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Ashe J, Bentley-Edwards K, Skipper A, Cuevas A, Vieytes CM, Bah K, Evans MK, Zonderman AB, Waldstein SR. Racial Discrimination, Religious Coping, and Cardiovascular Disease Risk Among African American Women and Men. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02113-x. [PMID: 39160432 DOI: 10.1007/s40615-024-02113-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 07/10/2024] [Accepted: 07/26/2024] [Indexed: 08/21/2024]
Abstract
OBJECTIVE This cross-sectional study examined whether religious coping buffered the associations between racial discrimination and several modifiable cardiovascular disease (CVD) risk factors-systolic and diastolic blood pressure (BP), glycated hemoglobin (HbA1c), body mass index (BMI), and cholesterol-in a sample of African American women and men. METHODS Participant data were taken from the Healthy Aging in Neighborhoods of Diversity Across the Life Span study (N = 815; 55.2% women; 30-64 years old). Racial discrimination and religious coping were self-reported. CVD risk factors were clinically assessed. RESULTS In sex-stratified hierarchical regression analyses adjusted for age, socioeconomic status, and medication use, findings revealed several significant interactive associations and opposite effects by sex. Among men who experienced racial discrimination, religious coping was negatively related to systolic BP and HbA1c. However, in men reporting no prior discrimination, religious coping was positively related to most risk factors. Among women who had experienced racial discrimination, greater religious coping was associated with higher HbA1c and BMI. The lowest levels of CVD risk were observed among women who seldom used religious coping but experienced discrimination. CONCLUSION Religious coping might mitigate the effects of racial discrimination on CVD risk for African American men but not women. Additional work is needed to understand whether reinforcing these coping strategies only benefits those who have experienced discrimination. It is also possible that religion may not buffer the effects of other psychosocial stressors linked with elevated CVD risk.
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Affiliation(s)
- Jason Ashe
- Laboratory of Epidemiology and Population Sciences, National Institute On Aging, Baltimore, MD, USA.
| | - Keisha Bentley-Edwards
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Duke Cancer Institute, Duke University, Durham, NC, USA
- Samuel DuBois Cook Center On Social Equity, Duke University, Durham, NC, USA
| | - Antonius Skipper
- The Gerontology Institute, Georgia State University, Atlanta, GA, USA
| | - Adolfo Cuevas
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, USA
- Center for Anti-Racism, Social Justice, and Public Health, New York University School of Global Public Health, New York, NY, USA
| | - Christian Maino Vieytes
- Laboratory of Epidemiology and Population Sciences, National Institute On Aging, Baltimore, MD, USA
| | - Kristie Bah
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute On Aging, Baltimore, MD, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute On Aging, Baltimore, MD, USA
| | - Shari R Waldstein
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD, USA
- Division of Gerontology, Geriatrics, and Palliative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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Batayeh B, Shelton R, Factor-Litvak P, Link BG, Suglia SF. Racial Disparities in Avoidant Coping and Hypertension Among Midlife Adults. J Racial Ethn Health Disparities 2023; 10:410-417. [PMID: 35040108 PMCID: PMC9346605 DOI: 10.1007/s40615-022-01232-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/08/2021] [Accepted: 01/05/2022] [Indexed: 02/03/2023]
Abstract
While associations between stress and hypertension have been documented, little research has examined the association between coping and hypertension, especially in the context of understanding racial disparities. Utilizing data from the CHDS-DISPAR study, we examine the association between avoidant coping and hypertension among adults age 50 while assessing for potential differences across (1) coping in response to the general stress and discrimination and (2) African American and White racial groups. Coping was measured using a 9-item scale with an avoidant coping subscale (e.g., drinking alcohol). Mean avoidance coping scores were calculated for both general stress and discrimination. No racial differences in avoidant coping were found. Within our sample (n = 414), there was a high burden of hypertension among African American respondents compared to White respondents (50.3% vs. 22.6%). Models assessed associations between avoidant coping and hypertension adjusted for sociodemographic factors, obesity, and either experience of stress or discrimination depending on the coping domain examined. Avoidant coping in response to the general stress and discrimination was associated with increased hypertension among White respondents (PR: 1.63 [95%CI 1.01, 2.24]; PR: 1.69 [95%CI 1.12, 2.26], respectively) and no associations among African American respondents (PR: 0.83 [95%CI 0.57, 1.09]; PR: 0.82 [95%CI 0.52, 1.12], respectively). This research suggests that racial disparities in hypertension may not be attributable to individual-level coping behaviors.
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Affiliation(s)
- Brian Batayeh
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA, 30322, USA
| | - Rachel Shelton
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, 722 West 168th Street, New York, NY, 10032, USA
| | - Bruce G Link
- Department of Sociology, University of California Riverside, Riverside, CA, USA
| | - Shakira F Suglia
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA, 30322, USA.
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Teteh DK, Dawkins-Moultin L, Hooker S, Hernandez W, Bonilla C, Galloway D, LaGroon V, Santos ER, Shriver M, Royal CDM, Kittles RA. Genetic ancestry, skin color and social attainment: The four cities study. PLoS One 2020; 15:e0237041. [PMID: 32813691 PMCID: PMC7446776 DOI: 10.1371/journal.pone.0237041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/17/2020] [Indexed: 12/26/2022] Open
Abstract
Introduction The Black population in the US is heterogeneous but is often treated as monolithic in research, with skin pigmentation being the primary indicator of racial classification. Objective: This paper examines the differences among Blacks by comparing genetic ancestry, skin color and social attainment of 259 residents across four US cities—Norman, Oklahoma; Cincinnati, Ohio; Harlem, New York; and Washington, District of Columbia. Methods Participants were recruited between 2004 and 2006 at community-based forums. Cross-sectional data were analyzed using chi-square tests, correlation analyses and logistic regression. Results There were variations in ancestry, melanin index and social attainment across some cities. Overall, men with darker skin color, and women with lighter skin color were significantly more likely to be married. Darker skin individuals with significantly more West African ancestry reported attainment of graduate degrees, and professional occupations than lighter skin individuals. Conclusions Our findings suggest differences in skin pigmentation by geography and support regional variations in ancestry of US Blacks. Biomedical research should consider genetic ancestry and local historical/social context rather than relying solely on skin pigmentation as a proxy for race.
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Affiliation(s)
- Dede K. Teteh
- Division of Health Equities, Department of Population Sciences, City of Hope Medical Center, Duarte, California, United States of America
| | - Lenna Dawkins-Moultin
- Department of Health Disparities Research, M.D. Anderson Cancer Center, Houston, Texas, United States of America
| | - Stanley Hooker
- Division of Health Equities, Department of Population Sciences, City of Hope Medical Center, Duarte, California, United States of America
| | - Wenndy Hernandez
- Department of Medicine, Section of Cardiology, University of Chicago, Chicago, Illinois, United States of America
| | - Carolina Bonilla
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, Butanta, Brazil
| | - Dorothy Galloway
- Division of Health Equities, Department of Population Sciences, City of Hope Medical Center, Duarte, California, United States of America
| | - Victor LaGroon
- Division of Health Equities, Department of Population Sciences, City of Hope Medical Center, Duarte, California, United States of America
| | | | - Mark Shriver
- Department of Anthropology, The Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - Charmaine D. M. Royal
- Department of African & African American Studies, Duke University, Durham, North Carolina, United States of America
| | - Rick A. Kittles
- Division of Health Equities, Department of Population Sciences, City of Hope Medical Center, Duarte, California, United States of America
- * E-mail:
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