Lam Vincent, Gupta Sonali, Jordan I King, Mariño-Ramírez Leonardo
National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA.
IHRC-Georgia Tech Applied Bioinformatics Laboratory, Atlanta, Georgia, USA.
medRxiv. 2024 Oct 13:2024.10.11.24315343. doi: 10.1101/2024.10.11.24315343.
The goal of this study was to investigate the association of perceived discrimination with health outcomes and disparities.
The study cohort consists of 60,180 participants from the four largest SIRE groups in the Research Program participant body: Asian (1,291), Black (4,726), Hispanic (5,336), and White (48,827). A perceived discrimination index (PDI) was derived from participant responses to the "Social Determinants of Health" survey, and the Researcher Workbench was used to analyze associations and mediation effects of PDI and self-identified race and ethnicity (SIRE) with 1,755 diseases.
The Black SIRE group has the greatest median PDI, followed by the Asian, Hispanic, and White groups. The Black SIRE group shows the greatest number of diseases with elevated risk relative to the White reference group, followed by the Hispanic and Asian groups. PDI was found to be positively and significantly associated with 489 out of 1,755 (27.86%) diseases. 'Mental Disorders' is the disease category with the greatest proportion of diseases positively and significantly associated with PDI: 59 out of 72 (81.94%) diseases. Mediation analysis showed that PDI mediates 69 out of 351 (19.66%) Black-White disease disparities.
Perceived discrimination is significantly associated with risk for numerous diseases and mediates Black-White disease disparities in the participant cohort.
This work highlights the role of discrimination as an important social determinant of health and provides a means by which it can be quantified and modeled on the platform.
本研究的目的是调查感知到的歧视与健康结果及差异之间的关联。
研究队列由研究项目参与者群体中四个最大的自我认定种族和族裔（SIRE）群体的60180名参与者组成：亚洲人（1291名）、黑人（4726名）、西班牙裔（5336名）和白人（48827名）。感知歧视指数（PDI）源自参与者对“健康的社会决定因素”调查的回答，研究人员利用工作台分析PDI以及自我认定的种族和族裔（SIRE）与1755种疾病之间的关联和中介效应。
黑人SIRE群体的PDI中位数最高，其次是亚洲人、西班牙裔和白人群体。与白人参照组相比，黑人SIRE群体显示出风险升高的疾病数量最多，其次是西班牙裔和亚洲人群体。在1755种（27.86%）疾病中，发现PDI与489种疾病呈正相关且具有显著相关性。“精神障碍”是与PDI呈正相关且具有显著相关性的疾病比例最高的疾病类别：72种疾病中有59种（81.94%）。中介分析表明，PDI介导了351种黑人与白人疾病差异中的69种（19.66%）。
在参与者队列中，感知到的歧视与多种疾病的风险显著相关，并介导了黑人与白人之间的疾病差异。
这项工作突出了歧视作为健康的重要社会决定因素的作用，并提供了一种在该平台上对其进行量化和建模的方法。
