Is discrimination associated with medical symptoms and psychological distress among women with substance use disorders?

While a significant body of work has established that racial discrimination adversely affects health, few studies have assessed discrimination stemming from other dimensions of social inequalities, in addition to discrimination due to race, and few have examined this association after controlling for other potentially confounding psychosocial stressors. Our study investigated whether two distinct forms of perceived discrimination were each positively associated with medical symptomatology and psychological distress over and above other psychosocial stressors and whether these associations differed by race/ethnicity. Participants were 437 clients in treatment for substance use disorders in Massachusetts. Multiple linear regression models, overall and stratified by race/ethnicity, assessed associations of two forms of perceived discrimination with medical symptomatology and psychological distress after controlling for lifetime stressors, perceived stress, posttraumatic stress symptomatology and alcohol and drug use. Our findings showed that the two forms of perceived discrimination were significantly associated with higher medical symptomatology (B=.113, p=.01 & B=.101, p=.05) and higher psychological distress (B=.111, p=.01 & B=.103, p=.05) over and above other potential confounding psychosocial stressors. Models stratified by race/ethnicity showed adverse discrimination-health associations significant only for Whites and Latinas. Understanding perceived discrimination based on a range of social factors is important for reducing racial/ethnic health disparities and the disproportionate number of medical burden consequences harmfully affecting minority women with substance use disorders.