Multiple Social Roles and Blood Pressure of Black and White Women: The CARDIA Study

Abstract

Multiple social roles in women—marriage, motherhood, and work—are viewed by some as beneficial, by others as stressful, and by others as reflecting a balance between benefits and stress. The impact of social roles on blood pressure (BP) were analyzed in 1,473 blacks and 1,301 whites, ages 18–30, by analysis of covariance (ANCOVA), in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Differential BP by educational level in black women with multiple roles: Better educated black women with multiple roles had lower mean BP than those in fewer roles (−1.3 to −8.0 mmHg systolic); less well-educated women generally had higher mean BP (+0.6 to +3.1 mmHg systolic). In whites, there was no consistent association between multiple roles and BP. In whites, marriage and motherhood were each independently related to BP regardless of education; marriage with higher BP (+0.1 to +2.4 mmHg) and motherhood with lower BP (−0.4 to −2.6 mmHg). In blacks, marriage, motherhood, and education were not independent; married mothers had higher BP (+2.2 mmHg) than single mothers among the less well educated, whereas among the better educated, married mothers had lower BP (−2.3 mmHg). In better educated blacks only, BP was lower for working women. Explanations for these associations remain to be explored. If social roles affect BP, the findings suggest the effects differ by race and, in blacks, by education.