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非贫困非裔美国人和西班牙裔人群健康的种族差异:急性和慢性歧视的作用。

Racial disparities in health among nonpoor African Americans and Hispanics: The role of acute and chronic discrimination.

机构信息

Department of Sociology, Ohio State University, United States.

Department of Sociology & Criminology, Penn State University, United States.

出版信息

Soc Sci Med. 2018 Feb;199:167-180. doi: 10.1016/j.socscimed.2017.04.051. Epub 2017 May 6.

Abstract

Racial disparities in health tend to be more pronounced at the upper ends of the socioeconomic (SES) spectrum. Despite having access to above average social and economic resources, nonpoor African Americans and Latinos report significantly worse health compared to nonpoor Whites. We combine data from the parents and children of the 1979 National Longitudinal Survey of Youth (NLSY79) to address two specific research aims. First, we generate longitudinal SES trajectories over a 33-year period to estimate the extent to which socioeconomic mobility is associated with exposure to discrimination (acute and chronic) across different racial/ethnic groups (nonHispanic Whites, nonHispanic Blacks, and Hispanics). Then we determine if the disparate relationship between SES and self-rated health across these groups can be accounted for by more frequent exposure to unfair treatment. For Whites, moderate income gains over time result in significantly less exposure to both acute and chronic discrimination. Upwardly mobile African Americans and Hispanics, however, were significantly more likely to experience acute and chronic discrimination, respectively, than their socioeconomically stable counterparts. We also find that differential exposure to unfair treatment explains a substantial proportion of the Black/White, but not the Hispanic/White, gap in self-rated health among this nationally representative sample of upwardly mobile young adults. The current study adds to the debate that the shape of the SES/health gradient differs, in important ways, across race and provides empirical support for the diminishing health returns hypothesis for racial/ethnic minorities.

摘要

健康方面的种族差异往往在社会经济地位(SES)较高的人群中更为明显。尽管非贫困的非裔美国人和拉丁裔人群能够获得高于平均水平的社会和经济资源,但与非贫困的白人相比,他们的健康状况却明显更差。我们结合了 1979 年全国青年纵向调查(NLSY79)的父母和子女的数据,以实现两个具体的研究目标。首先,我们生成了 33 年的纵向 SES 轨迹,以估计社会经济流动性与不同种族/族裔群体(非西班牙裔白人、非西班牙裔黑人以及西班牙裔)中歧视(急性和慢性)暴露之间的关联程度。然后,我们确定了这些群体中 SES 与自我报告的健康状况之间的差异关系是否可以归因于更频繁地遭受不公平待遇。对于白人来说,随着时间的推移,中等收入的增加导致他们受到急性和慢性歧视的可能性显著降低。然而,向上流动的非裔美国人和西班牙裔人经历急性和慢性歧视的可能性分别比他们社会经济地位稳定的同龄人高得多。我们还发现,不公平待遇的差异暴露在很大程度上解释了在这个具有全国代表性的向上流动年轻成年人样本中,自我报告的健康状况在黑人和白人之间的差距,但不能解释西班牙裔和白人之间的差距。本研究增加了关于 SES/健康梯度的形状在不同种族之间存在重要差异的争论,并为少数族裔的健康回报递减假说提供了经验支持。

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