Twitter-Characterized Sentiment Towards Racial/Ethnic Minorities and Cardiovascular Disease (CVD) Outcomes

Abstract

Sentiments towards racial/ethnic racial/ethnic minorities may impact cardiovascular disease (CVD) through direct and indirect pathways. In this study, we assessed the association between Twitter-derived sentiments towards racial/ethnic minorities at state level and individual level CVDrelated outcomes from the 2017 Behavioral Risk Factor Surveillance System (BRFSS). Outcomes included hypertension, diabetes, obesity, stroke, myocardial infarction (MI), coronary heart disease (CHD), and any CVD from BRFSS 2017 (N=433,434 to 433,680 across outcomes). A total of 30 million race-related tweets were collected using Twitter Streaming Application Programming Interface (API) from 2015 to 2018. Prevalence of negative and positive sentiment towards racial/ ethnic minorities were constructed at state level and merged with CVD outcomes. Poisson regression was used, and all the models adjusted for individual level demographics as well as state level demographics. Individuals living in states with the highest level of negative sentiment towards racial/ethnic minorities had 11% higher prevalence of hypertension (

Exploring U.S. Shifts in Anti-Asian Sentiment with the Emergence of COVID-19

“…A rise in negative racial attitudes and racial bias can have significant social, economic, and mental and physical health impacts [ 6 , 7 , 8 ]. Prior research has shown that community-level racial climate is related to birth outcomes [ 9 , 10 , 11 ], cardiovascular outcomes [ 12 ], and mortality [ 13 ] of the area. Such attitudes reflect cultural racism, defined as the infusion of the ideology of racial inferiority in the values, language, imagery, symbols, and unstated assumptions of the larger society [ 14 ].…”

Whites’ County-Level Racial Bias, COVID-19 Rates, and Racial Inequities in the United States

“…Finally, chronic contextual stress (stress resulting from the socio-political climate and inequitable social structure) [ 54 ] may be more salient in counties with more racial bias. Indeed, previous work has linked community-level racial bias with stress-related outcomes among racially minoritized groups, including cardiovascular risk factors and adverse birth outcomes [ 25 , 27 , 29 ]. Future research should examine these potential mediating pathways linking area-level bias to COVID-19 and other adverse health outcomes.…”

“…Area-level bias may reflect norms and attitudes in a community or may represent a distinct community-level construct and has been shown to predict various domains of population health and health inequities [ 19 , 22 , 23 ]. For example, states with higher anti-Black bias spend less on disabled Medicaid enrollees [ 24 ], and various area-level measures of racial bias have been linked with overall rates of, and racial inequities in: adverse birth outcomes [ 25 ], police killings [ 26 ], cardiovascular risk factors [ 27 ], overall mortality [ 28 ], and mortality related to circulatory disease [ 29 , 30 ]. Proposed pathways linking area-level racial bias to health include institutional discrimination [ 29 ], disrupted social capital and community cohesion [ 28 ], and increased psychosocial stress [ 23 ], which can undermine health for both racially minoritized and White groups [ 27 , 28 , 29 , 30 ].…”

“…For example, states with higher anti-Black bias spend less on disabled Medicaid enrollees [24], and various area-level measures of racial bias have been linked with overall rates of, and racial inequities in: adverse birth outcomes [25], police killings [26], cardiovascular risk factors [27], overall mortality [28], and mortality related to circulatory disease [29,30]. Proposed pathways linking area-level racial bias to health include institutional discrimination [29], disrupted social capital and community cohesion [28], and increased psychosocial stress [23], which can undermine health for both racially minoritized and White groups [27][28][29][30]. The relationship between area-level racial bias and COVID-19 outcomes have not, to our knowledge, been evaluated.…”

Evaluating associations between area-level Twitter-expressed negative racial sentiment, hate crimes, and residents' racial prejudice in the United States

“…Building on prior research, our measure offers new, cost-efficient data sources for characterizing area-level racial sentiment ( Nguyen et al, 2019 ). The measure demonstrated associations with adverse birth outcomes (T. Nguyen et al, 2020 ; Nguyen et al, 2018 ) and cardiovascular outcomes ( Huang, Huang, Adams, Nguyen, & Nguyen, 2020 ).…”