Racial discrimination, psychological distress, and self-rated health among US-born and foreign-born Black Americans

Abstract

Objectives: We investigated associations among racial discrimination, psychological distress, and self-rated health among US-born and immigrant Black Americans.

Methods: We conducted a cross-sectional analysis of a cohort of employed working-class Black Americans (193 US-born, 275 foreign-born).

Results: 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.

Conclusions: Our results attest to the salience of racial discrimination, nativity, and socioeconomic position in understanding the experiences and psychological health of Black Americans.

FIGURE 1

Self-reported experiences of racial discrimination, by nativity: Black participants in the United for Health study, Boston, Massachusetts, 2003–2004.