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Abstract
BackgroundTo date, research on racial discrimination and health typically has employed explicit self-report measures, despite their potentially being affected by what people are able and willing to say. We accordingly employed an Implicit Association Test (IAT) for racial discrimination, first developed and used in two recent published studies, and measured associations of the explicit and implicit discrimination measures with each other, socioeconomic and psychosocial variables, and smoking.Methodology/Principal FindingsAmong the 504 black and 501 white US-born participants, age 35–64, randomly recruited in 2008–2010 from 4 community health centers in Boston, MA, black participants were over 1.5 times more likely (p<0.05) to be worse off economically (e.g., for poverty and low education) and have higher social desirability scores (43.8 vs. 28.2); their explicit discrimination exposure was also 2.5 to 3.7 times higher (p<0.05) depending on the measure used, with over 60% reporting exposure in 3 or more domains and within the last year. Higher IAT scores for target vs. perpetrator of discrimination occurred for the black versus white participants: for “black person vs. white person”: 0.26 vs. 0.13; and for “me vs. them”: 0.24 vs. 0.19. In both groups, only low non-significant correlations existed between the implicit and explicit discrimination measures; social desirability was significantly associated with the explicit but not implicit measures. Although neither the explicit nor implicit discrimination measures were associated with odds of being a current smoker, the excess risk for black participants (controlling for age and gender) rose in models that also controlled for the racial discrimination and psychosocial variables; additional control for socioeconomic position sharply reduced and rendered the association null.ConclusionsImplicit and explicit measures of racial discrimination are not equivalent and both warrant use in research on racial discrimination and health, along with data on socioeconomic position and social desirability.
Highlights
One important challenge confronted by empirical research on racial discrimination and health is how best to measure the relevant exposures at the relevant levels – whether structural, institutional, interpersonal, or internalized [1,2,3]
The Experiences of Discrimination (EOD) is a 9-item measure that is conceptualized as measuring ‘‘self-reported experiences of discrimination,’’ recognizing that the data obtained depend on people’s willingness and/ or ability to report these experiences [1,18,36], as per the predicted weak association we found between the EOD and the Implicit Association Test (IAT) [8,9]
Despite the commonality of being community health center members, the black participants’ current and lifetime socioeconomic profile was notably worse than that of the white participants (Table 1), with all differences statistically significant (p,0.05) unless otherwise noted. They were over 1.5 times more likely to be impoverished (33.8% vs 21.3%), to live in a census tract meeting the federal definition of poverty area
Summary
One important challenge confronted by empirical research on racial discrimination and health is how best to measure the relevant exposures at the relevant levels – whether structural, institutional, interpersonal, or internalized [1,2,3]. Most studies in this still relatively new field of inquiry have focused on testing associations between people’s self-reported experiences of racial discrimination and their concurrent or subsequent health status [1,2,3,4,5,6]. Self-report data on racial discrimination have the distinction of plausibly being affected by the very exposure under study, given the power differentials and social sensitivities involved. Research on racial discrimination and health typically has employed explicit self-report measures, despite their potentially being affected by what people are able and willing to say. We employed an Implicit Association Test (IAT) for racial discrimination, first developed and used in two recent published studies, and measured associations of the explicit and implicit discrimination measures with each other, socioeconomic and psychosocial variables, and smoking
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