Everyday Racial Discrimination and Hypertension among Midlife African American Women: Disentangling the Role of Active Coping Dispositions versus Active Coping Behaviors

Abstract

Racial discrimination, a psychosocial stressor, may contribute to disproportionate rates of hypertension among African American women. Coping moderates the effects of psychosocial stress on health. Coping dispositions describe stable personality characteristics, whereas contextual frameworks emphasize flexible coping behaviors in response to specific stressful encounters. Using data from the African American Women’s Heart and Health Study—a non-probability cross-section of 208 midlife African American women in Northern California—we estimated the association between everyday racial discrimination (Everyday Discrimination Scale, EDS) and prevalence of hypertension (HTN), and evaluated moderation by coping disposition (John Henryism Active Coping scale, JH) versus context-specific active coping behavior (Active Coping with Racism scale, ACR). There were no main associations between EDS, JH, or ACR on HTN prevalence. There was evidence of statistical interaction between EDS and ACR (p-int = 0.05), but not JH (p-int = 0.90). Among those with high levels of ACR, reporting monthly (prevalence ratio (PR) = 2.35, 95% confidence interval (CI) = 1.13, 4.87), weekly (PR = 2.15, 95% CI = 1.01, 4.61), or daily (PR = 2.36, 95% CI = 1.14, 4.88) EDS was associated with higher HTN prevalence, versus reporting racial discrimination yearly or less. In contrast, among those with low levels of ACR, reporting more chronic racial discrimination was associated with lower hypertension prevalence, although results were less precise. Findings suggest that ongoing active coping with chronic racial discrimination may contribute to hypertension risk among African American women.

The Cardiovascular Conundrum in Ethnic and Sexual Minorities: A Potential Biomarker of Constant Coping With Discrimination

“…The authors conclude that the use of these habitual emotion regulation strategies may be associated with altered autonomic and central nervous systems coupling in African Americans ( Thayer and Koenig, 2019 ). In a large sample of African American women ( N = 208), only those reporting active coping with racism were characterized by a positive association between daily discrimination and hypertension, whereas the opposite pattern emerged for those characterized by low levels of active coping ( Michaels et al, 2019 ). A number of recent studies provide support for the association between perceived discrimination or racism and poorer cardiovascular health in African Americans (e.g., metabolic syndrome in Cardel et al, 2020 ; several stress markers in Cedillo et al, 2020 ; urinary catecholamines in Homandberg and Fuller-Rowell, 2020 ).…”

Immigrant and U.S.-born migrant farmworkers: Dual paths to discrimination-related health outcomes.

“…Such experiences of discrimination are directly linked with depression and anxiety outcomes in this population (Andrews et al, 2020; Ramos et al, 2016). A wealth of research also supports the role of discrimination in multiple stress and inflammation-related outcomes such as hypertension, though primarily in African American samples (Brondolo et al, 2011; Dolezsar et al, 2014; Krieger & Sidney, 1996; Michaels et al, 2019).…”

Strategi Coping Stress Mahasiswa Dalam Penulisan Skripsi

“…Tindakan mengatasi masalah yang dilakukan oleh subjek merupakan usaha untuk mencoba memperbaiki dampak yang bisa ditimbulkan atau untuk menghindari tekanan yang ada. Tindakan-tindakan tersebut berupa sikap menanyakan dan memperjelas penyebab stressor atau meninggalkan stressor (Michaels et al, 2019). Hal ini tampak dalam pernyataan subjek:…”