Does Family Context Moderate the Effects of Discrimination on Emerging Adults’ Health?

Abstract

Given the adverse impacts of discrimination on overall well-being, this study tests whether family context, specifically family hostility (FH) and positive family environment (PFE), moderate well-documented associations between discrimination and mental and physical health symptoms. Diverse emerging adults (n = 345) completed an online questionnaire about perceived discrimination due to a broad range of characteristics, positive and negative qualities of their families of origin, and depressive, anxiety, and physical health symptoms. Multiple linear regression analyses indicated that family factors moderated the effects of discrimination, such that discrimination was more strongly linked with health symptoms in the context of low, compared to high, family risk. Conversely, some models showed independent, non-interactive effects of discrimination and family factors on health. Gender differences emerged, though with no consistent pattern of effects. Together, these findings highlight that discrimination and negative family factors are salient social-environmental risks for emerging adults.

Keywords

discrimination family relationships mental health health transitions to adulthood

Discrimination due to characteristics such as race (Lee et al., 2019), religion (Pew Research Center, 2019), and gender and sexuality (Casey et al., 2019) is still prevalent in the United States today. Adverse discrimination-related outcomes, typically assessed in adolescents and adults, consistently include poorer mental health (Priest et al., 2013; Schmitt et al., 2014) and a wide-range of physical health problems (Lewis et al., 2014; Vadiveloo & Mattei, 2017). The present study focuses on discrimination-related health risks in emerging adulthood, a developmental period often marked by heightened discrimination (Hughes et al., 2006) and by the onset of certain mental (Kessler et al., 2007) and physical health challenges (CDC, 2018a; CDC, 2018b). Specifically, we explore whether family influences exacerbate or ameliorate the health risk of discrimination—a key issue for emerging adults who are establishing autonomy and positioning themselves in the extrafamilial social world. Positive family factors can lessen the impact of serious risks to health faced outside of the family, whereas negative family factors can exacerbate these risks (Masten & Narayan, 2012). With respect to discrimination, preliminary evidence points to resilience-promoting effects of positive family relationships (Benner, 2017), and few studies have yet to examine risky family environments. Given the largely separate but interconnected social spheres of the external social world in which discrimination occurs and the more proximal family life, the current study is designed to investigate whether positive and negative family influences moderate the relationship between discrimination and mental and physical health symptoms.

Studying Discrimination

Discrimination has most frequently been studied specific to a single dimension of identity-based discrimination such as race, class, and sexual orientation. However, discrimination, regardless of type, threatens people on the basis of their identity and, as such, is a salient psychosocial stressor. Additionally, experiencing discrimination due to multiple identities may be more deleterious than discrimination on the basis of a single identity (Mulvey et al., 2018). Without necessarily equating all forms of discrimination, we can broaden investigations of discrimination by examining an array of heterogeneous characteristics, from traditionally studied group-based identities (e.g., race and gender) to targeted personal characteristics (e.g., weight and language), and extend prior work to draw broader conclusions about the effects on health of discrimination itself (Brandt & Crawford, 2019).

In fact, discrimination due to a variety of marginalized identities and experiences has similar negative impacts on various mental and physical health outcomes (Frost et al., 2015; Logie et al., 2013; Pieterse et al., 2012). Thus, it is likely that there are core features of discrimination that account for its consistent impact on health. Discrimination has been conceptualized as a social stressor that activates a physiological stress response, which when chronically activated, leads to adverse negative mental and physical health outcomes (Clark et al.,1999). In addition, experiencing discrimination can impact self-control resources and increase health-deteriorating behaviors (Pascoe & Richman, 2009). This social stress model of discrimination elucidates pathways through which discrimination negatively impacts health.

Gender differences have been found in links between non-gender-related discrimination and mental and physical health, although findings are mixed in whether these associations are stronger in men or women. For instance, associations between racial discrimination and poorer mental health was stronger in Black and Arab American men than their female counterparts (Assari & Lankarani, 2017; Assari et al., 2017), but other studies found stronger associations between racial discrimination and poorer mental health in Latina and Asian-American women than their male counterparts (Flores et al., 2008; Hahm et al., 2010). Flores and colleagues (2008) also found stronger effects of racial discrimination on poorer general health for Latinos than Latinas. With such mixed findings, further research investigating gender differences in impacts of discrimination is needed.

Understanding Family as Additional Psychosocial Context

While links between discrimination and mental and physical health have been well-established, less is understood about the implications of additional psychosocial contexts that victims of discrimination are embedded within. For example, relationally proximal social connections, such as family, can provide social support in the face of difficult experiences by providing empathy and instrumental support (Morelli et al., 2015). Indeed, social support is associated with reduced negative impact of discrimination on mental and physical health (Kim, 2014; Seawell et al., 2014). These additional proximal relational contexts may hold key information to mitigating discrimination’s negative health effects.

While effects of families of origin are often studied for children and adolescents, they are examined less often in emerging adults. Yet, emerging adulthood is a unique developmental stage in which individuals are developing independence from but also still remaining closely tied to their family of origin. Additionally, the qualities of emerging adults in the United States have shifted in the past few decades. Modern emerging adults are more likely to live in their parents’ home and delay marriage (Vespa, 2017), tying emerging adults more closely to their families of origin than in the past. Therefore, examining differing familial contexts in modern emerging adults may be even more important and relevant than in previous decades. Moreover, there are long-lasting impacts of the quality of family relationships during childhood (VanderValk et al., 2005), with emerging adults reporting family relationships as an enduring source of personal meaning (Lambert et al., 2010), for better or worse (Ryan et al., 2009). Therefore, even emerging adults who have left their childhood homes continue to be impacted by their families of origin.

Qualities of the family of origin can interact with external stressors in a myriad of ways. According to risky family models (Repetti et al., 2002; Ryan et al., 2009), a negative emotional family climate can trigger psychological vulnerabilities that interact with and exacerbate other stresses (Wickrama & Kaspar, 2007) or, alternatively, supportive family relationships can provide buffers that lessen the impact of serious risks faced outside of the family (Masten, 2018). Family qualities promoting resilience include warm parenting, family cohesion, and communication (Benzies & Mychasiuk, 2009; Black & Lobo, 2008). However, while families are often a source of resilience for many, not all families are safe places to receive support and may even be a source of stress. Direct effects of parent-to-child aggression are associated with adult mental health problems, substance abuse issues, and physical health problems (Gershoff & Grogan-Kaylor, 2016; Herrenkohl et al., 2013), and parent-to-parent aggression is similarly associated with increased mental health problems, substance abuse issues, and physiological dysregulation (Howell et al., 2016; MacDonell, 2012). Gender differences in the effects of family as risk and resilience are also found. For example, changes in perceived maternal support are predictive of depressive symptoms among emerging adult African-American men but not women (Assari et al., 2015).

The few studies examining family influence on the association between discrimination and health mainly focus on positive family factors as buffers of this link. Evidence points to protective effects of positive family qualities, not confined to direct social support, but general family qualities as well, such as nurturing parenting and low levels of family conflict among adolescents (Benner, 2017). Among racially diverse adolescents, more supportive family environments (i.e., emotional support, less parent-child conflict, organization in the home, and family cohesion) buffered effects of racial discrimination on internalizing problems (Juang & Alvarez, 2010), externalizing problems (Park et al., 2018), and epigenetic aging (Brody et al., 2016). Studies examining the effects of family context on discrimination-related distress on adults have primarily focused on Asian and Asian-American adults, perhaps due to the centrality of the family in many Asian cultures (Park & Chesla, 2007). Among immigrant women in Taiwan, family adaptability and cohesion buffered effects of discrimination on depression (Yang et al., 2014). Chae and colleagues (2012) also found that among Asian Americans, family support buffered effects of discrimination on depression, but only at low levels of discrimination, suggesting that at high levels of discrimination, family support was not effective in reducing distress. As contrasted with the buffering effects of family support, one study by Ayón and colleagues (2010) on Latinx parents and their adolescent children did not find buffering effects of strong ties within family members on the negative effects of racial discrimination, but rather independent, direct effects of family factors and discrimination on mental health on Latinx adolescents.

Families can also be a source of considerable stress, particularly when family relations lack warmth, are aggressive, or the overall family environment is chaotic (Repetti et al., 2002). To our knowledge, only two studies have investigated negative family factors and discrimination—again showing a combination of interactive and independent effects. Juang and Alvarez (2010) reported interactive effects in that family conflict exacerbated negative effects of discrimination on anxiety in adolescents. Chae and colleagues (2012), however, reported independent effects in that both discrimination and negative family interactions had independent, adverse effects on depression. These mixed findings raise questions about the interactive or independent nature of discrimination and family environmental context.

The Present Study

The present study seeks to test whether positive and negative family factors moderate associations between discrimination and mental and physical health outcomes in a diverse, urban sample of emerging adults. This study expands on prior studies in four ways. First, whereas previous studies examining moderating effects of family factors predominantly investigate mental health outcomes (with the exception of Brody et al., 2016), the present study investigates both self-reported physical health and mental health outcomes. Second, only one other study has investigated putative dimensions of both family risk and resilience as related to discrimination, with no studies yet examining family aggression as a risk factor. Third, the present study’s sample is unique among studies of family factors in the link between discrimination and health, as no studies have yet examined emerging adults. Fourth, we conceptualize discrimination as multi-dimensional, assessing discrimination with regard to various personal characteristics and group identities to broaden previous studies’ scope of discrimination.

Our hypotheses are as follows: Testing a replication of prior findings, we hypothesize that discrimination based on wide-ranging characteristics has direct, cross-sectional associations with depressive, anxiety, and physical health symptoms (HO1). In line with prior research with adolescents, we hypothesize interactive effects between discrimination and family factors such that positive family environment will buffer the positive associations between discrimination and poorer mental and physical health outcomes (HO2), whereas hostile family interaction will amplify those associations (HO3). Finally, we explore gender as a moderator when testing family factors in discrimination-health links due to previous mixed findings of gender differences in the links between discrimination and health and family factors.

Method

Overview and Participants

The sample for the current study is from the [blinded], which investigates the intergenerational transmission of aggression. Of the 345 participants (179 women; 166 men) in the present study, 172 were part of a longitudinal study that began in early adolescence and is now focusing on emerging adult romantic relationships; an additional 173 were recruited via flyers and Craigslist for our ongoing study on emerging adult couples. Recruitment for the additional participants required that at least one partner was between ages of 18–25 years and one partner had lived in a two-parent family at least through age 10 yaers. Mean age of the sample was 22.1 years (SD = 1.9) for women and 22.6 years (SD = 2.0) for men. Participants represent the racially and ethnically diverse large metropolitan community from which they were recruited: 32.9% White, 26.3% Latinx, 14.2% African American, 15.3% Multiracial, and 9.0% Asian. In the sample, 26.8% worked either full-time or part-time and 47.5% were enrolled in school either full-time or part-time. A comparison of demographics between the two recruitment strategies revealed no significant differences in age, race, or student and work status.

As the present wave of data collection was focused on couples’ interactions, 254 participants were partnered. As part of an online survey, participants answered questions about past discrimination, family hostility (FH), positive family environment (PFE), and symptoms of depression, anxiety, and health problems. The entire survey took approximately 1 to 2 hours, and participants received $50 as compensation. The protocol and measures were approved by the [University blinded]’s Institutional Review Board.

Measures

Perceived discrimination

A 26-item discrimination survey assessed the extent to which participants “have ever been teased, picked on, excluded from something [they] wished to do, felt disliked, or discriminated against” due to a range of identities and characteristics (Rasmussen et al., 2018). Characteristics spanned race/ethnicity, religion, physical appearance, weight, and family not having enough money. The most commonly reported items for both men and women were discrimination due to physical appearance (54.2% endorsement for men; 55.3% for women), clothes or how they dressed (40.4% for men; 36.9% for women), and being too smart (36.1% for men; 32.4% for women). On average, women and men both endorsed 5.0 items. Responses were reported on a four-point scale (0 = not at all, 1= a little, 2 = some, 3 = a lot). Reliability across items for participants in the present study for this scale was strong (α = .84).

Positive family environment

We assessed PFE through six items about family presence and positive qualities of the family. Participants completed three items about present-day emotional closeness with their father, mother, and sibling(s), with responses ranging from 0 (we are very distant emotionally) to 4 (we are very close emotionally). For participants without siblings, the sibling item was not included. Participants also rated three statements from the Security in the Family Systems scales (Forman and Davies, 2005) assessing how much their family let them know they care about them, they could talk about problems with family, and they felt loved and important in their family growing up; items were rated on a five-point scale (0 = never) to (4 = always). Cronbach’s α = .75 across all items.

Family hostility

Participants responded to a 28-item scale on family-of-origin physical and verbal hostility, with half of the items assessing parent-to-child aggression from a modified version of the Parent-Child Conflict Tactics Scales (Straus, 1979; Straus et al., 1998) and half assessing parent-to-parent aggression from a modified version of the Domestic Conflict Inventory (Margolin et al., 1998). Examples of parent-to-child aggression include a parent/stepparent “insulted or shamed you in front of others” or “kicked you out of the house or car”. Examples of parent-to-parent aggression include “swore or cursed at other parent or parent-like figure” or “twisted arm of other parent or parent-like figure out of anger.” Items were assessed on a five-point scale (0 = none, 1 = once, 2 = twice, 3 = 3–5 times, 4 = experienced >6 times at any point in their lives). Items showed strong internal consistency for the present study (α = .94). Out of the entire sample, 87.9% reported some family hostility (87.8% of women and 87.9% of men).

Depressive symptoms

Depressive symptoms were measured using a 20-item version of Beck Depression Inventory-II (Beck et al., 1996) that omitted the item assessing suicidality. Participants rated statements on a scale ranging from 0 (indicating minimal to no symptoms) to 3 (indicating more severe symptom levels) over the past two weeks. Internal consistency was strong for this scale in the present study (α = .89).

Anxiety symptoms

The Generalized Anxiety Disorder seven-item scale (Spitzer et al., 2006) was used to assess general anxiety symptoms over the past two weeks. Participants responded to questions about how often they had been bothered by problems such as feelings of anxiety and difficulty relaxing. Responses ranged from 1 (not at all) to 4 (nearly every day). Cronbach’s α in the present study was .89.

Health symptoms

A 23-item checklist of physical health symptoms for emerging adults was developed for this study. Participants indicated the presence or absence of symptoms over the past year, yielding a total number of symptoms experienced. Examples of symptoms include headaches, head cold, diarrhea, and high blood pressure. Most (96.8%) participants reported at least one symptom. On average, women reported 10.0 (SD = 4.6) symptoms; men reported 8.5 (SD = 4.5). Internal consistency in the present study for this scale was good (α = .83).

Data Analysis Plan

We ran six stepwise linear regression models with discrimination as the predictor, either PFE or FH as the moderator, and one of the three outcomes: depressive symptoms, anxiety symptoms, and health symptoms. Covariates (age and race) were entered at Step 1, and discrimination, either PFE or FH, and gender were entered at Step 2. Step 3 tested two-way interactions between discrimination and either PFE or FH and two-way interactions between gender and each of these predictors, and Step 4 tested the three-way interaction between discrimination, PFE or FH, and gender. Significant interactions were probed through simple slopes analyses. Variables were tested at +/-1 SD for low and high levels of PFE, while discrimination and FH were tested at their minimum values, −0.95 SD and −0.94 SD, respectively, and +1SD for high levels. Race and gender were effect coded to increase interpretability of parameter estimates.

Results

Descriptive Statistics

Table 1 presents descriptive statistics and correlation coefficients for variables of interest. Participants reporting more discrimination also reported less PFE and more FH. Discrimination and FH were associated with greater mental and physical health symptoms, whereas PFE was related to fewer mental, but not physical, health symptoms. Depressive, anxiety, and physical health symptoms were significantly associated.

Table 1.

Descriptive Statistics and Correlation Coefficients for Study Variables.

Variables	M	SD	Range	1	2	3	4	5
1. Discrimination	0.29	0.31	0-1.92
2. Positive family environment	2.97	0.82	0.25-4.00	−.20**
3. Family hostility	0.77	0.81	0-3.64	.40**	−.38**
4. Depression symptoms	0.50	0.45	0-2.30	.41**	−.33**	.35**
5. Anxiety symptoms	1.70	0.68	0-4.00	.39**	−.27**	.39**	.68**
6. Physical health symptoms	9.29	4.61	0-21.00	.24**	−.07	.20**	.22**	.23**

Note. All scores are means across items except physical health symptoms, a count score. *p < .05, **p < .01, ***p < .001.

Regression Analyses

Table 2 presents the six linear regression analyses representing the main and interactive effects of discrimination and family context on depressive symptoms (left), anxiety symptoms (center), and physical health symptoms (right). Parameter estimates are presented from models that include three-way interactions between discrimination, family context, and gender when three-way interactions are significant. If the three-way interaction was not significant, estimates are presented from models omitting the three-way interaction.

Table 2.

PFE and FH as Moderators of the Associations Between Discrimination and Depression Symptoms, Anxiety Symptoms, and Physical Health Symptoms.

	Depressive Symptoms					Anxiety Symptoms					Physical Health Symptoms
Model	ΔR²	b	B	SE	CI	ΔR²	b	B	SE	CI	ΔR²	b	B	SE	CI
Positive Family Environment (PFE)
Step 1: Covariates	.03					.01					.08***
Age		−0.01	−0.03	0.01	[−0.03, 0.02]		−0.02	−0.06	0.02	[−0.05, 0.02]		−0.18	−0.08	0.12	[−0.42, 0.06]
Asian		−0.03	−0.02	0.07	[−0.16, 0.10]		−0.10	−0.09	0.10	[−0.30, 0.11]		0.29	0.02	0.72	[−1.12, 1.71]
African American		0.08	0.07	0.06	[−0.03, 0.19]		0.07	0.07	0.09	[−0.10, 0.24]		−1.45*	−0.12	0.60	[−2.63, −0.27]
Latinx		0.03	0.03	0.05	[−0.06, 0.12]		−0.04	−0.05	0.07	[−0.18, 0.10]		0.88	0.09	0.50	[−0.11, 1.87]
Multiracial		−0.06	−0.06	0.06	[−0.17, 0.04]		−0.02	−0.02	0.09	[−0.19, 0.15]		1.69**	0.15	0.60	[0.52, 2.86]
Other		0.05	0.06	0.12	[−0.18, 0.29]		0.11	0.08	0.19	[−0.25, 0.48]		−2.60*	−0.29	1.29	[−5.15, −0.06]
White		−0.07	−0.08	0.04	[−0.15, 0.02]		−0.02	−0.02	0.07	[−0.15, 0.11]		1.19*	0.13	0.47	[0.27, 2.12]
Step 2	.23***					.20***					.07***
Discrimination (Dis)		0.54***	0.37	0.08	[0.40, 0.69]		0.82***	0.37	0.12	[0.59, 1.05]		3.57***	0.24	0.82	[1.96, 5.17]
PFE		−0.15***	−0.27	0.03	[−0.20, −0.10]		−0.19***	−0.22	0.04	[−0.27, −0.10]		0.01	0.00	0.29	[−0.57, 0.59]
Gender		0.04	0.08	0.02	[−0.01, 0.08]		0.08*	0.12	0.03	[0.02, 0.15]		0.70**	0.15	0.23	[0.24, 1.16]
Step 3	.01					.01					.03*
Gender x Dis		−0.05	−0.04	0.07	[−0.20, 0.09]		−0.06	−0.03	0.11	[−0.28, 0.16]		0.35	0.02	0.78	[−1.19, 1.88]
Gender x PFE		0.03	0.06	0.03	[−0.02, 0.09]		0.06	0.08	0.04	[−0.02, 0.15]		−0.82**	−0.15	0.30	[−1.40, −0.23]
Dis x PFE		0.18	0.10	0.09	[−0.00, 0.35]		0.14	0.05	0.14	[−0.14, 0.41]		1.66	0.09	0.97	[−0.25, 3.57]
Step 4	.01*					–					–
Gender x Dis x PFE		−0.18*	−0.11	0.09	[−0.36, 0.00]		–	–	–	–		–	–	–	–
Family Hostility (FH)
Step 1: Covariates	.03					.01					.08***
Age		0.00	−0.02	0.01	[−0.03, 0.02]		−0.01	−0.03	0.02	[−0.04, 0.02]		−0.22	−0.09	0.12	[−0.46, 0.01]
Asian		0.03	0.04	0.07	[−0.10, 0.16]		−0.03	−0.03	0.10	[−0.23, 0.17]		0.75	0.05	0.71	[−0.64, 2.14]
African American		0.07	0.10	0.06	[−0.04, 0.18]		0.07	0.07	0.08	[−0.10, 0.23]		−1.57**	−0.13	0.60	[−2.75, −0.40]
Latinx		0.04	0.08	0.05	[−0.05, 0.14]		−0.01	−0.01	0.07	[−0.15, 0.13]		1.14*	0.12	0.50	[0.15, 2.12]
Multiracial		−0.07	−0.11	0.06	[−0.18, 0.04]		−0.06	−0.06	0.08	[−0.22, 0.10]		1.74**	0.15	0.59	[0.58, 2.89]
Other		−0.03	−0.03	0.12	[−0.26, 0.21]		0.03	0.02	0.18	[−0.33, 0.38]		−3.35**	−0.37	1.28	[−5.87, −0.84]
White		−0.05	−0.05	0.04	[−0.13, 0.04]		0.01	0.01	0.07	[−0.12, 0.14]		1.30**	0.14	0.47	[0.39, 2.22]
Step 2	.20***					.22***					.08***
Discrimination (Dis)		0.57***	0.39	0.09	[0.40, 0.73]		0.78***	0.35	0.13	[0.53, 1.03]		3.70***	0.25	0.90	[1.93, 5.47]
FH		0.14***	0.25	0.03	[0.08, 0.20]		0.25***	0.30	0.05	[0.16, 0.34]		0.96**	0.17	0.32	[0.33, 1.58]
Gender		0.04	0.10	0.02	[0.00, 0.09]		0.10**	0.15	0.03	[0.03, 0.17]		0.67**	0.15	0.23	[0.21, 1.13]
Step 3	.02*					.02*					.03**
Gender x Dis		−0.04	−0.03	0.08	[−0.19, 0.12]		0.08	0.04	0.13	[−0.17, 0.33]		0.30	0.02	0.82	[−1.32, 1.92]
Gender x FH		−0.02	−0.04	0.03	[−0.08, 0.04]		−0.08	−0.10	0.05	[−0.17, 0.01]		0.18	0.03	0.32	[−0.44, 0.80]
Dis x FH		−0.18*	−0.15	0.07	[−0.31, −0.04]		−0.17	−0.09	0.10	[−0.38, 0.03]		−2.58***	−0.21	0.73	[−4.01, -1.16]
Step 4	–					.02**					–
Gender x Dis x FH		–	–	–	–		−0.27**	−0.15	0.10	[−0.48, −0.07]		–	–	–	–

Note. Parameter estimates are from 3-way interaction models with each outcome in a separate model. In the absence of a significant 3-way interaction, parameter estimates from 2-way interaction models were reported to allow for interpretation. Reported ΔR² values are from models testing only covariates, after adding main effects, after adding 2-way interactions, and after adding 3-way interactions. Effects coding was used for gender and race categories. Reported values are from models run with “other” race category excluded from the model. Models with “white” race category excluded were also run to calculate “other” race category values. *p < .05, **p < .01, ***p < .001.

Depressive symptoms

Discrimination, PFE, and FH were associated with depressive symptoms in anticipated directions. In the model testing PFE as a moderator, there was a significant three-way interaction between discrimination, PFE, and gender predicting depressive symptoms, which is plotted in Figure 1, panel A. As seen in this figure, all four significant slopes indicate that perceived discrimination is associated with more depressive symptoms. For men only, discrimination is more strongly associated with depressive symptoms at high compared to low PFE (estimate=0.36, p<.05); thus, rather than PFE buffering the effect of discrimination, the link between discrimination and depression is stronger in men who experience supportive family environments. For women, the effects of discrimination on depressive symptoms did not differ by levels of PFE (estimate=−0.01, p>.10); instead, both discrimination (b=0.49, p<.001) and PFE (b=−0.11, p<.01) independently predict women’s depressive symptoms.

Figure 1.

Simple slope plots of interactions between discrimination and positive family environment (PFE; left column) or family hostility (FH; right column).

When FH is tested as the moderator, a two-way interaction emerged between FH and discrimination, which is illustrated in Figure 1, panel B. The negative interaction term suggests that the strength of the positive relationship between discrimination and depressive symptoms is weaker at higher levels of FH. That is, although higher levels of discrimination were related to higher levels of depressive symptoms across all levels of FH, discrimination was more strongly associated with depressive symptoms in the absence, compared to presence, of FH. Thus, similar to the results for PFE for men, discrimination has stronger links to depression in the context of a less negative family setting (i.e., no family hostility or high PFE).

Anxiety symptoms

Discrimination, PFE, and FH were associated with anxiety in the expected directions. Women reported more anxiety symptoms than men. In the PFE model, discrimination and PFE each independently predicted anxiety symptoms, with no moderation effect (See Figure 1, panel C). In the FH model, a significant three-way interaction between discrimination, FH, and gender emerged. For women, discrimination is significantly associated with anxiety at both no and high FH. Similar to the results for depression, discrimination is more strongly associated with anxiety symptoms for those raised in homes with no, as compared to high, FH (See Figure 1, panel D; estimate=−0.45, p<.01). In other words, although still significant in those with no FH, the variance in anxiety symptoms due to discrimination is somewhat overshadowed by high FH. For men, there was no interaction between discrimination and FH (estimate=0.10, p>.10). Rather, discrimination (b=0.70, p<.001) and FH (b = 0.33, p<.001) independently predicted men’s anxiety symptoms.

Physical health symptoms

Discrimination and FH, but not PFE, were associated with physical health symptoms. Women reported more physical health symptoms than men. For the PFE model, discrimination alone was significantly related to health symptoms, with no interaction with PFE (See Figure 1, panel E). Although unrelated to our hypotheses, a significant two-way interaction between PFE and gender indicated that PFE was associated with fewer health symptoms overall for women (b = −0.98, p < .01), but not men (b = 0.62, p > .10). For the FH model, a significant two-way interaction emerged between discrimination and FH. The positive association between discrimination and physical health symptoms was stronger at no, compared to high, levels of FH (Figure 1, panel F). The association between discrimination and physical health symptoms is significant for participants reporting no FH but for those in a context of high FH, discrimination does not add unique variance to physical health symptoms.

Discussion

Confirming our first hypothesis, the current study’s findings support the literature demonstrating relationships between perceived discrimination and physical and mental health symptoms. The findings expand on prior work by showing that family context modifies links between perceived discrimination and health among emerging adults. Specifically, our models show perceived discrimination and FH are associated with increased risk for all three outcomes, and that PFE is negatively associated with depressive and anxiety symptoms. In partial support of our second and third hypotheses, there were interactions between discrimination and family context in predicting health outcomes. However, these interactions did not support the anticipated buffering of discrimination risk in the presence of PFE or the amplification of discrimination risk with FH. Rather, we found a stronger association between discrimination and depressive symptoms at high compared to low PFE for men. Similarly, at low compared to high FH, we found a stronger association between discrimination and depressive symptoms, anxiety symptoms in women, and physical health. These findings suggest that when family environment is not an additional stressor, perceived discrimination is strongly linked to depression, anxiety, and health symptoms. At the same time, when the family itself poses risk (due to either low positive environment or high hostility), the discrimination accounts for less variance in the health outcomes. That is, the negative family environment—particularly high family hostility—appears to overshadow some of the negative impacts of perceived discrimination. Alternatively, only independent effects of discrimination and family context emerged for some models, specifically for women’s depressive symptoms, anxiety symptoms in both men and women for PFE models, and men’s anxiety symptoms in the FH model. Together, these results underscore the importance of discrimination and family factors for emerging adults but do not support the anticipated synergistic effect of FH, that is, when co-occurring risk factors are worse than the sum of each risk factor on its own (Appleyard et al., 2005; Rutter, 1985), nor buffering effect of PFE on discrimination’s negative impact on health (Brody et al., 2016; Park et al., 2018). Moreover, although gender differences emerged, patterns were relatively inconsistent.

Findings from this study do support the idea that family environment is a meaningful context in which to understand the risk of discrimination. In some cases, family risk (high hostility or low positive environment) and discrimination both have independent, direct effects on mental and physical health. That is, beyond their shared variance, each risk alone has a significant independent association with the outcomes. Perceived discrimination and family risk may have unique qualities as psychosocial stressors. Being excluded, disrespected, or treated unfairly by others based on personal attributes that are often unmodifiable may create feelings of rejection (Feinstein et al., 2012), whereas experiencing hostility in one’s family may elicit self-blame (Buehler et al., 2007). Both rejection and self-blame can contribute to beliefs or emotions that lead to depression or anxiety (Gilbert & Miles, 2000; Leary, 1990), but perhaps through different cognitive and affective mechanisms. Moreover, that FH and PFE did not simply show an inverse pattern of findings and are only modestly associated (r(343) = -.38, p<.01) highlights the importance of exploring various dimensions of family socioemotional dynamics.

Models with significant interactions showed that discrimination-negative outcome links were strongest for those individuals with low family risk. These findings can be characterized in several ways. First, somewhat counterintuitively, the link between perceived discrimination and adverse health outcome is stronger in the context of safe (low FH and high PFE) family environments. Second, it is only at low levels of both family risk and perceived discrimination that participants showed better adjustment. Third, either perceived discrimination or family risk alone or both combined show somewhat comparable adverse outcomes in this non-clinical, emerging adult sample.

These results suggest that in emerging adulthood, perceived discrimination, family hostility, and low levels of a positive family environment are significant risk factors for depression, anxiety, and physical health. However, not finding buffering effects of positive family factors in emerging adults experiencing discrimination may suggest that emerging adulthood may be a developmental period in which resilience-promoting effects of supportive families of origin are not as protective as in earlier developmental stages. Buffering effects of positive family features on negative effects of discrimination on mental health have been found in Asian-American adults in previous studies (Chae et al., 2012; Yang et al., 2014), showing that a protective role for families can continue into adulthood. However, the only other study of family factors and discrimination in adults did not find buffering effects of family ties in Latinx families (Ayón et al., 2010), which may indicate that the role of positive family factors may differ across different racial and ethnic groups (Gillmore et al., 2011). As our study looked at racially diverse emerging adults, it is possible that positive family factors buffered effects of discrimination for some racial groups but not others, thus weakening any overall buffering effects. Additionally, previous studies have typically focused on racial discrimination while the current study used a measure of discrimination due to a heterogeneous variety of characteristics, the most commonly endorsed having to do with personal characteristics, which may have led to differing findings than previous studies. Due to power concerns, we did not examine differences in the role of family factors between racial groups; however, future studies should investigate this topic.

Additionally, emerging adults are still relatively healthy and are less likely to experience serious health problems than mid- to late-aged adults. Furthermore, the mean age of our emerging adults was 22 years, a few years before the median age of anxiety and mood disorders onset according to epidemiological studies (Kessler et al., 2007). There may be a “saturation” effect of the negative impacts posed by multiple threats to health (e.g., discrimination and family risk), such that risk in this developmental period only confers so much hazard to mental and physical health. If so, hazardous impacts in the age range may be more visible in intermediate health processes, such as stress physiology (Taylor, 2010) or cardiovascular reactivity (Uchino et al., 2005). Future research examining the impact of family context related to risks of discrimination on stress physiology in this particular developmental stage along with future follow up on health outcomes at a later developmental stage is warranted.

Limitations

Findings from the present study should be considered in light of several limitations. First, we combined discrimination experiences across various discriminated-against identities and characteristics due to a theorized similar stress mechanism (Clark et al., 1999; Pascoe & Richman, 2009). In doing so, our results do not distinguish between discrimination related to belonging to a particular stigmatized group and discrimination related to a unique personal characteristic. The impacts of each of these types of discrimination may differ, which future studies should examine. Second, the cross-sectional nature of the current study precludes being able to make any statements about causation. Relatedly, the effects of perceived discrimination are generally somewhat stronger in cross-sectional studies as compared to longitudinal studies (Paradies et al., 2015). Third, the timing and chronicity of perceived discrimination measured in the current study are unknown. For more precision in assessing the impact of perceived discrimination, repeated ecological momentary assessments (e.g., Livingston et al., 2017) could capture fluctuations in perceived discrimination experiences along with fluctuations in emotions, health symptoms, or even physiology. Fourth, given the inconsistency in gender differences observed in the current study, we hesitate to draw theoretical conclusions and suggest that future research test gender effects, specifically interactions with gender, with larger samples.

Conclusion

Despite these limitations, the key contribution of this study is evidence of the moderating effect of both positive and negative family dimensions on links between discrimination and health, as well as their potential independent contributions to physical and mental health. Both perceived that discrimination and negative family context (including lack of a positive family environment) are salient psychosocial stressors for emerging adults. Finding increased risk for negative outcomes in this sample of relatively well-functioning emerging adults emphasizes the potential harm of negative interpersonal encounters in both close relationships and more distal relationships in emerging adulthood. Although we did not find the buffering or exacerbating effects of family context in the expected patterns, we did find consistently strong effects of discrimination and family factors on mental and physical health outcomes. Future research is needed to identify other family qualities that can attenuate the harms of perceived discrimination as well as investigate the nuances of how individuals handle the co-occurrence of multiple psychosocial stressors.

Footnotes

Acknowledgments

The authors would like to thank the research participants and our USC Family Studies Project colleagues.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for this study was provided, in part, by NSF Grant No. BCS-1627272 (Margolin, PI), NIH-NICHD Grant No. R21HD072170 (Margolin, PI), and SC CTSI (NIH/NCATS) Grant No. 8UL1TR000130 (Margolin, PI), NSF GRFP Grant No. DGE-1842487 (Kim, PI), NSF SPRF Grant No. 1714304 (Schacter, PI), and NSF GRFP Grant No. DGE-1418060 (Corner & Rasmussen, PI).

ORCID iDs

Yehsong Kim

Hannah L. Schacter

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