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How others’ (and our) attitudes about race affect our health

Rodolfo Mendoza-Denton, professor of psychology | August 9, 2012

Health disparities across racial and ethnic groups suggest— but not conclusively— that discrimination affects your health. As a recent report from the American Psychological Association that I was a co-author on notes, minorities are far more susceptible to many diseases relative to majority groups, most notably heart disease, cancer, and diabetes. The data are as consistent as they are maddening.

The reason that the data are not conclusive on the effect of discrimination, though, is that the data only relate health outcomes to group membership — leaving the data open to other interpretations. A college professor of mine once floated to our class the possibility that higher blood pressure among African American might not be the result of constantly having to deal with discrimination. Rather, he conjectured, African slaves with higher blood pressure might have been more likely to survive the grueling trip from West Africa to the U.S. Shores than those with low blood pressure, thus “selecting” for high blood pressure among today’s African Americans. Others might point to the different diets among racial/ethnic groups as the culprits of these health disparities, or any number of cultural or social factors.

These potential explanations are of course inter-related; availability of food choices, living environments, and other context-level factors related to health are themselves intricately linked to discrimination. But can one’s psychological experience surrounding discrimination — how we and others feel about our racial group membership— itself be related to important health outcomes? Having data that directly addresses this critical question is an incredibly important tool for those of us who, like me, are interested in moving beyond armchair theorizing about the underlying reasons for health disparities.

New research from the laboratory of David Amodio of NYU promises to yield an important tool in the data-driven fight against discrimination. In a forthcoming paper in the journal Social Psychological and Personality Science, Amodio’s lab (Ratner, Halim, and Amodio, in press) directly establish a link between attitudes towards racial groups and important health markers.

Importantly, the authors did not just look at group-level differences (how Whites differ from Blacks as a group, for example), which leads to the problem of data interpretation I just described above. Rather, the researchers directly measured individual differences within a community of Black and Latina study participants in how negatively they thought other people judged their own group. They then examined whether these psychological variables helped explain variability in health risk within this community.

What were the health markers the group focused on? One of them was participants’ levels of the inflammatory cytokine IL-6, assayed from saliva. Chronic levels of inflammation are being increasingly recognized as a serious health risk that over time can lead to cardiovascular disease and cancer (which, coincidentally, are among the two outcomes that show the greatest minority-majority group disparities), and Il-6 serves as a marker of that risk. The researchers found that the more participants felt that their group was seen negatively by other people, the greater the levels of Il-6 in their saliva.

It’s important to point out that the community members that the researchers studied were not particularly unhealthy; they ranged in age from 18 to 44 with a mean age of 29. Beneath the surface, the data suggest, having to psychologically cope with others’ negative attitudes about one’s group is already exacting a toll on the immune and endocrine systems that, over time, become full blown health disparities.

As I often emphasize in this blog, though (see here and here), targets of discrimination are not passive recipients of the bias targeted at them. Rather, they find ways to cope, to survive — to thrive — in the face of such negativity. And the research bears this out as well. Specifically, the researchers also measured how people privately felt about their own group (this is in contrast to how one feels other people feel about one’s group, as above). The more participants reported agreeing to items such as “in general, I’m glad to be a member of my group,” the greater participants’ levels of a protective, stress-modulating hormone called DHEA-S.

Thus, this story has a silver lining. The study shows that attitudes about race directly impact health outcomes. But, while we can’t always influence others’ attitudes, we can influence our own attitudes— with the potential to benefit our health. So don’t take pride in your group for granted, especially when your group is stigmatized by society. Follow the lead of James Brown.

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 Copyright 2012 by R. Mendoza-Denton (MCN: BS8Y4-PNV7V-EVK9V); all rights reserved.

Comments to “How others’ (and our) attitudes about race affect our health

  1. Yes! I love your article.
    From personal experience, I can say this is so true. I am white with a half Asian daughter. We just finished living in rural Taiwan for a year and a half.

    In our town, people stared at us often, sometimes stopping in their tracks. It happened often. I also made people uncomfortable; people would often apologize and some would tremble when they felt obligated to speak English to me.

    This treatment from people was annoying, exhausting and I felt very stressed going out in public. It was difficult to not let these behaviours effect us. It was tough. I felt like my skin colour made our life difficult. At the end of our stay, my daughter also grew tired of people’s stares.

    I choose to bring us home to America because I didn’t want to experience being the foreign freak any longer. I couldn’t find a way to frame the staring, comments in Chinese, and fearful behaviours! I totally get your article. It’s hard to live with the unjust stereotyping of the majority. If that majority is reacting to you and your people, it’s agonizing to live with!

  2. “The data are as consistent as they are maddening” because we are losing the 60s era civil, voting and freedom of speech rights. Absolutely none of our institutions have protected those gains.

    One of the best metaphorical statements I have ever run across to describe our worst case scenario human condition is by your colleague Prof. John Searle “Like buffaloes being shot, they look on with interest when another of their number goes down, without seriously thinking that they may be next.”

    We failed completely to learn from the lessons of the 60s because humans have always been “like buffaloes” so we are paying the price of our failure to evolve one more time during the 2012 election cycle.

  3. Kudos for this very insightful post on racial group attitudes. There is no question that racial discrimination harms health. In public health, psychology, sociology, etc., numerous studies have shown that self-reported experiences of racial discrimination negatively impact health outcomes, both reported health outcomes and outcomes assessed more objectively as you state in your post.

    I wanted to comment on the latter part of your post about coping. In my field, public health, there has been some mixed evidence about the effects of self-reported racial discrimination. Some of this may be attributed to the way we study discrimination. Racial discrimination is often reported as a stressor. The stress literature tells us that stress is a process, not just the environmental demand or challenge we encounter. The process involves presentation of an environmental demand/challenge, our appraisal of the degree to which that demand is threatening, and our emotional, behavioral, cognitive, and physiologic response corresponding to that appraisal. Hence, threat appraisal and coping style are two key aspects of the stress response process and can modify the association between stress exposure and health outcomes. However, few studies — at least in public health — have explicitly measured things like threat appraisal and coping. Racial group attitude is tied to threat appraisal and coping and also not studied nearly enough in public health research.

    I would like to raise another issue I struggle with sometimes. I am a social epidemiologist. In epidemiology, we are taught to focus on modifiable risk factors. That is, those things that we can intervene upon to impact change in outcomes. What I often struggle with in doing research in this area is identifying the modifiable risk factors. Yes, we can intervene on individual coping style and maybe even threat appraisal and racial group attitudes. As a social epidemiologist, I usually think about the more upstream social causes of health outcomes such as racial discrimination itself. However, racial discrimination is not going to end tomorrow. Ultimately, that is the modifiable risk factor that we would like to intervene upon both at the individual level as well as the institutional and even structural level (eg, neighborhoods).

    Is focusing on the individual factors such as threat appraisal, coping style, racial group attitudes, etc. “victim blaming”? Of course, we have to do something in the short term since racial discrimination is not going to end tomorrow. But how do we start working towards the more lofty goal of addressing the social cause, discrimination itself? There is some research being done on this in public health but we are a long way off of having any viable solutions. By viable I mean solutions that are economically, policitically, and administratively feasible. Especially, when we live in a country where many people don’t even think racism still exists.

    In thinking about racial group attitudes, perhaps this is a way to get at some of the underlying causes. Can we intervene upon racial group attitudes for everyone as a way to change race relations more broadly, and thus create a society that experiences race differently than we do today?

    This was a great post. Thanks for initiating the conversation!

  4. Thanks for this! Note that the increased risk factors more or less mirror increased risk factors for obesity, which may indicate that discrimination against fat people is much more of a health risk than actually being fat. Data on this goes back to the 1950s. The Health at Any Size community has done a little work on this, but there is much more to be done.

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