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Racial discrimination & cardiovascular disease risk: my body my story study of 1005 US-born black and white community health center participants (US).

Publication ,  Journal Article
Krieger, N; Waterman, PD; Kosheleva, A; Chen, JT; Smith, KW; Carney, DR; Bennett, GG; Williams, DR; Thornhill, G; Freeman, ER
Published in: PloS one
January 2013

To date, limited and inconsistent evidence exists regarding racial discrimination and risk of cardiovascular disease (CVD).Cross-sectional observational study of 1005 US-born non-Hispanic black (n = 504) and white (n = 501) participants age 35-64 randomly selected from community health centers in Boston, MA (2008-2010; 82.4% response rate), using 3 racial discrimination measures: explicit self-report; implicit association test (IAT, a time reaction test for self and group as target vs. perpetrator of discrimination); and structural (Jim Crow status of state of birth, i.e. legal racial discrimination prior 1964).Black and white participants both had adverse cardiovascular and socioeconomic profiles, with black participants most highly exposed to racial discrimination. Positive crude associations among black participants occurred for Jim Crow birthplace and hypertension (odds ratio (OR) 1.92, 95% confidence interval (CI) 1.28, 2.89) and for explicit self-report and the Framingham 10 year CVD risk score (beta = 0.04; 95% CI 0.01, 0.07); among white participants, only negative crude associations existed (for IAT for self, for lower systolic blood pressure (SBP; beta = -4.86; 95% CI -9.08, -0.64) and lower Framingham CVD score (beta = -0.36, 95% CI -0.63, -0.08)). All of these associations were attenuated and all but the white IAT-Framingham risk score association were rendered null in analyses that controlled for lifetime socioeconomic position and additional covariates. Controlling for racial discrimination, socioeconomic position, and other covariates did not attenuate the crude black excess risk for SBP and hypertension and left unaffected the null excess risk for the Framingham CVD score.Despite worse exposures among the black participants, racial discrimination and socioeconomic position were not associated, in multivariable analyses, with risk of CVD. We interpret results in relation to constrained variability of exposures and outcomes and discuss implications for valid research on social determinants of health.

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Published In

PloS one

DOI

EISSN

1932-6203

ISSN

1932-6203

Publication Date

January 2013

Volume

8

Issue

10

Start / End Page

e77174

Related Subject Headings

  • White People
  • Socioeconomic Factors
  • Risk Factors
  • Racism
  • Prejudice
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Humans
  • General Science & Technology
 

Citation

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Chicago
ICMJE
MLA
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Krieger, N., Waterman, P. D., Kosheleva, A., Chen, J. T., Smith, K. W., Carney, D. R., … Freeman, E. R. (2013). Racial discrimination & cardiovascular disease risk: my body my story study of 1005 US-born black and white community health center participants (US). PloS One, 8(10), e77174. https://doi.org/10.1371/journal.pone.0077174
Krieger, Nancy, Pamela D. Waterman, Anna Kosheleva, Jarvis T. Chen, Kevin W. Smith, Dana R. Carney, Gary G. Bennett, David R. Williams, Gisele Thornhill, and Elmer R. Freeman. “Racial discrimination & cardiovascular disease risk: my body my story study of 1005 US-born black and white community health center participants (US).PloS One 8, no. 10 (January 2013): e77174. https://doi.org/10.1371/journal.pone.0077174.
Krieger N, Waterman PD, Kosheleva A, Chen JT, Smith KW, Carney DR, et al. Racial discrimination & cardiovascular disease risk: my body my story study of 1005 US-born black and white community health center participants (US). PloS one. 2013 Jan;8(10):e77174.
Krieger, Nancy, et al. “Racial discrimination & cardiovascular disease risk: my body my story study of 1005 US-born black and white community health center participants (US).PloS One, vol. 8, no. 10, Jan. 2013, p. e77174. Epmc, doi:10.1371/journal.pone.0077174.
Krieger N, Waterman PD, Kosheleva A, Chen JT, Smith KW, Carney DR, Bennett GG, Williams DR, Thornhill G, Freeman ER. Racial discrimination & cardiovascular disease risk: my body my story study of 1005 US-born black and white community health center participants (US). PloS one. 2013 Jan;8(10):e77174.

Published In

PloS one

DOI

EISSN

1932-6203

ISSN

1932-6203

Publication Date

January 2013

Volume

8

Issue

10

Start / End Page

e77174

Related Subject Headings

  • White People
  • Socioeconomic Factors
  • Risk Factors
  • Racism
  • Prejudice
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Humans
  • General Science & Technology