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Experiences of Discrimination Linked to Higher Mortality

, by Jennifer Loukissas, M.P.P.

Illustration of a diverse group of people.

A new study of data from participants in the Multi‐Ethnic Study of Atherosclerosis (MESA), links experiences of discrimination to higher risk of all-cause and cardiovascular mortality with stronger associations observed for cardiovascular than for all-cause mortality, particularly for Black individuals. Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States. The findings were published in the journal Circulation: Cardiovascular Quality and Outcomes, on April 5, 2023. 

For this analysis, Wayne Lawrence, Dr.P.H., M.P.H., and colleagues utilized the MESA study, a large multi-ethnic cohort with nearly two decades of follow-up that includes 1,633 Black, 1,403 Hispanic/Latino, and 2,473 White participants aged 45 to 84 years.   

 Discrimination was measured using the lifetime discrimination (major experiences of unfair treatment) and everyday discrimination (day-to-day experiences of unfair treatment) scales. While the relationship between lifetime discrimination and adverse health outcomes may differ by sociodemographic characteristics, the investigators observed the association across all racial/ethnic groups but strongest among Black participants. The relationship between discrimination and risk remained after controlling for sociodemographic factors, health behaviors, and clinical risk factors.  

For Black participants, each increase in reports of lifetime discrimination was associated with 8% higher all-cause mortality and 18% higher cardiovascular mortality. These findings and prior literature indicate that Black participants, compared to other racial/ethnic groups, were exposed to more major experiences of discrimination over their life course, thus leading to more adverse health outcomes than their non-Black counterparts.  

These results highlight the need for policies and public health interventions aimed at eliminating discrimination and mitigating its adverse effects on health. Future studies exploring the intersectionality of race/ethnicity and gender are needed among a larger and more diverse cohort to better understand population differences in the relationships between frequency and type of discrimination and mortality. 


Lawrence, W, et al. Discrimination Experiences and All-cause and Cardiovascular Mortality: The Multi-Ethnic Study of AtherosclerosisCirc Cardiovasc Qual Outcomes. April 2023.