Abstract
This study examines the frequency of specific discrimination experiences by attribution and social identities (i.e., race, gender) and quantifies if both frequent discrimination experiences and different types of discrimination are associated with violence exposure (i.e., victimization, aggression) and its behavioral and mental health risk factors for violent injury (e.g., substance use). We analyzed baseline survey data from a multi-site longitudinal study of emerging adults aged 18 to 24 recruited from emergency departments in Seattle, Philadelphia, and Flint (n = 1,506). We examined the frequency and attribution of discrimination experiences and assessed associations with violence exposure and its relevant behavioral and mental health risk factors, including suicidal ideation, substance use, and anxiety/depression. Overall, 79.1% reported experiencing discrimination in daily life and 31.2% experienced it more than weekly. Reports of more-than-weekly discrimination were highest among multiracial (40%) and non-gender conforming individuals (41.5%). Race, gender, and age were the most cited reasons. Participants reporting ≥weekly discrimination were more likely to report suicidal ideation in the past 2 weeks, drug misuse, firearm victimization, and recent mental health symptoms (depression and anxiety symptoms in the past 2 weeks; post-traumatic stress disorder symptoms in the past month) compared to those with less frequent or no discrimination. Of note, discrimination related to being treated as inferior, unintelligent, or with less courtesy showed the strongest associations with mental health symptoms, while more static associations, across discrimination types, were found with regard to substance use and violence outcomes. Given that types of discrimination experiences may be more strongly linked to mental health symptoms, highlighting the need to consider the specific nature of these experiences. Moreover, discrimination was more pervasive among some minoritized groups (e.g., multiracial, gender non-conforming), underscoring the need for an intersectional lens to understand and address this stressor effectively.
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