Racial discrimination linked to higher risk of chronic illness in black women in new study

A protester marches through stopped cars while in the Alameda-Oakland tunnel during a "Millions March" demonstration in Oakland protesting the killing of unarmed black men by police in this Dec. 13, 2014 photo. A new study out of UC Berkeley found that less-educated black women who report high levels of racial discrimination may face higher risk of developing chronic diseases. less A protester marches through stopped cars while in the Alameda-Oakland tunnel during a "Millions March" demonstration in Oakland protesting the killing of unarmed black men by police in this Dec. 13, 2014 ... more Photo: Elijah Nouvelage/Getty Images Photo: Elijah Nouvelage/Getty Images Image 1 of / 32 Caption Close Racial discrimination linked to higher risk of chronic illness in black women in new study 1 / 32 Back to Gallery

A new study out of UC Berkeley found that less-educated black women who report high levels of racial discrimination may face higher risk of developing chronic diseases.

Amani M. Allen, an associate professor of epidemiology and community health sciences in UC Berkeley's School of Public Health, was the lead author on the study, the results of which were published earlier this month in the journal Psycho­neuro­endocrinology.

Allen and her team studied 208 black women between the ages 30 and 50 from the Bay Area in order to examine the relationship between racial discrimination and allostatic load, a measure of chronic physiologic stress in the body and predictor of chronic diseases.

"Racial discrimination has many faces. It is not being able to hail a cab, getting poor service in stores and restaurants, being treated unfairly at work, being treated unfairly by police and law enforcement and being followed around in stores because of racial stereotypes," Allen said to UC Berkeley's news website. "We found that experiencing racial discrimination repeatedly can create a state of biological imbalance that leaves certain groups of people more susceptible to chronic disease."

Several previous studies have linked allostatic load with numerous chronic diseases, such as heart disease, stroke, and diabetes, and mortality and decreased brain function, according to the UC Berkeley study. Other studies have found that black women disproportionately experience high allostatic loads.

"Social stress has been associated with allostatic load," said Marilyn D. Thomas, a doctoral candidate in epidemiology at UC Berkeley who was one of the researchers on the study. "Prior work has also shown that racial discrimination itself is a particular stressor in the lives of African American women."

And although previous studies have linked racial discrimination to specific conditions in African American women, this is the first to study the link between allostatic load and racial discrimination in this population.

"One of the motivations for the study was the position of black women as an at-risk group, especially for cardiometabolic health," Allen said. "We know that black women are among some of the most at-risk groups for a variety of poor health outcomes, including cardiovascular disease, diabetes, cancer. However, the reasons for these poor health outcomes in African-American women is poorly understood.

"And the typical factors that we look at like health behaviors, access to healthcare, genetics and even socioeconomic factors have been examined, but none of them fully explain the heightened health risk observed among black women."

The study also found that higher levels of education (data from the women studied was split by those who had more than a high school diploma and those with less than or equal to a high school diploma) may serve as a buffer for some of the negative health effects of discrimination. Thomas said "it was surprising" to discover that.

"If you look at the data building up to our question, we saw a lot of information suggesting that higher levels of racial discrimination would predict higher levels of allostatic load, which is generally what we saw" she said.

"But when we split the two groups by educational attainment and we saw that less-educated women reporting the highest levels of chronic experiences of discrimination had higher levels of allostatic load, but more-educated women reporting the same levels of discrimination had lower levels of allostatic load. That was very surprising. We did not expect that."

Thomas and Allen said that the finding generated several other questions, and led them to some hypotheses, which Allen made clear were still "speculations that warrant further research." One of the reasons Allen offered for this difference is that less-educated black women might be blaming themselves for negative experiences that they might be having due to racial discrimination.

"We know that acknowledging racial discrimination in particular can be protective versus internalizing those experiences and potentially engaging in self-blame," Allen said.

Another is looking at how people choose to cope with their experiences of racial discrimination. Allen said that previous studies found that black people who engage in "active coping strategies," like speaking up about their experiences of racial discrimination, have better cardiovascular health compared to those who keep it to themselves.

"But this is less about teaching people how to cope better and more about how racial discrimination is harmful to one's health," Allen said.

"And I've been asked that question before in previous research that I've done about racial discrimination. People will say, 'Oh, so people just need to learn how to cope better, right?' I think that's the wrong message to send. One might argue that regardless of whether one is able to cope with it better or not, the problem is not the ability to cope, but having to cope with it at all."

The findings from the report speak to the need to address race relations more broadly, Allen said. Thomas agreed, adding that when most people think about racism, they think about specific instances of discrimination, but that their findings begin to suggest that day-to-day experiences of racism can lead to increased susceptibility to disease.

"We see that racial discrimination can literally change one's physiology. When we think about current event in our society today, there's been a lot of discussion about race relations," Allen said. "And we see things like police profiling and egregious acts such as ... being shot in the back while handcuffed face down as we saw here [with Oscar Grant] in the Bay Area.

"But I think one take away from our study is that the effects of racial discrimination take its toll on the body in ways that are not always visible. Stress has been called the silent killer and our study is just one example of how that happens."