What do we measure when we measure perceptions of everyday discrimination?

RATIONALE: The Everyday Discrimination Scale forms the backbone of hundreds of studies documenting the health effects of perceived discrimination. Researchers regularly use the scale to examine specific types of discrimination (e.g., racial, ethnic, gender- and age-based) as well as discrimination more generally among the "general population." To date, no study has analyzed the frameworks respondents use to interpret and answer the questions that comprise the scale. As such, what exactly researchers are measuring when they ask about "everyday discrimination" - and how this may vary within and across social groups - remains unknown. OBJECTIVE: This study analyzes data from cognitive interviews to assess patterns of interpretation and response to the EDS to assess whether the meaning of the resulting data may vary across diverse social groups. METHODS: Researchers conducted structured cognitive interviews with a diverse sample of thirty-eight adults in the Southeastern United States (US). Interview transcripts were qualitatively analyzed using MAXQDA, in a process of reiterative coding. RESULTS: Results show that respondents interpret the survey questions in markedly different ways, with some interpreting the scale as asking about negative interactions; others viewing it through a lens of social inequalities; and still others through a lens specifically of racism. Racial/ethnic and gender statuses may structure question interpretation. CONCLUSIONS: Pronounced and patterned variation in respondents' interpretation raises questions about its validity. Findings underscore the importance of schemas for assessing the meaning of data generated by the EDS and for measuring the health effects of perceived discrimination and mistreatment.

Does the Everyday Discrimination Scale generate meaningful cross-group estimates? A psychometric evaluation.

RATIONALE: Studies linking discrimination to poor mental and physical health constitute one of the most robust branches of health inequities research. For more than two decades, and in more than a dozen countries, scholars working in this field have used the Everyday Discrimination Scale (EDS) to assess perceptions of discrimination. Two recent studies (Harnois et al., 2020; Harnois et al., 2019) cast doubt on the instrument's psychometric equivalence across diverse social groups, however. OBJECTIVE: Our study builds on these previous analyses using a larger and more ethnically and geographically diverse sample of adults in the US, the Collaborative Psychiatric Epidemiology Surveys. METHOD: Multi-group Confirmatory Factor Analyses were carried out to compare the configural, metric, and scalar structures of the EDS. RESULTS: Analyzing perceptions of racial/ethnic discrimination, we find a lack of equivalence across race/ethnicity, consistent with previous research. Reports of general mistreatment are found to be equivalent across gender-based groups, but not across race/ethnicity, age- or education-based groups. CONCLUSIONS: Our study provides further evidence that the EDS should be used with caution, particularly when assessing general perceptions of discrimination, and particularly when making cross-group comparisons. Measurement invariance is required to effectively assess the relationship between discrimination and health; further refinement of the scale may be needed to achieve this goal.

Higher exposure, lower vulnerability? The curious case of education, gender discrimination, and Women's health.

Workplace gender discrimination persists in American society and women's experiences of discrimination are linked to diminished mental and physical well-being. While higher socioeconomic status (SES) decreases exposure to a number of work-related stressors, research suggests higher SES may also be associated with increased rates of perceived gender discrimination at work. We conceptualize educational attainment as a "metamechanism" that shapes women's work lives, family lives, as well as their ideologies. We argue that these factors in turn structure women's exposure and vulnerability to gender discrimination. We assess the influence of educational attainment on women's perceptions of workplace discrimination, as well as its health consequences, by analyzing national data from the 2002-2014 General Social Surveys. Our analyses show that women with high levels of education are more likely than women with lower levels of education to work full-time and in well-compensated, male-dominated occupations, and it is in these contexts where women are most likely to perceive gender discrimination. While educational attainment is associated with increased reports of workplace gender discrimination, it also sometimes provides women with resources that buffer its negative health consequences. For women with lower levels of education, perceived gender discrimination is associated with worse mental health, lower quality sleep, less happiness, and lower job satisfaction, but these particular health tolls diminish or disappear at higher levels of education. Our results shed light on the multi-level processes through which gender and education work together to structure health outcomes.

Measuring perceived mistreatment across diverse social groups: An evaluation of the Everyday Discrimination Scale.

RATIONALE: Research assessing the health-related consequences of perceived discrimination depends upon high quality measures of perceived discrimination. The Everyday Discrimination Scale (EDS) is among the most frequently used instruments to assess perceptions of discrimination in general, as well as specific types of discrimination (e.g., based on race/ethnicity or age). While numerous studies attest to its validity and reliability for racial/ethnic minority groups, no existing study has examined its psychometric equivalence across gender, age, or socio-economic groups. This study fills this gap. HYPOTHESIS: We hypothesize that because social hierarchies of race/ethnicity, age, gender and class have different histories and are differently organized and institutionalized in contemporary United States, racial/ethnic, age, gender, and education-based groups differ in the types of discrimination they experience and perceive. As a result, the EDS may not be equivalent across these social groups. METHOD: We test this hypothesis by analyzing data from the 2015 US Texas Diversity Study (N=1,049), a telephone survey of English- and Spanish-speaking adults. We examine two forms of the EDS - one focusing on discrimination regardless of attribution and one focusing specifically on discrimination attributed to respondents' race/ethnicity. RESULTS: Multi-group confirmatory factor analyses revealed that neither version of the scale generates estimates of discrimination that can be meaningfully compared across all racial/ethnic, age, gender, and education-based groups. CONCLUSIONS: Our results urge caution when drawing comparisons of perceived discrimination across diverse social groups based on the EDS and point to avenues for future scale development.

Discrimination, Harassment, and Gendered Health Inequalities: Do Perceptions of Workplace Mistreatment Contribute to the Gender Gap in Self-reported Health?

This study examines the extent to which discrimination and harassment contribute to gendered health disparities. Analyzing data from the 2006, 2010, and 2014 General Social Surveys ( N = 3,724), we ask the following: (1) To what extent are perceptions of workplace gender discrimination and sexual harassment associated with self-reported mental and physical health? (2) How do multiple forms of workplace mistreatment (e.g., racism, ageism, and sexism) combine to structure workers' self-assessed health? and (3) To what extent do perceptions of mistreatment contribute to the gender gap in self-assessed health? Multivariate analyses show that among women, but not men, perceptions of workplace gender discrimination are negatively associated with poor mental health, and perceptions of sexual harassment are associated with poor physical health. Among men and women, perceptions of multiple forms of mistreatment are associated with worse mental health. Gender discrimination partially explains the gender gap in self-reported mental health.

Health care barriers, racism, and intersectionality in Australia.

While racism has been shown to negatively affect health care quality, little is known about the extent to which racial discrimination works with and through gender, class, and sexuality to predict barriers to health care (e.g., perceived difficulty accessing health services). Additionally, most existing studies focus on racial disparities in the U.S. context, with few examining marginalized groups in other countries. To address these knowledge gaps, we analyze data from the 2014 Australian General Social Survey, a nationally representative survey of individuals aged 15 and older living in 12,932 private dwellings. Following an intersectional perspective, we estimate a series of multivariable logit regression models to assess three hypotheses: racial discrimination will be positively associated with perceived barriers to health care (H1); the effect of perceived racial discrimination will be particularly severe for women, sexual minorities, and low socio-economic status individuals (H2); and, in addition to racial discrimination, other forms of perceived discrimination will negatively impact perceived barriers to health care (H3). Findings show that perceptions of racial discrimination are significantly associated with perceived barriers to health care, though this relationship is not significantly stronger for low status groups. In addition, our analyses reveal that perceived racism and other forms of discrimination combine to predict perceived barriers to health care. Taken together, these results speak to the benefits of an intersectional approach for examining racial inequalities in perceived access to health care.