Hypothesis: Internalized Racism (INR) the psychological state of believing, internalizing, and acting in accordance with the negative stereotypes and beliefs of another ethnic groups produces a chronic defeat response to psychosocial stresses which leads to impaired cortisol levels. Background: It’s been demonstrated in African Caribbean women that high levels of INR is associated with a reduced difference between peak morning and low evening salivary Cortisol levels, suggesting dysregulation (impaired) of Cortisol. Aim: The aim of this study is to determine if high levels of INR in a convenient South African sample leads to impaired Cortisol levels. Methods: In South Africa INR was measured and collected from male and female non-diabetic South Africans ages 20 and above with high and low INR. Cortisol levels were collected and determined from each patient using saliva samples collected from 9:00AM-11:30AM and 2:45PM-4:00PM. Results: The data suggest INR leads to impaired Cortisol regulation in South Africans. This is shown through the reduced difference between the morning and afternoon samples of patients with high INR in the diurnal rhythm in cortisol secretion of those with low INR.

1. Internalized Racism and it’s effect on Cortisol Levels Tyler Thompson, Alicia Cosey, Eugene Machaba, Zodwa Masinga, Dr. Ephraim Gwebu, Dr. Eugene Tull, Prof. Opoku, & Dr. Malcolm Cort Elizabeth City State University & University of Zululand

3. Cortisol’s dysregulation in response to continuous stress has been shown to lead to Insulin resistance which has adverse affects such as the Metabolic Syndrome. (Hypertension, Hyperglycemia, Large Waist Circumference, etc)

4. The Health Disparities among blacks are significantly different in comparison with their Caucasian counterparts and INR as a psychosocial stressor could be the reason why.

6. Normal function of the HPA axis is characterized by a diurnal rhythm in cortisol secretion, with peak levels in the morning followed by lower levels into evening. (Peeters F, Nicholson NA, et al.)

7. The recent work of Per Bjorntorp et al. relating stress-mediated dysfunction of the hypothalamic-pituitary-adreanal (HPA) axis to abdominal obesity and glucose intolerance in humans suggest a possible psychobiological pathway that may link a high level of INR to adverse metabolic outcomes such as abdominal obesity, hypertension, and cardiovascular risks (CVD).Literature Review

8. Hypothesis: Long-term exposure to acculturative stress may lead to insulin resistance mediated clustering of cardio-metabolic abnormalities. Elevated Glucose Elevated Blood Pressure Elevated Triglycerides Met-S Acculturative Stress Insulin Resistance Low HDL cholesterol Large Waist cm Met-S – Metabolic Syndrome Acculturative Stress– Feelings of social disconnection and despair

9. Literature Review Cont.

10. Literature Review Cont. Hypothalamic-Pituitary-Adrenal (HPA) Axis in Response to Stress (www.vitalifenetworks.com/VL_Cortisol.php) Elevated Glucose Hypertension Large Waist Circum. Etc. Acculturative Stress Insulin Resistance

12. Determine the correlation of INR to the stress hormone Cortisol levels.

13. Determine if INR leads to Cortisol dysregulation by comparing the difference between the AM and PM samples between high and low INR patients.

14. Cortisol- is a steroid hormone produced by the adrenal cortex which is secreted in response to any stress in the body. It is the most potent glucocorticoid and helps regulate blood pressure and the body’s use of proteins, carbohydrates, and fats.Objective & Conceptual Model Impaired Cortisol Levels High INR

16. NAD is a 24-item scale measuring the extent to which blacks have internalized racist concepts

17. Higher scores indicate a greater internalization of the negative stereotypes or belief of another society.Methodology

19. Blacks are born with greater sexual desire than white people

20. Blacks are born with greater physical strength and endurance than whites

21. Blacks are born with more musical talent than whites

22. Black men are better at sex than white men

25. Each sample was centrifuged for 10 min and stored at 20C.

26. 100 l of each Cortisol standards and samples were dispensed into their appropriate wells that contained a Cortisol antibody binding sites.

27. 200 l of Cortisol Conjugated to horseradish peroxidase (C-HRP) was added to the samples and allowed to incubate for 1 hour to allow C-HRP to bind to the remaining unbounded Cortisol antibody binding sites in the wells.Cortisol Assay Methodology

29. 200 l of Substrate solution Tetramethylbenzidine (TMB) & H2O2 was added and incubated for 30 minutes to allow TMB to be oxidized.

30. 100 l of the Stop solution H2SO4 was added to denature the HRP enzyme and stop any further oxidization of TMB.

31. The absorbance of each well was determined at 450 + 10nm.Methodology Cont.

32. Results Cortisol Plate #1 Standard Curve June 1st 2010

33. These samples were collected on May 27, 2010, May 31, 2010, and June 2, 2010.

34. Results Table 1 Characteristics of South Africans with High and Low levels of INR

37. Morning samples of Cortisol show to be statistically higher in the morning than the afternoon.

38. The data suggest that INR leads to impaired Cortisol levels. This is shown through the reduced difference between the morning and afternoon samples of patients with high INR.