Impact of change over time in self-reported discrimination on blood pressure: implications for inequities in cardiovascular risk for a multi-racial urban community

ABSTRACT

Objectives: The 21st century has seen a rise in racism and xenophobia in the United States. Few studies have examined the health implications of heightened institutional and interpersonal racism. This study examines changes in reported discrimination and associations with blood pressure over time among non-Latino Blacks (NLBs), Latinos, and non-Latino Whites (NLWs) in an urban area, and variations by nativity among Latinos.

Design: Data from a probability sample of NLB, Latino, and NLW Detroit, Michigan residents were collected in 2002–2003, with follow-up at the same addresses in 2007–2008. Surveys were completed at 80% of eligible housing units in 2008 (n = 460). Of those, 219 participants were interviewed at both time points and were thus included in this analysis. Discrimination patterns across racial/ethnic groups and associations with blood pressure were examined using generalized estimating equations.

Results: From 2002 to 2008, NLBs and Latinos reported heightened interpersonal and institutional discrimination, respectively, compared with NLWs. There were no differences in associations between interpersonal discrimination and blood pressure. Increased institutional discrimination was associated with stronger increases in systolic and diastolic blood pressure for NLBs than NLWs, with no differences between Latinos and NLWs. Latino immigrants experienced greater increases in blood pressure with increased interpersonal and institutional discrimination compared to US-born Latinos.

Conclusions: Together, these findings suggest that NLBs and Latinos experienced heightened discrimination from 2002 to 2008, and that increases in institutional discrimination were more strongly associated with blood pressure elevation among NLBs and Latino immigrants compared to NLWs and US-born Latinos, respectively. These findings suggest recent increases in discrimination experienced by NLBs and Latinos, and that these increases may exacerbate racial/ethnic health inequities.

KEYWORDS:

• Discrimination
• blood pressure
• cardiovascular risk
• Latino
• Hispanic
• non-Latino Black
• non-Hispanic Black
• non-Latino White
• non-Hispanic White
• immigrant
• immigration policy
• health disparities
• health inequities

Acknowledgements

The Healthy Environments Partnership (HEP) (www.hepdetroit.org) is a community-based participatory research partnership affiliated with the Detroit Community-Academic Urban Research Center (www.detroiturc.org). We thank the members of the HEP Steering Committee for their contributions to the work presented here, including representatives from Detroit Hispanic Development Corporation, Detroit Institute for Population Health, Detroit Health Department, Friends of Parkside, Chandler Park Conservancy, Henry Ford Health System, Eastside Community Network, the University of Michigan School of Public Health, and community-members at large. The results presented here are solely the responsibility of the authors and do not necessarily represent the views of these supporting institutions. We also thank the HEP Community Survey participants for their participation in the study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The study and analysis were supported by the National Institute of Environmental Health Sciences (NIEHS) [R01ES10936, R01ES014234]; National Institute on Minority Health and Health Disparities (NIMHD) [P60MD002249, 5-R25-GM-058641-11]; and the University of Michigan National Center for Institutional Diversity.