Associations between perceived discrimination and health: a cross-sectional public health study

Many people experience discrimination based on factors such as age, gender, illness, disability, ethnicity, skin color, religion, beliefs or sexuality. Discrimination can lead to marginalization and be linked to poor health. As a result, there is a growing interest in exploring the underlying causes of discrimination and its cumulative consequences. The aim of the present study was to explore the prevalence of perceived discrimination (PD) in a large cross-sectional public health study and its association with self-rated health and mental distress.

The study was based on data from 18,517 participants in the 2023 Norwegian Counties Public Health Survey (NCPHS) in Agder County. The participants were asked if they had experienced discrimination in the past 12 months and could specify different reasons. Furthermore, they were asked about their self-rated health, mental distress, and sociodemographic factors. In the analysis of the responses, PD was categorized based on the number of reasons, ranging from no PD to one, two, or three or more reasons.

Among the participants, 17.8% reported experiencing discrimination for at least one reason. Compared with those who experienced no discrimination, participants reporting discrimination for one reason were twice as likely to report poor self-rated health or mental distress. The odds increased to a range between two and a half to three times for those facing discrimination on two grounds. For individuals experiencing discrimination for three or more reasons, the likelihood rose substantially: Four times higher for poor self-rated health and approximately three times higher for mental distress.

There is a clear association between multiple reasons for PD and low scores in mental and/or physical health, suggesting a cumulative influence. To address this issue effectively, prevention efforts should be implemented at both the national level and within local public health strategies.