In a report just released from the NIH, as many as 1 in 100 black men and women develop heart failure before the age of 50, which is 20 times the rate in whites in the same age group. In public health terms, these racial differences in health are referred to as “health disparities,” and the newly released report from the NIH raises questions about why there are such stark disparities across racial groups ( photo credit: derek*b).
According to the NIH, this sharp rise in heart failure is directly related to the increased levels of hypertension (aka, high blood pressure) for blacks. There’s a growing body of scientific literature which points to the experience of racism as a major factor in elevated blood pressure, one of the leading risk factors for early heart failure. David Williams was a pioneer in this field with his 2001 article, “Racism, discrimination and hypertension: evidence and needed research,” (Ethn Dis. 2001 Fall;11(4):800-16). That piece spawned a bunch of others, including an excellent piece by Wyatt and colleagues entitled, “Racism and cardiovascular disease in African Americans,” (Am J Med Sci. 2003 Jun;325(6):315-31), which posits that there are three levels of racism that affect the cardiovascular disease (CVD) of African Americans, namely:
First, institutional racism can lead to limited opportunities for socioeconomic mobility, differential access to goods and resources, and poor living conditions that can adversely affect cardiovascular health. Second, perceived/personally mediated racism acts as a stressor and can induce psychophysiological reactions that negatively affect cardiovascular health. Third, in race-conscious societies, such as the United States, the negative self-evaluations of accepting negative cultural stereotypes as true (internalized racism) can have deleterious effects on cardiovascular health.
And, in a recent cross-sectional study that included African American men (n = 393) and women (n = 717), researchers at the University of North Carolina Chapel Hill found that the likelihood of hypertension significantly increased with higher levels of perceived stress following racism from non-African-Americans.
While many people contend that racism is no longer a relevant or life-threatening issue, this kind of evidence persuades me that addressing racism is more crucial than ever.
I am so glad that there are studies legitimizing the fact that racism can affect health. Unfortunately, even health professionals at respected universities are providing misinformation based on negative and foundation-less racial stereotyping. I am currently in a graduate course on race and health at my university and an instructor in another section had the audacity to explain the higher rate of heart failure for African American women based on their diet that consists mainly of “fried chicken and corn bread.” I was a bit shocked that this was the explanation given to all the students. My section is an online course and I often find our forum questions each week are more concerned with promoting racial stereotypes rather than engaging the course material from lectures and readings.
People will argue that that racism may not be the cause because there are apparently other diseases that blacks of Caribbean descent get because…they are blacks of Caribbean descent. Namely certain anemias (esp. sickle-cell). If this is true, then perhaps blacks having higher rates of hypertension just goes with being black.
Of course, I don’t really buy this, but I would like a more solid argument to put out there when I inevitably get confronted with this sort of denial.
Alston, great question and a great point was brought up in my critical race theory course to discuss it. A study (don’t have the citation, but I will ask my professor for it) found that the birth weights of Blacks and Latinos in the U.S. were lower than for whites even when they access to resources, income, etc. The researchers then went to West Africa to measure the birth weights of the women in that region, where it is assumed most African Americans can trace back their ancestry, and even with medical technology not yet as sophisticated as the U.S. the birthweights were higher for the women in West Africa! So, there is something unique about the racial experience in the United States, like the effects of PTSD, it can affect physical health.
I believe Nancy Krieger and Stephen Sidney, “Racial Discrimination and Blood Pressure,” American
Journal of Public Health 86 (1996): 1370–78, is the pioneering early work on high blood pressure and racism.