Study Corroborates ‘Weathering,’ Links Racism to Racial Health Disparities

More research is adding to the evidence indicating that the weathering hypothesis has some merit, with new data from Boston University showing that experiences with racism have led to racial health disparities in heart disease.

The study, which looked at more than 48,000 Black women over 22 years, found that experiences of interpersonal racism at work, in housing, and in interactions with the police led to a 26 percent greater risk of coronary heart disease.

“This is the first longitudinal evidence that perceived racism is associated with increased risk of coronary heart disease,” Shanshan Sheehy, a BU Chobanian & Avedisian School of Medicine assistant professor, stated publicly. “Racism has a real impact on the heart health of Black women.”

The fact that Black women carry a disproportionate heart disease burden isn’t new. Per figures from the American Heart Association, half of Black women over age 20 have a cardiovascular disease, with an annual death toll of around 50,000. Previously, this racial health disparity has been explained by genetics and higher rates of comorbidities, but this study showed that the difference is deeper than that.

Instead, it showed that the weathering hypothesis—which states that “chronic exposure to social and economic disadvantage leads to accelerated decline in physical health outcomes”—could be at play here.

The researchers recruited nearly 60,000 Black women, all of whom seemingly had healthy hearts, back in 1997 and looked at how their experiences with interpersonal racism over time were linked to heart disease.

Women began by listing how they experienced racism during the job hunt, when looking for housing, or when interacting with the police. In surveys issued over the study’s 22-year period, participants also listed how they’ve experienced racism in their everyday lives, like when going shopping or in a restaurant.

By the end of the study, more than 1,000 of the participants had developed heart disease, and there was a link between that risk of heart disease and the reported experiences of racism in work, housing, and police interactions.

That same link was not apparent when looking at discrimination in everyday life, something Sheehy credits to the varied consequences of each kind of interaction. While discrimination in a store is abhorrent, individuals may have their own personal strategies for coping with the interaction and halting potential health impacts.

But consequences of racism during the job hunt or a traffic stop, however, are greater, Sheehy said.

“When we think about how racism impacts our health, it’s a psychosocial stressor,” Sheehy, who’s also affiliated with the BU Slone Epidemiology Center, added. “It increases your blood pressure, your level of inflammation—all of these biological mechanisms increase your risk of coronary heart disease.”

Moving forward, the researchers plan to look at how structural racism impacts heart disease health disparities.

“Structural racism is real—on the job, in educational circumstances, and in interactions with the criminal justice system,” coauthor Michelle A. Albert, American Heart Association president and a University of California at San Francisco professor of medicine, said in the press release. “Now, we have hard data linking it to cardiovascular outcomes, which means that we as a society need to work on the things that create the barriers that perpetuate structural racism.”

This study adds to the growing literature testing the weathering hypothesis, a concept that is starting to gain notoriety as the longitudinal studies required to prove it are coming to close. In February 2023, at study out of the Massachusetts-based McLean Hospital found that Black kids are more likely to have adverse childhood experiences (ACEs), which can have consequences on brain health.

Particularly, the disproportionate amount of childhood adversity Black kids face—mostly racism and socioeconomic burden—was linked to changes in the parts of the brain associated with PTSD. ACEs like racism can work as a “toxic stressor” to the brain, the researchers said.

“Our research provides substantial evidence of the effects structural racism can have on a child’s developing brain, and these small differences may be meaningful for their mental health and well-being through adulthood,” Nathaniel G. Harnett, director of the Neurobiology of Affective Traumatic Experiences Laboratory at McLean Hospital, which is part of Mass General Brigham, stated publicly.