Chronic discrimination predicts higher circulating levels of E-selectin in a national sample: the MIDUS study.

Chronic discrimination in both minority and non-minority populations is linked to adverse health outcomes, including increased risk of cardiovascular disease and increased mortality, but the biological processes through which discrimination affects health are unclear. The current study tested the hypothesis that discrimination in a sample of Caucasians would predict elevated serum levels of E-selectin, an indication of endothelial dysfunction which itself is associated with atherosclerosis and cardiovascular disease risk. Participants (N=804) in the biomarker sample from the Survey of Midlife in the United States (MIDUS) provided information about experiences of both major and everyday discrimination at two times separated by a 9-10 year interval. The discrimination measures were designed to assess perceived unfair treatment (e.g. being fired unfairly) independently of the perceived reasons for the unfair treatment (e.g. race, gender). Serum E-selectin was measured at the second wave of data collection. Women reported significantly more instances of major (P<0.05) and everyday P<0.001) discrimination than men. Analyses of Covariance (ANCOVA) showed that both greater lifetime exposure to major discrimination (P<0.05) and chronic exposure to everyday discrimination (P<0.05) predicted higher circulating levels of E-selectin, but only in men. These associations remained statistically significant after adjustments for potential confounding variables, including age, race, socioeconomic status, health status, and health behavior. These results highlight a potential biological mechanism by which exposure to unfair treatment may be related to health, particularly cardiovascular function. Moreover, they add to a growing literature suggesting that unfair treatment in general may predict adverse health outcomes.