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Discrimination Experiences and All-Cause and Cardiovascular Mortality: Multi-Ethnic Study of Atherosclerosis
Journal article   Open access   Peer reviewed

Discrimination Experiences and All-Cause and Cardiovascular Mortality: Multi-Ethnic Study of Atherosclerosis

Wayne R Lawrence, Gieira S Jones, Jarrett A Johnson, Koya P Ferrell, Jacquita N Johnson, Meredith S Shiels, Ana V Diez Roux and Allana T Forde
Circulation Cardiovascular quality and outcomes, v 16(4), 009697
05 Apr 2023
DOI: https://doi.org/10.1161/CIRCOUTCOMES.122.009697
PMID: 37017086
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1161/circoutcomes.122.009697View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open
url
https://doi.org/10.1161/CIRCOUTCOMES.122.009697View
Published, Version of Record (VoR) Open

Abstract

racism ethnicity heart disease mortality residential segregation
Epidemiologic studies have documented the associations between experiences of discrimination and adverse health outcomes. However, the relationship between discrimination and mortality, and the factors that may moderate this relationship are not well understood. This study examined whether lifetime and everyday discrimination were associated with all-cause and cardiovascular mortality and whether these associations differed by race and ethnicity, gender, and racial and ethnic residential segregation. The study included 1633 Black, 1403 Hispanic/Latino, and 2473 White participants aged 45 to 84 years from the Multi-Ethnic Study of Atherosclerosis, enrolled from 2000 to 2002 and followed across 5 exams (2002-2018). Discrimination was measured using the lifetime discrimination (major experiences of unfair treatment) and everyday discrimination (day-to-day experiences of unfair treatment) scales. Racial and ethnic residential segregation was measured using the statistic. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% CIs, adjusting for sociodemographic characteristics, health behaviors, and clinical risk factors. Each increase in reports of lifetime discrimination was associated with increased all-cause (HR, 1.06 [95% CI, 1.00-1.11]) and cardiovascular (HR, 1.15 [95% CI, 1.04-1.27]) mortality, adjusting for sociodemographic factors, health behaviors, and clinical risk factors. Associations between lifetime discrimination and cardiovascular mortality were observed across all racial and ethnic groups but were strongest and only statistically significant among Black participants (HR, 1.18 [95% CI, 1.02-1.37]). Additionally, in the fully adjusted model, each increase in reports of everyday discrimination was strongly associated with increased cardiovascular mortality (HR, 1.21 [95% CI, 1.03-1.43]). Associations for lifetime and everyday discrimination with all-cause and cardiovascular mortality were not modified by race and ethnicity, gender, or racial and ethnic residential segregation. These findings suggest that experiences of discrimination are associated with increased all-cause and cardiovascular mortality.

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14 Record Views
25 citations in Web of Science
11 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#10 Reduced Inequalities
#3 Good Health and Well-Being

InCites Highlights

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Collaboration types
Domestic collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
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