Sutin Angelina R, Stephan Yannick, Carretta Henry, Terracciano Antonio
Florida State University College of Medicine, Tallahassee, FL.
University of Montpellier, Montpellier, France.
Am J Geriatr Psychiatry. 2015 Feb;23(2):171-9. doi: 10.1016/j.jagp.2014.03.007. Epub 2014 Mar 21.
To examine whether perceived discrimination based on multiple personal characteristics is associated with physical, emotional, and cognitive health concurrently, prospectively, and with change in health over time among older adults.
Longitudinal.
Health and Retirement Study (HRS).
Participants (N = 7,622) who completed the Leave-Behind Questionnaire as part of the 2006 HRS assessment (mean age 67 years); participants (N = 6,450) completed the same health measures again in 2010.
Participants rated their everyday experience with discrimination and attributed those experiences to eight personal characteristics: race, ancestry, sex, age, weight, physical disability, appearance, and sexual orientation. At both the 2006 and 2010 assessments, participants completed measures of physical health (subjective health, disease burden), emotional health (life satisfaction, loneliness), and cognitive health (memory, mental status).
Discrimination based on age, weight, physical disability, and appearance was associated with poor subjective health, greater disease burden, lower life satisfaction, and greater loneliness at both assessments and with declines in health across the four years. Discrimination based on race, ancestry, sex, and sexual orientation was associated with greater loneliness at both time points, but not with change over time. Discrimination was mostly unrelated to cognitive health.
The detrimental effect of discrimination on physical and emotional health is not limited to young adulthood but continues to contribute to health and well-being in old age. These effects were driven primarily by discrimination based on personal characteristics that change over time (e.g., age, weight) rather than discrimination based on more stable characteristics (e.g., race, sex).
探讨基于多种个人特征的感知歧视是否与老年人的身体、情感和认知健康同时、前瞻性地相关,以及是否与健康随时间的变化相关。
纵向研究。
健康与退休研究(HRS)。
作为2006年HRS评估一部分完成留置问卷的参与者(N = 7622)(平均年龄67岁);2010年,参与者(N = 6450)再次完成相同的健康测量。
参与者对他们日常遭遇歧视的经历进行评分,并将这些经历归因于八个个人特征:种族、祖籍、性别、年龄、体重、身体残疾、外貌和性取向。在2006年和2010年的评估中,参与者均完成了身体健康(主观健康、疾病负担)、情感健康(生活满意度、孤独感)和认知健康(记忆力、精神状态)的测量。
在两次评估中,基于年龄、体重、身体残疾和外貌的歧视均与较差的主观健康、更大的疾病负担、较低的生活满意度和更强的孤独感相关,并且与四年间的健康状况下降相关。基于种族、祖籍、性别和性取向的歧视在两个时间点均与更强的孤独感相关,但与随时间的变化无关。歧视大多与认知健康无关。
歧视对身体和情感健康的有害影响并不局限于年轻成年期,而是会持续影响老年人的健康和幸福。这些影响主要是由基于随时间变化的个人特征(如年龄、体重)的歧视驱动的,而非基于更稳定特征(如种族、性别)的歧视。