Social Science and Medicine
Volume 194, 2017, Pages 135-141
Associations between race, discrimination and risk for chronic disease in a population-based sample from Canada (Article)
Siddiqi A.* ,
Shahidi F.V. ,
Ramraj C. ,
Williams D.R.
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a
Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada, Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, Chapel Hill, United States
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b
Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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c
Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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d
Department of Social and Behavioral Sciences, Harvard School of Public Health, Harvard University, Boston, United States, Departments of African and African American Studies and Sociology, Harvard University, Cambridge, United States
Abstract
A major epidemiological finding emerging from studies using U.S. samples is that racial differences in experiences of discrimination are associated with racial differences in health. A newer area of research is exploring the population-level dynamics between race, discrimination, and health status in various societies. The objective of this study is to assess for the first time in a national sample from Canada: (a) racial differences in experiences of discrimination and, (b) the association between discrimination and chronic conditions and their major risk factors. Data were obtained from the 2013 Canadian Community Health Survey (n = 16,836). Race was categorized as Aboriginal, Asian, Black, or White. Discrimination was measured using the Williams Everyday Discrimination Scale. Outcomes included having any chronic condition or major risk factors (obesity, hypertension, smoking, binge drinking, infrequent physical activity, and poor self-rated health). Crude and adjusted (for age, sex, immigrant status, socioeconomics) logistic regressions modeled the association between (a) race and discrimination and, (b) discrimination and each outcome. Results indicated that Blacks were most likely to experience discrimination, followed by Aboriginals. For example, Blacks were almost twice as likely (OR: 1.92, 95% CI: 1.19–3.11), and Aboriginals 75 percent more likely (OR: 1.75, 95% CI: 1.37–2.22) to report being treated with less courtesy or respect than others. Blacks were more than four times as likely (OR: 4.27, 95% CI: 2.23–8.19), and Aboriginals more than twice as likely (OR: 2.26, 95% CI: 1.66–3.08) to report being feared by others. Asians were not statistically different from Whites. With two exceptions (binge drinking and physical activity), discrimination was associated with chronic conditions and their risk factors (OR for any chronic condition: 1.78, 95% CI: 1.52–2.08). Initial results suggest that in Canada, experience of discrimination is a determinant of chronic disease and chronic disease risk factors, and Blacks and Aboriginals are far more exposed to experiences of discrimination. © 2017 Elsevier Ltd
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https://www.scopus.com/inward/record.uri?eid=2-s2.0-85032306258&doi=10.1016%2fj.socscimed.2017.10.009&partnerID=40&md5=1dbb95e75960ba989c2ffa5b4369fff8
DOI: 10.1016/j.socscimed.2017.10.009
ISSN: 02779536
Cited by: 4
Original Language: English