Major Lifetime Discrimination Research Articles

Disparities in Stress Exposure and Later-Life Disability

Abstract Background and Objectives Drawing from cumulative inequality theory and the weathering hypothesis, this study examined the relationship between life course stress exposure (measured cumulatively and by domains) and the onset of disability in later life among White, Black, US-born Hispanic, and foreign-born Hispanic older adults. Research Design and Methods Cross-sectional and longitudinal models were estimated using nationally representative data from the Health and Retirement Study (N=11,483). We used logistic regression models to examine associations between stress exposure and wave 1 disability (i.e., occurrence), and Weibull accelerated failure-time models to examine the relationship between stress exposure and age of onset of disability 12-14 years later (i.e., incidence). We tested for moderation between stress and disability by race, ethnicity, and Hispanic nativity. Results At wave 1, higher odds of disability occurrence were associated with cumulative stress burden (CSB) (OR= 4.93, 95% CI: 2.95-8.23). In a model specifying domains of stressors, disability occurrence was associated with childhood financial strain (OR=1.22, CI: 1.01-1.46), lifetime traumatic events (OR=1.92, CI: 1.41-2.62), neighborhood disadvantage (OR=1.32, CI: 1.01-1.73), and major lifetime discrimination (OR=1.64, CI: 1.12-2.41). Over time, earlier onset of disability was associated with CSB (β = -0.39), childhood traumatic events (β = -0.16), adult financial strain (β = -0.17), everyday discrimination (β = -0.15), and major lifetime discrimination (β = -0.13). The effect of childhood traumatic events on the transition to disability was stronger for US-born Hispanic adults than White adults (occurring 33% earlier). Discussion and Implications To reduce racial, ethnic, and nativity disparities in disability, it is important to consider the historical and structural disadvantages associated with stress exposure across the life course. It is also important to acknowledge that nativity influences stratification processes associated with disparities in racial and ethnic health trajectories.

Associations of Everyday and Lifetime Experiences of Discrimination With Willingness to Undergo Alzheimer Disease Predictive Testing.

Rapid developments in Alzheimer disease (AD) biomarker research suggest that predictive testing may become widely available. To ensure equal access to AD predictive testing, it is important to understand factors that affect testing interest. Discrimination may influence attitudes toward AD testing, particularly among racially and ethnically minoritized populations, because of structural racism in health care systems. This study examined whether everyday or lifetime discrimination experiences shape interest in AD predictive testing. In the 2010 and 2012 biennial Health and Retirement Study waves, respondents were randomly selected to complete questions on interest in receiving free testing that could determine whether they would develop AD in the future. The exposures were everyday discrimination (6 items) and lifetime discrimination (7 items); both were transformed into a binary variable. Logistic regression models predicting interest in AD testing were controlled for deciles of propensity scores for each discrimination measure. Odds ratios were re-expressed as risk differences (RDs). Our analytic sample included 1,499 respondents. The mean age was 67 (SD = 10.2) years, 57.4% were women, 65.7% were White, and 80% endorsed interest in AD predictive testing. Most of the participants (54.7%) experienced everyday discrimination in at least one domain; 24.1% experienced major lifetime discrimination in at least one domain. Those interested in predictive testing were younger (66 vs 70 years) and more likely to be Black (20% vs 15%) or Latinx (14% vs 8%) than participants uninterested in testing. The probability of wanting an AD test was not associated with discrimination for Black (RD everyday discrimination = -0.026; 95% CI [-0.081 to 0.029]; RD lifetime discrimination = -0.012; 95% CI [-0.085 to 0.063]) or Latinx (RD everyday discrimination = -0.023, 95% CI [-0.082 to 0.039]; RD lifetime discrimination = -0.011; 95% CI [-0.087 to 0.064]) participants. Despite historical and contemporary experiences of discrimination, Black and Latinx individuals express interest in AD testing. However, Black and Latinx individuals remain underrepresented in AD research, including research on AD testing. Interest in personalized information about dementia risk may be a pathway to enhance their inclusion in research and clinical trials.

RACIAL–ETHNIC DISPARITIES IN STRESS EXPOSURE AND THE ONSET OF LATER-LIFE LIMITATIONS IN ACTIVITIES OF DAILY LIVING

Abstract This study investigates the relationship between stress exposure – including cumulative stress burden and domain-specific stressors – and the onset of activities of daily living (ADL) limitations in later life and examines whether there are racial-ethnic and nativity differences in this relationship. Examining data from the Health and Retirement study (HRS), we apply logistic regression and Weibull accelerated failure-time models to examine associations between stress and baseline ADL limitations as well as stress exposure and age of onset of ADL limitations over a decade. Interaction tests between stress and race-ethnicity and nativity were employed to understand how stress exposure uniquely influences ADL limitations among White, Black, US-born Hispanic, and foreign-born Hispanic older adults. Black, US-born Hispanic, and foreign-born Hispanic adults were more likely to develop an ADL limitation at a younger age compared to White adults (β = -0.06; β = -0.07; β = -0.09; respectively). Cumulative stress burden, childhood traumatic events, adult financial strain, everyday discrimination, and major lifetime discrimination were associated with an earlier onset of ADL limitation among White, Black, US-born Hispanic and foreign-born Hispanic adults. Further, US-born Hispanic adults that experienced the same amount of childhood traumatic events as White adults experienced an earlier transition to ADL limitation by a factor of 0.65 or in about 35% of the time. Reducing racial-ethnic and nativity disparities in ADL limitations in later-life will require efforts to adjudicate the long lasting historical and structural disadvantages that contribute to differential stress exposure across the life course.

Experiences of Discrimination and Interest in Alzheimer’s Disease Predictive Testing in the Health and Retirement Study

AbstractBackgroundRapid developments in Alzheimer’s disease (AD) biomarker research suggest predictive testing may soon become a feasible option available to the public. Future reduction of racial and ethnic disparities in AD requires understanding of potential differences in drivers of interest in AD diagnostic testing. Experiences of discrimination may influence attitude toward AD testing, particularly among racially and ethnically minoritized populations. This study examines whether everyday or lifetime discrimination shapes interest in AD predictive testing.MethodData were collected from 1,472 participants in the 2010 and 2012 waves of the Health and Retirement Study who answered a module on interest in receiving a free test that could tell whether they would develop AD in the future, along with measures of Everyday Discrimination and Lifetime Discrimination. Logistic models were controlled for deciles of propensity scores (estimated using demographic and socioeconomic variables) and odds ratios were re‐expressed as risk differences (RD). The RD is the difference in the probability a person expressed interest in receiving a future AD predictive test based on past experiences of discrimination.ResultThe mean age of the sample was 67 (SD = 10.2), 65.9% were white, and 80% endorsed interest in AD predictive testing. Most (64.1%) participants indicated experiencing everyday discrimination in at least one domain, and 34.8% experienced major lifetime discrimination in at least one domain. Those interested in predictive testing were younger (66 vs 70 years) and more likely to be Black (20% vs 15%) or Latinx (14% vs 8%) than participants uninterested in testing. The probability of wanting an AD test was not associated with discrimination experiences for Black (RD everyday discrimination = 0.104, p = 0.285; RD lifetime discrimination = ‐0.038; p = 0.626) or Latinx (RD everyday discrimination = ‐0.003, p = 0.974; RD lifetime discrimination = ‐0.053; p = 0.692) participants.ConclusionDespite historical and contemporary experiences of discrimination, Black and Latinx individuals express interest in AD testing. This finding implicates structural and systemic barriers, such as systemic racism and institutional gaps in access to clinical research, as likely explanations for underrepresentation of racially and ethnically minoritized persons in research on AD testing.

Evaluating interpersonal discrimination and depressive symptoms as partial mediators of the effects of education on cognition: Evidence from the Study of Healthy Aging in African Americans (STAR).

Education is correlated with positive health outcomes, but associations are sometimes weaker among African Americans. The extent to which exposure to discrimination and depressive symptoms attenuates the education-cognition link has not been investigated. Study of Healthy Aging in African Americans (STAR) participants (n=764; average age 69 years) completed the Spanish and English Neuropsychological Assessment Scales. We assessed everyday and major lifetime discrimination and depressive symptoms as mediators of education effects on cognition using G-estimation with measurement error corrections. Education was correlated with greater major lifetime and everyday discrimination but lower depressive symptoms. Accounting for discrimination and depressive symptoms slightly reduced the estimated effect of education on cognition. The estimated total effect of graduate education (vs<Bachelor's) was 0.66 (95% confidence interval [CI]: 0.62, 0.68), and the direct effect not mediated by discrimination or depressive symptoms was 0.60 (95% CI: 0.43, 0.76). Education has robust effects on later-life cognition after controlling multiple mediating pathways and offsetting mechanisms.

Discrimination and Sleep: Differential Effects by Type and Coping Strategy.

Discrimination has been posited as a contributor of sleep disparities for Latinxs. The strategy used to cope with discrimination may reduce or exacerbate its effects on sleep. This study examined whether different types of discrimination (everyday and major lifetime discrimination) were associated with sleep indices (quality, disturbances, efficiency) and whether coping strategy used moderated associations. Data of Latinx adults (N = 602; 51% women, 65% Dominican, Mage = 46.72 years) come from the Latino Health and Well-being Project, a community-based, cross-sectional study of Latinxs in Lawrence, MA. Multiple linear regressions were estimated separately for each sleep outcome. Everyday discrimination was significantly associated with poorer sleep quality and greater disturbances; major lifetime discrimination was significantly associated with worse sleep across the three sleep indices. Coping strategy moderated associations between discrimination and sleep. Compared with Latinxs who used passive coping, those who used passive-active coping strategies had poorer sleep quality the more they experienced everyday discrimination. Latinxs who used any active coping strategy, compared with passive coping, had greater sleep disturbances the more frequently they experienced major lifetime discrimination. Findings show that everyday discrimination and major lifetime discrimination are associated with different dimensions of sleep and suggest that coping with discrimination may require the use of different strategies depending on the type of discrimination experienced.

Experiences of Discrimination on Cognitive Function and Aging among the Oldest Old: LifeAfter90 (LA90) Study

AbstractBackgroundDiscrimination is a primary cause of health inequities, and racial/ethnic disparities in dementia are well documented. However, it is unclear whether longevity into old age indicates overcoming discriminatory experiences. Using data from the LifeAfter90 (LA90) Study, we examined the impact of major lifetime discrimination on cognitive function and decline in those 90+.MethodLA90 enrolled Asian, Black, Latino, white, and multi‐racial Kaiser Permanente Northern California members who were followed for incident dementia and aged 90+. Discrimination was measured using the Major Experiences of Discrimination Scale. Latent class analysis identified three groups based on responses to the 10‐item scale, gender, and race/ethnicity. Executive function, verbal episodic memory, and semantic memory were assessed every six months with the Spanish and English Neuropsychological Assessment Scales and scores were z‐standardized to baseline. Linear mixed models with random intercepts and slopes associated latent classes of discrimination with cognitive change over 3 waves (mean = 1.2 years). Models adjusted for age, education, cognitive status (normal/mild cognitive impairment‐ accounting for recall bias), practice effects, follow‐up time, and class*time interactions.ResultOur analytic sample of 445 participants had a mean age of 92.7(SD = 2.3) (Table 1). Class‐1 included mostly white men who reported workplace discrimination and had an average of 2 major discrimination experiences. Class‐2 included white women and non‐white participants who reported little/no discrimination averaging 0 experiences. Class‐3 included all non‐white participants who reported a mean of 4 discrimination experiences. At baseline, using Class‐2 as reference, participants in Class‐1 had significantly better executive function (β(95% CI): 0.28(0.03, 0.52) while Class‐3 did not differ (Table 2). Baseline semantic memory was significantly better for Class‐1 (β(95% CI): 0.33(0.07, 0.58)) and significantly worse for Class‐3 (β(95% CI): ‐0.24(‐0.48, ‐0.00)) compared to Class‐2. We found no class differences in baseline verbal episodic memory. Cognition declined over time across all three cognitive domains (β range: ‐0.31 to ‐0.46), but rate of change did not differ significantly by latent class (Table 3).ConclusionAmong the oldest old, inequalities in cognition persist after accounting for experiences of lifetime discrimination. Despite participants’ incredible longevity, experiences of discrimination have an indelible association with cognitive health.

Does discrimination mediate the association between education and later‐life cognitive outcomes in a cohort of Black Americans? An example of parametric g‐estimation with latent variables in the STAR study

AbstractBackgroundIdentifying mediators between education and later‐life cognition is an important step in developing prevention measures. We evaluate everyday and major lifetime discrimination as potential mediators of the impact of education on later‐life cognition. To address bias that might occur due to either time‐varying confounding or unreliable measurement of discrimination, we use a novel parametric g‐estimation approach.MethodParticipants in the Study of Healthy Aging in African Americans (STAR, n = 764, ages 52‐90) self‐reported education (high school [HS] degree, general educational development [GED], or less [ref]; bachelor’s degree; or graduate degree). Validated measures of everyday discrimination (9‐items assessing frequency with 6‐point Likert responses) and major lifetime discrimination (9‐items, dichotomous yes‐no), were conceptualized as latent variables (Table 1). The observed cognitive outcome was the average of the verbal episodic memory, semantic memory, and executive function Spanish and English Neuropsychological Assessment Scales (SENAS). We used linear regression to estimate the total effect of education on later‐life cognition and parametric g‐estimation with latent discrimination measures to estimate the controlled direct effect (CDE) of education on cognition if the discrimination measures were set to their sample averages. Models were adjusted for measurement error in the discrimination measures using Fuller’s Method. Standard errors were bootstrapped.ResultMost participants were female (68.32%) and the average age was 69.0 (Table 2). Both bachelor’s (b=0.41[0.21,0.60]) and graduate (b=0.43[0.22,0.64]) degrees were associated with better cognition compared to HS/GED or less (Table 3). More education was associated with higher levels of major lifetime discrimination. The CDEs of a bachelor’s and graduate degree, if everyone had the average level of everyday and major life discrimination, were 0.32[0.06,0.61] and 0.55[0.24,0.82], respectively (Table 3 and as a function of different fixed averages in Figure 2).ConclusionThis study provides a novel demonstration of parametric g‐estimation methods that correct for measurement error with latent variables and allow for possible feedback between education and early and late‐life confounders. Accounting for exposure to discrimination slightly increased the magnitude of the association between graduate education and cognition in this older sample of Black American adults, because education was associated with greater exposure to major life discrimination.

Perceived Discrimination, Nativity, and Cognitive Performance in a Multiethnic Study of Older Adults: Findings From the Kaiser Healthy Aging and Diverse Life Experiences Study.

Despite growing research on the association between discrimination and disparities in cognitive aging, an evidence gap remains on how the association varies by racial/ethnic group. This study evaluates the associations of experiences of discrimination with cognitive function and whether these associations varied by race/ethnicity and nativity. Using the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) cohort (N = 1 712) with approximately equal groups of Black, White, Latino, and Asian community-dwelling older adults aged 65 years and older, we evaluated the associations between self-reported experiences of everyday and major lifetime discrimination with overall cognitive performance and domain-specific cognition (verbal episodic memory, semantic memory, and executive functioning) across race/ethnicity and nativity. Linear regression models examined the cross-sectional association between self-reported experiences of everyday and major lifetime discrimination with z-standardized coefficients for cognition. We tested for effect modification by race and nativity. All models controlled for age, sex, and education. Among KHANDLE participants (mean age: 76 years; SD: 6.8), everyday discrimination was not associated with cognitive scores. Major lifetime discrimination was associated with better average cognitive scores among Black participants but not among other racial/ethnic groups. Major lifetime discrimination was associated with better average cognitive scores among U.S.-born but not among non-U.S.-born individuals. Our findings do not imply that discrimination improves cognition, but rather suggest that future research should include more detailed measures on discrimination and unfair treatment that could help disentangle the extent to which relationships are causal or reflect some other underlying factor.

Socioeconomic and psychosocial mechanisms underlying racial/ethnic disparities in cognition among older adults.

Objective: Racial/ethnic disparities in cognitive aging are only partly attributable to socioeconomic indicators. Psychosocial factors, such as discrimination and perceived control, also differ across racial/ethnic groups, and emerging literature highlights their potential role in contributing to cognitive disparities in addition to socioeconomic status. Method: 1,463 older adults (51% Hispanic, 27% non-Hispanic Black, and 22% non-Hispanic White) in the Washington Heights-Inwood Columbia Aging Project completed cognitive and psychosocial measures, including a comprehensive neuropsychological battery, Everyday and Major Experiences of Lifetime Discrimination scales, and the Perceived Control scale. Mediation models quantified separate indirect effects of Black race and Hispanic ethnicity on global cognitive composite scores through education, income, discrimination, and external perceived control. Results: Educational attainment, income, and perceived control each mediated racial/ethnic disparities in global cognition. Socioeconomic indicators (i.e., lower education and lower income) explained approximately 50% of the Black-White and Hispanic-White disparities in global cognition, and more external perceived control explained an additional 5%-8%. Hispanics reported the lowest levels of discrimination, while non-Hispanic Blacks reported the highest levels. However, neither everyday nor major lifetime discrimination was associated with global cognition. Significant racial/ethnic disparities in global cognition remained after accounting for the included socioeconomic and psychosocial factors. Conclusions: This study suggests that psychosocial factors may explain racial/ethnic disparities in cognitive aging above and beyond socioeconomic indicators. More external perceived control, which could reflect chronic exposure to interpersonal and institutional marginalization, may be a particularly salient psychosocial risk factor for poorer cognitive aging among non-Hispanic Black and Hispanic older adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Colorism and Physical Health: Evidence from a National Survey.

This study uses nationally representative data to extend a steadily growing body of research on the health consequences of skin color by comparatively examining the consequences of perceived ingroup and outgroup skin color discrimination (perceived colorism) for physical health among African Americans. Using a comprehensive set of measures of physical health, I find that perceived ingroup colorism is significantly associated with worse physical health outcomes among African Americans. Notably, the magnitude of ingroup colorism's associations with most of these outcomes rivals or even exceeds that of major lifetime discrimination, everyday discrimination, and perceived outgroup colorism. These findings compellingly suggest the inclusion of perceived colorism measures in future survey data collection efforts.

Discrimination and Protective Factors to Cognitive Health: Testing NIA’s Health Disparities Framework

Cognitive impairment is a worldwide epidemic. Informed by NIA’s Health Disparities Framework, this study investigated interpersonal, behavioral, and sociocultural risk and protective factors associated with cognitive health trajectories. Mixed models examined factors associated with cognitive health with data from the Health and Retirement Study among Whites, Blacks, and Hispanics (2008-2014, N=4,511). A majority of respondents who experienced everyday discrimination attributed it to ageism among this racially and ethnically diverse sample. Stratified mixed models of everyday discrimination by attribution (racism or ageism) revealed worse cognitive functioning. Major lifetime discrimination was not statistically associated with cognitive functioning. Economic factors (education, income, assets) and religious activity protected cognitive functioning and were particularly salient for Blacks and Hispanics. Strategies that bolster individual resilience as well as social policies that address discrimination and structural inequities will likely reduce health disparities and improve population health.

Multiple Dimensions of Perceived Discrimination, Race-Ethnicity, and Mortality Risk Among Older Adults

The present study utilized data from the Health and Retirement Study (N=12,988) to investigate the joint consequences of multiple dimensions of perceived discrimination on mortality risk. Perceived discrimination is based on responses from the 2006/2008 HRS waves and included everyday discrimination, the number of attributed reasons for everyday discrimination, and major lifetime discrimination. Vital status was obtained from the National Death Index and reports from key household informants (spanning 2006–2016). Cox proportional hazard models were used to estimate the risk of mortality. During the observation period, 3,494 deaths occurred. Only the number of attributed reasons for discrimination predicted mortality risk when all discrimination measures were estimated in the same model (Hazard Ratio [HR]=1.09; 95%, Confidence Interval [CI]=1.05 - 1.14), holding all else constant. Overall, the number of attributed reasons for everyday discrimination is a particularly salient risk factor for mortality in later life.

Exploring the Consequences of Major Lifetime Discrimination, Neighborhood Conditions, Chronic Work, and Everyday Discrimination on Health and Retirement.

This study examines the associations of multiple forms of perceived discrimination and negative neighborhood conditions with mental health and retirement age. Respondents aged above 51 years from the Health and Retirement Study were selected in 2006 and surveyed through 2014. Ordinary least squares regression evaluated associations. Bias-corrected bootstrap resampling method tested whether mental health mediated the relationships between disadvantages and retirement age. Major lifetime and work discrimination, as well as neighborhood conditions, were directly associated with earlier retirement. Individuals who did not experience disadvantages retired at age 65, whereas respondents with the highest levels of disadvantage retired earlier (at age 62). Mental health partially mediated relationships between major lifetime discrimination, neighborhood conditions, and work discrimination with retirement age, whereas mental health fully mediated the relationship between everyday discrimination and retirement age. Efforts to promote civil rights, reduce discrimination, and enhance individual resilience may promote mental health and capacity to work longer.

Self-reported Instances of Major Discrimination, Race/Ethnicity, and Inflammation Among Older Adults: Evidence From the Health and Retirement Study.

This study examines the relationship between self-reported instances of major discrimination and inflammation among older adults, and explores whether this relationship varies in accordance with race/ethnicity. We hypothesized that self-reported instances of major discrimination would be associated with higher levels of high-risk inflammation and that this relationship would be stronger for racial/ethnic minorities than whites. Data from the 2006/2008 Health and Retirement Study, an ongoing biennial nationally representative sample of older adults in the United States, were used to collect measures of self-reported instances of major discrimination and high-risk C-reactive protein (CRP), which was assayed from blood samples. Modified Poisson regression with robust standard errors was applied to estimate the prevalence ratios of self-reported instances of major discrimination, as it relates to high-risk CRP (CRP ≥ 22 kg/m2), and test whether this relationship varies by race/ethnicity. Respondents who experienced any instances of major discrimination had a higher likelihood of high-risk CRP (prevalence ratio [PR]: 1.14, 95% confidence interval [CI] = 1.07-1.22) than those who did not report experiencing any instances of major discrimination. This association was independent of differences in newly diagnosed health conditions and socioeconomic status. The relationship between any self-reported instance of major discrimination and high-risk CRP was weaker for blacks than whites (PR: 0.81, 95% CI = 0.69-0.95). Our study confirms that self-reported instances of major lifetime discrimination is a psychosocial factor that is adversely associated with high-risk CRP among older adults; this association is especially pronounced among older whites. Future studies among this population are required to examine whether the relationship between self-reported instances of major discrimination and high-risk CRP changes over time.

Exploring the Consequences of Discrimination and Health for Retirement by Race and Ethnicity: Results from the Health and Retirement Study

This paper examines the association of structural discriminatory risk factors and health with retirement age. It uses data from the Health and Retirement Study (HRS). Critical components of the analysis include ordinary least squares regressions to evaluate associations of discrimination (major lifetime discrimination, neighborhood disadvantage, work discrimination and everyday discrimination) and health with retirement age, while controlling for time, cohort, race, ethnicity, gender, marital status, education, health insurance, income and wealth. Interaction effects explore differences by discrimination and health. Individuals’ ages 51, employed full-time, part-time, or unemployed were drawn from the HRS Leave-Behind Questionnaire in 2006. Approximately half of the sample retired during the observation period 2008-2014. Key limitations are that valid and reliable measures of discrimination were queried only twice during an 8-year period, limiting our understanding of the timing of events as they relate to health and economic outcomes.

Self-Rated Health, Discrimination, and Racial Group Identity: the Consequences of Ethnicity and Nativity Among Black Americans

In this study, we examine how ethnic heterogeneity and nativity shape the relationships among self-rated health, discrimination, and racial group identity for a representative sample of African Americans, U.S.-born Caribbean Blacks, and foreign-born Caribbean Blacks (National Survey of American Life; N = 4091). Our study includes two forms of discrimination, major lifetime discrimination and day-to-day discrimination, as well as two forms of racial group identity, closeness to other Blacks and Black group evaluation. Closeness to other Blacks improves the self-rated health of U.S.-born Caribbean Blacks who reported experiencing high levels of major discrimination. Black group evaluation improved the health of foreign-born Caribbean Blacks, who reported low levels of major discrimination, and African Americans, with high levels of major discrimination. Finally, for both foreign-born Caribbean Blacks and African Americans, who experience high discrimination, Black group evaluation weakens the influence of day-to-day discrimination on self-rated health.

Investigating the Relationship between Perceived Discrimination, Social Status, and Mental Health.

A growing body of evidence suggests that experiences with discrimination have implications for mental health and that these associations may vary by social status. We use data from the Chicago Community Adult Health Study (CCAHS) to examine how two types of perceived discrimination, chronic everyday discrimination and major lifetime discrimination, are linked to mental health, and how this association varies by race/ethnicity, gender, and socioeconomic status. Results indicate that everyday discrimination is generally independently linked to greater depressive symptoms, loneliness, and hostility across all social status groups. Major discrimination is not associated with depressive symptoms or loneliness after adjusting for a host of covariates, but is associated with hostility, especially for certain groups. These findings highlight the need to examine multiple indicators of discrimination and mental health, and to pay attention to both differences and similarities in these associations by social status.

Suicidal and Depressive Symptoms in Filipino Home Care Workers in Israel

The study consisted of a cross sectional sample of 178 Filipino home care workers who completed the Paykel Suicide Scale and the Patient Health Questionnaire-9. Respondents also completed questionnaires about exposure to abuse and perceived social support. Overall, 35% of the sample reported exposure to some type of abuse within their home/work environment. For those reporting low levels of satisfaction with care recipient, higher exposure to major lifetime discrimination was associated with higher SIA, whereas for those reporting high levels of satisfaction with care recipient, there was no relationship between exposure to major lifetime discrimination and SIA. Abuse within the home/work environment was the only predictor of depressive symptoms, with greater abuse being associated with higher levels of depressive symptoms. Filipino home care workers in Israel likely are exposed to moderate levels of abuse and discrimination within the home/work environment as well as within society at large. Because live-in home care workers spend the majority of their time within the home/work environment, their relationship with their care recipients have protective qualities that can serve as a buffer against discrimination. Nevertheless, abusive working conditions within their home/work environment have detrimental effects on their mental health.

The relationships between major lifetime discrimination, everyday discrimination, and mental health in three racial and ethnic groups of older adults

Objectives: To evaluate the relationships between perceived exposure to major lifetime discrimination, everyday discrimination, and mental health in three racial/ethnic groups of older adults. Design: The Health and Retirement Study is a nationally representative sample of individuals 50 years and older living in the United States. A total of 6455 Whites, 716 Latinos, and 1214 Blacks were eligible to complete a self-report psychosocial questionnaire in the year 2006. Results: Whereas 30% of the general population reported at least one type of major lifetime discrimination, almost 45% of Black older adults reported such discrimination. Relative to the other two racial/ethnic groups (82% Whites, 82.6% Blacks), Latinos were significantly less likely to report any everyday discrimination (64.2%), whereas Blacks reported the greatest frequency of everyday discrimination. Whites reported the highest levels of life satisfaction and the lowest levels of depressive symptoms. Relative to major lifetime discrimination, everyday discrimination had a somewhat stronger correlation with mental health indicators. The relationships between discrimination and mental health outcomes were stronger for White compared to Black older adults, although everyday discrimination was still significantly associated with outcomes for Black older adults. Conclusions: Black older adults experience the greatest number of discriminative events, but weaker associated mental health outcomes. This could be because they have become accustomed to these experiences, benefit from social or cultural resources that serve as buffers, or selective survival, with the present sample capturing only the most resilient older adults who have learned to cope with the deleterious effects of discrimination.