Date of Award


Document Type

Open Access Thesis


Epidemiology and Biostatistics


Norman J. Arnold School of Public Health

First Advisor

Kellee White


Background: Numerous studies have utilized race to document health inequities. As race is considered a social classification of persons based upon physical traits, studies have begun to consider socially assigned race defined as the race/ethnicity perceived by others. Socially assigned race may serve as the basis for differential or unfair treatment of persons ascribed to historically oppressed groups. Socially assigned race may also provide additional insight into racial health disparities, particularly among Latino populations who are commonly defined by their ethnicity. This study assesses the relationship between self-identified and socially assigned race/ethnicity and tests the moderating effects of emotional and physical reactions to perceived racial discrimination.

Methods: A cross-sectional analysis of the 2013 and 2014 Arizona Behavioral Risk Factor Surveillance System was conducted (N=8581). Non-Hispanic white, black and Latino respondents were categorized into groups based upon self-identified-socially assigned race/ethnicity concordance: concordant non-Hispanic white, discordant Latino, concordant Latino and concordant black. The outcome of interest was type II diabetes mellitus (T2DM) ascertained by age of diagnosis and current insulin use. Modified Poisson regression models were fit to estimate prevalence ratios (PR) and 95% confidence intervals (CI) after adjusting for confounders. Experiences of physical and emotional reactions to perceived racial discrimination were assessed as modifiers in the association between self-identified-socially assigned race/ethnicity and type II diabetes mellitus.

Results: Reports of emotional reactions to perceived racial discrimination were more prevalent among discordant Latinos (10.1%), while concordant black participants were more likely to report physical reactions (6.3%). In fully adjusted models, concordant Latinos were significantly more likely to have T2DM than whites (aPR: 2.05, 95% CI: 1.47, 2.87). Neither emotional nor physical reactions to perceived racial discrimination modified the association between self-identified-socially assigned race/ethnicity categorization and T2DM.

Conclusion: Compared to whites, social assignment as Latino among self-identified Latino respondents is associated with increased risk of T2DM. However, this increased risk was not present among Latinos socially assigned as white and was attenuated among black respondents after adjusting for additional covariates. Socially assigned race/ethnicity may aid in characterizing ethnic/racial health disparities in chronic diseases and targeting interventions to high-risk groups.

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