Perceived Discrimination and Physical, Cognitive, and Emotional Health in Older Adulthood

Published:March 24, 2014DOI:


      To examine whether perceived discrimination based on multiple personal characteristics is associated with physical, emotional, and cognitive health concurrently, prospectively, and with change in health over time among older adults.




      Health and Retirement Study (HRS).


      Participants (N = 7,622) who completed the Leave-Behind Questionnaire as part of the 2006 HRS assessment (mean age 67 years); participants (N = 6,450) completed the same health measures again in 2010.


      Participants rated their everyday experience with discrimination and attributed those experiences to eight personal characteristics: race, ancestry, sex, age, weight, physical disability, appearance, and sexual orientation. At both the 2006 and 2010 assessments, participants completed measures of physical health (subjective health, disease burden), emotional health (life satisfaction, loneliness), and cognitive health (memory, mental status).


      Discrimination based on age, weight, physical disability, and appearance was associated with poor subjective health, greater disease burden, lower life satisfaction, and greater loneliness at both assessments and with declines in health across the four years. Discrimination based on race, ancestry, sex, and sexual orientation was associated with greater loneliness at both time points, but not with change over time. Discrimination was mostly unrelated to cognitive health.


      The detrimental effect of discrimination on physical and emotional health is not limited to young adulthood but continues to contribute to health and well-being in old age. These effects were driven primarily by discrimination based on personal characteristics that change over time (e.g., age, weight) rather than discrimination based on more stable characteristics (e.g., race, sex).

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        • Kessler R.C.
        • Mickelson K.D.
        • Williams D.R.
        The prevalence, distribution, and mental health correlates of perceived discrimination in the United States.
        J Health Soc Behav. 1999; 40: 208-230
        • Pascoe E.A.
        • Smart Richman L.
        Perceived discrimination and health: a meta-analytic review.
        Psychol Bull. 2009; 135: 531-554
        • Williams D.R.
        • Mohammed S.A.
        Discrimination and racial disparities in health: evidence and needed research.
        J Behav Med. 2009; 32: 20-47
        • Lewis T.T.
        • Aiello A.E.
        • Leurgans S.
        • et al.
        Self-reported experiences of everyday discrimination are associated with elevated C-reactive protein levels in older African-American adults.
        Brain Behav Immun. 2010; 24: 438-443
        • Brondolo E.
        • Love E.E.
        • Pencille M.
        • et al.
        Racism and hypertension: a review of the empirical evidence and implications for clinical practice.
        Am J Hypertens. 2011; 24: 518-529
        • Barnes L.L.
        • de Leon C.F.
        • Lewis T.T.
        • et al.
        Perceived discrimination and mortality in a population-based study of older adults.
        Am J Public Health. 2008; 98: 1241-1247
        • Greene M.L.
        • Way N.
        • Pahl K.
        Trajectories of perceived adult and peer discrimination among Black, Latino, and Asian American adolescents: patterns and psychological correlates.
        Dev Psychol. 2006; 42: 218-236
        • Gee G.C.
        • Spencer M.
        • Chen J.
        • et al.
        The association between self-reported racial discrimination and 12-month DSM-IV mental disorders among Asian Americans nationwide.
        Soc Sci Med. 2007; 64: 1984-1996
        • Hwang W.C.
        • Goto S.
        The impact of perceived racial discrimination on the mental health of Asian American and Latino college students.
        Cultur Divers Ethnic Minor Psychol. 2008; 14: 326-335
        • Clark R.
        • Anderson N.B.
        • Clark V.R.
        • et al.
        Racism as a stressor for African Americans. A biopsychosocial model.
        Am Psychol. 1999; 54: 805-816
        • Szanton S.L.
        • Rifkind J.M.
        • Mohanty J.G.
        • et al.
        Racial discrimination is associated with a measure of red blood cell oxidative stress: a potential pathway for racial health disparities.
        Int J Behav Med. 2012; 19: 489-495
        • Purnell J.Q.
        • Peppone L.J.
        • Alcaraz K.
        • et al.
        Perceived discrimination, psychological distress, and current smoking status: results from the Behavioral Risk Factor Surveillance System Reactions to Race module, 2004–2008.
        Am J Public Health. 2012; 102: 844-851
        • Gibbons F.X.
        • O'Hara R.E.
        • Stock M.L.
        • et al.
        The erosive effects of racism: reduced self-control mediates the relation between perceived racial discrimination and substance use in African American adolescents.
        J Pers Soc Psychol. 2012; 102: 1089-1104
        • Zucker A.N.
        • Landry L.J.
        Embodied discrimination: the relation of sexism and distress to women's drinking and smoking behaviors.
        Sex Roles. 2007; 56: 193-203
        • Hatzenbuehler M.L.
        • McLaughlin K.A.
        • Slopen N.
        Sexual orientation disparities in cardiovascular biomarkers among young adults.
        Am J Prev Med. 2013; 44: 612-621
        • Levy B.R.
        • Slade M.D.
        • Murphy T.E.
        • et al.
        Association between positive age stereotypes and recovery from disability in older persons.
        JAMA. 2012; 308: 1972-1973
        • Levy B.R.
        • Zonderman A.B.
        • Slade M.D.
        • et al.
        Memory shaped by age stereotypes over time.
        J Gerontol B Psychol Sci Soc Sci. 2012; 67: 432-436
        • Stephan Y.
        • Caudroit J.
        • Jaconelli A.
        • et al.
        Subjective age and cognitive functioning: a 10-year prospective study.
        Am J Geriatr Psychiatry. 2014; 22: 1180-1187
        • Luo Y.
        • Xu J.
        • Granberg E.
        • et al.
        A longitudinal study of social status, perceived discrimination, and physical and emotional health among older adults.
        Res Aging. 2012; 34: 275-301
        • Health and Retirement Study
        2006 and 2010 core public use dataset.
        Produced and distributed by the University of Michigan with funding from the National Institute on Aging (grant number NIA U01AG009740), Ann Arbor, MI2012 (Available at:
        • Williams D.R.
        • Yu Y.
        • Jackson J.S.
        • et al.
        Racial differences in physical and mental health. Socio-economic status, stress and discrimination.
        J Health Psychol. 1997; 2: 335-351
        • Borrell C.
        • Artazcoz L.
        • Gil-González D.
        • et al.
        Perceived sexism as a health determinant in Spain.
        J Womens Health. 2010; 19: 741-750
        • Andreyeva T.
        • Puhl R.M.
        • Brownell K.D.
        Changes in perceived weight discrimination among Americans, 1995–1996 through 2004–2006.
        Obesity. 2008; 16: 1129-1134
        • Sutin A.R.
        • Terracciano A.
        Perceived weight discrimination and obesity.
        PLoS One. 2013; 8: e70048
        • Idler E.L.
        • Benyamini Y.
        Self-rated health and mortality: a review of twenty-seven community studies.
        J Health Soc Behav. 1997; 38: 21-37
        • Diener E.
        • Emmons R.A.
        • Larsen R.J.
        • et al.
        The Satisfaction With Life Scale.
        J Pers Assess. 1985; 49: 71-75
        • Hughes M.E.
        • Waite L.J.
        • Hawkley L.C.
        • et al.
        A short scale for measuring loneliness in large surveys: Results from two population-based studies.
        Res Aging. 2004; 26: 655-672
        • Fisher G.G.
        • Hassan H.
        • Rodgers W.L.
        • et al.
        Health and Retirement Study Imputation of Cognitive Functioning Measures: 1992–2010 Early Release.
        Survey Research Center University of Michigan, Ann Arbor, MI2012
        • Bryant A.N.
        • Ford K.L.
        • Kim G.
        Racial/ethnic variations in the relation between body mass index and cognitive function among older adults.
        Am J Geriatr Psychiatry. 2014; 22: 653-660
        • Aiken L.S.
        • West S.G.
        Multiple Regression: Testing and Interpreting Interactions.
        Sage, Thousand Oaks, CA1991
        • Ofstedal M.B.
        • Weir D.R.
        • Chen K.-T.
        • et al.
        Updates to HRS sample weights.
        University of Michigan, Ann Arbor, MI2011
        • Puhl R.M.
        • Moss-Racusin C.A.
        • Schwartz M.B.
        • et al.
        Weight stigmatization and bias reduction: Perspectives of overweight and obese adults.
        Health Educ Res. 2008; 23: 347-358
        • Hawkley L.C.
        • Cacioppo J.T.
        Loneliness matters: a theoretical and empirical review of consequences and mechanisms.
        Ann Behav Med. 2010; 40: 218-227
        • Chou K.L.
        • Cacioppo J.T.
        • Kumari M.
        • et al.
        Influence of social environment on loneliness in older adults: moderation by polymorphism in the CRHR1.
        Am J Geriatr Psychiatry. 2014; 22: 510-518
        • Kuwert P.
        • Knaevelsrud C.
        • Pietrzak R.H.
        Loneliness among older veterans in the United States: results from the National Health and Resilience in Veterans Study.
        Am J Geriatr Psychiatry. 2014; 22: 564-569
        • Innamorati M.
        • Pompili M.
        • Di Vittorio C.
        • et al.
        Suicide in the old elderly: results from one Italian county.
        Am J Geriatr Psychiatry. 2014; 22: 1158-1167
        • Chae D.H.
        • Lincoln K.D.
        • Adler N.E.
        • et al.
        Do experiences of racial discrimination predict cardiovascular disease among African American men? The moderating role of internalized negative racial group attitudes.
        Soc Sci Med. 2010; 71: 1182-1188
        • Mayrl D.
        • Saperstein A.
        When white people report racial discrimination: the role of region, religion, and politics.
        Soc Sci Res. 2013; 42: 742-754
        • Nussbaum A.D.
        • Steele C.M.
        Situational disengagement and persistence in the face of adversity.
        J Exp Soc Psychol. 2007; 43: 127-134