Discrimination and Cardiovascular Health in Black Americans: Exploring Inflammation as a Mechanism and Perceived
Carrington C Merritt1, Keely A Muscatell
1From the Department of Psychology and Neuroscience (Merritt, Muscatell), Lineberger Comprehensive Cancer Center (Muscatell), and Carolina Population Center (Muscatell), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Psychosomatic Medicine
|March 4, 2024
Summary
Discrimination increases cardiovascular risk in Black Americans through inflammation. Perceived control may offer protection against these effects, suggesting potential intervention targets.
Area of Science:
- Social Epidemiology
- Psychoneuroimmunology
- Health Disparities Research
Background:
- Systemic inflammation is a potential mechanism linking discrimination to cardiovascular disease.
- Psychosocial factors, such as perceived control, may buffer the adverse health impacts of discrimination.
- Racial health disparities in cardiovascular health are a significant public health concern.
Purpose of the Study:
- To investigate if systemic inflammation mediates the relationship between discrimination and cardiovascular health.
- To examine whether perceived control moderates the association between discrimination, inflammation, and cardiovascular health.
- To explore potential protective factors against the cardiovascular consequences of discrimination in Black Americans.
Main Methods:
- Cross-sectional study of 347 non-Hispanic/Latinx Black adults from the Midlife in the United States study.
- Assessment of perceived control and daily discrimination via self-report.
- Measurement of inflammation using C-reactive protein (CRP), interleukin-6 (IL-6), fibrinogen, and tumor necrosis factor α; cardiovascular health assessed by morbidity of heart disease, hypertension, and/or stroke.
Main Results:
- C-reactive protein (CRP) and fibrinogen levels mediated the association between discrimination and cardiovascular conditions.
- Perceived control significantly moderated the relationship between discrimination and CRP levels.
- Inflammation's mediating role in linking discrimination to cardiovascular conditions was evident primarily in individuals with low perceived control.
Conclusions:
- Inflammation serves as an empirical mechanism connecting experiences of discrimination to cardiovascular conditions among Black Americans.
- Perceived control demonstrates a potential protective effect, mitigating the negative impact of discrimination on cardiovascular health.
- Beliefs about control represent a promising target for interventions aimed at reducing discrimination-related cardiovascular risks in Black Americans.
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