Coley Sheryl L, Mendes de Leon Carlos F, Ward Earlise C, Barnes Lisa L, Skarupski Kimberly A, Jacobs Elizabeth A
University of Wisconsin Madison, Madison, WI, USA.
School of Medicine and Public Health, University of Wisconsin Madison, WARF Building, 610 Walnut St, 9th Floor, Suite 957, Madison, WI, 53726, USA.
Qual Life Res. 2017 Dec;26(12):3449-3458. doi: 10.1007/s11136-017-1663-9. Epub 2017 Jul 25.
Emerging data suggest that African-American women may fare worse than African-American men in health-related quality-of-life (HRQOL). Perceived discrimination is an important contributor to poor health overall among African Americans, but few studies examined the intersecting effects of perceived discrimination and gender in explaining HRQOL disparities. We investigated gender differences in HRQOL and tested whether perceived discrimination accounted for these differences.
We examined data from the Chicago Health and Aging Project in which 5652 African-American adults aged 65 and older completed structured questionnaires about demographic and socioeconomic characteristics, HRQOL, perceived discrimination, and health-related variables. Logistic regression models were used to identify associations between perceived discrimination and gender differences in poor HRQOL outcomes (defined as 14+ unhealthy days in overall, physical, or mental health over the past 30 days) when controlling for the other variables.
More women reported poor overall HRQOL than men (24 vs. 16% respectively). Higher perceived discrimination was significantly associated with worse overall HRQOL (OR 1.11; 95% CI 1.08, 1.15), with stronger effects for women in overall and mental HRQOL. These gender disparities remained significant until controlling for potentially confounding variables. Perceived discrimination did not account for gender differences in poor physical HRQOL.
Perceived discrimination is associated with poor HRQOL in older African Americans, with this association appearing stronger in women than men for mental HRQOL. These findings warrant further investigation of effects of perceived discrimination in gender disparities in overall health, and such research can inform and guide efforts for reducing these disparities.
新出现的数据表明，非裔美国女性在健康相关生活质量（HRQOL）方面可能比非裔美国男性更差。感知到的歧视是导致非裔美国人整体健康状况不佳的一个重要因素，但很少有研究探讨感知到的歧视和性别在解释HRQOL差异方面的交叉影响。我们调查了HRQOL中的性别差异，并测试了感知到的歧视是否能解释这些差异。
我们研究了芝加哥健康与老龄化项目的数据，该项目中5652名65岁及以上的非裔美国成年人完成了关于人口统计学和社会经济特征、HRQOL、感知到的歧视以及健康相关变量的结构化问卷。在控制其他变量时，使用逻辑回归模型来确定感知到的歧视与不良HRQOL结果（定义为过去30天内总体、身体或心理健康方面有14天及以上不健康天数）中的性别差异之间的关联。
报告整体HRQOL较差的女性比男性更多（分别为24%和16%）。更高的感知到的歧视与更差的整体HRQOL显著相关（OR 1.11；95% CI 1.08，1.15），对女性在整体和心理HRQOL方面的影响更强。在控制潜在的混杂变量之前，这些性别差异仍然显著。感知到的歧视并不能解释身体HRQOL较差方面的性别差异。
在老年非裔美国人中，感知到的歧视与不良HRQOL相关，这种关联在女性中比男性在心理HRQOL方面表现得更强。这些发现值得进一步研究感知到的歧视在整体健康性别差异中的影响，此类研究可为减少这些差异的努力提供信息和指导。
