The color of health: skin color, ethnoracial classification, and discrimination in the health of Latin Americans

Abstract

Latin America is one of the most ethnoracially heterogeneous regions of the world. Despite this, health disparities research in Latin America tends to focus on gender, class and regional health differences while downplaying ethnoracial differences. Few scholars have conducted studies of ethnoracial identification and health disparities in Latin America. Research that examines multiple measures of ethnoracial identification is rarer still. Official data on race/ethnicity in Latin America are based on self-identification which can differ from interviewer-ascribed or phenotypic classification based on skin color. We use data from Brazil, Colombia, Mexico, and Peru to examine associations of interviewer-ascribed skin color, interviewer-ascribed race/ethnicity, and self-reported race/ethnicity with self-rated health among Latin American adults (ages 18-65). We also examine associations of observer-ascribed skin color with three additional correlates of health - skin color discrimination, class discrimination, and socio-economic status. We find a significant gradient in self-rated health by skin color. Those with darker skin colors report poorer health. Darker skin color influences self-rated health primarily by increasing exposure to class discrimination and low socio-economic status.

Keywords: Discrimination; Latin America; Latino; Race/ethnicity; Self-rated health; Skin color; Socio-economic status (SES).

Figure 1. Very Good to Good Health by Skin Color, Interviewer-Ascribed Race/Ethnicity, and Self-Reported Race/Ethnicity (All countries, N=4,921)

*p<.05, ** p<.01, ***p<.001 Note: Odds Ratios (OR) are estimated from logistic regressions of self-reported health on skin color, interviewer-ascribed race/ethnicity, and self-reported race/ethnicity, respectively. All regressions included controls for sex, age, and country of origin.

Figure 2. SES and Discrimination, by Skin Color (All countries, N=4,921)

*p<.05, **p<.01, ***p<.001 Note: Ordinary least squares regressions were estimated to show the associations of skin color with years of education and wealth, respectively. Logistic regressions were estimated to show the association of skin color with the experiencing any color discrimination and any class discrimination, respectively. All regressions included controls for sex, age, and country of origin.