November 15, 2023
2 minute read
Important points:
- Experiencing racial discrimination in employment, housing, and interactions with police was found to increase the risk of stroke.
- Interpersonal racism in these three areas was also associated with increased stroke risk.
Black women in the United States who reported experiencing interpersonal racism in employment, housing, and interactions with police had an increased risk of stroke, according to a study published today. JAMA network open.
“Black women in particular have higher rates of stroke and stroke-related mortality and earlier onset than women of other racial groups.” Shanshan Shihei, ScD, write the assistant professor and colleagues at Boston University’s Sloan Epidemiology Center. “Racism in the United States, both interpersonal and structural, disproportionately impacts Black individuals. Racism is a complex structure, with multiple forms and direct evidence linking racism and stroke incidents is very limited.”
Sheehy and colleagues conducted the Black Women’s Health Study, a prospective cohort study of 48,375 black women in the United States (mean age 41 years). This study assessed the association between perceptions of interpersonal racism and stroke incidence in this cohort. Participants completed a survey in 1997 reporting their experiences of racial discrimination in situations such as daily life, employment, housing, and interactions with police. Every 2 years, all participants updated their health information with follow-up via mail or web-based questionnaires. Follow-up continued until 2019.
The primary outcome was stroke identified by linking self-reported medical records to the National Death Index.
During 22 years of follow-up, researchers identified 1,664 strokes. Of these, 550 were definitive and confirmed by neurologist examination and/or linkage to the National Death Index. Black women who reported experiencing racial discrimination in employment, housing, and interactions with police had a 38% increase in stroke incidence (HR = 1.38; 95% CI, 1.14-1.67; P < .001), with a 37% increase in definite stroke (HR = 1.37; 95% CI, 1-1.88; P = .05) compared to Black women who did not report experiencing racial discrimination in these areas.
When comparing the top quartile of black women who experience interpersonal racism in their daily lives, the hazard ratios for paroxysmal stroke and definite stroke were 1.14 (95% CI, 0.97-1.35), respectively. and 1.09 (95% CI, 0.83-1.45). Those in the bottom quartile.
“The increased risk of stroke was present not only in analyzes that included all strokes that occurred, but also in analyzes that were restricted to confirmed strokes,” the researchers wrote. “Perceived interpersonal racism in everyday life was associated with an increased risk of stroke in an analysis that included all stroke cases, but was associated with an increased risk of stroke based on an analysis of a small number of distinct cases. There was no evidence of that.”
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Disclosure: Sheehy does not report any relevant financial disclosures. Please refer to this study for relevant financial disclosures of all other authors.
race and medicine
