“How does the lived and social experience of race turn into racial differences in health — into higher levels of Type 2 diabetes or cardiovascular disease or higher rates of infant mortality?” These questions sit at the center of several new studies undertaken by researchers like Amani Nuru-Jeter, a social epidemiologist at the University of California–Berkeley, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. Increasingly their data suggests that “lived experiences” – particularly those surrounding racial trauma and discrimination impact stress levels and play a role in health disparities.
Rochelle P. Walensky, Centers for Disease Control and Prevention director, noted that the COVID-19 illuminated inequities that have existed for generations and revealed racism as unaddressed parallel pandemic impacting public health.
“What we know is this: racism is a serious public health threat that directly affects the well-being of millions of Americans. As a result, it affects the health of our entire nation,” Walensky wrote in CDC commentary. “Racism is not just the discrimination against one group based on the color of their skin or their race or ethnicity, but the structural barriers that impact racial and ethnic groups differently to influence where a person lives, where they work, where their children play, and where they gather in community.”
Across the country, racial and ethnic minority populations experience higher rates of poor health and disease in a range of health conditions, including diabetes, hypertension, obesity, asthma, and heart disease, when compared to their White counterparts. The life expectancy among Black/African Americans is four years lower than that of White Americans.
“Just the fact that the nation continues to make comparisons between “racial” groups – as if diseases consciously work along our constructed labeling is problematic,” biology graduate student Georges Diop told the Informer. “Under the social bullying and frailty that make up white supremacy, sane professionals cannot sweep aside how being denied access to proper housing, employment – or those rights forged in our Constitution: life, liberty, and the pursuit of happiness – impact the mental and physical health of those groups. It also does not take into account the mental health of those denying others access.”
A 2015 review by Trusted Source collated the results of almost 300 studies examining how racism affects the physical and mental health of Asian American, African American, and Latinx American people. Among their findings, Trusted Sourced found 1) considerable data that the stress associated with experiencing racism can have long-lasting physical effects, 2) stress can elevate blood pressure and weaken the immune system, which, in turn, raises the risk of developing long-term health conditions, 3) stress as a result of racism can also lead to behaviors that may cause further risk to physical health. For example, research has found that discrimination is linked to higher rates of smoking, alcohol use, drug use, and unhealthful eating habits.
“The research has been there for quite a while, but not taken into consideration within health communities,” said health analyst Ronda Smith. “There is no trickle down from the lab to the clinic, so we go about treating Black people as if they are genetically predisposed to conditions that are actually causal… they have their roots in trauma.”
Smith points to a 2019 study that found racist experiences appear to increase inflammation in African Americans, raising their risk of developing chronic conditions such as heart disease and kidney disease. She notes that few physicians caring for African American patients for these conditions approach their treatment through stress relief or therapy.
“Confronting the impact of racism will not be easy. We must recognize that we are working to overcome centuries of discrimination. We will only be successful in undoing the entrenched systemic and structural barriers if we work in collaboration with our public health partners, and deeply within our communities, across the country,” Walensky said. “I know that we can meet this challenge. I know that we can create an America where all people have the opportunity to live a healthy life. I know that we can do this if we each take responsibility and work together.”