The association of discrimination, inflammation, and coping style on self-rated health among South Asian individuals in the MASALA Study.

Abstract

Objectives: South Asian individuals (SAs) may have heightened levels of inflammatory markers, such as C reactive protein (CRP), Tumor Necrosis Factor-α (TNF-α), leptin, and resistin, and decreased levels of anti-inflammatory adiponectin, contributing to higher cardiovascular disease (CVD) incidence. Social determinants of health, like discrimination, are also associated with risks for CVD in SAs. This study examined the associations between discrimination and inflammation and whether coping styles moderated the association between discrimination and self-rated health (SRH) among SAs in the United States.

Design: Secondary analysis of data obtained from 1164 SAs (mean age = 57 years, SD = 9.4, 48% women) enrolled in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study was conducted. Discrimination was measured using the Everyday Discrimination Scale (EDS). Inflammatory markers (CRP, TNF-α, leptin, resistin) and anti-inflammatory adiponectin were measured from blood samples. SRH was self-reported by participants. Coping styles were defined as problem-focused or emotion-focused. Multiple regression with bootstrapping was used to examine associations between discrimination and inflammatory markers and adiponectin. Moderation analysis assessed whether coping styles moderated the association between discrimination and SRH.

Results: No significant associations were found between discrimination and inflammation. Discrimination was inversely associated with SRH (OR = 0.969, p = 0.005). Emotion-focused coping moderated the association between discrimination and SRH (OR = 0.969, 95% CI = 0.940-0.999, p = 0.044). Among participants who used emotion-focused coping strategies, an increase in self-reported discriminatory experiences was associated with lower odds of having good or excellent SRH. Problem-focused coping did not moderate the association between discrimination and SRH.

Conclusion: The unknown magnitude and duration, and the lack of variability in discrimination among participants could explain the null findings between discrimination and inflammation. Gaining a better understanding of the ways in which SAs appraise and cope with discriminatory experiences may help to develop future interventions targeted to reduce the adverse health consequences of discrimination among SAs.