Black women who experienced racism had a 38 percent increased risk of stroke, underscoring the impact of racism as a critical social determinant of health (SDoH).
The burden of racism on Black women in the United States is taking a serious toll on their physical health, according to a recent study published by JAMA Network Open.
The study sought to examine the association between experiences of racism and stroke risk among Black women. Though there are increased rates of stroke and stroke-related mortality among Black individuals at younger ages, and more often, than any other racial group, studies on the matter have been lacking, according to the research team.
For this study, they used survey data from the Black Women’s Health Study, which asked 48,375 Black women across the country about their perceived interpersonal racism in everyday life, such as situations with employment, housing, and interactions with police, in 1997 and again in 2019.
All the women included in the study in 1997 were free of cardiovascular disease and cancer. But during the 22 years of follow-up, there were 1,664 incidences of stroke cases, with 550 confirmed by a neurologist and/or National Death Index linkage. The women who reported experiences of racism in employment, housing, or in their interactions with police were 38 percent more likely to have had a stroke than those who did not report experiences with racism.
The study also revealed the frequency of perceived racism in different settings. Of the women surveyed, 59 percent perceived racism in employment, 35 percent perceived racism in housing, and 24 percent perceived racism in their interactions with police. More than 5,000 women (11 percent) experienced perceived racism in all three settings, whereas 30 percent said they did not experience racism.
The findings indicate the role racism plays as a SDoH, noted the research team. “Racism may act as a psychosocial stressor and thereby elevate systemic inflammation, impair endothelial function, and dysregulate the hypothalamic-pituitary-adrenal axis,” they wrote. “Previous studies have linked perceived interpersonal racism with worse mental health outcomes, higher risk of hypertension, increased systolic blood pressure, unhealthy behavior and lifestyles, higher allostatic load, higher inflammatory markers, hormone dysregulation, and shorter telomere length.”