Browsing by Author "Brown, Tyson H"

This dissertation builds on over 40 years of research demonstrating the negative effects of discrimination on health. Though there is a copious amount of studies on discrimination frequency, this rich literature largely neglects discrimination attribution processes (i.e., perceptions of which factors motivated the discriminatory treatment). This dissertation is comprised of three studies that employ latent class analysis to illuminate how attributions cluster, and regression to examine the implications of those clusters for health outcomes and individuals’ responses to discrimination in healthcare settings. Study 1 examines the extent to which attribution processes vary by race, gender, and race-gender groups among a Black and White young adult sample drawn from the Panel Study on Income Dynamics Transitioning to Adulthood Supplement. Results reveal that race-gender subgroups experience distinct clusters of attributions for discriminatory experiences—patterns that are obscured when estimating latent classes of attributions in the full sample. Study 2 estimates the extent to which emergent latent attribution classes from Study 1 predict health outcomes among Black and White young adults, disentangling the effects of two dimensions of interpersonal discrimination: attributions and frequency. Findings demonstrate that membership in any latent attribution class is not always associated with worse health outcomes and significant associations between health and dimensions of discrimination (i.e., frequency and attributions) vary across race-gender groups and health outcomes. Study 3 employs nationally representative data from the Health Reform Monitoring Survey to investigate how patients interpret and respond to provider mistreatment, and examine associations between the two. Resulting emergent attribution classes vary across racial groups, with race being more salient among Black patients relative to White and Latino patients. In contrast, emergent latent reaction classes are similar across groups wherein patients either disengage from healthcare (e.g., delaying or avoiding care) or do not modify their care plans after mistreatment. Furthermore, patients who attribute discrimination to many concurrent items have higher odds of disengagement relative to those who select fewer attribution items. These studies underscore the importance of social group specificity in understanding the implications of attributions for health, and they demonstrate how provider mistreatment may further exacerbate patient health inequities.

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