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The pathways from perceived discrimination to self-rated health: An investigation of the roles of distrust, social capital, and health behaviors

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  • Chen, Danhong
  • Yang, Tse-Chuan

Abstract

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.

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  • Chen, Danhong & Yang, Tse-Chuan, 2014. "The pathways from perceived discrimination to self-rated health: An investigation of the roles of distrust, social capital, and health behaviors," Social Science & Medicine, Elsevier, vol. 104(C), pages 64-73.
    • Handle: RePEc:eee:socmed:v:104:y:2014:i:c:p:64-73
    DOI: 10.1016/j.socscimed.2013.12.021
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    7. Kellogg, Alexander J. & Hancock, David W. & Cho, Grace Y. & Reid, Allecia E., 2023. "Reprint of: Community-level age bias and older adult mortality," Social Science & Medicine, Elsevier, vol. 320(C).
    8. Xiangdan Piao & Xinxin Ma & Tetsuya Tsurumi & Shunsuke Managi, 2022. "Social Capital, Negative Event, Life Satisfaction and Sustainable Community: Evidence from 37 Countries," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 17(3), pages 1311-1330, June.
    9. Hisler, Garrett C. & Brenner, Rachel E., 2019. "Does sleep partially mediate the effect of everyday discrimination on future mental and physical health?," Social Science & Medicine, Elsevier, vol. 221(C), pages 115-123.
    10. Alexander, Adam C. & Nollen, Nicole L. & Ahluwalia, Jasjit S. & Hébert, Emily T. & Businelle, Michael S. & Kendzor, Darla E., 2019. "Darker skin color is associated with a lower likelihood of smoking cessation among males but not females," Social Science & Medicine, Elsevier, vol. 240(C).
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