Correction: The following Race, Racism and Health – Health Forum is scheduled for tomorrow – Tuesday – November 13th, 2018 at 5:00 PM. You must Register for this Event at www.TinyURL.com/racism-health
Health disparities refer to the differences in healthcare accessibility and status of different people. They result in adverse effects on marginalized populations and result in a disproportionate burden of disease, injury, disability, and premature death. This could translate into lower life expectancy, decreased quality of care and life, and perceptions of injustice, which causes decreased productivity, increased healthcare cost, and amplified social inequalities. Regardless of insurance status, Black men are less likely to receive timely preventable services and more likely to suffer the consequences of delayed attention. At every education level, Whites live longer than Blacks (Whites who graduate from high school live longer than Blacks who graduate from college). Black women experience the highest increase of obesity, which could lead to other health concerns. In addition, immigrants have increased risks for chronic diseases and injury because of their lack of familiarity with the U.S. healthcare system, different cultural attitudes regarding medicine, and language barriers. Discrimination is one of the mechanisms that explain the health gap between Whites and people of color. Healthcare differences based on race and ethnicity has been noted as a problem in the 1980s and the U.S. Department of Health and Human Services has coordinated efforts dedicated to reducing the extent of this issue. However, discrimination in the healthcare setting still remains a problem. Physicians could be unaware of their unconscious racial biases and hold negative stereotypes, which result in discriminatory actions when they encounter a person from a different racial group. While discrimination can be unintentional, perception of discrimination could result in physical and psychological distress that could impair health.
Research has found that higher levels of discrimination could result in higher risks for diseases. At a young age, Black teens who experience discrimination reported higher levels of stress, blood pressure, and weight by the age of 20. Stress from discrimination can cause distress and has been ranked in significance with other stressful major events, such as loss of a job, divorce, or loss of a loved one. In addition, stress from discriminatory events are associated with weight gain and could lead to unhealthy behaviors such as smoking or drinking. Perceived racial discrimination has been associated with obesity in Asian American women and Black women because discrimination serves as an important social stressor in the lives of people of color. Experiences of racism have been linked to weight gain and greater increase in waist sizes. There are stronger associations between obesity and women who face consistent experiences of racism over time. Black women have the highest prevalence of diabetes, suggesting that the experiences of racism, compared to their White counterparts, could partially explain this high prevalence. Residential segregation also plays a role in experiences of racism. In the U.S., institutional racial discrimination (discrimination in social institutions) takes form in residential segregation, which has the highest prevalence among Blacks. Residentially segregated neighborhoods are less likely to have fresh produce, recreational activities, and more likely to have fast food restaurants.
In addition to the physical health damages of discrimination, there are also psychological effects. Discrimination could lead to an increase risk of depressive symptoms and decreased self-esteem. Discrimination is cumulative and occurs throughout a lifetime and creates ongoing problems. It chips away at a person’s dignity and respect. The Weathering hypothesis explains that racial health disparities deteriorate health status in detectable ways in young adults because of continuous social and environment effects. Therefore, Blacks, in the face of social and economic trajectories are at a greater risk for poor physical and mental health outcomes. Mental health and physical health could be connected because respondents who reported a higher number of mental health problems also report engaging in unhealthy behaviors, such as smoking or drinking.
While self-perceived discrimination is important, being socially assigned an ethnic identity also plays a role in health advantages/disadvantages. Socially identifying and socially assigned dominant ethnicities (European descent) have been found to have the lowest psychological distress and have the highest odd of reporting optimal self-rated health. Socially identifying and socially assigned as a minority group result in significantly lower self-rated general health. People who socially identified as a minority, but were socially assigned as a dominant group are linked to higher odds of reporting optimal self-rated health compared to socially identified and assigned minorities. These differences between socially assigned and identified groups could be due to increased socioeconomic disadvantages and exposure to racial discrimination. Individuals who socially identify as a dominant group, but were socially assigned as a minority group experience the highest level of psychological distress. This mismatch acts as a stressor because it challenges the ‘non-racial’ identity that most Whites have. In racialized societies such as the U.S., social identification and social assignment of ethnic groups are important for understanding racial effects of physical and mental health outcomes. Social identification captures the important dimensions of structural racism. Social assignment measures the exposure of racial discrimination and provides another tool for assessing the health impacts of social processes of racialization.
Research about discrimination in healthcare is still scarce. Most research focuses on discrimination that occurs at one point in a person’s life. However, perception of discrimination causes a physical and mental response, which causes long-term health consequences for socially disadvantaged groups in different societies. Results from research need to be translated into real life applications and solutions; social issues need to be integrated into the U.S. healthcare system to bring more awareness to these racial aspects associated with health.
Want to learn more? Watch this video of discrimination as a health concern by David R. Williams:
Come hear Dr. Williams speak at the CBHC Health Forum on Tuesday –
November 21st, 2018 The correct date is November 13th, 2018:
By: Angela Ho, University of Denver Student