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Older adults and people with disabilities are especially vulnerable to experiences of discrimination. The health vulnerabilities of older adults may amplify the health effects of discrimination. Although categories such as race or gender alone may influence how individuals experience discrimination, it is equally important to understand how being a part of several affected groups simultaneously e. For example, black women are differentially situated economically, socially, and politically—and may experience discrimination differently—than other women or black men; this may affect health outcomes.

Given the health impacts of discrimination on various populations, there is an ongoing need for innovative research methods, improved instrumentation, and new approaches for identifying all types of discrimination and its impact on health and health care. This additional evidence will help facilitate public health efforts to address discrimination as a social determinant of health.

As a result, there may be variability in the use of terms, for example, black versus African American. Perceived discrimination in US healthcare: charting the effects of key social characteristics within and across racial groups.

158 Resources to Understand Racism in America

Prev Med Rep. Disparities and distrust: the implications of psychological processes for understanding racial disparities in health and health care. Soc Sci Med. A longitudinal study of social status, perceived discrimination, and physical and emotional health among older adults. Res Aging. Racist America: roots, current realities, and future reparations.


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New York: Routledge; Perceived discrimination and health: a meta-analytic review. Psychol Bull. Structural racism and myocardial infarction in the United States.

Discrimination and health. Social Epidemiology. N, Hamilton VJ. Does perceived discrimination affect health? Longitudinal relationships between work discrimination and women's physical and emotional health.

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J Health Soc Behav. Racial differences in physical and mental health: Socio-economic status, stress and discrimination. Journal of health psychology, 2 3 , The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. Understanding everyday racism: an interdisciplinary theory. Sage Publications, Inc. School contexts as social determinants of child health: current practices and implications for future public health practice. Public Health Reports. The sociology of discrimination: racial discrimination in employment, housing, credit, and consumer markets.

Annu Review of Sociol. Imprisoning America: the social effects of mass incarceration. Russell Sage Foundation; Locked out: felon disenfranchisement and American democracy. Oxford University Press; Racial residential segregation: a fundamental cause of racial disparities in health. Public Health Rep. The effect of childhood segregation on minority academic performance at selective colleges. Ethnic and Racial Studies.

Why segregation matters: poverty and educational inequality. Adverse effects of U. Am J Public Health. The growth of incarceration in the United States: Exploring causes and consequences. Marked: race, crime, and finding work in an era of mass incarceration. University of Chicago Press; Reported racial discrimination, trust in physicians, and medication adherence among inner-city African Americans with hypertension.

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Discrimination and unfair treatment: relationship to cardiovascular reactivity among African American and European American women. Health Psychol. A nationwide study of discrimination and chronic health conditions among Asian Americans. Building on their earlier study of gay and straight workers, as well as the existing literature on concealable stigmas and stigma management, the authors developed several hypotheses about why certain kinds of jobs -- including faculty positions -- reportedly employ a disproportionate number of gay men and women.

That premise was supported by survey results from gay and lesbian workers in the U. Such findings were consistent with existing qualitative research on sexual orientation and management of concealable stigma, such as literature on adolescent development suggesting that lesbian and gay youths need to develop a high level of social sensitivity and diagnostic accuracy relatively early in life as an adaptation or coping skill. To test their hypotheses, the authors need a large and ideally nationally representative sample in which to identify gays and lesbians and their career choices.

They found that in the American Community Survey, the U. The authors also needed information on occupation characteristics, such as the level of task independence and social perceptiveness associated with various jobs. It measures cognitive, creative, technical and social skills of a given occupation.

An additional resource was the U. National Longitudinal Study of Adolescent Health. All that yielded data on occupations and 4. Although that number seems low, when comparing same-sex cohabiting couples with other cohabiting couples, the proportion of gay and lesbian workers is in line with expectations, or about 9. The Add Health data also were representative with general figures on sexual orientation, in that about 2 percent identified as gay or lesbian, 7 percent reported same-sex attraction and 10 percent reported same-sex sexual contact.

Controlling for such variables as education level, whether a sector tended to be politically liberal or conservative, and urban location all of which could arguably skew the results , the authors conducted three types of regression analysis. They first used the American Community Survey Data at the occupational level to examine the relationship between the proportion of gay and lesbian workers in the occupation and the extent to which the occupation requires social perceptiveness and provides task independence.

Next, they applied the community survey data at the individual level. And because the community survey data only contained that on same-sex couples, not individually identifiable gay or lesbian respondents, the authors conducted an individual-level analysis with the Add Health data. The analysis yielded lists of occupations with the highest proportion of gay and lesbian workers.

Most all of them are associated with above-average social perceptiveness and above-average task independence. Psychologists show up again, along with sociologists but not postsecondary faculty in the analysis regarding jobs with high proportions of lesbians among female workers in female-majority occupations. The top five, in descending order, are:. No academic-specific jobs show up in the top five lists concerning gay men in male- or female-dominated jobs, or for women in male-dominated jobs.

The authors note that their analysis begins to explain the seemingly heterogeneous kinds of jobs in which gays and lesbians have clustered over time -- from professor to probation officer -- and what kinds of unique skills these workers bring to the table. Eddy Ng, the F. He pointed out that the study was right to control for education level and political leanings in that professors are obviously highly educated and tend to be more socially liberal that workers in many other fields.

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He urged caution regarding identifying people as just gay or straight, but said he recognized it was sometimes necessary in research. Over all, Cohen said, he was impressed with the study and called its premise plausible. Like Ng, he also offered an additional possible explanation for the finding regarding professors in particular.

Another possible interpretation of the results is that those gay men and lesbians who are attracted to jobs valuing social perception and allowing task independence are also more likely to identify their gay or lesbian sexual orientation, he added via email. It may be that there are many more gay men and lesbians in jobs that don't value these traits, but they are less likely to be out as gay or lesbian. Tilcsik, the lead author, said the paper tried to explain economic trends rather than provide useful data for any one sector. That could help reveal to a much greater degree how the trend plays out in higher education, he suggested.

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