Connor D Martz1, Amani M Allen2, Thomas E Fuller-Rowell3, Erica C Spears4, S Sam Lim5,6, Cristina Drenkard5,6, Kara Chung3, Evelyn A Hunter7, David H Chae3. 1. Department of Human Development and Family Studies, Auburn University, College of Human Sciences, Auburn, AL, USA. connordmartz@auburn.edu. 2. Divisions of Community Health Sciences and Epidemiology, University of California - Berkeley, School of Public Health, Berkeley, CA, USA. 3. Department of Human Development and Family Studies, Auburn University, College of Human Sciences, Auburn, AL, USA. 4. Department of Health Behavior and Health Systems, University of North Texas Health Sciences Center, School of Public Health, Fort Worth, TX, USA. 5. Department of Medicine, Division of Rheumatology, Emory University, School of Medicine, Atlanta, GA, USA. 6. Department of Epidemiology, Emory University, Rollins School of Public Health, Atlanta, GA, USA. 7. Department of Special Education, Rehabilitation and Counseling, Auburn University, College of Education, Auburn, AL, USA.
Abstract
BACKGROUND: Indirect or vicarious exposure to racism (e.g., hearing about or observing acts of racism or discrimination) is a salient source of stress for African Americans. Emerging research suggests that these "secondhand" experiences of racism may contribute to racial health inequities through stress-mediated pathways. Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disease that disproportionately impacts African American women and is characterized by racial disparities in severity. Health outcomes in this population may be susceptible to vicarious racism given that SLE is shown to be sensitive to psychosocial stress. METHODS: Data are from 431 African American women with SLE living in Atlanta, Georgia in the Black Women's Experiences Living with Lupus (BeWELL) Study (2015-2017). Vicarious racism stress was measured with four items assessing distress from (1) hearing about racism in the news; (2) experiences of racism among friends or family; (3) witnessing racism in public; and (4) racism depicted in movies and television shows. Multivariable linear regression was used to examine associations with disease activity measured using the Systemic Lupus Activity Questionnaire. RESULTS: Adjusting for sociodemographic and health-related covariates, vicarious racism stress was associated with greater disease activity (b = 2.15; 95% CI = 1.04-3.27). This association persisted even after adjustment for personal experiences of racial discrimination (b = 1.80; 95% CI = 0.67-2.92). CONCLUSIONS: Vicarious racism may result in heightened disease activity and contribute to racial disparities in SLE. Our findings suggest that acts of racism committed against members of one's racial group may have distinct health consequences beyond the immediate victim or target.
BACKGROUND: Indirect or vicarious exposure to racism (e.g., hearing about or observing acts of racism or discrimination) is a salient source of stress for African Americans. Emerging research suggests that these "secondhand" experiences of racism may contribute to racial health inequities through stress-mediated pathways. Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disease that disproportionately impacts African American women and is characterized by racial disparities in severity. Health outcomes in this population may be susceptible to vicarious racism given that SLE is shown to be sensitive to psychosocial stress. METHODS: Data are from 431 African American women with SLE living in Atlanta, Georgia in the Black Women's Experiences Living with Lupus (BeWELL) Study (2015-2017). Vicarious racism stress was measured with four items assessing distress from (1) hearing about racism in the news; (2) experiences of racism among friends or family; (3) witnessing racism in public; and (4) racism depicted in movies and television shows. Multivariable linear regression was used to examine associations with disease activity measured using the Systemic Lupus Activity Questionnaire. RESULTS: Adjusting for sociodemographic and health-related covariates, vicarious racism stress was associated with greater disease activity (b = 2.15; 95% CI = 1.04-3.27). This association persisted even after adjustment for personal experiences of racial discrimination (b = 1.80; 95% CI = 0.67-2.92). CONCLUSIONS:Vicarious racism may result in heightened disease activity and contribute to racial disparities in SLE. Our findings suggest that acts of racism committed against members of one's racial group may have distinct health consequences beyond the immediate victim or target.
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