Association between racial discrimination and health-related quality of life and the impact of social relationships
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Association between racial discrimination and health‑related quality of life and the impact of social relationships Genevieve Bergeron1,2 · Nneka Lundy De La Cruz1 · L. Hannah Gould1 · Sze Yan Liu1 · Amber Levanon Seligson1 Accepted: 7 May 2020 © Springer Nature Switzerland AG 2020
Abstract Purpose Interpersonal racial discrimination is associated with poor health. Social relationships may moderate the impact of discrimination and represent modifiable behaviors that can be targeted by public health interventions. We described citywide associations between self-reported racial discrimination and health-related quality of life among the overall New York City (NYC) adult residential population and by four main race/ethnicity groups and explored whether social relationships moderated health effects of discrimination. Methods We analyzed cross-sectional survey data from 2335 adults weighted to be representative of the NYC population. We measured exposures to lifetime interpersonal racial discrimination in nine domains using a modified version of the Experiences of Discrimination scale. We performed unadjusted and adjusted regression analyses on four self-rated healthrelated quality of life outcomes including general health, physical health, mental health, and limitations from physical or mental health. Results Overall, 47% [95% CI 44.5, 50.3] of respondents reported having experienced racial discrimination in at least one domain. In the overall population, significant associations with racial discrimination were noted in adjusted models for poor physical health, poor mental health, and limitations by poor physical and mental health. Among those exposed to racial discrimination, the risk of experiencing poor mental health was lower among those who had contact with family or friends outside their household at least once a week, compared with those who had less frequent social contact. Conclusion This study provides evidence that social relationships may moderate the impact of racial discrimination on mental health and should be integrated into health promotion efforts. Keywords Health-related quality of life · Racial discrimination · Social relationships · Race/ethnicity · Racism · Social determinants of health
Introduction Experiencing interpersonal racial discrimination is associated with poor health for an array of health outcomes including hypertension [1], obesity [2], breast cancer [3], asthma [4], mental health [5], and mortality [6]. The association persists even when adjusting for socioeconomic status [7]. * Genevieve Bergeron [email protected] 1
New York City Department of Health and Mental Hygiene, New York, New York, United States
Division of Scientific Education and Professional Development, Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
2
The underlying physiologic mechanisms have not been fully explained. However, research indicates metabolic pathways such as increased inflammation [8, 9], increased stress on biological systems [
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