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In racial disparities research, perceived discrimination is a proposed risk factor for unfavorable health outcomes. In a proposed "threshold-constraint" theory, discrimination intensity may exceed a threshold and require coping strategies, but social constraint limits coping options for African Americans, who may react to perceived racial discrimination with disengagement, because active strategies are not viable under this social constraint. Caucasian Americans may experience less discrimination and lower social constraint, and may use more active coping strategies. There were 213 African Americans and 121 Caucasian Americans with cancer who participated by completing measures of mistreatment, coping, and quality of life. African Americans reported more mistreatment than Caucasian Americans (p &lt; 001) and attributed mistreatment more to race or ethnicity (p &lt; .001). In the mistreatment-quality of life relationship, disengagement was a significant mediator for Caucasians (B = -.39; CI .13-.83) and African Americans (B = -.20; CI .07-.43). Agentic coping was a significant mediator only for Caucasians (B = -.48; CI .18-.81). Discrimination may exceed threshold more often for African Americans than for Caucasians and social constraint may exert greater limits for African Americans. Results suggest that perceived discrimination affects quality of life for African Americans with cancer because their coping options to counter mistreatment, which is racially based, are limited. This process may also affect treatment, recovery, and survivorship.

Perceived discrimination, coping, and quality of life for African-American and Caucasian persons with cancer.