Department of Family and Preventive Medicine, Rush Medical College, Chicago, Illinois, USA.
Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.
J Gerontol A Biol Sci Med Sci. 2024 May 1;79(5). doi: 10.1093/gerona/glae089.
Everyday discrimination-experiences of being treated unfairly based on background characteristics like race-is linked to poor physical and mental health throughout the lifespan. Whether more experiences of discrimination are associated with higher odds of being hospitalized in older African Americans has not been explored.
Community-dwelling participants from 3 longitudinal cohort studies (N = 446, age 65+ years) with discrimination scores and ≥12 months of linked Medicare claims were included. Hospitalizations were identified using Medicare fee-for-service claims, available for an average of 6.2 (SD: 3.7) years of follow-up after baseline.
In mixed-effects ordinal logistic regression models (outcomes of 0, 1, or 2+ hospitalizations per year) adjusted for age, sex, education, and income, higher discrimination was associated with higher odds of total annual hospitalizations (odds ratio [OR] per point higher = 1.09, 95% confidence intervals [95% CI]: 1.02-1.17). Results were similar when accounting for depressive symptoms.
Higher exposure to everyday discrimination is associated with higher odds of hospitalization among older African Americans. Mechanisms underlying associations should be explored further to understand how hospitalizations may be reduced in older African Americans.
日常生活中的歧视——基于种族等背景特征的不公平待遇经历——与整个生命周期的身心健康不良有关。尚未探讨更多的歧视经历是否与老年非裔美国人住院的几率更高有关。
本研究纳入了来自 3 项纵向队列研究的社区居民参与者（N=446，年龄≥65 岁），这些参与者具有歧视评分和≥12 个月的相关医疗保险索赔记录。使用医疗保险按服务收费索赔来确定住院情况，在基线后平均有 6.2（SD：3.7）年的随访时间可获取这些索赔记录。
在调整年龄、性别、教育程度和收入的混合效应有序逻辑回归模型（每年 0、1 或 2+次住院的结局）中，较高的歧视与每年总住院次数的几率较高相关（每增加 1 分的比值比[OR]为 1.09，95%置信区间[95%CI]：1.02-1.17）。当考虑到抑郁症状时，结果仍然相似。
更高程度的日常歧视与老年非裔美国人住院的几率增加有关。应进一步探讨关联的潜在机制，以了解如何降低老年非裔美国人的住院率。
