Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, 4200 Valley Drive, College Park, MD, 20742, USA.
Department of Medical Oncology, Division of Population Science, Thomas Jefferson University, 834 Chestnut Street, Philadelphia, PA, 19107, USA.
J Racial Ethn Health Disparities. 2022 Aug;9(4):1262-1275. doi: 10.1007/s40615-021-01067-8. Epub 2021 Jun 4.
We aimed to examine the relationship between everyday and major racial discrimination with health-related quality of life (HRQOL), which consists of self-rated health, days of poor physical health, mental health, and activity limitation.
In a cross-sectional analytic sample of 524 foreign-born Asian adults, aged 18 years and older, we conducted multivariable logistic regression and multivariable negative binomial regression to examine associations between discrimination and HRQOL. Furthermore, potential effect modification was tested by gender, ethnicity, and social support.
Associations were found between everyday racial discrimination and days of poor physical health (incidence rate ratio, IRR = 1.05), mental health (IRR = 1.03), and activity limitation (IRR = 1.05). Stronger significant associations were observed between major racial discrimination and days of poor physical health (IRR = 1.21), mental health (IRR = 1.16), and activity limitation (IRR = 1.53), adjusting for all covariates. Racial discrimination was not associated with poor self-rated health. In addition, gender significantly modified the relationship between continuous racial discrimination and activity limitation days with associations of greater magnitude among men, while social support significantly modified the association between categorized major racial discrimination and physically unhealthy days. When stratified, the association was only significant among those with low social support (IRR = 3.04; 95% CI: 1.60, 5.79) as opposed to high social support.
This study supports the association between racial discrimination and worse HRQOL among Asian Americans, which can inform future interventions, especially among men and those with low social support, aimed at improving the quality of life in this population.
我们旨在研究日常和重大种族歧视与健康相关生活质量(HRQOL)之间的关系,后者由自评健康、身体不适天数、心理健康和活动受限构成。
在一项包含 524 名 18 岁及以上的外国出生亚洲成年人的横断面分析样本中,我们进行了多变量逻辑回归和多变量负二项回归分析,以研究歧视与 HRQOL 之间的关联。此外,通过性别、族裔和社会支持测试了潜在的效应修饰作用。
发现日常种族歧视与身体不适天数(发病率比,IRR=1.05)、心理健康(IRR=1.03)和活动受限(IRR=1.05)之间存在关联。重大种族歧视与身体不适天数(IRR=1.21)、心理健康(IRR=1.16)和活动受限(IRR=1.53)之间存在更强的显著关联,所有协变量都进行了调整。种族歧视与自评健康状况不佳无关。此外,性别显著修饰了连续种族歧视与活动受限天数之间的关系,这种关联在男性中更为显著,而社会支持则显著修饰了分类重大种族歧视与身体不健康天数之间的关系。分层后,这种关联仅在社会支持度低的人群中显著(IRR=3.04;95%CI:1.60,5.79),而在社会支持度高的人群中不显著。
这项研究支持了种族歧视与亚裔美国人较差的 HRQOL 之间的关联,这为未来的干预措施提供了依据,特别是针对男性和社会支持度低的人群,旨在提高该人群的生活质量。