Perceived discrimination and health among Puerto Rican and Mexican Americans: Buffering effect of the Lazo matrimonial?

Abstract

An emerging body of research shows that perceived discrimination adversely influences the mental health of minority populations, but is it also deleterious to physical health? If yes, can marriage buffer the effect of perceived discrimination on physical health? We address these questions with data from Puerto Rican and Mexican American residents of Chicago. Multivariate regression analyses reveal that perceived discrimination is associated with more physical health problems for both Puerto Rican and Mexican Americans. In addition, an interaction effect between marital status and perceived discrimination was observed: married Mexican Americans with higher perceived discrimination had fewer physical health problems than their unmarried counterparts even after adjusting for differential effects of marriage by nativity. The findings reveal that perceived discrimination is detrimental to the physical health of both Puerto Rican and Mexican Americans, but that the stress-buffering effect of marriage on physical health exists for Mexican Americans only.

Introduction

Discrimination as a major form of racism is widely recognized as a source of ethnic health inequality (Kessler, Mickelson, & Williams, 1999). Considerable research shows that perceived discrimination adversely affects the health of racial/ethnic minority groups such as Hispanic Americans. Although most studies on discrimination and health among Hispanic Americans focus on mental health (Finch et al., 2000, Ryff et al., 2003), there is an emerging body of research examining the consequences to physical health (Finch et al., 2001, Ryan et al., 2006).

For research on Hispanic Americans, there is the question of heterogeneity within this population. Most research either examines Mexican Americans (Finch et al., 2000) or treats Hispanic Americans as a single ethnic group (e.g., Stuber, Galea, Ahern, Blaney, & Fuller, 2003). Such studies have been insightful for research on the topic, but a logical next step is to disaggregate the Hispanic population into more readily identifiable ethnic groups such as Puerto Rican and Mexican Americans (Tafoya, 2004). Indeed, it is important to consider differences in the migration histories and health status of various Hispanic groups when studying the relationship between discrimination and physical health.

Puerto Rican and Mexican Americans generally have lower socioeconomic standing than non-Hispanic White Americans. There has been some evidence and conjecture, however, that social capital and ethnic resources among Hispanic Americans, especially Mexican Americans, may help to offset the accumulated disadvantages of lower socioeconomic status and other inequalities (Galbraith et al., 2007, Portes, 1998, Zhou and Kim, 2006). In particular, it has been observed that Hispanic Americans have a supportive cultural orientation to marriage (Oropesa & Landale, 2004) and strong family ties (Landale, Oropesa, & Gorman, 2000), which can be especially resourceful during difficult times.

The lazo matrimonial (marital bond) is highly valued in most Hispanic American communities and may play a role in the lower divorce rates among Hispanic Americans compared to White Americans (U.S. Census Bureau, 2003). Marriage has the potential to buffer many health risks (Waite, 1995), but can marriage offset the adverse effects of perceived discrimination on health? And would this buffering effect be present in the various ethnic groups we commonly refer to as Hispanic Americans? We systematically address these questions among Puerto Rican and Mexican Americans to better understand the consequences of perceived discrimination on health and the potential value of social ties for minimizing the health threat. We begin by considering the link between perceived discrimination and health, then turn to the potential moderating effect of the marital bond.

Although racism is manifested distinctly at institutionalized and personal levels (Jones, 2000) and each level has unique effects on health (Gee, 2002), personal discriminatory experience and institutionalized racism are closely related to each other and may exacerbate health inequality. Racial/ethnic minority groups face different types of discrimination including macro-level discrimination such as residential segregation and unfair treatments by health agencies (Guyll, Matthews, & Bromberger, 2001) as well as micro-level discrimination through interpersonal relationships. Although the severity of discrimination effects may vary, both types of discrimination can be chronic stressors for racial/ethnic minority people. Most explanations for why discrimination influences mental and physical health focus on the stress process (Kessler et al., 1999).

Pearlin's (1981) stress process theory has provided an insightful perspective on the relationship between stress and health. Sociologically speaking, stressful events are often attributable to structural conditions due to inequalities based on ethnicity, gender, and socioeconomic status. Disadvantaged positions increase exposure to stressors, but status inequality does not directly determine the consequences of such exposure. Rather, the links between stressors and health outcomes are often affected by social relationships that provide support and coping resources. Marriage is a fundamental unit of social organization that has the potential to soften the insults of stressors. Indeed, research has long shown that having just one confidant can reduce the deleterious effects of stressors and that unmarried people are more frequently exposed and vulnerable to stressors than are married people (Pearlin & Johnson, 1977).

Despite the early focus on mental health, recent work by Pearlin, Schieman, Fazio and Meersman (2005) provides additional insight on the relationship between stressors and health inequality. They point out that “stressors related to ascribed statuses, such as those of race and gender, have powerful consequences, both because they challenge important rights and opportunities and because they are a threat to important identities” (Pearlin et al., 2005, pp. 208–209). Over time, the accumulated exposure of a chronic stressor may result in the development of specific acute and chronic health conditions. Discrimination based on ascribed characteristics is likely to be a chronic stressor, repeated over the life course and pervading various life domains.

Comparisons between married and unmarried people show that married people have better health and lower mortality risk (Elwert & Christakis, 2006); when considering childbearing, infant mortality is also lower for married women than for unmarried women. The health benefits that married people experience are often attributed to their relatively advantaged life circumstances such as higher household income and social integration. Families routinely provide care, instrumental aid, and emotional support. Families also play a valuable role by integrating individuals into kin networks and community, and this integration may aid coping during difficult times (Pearlin & Johnson, 1977). Marriage benefits couples by providing social integration through shared household living, which provides emotional support and direct care (Elwert & Christakis, 2006). Also, social attachment provided by marriage can reduce psychological distress and health problems.

Social relations, including instrumental and emotional support, may be especially helpful for minorities in buffering the adverse effects of discrimination. Through supportive relationships, ethnic minorities cannot only obtain practical aids but also feel empathy and comfort by sharing their experiences (Noh & Kaspar, 2003). For immigrants, shared adversity in migration and settlement processes can influence and enhance family cohesion. Thus, married couples may be in a better position than single persons to diffuse some of the pain of discrimination by discussing their experiences. A married couple can be a team to cope with discrimination; married couples may share their experiences, feelings, and empathy, and encourage one another to have healthy behaviors and better coping strategies.

Marriage is not universal in its effects, however, and ethnic communities shape the meaning of marriage—the values, norms, and sanctions regarding how couples are to interact. As a result, the potential of marriage to deliver health benefits may vary by ethnic or cultural context. Previous research reveals that marital expectations and processes vary across ethnic groups (Goodwin, 2003, McLoyd et al., 2000).

For the present study, the purported health benefits of marriage may vary due to the unique migration history and cultural practices among groups of Hispanic Americans. Although marriage is generally held in high esteem among Hispanic Americans, differences between Puerto Rican and Mexican Americans are noteworthy. Oropesa and Landale (2004) contend that Hispanic Americans are more supportive of marriage than White people, but this is especially the case for Mexican Americans: “Puerto Ricans differ from Mexican Americans in that they are more accepting of cohabitation, even in the absence of plans to marry” (p. 906). Indeed, Mexican Americans are more likely than Puerto Ricans to marry and less likely to divorce, even after standardizing rates by age and generation (Oropesa, 1996). Mexican culture generally promotes marriage and marriage-based family structure; thus, the lazo matrimonial is probably more salient in Mexican American than in Puerto Rican communities.

Differing marital value and context between Puerto Rican and Mexican Americans also influences family structure and life. Notably, the percentage of female-headed households is markedly higher among Puerto Rican than Mexican Americans (McLoyd et al., 2000). In addition, “Puerto Rican women tend to have their first child before marriage, whereas Mexican American women tend to do so within marriage” (McLoyd et al., 2000, p. 1072). Considering the fact that family structure is highly associated with poverty, it is not surprising that Puerto Rican families are more likely than Mexican American families to have incomes below the poverty line (Baker, 2002, Tafoya, 2004).

Marriage can be beneficial for Hispanic American families because of financial, social, and emotional resources. For some Hispanic minority groups, marriage can be a safeguard against hazards by providing support and resources, perhaps reducing the effects of external stressors. For Mexican Americans, more so than for White and Puerto Rican Americans, the higher value placed on marriage may make marriage more normative and resourceful, which may also make it more likely to buffer the effects of stressors. If marriage is more normative and resourceful to a certain ethnic group, those married people are better positioned for emotional support and integration than their counterparts in other ethnic groups. Valuing marriage also often means more communication regarding coping strategies (e.g., refraining from the internalization of discriminatory experiences).

The potential benefits of marriage on health may also be influenced by immigration experiences, which are distinct for the two groups. Marriage and family networks probably play a stronger role in the migration decision and adjustment process for Mexican Americans than for Puerto Rican Americans (Kandel & Massey, 2002). Also, Puerto Ricans living in the United States are typically more acculturated and positioned for a wider array of social contacts. Thus, any test of the stress-buffering role of lazo matrimonial needs to account for differences in nativity and acculturation. Failure to do so might lead to overestimating the beneficial effects of marriage on health.