- New research suggests that discrimination in the workplace can directly affect a person’s risk of developing high blood pressure.
- Chronic stress from workplace discrimination can cause an over-activation of the cardiovascular system, leading to hypertension and other cardiovascular disorders.
- Experts say individual coping mechanisms can be helpful to individuals who are experiencing workplace stress, but not everyone possesses higher coping skills.
Discrimination in the workplace is an issue that affects people across industries and walks of life.
Back in 2020, Glassdoor reported that 61% of employees in the United States have either experienced or seen discrimination tied to one’s race, age, gender, or LGBTQIA+ identity at work.
This pervasive presence of workplace discrimination in American life can move from the office to other aspects of one’s life.
The buildup of stress, anxiety, and depression from discriminatory practices experienced at one’s job can have wide-ranging effects on overall health, and one recent study published in the Journal of the American Heart Association shows that people who felt discrimination at work faced increased high blood pressure risk.
Experts say the new research not only offers a window into how the way we’re treated at work can affect our health but also sheds a spotlight on the changes some companies may need to make to ensure workers’ overall well-being is prioritized.
Examining the data from the study
For this study, the researchers reviewed data from the Midlife in the United States Study (MIDUS) on U.S. adults who spanned education levels and jobs. They looked at data on 1,246 adults who did not show high blood pressure between 2004 and 2006 — the start of the study — and were then documented until the 2013 to 2014 marker. Most of those studied were white, with roughly half women.
They mostly broke down into these age categories:
- younger than 45
- ages 46 to 55
- 56 and older
Most self-reported that they were non-smokers, engaged in no-to-moderate alcohol consumption, and also participated in moderate-to-high physical exercise at the beginning of the study period, according to a press release.
The research team defined workplace discrimination as “unfair conditions or unpleasant treatment at work because of personal characteristics, particularly race, sex, or age.”
To determine whether they experienced this discrimination at their jobs, the participants responded to survey questions about what they experienced at work, like whether or not they were treated unfairly or observed more closely than others, or ignored. The participants were also asked if promotions were given out fairly and to describe the frequency of sexual, racial, or ethnic jokes and slurs at their workplaces.
They found that 319 participants developed high blood pressure after roughly eight-year of the follow-up period at the end of the study.
Those who had “intermediate workplace discrimination exposure scores” were 22% more likely to report high blood pressure than those who reported “low workplace discrimination scores.”
Additionally, people with high workplace discrimination exposure scores were 54% more likely to report high blood pressure readings during the follow-up study period compared to those who had reported low workplace discrimination scores.
Lead study author Dr. Jian Li, M.D, Ph.D., 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, told Healthline that he initially hypothesized there would be a link between high blood pressure and workplace discrimination heading into this project.
He said he was “excited to see the association” between discrimination and blood pressure to be so strong.
Why does workplace discrimination impact high blood pressure?
“Under stressful situations, the human body will be activated in order to cope with the stimulus, through the hypothalamic-pituitary-adrenocortical axis, autonomic nervous system, and inflammatory immune response. In simple words, it is called ‘fight or flight,’ ” Li explained. “Chronic stress will lead to over-activation of the cardiovascular system, thus hypertension and other cardiovascular disorders may occur in the long run.”
The hypothalamic-pituitary-adrenocortical axis stimulates one’s cortisol levels — a steroid hormone that flows into the bloodstream during increased stress — fueling that flight or flight response, creating a “whole cascade that results in cardiovascular disease in general, like heart disease, strokes, hypertension, and vascular conditions,” said Dr. Michelle Albert, MPH, the Walter A. Haas-Lucie Stern Endowed Chair in Cardiology and Professor in Medicine at the University of California at San Francisco (UCSF), Admissions Dean for UCSF Medical School and Director of the CeNter for the StUdy of AdveRsiTy and CardiovascUlaR DiseasE (NURTURE Center.
Albert, who is unaffiliated with Li’s research, told Healthline that someone who is experiencing discrimination in the workplace might also experience behavioral shifts on top of these biological stress responses. You might isolate and experience anxiety and depression, which can play into cardiovascular risk factors and result in things like worsened blood pressure and heart attacks and strokes.
How you can manage discrimination-fueled high blood pressure
If you are experiencing spikes in blood pressure — or other changes to your cardiovascular health — as a result of discrimination at the office, what do you do?
Li said employees could turn to self-regulated stress management, like mindfulness practices. He said that research suggests that “mindfulness-based stress reduction could lower blood pressure.”
When it comes to these individual actions to help manage the impacts on blood pressure from discrimination at the office, Albert said these individual coping mechanisms can be helpful for the individual, but not everyone possesses higher coping skills.
“Those who have higher coping skills will have better biological responses, meaning they are less likely to develop high blood pressure and other forms of cardiovascular disease,” she explained.
That being said, it puts a lot of onus on the individual, Albert stressed.
“The thing about coping that I’ve always had a problem with honestly is that it leaves it on the individual and does not necessarily move toward the systems and the structural parts. You need both,” she said. “You need to have interventions that address structural discrimination as well as interventions that help persons work through being less impacted on a biological level.”
Reforming discriminatory systems
In many ways, this conversation dovetails with the larger questions around discrimination tied to issues like sexism, racism, ageism, homophobia, and transphobia (among many others) that our society has been grappling with at large in recent years.
Reforming systems that structurally enable discriminatory practices can go a long way in closing health disparities among groups that are most vulnerable.
“I think it goes back to the fact that we have to set up frameworks, we have to address this on the axis of: how do you dismantle structural discrimination on a systemic level?’ ” Albert said.
She explained that workplaces have to collect data on the lived experiences of their employees while at work. How might experiences differ based on that person’s individual experience? From there, look at how those experiences relate to one another. The work of doing this kind of structural review can be complex.
Gathering data on these things would involve looking at issues around fair pay, salary equity, fairness related to parental leave, child care, and elder care, among other quality of life at work issues.
“What kind of culture does the employer have that engenders belonging for everybody whether race, sex, gender identity all of that? Those are things at the systematic level. On the individual level, there might be the opportunity for the formation of groups, for support groups. There may be mindfulness activities that a person can engage in,” Albert added.
She said that underlying issues around physical activity and one’s overall health play a role.
Those with low levels of physical activity are more likely to develop hypertension, and then, of course, the inverse is true. If workplace discrimination at a given office or job decreases, one’s stress level will decrease and that person could be more prone to engage in improved physical activities.
Addressing all of these issues involves a “multi-pronged approach,” Albert said — addressing the larger cultural systemic issues and the personal, individual issues in tandem.
Li said that if you are hoping to enact some change in your workplace, you could file a complaint or charge of discrimination with the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP).
Additionally, you could file a complaint with the U.S. Equal Employment Opportunity Commission (EEOC).
“At the organizational level, diversity, equity, and inclusion are the keys for employers and managers to create an anti-discrimination workplace. Remember, a healthy and safe workplace is our human right,” Li said.
Who is most impacted by workplace discrimination?
When asked what groups are most impacted and at risk for the negative effects of workplace discrimination, Li said that the range is wide.
Discrimination could target an individual for everything from their race, age, sex and gender identity, sexual orientation, religion, national origin, living with a particular health condition, or their physical appearance, among other factors.
In the new study, one stated limitation of the research involves the fact that non-white people with lower education levels who find themselves in positions where they have less control over their positions at their place of work tended to not participate in the follow-up questionnaire sessions. Li said it is important to address some of these gaps in future research.
“As the first evidence in this regard, our study was not perfect due to a couple of limitations. We are looking for more research opportunities to explore causal links between psychosocial risk factors at work ( including workplace discrimination) and cardiovascular diseases,” Li explained. “In addition, specific biomarkers to detect early risk and effective multi-level interventions are urgently needed.”
Given that, Albert said, it is important to note that most of the people in this particular study self-identified their race as white.
Given the larger structural barriers the most vulnerable members of our society face due to their race and ethnicity, their sex and gender identity, and their sexual orientation, for a few examples, she said it isn’t hard to imagine those same groups would also have some of the worst experiences with discrimination, and, in turn, these negative impacts on cardiovascular health.
Right now, there isn’t much data at large on this, she said. She pointed to research she has worked on and presented on Black women’s experiences with discrimination and how it has affected cardiovascular health.
“[This discrimination] was associated with at least 30-50% higher risk of coronary heart disease, the thing that causes heart attacks,” Albert said.
She said the new study and this other work can all be put into context to show that those groups that have a higher risk of experiencing discrimination, will most likely show signs of worsening heart health and a higher risk of cardiovascular complications.
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