Young adults who experience discrimination about their bodies, race, age or sex have a greater risk of dealing with mental health problems than those who do not, a new study has found.
Encountering discrimination – especially racism – has long been associated with negative effects on overall well-being, such as higher levels of stress, poor cognitive function, anxiety, depression and substance use, previous studies have found.
Those who faced discrimination frequently – at least a few times per month – were around 25% more likely to be diagnosed with a mental disorder and twice as likely to develop severe psychological distress than people who didn’t experience discrimination or did less often, according to a study published Monday in the journal Pediatrics.
Having dealt with any degree of discrimination was linked with a 26% higher risk for having poor overall health, according to the participants’ responses. Often experiencing discrimination wasn’t strongly associated with binge drinking but was linked with more use of drugs such as amphetamines, marijuana, tranquilizers, barbiturates or cocaine in the last year without a doctor’s prescription.
The authors analyzed a decade’s worth of data from 1,834 American participants who had reported details about their mental and behavioral health and discrimination from when they were age 18 in 2007 to age 28 in 2017. In this study, discrimination referred to “perceived” interpersonal discrimination, defined as “the behavior of individual members of one group that is intended to have a harmful effect on the members of another group,” the authors wrote. This differs from institutional and structural discrimination, which can influence and reinforce discrimination between individuals.
The participants answered questions about how often they were treated with less courtesy; given poorer service; or treated as if they were stupid, scary, dishonest or inferior. Then they shared whether they attributed the main reason for their experiences to their ancestry, national origin, race or ethnicity; sex; age; height; weight or other physical aspect.
About 93% of participants said they had experienced discrimination a varying number of times throughout the 10-year study period, the authors found – this included 91% to 94% of each category of adults (White, Black, Hispanic or Latinx, Asian, native Hawaiian and other Pacific Islander, American Indian, Alaska Native and other Indigenous peoples). Ageism was the highest reported reason for discrimination, followed by physical appearance, sexism and racism.
Before this study, researchers had still been looking into the impact of discrimination over time and at specific developmental periods, such as when someone transitions into adulthood between ages 18 and 28, the authors wrote. The study is the first to focus on the transition to adulthood and follow the same group of adults over time, according to the authors.
“With 75% of all lifetime mental health disorders presenting by age 24, the transition to adulthood is a crucial time to prevent mental and behavioral health problems,” said Yvonne Lei, the study’s corresponding author and a medical student at the University of California, Los Angeles’ David Geffen School of Medicine, in a statement.
The findings mirror the clinical experiences of psychologist John Duffy and his colleagues, said Duffy, who wasn’t involved in the study.
“The more a young person is discriminated against, the more likely they will experience emotional difficulties including depression, anxiety, self-esteem issues and even suicidal ideation,” said Duffy, who specializes in work with teens, parents, couples and families, and wrote the book “Parenting the New Teen in the Age of Anxiety.” “I also find that, as the study concludes, substance use tends to increase with discrimination experienced.”
How discrimination could impact one’s health
A person’s stress response to mistreatment could be the way discrimination affects health, the researchers suggested.
Black women who were participants of a separate 2020 study and often experienced racism including racial slurs, poor store service or stereotyping had 2.75 times the risk of poor subjective cognitive functioning than women who had faced less racism. Cognitive function is a person’s mental capacity for learning, thinking, reasoning, problem-solving, decision-making, remembering and paying attention.
“The associations we found are likely also intertwined with mental health care service disparities – including inequities in care access, provider biases and structural and institutional discrimination in health care – leading to inequities in diagnoses, treatment and outcomes,” said the study’s senior author Dr. Adam Schickedanz, an assistant professor of pediatrics at UCLA’s Geffen School of Medicine, in a statement.
Many people who face discrimination already feel some insecurity about the issue, whether it’s gender, race, age or appearance, Duffy said. “This compounds the damage to the psyche, as the discrimination can serve to confirm a bias the victim already holds about his or her worth.”
Additionally, sex or gender, race, age and appearance all have one thing in common: They’re outside the mistreated person’s control, so they can’t change them nor hide from them, either, Duffy said.
And the type of ageism young adults experience depends on their age. Ageism toward younger people might look like disrespecting their opinions due to their lack of experience, Duffy said in an email. “For those in the 18-21 range or so, they feel as if they have learned a lot, and have access to far more data and information than previous generations did at that age. They also feel they are more discerning, so having their ideas and thoughts disrespected or dismissed is particularly difficult for them.”
On the other hand, adults between ages 25 and 28 might be discriminated against in a way that makes them feel too old to be attractive or to be successful if they haven’t accomplished career goals, he added. “Discrimination in this direction diminishes their sense of hope for the future.”
Appearance discrimination can lower people’s self-esteem, said Ann Kearney-Cooke, a psychologist who specializes in body image and eating disorders and wasn’t involved in the study.
If you’re struggling with such mistreatment, Kearney-Cooke recommended focusing on your signature strengths and choices that make you feel good about yourself.
“Don’t let people make you feel uncomfortable or like you’re not good enough,” she said. “I encourage people to be with people who aren’t like that. Sometimes we can’t have control with our family or job, but really think about who you surround yourself with.”