Abstract P122: Intersectional Effects of Racial and Gender Discrimination on Cardiovascular Health Vary Among Black and White Women and Men in the Cardia Study

Abstract

Background: Some evidence suggests an association of perceived racial but not gender discrimination with disparities in cardiovascular health (CVH) among U.S. black women and men. We assessed whether there are race-gender differences in the effects of reporting experiences of racial and gender discrimination simultaneously compared with racial or gender discrimination alone, or no discrimination, on future CVH. Methods: Data were from a sample of 3,758 black or white adults in CARDIA, a population-based cohort recruited in Birmingham, AL; Chicago, IL; Minneapolis, MN, and Oakland, CA in 1985-6 (year 0). Racial and gender discrimination were assessed using the Lifetime Discrimination Scale at year 7. CVH at year 30 was evaluated using a 12-point composite outcome modified from the AHA’s Simple 7, with higher scores indicating better health. Multivariable linear regressions evaluated the associations between level of perceived discrimination at year 7 and CVH scores at year 30 stratified by race-gender. Results: Reporting racial and gender discrimination in ≥2 settings were 48% (496/1039) of black women, 42% (311/743) of black men, 10% (109/1045) of white women, and 5% (45/931) of white men. Year 30 CVH scores (mean, SD) were 7.9 (1.4), 8.1 (1.6), 8.8 (1.6), and 8.7 (1.3), respectively. Table: Compared with those of their race-gender groups reporting no discrimination, white women reporting gender only saw an adjusted score difference of +0.3 ( p =0.04); white men reporting racial only, +0.4 ( p =0.02), and both racial and gender, -0.6 ( p =0.03). Conclusions: Racial and gender discrimination interact in their association with CVH differently for different race-gender groups. While modest, a 1-point decrease in CVH score among white men has been shown to correspond to an ~30% increase in the rate of CVD development. More research is needed to understand why perceived discrimination might better predict CVH for whites than blacks, and which other factors associated with race-gender contribute variability to CVH among these groups.