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.
Article info
Publication history
Published online: October 29, 2022
Accepted:
September 22,
2022
Received in revised form:
September 1,
2022
Received:
December 22,
2021
Footnotes
Funding Statement: Supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Number R01AR065493 (David H. Chae). Nicole D. Fields is supported by the National Heart, Lung, and Blood Institute under Award Number T32HL1300025. Nicole A. VanKim was supported by the National Institute of Diabetes and Digestive and Kidney Diseases under Award Number K01DK123193. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors declare no conflict of interest.
Identification
Copyright
© 2022 Jacobs Institute of Women's Health, George Washington University. Published by Elsevier Inc. All rights reserved.
