Experiences of Discrimination Are Associated With Worse Metabolic Syndrome Severity Among African Americans in the Jackson Heart Study

Ann Behav Med. 2021 Mar 20;55(3):266-279. doi: 10.1093/abm/kaaa050.

Abstract

Background: Metabolic syndrome (MetS) is a risk factor for the development of cardiovascular disease and type 2 diabetes. Although the development of MetS is attributed to known lifestyle factors, perceived discrimination may also contribute to MetS development and severity.

Purpose: We examined the associations of perceived discrimination with MetS severity among African American adults at baseline and 8-year follow-up.

Methods: Three thousand eight hundred and seventy participants (mean age 53.8 ± 13.0; 63.1% female) without diabetes and no missing MetS severity scores at baseline were included. Each self-reported measure of discrimination at baseline (everyday, lifetime, and burden of lifetime) was classified into tertiles (low, medium, high). After adjustment for demographics and MetS risk factors, associations of discrimination were examined with a sex- and race/ethnicity-specific MetS severity Z-score. We employed a mixed model approach that allowed for the assessment of an overall association between reported discrimination at baseline and MetS severity, and for the possible change over time.

Results: Sex and age differences were observed in experiences with discrimination, such that men reported higher levels of all aspects of discrimination relative to women. Everyday discrimination decreased with age, whereas lifetime discrimination increased with age (p < .05). Independent of lifestyle and demographic factors, everyday and lifetime discrimination were significantly associated with MetS severity (p = .003 and p = .017, respectively) and the associations remained constant over the 8 years (i.e., no interaction with time).

Conclusions: Our results suggest that, in a large community-based sample of African Americans, discrimination is a salient psychosocial risk factor for severity of MetS.

Keywords: Adults; African Americans; Discrimination; Metabolic syndrome; Psychosocial.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • African Americans / psychology*
  • African Americans / statistics & numerical data
  • Aged
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Metabolic Syndrome / psychology*
  • Middle Aged
  • Racism / psychology*
  • Racism / statistics & numerical data
  • Risk Factors
  • Severity of Illness Index