Perceived Racism and Coping: Joint Predictors of Blood Pressure in Black Americans

Article excerpt

Abstract

Black Americans suffer disproportionate incidences of severe complications associated with hypertension and cardiovascular disease. Psychosocial factors and subsequent coping responses have been implicated in the etiology of disease. Perceived racism has been identified as a source of stress for Blacks and is related to anger, hostility, paranoia, and greater blood pressure reactivity. The impact of coping responses to perceived racism on blood pressure levels in 52 Black adults was examined in this study. Twenty-four hour ambulatory blood pressure, self-reported perceived racism, and coping responses to racism measures were assessed. Regression analyses indicated that (a) passive coping (i.e., avoidance) predicted higher blood pressure levels and (b) active coping (i.e., trying to change things) predicted lower blood pressure levels. Additionally, blood pressure levels were significantly higher in those reporting greater exposure to racism.

Introduction

During the last two decades, research has examined the impact of racial discrimination on the health of Black Americans in the United States. Within the last decade, the research has begun to focus on the relationship between coping with racial discrimination and health outcomes (Clark, 2000; Combs, Perm, Cassisi, Michael, Wood, Wanner, & Adams, 2006; Harrell, Hall, & Taliaferro, 2003; Jones, Cross, & Defour, 2007; Tuli, Sheu, Butler, & Cornelious, 2005; Utsey, 1998; Williams, Neighbors, & Jackson, 2003). Racism and discrimination have been identified as a significant source of stress (Krieger & Sidney, 1996; McNeilly, Anderson, Robinson, McManus, Armstead, Clark, et al., 1996). Perceived racism is described as a source of stress (Lepore, Revenson, Weinberger, Weston, Frisina, Robertson, et al. , 2006) and has been related to hostility and paranoia (Combs, Perm, Cassisi, Michael, Wood, Wanner, et al., 2006), depression (Jones, Cross, & Defour, 2007), high blood pressure variability (Clark & Adams, 2004; Clark & Anderson, 2001 ; Clark & Gochett, 2006; Guyll, Matthews, & Bromberger, 2001 ; Knox, Hausdorff, & Markovitz, 2002; Mays, Cochran, & Barnes, 2007), and internalized anger (Steffen, McNeilly, Anderson, & Sherwood, 2003). A wide range of health issues have been associated with prolonged stress, including heart disease, cardiovascular disease, hypertension, depression, insomnia, migraine headaches, and skin disorders. Further, stress is known to exacerbate pre-existing health conditions (Everson-Rose & Lewis, 2005; Myers, 2005; Kolb & Whishaw, 2001).

Though debated, racism and discrimination still occur frequently today (Akbar, 2004; Harrell, 1999; Jones et al., 2007; Kambon, 2003, 2006). Real or imagined, experiencing racism and discrimination can produce extreme mental and physical stress reactions. In addition to the exposure to racial discrimination, often Blacks must defend their thoughts and interpretations of the perceived racial discrimination to those who challenge the existence of racial discrimination or to those who have accepted the acts as "normal" intergroup dynamics (Kambon, 2003). Research has indicated that Blacks are at a substantially greater risk for developing hypertension than Whites (Dimsdale, 2000; Douglas, Bakris, Epstein, Ferdinand, Ferrario, Hack, et al., 2003; Wilson, Kli ewer, Plybon, & Sica, 2000). Additionally, they have been shown to develop earlier and more severe complications from hypertension when compared to other racial groups. (Douglas et al., 2003; Martins & Norris, 2004). For example, Blacks tend to experience greater cardiovascular and renal damage from hypertension at any level of blood pressure (Dimsdale, 2000; Martins & Norris, 2004).

Blood Pressure and Racism

Some researchers propose that the cardiovascular differences in health outcomes may be attributed to socioeconomic status (Schmeelk-Cone, Zimmerman, & Abelson, 2003; Tuli, Sheu, Butler, & Cornelious, 2005; Wilson et al. …