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Self-reported experiences of discrimination and health: scientific advances, ongoing controversies, and emerging issues.

ABSTRACT: Over the past two decades, research examining the impact of self-reported experiences of discrimination on mental and physical health has increased dramatically. Studies have found consistent associations between exposure to discrimination and a wide range of Diagnostic and Statistical Manual of Mental Disorders (DSM)-diagnosed mental disorders as well as objective physical health outcomes. Associations are seen in cross-sectional as well as longitudinal studies and persist even after adjustment for confounding variables, including personality characteristics and other threats to validity. However, controversies remain, particularly around the best approach to measuring experiences of discrimination, the significance of racial/ethnic discrimination versus overall mistreatment, the need to account for "intersectionalities," and the importance of comprehensive assessments. These issues are discussed in detail, along with emerging areas of emphasis including cyber discrimination, anticipatory stress or vigilance around discrimination, and interventions with potential to reduce the negative effects of discrimination on health. We also discuss priorities for future research and implications for interventions and policy.

SUBMITTER: Lewis TT

PROVIDER: S-EPMC5555118 | biostudies-other | 2015

REPOSITORIES: biostudies-other

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Project description:ObjectivesTo advance understanding of the relationship between discrimination and sleep duration and difficulties, with consideration of multiple dimensions of discrimination, and attention to concurrent stressors; and to examine the contribution of discrimination and other stressors to racial/ ethnic differences in these outcomes.DesignCross-sectional probability sample.SettingChicago, IL.ParticipantsThere were 2,983 black, Hispanic, and white adults.Measurements and resultsOutcomes included self-reported sleep duration and difficulties. Discrimination, including racial and nonracial everyday and major experiences of discrimination, workplace harassment and incivilities, and other stressors were assessed via questionnaire. In models adjusted for sociodemographic characteristics, greater exposure to racial (? = -0.14)) and nonracial (? = -0.08) everyday discrimination, major experiences of discrimination attributed to race/ethnicity (? = -0.17), and workplace harassment and incivilities (? = -0.14) were associated with shorter sleep (P < 0.05). The association between major experiences of discrimination attributed to race/ethnicity and sleep duration (? = -0.09, P < 0.05) was independent of concurrent stressors (i.e., acute events, childhood adversity, and financial, community, employment, and relationship stressors). Racial (? = 0.04) and non-racial (? = 0.05) everyday discrimination and racial (? = 0.04) and nonracial (? = 0.04) major experiences of discrimination, and workplace harassment and incivilities (? = 0.04) were also associated with more (log) sleep difficulties, and associations between racial and nonracial everyday discrimination and sleep difficulties remained after adjustment for other stressors (P < 0.05). Racial/ethnic differences in sleep duration and difficulties were not significant after adjustment for discrimination (P > 0.05).ConclusionsDiscrimination was associated with shorter sleep and more sleep difficulties, independent of socioeconomic status and other stressors, and may account for some of the racial/ethnic differences in sleep.

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Self-reported experiences of discrimination and health: scientific advances, ongoing controversies, and emerging issues.

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