IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0077174.html
   My bibliography  Save this article

Racial Discrimination & Cardiovascular Disease Risk: My Body My Story Study of 1005 US-Born Black and White Community Health Center Participants (US)

Author

Listed:
  • Nancy Krieger
  • Pamela D Waterman
  • Anna Kosheleva
  • Jarvis T Chen
  • Kevin W Smith
  • Dana R Carney
  • Gary G Bennett
  • David R Williams
  • Gisele Thornhill
  • Elmer R Freeman

Abstract

Objectives: To date, limited and inconsistent evidence exists regarding racial discrimination and risk of cardiovascular disease (CVD). Methods: Cross-sectional observational study of 1005 US-born non-Hispanic black (n = 504) and white (n = 501) participants age 35–64 randomly selected from community health centers in Boston, MA (2008–2010; 82.4% response rate), using 3 racial discrimination measures: explicit self-report; implicit association test (IAT, a time reaction test for self and group as target vs. perpetrator of discrimination); and structural (Jim Crow status of state of birth, i.e. legal racial discrimination prior 1964). Results: Black and white participants both had adverse cardiovascular and socioeconomic profiles, with black participants most highly exposed to racial discrimination. Positive crude associations among black participants occurred for Jim Crow birthplace and hypertension (odds ratio (OR) 1.92, 95% confidence interval (CI) 1.28, 2.89) and for explicit self-report and the Framingham 10 year CVD risk score (beta = 0.04; 95% CI 0.01, 0.07); among white participants, only negative crude associations existed (for IAT for self, for lower systolic blood pressure (SBP; beta = −4.86; 95% CI −9.08, −0.64) and lower Framingham CVD score (beta = −0.36, 95% CI −0.63, −0.08)). All of these associations were attenuated and all but the white IAT-Framingham risk score association were rendered null in analyses that controlled for lifetime socioeconomic position and additional covariates. Controlling for racial discrimination, socioeconomic position, and other covariates did not attenuate the crude black excess risk for SBP and hypertension and left unaffected the null excess risk for the Framingham CVD score. Conclusion: Despite worse exposures among the black participants, racial discrimination and socioeconomic position were not associated, in multivariable analyses, with risk of CVD. We interpret results in relation to constrained variability of exposures and outcomes and discuss implications for valid research on social determinants of health.

Suggested Citation

  • Nancy Krieger & Pamela D Waterman & Anna Kosheleva & Jarvis T Chen & Kevin W Smith & Dana R Carney & Gary G Bennett & David R Williams & Gisele Thornhill & Elmer R Freeman, 2013. "Racial Discrimination & Cardiovascular Disease Risk: My Body My Story Study of 1005 US-Born Black and White Community Health Center Participants (US)," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-15, October.
    • Handle: RePEc:plo:pone00:0077174
    DOI: 10.1371/journal.pone.0077174
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0077174
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0077174&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0077174?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Krieger, Nancy, 1994. "Epidemiology and the web of causation: Has anyone seen the spider?," Social Science & Medicine, Elsevier, vol. 39(7), pages 887-903, October.
    2. Krieger, Nancy & Chen, Jarvis T. & Waterman, Pamela D. & Hartman, Cathy & Stoddard, Anne M. & Quinn, Margaret M. & Sorensen, Glorian & Barbeau, Elizabeth M., 2008. "The inverse hazard law: Blood pressure, sexual harassment, racial discrimination, workplace abuse and occupational exposures in US low-income black, white and Latino workers," Social Science & Medicine, Elsevier, vol. 67(12), pages 1970-1981, December.
    3. Sims, M. & Diez-Roux, A.V. & Dudley, A. & Gebreab, S. & Wyatt, S.B. & Bruce, M.A. & James, S.A. & Robinson, J.C. & Williams, D.R. & Taylor, H.A., 2012. "Perceived discrimination and hypertension among African Americans in the Jackson Heart Study," American Journal of Public Health, American Public Health Association, vol. 102(S2), pages 258-265.
    4. Bastos, Joao Luiz & Celeste, Roger Keller & Faerstein, Eduardo & Barros, Aluisio J.D., 2010. "Racial discrimination and health: A systematic review of scales with a focus on their psychometric properties," Social Science & Medicine, Elsevier, vol. 70(7), pages 1091-1099, April.
    5. Krieger, Nancy & Smith, Kevin & Naishadham, Deepa & Hartman, Cathy & Barbeau, Elizabeth M., 2005. "Experiences of discrimination: Validity and reliability of a self-report measure for population health research on racism and health," Social Science & Medicine, Elsevier, vol. 61(7), pages 1576-1596, October.
    6. Krieger, N., 2012. "Methods for the scientific study of discrimination and health: An ecosocial approach," American Journal of Public Health, American Public Health Association, vol. 102(5), pages 936-945.
    7. Michael Greenstone & Kenneth Y. Chay, 2000. "The Convergence in Black-White Infant Mortality Rates during the 1960's," American Economic Review, American Economic Association, vol. 90(2), pages 326-332, May.
    8. Krieger, Nancy, 1990. "Racial and gender discrimination: Risk factors for high blood pressure?," Social Science & Medicine, Elsevier, vol. 30(12), pages 1273-1281, January.
    9. Borrell, Luisa N. & Kiefe, Catarina I. & Williams, David R. & Diez-Roux, Ana V. & Gordon-Larsen, Penny, 2006. "Self-reported health, perceived racial discrimination, and skin color in African Americans in the CARDIA study," Social Science & Medicine, Elsevier, vol. 63(6), pages 1415-1427, September.
    10. King, Gary & Honaker, James & Joseph, Anne & Scheve, Kenneth, 2001. "Analyzing Incomplete Political Science Data: An Alternative Algorithm for Multiple Imputation," American Political Science Review, Cambridge University Press, vol. 95(1), pages 49-69, March.
    11. Krieger, N. & Carney, D. & Lancaster, K. & Waterman, P.D. & Kosheleva, A. & Banaji, M., 2010. "Combining explicit and implicit measures of racial discrimination in health research," American Journal of Public Health, American Public Health Association, vol. 100(8), pages 1485-1492.
    12. Nancy Krieger & Pamela D Waterman & Anna Kosheleva & Jarvis T Chen & Dana R Carney & Kevin W Smith & Gary G Bennett & David R Williams & Elmer Freeman & Beverley Russell & Gisele Thornhill & Kristin M, 2011. "Exposing Racial Discrimination: Implicit & Explicit Measures–The My Body, My Story Study of 1005 US-Born Black & White Community Health Center Members," PLOS ONE, Public Library of Science, vol. 6(11), pages 1-24, November.
    13. Jennifer A. Heerwig & Brian J. McCabe, 2009. "Education and Social Desirability Bias: The Case of a Black Presidential Candidate," Social Science Quarterly, Southwestern Social Science Association, vol. 90(3), pages 674-686, September.
    14. Gee, G.C. & Walsemann, K.M. & Brondolo, E., 2012. "A life course perspective on how racism may be related to health inequities," American Journal of Public Health, American Public Health Association, vol. 102(5), pages 967-974.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Nancy Krieger & Pamela D Waterman & Anna Kosheleva & Jarvis T Chen & Dana R Carney & Kevin W Smith & Gary G Bennett & David R Williams & Elmer Freeman & Beverley Russell & Gisele Thornhill & Kristin M, 2011. "Exposing Racial Discrimination: Implicit & Explicit Measures–The My Body, My Story Study of 1005 US-Born Black & White Community Health Center Members," PLOS ONE, Public Library of Science, vol. 6(11), pages 1-24, November.
    2. Cunningham, Timothy J. & Seeman, Teresa E. & Kawachi, Ichiro & Gortmaker, Steven L. & Jacobs, David R. & Kiefe, Catarina I. & Berkman, Lisa F., 2012. "Racial/ethnic and gender differences in the association between self-reported experiences of racial/ethnic discrimination and inflammation in the CARDIA cohort of 4 US communities," Social Science & Medicine, Elsevier, vol. 75(5), pages 922-931.
    3. Eli K. Michaels & Alexis N. Reeves & Marilyn D. Thomas & Melisa M. Price & Rebecca E. Hasson & David H. Chae & Amani M. Allen, 2019. "Everyday Racial Discrimination and Hypertension among Midlife African American Women: Disentangling the Role of Active Coping Dispositions versus Active Coping Behaviors," IJERPH, MDPI, vol. 16(23), pages 1-18, November.
    4. Krieger, Nancy & Chen, Jarvis T. & Waterman, Pamela D. & Hartman, Cathy & Stoddard, Anne M. & Quinn, Margaret M. & Sorensen, Glorian & Barbeau, Elizabeth M., 2008. "The inverse hazard law: Blood pressure, sexual harassment, racial discrimination, workplace abuse and occupational exposures in US low-income black, white and Latino workers," Social Science & Medicine, Elsevier, vol. 67(12), pages 1970-1981, December.
    5. Priest, Naomi & Paradies, Yin & Trenerry, Brigid & Truong, Mandy & Karlsen, Saffron & Kelly, Yvonne, 2013. "A systematic review of studies examining the relationship between reported racism and health and wellbeing for children and young people," Social Science & Medicine, Elsevier, vol. 95(C), pages 115-127.
    6. Colen, Cynthia G. & Ramey, David M. & Cooksey, Elizabeth C. & Williams, David R., 2018. "Racial disparities in health among nonpoor African Americans and Hispanics: The role of acute and chronic discrimination," Social Science & Medicine, Elsevier, vol. 199(C), pages 167-180.
    7. Harnois, Catherine E. & Bastos, João L. & Campbell, Mary E. & Keith, Verna M., 2019. "Measuring perceived mistreatment across diverse social groups: An evaluation of the Everyday Discrimination Scale," Social Science & Medicine, Elsevier, vol. 232(C), pages 298-306.
    8. Gilbert, Paul A. & Zemore, Sarah E., 2016. "Discrimination and drinking: A systematic review of the evidence," Social Science & Medicine, Elsevier, vol. 161(C), pages 178-194.
    9. Priest, Naomi & Doery, Kate & Lim, Chiao Kee & Lawrence, Jourdyn A. & Zoumboulis, Georgia & King, Gabriella & Lamisa, Dewan & He, Fan & Wijesuriya, Rushani & Mateo, Camila M. & Chong, Shiau & Truong, , 2024. "Racism and health and wellbeing among children and youth–An updated systematic review and meta-analysis," Social Science & Medicine, Elsevier, vol. 361(C).
    10. Lukachko, Alicia & Hatzenbuehler, Mark L. & Keyes, Katherine M., 2014. "Structural racism and myocardial infarction in the United States," Social Science & Medicine, Elsevier, vol. 103(C), pages 42-50.
    11. Pam Phojanakong & Emily Brown Weida & Gabriella Grimaldi & Félice Lê-Scherban & Mariana Chilton, 2019. "Experiences of Racial and Ethnic Discrimination Are Associated with Food Insecurity and Poor Health," IJERPH, MDPI, vol. 16(22), pages 1-13, November.
    12. Johnston, David W. & Lordan, Grace, 2012. "Discrimination makes me sick! An examination of the discrimination–health relationship," Journal of Health Economics, Elsevier, vol. 31(1), pages 99-111.
    13. Slaughter-Acey, Jaime C. & Brown, Tony N. & Keith, Verna M. & Dailey, Rhonda & Misra, Dawn P., 2020. "A tale of two generations: Maternal skin color and adverse birth outcomes in Black/African American women," Social Science & Medicine, Elsevier, vol. 265(C).
    14. Sabo, Samantha & Shaw, Susan & Ingram, Maia & Teufel-Shone, Nicolette & Carvajal, Scott & de Zapien, Jill Guernsey & Rosales, Cecilia & Redondo, Flor & Garcia, Gina & Rubio-Goldsmith, Raquel, 2014. "Everyday violence, structural racism and mistreatment at the US–Mexico border," Social Science & Medicine, Elsevier, vol. 109(C), pages 66-74.
    15. Paula Braveman & Katherine Heck & Susan Egerter & Tyan Parker Dominguez & Christine Rinki & Kristen S Marchi & Michael Curtis, 2017. "Worry about racial discrimination: A missing piece of the puzzle of Black-White disparities in preterm birth?," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-17, October.
    16. Barr, Ashley B. & Simons, Ronald L. & Beach, Steven R.H. & Simons, Leslie Gordon, 2022. "Racial discrimination and health among two generations of African American couples," Social Science & Medicine, Elsevier, vol. 296(C).
    17. Seung-Sup Kim & Yeonseung Chung & S V Subramanian & David R Williams, 2012. "Measuring Discrimination in South Korea: Underestimating the Prevalence of Discriminatory Experiences among Female and Less Educated Workers?," PLOS ONE, Public Library of Science, vol. 7(3), pages 1-8, March.
    18. Bauer, Greta R., 2014. "Incorporating intersectionality theory into population health research methodology: Challenges and the potential to advance health equity," Social Science & Medicine, Elsevier, vol. 110(C), pages 10-17.
    19. Sparkle Springfield-Trice & Grishma Reddy & Cara Joyce & Benito M. Garcia & Palak Shah & Sean Agbor-Enoh & Hannah Valantine, 2025. "Barriers to Immunosuppressant Medication Adherence in Thoracic Transplant Recipients: Initial Findings," IJERPH, MDPI, vol. 22(7), pages 1-30, July.
    20. Krista Stelkia, 2023. "Structural Racism as an Ecosystem: An Exploratory Study on How Structural Racism Influences Chronic Disease and Health and Wellbeing of First Nations in Canada," IJERPH, MDPI, vol. 20(10), pages 1-18, May.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0077174. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.