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![]() 262743 Evaluating Racism and Cardiovascular Health: A Systematic Review of Epidemiological EvidenceMonday, October 29, 2012
Background: Racial disparities in high blood pressure (BP) are widely documented in the United States, especially among African Americans who suffer disproportionately from hypertension, a risk factor for heart disease, stroke, and kidney disease. Theories point to physiological impacts of racial discrimination on cardiovascular health, considering racism as a chronic and cumulative stressor triggering elevated cardiovascular responses. This review systematically examines the epidemiological evidence regarding the direct relationship between racism and BP, a critical correlation in addressing racial health disparities.
Methods: Published original studies (n=23) in the PubMed database, investigating the relationship between perceived racism and BP, were reviewed according to their association's direction and strength. Studies were 61% cross-sectional, 30% experimental/quasi-experimental, and adjusted for multiple confounders. All studies investigated African Americans, 13% included Latinos, and 26% included White participants. Results: Analysis revealed inconclusive evidence where 43% of studies observed no association, 39% showed positive associations correlating higher perceived racism with elevated BP, 9% found negative results, and three exhibited conditional or U-shaped relationships. Thirteen studies showed statistically significant associations (p<.05), though directions were mixed. Experimental and quasi-experimental studies (67%) yielded largely positive results, as did studies measuring ambulatory BP (75%). Associations were strongest for African Americans, followed by Latinos, and Whites. Conclusions: Limited evidence supported the hypothesis that racism is detrimental to cardiovascular health, however methodological gaps were identified, including small sample sizes, variations in measurement instruments, and inconsistent operational definitions of �racism.' Future research should examine longitudinal evidence, clarify the effects of confounders, and consider intersecting oppressions.
Learning Areas:
Chronic disease management and preventionEpidemiology Learning Objectives: Keywords: Health Disparities, Hypertension
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: As a second year MPHc student, I have dedicated the past year to developing competency in reviewing epidemiological evidence, and have maintained a strong commitment to reducing health disparities through public health research. I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.
Back to: 3299.0: Epidemiology & Biostatistics for Health Solutions
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