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BRIEF RESEARCH REPORT article

Front. Public Health

Sec. Life-Course Epidemiology and Social Inequalities in Health

Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1575793

This article is part of the Research TopicExploring Health Disparities in Black Communities: Historical Perspectives, Present Challenges, and Future DirectionsView all 7 articles

Perceived Racial Discrimination, Childhood Adversity, and Self-Reported High Blood Pressure among adults in Rural Alabama

Provisionally accepted
  • University of Alabama, Tuscaloosa, United States

The final, formatted version of the article will be published soon.

Introduction: Disproportionate 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. Methods: Data 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. Results: Ninety-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. Discussion: Findings highlight the importance of multilevel interventions that are both trauma-informed and culturally tailored to reduce health disparities in rural Black communities.

Keywords: Rurality, Childhood Adversity, Racial discrimination, health disparities Font: Not Bold, Complex Script Font: Not Bold

Received: 13 Feb 2025; Accepted: 27 Jun 2025.

Copyright: © 2025 Littleton, Giorgio, Okine and Newman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Tenesha Littleton, University of Alabama, Tuscaloosa, United States

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