Racism: The Impact on Health

A recent article in the American Journal of Public Health presents findings on experiences of everyday racism and HIV testing which are consistent with those from two other studies examining experiences of everyday racism’s relationship to preventive behaviors (condom use behaviors & mammography screening).  The greater the level of everyday racism, the less likely people are to engage in health prevention behaviors.   (Full citation for the article, which is behind a paywall: Ford CL, Daniel M, Earp JL, Kaufman JS, Golin CE, Miller WC. Perceived Everyday Racism, Residential Segregation and HIV Testing in an STD Clinic Sample. American Journal of Public Health Apr 2009 99;(Supp 1):S137-S143.)

The fact that racism takes a toll on the lives of people of color, and in particular on African Americans, is not especially new information.   There’s a literature on this that’s been growing for some years.  For example, Joe’s book with Karyn McKinney, The Many Costs of Racism, details the physical and psychological toll of racism on African American’s health.

What seems to be new here is that scholars in public health are increasingly documenting racism as an important underlying factor, if not a causal variable, in creating a number of specific health hazards and pathways to disease and mortality.   In the past, public health – like many other fields – had attributed racial inequality to the vagueness of social determinants phrased in the passive voice.   A research agenda that now explicitly includes racism is a step forward.

However, researchers are still overly cautious in their use of the term “perceived” as an ubiquitous qualifier to “everyday racism.”   Calling the experiences of everyday racism “perceived” leaves open the possibility that these experiences were not, in fact, racism but instead, a misundertanding of the actual situation.  If there is a “perception” of racism, then perhaps there is room for “misperception.”

Why does this matter?  It leaves unsettled then what the root cause is:  is it white racism that’s inflicting real harm on real people?  Or, is it the “perceptions” of black folks and other people of color that need to be adjusted?

Make no mistake, this burgeoning field of studying the impact on health of racism is important.  Yet, still largely missing here is a robust analysis of the cost of racism to whites.  A colleague of mine, Amy J. Schultz and I wrote a book chapter on this “Whiteness and the Construction of Health Disparities,” (Jessie Daniels and  Amy J. Schulz, pp. 89-127,  in Gender, Race, Class, and Health, (Jossey-Bass, 2006), Leith Mullings and Amy J. Schulz, Eds.).  Also missing here is what might be effective interventions, to use the public health language, to reduce the level of racism so that black and brown people might live longer, healthier lives.

Updated 6/26 to add: There’s an important piece on Racism’ Health Toll at Miller-McCune (from 6/15) that I should have referenced here.   Highly recommended.