Perceived discrimination is associated with health behaviours among African-Americans in the Jackson Heart Study

Sims, Mario; Diez‐Roux, Ana V.; Gebreab, Samson Y.; Brenner, Allison B.; Dubbert, Patricia M.; Wyatt, Sharon B.; Bruce, Marino A.; Hickson, DeMarc A.; Payne, Thomas J.; Taylor, Herman A.

doi:10.1136/jech-2015-206390

Cited by 119 publications

(94 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…First, while discrimination has been associated with a higher prevalence of some CV risk factors, such as hypertension 7 and tobacco use 20,24 , it has also been linked with CV-protective behaviors such as physical activity. 9 Second, data on the associations of perceived discrimination and subclinical CVD have had mixed results, with one study demonstrating a positive association with coronary artery calcium 25 and another finding no relationship between discrimination and either coronary artery calcification or aortic wall thickness 19 .…”

Section: Discussionmentioning

confidence: 99%

Perceived Discrimination and Cardiovascular Outcomes in Older African Americans

Dunlay

Lippmann

Greiner

et al. 2017

Mayo Clinic Proceedings

Self Cite

View full text Add to dashboard Cite

Objective To assess the associations of perceived discrimination and CV outcomes in African Americans (AA) in the Jackson Heart Study. Methods In 5085 AA free of clinical CV disease at baseline enrolled in the Jackson Heart Study from September 26, 2000–March 31, 2004 and followed through 2012, associations of everyday discrimination (frequency of occurrences of perceived unfair treatment) and lifetime discrimination (perceived unfair treatment in 9 life domains) with CV outcomes (all-cause mortality, incident coronary heart disease [CHD], incident stroke, and heart failure [HF] hospitalization) were examined using Cox models. Results Greater everyday and lifetime discrimination were more common in participants who were younger, male, had higher education and income, a lower perceived community standing, worse healthcare access, and fewer comorbidities. Prior to adjustment, greater everyday and lifetime discrimination were associated with a lower risk of all-cause mortality, incident CHD, stroke, and HF hospitalization. After adjustment for potential confounders, we found no association of everyday/lifetime discrimination with incident CHD, incident stroke or HF hospitalization; however, a decrease in all-cause mortality with progressively higher everyday discrimination persisted (HR per unit increase in discrimination 0.90, 95% CI 0.82–0.99, P=.02). The unexpected association of everyday discrimination and all-cause mortality was partially mediated by perceived stress. Conclusion We found no independent associations of perceived discrimination with risk of incident CV disease or HF hospitalization in this AA population. An observed paradoxical negative association of everyday discrimination and all-cause mortality was partially mediated by perceived stress.

show abstract

Section: Discussionmentioning

confidence: 99%

Perceived Discrimination and Cardiovascular Outcomes in Older African Americans

Dunlay

Lippmann

Greiner

et al. 2017

Mayo Clinic Proceedings

Self Cite

View full text Add to dashboard Cite

show abstract

“…AAs report more discriminatory experiences and distrust than other racial ethnic groups. 4,9,[25][26] The majority of AAs attribute experiences of discrimination to race/ethnicity, most likely due to the historical treatment of AAs by Caucasians. 24,27 AAs may generalize feelings of discrimination to Caucasians, which could influence attitudes toward providers.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5] Researchers have reported links between trust, satisfaction and perceptions of discrimination from providers. [6][7][8][9] Trust in health care providers is the belief that the provider will act for the benefit of the patient. 10 Satisfaction, which is related but distinct from trust, is an evaluation of past experiences with health care providers or the health care system.…”

Section: Introductionmentioning

confidence: 99%

Perceived Discrimination and Reported Trust and Satisfaction in African Americans: The Jackson Heart Study

2017

Self Cite

View full text Add to dashboard Cite

Objectives: 1) To examine the association of multiple dimensions of discrimination with reported trust and satisfaction with providers; 2) to report within-group differences among African Americans (AAs). Methods: Descriptive cross sectional study. The study population included AAs aged 35 to 84 years from the Jackson Heart Study (JHS) (N=5,301). Poisson regression (PR) was used to quantify the association between perceived discrimination and reported trust and satisfaction with providers before and after controlling for selected characteristics. Main Measures: Measures of perceived discrimination included everyday, lifetime, burden from lifetime discrimination, and stress from discrimination. Outcomes included trust and satisfaction with providers. Results: The mean everyday discrimination score was 2.11 (SD±1.02), and the mean lifetime discrimination score was 2.92 (SD±2.12). High (vs low) levels of everyday discrimination were associated with a 3% reduction in the prevalence of trust in providers (PR .97, 95% CI .96, .99) in all models. In fully-adjusted models, high (vs low) lifetime discrimination was associated with a 4% reduction in the prevalence of trust and satisfaction (PR .96, 95% CI .95, .98). Burden of discrimination was not associated with trust or satisfaction, but stress from discrimination was inversely associated with satisfaction. Conclusions: The significant association between discrimination and mistrust and dissatisfaction suggests that health care providers should be made aware of AA perceptions of discrimination, which likely affects their levels of trust and satisfaction.Ethn Dis. 2017;27(3):209-216; doi:10.18865/ed.27.3.209

show abstract

“…This suggests that perceived discrimination might affect adiposity (eg, through hypercortisolism) across the whole body, rather than specific areas (eg, abdominal region). Increased fat and sugar intake due to chronic stress could also be equally related to increased BMI and WC 10 31…”

Section: Discussionmentioning

confidence: 99%

“…There is some evidence indicating a positive association of perceived discrimination with obesity 6 7. This association might work through depressive symptoms,8 9 health behaviours10 and direct physiological stress pathways (eg, hypothalamic–pituitary–adrenal axis) 11–13…”

Section: Introductionmentioning

confidence: 99%