The Longitudinal Association between Gendered Racism and Disease Activity among Black Women Living with Lupus

• In Event: 30252 - Racialized Health Injustice

Abstract

Prior research has established gendered racism (interlocking injustices of racism and sexism) as a contributor to poor mental health though its association with physical health outcomes is not well understood. This study investigates whether interpersonal gendered racism is associated with disease activity among Black women living with Systemic Lupus Erythematosus (SLE), a demographic group with high prevalence of the disease. Data are from the Vascular Aging, Inflammation, and Stress in African American Women’s Health research Study (VISTA), a longitudinal cohort of Black women living with and without SLE. Data collection occurred between 2017 and 2023. The analysis was restricted to Black women with SLE (N = 201). Disease activity was assessed using the systemic lupus activity questionnaire (SLAQ) and was reported at five time points. A continuous (Mean [M] = 15.44) and clinically important cut-off of SLAQ (score ≥ 9; 78%) were the dependent measures. Interpersonal gendered racism was assessed using the Gendered Racial Microaggressions Scale (GRMS) at baseline. GRMS includes four dimensions: Assumptions of Beauty and Sexual Objectification, Silenced and Marginalized, Strong Black Woman Stereotype, and Angry Black Woman Stereotype. Linear and logistic random intercept mixed-effects models using maximum likelihood estimation were utilized. Models adjusted for baseline age (M = 35.98 years), relationship status, employment status, education, income, body mass index (BMI), current smoking status, and number of years living with SLE (M = 10.61 years). Results revealed more frequent experiences of GRMS were associated with greater disease activity (β = 2.82; p <.001). GRMS was also associated with clinically important disease activity (i.e., score ≥ 9; OR = 2.79; p <.001). Gendered racism experiences linked to Assumptions of Beauty and Sexual Objectification had the most robust association with disease activity. Study results underscore the importance of examining injustices rooted in racism and sexism as potential determinants of health.

Authors

• Christy L Erving, University of Texas-Austin

• Khadijah Abdallah, Emory University

• Rachel Parker, Emory University

• Jordan E Parker, University of California, Los Angeles

• Raphiel Murden, Emory University

• Shivika Udaipuria, Emory University

• Francisco Rios Casas, University of Texas-Austin

• Nicole D Fields, Northwestern University

• Zachary T Martin, Emory University

• Lori S Hoggard, North Carolina State University

• Bianca Booker, Emory University

• LaKeia Culler, Emory University

• Seegar Swanson, Emory University

• Jordan S Wilson, Drexel University

• Reneé H Moore, Drexel University

• Viola Vaccarino, Emory University

• S Sam Lim, Emory University

• Tene T. Lewis, Rollins School of Public Health, Emory University