Discrimination and Cardiovascular Health in Black Americans: Exploring Inflammation as a Mechanism and Perceived Control as a Protective Factor

Abstract

ABSTRACT Objective Inflammation may be an integral physiological mechanism through which discrimination impacts cardiovascular health and contributes to racial health disparities. Limited research has examined psychosocial factors that protect against the negative effects of discrimination on inflammation. Perceived control is a promising possible protective factor, given that it has been shown to moderate the relationship between other psychosocial stressors and physiological outcomes. This study thus tested whether systemic inflammation mediated the link between discrimination and cardiovascular health and whether perceived control moderated this relationship. Methods Data for this project included 347 non-Hispanic/Latinx Black adults (Mage = 51.64, SD = 11.24; 33% female) taken from the MIDUS study. Perceived control and daily discrimination were assessed via self-report and inflammation was measured via circulating levels of CRP, IL-6, fibrinogen, and TNF-α. Cardiovascular health was measured by morbidity of cardiovascular conditions: heart disease, hypertension, and/or stroke. Results CRP (Indirect effect: b = 0.004, 95% CI = [0.001; 0.007]) and fibrinogen (Indirect effect: b = 0.002, 95% CI = [0.0003; 0.005]) mediated the link between discrimination and cardiovascular conditions. Perceived control moderated the relationship between discrimination and CRP (F(1, 293) = 4.58, ΔR 2 = 0.013, b = -0.02, SE = 0.01, p = .033). CRP mediated the link between discrimination and cardiovascular conditions only for those who reported low levels of perceived control (Index = -0.003, 95% CI = [-0.007; -0.0001]). Conclusion Findings provide empirical evidence of inflammation as a mechanism linking discrimination to cardiovascular conditions among Black Americans. Additionally, perceived control may be protective. Findings could suggest beliefs about control as a potential intervention target to help reduce the negative effects of discrimination on cardiovascular health among Black Americans.