Racism in employment, housing, police interactions may raise Black women's heart disease risk

Interpersonal racism experienced through employment, housing and interactions with police may increase the risk for heart disease in Black women, new research suggests.

The findings, considered preliminary until full results are published in a peer-reviewed journal, were presented Wednesday at the American Heart Association's Epidemiology, Prevention, Lifestyle and Cardiometabolic Health conference in Boston.

"Many Black adults in the U.S. are already at higher risk of developing heart disease due to high blood pressure or Type 2 diabetes," lead study author Shanshan Sheehy said in a news release. Sheehy is an assistant professor at Boston University's Slone Epidemiology Center and Chobanian & Avedisian School of Medicine.

"Current evidence shows that racism may act as a chronic stressor in the human body, and chronic stress may lead to high blood pressure, which increases the risk of heart attack and stroke," she said.

In the new study, researchers scored and analyzed responses to questions about interpersonal racism from roughly 48,000 Black women enrolled in the Black Women's Health Study, the largest follow-up study on the health of Black women in the U.S. The women were free of cardiovascular disease and cancer when they filled out the questionnaires in 1997, and they ranged in age from 22 to 72.

By 2019, 1,036 of the women had developed coronary heart disease.

Perceived interpersonal racism scores were calculated for questions related to everyday life activities and those related to jobs, housing and police interactions. For example, one question asked how often the women felt people suspected them of being dishonest. Employment questions focused on hiring, promotions and firings, while other questions asked about how the women felt they were treated when renting or buying a home and applying for mortgages. They also were asked whether they were stopped, searched or threatened by police.

The analysis showed no association between perceived racism in everyday life and heart-health risks. However, women who reported experiencing racism related to employment, housing and police interactions faced a 26% higher risk of heart disease than those who said they did not experience racism in those areas.

"Structural racism is real – on the job, in educational circumstances and in interactions with the criminal justice system," study co-author Dr. Michelle A. Albert said in the release. Albert is president of the AHA, a professor of medicine at the University of California, San Francisco, and admissions dean for UCSF Medical School.

"Now we have hard data linking it to cardiovascular outcomes, which means that we as a society need to work on the things that create the barriers that perpetuate structural racism," she said.

"Future research is needed to examine the impacts of structural racism on cardiovascular health," Sheehy said, "as well as to evaluate the joint impacts of perceived interpersonal racism and structural racism."

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