Assessing mediators between discrimination, health behaviours and physical health outcomes: a representative cross-sectional study

Bastos, Joao Luiz, Celeste, Roger Keller, Silva, Diego Augusto Santos, Priest, Naomi and Paradies, Yin Carl 2015, Assessing mediators between discrimination, health behaviours and physical health outcomes: a representative cross-sectional study, Social psychiatry and psychiatric epidemiolo, vol. 50, no. 11, pp. 1731-1742, doi: 10.1007/s00127-015-1108-0.

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Title Assessing mediators between discrimination, health behaviours and physical health outcomes: a representative cross-sectional study
Author(s) Bastos, Joao Luiz
Celeste, Roger Keller
Silva, Diego Augusto Santos
Priest, Naomi
Paradies, Yin CarlORCID iD for Paradies, Yin Carl
Journal name Social psychiatry and psychiatric epidemiolo
Volume number 50
Issue number 11
Start page 1731
End page 1742
Total pages 12
Publisher Springer
Place of publication New York, N.Y.
Publication date 2015-11
ISSN 1433-9285
Keyword(s) Brazil
Health behaviour
Physical health
Social discrimination
Science & Technology
Life Sciences & Biomedicine
Brazil Social discrimination
Summary PURPOSE: Discrimination is a social determinant of health; however, the pathways linking discrimination to ill-health are under-researched. This study investigated the mediators through which discrimination affects health behaviours and physical health outcomes, as well as assessed whether sex moderated these mechanisms. METHODS: Data from a representative survey (n = 1023) of undergraduate students enrolled in a Brazilian university in 2012 were used. Structural equation models were applied to assess the following mediation mechanisms--(1) discrimination influences self-rated health and body mass index via anxiety/depression; (2) discrimination affects behaviours (alcohol consumption, problem drinking, smoking, fruit/vegetable consumption, and physical activity) through discomfort associated with discriminatory experiences. The potential of sex to act as an effect-modifying variable was also explored in each of the postulated pathways. RESULTS: The effect of discrimination on self-rated poor health was totally (100.0%) mediated by anxiety/depression, while body mass index was not correlated with discrimination. Self-reported discrimination was associated with some behaviours via discomfort. Particularly, discomfort partially mediated the positive association between discrimination, leisure time physical activity (43.3%), and fruit/vegetable consumption (52.2%). Sex modified the association between discrimination, discomfort and physical activity in that such mechanism (more discrimination → more discomfort → more physical activity) was statistically significant in the entire sample and among females, but not among males. CONCLUSIONS: This is one of the first studies to demonstrate that discrimination is associated with physical health outcomes and behaviours via distinct pathways. Future investigations should further explicate the mediational pathways between discrimination and key health outcomes.
Language eng
DOI 10.1007/s00127-015-1108-0
Field of Research 1103 Clinical Sciences
1702 Cognitive Science
1701 Psychology
169999 Studies in Human Society not elsewhere classified
Socio Economic Objective 970116 Expanding Knowledge through Studies of Human Society
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, Springer
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