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Impact of Discrimination on Cardiovascular Mortality Rates


A new study set out to delve deeper into the relationship between discrimination and mortality to find out who it affects most. 

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Experiencing discrimination may increase the chance of dying, especially from cardiovascular-related causes, according to a study published in Circulation: Cardiovascular Quality and Outcomes on April 5.

Previous studies have found links between discrimination and conditions such as heart disease, diabetes and obesity, but this new study set out to delve deeper into the relationship between discrimination and mortality to find out who it affects most. Lifetime discrimination was much more common among Black participants, at 61%, compared to 39% among Hispanic participants and 37% among white participants.

The research team studied 4,506 people from different racial backgrounds, aged 45 to 84, between 2000 and 2018. They asked participants about unfair treatment in various areas like work and housing. They also inquired about daily experiences of discrimination, such as being treated disrespectfully or underestimated in intelligence.

The study showed a link between more experiences of unfair treatment throughout life and higher mortality rates from various cardiovascular conditions. The rise in cardiovascular deaths was highest and reached statistical significance only for Black participants, with an 18% increased risk. Meanwhile, the effect of everyday discrimination on cardiovascular mortality risk reached statistical significance only among white participants, who had an increased risk of 51%. The researchers said this might reflect white participants with lower socioeconomic status or who belong to ethnic groups that experience historical prejudice, such as Jewish people.

Men reported slightly higher cardiovascular death rates than women. Wayne Lawrence, the study's lead author and a research fellow at the National Cancer Institute, said that although the research team did not explore the reasons for this disparity, previous studies suggest women are better at seeking support and coping with discrimination. 

While he'd expected a higher death rate for people experiencing discrimination, Lawrence said he didn't expect it to be "so much higher for cardiovascular mortality." He urged health care professionals and policymakers to take proactive measures, such as screening people for stressors and providing resources to mitigate health impacts. He has also emphasized the need for future research to identify the most impactful forms of discrimination and practical strategies to reduce its effects.

While the study touched on residential segregation, it lacked sufficient data for conclusive findings. It also did not assess how discrimination affects the health of Asian Americans. Future research, Lawrence says, should strive to fill these gaps. 

Dr. Karol Watson, a cardiologist and professor of medicine at the David Geffen School of Medicine at the University of California, Los Angeles, who was not involved in the research, said the study’s observational structure and the subjective nature of discrimination were limitations. Still, she praised it as "an important study that tries to tease out the association between experiences of discrimination and mortality."

Watson also said doctors must factor discrimination "into our risk estimations" and encourage people to seek social support. She called for future studies on how social support, mindfulness and psychological interventions might improve health outcomes.

American Heart Association