Racism's Impact on Health and Society

 
Racism and Health I:
Pathways and Scientific Evidence
David R. Williams and Selina A. Mohammed
 
Article Discussion
NM CARES
April 15, 2014
 
Racism and Health
 
Racial minorities have poorer health as evidenced by
higher rates of mortality, earlier onset of disease,
greater severity and progression of disease, and higher
levels of comorbidity and impairment
 
Disadvantaged racial populations also have lower levels
of access to medical care and receive care that is
poorer in quality
 
Article describes the complex nature of contemporary
racism in the U.S. and how racism affects health.
 
Overview of Racism and its Persistence
 
RACISM – an organized system premised on the
categorization and ranking of social groups into
races and devalues, disempowers, and
differentially allocates desirable societal
opportunities and resources to racial groups
regarded as inferior (Bonilla-Silva, 1996; D
Williams, 2004)
 
Overview of Racism and its Persistence
 
Racism leads to the development of negative
attitudes 
(PREJUDICE) 
and beliefs
(STEREOTYPES) 
toward nondominant,
stigmatized racial groups and differential
treatment 
(DISCRIMINATION)
 
Evidence of Persistence
 
Whites reveal positive changes over time in support of
the principle of racial equality
 
BUT support for laws and policies to achieve equality
lags behind support for the principle of equality
 
74% of Blacks and 31% of blacks report that they have
personally experienced racial discrimination
 
70% of Americans have implicit biases that favor
Whites over Blacks
 
Discrimination
 
Racial discrimination persists in contemporary
society:
Audit studies in employment
Prices of fast food meals in Black
neighborhoods
Subprime lending
 
Institutional Racism
 
Residential Segregation
 
High levels of incarceration of Blacks and
other minorities
 
Institutional Racism and Health
 
“Although institutional racism is arguable the
most important mechanism by which racism
adversely affects health, it is challenging to
capture in traditional epidemiological research,
and we have not fully quantified the impact of
institutional racism on health.”
 
Institutional Racism and Health
 
Racial segregation
Restrict social mobility by limiting access of
education
Reduces access to employment opportunities
Poorer quality houses
Neighborhood environments that are deficient in
resources including medical care
RESULT:  lower access and poorer quality of health
care and higher rates of violent crime and homicide
 
Cultural Racism
 
The persistence of institutional and interpersonal discrimination is
drive by racism that is deeply ingrained in American culture
 
Ideas of Black inferiority and White superiority
 
Anti-Black ideology and representation is the benchmark
to which other groups are compared
 
Examples:  Pop culture, TV programs, description of
convicts in newspapers, language studies
 
Cultural Racism and Health
 
Lack of positive emotion for stigmatized racial groups can lead to
lack of political will to address racial inequalities including those in
health
 
Recent research reveals that racial prejudice is a driver of Obama’s
health reform legislation
 
Internalized racism 
 alcohol use, distress, overweight, violence,
delinquent behavior
 
Stereotype threat 
 anxiety
 
Unconscious bias 
 blacks and other minorities receive fewer
procedures and poorer-quality medical care than Whites (IAT)
 
Experiences of Discrimination
 
Psychosocial stress 
 adverse affect on health
outcomes and risk behaviors
Coronary artery calcification, CRP, blood pressure,
lower-birth-weight infant births, cognitive
impairment, poor sleep, visceral fat, 
mortality
Lower levels of health care seeking and adherence
among racial minorities partly due to racial bias
Sept 11 – Low birth weight among Arab American
women
 
How Racism Can Affect Health
 
Conclusions
 
Racial variations in health are not simply genetic or
biological but rather contributed to by institutional and
cultural forms of racism
Inadequate research attention to ways multiple aspects
of racism relate to each other and combine with other
psychosocial risks and resources to affect health.
 
New analytic models are needed.
 
We need a science base to intervene to reduce and
eliminate the effects of racism on health.
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Racism plays a significant role in the health disparities experienced by racial minorities in the US, leading to higher mortality rates, increased disease severity, and reduced access to quality healthcare. This systematic organization of social groups based on race perpetuates negative attitudes, beliefs, and discriminatory practices, affecting individuals across various sectors such as employment, housing, and incarceration. Despite some positive shifts in attitudes, racial discrimination persists, highlighting the need for continued efforts to address institutional racism and promote racial equality.

  • Racism
  • Health Disparities
  • Discrimination
  • Institutional Racism
  • Social Inequality

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  1. Racism and Health I: Pathways and Scientific Evidence David R. Williams and Selina A. Mohammed Article Discussion NM CARES April 15, 2014

  2. Racism and Health Racial minorities have poorer health as evidenced by higher rates of mortality, earlier onset of disease, greater severity and progression of disease, and higher levels of comorbidity and impairment Disadvantaged racial populations also have lower levels of access to medical care and receive care that is poorer in quality Article describes the complex nature of contemporary racism in the U.S. and how racism affects health.

  3. Overview of Racism and its Persistence RACISM an organized system premised on the categorization and ranking of social groups into races and devalues, disempowers, and differentially allocates desirable societal opportunities and resources to racial groups regarded as inferior (Bonilla-Silva, 1996; D Williams, 2004)

  4. Overview of Racism and its Persistence Racism leads to the development of negative attitudes (PREJUDICE) and beliefs (STEREOTYPES) toward nondominant, stigmatized racial groups and differential treatment (DISCRIMINATION)

  5. Evidence of Persistence Whites reveal positive changes over time in support of the principle of racial equality BUT support for laws and policies to achieve equality lags behind support for the principle of equality 74% of Blacks and 31% of blacks report that they have personally experienced racial discrimination 70% of Americans have implicit biases that favor Whites over Blacks

  6. Discrimination Racial discrimination persists in contemporary society: Audit studies in employment Prices of fast food meals in Black neighborhoods Subprime lending

  7. Institutional Racism Residential Segregation High levels of incarceration of Blacks and other minorities

  8. Institutional Racism and Health Although institutional racism is arguable the most important mechanism by which racism adversely affects health, it is challenging to capture in traditional epidemiological research, and we have not fully quantified the impact of institutional racism on health.

  9. Institutional Racism and Health Racial segregation Restrict social mobility by limiting access of education Reduces access to employment opportunities Poorer quality houses Neighborhood environments that are deficient in resources including medical care RESULT: lower access and poorer quality of health care and higher rates of violent crime and homicide

  10. Cultural Racism The persistence of institutional and interpersonal discrimination is drive by racism that is deeply ingrained in American culture Ideas of Black inferiority and White superiority Anti-Black ideology and representation is the benchmark to which other groups are compared Examples: Pop culture, TV programs, description of convicts in newspapers, language studies

  11. Cultural Racism and Health Lack of positive emotion for stigmatized racial groups can lead to lack of political will to address racial inequalities including those in health Recent research reveals that racial prejudice is a driver of Obama s health reform legislation Internalized racism alcohol use, distress, overweight, violence, delinquent behavior Stereotype threat anxiety Unconscious bias blacks and other minorities receive fewer procedures and poorer-quality medical care than Whites (IAT)

  12. Experiences of Discrimination Psychosocial stress adverse affect on health outcomes and risk behaviors Coronary artery calcification, CRP, blood pressure, lower-birth-weight infant births, cognitive impairment, poor sleep, visceral fat, mortality Lower levels of health care seeking and adherence among racial minorities partly due to racial bias Sept 11 Low birth weight among Arab American women

  13. How Racism Can Affect Health

  14. Conclusions Racial variations in health are not simply genetic or biological but rather contributed to by institutional and cultural forms of racism Inadequate research attention to ways multiple aspects of racism relate to each other and combine with other psychosocial risks and resources to affect health. New analytic models are needed. We need a science base to intervene to reduce and eliminate the effects of racism on health.

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