Everyday discrimination and physical health: Exploring mental health processes

By Cayla Scheintaub 

Discrimination plays a role in our everyday lives. Yet, we often don’t realize the detrimental effects it has on our physical and mental health.  Discrimination can lead to stress and depressive symptoms, which is the root of a myriad of other health problems. The marginalization of a social, cultural or ethnic group can lead that group to have worse health than other groups. This study explored how everyday discrimination, stress, depressive symptoms, and health are related. 

Who does this study concern?  

This study’s sample consisted of mostly African American (62%) residents in a low-income area of New Haven, Connecticut. Surveys were distributed to adults ranging from 18-65 years old.  The majority of the participants identified as women, with an average age of 40.  

How were health and discrimination measured?  

The survey consisted of questions concerning three different factors: physical health, discrimination, and mental health. Overall physical health was measured by asking participants to rate their health on a 5-point scale, from poor to excellent. They were also asked the amount of times they visited an emergency hospital department in the past year. Answers were coded as zero visits or one or more visits. Finally, participants indicated if they had any chronic conditions including high cholesterol, diabetes, stroke, asthma, bronchitis, emphysema or cancer. Answers were coded to reflect zero chronic conditions or one or more chronic conditions. Participants also indicated their weight, height, BMI and several other physical characteristics.  

Discrimination was measured using the 5-item Everyday Discrimination Scale, consisting of questions regarding how frequently participants were treated with less respect, not smart, dishonest, or inferior to others and if they were insulted or called names on a 5-point scale from never to very often. Stress was measured with Cohen’s 4-item Perceived Stress Scale. This asks about how much control or lack of control participants have over important things in their life. Depressive symptoms were measured with items from the Perceived Health Questionnaire. Participants were asked how often they felt bothered by feeling down, depressed, or hopeless, and by little interest or pleasure in doing things, ranging from “not at all” to “every day”.  Other stressors that participants indicated were their perceived unsafety, food insecurity, and financial status. 

What were the results?  

Results of the study suggest that more frequent experiences of everyday discrimination are associated with more stress, more stress is associated with greater depressive symptoms, and greater depressive symptoms ultimately are associated with worse health. Everyday discrimination predicted stress, depressive symptoms, and health outcomes even controlling for other significant stressors in participants lives, including perceived unsafety, food insecurity, and financial stress. The results were consistent across racial/ethnic groups in the sample. The figure below shows the path model that was tested.  


Why does this study matter?  

The results add to other studies showing that discrimination leads to poor health outcomes. This study suggests that everyday discrimination could lead to greater stress, and then this stress may lead to greater depressive symptoms. These depressive symptoms, in turn, undermine a wide range of health outcomes. The study also suggests that everyday discrimination is an important stressor in people’s lives, with impacts on health above and beyond other stressors including safety concerns, food insecurity, and financial stress.  

This study also suggests that interventions to mitigate depressive symptoms and stress may enhance physical and mental health among people who face discrimination. Understanding and addressing the factors that link discrimination with health outcomes can help people attain healthier and happier lifestyle. Ultimately, however, it is important to eliminate discrimination so that no one’s mental or physical health suffers from being mistreated by others. 


Reference: Earnshaw, V. A., Rosenthal, L., Carroll-Scott, A., Santilli, A., Gilstad-Haydan, K., & Ickovics, J. R. (2016). Everyday discrimination and physical health: Exploring mental health processes. Journal of Health Psychology, 21, 2218-2228