Experience with discrimination may increase cardiovascular, all-cause mortality
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Key takeaways:
- People who experienced lifetime and/or everyday discrimination had higher risk for all-cause mortality than those who did not.
- The same was true for cardiovascular mortality.
People who experienced lifetime and everyday discrimination had elevated risk for cardiovascular and all-cause mortality compared with those who did not, according to data published in Circulation: Cardiovascular Quality and Outcomes.
“These study findings contribute to the literature on discrimination and physical health by providing greater understanding of the harmful effects of discrimination on mortality,” Wayne R. Lawrence, DrPH, MPH, research fellow in the division of cancer epidemiology and genetics at the National Cancer Institute, and colleagues wrote.
The researchers followed participants from the MESA cohort aged 45 to 84 years without a history of CVD (1,633 Black, 1,403 Hispanic/Latino and 2,473 white) across five exams from 2002 to 2018.
Participants’ experiences of discrimination were recorded at baseline using the Lifetime Discrimination Scale, which consisted of six items to evaluate unfair treatment throughout the patient’s lifetime, and the Everyday Discrimination Scale, which consisted of 9 items to evaluate day-to-day occurrences of unfair treatment.
Researchers found that after adjustment for sociodemographic factors, health behaviors or clinical risk factors, each increase in reports of lifetime discrimination was associated with 6% higher all-cause mortality (HR = 1.06; 95% CI, 1-1.11) and 15% higher CV mortality (HR = 1.15; 95% CI, 1.04-1.27) in the general population.
The tie between lifetime discrimination and mortality was most pronounced among Black participants, with each increase in lifetime discrimination being associated with 8% higher all-cause mortality (HR = 1.08; 95% CI, 1-1.16) and 18% higher CV mortality (HR = 1.18; 95% CI, 1.02-1.37).
After adjustments, each increase in everyday discrimination was associated with higher CV mortality (HR = 1.21; 95% CI, 1.03-1.43) and a trend toward higher all-cause mortality (HR = 1.07; 95% CI, 0.98-1.17) in the overall population.
The researchers found no association between everyday discrimination and all-cause mortality in Black participants, but did find a modest association among white and Hispanic/Latino participants. The relationship between everyday discrimination and CV mortality was present in white participants but not significant in those of other races and ethnicities, according to the researchers.
“The present study findings suggest that experiences of discrimination are associated with all-cause and cardiovascular mortality,” Lawrence and colleagues wrote. “These results highlight the need for policies and public health interventions aimed at eliminating discrimination and mitigating its adverse effects on health.”
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Lawrence WR, et al. Circ Cardiovasc Qual Outcomes. 2023;doi:10.1161/CIRCOUTCOMES.122.009697.
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