Coping, Discrimination, and Physical Health Conditions Among Predominantly Poor, Urban African Americans: Implications for Community-Level Health Services

Abstract

African Americans and ethnic minorities experience racial discrimination in a variety of settings. Racial discrimination is a potent stressor that has been linked to psychosocial stress and poor physical health. To cope with discriminatory experiences and daily life event stressors, African Americans frequently use the concept of John Henryism (a high effort coping strategy with prolonged exposure to stress). This cross-sectional analysis explored the relationship between racism/discrimination, John Henryism, and health problems in a predominately African American sample. Data were collected through health care screenings for hypertension, diabetes, and obesity and a self-report survey to assess experiences of discrimination and use of John Henryism. Logistic and linear regression models were used to assess the relationship between the John Henryism score, racism/discrimination score, and health problems among 352 participants. John Henryism was associated with a decrease in systolic blood pressure (b = − 12.50, 95% CI = − 23.05, − 1.95) among men, after adjusting for experiences of racism/discrimination and demographic characteristics. Experiences of racism/discrimination were associated with an increase in systolic blood pressure (b = 11.23, 95% CI = 0.38, 22.09) among men, after adjusting for John Henryism and demographic characteristics. Among women, there was no association found between John Henryism and experiences of racism/discrimination with systolic blood pressure. No association was found between John Henryism and experiences of racism/discrimination with being overweight/obese in women nor men. The study found that John Henryism was positively associated with the health of men, while experiences of racism/discrimination were negatively associated with their health. Limitations of the study are discussed, and recommendations are made to guide future research exploring the concept of John Henryism as a relevant factor between stress, racial discrimination and poor health.

Racial-Ethnic Inequity in Young Adults With Type 1 Diabetes

“…We also found that Black–White disparity in glycemic control stemmed from higher levels of self-reported diabetes distress and lower self-management scores in Black YA. The exact causes of these self-reports cannot be discerned from this study, but prior studies have suggested that low social and disease-related support in low SES communities contributes to higher perceived stress and lower self-management ( 48 ). In the YA context, support for diabetes-related distress and self-management may be particularly necessary during the developmental transition to adulthood as well ( 10 ).…”

Health Equity Among Black Women in the United States

“…Racial discrimination is a toxic ''uncontrollable or unpredictable'' stressor that is associated not only with poor physical health but also with psychological stress. [76][77][78][81][82][83][84][85] Chronic stressors reduce coping resources and increase vulnerability to mental health problems. 76,85 Non-Hispanic Blacks with higher levels of multiple stress measures are less likely to achieve intermediate or ideal levels of overall CV health.…”

“…[76][77][78][81][82][83][84][85] Chronic stressors reduce coping resources and increase vulnerability to mental health problems. 76,85 Non-Hispanic Blacks with higher levels of multiple stress measures are less likely to achieve intermediate or ideal levels of overall CV health. 86 Research suggests that chronic exposure to environmental stressors, such as racism, across the life span contributes to the weathering of the health of Black women, increasing their allostatic load and, consequently, compromising their reproductive health.…”

“…86 Research suggests that chronic exposure to environmental stressors, such as racism, across the life span contributes to the weathering of the health of Black women, increasing their allostatic load and, consequently, compromising their reproductive health. 76,77,[81][82][83][84][85] Allostatic load is a measure of the physiological dysregulation that results from cumulative chronic stress on the body. 76,87 It is a relevant measure for health disparities research because it can be utilized to assess racial/ethnic differences in biological responses to stressors and their relationship with adverse health outcomes.…”

Black and Minority Ethnic (BAME) Alliance Against COVID-19: One Step Forward

“…It is also important to assess the need to decrease cultural barriers, which may prevent BAME from benefiting from the full services provided by the NHS. In addition, racial discrimination was also shown to be associated with diabetes and hypertension [13][14][15][16]. Significant exposure to stress can decrease immunity, and stress in BAME population can be attributed to social isolation, lack of spiritual activities, concern about wellbeing and health of families in the UK and overseas, financial constraints and the fading of resilience especially with longer duration of the lockdown [17].…”