From the Department of Psychology and Neuroscience (Merritt, Muscatell), Lineberger Comprehensive Cancer Center (Muscatell), and Carolina Population Center (Muscatell), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Psychosom Med. 2024 Apr 1;86(3):181-191. doi: 10.1097/PSY.0000000000001300. Epub 2024 Mar 4.
Inflammation may be an integral physiological mechanism through which discrimination impacts cardiovascular health and contributes to racial health disparities. Limited research has examined psychosocial factors that protect against the negative effects of discrimination on inflammation. Perceived control is a promising possible protective factor, given that it has been shown to moderate the relationship between other psychosocial stressors and physiological outcomes. This study thus tested whether systemic inflammation mediated the link between discrimination and cardiovascular health and whether perceived control moderated this relationship.
Data for this project included 347 non-Hispanic/Latinx Black adults (mean [standard deviation] age = 51.64 [11.24] years; 33% female) taken from the Midlife in the United States study. Perceived control and daily discrimination were assessed via self-report, and inflammation was measured via circulating levels of C-reactive protein (CRP), interleukin-6 (IL-6), fibrinogen, and tumor necrosis factor α. Cardiovascular health was measured by morbidity of cardiovascular conditions: heart disease, hypertension, and/or stroke.
CRP (indirect effect: b = 0.004, 95% confidence interval [CI] = 0.001-0.007) and fibrinogen (indirect effect: b = 0.002, 95% CI = 0.0003-0.005) mediated the link between discrimination and cardiovascular conditions. Perceived control moderated the relationship between discrimination and CRP ( F (1, 293) = 4.58, Δ R2 = 0.013, b = -0.02, SE = 0.01, p = .033). CRP mediated the link between discrimination and cardiovascular conditions only for those who reported low levels of perceived control (Index = -0.003, 95% CI = -0.007 to -0.0001).
Findings provide empirical evidence of inflammation as a mechanism linking discrimination to cardiovascular conditions among Black Americans. Additionally, perceived control may be protective. Findings could suggest beliefs about control as a potential intervention target to help reduce the negative effects of discrimination on cardiovascular health among Black Americans.
炎症可能是一种完整的生理机制，通过该机制，歧视会影响心血管健康，并导致种族健康差异。有限的研究探讨了保护人们免受歧视对炎症的负面影响的心理社会因素。由于已经表明，知觉控制可以调节其他心理社会压力源与生理结果之间的关系，因此它是一种很有前途的保护因素。因此，本研究测试了系统性炎症是否在歧视与心血管健康之间的联系中起中介作用，以及知觉控制是否调节了这种关系。
本项目的数据来自美国中年生活研究中的 347 名非西班牙裔/拉丁裔黑人成年人（平均[标准差]年龄=51.64[11.24]岁；33%为女性）。通过自我报告评估知觉控制和日常歧视，通过循环 C 反应蛋白（CRP）、白细胞介素 6（IL-6）、纤维蛋白原和肿瘤坏死因子α的水平来衡量炎症。心血管健康通过心血管疾病的发病率来衡量：心脏病、高血压和/或中风。
CRP（间接效应：b=0.004，95%置信区间[CI] = 0.001-0.007）和纤维蛋白原（间接效应：b=0.002，95%CI = 0.0003-0.005）介导了歧视与心血管疾病之间的联系。知觉控制调节了歧视与 CRP 之间的关系（F（1,293）=4.58，ΔR2=0.013，b=-0.02，SE=0.01，p=0.033）。只有那些报告知觉控制水平较低的人，CRP 才会介导歧视与心血管疾病之间的联系（指数=-0.003，95%CI=-0.007 至-0.0001）。
研究结果为炎症作为一种机制提供了实证证据，该机制将歧视与美国黑人的心血管疾病联系起来。此外，知觉控制可能具有保护作用。这些发现可能表明，控制信念可能是一个潜在的干预目标，有助于减少歧视对美国黑人心血管健康的负面影响。
