Primary Submission Category: Race/Ethnicity
Intragroup Marginalization and Self-Reported Health Among Young Adults in the San Francisco Bay Area
Authors: Mary Roberts Louisa Holmes
Presenting Author: Mary Roberts*
Intragroup marginalization occurs when people experience social exclusion from within their ‘heritage culture’ of family and friends due to perceived affiliation and expression of the cultural norms and values of another racial or ethnic group. Such affiliation is often perceived as a threat to the heritage group’s identity, which can lead to ostracization and marginalization of the people perceived as taking on a non-normative cultural identity. Previous research on intragroup marginalization has mostly focused on adolescents and college age youth of Latino/a/x background. Many of these studies have addressed the impact of acculturation – the adoption of cultural norms and practices of the “host society”– in leading to sociocultural stress especially in educational settings. Researchers have also examined the relationship between experiences of psychosocial stress due to intragroup marginalization and coping behaviors such as increased alcohol consumption.22 However, intragroup marginalization has been understudied among young adults, who are in the process of forming their identities independent from their families, and who therefore may be particularly susceptible to marginalizing stressors. Young adults have also been shown to be more prone to psychological distress than older adults, though the focus of this research has been on negative life events and coping capacity. Nor has research in this area always included large enough samples of racially/ethnically-identifying populations to focus on experiences within subgroups.
Growing evidence indicates that intragroup marginalization induces psychosocial stress and poor mental health, psychological distress and unhealthy coping behaviors. The effects of intragroup marginalization on self-rated and physical health outcomes are less well established. Thus, in this study we investigate associations between experiences of intragroup marginalization (IM) and self-rated health, an indicator of global health and wellness shown to be predictive of mortality30, among young adults in California, using data from the 2014 San Francisco Bay Area Young Adult Health Survey (BAYAHS). We exclude young adults racialized as White from the analyses as they do not share the experiences of systemic racism with other populations, nor are they generally associated with having a particular “heritage culture” in the US, and their use as a reference group may therefore skew findings. Further, there is a growing body of literature in health disparities research that calls for measuring race and ethnicity in ways that do not reify racial hierarchy, and we seek to explore intersectional meanings of marginalization as they relate to health. We hypothesize the following:
- Experiencing intragroup marginalization will be associated with worse self-rated health among populations racialized as non-White.
- Negative health behaviors – tobacco use, alcohol consumption, and cannabis use – will moderate the association between marginalization and very good/excellent self-rated health.
- Perceived social support and sleep will mediate the relationship between intragroup marginalization and very good/excellent self-rated health.
We used Stata version 17 and the “svyset” command to account for the sample design. We also used the “subpop” command for all analyses to account for our exclusion of Non-Hispanic White respondents, which uses the entire sample to calculate standard errors. Before beginning calculations, we imputed the data to account for missing data among our variables of interest. to Next, we calculated descriptive statistics of the weighted sample for all variables and means of intragroup marginalization by race. Second, using logistic regression we estimate the associations between intragroup marginalization and self-rated health accounting for demographic characteristics, health behaviors, social support and sleep. Third, using Karlson-Holm-Breen (KHB) method which compares regression coefficients for the independent variable (intragroup marginalization) in two models – one that includes intragroup marginalization and the mediator variables and one that includes intragroup marginalization and a residual of the mediator variables that are uncorrelated with intragroup marginalization.34 Confounding variables are examined in groups. First, negative health behaviors – tobacco use, alcohol consumption, cannabis use – that are expected to moderate the relationship between intragroup marginalization and self-rated health. Significant moderation occurs when a the KHB results are negative and statistically significant. Next, We examine the mediating role of the social support, increase quantity of sleep, and better quality sleep in the association between intragroup marginalization and participant self-rated health. Each KHB model includes concomitant variables – age, sex, and mother’s education.
Our study is one of the first descriptive studies on the relationship between intragroup marginalization and self-rated health and expands the literature by examining racialized populations other than Latinos, the group that dominates much of the research on intragroup marginalization. We find no statistically significant direct relationships between intragroup marginalization and self-rated health. However, previous research indicates that indirect effect should still be tested for in the absence of a significant relationship between key variables as independent variables may have a stronger association with intervening variables than with dependent variables, resulting in a significant indirect association. Our full sample results indicate the importance of moderating influence of tobacco use, alcohol consumption and cannabis use between intragroup marginalization and self-rated health. Moreover, our results indicate that the positive influence of perceived social support and sleep have on individuals’ self-rated health. Previous research has indicated that intragroup marginalization plays a role in the mental distress among Latino young adults. Moreover, research on stress and health has shown that long-term exposure to experiences of stress can have significant impacts on physical health.