High Blood Pressure Among Black Adults Linked to Discrimination and Unfair Treatment
For immediate release: October 23, 1996
Boston, MA--Experiences of racial discrimination and unfair treatment may be associated with blood pressure and contribute substantially to black/white differences in blood pressure, according to a study of 4,086 black and white women and men. And, black professionals who name and challenge racial discrimination appear to be at lower risk of elevated blood pressure than working class black women and men who report not having experienced racial discrimination and not challenging unfair treatment. The study is reported in this month's American Journal of Public Health and is the first of its kind to examine relationships between blood pressure and experiences of racial discrimination in relation to social class and gender, and also to assess empirically how racial discrimination contributes to black/white differences in blood pressure. Previous studies report a two-fold greater prevalence of hyptertension in the U.S. black population compared to white population but work to date has not adequately explained why this disparity exists.
The authors report that blood pressure differences linked to reported experiences of discrimination and unfair treatment are on par with those associated with other cardiovascular risk factors regarding exercise, smoking, and unhealthy diet. "Public health researchers typically have treated 'race', erroneously, as a biological variable and have rarely attempted to examine how people's experiences of and reactions to racial discrimination can affect health status," comments Nancy Krieger, lead author and assistant professor at the Harvard School of Public Health. "In doing this study, we sought to understand how racial discrimination affects health in ways that may be modified by social class and gender. This is profoundly different from approaches that treat 'race' as if it were some kind of inherent characteristic. I think it is critically important to understand how literal embodiment, biologically, of experiences and consequences of racial discrimination can harm health."
The study cohort consisted of relatively young black and white women and men (ages 25-37), who are enrolled in an on-going multi-site community-based study of risk factors for cardiovascular disease (CARDIA study). The authors report that 80% of the black women and men reported experiencing racial discrimination in at least one of seven specified situations. Among working class black women and men, systolic blood pressure was highest among those who reported not having experienced racial discrimination and was lowest among those who said they had experienced moderate racial discrimination (in one or two of the specified situations). Among the women, it was highest among those who said they typically responded to unfair treatment by accepting it as a fact of life and keeping it to themselves, while among the men, it was highest among those who accepted unfair treatment as a fact of life but talked to others about it.
The authors suggest that among these working class participants, higher blood pressure may be attributable to suppressed or internalized responses to racial discrimination. Notably, blood pressure among the working class black men and women with the lowest blood pressure, i.e., reporting moderate racial discrimination, was, respectively, the same as or only slightly higher than that of their white working class counterparts.
Among black professional women, blood pressure was lowest among those reporting moderate discrimination and who typically took action in response to unfair action but did not talk to others; their blood pressure did not differ from that of the white professional women. Among black professional men, blood pressure was lowest among those reporting no discrimination and who also responded to unfair treatment by taking action and not talking to others about it. Their blood pressure likewise did not differ from that of white professional men. The authors suggest that enhanced social and economic resources among black professionals may contribute to a greater willingness to name and challenge discriminatory treatment, thereby reducing risk of elevated blood pressure.
For further information, please contact:
Office of Communications
Harvard School of Public Health
677 Huntington Avenue
Boston, MA 02115