Association between perceived racism and physiological stress indices in Native Hawaiians

Abstract

The association between racism and the physical health of native U.S. populations has yet to be examined despite their high risk for stress-related disorders and a history of discrimination toward them. We examined the correlation between perceived racism and the two physiological stress indices of cortisol level and blood pressure in 146 adult Native Hawaiians. Attributed and felt racism were assessed with a 10-item shortened version of the Oppression Questionnaire. Height, weight, blood pressure (BP), and salivary cortisol samples (AM and PM) were collected and analyzed along with information on Hawaiian ancestry, BMI, age, sex, marital status, education level, general psychological stress, and ethnic identity. The results indicated that Native Hawaiians reporting more attributed racism had significantly (p < .05) lower average cortisol levels than those reporting less attributed racism, after adjusting for socio-demographic, biological, and psychosocial confounders. Native Hawaiians reporting more felt racism had a significantly higher systolic BP than those reporting less, but this association was not significant after adjusting for the aforementioned confounders. Racism appears to be a chronic stressor that can “get under the skin” of Native Hawaiians by affecting their physical health and risk for stress-related diseases, possibly, through mechanisms of cortisol dysregulation.

Associations between self-reported discrimination and diurnal cortisol rhythms among young adults: The moderating role of racial–ethnic minority status

“…We believe these findings do not necessarily suggest discriminatory experiences are unrelated to HPA axis activity in Hispanic individuals or other racial/ethnic minority members, as theory would suggest that perceived discrimination has the ability to illicit a cortisol response across all ethnic and racial groups. In fact, recent work has found a positive relation between self-reported discrimination and cortisol across the day among Mexican American adolescents (Zeiders et al, 2012) and among Native Hawaiian adults (Kaholokula et al, 2012). Rather, the lack of association in the current study could be related to the limited sample of individuals within each group and/or our inability to measure distinctive characteristics and constructs (e.g., country origin, cultural values, acculturation level) known to be important among minority populations (Knight et al, 2009).…”

Culturally responsive approaches to health promotion for Native Hawaiians and Pacific Islanders

“…The family and community focused component aimed to help participants elicit support from their friends and family, increase family activities around eating and being active, manage challenging social situations, effectively communicate one’s healthy lifestyle goals, and identify and utilize community resources (e.g., parks and farmers markets). Kaholokula, Mau, et al (2012) provide a summary of the family and community curriculum.…”

“…To test the weight-loss maintenance efficacy of the 6-month family and community phase of the PLP, 144 NHPI who completed the adapted DPP-LI in the original study (Mau et al 2010), and were willing to continue on, were randomized to either receive the PLP family and community intervention (n = 72) or to a standard behavioural follow-up (n = 72) (Kaholokula et al, 2012). The latter included once a month phone calls and mailers to follow-up with participants on the adapted DPP-LI lessons and as a check-in.…”

“…Also worth noting is that perceptions of ethnic discrimination decreased for both NH and Chuukese participants who underwent the intervention. Previous studies have linked perceptions of discrimination to hypertension (Kaholokula, Iwane, and Nacapoy 2010) and to indices of physiological stress (Kaholokula, Grandinetti, et al 2012). A cultural grounded intervention, such as hula, could have more than just clinical benefits but sociocultural benefits as well.…”

Developmental histories of perceived racial discrimination and diurnal cortisol profiles in adulthood: A 20-year prospective study

“…The hypothalamic–pituitary–adrenal (HPA) axis and its primary product cortisol are frequently implicated in theoretical models of race-based stress and health (Myers, 2009). Racial/ethnic differences have been found in diurnal cortisol rhythms (Cohen et al, 2006; DeSantis et al, 2007), and perceived discrimination has been associated with altered basal/diurnal levels of cortisol in past research (Kaholokula et al, 2012; Zeiders et al, 2012). …”