Links between discrimination and cardiovascular health among socially stigmatized groups: A systematic review

Panza, Gregory A.; Puhl, Rebecca M.; Taylor, Beth A.; Zaleski, Amanda L.; Livingston, Jill; Pescatello, Linda S.

doi:10.1371/journal.pone.0217623

Cited by 110 publications

(69 citation statements)

References 123 publications

(136 reference statements)

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“…Several studies pointed out that weight-related stigma can lead to negative outcomes, e.g. increased physiological dysfunction ( 27 ), as well as decreased cardiovascular ( 28 ) and mental health ( 12 , 14 ). Moreover, weight-related stigma is associated with increased weight and waist circumference ( 13 , 29 ) and increased risk of becoming overweight ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

Responsibility of Individuals and Stakeholders for Obesity and a Healthy Diet: Results From a German Survey

et al. 2020

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Introduction Overweight and obesity are thought to be mainly caused by an energy-rich diet and a sedentary lifestyle. The opinions of those with and without obesity about an individual´s and stakeholder´s responsibility for overweight and obesity as well as a healthy diet is rather unclear. Therefore, a survey was conducted to assess the thoughts of persons with and without obesity about the responsibilities for a high body weight and healthy diet. Methods This telephone-based survey was conducted in Germany. Landline and mobile phone users older than 17 years were quota sampled to represent the German population (n=1,003). Additionally, 354 adults with a body mass index (BMI) ≥ 30 kg/m 2 were included in the survey population. Questions on weight management, eating and drinking and anthropometry were asked. Furthermore, the opinions of participants on the responsibility of individuals and stakeholders for obesity and a healthy diet were collected. Data was statistically weighted by age, gender, education, domicile, and BMI. Results Data of 1,357 persons (51.1% female, age: 50.5 ± 18.5 years, 15.9% with BMI ≥ 30 kg/m 2 ) were analyzed. Participants responded that the general causes of a high body weight were low physical activity (82.7%) and excessive caloric intake (80.5%) followed by a lack of will power (72.1%). Almost 90% of the survey population reported that each individual is responsible for his/her own healthy diet. More than 85% of the survey population agreed that a healthy diet in kindergarten and nutrition education at schools should be the preferred approaches when politics take care of a person´s healthy diet. Sub-analyses revealed that BMI, sex, age, and education are potential confounders. Conclusion This German survey showed that the majority of participants indicated that the responsibility for a healthy diet lies with the individual and high body weight is caused by self-controlled attitudes. These results suggest that the survey population underestimates societal and environmental factors that contribute to the development of obesity, which could lead to attitudes that facilitate weight-related stigmatization. Furthermore, survey participants indicated that they would support policy-driven measures that promote a healthy diet.

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Section: Discussionmentioning

confidence: 99%

Responsibility of Individuals and Stakeholders for Obesity and a Healthy Diet: Results From a German Survey

et al. 2020

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“…The simultaneous attention to disease interaction and disease concentration keeps in the foreground that physiological dysregulation and possible interactions between COVID‐19 and cardiometabolic disease are socially patterned. Indeed, the same physiological systems that are the focus of interactions among hypertension, diabetes, and COVID‐19 are also involved in the pathways that link neighborhood disadvantage, racial discrimination, and poverty to racial inequities in hypertension and diabetes (Cobb, Parker, & Thorpe, 2020; Dolezsar, McGrath, Herzig, & Miller, 2014; Dusendang et al, 2019; Lei, Beach, & Simons, 2018; Panza et al, 2019; Simons et al, 2018). It is plausible, therefore, that the COVID‐19 pandemic in the U.S. involves both kinds of interactions put forward by syndemic theory: (a) biological interactions between overlapping diseases (ie, diabetes, hypertension, and COVID‐19) and (b) biosocial ones between noxious social conditions and the biological processes involved in progression of SARS‐CoV‐2 infection to COVID‐19 risk.…”

Section: Relevance To Covid‐19mentioning

confidence: 99%

Systemic racism, chronic health inequities, andCOVID‐19: A syndemic in the making?

Gravlee

2020

American J Hum Biol

310

240

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For a brief moment, in the early days of COVID-19, some reports heralded the new coronavirus, SARS-CoV-2, as a "great equalizer." It is unlikely that any anthropologist, human biologist, historian, or public health scientist found this idea tempting. Pandemics always follow the fault lines of society-exposing and often magnifying power inequities that shape population health even in normal times (Wade, 2020). Soon, that stark reality became clear to all. By early April, evidence began to emerge in the United Statesfirst in Milwaukee, then in Detroit, eventually everywhere data were disaggregated by race-that mortality from COVID-19 was disproportionately affecting Black people and communities (Johnson & Buford, 2020). During the entire course of the pandemic so far, data compiled by the non-profit APM Research Lab (2020) has shown that the crude death rate for Black Americans is more than double that for all other racialized groups. When adjusted for age, the risk of death from COVID-19 is as much as nine times higher for African Americans than it is for whites (Bassett, Chen, & Krieger, 2020). This inequity-as appalling as it is-may still underestimate the problem, as data remain woefully incomplete. Despite calls for comprehensive, nationwide data on COVID-19 cases and deaths by race and socioeconomic status, the U.S. federal government has no such system in place, and journalists and scholars have stepped in to collate disaggregated data by race from a patchwork of state health departments. The need for better data remains. But data alone are not enough. We also need an explicit conceptual framework to know what the numbers mean, shape the questions researchers ask, and direct attention to appropriate public health and policy responses. In the absence of such a framework, the legacy of racial-genetic determinism in American medicine makes it likely that excess Black death will be interpreted as intrinsic Black vulnerability-a pattern that has already begun to emerge (Gravlee, 2020). Here I propose that the theory of syndemics may be a useful framework for making sense of the unfolding pandemic and directing future research on COVID-19.

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“…This study lends credence to the fact that CVD may have a low traumatic potential 35 . Although CVD is associated with its share of social stigma 36 , it may be less stigmatized than non-medical trauma (e.g., rape 37 ). Consequently, patients with CVD tend to more naturally utilize their social support network, which is known to have a protective effect against the development of PTSD 38 , thereby potentially contributing to the less psychologically traumatic nature of CVD disease.…”

Section: Discussionmentioning

confidence: 99%

Posttraumatic Stress Disorder and the Nature of Trauma in Patients with Cardiovascular Diseases: A Case-Control study

Cyr

Marcil

Long

et al. 2021

Preprint

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IntroductionA large body of evidence indicates a significant and morbid association between posttraumatic stress disorder (PTSD) and cardiovascular disease (CVD). Few studies, however, have addressed the range of trauma in this medical population, from massive heart attack, to defibrillator shock to previous interpersonal aggression.ObjectiveThe main objective of this study was to examine the nature of trauma associated with the development of PTSD in CVD patients. More precisely, we were interested in knowing if trauma was medical in nature and whether cumulative trauma resulted in PTSD.MethodsWe performed a 1:3 case-control study. The authors compared CVD patients diagnosed with PTSD (n=37) to those with adjustment disorder (n=111) in terms of trauma/stressor types and medical and demographic characteristics.ResultsHalf (51%) of CVD patients suffering from PTSD had endured a medical trauma, 35% an external (non-medical) trauma, and 14% both. There were no significant differences with CVD patients diagnosed with adjustment disorder, 40% of them having experienced a medical stressor, 40% an external (non-medical) stressor and 20% both. Cumulative trauma was seen in only 19% of CVD patients suffering from PTSD. Traditional risk factors (female sex, younger age) were not prominent in CVD patients with PTSD as compared to those with adjustment disorder. Cases were, however, significantly more likely to have psychiatric antecedents and recent surgical interventions.ConclusionsBy uncovering characteristics of PTSD patients/trauma in CVD patients, this work will serve future research and clinical initiatives to better screen at-risk patients or at-risk medical situations.

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Links between discrimination and cardiovascular health among socially stigmatized groups: A systematic review

Cited by 110 publications

References 123 publications

Responsibility of Individuals and Stakeholders for Obesity and a Healthy Diet: Results From a German Survey

Responsibility of Individuals and Stakeholders for Obesity and a Healthy Diet: Results From a German Survey

Systemic racism, chronic health inequities, andCOVID‐19: A syndemic in the making?

Posttraumatic Stress Disorder and the Nature of Trauma in Patients with Cardiovascular Diseases: A Case-Control study

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