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Racial Disparities in Avoidant Coping and Hypertension Among Midlife Adults

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Abstract

While associations between stress and hypertension have been documented, little research has examined the association between coping and hypertension, especially in the context of understanding racial disparities. Utilizing data from the CHDS-DISPAR study, we examine the association between avoidant coping and hypertension among adults age 50 while assessing for potential differences across (1) coping in response to the general stress and discrimination and (2) African American and White racial groups. Coping was measured using a 9-item scale with an avoidant coping subscale (e.g., drinking alcohol). Mean avoidance coping scores were calculated for both general stress and discrimination. No racial differences in avoidant coping were found. Within our sample (n = 414), there was a high burden of hypertension among African American respondents compared to White respondents (50.3% vs. 22.6%). Models assessed associations between avoidant coping and hypertension adjusted for sociodemographic factors, obesity, and either experience of stress or discrimination depending on the coping domain examined. Avoidant coping in response to the general stress and discrimination was associated with increased hypertension among White respondents (PR: 1.63 [95%CI 1.01, 2.24]; PR: 1.69 [95%CI 1.12, 2.26], respectively) and no associations among African American respondents (PR: 0.83 [95%CI 0.57, 1.09]; PR: 0.82 [95%CI 0.52, 1.12], respectively). This research suggests that racial disparities in hypertension may not be attributable to individual-level coping behaviors.

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Data Availability

Data and materials relevant to this study can be made available upon contacting the corresponding author.

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Acknowledgements

We would like to acknowledge Barbara Cohn, Piera Cirillo, and Katrina Kezios for their assistance. This work was supported by the National Institutes of Health R01HD058515 (Co-PIs: Link & Cohn) and R01AG058704 (Suglia and Shelton).

Funding

This study was funded by the National Institutes of Health.

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Authors and Affiliations

  1. Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA, 30322, USA

    Brian Batayeh & Shakira F. Suglia

  2. Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA

    Rachel Shelton

  3. Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, 722 West 168th Street, New York, NY, 10032, USA

    Pam Factor-Litvak

  4. Department of Sociology, University of California Riverside, Riverside, CA, USA

    Bruce G. Link

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  1. Brian Batayeh
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  5. Shakira F. Suglia
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Contributions

Brian Batayeh: conceptualization, methodology, software, formal Analysis, and writing—original draft; Rachel Shelton: writing—review and editing and funding acquisition; Bruce Link: investigation, resources, data curation, project administration, and funding acquisition; Pam Factor-Litvak: writing- review and editing; Shakira F. Suglia: conceptualization, methodology, resources, supervision, project administration, and funding acquisition.

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Correspondence to Shakira F. Suglia.

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The methodology for this study was approved by the Human Research Ethics committee of Emory University (IRB00100708).

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Written informed consent was obtained from all individual participants included in the study.

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All participants provided written informed consent for the dissemination of study findings, including research publications.

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The authors declare no competing interests.

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Batayeh, B., Shelton, R., Factor-Litvak, P. et al. Racial Disparities in Avoidant Coping and Hypertension Among Midlife Adults. J. Racial and Ethnic Health Disparities 10, 410–417 (2023). https://doi.org/10.1007/s40615-022-01232-7

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