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October 1, 2019

Expecting Lots of Racist Treatment May Endanger Health For African Americans

By Society for Biopsychosocial Science and Medicine

Contact: Tené Lewis, PhD

For Release: Immediately

A consistent link has been found between African Americans’ reported experiences of racism and their risk for having a heart attack or stroke.  Now preliminary new evidence suggests that just expecting racism treatment—whether you’ve encountered it or not—may increase African Americans’ risk for cardiovascular disease.

It’s believed to be the first scientific study to detect a link between expectations of racism and a biological sign of heart attack and stroke risk for African Americans.  The report appears in the October issue of Psychosomatic Medicine, journal of the Society for Biopsychosocial Science and Medicine.

Study participants were 52 healthy African American women 35 to 50 years old.  They all filled out questionnaires on their experiences and expectations of discriminatory treatment.  Researchers also measured the intima-media thickness (IMT) of their carotid arteries; greater thickness correlates with a greater risk for strokes and heart attacks.  IMT is typically higher among African Americans than whites, notes study leader Tené Lewis, PhD, Associate Professor of Epidemiology in the Rollins School of Public Health at Emory University.

Unlike in some other studies, there was no association between experiences of racism and the women’s IMT.  The women reported relatively few racist encounters.  But a significant link emerged between their expectation of racist treatment and carotid artery thickness:  The more they expected to be confronted with racism, the thicker their IMT.

“Expectations of racism may be related to threat and fear, and we know that fear elevates your heart rate and blood pressure—and keeps them elevated,” says Lewis.  “Women who expect to experience racism are likely to be walking around in a chronic state of vigilance and anxiety due to their fear that something threatening could happen.  These women are always on guard.”

Such hyper-vigilance raises blood pressure, some studies have found.  And there’s a strong relationship between higher blood pressure and carotid artery thickening, Lewis adds.  You don’t need to have encountered a lot of racism yourself to hold expectations of it, Lewis observes.  “Vicarious experiences may play a role.  Maybe you were never pulled over unfairly by the police but you know people who have been, or have been treated poorly in other ways because of their race.  That alone can lead to heightened expectations.”

Most women in her sample fell somewhere in the middle on the expectations scale.  Also, their IMT scores mirrored average scores for African American women. Longer-term studies with larger, more diverse samples would be helpful in pinpointing causes, she adds.  “We’re just beginning to scratch the surface in understanding how expectations might impact health.  There are definitely a number of different avenues for future research.”


Study Link: https://journals.lww.com/psychosomaticmedicine/Abstract/2019/10000/Expectations_of_Racism_and_Carotid_Intima_Media.11.aspx

Faculty Page Link: https://www.sph.emory.edu/faculty/profile/#TTLEWIS

The Society for Biopsychosocial Science and Medicine (APS) (http://www.thesbsm.org), founded in 1943, is an international multidisciplinary academic society that organizes an annual scientific meeting and educational programs. Psychosomatic Medicine is its scientific journal. The membership of over 700 is composed of academic scientists and clinicians in medicine, psychiatry, epidemiology, health psychology and allied health services. The mission of the SBSM is “to advance and integrate the scientific study of biological, psychological, behavioral and social factors in health and disease.”

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