Workplace Discrimination, Weathering Key SDOH in Blood Pressure Control

April 27, 2023 - The evidence keeps piling up, cementing weathering as a key social determinant of health (SDOH). New data from the American Heart Association highlighted the link between workplace discrimination and high blood pressure, showing the clinical impact that chronic exposure to discrimination can have.

Overall, people who reported moderate workplace discrimination—defined as unfair conditions or unpleasant treatment because of personal characteristics like age, sex, and race—were 22 percent more likely to report high blood pressure by the end of the eight-year study period. For those reporting high workplace discrimination, the odds of developing high blood pressure were 54 percent higher.

These findings are novel because they look at how discrimination in a specific setting can impact health outcomes, according to Jian Li, MD, PhD, the study’s lead author.

“Scientists have studied the associations among systemic racism, discrimination and health consequences. However, few studies have looked specifically at the health impact of discrimination in the workplace, where adults, on average, spend more than one-third of their time,” Li, who is also a professor of work and health in the Fielding School of Public Health and the School of Nursing at the University of California, Los Angeles, said in a press release.

“To the best of our knowledge, this is the first scientific evidence indicating workplace discrimination may increase people’s long-term risk of developing high blood pressure.”

The researchers looked at a population of more than 1,200 people over an eight-year period to look at how they reported workplace discrimination and the change in their blood pressure over time. All participants began the study with no reports of high blood pressure. Blood pressure at the end of study was based on participant self-reports.

They also filled out surveys about workplace discrimination, including whether they believed they have been treated unfairly, are monitored more closely than others, or ignored more than others. The surveys also asked about the fairness of promotions.

Additionally, the surveys asked about more explicit forms of discrimination, like the use of ethnic, racial, or sexual slurs or jokes at work.

The researchers used this information to give participants a discrimination score, putting them into low, moderate, or high discrimination categories.

Overall, around a quarter of participants had developed high blood pressure after the eight-year study period, with those who reported at least moderate workplace discrimination being more likely to fall into this bucket.

Those who reported moderate workplace discrimination were 22 percent more likely to develop high blood pressure than those who reported none. Additionally, those who reported high workplace discrimination were 54 percent more likely to have high blood pressure than those who reported none.

These results give further credence to the weathering hypothesis, which states that chronic exposure to discrimination, including workplace discrimination, can adversely impact clinical outcomes.

Li and colleagues said, given this evidence confirming the weathering hypothesis, efforts to curb workplace discrimination are necessary.

“There are several implications from these findings,” Li said. “First, we should increase public awareness that work is an important social determinant of health. Second, in addition to traditional risk factors, stressful experiences at work due to discrimination are an emerging risk factor for high blood pressure.”

Workplaces of all kinds should consider their organizational policies to monitor and flag instances of workplace discrimination, the authors recommended.