Discrimination as a Psychosocial Risk Factor for Multimorbidity: A Literature Review Centered on the Health of Black Adults

• Charlotte Higginson, Human Services, University of Delaware

• Heather Farmer, Human Development and Family Sciences, University of Delaware

Research suggests that Black adults experience disproportionately greater risk for various chronic conditions, including heart disease, diabetes, and cancer. Growing scholarship shows that discrimination is a significant stressor faced by Black adults and may contribute to their elevated morbidity. However, limited attention has been paid to discrimination and multimorbidity – the clustering of health conditions – which is more frequently documented in Black adults. Multimorbidity is an increasing public health concern that negatively reduces quality of life, increases risk for disability, and predicts premature mortality. This investigation was a literature extensive review that sought to identify and summarize existing scholarship on the relationship between discrimination and multimorbidity. A total of 4 studies were identified, all using national or state-level data. Though all studies focused on adults, two examined midlife and older populations, and two studies drew data from the general adult population aged 18 and above. All studies reported a significant positive association between everyday discrimination and multimorbidity, suggesting that discrimination represents a risk for development of multiple chronic conditions. Despite this evidence, however, some work suggested that discrimination corresponded to similar risks for multimorbidity across race groups. The key findings from this literature review indicate that more frequent exposure to discrimination may serve as a chronic stressor that contributes to an increased risk of multimorbidity in the adult population, and specifically within Black adults. The findings from these studies illustrate the importance of investigating discrimination as a psychosocial risk factor for Black Americans’ health to better address population health equity and promote healthy aging among Black adults.