Center for Population Health and Health Disparities, Northeastern University, Boston, USA.
Sociol Health Illn. 2010 Sep;32(6):843-61. doi: 10.1111/j.1467-9566.2010.01257.x. Epub 2010 Jul 23.
Racism and discrimination can have significant implications for health, through complex biopsychosocial interactions. Latino groups, and particularly Puerto Ricans, are an understudied population in the United States in terms of the prevalence of discrimination and its relevance to health. Participants in our study were 45- to 75-year-old (N = 1122) Puerto Ricans. The measures were perceived discrimination, depressive symptomatology (CES-D), perceived stress (PSS), self-rated health, medical conditions, blood pressure, smoking and drinking behaviours, demographics. Our findings show that 36.9 per cent of participants had at some time experienced discrimination, with men, those with more years of education, currently employed and with higher incomes being more likely to report it. Experiences of discrimination were associated with increased levels of depressive symptoms and perceived stress. When controlling for covariates, perceived discrimination was predictive of the number of medical conditions, of ever having smoked and having been a drinker, and having higher values of diastolic pressure. Depressive symptoms are a mediator of the effect of perceived discrimination on medical conditions, confirmed by the Sobel test: z = 3.57, p < 0.001. Mediating roles of perceived stress, smoking and drinking behaviours were not confirmed. Increased depressive symptoms might be the main pathway through which perceived discrimination is associated with a greater number of medical diagnoses.
种族主义和歧视会通过复杂的生物心理社会相互作用对健康产生重大影响。在歧视的普遍性及其与健康的相关性方面,拉丁裔群体,尤其是波多黎各人,是美国研究不足的人群。我们研究的参与者是 45 至 75 岁(N = 1122)的波多黎各人。测量指标包括感知歧视、抑郁症状(CES-D)、感知压力(PSS)、自评健康、医疗状况、血压、吸烟和饮酒行为以及人口统计学特征。我们的研究结果表明,36.9%的参与者曾经历过某种形式的歧视,男性、受教育程度较高、目前在职和收入较高的人更有可能报告这种情况。歧视经历与抑郁症状和感知压力的增加水平有关。在控制了协变量后,感知歧视与医疗状况的数量、吸烟和饮酒行为以及舒张压的数值升高有关。抑郁症状是感知歧视对医疗状况影响的中介因素,这一结论得到 Sobel 检验的证实:z = 3.57,p < 0.001。感知压力、吸烟和饮酒行为的中介作用并未得到证实。抑郁症状的增加可能是感知歧视与更多医疗诊断相关的主要途径。