Mediating effect of reported stress on gender discrimination and drug and alcohol use

Gender discrimination is a key social and political determinant of women's health outcomes. The stress and coping process is a potential mechanism by which discrimination affects health; discrimination acts as stressor that may initiate maladaptive coping strategies. Indeed, research suggests that individuals deal with chronic stress by engaging in negative health behaviors, such as smoking, alcohol use, drug use or overeating. Hence, the level of stress one experiences from a discriminatory event may influence the activation and types of coping responses. This study examines whether reported stress from gender discrimination mediates the relationship between reported gender discrimination experiences and drug and alcohol use. We used data from a racially-diverse sample of 754 women attending family planning clinics in Northern California (11.4% African American, 16.8% Latina, 10.1% Asian and 61.7% Caucasian). Bivariate analyses revealed that higher reports of gender discrimination were significantly related to both increasing alcohol (Never, Once a week, More than once a week and Daily/Almost daily) and drug use (Never, Ever in lifetime). We used ordered logistic regression and logistic regression to test the mediation hypothesis for alcohol use and drug use, respectively and controlled for sociodemographic characteristics. Including stress as a mediator reduced the coefficient of discrimination on lifetime drug use, but not alcohol use. The mediation effect on drug use was not significant when tested with the Sobel test, however. Our findings suggest that discriminatory events may still activate negative coping strategies, even when they are not acknowledged as being stressful.