The effects of racism on health and mental health

Racism, or discrimination based on race or ethnicity, is a key contributing factor in the onset of disease. It is also responsible for increasing disparities in physical and mental health among Black, Indigenous, and people of color (BIPOC).

This article looks at some of the ways that racism can affect health, how a person can live healthfully while facing the burden of racism, and how socioeconomic factors associated with racism can continue to pose risks to both physical and mental health.

In adults

A 2015 systematic review collated the results of almost 300 studies to look at how racism affects the physical and mental health of Asian American, African American, and Latinx American people.

The sections below will detail the conclusions of this review, as well as those of other studies.

Physical health

The aforementioned systematic review found that experiencing racism is associated with poor mental health and, to a lesser extent, poor physical health.

There is considerable research to suggest that the stress associated with experiencing racism can have long lasting physical effects.

Stress can elevate blood pressure and weaken the immune system, which, in turn, raises the risk of developing long-term health conditions.

Racism is associated with higher rates of stress, increasing a person of color’s risk of developing high blood pressure. In fact, the Centers for Disease Control and Prevention (CDC) report that Black people are more likely to have hypertension than any other racial or ethnic group.

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.

Also, a 2019 study found that racist experiences appear to increase inflammation in African American people, raising their risk of developing chronic conditions such as heart disease and kidney disease.

Another study found that unfair treatment of people of color has a significant consequential effect on sleep and physiological functioning in midlife.

Many studies have cited structural racism within medical care as a key factor in poor physical health. For example, a 2016 study into racial bias and pain management found a link between undertreating pain in Black patients and false biological beliefs, such as, “Black people’s skin is thicker than white people’s skin.”

A 2015 study found that compared with other racial groups, Black children with severe pain from appendicitis are less likely to receive pain medication. This suggests that racial bias is causing medical professionals to use different thresholds of pain for different racial groups, either inadvertently or purposefully, before administering care.

Mental health

The 2015 meta-analysis found that racism is twice as likely to affect mental health than physical health. Of those the researchers sampled, BIPOC who reported experiences of racism also experienced the following mental health issues:

• depression
• stress
• emotional distress
• anxiety
• post-traumatic stress disorder (PTSD)
• suicidal thoughts

A 2011 meta-analysis of studies into racism and mental health among Asian American people also revealed significant relationships between racial discrimination and depression and anxiety.

A 2018 paper suggested that fear of racism itself is harmful, and that it can undermine good mental health characteristics, such as resilience, hope, and motivation. The paper also underlined how verbal and physical assault can cause PTSD.

In children and young people

The American Academy of Pediatrics (AAP) are so concerned about how racism affects the well-being of young people that they released a 2019 policy statement on it.

The statement says that failure to address racism in the United States “will continue to undermine health equity of all children, adolescents, emerging adults, and their families.”

Physical health

Racism is already linked to poorer birth outcomes, such as infant mortality, for BIPOC. Studies suggest that mothers who report experiences of racism are more likely to have babies with a low birth weight, which can cause further health problems for the infants later in life.

Just as with older BIPOC, young people also experience the ongoing stress of living with and witnessing racism and discrimination. As young BIPOC get older, they have similar risks of developing chronic health conditions as their parents.

Mental health

The AAP recommend that young people who report experiences of racism should undergo routine assessment for mental health conditions, including:

• PTSD
• anxiety
• grief
• depression

The AAP also say that even if children do not directly experience racism themselves, they can be just as significantly affected by witnessing racism as those who experience it firsthand.

Intense and persistent stress can influence how the brain develops, intensifying negative emotions such as fear and impacting learning and memory.

How to live healthfully while facing racism

BIPOC alone should not carry the burden of coping with racism. Everyone needs to address structural disadvantage, socioeconomic deprivation, and institutionalized racism to reduce discrimination.

However, there is evidence to suggest that certain factors can help people cope with the negative effects of racism, both physically and mentally.

The sections below will discuss these factors in more detail.

Talk about racist experiences with others

Many studies have suggested that talking about racist experiences, instead of bottling them up, can help a person process feelings of stress, anger, and frustration.

Similarly, engaging with — instead of ignoring — racism is likely to be beneficial.

Foster a strong sense of racial identity

Studies into racism and its effects on mental health have found that BIPOC who felt strongly about their racial identity were less likely to be distressed by racism and less likely to be physically or mentally affected by it.

Therefore, having a well-developed sense of ethnic or racial identity may help blunt or buffer the effects of racism. However, research must continue in this area, as findings are still limited.

Lean on friends and family

Having a network of people to talk to for support, advice, and comfort can help people cope with racial discrimination. It can encourage a sense of security and identity and reduce negative thoughts and feelings.

Some studies have also found that having a strong support network may even combat depression.

On socioeconomic status

According to the American Psychological Association, socioeconomic status can directly affect both physical and mental health. Researchers have linked low socioeconomic status and a lack of economic development to poor health and a shorter life expectancy.

Physical health

According to a 2017 analysis of 1.7 million people, having a low socioeconomic status can be as bad for a person’s health as smoking, drinking a lot of alcohol, or eating an unhealthful diet.

People with low socioeconomic status are also more likely to have avoidable medical procedures and hospitalizations, as well as conditions that go untreated.

Mental health

Reduced access to housing, employment, and mortgage lending due to low socioeconomic status can adversely affect mental health and increase feelings of depression, stress, and anxiety.

Although Hispanic and African American people seem to have a lower risk of mental health conditions than those in other racial or ethnic groups, those who do develop such conditions tend to have more persistent psychological issues.

However, it is worth noting that this perceived lower risk may be due to racial inequities in the healthcare system.

Also, although there is an association between socioeconomic status and race, there is not perfect correspondence between race and low socioeconomic status. Indeed, even among BIPOC of middle and upper socioeconomic status, the effects of racism on mental and physical health persist.

Summary

Racism can be a key factor in the onset of physical and mental health issues in BIPOC.

Research suggests that the stress that develops due to experiencing or witnessing racism can have long lasting effects, increasing the risk of chronic disease and mental health conditions such as anxiety and depression in both children and adults.

Utilizing the support of peers and community, forging a strong sense of racial identity, and talking about racist experiences can all be effective ways of coping with the stress of racism.

Research suggests that low socioeconomic status has the same impact on physical health as smoking, heavy alcohol use, or an unhealthful diet. Racial groups with higher levels of low socioeconomic status also tend to have more persistent mental health conditions.

Last medically reviewed on July 28, 2020

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