Health Disparities
Prenatal exposure to race-based stressors and cardiovascular health: The Bogalusa Heart Study Emily Harville* Emily Harville Maya David Patrizia Maria Santos Lydia Bazzano
Prenatal stress has been associated with cardiovascular health in offspring, and race-based stress may be particularly damaging. Bogalusa, Louisiana was a hotspot of the Civil Rights Movement and reactionary violence in the 1960s, while the Bogalusa Heart Study, a seminal study in childhood cardiovascular health, began in 1973. We aimed to examine whether cardiometabolic risk levels differed in children who were in utero during peak times of violence. We categorized time as “Bloody Bogalusa” (June-July 1965), early tensions (May 1964-May 1965), later tensions (August 1965-August 1966), and prior to (January 1960 to April 1964), and after this period (August 1966-December 1969). Mean levels of each cardiometabolic marker were examined by time period, stratified by race, with control for age, sex, and secular trend. Birthweight and gestational age were also examined. The study population was one-third Black (n=1277, 33.8%) and two-thirds white (n=2498, 66.2%). Mean age at study visit was 8.6 years. Sixty-two were born during the Bloody Bogalusa period, 437 in the period directly before, and 359 in the period directly after. The outcomes that most closely conformed to the hypothesis were glucose and gestational age: glucose levels were highest among Black children born during the Bloody Bogalusa period (beta=64.12 compared to the earliest period, p<0.01), and gestational age was lower for Black participants born during this time (beta=-1.29 weeks, p=0.05), while no difference was seen for white participants (p for interaction < 0.01 for both). However, for glucose, this is based on a very small number of births. In utero exposure was not associated with other outcomes. Effects of these prenatal exposures were insufficiently large to be clearly demonstrated in a sample of this size. Future studies will need to examine more detailed social and biological measures to identify which aspects of these events were relevant to health.