Discrimination and the HPA axis: current evidence and future directions.
Numerous studies suggest that discrimination is associated with poor physical and mental health outcomes. Whereas the cardiovascular system has been extensively studied as a potential pathway linking discrimination with disease, the role of the hypothalamic-pituitary-adrenal (HPA) axis remains understudied. We conducted a systematic review of research on discrimination and related constructs as predictors and correlates of HPA axis activity. Twenty seven studies (10 experimental, 17 observational) met inclusion criteria. Studies suggest that discrimination is associated with alterations in HPA axis activity and that the direction of this association depends on the timing and chronicity of the discrimination experience. There is also evidence of important modulating variables (race, socioeconomic status) and contextual confounders (emotional, situational) that warrant further study. Accounting for the HPA axis in addition to the cardiovascular system will contribute to a more comprehensive understanding of the biobehavioral pathways contributing to physical and mental health inequities related to discrimination.
Department of Psychology and Social Behavior, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA, 92697-7085, USA.
David
D
Busse
Department of Psychology and Social Behavior, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA, 92697-7085, USA. ilona.yim@uci.edu.
Ilona S
IS
Yim
Department of Chicano/Latino Studies, University of California, Irvine, Irvine, CA, USA.
Belinda
B
Campos
Department of Psychology and Social Behavior, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA, 92697-7085, USA.|Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, USA.
Christopher K
CK
Marshburn
D004644:Emotions / Q000502:physiology*; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D011287:Prejudice / Q000523:psychology*
D006854:Hydrocortisone
Cortisol; Discrimination; Prejudice; Stigma; Stress