TY - JOUR
T1 - Perceived racial discrimination and risk of uterine leiomyomata
AU - Wise, Lauren A.
AU - Palmer, Julie R.
AU - Cozier, Yvette C.
AU - Hunt, Matthew O.
AU - Stewart, Elizabeth A.
AU - Rosenberg, Lynn
PY - 2007/11
Y1 - 2007/11
N2 - BACKGROUND: The incidence of uterine leiomyomata (fibroids, myomas) is 2-3 times higher in black women than white women. Black women also report higher levels of racial discrimination. We evaluated the hypothesis that greater exposure to racism increases myoma risk in black women. METHODS: Data were derived from the Black Women's Health Study, a prospective cohort study of US black women age 21-69 years in 1995. In 1997, women reported on "everyday" and "lifetime" experiences of racism. From 1997 through 2003, we followed 22,002 premenopausal women to assess the association between self-reported racism and risk of myomas. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated from Cox regression models. RESULTS: During 107,127 person-years of follow-up, 3440 new cases of uterine myomas confirmed by ultrasound (n = 2774) or surgery (n = 666) were reported. All IRRs for "lifetime" and "everyday" experiences of racism were above 1.0. Using a summary variable that averaged the responses from 5 "everyday" racism items, multivariable IRRs comparing quartiles 2, 3, and 4 to quintile 1 (lowest) were 1.16 (95% CI = 1.04-1.29), 1.19 (1.06-1.32), and 1.27 (1.14-1.43), respectively. Multivariable IRRs comparing women who reported 1, 2, or 3 lifetime occurrences of major discrimination (ie, job, housing, or police) relative to those who reported none were 1.04 (0.96-1.13), 1.17 (1.07-1.28), and 1.24 (1.10-1.39), respectively. Results did not vary according to case definition (ultrasound vs. surgery) or health care utilization. Associations were weaker among foreign-born women and among women with higher coping skills. CONCLUSIONS: Perceived racism was associated with an increased risk of uterine myomas in US-born black women.
AB - BACKGROUND: The incidence of uterine leiomyomata (fibroids, myomas) is 2-3 times higher in black women than white women. Black women also report higher levels of racial discrimination. We evaluated the hypothesis that greater exposure to racism increases myoma risk in black women. METHODS: Data were derived from the Black Women's Health Study, a prospective cohort study of US black women age 21-69 years in 1995. In 1997, women reported on "everyday" and "lifetime" experiences of racism. From 1997 through 2003, we followed 22,002 premenopausal women to assess the association between self-reported racism and risk of myomas. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated from Cox regression models. RESULTS: During 107,127 person-years of follow-up, 3440 new cases of uterine myomas confirmed by ultrasound (n = 2774) or surgery (n = 666) were reported. All IRRs for "lifetime" and "everyday" experiences of racism were above 1.0. Using a summary variable that averaged the responses from 5 "everyday" racism items, multivariable IRRs comparing quartiles 2, 3, and 4 to quintile 1 (lowest) were 1.16 (95% CI = 1.04-1.29), 1.19 (1.06-1.32), and 1.27 (1.14-1.43), respectively. Multivariable IRRs comparing women who reported 1, 2, or 3 lifetime occurrences of major discrimination (ie, job, housing, or police) relative to those who reported none were 1.04 (0.96-1.13), 1.17 (1.07-1.28), and 1.24 (1.10-1.39), respectively. Results did not vary according to case definition (ultrasound vs. surgery) or health care utilization. Associations were weaker among foreign-born women and among women with higher coping skills. CONCLUSIONS: Perceived racism was associated with an increased risk of uterine myomas in US-born black women.
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U2 - 10.1097/EDE.0b013e3181567e92
DO - 10.1097/EDE.0b013e3181567e92
M3 - Article
C2 - 17917606
AN - SCOPUS:37349014848
SN - 1044-3983
VL - 18
SP - 747
EP - 757
JO - Epidemiology
JF - Epidemiology
IS - 6
ER -