动脉粥样硬化的多种族研究:歧视经验、全因死亡率和心血管死亡率。

IF 6.9 2区 医学
Wayne R Lawrence, Gieira S Jones, Jarrett A Johnson, Koya P Ferrell, Jacquita N Johnson, Meredith S Shiels, Ana V Diez Roux, Allana T Forde
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引用次数: 1

摘要

背景:流行病学研究证明了歧视经历与不良健康结果之间的关联。然而,歧视与死亡率之间的关系以及可能缓和这种关系的因素尚未得到很好的理解。本研究调查了终生和日常歧视是否与全因死亡率和心血管死亡率相关,以及这些关联是否因种族和民族、性别、种族和民族居住隔离而异。方法:该研究包括来自动脉粥样硬化多种族研究的1633名黑人、1403名西班牙裔/拉丁裔和2473名年龄在45至84岁之间的白人参与者,他们于2000年至2002年入组,并进行了5次检查(2002年至2018年)。歧视是用终身歧视(主要不公平待遇经历)和日常歧视(每天不公平待遇经历)量表来衡量的。种族和民族居住隔离是用Gi*统计来衡量的。Cox比例风险回归用于估计风险比(hr)和95% ci,调整社会人口统计学特征、健康行为和临床危险因素。结果:在调整了社会人口因素、健康行为和临床危险因素后,终生歧视报告的每增加都与全因死亡率(HR, 1.06 [95% CI, 1.00-1.11])和心血管死亡率(HR, 1.15 [95% CI, 1.04-1.27])的增加相关。在所有种族和民族中都观察到终生歧视与心血管死亡率之间的关联,但在黑人参与者中最强且仅具有统计学意义(HR, 1.18 [95% CI, 1.02-1.37])。此外,在完全调整模型中,日常歧视报告的每增加都与心血管死亡率的增加密切相关(HR, 1.21 [95% CI, 1.03-1.43])。终生和日常歧视与全因死亡率和心血管死亡率的关联不受种族和民族、性别或种族和民族居住隔离的影响。结论:这些发现表明,歧视经历与全因死亡率和心血管死亡率增加有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Discrimination Experiences and All-Cause and Cardiovascular Mortality: Multi-Ethnic Study of Atherosclerosis.

Discrimination Experiences and All-Cause and Cardiovascular Mortality: Multi-Ethnic Study of Atherosclerosis.

Discrimination Experiences and All-Cause and Cardiovascular Mortality: Multi-Ethnic Study of Atherosclerosis.

Discrimination Experiences and All-Cause and Cardiovascular Mortality: Multi-Ethnic Study of Atherosclerosis.

Background: Epidemiologic studies have documented the associations between experiences of discrimination and adverse health outcomes. However, the relationship between discrimination and mortality, and the factors that may moderate this relationship are not well understood. This study examined whether lifetime and everyday discrimination were associated with all-cause and cardiovascular mortality and whether these associations differed by race and ethnicity, gender, and racial and ethnic residential segregation.

Methods: The study included 1633 Black, 1403 Hispanic/Latino, and 2473 White participants aged 45 to 84 years from the Multi-Ethnic Study of Atherosclerosis, enrolled from 2000 to 2002 and followed across 5 exams (2002-2018). Discrimination was measured using the lifetime discrimination (major experiences of unfair treatment) and everyday discrimination (day-to-day experiences of unfair treatment) scales. Racial and ethnic residential segregation was measured using the Gi* statistic. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% CIs, adjusting for sociodemographic characteristics, health behaviors, and clinical risk factors.

Results: Each increase in reports of lifetime discrimination was associated with increased all-cause (HR, 1.06 [95% CI, 1.00-1.11]) and cardiovascular (HR, 1.15 [95% CI, 1.04-1.27]) mortality, adjusting for sociodemographic factors, health behaviors, and clinical risk factors. Associations between lifetime discrimination and cardiovascular mortality were observed across all racial and ethnic groups but were strongest and only statistically significant among Black participants (HR, 1.18 [95% CI, 1.02-1.37]). Additionally, in the fully adjusted model, each increase in reports of everyday discrimination was strongly associated with increased cardiovascular mortality (HR, 1.21 [95% CI, 1.03-1.43]). Associations for lifetime and everyday discrimination with all-cause and cardiovascular mortality were not modified by race and ethnicity, gender, or racial and ethnic residential segregation.

Conclusions: These findings suggest that experiences of discrimination are associated with increased all-cause and cardiovascular mortality.

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来源期刊
Circulation. Cardiovascular Quality and Outcomes
Circulation. Cardiovascular Quality and Outcomes Medicine-Cardiology and Cardiovascular Medicine
CiteScore
9.80
自引率
2.90%
发文量
357
期刊介绍: Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal, publishes articles related to improving cardiovascular health and health care. Content includes original research, reviews, and case studies relevant to clinical decision-making and healthcare policy. The online-only journal is dedicated to furthering the mission of promoting safe, effective, efficient, equitable, timely, and patient-centered care. Through its articles and contributions, the journal equips you with the knowledge you need to improve clinical care and population health, and allows you to engage in scholarly activities of consequence to the health of the public. Circulation: Cardiovascular Quality and Outcomes considers the following types of articles: Original Research Articles, Data Reports, Methods Papers, Cardiovascular Perspectives, Care Innovations, Novel Statistical Methods, Policy Briefs, Data Visualizations, and Caregiver or Patient Viewpoints.
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