Does Racism Increase Risk of Heart Disease in Black Women?

According to the Centers for Disease Control and Prevention (CDC), there has been a decline in both heart morbidity and mortality. Despite this, the rate of heart disease remains high amongst certain demographics. 

With rates of heart disease being higher amongst African Americans, research into these racial disparities continues to grow. A new study points to another risk factor that may be contributing to higher rates of heart disease among black people – racism.

Racism and How It Affects Healthspan

The aforementioned study isn’t the first to highlight how social inequalities and prejudices may influence an individual’s health. 

• For instance, a 2003 study highlighted how racism limits socioeconomic mobility, which can adversely affect heart health. The same study found that perceived racism may induce high levels of stress, which has been linked to heart disease. 
• A 2018 study from UC Berkeley researchers found that less-educated African American women experiencing racial discrimination raised their allostatic load, which includes their blood pressure and blood sugar. According to the study, the increased allostatic load would make the individual more susceptible to chronic illnesses. 
• In a separate and more recent study published in 2020, researchers found that African American patients who experienced moderate discrimination throughout their lives faced a higher risk of developing hypertension. 
• Telomeres are protective caps found at the end of our chromosomes, and their premature shortening has been linked to poor health. According to a 2021 study, “higher institutional discrimination was associated with shorter telomere length among employed African American women with lower education.“

Racism and Heart Health: Is There A Link?

Cardiovascular disease kills more than 50, 000 African American women every year, and African American women are more likely to die of heart disease, and at younger ages, than white women.

In a recent study, teachers attempted to examine racial factors contributing to this wide disparity. 

For the study, researchers analyzed the data of 48, 305 African American women. The women were part of Boston University’s Black Women’s Health Study, a research study that was compiled in 1995 to track and better understand the health of black women in the United States.

This particular study began in 1997 when women answered two sets of questions about their experiences with racism. The first set of questions inquired about their experiences with structural racism. This would include perceived discrimination and unfair treatment while job hunting, at the office, during a stop and search, or when attempting to rent or buy a home.

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The second set of questions inquired about experiences of interpersonal racism in everyday life. This includes receiving poor service at a restaurant or being considered inferior, unintelligent, dishonest, or a threat.

The study went on for a period of 22 years, and during this time, the researchers tracked the women’s well-being. Now, the women all began the study with apparent healthy hearts. However, this soon changed by 2019 with 1,947 having developed coronary heart disease.

Is Racism A Cardiovascular Risk?

According to the study’s findings, which were presented on March 1 at the American Heart Association’s Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions, black women who experienced structural racism faced a 26% higher risk of coronary heart disease than those who did not report experiencing structural racism. 

“When we think about how racism impacts our health, it’s a psychosocial stressor. It increases your blood pressure, your level of inflammation—all of these biological mechanisms increase your risk of coronary heart disease.”– Shanshan Sheehy, lead author.

While Dr. Sheehy, who is also an epidemiologist at Boston University, did find an association between an increased risk of heart disease and structural racism, the same increased risk could not be found with everyday racism.

According to Dr. Sheehy, this may be because everyday racism, such as being looked down on at a restaurant or followed around in a store, may be easier to deal with than having to accept losing out on a job or house because of your skin color. 

“The consequences of being treated unfairly at job, housing, and by the police are much harder to tune out by talking with a friend,” Sheehy added.

Better heart health for black women

It’s important to note that the study does have its limitations. After all, the experiences of racism were self-reported and individuals may have a different perception of what constitutes racism. Additionally, throughout the 22-year period in which the study took place, the information was only collected once. 

Nonetheless, Dr. Sheehy highlights one takeaway from the study. The findings lead credence to the idea of racism being responsible for high rates of heart disease amongst the black population. 

Speaking of these disproportionately high rates, Dr. Sheehy reminds this particular demographic to do their part to improve and protect their health, 

“Keeping blood pressure in the normal range, not smoking, leading a physically active life, and sleeping well are good for your heart,” Sheehy advises.

References

Thomas, M. D., Sohail, S., Mendez, R. M., Márquez-Magaña, L., & Allen, A. M. (2021). Racial Discrimination and Telomere Length in Midlife African American Women: Interactions of Educational Attainment and Employment Status. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 55(7), 601–611. https://doi.org/10.1093/abm/kaaa104

Wyatt, S. B., Williams, D. R., Calvin, R., Henderson, F. C., Walker, E. R., & Winters, K. (2003). Racism and cardiovascular disease in African Americans. The American journal of the medical sciences, 325(6), 315–331. https://doi.org/10.1097/00000441-200306000-00003