Discrimination and modifiable health risk factors: A focus on tobacco, alcohol, and obesity related risk behaviors

Debra Marie Rios, The University of Texas School of Public Health


Tobacco use, poor diet, physical inactivity, and alcohol use contribute to the leading causes of death in the U.S. and racial/ethnic minorities are disproportionately affected by these modifiable health risk factors. Discrimination is a stressor that is more commonly experienced by racial/ethnic minorities and may be a mechanism contributing to health disparities. The current dissertation further explored these relations in the following ways: 1) through a systematic review examining discrimination and tobacco use behavior; 2) a quantitative study that explored the associations between discrimination and tobacco and alcohol use; and 3) a quantitative study that explore the association between discrimination and obesity status, dietary risk factors, insufficient physical activity, and increased sedentary behavior. The systematic review was conducted using multiple databases including OVID medline, Ovid PsychoINFO, and National Library Medicine PubMed. There were forty-three studies between 2008-2015 that investigated the relationship between discrimination and multiple tobacco use behaviors. There is strong evidence that perceived discrimination is linked to current smoking status across race/ethnic groups. However, continued research efforts are needed in order to determine causality between discrimination and additional tobacco use behaviors. The two quantitative studies were conducted using secondary data from the Pathways between Socioeconomic Status and Behavioral Cancer Risk Factors (PATHS) study. The two quantitative studies highlighted that African Americans experience the highest rates of everyday and major discrimination. Participants indicated race/ethnicity as the main reason for experiencing everyday discrimination. In addition, the most common types of major discrimination experiences were related to the workplace. There was a suggestive association between discrimination and nicotine dependence and cigarettes per day, however, there were not significant links detected between discrimination and alcohol use behaviors. Future research should aim to measure these relationships prospectively in order to infer causality and temporality. In addition, researchers should explore these behaviors as coping mechanisms to experiences of discrimination. Discrimination was also linked to self-reported average daily sedentary minutes and fast food consumption. There are substantial gaps in the literature regarding discrimination and obesity related risk factors. Therefore, it is recommended that researchers continue to explore these relationships and additional mechanisms that may be affecting these relationships. Lastly, research examining the associations between discrimination and sedentary behavior should be further explored by sedentary behavior domains (e.g., leisure-time and occupational) in order to gain a better understanding of the link to discrimination.

Subject Area

Public health

Recommended Citation

Rios, Debra Marie, "Discrimination and modifiable health risk factors: A focus on tobacco, alcohol, and obesity related risk behaviors" (2016). Texas Medical Center Dissertations (via ProQuest). AAI10248074.