The weight of racism: Vigilance and racial inequalities in weight-related measures

Abstract

In the United States, racial/ethnic inequalities in obesity are well-documented, particularly among women. Using the Chicago Community Adult Health Study, a probability-based sample in 2001–2003 (N=3,105), we examined the roles of discrimination and vigilance in racial inequalities in two weight-related measures, body mass index (BMI) and waist circumference (WC), viewed through a cultural racism lens. Cultural racism creates a social environment in which Black Americans bear the stigma burden of their racial group while White Americans are allowed to view themselves as individuals. We propose that in this context, interpersonal discrimination holds a different meaning for Blacks and Whites, while vigilance captures the coping style for Blacks who carry the stigma burden of the racial group. By placing discrimination and vigilance within the context of cultural racism, we operationalize existing survey measures and utilize statistical models to clarify the ambiguous associations between discrimination and weight-related inequalities in the extant literature. Multivariate models were estimated for BMI and WC separately and were stratified by gender. Black women had higher mean BMI and WC than any other group, as well as highest levels of vigilance. White women did not show an association between vigilance and WC but did show a strong positive association between discrimination and WC. Conversely, Black women displayed an association between vigilance and WC, but not between discrimination and WC. These results demonstrate that vigilance and discrimination may hold different meanings for obesity by ethnoracial group that are concealed when all women are examined together and viewed without considering a cultural racism lens.

Weighed down by discriminatory policing: Perceived unfair treatment and black-white disparities in waist circumference

“…UTBP simultaneously represents a threat to physical safety, freedom, financial wellbeing, sense of agency, and sense of self ( Harris, 2010 , Brunson, 2007 , Henning, 2017 ). One study, for instance, showed that exposure to racial discrimination was associated with increased body mass index (BMI) and waist circumference because those who experienced discrimination also experienced chronic vigilance ( Hicken, Lee, & Hing, 2017 ). This pattern may extend to exposure to UTBP as well.…”

“…Racial disparities in obesity-related outcomes including BMI and waist circumference are more pronounced among females ( Jackson et al, 2013 , Mensah et al, 2005 , Wang and Beydoun, 2007 ). Moreover, some research reports that exposure to stressors is more likely to result in increased BMI among females than males ( Hicken, Lee, & Hing, 2017 ). In this study, we test whether UTBP exposure partially accounts for black-white disparities in WC separately for women and men.…”

The Price of the Ticket: Health Costs of Upward Mobility among African Americans

“…Several scholars have found support for the weathering hypothesis, as there is evidence of elevated allostatic load (a measure of chronic physiological stress) scores among Black adults, compared to whites, which likely contributes to Black-White health inequities. As it relates to frequent navigation of white spaces, Hicken and colleagues have found that when people's stress response is repeatedly activated due to apprehension over facing racism and discrimination (vigilance), dysfunction in the body's regular stress response system occurs [33][34][35]. Even if an act of discrimination is not perceived, Black people remain hyper-alert and prepared to confront any instance of intentional or unconscious racism.…”

“…The sum of these efforts to "perform" is exhausting. Findings from multiple papers indicate that effort to maintain a public face exacts a toll on Black Americans and leads to burnout [33,35,54]. Respondents in qualitative investigations of upwardly mobile African Americans report feelings of anger, hurt, disappointment and even rage as they struggle to outpace hegemonic, negative stereotypes and fight for professional legitimacy within white settings [55].…”

It Works, But For Whom? Examining Racial Bias in Carding Experiences and Acceptance of a County Identification Card

“…These discriminatory interactions can themselves change behavior, and can make ID-related interactions a location for anticipatory stress, or racism-related vigilance, which can take its own toll on health and well-being. 45 That is, above and beyond differences in ID acceptance, negative commentary can inhibit individuals from repeated use of their Washtenaw IDs, therefore, creating a racially biased system and enhancing community distrust of an equity-driven community intervention. Furthermore, the act of questioning government paperwork is a symbolic interaction often linked to the threat of deportation.…”