Black women who are exposed to certain forms of racism may be more likely to develop heart disease, researchers say.
Specifically, Black women who said they faced discrimination in employment, housing and in their interactions with the police were 26% more likely to develop heart disease than their counterparts who had not experienced such structural racism.
Structural racism refers to the ways that a society fosters racial discrimination through housing, education, employment, health care and criminal justice systems.
The new study wasn't designed to determine how perceived racism increases heart disease risk, but researchers have their theories. “Chronic psychosocial stressors such as racism increase levels of inflammation, blood pressure and other risks for heart disease,” said study author Shanshan Sheehy. She is an assistant professor of medicine at Boston University Chobanian & Avedisian School of Medicine.
For the study, the researchers tracked more than 48,000 women enrolled in the Black Women's Health Study from 1997 to 2019. None had heart disease in 1997. During 22 years of follow-up, 1,947 women developed heart disease.
Women answered five questions in 1997 about their experiences related to racism in their everyday lives and three questions about structural racism in employment, housing or in their interactions with police.
Heart disease risk wasn't tied to experiences of racism in everyday life, but women who reported experiencing racism in employment, housing and in their interactions with police were at higher risk of heart disease compared with those women who answered no to all three questions on structural racism.
Still, the study is observational and cannot prove a direct cause-and-effect relationship.
In the future, researchers plan to look at other types of racism and see how or if they affect heart health. “This may lead to new insights and advance our understanding of how racism impacts heart health,” Sheehy said.
Many Black adults are already at higher risk of developing heart disease due to high blood pressure or type 2 diabetes, so it's important that they do all that they can to improve their heart health. “Keeping blood pressure in the normal range, not smoking, leading a physically active life, and sleeping well are good for your heart,” Sheehy added.
The findings were scheduled for presentation in Boston this week at a meeting of the American Heart Association. Findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.
The new study adds to a growing body of research on how racism affects health, said Tené Lewis. She is an associate professor of epidemiology at Emory University Rollins School of Public Health, in Atlanta.
“There are studies that show reports of discrimination are associated with early heart disease and inflammatory markers, but studies linking racism to clinical endpoints have been few and far between until now,” said Lewis, who wasn't involved in the new study.
“[Racism's effect on health] matters, we know it matters, and here is the proof, so it's time to take a larger and more collective action against racism,” she said.
The onus is on society. “Pushing these issues under the rug doesn't help anyone. We need to acknowledge the complexity of our history around race and begin to think about what we can do to promote equality for everyone as a society,” Lewis said.
"We need to acknowledge that this is something that exists and that it's OK not to be OK," she added.
Racism causes stress, so taking steps to reduce stress may have positive effects on health. “Seek social support, practice mindfulness and get exercise,” Lewis suggested.
The American Heart Association has more on structural racism and how it affects health.
SOURCES: Shanshan Sheehy, ScD, assistant professor, medicine, Slone Epidemiology Center, Chobanian & Avedisian School of Medicine, Boston University; Tené Lewis, PhD, associate professor, epidemiology, Rollins School of Public Health, Emory University, Atlanta; American Heart Association, annual meeting, Boston, Feb. 28 to March 3, 2023