Experiencing discrimination has long been associated with risk factors for myocardial infarction (MI). But new research suggests that perceptions of discrimination could also affect people’s health status after an MI.
In a study of more than 2,600 heart attack survivors, those who perceived more discrimination in their daily lives had a higher risk of worse outcomes than those who experienced little or no discrimination in the year after a heart attack. Perceived discrimination refers to the perception of being treated unfairly in everyday interactions due to personal characteristics, such as race, gender, ethnicity, or socioeconomic status.
The study results were presented at the American Heart Association (AHA) Scientific Sessions 2022 in Chicago.
The authors reached their conclusions after analyzing data on health outcomes after myocardial infarction among participants in the “Variation in Recovery: Role of Gender in Outcomes of Young AMI Patients” study. The outcomes they observed included chest pain, physical limitations, patient-reported general physical and mental health status, satisfaction with treatment, and general quality of life. The participants were between 18 and 55 years old. About two-thirds were women and 76% self-identified as white, with the rest made up of black and “other” adults.
Participants were asked to complete 3 questionnaires 1 month and 12 months after their heart attack to assess their level of perceived discrimination, MI recovery status (measured by physical limitation and frequency of chest pain), quality of life and the general state of health. In addition, they reported perceived discrimination of any kind, general physical and mental health status, MI recovery status, treatment satisfaction, and quality of life.
Analyzes of scores and questionnaire data revealed that:
- more than a third of the participants reported experiencing discrimination in their daily lives,
- greater exposure to perceived discrimination was primarily associated with poorer myocardial infarction recovery status (indicated by lower scores on the Seattle Angina Questionnaire, one of the tools used to measure patient satisfaction and quality of life ),
- people with higher levels of perceived discrimination were more likely to report physical limitations and more frequent chest pain up to one year after the MI recovery period, and
- Patients who reported higher levels of perceived discrimination also reported worse mental health status, treatment satisfaction, and quality of life within the first year after MI.
“Perceived discrimination acts as a chronic stressor that negatively affects cardiovascular disease through increased stress levels and inflammation,” said Andrew Arakaki, MPH, one of the study’s authors and a doctoral candidate in the department. in the epidemiology of chronic diseases at the Yale School of Public Health. Press release. “Perceived discrimination is also associated with other psychosocial factors, such as low social support and distrust in the health system, which can affect the recovery of patients after a heart attack.”
Arakaki said the research demonstrates the important role perceived discrimination plays in determining the specific outcomes of a heart attack compared to general/generic measures of physical and mental health status. He and the other authors cautioned that since the majority of study participants were white and female, and the data analyzes did not include those who did not complete the perceived discrimination questionnaire, the results may not generalize to the public. .
“Perceived discrimination acts as a chronic stressor that negatively affects cardiovascular disease through increased stress levels and inflammation…and is also associated with other psychosocial factors, such as low social support and mistrust of others. the health care system, which can affect the recovery of patients. after a heart attack”.
Michelle A. Albert, MD, MPH, president of the AHA, said the study shows that “health professionals need to really understand the impact of structural racism and structural discrimination on health outcomes in this regard. That means we must double down on having culturally competent physicians and other health professionals who understand their patients’ experiences, and also listen to their patients’ concerns.”
Study Summary: Arakaki AJ, Dreyer RP, Murphy T, et al. Evaluation of the association between perceived discrimination and health status outcomes among young adults hospitalized for acute myocardial infarction. Abstract presented at the American Heart Association Scientific Sessions 2022; November 1-4, 2022; Chicago, Ill.