Effects of perceived racial discrimination on health status and health behavior: A differential mediation hypothesis.

Frederick X. Gibbons · John H. Kingsbury · Chih‐Yuan Weng · Meg Gerrard · Carolyn E. Cutrona · Thomas A. Wills +1 more

105 citations0/0 files storedHealth Psychology

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Racial and Ethnic Identity Research Health disparities and outcomes Gender, Health, and Social Inequality

Abstract

OBJECTIVE: Prospective data tested a "differential mediation" hypothesis: The relations (found in previous research) between perceived racial discrimination and physical health status versus health-impairing behavior (problematic substance use) are mediated by two different types of affective reactions, internalizing and externalizing. METHOD: The sample included 680 African American women from the Family and Community Health Study (M age = 37 years at Time 1; 45 years at Time 4). Four waves of data were analyzed. Perceived discrimination was assessed, along with anxiety and depression (internalizing) and hostility/anger (externalizing) as mediators, and physical health status and problematic substance use (drinking) as outcomes. RESULTS: Structural equation modeling indicated that discrimination predicted increases in both externalizing and internalizing reactions. These affective responses, in turn, predicted subsequent problematic substance use and physical health status, respectively, also controlling for earlier reports. In each case, the indirect effects from discrimination through the affective mediator to the specific health outcome were significant and consistent with the differential mediation hypothesis. CONCLUSIONS: Perceived racial discrimination is associated with increases in internalizing and externalizing reactions among Black women, but these reactions are related to different health outcomes. Changes in internalizing are associated with self-reported changes in physical health status, whereas changes in externalizing are associated with changes in substance use problems. Discussion focuses on the processes whereby discrimination affects health behavior and physical health status.

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References

1996A 12-Item Short-Form Health Survey 1997Self-Rated Health and Mortality: A Review of Twenty-Seven Community Studies 2009Perceived discrimination and health: A meta-analytic review.2008Discrimination and racial disparities in health: evidence and needed research 1999Racism as a stressor for African Americans: A biopsychosocial model.2003Racial/Ethnic Discrimination and Health: Findings From Community Studies 2008Constructive and unconstructive repetitive thought.1996The Schedule of Racist Events: A Measure of Racial Discrimination and a Study of Its Negative Physical and Mental Health Consequences

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