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Racism-Related Experiences and Adiposity: Findings From the Black Women's Experiences Living With Lupus (BeWELL) Study

Published:October 29, 2022DOI:https://doi.org/10.1016/j.whi.2022.09.004

      Abstract

      Introduction

      Studies suggest that higher rates of excess adiposity in Black women may in part be driven by experiences of racism. Racial microaggressions, which include unintentional and subtle slights and insults, and responses to racism such as racism-related vigilance, may contribute to adiposity in this population. This study examined these understudied racism-related facets as well as interpersonal racial discrimination in relation to adiposity in a cohort of Black women with systemic lupus erythematosus.

      Methods

      Data are from the Black Women's Experiences Living with Lupus (BeWELL) Study (2015–2017; n = 432). Linear regression was used to examine adiposity measures (body mass index [BMI], percent body fat, and waist-to-hip ratio) measured during a physical examination, in relation to self-reported measures of racial microaggressions, racism-related vigilance, and interpersonal racial discrimination.

      Results

      Compared with infrequent microaggressions, very frequent experiences of microaggressions were associated with 2.9 kg/m2 higher BMI (95% confidence [CI], 0.63–5.21) and 2.6% higher body fat (95% CI, 0.32–4.80) after adjusting for covariates. Racism-related vigilance, measured continuously, was positively associated with BMI (b = 0.84; 95% CI–0.08, 1.61) and percent body fat (b = 0.89; 95% CI, 0.14–1.64). Very frequent experiences of everyday discrimination were associated with a higher BMI (b = 2.70; 95% CI, 0.58–4.83) and waist-to-hip ratio (b = 0.32; 95% CI, 0.09–0.55) compared with less frequent everyday discrimination.

      Conclusions

      Our results suggest that various dimensions of racism are associated with excess adiposity. Efforts to address obesity among Black women with systemic lupus erythematosus should consider these multiple aspects to decrease racial inequities in adiposity.
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      Biography

      Nicole D. Fields, PhD, MPH, received her PhD in Epidemiology from the University of Massachusetts Amherst. She is a postdoctoral fellow at Rollins School of Public Health at Emory University. Her research examines social determinants and cardiometabolic disorders in marginalized populations.

      Biography

      Nicole A. VanKim, PhD, MPH, is an Assistant Professor in the Department of Epidemiology at the University of Massachusetts Amherst. Her research focuses on sexual orientation- and gender-based disparities in weight-related health behaviors and outcomes.

      Biography

      Brian W. Whitcomb, PhD, is Professor of Epidemiology at the University of Massachusetts Amherst. His research focuses on environmental/molecular influences of reproductive health, and epidemiologic methods for causal inference from biomarker data.

      Biography

      Elizabeth Bertone-Johnson, ScD, is Professor of Epidemiology and Chair of the Department of Health Promotion and Policy at the University of Massachusetts Amherst. She conducts research in women's mental and reproductive health.

      Biography

      Airín D. Martínez, PhD, is an Assistant Professor in the Department of Health Promotion and Policy at the University of Massachusetts Amherst. Her interdisciplinary research uses mixed methods to examine how structural and institutional racism produce cardiometabolic risk primarily in Latinx persons.

      Biography

      David H. Chae, ScD, is an Associate Professor, Director of the Society, Health, and Racial Equity (SHARE) Lab, and Associate Dean for Research at Tulane University, School of Public Health and Tropical Medicine. His research focuses on social determinants and embodiment of racism.