Influence of perceived discrimination on health related quality of life in an east coast American Indian tribe

Perceived discrimination is associated with smoking, low self-rated health, psychological distress, depression, and alcohol abuse. Few studies have examined the association between perceived discrimination and health in American Indian and Alaska Native (AI/AN) populations, and these studies may not generalize to other AI/AN, since geographically and culturally distinct tribes differ in patterns of disease and risk factors.

We examined the association of perceived discrimination and health related quality of life, using cross-sectional survey data of adult American Indians with a long history of discrimination in the northeastern United States. Our sampling frame included all 387 tribal members ages ≥18, who lived on their reservation or in the surrounding county. We measured perceived discrimination using a nine item discrimination scale and measured health related quality of life with the mental component summary (MCS) and physical component summary (PCS) scores of the Short Form-12 questionnaire.

Perceived discrimination was significantly associated with worse mental health. On average, the MCS decreased 0.6 units (p = 0.003) for every 1-unit increase in the perceived discrimination score, and this association persisted after adjusting for age, sex, marital status, education level, smoking status, and body mass index. The PCS did not show a significant association between perceived discrimination and physical functioning.

Our findings support results from previous studies linking discrimination to worse mental health outcomes. Given the diversity of AI/AN communities, future studies should examine the association of perceived discrimination and health status in other AI/AN populations, including rural reservation and urban samples.