From the Department of Epidemiology (Van Dyke, Lewis), Rollins School of Public Health, Emory University, Atlanta, Georgia; Department of Native Hawaiian Health (Baumhofer), John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii; Department of Epidemiology and Biostatistics (Slopen), School of Public Health, University of Maryland, College Park, Maryland; Division of Epidemiology (Mujahid), School of Public Health, University of California at Berkeley, Berkeley, California; and Brigham and Women's Hospital (Clark), Harvard Medical School, and Department of Social and Behavioral Sciences (Williams), Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
Psychosom Med. 2020 Apr;82(3):316-323. doi: 10.1097/PSY.0000000000000788.
This study aimed to examine associations among race, the accumulation of multiple forms of discriminatory experiences (i.e., "pervasive discrimination"), and allostatic load (AL) in African Americans and whites in midlife.
Using data collected in 2004 to 2006 from 226 African American and 978 white adults (57% female; mean [SD] age = 54.7 [0.11] years) in the Midlife in the United States II Biomarker Project, a pervasive discrimination score was created by combining three discrimination scales, and an AL score was created based on 24 biomarkers representing seven physiological systems. Linear regression models were conducted to examine the association between pervasive discrimination and AL, adjusting for demographics and medical, behavioral, and personality covariates. A race by pervasive discrimination interaction was also examined to determine whether associations varied by race.
African Americans had higher pervasive discrimination and AL scores than did whites. In models adjusted for demographics, socioeconomic status, medications, health behaviors, neuroticism, and negative affect, a pervasive discrimination score of 2 versus 0 was associated with a greater AL score (b = 0.30, SE = 0.07, p < .001). Although associations seemed to be stronger among African Americans as compared with whites, associations did not statistically differ by race.
More pervasive discrimination was related to greater multisystemic physiological dysregulation in a cohort of African American and white adults. Measuring discrimination by combining multiple forms of discriminatory experiences may be important for studying the health effects of discrimination.
本研究旨在检验种族、多种形式的歧视经历积累(即“普遍歧视”)与中年非裔美国人和白种人之间的应激负荷(AL)之间的关联。
使用 2004 年至 2006 年在美国中期生物标志物项目中收集的 226 名非裔美国人和 978 名白人成年人(57%为女性;平均[SD]年龄=54.7[0.11]岁)的数据,通过合并三个歧视量表创建了一个普遍歧视评分,根据代表七个生理系统的 24 个生物标志物创建了一个 AL 评分。采用线性回归模型,调整人口统计学、医疗、行为和人格协变量,检验普遍歧视与 AL 之间的关联。还检验了种族与普遍歧视的交互作用,以确定关联是否因种族而异。
非裔美国人的普遍歧视和 AL 评分均高于白人。在调整人口统计学、社会经济地位、药物、健康行为、神经质和负性情绪的模型中,普遍歧视评分从 2 变为 0 与 AL 评分增加(b=0.30,SE=0.07,p<0.001)相关。尽管与白人相比,非裔美国人的关联似乎更强,但关联在统计学上并未因种族而异。
在一个非裔美国人和白种人成年人队列中,更多的普遍歧视与多系统生理失调的相关性更大。通过合并多种形式的歧视经历来衡量歧视可能对研究歧视的健康影响很重要。