Gendered Race and Setting Matter: Sources of Complexity in the Relationships Between Reported Interpersonal Discrimination and Cardiovascular Health in the CARDIA Study
- 6 Downloads
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.
KeywordsGendered 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
University of Minnesota
Kaiser Permanente, Research Division
- 1.Secretary’s Advisory Committee on Health Promotion and Disease Prevention Objectives for 2020. Healthy people 2020: an opportunity to address the societal determinants of health in the United States. 2010. Accessed online at https://www.healthypeople.gov/sites/default/files/SocietalDeterminantsHealth.pdf. Accessed 01 Apr 2019.
- 17.Johnson P, Markham Risica P, Gans KM, Kirtania U, Kumanyika SA. Association of perceived racial discrimination with eating behaviors and obesity among participants of the SisterTalk study. J Black Nurses Assoc. 2012;23(1):34–40.Google Scholar
- 18.Cunningham TJ, Seeman TE, Kawachi I, Gortmakera SL, Jacobs DR, Kiefe CI, et al. Racial/ethnic and gender differences in the association between self-reported experiences of racial/ethnic discrimination and inflammation in the CARDIA cohort of 4 US communities. Soc Sci Med. 2012;75(5):922–31.CrossRefGoogle Scholar
- 22.Author and manuscript information blinded for review.Google Scholar
- 23.Essed P. Understanding everyday racism: an interdisciplinary theory. CA: Sage Publications; 1991.Google Scholar
- 27.Crenshaw K. Demarginalizing the intersection of race and sex: a black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. Univ Chic Leg Forum. 1989;1989(1):139–67.Google Scholar
- 34.Krieger N, Chen JT, Waterman PD, Hartman C, Stoddard AM, Quinn MM, et al. The inverse hazard law: blood pressure, sexual harassment, racial discrimination, workplace abuse, and occupational exposures in US low-income black, white, and Latino workers. Soc Sci Med. 2008;67(12):1970–81.CrossRefGoogle Scholar
- 36.Brewer LC, Cooper LA. Race, discrimination, and cardiovascular disease. Virt Mentor AMA J Ethics. 2014;16(6):455–60.Google Scholar