Dual Sensory Impairment and Perceived Everyday Discrimination in the United States

Perceived everyday discrimination is a psychosocial stressor that has been linked to adverse health outcomes including increased mortality. We assessed the association of vision, hearing and dual sensory impairments (VI, HI, and DSI, respectively) with the perception of everyday discrimination using a cross-sectional analysis of the Health and Retirement Study 2006 and 2008 visits. Perceived everyday discrimination was measured on the validated Williams scale (range 0 to 5). Participants rated their vision and hearing, using eyeglasses or hearing aids if applicable, on an ordinal scale (poor, fair, good, very good, excellent). Sensory impairment was defined as poor or fair self-rated ability in the relevant sensory modality, and sensory impairment was categorized as neither sensory impairment (NSI), VI alone, HI alone, and DSI. Linear regression models were used to estimate differences in perceived discrimination associated with sensory impairment, after adjusting for age, sex, race, ethnicity, foreign birth, body mass index, relationship status, net household wealth, and number of chronic diseases (among diabetes, hypertension, heart disease, stroke, lung disease, non-skin cancer, and arthritis). Analyses were adjusted for the complex survey design and differential nonresponse. Nursing home residents were excluded. We included 13,092 individuals. After applying survey weights, 11.7% had VI alone, 13.1% had HI alone, and 7.9% had DSI. In the fully adjusted model, participants with VI alone (β = 0.07; CI = 0.02 – 0.13) and HI alone (β = 0.07; CI = 0.02 – 0.11) perceived greater everyday discrimination compared with participants with NSI. The DSI group perceived greater discrimination (β = 0.23; CI = 0.16 – 0.29) compared with NSI, VI alone (β = 0.16; CI = 0.08 – 0.23), and HI alone (β = 0.16; CI = 0.09 – 0.23) groups. Older adults with hearing or vision loss in the United States perceive greater discrimination in their day-to-day lives than non-sensory impaired older adults. Older adults with both hearing and vision loss perceive even more discrimination than those with either hearing or vision loss alone.