Black Women Experiencing Racism in 3 Categories Have Increased Risk of Coronary Heart Disease

For Black women, experiencing racism at their place of work, where they live, and in interactions with the police has been associated with a higher risk of coronary heart disease (CHD), according to findings presented in an abstract at the American Heart Association's Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions. According to a press release, Black women have a disproportionately higher burden of CHD and CHD-related mortality as well as earlier onset compared to women in other racial of ethnic groups.¹

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There have been few studies that identify whether perceived interpersonal racism could be associated with risk of CHD, according to the study authors.²

“Our study provides longitudinal evidence on the relationship between perceived interpersonal racism and incident cardiovascular endpoints, suggesting that Black women with higher levels of perceived interpersonal racism may subsequently have a higher risk of incident CHD,” Shanshan Sheehy, MD, MSc, ScD, assistant professor of medicine at Boston University Chobanian & Avedisian School of Medicine, said in a press release.¹

In the study, published in Circulation, investigators followed 48,305 individuals in the Black Women’s Health Study via mailed and internet-based questionnaires from 1997 to the end of 2019 biennially. All individuals were free of CHD in 1997, according to the study. Responses were to an averaged of 5 validated questions that asked about perceived interpersonal racism in everyday activities, such as “people act as if they think you are dishonest,” according to the study authors. The positive responses were summed to 3 questions about perceived racism in interactions that involved their job, place of living, and police, ranging from 0 (no to all) and 3 (yes to all).²

CHD cases were defined as nonfatal myocardial infarctions, validated through medical records, fatal cases identified through the National Death Index, and self-reported revascularization events. In the 22 years of follow-up, investigators found 1947 incidences of CHD. Those who had experienced all 3 categories of racism (place of work, where they live, and in interactions with police) had a 26% higher risk of heart disease compared to those who answered negatively to all 3 questions.²

Further, the investigators said that they observed differences in associations with CHD between perceived racism in daily life, and perceived racism on the job, in housing, and by police.¹ They also found that perceived racism in everyday life was not associated with higher risk, just when in those 3 categories, according to the study.²

“The types of perceived racism may be reported with different accuracy by participants. Participants might have a more accurate recall of experiences of racism in job, housing and with the police than experiences of racism in daily life. Being denied at job promotion, mortgage application, or being treated unfairly by the police might be harder to forget and might have greater association with Black women’s social, emotional, and physical wellbeing, compared with experiences of racism in daily life such as receiving poor services at a restaurant,” Sheehy said in the press release.¹

Limitations of the study included that the investigation was limited to perceived interpersonal racism, which is subjective, and racism is an incredibly complex topic with different presentations, according to the study authors.²

References

1. BU study: experiences of racism may contribute to the disproportionately high incidence of cardiovascular disease in Black women. News release. Eurekalert. January 18, 2024. Accessed January 31, 2024. https://www.eurekalert.org/news-releases/1031714
2. Sheehy S, Brock M, Palmer JR, Albert MA, Cozier Y, Rosenberg L. Perceived Interpersonal Racism in Relation to Incident Coronary Heart Disease Among Black Women. Circulation. 2023. doi:10.1161/CIRCULATIONAHA.123.066471