Perceptions of Race/Ethnic Discrimination in Relation to Mortality Among Black Women: Results From the Black Women's Health Study | Cardiology | JAMA Internal Medicine | JAMA Network
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Original Investigation
May 24, 2010

Perceptions of Race/Ethnic Discrimination in Relation to Mortality Among Black Women: Results From the Black Women's Health Study

Author Affiliations

Author Affiliations: Center for Cardiovascular Disease Prevention, Donald W. Reynolds Center for Cardiovascular Disease Research (Drs Albert, Ridker, Glynn, and Halevy and Ms Rose), Divisions of Cardiovascular Diseases and Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School (Drs Albert and Ridker), and Slone Epidemiology Center at Boston University (Drs Cozier, Palmer, and Rosenberg), Boston, Massachusetts.

Arch Intern Med. 2010;170(10):896-904. doi:10.1001/archinternmed.2010.116

Background  Because racial discrimination is a form of chronic psychological stress that might unfavorably affect health, we examined whether perceived experiences of racism among black women are associated with mortality.

Methods  We followed 48 924 participants in the Black Women's Health Study (mean age, 40.5 years) for 8 years to assess the risk of all-cause mortality associated with perceived experiences of racism. Subanalyses of cancer and cardiovascular mortality were also conducted. Perceived racism was evaluated by 8 questions about institutionalized racism (unfair treatment on the job, in housing, or by the police) and everyday experiences of racism (eg, others acting as if the woman was not intelligent). We estimated the relative risk of death with Cox proportional hazard models, adjusting for traditional and socioenvironmental risk factors.

Results  During 412 224 person years of follow-up from 1997 to 2005, there were 920 deaths, including 277 due to cancer and 195 due to cardiovascular causes. All-cause mortality was not associated with institutionalized racism (relative risk, 1.0; 95% confidence interval, 0.8-1.2) for the highest category vs the lowest or with everyday racism (relative risk, 0.9; 95% confidence interval, 0.8-1.2) for the highest quartile compared with the lowest. Risk estimates for the highest categories of perceived racism relative to the lowest were greater than 1.0 for cancer deaths and less than 1.0 for cardiovascular disease death but were not statistically significant.

Conclusions  In this large prospective study of black women, reported experiences of racism were not significantly related to mortality. Longer follow-up of this relatively young cohort and further work is warranted in this complex area of research because continued race/ethnic disparities in mortality are not entirely explained by traditional risk factors.