Perceptions of Racial Discrimination, Mental Health, Health Care Utilization and Health Outcomes in Mississippi: Is there a Pathway?

Introduction Disparities and Inequities in health due to race have been identified as key variables that drive overall health (Hausman et al 2009, 2008, Barnes et al 2008, Williams, Neighbors and Jackson, 2003, Smedley et al 2003). In Mississippi, health burdens for Blacks drive overall rates, which are significantly worse than national levels. Among inequities, health care utilization have been linked to race. Effects of race have not however been linked to intermediate factors delineating specific pathways amenable to planned interventions. Thus, it is unclear if racial discrimination actually impacts health outcomes through mental health that drives the known health seeking risk factors. We therefore examine relationships between perceptions of discrimination and health seeking behavior (defined here as health care utilization) to see whether there is a pathway or a simple relationship.

Methods Using 5,257 respondents, we examine the 2004 BRFSS data for Mississippi to determine the associations between perception of racial discrimination, mental health and health care utilization. We defined and examined: 1. Perceptions of Racial Discrimination; 2. Mental Health, 3.Health care utilization and 4. Prostate and Breast cancers. Using multivariate logistic regression analyses and path analyses, we differentiate between health seeking behaviors stemming from perception of racial discrimination and those that are not, in relation to Prostate and Breast, cancers.

Results Results show significant relationships between perceptions of racial discrimination and health care utilization. However, the pathway of discrimination, mental health and health seeking behavior was not very clear.