Perceived discrimination increases health risks among African Americans, UF Health research finds
University of Florida Health researchers have found a significant association between perceived discrimination and worsening severity of a health condition known as metabolic syndrome in African Americans.
“We found that African Americans who reported higher scores for everyday and lifetime discrimination also had more severe metabolic syndrome,” said Michelle Cardel, Ph.D., R.D., an assistant professor in the UF College of Medicine’s department of health outcomes and biomedical informatics.
People with metabolic syndrome have three or more risk factors for Type 2 diabetes and heart disease, including excess abdominal fat, high blood pressure, high blood sugar, low HDL (good) cholesterol and high triglycerides.
Other studies have shown that as many as one in three African American adults has metabolic syndrome, making them five times more likely to develop Type 2 diabetes and twice as likely to develop heart disease as healthy people with fewer or no risk factors.
According to Cardel, poor diet, physical inactivity and cigarette smoking all contribute to the development and severity of metabolic syndrome. But Cardel’s research, published recently in the Annals of Behavioral Medicine, suggests perceived racial discrimination also plays a significant role.
“Our findings suggest that discrimination may be an important risk factor for heart disease and diabetes in African Americans,” Cardel said.
Cardel’s team evaluated data collected over eight years from 3,870 African American adults participating in the Jackson Heart Study, the largest longitudinal study of African Americans ever conducted. Since 2000, researchers with the Jackson Heart Study have been collecting data from thousands of African American women and men living in Jackson, Mississippi, to help understand why African Americans have higher rates of cardiovascular disease, or CVD, and higher rates of premature deaths from CVD than non-Hispanic white Americans do. The Jackson Heart Study is funded by the National Heart, Lung and Blood Institute, a branch of the National Institutes of Health.
The UF Health team calculated the severity of metabolic syndrome using data collected from the study participants at the beginning of the study period and again eight years later.
The researchers used participant responses to questionnaires to assess their individual experiences with and reactions to three categories of discrimination: everyday discrimination, lifetime discrimination and the lifetime burden of discrimination.
To measure everyday discrimination, participants were asked how often during a typical day they felt they were treated less courteously, given poor service or treated unfairly. They were also asked how often others treated them as dishonest or threatening. Responses ranged from “never’’ to ‘‘several times a day.’’
To assess lifetime discrimination, participants were asked about the number of times in their lifetime they experienced unfair treatment at school, getting a job, at work, getting housing, getting resources or money, getting medical care, on the street or at another public place, and getting services.
Participants who reported experiencing lifetime discrimination in at least one area were asked questions about the burden of lifetime discrimination, such as, “When you had experiences like these over your lifetime, have they been very stressful, moderately stressful or not stressful?”
The team also gathered information on participants’ education and income level, along with health habits such as cigarette smoking, alcohol consumption, diet and physical activity.
Across both visits and controlling for other variables, the team found that participants who had higher scores for everyday and lifetime discrimination also had more severe metabolic syndrome, especially middle-aged adults.
Previous studies have found correlations between perceived discrimination and prevalence of metabolic syndrome in other minority groups.
Cardel said one way discrimination can undermine physical health is by activating a stress response in the body, which releases a flood of hormones like cortisol. Repeated activation of the stress response can lead to wear and tear on the body over time and increase an individual’s risk for diabetes and heart disease.
“This study, as well as the work of others, highlights the adverse health outcomes that result from racism and discrimination,” Cardel said.