Miriam E Van Dyke1, Viola Vaccarino2, Sandra B Dunbar3, Priscilla Pemu4, Gary H Gibbons5, Arshed A Quyyumi6, Tené T Lewis7. 1. 1518 Clifton Rd, NE, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA. Electronic address: Mvandy2@emory.edu. 2. 1518 Clifton Rd, NE, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA. Electronic address: lvaccar@emory.edu. 3. 1520 Clifton Rd, NE, Neil Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, 30322, USA. Electronic address: sbdunba@emory.edu. 4. 720 Westview Drive, Morehouse School of Medicine, Atlanta, GA, 30310, USA. Electronic address: pipemu@msm.edu. 5. National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, 20824, USA. Electronic address: gary.gibbons@nih.gov. 6. 1462 Clifton Road, NE, Suite 507, Division of Cardiology, School of Medicine, Emory University, Atlanta, GA, 30322, USA. Electronic address: aquyyum@emory.edu. 7. 1518 Clifton Rd, NE, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA. Electronic address: tene.t.lewis@emory.edu.
Abstract
OBJECTIVES: We examined the association between socioeconomic status (SES) discrimination and C-reactive protein (CRP) in a biracial cohort of middle-aged adults using an intersectionality framework. METHODS: Participants were 401 African-American and White adults from a population-based cohort in the Southeastern United States. SES discrimination was self-reported with a modified Experiences of Discrimination Scale, and CRP levels were assayed from blood samples. Linear regression analyses were used to examine the associations among SES discrimination, race, education, and CRP after controlling for age, gender, racial and gender discrimination, financial and general stress, body mass index, smoking, sleep quality, and depressive symptoms. Intersectional effects were tested using race×SES discrimination, education×SES discrimination and race×education×SES discrimination interactions. RESULTS: Adjusting for sociodemographics, racial discrimination, gender discrimination, and all relevant two-way interaction terms, we observed a significant race×education×SES discrimination interaction (p=0.019). In adjusted models stratified by race and education, SES discrimination was associated with elevated CRP among higher educated African-Americans (β=0.29, p=0.018), but not lower educated African-Americans (β=-0.13, p=0.32); or lower educated (β=-0.02, p=0.92) or higher educated (β=-0.01, p=0.90) Whites. CONCLUSIONS: Findings support the relevance of SES discrimination as an important discriminatory stressor for CRP specifically among higher educated African-Americans.
OBJECTIVES: We examined the association between socioeconomic status (SES) discrimination and C-reactive protein (CRP) in a biracial cohort of middle-aged adults using an intersectionality framework. METHODS:Participants were 401 African-American and White adults from a population-based cohort in the Southeastern United States. SES discrimination was self-reported with a modified Experiences of Discrimination Scale, and CRP levels were assayed from blood samples. Linear regression analyses were used to examine the associations among SES discrimination, race, education, and CRP after controlling for age, gender, racial and gender discrimination, financial and general stress, body mass index, smoking, sleep quality, and depressive symptoms. Intersectional effects were tested using race×SES discrimination, education×SES discrimination and race×education×SES discrimination interactions. RESULTS: Adjusting for sociodemographics, racial discrimination, gender discrimination, and all relevant two-way interaction terms, we observed a significant race×education×SES discrimination interaction (p=0.019). In adjusted models stratified by race and education, SES discrimination was associated with elevated CRP among higher educated African-Americans (β=0.29, p=0.018), but not lower educated African-Americans (β=-0.13, p=0.32); or lower educated (β=-0.02, p=0.92) or higher educated (β=-0.01, p=0.90) Whites. CONCLUSIONS: Findings support the relevance of SES discrimination as an important discriminatory stressor for CRP specifically among higher educated African-Americans.
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