Correlates of racial discrimination trajectories among black middle-aged and older adults

Abstract Single cross-sectional measures of racial discrimination may mask the dynamic nature and cumulative impact of repeated exposures to discrimination. Characterizing racial discrimination trajectories, patterns of repeated exposure, may provide insight on age-related patterns of health risk and resilience. However, there is a dearth of research exploring racial discrimination trajectories. This study characterizes racial discrimination trajectories and identifies trajectory correlates among a nationally representative sample of middle-aged and older black adults who participated in the Health and Retirement Study (2006-2018). Repeated measures latent profile analysis was employed to identify racial discrimination trajectories. Logistic regression models, estimating odds ratios (ORs) and 95% confidence intervals (CIs), were conducted to investigate sociodemographic and neighborhood-level predictors of racial discrimination trajectories. Two racial discrimination trajectories were identified: low to moderate (82%) and persistently high (18%). Individuals 65+ (OR: 0.45; 95% CI: 0.32, 0.64) and female sex (OR: 0.59; 95% CI: 0.45, 0.76) were associated with a lower odds of belonging to the persistently high racial discrimination trajectory class. Individuals reporting higher levels of major lifetime experiences of discrimination (OR: 1.47; 95% CI: 1.33, 1.63) and greater neighborhood social cohesion (OR: 1.30; 95% CI: 1.1, 1.50) predicted membership in the persistently high racial discrimination trajectory class. These findings suggest heterogeneity in the cumulative patterning of discrimination among black middle-aged and older adults. Discrimination trajectories may enable greater precision in estimating the health consequences of cumulative exposure to discrimination. Future studies are warranted to determine whether membership in specific trajectory classes confers differential risk to age-related conditions.