Psychosocial resilience may indicate CV health in Black adults
Higher levels of psychosocial resilience in Black adults indicated better CV health as indicated by Life’s Simple 7 scores compared with lower levels of psychosocial resilience, researchers found.
“It was somewhat surprising that our psychosocial resilience measures were more strongly associated with cardiovascular health than the neighborhood-level resilience measure,” Tené T. Lewis, PhD, clinical psychologist and associate professor of epidemiology at Emory University Rollins School of Public Health, said in a press release. “We assumed that being both high on psychosocial resilience and living in a resilient neighborhood would be the most beneficial for cardiovascular health, yet what we found was that psychosocial resilience demonstrated the most robust association regardless of the neighborhood resilience measure.”
Adults free from CVD
In this study published in Circulation: Cardiovascular Quality and Outcomes, Jeong Hwan Kim, MD, cardiology fellow at Emory University School of Medicine, and colleagues analyzed data from 389 Black adults (mean age, 53 years; 39% men) aged 30 to 70 years living in Atlanta. Participants had no known history of CVD.
Upon enrollment, participants underwent a physical examination, blood draw and questionnaires, which were used to assess five domains of individual psychosocial well-being: optimism, environmental mastery, purpose of life, resilient coping and depressive symptoms. Researchers created a composite score based on these responses to determine individual psychosocial resilience. Neighborhood-level CV resilience was determined through census tract-level rates of adverse CV events in Black residents. Another metric of CV health used in this study was a Life’s Simple 7 score.
Participants with higher individual psychosocial resilience often had higher Life’s Simple 7 scores after adjusting for sex, age, education, income, employment status and marital status (beta per 1 standard deviation = 0.38; 95% CI, 0.16-0.59). This was also observed for higher neighborhood-level CV resilience after adjusting for the same covariates (beta per 1 standard deviation = 0.23; 95% CI, 0.02-0.45).
When individual psychosocial resilience and neighborhood-level CV resilience were assessed together, high individual psychosocial resilient was independently linked to a higher Life’s Simple 7 score (beta = 0.73; 95% CI, 0.31-1.17). This was not observed for high neighborhood-level resilience.
The largest difference in Life’s Simple 7 scores was seen in participants with high individual psychosocial resilience living in low-resilience neighborhoods (8.38; 95% CI, 7.9-8.86) and those with low individual psychosocial resilience who live in low-resilience neighborhoods (7.42; 95% CI, 7.04-7.79). This corresponded with a 12.5% lower incidence of CVD.
“Although policy-level interventions and systemic change that guarantee equal rights and improved access to health care, education and other opportunities for minorities is the ultimate goal, interventions that promote positive well-being and capitalize on psychosocial resilience at the individual level might prove beneficial for the CV [health] of Black Americans, particularly for those living in communities with poorer overall CV health,” Kim and colleagues wrote.
Efforts to eliminate disparities
In a related editorial, Amber E. Johnson, MD, MS, MBA, assistant professor of medicine at University of Pittsburgh School of Medicine, and Jared W. Magnani, MD, MS, associate professor of medicine at University of Pittsburgh School of Medicine, wrote: “The goal should be to work with communities that have been historically marginalized or made vulnerable to restore agency for positive outcomes. Eliminating disparities in cardiovascular health will require community-engaged partnerships based on common goals to provide care and to rebuild health care systems. We advocate for promoting health equity and social justice first, thereby rendering interventions to bolster resilience unnecessary.”
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