Dimensions of and Responses to Perceived Discrimination and Subclinical Disease Among African-Americans in the Jackson Heart Study.

BACKGROUND: Although discrimination among African Americans (AAs) has been linked to various health outcomes, few studies have examined associations of multiple measures of discrimination with prevalent subclinical disease in a large sample of AAs. OBJECTIVES: To examine the associations of measures of discrimination and coping responses to discrimination with prevalent subclinical disease among AAs in the Jackson Heart Study (JHS); and whether this association is modified by sex. METHODS: We examined the associations of everyday, lifetime, and burden of lifetime discrimination with carotid intima-media thickness (cIMT), and left ventricular hypertrophy (LVH) among 3029 AAs in the JHS. Prevalence ratios (PR 95% confidence interval-CI) and odds ratios (OR 95% CI) were estimated for above-median cIMT and LVH, respectfully, adjusting for demographic, behavioral, and clinical risk factors. RESULTS: No significant associations were found between everyday and lifetime discrimination and median cIMT and LVH. Participants who reported high (vs. no) burden of lifetime discrimination had a 48% reduced odds of LVH (OR, 0.52; 95% CI, 0.29, 0.94) after full adjustment. There was evidence of effect modification by sex in the association of coping with everyday discrimination and LVH after full adjustment (p value for interaction < 0.01). Women who actively (vs. passively) coped with everyday discrimination had a greater odds of prevalent LVH (OR, 2.49; 95% CI, 1.39, 4.46). CONCLUSIONS: This study suggests that the manner by which AA women cope with discriminatory events is associated with subclinical disease.

Duke Scholars

Author LaShaunta Glover Population Health Sciences