Discrimination linked to increased risk of death, especially from cardiovascular disease

A new study that followed participants for nearly 20 years found that experiencing discrimination can make you more likely to die, especially from cardiovascular-related causes.

Previous studies have found associations between discrimination and conditions such as heart disease, diabetes, and obesity.About the new study published Wednesday in the American Heart Association Journal Circulation: Cardiovascular Quality and Outcomesresearchers wanted to dig deeper into the relationship between discrimination and mortality to find out who it affects most.

The study included 1,633 black, 1,403 Hispanic, and 2,473 white participants aged 45 to 84 with no history of cardiovascular disease. Surveys were conducted in New York City, Los Angeles, Chicago, Baltimore, St. Paul, Minnesota, and Forsyth County, North Carolina. The researchers said he tested the participants six times between 2000 and 2018.

Participants were asked questions in six main areas about being unfairly treated at any point in their lives, such as being denied a promotion or being prevented from moving to the neighborhood. Other questions included experiences of discrimination in everyday life, such as being treated poorly or lacking intelligence.

Lifetime discrimination was much more common in 61% of black participants compared to 39% of Hispanic participants and 37% of white participants.

After adjusting for factors such as age, race, income, hypertension, and diabetes, the study found that each 1-point increase in lifetime discrimination was associated with a 6% increase in all-cause mortality and a 15% increase in coronary heart disease. found to rise. Illness, stroke, and other cardiovascular-related deaths. When the researchers sorted the lifetime discrimination data by race and ethnicity, they found that only black participants, who had the highest increase in cardiovascular deaths and an 18% increased risk, reached statistical significance.

The lead author of the study, Wayne Lawrence, a research fellow at the National Cancer Institute, had expected higher overall mortality among people experiencing discrimination, but “cardiovascular disease mortality “I didn’t expect the rate to be that high,” he said. death. “

The effect of daily discrimination on cardiovascular mortality risk reached statistical significance only among Caucasian participants, who had a 51% increased risk. The researchers said this may reflect white participants of lower socioeconomic status, or belonging to ethnic groups that experience historical prejudice, such as Jews.

According to Lawrence, when the results were broken down by gender, they found that men who reported experiencing discrimination on a daily basis had slightly higher cardiovascular mortality than women. Although the researchers have not explored the reasons behind the gender differences, “previous research suggests that women are better than men at finding and using social support and other ways of coping with discrimination. It is suggested that

Lawrence urges health professionals and policy makers to “screen patients for psychosocial stressors, provide resources that may reduce their adverse health effects, and provide new policies and strategies to end discrimination.” He called for active engagement in “finding interventions.”

He also called for future research investigating which forms of discrimination have the greatest impact on health and how best to “mitigate the adverse health effects of discrimination”.

Lawrence also would like to see more research into how the racial composition of a neighborhood affects how people deal with discrimination. He said he did not find enough data to draw out

Research is also needed on how discrimination affects the health of Asian Americans, he said.

Dr. Karol Watson, who was not involved in the study, said the study was limited by its observational structure and the subjective nature of discrimination.

Still, she praised it as “an important study that seeks to unravel the link 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 should factor discrimination into “risk estimates” and encourage patients to seek social support.

She called for future research into how social support, mindfulness, and psychological interventions improve outcomes.

“Discrimination is obviously difficult to modify, but patients can try to modify their reactions to experiences of discrimination.”