Dataset Information

Past-Year Racial Discrimination and Allostatic Load Among Indigenous Adults in Canada: The Role of Cultural Continuity.

ABSTRACT:

Objective

This study aimed to examine the association between racial discrimination and allostatic load (AL) and whether this association was moderated by cultural continuity among Indigenous adults.

Methods

Data were collected from Indigenous adults attending university in a small city in western Canada between 2015 and 2017 (mean age = 27.8 years). The Experience of Discrimination Situation Score and the Vancouver Index Enculturation Subscale were used to assess racial discrimination and cultural continuity, respectively. AL was measured as a composite of seven biomarkers assessing neuroendocrine, cardiovascular, metabolic, and immune system function. Bias-corrected and accelerated bootstrapped linear regression models were used to examine associations adjusting for confounders (n = 104; 72.5% women).

Results

Across the full sample, racial discrimination was associated with a linear, dose-response increase in AL score after adjustment for confounders. Among adults with low cultural continuity, past-year discrimination was associated with increased AL and explained 22% (adjusted R) of the variance in AL score. Taken together, the full model including age, sex, and income explained 38% of the variance in AL score in this subgroup. Among adults with high cultural continuity, racial discrimination was not associated with AL, whereas age remained significant and explained 13% of the variance in AL score.

Conclusions

Past-year racial discrimination was associated with early and more pronounced wear and tear on stress response systems among Indigenous adults relative to peers. Indigenous cultural continuity served as an important buffer that promoted biological resilience against the adverse effects of racial discrimination on physiologic regulation among Indigenous adults.

SUBMITTER: Currie CL

PROVIDER: S-EPMC6946095 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundDiscrimination promotes multisystem physiological dysregulation termed allostatic load, which predicts morbidity and mortality. It remains unclear whether weight-related discrimination influences allostatic load.PurposeThe aim of this study was to prospectively examine 10-year associations between weight discrimination, allostatic load, and its components among adults 25-75 years in the Midlife Development in the US Biomarker Substudy.MethodsParticipants with information on weight discrimination were analyzed (n=986). At both timepoints, participants self-reported the frequency of perceived weight discrimination across nine scenarios as "never/rarely" (scored as 0), "sometimes" (1), or "often" (2). The two scores were averaged and then dichotomized as "experienced" versus "not experienced" discrimination. High allostatic load was defined as having ≥3 out of 7 dysregulated systems (cardiovascular, sympathetic/parasympathetic nervous systems, hypothalamic pituitary axis, inflammatory, lipid/metabolic, and glucose metabolism), which collectively included 24 biomarkers. Relative risks (RR) were estimated from multivariate models adjusted for sociodemographic and health characteristics, other forms of discrimination, and BMI.ResultsOver 41% of the sample had obesity, and 6% reported weight discrimination at follow-up. In multivariable-adjusted analyses, individuals who experienced (versus did not experience) weight discrimination had twice the risk of high allostatic load (RR, 2.07; 95 % CI, 1.21; 3.55 for baseline discrimination; 2.16, 95 % CI, 1.39; 3.36 for long-term discrimination). Weight discrimination was associated with lipid/metabolic dysregulation (1.56; 95 % CI 1.02, 2.40), glucose metabolism (1.99; 95 % CI 1.34, 2.95), and inflammation (1.76; 95 % CI 1.22, 2.54), but no other systems.ConclusionsPerceived weight discrimination doubles the 10-year risk of high allostatic load. Eliminating weight stigma may reduce physiological dysregulation, improving obesity-related morbidity and mortality.

Project description:The objective of this paper is to examine associations between multiple measures of discrimination (i.e., everyday, lifetime, and appraised burden) and components of allostatic load (AL). We drew on pooled cross-sectional data from the Biomarker Project of the Midlife in the United States study (n = 2118). Ages ranged from 25 to 84 years and included mostly Black (n = 389) and white (n = 1598) adults. Quasi-Poisson models were fit to estimate prevalence ratios for each discrimination measure and high-risk quartiles across seven physiological systems (i.e., sympathetic and parasympathetic nervous system; HPA axis; inflammation; cardiovascular; metabolic glucose; and metabolic lipids) and overall AL scores. In fully adjusted models, everyday discrimination was associated with elevated lipids (aPR: 1.07; 95% CI 1.01, 1.13). Lifetime experiences of discrimination were associated with lower sympathetic nervous system (aPR: 0.82; 95% CI: 0.69, 0.98) and greater cardiovascular risk scores (aPR: 1.17; 95% CI: 1.02, 1.34) among those reporting three or more experiences, as well as increased inflammation (aPR: 1.13; 95% CI: 1.02, 1.25; aPR: 1.28; 95% CI: 1.14, 1.43), metabolic glucose (aPR: 1.35; 95% CI: 1.19, 1.54; aPR: 1.45; 95% CI: 1.24, 1.68), and metabolic lipids (aPR: 1.13; 95% CI: 1.03, 1.24; aPR: 1.28; 95% CI: 1.15, 1.43) scores for those reporting one to two and three or more experiences. Appraised burden yielded nuanced associations with metabolic glucose and parasympathetic nervous system scores. Everyday and lifetime measures were also associated with higher overall AL, though burden of discrimination was only associated with AL among those reporting "a little" burden. While AL summary scores provide insight into the cumulative impacts of discrimination on health, there appear to be distinct physiologic pathways through which varying forms of discrimination contribute to AL and, ultimately, to poorer health. These unique pathways may be useful in identifying potential points of intervention to mitigate the impacts of discrimination on health inequities.