OBJECTIVE:To develop an instrument to assess discrimination effects on health outcomes and behaviors, capable of distinguishing harmful differential treatment effects from their interpretation as discriminatory events.
METHODS:Successive versions of an instrument were developed based on a systematic review of instruments assessing racial discrimination, focus groups and review by a panel comprising seven experts. The instrument was refi ned using cognitive interviews and pilot-testing. The fi nal version of the instrument was administered to 424 undergraduate college students in the city of Rio de Janeiro, Southeastern Brazil, in 2010. Structural dimensionality, two types of reliability and construct validity were analyzed.
RESULTS:Exploratory factor analysis corroborated the hypothesis of the instrument's unidimensionality, and seven experts verified its face and content validity. The internal consistency was 0.8, and test-retest reliability was higher than 0.5 for 14 out of 18 items. The overall score was higher among socially disadvantaged individuals and correlated with adverse health behaviors/conditions, particularly when differential treatments were attributed to discrimination.
CONCLUSIONS:These fi ndings indicate the validity and reliability of the instrument developed. The proposed instrument enables the investigation of novel aspects of the relationship between discrimination and health.
DESCRIPTORS:Prejudice. Interpersonal Relations. Socioeconomic Factors. Health Inequalities.
Explicit discrimination and health Bastos JL et alThe discrimination construct is closely related to the idea of injustice and, as such, has been conceptualized as the "process by which a member, or members, of a socially defi ned group is, or are, treated differently (especially unfairly) because of his/ her/ their membership of that group." 15 It has been studied worldwide in several fi elds of knowledge, such as anthropology, epidemiology, sociology and psychology, with extensive literature documenting important discrimination effects on people's daily lives. For instance, discrimination has been associated with negative health outcomes, 25 diffi cult access to the labor market, 6 and residential segregation. 25 Disc riminatory practices may be based on characteristics such as gender, age, physical appearance, race, ethnicity, social class, and other socially ascribed or acquired characteristics. These multiple types of discrimination may also be combined and experienced all at once by their victims. 4 Yet, discriminatory practices and their behavioral and cognitive responses may vary depending on the social context and historical time period.A systematic review of instruments assessing racial discrimination 3 found no widely employed instrument RESUMO OBJETIVO: Desenvolver instrumento para avaliar os efeitos de experiências discriminatórias sobre condições e comportamentos em saúde, capaz de distinguir efeitos patológicos da exposição a tratamentos diferenciais de sua interpretação como eventos discriminatórios.
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