Perceived stress following race-based discrimination at work is associated with hypertension in African–Americans. The metro Atlanta heart disease study, 1999–2001

• Published in: Social science & medicine (1982) Vol. 58; no. 3; pp. 449 - 461
• Main Authors: Din-Dzietham, Rebecca, Nembhard, Wendy N, Collins, Rakale, Davis, Sharon K
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-02-2004; Elsevier; Pergamon Press Inc
• Series: Social Science & Medicine
• Subjects: Adult; African Americans; African Americans - psychology; Arterial hypertension. Arterial hypotension; Atlanta; Atlanta, Georgia; between-group racism; Biological and medical sciences; Black American people; Blood and lymphatic vessels; Blood Pressure; Cardiology. Vascular system; Cardiovascular disease; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Cross-Sectional Studies; Discrimination; discrimination Perceived stress Hypertension Blood pressure Worksite USA; Employment; Female; Georgia; Georgia (U.S.A.); Health; Heart Diseases; Heart Diseases - ethnology; Humans; Hypertension; Hypertension - ethnology; Hypertension - etiology; Inter/between-group racism/discrimination; Intra-group discrimination; Intra-group discrimination Inter; Logistic Models; Male; Medical sciences; Medicine; Mental stress; Middle Aged; Occupational stress; Perceived stress; Perception; Prejudice; Racial discrimination; Racism; Social sciences; Stress; Stress, Psychological - complications; Stress, Psychological - ethnology; U.S.A; Urban Health; USA; Workplace - psychology; Worksite; United States; North America; America; Georgia; Atlanta Georgia; United States > US; USA, Georgia, Atlanta; Hypertension; USA; Worksite; Intra-group discrimination; Blood pressure; Perceived stress; Inter/between-group racism/discrimination; Work place; Statistical analysis; Negroid; Cardiovascular disease; Stress; Discrimination; Heart disease; Race; Work; Social aspect; Public health; African American
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/S0277-9536(03)00211-9

There is increasing evidence of an association between stress related to job strain and hypertension. However little data exist on stress from racism and race-based discrimination at work (RBDW). The objective of this study was to investigate whether blood pressure (BP) outcomes are positively associated with stressful racism towards African–Americans from non-African–Americans as well as RBDW from other African–Americans. The metro Atlanta heart disease study was a population-based study which included 356 African–American men and women, aged ⩾21 years, residing in metropolitan Atlanta, Georgia during 1999–2001. Perceived stress was self-reported by 197 participants for racism from non-African–Americans and 95 for RBDW from other African–Americans. Sitting systolic (SBP) and diastolic (DBP) BP were taken at a clinic visit and was the average of the last two of three BP measures. Hypertension was self-reported as physician-diagnosed high BP on 2 or more visits. Logistic and least-squares linear regression models were fit accordingly and separately for each type of stress, adjusting for age, gender, body mass index, and coping abilities. The likelihood of hypertension significantly increased with higher levels of perceived stress following racism from non-African–Americans, but not from RBDW from other African–Americans; adjusted odd ratios (95% CI) were 1.4 (1.0, 1.9) and 1.2 (0.8, 1.5) per unit increment of stress. The adjusted magnitude of SBP and DBP increase between low and very high level of stress, conversely, was greater when RBDW originated from African–Americans than racism from non-African–Americans. Stressful racism and RBDW encounters are associated with increased SBP and DBP and increased likelihood of hypertension in African–Americans. Future studies with a larger sample size are warranted to further explore these findings for mechanistic understanding and occupational policy consideration regarding stress risk reduction.