Abstract

Introduction: Racial discrimination has been linked with chronic inflammation among African American women, and may help explain their heightened risk of coronary artery disease. However, the mechanisms linking the two remain unclear. Objectives: We assessed the hypothesis that cognitive stress appraisals and coping mechanisms modify the association between racial discrimination and chronic inflammation among African American women. Methods: The African American Women’s Heart & Health Study recruited a community sample of African American women ages 30-50 residing in the San Francisco Bay area (n=200). Data collection included interviewer-administered questionnaire, computer assisted self-interview, anthropometric assessment, and venous blood draws. Blood samples were assayed for a variety of biomarkers including pro-inflammatory cytokines (e.g., IL-6) and acute phase proteins (e.g., hsCRP). Ordinary Least Squares regression was used to examine associations between study variables. Results: Cognitive stress appraisal and coping style both modified the association between racial discrimination and inflammation. Anticipatory Racism Threat (aRT) is a unique cognitive appraisal process commonly reported by African Americans (α=.90). Superwoman Schema (SWS) is a coping style commonly reported among African American women (α=.93). There were no significant main effects of racial discrimination on inflammation. However, there was a significant interaction between racial discrimination and both aRT and SWS (p<.05). Interaction results show a positive association between racial discrimination and elevated levels of pro-inflammatory biomarkers (IL-6, TNFα, hsCRP) among women reporting higher vs. lower levels of aRT (p<.05). There was also a significant inverse association between racial discrimination and inflammation among women reporting higher vs. lower levels of SWS (p<.05). Conclusions: The unique stress appraisals and coping styles used by African American women experiencing racial discrimination may represent novel bio-behavioral mechanisms linking racial discrimination to cardiovascular risk, particularly coronary heart disease, via inflammation and serve as potential avenues for intervention.

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