Perceived racism and incident diabetes in the Black Women’s Health Study

Aims/hypothesis Our aim was to assess the association of perceived racism with type 2 diabetes, and the possible mediating influence of diet and BMI. Methods The Black Women’s Health Study, a follow-up of 59,000 African-American women, began in 1995. Over 16 years 5344 incident cases of diabetes occ...

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Bibliographic Details
Published in:Diabetologia 2017-11, Vol.60 (11), p.2221-2225
Main Authors: Bacon, Kathryn L., Stuver, Sherri O., Cozier, Yvette C., Palmer, Julie R., Rosenberg, Lynn, Ruiz-Narváez, Edward A.
Format: Article
Language:English
Subjects:
Diabetes
Diabetes mellitus
Health risk assessment
Human Physiology
Internal Medicine
Medicine
Medicine & Public Health
Metabolic Diseases
Obesity
Physical activity
Racism
Short Communication
Smoking
Womens health
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Summary:Aims/hypothesis Our aim was to assess the association of perceived racism with type 2 diabetes, and the possible mediating influence of diet and BMI. Methods The Black Women’s Health Study, a follow-up of 59,000 African-American women, began in 1995. Over 16 years 5344 incident cases of diabetes occurred during 576,577 person-years. Cox proportional hazards models were used to estimated HRs and 95% CIs for categories of ‘everyday racism’ (interpersonal racism in daily life) and ‘lifetime racism’ (reporting ever treated unfairly due to race with respect to police, housing or work) and incident type 2 diabetes. Models were adjusted for age, questionnaire cycle, marital status, socioeconomic status, education, family history of diabetes, physical activity, alcohol use and smoking status, with and without inclusion of terms for dietary patterns and adult BMI. Results Compared with women in the lowest quartile of exposure, women in the highest quartile of exposure to everyday racism had a 31% increased risk of diabetes (HR 1.31; 95% CI 1.20, 1.42) and women with the highest exposure to lifetime racism had a 16% increased risk (HR 1.16; 95% CI 1.05, 1.27). Mediation analysis estimated that BMI accounted for half of the association between either the everyday or lifetime racism measure and incident diabetes. Conclusions/interpretation Perceived everyday and lifetime racism were associated with increased risk of type 2 diabetes in this cohort of African-American women and appear to be at least partly mediated by BMI.
ISSN:0012-186X
1432-0428
DOI:10.1007/s00125-017-4400-6