Date of Conferral

2016

Degree

Ph.D.

School

Public Health

Advisor

Angela Witt Prehn

Abstract

Blacks in the United States have the highest rates of hypertension in the world, and their cardiovascular disease mortality rates are higher than for any other population group as a result of traditional risk factors such as obesity and stronger family history. However, additional underlying factors, such as social determinants of health (e.g., socioeconomic status [SES]) and macrosocial factors (e.g., racism), also correlate with adverse health outcomes. This study investigated whether the interaction between SES mobility over the lifecourse and lifetime racial discrimination influenced the extent to which hypertension contributed to the cardiovascular disease health disparities observed among Blacks in the Jackson Heart Study (JHS). Using a socioecological framework, cross-sectional data collected from the baseline period on a cohort of 5,302 JHS participants were analyzed with multiple regression techniques. The study findings indicated that SES mobility, as measured by education, predicted both the racial discrimination exposure and the burden that individuals experience. However, neither SES mobility nor racial discrimination had any effect in moderating the relationship between hypertension and cardiovascular disease when examined individually or collectively. This study examined a new approach for measuring the influence of racial discrimination on health outcomes. Multidisciplinary public health and research partners should continue to advance understanding of the complex health impact of such experiences on individuals and the dynamics that create racial factors in order to effect social change.

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