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AJPH First Look, published online ahead of print May 29, 2008
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American Journal of Public Health, 10.2105/AJPH.2007.114397

Research and Practice

Perceived Discrimination and Mortality in a Population-Based Study of Older Adults

Lisa L. Barnes 1*, Carlos F. Mendes de Leon 1, Tené T. Lewis 2, Julia L. Bienias 1, Robert S. Wilson 1, Denis A. Evans 1

1 Rush University Medical Center
2 Yale School of Medicine

* To whom correspondence should be addressed. E-mail: lbarnes1{at}rush.edu.


  Abstract

Objectives. We examined the relation of individual-level perceived discrimination to mortality in a biracial, population-based sample.

Methods. Participants were 4154 older adults from the Chicago Health and Aging Project who underwent up to 2 interviews over 4.5 years. Perceived discrimination was measured at baseline, and vital status was obtained at each followup and verified through the National Death Index.

Results. During follow-up, 1166 deaths occurred. Participants reporting more perceived discrimination had a higher relative risk of death (hazard ratio [HR]=1.05; 95% confidence interval [CI]=1.01, 1.09). This association was independent of differences in negative affect or chronic illness and appeared to be stronger among Whites than among Blacks (Whites: HR=1.12; 95% CI=1.04, 1.20; Blacks: HR=1.03; 95% CI=0.99, 1.07). Secondary analyses revealed that the relation to mortality was related to discriminatory experiences of a more demeaning nature and that racial differences were no longer significant when the sample was restricted to respondents interviewed by someone of the same race.

Conclusions. Perceived discrimination was associated with increased mortality risk in a general population of older adults. The results suggest that subjective experience of interpersonal mistreatment is toxic in old age. This study adds to a growing literature documenting discrimination as an important social determinant of health.

Key Words: Aging, Epidemiology, African Americans/Blacks, Urban Health




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