groups in both countries, except Brazilian White men, reports of discrimination were higher among the more educated, though adjusting for educational differences across groups did not explain group differences. In Brazil, we found the greatest racial disparities among the college educated, while U.S. Black men were more likely to report discrimination than White men at all levels of education. Results reveal broad similarities across countries, despite important differences in their histories, and an intersectional approach contributed to identification of these similarities and some differences in discrimination experiences. These findings have implications for social and public health surveillance and intervention to address the harmful consequences of discrimination.
Collapse
Affiliation(s)
- Sarah Burgard
- Department of Sociology, University of Michigan, Ann Arbor, U.S.A
| | | | - Katherine Y. Lin
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, U.S.A
| | - Aline A. Nobre
- Programa de Computação Científica, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Estela M. L. Aquino
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
| | - Alexandre C. Pereira
- Laboratório de Cardiologia Genética e Molecular, Universidade de São Paulo, São Paulo, Brasil
| | | | - Sandhi M. Barreto
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Dora Chor
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| |
Collapse
|
26
|
Bastos JL, Harnois CE, Paradies YC. Health care barriers, racism, and intersectionality in Australia. Soc Sci Med 2017; 199:209-218. [PMID: 28501223 DOI: 10.1016/j.socscimed.2017.05.010] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 05/01/2017] [Accepted: 05/03/2017] [Indexed: 12/21/2022]
Abstract
While racism has been shown to negatively affect health care quality, little is known about the extent to which racial discrimination works with and through gender, class, and sexuality to predict barriers to health care (e.g., perceived difficulty accessing health services). Additionally, most existing studies focus on racial disparities in the U.S. context, with few examining marginalized groups in other countries. To address these knowledge gaps, we analyze data from the 2014 Australian General Social Survey, a nationally representative survey of individuals aged 15 and older living in 12,932 private dwellings. Following an intersectional perspective, we estimate a series of multivariable logit regression models to assess three hypotheses: racial discrimination will be positively associated with perceived barriers to health care (H1); the effect of perceived racial discrimination will be particularly severe for women, sexual minorities, and low socio-economic status individuals (H2); and, in addition to racial discrimination, other forms of perceived discrimination will negatively impact perceived barriers to health care (H3). Findings show that perceptions of racial discrimination are significantly associated with perceived barriers to health care, though this relationship is not significantly stronger for low status groups. In addition, our analyses reveal that perceived racism and other forms of discrimination combine to predict perceived barriers to health care. Taken together, these results speak to the benefits of an intersectional approach for examining racial inequalities in perceived access to health care.
Collapse
Affiliation(s)
- João L Bastos
- Department of Public Health, Federal University of Santa Catarina, Campus Universitário Trindade, Florianópolis, SC, Brazil.
| | - Catherine E Harnois
- Department of Sociology, Wake Forest University, Winston-Salem, NC, United States
| | - Yin C Paradies
- Alfred Deakin Institute for Citizenship and Globalisation, Faculty of Arts and Education, Deakin University, Melbourne, VIC, Australia
| |
Collapse
|
27
|
Brandelli Costa A, Pasley A, Machado WDL, Alvarado E, Dutra-Thomé L, Koller SH. The Experience of Sexual Stigma and the Increased Risk of Attempted Suicide in Young Brazilian People from Low Socioeconomic Group. Front Psychol 2017; 8:192. [PMID: 28275356 PMCID: PMC5319990 DOI: 10.3389/fpsyg.2017.00192] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 01/30/2017] [Indexed: 11/25/2022] Open
Abstract
This study was intended to analyze the intersection of experience of sexual stigma low-socioeconomic status, and suicide attempt amongst young Brazilians (11–24 years old). In each of the data collection periods (2004–2006: n = 7185; 2010–2012: n = 2734), participants completed a questionnaire-based instrument. Network analysis provided support for a Minority Stress Model, oriented around whether participants had experienced sexual stigma. Although suicide attempts decreased by 20% for participants who had not experienced sexual stigma, there was a 60% increase for those who had experienced sexual stigma. Of particular note were the increases in rates of reported community and familial physical assault, molestation, and rape for those who had experienced sexual stigma. An analysis of centrality statistics demonstrated that both experiences of this Minority Stress Model were fundamentally different, and that those disparities increased over the time frame observed in this study. At the center of this model, shortest paths statistics exhibited a direct conditioned connection between experiencing sexual stigma and suicide attempts. We discuss the social and historical contexts that contributed to these dynamics, and emphasize the need for policy change.
Collapse
Affiliation(s)
- Angelo Brandelli Costa
- Research Group Prejudice, Vulnerability and Psychosocial Processes, Department of Psychology, Pontifícia Universidade Católica do Rio Grande do Sul Porto Alegre, Brazil
| | - Andrew Pasley
- Department of Education and Social Work, University of Auckland Auckland, New Zealand
| | - Wagner de Lara Machado
- Research Group Psychological Assessment on Human Potential, Department of Psychology, Pontifícia Universidade Católica de Campinas Campinas, Brazil
| | - Ernesto Alvarado
- Center of Psychological Studies, Institute of Psychology, Universidade Federal do Rio Grande do Sul Porto Alegre, Brazil
| | - Luciana Dutra-Thomé
- Center of Psychological Studies, Institute of Psychology, Universidade Federal do Rio Grande do Sul Porto Alegre, Brazil
| | - Silvia Helena Koller
- Center of Psychological Studies, Institute of Psychology, Universidade Federal do Rio Grande do Sul Porto Alegre, Brazil
| |
Collapse
|
28
|
Leal MDC, Gama SGND, Pereira APE, Pacheco VE, Carmo CND, Santos RV. A cor da dor: iniquidades raciais na atenção pré-natal e ao parto no Brasil. CAD SAUDE PUBLICA 2017; 33Suppl 1:e00078816. [DOI: 10.1590/0102-311x00078816] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 01/09/2017] [Indexed: 11/22/2022] Open
Abstract
Poucas pesquisas com foco nas influências da raça/cor no tocante à experiência de gestação e parto foram conduzidas no Brasil, sendo inédita a análise de abrangência nacional. Este estudo teve como objetivo avaliar as iniquidades na atenção pré-natal e parto de acordo com a raça/cor utilizando o método de pareamento baseado nos escores de propensão. Os dados são oriundos da pesquisa Nascer no Brasil: Pesquisa Nacional sobre Parto e Nascimento, um estudo de base populacional de abrangência nacional com entrevista e avaliação de prontuários de 23.894 mulheres em 2011/2012. Regressões logísticas simples foram utilizadas para estimar as razões de chance (OR) e respectivos intervalos de 95% de confiança (IC95%) da raça/cor associada aos desfechos analisados. Em comparação às brancas, puérperas de cor preta possuíram maior risco de terem um pré-natal inadequado (OR = 1,6; IC95%: 1,4-1,9), falta de vinculação à maternidade (OR = 1,2; IC95%: 1,1-1,4), ausência de acompanhante (OR = 1,7; IC95%: 1,4-2,0), peregrinação para o parto (OR = 1,3; IC95%: 1,2-1,5) e menos anestesia local para episiotomia (OR = 1,5 (IC95%: 1,1-2,1). Puérperas de cor parda também tiveram maior risco de terem um pré-natal inadequado (OR = 1,2; IC95%: 1,1-1,4) e ausência de acompanhante (OR = 1,4; IC95%: 1,3-1,6) quando comparadas às brancas. Foram identificadas disparidades raciais no processo de atenção à gestação e ao parto evidenciando um gradiente de pior para melhor cuidado entre mulheres pretas, pardas e brancas.
Collapse
|
29
|
Nunes MA, Pinheiro AP, Bessel M, Brunoni AR, Kemp AH, Benseñor IM, Chor D, Barreto S, Schmidt MI. Common mental disorders and sociodemographic characteristics: baseline findings of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). BRAZILIAN JOURNAL OF PSYCHIATRY 2016; 38:91-7. [PMID: 27304755 PMCID: PMC7111374 DOI: 10.1590/1516-4446-2015-1714] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 01/08/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To assess the prevalence of common mental disorders (CMD) and the association of CMD with sociodemographic characteristics in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort. METHODS We analyzed data from the cross-sectional baseline assessment of the ELSA-Brasil, a cohort study of 15,105 civil servants from six Brazilian cities. The Clinical Interview Schedule-Revised (CIS-R) was used to investigate the presence of CMD, with a score ≥ 12 indicating a current CMD (last week). Specific diagnostic algorithms for each disorder were based on the ICD-10 diagnostic criteria. Prevalence ratios (PR) of the association between CMD and sociodemographic characteristics were estimated by Poisson regression. RESULTS CMD (CIS-R score ≥ 12) was found in 26.8% (95% confidence intervals [95%CI] 26.1-27.5). The highest burden occurred among women (PR 1.9; 95%CI 1.8-2.0), the youngest (PR 1.7; 95%CI 1.5-1.9), non-white individuals, and those without a university degree. The most frequent diagnostic category was anxiety disorders (16.2%), followed by depressive episodes (4.2%). CONCLUSION The burden of CMD was high, particularly among the more socially vulnerable groups. These findings highlight the need to strengthen public policies aimed to address health inequities related to mental disorders.
Collapse
Affiliation(s)
- Maria A Nunes
- Universidade Federal do Rio Grande do Sul, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS , Brazil, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Andréa P Pinheiro
- Universidade Federal do Rio Grande do Sul, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS , Brazil, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Marina Bessel
- Universidade Federal do Rio Grande do Sul, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS , Brazil, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - André R Brunoni
- Hospital Universitário, Universidade de São Paulo, Universidade de São Paulo, São Paulo, SP , Brazil, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Andrew H Kemp
- Hospital Universitário, Universidade de São Paulo, Universidade de São Paulo, São Paulo, SP , Brazil, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil.,School of Psychology, Faculty of Science, University of Sydney, University of Sydney, Sydney, New South Wales , Australia, School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia.,Discipline of Psychiatry, Northern Clinical School, Faculty of Medicine, University of Sydney, University of Sydney, Sydney, New South Wales , Australia, Discipline of Psychiatry, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Isabela M Benseñor
- Hospital Universitário, Universidade de São Paulo, Universidade de São Paulo, São Paulo, SP , Brazil, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Dora Chor
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro. RJ , Brazil, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Sandhi Barreto
- Universidade Federal de Minas Gerais, Universidade Federal de Minas Gerais, Belo Horizonte, MG , Brazil, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maria I Schmidt
- Universidade Federal do Rio Grande do Sul, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS , Brazil, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| |
Collapse
|
30
|
Loret de Mola C, Hartwig FP, Gonçalves H, Quevedo LDA, Pinheiro R, Gigante DP, Motta JVDS, Pereira AC, Barros FC, Horta BL. Genomic ancestry and the social pathways leading to major depression in adulthood: the mediating effect of socioeconomic position and discrimination. BMC Psychiatry 2016; 16:308. [PMID: 27596337 PMCID: PMC5011949 DOI: 10.1186/s12888-016-1015-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 08/23/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence suggests that there is an association between ethnicity/skin color and depression; however, many contextual and individual variables, like sense of discrimination and socioeconomic position (SEP), might influence the direction of this association. We assessed the association between African ancestry and major depression among young adults that have been followed-up since birth in a Southern Brazilian city, and the mediating effect of SEP and discrimination. METHODS In 1982, all hospital deliveries in Pelotas (Southern Brazil) were identified; liveborns were examined and their mothers interviewed (n = 5914). In 2012-13, at 30 years of age, we used the Mini International Neuropsychiatric Interview (MINI) for major depression diagnosis. In addition, DNA samples were genotyped for approximately 2.5 million single nucleotide polymorphisms (SNPs) using Illumina (CA, USA) HumanOmni2.5-8v1 array. Genomic ancestry estimation was based on approximately 370 000 single nucleotide polymorphisms (SNPs) mutually available for the Pelotas cohort and selected samples (used as reference panels) of the HapMap and Human Genome Diversity (HGDP). We estimated prevalence ratios (PR) using Poisson regression models and evaluated the association between percentage of African ancestry and major depression. We used G-computation for mediation analysis. RESULTS At 30 years, 3576 individuals were evaluated for major depression (prevalence = 7.9 %). Only individuals in the highest SEP, who had a percentage of African ancestry between >5-30 % and >30 % had a prevalence of major depression 2.16 (PR = 2.16 95 % CI [1.05-4.45]) and 2.74 (PR = 2.74 95 % CI [1.06-7.06]) times higher, than those with 5 % or less, respectively. Among these subjects, sense of discrimination by skin color, captured 84 % of the association between African ancestry and major depression. CONCLUSION SEP is an important effect modifier of the positive association between African ancestry and major depression. In addition, this association is predominantly mediated by the sense of feeling discriminated by skin color.
Collapse
Affiliation(s)
- Christian Loret de Mola
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° Piso, Bairro Centro. Cep: 96020-220, Caixa Postal 464, Pelotas, RS Brazil
| | - Fernando Pires Hartwig
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° Piso, Bairro Centro. Cep: 96020-220, Caixa Postal 464, Pelotas, RS Brazil
| | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° Piso, Bairro Centro. Cep: 96020-220, Caixa Postal 464, Pelotas, RS Brazil
| | - Luciana de Avila Quevedo
- Health and Behavior Postgraduate Program, Universidade Católica de Pelotas – UCPEL, Rua Gonçalves Chaves, 377 - sala 411, prédio C. CEP: 96015-560, Pelotas, RS Brazil
| | - Ricardo Pinheiro
- Health and Behavior Postgraduate Program, Universidade Católica de Pelotas – UCPEL, Rua Gonçalves Chaves, 377 - sala 411, prédio C. CEP: 96015-560, Pelotas, RS Brazil
| | - Denise Petrucci Gigante
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° Piso, Bairro Centro. Cep: 96020-220, Caixa Postal 464, Pelotas, RS Brazil
| | - Janaína Vieira dos Santos Motta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° Piso, Bairro Centro. Cep: 96020-220, Caixa Postal 464, Pelotas, RS Brazil
- Health and Behavior Postgraduate Program, Universidade Católica de Pelotas – UCPEL, Rua Gonçalves Chaves, 377 - sala 411, prédio C. CEP: 96015-560, Pelotas, RS Brazil
| | - Alexandre C. Pereira
- Heart Institute, University of São Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César - CEP: 01246903, São Paulo, SP Brazil
| | - Fernando C. Barros
- Health and Behavior Postgraduate Program, Universidade Católica de Pelotas – UCPEL, Rua Gonçalves Chaves, 377 - sala 411, prédio C. CEP: 96015-560, Pelotas, RS Brazil
| | - Bernardo Lessa Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° Piso, Bairro Centro. Cep: 96020-220, Caixa Postal 464, Pelotas, RS Brazil
| |
Collapse
|
31
|
Du Mont J, Forte T. Perceived discrimination and self-rated health in Canada: an exploratory study. BMC Public Health 2016; 16:742. [PMID: 27502071 PMCID: PMC4977718 DOI: 10.1186/s12889-016-3344-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 06/20/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Our objective was to explore whether the link between discrimination and self-rated health status differed as a function of discrimination type, including discrimination based on ethnicity/culture, race, physical appearance (other than skin colour), religion, age, and disability. METHODS A sample of 19,422 men and women aged 15 and older was included in this study. A multivariate logistic regression analysis was used to measure the association between perceived discrimination types and self-reported health status defined as excellent/good versus fair/poor. RESULTS The prevalence of experiencing any discrimination in the past five years was higher among those who rated their health as fair or poor (21.8 %) compared to those who rated their health as excellent or good (14.5 %, p < 0.0001). After controlling for all other covariates, there was a positive association between poorer self-rated health and two of the six specific discrimination variables entered into the model: perceived discrimination based on physical appearance (other than skin colour) (OR = 1.79, 95 % CI: 1.24, 2.58) and perceived discrimination based on a having a disability (OR = 1.59, 95 % CI: 1.04, 2.41). CONCLUSIONS Our main findings indicate that perceived discrimination based on physical appearance and disability may have an adverse impact on health. The results highlight the need for a comprehensive approach to improving health outcomes that should include policies that are targeted against specific types of discrimination.
Collapse
Affiliation(s)
- Janice Du Mont
- Women's College Research Institute, Women's College Hospital, 76 Grenville Street, 6th Floor, Toronto, ON, M5S 1B2, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Tonia Forte
- Women's College Research Institute, Women's College Hospital, 76 Grenville Street, 6th Floor, Toronto, ON, M5S 1B2, Canada
| |
Collapse
|
32
|
Jorge JG, Botelho C, Silva AMC, Moi GP. Influence of passive smoking on learning in elementary school. J Pediatr (Rio J) 2016; 92:260-7. [PMID: 26859248 DOI: 10.1016/j.jped.2015.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 08/13/2015] [Accepted: 08/26/2015] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To analyze the association between household smoking and the development of learning in elementary schoolchildren. METHODS Cross-sectional study with 785 students from the 2nd to the 5th year of elementary school. Students were evaluated by the School Literacy Screening Protocol to identify the presence of learning disabilities. Mothers/guardians were interviewed at home through a validated questionnaire. Descriptive and bivariate analysis, as well as multivariate Poisson regression, were performed. RESULTS In the final model, the variables associated with learning difficulties were current smoking at the household in the presence of the child (PR=6.10, 95% CI: 4.56 to 8.16), maternal passive smoking during pregnancy (PR=1.46, 95% CI: 1.07 to 2.01), students attending the 2nd and 3rd years of Elementary School (PR=1.44, 95% CI: 1.10 to 1.90), and being children of mothers with only elementary level education (PR=1.36, 95% CI: 1.04 to 1.79). CONCLUSION The study demonstrated an association between passive exposure to tobacco smoke and learning difficulties at school.
Collapse
Affiliation(s)
| | - Clóvis Botelho
- School of Medicine, Universidade Federal de Mato Grosso (UFMT), Cuiabá, MT, Brazil
| | | | - Gisele Pedroso Moi
- Centro Universitário de Várzea Grande (UNIVAG), Várzea Grande, MT, Brazil
| |
Collapse
|
33
|
Influence of passive smoking on learning in elementary school. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2016. [DOI: 10.1016/j.jpedp.2016.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
34
|
de Souza MVC, Lemkuhl I, Bastos JL. Discrimination and common mental disorders of undergraduate students of the Universidade Federal de Santa Catarina. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2015; 18:525-37. [PMID: 26247179 DOI: 10.1590/1980-5497201500030001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 01/12/2015] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The pathogenic and consistent effect of discrimination on mental health has been largely documented in the literature. However, there are few studies measuring multiple types of discrimination, evaluating the existence of a dose-response relationship or investigating possible effect modifiers of such an association. OBJECTIVE To investigate the association between experiences of discrimination attributed to multiple reasons and common mental disorders, including the adjustment for potential confounders, assessment of dose-response relations, and examination of effect modifiers in undergraduate students from southern Brazil. METHODS In the first semester of 2012, 1,023 students from the Universidade Federal de Santa Catarina answered a self-administered questionnaire on socio-demographic characteristics, undergraduate course, experiences of discrimination and common mental disorders. Associations were analyzed through logistic regression models, estimation of Odds Ratios and 95% confidence intervals (95%CI). RESULTS The study results showed that students reporting discrimination at high frequency and intensity were 4.4 (95%CI 1.6 - 12.4) times more likely to present common mental disorders. However, the relationship between discrimination and common mental disorders was protective among Electrical Engineering students, when compared to Accounting Sciences students who did not report discrimination. CONCLUSION The findings suggest that the dose-response relationship between experiences of discrimination and common mental disorders reinforces the hypothetical causal nature of this association. Nevertheless, the modification of effect caused by the undergraduate course should be considered in future studies for a better understanding and measurement of both phenomena.
Collapse
Affiliation(s)
| | - Isabel Lemkuhl
- School of Dentistry, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - João Luiz Bastos
- Department of Public Health, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| |
Collapse
|
35
|
Coelho IZ, Bastos JL, Celeste RK. Moderators of the association between discrimination and alcohol consumption: findings from a representative sample of Brazilian university students. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2015. [PMID: 26222299 DOI: 10.1590/2237-6089-2014-0039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Few studies about discrimination and patterns of alcohol consumption among youth populations have been conducted outside the United States addressing different types of discriminatory experiences, in addition to racially motivated events. This study investigated moderators of the association between discrimination attributed to single and multiple reasons and patterns of alcohol consumption. METHODS This cross-sectional study enrolled a representative sample (n = 1,264) of undergraduate students from Florianópolis, southern Brazil, in 2013. Analyses included adjustment of associations for covariates in ordinal logistic regression models and the examination of effect modification by common mental disorders, year of study and age. RESULTS Discrimination was reported by 65.8% of the students, and alcohol consumption, by 80.0%. Over half of the students reported being discriminated against for two or more reasons. The odds of alcohol-related problems were higher among lastyear students that reported discrimination (odds ratio [OR] = 1.9, 95% confidence interval [95%CI] 1.0-3.4) or multiple reasons for being discriminated against (OR = 2.3, 95%CI 1.3- 4.3), when compared to first-year students that did not report discrimination. For the whole sample, there were no associations between discrimination, discrimination attributed to multiple reasons and patterns of alcohol consumption (OR = 1.0, 95%CI 0.8-1.4; and OR = 0.9, 95%CI 0.5-1.6). CONCLUSIONS The effects of discrimination on the patterns of alcohol consumption are seen at a critical period in university life, specifically during the completion of undergraduate studies.
Collapse
Affiliation(s)
| | - João Luiz Bastos
- Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | | |
Collapse
|