Chest
Original Research: AsthmaExperiences of Racism and the Incidence of Adult-Onset Asthma in the Black Women's Health Study
Section snippets
Establishment of the Black Women's Health Study
The Black Women's Health Study (BWHS) is a prospective cohort study established in 1995, when 59,000 black women aged 21 through 69 years enrolled by completing health questionnaires.27 The baseline questionnaire elicited information on demographic and lifestyle factors, reproductive history, and medical conditions. The cohort is followed biennially by mailed questionnaires to update exposures and ascertain incident disease. Follow-up of the original cohort through seven completed questionnaire
Results
Women in the analytic cohort were followed for an average of 13 years, for a total of 227,651 person-years. At baseline in 1997, compared with women in the lowest quartile of the everyday racism score, those in the highest quartile were younger, more highly educated, and heavier; had greater exposure to secondhand smoke; and were more likely to have used female hormones, to be current drinkers, and to report more pack-years of smoking (Table 1). Women who answered “yes” to all three lifetime
Discussion
In this large population of black women, experiences of everyday and lifetime racism were associated with an increased incidence of adult-onset asthma. The associations were stronger when we confined the analyses to women who reported the same level of everyday and lifetime racism in 1997 and 2009; these women may have had more consistent experiences of racism over time.
Previous studies, none reporting on racism, have found associations between a variety of types of stress and asthma incidence.
Conclusions
Experiences of racism were positively associated with adult-onset asthma in this large cohort of black women, suggesting that the chronic stress associated with such racism contributes to the onset of asthma in adults. Given the high prevalence of this stressor in the lives of black women,45 the association is of significant public health importance. Our observations contribute to a growing body of evidence indicating that experiences of racism can have adverse health effects. School- and
Acknowledgments
Author contributions: Dr Coogan takes responsibility for the content of the manuscript, including the data and analysis.
Dr Coogan: contributed to the idea for this study, study design conceptualization, analysis and interpretation of the data, and writing of the manuscript.
Mr Yu: contributed to the study design conceptualization, analysis and interpretation of the data, and critical rewriting and approval of the final version of the manuscript.
Dr O'Connor: contributed to the study design
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Funding/Support: This work was funded by grants from the National Heart, Lung, and Blood Institute [R01 HL107314] and the National Cancer Institute [R01 CA058420].
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