Invited commentary: Discrimination--an emerging target for reducing risk of cardiovascular disease?

A growing body of research suggests that perceived discrimination, in multiple societies, is a neglected but important predictor of increased risk of disease for a broad range of health status indicators. Several prior studies propose that discrimination is adversely related to increased cardiovascular disease risk. The studies by Hunte (Am J Epidemiol. 2011;173(11):1223-1231) and Lewis et al. (Am J Epidemiol. 2011;173(11):1232-1239) find that self-reported discrimination is associated with increased risk of adiposity for men and women. These studies highlight the potentially important role of discrimination as a risk factor for excess fat but also raise important research questions regarding the role of fat in cardiovascular disease and racial differences in these processes. More generally, they also provide an important reminder to epidemiologists and medical professionals that discrimination and other aspects of racism persist in contemporary society and that increased efforts are needed to document the extent to which they may have pathogenic consequences and to identify the most promising initiatives to reduce any observed negative effects. Equally important, these studies remind us that, although social stressors are difficult to measure accurately and comprehensively, understanding how multiple stressors combine over the life course to affect the risk of morbidity and mortality remains an important priority for concerted research attention.