Racial Discrimination, Religious Coping, and Cardiovascular Disease Risk Among African American Women and Men

OBJECTIVE

This cross-sectional study examined whether religious coping buffered the associations between racial discrimination and several modifiable cardiovascular disease (CVD) risk factors-systolic and diastolic blood pressure (BP), glycated hemoglobin (HbA1c), body mass index (BMI), and cholesterol-in a sample of African American women and men.

METHODS

Participant data were taken from the Healthy Aging in Neighborhoods of Diversity Across the Life Span study (N = 815; 55.2% women; 30-64 years old). Racial discrimination and religious coping were self-reported. CVD risk factors were clinically assessed.

RESULTS

In sex-stratified hierarchical regression analyses adjusted for age, socioeconomic status, and medication use, findings revealed several significant interactive associations and opposite effects by sex. Among men who experienced racial discrimination, religious coping was negatively related to systolic BP and HbA1c. However, in men reporting no prior discrimination, religious coping was positively related to most risk factors. Among women who had experienced racial discrimination, greater religious coping was associated with higher HbA1c and BMI. The lowest levels of CVD risk were observed among women who seldom used religious coping but experienced discrimination.

CONCLUSION

Religious coping might mitigate the effects of racial discrimination on CVD risk for African American men but not women. Additional work is needed to understand whether reinforcing these coping strategies only benefits those who have experienced discrimination. It is also possible that religion may not buffer the effects of other psychosocial stressors linked with elevated CVD risk.

Experiencing Burnout: John Henryism, Gender Role Conflict, and Anxiety Among Incarcerated Black Men

At the intersection of race and gender, Black men encounter conflicting and often stress-inducing gender norms. Research suggests Black men may utilize John Henryism Active Coping (JHAC), a culturally-relevant strategy to manage stress. However, little is known about how incarcerated Black men cope with gender role conflict (GRC) and resulting psychological distress. To better understand stressors and coping strategies among Black male prisoners, the current study examined the relationships between GRC, anxiety, and JHAC among N = 193 incarcerated Black men nearing community reentry. Hierarchical linear regression results showed length of incarceration, GRC, and anxiety were all negatively associated with JHAC. Full-time employment prior to incarceration was positively associated with JHAC. Moderation analyses indicated anxiety increased the strength of the negative association between GRC and JHAC. Implications highlight incarcerated Black men may benefit from interventions that encourage active coping strategies to manage gender-related stress and anxiety.

Denominational and Gender Differences in Hypertension Among African American Christian Young Adults

Hypertension, a major cardiovascular disease risk factor, is disproportionately prevalent among African American young adults. Religion and spirituality (R/S) have been studied for their potential effect on blood pressure (BP) outcomes. Despite their disproportionate hypertension risk and high levels of R/S engagement, limited research explores BP differences among religious African Americans. This study investigates whether denominational affiliation predicts within-group differences in odds of having hypertension among African American Christian young adults. Data from Wave IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health) were used to examine hypertension differences between 1932 African American young adults based on self-reported religious denomination. Gender-separated logistic regressions included religious service attendance and coping measures, as well as personal characteristics and health behaviors to adjust for potential effects on BP. The odds of having hypertension were higher for Pentecostal women compared to Baptist and Catholic women. Hypertension odds for women who reported attending services more than once weekly were lower than those who never attended church. For women, frequent use of religious coping predicted higher odds of having hypertension than seldom or never using religious coping. R/S variables did not predict significant differences among men. The health benefits of R/S do not appear to be consistent within African American Christian young adults. Religion may be viewed as a source of BP risk and resilience, especially among African American young women.

Coping, Discrimination, and Physical Health Conditions Among Predominantly Poor, Urban African Americans: Implications for Community-Level Health Services

African Americans and ethnic minorities experience racial discrimination in a variety of settings. Racial discrimination is a potent stressor that has been linked to psychosocial stress and poor physical health. To cope with discriminatory experiences and daily life event stressors, African Americans frequently use the concept of John Henryism (a high effort coping strategy with prolonged exposure to stress). This cross-sectional analysis explored the relationship between racism/discrimination, John Henryism, and health problems in a predominately African American sample. Data were collected through health care screenings for hypertension, diabetes, and obesity and a self-report survey to assess experiences of discrimination and use of John Henryism. Logistic and linear regression models were used to assess the relationship between the John Henryism score, racism/discrimination score, and health problems among 352 participants. John Henryism was associated with a decrease in systolic blood pressure (b = - 12.50, 95% CI = - 23.05, - 1.95) among men, after adjusting for experiences of racism/discrimination and demographic characteristics. Experiences of racism/discrimination were associated with an increase in systolic blood pressure (b = 11.23, 95% CI = 0.38, 22.09) among men, after adjusting for John Henryism and demographic characteristics. Among women, there was no association found between John Henryism and experiences of racism/discrimination with systolic blood pressure. No association was found between John Henryism and experiences of racism/discrimination with being overweight/obese in women nor men. The study found that John Henryism was positively associated with the health of men, while experiences of racism/discrimination were negatively associated with their health. Limitations of the study are discussed, and recommendations are made to guide future research exploring the concept of John Henryism as a relevant factor between stress, racial discrimination and poor health.