Vicarious Racism Stress, Racial Discrimination, and Disease Activity: The Black Women’s Experiences Living with Lupus (BeWELL) Study

Abstract

Systemic lupus erythematosus (SLE) is characterized by Black-White disparities in severity, which in part are associated with group differences in exposure to psychosocial stress. Among salient sources of stress are those tied to racial minority status, such as direct interpersonal experiences of racial discrimination, as well as vicarious racism (hearing about or observing others’ experiences of racism). Previous research has focused primarily on interpersonal discrimination; yet facets of racism going beyond the immediate target remain understudied. We examined associations between vicarious (indirect) racism, direct experiences of everyday racial discrimination, and disease activity among 432 African American women with SLE recruited to the Black Women’s Experiences Living with Lupus (BeWELL) Study (2015-2017). Multivariable analyses indicate vicarious racism stress (b=1.83, 95% CI:0.70-2.95) was positively associated with SLE activity, even after adjusting for everyday discrimination (b=1.12, 95% CI:0.41-1.84). Our findings suggest that similar to more commonly studied direct experiences of racial discrimination, future research may also consider “secondhand” exposure to racism as a cause of heightened disease activity and subsequent health risk in the context of SLE.