Differences in Emotion Expression, Suppression, and Cardiovascular Consequences Between Black and White Americans in the Midlife in the United States (MIDUS) Study

Objective: Recent theoretical work suggests that the expression of emotions may differ among Black and White Americans, such that Black Americans engage more frequently in expressive suppression to regulate emotions and avoid conflict. Prior work has linked expressive suppression usage with increases in cardiovascular disease risk, suggesting that racialized differences in expressive suppression usage may be one mechanism by which racism "gets under the skin" and creates health disparities.

Method: To examine racialized differences in expressive suppression and blood pressure (a measure of cardiovascular disease risk), we used self-report and facial electromyography (fEMG) data from two cohorts of Black and White Americans from the Midlife in the United States (MIDUS) longitudinal study (MIDUS 2, n = 271, 34.7% Black, collected from 2004 to 2009; MIDUS Refresher 1, n = 114, 31.6% Black, collected from 2012 to 2016; total N = 385, 33.9% Black).

Results: Black Americans reported engaging in expressive suppression more frequently than White Americans ( t (260.95) = 2.18, p = .002) and showed less corrugator fEMG activity during negative images ( t (969) = 2.38, pFDR = .026). Less corrugator activity during negative images was associated with higher systolic blood pressure only for Black Americans ( b = -4.63, t (375) = 2.67, p = .008).

Conclusion: Overall, results are consistent with theoretical accounts that Black Americans engage more frequently in expressive suppression, which in turn is related to higher cardiovascular risk. Additional research is needed to further test this claim, particularly in real-world contexts and self-reports of in-the-moment usage of expressive suppression.