Social Science & Medicine
Volume 63, Issue 6 , September 2006, Pages 1415-1427

Self-reported health, perceived racial discrimination, and skin color in
African Americans in the CARDIA study

Luisa N. Borrella, , , Catarina I. Kiefeb, , David R. Williamsc, , Ana V.
Diez-Rouxc,  and Penny Gordon-Larsend,

aColumbia University New York, NY, USA
bUniversity of Alabama, USA
cUniversity of Michigan, USA
dUniversity of North Carolina, USA

Abstract
This study investigates the association between self-reported physical and
mental health and both perceived racial discrimination and skin color in
African American men and women. We used data from the longitudinal coronary
artery risk development in young adults study (CARDIA) in African American
men and women (n=1722) in the USA. We assessed self-reported mental and
physical health status and depressive symptoms at the Year 15 (2000–2001)
follow-up examination using the Medical Outcomes Study Short Form (SF-12)
and the Center for Epidemiologic Studies Depression scale. Skin color was
measured at the Year 7 examination (1992–1993). To assess racial
discrimination, we used a summary score (range 0–21) for 7 questions on
experiencing racial discrimination: at school, getting a job, getting
housing, at work, at home, getting medical care, on the street or in a
public setting. Self-reported racial discrimination was more common in men
than in women (78.1% versus 73.0%, p<0.05) and in those with higher educati
onal attainment, independent of gender. Discrimination was statistically
significantly associated with worse physical and mental health in both men
and women, before and after adjustment for age, education, income, and skin
color. For example, mental health (0–100 scale) decreased an average of
0.29 units per unit increase in racial discrimination score in men; this
became 0.32 units after adjustment. There was no association between
self-reported physical and mental health and skin color. Further studies of
the health consequences of discrimination will require investigation of
both the upstream determinants of discrimination and the downstream
mechanisms by which perceived discrimination affects health outcomes.

Keywords: Racial discrimination; Racism; Skin color; Physical health;
Mental health; African Americans; Gender; USA



Corresponding author. Tel.: +1 212 304 6413.

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