Workplace discrimination may raise blood pressure
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Key takeaways:
- Adults exposed to high levels of workplace discrimination were more likely to develop high blood pressure than those exposed to low levels.
- Workplace stress management interventions may lower disease risk.
U.S. adults who report exposure to high levels of workplace discrimination are 54% more likely to develop hypertension compared with people who report low levels of discrimination exposure, researchers reported.
“Much research evidence has been gained that perceived discrimination is related to mental and physical health outcomes; however, the role of the workplace is not well recognized,” Jian Li, MD, PhD, professor of work and health at the Fielding School of Public Health at the University of California, Los Angeles, told Healio. “Our study, for the first time, suggests that workplace discrimination could increase risk of hypertension among workers.”
Data were derived from Li J, et al. J Am Heart Assoc. 2023;doi:10.1161/JAHA.122.027374.
Li and colleagues analyzed data from 1,246 adults who participated in the prospective Midlife in the United States (MIDUS) study (48.07% men; 93.5% white). Researchers collected baseline data between 2004 and 2006 and followed the cohort for an average of 8 years; adults who self-reported hypertension at baseline were excluded. Researchers assessed workplace discrimination using a validated six-item instrument. Questions included:
- “How often do you think you are unfairly given the jobs that no one else wanted to do?”
- “How often are you watched more closely than other workers?”
- “How often does your supervisor or boss use ethnic, racial or sexual slurs or jokes?”
- “How often do your co-workers use ethnic, racial, or sexual slurs or jokes?”
- “How often do you feel that you are ignored or not taken seriously by your boss?”
- “How often has a co-worker with less experience and qualifications gotten promoted before you?
Each item was measured on a 5-point Likert response scale (1 = never; 5 = once a week or more). Discrimination scores were constructed by calculating the sum of the values of the six items. The participants were stratified into tertiles — low, intermediate or high levels of workplace discrimination — based on discrimination scores.
The findings were published in the Journal of the American Heart Association.
During follow-up with 9,923.17 person-years, 319 workers reported developing hypertension. The incidence rates of hypertension were 25.9, 30.84 and 39.33 per 1,000 person-years among participants with low, intermediate and high levels of workplace discrimination, respectively.
In regression analyses, researchers found that workers who experienced intermediate exposure to workplace discrimination were 22% more likely to develop hypertension during follow-up compared with those who reported low exposure to workplace discrimination (adjusted HR = 1.22; 95% CI, 0.9-1.65). Those who reported exposure to high levels of workplace discrimination were 54% more likely to develop hypertension during follow-up (aHR = 1.54; 95% CI, 1.11-2.13). The association was slightly stronger in sensitivity analysis that excluded more baseline hypertension cases based on additional information on BP plus antihypertensive medication use (n = 975).
A trend analysis showed an exposure-response association.
The researchers noted that some research suggests workplace interventions that improve conditions such as decreasing job demand and increasing job control may reduce systolic BP levels.
“During clinical practices, physicians and nurses should pay more attention to psychosocial factors at work, such as workplace discrimination, as potential risk factors for hypertension in working-age population,” Li told Healio. “As CVD is the leading cause of health burden, it would be crucial to investigate causal links between workplace discrimination and CVD. In addition, interventional measures need to be developed to eliminate workplace discrimination in occupational settings.”
Reference:
- American Heart Association. newsroom.heart.org/news/u-s-adults-who-felt-discrimination-at-work-faced-increased-risk-of-high-blood-pressure. Published April 26, 2023. Accessed April 26, 2023.
For more information:
Jian Li, MD, PhD, can be reached at jianli2019@g.ucla.edu.
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