Discrimination at work is linked to high blood pressure

Experiencing high levels of discrimination at work has been linked to potential harm to heart health, according to a study published in the Journal of the American Heart Association in 2023. 

The research revealed that individuals reporting elevated levels of workplace discrimination were at a greater risk of developing high blood pressure compared to those reporting lower levels of discrimination. 

As per an article by Harvard Health, workplace discrimination encompasses unfair treatment or unfavourable conditions based on personal attributes such as race, gender, or age.

How can discrimination affect our health?

"The daily hassles and indignities people experience from discrimination are a specific type of stress that is not always included in traditional measures of stress and adversity," says sociologist David R. Williams, professor of public health at the Harvard T.H. Chan School of Public Health.

Multiple studies have consistently shown that experiencing discrimination heightens the risk of developing various factors associated with heart disease. In addition to high blood pressure, these factors can encompass chronic low-grade inflammation, obesity, and type 2 diabetes.

Over 25 years ago, Williams devised the Everyday Discrimination Scale, which remains the most extensively employed tool for assessing the impact of discrimination on health.

Who participated in the study of workplace discrimination?

The study followed a nationwide sample of 1,246 adults across a broad range of occupations and education levels, with roughly equal numbers of men and women.

Most were middle-aged, white, and married. They were mostly nonsmokers, drank low to moderate amounts of alcohol, and did moderate to high levels of exercise. None had high blood pressure at the baseline measurements.

How was discrimination measured and what did the study find?

The study is the first to show that discrimination in the workplace can raise blood pressure.

To measure discrimination levels, researchers used a test that included these six questions:

• How often do you think you are unfairly given tasks that no one else wanted to do?
• How often are you watched more closely than other workers?
• How often does your supervisor or boss use ethnic, racial, or sexual slurs or jokes?
• How often do your coworkers use ethnic, racial, or sexual slurs or jokes?
• How often do you feel that you are ignored or not taken seriously by your boss?
• How often has a coworker with less experience and qualifications gotten promoted before you?

Based on the responses, researchers calculated discrimination scores and divided participants into groups with low, intermediate, and high scores.

After a follow-up of roughly eight years, about 26% of all participants reported developing high blood pressure.

Compared to people who scored low on workplace discrimination at the start of the study, those with intermediate or high scores were 22% and 54% more likely, respectively, to report high blood pressure during the follow-up.

How could discrimination affect blood pressure?

Discrimination can induce emotional stress, activating the body's fight-or-flight response. This surge in hormones leads to an increased heart rate and narrowed blood vessels, resulting in a temporary rise in blood pressure. 

However, if this stress response is recurrent, blood pressure may remain consistently elevated.

Discrimination may stem from unfair treatment based on various factors such as race, gender, religion, or sexual orientation. According to Williams, the specific reason for discrimination doesn't seem to significantly alter its health effects. 

"In essence, regardless of the cause, discrimination's impact on health appears similar," he explains. Williams highlights that the Everyday Discrimination Scale was purposely developed to encompass various forms of discrimination.

What are the limitations of this study?

One constraint of this recent study is that merely 6% of the participants belonged to nonwhite racial groups, and these individuals were less inclined to participate in the study's follow-up session. Consequently, the study might not have comprehensively or precisely depicted workplace discrimination across various racial demographics. 

Additionally, blood pressure data relied on self-reporting, which could be less dependable compared to measurements directly administered by medical professionals.

What may limit the health impact of workplace discrimination?

At the organizational level, no studies have directly addressed this issue. Preliminary evidence suggests that improving working conditions, such as decreasing job demands and increasing job control, may help lower blood pressure, according to the study authors. In addition, the American Heart Association recently released a report, Driving Health Equity in the Workplace, that aims to address drivers of health inequities in the workplace.

Encouraging greater awareness of implicit bias may be one way to help reduce discrimination in the workplace. Implicit bias refers to the unconscious assumptions and prejudgments people have about groups of people that may underlie some discriminatory behaviors. You can explore implicit biases with these tests, which were developed at Harvard and other universities.

On an individual level, stress management training can reduce blood pressure. A range of stress-relieving strategies may offer similar benefits. Regularly practicing relaxation techniques or brief mindfulness reflections, learning ways to cope with negative thoughts, and getting sufficient exercise can help.