Associations between multiple indicators of discrimination and allostatic load among middle-aged adults

Dados Bibliográficos

ID4594433
AutoresJourdyn A Lawrence (0000-0003-4162-9860, Harvard University, autor correspondente), Ichiro Kawachi (0000-0003-3579-4456, Harvard University), Tori L Cowger (0000-0001-5359-8155), K White (0000-0002-0939-8073, University of Maryland, College Park), Mary T Bassett (0000-0002-7810-4163, Harvard University), David R Williams (0000-0001-9922-8117)
Ano2022
Volume298
Páginas114866
Data de publicação2022-04-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoSocial Science & Medicine (JOURNAL)
Identificadores do periódicoISSN: 0277-9536 • E-ISSN: 1873-5347
EditoraElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2022.114866
PMID35278977
OpenAlexW4214865859
IdiomaEN
Citações recebidas12
Referências citadas65

The objective of this paper is to examine associations between multiple measures of discrimination (i.e., everyday, lifetime, and appraised burden) and components of allostatic load (AL). We drew on pooled cross-sectional data from the Biomarker Project of the Midlife in the United States study (n = 2118). Ages ranged from 25 to 84 years and included mostly Black (n = 389) and white (n = 1598) adults. Quasi-Poisson models were fit to estimate prevalence ratios for each discrimination measure and high-risk quartiles across seven physiological systems (i.e., sympathetic and parasympathetic nervous system; HPA axis; inflammation; cardiovascular; metabolic glucose; and metabolic lipids) and overall AL scores. In fully adjusted models, everyday discrimination was associated with elevated lipids (aPR: 1.07; 95% CI 1.01, 1.13). Lifetime experiences of discrimination were associated with lower sympathetic nervous system (aPR: 0.82; 95% CI: 0.69, 0.98) and greater cardiovascular risk scores (aPR: 1.17; 95% CI: 1.02, 1.34) among those reporting three or more experiences, as well as increased inflammation (aPR: 1.13; 95% CI: 1.02, 1.25; aPR: 1.28; 95% CI: 1.14, 1.43), metabolic glucose (aPR: 1.35; 95% CI: 1.19, 1.54; aPR: 1.45; 95% CI: 1.24, 1.68), and metabolic lipids (aPR: 1.13; 95% CI: 1.03, 1.24; aPR: 1.28; 95% CI: 1.15, 1.43) scores for those reporting one to two and three or more experiences. Appraised burden yielded nuanced associations with metabolic glucose and parasympathetic nervous system scores. Everyday and lifetime measures were also associated with higher overall AL, though burden of discrimination was only associated with AL among those reporting "a little" burden. While AL summary scores provide insight into the cumulative impacts of discrimination on health, there appear to be distinct physiologic pathways through which varying forms of discrimination contribute to AL and, ultimately, to poorer health. These unique pathways may be useful in identifying potential points of intervention to mitigate the impacts of discrimination on health inequities

Allostasis · Allostatic load · Autonomic nervous system · Blood pressure · Confidence interval · Cross-sectional study · Diabetes mellitus · Heart rate · Metabolic syndrome · Pathology · Quartile · Sympathetic nervous system · Young adult · Demography · Employment and Welfare Studies · Health disparities and outcomes · Medicine · Racial and Ethnic Identity Research · Endocrinology · Epidemiology · Gerontology · Internal Medicine · Physiology