Research Highlights:

  • U.S. adults who reported feeling highly discriminated against at work had an increased risk of developing high blood pressure than those who reported low discrimination at work.
  • Researchers suggest government and employer anti-discrimination policies and interventions may help to eliminate discrimination in the workplace.

Newswise — DALLAS, April 26, 2023 —

Recent research published in the American Heart Association's open access, peer-reviewed Journal revealed that U.S. adults who experienced workplace discrimination and reported it had a greater chance of developing high blood pressure than those who reported minimal or no discrimination at work.

The study authors highlighted that systemic racism and discrimination's health impacts on cardiovascular disease and other illnesses are becoming a growing concern among individuals, considering that high blood pressure, a significant risk factor for cardiovascular disease, affects nearly half of U.S. adults as per the 2023 American Heart Association statistics, making it the leading cause of death among Americans.

Jian Li, M.D., Ph.D., a professor of work and health at the University of California, Los Angeles, stated that although scientists have explored the relationship between systemic racism, discrimination, and health outcomes, few studies have specifically examined the health effects of discrimination in the workplace, where adults spend more than one-third of their time on average. According to Dr. Li, this study provides the first scientific evidence that workplace discrimination may raise the risk of long-term high blood pressure development.

The researchers, including Dr. Li, defined workplace discrimination as unfavorable treatment or conditions at work due to personal characteristics, particularly race, sex, or age. For the study, they utilized data from the Midlife in the United States Study (MIDUS), which involved a national sample of U.S. adults from diverse occupations and education levels. The study started with 1,246 participants who had no high blood pressure between 2004 and 2006 (baseline) and were monitored for roughly eight years until 2013-2014. The majority of participants were white, and approximately half were women. About one-third of the participants were in each of the three age groups: under 45, 46-55, and 56 and older. At the beginning of the study, most participants stated that they were non-smokers, had no to moderate alcohol consumption, and participated in moderate to high physical activity.

To determine workplace discrimination, participants completed a survey about their workplace experiences, including whether they felt unfairly treated, monitored more closely than others, or ignored more frequently than others. The survey also inquired about the frequency of ethnic, racial, or sexual slurs or jokes in the workplace, as well as whether respondents believed job promotions were given equitably. The researchers calculated discrimination scores based on the survey responses and then grouped participants into low (score 6-7), intermediate (score 8-11), or high (score 12-30) discrimination categories. All items and responses in the survey were given equal weight.

The analysis found:

  • Of the 1,246 people in the study, 319 reported developing high blood pressure after approximately eight years of follow-up (blood pressure noted twice: at the start of study and during follow-up period).
  • Compared to people who scored low workplace discrimination at the beginning of the study, participants with intermediate workplace discrimination exposure scores were 22% more likely to report high blood pressure during the follow-up.
  • Compared to people who scored low workplace discrimination at enrollment in the study, participants with high workplace discrimination exposure scores were 54% more likely to report high blood pressure during the follow-up.

Dr. Li emphasized that these findings have several implications. Firstly, there is a need to raise public awareness that work is a critical social determinant of health. Secondly, in addition to traditional risk factors, workplace discrimination is a developing risk factor for high blood pressure.

The study authors suggest that a combination of organizational policies and interventions could be possible solutions to eliminate workplace discrimination. These approaches, when combined with stronger anti-discrimination policies by employers, may help to enhance workers' coping skills.

It is important to note some limitations of this study. Firstly, participants who did not participate in the follow-up session had a higher prevalence of hypertension and were more likely to be non-white, have lower education levels, and work in positions with lower job control. Secondly, high blood pressure was self-reported based on a survey of doctor-diagnosed cases. Future studies could potentially improve the validity of research findings by including medical examinations to measure diastolic and systolic blood pressure. Additionally, the measure of workplace discrimination used in the MIDUS study was general, and future studies could focus on exploring specific types of discrimination at work, such as race-, sex-, or age-related discrimination.

Dr. Eduardo Sanchez, the American Heart Association's chief medical officer for prevention, who was not involved in this study, commented that the study adds to the increasing evidence that any type of discrimination may significantly increase the risk of cardiovascular disease, including high blood pressure. Dr. Sanchez also emphasized the American Heart Association's dedication to addressing health equity in the workplace to improve individual health. He stated that the Association is building collaborations to break down barriers to health equity and improve the health of all Americans.

It's great to hear about the American Heart Association's efforts to address health equity in the workplace. Could you please provide more information on the "Driving Health Equity in the Workplace" report and the Health Equity in the Workforce initiative?

Co-authors of the study are Timothy A. Matthews, M.S.; Thomas Clausen, Ph.D.; and Reiner Rugulies, Ph.D. Authors’ disclosures are listed in the manuscript.

The Targeted Research Training Program of the Southern California National Institute for Occupational Safety and Health Education and Research Center, along with the U.S. Centers for Disease Control and Prevention and the University of California, Los Angeles provided funding for this study.

Studies published in the American Heart Association’s scientific journals are peer-reviewed. The statements and conclusions in each manuscript are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association’s overall financial information are available here.

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About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

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Journal Link: Journal of the American Heart Association

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CITATIONS

Journal of the American Heart Association

TYPE OF ARTICLE
Research Results
SECTION
CHANNELS
All Journal News Cardiovascular Health Gender Issues Heart Disease In the Workplace Race and Ethnicity
KEYWORDS
Discrimination High Blood Pressure
COMMENTS | COMMENTING POLICY