Racial Discrimination, Psychological Distress, and Self-Rated Health Among US-Born and Foreign-Born Black Americans

• Published in: American journal of public health (1971) Vol. 101; no. 9; pp. 1704 - 1713
• Main Authors: KRIEGER, Nancy, KOSHELEVA, Anna, WATERMAN, Pamela D, CHEN, Jarvis T, KOENEN, Karestan
• Format: Journal Article
• Language: English
• Published: Washington, DC American Public Health Association 01.09.2011
• Subjects: Adult; Adult and adolescent clinical studies; African Americans - psychology; African Americans - statistics & numerical data; Age; Biological and medical sciences; Black people; Cohort Studies; Cross-Sectional Studies; Emigrants and Immigrants - psychology; Emigrants and Immigrants - statistics & numerical data; Female; General aspects; Health Status; Health Status Disparities; Humans; Immigrants; Immigration; Immigration policy; Investigations; Labor Unions - statistics & numerical data; Male; Meat processing; Medical sciences; Mental disorders; Mental Health; Middle Aged; Miscellaneous; Noncitizens; Population; Poverty; Prejudice; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Racial discrimination; Research and Practice; Self Report; Sociodemographics; Socioeconomic Factors; Stress, Psychological - ethnology; Stress, Psychological - etiology; Studies; Variables; Working class; United States > US; Human; Discrimination; Self evaluation; Psychological distress; Health; Race; Ethnic group; African American
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2011.300168

We investigated associations among racial discrimination, psychological distress, and self-rated health among US-born and immigrant Black Americans. We conducted a cross-sectional analysis of a cohort of employed working-class Black Americans (193 US-born, 275 foreign-born). Both US-born and foreign-born Black participants had high levels of exposure to poverty (51% and 57%, respectively) and racial discrimination (76% and 60%) and reported high levels of severe psychological distress (14% and 16% had a Kessler 6 [K6] score of 13 or greater); 17% and 7% reported fair or poor health. After controlling for relevant covariates, their risk parameters for racial discrimination (high vs no exposure) were 4.0 (95% confidence interval [CI] = 2.3, 5.6) and 3.3 (95% CI = 2.1, 4.5), respectively, for continuous K6 score; corresponding odds ratios for severe psychological distress were 6.9 (95% CI = 1.4, 35.7) and 6.8 (95% CI = 2.5, 18.3). No associations existed between racial discrimination and self-reported health, suggesting that an underlying propensity to report adversity does not account for our psychological distress findings. Our results attest to the salience of racial discrimination, nativity, and socioeconomic position in understanding the experiences and psychological health of Black Americans.