BWHS Publications on Racism and Health
Rosenberg L, Palmer JR, Wise LA, Horton NJ, Corwin MJ. Perceptions of racial discrimination and the risk of preterm birth. Epidemiology 2002;13:646-52.
Black babies are more often born preterm (premature or early) than white babies. These analyses were based on births reported on the 1997 and 1999 questionnaires: the mothers of 422 preterm babies were compared to the mothers of 4544 full term babies. Overall, the risk of preterm birth was not related to responses to 7 of 9 questions about experiences of racism, but risk was slightly higher for women who reported unfair treatment on the job and that people acted afraid of them at least once a week. Among women with 12 years or less education, there were increased risks of preterm birth for 4 of the questions about racism. These data are suggestive. It will be important to reassess the question of whether experiences of racism increase preterm birth based on births reported by BWHS participants on the questionnaires. link to online article
Cozier YC, Palmer JR, Horton NJ, Fredman L, Wise LA, Rosenberg L. Racial discrimination and the incidence of hypertension in U.S. Black women. Ann Epidemiol 2006;16:681-7.
The occurrence of hypertension (high blood pressure) is 2-3 times greater in Black women than white women, and the condition increases the risk of heart disease and other serious illnesses. Stressors, such as experiences of racial discrimination, may increase the risk of hypertension. To see if this was happening in the BWHS, we studied the experiences of racism reported by BWHS participants on the 1997 BWHS health survey in relation to the occurrence of hypertension in the following years. Overall, the occurrence of hypertension was similar in women who did and did not experience racial discrimination. However, in the foreign born women, those who reported more experiences of discrimination also developed more hypertension. If confirmed, this finding may mean that foreign born women have a different response to experiences of racism than women born in the United States. link to online article
Wise LA, Palmer JR, Cozier YC, Hunt MO, Stewart EA, Rosenberg L. Perceived racial discrimination and risk of uterine leiomyomata. Epidemiology 2007;18(6):747-57.
Uterine fibroids (fibroids in the womb) occur 2-3 times more commonly in Black women than in white women and the reasons for the difference are unknown. We studied whether experiences of racism, reported on the 1997 BWHS health survey, were related to the development of uterine fibroids. The analysis was based on 22,000 premenopausal participants followed in the BWHS from 1997 through 2003. During that time period 3,440 women reported having been diagnosed with uterine fibroids. We found that the condition occurred more often in BWHS participants who reported higher levels of racial discrimination than in those who reported lower levels. There was a suggestion in the data that the increased occurrence of fibroids among women who experienced racism might be smaller or absent among those who had skills for coping with stress, such as getting support from friends or family. This is the first study to suggest that racism may contribute to an increased occurrence of uterine fibroids. link to online article
Cozier YC, Wise LA, Palmer JR, Rosenberg L. Perceived racism in relation to weight change in the Black Women's Health Study. Ann Epidemiol 2009;19:379-87. doi: 10.1016/j.annepidem.2009.01.008.
In an assessment of weight change between 1997 and 2005 among BWHS participants, we found that women who reported frequent experiences of racism gained more weight than women who reported that they rarely or never experienced racism. These results suggest that experiences of racism may contribute to the occurrence of overweight and obesity among African American women. link to online article
Mouton CP, Carter-Nolan PL, Makambi KH, Taylor TR, Palmer JR, Rosenberg L, Adams-Campbell LL. Impact of perceived racial discrimination on health screening in Black women. J Health Care Poor Underserved 2010;21(1):287-300. NIHMSID: NIHMS209351.
Perceived discrimination has been associated with health screening behavior in some populations. We assessed whether experiences of discrimination, as reported by BWHS participants in 1997, are associated with having had Pap smears, mammography, or colonoscopy. Both everyday discrimination and discrimination on the job, in housing, or by police were associated with not having received a Pap smear. There was no relation between discrimination and mammography or colonoscopy use. link to online article
Coogan PF, Yu J, O’Connor GT, Brown TA, Cozier YC, Palmer JR, Rosenberg L. Experiences of racism and the incidence of adult-onset asthma. Chest 2014;145(3):480-5. doi: 10.1378/chest.13-0665.
In the BWHS, more than 1000 women have reported the development of asthma. We found that the incidence of asthma was increased among women who reported hight levels of experiences of racism. It may be that chronic stress resulting from experiences of racism increases the incidence of adult-onset asthma through effects on the immune system and the airways. link to online article
Cozier YC, Yu J, Coogan PF, Bethea TN, Rosenberg L, Palmer JR. Racism, segregation, and risk of obesity in the Black Women's Health Study. Am J Epidemiol 2014;179(7):875-83. doi: 10.1093/aje/kwu004.
Experiences of racism are stressors that might result in increased obesity, for example through changes in eating or exercise habits. In the BWHS, the occurrence of obesity was greater among women who had the greatest experiences of racism. This was the case whether women lived in segregated or nonsegregated neighborhoods. link to online article
Bacon KL, Stuver SO, Cozier YC, Palmer JR, Rosenberg L, Ruiz-Narváez EA. Perceived racism and incident diabetes in the Black Women’s Health Study. Diabetologia 2017;60(11):2221-5. doi: 10.1007/s00125-017-4400-6.
BWHS participants have been asked questions about experience with interpersonal racism in daily life (everyday racism) and lifetime racism with respect to police, housing, and work. We assessed racism in relation to type 2 diabetes from 1995 through 2011 in the BWHS, during which time 5,344 women were diagnosed with diabetes. Both everyday and lifetime racism were associated with increased risk of developing type 2 diabetes. Increased weight associated with racism accounted for about half of the increase in risk. link to online article
Griswold MK, Crawford SL, Perry DJ, Person SD, Rosenberg L, Cozier YC, Palmer JR. Experiences of racism and breastfeeding initiation and duration among first-time mothers of the Black Women’s Health Study. J Racial Ethn Health Disparities 2018;5(6):1180-91. doi: 10.1007/s40615-018-0465-2.
Black women are less likely to breastfeed than other groups in the U.S. We analyzed BWHS data to explore whether neighborhood segregation, birthplace (first or second generation US born vs foreign-born) and experiences of racism influenced breastfeeding initiation and duration. We found that BWHS participants born in the US were less likely to breastfeed, or they breastfed for a shorter time. The same was true for women who grew up in a predominantly Black neighborhood compared to those who grew up in a predominantly White neighborhood. Experience of racism on the job was associated with a shorter duration of breastfeeding. These results indicate that structural-level interventions are needed to lessen racial disparities in breastfeeding rates in the U.S. link to online article
Lu D, Palmer JR, Rosenberg L, Shields AE, Orr EH, DeVivo I, Cozier YC. Perceived racism in relation to telomere length among African-American women in the Black Women’s Health Study. Ann Epidemiol 2019;36:33-9. doi: 10.1016/j.annepidem.2019.06.003.
Telomeres (protein structures at the ends of chromosomes) become shorter as a person becomes older. Telomeres that are shorter than expected for a given age have been found to be associated with premature morbidity and mortality (earlier ages of death and illness). In the BWHS, an analysis of telomere length and self-reported experience of everyday racism found shorter telomere length among women who reported not discussing those experiences of racism with others. Further work is need to confirm this association. link to online article