Date of Award

5-31-2022

Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Gerontology

First Advisor

Elizabeth Dugan

Second Advisor

Jeffrey Stokes

Third Advisor

Sarah Forrester

Abstract

Discrimination and experiences of prejudice are a social determinant of health, with potential consequences at the individual, interpersonal, and systemic levels. This study aimed to first, investigate the relationship between discrimination experienced by older adults and mortality, and second to examine the moderating effect discrimination has on the relationship between age, race, and gender and health outcomes. Data were drawn from 14,948 participants from the Health and Retirement Study, who completed the Leave Behind Questionnaire in 2012 or 2014. Logistic regressions were conducted to examine relationships between age, gender, and race/ethnicity and self-reported health (SRH), risk of stroke, and heart attack. Interaction terms were tested for everyday discrimination and age, gender, and race/ethnicity, then for health discrimination and age, gender, and race/ethnicity. Results found associations between age, gender, and race and SRH, stroke, and heart attack. Everyday discrimination moderated the association between gender and risk of heart attack, where differences in men and women’s risk of heart attack were exacerbated at higher levels of discrimination. Similarly, everyday discrimination moderated the association between race and risk of heart attack, where differences in white and non-white participant’s risk of heart attack were exacerbated at higher levels of discrimination. Experiences of discrimination in healthcare moderated associations between gender and both SRH and heart attack. Reduction in experiences of discrimination in all settings, but especially in healthcare, should be a top priority. Future work in the field of research around discrimination and health outcomes should address the mechanisms that are a product of historical systemic racism, ageism, and misogyny that impact the everyday lives of older adults, people of color, and women.

Comments

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