McCubbin Laurie D, Antonio Mapuana
Educational Leadership and Counseling Psychology, Washington State University, Pullman, WA 99164, USA.
Hawaii J Med Public Health. 2012 Dec;71(12):346-52.
Among ethnic populations in Hawai'i, Native Hawaiians continue to be over-represented with the highest rates in: morbidity and mortality, chronic health conditions, and the health risks of being overweight and obese. Focused on these two health risks, the investigation reported in this article has a specific aim of empirically determining whether social stigma as manifested in the form of perceived overt or covert discrimination is a contributing factor. Current studies focused on select ethnic populations, particularly African Americans point to discrimination as an important but understudied predictor of adverse health outcomes. Acknowledging the paucity of research on discrimination and its role in the health of Native Hawaiians, this investigation utilizes data from the 2007 Hawaiian Health Survey which was coordinated by the Department of Health, and the Office of Health Status Monitoring and implemented by SMS Hawai'i. The weighted sample of Hawai'i adults included measures of race/ethnicity and of everyday discrimination and the BMI (Body Mass Index). Logistic regression analyses were applied to determine if: (a) discrimination was significantly related to being overweight and/or obesity; and (b) whether this relationship remained a salient predictor after key demographic factors of gender, age, education, income, and length of time in the Islands were taken into account. This study confirmed the negative influence of overt discrimination as well as the protective nature of covert discrimination in explaining the variability in obesity/overweight in Native Hawaiians. The implications of this study for strategic interventions and research are discussed.
在夏威夷的各族裔人群中,夏威夷原住民在发病率和死亡率、慢性健康状况以及超重和肥胖的健康风险方面的比例仍然过高。针对这两种健康风险,本文所报告的调查有一个具体目标,即通过实证确定以明显或隐蔽的歧视形式表现出来的社会耻辱感是否是一个促成因素。目前针对特定族裔人群的研究,特别是针对非裔美国人的研究指出,歧视是不良健康结果的一个重要但研究不足的预测因素。鉴于对歧视及其在夏威夷原住民健康中的作用的研究匮乏,本调查利用了由卫生部协调、健康状况监测办公室负责并由夏威夷短信公司实施的2007年夏威夷健康调查的数据。夏威夷成年人的加权样本包括种族/族裔、日常歧视以及体重指数(BMI)的测量。应用逻辑回归分析来确定:(a)歧视是否与超重和/或肥胖显著相关;以及(b)在考虑了性别、年龄、教育程度、收入和在该岛屿居住时间等关键人口因素后,这种关系是否仍然是一个显著的预测因素。本研究证实了明显歧视的负面影响以及隐蔽歧视在解释夏威夷原住民肥胖/超重差异方面的保护性质。本文还讨论了该研究对战略干预和研究的意义。