Impact of minority stress on cardiovascular disease risk and resilience

7. PROJECT SUMMARY/ABSTRACT
This project is responsive to NOT-MD-19-001 Notice of Special Interest in Research on the Health of Sexual and
Gender Minority (SGM) Populations. Gender minority populations are at increased risk for cardiovascular
disease (CVD) morbidity and mortality. Specifically, Behavioral Risk Factor Surveillance System data suggest
that, compared to cisgender people, gender minorities are at more than double the risk for myocardial infarction
and report greater depression, physical inactivity, and elevated body mass index (BMI), as well as poorer access
to healthcare, all of which increase CVD risk. Further, many gender minority individuals take hormones, which
may further increase their risk of CVD. According to minority stress theory, the negative impact of prejudice and
discrimination is one contributor to CVD risk disparities. Although previous studies have found associations
between gender minority stress and poorer self-reported mental health, the impact of minority stress on physical
health outcomes, including CVD risk, has not been examined in gender minority populations. The goal of this
study is to advance our understanding of how minority stress and resilience affect CVD risk. In an established
longitudinal, multisite cohort of gender minority individuals in three U.S. cities (N=390), we aim to: (1)
determine the association of minority stress with mental health and CVD risk; (2) determine the impact of social
support, access to care, and identity development on mental health and CVD risk; and (3) identify modifiable
resilience factors that may influence the relationship of minority stress to mental health and CVD risk in this
health disparity population. In addition to structured interviews and Ecological Momentary Assessments (EMA)
of stress and resilience at baseline and 2-year follow-up, we will collect 2-week bursts of objective measurements
of blood pressure, sleep and physical activity. The proposed research will provide the best evidence to date to
guide researchers and clinicians working to develop interventions to reduce CVD disparities in gender minority
populations, and promote their long-term health and wellbeing.

Grant Number: 5R01HL151559-04
NIH Institute/Center: NIH
Principal Investigator: WALTER BOCKTING