Original article| Volume 24, ISSUE 1, e53-e59, January 2014

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Racial and Gender Discrimination, Early Life Factors, and Chronic Physical Health Conditions in Midlife

Published:December 16, 2013DOI:



      Most studies of perceived discrimination have been cross-sectional and focused primarily on mental rather than physical health conditions. We examined the associations of perceived racial and gender discrimination reported in adulthood with early life factors and self-reported physician diagnosis of chronic physical health conditions.


      We used data from a racially diverse birth cohort of U.S. women (n = 168; average age, 41 years) with prospectively collected early life data (e.g., parental socioeconomic factors) and adult reported data on perceived discrimination, physical health conditions, and relevant risk factors. We performed modified robust Poisson regression owing to the high prevalence of the outcomes.


      Fifty percent of participants reported racial and 39% reported gender discrimination. Early life factors did not have strong associations with perceived discrimination. In adjusted regression models, participants reporting at least three experiences of gender or racial discrimination had a 38% increased risk of having at least one physical health condition (relative risk, 1.38; 95% confidence interval, 1.01–1.87). Using standardized regression coefficients, the magnitude of the association of having physical health condition(s) was larger for perceived discrimination than for being overweight or obese.


      Our results suggest a substantial chronic disease burden associated with perceived discrimination, which may exceed the impact of established risk factors for poor physical health.
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      Jasmine A. McDonald, PhD, is a postdoctoral fellow in the Department of Epidemiology at the Mailman School of public Health at Columbia University. Her research interests are in early life exposures and the development of chronic conditions in later life.


      Mary Beth Terry, PhD, is a professor of epidemiology at Columbia University Mailman School of Public Health. Her research focuses on breast cancer and in the molecular epidemiology and lifecourse methods of the disease.


      Parisa Tehranifar, DrPH, is an assistant professor of epidemiology at Columbia University Mailman School of Public Health. Her research examines social inequalities in cancer and other chronic disease risk.