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Racial discrimination and health: A systematic review of scales with a focus on their psychometric properties

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  • Bastos, Joao Luiz
  • Celeste, Roger Keller
  • Faerstein, Eduardo
  • Barros, Aluisio J.D.

Abstract

The literature addressing the use of the race variable to study causes of racial inequities in health is characterized by a dense discussion on the pitfalls in interpreting statistical associations as causal relationships. In contrast, fewer studies have addressed the use of racial discrimination scales to estimate discrimination effects on health, and none of them provided a thorough assessment of the scales' psychometric properties. Our aim was to systematically review self-reported racial discrimination scales to describe their development processes and to provide a synthesis of their psychometric properties. AÂ computer-based search in PubMed, LILACS, PsycInfo, Scielo, Scopus and Web of Science was conducted without any type of restriction, using search queries containing free and controlled vocabulary. After initially identifying 3060 references, 24 scales were included in the review. Despite the fact that discrimination stands as topic of international relevance, 23 (96%) scales were developed within the United States. Most studies (67%, N = 16) were published in the last 12 years, documenting initial attempts at scale development, with a dearth of investigations on scale refinements or cross-cultural adaptations. Psychometric properties were acceptable; sixteen of all scales presented reliability scores above 0.7, 19 out of 20 instruments confirmed at least 75% of all previously stated hypotheses regarding the constructs under consideration, and conceptual dimensional structure was supported by means of any type of factor analysis in 17 of 21 scales. However, independent researchers, apart from the original scale developers, have rarely examined such scales. The use of racial terminology and how it may influence self-reported experiences of discrimination has not yet been thoroughly examined. The need to consider other types of unfair treatment as concurrently important health-damaging exposures, and the idea of a universal instrument which would permit cross-cultural adaptations, should be discussed among researchers in this emerging field of inquiry.

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  • Bastos, Joao Luiz & Celeste, Roger Keller & Faerstein, Eduardo & Barros, Aluisio J.D., 2010. "Racial discrimination and health: A systematic review of scales with a focus on their psychometric properties," Social Science & Medicine, Elsevier, vol. 70(7), pages 1091-1099, April.
    • Handle: RePEc:eee:socmed:v:70:y:2010:i:7:p:1091-1099
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    References listed on IDEAS

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    3. Gilbert, Paul A. & Zemore, Sarah E., 2016. "Discrimination and drinking: A systematic review of the evidence," Social Science & Medicine, Elsevier, vol. 161(C), pages 178-194.
    4. Scheim, Ayden I. & Bauer, Greta R., 2019. "The Intersectional Discrimination Index: Development and validation of measures of self-reported enacted and anticipated discrimination for intercategorical analysis," Social Science & Medicine, Elsevier, vol. 226(C), pages 225-235.
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    6. Harnois, Catherine E. & Bastos, João L. & Campbell, Mary E. & Keith, Verna M., 2019. "Measuring perceived mistreatment across diverse social groups: An evaluation of the Everyday Discrimination Scale," Social Science & Medicine, Elsevier, vol. 232(C), pages 298-306.
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    8. Nancy Krieger & Pamela D Waterman & Anna Kosheleva & Jarvis T Chen & Kevin W Smith & Dana R Carney & Gary G Bennett & David R Williams & Gisele Thornhill & Elmer R Freeman, 2013. "Racial Discrimination & Cardiovascular Disease Risk: My Body My Story Study of 1005 US-Born Black and White Community Health Center Participants (US)," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-15, October.
    9. Colen, Cynthia G. & Ramey, David M. & Cooksey, Elizabeth C. & Williams, David R., 2018. "Racial disparities in health among nonpoor African Americans and Hispanics: The role of acute and chronic discrimination," Social Science & Medicine, Elsevier, vol. 199(C), pages 167-180.
    10. Priest, Naomi & Paradies, Yin & Trenerry, Brigid & Truong, Mandy & Karlsen, Saffron & Kelly, Yvonne, 2013. "A systematic review of studies examining the relationship between reported racism and health and wellbeing for children and young people," Social Science & Medicine, Elsevier, vol. 95(C), pages 115-127.
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    12. Johnson, Blair T. & Acabchuk, Rebecca L., 2018. "What are the keys to a longer, happier life? Answers from five decades of health psychology research," Social Science & Medicine, Elsevier, vol. 196(C), pages 218-226.

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