Marc Halusic

We Can Get Along

Health Consequences of Race-Based Social Rejection

Evidence that perceived racism causes health problems, and what to do about it.

Posted Jun 22, 2014

It’s a truism that humans are, at our core, a fundamentally social species.  Our friends and personal connections imbue our lives with meaning (Hicks & King, 2009) and theories of human psychological needs routinely include ideas such as the need to belong, or the need for relatedness, as basic for human thriving (Baumeister & Leary, 1995).  Just as social inclusion through positive relationships fosters growth, social exclusion engenders distress.

            Some researchers now think that this form of stress could be one factor causing health disparities among some ethnic minority Americans. Public health researchers have already proposed that higher-than-expected rates of cardiovascular disease in Black American populations (even when controlling for other factors, such as diet and socioeconomic status) is likely the result of chronic stress from perceived racial prejudice (Wyatt et al., 2003).  Recently, Elizabeth Page-Gould and her colleagues have investigated one particular form of perceived prejudice, namely the belief that you will be rejected because of your race, as a unique cause of stress that leads to symptoms related to poor physical health.  In a variety of studies, these researchers have established that race-based rejection sensitivity (RS-Race) does in fact predict greater stress response following cross-race interactions.

            Until recently, however, it had not been clear how this phenomenon translates to real-world stress levels, and what, if anything, could be done to help people cope with this kind of stress.  In a new set of studies, Page-Gould and colleagues (Page-Gould, Mendoza-Denton, & Mendes, 2014), published in the Journal of Social Issues,

investigated one possible mitigating factor: cross-race friends. This article was published in a special issue, titled, “Ethnic-Racial Stigma and Physical Health Disparities in the United States of America: From Psychological Theory and Evidence to Public Policy Solutions,” edited by Luis M. Rivera, Danielle L. Beatty Moody.

In their research, these investigators reasoned that cross-race friends could serve as a resource to people who report high levels of race-based rejection sensitivity (RS-Race), giving them concrete, positive cross-race experiences to reflect upon. Cross-race friends also can be supportive when people perceive race-based rejection as a threatening possibility.  In one study, the researchers measured RS-Race by having Black Americans imagine a variety of situations, such as raising their hand in class along with other students after the teacher asked a difficult question, and wondering who the teacher will call upon.  People who expected to be excluded because of race, and who found that idea stressful were categorized as high on RS-Race.  Consistent with theorizing, in this study, RS-Race predicted stress-related physical symptoms, even when accounting for general rejection sensitivity.  The researchers found that this relationship went away, however, for people with a lot of cross-race friends. For other research on the benefits of cross-race friendships, check out our previous post called “Children’s Friends Matter.”

            So this finding supported their hypotheses, but we all know that correlation is not causation, so Page-Gould and colleagues decided to test their ideas in an experimental study where friendships were experimentally manipulated.  In this study, they recruited White and Hispanic participants, and asked them participate in a friendship building exercise over a 3-week period with either a same-race or cross-race peer.  At the end of the 3 weeks, each participant filled out a measure of anxiety related symptoms (e.g. headaches, chest pains, fatigue) each night for 10 nights.  Controlling for race, sex, and general rejection sensitivity, the results showed, again, that RS-Race predicted greater physical symptomology for people in the same-race friend condition, but that effect vanished for people in the cross-race friend condition.

            Together, these findings give us a better sense of one reason why being a minority in the United States is itself a risk factor for poorer health.  The universal worry of social neglect and rejection can be more acute when some groups of people perceive that their heritage is itself a social liability, and that worry can cause chronic stress.  More importantly, this research also gives us an avenue to pursue to lessen that risk.  By building friendships that span racial divides using formal interventions such as the jigsaw classroom (Aronson, 1978), or just reaching out as individuals to other individual other-group members, we can create a society that is a healthier one.


Aronson, E. (1978). The jigsaw classroom. Sage.

Baumeister, R. F., & Leary, M. R. (1995). The need to belong: desire for interpersonal attachments as a fundamental human motivation. Psychological Bulletin, 117, 497.

 Hicks, J. A., & King, L. A. (2009). Positive mood and social relatedness as information about meaning in life. The Journal of Positive Psychology, 4, 471-482.

Page-Gould, E., Mendoza-Denton, R., & Mendes, W. B. (2014). Stress and Coping in Interracial Contexts: The Influence of Race-Based Rejection Sensitivity and Cross-Group Friendship in Daily Experiences of Health. Journal of Social Issues, 70, 256–278.

Rivera, L. M. & Beatty Moody, D. L. (Editors, 2014). Ethnic-Racial Stigma and Physical Health Disparities in the United States of America: From Psychological Theory and Evidence to Public Policy Solutions. Journal of Social Issues, 70(2),197–391.

Wyatt, S. B., Williams, D. R., Calvin, R., Henderson, F. C., Walker, E. R., & Winters, K. (2003). Racism and cardiovascular disease in African Americans. The American journal of the medical sciences, 325, 315-331.

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