TY - JOUR
T1 - Discrimination is associated with elevated cardiovascular disease risk among african immigrants in the African immigrant health study
AU - Turkson-Ocran, Ruth Alma N.
AU - Szanton, Sarah L.
AU - Cooper, Lisa A.
AU - Golden, Sherita H.
AU - Ahima, Rexford S.
AU - Perrin, Nancy
AU - Commodore-Mensah, Yvonne
N1 - Funding Information:
Dr. Turkson-Ocran is supported by the Strategically Focused Research Network Award from the American Heart Association: 17SFRN33590069 and training grants from the National Institute of Nursing Research and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) under award numbers T32NR012704 and 3T32DK062707, respectively. Dr. Szanton is supported by a National Institute on Aging grant (R01AG056607). Dr. Golden is supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases (U01DK048485). Dr. Cooper is supported by a grant from the National Heart, Lung, and Blood Institute and the Patient-Centered Outcomes Research Institute (UH3HL130688). Dr. Commodore-Mensah is supported by the Johns Hopkins Institute of Clinical and Translational Research through a grant from the National Center for Advancing Translational Sciences of the National Institutes of Health under award number: 5KL2TR001077-05. The authors thank the other investigators, staff, and participants of the AIHS study for their valuable contributions.
Funding Information:
This study was approved by the Johns Hopkins University institutional review board (IRB) and all procedures followed were in accordance with the ethical standards of the IRB and the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all individuals who participated in the study. Dr. Turkson-Ocran is supported by the Strategically Focused Research Network Award from the American Heart Association: 17SFRN33590069 and training grants from the National Institute of Nursing Research and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) under award numbers T32NR012704 and 3T32DK062707, respectively. Dr. Szanton is supported by a National Institute on Aging grant (R01AG056607). Dr. Golden is supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases (U01DK048485). Dr. Cooper is supported by a grant from the National Heart, Lung, and Blood Institute and the Patient-Centered Outcomes Research Institute (UH3HL130688). Dr. Commodore-Mensah is supported by the Johns Hopkins Institute of Clinical and Translational Research through a grant from the National Center for Advancing Translational Sciences of the National Institutes of Health under award number: 5KL2TR001077-05. The authors thank the other investigators, staff, and participants of the AIHS study for their valuable contributions.
Publisher Copyright:
© 2020 Ethnicity and Disease, Inc.. All rights reserved.
PY - 2020
Y1 - 2020
N2 - Background: African Americans and other persons of African descent in the United States are disproportionately affected by cardiovascular diseases (CVD). Discrimination is associated with higher CVD risk among US adults; however, this relationship is unknown among African immigrants. Objective: To examine the associations among discrimination, resilience, and CVD risk in African immigrants. Methods: The African Immigrant Health Study was a cross-sectional study of African immigrants in Baltimore-Washington, DC, with recruitment and data collection taking place between June 2017 and April 2019. The main outcome was elevated CVD risk, the presence of ≥3 CVD risk factors including hypertension, diabetes, high cholesterol, overweight/obesity, tobacco use, and poor diet. The secondary outcomes were these six individual CVD risk factors. The exposure was discrimination measured with the Everyday Discrimination Scale; summed scores ≥2 on each item indicated frequent experiences of discrimination. Resilience was assessed with the 10-item Connor-Davidson resilience scale. Logistic regression was used to examine the odds of elevated CVD risk, adjusting for relevant covariates. Results: We included 342 participants; 61% were females. The mean (±SD) age was 47(±11) years, 61% had at least a bachelor’s degree, 18% had an income <$40,000, and 49% had lived in the US ≥15 years. Persons with frequent experiences of discrimination were 1.82 times (95%CI: 1.04–3.21) more likely to have elevated CVD risk than those with fewer experiences. Resilience did not moderate the relationship between CVD risk and discrimination. Conclusion: African immigrants with frequent experiences of discrimination were more likely to have elevated CVD risk. Targeted and culturally appropriate interventions are needed to reduce the high burden of CVD risk in this population. Health care providers should be aware of discrimination as a meaningful social determinant of CVD risk. At the societal level, policies and laws are needed to reduce the occurrence of discrimination among African immigrants and racial/ethnic minorities.
AB - Background: African Americans and other persons of African descent in the United States are disproportionately affected by cardiovascular diseases (CVD). Discrimination is associated with higher CVD risk among US adults; however, this relationship is unknown among African immigrants. Objective: To examine the associations among discrimination, resilience, and CVD risk in African immigrants. Methods: The African Immigrant Health Study was a cross-sectional study of African immigrants in Baltimore-Washington, DC, with recruitment and data collection taking place between June 2017 and April 2019. The main outcome was elevated CVD risk, the presence of ≥3 CVD risk factors including hypertension, diabetes, high cholesterol, overweight/obesity, tobacco use, and poor diet. The secondary outcomes were these six individual CVD risk factors. The exposure was discrimination measured with the Everyday Discrimination Scale; summed scores ≥2 on each item indicated frequent experiences of discrimination. Resilience was assessed with the 10-item Connor-Davidson resilience scale. Logistic regression was used to examine the odds of elevated CVD risk, adjusting for relevant covariates. Results: We included 342 participants; 61% were females. The mean (±SD) age was 47(±11) years, 61% had at least a bachelor’s degree, 18% had an income <$40,000, and 49% had lived in the US ≥15 years. Persons with frequent experiences of discrimination were 1.82 times (95%CI: 1.04–3.21) more likely to have elevated CVD risk than those with fewer experiences. Resilience did not moderate the relationship between CVD risk and discrimination. Conclusion: African immigrants with frequent experiences of discrimination were more likely to have elevated CVD risk. Targeted and culturally appropriate interventions are needed to reduce the high burden of CVD risk in this population. Health care providers should be aware of discrimination as a meaningful social determinant of CVD risk. At the societal level, policies and laws are needed to reduce the occurrence of discrimination among African immigrants and racial/ethnic minorities.
KW - African immigrants
KW - Cardiovascular disease risk
KW - Discrimination
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UR - http://www.scopus.com/inward/citedby.url?scp=85092121875&partnerID=8YFLogxK
U2 - 10.18865/ED.30.4.651
DO - 10.18865/ED.30.4.651
M3 - Article
C2 - 32989365
AN - SCOPUS:85092121875
SN - 1049-510X
VL - 30
SP - 651
EP - 660
JO - Ethnicity and Disease
JF - Ethnicity and Disease
IS - 4
ER -