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Anticipatory racism stress, smoking and disease activity: the Black women’s experiences living with lupus (BeWELL) study

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Abstract

African American women with systemic lupus erythematosus (SLE) have worse disease outcomes compared to their White counterparts. Stressors associated with race may contribute to poorer health in this population through maladaptive behavioral pathways. This study investigated relationships between stress associated with anticipating racism, smoking, and SLE disease activity. Data were from 432 African American women with SLE in the Black Women’s Experiences Living with Lupus (BeWELL) Study. Controlling for sociodemographic and health-related covariates, multivariable regression analyses revealed a significant association between anticipatory racism stress (ARS) and disease activity (p = 0.00, b = 1.13, 95% CI [0.43, 1.82]). A significant interaction between ARS and smoking also indicated that smoking exacerbated the effect of ARS on disease activity (p = 0.04, b = 1.95, CI = 0.04, 3.96). Test for evidence of smoking mediating the effect of ARS on disease activity were not statistically significant (z = 1.77, p = 0.08). Findings have implications for future SLE disparities research among African American women with SLE.

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References

  • Adams, S. G., Dammers, P. M., Saia, T. L., Brantley, P. J., & Gaydos, G. R. (1994). Stress, depression, and anxiety predict average symptom severity and daily symptom fluctuation in systemic lupus erythematosus. Journal of Behavioral Medicine, 17, 459–477.

    Article  PubMed  Google Scholar 

  • Allen, A., Thomas, M., Michael, E., Reeves, A., Okoye, U., Price, M., et al. (2018). Racial discrimination, educational attainment, and biological dysregulation among midlife African American women. Psychoneuroendocrinology, 99, 225–235.

    Article  PubMed  PubMed Central  Google Scholar 

  • Arnson, Y., Shoenfeld, Y., & Amital, H. (2010). Effects of tobacco smoke on immunity, inflammation and autoimmunity. Journal of Autoimmunity, 34, J258–J265.

    Article  CAS  PubMed  Google Scholar 

  • Azizoddin, D. R., Zamora-Racaza, G., Ormseth, S. R., Sumner, L. A., Cost, C., Ayeroff, J. R., Weisman, M. H., & Nicassio, P. M. (2017). Psychological factors that link socioeconomic status to depression/anxiety in patients with systemic lupus erythematosus. Journal of Clinical Psychology in Medical Settings, 24, 302–315. https://doi.org/10.1007/s10880-017-9505-z

    Article  PubMed  Google Scholar 

  • Berg, C. J., Haardörfer, R., McBride, C. M., Kilaru, V., Ressler, K. J., Wingo, A. P., Saba, N. F., Payne, J. B., & Smith, A. (2017). Resilience and biomarkers of health risk in Black smokers and nonsmokers. Health Psychology, 36, 1047–1058. https://doi.org/10.1037/hea0000540

    Article  PubMed  PubMed Central  Google Scholar 

  • Berg, C. J., Wen, H., Cummings, J. R., Ahluwalia, J. S., & Druss, B. G. (2013). Depression and substance abuse and dependency in relation to current smoking status and frequency of smoking among nondaily and daily smokers. The American Journal on Addictions, 22, 581–589. https://doi.org/10.1111/j.1521-0391.2013.12041.x

    Article  PubMed  PubMed Central  Google Scholar 

  • Blendon, R. J., Aiken, L. H., Freeman, H. E., & Corey, C. R. (1989). Access to medical care for black and white Americans: A matter of continuing concern. JAMA, 261, 278–281.

    Article  CAS  PubMed  Google Scholar 

  • Borrell, L. N., Kiefe, C. I., Diez-Roux, A. V., Williams, D. R., & Gordon-Larsen, P. (2013). Racial discrimination, racial/ethnic segregation, and health behaviors in the CARDIA study. Ethnicity & health, 18(3), 227–243. https://doi.org/10.1080/13557858.2012.713092

    Article  Google Scholar 

  • Brondolo, E., Blair, I. V., & Kaur, A. (2018). Biopsychosocial mechanisms linking discrimination to health: A focus on social cognition. In B. Major, J. F. Dovidio, & B. G. Link (Eds.), The Oxford handbook of stigma, discrimination, and health (pp. 219–240). Oxford University Press.

  • Burgos, P., McGwin, G., Pons-Estel, G., Reveille, J., Alarcón, G., & et al. (2011). US patients of Hispanic and African ancestry develop lupus nephritis early in the disease course: data from LUMINA, a multiethnic US cohort (LUMINA LXXIV) - ProQuest.

  • Calvo-Alén, J., Toloza, S. M. A., Fernández, M., Bastian, H. M., Fessler, B. J., Roseman, J., et al. (2005). Systemic lupus erythematosus in a multiethnic US cohort (LUMINA): XXV. Smoking, older age, disease activity, lupus anticoagulant, and glucocorticoid dose as risk factors for the occurrence of venous thrombosis in lupus patients. Arthritis & Rheumatism, 52 2060–2068.

    Article  Google Scholar 

  • Carter, R. T. (2007). Racism and psychological and emotional injury: Recognizing and assessing race-based traumatic stress. The Counseling Psychologist, 35(1), 13–105.

    Article  Google Scholar 

  • Centers for Disease Control and Prevention. (2017). NHIS - Adult Tobacco Use - Glossary. Retrieved April 30, 2018, from https://www.cdc.gov/nchs/nhis/tobacco/tobacco_glossary

  • Centers for Disease Control and Prevention. (2018). Detailed Fact Sheet | Lupus | CDC. Retrieved April 17, 2018, from https://www.cdc.gov/lupus/facts/detailed.html

  • Chae, D. H., Drenkard, C. M., Lewis, T. T., & Lim, S. S. (2015). Discrimination and cumulative disease damage among African American women with systemic lupus erythematosus. American Journal of Public Health, 105, 2099–2107.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chae, D., Martz, C., Fuller-Rowell, T., Spears, E., Gao Smith, T., Hunter, E., Drenkard, C., & Lim, S. S. (2019). Racial discrimination, disease activity, and organ damage: The black women’s experiences living with lupus study. American Journal of Epidemiology., 188, 1434–1443.

    PubMed  PubMed Central  Google Scholar 

  • Chua, M. H. Y., Nfdfg, I. A. T., Mike, W. L. C., & Mak, A. (2020). Association between Cigarette Smoking and Systemic Lupus Erythematosus: An Updated Multivariate Bayesian Metaanalysis. The Journal of Rheumatology, 47, 1514–1521. https://doi.org/10.3899/jrheum.190733

    Article  PubMed  Google Scholar 

  • Clark, R., Benkert, R. A., & Flack, J. M. (2006). Large Arterial Elasticity Varies as a Function of Gender and Racism-Related Vigilance in Black Youth. Journal of Adolescent Health, 39, 562–569.

    Article  Google Scholar 

  • Clark, V. R. (2001). The perilous effects of racism on blacks. Ethnicity & Disease, 11(4), 769–772.

    CAS  Google Scholar 

  • Collins, P. H., & Bilge, S. (2016). Intersectionality. John Wiley & Sons.

    Google Scholar 

  • Costa-Reis, P., & Sullivan, K. E. (2013). Genetics and epigenetics of systemic lupus erythematosus. Current Rheumatology Reports, 15, 369.

    Article  PubMed  Google Scholar 

  • Cunningham, T. J., Seeman, T. E., Kawachi, I., Gortmaker, S. L., Jacobs, D. R., Kiefe, C. I., & Berkman, L. F. (2012). Racial/ethnic and gender differences in the association between self-reported experiences of racial/ethnic discrimination and inflammation in the CARDIA cohort of 4 US communities. Social Science & Medicine, 75, 922–931.

    Article  Google Scholar 

  • Dickerson, S. S., Gable, S. L., Irwin, M. R., Aziz, N., & Kemeny, M. E. (2009). Social-evaluative threat and proinflammatory cytokine regulation: An experimental laboratory investigation. Psychological Science, 20, 1237–1244.

    Article  PubMed  Google Scholar 

  • Dickerson, S. S., Gruenewald, T. L., & Kemeny, M. E. (2009). Psychobiological responses to social self threat: Functional or detrimental? Self & Identity, 8, 270–285.

    Article  Google Scholar 

  • Dickerson, S. S., & Kemeny, M. E. (2004). Acute stressors and cortisol responses: A theoretical integration and synthesis of laboratory research. Psychological Bulletin, 130, 355–391.

    Article  PubMed  Google Scholar 

  • Drenkard, C., & Lim, S. S. (2019). Update on lupus epidemiology: Advancing health disparities research through the study of minority populations. Current Opinion in Rheumatology, 31(6), 689.

    Article  Google Scholar 

  • Drenkard, C., Rask, K. J., Easley, K. A., Bao, G., & Lim, S. S. (2013, October). Primary preventive services in patients with systemic lupus erythematosus: Study from a population-based sample in Southeast US. In Seminars in arthritis and rheumatism (Vol. 43, No. 2, pp. 209–216). WB Saunders. https://doi.org/10.1016/j.semarthrit.2013.04.003

  • Ewart, C., Jorgenson, R., Schroder, K., Suchday, S., & Sherwood, A. (2004). Vigilance to a persisting personal threat: Unmasking cardiovascular consequences in adolescents with the Social Competence Interview. Psychophysiology, 41, 799–804.

    Article  PubMed  Google Scholar 

  • Formica, M. K., Palmer, J. R., Rosenberg, L., & McAlindon, T. E. (2003). Smoking, alcohol consumption, and risk of systemic lupus erythematosus in the Black Women’s Health Study. The Journal of Rheumatology, 30, 1222–1226.

    PubMed  Google Scholar 

  • Forsyth, J., & Carter, R. T. (2012). The relationship between racial identity status attitudes, racism-related coping, and mental health among Black Americans. Cultural Diversity and Ethnic Minority Psychology, 18, 128.

    Article  PubMed  Google Scholar 

  • Fuller-Rowell, T. E., Cogburn, C. D., Brodish, A. B., Peck, S. C., Malanchuk, O., & Eccles, J. S. (2012). Racial discrimination and substance use: Longitudinal associations and identity moderators. Journal of Behavioral Medicine, 35, 581–590.

    Article  PubMed  Google Scholar 

  • Fuller-Rowell, T. E., Curtis, D. S., Doan, S. N., & Coe, C. L. (2015). Racial disparities in the health benefits of educational attainment: A study of inflammatory trajectories among African American and white adults. Psychosomatic Medicine, 77(1), 33–40.

    Article  PubMed  Google Scholar 

  • Gallo, L. C., & Matthews, K. A. (2003). Understanding the association between socioeconomic status and physical health: Do negative emotions play a role? Psychological Bulletin, 129, 10–51.

    Article  PubMed  Google Scholar 

  • Gee, G. C., & Payne-Sturges, D. C. (2004). Environmental health disparities: A framework integrating psychosocial and environmental concepts. Environmental Health Perspectives, 112, 1645–1653.

    Article  PubMed  PubMed Central  Google Scholar 

  • Geronimus, A. T., Bound, J., Waidmann, T. A., Colen, C. G., & Steffick, D. (2001). Inequality in life expectancy, functional status, and active life expectancy across selected black and white populations in the United States. Demography, 38, 25.

    Article  Google Scholar 

  • Ghaussy, N. O., Sibbitt, W. L., & Qualls, C. R. (2001). Cigarette smoking, alcohol consumption, and the risk of systemic lupus erythematosus: A case-control study. The Journal of Rheumatology, 28, 2449–2453.

    CAS  PubMed  Google Scholar 

  • Ghaussy, N. O., Sibbitt, W., Bankhurst, A. D., & Qualls, C. R. (2003). Cigarette smoking and disease activity in systemic lupus erythematosus. The Journal of Rheumatology, 30, 1215–1221.

    PubMed  Google Scholar 

  • Gorber, S. C., Schofield-Hurwitz, S., Hardt, J., Levasseur, G., & Tremblay, M. (2009). The accuracy of self-reported smoking: A systematic review of the relationship between self-reported and cotinine-assessed smoking status. Nicotine & Tobacco Research, 11, 12–24.

    Article  Google Scholar 

  • Guthrie, B. J., Young, A. M., Williams, D. R., Boyd, C. J., & Kintner, E. K. (2002). African American Girls’ smoking habits and day-to-day experiences with racial discrimination. Nursing Research, 51, 183–190.

    Article  PubMed  Google Scholar 

  • Hänsel, A., Hong, S., Cámara, R. J. A., & von Känel, R. (2010). Inflammation as a psychophysiological biomarker in chronic psychosocial stress. Neuroscience & Biobehavioral Reviews, 35, 115–121. https://doi.org/10.1016/j.neubiorev.2009.12.012

    Article  Google Scholar 

  • Hicken, M. T., Lee, H., Ailshire, J., Burgard, S. A., & Williams, D. R. (2013). “Every Shut Eye, Ain’t Sleep”: The Role of Racism-Related Vigilance in Racial/Ethnic Disparities in Sleep Difficulty. Race and Social Problems, 5, 100–112.

    Article  PubMed  PubMed Central  Google Scholar 

  • Himmelstein, M. S., Young, D. M., Sanchez, D. T., & Jackson, J. S. (2015). Vigilance in the discrimination-stress model for Black Americans. Psychology & Health, 30, 253–267.

    Article  Google Scholar 

  • Jackson, F. M., Phillips, M. T., Hogue, C. J. R., & Curry-Owens, T. Y. (2001). Examining the burdens of gendered racism: Implications for pregnancy outcomes among college-educated African American Women. Maternal and Child Health Journal, 5, 95–107.

    Article  CAS  PubMed  Google Scholar 

  • Jones, C. P. (2000). Levels of racism: A theoretic framework and a gardener’s tale. American Journal of Public Health, 90, 1212–1215.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Karlson, E. W., Daltroy, L. H., Rivest, C., Ramsey-Goldman, R., Wright, E. A., Partridge, A. J., et al. (2003). Validation of a systemic lupus activity questionnaire (SLAQ) for population studies. Lupus, 12, 280–286. https://doi.org/10.1191/0961203303lu332oa

    Article  CAS  PubMed  Google Scholar 

  • Kimble, M., Boxwala, M., Bean, W., Maletsky, K., Halper, J., Spollen, K., & Fleming, K. (2014). The impact of hypervigilance: Evidence for a forward feedback loop. Journal of Anxiety Disorders, 28, 241–245. https://doi.org/10.1016/j.janxdis.2013.12.006

    Article  PubMed  Google Scholar 

  • Kinsey, D., Paul, C. P., Taylor, D., Caricchio, R., Kulathinal, R. J., & Hayes-Conroy, A. (2018). The whole lupus: Articulating biosocial interplay in systemic lupus erythematosus epidemiology and population disparities. Health & Place, 51, 182–188.

    Article  Google Scholar 

  • Krieger, N., & Sidney, S. (1996). Racial discrimination and blood pressure: The CARDIA Study of young black and white adults. American Journal of Public Health, 86, 1370–1378.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Krieger, N., Rowley, D., Herman, A., Avery, B., et al. (1993). Racism, sexism, and social class: Implications for studies of health, disease, and well-being. American Journal of Preventive Medicine, 9, 82–122.

    Article  CAS  PubMed  Google Scholar 

  • Landrine, H., & Klonoff, E. A. (2000). Racial discrimination and cigarette smoking among Blacks: Findings from two studies. Ethnicity & Disease, 10, 195–202.

    CAS  Google Scholar 

  • Lee, D. B., Kim, E. S., & Neblett, E. W. (2017). The link between discrimination and telomere length in African American adults. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 36, 458–467.

    Article  Google Scholar 

  • Lim, S. S., Bayakly, A. R., Helmick, C. G., Gordon, C., Easley, K. A., & Drenkard, C. (2014). The incidence and prevalence of systemic lupus erythematosus, 2002–2004: The Georgia Lupus Registry. Arthritis & Rheumatology, 66(2), 357–368.

    Article  Google Scholar 

  • Lim, S. S., Helmick, C. G., Bao, G., Hootman, J., Bayakly, R., Gordon, C., & Drenkard, C. (2019). Racial disparities in mortality associated with systemic lupus erythematosus—Fulton and DeKalb Counties, Georgia, 2002–2016. Morbidity and Mortality Weekly Report, 68(18), 419.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lewis, T. T., Aiello, A. E., Leurgans, S., Kelly, J., & Barnes, L. L. (2010). Self-reported experiences of everyday discrimination are associated with elevated C-reactive protein levels in older African-American adults. Brain, Behavior, and Immunity, 24, 438–443.

    Article  CAS  PubMed  Google Scholar 

  • MacKinnon, D. P., Warsi, G., & Dwyer, J. H. (1995). A simulation study of mediated effect measures. Multivariate Behavioral Research, 30, 41–62.

    Article  PubMed  PubMed Central  Google Scholar 

  • Martz, C. D., Allen, A. M., Fuller-Rowell, T. E., Spears, E. C., Lim, S. S., Drenkard, C., et al. (2019). Vicarious racism stress and disease activity: The black women’s experiences living with lupus (BeWELL) study. Journal of Racial and Ethnic Health Disparities. https://doi.org/10.1007/s40615-019-00606-8

    Article  PubMed  PubMed Central  Google Scholar 

  • McEwen, B. S. (1998). Stress, adaptation, and disease: allostasis and allostatic load. Annals of the New York Academy of Sciences, 840, 33–44.

    Article  CAS  PubMed  Google Scholar 

  • McEwen, B. S. (2005). Stressed or stressed out: What is the difference? Journal of Psychiatry and Neuroscience, 30, 315–318.

    PubMed  PubMed Central  Google Scholar 

  • Montes, R. A., Mocarzel, L. O., Lanzieri, P. G., Lopes, L. M., Carvalho, A., & Almeida, J. R. (2016). Smoking and Its association with morbidity in systemic lupus erythematosus evaluated by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index: Preliminary Data and Systematic Review. Arthritis & Rheumatology, 68 441–448. https://doi.org/10.1002/art.39427

    Article  Google Scholar 

  • Nuru-Jeter, A., Dominguez, T. P., Hammond, W. P., Leu, J., Skaff, M., Egerter, S., et al. (2009). “It’s the skin you’re in”: African-American women talk about their experiences of racism. An exploratory study to develop measures of racism for birth outcome studies. Maternal and Child Health Journal, 13, 29.

  • Nuru-Jeter, A., Chae, D. H., Price, M., Telesford, J., Mendoza-Denton, R., & Woods-Giscombe, C. (2013). Abstract 9550: Anticipatory racism threat and superwoman schema: Elucidating the relationship between racial discrimination and chronic inflammation. Circulation, 128, A9550–A9550.

    Google Scholar 

  • Paradies, Y., Ben, J., Denson, N., Elias, A., Priest, N., Pieterse, A., et al. (2015). Racism as a determinant of health: A systematic review and meta-analysis. PLoS ONE, 10, 1–48. https://doi.org/10.1371/journal.pone.0138511

    Article  CAS  Google Scholar 

  • Peralta-Ramirez, M., Jimenez-Alonso, J., Godoy-Garcia, J., Perez-Garcia, M., & Group Lupus Virgen de las Nieves. (2004). The effects of daily stress and stressful life events on the clinical symptomalogy of patients with lupus erythematosus. Psychosomatic Medicine, 66, 788–794

  • Perricone, C., Versini, M., Ben-Ami, D., Gertel, S., Watad, A., Segel, M. J., et al. (2019). Chapter 37—smoke and autoimmunity: the fire behind the disease. In C. Perricone & Y. Shoenfeld (Eds.), Mosaic of Autoimmunity (pp. 383–415).

  • Plantinga, L., Lim, S. S., Bowling, C. B., & Drenkard, C. (2017). Perceived stress and reported cognitive symptoms among Georgia patients with systemic lupus erythematosus. Lupus, 26(10), 1064–1071.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Sawyer, P. J., Major, B., Casad, B. J., Townsend, S. S. M., & Mendes, W. B. (2012). Discrimination and the stress response: Psychological and physiological consequences of anticipating prejudice in interethnic interactions. American Journal of Public Health, 102, 1020–1026.

    Article  PubMed  PubMed Central  Google Scholar 

  • Settles, I. H. (2006). Use of an intersectional framework to understand black women’s racial and gender identities. Sex Roles, 54, 589–601.

    Article  Google Scholar 

  • Shorter-Gooden, K. (2004). Multiple resistance strategies: How African American women cope with racism and sexism. Journal of Black Psychology, 30, 406–425.

    Article  Google Scholar 

  • Smart Richman, L., & Leary, M. R. (2009). Reactions to discrimination, stigmatization, ostracism, and other forms of interpersonal rejection: A multimotive model. Psychological Review, 116, 365–383.

    Article  PubMed  Google Scholar 

  • Somers, E. C., Marder, W., Cagnoli, P., Lewis, E. E., DeGuire, P., Gordon, C., et al. (2014). Population-based incidence and prevalence of systemic lupus erythematosus: The Michigan Lupus Epidemiology and Surveillance program. Arthritis & rheumatology, 66(2), 369–378. https://doi.org/10.1002/art.38238

    Article  Google Scholar 

  • Speyer, C. B., & Costenbader, K. H. (2018). Cigarette smoking and the pathogenesis of systemic lupus erythematosus. Expert Review of Clinical Immunology, 14(6), 481–487. https://doi.org/10.1080/1744666X.2018.1473035

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Stojan, G., & Petri, M. (2018). Epidemiology of systemic lupus erythematosus: An update. Current Opinion in Rheumatology, 30, 144–150.

    Article  PubMed  PubMed Central  Google Scholar 

  • Utsey, S. O., Belvet, B., Hubbard, R. R., Fischer, N. L., Opare-Henaku, A., & Gladney, L. L. (2013). Development and validation of the prolonged activation and anticipatory race-related stress scale. Journal of Black Psychology, 39(6), 532–559. https://doi.org/10.1177/0095798412461808

    Article  Google Scholar 

  • Wallace, D., & Hahn, B. H. (2018). Dubois’ Lupus Erythematosus and Related Syndromes E-Book: Expert Consult - Online. Elsevier Health Sciences. 

  • Williams, D. R., & Mohammed, S. A. (2009). Discrimination and racial disparities in health: Evidence and needed research. Journal of Behavioral Medicine, 32, 20.

    Article  PubMed  Google Scholar 

  • Williams, E. M., Penfield, M., Kamen, D., & Oates, J. C. (2014). An intervention to reduce psychosocial and biological indicators of stress in African American lupus patients: the balancing lupus experiences with stress strategies study. Open Journal of Preventive Medicine, 4, 22–31.

    Article  PubMed  Google Scholar 

  • Woods-Giscombé, C. (2010). Superwoman schema: African American women’s views on stress, strength, and health. Qualitative Health Research, 20(5), 1–16.

  • Yen, E. Y., Shaheen, M., Woo, J. M. P., Mercer, N., Li, N., McCurdy, D. K., et al. (2017). 46-Year Trends in Systemic Lupus Erythematosus Mortality in the United States, 1968 to 2013: A Nationwide Population-Based Study. Annals of Internal Medicine, 167, 777–785.

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

This study was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under award number R01AR065493. The content is the sole responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA

    Erica C. Spears

  2. Divisions of Community Health Sciences and Epidemiology, School of Public Health, University of California, Berkeley, CA, USA

    Amani M. Allen

  3. Department of Human Development and Family Studies, College of Human Sciences, Auburn University, Auburn, AL, USA

    Kara W. Chung, Connor D. Martz & Thomas E. Fuller-Rowell

  4. Department of Special Education, Rehabilitation & Counseling, College of Education, Auburn University, Auburn, AL, USA

    Evelyn A. Hunter

  5. Department of Medicine, Division of Rheumatology, Emory University School of Medicine, Atlanta, GA, USA

    S. Sam Lim & Christina Drenkard

  6. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA

    S. Sam Lim & Christina Drenkard

  7. Department of Global Community Health and Behavioral Science, School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA, USA

    David H. Chae

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  1. Erica C. Spears
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Contributions

Erica Spears and David Chae were involved in all aspects of the manuscript, from conceptualization to the presentation of results. Amani Allen was involved in the conceptualization of the manuscript, guided the use of the anticipatory racism stress scale, and contributed to the interpretation of the study’s results. Kara Chung and Connor Martz conducted the analyses and helped to interpret the study’s results. Evelyn Hunter’s mental health expertise was utilized to guide the use and interpretation of psychosocial measures and psychological literature used to support the study’s premise and interpretation of results. Thomas Fuller-Rowell’s methodological and discrimination expertise were used in the design of the analytic plan and interpretation of findings. Sam Lim and Christina Drenkard served as medical and rheumatology experts whose expertise was used to guide the selection of appropriate health covariates and outcome measures for the study population. All authors discussed the results and contributed to the final manuscript.

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Correspondence to Erica C. Spears.

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Spears, E.C., Allen, A.M., Chung, K.W. et al. Anticipatory racism stress, smoking and disease activity: the Black women’s experiences living with lupus (BeWELL) study. J Behav Med 44, 760–771 (2021). https://doi.org/10.1007/s10865-021-00235-9

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