Abstract
Association of Perceived Lifetime Discrimination With COVID-19 Infection, Hospitalization and Death: The Collaborative Cohort of Cohorts for COVID-19 Research (C4R) Study
Circulation (New York, N.Y.), v 149(Suppl_1), P240
19 Mar 2024
Abstract
Rationale: Perceived discrimination adversely impacts individual and population health. However, limited studies have examined associations between discrimination and COVID-19 severity in a diverse cohort of adults. We investigated the association between lifetime discrimination and risk of severe COVID-19.
Methods: This study included Black, Chinese, Hispanic, and White participants (45-84 years of age) from the Multi-Ethnic Study of Atherosclerosis (MESA). Lifetime discrimination (experiences of unfair treatment in 6 domains) was assessed at baseline (2000-2002). Incident COVID-19 was ascertained by the Collaborative Cohort of Cohorts for COVID-19 Research (C4R) via questionnaires, serosurvey, and medical records in 2020-2023. Hospitalized and fatal cases were defined as severe; all other cases were defined as non-severe. Associations of lifetime discrimination and incident severe and non-severe COVID-19 were examined via Fine-Gray proportional sub-distribution hazards models, adjusting for covariates. Effect modification by sex, race/ethnicity, and educational attainment was tested.
Results: Of 3,441 participants (mean age 76 years, 54% female, 13% Chinese, 20% Hispanic, 25% Black, 41% White), there were 248 cases of non-severe COVID-19 and 83 cases of severe COVID-19. Individuals reporting lifetime discrimination in ≥2 domains (vs none) had a two-fold higher hazard of severe COVID-19. Effect modification was observed by sex (P=.003) and educational attainment (P=.072), but not by race/ethnicity (P=.24). In stratified models, associations of lifetime discrimination and severe COVID-19 were stronger in women versus men and in participants with lower versus higher educational attainment ( Table ).
Conclusion: Lifetime discrimination was associated with greater risk of severe COVID-19, particularly in women and persons with lower educational attainment. Further research is needed to understand mechanisms underlying these associations and to inform prevention and risk mitigation.
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Details
- Title
- Association of Perceived Lifetime Discrimination With COVID-19 Infection, Hospitalization and Death: The Collaborative Cohort of Cohorts for COVID-19 Research (C4R) Study
- Creators
- Kellee White Whilby - University of Maryland, College ParkYiqun Jin - Columbia UniversityPallavi Balte - Columbia UniversityDebora Kamin Mukaz - University of VermontKaren Hinckley Stukovsky - University of WashingtonJana Hirsch - Drexel UniversityNorrina B Allen - Northwestern UniversityWendy S Post - Johns Hopkins UniversityMario Sims - University of California, RiversideElizabeth Oelsner - Columbia University
- Publication Details
- Circulation (New York, N.Y.), v 149(Suppl_1), P240
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS; PHILADELPHIA
- Number of pages
- 3
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Urban Health Collaborative; Epidemiology and Biostatistics
- Web of Science ID
- WOS:001265904800259
- Other Identifier
- 991021889615504721
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Peripheral Vascular Disease