Research Article: Perceived Interpersonal Discrimination and Older Women’s Mental Health: Accumulation Across Domains, Attributions, and Time

Date Published: May 04, 2018

Publisher: Oxford University Press

Author(s): Laia Bécares, Nan Zhang.

http://doi.org/10.1093/aje/kwx326

Abstract

Experiencing discrimination is associated with poor mental health, but how cumulative experiences of perceived interpersonal discrimination across attributes, domains, and time are associated with mental disorders is still unknown. Using data from the Study of Women’s Health Across the Nation (1996–2008), we applied latent class analysis and generalized linear models to estimate the association between cumulative exposure to perceived interpersonal discrimination and older women’s mental health. We found 4 classes of perceived interpersonal discrimination, ranging from cumulative exposure to discrimination over attributes, domains, and time to none or minimal reports of discrimination. Women who experienced cumulative perceived interpersonal discrimination over time and across attributes and domains had the highest risk of depression (Center for Epidemiologic Studies Depression Scale score ≥16) compared with women in all other classes. This was true for all women regardless of race/ethnicity, although the type and severity of perceived discrimination differed across racial/ethnic groups. Cumulative exposure to perceived interpersonal discrimination across attributes, domains, and time has an incremental negative long-term association with mental health. Studies that examine exposure to perceived discrimination due to a single attribute in 1 domain or at 1 point in time underestimate the magnitude and complexity of discrimination and its association with health.

Partial Text

Four distinct classes of perceived interpersonal discrimination were identified in the latent class analyses (see Table 1). Class characteristics are shown in Web Table 1 (available at https://academic.oup.com/aje). The largest proportion of the sample (34%; class 3: accumulation of several domains over time; attribution due to sex and other reasons) experienced the accumulation of several domains of perceived interpersonal discrimination over time (namely being treated with less courtesy or respect; receiving poorer service; people acting as if the respondent was not smart or as if they were better than the respondent; and being ignored) and attributed their experiences of perceived interpersonal discrimination mainly to sex and other attributes. The second largest class (28%; class 4: accumulation of some domains over time; attribution due to other reasons; reduction over time) experienced accumulation of perceived interpersonal discrimination across some domains (being treated with less courtesy or respect and people acting as if they were better than the respondent), although experiences diminished over time. Attributions in class 4 were to reasons other than race/ethnicity or sex. Class 1 (21%; accumulation of perceived interpersonal discrimination over time, domains, and attributes) captured participants who had experienced the highest accumulation of perceived interpersonal discrimination over time, domains, and attributes. Finally, class 2 (17%; no experiences of perceived interpersonal discrimination) included participants who reported having no experiences or very minimal experiences of perceived interpersonal discrimination across any of the 6 time points.
Table 1.Indices of the Fit of Classes of Perceived Interpersonal Discrimination Identified in Latent Class Analysis, Study of Women’s Health Across the Nation, 1996–2008No. of ClassesSample-Size-Adjusted BICEntropyLog-LikelihoodVuong-Lo-Mendell-Rubin Likelihood Ratio Test (Δ)P for Δa2184,538.2160.962−91,897.8633175,636.5440.941−87,260.2069,260.4120.00004172,540.1570.920−85,525.1923,464.4530.00005171,291.2390.903−84,713.9131,619.9520.4688Abbreviation: BIC, Bayesian Information Criterion.aP value for the likelihood ratio test.

 

Source:

http://doi.org/10.1093/aje/kwx326

 

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