Burden of Unfair Treatment and Subclinical Atherosclerotic Risk Among Black Adults: The Moderating Role of Religious...

This study examined whether religious coping modified the longitudinal associations between lifetime discrimination and subclinical atherosclerotic cardiovascular disease risk among Black individuals, and if these effects differed by sex.

Data were collected from 753 Black adult participants (44.5% men; mean age=49.3 years) in the Healthy Aging in Neighborhoods of Diversity across the Life Span study. Carotid intima-media thickness (CIMT) was measured using ultrasonography at baseline (Wave 1: 2004-2009) and a subsequent follow-up visit (Wave 4: 2013-2017). Abnormal CIMT was defined as ≥1.0 mm of plaque buildup. Religious coping, racial discrimination, and burden of lifetime discrimination were self-reported at baseline.

Mixed-effects multivariable logistic regression analyses estimated the longitudinal associations between a 3-way interaction term (discrimination, religious coping, and sex) and abnormal CIMT in models adjusted for age and socioeconomic status. For Black men, those who engaged in religious coping the least had higher odds of abnormal CIMT for both racial (OR=1.22, 95% CI [1.02-1.48], P=0.03) and burden of lifetime discrimination (OR=1.75, 95% CI [1.14-2.69], P=0.01). The associations were attenuated at higher levels of religious coping. No associations were found among women.

The effects of discrimination on abnormal CIMT lessened as religious coping increased for Black men. Future research is needed to disentangle how aspects of religious coping might yield benefits linked with atherosclerotic cardiovascular disease risk for this group and identify alternative psychosocial resources effective in mitigating discrimination effects on health for Black women.