The Relationship Between Perceived Racial Discrimination and Health in an Urban African American Community Cohort Followed Longitudinally: Implications for Community-Based Interventions

Introduction: Experiences of racial discrimination, an important social stressor among minority groups, has been proposed as a key determinant of health and may account in part for increased risk of poor health outcomes seen among African Americans relative to other racial/ethnic groups. Hence there is a need for research that investigates both the determinants of perceived discrimination and the mechanisms by which discrimination affects health, as this topic has rarely been studied from a developmental perspective.

Methods: This study explores perceived racial discrimination in a community cohort of urban African Americans (N=1242) followed longitudinally from ages 6 to 42 with assessments in childhood, adolescence, young adulthood, and midlife. It identifies predictors and consequences of discrimination and examines social support as a potential buffer of the relationship between discrimination and health. We characterize the sources and rates of perceived racial discrimination, examine its association with other life adversities, and identify its association with both physical and mental health outcomes and health behaviors.  We analyze our results separately for men and women as previous work suggests that perceptions of racial discrimination vary by gender.

Results: We found high rates of discrimination in adulthood within this community cohort, especially among men, with significant risk factors for perceived discrimination evident as early as first grade.  Preliminary analyses revealed a significant relationship between perceived discrimination and multiple health behaviors and outcomes, including later self-rated physical health, the development of alcohol and drug disorders, and anxious mood at midlife, with significant differences by gender. Multivariate regression modeling will test social support as a moderator for these effects, yielding results which may inform novel strategies for community-based interventions.

Conclusions: A national strategy for health must include consideration of reducing racial and ethnic health disparities. Findings should have implications for the design of appropriate interventions for urban, minority communities, potentially building on social support as a buffer of negative outcomes.  Targeting risk factors for perceived racial discrimination and buffers of perceived discrimination may hold promise for improving health in minority communities.