Black women who reported experiencing racism may be at higher risk of stroke, according to a new study.
Participants who reported experiencing racism in employment, housing and interactions with police were about 38% more likely to experience all types of stroke compared to Black women who did not perceive they had experienced racism, the study found. .
The study, published as part of Boston University’s Black Women’s Health Study (BHWS), followed 48,375 Black women between 1997 and 2019 who were free of cardiovascular disease and cancer at the start of the study. Over the 22-year period, the study identified 1,664 cases of black women who suffered strokes.
Black adults are 50% more likely suffer a stroke compared to white adults, and black women are twice as likely to suffer a stroke as white women, according to the U.S. Department of Health and Human Services.
While experts have cited factors such as obesity or hypertension as the cause of such high rates, the BWHS aimed to show that the possible causes of environmental and social factors that individuals cannot change, such as racism, must also be considered, according to the Dr. Julie. Palmer, director of the Slone Epidemiology Center at Boston University and co-author of the study.
“Our goal is really to provide information that is useful so that fewer people get serious illnesses,” Palmer said.
Boston University’s BHWS was started in 1995 in response to “very little research” being done on black women’s health, Palmer said. Inspired by the Nurses’ Health Study, BHWS collected data from 59,000 Black women nationwide and followed up every two years for any changes in their health. While the study did not include women of other races, the fact that it focused solely on black women is more of a strength than a limitation, because experiences of discrimination can vary for each group, said Shanshan Sheehy, an assistant professor at the University from Boston. University Faculty of Medicine and co-author of the study.
This study specifically focused on perceived racism, which relies on participants reporting their experiences on the questionnaire. Additional findings from the study revealed that participants who experienced racism in employment, housing, and with the police were more likely to live in high socioeconomic neighborhoods, have higher levels of education, and were less likely to live in the South.
When it comes to the association between racism and higher educational attainment, Palmer said it could be because educated women are more willing to put a name to racism and “recognize what they are experiencing as racism or being treated differently.” “.
Black women who live in regions “with high structural racism may not be aware of it or willing to report it on a questionnaire,” Sheehy added, which may also affect the study’s findings.
What puts black communities at higher risk for stroke?
Strokes are caused by damaged or blocked blood vessels that deprive the brain of oxygen, resulting in brain death, said Dr. Olajide Williams, professor of neurology and vice dean of community health at the Vagelos College of Physicians and Surgeons. from Columbia University. Chronic psychosocial stressors, such as discrimination, he said, can lead to toxic stress, which is dangerous for the body.
Countless research confirms that factors of racism and discrimination have disproportionately affected Black people and led to negative health outcomes. A survey conducted by the Pew Research Center in 2021 found that about 79% of Black Americans said they have experienced discrimination because of their race or ethnicity. Another 63% of African Americans said racism is an extremely big or very big problem they face, according to additional survey data.
In addition to increasing the likelihood of stroke, the Boston University study found that racism can act as a psychological stressor, elevating systemic inflammation in the body. Previous findings from Boston University identified associations between perceived interpersonal racism and increased risks of obesity, type 2 diabetes, and even decreased subjective cognitive function, often resulting in frequent confusion and memory loss. Other studies have also linked perceived interpersonal racism to an increased risk of hypertension, hormonal dysregulation, and unhealthy behaviors and lifestyles, among other health problems.
Having medical conditions such as diabetes and hypertension increases the chance of having a stroke, so it’s important for people to identify these conditions and manage them long-term, said Dr. Carolyn D. Brockington, director of the Stroke Center at Mount Sinai. West and Mount Sinai Morningside in New York City. She also said it’s important to recognize the signs of a stroke, known as “BE QUICK” such as a drooping face or difficulty speaking and other symptoms, to seek help immediately as 1.9 million brain cells are lost per minute during a stroke.
“Those are brain cells that are not going to come back,” Brockington said. “So we would like people to be able to recognize the signs and symptoms of stroke and understand that stroke is an emergency.”
Reduce health disparities
Palmer said she hopes policymakers will use the data from her study, which provides more evidence of the harm institutional racism causes to Black people, to bring about change. There are multiple environmental factors within Black communities, including a disproportionately high number of fast-food restaurants and smoking, that increase the likelihood that someone will suffer a stroke, Williams said. She also said the public health system must be held accountable for the “devastating effects of structural racism.”
Williams said biased housing practices that affect the makeup of neighborhoods are also to blame.
“We are still suffering in our communities, not only from the lingering effects of redlining, but also from the effects of unconscious bias that still plagues American society,” Williams said.
As for black women, Palmer said she wants the findings to help them do activities to reduce their risk of stroke, including exercising regularly and eating a healthy diet. Brockington suggests that patients should work with their doctor to identify their own risk factors, which “can significantly reduce the risk of having a stroke,” she said.
“It’s a constant conversation,” he said. “It’s not just about having a meeting with a doctor and that’s it, right? “These will be lifestyle changes for your entire life.”
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