Abstract
Introduction: Discrimination affects the health and well-being of those who experience it. The relationship between discrimination and mental health in migrant communities and in the Chilean child and youth population has been previously studied, however, there is little evidence regarding the effects of discrimination on the general population. Objective: To analyze the relationship between discrimination and the presence of anxious and depressive symptoms in the Chilean population. Methods: Prospective cross-sectional study evaluating 927 subjects in the cities of Arica, Antofagasta, and Santiago. To evaluate discrimination the Krieger Discrimination Experience Scale is used. To asses depressive and anxious symptomatology, the Beck scales for BDI Depression and BAI Anxiety were implemented. Results: The mean age of the sample is 33.9 years (Range 18-70 years; SD=13.13). 59.5% of the participants are female. 36% of the participants reported having experienced discrimination in some aspect of their lives. The highest perception of discrimination is associated with employment (42%) and the main reported causes are level of education or income, age, and gender. Experiences of discrimination exert statistically significant positive effects of moderate magnitude (b>.30) on depressive (b=.460, p<.001) and anxious (b=.480, p<.001) symptomatology, the latter being interrelated (b=.636, p<.001). Conclusions: More than a third of the population studied reported having been discriminated in some aspect of their lives. This perception is further accentuated in relation to employment. The perception of discrimination is associated with an increase in anxious and depressive symptoms in the Chilean population.
References
Adam, E., Quinn, M., Tavernier, R., McQuillan, M., Dahlke, K., & Gilbert K. (2017) Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis. Psychoneuroendocrinology, 83, 25-41. https://doi.org/gbv8pd
Andrade, N., Ford, A. D., & Alvarez, C. (2021). Discrimination and Latino health: A systematic review of risk and resilience. Hispanic Health Care International: The Official Journal of the National Association of Hispanic Nurses, 19(1), 5–16. https://doi.org/10.1177/1540415320921489
Barnes, L., Mendes de Leon, C., Lewis, T., Bienias, J., Wilson, R., & Evans, D. (2008) Perceived Discrimination and Mortality in a Population-Based Study of Older Adults. American Journal of Public Health, 98 (7), 1241-1247. https://doi.org/c8jq8k
Barrientos, J., y Bozon, M. (2014). Discrimination and victimization against gay men and lesbians in Chile: Two patterns or just one? Interdisciplinaria Revista de PsicologÃa y Ciencias Afines, 31(2). https://doi.org/10.16888/interd.2014.31.2.8
Barrientos, J., Silva, J., Catalan, S., Gomez, F., & Longueira, J. (2010). Discrimination and victimization: parade for lesbian, gay, bisexual, and transgender (LGBT) pride, in Chile. Journal of Homosexuality, 57(6), 760–775. https://doi.org/cd6x9k
Beauducel, A., & Herzberg, P. Y. (2006). On the performance of maximum likelihood versus means and variance adjusted weighted least squares estimation in CFA. Structural Equation Modeling: A Multidisciplinary Journal, 13(2), 186–203. https://doi.org/10.1207/s15328007sem1302_2
Becerra, S., Merino, M. E., & Mellor, D. (2015). Ethnic discrimination against mapuche students in urban high schools in the araucanÃa region, Chile. International education studies, 8(10). https://doi.org/10.5539/ies.v8n10p96
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4(6), 561–571. https://doi.org/10.1001/archpsyc.1961.01710120031004
Beck, A.T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of consulting and clinical psychology, 56(6), 893–897. https://doi.org/10.1037/0022-006x.56.6.893
Beck, A.T., Steer, R. A., & Carbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8(1), 77–100. https://doi.org/10.1016/0272-7358(88)90050-5
Capezza, N. M., Zlotnick, C., Kohn, R., Vicente, B., & Saldivia, S. (2012). Perceived discrimination is a potential contributing factor to substance use and mental health problems among primary care patients in Chile. Journal of Addiction Medicine, 6(4), 297–303. https://doi.org/10.1097/ADM.0b013e3182664d80
Caqueo-UrÃzar, A., Urzúa, A., Mena-Chamorro, P., Flores, J., Irarrázaval, M., Graniffo, E., & Williams, D. R. (2021). Relationship between Everyday Discrimination and Substance Use among Adolescents in Northern Chile. International Journal of Environmental Research and Public Health, 18(12), 6485. https://doi.org/10.3390/ijerph18126485
Cohen, J. (2013). Statistical Power Analysis for the Behavioral Sciences. Elsevier Science.
Dolezsar,C., McGrath, J., Herzig, A., & Miller, S. (2014) Perceived racial discrimination and hypertension: a comprehensive systematic review. Health Psychology, 33(1), 20-34. https://doi.org/10.1037/a0033718
Durso, L., Latner, J., & Hayashi, K. (2012) Perceived discrimination is associated with binge eating in a community sample of non-overweight, overweight, and obese adults. Obes Facts, 5 (6), 869-880. https://doi.org/10.1159/000345931
Energici. M., Acosta E., Bórquez, F., & Huaiquimilla, M. (2017) Gordura, discriminación y clasismo: Un estudio en jóvenes de Santiago de Chile. Psicologia e Sociedade, 29, e164178. https://doi.org/10.1590/1807-0310/2017v29164178
Finkeldey, J. G., & Demuth, S. (2021). Race/ethnicity, perceived skin color, and the likelihood of adult arrest. Race and Justice, 11(4), 567–591. https://doi.org/mdcx
Flores, J., Caqueo-UrÃzar, A., Quintana, L., Urzúa, A., & Irarrázaval, M. (2021). Perceived discrimination and contextual problems among children and adolescents in northern Chile. PloS One, 16(2), e0246998. https://doi.org/10.1371/journal.pone.0246998
Gee, G., Spencer, M., Chen, J., Yip, T., & Takeuchi, D. (2007) The association between self-reported racial discrimination and 12-month DSM-IV mental disorders among Asian Americans nationwide. Social Science & Medicine, 64 (10), 1984-1996. https://doi.org/10.1016/j.socscimed.2007.02.013
Giasson, H. L., Queen, T. L., Larkina, M., & Smith, J. (2017). Age group differences in perceived age discrimination: Associations with self-perceptions of aging. The Gerontologist, 57(suppl_2), S160–S168. https://doi.org/10.1093/geront/gnx070
Harrell, J. P., Hall, S., & Taliaferro, J. (2003). Physiological responses to racism and discrimination: An assessment of the evidence. American Journal of Public Health, 93(2), 243–248. https://doi.org/10.2105/ajph.93.2.243
Hu, R. X., Luo, M., Zhang, A., & Li, L. W. (2021). Associations of ageism and health: A systematic review of quantitative observational studies. Research on Aging, 43(7–8), 311–322. https://doi.org/10.1177/0164027520980130
Hughes, D., Witherspoon, D., Rivas-Drake, D., & West-Bey, N. (2009). Received ethnic-racial socialization messages and youths’ academic and behavioral outcomes: Examining the mediating role of ethnic identity and self-esteem. Cultural Diversity & Ethnic Minority Psychology, 15(2), 112–124. https://doi.org/10.1037/a0015509
Instituto Nacional de Derechos Humanos. (January 30, 2017). Informe Anual Situación de los Derechos Humanos en Chile 2017. INDH. http://tinyurl.com/3v6rfrz8
Instituto Nacional de EstadÃsticas. (June 2018). SÃntesis de Resultados CENSO 2017, INE.. http://tinyurl.com/yc6v5k3v
Kessler, R. C., Mickelson, K. D., & Williams, D. R. (1999). The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. Journal of Health and Social Behavior, 40(3), 208–230. https://doi.org/10.2307/2676349
Krieger, N. (2001). A glossary for social epidemiology. Journal of Epidemiology and Community Health, 55(10), 693–700. https://doi.org/10.1136/jech.55.10.693
Krieger, N., Smith, K., Naishadham, D., Hartman, C., & Barbeau, E. M. (2005). Experiences of discrimination: validity and reliability of a self-report measure for population health research on racism and health. Social Science & Medicine (1982), 61(7), 1576–1596. https://doi.org/10.1016/j.socscimed.2005.03.006
Lewis, T. T., Cogburn, C. D., & Williams, D. R. (2015). Self-reported experiences of discrimination and health: scientific advances, ongoing controversies, and emerging issues. Annual Review of Clinical Psychology, 11(1), 407–440. https://doi.org/gf8gmz
Ley N° 20.609. Establece medidas contra la discriminación. Diario Oficial de la República de Chile, Santiago, July 24, 2012. https://bcn.cl/324ve
Magan, I., Sanz, J., & GarcÃa-Vera, M. P. (2008). Psychometric properties of a Spanish version of the Beck Anxiety Inventory (BAI) in general population.The Spanish Journal of Psychology, 11(2), 626–640. https://doi.org/10.1017/S1138741600004637
Mellor, D., Merino, M., Saiz, J., Quilaqueo, D. (2009). Emotional Reactions, Coping and Long-term Consequences of Perceived Discrimination Among the Mapuche People of Chile. Journal of Community and Applied Social Psychology, 19(6), 473–491. https://doi.org/10.1002/casp.996
Oakley, R., & Cidlowski, J. (2013) The biology of the glucocorticoid receptor: new signaling mechanisms in health and disease. Journal of Allergy and Clinical Immunology, 132(5), 1033-1044. https://doi.org/10.1016/j.jaci.2013.09.007
OrtÃz, M., Baeza-Rivera MarÃa, S., Natalia, F., & Patricia, B. (2016). Atribución de malos tratos en servicios de salud a discriminación y sus consecuencias en pacientes diabéticos mapuche. Revista médica de Chile, 144(10), 1270–1276. https://doi.org/mdcz
Oyarzún, J. D., Parcerisa, L., & Carrasco, A. (2022). Discriminación étnica y cultural en procesos de elección de escuela en minorÃas socioculturales en Chile. Psicoperspectivas, 21(1), 87–98. https://doi.org/10.5027/psicoperspectivas-vol21-issue1-fulltext-2537
Panza, G. A., Puhl, R. M., Taylor, B. A., Zaleski, A. L., Livingston, J., & Pescatello, L. S. (2019). Links between discrimination and cardiovascular health among socially stigmatized groups: A systematic review. PloS One, 14(6): e0217623. https://doi.org/10.1371/journal.pone.0217623
Pascoe, E. A., & Smart Richman, L. (2009). Perceived discrimination and health: a meta-analytic review. Psychological Bulletin, 135(4), 531–554. https://doi.org/d3ccxs
Pearlin, L. I., Schieman, S., Fazio, E. M., & Meersman, S. C. (2005). Stress, health, and the life course: some conceptual perspectives. Journal of Health and Social Behavior, 46(2), 205–219. https://doi.org/10.1177/002214650504600206
Ramiah, A., Hewstone, A., Dovidio, M., & Penner, J. F. (2010). Making Equality Count: Irish and International Approaches to Measuring Discrimination. Springer.
RamÃrez, B., Goic, E., & Yzerbyt, C. (2016). Correlational study on implicit and explicit prejudice and discrimination in a magellan sample. Atenea, (513), 251–262. https://doi.org/10.4067/S0718-04622016000100016
Sandoval Obando, E., & Peña, J. C. (2019). Violencia de género y discriminación arbitraria en una universidad privada chilena: una exploración inicial. Sophia, 15(2), 55–70. https://doi.org/10.18634/sophiaj.15v.2i.945
Sanz, J., & Vázquez, C. (1998). Validez y datos normativos del Inventario para la depresión de Beck. Psicothema, 10(2), 303–318.
Sanz, J. (2014). Recomendaciones para la utilización de la adaptación española del Inventario de Ansiedad de Beck (BAI) en la práctica clÃnica. ClÃnica y salud, 25(1), 39–48. https://doi.org/10.1016/s1130-5274(14)70025-8
Scholaske, L., Wadhwa, P. D., & Entringer, S. (2021). Acculturation and biological stress markers: A systematic review. Psychoneuroendocrinology, 132: 105349. https://doi.org/10.1016/j.psyneuen.2021.105349
Schmitt, M. T., Branscombe, N. R., Postmes, T., & Garcia, A. (2014). The consequences of perceived discrimination for psychological well-being: a meta-analytic review. Psychological Bulletin, 140(4), 921–948. https://doi.org/10.1037/a0035754
Schreiber, J. B. (2017). Update to core reporting practices in structural equation modeling. Research in Social & Administrative Pharmacy, 13(3), 634–643. https://doi.org/10.1016/j.sapharm.2016.06.006
Urzúa, A., Caqueo-UrÃzar, A., Aragón, D. (2020) Prevalencia de sintomatologÃa ansiosa y depresiva en migrantes colombianos en Chile. Revista médica de Chile, 148(9), 1271-1278. https://doi.org/10.4067/S0034-98872020000901271
Urzúa, A., Ferrer, R., Olivares, E., Rojas, J., & RamÃrez, R. (2019a). El efecto de la discriminación racial y étnica sobre la autoestima individual y colectiva según el fenotipo auto-reportado en migrantes colombianos en Chile. Terapia Psicológica, 37(3), 225–240. https://doi.org/10.4067/S0718-48082019000300225
Urzúa, A., Cabrera, C., Carvajal, C. C., & Caqueo-UrÃzar, A. (2019b). The mediating role of self-esteem on the relationship between perceived discrimination and mental health in South American immigrants in Chile. Psychiatry Research, 271, 187–194. https://doi.org/10.1016/j.psychres.2018.11.028
Urzúa, A., Caqueo-UrÃzar, A., HenrÃquez, D., Domic, M., Acevedo, D., Ralph, S., Reyes, G., & Tang, D. (2021b). Ethnic identity as a mediator of the relationship between discrimination and psychological well-being in South-South migrant populations. International Journal of Environmental Research and Public Health, 18(5). https://doi.org/10.3390/ijerph18052359
Urzúa, A., Caqueo-UrÃzar, A., HenrÃquez, D., & Williams, D. R. (2021a). Discrimination and health: The mediating effect of Acculturative Stress. International Journal of Environmental Research and Public Health, 18(10): 5312. https://doi.org/mdc2
Urzúa, A., Ferrer, R., Godoy, N., Leppes, F., Trujillo, C., Osorio, C., & Caqueo-UrÃzar, A. (2018). The mediating effect of self-esteem on the relationship between perceived discrimination and psychological well-being in immigrants. PloS One, 13(6): e0198413. https://doi.org/10.1371/journal.pone.0198413
Valdés, C., Morales-Reyes, I., Pérez, J. C., MedellÃn, A., Rojas, G., & Krause, M. (2017). Propiedades psicométricas del inventario de depresión de Beck IA para la población chilena. Revista médica de Chile, 145(8), 1005–1012. https://doi.org/10.4067/s0034-98872017000801005
Vargas, S. M., Huey, S. J., & Miranda, J. (2020). A critical review of current evidence on multiple types of discrimination and mental health. The American Journal of Orthopsychiatry, 90(3), 374–390. https://doi.org/10.1037/ort0000441
Williams, D. R., Lawrence, J. A., Davis, B. A., & Vu, C. (2019). Understanding how discrimination can affect health. Health Services Research, 54(S2), 1374–1388. https://doi.org/10.1111/1475-6773.13222
Williams, D. R., & Mohammed, S. A. (2009). Discrimination and racial disparities in health: evidence and needed research. Journal of Behavioral Medicine, 32(1), 20–47. https://doi.org/10.1007/s10865-008-9185-0
