The continuing significance of discrimination: Multiple forms of discrimination and health

Researchers have documented the continuing significance of discrimination as a key mechanism through which social inequality is produced and maintained. While evidence confirms the consistent, wide-reaching impact of discrimination on health, prior research has yielded mixed findings regarding the extent to which these experiences contribute to health disparities. In this dissertation, I advance a multidimensional conceptualization of discrimination and provide a more comprehensive assessment of the health consequences of these experiences in three ways. First, using data from the Health and Retirement Study (HRS), and the National Survey for Midlife Development in the US (MIDUS), I assess whether the prevalence, distribution, and health consequences of differential treatment vary by question wording ("unfair treatment" versus "discrimination"). I find that the language of "unfair treatment" yields greater reports of differential treatment than do reports of "discrimination." This difference, however, is due to increased reports among privileged social groups, particularly whites. In addition, unfair treatment has a larger negative impact on mental (but not physical) health than discrimination - an effect that is limited to whites. I argue that unfair treatment and discrimination likely reflect distinct concepts, as such cannot be used interchangeably in research. Second, I use MIDUS data to assess the links between multiple disadvantaged statuses, multiple dimensions of discrimination, and health. I find that adults who hold multiple stigmatized statuses are at an elevated risk for poor mental and physical health because they face more forms of discrimination (e.g., race and gender) than their more privileged counterparts. Finally, I use data from the Black Youth Culture Survey to investigate the association between multiple forms of discrimination and sexual health among Black, Latina/o, and white heterosexual youth. I find that youth who face more frequent exposure to multiple forms of discrimination are more likely to engage in risky sexual behaviors: early sexual initiation, multiple sex partners, and inconsistent condom and contraceptive use. These practices, in turn, increase their likelihood of teen pregnancy and having an abortion. Taken together, this dissertation offers ways to better conceptualize and measure discrimination and to assess the broad reach of its consequences for victims' health and well-being.

Copyright - Copyright ProQuest, UMI Dissertations Publishing 2013 Last updated - 2013-09-03 First page - n/a

Epidemiology

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