TY - JOUR
T1 - The pathways from perceived discrimination to self-rated health
T2 - An investigation of the roles of distrust, social capital, and health behaviors
AU - Chen, Danhong
AU - Yang, Tse Chuan
N1 - Funding Information:
We acknowledge assistance provided by Population Research Institute at Penn State University, which receives core funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development ( R24-HD041025 ). We also acknowledge Penn State's Social Science Research Institute and libraries for securing the data license.
PY - 2014/3
Y1 - 2014/3
N2 - Although there has been extensive research on the adverse impacts of perceived discrimination on health, it remains unclear how perceived discrimination gets under the skin. This paper develops a comprehensive structural equation model (SEM) by incorporating both the direct effects of perceived discrimination on self-rated health (SRH), a powerful predictor for many health outcomes, and the indirect effects of perceived discrimination on SRH through health care system distrust, neighborhood social capital, and health behaviors and health conditions. Applying SEM to 9880 adults (aged between 18 and 100) in the 2008 Southeastern Pennsylvania Household Health Survey, we not only confirmed the positive and direct association between discrimination and poor or fair SRH, but also verified two underlying mechanisms: 1) perceived discrimination is associated with lower neighborhood social capital, which further contributes to poor or fair SRH; and 2) perceived discrimination is related to risky behaviors (e.g., reduced physical activity and sleep quality, and intensified smoking) that lead to worse health conditions, and then result in poor or fair SRH. Moreover, we found that perceived discrimination is negatively associated with health care system distrust, but did not find a significant relationship between distrust and poor or fair SRH.
AB - Although there has been extensive research on the adverse impacts of perceived discrimination on health, it remains unclear how perceived discrimination gets under the skin. This paper develops a comprehensive structural equation model (SEM) by incorporating both the direct effects of perceived discrimination on self-rated health (SRH), a powerful predictor for many health outcomes, and the indirect effects of perceived discrimination on SRH through health care system distrust, neighborhood social capital, and health behaviors and health conditions. Applying SEM to 9880 adults (aged between 18 and 100) in the 2008 Southeastern Pennsylvania Household Health Survey, we not only confirmed the positive and direct association between discrimination and poor or fair SRH, but also verified two underlying mechanisms: 1) perceived discrimination is associated with lower neighborhood social capital, which further contributes to poor or fair SRH; and 2) perceived discrimination is related to risky behaviors (e.g., reduced physical activity and sleep quality, and intensified smoking) that lead to worse health conditions, and then result in poor or fair SRH. Moreover, we found that perceived discrimination is negatively associated with health care system distrust, but did not find a significant relationship between distrust and poor or fair SRH.
KW - Health care system distrust
KW - Neighborhood social capital
KW - Perceived discrimination
KW - Self-rated health
KW - Structural equation model
KW - USA
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U2 - 10.1016/j.socscimed.2013.12.021
DO - 10.1016/j.socscimed.2013.12.021
M3 - Article
C2 - 24581063
AN - SCOPUS:84896708478
SN - 0277-9536
VL - 104
SP - 64
EP - 73
JO - Social Science and Medicine
JF - Social Science and Medicine
ER -