By Thor Christensen, American Heart Association News
Experiencing discrimination may increase the chance of dying, especially from
cardiovascular-related causes, according to a new study that followed
participants for nearly two decades.
Previous studies have found links between discrimination and conditions such as
heart disease, diabetes and obesity. For the new study, published Wednesday in
the American Heart Association journal Circulation: Cardiovascular Quality and
Outcomes, researchers wanted to delve deeper into the relationship between
discrimination and mortality to find out who it affects the most.
The study included 1,633 Black, 1,403 Hispanic and 2,473 white participants ages
45 to 84 with no prior history of cardiovascular disease. Research took place in
New York City, Los Angeles, Chicago, Baltimore, St. Paul, Minnesota, and Forsyth
County, North Carolina. Researchers examined participants six times between 2000
and 2018.
Participants answered questions about being treated unfairly at any point in
their lives in six major areas, such as being denied a promotion or being
prevented from moving into a neighborhood. Other questions covered
discrimination experiences in day-to-day life, such as being treated with less
courtesy or as lacking intelligence.
Lifetime discrimination was much more common among Black participants, at 61%
compared to 39% among Hispanic participants and 37% among white participants.
After adjusting for age, race, income, high blood pressure, diabetes and other
factors, the study found that each one-point increase in lifetime discrimination
was associated with a 6% rise in all-cause mortality and a 15% increase in
coronary heart disease, stroke and other cardiovascular-related deaths. When
researchers broke down the lifetime discrimination data by race and ethnicity,
they found the rise in cardiovascular deaths was highest and reached statistical
significance only for Black participants, who had an 18% increased risk.
Wayne Lawrence, the study’s lead author and a research fellow at the National
Cancer Institute, said that while he’d expected to see an overall higher death
rate for people experiencing discrimination, he didn’t expect it to be ”so much
higher for cardiovascular mortality.”
The effect of everyday discrimination on cardiovascular mortality risk reached
statistical significance only among white participants, who had an increased
risk of 51%. The researchers said this may reflect white participants with lower
socioeconomic status or who belong to ethnic groups that experience historical
prejudice, such as Jewish people.
Breaking down the results by gender, the study found men who reported
experiencing everyday discrimination had a slightly higher cardiovascular death
rate than women, Lawrence said. While researchers didn’t explore the reasons
behind the gender differences, ”previous studies suggest women are better than
men at finding and using social support and other ways of coping with
discrimination,” he said.
Lawrence called on medical professionals and policymakers to be more proactive
in ”screening patients for psychosocial stressors, providing resources that
might mitigate their adverse health effects, and finding new policies and
interventions to end discrimination.”
He also called for future studies that explore which forms of discrimination
have the greatest impact on health and the best methods for ”buffering the
adverse health effects of discrimination.”
Lawrence also would like to see further research on how the racial makeup of
neighborhoods affects how people cope with discrimination. While the study did
look at the effect of residential segregation, it didn’t find enough data to
draw conclusions, he said.
There’s also a need for research on how discrimination impacts the health of
Asian Americans, he said.
Dr. Karol Watson, who was not involved in the research, said the study was
limited by its observational structure and the subjective nature of
discrimination.
Still, she praised it as ”an important study that tries to tease out the
association between experiences of discrimination and mortality.”
Watson, a cardiologist and professor of medicine at the David Geffen School of
Medicine at the University of California, Los Angeles, said doctors need to
factor discrimination ”into our risk estimations” and encourage patients to seek
out social support.
She called for future studies on how social support, mindfulness and
psychological interventions might improve outcomes.
”Discrimination is obviously difficult to modify,” she said, ”but patients can
try to modify their reactions to experiences of discrimination.”
Copyright is owned or held by the American Heart Association, Inc., and all
rights are reserved. Permission is granted, at no cost and without need for
further request, for individuals, media outlets, and non-commercial education
and awareness efforts to link to, quote, excerpt or reprint from these stories
in any medium as long as no text is altered and proper attribution is made to
American Heart Association News.
Other uses, including educational products or services sold for profit, must
comply with the American Heart Association’s Copyright Permission Guidelines.
See full terms of use. These stories may not be used to promote or endorse a
commercial product or service.
HEALTH CARE DISCLAIMER: This site and its services do not constitute the
practice of medical advice, diagnosis or treatment. Always talk to your health
care provider for diagnosis and treatment, including your specific medical needs.
If you have or suspect that you have a medical problem or condition, please
contact a qualified health care professional immediately. If you are in the
United States and experiencing a medical emergency, call 911 or call for
emergency medical help immediately.
Copyright 2023 American Heart Association News
