Daily discrimination can influence unhealthy coping behaviors, such as smoking, and thereby increase the risk of heart disease, according to a new study published today. American Heart Association Journal. However, the impact varies by individual identity, with Hispanic women at highest risk for heart disease as a result of discrimination.

“Experiences of discrimination are shaped by individual cultural realities and context,” said Stephanie Cook, assistant professor of biostatistics and social and behavioral sciences at New York University’s School of Global Public Health and lead author of the study. says. “Discrimination at the intersection of multiple marginalized identities can have particularly negative health consequences.”

Heart disease is the leading cause of death in the United States, but some people are at greater risk depending on their race, ethnicity, and gender. These disparities can be explained in part by social determinants of health: the environmental conditions in our lives that affect our health, from income and education to air pollution and access to healthy foods. .

Discrimination is another social determinant of health, and research shows that the stress caused by this mistreatment can worsen heart health. This may be because discrimination alters the function of physiological stress systems, which can lead to inflammation and thickening of arteries. Research also shows that experiencing discrimination can lead to unhealthy coping behaviors, such as smoking, which is a well-known risk factor for heart disease.

Most studies have examined the health effects of discrimination in the context of a single identity, such as race, gender, or sexual orientation. But this ignores the reality of having overlapping identities, a concept known as intersectionality.

To understand the relationship between discrimination, smoking, and heart health, Dr. Cook and colleagues analyzed data from the Multi-Ethnic Study of Atherosclerosis, a national study sponsored by the National Heart, Lung, and Blood Institute (NHLBI). . More than 6,800 adults with undiagnosed heart disease were questioned about health behaviors, heart disease-related risk factors, demographics, and whether they felt discriminated against. Researchers looked at associations between discrimination, smoking, and two measures of heart health: carotid intima-media thickness and carotid plaque. All of these are strong predictors of future cardiovascular events.

They found that discrimination had an indirect effect on measures of heart health, but only in certain populations. Hispanic women were most affected, which was associated with greater discrimination and increased smoking, which in turn was associated with increased arterial plaque. Hispanic men also experience the effects of discrimination, with increased discrimination associated with increased smoking and increased plaque and carotid intima-media thickness.

Researchers say the results demonstrate the importance of considering multiple identities when studying health disparities and creating interventions to improve health.

“The key takeaway from this analysis is that we need more cross-sectional studies of cardiovascular disease,” Cook said. “If we do not consider mechanisms such as smoking from an intersectionality perspective, we will miss the association between discrimination and cardiovascular disease. , or designing programs that reduce heart disease only among specific racial groups is not enough.”

Cook completed this research as part of the NHLBI BioData Catalyst Fellows Program. The program provided researchers with funding to support projects that use innovative data science to study pressing issues related to cardiovascular health.

In addition to Cook, study authors include Erica Wood of the New York University School of Global Public Health, James Stein of the University of Wisconsin School of Medicine and Public Health, and Robin McClelland of the University of Washington School of Public Health. In addition to Cook, study authors include Erica Wood of the New York University School of Global Public Health, James Stein of the University of Wisconsin School of Medicine and Public Health, and Robin McClelland of the University of Washington School of Public Health. This study was funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health (#OT2HL167310).

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

About New York University School of Global Public Health

New York University School of Global Public Health (NYU GPH) prepares the next generation of public health pioneers with the critical thinking skills, acumen, and entrepreneurial spirit needed to solve global health challenges . NYU GPH is dedicated to employing non-traditional, interdisciplinary models to uniquely combine global public health research, research, and practice to improve health around the world. The school is located in the heart of New York City, with New York University’s global network reaching across six continents. Innovation is at the core of our ambitious approach, thinking and teaching. For more information, please visit http://publichealth.nyu.edu/.