The role of perceived discrimination in predicting changes in health behaviours among African Americans in the Jackson Heart Study

Background This study examined whether perceived discrimination was associated with health behaviours over time and whether associations of discrimination with behaviours varied by attribution of discrimination. Methods Multinomial logistic regression was used to estimate ORs and CIs for the associations of discrimination (everyday, lifetime, stress from lifetime discrimination) with health behaviours (cigarette smoking, alcohol use) over time among 3050 African Americans in the Jackson Heart Study from visit 1 (2000-2004) to visit 3 (2009-2013). Smoking status was classified as persistent current, persistent former, persistent never, current to former and former/never to current smokers. Alcohol use status was classified as persistent heavy, persistent moderate/none, heavy to moderate/none and moderate/none to heavy alcohol users. Results Higher everyday discrimination was associated with persistent current smoking (OR per SD higher discrimination 1.26, 95% CI 1.11, 1.43) and with persistent former smoking (high vs low OR 1.32, 95% CI 1.02, 1.70) relative to persistent never smoking. Similar findings were observed for lifetime discrimination and persistent current smoking (high vs low OR 1.85, 95% CI 1.15, 2.95) and with persistent former smoking (high vs low OR 1.45, 95% CI 1.06,1.98). Participants reporting lifetime discrimination as very stressful compared with not stressful were more likely to be persistent former smokers (OR 1.44, 95% CI 1.04,1.99). Associations did not vary by discrimination attribution. Conclusion Discrimination did not predict changes in smoking status or alcohol use. Discrimination was associated with persistent current smoking status, which may provide a plausible mechanism through which discrimination impacts the health of African Americans.

Automated summary

The study investigated the association between perceived discrimination and health behaviors among African Americans, finding that everyday and lifetime discrimination were related to persistent current and former smoking behaviors. Those reporting lifetime discrimination as very stressful were more likely to be former smokers. Associations did not vary by discrimination attribution.