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The association between income, education, and experiences of discrimination in older African American and European American patients
Quantitative Health Sciences Publications and Presentations
  • Jewell H. Halanych, University of Alabama
  • Monika M. Safford, University of Alabama
  • James M. Shikany, University of Alabama at Birmingham
  • Yendelela L. Cuffee, University of Massachusetts Medical School
  • Sharina D. Person, University of Massachusetts Medical School
  • Isabel C. Scarinci, University of Alabama
  • Catarina I. Kiefe, University of Massachusetts Medical School
  • Jeroan J. Allison, University of Massachusetts Medical School
UMMS Affiliation
Department of Quantitative Health Sciences
Publication Date
Document Type
*African Americans; Aged; Aged, 80 and over; Cross-Sectional Studies; *Educational Status; *European Continental Ancestry Group; Female; Humans; *Income; *Life Change Events; Male; Middle Aged; *Prejudice; Southeastern United States

OBJECTIVE: Racial/ethnic discrimination has adverse effects on health outcomes, as does low income and education, but the relationship between discrimination, income, and education is not well characterized. In this study, we describe the associations of discrimination with income and education in elderly African Americans (AA) and European Americans (EA).

DESIGN: Cross-sectional observational study involving computer-assisted telephone survey.

SETTING: Southeastern United States.

PARTICIPANTS: AA and EA Medicare managed care enrollees.

MAIN OUTCOME MEASURES: Discrimination was measured with the Experience of Discrimination (EOD) scale (range 0-35). We used zero-inflated negative binomial models to determine the association between self-reported income and education and 1) presence of any discrimination and 2) intensity of discrimination.

RESULTS: Among 1,800 participants (45% AA, 56% female, and mean age 73 years), EA reported less discrimination than AA (4% vs. 47%; P < .001). AA men reported more discrimination and more intense discrimination than AA women (EOD scores 4.35 vs. 2.50; P < .001). Both income and education were directly and linearly associated with both presence of discrimination and intensity of discrimination in AA, so that people with higher incomes and education experienced more discrimination. In adjusted models, predicted EOD scores among AA decreased with increasing age categories (3.42, 3.21, 2.99, 2.53; P < .01) and increased with increasing income (2.36, 3.44, 4.17; P < .001) and education categories (2.31, 3.09, 5.12; P < .001).

CONCLUSIONS: This study suggests future research should focus less on differences between racial/ethnic groups and more on factors within minority populations that may contribute to healthcare disparities.

Ethn Dis. 2011 Spring;21(2):223-9.
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Citation Information
Jewell H. Halanych, Monika M. Safford, James M. Shikany, Yendelela L. Cuffee, et al.. "The association between income, education, and experiences of discrimination in older African American and European American patients" Vol. 21 Iss. 2 (2011) ISSN: 1049-510X (Linking)
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