• Posted October 24, 2023

Racism's Effects Are Harming the Hearts of Black Americans

Research has shown that older Black adults are more likely to have poor heart health when compared with white adults and other minority groups.

Now, a new study finds that chronic stress from racism and impoverished neighborhood conditions influence that disparity.

This impact on heart health from these stressors did vary by gender, with Black women affected more by discrimination and Black men affected more by neighborhood safety.

“Our goal was to understand what types of factors contribute to the stress experiences of Black people. If we can identify certain stressors to target in our mitigation strategies, we can hopefully improve cardiovascular health outcomes and reduce disparities in heart disease,” said lead author Anika Hines, an assistant professor in the Department of Health Behavior and Policy at Virginia Commonwealth University's School of Population Health.

Heart disease is the leading cause of death in the United States.

Black individuals are also more likely to develop risk factors for heart disease, such as obesity and high blood pressure, at earlier ages.

Experts think the cumulation of stress from a lifetime of structural and interpersonal racism may cause Black individuals to have these outcomes.

“We have these natural mechanisms in our body which respond to stressful situations, often referred to your fight-or-flight response. However, being persistently exposed to various stressors can throw your system off balance. Over time, the various systems that are supposed to help you during periods of stress can actually deteriorate your organ functioning,” Hines said in a university news release.

To study this, researchers used data from the REGARDS project, a national study focused on better understanding geographic and racial differences in stroke deaths.

They examined both survey responses and health information collected from more than 7,500 people.

The researchers scored each person for certain health behaviors: cigarette smoking, diet, physical activity and body mass index. Scores also factored in blood pressure, cholesterol and glucose levels.

Participants reported how often they experienced racial discrimination, including at school, while receiving medical care or from the police. They were asked about whether they felt safe in their neighborhood, what the noise and traffic level was like and whether there was adequate access to grocery stores, parks and playgrounds.

Those surveyed also provided information about how connected they feel to their neighborhood, such as whether neighbors get along, share the same values and are willing to help one another.

The scientists found that Black men had 27% lower odds of having better cardiovascular health than white men. Meanwhile, Black women had 55% lower odds than white women.

Black participants reported higher levels of perceived stress and more often reported instances of discrimination. They also reported worse neighborhood conditions and more often reported that their neighborhoods were unsafe.

According to the researchers' calculations, stress from discrimination explained 11% of the racial difference in heart health between Black and white participants.

The study also showed that stress from neighborhood conditions influenced this racial disparity, specifically the level of safety at 6%, physical features at 5% and social connectedness at 1% within a neighborhood.

Discrimination explained 14% of the racial differences in heart health among women. Neighborhood safety reduced these racial differences by 12% among men.

The authors noted that the findings suggest that public health approaches for reducing heart disease disparities should target certain stressors.

For Black women, that would mean addressing stressors that tie into coping with discrimination. For Black men, addressing the impact of neighborhood violence may be more important.

The findings were published recently in the journal JAMA Network Open.

“This study shows the importance of intersectional experiences when considering solutions for health disparities,” Hines said. “Marginalized groups aren't monoliths. Even in the umbrella of marginalization related to race, there can be differential experiences based on gender, socioeconomic status and other factors.”

These researchers are now working with community members to design feasible interventions for young Black women to combat this stress.

“We measure things so that we can do something about it. We hope that our findings help inform strategies, both in terms of policies and therapies, for dismantling these health disparities,” Hines said. “The more evidence we build in this field, the more improvements we can hopefully make in terms of structural change.”

More information

The American Heart Association has more on stress and heart health.

SOURCE: Virginia Commonwealth University, news release, Oct. 23, 2023