Racial Discrimination and Cardiovascular Disease Risk in African American and White Adults and the Role of Race and Socioeconomic Status 公开
Speight, Candace (2014)
Abstract
Recently, there has been increased interest in studying racial discrimination as a predictor of cardiovascular health. African Americans report more racial discrimination than Whites and are overrepresented among those with cardiovascular disease (CVD). Additionally, among African Americans, those with high socioeconomic status (SES) report the most racial discrimination; thus discrimination may impact CVD health differently, depending on SES level. This study examined the association between Experiences of Discrimination and two indicators of CVD risk --C-reactive protein (CRP) and sleep quality. It further examined whether the association between racial discrimination and CVD risk was stronger for African Americans compared to Whites and whether the effect of racial discrimination differed by education level among African Americans. Data came from META-Health, a two-stage cross-sectional random-digit dialing study of African American and White adults (n=3391). A subset (n=458) attended a clinic visit for further interview and clinical assessment. Linear regression analyses were used to evaluate the relationship between racial discrimination and both CRP and sleep quality after adjusting for demographic factors, additional risk factors and depression. Racial discrimination was a not a significant predictor of CRP levels (p > 0.05) and there was no race by racial discrimination interaction (p > 0.05). There was also no education by racial discrimination interaction among African Americans (p > 0.05). Racial discrimination was a significant predictor of decreased sleep quality (reference: 0 experiences; 1-2 experiences: β =1.09, p = 0.004; 3+ experiences: β = 0.88, p = 0.02) although the effect was similar for both races (p = 0.36). Among African Americans with a high school education or less, those who reported 1-2 experiences of racial discrimination had significantly lower sleep quality (β = 4.32, p = 0.02) compared to those who reported no racial discrimination. However, this relationship was attenuated by depression in the final model (β = 2.48, p = 0.13). In conclusion, although racial discrimination was not significantly associated with CRP levels, it was significantly associated with poor sleep quality in both African Americans and Whites. In African Americans, this effect seemed to hold only for low SES African Americans.
Table of Contents
Chapter I --Background...1
Chapter II - Manuscript... 8
Title, Authors...8
Abstract...9
Introduction...10
Methods...12
Results...16
Discussion...19
References...23
Tables...30
Chapter III- Summary, Public Health Implications and Future Directions...37
Appendix...40
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