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Open AccessArticle

Everyday Racial Discrimination and Hypertension among Midlife African American Women: Disentangling the Role of Active Coping Dispositions versus Active Coping Behaviors

1
Division of Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA 94720-7360, USA
2
Division of Community Health Sciences, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA 94720-7360, USA
3
Schools of Kinesiology and Public Health, University of Michigan, 2110 Observatory Lodge/1402 Washington Heights, Ann Arbor, MI 48109-2029, USA
4
Department of Human Development and Family Studies, College of Human Sciences, Auburn University, 210 Spidle Hall, Auburn, GA 36849, USA
5
Divisions of Community Health Sciences and Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA 94720-7360, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(23), 4759; https://doi.org/10.3390/ijerph16234759
Received: 23 September 2019 / Revised: 24 November 2019 / Accepted: 25 November 2019 / Published: 27 November 2019
Racial discrimination, a psychosocial stressor, may contribute to disproportionate rates of hypertension among African American women. Coping moderates the effects of psychosocial stress on health. Coping dispositions describe stable personality characteristics, whereas contextual frameworks emphasize flexible coping behaviors in response to specific stressful encounters. Using data from the African American Women’s Heart and Health Study—a non-probability cross-section of 208 midlife African American women in Northern California—we estimated the association between everyday racial discrimination (Everyday Discrimination Scale, EDS) and prevalence of hypertension (HTN), and evaluated moderation by coping disposition (John Henryism Active Coping scale, JH) versus context-specific active coping behavior (Active Coping with Racism scale, ACR). There were no main associations between EDS, JH, or ACR on HTN prevalence. There was evidence of statistical interaction between EDS and ACR (p-int = 0.05), but not JH (p-int = 0.90). Among those with high levels of ACR, reporting monthly (prevalence ratio (PR) = 2.35, 95% confidence interval (CI) = 1.13, 4.87), weekly (PR = 2.15, 95% CI = 1.01, 4.61), or daily (PR = 2.36, 95% CI = 1.14, 4.88) EDS was associated with higher HTN prevalence, versus reporting racial discrimination yearly or less. In contrast, among those with low levels of ACR, reporting more chronic racial discrimination was associated with lower hypertension prevalence, although results were less precise. Findings suggest that ongoing active coping with chronic racial discrimination may contribute to hypertension risk among African American women. View Full-Text
Keywords: racial discrimination; hypertension; stress; coping; John Henryism; African American; health disparities racial discrimination; hypertension; stress; coping; John Henryism; African American; health disparities
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MDPI and ACS Style

Michaels, E.K.; Reeves, A.N.; Thomas, M.D.; Price, M.M.; Hasson, R.E.; Chae, D.H.; Allen, A.M. Everyday Racial Discrimination and Hypertension among Midlife African American Women: Disentangling the Role of Active Coping Dispositions versus Active Coping Behaviors. Int. J. Environ. Res. Public Health 2019, 16, 4759. https://doi.org/10.3390/ijerph16234759

AMA Style

Michaels EK, Reeves AN, Thomas MD, Price MM, Hasson RE, Chae DH, Allen AM. Everyday Racial Discrimination and Hypertension among Midlife African American Women: Disentangling the Role of Active Coping Dispositions versus Active Coping Behaviors. International Journal of Environmental Research and Public Health. 2019; 16(23):4759. https://doi.org/10.3390/ijerph16234759

Chicago/Turabian Style

Michaels, Eli K.; Reeves, Alexis N.; Thomas, Marilyn D.; Price, Melisa M.; Hasson, Rebecca E.; Chae, David H.; Allen, Amani M. 2019. "Everyday Racial Discrimination and Hypertension among Midlife African American Women: Disentangling the Role of Active Coping Dispositions versus Active Coping Behaviors" Int. J. Environ. Res. Public Health 16, no. 23: 4759. https://doi.org/10.3390/ijerph16234759

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