>I'm back too. Did you miss me? Just a little?
But of course.
> Here's something from the
>imperial media for everyone to chew on. According to the May 29th issue of
>_Time_ (p. 89) which sourced the May 16th Journal of the American Medical
>Association, anger and cynicism _may_ be bad for one's health.
>
>"Fight Club. Sure, it's cool to be angry and cynical when you're young, but
>such traits may damage the heart. Just as doctors have linked anger and
>heart disease in older adults, they now find that high hostility levels in
>18-to-30-year-olds more than double the risk of calcifications in the
>coronary arteries - an early sign of heart disease. So if you're young and
>rage-prone, here's what's *really* cool: meditation, yoga and exercise, all
>know anger relievers."
[excerpts from Nancy Krieger and Stephen Sidney, "Racial Discrimination and Blood Pressure: The CARDIA Study of Young Black and White Adults," American Journal of Public Health, 86 (1996), pp. 1372-1373]
RESULTS
Population Characteristics
Participants, on average, were slightly more than 31 years old, and they spanned a broad socioeconomic spectrum (Table 1). Black participants were, on average, I year younger than White participants and between 1.5 and 3.3 times more likely to be working class, have a lower annual family income. rent their home, and have less than a high school education. Patterns of BlackWhite differences for anthropometric and other selected covariates varied by gender (data are available on request).
Self-Reported Responses to Unfair Treatment and Experiences of Racial Discrimination
With respect to responses to unfair treatment, between 70% and 80% of the Black and White men and women rcported that they typically tried to do something about being treated unfairly and talked to others about it (Table 2). Approximately 18% reported that they typically accepted such treatment as a fact of life but nonetheless talked to others about it, and 2% to 8% reported that they kept it to themselves and either tried to do something about it or accepted it as a fact of life. Black women, however, were 1.5 times (95% confidence interval [CI] = 1.0. 2.1) more likely than White women to report that they responded by keeping it to themselves. By contrast, Black and White men were equally likely to report this response and were 1.9 times (95% CI = 1.4, 2.5) and 2.6 times (95% CI = 1.9, 3.5) more likely to do so, respectively, than their female counterparts.
Overall, 77% of Black women and 84% of Black men reported experiencing racial discrimination in at least one of the seven specified situations, and nearly 50% and 60%, respectively, reported experiencing racial discrimination in three or more situations. Among both women and men, the most commonly reported situation was on the street or in a public setting (59% and 66%, respectively). Next for the women was at work (52%), and next for the men was from the police or in the courts (58%). Black women and men were equally likely to report discrimination in four of the seven situations (at school, at work, getting housing, and getting medical care). In the remaining three situations, Black men reported experiencing racial discrimination between 1.2 and 2.1 times more than Black women on the street or in a public setting (relative risk [RRI = 1.1, 95% CI = 1.0, 1.2), getting a job (RR = 1.2, 95% C1 = 1.1, 1.3), and from the police or in the courts (RR = 2.1, 95% CI = 1.9, 2.4).
Black Participants' Blood Pressure in Relation to Racial Discrimination and Response to Unfair Treatment
Overall, mean systolic and diastolic blood pressure levels among Black women were, respectively, 108.8 mm Hg (SD = 13.2) and 67.7 mm Hg (SD = 11.1). Among Black men, the corresponding mean values were 114.7 mm Hg (SD 12.0) and 72.3 mm Hg (SD = 10.7).
Associations of systolic and diastolic blood pressure with self-reported experiences of racial discrimination and response to unfair treatment, adjusted for relevant covariates, were stratified by class (see Table 3). For reported experiences of racial discrimination, we compared the extremes (in none or three or more of the specified situations) with moderate experience (in one or two situations). For responses to unfair treatment, we set as the referent group those who typically tried to do something about it and talked to others. In all models, effects of reported racial discrimination and response to unfair treatment were independent of each other. Patterns of association were similar for systolic and diastolic blood pressure.
Among working-class Black women, systolic blood pressure tended to be 4 mm Hg higher among those reporting that they typically responded to unfair treat ment by accepting it as a fact of life and keeping it to themselves, as compared \kith those who tried to do something about it and talked to others. It was also nearly 4 mm Hg higher among those saying that they had experienced racial discrimination in none, as compared with one or two, of the seven specified situations. These effects were additive: when the combined indicator variable was used, systolic blood pressure was 7.4 mm Hg higher (95% Cl = -0.6. 15.5) among women who reported no racial discrimination and responded to unfair treatment by accepting it and keeping it to themselves than among women who reported racial discrimination in one or two situations and both tried to do something about unfair treatment and talked to others about it.
Among working-class Black men, systolic blood pressure was nearly 4 mm Hg higher among those reporting that they typically accepted unfair treatment as a fact of life but talked to others about it than among those who tried to do something and talked to others. It also was, respectively, 3 mm and slightly more than 4 mm higher among men reporting racial discrimination in three or more and in none, as compared with one or two. of the situations. These effects again were additive: when the combined indicator variable was used. systolic blood pressure was 7.4 mm Hg higher (95% CI = 3.3, 11.4) among men who reported no discrimination and both accepted unfair treatment and talked to others about it than among men who reported discrimination in one or two situations and both tried to do something about unfair treatment and talked to others about it.
The patterns of association differed by class among both the Black women and the Black men. Among professional women with the same referent groups, systolic blood pressure was 7 mm Hg lower among those who reported that they tried to do something about unfair treatment and kept it to themselves. It was slightly more than 2 mm Hg higher among those reporting experiencing racial discrimination in three or more situations. Evidence for an additive effect was again provided by the model using the combined indicator variable, in which systolic blood pressure was 9.4 mm Hg lower (95% CI = -24. 1, 5.2) among women in the lowest vs highest risk groups.
Among the professional men, systolic blood pressure was about 5 mm Hg lower among men who reported that they tried to do something about unfair treatment but kept it to themselves. It was also nearly 6 mm Hg lower among those reporting racial discrimination in none of the situations. When the combined indicator variable was used, the net difference between those in the least and most elevated categories was -10.4 mm Hg (95% Cl -23.8, 2.9).
Black-White Differences in Blood Pressure
Overall Black-White differences in systolic blood pressure, adjusted for relevant covariates, were evident in each class stratum for both women and men and were greatest among those categorized as working class (model 1) (Table 4). Taking into account both reported racial discrimination and response to unfair treatment (model 2). systolic blood pressure, as compared with that among working-class White women, was nearly 7 mm Hg higher among working-class Black women who reported experiencing racial discrimination in none of the specified situations, 4 mm Hg higher among those reporting this discrimination in three or more situations. and slightly less than 3 mm Hg higher among those reporting racial discrimination in one or two situations. Corresponding figures for comparisons of working-class Black and White men were 6.0, 4.7, and 1. 1 mm Hg.
Among professional women, no differences in systolic blood pressure were evident between Black women reporting racial discrimination in one or two situations and their White counterparts. Among professional men, systolic blood pressure of Black men reporting no racial discrimination was comparable to that of White men and diastolic blood pressure of these Black men was, in fact, 4.5 mm Hg lower (95% CI = -7.7, -1.3) than that of their White counterparts.