Maternal experiences of ethnic discrimination and child cardiometabolic outcomes in the Study of Latino Youth

Childhood Racism and Cardiometabolic Risk in Latina Mothers Across the First Postpartum Year

OBJECTIVE

Immigrant Latinas, particularly of Mexican descent, initially achieve healthy perinatal outcomes. Although this advantage wears off across generations in the United States (US), the early life psychosocial mechanisms that may initiate a cascade of biological vulnerabilities remain elusive. The current investigation aimed to understand the extent to which childhood experiences of racism may contribute to elevated levels of C-reactive protein (CRP), an early indicator of cardiometabolic risk, during the first postpartum year.

METHODS

Latinas from the Community and Child Health Network ( N = 457) retrospectively reported experiences of childhood racism and childhood country of residence via structured questionnaires. Interviewers collected CRP bloodspots and height and weight measurements for body mass index at 6 months and 1 year postpartum.

RESULTS

Latinas who grew up in the US experienced a steeper increase of CRP levels across the first postpartum year ( β = 0.131, p = .009) and had higher CRP levels 1 year postpartum than Latinas who grew up in Latin America. Based on Bayesian path analyses, Latinas who grew up in the US reported higher levels of childhood racism than Latinas who immigrated after childhood ( β = 0.27; 95% credible interval = 0.16-0.37). In turn, childhood racism mediated the relationship between country of childhood residence and elevated CRP at 6 months and 1 year postpartum, even after adjusting for sociodemographic and behavioral covariates. After adjusting for body mass index, mediational relationships became nonsignificant.

CONCLUSIONS

This study is an important first step toward understanding how childhood racism may contribute to postmigratory health patterns among Latinas, particularly cardiometabolic risk 1 year after childbirth.

Racial/Ethnic Discrimination and Cardiometabolic Diseases: A Systematic Review

INTRODUCTION

Racial discrimination has been identified as a risk factor for cardiometabolic diseases, the leading cause of morbidity and mortality among racial/ethnic minority groups; however, there is no synthesis of current knowledge on the association between discrimination and cardiometabolic diseases. The objective of this systematic review was to summarize evidence linking racial/ethnic discrimination and cardiometabolic diseases.

METHODS

The review was conducted based on studies identified via electronic searches of 5 databases (PubMed, Google Scholar, WorldWideScience.org, ResearchGate and Microsoft Academic) using terms related to discrimination and cardiometabolic disease.

RESULTS

Of the 123 eligible studies included in the review, 87 were cross-sectional, 25 longitudinal, 8 quasi-experimental, 2 randomized controlled trials and 1 case-control. Cardiometabolic disease outcomes discussed were hypertension (n = 46), cardiovascular disease (n = 40), obesity (n = 12), diabetes (n = 11), metabolic syndrome (n = 9), and chronic kidney disease (n = 5). Although a variety of discrimination measures was employed across the studies, the Everyday Discrimination Scale was used most often (32.5%). African Americans/Blacks were the most frequently studied racial/ethnic group (53.1%), and American Indians the least (0.02%). Significant associations between racial/ethnic discrimination and cardiometabolic disease were found in 73.2% of the studies.

DISCUSSION

Racial/ethnic discrimination is positively associated with increased risk of cardiometabolic disease and higher levels of cardiometabolic biomarkers. Identifying racial/ethnic discrimination as a potential key contributor to the health inequities associated with cardiometabolic diseases is important for addressing the significant burden borne by racial/ethnic minorities.

Risk and protective processes in the link between racial discrimination and Chinese American mothers' psychologically controlling parenting

OBJECTIVES

Racial-ethnic minority parents' experiences with racial discrimination may function as a contextual stressor that negatively impacts psychological functioning to shape less effective parenting practices, including the use of more psychological control. Moreover, various factors can enhance or diminish psychological functioning in the face of racial discrimination. Accordingly, we examined the associations between Chinese American mothers' experiences of racial discrimination and three subdimensions of psychologically controlling parenting by considering the mediating roles of negative (depressive symptoms) and positive (psychological well-being) psychological functioning and the moderating role of maternal acculturation toward the mainstream culture (AMC) as a protective factor.

METHOD

Participants comprised 226 Chinese American mothers of preschoolers (Mage = 37.65; SDage = 4.39). Two separate moderated-mediation models with depressive symptoms or psychological well-being as mediators were tested using maximum-likelihood estimation.

RESULTS

Findings revealed significant direct positive associations between racial discrimination and all three subdimensions of psychological control (love withdrawal, guilt induction, and shaming practices), as well as indirect associations through depressive symptoms but not psychological well-being. Importantly, the indirect associations were further moderated by maternal AMC.

CONCLUSIONS

Results illustrate the importance of incorporating the contextual stressor of perceived racial discrimination in parenting determinant models and examining specific and nuanced processes in understanding the role of psychological adjustment. Support for Chinese American mothers' engagement in and access to various resources in the mainstream cultural context may help alleviate the adverse impact of racial discrimination on mothers' psychological health and ultimately on their negative parenting behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The associations among racial discrimination, pubertal timing, neighborhoods, and mental health among U.S. Mexican boys

The present study addressed gaps in puberty and weathering research by examining the relation between peer racial discrimination, pubertal timing, internalizing and externalizing symptoms, and neighborhood context among a longitudinal sample of U.S. Mexican boys. Using three waves of data (N = 383; mean ages: 10.3-15.8 years), we examined the weathering hypothesis: Whether peer racial discrimination experiences in late childhood predicted earlier pubertal timing in adolescence and subsequent mental health problems. We also examined whether variability in youths' neighborhood contexts qualified these associations. Consistent with the weathering hypothesis, exposure to peer racial discrimination in 5th grade, predicated earlier pubertal timing in the 7th grade, which, in turn, predicted increases in internalizing symptoms in the 10th grade. However, this pattern only applied to boys residing in neighborhoods with higher levels of Latinx concentration in 5th grade. Additionally, early timing in the 7th grade predicted increases in externalizing symptoms, but this association was significant only when boys lived in neighborhoods that were lower on Latinx concentration. There was evidence of weathering in context with specific implications for internalizing symptoms, and that neighborhood Latinx concentration was both inhibiting and promoting at unique places in the hypothesized model. The findings advance existing understandings of weathering patterns and individual variation in pubertal timing among U.S. Mexican boys. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Health of Hispanic Children from Birth to Emerging Adulthood

This article summarizes frameworks for understanding Hispanic children's health, sources of national data available to evaluate their health, and variations in health among Hispanic children. Following ecological and life-course perspectives, we organize our review of the literature on Hispanic children's health and development according to three key stages of child development (zero to three, early to middle childhood, and adolescence to emerging adulthood) with attention to how each stage influences the next. Within each stage, we consider how social position (i.e. skin color, social class, gender, and nativity), social contexts (i.e. family, school, and neighborhood), and political and legal contexts influence Hispanic children's health and development. To improve the health and development of Hispanic children, federal, state, and local policies must address social and economic injustices that lead to declines in health across immigrant generations and persistent racial/ethnic health disparities.

Social Determinants of Cardiovascular Health in African American Children With CKD: An Analysis of the Chronic Kidney Disease in Children (CKiD) Study

RATIONALE & OBJECTIVE

To identify differences in socioeconomic factors (SES) and subclinical cardiovascular disease (CVD) markers by race among Chronic Kidney Disease in Children (CKiD) participants and determine whether differences in CVD markers persist after adjusting for SES.

STUDY DESIGN

Analysis of 3,103 visits with repeated measures from 628 children (497 White participants; 131 African American participants) enrolled in the CKiD study.

SETTING & PARTICIPANTS

Children with mild-moderate CKD with at least 1 cardiovascular (CV) parameter (ambulatory blood pressure, left ventricular mass index [LVMI], or lipid profile) measured.

EXPOSURE

African American race.

OUTCOMES

Ambulatory hypertension, LVMI, triglycerides, high-density lipoprotein cholesterol.

ANALYTICAL APPROACH

Due to increased CV risks of glomerular disease, the analysis was stratified by CKD cause. Inverse probability weighting was used to adjust for SES (health insurance, household income, maternal education, food insecurity, abnormal birth history). Linear and logistic regression were used to evaluate association of race with CV markers.

RESULTS

African American children were disproportionately affected by adverse SES. African Americans with nonglomerular CKD had more instances of ambulatory hypertension and higher LVMI but more favorable lipid profiles. After adjustment for SES, age, and sex, the magnitude of differences in these CV markers was attenuated but remained statistically significant. Only LVMI differed by race in the glomerular CKD group, despite adjustment for SES.

LIMITATIONS

Study design limits causal inference.

CONCLUSION

African American children with CKD are disproportionately affected by socioeconomic disadvantages compared with White children. The degree to which CV markers differ by race is influenced by disease etiology. African Americans with nonglomerular CKD have increased LVMI, more ambulatory hypertension, and favorable lipid profile, but attenuation in magnitude after adjustment for SES was observed. African Americans with glomerular CKD had increased LVMI, which persisted after SES adjustment. As many social determinants of health were not captured, future research should examine effects of systemic racism on CV health in this population.

Experiences of racial discrimination and cardiometabolic risk among Australian children

Cardiometabolic disease is a leading cause of adult morbidity and mortality globally. There is considerable evidence that childhood adversity is associated with markers of cardiometabolic disease risk in childhood, including obesity, blood pressure trajectories, and chronic inflammation. Experiences of racial discrimination may be an important, yet under explored, form of childhood adversity influencing childhood cardiometabolic risk. This study aimed to examine associations between self-reported racial discrimination and cardiometabolic risk markers among children. A total of 124 children (73 female) aged 11.4 years (SD 0.71) participated in the study. Most children (n = 79) identified as being from an Indigenous or an ethnic minority background. Markers of cardiometabolic risk were BMI, waist circumference, weight height ratio, systolic and diastolic blood pressure, and five inflammatory markers (C-reactive protein (CRP), Interleukin (IL)-1β, IL-6, IL-8, and TNF-α). Results showed that two or more reported experiences of racial discrimination were associated with increased BMI z-score (Beta 0.58, 95% CI 0.18, 0.99), waist circumference (Beta 4.91 cm, 95% CI 0.71, 9.1), systolic blood pressure (Beta 2.07 mmHg, 95% CI 0.43, 3.71) and IL-6 (Beta 0.13, 95% CI 0.00, 0.27) and marginally associated with TNF-α (Beta 0.22, 95% CI -0.09, 0.54) after adjusting for socio-demographic covariates. Findings from this study suggest the need to address racism and racial discrimination as important social determinants of cardiometabolic risk and of the inequitable burden of cardiometabolic disease experienced by those from Indigenous and minoritized ethnic backgrounds.

Racial discrimination and child and adolescent health in longitudinal studies: A systematic review

RATIONALE

The association between racial discrimination and adverse health outcomes has been documented across an increasing body of evidence in recent years, although a close examination of longitudinal studies has not yet taken place. This review applied a life course lens in examining the evidence for a longitudinal association between racial discrimination exposure during childhood and adolescence, and later mental and physical health outcomes.

METHOD

Medline, PsycINFO, Global Health, ERIC, CINAHL Plus, Academic Search Premier and SocINDEX were searched from earliest records to October 2017 for eligible articles. Results were described through a narrative synthesis of the evidence.

RESULTS

Findings from 46 studies reported in 88 empirical articles published between 2003 and 2017 were identified. Studies were primarily based on cohorts from the United States, comprised of young people aged 11-18 years, and were published since 2010. Data were most frequently collected over two to three timepoints at intervals exceeding 12 months. Statistically significant associations with racial discrimination were most commonly reported for behaviour problems including delinquency and risk-taking behaviour, with significant adverse effects found in 74% of these associations. Statistically significant adverse effects were also reported in 63% of associations with health-harming behaviours including substance use, and 61% found associations with mental health outcomes. Consistently significant associations were reported between accumulated racism and later health outcomes, and the health effects of racism were reported to vary with developmental periods, although few studies featured these analyses.

CONCLUSIONS

Evidence from this review highlights that the duration and timing of exposure to racial discrimination matters. This review emphasises the need to gain evidence for the mechanisms linking early racism exposure to adverse health outcomes in later life. Future longitudinal research can address this need by capitalising on prospective cohort studies and ensuring that proposed analysis informs variable selection and timing of data collection.