Gendered Race and Setting Matter: Sources of Complexity in the Relationships Between Reported Interpersonal Discrimination and Cardiovascular Health in the CARDIA Study

  • G. S. BeyEmail author
  • S. D. Person
  • C. Kiefe



Using data from black and white adults enrolled in a community-based, multi-city cohort assembled in the mid-1980s, we examined whether reported experiences of interpersonal racial and gender discrimination differentially impacted on future cardiovascular health (CVH) depending on gendered race and the setting in which the interactions were reported to have occurred.


Discrimination in eight possible settings was assessed using the Experiences of Discrimination scale at year 7; CVH two decades later was examined using a modified Life’s Simple 7 score, with higher scores indicating better health. Separate multivariable linear regressions evaluated the associations between reports of racial and gender discrimination and CVH score in each possible setting stratified by gendered race.


Mean (SD) CVH scores at year 30 were 7.8(1.9), 8.1(1.8), 8.9(2. 0), and 8.8(1.8) among black women, black men, white women, and white men, respectively. For black women, reporting both racial and gender discrimination while receiving medical care was associated with lower CVH score. Among black men, reporting both forms of discrimination while getting a job, at work, at school, and receiving medical care was associated with lower CVH score. Among whites, reported discrimination while obtaining housing and by the police or courts (women), and in public and at work (men), was associated with a lower CVH score.


The setting in which discrimination is reported may be an important indicator of whether discriminatory experiences are negatively associated with CVH, providing insight on distinct effect pathways among black and white women and men.


Gendered race Interpersonal discrimination Cardiovascular health Intersectionality Identity pathology Social context 


Compliance with Ethical Standards

Approval for the use of Human Subjects data in the CARDIA study was granted by the Institutional Review Boards of the following institutions:

University of Alabama at Birmingham

Northwestern University

University of Minnesota

Kaiser Permanente, Research Division

Supplementary material

40615_2020_699_MOESM1_ESM.docx (15 kb)
ESM 1 (DOCX 14 kb)


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Copyright information

© W. Montague Cobb-NMA Health Institute 2020

Authors and Affiliations

  1. 1.Department of Epidemiology, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Department of Population and Quantitative Health SciencesUniversity of Massachusetts Medical SchoolWorcesterUSA

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