Evidence map›Paper›PMID 40775568›Full record

ArticleJournal of racial and ethnic health disparities2026

Experiences of In-Group and Out-Group Skin Tone Discrimination and Their Associations with Incident Cardiovascular Disease Among African American Adults in the Jackson Heart Study.

Sydney A Barlow, Jessica R Fernandez, Juliana S Sherchan, Ellis P Monk, Jaime Slaughter-Acey, Mario Sims, Allana T Forde

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of racial and ethnic health disparities, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Sydney A BarlowDivision of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
Jessica R FernandezDivision of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
Juliana S SherchanDivision of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
Ellis P MonkDepartment of Sociology, Harvard University, Cambridge, MA, USA.
Jaime Slaughter-AceyDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Mario SimsDepartment of Social Medicine, Population and Public Health, University of California, Riverside School of Medicine, Riverside, CA, USA.
Allana T FordeDivision of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA. allana.forde@nih.gov.ORCID 0000-0002-3097-0038

Funding

NHLBI NIH HHS #R21HL150424
6 · The paper itself

Abstract

backgroundAfrican American adults face an elevated risk of cardiovascular disease (CVD) compared to other racial and/or ethnic groups in the USA. Although discrimination has been linked to this disparity, the relationship between skin tone discrimination and CVD incidence remains scarce. This study investigated the associations of in-group discrimination (from African American individuals) and out-group skin tone discrimination (from White individuals) with incident CVD and whether these associations differed by sex and optimism.

methodsThis study analyzed data from 3519 African American participants (aged 21-95 years) in the Jackson Heart Study from 2000 to 2016. Cox Proportional Hazards regression assessed associations between skin tone discrimination and CVD (including stroke and coronary heart disease (CHD)). Each CVD component, along with heart failure (HF), was also analyzed separately. Models adjusting for sociodemographic characteristics, health behaviors, and CVD risk factors estimated hazard ratios (HR) and 95% confidence intervals (CI). Interaction terms were included in the fully adjusted models to assess the moderating roles of sex and optimism.

resultsOver the 16-year follow-up, 8.0% of participants developed CVD, 3.9% developed stroke, 4.9% developed CHD, and 7.3% developed HF. Participants who reported that Black individuals treated them better than other Black individuals because of their skin tone had an increased risk of CVD (HR 1.33, 95% CI 0.95-1.83). Out-group skin tone discrimination, whether better or worse treatment, was associated with a higher incidence of CHD (HRs ranged from 1.23 to 1.43), although CIs were wide. These associations did not vary by sex. Optimism moderated the association between out-group skin tone discrimination and HF, such that those who reported worse treatment and had the highest level of optimism had the greatest risk of HF. Optimism did not moderate the associations between in-group skin tone discrimination and the CVD outcomes.

conclusionsThese findings highlight the differential impact of in-group and out-group skin tone discrimination on cardiovascular health. Better in-group treatment was marginally linked to a higher CVD risk, while out-group skin tone discrimination, whether better or worse treatment, marginally increased CHD risk. Skin tone discrimination may therefore be a unique risk factor for CVD for African American individuals.

Indexed as

Black or African AmericanCardiovascular DiseasesRacismAdultAgedAged, 80 and overFemaleHumansIncidenceMaleMiddle AgedMississippiRisk FactorsWhiteYoung AdultCardiovascular diseaseJackson heart studyOptimismSkin tone discrimination

Identifiers

PMID40775568
PMCPMC12966262

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.