Cross-Sectional Association between Perceived Discrimination and Hypertension in African-American Men and Women The Pitt County Study

Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA.
American journal of epidemiology (Impact Factor: 5.23). 04/2008; 167(5):624-32. DOI: 10.1093/aje/kwm334
Source: PubMed


Few studies have examined the impact of the frequency of discrimination on hypertension risk. The authors assessed the cross-sectional associations between frequency of perceived racial and nonracial discrimination and hypertension among 1,110 middle-aged African-American men (n = 393) and women (n = 717) participating in the 2001 follow-up of the Pitt County Study (Pitt County, North Carolina). Odds ratios were estimated using gender-specific unconditional weighted logistic regression with adjustment for relevant confounders and the frequency of discrimination. More than half of the men (57%) and women (55%) were hypertensive. The prevalences of perceived racial discrimination, nonracial discrimination, and no discrimination were 57%, 29%, and 13%, respectively, in men and 42%, 43%, and 15%, respectively, in women. Women recounting frequent nonracial discrimination versus those reporting no exposure to discrimination had the highest odds of hypertension (adjusted odds ratio = 2.34, 95% confidence interval: 1.09, 5.02). A nonsignificant inverse odds ratio was evident in men who perceived frequent exposure to racial or nonracial discrimination in comparison with no exposure. A similar association was observed for women reporting perceived racial discrimination. These results indicate that the type and frequency of discrimination perceived by African-American men and women may differentially affect their risk of hypertension.

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    • "Most directly tied to our analysis, discrimination on the basis of one's race/ethnicity has become one of the most debatable and stimulating social issues in the United States and among the most studied among social scientists. However, a vast majority of this work focuses on the African American population (Aguirre and Turner 2004; Chae et al. 2010; Chae, Lincoln, and Jackson 2011; Chae, Nuru-Jeter, and Adler 2012; Dotterer, McHale, and Crouter 2009; Odom and Vernon-Feagans 2010; Roberts et al. 2008; Seaton, Yip, and Sellers 2009; Sellers et al. 2003; Smalls et. al. 2007). "
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    ABSTRACT: Discrimination based on one’s racial or ethnic background is one of the oldest and most perverse practices in the United States. Although much research has relied on self-reported racial categories, a growing body of research is designed to measure race through socially assigned race. Socially assigned or ascribed race measures how individuals feel they are classified by other people. In this study, the authors draw on the socially assigned race literature and explore the impact of socially assigned race on experiences with discrimination using a 2011 nationally representative sample of Latina/os (n = 1,200). Although much of the current research on Latina/os has been focused on aggregation across national-origin group members, this study marks a deviation in the use of socially assigned race and national origin to understand how being ascribed as Mexican is associated with experiences of discrimination. The authors find evidence that being ascribed as Mexican increases the likelihood of experiencing discrimination relative to being ascribed as White or Latina/o. Furthermore, the authors find that being misclassified as Mexican (ascribed as Mexican but not of Mexican origin) is associated with a higher likelihood of experiencing discrimination compared with being ascribed as White, ascribed as Latina/o, and correctly ascribed as Mexican. The authors provide evidence that socially assigned race is a valuable complement to self-identified race/ethnicity for scholars interested in assessing the impact of race/ethnicity on a wide range of outcomes.
    Full-text · Article · Jan 2016
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    • "Interviewers asked fifteen questions pertaining to experiences of discrimination. The items were adapted from the Major Experiences of Discrimination scale and the Everyday Discrimination Scale created by Williams and colleagues [22] and utilized by numerous others e.g., [23-25]. The items are intended to measure major experiences of unfair treatment as well as chronic, routine experiences of unfair treatment in everyday life. "
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    ABSTRACT: Introduction Canadian research on racial health inequalities that foregrounds socially constructed racial identities and social factors which can explain consequent racial health inequalities is rare. This paper adopts a social typology of salient racial identities in contemporary Canada, empirically documents consequent racial inequalities in hypertension in an original survey dataset from Toronto and Vancouver, Canada, and then attempts to explain the inequalities in hypertension with information on socioeconomic status, perceived experiences with institutionalized and interpersonal discrimination, and psychosocial stress. Methods Telephone interviews were conducted in 2009 with 706 randomly selected adults living in the City of Toronto and 838 randomly selected adults living in the Vancouver Census Metropolitan Area. Bivariate analyses and logistic regression modeling were used to examine relationships between racial identity, hypertension, socio-demographic factors, socioeconomic status, perceived discrimination and psychosocial stress. Results The Black Canadians in the sample were the most likely to report major and routine discriminatory experiences and were the least educated and the poorest. Black respondents were significantly more likely than Asian, South Asian and White respondents to report hypertension controlling for age, immigrant status and city of residence. Of the explanatory factors examined in this study, only educational attainment explained some of the relative risk of hypertension for Black respondents. Most of the risk remained unexplained in the models. Conclusions Consistent with previous Canadian research, socioeconomic status explained a small portion of the relatively high risk of hypertension documented for the Black respondents. Perceived experiences of discrimination both major and routine and self-reported psychosocial stress did not explain these racial inequalities in hypertension. Conducting subgroup analyses by gender, discerning between real and perceived experiences of discrimination and considering potentially moderating factors such as coping strategy and internalization of racial stereotypes are important issues to address in future Canadian racial inequalities research of this kind.
    Full-text · Article · Oct 2012 · International Journal for Equity in Health
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    • "Although less is known about the attribution of and the coping strategies in response to discrimination (i.e., secondary dimensions of discrimination), and to be consistent with current theoretical work in this area [31], we further hypothesized that discrimination attributed to racial and non-racial factors and passive coping behaviors in response to discrimination would be associated with greater VAT and SAT. Finally, given the differences in the reporting of perceived discrimination by sex [25, 26] and age [29] and the differences in VAT and SAT volumes by sex [5] and age [27, 28], we further hypothesized that these associations would differ by sex and age. "
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    ABSTRACT: Discrimination may be adversely associated with abdominal obesity, but few studies have examined associations with abdominal fat. The purpose of this study was to examine whether discrimination was independently associated with visceral (VAT) and subcutaneous (SAT) fat and whether these associations differed by sex and age. Participants self-reported experiences of everyday and lifetime discrimination. The main reason for and the coping response to these experiences were also reported. VAT and SAT were quantified by computed tomography. In fully adjusted models, higher reports of everyday discrimination were associated with greater SAT, but not VAT, volumes in men only: SAT increased by 3.6 (standard error = 1.8) cm(3) for each unit increase in the everyday discrimination score. In women, higher reports of lifetime non-racial discrimination were associated with greater VAT (71.6 ± 32.0, P < 0.05) and SAT (212.6 ± 83.6, P < 0.05), but these relationships were attenuated after controlling for body mass index. These cross-sectional findings do not fully support the independent hypothesis of discrimination and abdominal fat. Additional investigations involving longitudinal designs are warranted.
    Full-text · Article · Feb 2012 · Annals of Behavioral Medicine
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