Skrine Jeffers Kia, Walton Quenette L, Robinson Millicent N, Thomas Tobin Courtney S
School of Nursing, University of California, 700 Tiverton Ave., Box 956918, Los Angeles, CA 90095, USA.
Graduate College of Social Work, University of Houston, 3511 Cullen Blvd., Houston, TX 77204-4013, USA.
Healthcare (Basel). 2021 Nov 9;9(11):1528. doi: 10.3390/healthcare9111528.
To clarify the ways in which Black Americans' experiences of structural racism may influence their mental and physical health in distinct ways, the present study evaluated whether major discrimination moderates the association between depressive symptoms and chronic physical health conditions among this population. -tests and chi-squared tests of significance were used to determine significant differences between women and men. The association between major discrimination and depressive symptoms was examined by assessing mean depressive symptoms scores across levels of major discrimination. ANOVA tests indicated whether there were significant differences in symptom scores across each discrimination category. Additional -tests determined significant gender differences within each level of discrimination. Gender-stratified negative binomial models were used, and odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for the relationship between depressive symptoms, major discrimination, and chronic conditions. Our findings indicated that the association between depressive symptoms and chronic conditions depends on lifetime experiences of major discrimination among Black Americans and varies significantly between women and men. Considering that major discrimination conditioned the depressive symptom-chronic conditions association among our sample, this provides insight into potential pathways for intervention in efforts to offset the detrimental mental and physical consequences of experiencing racism.
为了阐明美国黑人遭受结构性种族主义的经历可能以不同方式影响其身心健康的途径，本研究评估了主要歧视是否会调节该人群中抑郁症状与慢性身体健康状况之间的关联。使用t检验和卡方显著性检验来确定女性和男性之间的显著差异。通过评估主要歧视各水平下的平均抑郁症状得分，来检验主要歧视与抑郁症状之间的关联。方差分析测试表明各歧视类别在症状得分上是否存在显著差异。额外的t检验确定了每个歧视水平内显著的性别差异。使用了按性别分层的负二项模型，并估计了抑郁症状、主要歧视和慢性病之间关系的比值比（OR）和95%置信区间（CI）。我们的研究结果表明，抑郁症状与慢性病之间的关联取决于美国黑人一生中遭受主要歧视的经历，并且在女性和男性之间存在显著差异。鉴于主要歧视调节了我们样本中抑郁症状与慢性病之间的关联，这为干预措施提供了潜在途径，以努力抵消经历种族主义所带来的有害身心健康后果。
