Is racial discrimination a public health issue?

A growing body of public health research has been dedicated to studying the impact of experiences of racial discrimination on outcomes ranging from mental disorders such as depression and anxiety, to chronic illnesses such as heart disease and breast cancer. Studies have consistently found that experiencing discrimination is associated with poorer health outcomes overall, but findings on the specific factors have been mixed. Much depends on the health problem in question as well as different approaches to studying these issues, highlighting the need to further understand existing controversies in the field.

A recent example of this research is a 2015 paper published in the Annual Review of Clinical Psychology, “Self-Reported Experiences of Discrimination and Health: Scientific Advances, Ongoing Controversies, and Emerging Issues,” Tené T. Lewis of the Rollins School of Public Health at Emory University, Courtney D. Cogburn of the Columbia University School of Social Work, and David R. Williams of the Harvard T.H. Chan School of Public Health examine this issue and make some fascinating observations.  Key points highlighted in the review include:

• While many interpreted the election of Barack Obama as being indicative of a new “post-racial” America, discrimination based on race or ethnicity continues to be a persistent experience for people of color in the United States across numerous domains, including housing, community policing, and health care treatment.
• Experiences of discrimination are a form of stress that can have serious implications for mental and physical health, ranging from depression, anxiety and post-traumatic stress disorder to all-cause mortality and hypertension. Research has also found discrimination to be associated with, “silent indicators of poor health and premature aging,” like allostatic load and cortisol dysregulation.

Lewis and colleagues conclude that the “overwhelming body of research on discrimination and health indicates that self-reported experiences of discrimination are an important risk factor for poor mental and physical health.” However, to adequately address these disparities, “significant inroads need to be made in order to dismantle the institutional policies, structures, and processes that underlie societal inequality and race-related discrimination. As research documenting the adverse effects of discrimination on health continues to grow, these efforts will become critically important as a means of improving health in societies shaped by racism and other forms of discrimination.”