Racial discrimination associated with higher diastolic blood pressure in a sample of <scp>A</scp>merican <scp>I</scp>ndian adults

Thayer, Zaneta M.; Blair, Irene V.; Buchwald, Dedra; Manson, Spero M.

doi:10.1002/ajpa.23190

Cited by 27 publications

(22 citation statements)

References 62 publications

(71 reference statements)

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“…Cross-sectional studies ( n = 35) assessed race discrimination using a variety of self-report questionnaires and BP was measured with a range of methods (S2 Table). Of these cross-sectional studies, 22 [24–37,37–42] found significant associations between racial discrimination and BP in their primary analysis. Two cross-sectional studies [43,44] did not find a significant association between racial discrimination and BP in their primary analysis among the entire sample.…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2019

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Background There is a high prevalence of cardiovascular disease across diverse groups in the U.S. population, and increasing research has identified stigma as a potential barrier to cardiovascular disease prevention and treatment. This systematic review examines evidence linking discrimination and cardiovascular health among socially stigmatized groups. Study Design Six databases were systematically reviewed from inception through February 2018 for studies with adult subjects, focusing on cardiovascular health indicators among social groups stigmatized because of their gender, race/ethnicity, age, body weight/obesity, or sexual orientation. The Newcastle-Ottawa Scale was used to evaluate the methodological quality and risk of bias for nonrandomized studies, and the Cochrane Collaboration 7-item domain for randomized controlled and experimental trials. Results The search identified 84 eligible studies published between 1984 and 2017. Studies retrieved were categorized according to demonstrated links between stigma and cardiovascular disease risk factors including blood pressure ( n = 45), heart rate variability ( n = 6), blood/saliva cardiovascular biomarkers ( n = 18), as well as other indicators of cardiovascular health ( n = 15). Based on the findings from included studies, 86% concluded that there was a significant relationship among stigma or discrimination and cardiovascular health indicators among socially stigmatized groups. However, there were varying degrees of evidence supporting these relationships, depending on the type of discrimination and cardiovascular health indicator. The current evidence implies an association between perceived discrimination and cardiovascular health. However, a majority of these studies are cross-sectional (73%) and focus on racial discrimination (79%), while using a wide variety of measurements to assess social discrimination and cardiovascular health. Conclusions Future research should include longitudinal and randomized controlled trial designs, with larger and more diverse samples of individuals with stigmatized identities, using consistent measurement approaches to assess social discrimination and its relationship with cardiovascular health.

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Section: Resultsmentioning

confidence: 99%

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

et al. 2019

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“…Exposure to discrimination and microaggressions are most commonly assessed in research via self-report measures and with African American samples [ 1 ], with relatively few measures that consider the unique racial/ethnic group experiences for AI/ANs (e.g., being told “you don’t look Indian”). Although some recent studies describe racial discrimination measures among AI/ANs (e.g., [ 17 , 49 , 55 ]), there has been limited replication or psychometric evaluation (see [ 17 ], for an exception).…”

Section: Introductionmentioning

confidence: 99%

“…Two of the measures were designed for use with any racial/ethnic group (Everyday Discrimination Scale [ 63 ]; Experiences of Discrimination [ 32 ];) and one measure is an AI/AN-specific discrimination and microaggressions scale (Microaggressions Distress Scale, [ 57 ]). While the Everyday Discrimination Scale is the most common measure of discrimination across racial and ethnic groups, only four studies with Indigenous samples have been conducted [ 17 , 49 , 50 , 55 ], sometimes with varying items or instructions.…”

Section: Introductionmentioning

confidence: 99%

Understanding measures of racial discrimination and microaggressions among American Indian and Alaska Native college students in the Southwest United States

2021

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Background Racial discrimination, including microaggressions, contributes to health inequities, yet research on discrimination and microaggressions has focused on single measures without adequate psychometric evaluation. To address this gap, we examined the psychometric performance of three discrimination/microaggression measures among American Indian and Alaska Native (AI/AN) college students in a large Southwestern city. Methods Students (N = 347; 65% female; ages 18–65) completed the revised-Everyday Discrimination Scale, Microaggressions Distress Scale, and Experiences of Discrimination measure. The psychometric performance of these measures was evaluated using item response theory and confirmatory factor analyses. Associations of these measures with age, gender, household income, substance use, and self-rated physical health were examined. Results Discrimination and microaggression items varied from infrequently to almost universally endorsed and each measure was unidimensional and moderately correlated with the other two measures. Most items contributed information about the overall severity of discrimination and collectively provided information across a continuum from everyday microaggressions to physical assault. Greater exposure to discrimination on each measure had small but significant associations with more substance use, lower income, and poorer self-rated physical health. The Experiences of Discrimination measure included more severe forms of discrimination, while the revised-Everyday Discrimination Scale and the Microaggressions Distress Scale represented a wider range of severity. Conclusions In clinical practice, these measures can index varying levels of discrimination for AI/ANs, particularly for those in higher educational settings. This study also informs the measurement of racial discrimination and microaggressions more broadly.

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“…A large body of research implicates the repeated daily experiences of discrimination as both acute and chronic stressors, which increase allostatic load and have long-term health consequences [ 183 ]. Among IP around the world, discrimination and microaggressions have been associated with a higher likelihood of self-reported diabetes among southwest AIs [ 56 ], increased diabetes distress and higher blood pressure in AI from the northern Midwest [ 184 , 185 , 186 ], higher self-reported CVD (including heart attack and stroke) among Maori in New Zealand [ 187 ] and CVD diagnosis among the Indigenous Sami population in Norway [ 188 ].…”

Section: Adulthood Stress and Trauma And Cmdmentioning

confidence: 99%

Stress and Cardiometabolic Disease Risk for Indigenous Populations throughout the Lifespan

Lewis

Volpert‐Esmond

Deen

et al. 2021

IJERPH

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Background: Indigenous people experience the greatest cardiometabolic disease disparity in the Unites States, yet high cardiometabolic disease risk factors do not fully explain the extent of the cardiometabolic disease disparity for Indigenous people. Stress, trauma, and racism occur at high rates within Indigenous communities and have not been well explored as significant contributors to cardiometabolic disease disparities despite emerging literature, and therefore will be described here. Methods: This descriptive study explores the relationship between cardiometabolic disease risks and Indigenous-specific stressors (e.g., early childhood stress and trauma, adulthood stress and trauma, and historical and intergenerational trauma) using current literature. Indigenous-specific protective factors against cardiometabolic disease are also reviewed. Results. Increasing research indicates that there is a relationship between Indigenous-specific stressful and traumatic life experiences and increased cardiometabolic disease risk. Mental health and psychophysiology play an important role in this relationship. Effective interventions to reduce cardiometabolic disease risk in Indigenous communities focus on ameliorating the negative effects of these stressors through the use of culturally specific health behaviors and activities. Conclusions: There is increasing evidence that cultural connection and enculturation are protective factors for cardiometabolic disease, and may be galvanized through Indigenous-led training, research, and policy change.

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Racial discrimination associated with higher diastolic blood pressure in a sample of American Indian adults

Cited by 27 publications

References 62 publications

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

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

Understanding measures of racial discrimination and microaggressions among American Indian and Alaska Native college students in the Southwest United States

Stress and Cardiometabolic Disease Risk for Indigenous Populations throughout the Lifespan

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