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Interactive effects of perceived racism and coping responses predict a school-based assessment of blood pressure in black youth

  • Published:
Annals of Behavioral Medicine

Abstract

Background: Research indicates that perceived racism and coping responses are associated with basal blood pressure (BP) levels and BP reactivity in Black adults. No study could be found, however, that has explored the independent and interactive effects of perceived racism and coping responses in a cohort who probably has the greatest risk of developing primary hypertension—Black youth.Purpose: This study examined the relationship of perceived racism and coping responses to a continuous measure of BP and to a categorical measure of BP status (normal vs. high-normal or high).Methods: The convenience sample consisted of 217 Black youth (M age = 11.4 years, SD = 1.3). Participants reported on perceived racism and coping responses (Accepting It, Self-Blame, Taking Action, and Talking to Someone). BP was assessed with an automated monitor in school.Results: Approximately 32% of the sample had average BP levels that were high-normal or high. Hierarchical linear and logistic regression analyses were used to assess the predictive utility of perceived racism and the four coping responses to the continuous and categorical BP assessments. Although perceived racism and the coping response variables did not emerge as significant independent predictors in the linear or logistic regression analyses, perceived racism interacted with Accepting It (p = .009) in the linear regression analysis predicting systolic BP. Follow-up linear regression analyses indicated that perceived racism was not significantly associated with systolic BP among participants low in Accepting It but was inversely related to systolic BP among participants high in Accepting It. Perceived racism also interacted with Accepting It (p = .016) and Talking to Someone (p = .0009) in the logistic regression analysis predicting BP status. Follow-up logistic regression analyses revealed that (a) perceived racism was not significantly associated with BP status among participants low in Accepting It but was inversely related to BP status among participants high in Accepting It, and (b) perceived racism was inversely associated with BP status among participants low in Talking to Someone but was not significantly related to BP status among participants high in Talking to Someone.Conclusions: The contribution of environmental and psychosocial factors to hypertension risk should be considered when exploring correlates of continuous and categorical assessments of BP in Black youth.

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References

  1. Chobanian AV, Bakris GL, Black HR, et al.: Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, National Heart, Lung, and Blood Institute, National High Blood Pressure Education Program Coordinating Committee: Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.Hypertension. 2003,42:1206–1252.

    Article  PubMed  CAS  Google Scholar 

  2. National Center for Health Statistics:Health, United States, 2003. Hyattsville, MD: U.S. Government Printing Office, 2003.

    Google Scholar 

  3. National Center for Health Statistics:Health, United States, 1998. Hyattsville, MD: U.S. Government Printing Office, 1998.

    Google Scholar 

  4. Rose KM, North K, Arnett DK, et al.: Blood pressure and pulse responses to three stressors: Associations with sociodemographic characteristics and cardiovascular risk factors.Journal of Human Hypertension. 2004,18:333–341.

    Article  PubMed  CAS  Google Scholar 

  5. National Heart, Lung, and Blood Institute: NIH Publication No. 96–3790. Hyattsville, MD: U.S. Government Printing Office, 1996.

  6. Treiber FA, Kamarck T, Schneiderman N, et al.: Cardiovascular reactivity and development of preclinical and clinical disease states.Psychosomatic Medicine. 2003,65:46–62.

    PubMed  Google Scholar 

  7. Murphy JK, Alpert BS, Walker SS, Wiley ES: Children’s cardiovascular reactivity: Stability of racial differences and relation to subsequent blood pressure over a one-year period.Psychophysiology. 1991,28:447–456.

    Article  PubMed  CAS  Google Scholar 

  8. Treiber FA, Musante L, Kapuku G, et al.: Cardiovascular (CV) responsivity and recovery to acute stress and future CV functioning in youth with family histories of CV disease: A 4-year longitudinal study.International Journal of Psychophysiology. 2001,41:65–74.

    Article  PubMed  CAS  Google Scholar 

  9. Clark R: Inter-ethnic group and intra-ethnic group racism: Perceptions and coping in Black university students.Journal of Black Psychology. 2004,30:506–526.

    Article  Google Scholar 

  10. Mattis JS, Bell CC, Jagers RJ, Jenkins E: A critical approach to stress-related disorders in African Americans.Journal of the National Medical Association. 1999,91:80–85.

    PubMed  CAS  Google Scholar 

  11. Harrell SP:A multidimensional conceptualization of racism-related stress: Implications for the well-being of people of color.American Journal of Orthopsychiatry. 2000,70:42–57.

    Article  PubMed  CAS  Google Scholar 

  12. Clark R, Coleman AP, Novak JD: Initial psychometric properties of the Everyday Discrimination Scale in Black adolescents.Journal of Adolescence. 2004,27:363–368.

    Article  PubMed  Google Scholar 

  13. Clark R, Anderson N, Clark VR, Williams DR: Racism as a stressor for African Americans: A biopsychosocial model.American Psychologist. 1999,54:805–816.

    Article  PubMed  CAS  Google Scholar 

  14. Anderson NB, McNeilly M, Myers H: Autonomic reactivity and hypertension in Blacks: A review and proposed model.Ethnicity & Disease. 1991,1:154–170.

    CAS  Google Scholar 

  15. Lazarus RS, Folkman S:Stress, Appraisal, and Coping. New York: Springer, 1984.

    Google Scholar 

  16. Clark R: Significance of perceived racism: Toward understanding ethnic-group disparities in health, the later years. In Anderson NB, Bulatao RA, Cohen B (eds),Critical Perspectives on Racial and Ethnic Differences in Health in Late Life. Washington, DC: National Academy Press, 2004, 540–566.

    Google Scholar 

  17. Brondolo E, Rieppi R, Kelly KP, Gerin W: Perceived racism and blood pressure: A review of the literature and conceptual and methodological critique.Annals of Behavioral Medicine. 2003,25:55–65.

    Article  PubMed  Google Scholar 

  18. Harrell JP, Hall S, Taliaferro J: Physiological responses to racism and discrimination: An assessment of the evidence.American Journal of Public Health. 2003,93:243–248.

    PubMed  Google Scholar 

  19. Clark R: Perceptions of inter-ethnic group racism predict increased vascular reactivity to a laboratory challenge in college women.Annals of Behavioral Medicine. 2000,22:214–222.

    Article  PubMed  CAS  Google Scholar 

  20. Stewart JC, France CR: Cardiovascular recovery from stress predicts longitudinal changes in blood pressure.Biological Psychology. 2001,58:105–120.

    Article  PubMed  CAS  Google Scholar 

  21. Steffen PR, McNeilly M, Anderson N, Sherwood A: Effects of perceived racism and anger inhibition on ambulatory blood pressure in African Americans.Psychosomatic Medicine. 2003,65:746–750.

    Article  PubMed  Google Scholar 

  22. Din-Dzietham R, Nembhard WN, Collins R, Davis SK: Perceived stress following race-based discrimination at work is associated with hypertension in African-Americans. The metro Atlanta heart disease study, 1999–2001.Social Science & Medicine. 2004,58:449–461.

    Article  Google Scholar 

  23. Bowen-Reid TL, Harrell JP: Racist experiences and health outcomes: An examination of spirituality as a buffer.Journal of Black Psychology. 2002,28:18–36.

    Article  Google Scholar 

  24. Peters RM: Racism and hypertension among African Americans.Western Journal of Nursing Research. 2004,26:612–631.

    Article  PubMed  Google Scholar 

  25. Matthews K, Salomon K, Kenyon K, Zhou F: Unfair treatment, discrimination, and ambulatory blood pressure in black and white adolescents.Health Psychology. 2005,24:258–265.

    Article  PubMed  Google Scholar 

  26. Clark R: Parental history of hypertension and coping responses predict blood pressure changes to a perceived racism speaking task in Black college volunteers.Psychosomatic Medicine. 2003,65:1012–1019.

    Article  PubMed  Google Scholar 

  27. Clark R, Anderson NB: Efficacy of racism-specific coping styles as predictors of cardiovascular functioning.Ethnicity & Disease. 2001,11:286–295.

    CAS  Google Scholar 

  28. Moghaddam FM, Taylor DM, Ditto B, Jacobs K, Bianchi E: Psychological distress and perceived discrimination: A study of women from India.International Journal of Intercultural Relations. 2002,26:381–390.

    Article  Google Scholar 

  29. LaVeist TA, Sellars R, Neighbors HW: Perceived racism and self and system blame attribution: Consequences for longevity.Ethnicity & Disease. 2001,11:711–721.

    CAS  Google Scholar 

  30. Clark R: Perceived racism and vascular reactivity in Black college females: Moderating effects of seeking social support.Health Psychology. 2006,25:20–25.

    Article  PubMed  Google Scholar 

  31. Amerena J, Julius S: The role of the autonomic nervous system in hypertension.Hypertension Research. 1995,18:99–110.

    Article  PubMed  CAS  Google Scholar 

  32. Harrell JP: Psychological factors and hypertension: A status report.Psychological Bulletin. 1980,87:482–501.

    Article  PubMed  CAS  Google Scholar 

  33. Krieger N, Sidney S: Racial discrimination and blood pressure: The CARDIA Study of young Black and White adults.American Journal of Public Health. 1996,86:1370–1378.

    PubMed  CAS  Google Scholar 

  34. Krieger N: Racial and gender discrimination: Risk factors for high blood pressure?Social Science & Medicine. 1990,12:1273–1281.

    Article  Google Scholar 

  35. Forman TA, Williams DR, Jackson JS: Race, place, and discrimination.Perspectives on Social Problems. 1997,9:231–261.

    Google Scholar 

  36. Alavi H, Prisant LM, Jupin D, Oracion A: Comparison of arterial elasticity measured in left and right arm using the HDI/ Pulsewave CR-2000 Research System.Blood Pressure Monitoring. 2002,7:277–280.

    Article  PubMed  Google Scholar 

  37. Gillman MW, Cook NR: Blood pressure measurement in childhood epidemiological studies.Circulation. 1995,92:1049–1057.

    PubMed  CAS  Google Scholar 

  38. Fernandes E, McCrindle BW: Diagnosis and treatment of hypertension in children and adolescents.Canadian Journal of Cardiology. 2000,16:801–811.

    PubMed  CAS  Google Scholar 

  39. Aiken LS, West SG:Multiple Regression: Testing and Interpreting Interactions. Newbury Park, CA: Sage, 1991.

    Google Scholar 

  40. Achenbach TM:Manual for the Child Behavior Checklist/4-18 and 1991 Profile. Burlington: University of Vermont, Department of Psychiatry, 1991.

    Google Scholar 

  41. Achenbach TM:Manual for the Teacher’s Report Form and 1991 Profile. Burlington: University of Vermont, Department of Psychiatry, 1991.

    Google Scholar 

  42. SAS Institute, Inc.:SAS System for Windows, Release 8.02. Cary, NC: SAS Institute, 2001.

    Google Scholar 

  43. Faul F, Erdfelder E, Power G: A priori, post-hoc, and compromise power analyses for MS-DOS [Computer program]. Bonn, Federal Republic of Germany: Bonn University, Department of Psychology, 1992.

  44. Pregibon D: Logistic regression diagnostics.Annals of Statistics. 1981,9:705–724.

    Article  Google Scholar 

  45. Klonoff EA, Landrine H: Cross-validation of the Schedule of Racist Events.Journal of Black Psychology. 1999,25:231–254.

    Article  Google Scholar 

  46. Clark R, Adams JH: Moderating effects of perceived racism on John Henryism and blood pressure reactivity in Black college females.Annals of Behavioral Medicine. 2004,28:126–131.

    Article  PubMed  Google Scholar 

  47. Williams DR, Neighbors HW, Jackson JS: Racial/ethnic discrimination and health: Findings from community studies.American Journal of Public Health. 2003,93:200–208.

    PubMed  Google Scholar 

  48. Utsey SO: Assessing the stressful effects of racism: A review of instrumentation.Journal of Black Psychology. 1998,24:269–288.

    Article  Google Scholar 

  49. Clark R: Self-reported racism and social support predict blood pressure reactivity in Blacks.Annals of Behavioral Medicine. 2003,25:127–136.

    Article  PubMed  Google Scholar 

  50. Clark R: Interactive but not direct effects of perceived racism and trait anger predict resting systolic and diastolic blood pressure in Black adolescents.Health Psychology (in press).

  51. Bullock SC, Houston E: Perceptions of racism by Black medical students attending White medical schools.Journal of the National Medical Association. 1987,79:601–608.

    PubMed  CAS  Google Scholar 

  52. National Institute of Mental Health:Research Highlights: Extramural Research. Washington, DC: U.S. Government Printing Office, 1983.

    Google Scholar 

  53. Hogan BE, Linden W: Anger response styles and blood pressure: At least don’t ruminate about it!Annals of Behavioral Medicine. 2004,27:38–49.

    Article  PubMed  Google Scholar 

  54. Ewart CK, Kolodner KB: Negative affect, gender, and expressive style predict elevated ambulatory blood pressure in adolescents.Journal of Personality & Social Psychology. 1994,66:596–605.

    Article  CAS  Google Scholar 

  55. Fields L, Prinz RJ: Coping and adjustment during childhood and adolescence.Clinical Psychology Review. 1997,17:937–976.

    Article  PubMed  CAS  Google Scholar 

  56. Krieger N, Smith K, Naishadham D, Hartman C, Barbeau EM: Experiences of discrimination: Validity and reliability of a self-report measure for population health research on racism and health.Social Science & Medicine. 2005,61:1576–1596.

    Article  Google Scholar 

  57. Gardner DG, Cummings LL, Bunham RB, Pierce JL: Single-item versus multiple-item measurement scales: An empirical comparison.Education & Psychological Measurements. 1998,58:898–915.

    Article  Google Scholar 

  58. McKinley S, Stein-Parbury J, Chehelnabi A, Lovas J: Assessment of anxiety in intensive care patients by using the Faces Anxiety Scale.American Journal of Critical Care. 2004,13:146–152.

    PubMed  Google Scholar 

  59. Elo AL, Leppanen A, Jahkola A: Validity of a single-item measure of stress symptoms.Scandinavian Journal of Work & Environmental Health. 2003,29:444–451.

    Google Scholar 

  60. Chandola T, Jenkinson C: Validating self-rated health in different ethnic groups.Ethnicity & Health. 2000,5:151–159.

    Article  CAS  Google Scholar 

  61. Burke V, Beilin LJ, Dunbar D, Kevan M: Associations between blood pressure and overweight defined by new standards for body mass index in childhood.Preventive Medicine. 2004,38:558–564.

    Article  PubMed  CAS  Google Scholar 

  62. Kannel WB: Risk stratification in hypertension: New insights from the Framingham study.American Journal of Hypertension. 2000,13:S3-S10.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Psychology, Wayne State University, USA

    Rodney Clark Ph.D. & Philip Gochett

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  1. Rodney Clark Ph.D.
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  2. Philip Gochett
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Additional information

Philip Gochett was a Ronald McNair Scholar and an undergraduate research apprentice in the Biobehavioral Research Laboratory. Preparation of this article was supported by Grant MH01867 to Rodney Clark from the National Institute of Mental Health.

We are grateful to Lesley Goins, Charles Williams, Karen Freeman, and the Biobehavioral Research Group for their assistance with data collection and entry. This article is dedicated to our fond memory of Lesley Goins.

On May 18, 2006, Dr. Clark passed away unexpectedly. This article is also dedicated to his memory.

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Clark, R., Gochett, P. Interactive effects of perceived racism and coping responses predict a school-based assessment of blood pressure in black youth. ann. behav. med. 32, 1–9 (2006). https://doi.org/10.1207/s15324796abm3201_1

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