Impact of the accumulation of different types of discrimination, over time, on women’s mental health #TimesUp Gender Inequality & Women’s Mental Health ESRC Festival of Social Science Laia Bécares, PhD
Multiple forms of discrimination Women have multiple intersecting identities and live in and negotiate several systems of privilege and oppression (racism, sexism, heterosexism, ableism, ageism…) • Intersecting social identities and systems of oppression result in multiple social inequalities that reproduce and maintain health inequalities Identifying single forms and attributions of discrimination (e.g., gender discrimination or racial discrimination) is problematic: • Strips away the context of people’s lives • Disregards the fact that women often embody more than 1 socially disadvantaged status Disadvantaged statuses and multiple experiences of discrimination interact to shape women’s health Bowleg, 2012; Brah & Phoenix, 2004; Crenshaw, 1989
Multiple types of discrimination Women experience different types/domains of discrimination (e.g., employment discrimination, verbal of physical harassment, discrimination in educational settings…) Clear dose-response relationship between increasing number of domains of discrimination experienced and incremental worsening of mental health. Mental health compared with those without racism exposure 0 -1 -2 -3 -4 -5 -6 Any experience of One type Two types Three or more types racism or discrimination Source: Wallace et al., 2016. Data presented includes women and men of ethnic minority background
…over the course of women’s lives Experiences of discrimination (in their different forms and types) occur throughout women’s lives – in childhood, adolescence, adulthood, late adulthood… These experiences accumulate over time to harm women’s mental health Mental health compared with those without racism exposure 0 -2 -4 -6 -8 -10 One event at one time Two or more events at One event at two times Two or more events one Two or more events one time time and one event at two times another Source: Wallace et al., 2016. Data presented includes women and men of ethnic minority background
Cumulative effects of types and forms of discrimination over time Putting all these pieces together… Aim : To measure women’s experiences of multiple forms and types of discrimination over time, and their association with mental health. Data : Study of Women’s Health Across the Nation (SWAN ) US-based longitudinal study designed to examine the health of women during their middle years. 10 waves. Mental health : Depression (20-item Center for Epidemiologic Studies Depression Scale) Discrimination : Frequency of experiences of perceived interpersonal discrimination (Everyday Discrimination Scale). 6 waves. “In your day -to- day life, have you had the following experiences?” Including “You are treated with less courtesy than other people,” “ You receive poorer service than other people at restaurants or stores,” and “People ignore you or act as if you are not there .” Attributions: race/ethnicity, gender, other (age, physical appearance, income level, sexual orientation, language)
Experiences of discrimination Class 1 (21%): Highest accumulation of perceived interpersonal discrimination over time, domains, and attributes Class 2 (17%): None or very minimal experiences of perceived interpersonal discrimination Class 3 (34%): Accumulation of several domains over time; attribution due mainly to gender Class 4 (28%): Accumulation of some domains over time; attribution due to other reasons; reduction over time % of the sample in each class of experienced discrimination 35 30 25 20 15 10 5 0 Class 1 Class 2 Class 3 Class 4
Widespread accumulation • Only a minority of the sample (17%) reported having no experiences or minimal experiences of perceived discrimination - the large majority of women experienced perceived discrimination that was attributed to multiple social identities • Only 2 women reported experiencing only racial discrimination, and only 1 reported experiencing only discrimination due to gender • Very few participants had experienced perceived interpersonal discrimination in 1 domain across waves or at 1 time point only Need to consider multiple social positions and oppressed identities when understanding experiences of interpersonal discrimination
Distribution of ethnic groups in each class 100 90 80 70 African-American and Chinese-American 60 women were about 6 times more likely than 50 non-Hispanic white women to be in class 1 compared to class 2 40 30 20 10 0 Class 1 Class 2 Class 3 Class 4 Black or African-American Chinese-American Japanese-American Non-Hispanic white
Accumulation of discrimination and mental health Highest reports of depression reported by with women who experienced the highest accumulation of perceived interpersonal discrimination (class 1) • Overall, women who reported the lowest levels of perceived interpersonal discrimination (class 2) had 54% less risk of depression compared with women in class 1 True across ethnic groups: • Compared with African-American women in class 1, African-American women in class 2 had 0.46 times the risk of reporting depression • Japanese-American women in class 2 had 0.65 times the risk of depression, compared with women in class 1 • Non-Hispanic white women in class 2 were 0.52 times as likely, respectively, to report depression compared with women in class 1
Conclusions • Women who experience the highest levels of cumulative discrimination are at greater risk of depression than women who experience minimal levels of discrimination • Discrimination is harmful for women regardless of ethnic background, but type and severity of discrimination (and therefore, the accumulated harm over the life course) differs across ethnic groups • Individuals who belong to multiple stigmatized groups, such as ethnic minority women and/or women with several marginalised identities, face the greatest burden of these experiences • Studies that examine exposure to perceived discrimination due to a single attribute in 1 domain or at 1 point in time underestimate the magnitude and complexity of discrimination and its association with health.
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References Bowleg, L. (2012). The problem with the phrase women and minorities: intersectionality-an important theoretical framework for public health. American journal of public health , 102(7), 1267-1273. Brah, A., & Phoenix, A. (2004). Ain’t I A Woman? Revisiting Intersectionality. Journal of International Women's Studies , 5(3), 75-86. Crenshaw K. (1989). Demarginalizing the intersection of race and sex: a black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. University of Chicago Legal Forum, 1989(1), 139 – 167. Wallace, S., Nazroo, J., & Bécares, L. (2016). Cumulative Effect of Racial Discrimination on the Mental Health of Ethnic Minorities in the United Kingdom. American journal of public health , 106 (7), 1294-300.
Thank you l.becares@sussex.ac.uk
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