Does health predict the reporting of racial discrimination or do reports of discrimination predict health? Findings from the National Longitudinal Study of Youth

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Abstract

Racial discrimination may contribute to diminished well-being, possibly through stress and restricted economic advancement. Our study examines whether reports of racial discrimination predict health problems, and whether health problems predict the reporting of racial discrimination. Data come from years 1979 to 1983 of the US National Longitudinal Study of Youth, focusing on respondents of Black (n = 1851), Hispanic (n = 1170), White (n = 3450) and other (n = 1387) descent. Our analyses indicate that reports of racial discrimination in seeking employment predict health-related work limitations, although these limitations develop over time, and not immediately. We also find that reports of discrimination at two time-points appear more strongly related to health-related work limitations than reports at one time-point. A key finding is that these limitations do not predict the subsequent reporting of racial discrimination in seeking employment. These findings inform our knowledge of the temporal ordering of racial discrimination in seeking employment and health-related work conditions among young adults. The findings also indicate that future research should carefully attend to the patterns and timing of discrimination.

Introduction

Hundreds of studies document the relationship between self-reported discrimination and illness (Mays et al., 2007, Paradies, 2006, Williams et al., 2003). Yet, most studies use cross-sectional data, leading to major questions as to the direction of causality. Whereas it is theorized that racial discrimination causes illness, few studies have examined whether illness causes one to report racial discrimination. In the current study, we focus on the United States and examine three questions: (1) does morbidity, as measured by health-related work limitations, predict subsequent reports of racial discrimination in employment; (2) do reports of such discrimination predict subsequent health-related work limitations; and (3) are patterns of reporting discrimination related to patterns of these limitations; for example, are repeated reports of discrimination more strongly associated with chronic work limitations than single reports? Informed by stress theory, we investigate these questions using data from the US National Longitudinal Study of Youth (NLSY).

Section snippets

Background

Discrimination refers to actions initiated and maintained by social institutions and individuals that systematically harm members of socially marginalized groups and reinforce systems of power and privilege (Feagin, 2000). These actions form a continuum, ranging from extreme violence to subtle disrespect, and may occur at both the structural and individual level (Carmichael & Hamilton, 1967) Discrimination related to employment and work may reduce one's ability to secure material resources and

Methods

We use data from the US National Longitudinal Survey of Youth, a nationally representative sample of young men and women ages 14–21 years in 1979 (Bureau of Labor Statistics, 2003). Our analyses focus on data collected between 1979 and 1983, the years when discrimination and health limitations were simultaneously measured.

We include respondents ages 16 or over who were asked about discrimination in 1979 (2507 youth ages 14–15 were not asked). Military personnel were excluded (n = 1649) because

Results

Table 2 shows the weighted characteristics of our study sample. About 12% of the sample were Black, 6% were Hispanic, 20% other race, and the remainder White. Women comprised 52% of the sample. About 5% of the respondents were foreign-born and about 30% were born in the U.S. South. In 1982, respondents were about 22 years of age and had 12.5 years of education. Approximately 67% were employed in 1982, and most were in sales or service occupations (46%). Nine percent reported at least one work

Discussion

Our analyses of longitudinal data from the NLSY indicate three major findings. First, the reporting of employment-based racial discrimination predicts subsequent health-related work limitations. Second, earlier, but not recent, reports of discrimination increase the odds of having a work limitation. Additionally, repeated reports of discrimination are strongly related to chronic limitations, but single reports of discrimination are not. Third, work limitations did not predict the reporting of

References (41)

  • S. Carmichael et al.

    Black power: The politics of liberation in America

    (1967)
  • S. Cohen

    Aftereffects of stress on human performance and social behavior

    Psychological Bulletin

    (1980)
  • J.R. Feagin

    Racist America: Roots, current realities, and future reparations

    (2000)
  • B.K. Finch et al.

    Perceived discrimination and depression among Mexican-origin adults in California

    Journal of Health and Social Behavior

    (2000)
  • G.C. Gee et al.

    Social support as a buffer for perceived unfair treatment among Filipino Americans: differences between San Francisco and Honolulu

    American Journal of Public Health

    (2006)
  • G.C. Gee et al.

    Age, cohort and perceived age discrimination: using the life course to assess self-reported age discrimination

    Social Forces

    (2007)
  • A.T. Geronimus et al.

    “Weathering” and age patterns of allostatic load scores among Blacks and Whites in the United States

    American Journal of Public Health

    (2006)
  • J.S. Jackson et al.

    Racism and the physical and mental health status of African Americans: a thirteen year national panel study

    Ethnicity and Disease

    (1996)
  • R.J. Johnson et al.

    The structure of health status among older adults: disease, disability, functional limitation, and perceived health

    Journal of Health and Social Behavior

    (1993)
  • R.C. Kessler et al.

    The prevalence, distribution, & mental health correlates of perceived discrimination in the U.S

    Journal of Health and Social Behavior

    (1999)
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    We thank Kaori Fujishiro for helpful comments with an earlier version of this manuscript.

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