Perceived racial discrimination, childhood adversity, and self-reported high blood pressure among adults in rural Alabama

IntroductionDisproportionate exposure to psychosocial stressors, such as racial discrimination, and other forms of adversity across the life course contributes to higher rates of hypertension among Black Americans. However, prior literature is limited by the underrepresentation of rural populations...

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Main Authors: Tenesha Littleton, Luciana Giorgio Cosenzo, Joana Okine, Sharlene D. Newman
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1575793/full
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author Tenesha Littleton
Luciana Giorgio Cosenzo
Joana Okine
Sharlene D. Newman
author_facet Tenesha Littleton
Luciana Giorgio Cosenzo
Joana Okine
Sharlene D. Newman
author_sort Tenesha Littleton
collection DOAJ
description IntroductionDisproportionate exposure to psychosocial stressors, such as racial discrimination, and other forms of adversity across the life course contributes to higher rates of hypertension among Black Americans. However, prior literature is limited by the underrepresentation of rural populations and narrow measurements of racial discrimination. This study examines associations between perceived racial discrimination (through a historical trauma lens), childhood adversity, and self-reported high blood pressure among adults living in predominantly Black communities in rural Alabama.MethodsData were collected using paper-and-pencil surveys from 184 participants across five rural communities in Alabama in Spring 2023. High blood pressure was assessed via self-report from a list of chronic conditions. Perceived racial discrimination was measured by a 5-item subscale of the African American Historical Trauma Questionnaire. Childhood adversity was measured by the 10-item ACE Study Questionnaire. Binary logistic regression examined associations between high blood pressure, childhood adversity, and perceived racial discrimination, adjusting for psychological distress and sociodemographic factors.ResultsNinety-two percent of the sample were Black Americans. Older age (OR = 1.09, 95% CI = 1.05, 1.12) and higher perceived racial discrimination scores (OR = 1.15, 95% CI = 1.04, 1.27) were significantly associated with increased odds of high blood pressure.DiscussionFindings highlight the importance of multilevel interventions that are both trauma-informed and culturally tailored to reduce health disparities in rural Black communities.
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spelling doaj-art-d035ea9efb1e47dfb89215acc27fca132025-08-20T03:17:47ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-07-011310.3389/fpubh.2025.15757931575793Perceived racial discrimination, childhood adversity, and self-reported high blood pressure among adults in rural AlabamaTenesha Littleton0Luciana Giorgio Cosenzo1Joana Okine2Sharlene D. Newman3School of Social Work, The University of Alabama, Tuscaloosa, AL, United StatesSchool of Social Work, The University of Alabama, Tuscaloosa, AL, United StatesSchool of Social Work, The University of Alabama, Tuscaloosa, AL, United StatesAlabama Life Research Institute, The University of Alabama, Tuscaloosa, AL, United StatesIntroductionDisproportionate exposure to psychosocial stressors, such as racial discrimination, and other forms of adversity across the life course contributes to higher rates of hypertension among Black Americans. However, prior literature is limited by the underrepresentation of rural populations and narrow measurements of racial discrimination. This study examines associations between perceived racial discrimination (through a historical trauma lens), childhood adversity, and self-reported high blood pressure among adults living in predominantly Black communities in rural Alabama.MethodsData were collected using paper-and-pencil surveys from 184 participants across five rural communities in Alabama in Spring 2023. High blood pressure was assessed via self-report from a list of chronic conditions. Perceived racial discrimination was measured by a 5-item subscale of the African American Historical Trauma Questionnaire. Childhood adversity was measured by the 10-item ACE Study Questionnaire. Binary logistic regression examined associations between high blood pressure, childhood adversity, and perceived racial discrimination, adjusting for psychological distress and sociodemographic factors.ResultsNinety-two percent of the sample were Black Americans. Older age (OR = 1.09, 95% CI = 1.05, 1.12) and higher perceived racial discrimination scores (OR = 1.15, 95% CI = 1.04, 1.27) were significantly associated with increased odds of high blood pressure.DiscussionFindings highlight the importance of multilevel interventions that are both trauma-informed and culturally tailored to reduce health disparities in rural Black communities.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1575793/fullhypertensionracial discriminationchildhood adversitytraumarural populationshealth disparities
spellingShingle Tenesha Littleton
Luciana Giorgio Cosenzo
Joana Okine
Sharlene D. Newman
Perceived racial discrimination, childhood adversity, and self-reported high blood pressure among adults in rural Alabama
Frontiers in Public Health
hypertension
racial discrimination
childhood adversity
trauma
rural populations
health disparities
title Perceived racial discrimination, childhood adversity, and self-reported high blood pressure among adults in rural Alabama
title_full Perceived racial discrimination, childhood adversity, and self-reported high blood pressure among adults in rural Alabama
title_fullStr Perceived racial discrimination, childhood adversity, and self-reported high blood pressure among adults in rural Alabama
title_full_unstemmed Perceived racial discrimination, childhood adversity, and self-reported high blood pressure among adults in rural Alabama
title_short Perceived racial discrimination, childhood adversity, and self-reported high blood pressure among adults in rural Alabama
title_sort perceived racial discrimination childhood adversity and self reported high blood pressure among adults in rural alabama
topic hypertension
racial discrimination
childhood adversity
trauma
rural populations
health disparities
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1575793/full
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AT joanaokine perceivedracialdiscriminationchildhoodadversityandselfreportedhighbloodpressureamongadultsinruralalabama
AT sharlenednewman perceivedracialdiscriminationchildhoodadversityandselfreportedhighbloodpressureamongadultsinruralalabama