Racism versus “race” and health

There’s an interesting story in the Baltimore Sun from yesterday, reporting on the results of a recent study (again by psychologists) on the physical consequences of racism, especially for Black men. Susan Brink writes:

Statistically, black men in America are at increased risk for just about every health problem known. African-Americans have a shorter life expectancy than any other racial group in America except Native Americans, and black men fare even worse than black women. Some of it can be chalked up to poverty, the most powerful determinant of health, or to lifestyle factors. But even when all those factors are accounted for in studies, the gap stubbornly persists. Now researchers are beginning to examine discrimination itself. Racism, more than race, may be cutting black men down before their time. …. heart disease, stroke, hypertension, diabetes, obesity and most cancers strike black men sooner, and cut them down more often, than white men. And the higher incidence of disease among black men is set against a backdrop of an increased incidence of poverty, which carries with it a multitude of health problems. Poor people smoke more, exercise less and are more likely to be victims of accidents and violence.

Typically, researchers have chalked the disparities in health between Blacks and whites to “race,” or the structural elements of racial inquality, rather than looking at racism and discrimination. For example, in a 2001 article in Public Health Reports, David Williams and C. Collins at the University of Michigan, explores the influence of racial residential segregation on health and find that this is a “fundamental cause” of health disparities. And, racial residential segregation was certainly a factor in the devastating health consequences of what happened in New Orleans. Yet, there’s a growing trend in this body of research toward also looking at the effects of racism and discrimination on health, along with these structural elements of racial inequality. Another article by David Williams, this one in the Annals of the New York Academy of Sciences, examines what he refers to as “the added effects” of racism and discrimination. Williams finds that:

“Racism can also directly affect health in multiple ways. …. racial bias in medical care, the stress of experiences of discrimination and the acceptance of the societal stigma of inferiority can have deleterious consequences for health.”

Vickie Mays, psychologist at UCLA and author of the study reported on in the Baltimore Sun, is quoted as saying:

“We have always thought of race-based discrimination as producing a kind of attitude. Now we think we have sufficient information to say that it’s more than just affecting your attitude. A person experiences it, has a response, and the response brings about a physiological reaction.”

There’s a lot of research that still needs to be done here, but I think one of the most interesting features of this particular piece of research is that here you have a psychologist who is making the case for moving away from racism “just affecting your attitude.” Of course, as a sociologist I’m a bit biased, but I think it’s progress when even the psychologists are arguing that we have to move away from an attitudinal approach to understanding racism.