Primary Submission Category: Structural factors
Individual-level dimensions of structural racism and disability disparities in Massachusetts
Authors: Emmanuella Asiedu Jennifer Tjia Sarah Forrester
Presenting Author: Emmanuella Asiedu*
Background: Structural racism, plays a large role in the everyday experiences of Black men and women in the United States by impacting how resources are distributed and accessed. Structural racism leads to individual level economic hardship, prolonged exposure to poor working conditions, physically demanding jobs, and poor social structural factors that can increase risk of disability.
Objectives: The purpose of this study is to determine if and how the individual-level dimensions (education, employment status, health insurance type, household income, poverty) of structural racism impact disability disparities in Massachusetts.
Methods: We used the 2020 5-year estimate American Community Survey (ACS) data to compare disability status for Black (n = 7,278) and White (n = 138,526) participants aged 45 and older, living in Massachusetts. We used logistic regression to analyze the impact of the individual-level dimensions of structural racism and disparities in 4 dichotomous (yes/no) disability types (cognitive difficulty, ambulatory difficulty, vision difficulty, hearing difficulty.
Results: 27% of Black participants and 20% of White participants indicated having at least one disability. Black participants had higher odds of any disability and individual disabilities for all except hearing. After adjusting for sex, age, and US citizenship status, the association between race and cognitive disability (OR = 1.39, 95% CI: 1.24 – 1.55) was attenuated when poverty was added to the model (OR = 1.07, 95% CI: 0.95 – 1.20) The association between race and all other disabilities remained significant even after dimensions were added.
Conclusion: Our analysis of the individual-level dimensions of structural racism indicate that the poverty dimension may account for much of the relationship between race and cognitive disability in a Massachusetts sample. Future research should explore associations between a multidimensional measure of structural racism and disability disparities.