Search

Studies suggest that higher rates of excess adiposity in Black women may in part be driven by experiences of racism. Racial microaggressions, which include unintentional and subtle slights and insults, and responses to racism such as racism-related vigilance, may contribute to adiposity in this population. This study examined these understudied racism-related facets as well as interpersonal racial discrimination in relation to adiposity in a cohort of Black women with systemic lupus erythematosus.Data are from the Black Women's Experiences Living with Lupus (BeWELL) Study (2015-2017; n = 432). Linear regression was used to examine adiposity measures (body mass index [BMI], percent body fat, and waist-to-hip ratio) measured during a physical examination, in relation to self-reported measures of racial microaggressions, racism-related vigilance, and interpersonal racial discrimination.Compared with infrequent microaggressions, very frequent experiences of microaggressions were associated with 2.9 kg/mOur results suggest that various dimensions of racism are associated with excess adiposity. Efforts to address obesity among Black women with systemic lupus erythematosus should consider these multiple aspects to decrease racial inequities in adiposity.

Nearly two-thirds of Black women in the US are obese. Studies have focused more on lifestyle and behavioral factors to explain racial disparities; less research has examined psychosocial factors such as psychological distress and social cohesion. While research suggests that social cohesion may confer benefits for health, no studies have assessed how social cohesion is related to both mental health and obesity, and potential racial differences. Our study examined associations between psychological distress, social cohesion, and obesity among Black and White adult women.Data are from the 2014-2018 National Health Interview Survey (Psychological distress was associated with a 1.19 and 1.31 higher odds of obesity for Black (95% confidence interval: 1.05, 1.36) and White women (1.24, 1.39), respectively. Social cohesion was associated with a 0.75 lower odds of obesity among White (0.69, 0.81) but not Black women (odds ratio 0.94; 0.80, 1.10). Tests of interaction indicated no differences by social cohesion or race in the association between psychological distress and obesity.Findings highlight complex relationships between psychological distress, obesity, and social cohesion in Black and White women. Public health efforts should focus on understanding mechanisms relating social factors to health.

Introduction: The loss of cardiovascular health (CVH) begins early in life and disproportionately affects racial/ethnic minorities, particularly children in single parent households, and households with lower education, family income and food insecurity. However, the contribution of these social determinants to CVH disparities in childhood are poorly understood. Hypothesis: We hypothesized that racial/ethnic differences in CVH among US children are explained by social disadvantages. Methods: Data from the 2013-2018 National Health and Nutrition Examination Survey for children aged 2-18 (N=4,792) were used. CVH was measured using the AHA Life’s Essential 8 scores that combine nicotine exposure, diet, physical activity, sleep, body mass index, and blood pressure, lipids, and glucose. Oaxaca-Blinder decomposition methods were used to quantify the contributions of parental education, marital status and household income to poverty ratio, and food security to differences in CVH by race and sex. Results: Mean CVH score was highest among non-Hispanic White (mean [SE] = 73.7 [0.5]) than non-Hispanic Black (71.3 [0.6]) and Hispanic children (71.0 [0.4]). There was no significant difference among Black-White boys (mean differences [MD] = -1.52; 95% CI: -3.25, 0.21). Black girls had significantly lower CVH than White girls (MD= -2.66; 95% CI: -4.40, -0.91). Differences in parental college education accounted for 46% of the differences in CVH scores (MD = -1.21; 95% CI: -1.89, -0.54). Among Hispanic children, both boys (MD = -2.47; 95% CI: -4.22, -0.73) and girls (MD = -3.09; 95% CI: -4.60, -1.58) had significantly lower CVH scores than White boys and girls, respectively. Differences in parental education explained 66% of the difference in CVH among White-Hispanic boys and girls (MD= -0.66; 95%CI-1.11, -0.20; and MD= -0.66; 95%CI-1.20, -0.13). Discussion: Differences in parental college education largely explained lower levels of CVH among US Black and Hispanic children, a predictor of future cardiovascular disease.

Introduction: Disparities in heart failure (HF) outcomes are due, in part, to social determinants of health. Structural racism is thought to be a fundamental cause of health disparities. A form of structural racism, redlining, was instituted in the 1930s to disinvest in neighborhoods with a high concentration of racial and ethnic minorities, leading to neighborhoods marred by crime, poverty, and disrepair. While studies have focused on how the contemporary neighborhood impacts health outcomes, few studies have examined how historical racist policies have shaped cardiovascular disease outcomes. Additionally, no studies have focused exclusively on the Southeastern region of the US where rates of cardiovascular disease and HF are among the highest in the country. This analysis examined the association between redlining and HF outcomes (e.g., 30-day readmission and mortality) among HF patients residing in Georgia. Hypothesis: Patients residing in “definitely declining” and “hazardous” neighborhoods will have a higher risk of both 30-day readmission and 30-day mortality compared to patients residing in “best” defined neighborhoods. Methods: Data are from a retrospective cohort of patients hospitalized for acute HF within Emory Healthcare from 2010 to 2018. Patient addresses were geocoded and linked to historically redlined neighborhoods at the census tract level using Home Owners’ Loan Corporation (HOLC) maps which classified neighborhoods as: “best”, “still desirable”, “definitely declining”, or “hazardous/redlined”. Neighborhood deprivation was assessed at the census tract level using the Social Vulnerability Index. Multivariable logistic regression was used to estimate the relative risk of 30-day readmission and 30-day mortality across HOLC-graded neighborhoods adjusted for patient demographics, clinical and hospital characteristics, and neighborhood deprivation. Results: Within the full sample, redlining was not associated with either 30-day readmission (RR 0.90; 95% CI: 0.62, 1.31) or mortality (RR 1.32; 95% CI: 0.79, 2.20). Redlining was not associated with 30-day mortality among Black patients. However, residing in a historically redlined neighborhood appeared to be associated with a two-fold increased risk in 30-day readmission for Black patients although results were non-significant (RR 1.98; 95% CI: 0.52, 7.59). Conclusion: In conclusion, redlining was not associated with HF readmission or mortality across racial groups. Findings among Black patients suggest that redlining may be associated with adverse heart failure outcomes. Further research with larger samples is needed.