Online Program

Perceived unfair treatment and daily cortisol decline among a diverse sample of Detroit residents

Monday, November 2, 2015

Erin Linnenbringer, MS, PhD, Division of Public Health Sciences, Washington University School of Medicine, Saint Louis, MO
Arline Geronimus, ScD, School of Public Health, University of Michigan, Ann Arbor, MI
Rachel Snow, DSc, Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Carmen A. Stokes, PhD, FNP-BC, RN, CNE, McAuley School ofNursing, University of Detroit Mercy, Detroit, MI
Amy Schulz, MPH, MSW, PhD, Health Behavior and Health Education, University of Michigan, Ann Arbor, MI
Background: Perceived unfair treatment has been linked to a wide range of physical and mental health outcomes, potentially via dysregulation of the hypothalamic-pituitary-adrenal axis (HPA). Diurnal salivary cortisol patterns can approximate basal HPA axis activity. Previous studies suggest that Blacks and Latinos are more likely than Whites to have flatter salivary cortisol patterns.  We hypothesized that higher levels of perceived unfair treatment are associated with flatter salivary cortisol patterns, and that this relationship would partially explain the racial/ethnic variation in salivary cortisol.

Methods: 184 Detroit residents (56% Black, 23% Latino, 21% White) were enrolled into this cross-sectional study. We examined basal HPA axis activity using a three-day average of the daily decline in salivary cortisol. Perceived acute unfair treatment was assessed via validated survey measures. Covariates (e.g., age, gender, education, poverty) were included in multilevel mixed effects linear regression models.

Results: Adjusting for all covariates, mean daily cortisol decline among Black (β = 0.338; p < 0.01) and Latino (β = 0.196; p = 0.02) participants was significantly flatter than among Whites. Higher levels of perceived acute unfair treatment were modestly associated with flatter declines (β = 0.190; p = 0.09). Adding acute unfair treatment to the model slightly reduced the coefficient among Blacks (0.338 vs. 0.354), but did not alter its significance.

Implications: Perceived acute unfair treatment may contribute to the observed Black-White differences in daily cortisol decline. Further investigation of other socially patterned factors is needed to address racial/ethnic disparities in HPA axis activity and subsequent health outcomes.

Learning Areas:

Public health biology
Public health or related research
Social and behavioral sciences

Learning Objectives:
Explain why racial/ethnic variation in diurnal cortisol patterns may be relevant to health inequalities. Discuss potential sources of racial/ethnic variation in diurnal cortisol patterns. Describe the relationship between perceived unfair treatment and diurnal cortisol patterns.

Keyword(s): Health Disparities/Inequities, Stress

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have recently completed my doctoral training in health behavior and social demography, focusing on social environmental factors that may contribute racial/ethnic health disparities. I have received additional training in the use of biomarkers in population health research.
Any relevant financial relationships? No

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.