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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2007.126003v1 99/S1/S144    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Chae, D. H. Articles by Walters, K. L. Search for Related Content PubMed PubMed Citation Articles by Chae, D. H. Articles by Walters, K. L. Related Collections Native Americans Lesbian/Gay/Bisexual/Transgender Persons

David H. Chae, ScD and Karina L. Walters, PhD

David H. Chae is with the School of Public Health, University of California, Berkeley, and the Center for Health and Community, University of California, San Francisco. Karina L. Walters is with the School of Social Work, University of Washington, Seattle.

Correspondence: Requests for reprints should be addressed to David H. Chae, University of California, San Francisco, Center for Health and Community, 3333 California St, Suite 465, Campus Box 0844, San Francisco, CA 94118 (e-mail: dhchae{at}post.harvard.edu).

Objectives. We examined associations between racial discrimination and actualization, defined as the degree of positive integration between self-identity and racial group identity, and self-rated health and physical pain and impairment.

Methods. We used logistic regressions to analyze data from 447 gay, lesbian, bisexual, and other sexual-minority American Indians/Alaska Natives.

Results. Greater self-reported discrimination was associated with higher odds of physical pain and impairment (odds ratio [OR] = 1.42; 95% confidence interval [CI] = 1.13, 1.78); high levels of actualization were associated with lower odds of physical pain and impairment (OR = 0.59; 95% CI = 0.35, 0.99) and self-rated fair or poor health (OR = 0.54; 95% CI = 0.32, 0.90). Actualization also moderated the influence of discrimination on self-rated health (t = –2.33; P = .020). Discrimination was positively associated with fair or poor health among participants with low levels of actualization, but this association was weak among those with high levels of actualization.

Conclusions. Among two-spirit American Indians/Alaska Natives, discrimination may be a risk factor for physical pain and impairment and for fair or poor self-rated health among those with low levels of actualization. Actualization may protect against physical pain and impairment and poor self-rated health and buffer the negative influence of discrimination.