Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA.
Department of Medicine, University of Mississippi Medical Center, Jackson Heart Study, 350 W. Woodrow Wilson Drive, Jackson, MS, 39213, USA.
J Racial Ethn Health Disparities. 2018 Oct;5(5):1084-1092. doi: 10.1007/s40615-017-0457-7. Epub 2018 Jan 8.
Although discrimination among African Americans (AAs) has been linked to various health outcomes, few studies have examined associations of multiple measures of discrimination with prevalent subclinical disease in a large sample of AAs.
To examine the associations of measures of discrimination and coping responses to discrimination with prevalent subclinical disease among AAs in the Jackson Heart Study (JHS); and whether this association is modified by sex.
We examined the associations of everyday, lifetime, and burden of lifetime discrimination with carotid intima-media thickness (cIMT), and left ventricular hypertrophy (LVH) among 3029 AAs in the JHS. Prevalence ratios (PR 95% confidence interval-CI) and odds ratios (OR 95% CI) were estimated for above-median cIMT and LVH, respectfully, adjusting for demographic, behavioral, and clinical risk factors.
No significant associations were found between everyday and lifetime discrimination and median cIMT and LVH. Participants who reported high (vs. no) burden of lifetime discrimination had a 48% reduced odds of LVH (OR, 0.52; 95% CI, 0.29, 0.94) after full adjustment. There was evidence of effect modification by sex in the association of coping with everyday discrimination and LVH after full adjustment (p value for interaction < 0.01). Women who actively (vs. passively) coped with everyday discrimination had a greater odds of prevalent LVH (OR, 2.49; 95% CI, 1.39, 4.46).
This study suggests that the manner by which AA women cope with discriminatory events is associated with subclinical disease.
尽管非裔美国人（AA）所遭受的歧视与各种健康结果有关，但很少有研究调查多种歧视措施与大量 AA 亚临床疾病之间的关联。
在 Jackson 心脏研究（JHS）中，研究歧视措施和应对歧视的应对方式与 AA 亚临床疾病之间的关联；以及这种关联是否因性别而异。
我们研究了日常、终身和终身歧视负担与 JHS 中 3029 名 AA 的颈动脉内膜中层厚度（cIMT）和左心室肥厚（LVH）之间的关联。分别调整人口统计学、行为和临床危险因素后，估计了高于中位数的 cIMT 和 LVH 的比值比（PR 95%置信区间-CI）和比值比（OR 95% CI）。
日常和终身歧视与中位数 cIMT 和 LVH 之间没有显著关联。与无（vs. 有）终生歧视负担的参与者相比，报告高（vs. 无）终生歧视负担的参与者 LVH 的几率降低了 48%（OR，0.52；95% CI，0.29，0.94），经过充分调整后。在充分调整后，应对日常歧视与 LVH 的关联存在性别效应修饰的证据（交互作用检验 p 值<0.01）。与被动应对日常歧视的女性相比，积极应对日常歧视的女性发生 LVH 的几率更高（OR，2.49；95% CI，1.39，4.46）。
这项研究表明，AA 女性应对歧视事件的方式与亚临床疾病有关。
