Developmental timing of initial racial discrimination exposure is associated with cardiovascular health conditions in adulthood
Developmental timing of initial racial discrimination exposure is associated with cardiovascular health conditions in adulthood
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DOI：
10.1080/13557858.2019.1613517
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发表时间：
2019-05-08
影响因子：
3.1
通讯作者：
Williams, David R.
中科院分区：
文献类型：
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作者：
Cuevas, Adolfo G.;Ho, Thao;Williams, David R.
目的探讨种族歧视初始暴露时间与心血管健康状况的关系。设计使用1995年底特律地区研究的数据，逻辑和负二项回归模型被用来评估初始暴露于种族/民族歧视的时间之间的关联，分为幼儿期（0-7），儿童期（8-12），青春期（13-19）和成年期（>19），在成年期医生诊断的心血管健康状况。每项分析均针对年龄、性别、种族/民族、收入、教育、婚姻状况、健康相关行为和既存健康状况进行了调整。结果在最终样本的1,106名参与者中，520名被确定为白色，586名被确定为黑色。超过一半（64%）的样本在研究时经历了至少一次重大心血管健康事件，39%报告了两次或两次以上的事件。逻辑回归模型的结果显示，与没有报告歧视的个体相比，在儿童早期最初暴露于种族歧视与以后生活中任何心血管相关健康状况的几率高2.96倍（95%CI：1.15，7.83）。负二项回归模型的结果表明，在儿童早期和青少年时期首次暴露于种族歧视的个体的CVD发病率分别是未报告歧视的个体的1.63（95%CI：1.11，2.38）和1.37（95%CI：1.10，1.69）倍。结论：在儿童早期和青少年时期，最初暴露于种族歧视可能会增加日后患心血管疾病的风险。临床医生和研究人员应将儿童时期的种族歧视视为疾病的可能风险因素。
Objective To examine the association between developmental timing of initial exposure to racial discrimination and cardiovascular health conditions. Design Using data from the 1995 Detroit Area Study, logistic and negative binomial regression models were used to assess the association between timing of initial exposure to racial/ethnic discrimination, classified as early childhood (0-7), childhood (8-12), adolescence (13-19), and adulthood (>19), on physician-diagnosed cardiovascular health conditions during adulthood. Each analysis adjusted for age, gender, race/ethnicity, income, education, marital status, health-related behaviors, and pre-existing health conditions. Results Of the 1,106 participants in the final sample, 520 identified as White and 586 identified as Black. Over half (64%) of the sample experienced at least one major cardiovascular health event at the time of the study, with 39% reporting two or more events. Results from logistic regression models showed that initial exposure to racial discrimination during early childhood was associated with a 2.96 (95%CI:1.15, 7.83) times greater odds of having any cardiovascular-related health condition later in life compared to individuals who reported no discrimination. Results from negative binomial regression models demonstrated that individuals who reported initial exposure to racial discrimination during early childhood and adolescence had a CVD incidence rate that was 1.63 (95%CI:1.11, 2.38) and 1.37 (95%CI:1.10, 1.69) times higher than individuals who reported no discrimination. Conclusion Initial exposure to racial discrimination in early childhood and adolescence may increase the risk of cardiovascular conditions later in life. Clinicians and researchers should consider racial discrimination during childhood as a possible risk factor for illness and disease.