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. 2018 May;37(5):491-500.
doi: 10.1037/hea0000616.

Longitudinal health consequences of socioeconomic disadvantage: Examining perceived discrimination as a mediator

Thomas E Fuller-Rowell  1 , David S Curtis  1 , David H Chae  1 , Carol D Ryff  2
Affiliations

Longitudinal health consequences of socioeconomic disadvantage: Examining perceived discrimination as a mediator

Thomas E Fuller-Rowell et al. Health Psychol. 2018 May.

Abstract

Objective: Foundational theoretical perspectives suggest that socioeconomic disadvantage (SED) increases an individual's risk of being exposed to unfair treatment or discrimination. However, little empirical attention has been given to the role of perceived discrimination in the SED-health gradient. Addressing this knowledge gap, the current study examined the mediating role of discrimination in the longitudinal association between SED and self-rated health.

Method: Participants in the Midlife in the United States (MIDUS) study were followed over 3 waves covering a 17- to 19-year period (N = 6,286; 53% female; 91% White; mean age at baseline = 47 years, SD = 13). SED was assessed from education, occupational prestige, income, and assets; self-rated health was measured at baseline and follow-up assessments. Two measures of discrimination-perceived inequality in work and everyday discrimination-were considered as mediators.

Results: Both measures of discrimination emerged as important explanatory variables in the link between SED and health. SED at the baseline assessment was associated with changes in self-rated health over the 17- to 19-year period (B = -.15, p < .001). Measures of discrimination partially mediated this longitudinal association, explaining 22% of the total effect. Exposure to discrimination and its health consequences were also more pronounced at younger ages.

Conclusion: Additional research is needed to replicate the findings of this study using objective health measures and to examine possible interventions. Challenging the ideologies and practices that underlie social class-related discrimination, or mitigating its harmful consequences, will both be important approaches to consider. (PsycINFO Database Record

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Figures

Figure 1
Figure 1
Path model results showing measures of perceived discrimination as mediators of the association between socioeconomic disadvantage and self-rated health. Note. Standardized regression coefficients [95% confidence intervals] and residual variances are shown. All coefficients are from Model 4, except for the unmediated association between socioeconomic disadvantage and health (shown on underside of model path). * p < .05. ** p < .01. *** p < .001.
Figure 2
Figure 2
Fitted interaction plots depicting the association between socioeconomic disadvantage and everyday discrimination, separated by four age categories (based on age at MIDUS 1).
Figure 3
Figure 3
Fitted interaction plots depicting the association between perceived work inequality and self-rated health, separated by four age categories (based on age at MIDUS 1)
See this image and copyright information in PMC

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