ECPN poster contestant: Sociodemographic Patterns of Discrimination and Health Behaviors: Implications for Health Disparities

Discrimination is a well-established risk factor for poor health outcomes. One key mechanism by which discrimination may be linked to health is via negative health behaviors, either directly or through enhanced stress. This study examines if experiences (‘amount’) of discrimination and membership in particular sociodemographic groups (for which individuals may be discriminated against) interact in predicting health behaviors. We examined the relationship between discrimination and health behaviors unadjusted and after controlling for overall perceived stress, and the potential moderating effect of sociodemographic factors on these relationships. A diverse community sample of 292 adults (mean age 55.4 years; 52.7% female; 42.1% Black; 39.2% HS degree; mean annual income $22,892) reported levels of everyday discrimination (e.g., poor service, being mistreated), perceived stress, and health behaviors (e.g., sleep, smoking, alcohol use). Reported discrimination was associated with higher stress (p<.0001). Additionally, discrimination was related to poor sleep (p<.001), greater likelihood of being a current smoker (p<.0001), and more cigarettes smoked per day (p<.01); these associations with health behaviors remained after controlling for stress. A race by discrimination interaction (p<.0001) indicated that stress was lower in Whites who reported less discrimination, but this was less true for Blacks (i.e., stress was more uniformly high). A race by discrimination interaction also showed that reported sleep quality was poorer with higher discrimination, yet this association was stronger for Blacks than for Whites (p=.05). Several significant SES by discrimination interactions were identified, suggesting that both stress (p<.0001) and likelihood of being a current smoker (p=.02) were more strongly associated with high levels of discrimination among those with relatively higher SES. This study is consistent with prior work suggesting that discrimination generally is perceived as a stressor, but extends this work by suggesting that discrimination may be an important predictor of health behaviors above and beyond the effects of stress. Our results suggest that sociodemographic factors may interact with experiences of discrimination to uniquely influence health. For instance, discrimination may have a stronger negative effect on sleep among racial minorities. These results also suggest, however, that discrimination may have unexpected relationships to health behaviors in some groups; for example, discrimination was more strongly related to increased risk from smoking behaviors among those of relatively higher SES. We conclude with comments on implications for future intervention efforts, particularly around health behaviors in at-risk samples.