Women’s Health
Perceived discrimination and cardiometabolic health in mid-life women: results from the Project Viva cohort Benjamin Grobman* Benjamin Grobman Sheryl L. Rifas-Shiman Izzudin Aris Wei Perng Stephen Juraschek Emily Oken Marie-France Hivert Mingyu Zhang
Background: Understanding how perceived interpersonal discrimination is associated with cardiometabolic health could inform place-based interventions aimed at reducing health disparities.
Methods: Participants are 450 middle-aged women from the Project Viva cohort. In 2021-2022, we assessed perceived interpersonal discrimination using the 9-item, race-neutral Williams Everyday Discrimination Scale (WEDS) via surveys. We also summed the 9-item WEDS into a total score. In 2022-2024, we measured weight, height, blood pressure (BP), and sleep duration (via actigraphy) and quality (via PROMIS Sleep Disturbance forms) during in-person visits. We defined obesity as BMI ≥30 kg/m2 and hypertension as systolic/diastolic BP ≥130/80 mmHg or the use of BP medications. We examined associations of WEDS (total and individual item scores) with cardiometabolic outcomes using linear or modified Poisson models, adjusting for age, household income, and education.
Results: At outcome measurement, women had a median age of 56.1 years (IQR: 53.2-59.2), with 74% self-identifying as White, 10% Black, 7% Hispanic, 7% Asian, and 2% others. At the time of surveys, 74% reported household incomes >$100,000/year. Higher total WEDS scores were associated with higher BMI, shorter sleep duration, greater sleep impairment and disturbance (Panel A), and higher obesity risk (Panel B). Further adjustment for race and ethnicity slightly attenuated these associations. Most individual WEDS items were consistently associated with BMI (Panel C) and sleep impairment (Panel D). Adjustment for perceived reasons for discrimination based on weight or appearance reduced, but did not eliminate, associations with BMI (Panel C). Adjustment for BMI prior to surveys (measured 2017-2021) did not change associations with sleep impairment (Panel D).
Conclusion: Higher perceived interpersonal discrimination was prospectively associated with higher BMI, obesity, and poorer sleep duration and quality among women in midlife.
