Personal and group discrimination and its association with depressive symptoms, suicidal ideation, and unmet healthcare needs: a nationally representative survey of 7,699 people with disabilities in South Korea

Discrimination harms health, but previous research has focused primarily on personal discrimination. This study examined the association between personal- and group-level perceived discrimination and health outcomes among people with disabilities. This study analyzed nationally representative data from the 2023 National Survey on Persons with Disabilities in South Korea. A total of 7,699 participants were included in the analysis. Personal discrimination was measured with the following question: “How much do you feel that you are being discriminated against because of your disability currently?” Group discrimination was measured with the following question: “How much discrimination do you think there is against people with disabilities in Korea?” Based on the combination of personal discrimination and group discrimination, perceived discrimination was classified into four categories: (1) neither personal nor group discrimination (None); (2) personal discrimination only (PD-only); (3) group discrimination only (GD-only); and (4) both personal and group discrimination (PD&GD). Outcome variables were depressive symptoms, suicidal ideation, and unmet healthcare needs over the past year. Each was measured as a binary (yes/no) response. Multiple logistic regression was used for all analyses. Among 7,699 participants, the prevalence of None, PD-only, GD-only, and PD&GD was 17.6%, 1.1%, 49.0%, and 32.3%, respectively. After adjusting for potential confounders such as type of disability, presence of multiple disabilities, and severity of disability, PD&GD was associated with unmet healthcare needs (aOR: 2.14, 95% CI: 1.75–2.61) as well as depressive symptoms (aOR: 1.99, 95% CI: 1.60–2.47) and suicidal ideation (aOR: 2.47, 95% CI: 1.89–3.23). PD-only was related to depressive symptoms (aOR: 2.70, 95% CI: 1.57–4.65) and suicidal ideation (aOR: 2.59, 95% CI: 1.34–4.97), whereas GD-only was associated with unmet healthcare needs (aOR: 1.41, 95% CI: 1.17–1.71). While personal discrimination was associated with poor mental health, group discrimination was associated with unmet healthcare needs. Efforts considering the level and context of discrimination are needed to promote the health of people with disabilities.