How Does Racism Affect Health?

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Race is at the forefront of our national consciousness this week as many mourn the death of George Floyd at the hands of a Minneapolis police officer, and protests and riots have erupted across the country.

While violence against racial minorities is a serious problem, the evidence shows that systemic racism in American society has broader effects as well.

When the mind senses a potentially harmful situation, it prepares the body by increasing heart rate, breathing and blood pressure. This response helped earlier humans outrun or fight predators and enemies. Today’s stressful situations, such as a challenging interaction at work or a misbehaving child, can result in the same physical reactions even though we are less likely to experience physical danger. The problem is, when this stress response is repeated frequently over time, evidence shows it can contribute to health problems, including depression, anxiety, insomnia, heart disease, skin rashes and gastrointestinal problems—just to name a few.

Now a growing body of evidence demonstrates that racial discrimination can trigger this stress response. Racial minorities may experience more health problems as a result. One review of 121 studies published in 2013 found that youth between the ages of 12 and 18 who reported experiencing discrimination were significantly more likely to experience mental health problems such as depression and anxiety compared to those who did not. Another review of 66 studies found that Black adults who perceived they were subjected to racism were more likely to experience mental health problems and more likely to report a lower quality of life. A third review breaks down types of racism in our society and explains the health implications of each.

A lead researcher in the field is Anthony Ong, a professor of human development in Cornell University’s College of Human Ecology. Ong explains that experiencing discrimination or mistreatment regularly can affect health through eroding a person’s self-worth and by foreclosing opportunities for purposeful living.

“Although increasing evidence suggests that chronic exposure to unfair treatment or day-to-day discrimination increases the risk for poor health, the overall dearth of data on biological mechanisms indicates it’s important to continue studying this topic,” Ong said.

He published a study in 2016 of more than 200 Black adults followed over the period of a decade. Participants completed surveys about everyday mistreatment such as being called names, insulted, threatened, or harassed. They also answered questions about acute occurrences of unfair treatment, such as being discouraged from continuing their education, not receiving a loan, or being hassled by the police.

Participants also underwent blood tests to identify 22 biomarkers of diseases including heart disease, diabetes, nerve problems and inflammation.

Ultimately, participants who reported experiencing more discrimination were in poorer health. Ong argues that’s because experiencing discrimination on a regular basis, even small instances of daily mistreatment, can lead to “wear-and-tear” on the body over time.

“Our findings suggest that coping with chronic experiences of day-to-day mistreatment and discrimination can elicit a cascade of responses that over time ‘weather’ or damage the physiological systems that regulate the body’s stress response,” he said.

Ong published a second study in 2017 of 152 Asian-American college students, who completed daily surveys of daily race-related stressors, moods, and physical health for two weeks. The study found that when participants experienced mistreatment, what some researchers call “racial microaggressions,” they reported poorer sleep quality and shorter sleep duration the following day. Participants who experienced more “stigma consciousness”—that is, they believed discrimination influenced their daily interactions with others—were more likely to experience poor sleep quality on nights after they reported experiencing mistreatment.

“Being constantly vigilant to race-related threats in the environment may keep you from getting a good night’s sleep,” Ong explained.

The broad take-home message here is that experiencing racial discrimination may lead to health problems that detract from quality-of-life over the course of a year or even a lifetime.

Visit Cornell University’s Bronfenbrenner Center for Translational Research’s website for more information on our work.