Liu Han, Yang Tse-Chuan
Department of Sociology, University at Albany, SUNY, 1400 Washington Avenue, Albany, NY 12222.
Department of Preventive Medicine and Population Health, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77551.
Popul Res Policy Rev. 2022 Aug;41(4):1757-1777. doi: 10.1007/s11113-022-09712-8. Epub 2022 Mar 21.
This study aims to fill two interrelated knowledge gaps in the extant literature on the association between perceived discrimination and health. First, potential selection bias associated with pre-existing health conditions has rarely been rigorously tested in empirical studies. Second, whether there is a reciprocal relationship between perceived discrimination and health has been underexplored. Using longitudinal data from the Americans' Changing Lives data, waves 3 to 5 (1,058), we test the reciprocity between perceived discrimination and health with a formal mediation analysis technique. We also use the Heckman correction to adjust for the potential selection bias associated with attrition. Our analysis indicates that perceived discrimination is associated with poor self-rated health and depressive symptoms even when previous health conditions are considered. Furthermore, net of other confounders, there is a reciprocal relationship between perceived discrimination and depressive symptoms. However, this reciprocity does not hold for self-rated health. These findings indicate that there is a vicious circle between perceived discrimination and mental health. That is, poor mental health may lead to perceived discrimination, and heightened perceived discrimination may subsequently increase depressive symptoms. Sensitivity tests suggest that this reciprocity may vary by gender and race.
本研究旨在填补现有文献中关于感知到的歧视与健康之间关联的两个相互关联的知识空白。第一，与既有健康状况相关的潜在选择偏差在实证研究中很少得到严格检验。第二，感知到的歧视与健康之间是否存在相互关系一直未得到充分探讨。利用来自“美国人生活变迁”数据第3至5波（共1058个样本）的纵向数据，我们采用正式的中介分析技术来检验感知到的歧视与健康之间的相互关系。我们还使用赫克曼校正法来调整与样本流失相关的潜在选择偏差。我们的分析表明，即使考虑了先前的健康状况，感知到的歧视仍与自评健康状况不佳和抑郁症状相关。此外，在排除其他混杂因素后，感知到的歧视与抑郁症状之间存在相互关系。然而，这种相互关系在自评健康方面并不成立。这些发现表明，感知到的歧视与心理健康之间存在恶性循环。也就是说，心理健康不佳可能导致感知到的歧视，而感知到的歧视加剧可能随后增加抑郁症状。敏感性检验表明，这种相互关系可能因性别和种族而异。
