Racism and Health

Health. No matter the goals and aspirations of a person... no matter their sex, religion, ethnicity or gender, one thing all humans have in common is the desire for good health. Good health is the foundation of a good life. No matter how much money or success one has, they will not fully enjoy their living experiences if their health is ill. We all desire to wake up feeling good every day.

As previously discussed in the article How Emotions Affect the Body, stress, anxiety, anger, disappointment… pretty much all pent up negative emotions cause havoc on the bodily systems. Conversely positive feelings promote healing and overall good health. The world is full of stressors that cause anxiety, fear, and low self-esteem. One of the greatest stressors in the world is the climate of racism. Sociologist and Harvard Professor David R. Williams has studied the affects of racism on health for the past several decades. His findings are both troubling and enlightening:

Every 7 minutes a black person dies prior to their life expectancy; that is over 200 black people prematurely dying every day. Furthermore, there is a previously held belief that education and economic status are the determining factors in health, but that is an incomplete truth. On average, black people live 4-6 years shorter than white people. And at every level of education, whites live longer than blacks. In fact, whites with only a high school degree live longer than blacks with college degrees. Williams developed a tool for measuring the affects of racism called the Everyday Discrimination Scale, which has become one of the most widely used discrimination scales in epidemiological and public health research. After numerous studies, research confirms that racism has a tangible effect on public health. Major racism, which comprises of overt bigotry and prejudice, is destructive in itself. However, minor racism in which people are less courteous to you, give diminished service at restaurants, do not hold doors open, act as if you are a threat etc. is just as damaging to the psyche or perhaps even more. People who routinely experience racism have their dignity and esteem chipped away on a daily basis, and research has shown that people who experience higher levels of discrimination are associated with an elevated risk of a broad spectrum of health risks such as hypertension, cancer, and obesity. One report shows that black teens with numerous experiences of discrimination have higher levels of stress hormones, blood pressure, and weight by age 20.

Not only does the stress and trauma of racism affect the health of black and other marginalized groups, but health institutions themselves also play a large part in the societal health discrepancies. Blacks and other minorities receive poorer care than whites across all medical treatments. This is in large part to implicit bias. Implicit bias, or unconscious discrimination, is when a negative stereotype is held against a group, that particular group is treated worse. It is an unconscious act. Even people who consider themselves fair minded, ethical, and well intended hold strong implicit biases, particularly to people of color. These biases are formed from a young age through media, rhetoric, advertisements, etc. and bombard all sensory inputs. Over time, the person holds deep seated beliefs and biases they may not even know are there. Negative stereotypes sustain individual and institutional discrimination.

To compound this issue, African Americans are less likely to seek out medical attention because of a deep seated mistrust of the medical institution. The Tuskegee Syphilis Experiment in which black men were unknowingly injected with syphilis and observed under the guise of "free health care" is an example of the black life being devalued, and thus, black people having apprehension about western medicine. In her book, Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present, author Harriet Washington eloquently describes the history of medical experimentation and abuse, demonstrating that mistrust of medical research and the health care infrastructure is extensive and persistent among African Americans. This mistreatment has more than four centuries of a sustained biomedical enterprise designed to exploit African Americans. As recently as the 1990s, unethical medical research involving African Americans has been conducted by highly esteemed academic institutions. For example, researchers at a prestigious U.S. university recruited African American boys into a study that hypothesized a genetic etiology of aggressive behavior. Through the use of monetary incentives, they were able to convince parents to enroll their sons in a study that included withdrawal from all medications (including asthma medications), ingesting a mono-amine (low protein) diet, an overnight stay (without parents), withholding of water, hourly blood draws, and the administration of fenfluramine, a drug known to increase serotonin levels and suspected to be associated with aggressive behaviors. In addition to these methods, several other significant human subject violations were cited, including restricting the recruitment to black children. It is fair to ask whether mistreatment of African Americans that has occurred more recently than the Tuskegee syphilis study is exacerbating mistrust today.

This is a world full of rich diversity - diverse peoples, ideas, cultures, and thoughts. It is a blessing to be inundated with so much variety. However, the need to feel a false sense of superiority towards others causes and fosters the ugly components of human behavior that manifest in the form of racism, sexism, religious intolerance etc. This article specifically deals with how racism affects health in a destructive way, but any group that deals with the daily stressors of intolerance, bigotry, and non-inclusion will ultimately suffer some ill affects to their psyche, and thus overall health. Fortunately, research is helping health care practitioners understand and come to grips with their implicit biases, and programs are being developed to monitor and combat it so that black people receive equal care and attention. Furthermore, there has been a greater awareness over the past several years of how destructive the negative stereotypes of black people portrayed in media and advertisements are to the psyche of all people; there has been a conscious and aggressive push spearheaded by African Americans to nullify these negative stereotypes with positive images of strong, successful, educated, compassionate etc. black people. But the world is still a work in progress… keep progressing. No one should die prematurely because they are born in a way that God designed them to be.