Abstract P359: Pervasive Discrimination and Allostatic Load in African-American and White Adults

Abstract

Introduction: Self-reported experiences of discrimination have been associated with a range of important clinical disease outcomes; however, most studies have focused on discrimination assessed using a single scale which may fail to capture the pervasive nature of experiences of discrimination in the lives of certain groups. We sought to examine associations between reports of “pervasive” discrimination—conceptualized by combining multiple scales assessing discriminatory experiences-- and an indicator of homeostatic dysfunction, allostatic load (AL), among African-Americans and Whites. We also examined whether associations were stronger among African-Americans than Whites. AL was chosen as it is a measure of cumulative “wear and tear” on the body caused by stressors (i.e., discrimination) and has been associated with cardiovascular-related outcomes. Hypothesis: We hypothesized that pervasive discrimination would be associated with higher allostatic load, and that associations would be stronger among African-Americans compared to Whites. Methods: We conducted linear regression models using data from 215 African-American and 985 White adults (57% female; mean age=54.7 years) in the Midlife in the United States II (MIDUS II) Biomarker Project. A pervasive discrimination score was created by combining three discrimination scales (Everyday Discrimination, Lifetime Discrimination, and Workplace Discrimination), resulting in a score measuring 0-3 domains of discrimination, and an AL score was created based on a set of 24 biomarkers representing 7 biological systems (including inflammation, lipid metabolism, and cardiovascular, among others). Results: African-Americans had higher pervasive discrimination and AL scores than Whites (p<0.001). In models fully-adjusted for demographics and other relevant covariates, raceхpervasive discrimination interaction was observed (p<0.05). A pervasive discrimination score of 2 vs. 0 was associated with a greater increase in AL among African-Americans (b=0.32; p<0.001) compared to Whites (b=0.18; p<0.001). Conclusions: African-Americans report more pervasive discrimination than Whites. This pervasive discrimination in turn, has a greater impact on multisystemic physiological dysregulation in African-Americans compared to Whites. Findings suggest that measuring discrimination by combining multiple forms of discriminatory experiences may be particularly important for studying the health effects of discrimination among African-Americans.