Everyday Discrimination and Metabolic Syndrome Incidence in a Racially/Ethnically Diverse Sample: Study of Women's Health Across the Nation

Moody, Danielle L. Beatty; Chang, Yue; Brown, Charlotte; Bromberger, Joyce T.; Matthews, Karen A.

doi:10.1097/psy.0000000000000516

Cited by 39 publications

(33 citation statements)

References 39 publications

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“…In the U.S., the broad health impacts of racially patterned social stress can be seen not only for non-Hispanic Blacks (Beatty Moody et al, 2018; Chae et al, 2010; Guyll et al, 2001; Lewis et al, 2010; Zahodne, Kraal, Zaheed, et al, 2019), but also for Hispanics (Beatty Moody et al, 2018; Cuevas et al, 2016; Molina et al, 2019), who represent the largest and fastest-growing minority group in the U.S. (Colby & Ortman, 2015). For example, greater racial/ethnic discrimination was associated with psychological distress, unhealthy body mass index, and sleep disturbances in a sample of 1,332 Hispanic adults in the Texas City Stress and Health Study (Garcini et al, 2018).…”

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confidence: 99%

Socioeconomic and psychosocial mechanisms underlying racial/ethnic disparities in cognition among older adults.

Zahodne¹,

Sharifian²,

Kraal³

et al. 2021

Neuropsychology

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Objective: Racial/ethnic disparities in cognitive aging are only partly attributable to socioeconomic indicators. Psychosocial factors, such as discrimination and perceived control, also differ across racial/ ethnic groups, and emerging literature highlights their potential role in contributing to cognitive disparities in addition to socioeconomic status. Method: 1,463 older adults (51% Hispanic, 27% non-Hispanic Black, and 22% non-Hispanic White) in the Washington Heights-Inwood Columbia Aging Project completed cognitive and psychosocial measures, including a comprehensive neuropsychological battery, Everyday and Major Experiences of Lifetime Discrimination scales, and the Perceived Control scale. Mediation models quantified separate indirect effects of Black race and Hispanic ethnicity on global cognitive composite scores through education, income, discrimination, and external perceived control. Results: Educational attainment, income, and perceived control each mediated racial/ethnic disparities in global cognition. Socioeconomic indicators (i.e., lower education and lower income) explained approximately 50% of the Black-White and Hispanic-White disparities in global cognition, and more external perceived control explained an additional 5%-8%. Hispanics reported the lowest levels of discrimination, while non-Hispanic Blacks reported the highest levels. However, neither everyday nor major lifetime discrimination was associated with global cognition. Significant racial/ethnic disparities in global cognition remained after accounting for the included socioeconomic and psychosocial factors. Conclusions: This study suggests that psychosocial factors may explain racial/ethnic disparities in cognitive aging above and beyond socioeconomic indicators. More external perceived control, which could reflect chronic exposure to interpersonal and institutional marginalization, may be a particularly salient psychosocial risk factor for poorer cognitive aging among non-Hispanic Black and Hispanic older adults. Key PointsQuestion: What factors explain racial/ethnic inequalities in cognitive functioning among older adults? Findings: Lower socioeconomic status and lower perceived control each contribute independently to racial/ethnic inequalities in cognitive functioning. Importance: Targeting both economic and psychosocial factors may help to reduce racial/ethnic inequalities in cognitive aging. Next Steps: Future research should disentangle causal pathways to inequality involving socioeconomic and psychosocial factors, which may be interactive and/or bidirectional.

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confidence: 99%

Socioeconomic and psychosocial mechanisms underlying racial/ethnic disparities in cognition among older adults.

Zahodne¹,

Sharifian²,

Kraal³

et al. 2021

Neuropsychology

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“…Recent studies using the Everyday Discrimination Scale have found a significant impact of reported discrimination on incident MetS (hazard ratio=1.33) among US women, 33 but only a weak association (OR=1.06) for ethnic groups living in the Netherlands. 34 Racial discrimination is one of many possible forms of unfair treatment, and new research emphasizes the need to consider the joint effects of multiple types of discrimination, both to gauge overall exposure and also to identify loci of unfair treatment rele-vant to prevention.…”

Section: Discussionmentioning

confidence: 97%

A Structural Model of Social Determinants of the Metabolic Syndrome

et al. 2020

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Objectives: The metabolic syndrome (MetS) refers to a cluster of interrelated physiological characteristics that are associated with an increased risk of cardiovascular disease and diabetes. While the clinical usefulness of the MetS has been the subject of controversy for years, increasingly sophisticated methods are being used to measure the concept.Participants: Study of community health center patients who were not diabetic; study group was evenly divided between Black and White adults.Methods: Structural equation modeling of MetS incorporating the effects of race/ethnicity, racial discrimination, socioeconomic position (SEP), and selected mediating variables.Main Outcome Measure: Latent MetS score and MetS status based on the five-point scale developed by the National Cholesterol Education Panel (NCEP).Results: The largest influences on latent MetS scores were SEP (negative relationship) and male gender (higher scores for men). Two mediating variables, physical activity and stress-related eating, had smaller impacts. Self-reported racial discrimination was associated with cynical hostility but did not influence the MetS level among nondiabetics. Despite higher NCEP scores and MetS prevalence rates for Blacks compared with Whites, race did not have direct effect on MetS levels when adjusted for the other characteristics in our model.Conclusions: Neither race nor self-reported racial discrimination had direct effects on MetS level in our structural model. The large effects of socioeconomic position and male gender were not mediated by the other variables in the model.Ethn Dis. 2020;30(2):331-338; doi:10.18865/ ed.30.2.331

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“…Transwomen of color may experience particularly high levels of discrimination and adverse health outcomes [ 60 , 62 ]. Discrimination experienced by women of color in midlife is associated with increased risk of hypertension and metabolic syndrome, higher levels of C-reactive protein, a nonspecific marker of inflammation, as well as reduced breast and cervical cancer screening [ 82 – 84 ]. Given the interconnectedness of social identities, discrimination, and health outcomes, it is particularly important for providers to create space during clinical encounters for patients to share their experiences.…”

Section: Considerations For Discussing Racism With Patients: Intersectionalitymentioning

confidence: 99%

This is our lane: talking with patients about racism

Diop

Taylor

Murillo

et al. 2021

womens midlife health

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Racism has significantly impacted communities of color for centuries. The year 2020 is a reminder that racism is an ongoing public health crisis. Healthcare institutions have an important role in dismantling racism because of their ability to implement innovative solutions that advance diversity, address social determinants of health, and promote health equity. Healthcare professionals have the unique opportunity to support patients by discussing patients’ experiences of bias and racism. Asking about discrimination, however, can be difficult because of the sensitive nature of the topic and lack of appropriate education. This review highlights the importance of addressing patients’ experiences of racism, utilizing the frameworks of trauma-informed care, structural competency, provider bias, and intersectionality. Furthermore, this review provides ways to engage in meaningful dialogue around discrimination and includes important patient-centric resources.

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Everyday Discrimination and Metabolic Syndrome Incidence in a Racially/Ethnically Diverse Sample: Study of Women's Health Across the Nation

Abstract: Everyday discrimination contributes to poorer metabolic health in midlife women in the United States. These findings have clinical implications for the development of MetS and, ultimately, cardiovascular disease and diabetes, and intervention strategies to reduce these outcomes.

Cited by 39 publications

References 39 publications

Socioeconomic and psychosocial mechanisms underlying racial/ethnic disparities in cognition among older adults.

Socioeconomic and psychosocial mechanisms underlying racial/ethnic disparities in cognition among older adults.

A Structural Model of Social Determinants of the Metabolic Syndrome

This is our lane: talking with patients about racism

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