CMHC Pulse Blog

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Perceived experiences of racism in employment, housing and the criminal justice system are associated with increased incidence for coronary heart disease (CHD) among Black women, researchers reported. The findings were reported at the American Heart Association’s Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions 2023.

“Many Black adults in the U.S. are already at higher risk of developing heart disease due to high blood pressure or type 2 diabetes,” Shanshan Sheehy, ScD, assistant professor of medicine at Boston University Chobanian & Avedisian School of Medicine, said in a press release. “Current evidence shows that racism may act as a chronic stressor in the human body and chronic stress may lead to high blood pressure, which increases the risk of heart attack and stroke.”

Sheehy and colleagues analyzed data from 48,297 participants in the Black Women’s Health Study, initiated in 1997, with follow-up through 2019. Participants were free of cardiovascular disease (CVD) and cancer at baseline.

Researchers assessed participant responses to five questions about perceived interpersonal racism in everyday activities, such as “How often do people act as if they think you are dishonest?” Researchers then calculated a score for self-perceived interpersonal racism in everyday life by averaging participants’ responses.

Participants also answered three additional questions that asked, “Have you ever been treated unfairly due to your race in any of the following circumstances?” The questions assessed interactions in employment, housing and encounters with police. For those questions, researchers averaged scores that ranged from 0 (no to all) to 3 (yes to all). Researchers then assessed the relationship of perceived interpersonal racism with incident CHD.

During 22 years of follow-up, researchers observed 1,036 incident CHD cases. Women in the highest quartile of perceived interpersonal racism in daily life had a 21% increased risk for incident CHD (HR = 1.21; 95% CI, 0.99-1.48; P for trend = .05) compared with women in the lowest quartile.

Women who reported experience of racism in employment, housing and the criminal justice system had a 29% increased risk for CHD (HR = 1.29; 95% CI, 1.03-1.63; P for trend = .05) compared with women who did not report perceived racism.

“Research is needed to examine the impacts of structural racism on cardiovascular health, as well as to evaluate the joint impacts of perceived interpersonal racism and structural racism,” Sheehy said in the release.


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