What if we prayed more? Discrimination, religious and spiritual coping, and cardiovascular disease risk among African American women and men
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Date
2023-01-01
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Department
Psychology
Program
Psychology
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Distribution Rights granted to UMBC by the author.
Access limited to the UMBC community. Item may possibly be obtained via Interlibrary Loan thorugh a local library, pending author/copyright holder's permission.
Abstract
Interpersonal discrimination is a chronic stressor for many African American (AA) adults and is implicated in racial disparities in cardiovascular diseases (CVDs). AAs, and particularly AA women, often turn to religion and spirituality (R/S) to cope with undue mistreatment and racism, but no prior studies have examined whether religious/spiritual coping might differentially buffer the associations of discrimination with CVD risk factors among AA women and men. This study examined the interactive relations of self-reported multidimensional discrimination, religious/spiritual coping, and sex with several traditional cardiovascular disease (CVD) risk factors ? including systolic and diastolic blood pressure (SBP, DBP), glycated hemoglobin (HbA1c), body mass index (BMI), and total cholesterol (TC) ? in a sample of midlife AA women and men. Data were drawn from 753 AA adults (52.9% = women; mean age = 48.73 years; 44.4% below the federal poverty level; 61.9% religiously affiliated with most identifying as Christian/Catholic) in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) epidemiological cohort study in Baltimore, Maryland. Participants underwent comprehensive medical examinations, including clinical assessment of SBP, DBP, HbA1c, BMI, and TC; self-reported multiple dimensions of interpersonal discrimination (social status-based, lifetime burden, gender, racial, and everyday) and endorsed frequency of religious/spiritual coping use. Multivariable linear regression examined interactive relations of multidimensional interpersonal discrimination, religious/spiritual coping, and sex to CVD risk factors in models that adjusted for age, poverty status, educational attainment, health insurance status, history of clinical CVDs, and use of antihypertensive, blood glucose-lowering, and lipid-lowering medications. Further sensitivity analyses adjusted for affective (depressive symptoms), biobehavioral (substance use history), social support (marital status, instrumental and emotional social support coping use), and biomedical (BMI when not assessed as an outcome) factors. Results revealed significant three-way interactions among discrimination, religious/spiritual coping use, and sex for SBP, DBP, BMI, and TC (after removal of one outlier). Although visual plots demonstrated similarly patterned findings across these CVD risk factors, all simple regression slopes were nonsignificant. Significant main effects of religious/spiritual coping (b = 0.45, p = .031) and sex (b = 2.50, p = .003) were noted for DBP levels. More frequent religious/spiritual coping use was associated with higher DBP; and men had higher DBP than women. These relations became nonsignificant when social support variables were added to the base models in sensitivity analyses; however, these variables did not mediate the associations. These largely null findings suggest that, in this sample of AA women and men, religious/spiritual coping use may not differentially buffer the associations between multidimensional interpersonal discrimination and CVD risk factors. However, complex methodological considerations lead us to call for further investigation of this topic using improved measurements of other forms of discrimination, multidimensional assessments of religious/spiritual coping use and other forms of religiosity, and increased attention to Intersectionality-driven statistical models.