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Racism Might Be Causing Black Women to Develop Heart Disease

As communities begin to grapple with their long and sordid history with inequity and inequality, more and more doctors, public health practitioners, and policymakers are looking into the impacts of racism on health—with many major bodies even going as far as calling it a public health crisis. It’s not just rhetoric: New studies are bearing out ​​the potentially lethal consequences of systemic racism.

Preliminary research analyzing responses from more than 48,000 people enrolled in the Black Women’s Health Study found that people who reported experiencing certain types of racial discrimination had higher rates of heart disease over a 22-year period. These findings were presented on March 1 at the American Heart Association’s Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions.

“Structural racism is real—on the job, in educational circumstances, and in interactions with the criminal justice system,” Michelle Albert, the president of the American Heart Association and an author on the research, said in a press release. “Now we have hard data linking it to cardiovascular outcomes, which means that we as a society need to work on the things that create the barriers that perpetuate structural racism.”

The Black Women’s Health Study is not new. In fact, researchers have been following nearly 60,000 people since 1995, when they mailed questionnaires to subscribers of Essence magazine and members of a few professional organizations. According to the Health Study’s website, its purpose is to follow these women over time and collect information about their health.

The data will help researchers answer certain questions about Black female health, such as why young Black women are more likely to be diagnosed with breast cancer than young white women, why Black women more commonly have lupus, and why Black babies are more often born prematurely. The researchers also pose a question that potentially links these observations: “Do experiences of racism affect the occurrence of various illnesses in Black women?”

Studies over the past two decades roundly suggest that it does. Stress can be separated into categories of acute and chronic—while the acute stress of rushing to meet a deadline can be bad enough for your health and sleep, a chronic stressor like racism can be even worse in the long run. For instance, people who report experiencing racial discrimination tend to have shorter telomeres, which are caps that protect chromosomes and are a marker of cellular aging. Shorter telomeres, in turn, are associated with shorter lifespans. This means that racism can literally age—and fatally injure—a person’s body.

But certain conditions, like heart disease, have never before been tracked over time and tied to perceived racism, Shanshan Sheehy, an epidemiologist at Boston University who led the research, told The Daily Beast in an email. In this preliminary research, Sheehy and her co-authors analyzed responses to eight survey questions sent to Black Women’s Health Study participants in 1997. They then tracked the respondents’ health until 2019 to see who developed heart disease, both fatal and nonfatal.

Nearly 2,000 participants developed heart disease over the course of those 22 years, allowing the researchers to see whether they agreed with statements like “People act as if they are afraid of you” or “You receive poorer service than other people at restaurants or stores” more often than those who didn’t.

Interestingly, responses to questions meant to measure interpersonal racism in daily life, like the two above, were not significantly tied to a Black woman’s risk for heart disease. This may be because the effects of racism in one’s daily life might be mitigated by a coping mechanism, such as talking to a friend, Sheehy said.

But looking at the responses of questions meant to measure perceived racism in jobs, housing, and police interactions told a different story. Black women who reported experiencing racism in these aspects of life were 26 percent more likely to develop heart disease than the women who did not report experiencing racism.

“The consequences of being treated unfairly at job, housing, and by the police are much harder to tune out by talking with a friend,” Sheehy added.

There are several factors to keep in mind when interpreting these statistics. For one thing, the women in this study were all compared to one another. There’s no telling whether significant differences might exist in heart disease risk based on experiences of daily interpersonal racism if these participants were compared to white women, for instance.

Additionally, this research did not measure structural forms of discrimination, like redlining. The survey responses “cannot capture racism existing outside of conscious awareness,” Sheehy said, though she added that future research using data from Black Women’s Health Study aims to incorporate measures of structural racism, too.

Ultimately, Sheehy said, the takeaway of the research is simple: “Racism has a real impact on the heart health of Black women.”

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March 2023
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