198896 Self-reported racial/ethnic discrimination among Asian Americans and Pacific Islanders in California

Tuesday, November 10, 2009: 11:00 AM

Salma N. Shariff-Marco, PhD, MPH , Division of Cancer Control and Population Sciences, Applied Research Program [Cancer Prevention Fellowship Program], National Cancer Institute, Rockville, MD
Gilbert C. Gee, PhD , School of Public Health, Community Health Sciences, University of California, Los Angeles, Los Angeles, CA
Nancy Breen, PhD , Applied Research Program, National Cancer Institute, Bethesda, MD
Gordon Willis, PhD , Division of Cancer Control and Prevention, National Cancer Institute, Rockville, MD
Bryce Reeve, PhD , National Cancer Institute, Bethesda, MD
David Grant, PhD , UCLA Center for Health Policy Research/California Health Interview Survey (CHIS), UCLA, Los Angeles, CA
Ninez Ponce, MPP, PhD , Department of Health Services, UCLA, Los Angeles, CA

Self-reported discrimination is associated with health problems among Asian Americans and Pacific Islanders (APIs). However, most measures of discrimination have not been validated for API populations. There are two major approaches to measuring discrimination, but it is not clear which approach is more valid and reliable for APIs. The first approach asks respondents directly if they encountered discrimination based on race/ethnicity (Early Attribution). The second approach asks respondents about their experiences of discrimination, and then asks if this discrimination was based on race/ethnicity (Late Attribution).

Objective: To evaluate the validity and reliability of two approaches to asking about racial/ethnic discrimination for APIs.


Over 1,300 APIs participated in the 2007 California Health Interview Survey field test. Using a split-ballot design, participants were randomized to each approach. Analyses included assessment of reliability and concurrent and predictive validity for each approach. Additionally, 100 of these interviews were recorded and behavior coded.


Depending on the approach used, 60-85% of Asian Americans and Pacific Islanders reported having discrimination experiences. Both approaches had acceptable psychometric properties. Early Attribution had a shorter administration time. Late Attribution provided larger prevalence estimates of discrimination. Respondents reporting discrimination were more likely to have increased odds of fair/poor self-rated health, poor mental health, ever having high blood pressure, and binge drinking. An important new finding is that strength of associations varied by approach.


Preliminary analyses suggest that both approaches to asking about discrimination are valid and reliable for APIs, but each approach has strengths and limitations.

Learning Objectives:
1) Describe methods used to evaluate validity and reliability of survey instruments 2) Understand the challenges in measuring discrimination using a brief instrument in the context of a public health survey for multi-ethnic and multilingual populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My doctoral training and dissertation research as well as my current research is focused on evaluating the role of discrimination on health. I am co-leading a study on how to measure discrimination. I also have several manuscripts that are under review and in preperation on this topic.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.