The Role of Stress, Perceived Discrimination, and Skin Tone On Cognitive Performance In Puerto Rican Adults



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Background: In the United States, Hispanic/Latin American (H/L) populations are typically conceptualized as a homogenous group despite their well-documented heterogenous identities. For example, H/Ls tend to vary in skin-tone and consequently there is variability in their racialized experiences. Factors, such as stress, have been associated with poorer health outcomes, but this relationship has been underexplored within the context of the heterogeneity of H/L identity, especially as it relates to skin-tone and cognition.

Objective: To examine the association between stress in the form of allostatic load, perceived stress, bad life events, and perceived discrimination, and skin-tone on cognition in a heterogenous sample of Puerto Rican Hispanic/Latin American adults.

Methods: Participants were 1,493 Puerto Ricans from the first wave of the Boston Puerto Rican Health Study (BPRHS). Participants completed a comprehensive neuropsychological battery and structured interview to assess cognition, socioeconomic status, acculturation, and psychosocial status. Structural Equation Modeling (SEM) was used to analyze the effects between skin tone, stressful life events, perceived stress, allostatic load, and cognition.

Results: Increased perceived stress, due to discrimination and bad life events, and allostatic load were associated with poorer cognitive performance, particularly in individuals with dark skin tones, even after adjusting for age, sex, acculturation, education, and socioeconomic status.

Discussion: The study provided greater insight into the racialized experiences of Puerto Rican individuals and highlighted its subsequent effect on cognition and role in racial and health disparities. Additional research with a robust, diverse sample of H/Ls is needed to continue examining the heterogeneity of H/L heritage groups across various health outcomes.



Cognition, Puerto Ricans, Hispanics, Latin American, Discrimination, Stress