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Published on: November 30, 2015
Perceived Discrimination, Trauma, Mental Health, and Blood Pressure Outcomes Among Young African American/Black
Alexandria Nyembwe1, Yihong Zhao2, Eugenia Millender3
1Alexandria Nyembwe, PhD, MBA, RN, PMH-BC, Center for Research on People of Color, Columbia University School of Nursing, New York, New York.
Background:
African American (AA) women are disproportionately affected by hypertension. Discrimination, which can be traumatic, and depressive symptoms are independently associated with blood pressure (BP).
Objective:
We assessed whether the combined influence of discrimination and race-related trauma and depressive symptoms influenced BP over time.
Methods:
We conducted a secondary data analysis of data from a longitudinal cohort study examining factors associated with BP in 250 AA/Black mother-child dyads. Eligible participants were AA/Black mothers, 21 years and older, with a biological child aged 3-5 years. Clinical (BP, body mass index) and psychosocial measures (racial discrimination, major discrimination, race-related stress, depressive symptoms) were examined. Principal component analysis and linear regression were completed to assess the associations of discrimination, race-related trauma, and depressive symptoms with maternal BP.
Results:
Data from 183 participants were analyzed. Principal component analysis identified 2 key components: overall discrimination and race-related trauma (principal component 1) and depressive symptoms (principal component 2), which explained 83% of data variation. Linear regression analyses revealed principal component 1 was associated with changes in systolic BP ( b = 0.92; P = .04), whereas principal component 2 was not ( b = 0.31; P = .71).
Conclusions:
Our findings highlight the need to further explore experiences of discrimination and race-related trauma as a contributing factor for hypertension. In addition, building on existing efforts, future studies should further analyze the presentation of depressive symptoms among AA women to inform the development and validation of culturally sensitive screening tools that effectively capture these symptoms and enhance access to care.
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