Vines Anissa I, Ward Julia B, Cordoba Evette, Black Kristin Z
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 266 Rosenau Hall, CB #7435, 135 Dauer Drive, Chapel Hill, NC 27599-7435.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB #7435, Chapel Hill, NC 27599-7435.
Curr Epidemiol Rep. 2017 Jun;4(2):156-165. doi: 10.1007/s40471-017-0106-z. Epub 2017 Apr 27.
Recent literature on racial or ethnic discrimination and mental health was reviewed to assess the current science and identify key areas of emphasis for social epidemiology. Objectives of this review were to: 1) Determine whether there have been advancements in the measurement and analysis of perceived discrimination; 2) Identify the use of theories and/or frameworks in perceived discrimination and mental health research; and 3) Assess the extent to which stress buffers are being considered and evaluated in the existing literature.
Metrics and analytic approaches used to assess discrimination remain largely unchanged. Theory and/or frameworks such as the stress and coping framework continue to be underused in majority of the studies. Adolescents and young adults experiencing racial/ethnic discrimination were at greater risk of adverse mental health outcomes, and the accumulation of stressors over the life course may have an aggregate impact on mental health. Some growth seems evident in studies examining the mediation and moderation of stress buffers and other key factors with the findings suggesting a reduction in the effects of discrimination on mental health.
Discrimination scales should consider the multiple social identities of a person, the context where the exposure occurs, how the stressor manifests specifically in adolescents, the historical traumas, and cumulative exposure. Life course theory and intersectionality may help guide future work. Despite existing research, gaps remain in in elucidating the effects of racial and ethnic discrimination on mental health, signaling an opportunity and a call to social epidemiologists to engage in interdisciplinary research to speed research progress.
回顾近期关于种族或民族歧视与心理健康的文献,以评估当前的科学研究状况,并确定社会流行病学的重点领域。本综述的目标如下:1)确定在感知歧视的测量和分析方面是否有进展;2)确定在感知歧视和心理健康研究中理论和/或框架的应用情况;3)评估现有文献中对压力缓冲因素的考虑和评估程度。
用于评估歧视的指标和分析方法基本未变。压力与应对框架等理论和/或框架在大多数研究中仍未得到充分利用。经历种族/民族歧视的青少年和年轻人出现不良心理健康结果的风险更高,一生中压力源的累积可能会对心理健康产生总体影响。在研究压力缓冲因素及其他关键因素的中介作用和调节作用方面,已有一些明显进展,研究结果表明歧视对心理健康的影响有所降低。
歧视量表应考虑一个人的多种社会身份、接触发生的背景、压力源在青少年中具体的表现形式、历史创伤以及累积接触情况。生命历程理论和交叉性理论可能有助于指导未来的研究工作。尽管已有相关研究,但在阐明种族和民族歧视对心理健康的影响方面仍存在差距,这为社会流行病学家提供了一个机会,也呼吁他们开展跨学科研究以加快研究进展。