Perreira Krista M, Wassink Joshua, Harris Kathleen Mullan
University of North Carolina, Chapel Hill.
Popul Res Policy Rev. 2019 Apr;38(2):271-299. doi: 10.1007/s11113-018-9503-3. Epub 2018 Dec 15.
Researchers typically identify health disparities using self-reported race/ethnicity, a measure identifying individuals' social and cultural affiliations. In this study, we use data from Waves 1, 3, and 4 of Add Health to examine health disparities by interviewer-ascribed skin color, a measure capturing the perceptions of race/ethnicity ascribed to individuals by others. Individuals with darker skin tones may face greater exposure to serious stressors such as perceived discrimination, poverty, and economic hardship which can accumulate over the lifecourse and increase the likelihood of poor health. We found significant gradients in Body Mass Index (BMI), obesity, self-reported health, and depressive symptoms by interviewer-ascribed skin color but results differed by gender. Associations of BMI, obesity, and fair/poor health among women were only partially mediated by discrimination, self-reported stress, or low socio-economic status and persisted after controlling for race/ethnicity. Among men, initial associations between skin color and both fair/poor health and depressive symptoms did not persist after controlling for race/ethnicity. This study demonstrates the value of considering stratification by skin color and gender in conjunction with race/ethnicity.
研究人员通常使用自我报告的种族/族裔来识别健康差异，这是一种识别个人社会和文化归属的指标。在本研究中，我们使用“青少年健康纵向研究”第1、3和4轮的数据，通过访员判定的肤色来研究健康差异，这一指标反映了他人对个人种族/族裔的认知。肤色较深的个体可能面临更多严重的压力源，如感知到的歧视、贫困和经济困难，这些压力源会在生命历程中不断累积，增加健康状况不佳的可能性。我们发现，根据访员判定的肤色，体重指数（BMI）、肥胖、自我报告的健康状况和抑郁症状存在显著梯度，但结果因性别而异。女性中BMI、肥胖与健康状况良好/不佳之间的关联仅部分由歧视、自我报告的压力或低社会经济地位介导，在控制种族/族裔后仍然存在。在男性中，在控制种族/族裔后，肤色与健康状况良好/不佳以及抑郁症状之间的初始关联不再存在。本研究证明了结合种族/族裔考虑肤色和性别分层的价值。
