A 1-unit increment in perceived discrimination score was associated with a lower incidence of new onset fibrotic-subpleural ILA (RR 0.83; 95% CI 0.71-0.98).
Cohort (n=5,889)
Yes
Does higher self-perceived discrimination associate with the incidence of fibrotic-subpleural interstitial lung abnormalities in older adults?
Contrary to hypothesis, higher perceived discrimination was associated with a lower incidence of fibrotic-subpleural interstitial lung abnormalities over time in a multi-ethnic cohort.
Effect estimate: RR 0.83 (95% CI 0.71-0.98)
Abstract Rationale Interstitial lung abnormalities (ILAs) are radiological findings that may represent the early stages of interstitial lung disease (ILD). Identifying modifiable risk factors that contribute to ILAs may provide insight into drivers of its development and possible targets for future intervention studies. Psychosocial stressors, including self-perceived discrimination, have been associated with adverse health outcomes. Conversely, some studies suggest that higher resilience, fostered through exposure to discrimination, may mitigate its harmful impact on health outcomes. We hypothesized that a higher perceived discrimination score would associate with a higher incidence of fibrotic-subpleural ILA in older adults. Methods Data was used from Multi-Ethnic Study of Atherosclerosis, an NIH-funded cohort of adults between 45-84 years recruited in 2000-2002 from six U.S. communities. Lifetime discrimination was assessed at baseline with Major Experiences of Discrimination Scale, which asks occurrence of lifetime unfair treatment (yes or no) in six domains (e.g., workplace, police encounters, educational environments, housing) (score range 0-6). Cardiac CT scans were conducted over time (2000-2012) at follow-up exam visits and assessed for ILA by trained thoracic radiologists. Cox proportional hazards models were used to examine associations of perceived discrimination with fibrotic-subpleural ILA incidence and adjusted for age, sex, self-reported race and ethnicity, smoking history, cigarette pack-years, body mass index, education, and income. Results Among 5,889 participants, 41% reported lifetime discrimination in ≥ 1 domain. Reporting of perceived discrimination affecting at least one domain varied significantly by race and ethnicity: non-Hispanic White (885/2,381, 37%), Black (873/1,431, 61%), Chinese (147/750, 20%), and Hispanic (519/1,327, 39%). Mean age of cohort was 62 years (SD 10.2), and 52% were women. At baseline, 24 participants(0.4%) had fibrotic-subpleural ILA and were excluded from the incidence analysis, giving a sample size of 5,865 for analysis. Over time, 171 (3%) developed onset fibrotic subpleural ILA. A 1-unit increment in discriminatory score was associated with a risk ratio (RR) of 0.83 (95%CI 0.71-0.98) for new onset fibrotic-subpleural ILA. In the Black subgroup, the discriminatory score was associated with a RR of 0.73 (95%CI 0.55-0.98). Conclusions Contrary to our hypothesis, a higher perceived discrimination score was associated with a lower incidence of fibrotic-subpleural ILA over time. These findings could reflect differences in social environment, coping strategies, or unmeasured confounders despite our adjustment for several covariates, including socioeconomic factors. Future work should explore both protective and harmful dimensions of perceived discrimination to better understand psychosocial contributions to the early development of chronic lung diseases. This abstract is funded by: NHLBI
Strickland et al. (Fri,) conducted a cohort in Interstitial lung abnormalities (n=5,889). Self-perceived discrimination was evaluated on New onset fibrotic-subpleural ILA (RR 0.83, 95% CI 0.71-0.98). A 1-unit increment in perceived discrimination score was associated with a lower incidence of new onset fibrotic-subpleural ILA (RR 0.83; 95% CI 0.71-0.98).