Dataset Information

Perceived Discrimination and Trajectories of C-Reactive Protein: The Jackson Heart Study.

ABSTRACT: INTRODUCTION:Perceiving discriminatory treatment may contribute to systemic inflammation, a risk factor of cardiovascular pathophysiology. This study evaluated the association of self-reported discrimination with changes in high-sensitivity C-reactive protein and the mediating role of adiposity. METHODS:The sample included 5,145 African-Americans, aged 21-92 years, in the Jackson Heart Study. Everyday, lifetime, and burden from perceived discrimination comprised primary predictors in 3 sets of multivariable linear regression models of baseline (2000-2004) discrimination and natural logarithm of high-sensitivity C-reactive protein. Multivariable linear mixed models assessed mean changes in natural logarithm of high-sensitivity C-reactive protein over the study period (2000-2013). Mediation was quantified by percentage changes in estimates adjusted for BMI, waist circumference, and waist-to-height ratio. Multiple imputation addressed missingness in baseline covariates and in high-sensitivity C-reactive protein taken at all 3 study examinations. Analyses were conducted in 2018. RESULTS:In cross-sectional analyses, male participants in the middle and highest tertiles of lifetime discrimination had natural logarithm of high-sensitivity C-reactive protein levels that were 0.13 (95% CI= -0.24, -0.01) and 0.15 (95% CI= -0.27, -0.02) natural logarithm(mg/dL) lower than those in the lowest tertile. In longitudinal analyses, all participants reporting more frequent everyday discrimination had a 0.07 natural logarithm(mg/dL) greater increase in natural logarithm of high-sensitivity C-reactive protein per examination than those reporting none (95% CI=0.01, 0.12). A similar trend emerged for lifetime discrimination and changes in natural logarithm of high-sensitivity C-reactive protein (adjusted mean increase per visit: 0.04 natural logarithm[mg/dL], 95% CI=0.01, 0.08). Adiposity did not mediate the longitudinal associations. CONCLUSIONS:Everyday and lifetime discrimination were associated with significant high-sensitivity C-reactive protein increases over 13 years. The physiologic response to discrimination may lead to systemic inflammation.

SUBMITTER: Sims KD

PROVIDER: S-EPMC6985923 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Perceived Discrimination and Trajectories of C-Reactive Protein: The Jackson Heart Study.

Sims Kendra D KD Sims Mario M Glover LáShauntá M LM Glover LáShauntá M LM Smit Ellen E Odden Michelle C MC

American journal of preventive medicine 20191210 2

<h4>Introduction</h4>Perceiving discriminatory treatment may contribute to systemic inflammation, a risk factor of cardiovascular pathophysiology. This study evaluated the association of self-reported discrimination with changes in high-sensitivity C-reactive protein and the mediating role of adiposity.<h4>Methods</h4>The sample included 5,145 African-Americans, aged 21-92 years, in the Jackson Heart Study. Everyday, lifetime, and burden from perceived discrimination comprised primary predictors ...[more]

PMID: 31831294

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Project description:ObjectivesThe aim of this study was to test the mediating role of perceived discrimination and stress on associations between perceived neighborhood social environment (PNSE) and TV viewing.MethodsBaseline data were used for 4716 participants (mean age = 55.1 y; 63.4% female) in the Jackson Heart Study (JHS), a large prospective cohort study of African Americans in Jackson, Mississippi. One binary TV viewing outcome was created: ≥4 h/day versus <4 h/day. PNSE variables included neighborhood violence, problems (higher value = more violence/problems), and social cohesion (higher value = more cohesion). Mediators included perceived lifetime discrimination, daily discrimination, and chronic stress (higher value = greater discrimination/stress). Multivariable regression was used with bootstrap-generated 95% bias-corrected confidence intervals (BC CIs) to test for mediation adjusting for demographics, health-related and psychosocial factors, and population density.ResultsNeighborhood violence, problems, and social cohesion were indirectly associated with TV viewing through lifetime discrimination (OR = 1.03, 95%BC CI = 1.00, 1.07; OR = 1.03, 95%BC CI = 0.99, 1.06 [marginal]; OR = 0.98, 95%BC CI = 0.94, 0.99, respectively) and chronic stress (OR = 0.95, 95%BC CI = 0.90, 0.99; OR = 0.96, 95%BC CI = 0.92, 0.99; OR = 1.05, 95%BC CI = 1.01, 1.10, respectively). Daily discrimination was neither directly nor indirectly associated with TV viewing.ConclusionsEach PNSE variable was indirectly associated with TV viewing via lifetime discrimination and perceived stress, but not with daily discrimination among JHS participants. Unexpected directionality of mediating effects of lifetime discrimination and chronic stress should be replicated in future studies. Further research is also needed to pinpoint effective community efforts and physical environmental policies (e.g., installing bright street lights, community policing) to reduce adverse neighborhood conditions and psychosocial factors, and decrease TV viewing and subsequent cardiovascular disease risk.

Project description:BackgroundLittle is known about the associations between perceived neighborhood social environment (PNSE) and depressive symptoms among African Americans. Furthermore, the role of physical activity (PA) as a mediator of this association has not been investigated. The two-fold objectives of this study, therefore, were (1) to examine the associations between PNSE and depressive symptoms among African Americans, and (2) to test the degree to which these associations were mediated by total PA.MethodsWe used baseline data from the Jackson Heart Study (JHS), a single-site, prospective, community-based study of African-American adults (n = 2209) recruited from Jackson, Mississippi. PNSE variables included scores for neighborhood violence (i.e., higher score = more violence), problems (higher score = more problems), and social cohesion (higher score = more cohesion). Depressive symptoms were measured by the 20-item Center for Epidemiological Studies Depression (CES-D) score. First, multilevel modeling, controlling for census tract clustering effects, was used to estimate associations between each PNSE variable and CES-D score, adjusting for covariates, including demographic, health-related, and population density. Second, validated, self-reported total PA, based on active living, sport, and home indices, was tested as the mediator. Multivariable linear regressions with bootstrap-generated 95% bias-corrected confidence intervals (BC CIs) were estimated to test for significant unstandardized indirect effects, controlling for all covariates.ResultsOur participants were 64.2% female with a mean age of 52.6 (SD = 12.2) and a mean CES-D score of 10.8 (SD = 8.1). In the fully-adjusted model, neighborhood violence and problems were positively related to depressive symptoms (B = 3.59, 95%CI = 0.93, 6.26, and B = 3.06, 95%CI = 1.19, 4.93, respectively). Neighborhood violence and problems were also indirectly related to depressive symptoms via total PA (B = 0.26, 95%BC CI = 0.05, 0.55; and B = 0.15, 95%BC CI = 0.02, 0.34, respectively). Social cohesion was neither directly nor indirectly related to depressive symptoms.ConclusionsWe found that higher levels of perceived neighborhood problems and violence were directly and positively associated with depressive symptoms. These associations may be explained in part by lower total PA levels. Future interventions to reduce depressive symptoms attributed to neighborhood features should consider emphasizing built environment features that facilitate PA increases in conjunction with community efforts to reduce neighborhood violence and problems.

Dataset Information

Perceived Discrimination and Trajectories of C-Reactive Protein: The Jackson Heart Study.

Publications

Perceived Discrimination and Trajectories of C-Reactive Protein: The Jackson Heart Study.

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