Coding the Everyday Discrimination Scale: implications for exposure assessment and associations with hypertension and depression among a cross section of mid-life African American women.
blood pressure
depression
measurement
social epidemiology
stress
Journal
Journal of epidemiology and community health
ISSN: 1470-2738
Titre abrégé: J Epidemiol Community Health
Pays: England
ID NLM: 7909766
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
26
06
2018
revised:
08
02
2019
accepted:
16
02
2019
pubmed:
22
3
2019
medline:
15
12
2020
entrez:
22
3
2019
Statut:
ppublish
Résumé
Studies suggest that racial discrimination impacts health via biological dysregulation due to continual adaptation to chronic psychosocial stress. Therefore, quantifying chronicity is critical for operationalising the relevant aetiological exposure and hence maximising internal validity. Using one of the most common discrimination scales in the epidemiological literature, we develop a novel approach for more accurately assessing chronicity and compare it with conventional approaches to determine whether coding influences differential exposure classification and associations with hypertension and depression among African American women. Data are from a socioeconomically diverse cross section of 208 mid-life African American women in Northern California (data collection: 2012-2013). Racial discrimination was assessed using the Everyday Discrimination Scale (α=0.95), and was coded using two conventional approaches: (1) Exposure classification differed by coding approach, by up to 41%. There was a positive association between racial discrimination and hypertension prevalence for chronicity coding only (prevalence ratio=1.61, 95% CI 1.03 to 2.49). For depressive symptoms, a dose-response relationship of similar magnitude was observed for all three coding approaches. Scale coding is an important methodological consideration for valid exposure assessment in epidemiological research. Coding can impact exposure classification and associations with important indicators of African American women's mental and physical health.
Sections du résumé
BACKGROUND
Studies suggest that racial discrimination impacts health via biological dysregulation due to continual adaptation to chronic psychosocial stress. Therefore, quantifying chronicity is critical for operationalising the relevant aetiological exposure and hence maximising internal validity. Using one of the most common discrimination scales in the epidemiological literature, we develop a novel approach for more accurately assessing chronicity and compare it with conventional approaches to determine whether coding influences differential exposure classification and associations with hypertension and depression among African American women.
METHODS
Data are from a socioeconomically diverse cross section of 208 mid-life African American women in Northern California (data collection: 2012-2013). Racial discrimination was assessed using the Everyday Discrimination Scale (α=0.95), and was coded using two conventional approaches: (1)
FINDINGS
Exposure classification differed by coding approach, by up to 41%. There was a positive association between racial discrimination and hypertension prevalence for chronicity coding only (prevalence ratio=1.61, 95% CI 1.03 to 2.49). For depressive symptoms, a dose-response relationship of similar magnitude was observed for all three coding approaches.
CONCLUSION
Scale coding is an important methodological consideration for valid exposure assessment in epidemiological research. Coding can impact exposure classification and associations with important indicators of African American women's mental and physical health.
Identifiants
pubmed: 30894420
pii: jech-2018-211230
doi: 10.1136/jech-2018-211230
pmc: PMC7200149
mid: NIHMS1577535
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
577-584Subventions
Organisme : NIMHD NIH HHS
ID : P60 MD006902
Pays : United States
Organisme : NIGMS NIH HHS
ID : UL1 GM118985
Pays : United States
Informations de copyright
© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
JAMA. 2014 Feb 5;311(5):507-20
pubmed: 24352797
Circulation. 2016 Jan 26;133(4):e38-360
pubmed: 26673558
Arch Gen Psychiatry. 2007 Apr;64(4):485-94
pubmed: 17404125
Int J Epidemiol. 2006 Aug;35(4):888-901
pubmed: 16585055
Am J Public Health. 2012 May;102(5):936-44
pubmed: 22420803
J Adolesc. 2004 Jun;27(3):363-8
pubmed: 15159094
Arch Gen Psychiatry. 2007 Mar;64(3):305-15
pubmed: 17339519
Ann N Y Acad Sci. 1998 May 1;840:33-44
pubmed: 9629234
Am J Hypertens. 2011 May;24(5):518-29
pubmed: 21331054
Soc Sci Med. 2005 Oct;61(7):1576-96
pubmed: 16005789
Ann Epidemiol. 2006 Sep;16(9):681-7
pubmed: 16458539
Psychosom Med. 2012 Nov-Dec;74(9):961-4
pubmed: 23107842
Am J Prev Med. 1994 Mar-Apr;10(2):77-84
pubmed: 8037935
Ethn Dis. 2001 Fall;11(4):711-21
pubmed: 11763865
Am J Public Health. 2012 May;102 Suppl 2:S258-65
pubmed: 22401510
Ann Epidemiol. 2016 Jan;26(1):7-13.e1
pubmed: 26549132
J Gerontol A Biol Sci Med Sci. 2009 Sep;64(9):1002-8
pubmed: 19429703
Am J Epidemiol. 2012 Mar 1;175(5):391-401
pubmed: 22306556
Am J Public Health. 1996 Oct;86(10):1370-8
pubmed: 8876504
Annu Rev Public Health. 2018 Apr 01;39:169-188
pubmed: 29328880
J Aging Health. 1993 May;5(2):179-93
pubmed: 10125443
Am J Epidemiol. 2006 Aug 1;164(3):257-62
pubmed: 16777930
Healthcare (Basel). 2018 Apr 23;6(2):
pubmed: 29690595
Am J Public Health. 2006 Jul;96(7):1265-70
pubmed: 16735638
BMC Public Health. 2013 Nov 20;13:1084
pubmed: 24256578
Ethn Dis. 2001 Fall;11(4):800-16
pubmed: 11763305
Am J Epidemiol. 2008 Mar 1;167(5):624-32
pubmed: 18083714
Ann Behav Med. 2019 Jun 4;53(7):608-620
pubmed: 30247506
Circulation. 2005 Feb 8;111(5):697-716
pubmed: 15699287
J Black Psychol. 2016 Jun;42(3):221-243
pubmed: 27529626
J Health Psychol. 1997 Jul;2(3):335-51
pubmed: 22013026
Health Psychol. 2014 Jan;33(1):20-34
pubmed: 24417692
Am Psychol. 1999 Oct;54(10):805-16
pubmed: 10540593
Am J Public Health. 2008 Sep;98(9 Suppl):S29-37
pubmed: 18687616
Psychoneuroendocrinology. 2019 Jan;99:225-235
pubmed: 30286445
Am Behav Sci. 2013 Aug 1;57(8):
pubmed: 24347666
Am J Public Health. 2006 May;96(5):826-33
pubmed: 16380565
Am J Public Health. 2003 Feb;93(2):243-8
pubmed: 12554577
Am Heart J. 2008 Dec;156(6):1103-9
pubmed: 19033005
BMC Med Res Methodol. 2003 Oct 20;3:21
pubmed: 14567763
Matern Child Health J. 2009 Jan;13(1):29-39
pubmed: 18463971