Dissertations & Theses (Open Access)
Date of Award
Spring 5-3-2024
Degree Name
Doctor of Philosophy in Nursing (PhD)
Advisor(s)
Jennifer Beauchamp, PhD
Second Advisor
Constance Johnson, PhD
Third Advisor
Sahiti Myneni, PhD
Abstract
Objectives: South Asian individuals (SAs) are found to have a heightened state of inflammation contributing to increased cardiovascular disease (CVD). Additionally, social determinants like discrimination are also associated with risks for CVD in SAs. This study examined the associations between discrimination and inflammation and whether an association between discrimination and self-rated health (SRH) is moderated by coping styles among SAs living in the United States to inform effective coping strategies against discrimination.
Design: This secondary data analysis used data from 1164 SAs (mean age = 57 years, SD 9.4, 48% women) enrolled in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. Discrimination was measured using the Everyday Discrimination Scale (EDS), and higher scores correspond to a greater frequency of discrimination. SRH was measured by asking participants to rate their health on a scale of 1-10 (7-10 indicates good/excellent SRH). Coping styles were defined as problem-focused (talking to other people about discrimination experienced) or emotion-focused (keeping the discriminatory experience to themselves). Multiple regression with bootstrapping was used to examine the associations between discrimination and inflammatory markers (C reactive protein, Tumor Necrosis Factor-α, leptin, and resistin) and anti-inflammatory adipokine (adiponectin) after controlling for covariates. Moderation analysis was used to assess whether coping styles moderated the association between discrimination and SRH.
Results: No significant associations were found between discrimination, inflammatory markers, and anti-inflammatory adipokine. Emotion-focused coping style moderated the association between discrimination and SRH (Odds Ratio =0.969, 95% CI = 0.940-0.999, p=0.044). Among participants who coped emotionally by keeping the discriminatory experience to themselves, a one-unit higher discrimination score was associated with 3% lower odds of a high SRH score ˃6, indicating better health (p=0.044). Problem-focused coping did not moderate the association between discrimination and SRH.
Conclusion: The unknown magnitude and duration of discrimination and the lack of variability in discrimination among the MASALA participants can possibly explain the null findings between discrimination and inflammation. Discrimination in SAs may be managed in a healthy way by assessing effective coping strategies that reduce the negative health consequences of discrimination among SAs.
Recommended Citation
Pillai, Raji, "The Association of Discrimination and Coping Style on Cardiovascular Health among South Asian Individuals in the MASALA Study" (2024). Dissertations & Theses (Open Access). 70.
https://digitalcommons.library.tmc.edu/uthson_etd/70
Keywords
South Asian, Immigrant, Discrimination, Inflammation, Inflammatory markers, Self-rated health, Coping style, MASALA