Perceived discrimination and mortality in a population-based study of older adults
Perceived discrimination and mortality in a population-based study of older adults
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DOI：
10.2105/ajph.2007.114397
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发表时间：
2008-07-01
影响因子：
12.7
通讯作者：
Evans, Denis A.
中科院分区：
文献类型：
--
作者：
Barnes, Lisa L.;de Leon, Carlos F. Mendes;Evans, Denis A.
目标。我们在一个基于人群的双族样本中检验了个体水平的知觉歧视与死亡率的关系。参与者是来自芝加哥健康和老龄化项目的4154名老年人，他们在4.5年的时间里接受了最多2次采访。在基线时测量知觉歧视，在每次随访时获得生命状态，并通过国家死亡指数进行验证。在随访期间，发生了1166例死亡。报告更多歧视的参与者死亡的相对风险更高(危险比[HR]=1.05；95%可信区间[CI]=1.01，1.09)。这种联系与消极情绪或慢性病的差异无关，而且在白人中似乎比黑人中更强(白人：HR=1.12；95%CI=1.04，11.20；黑人：HR=1.03；95%CI=0.99，1.07)。二次分析表明，与死亡率的关系与更具贬低性质的歧视经历有关，当样本仅限于同一种族的受访者时，种族差异不再显著。在一般老年人中，感知到的歧视与死亡风险的增加有关。结果表明，人际虐待的主观体验在老年是有害的。这项研究补充了越来越多的文献，证明歧视是健康的一个重要社会决定因素。
Objectives. We examined the relation of individual-level perceived discrimination to mortality in a biracial, population-based sample.Methods. Participants were 4154 older adults from the Chicago Health and Aging Project who underwent up to 2 interviews over 4.5 years. Perceived discrimination was measured at baseline, and vital status was obtained at each followup and verified through the National Death Index.Results. During follow-up, 1166 deaths occurred. Participants reporting more perceived discrimination had a higher relative risk of death (hazard ratio [HR]= 1.05; 95% confidence interval [Cl] = 1.01, 1.09). This association was independent of differences in negative affect or chronic illness and appeared to be stronger among Whites than among Blacks (Whites: HR = 1.12; 95% Cl = 1.04,11.20; Blacks: HR = 1.03; 95% Cl = 0.99, 1.07). Secondary analyses revealed that the relation to mortality was related to discriminatory experiences of a more demeaning nature and that racial differences were no longer significant when the sample was restricted to respondents interviewed by someone of the same race.Conclusions. Perceived discrimination was associated with increased mortality risk in a general population of older adults. The results suggest that subjective experience of interpersonal mistreatment is toxic in old age. This study adds to a growing literature documenting discrimination as an important social determinant of health.