Health Impact of Racism
Embodiment (Nancy Krieger, 2015)
- Our bodies tell stories about the conditions of our existence.
- Our bodies tell stories that match people’s verbal accounts of their history.
- Our bodies also tell the stories that people are unable, forbidden, or unwilling to tell.
Leukocyte telomere length (LTL) is a biological marker of systemic aging in humans and a measure commonly used to study disease risk in human populations. In considering the negative health impacts of discrimination, recent research by Lee et al. (2017) investigates the relationship between discrimination against African Americans and any potential effects it may have on LTL.
The scientific findings are clear: high levels of racial discrimination are associated with shorter LTL even after adjusting for varied sociodemographic, health, and mental health factors. Since increased discrimination is associated with shorter telomere lengths and LTL is an indicator of biological aging and disease risk, the data suggest that discrimination accelerates biological aging and generates vulnerability to disease in African Americans. This finding fits well into the reality of African American adults who experience disproportionately more diabetes, cardiovascular disease, premature aging, and hypertension than those from other racial groups (Lee et al., 2017).
Lee, D. B., Kim, E. S., & Neblett, E. W. (2017). The link between discrimination and telomere length in African American adults. Health Psychology, 36(5), 458–467. https://doi.org/10.1037/hea0000450
High blood pressure or hypertension is a fairly common condition in which there is excessive pressure against the artery walls, ultimately putting the body’s blood vessels and organs at risk. In considering the negative health impacts of discrimination, multiple research groups investigate the relationship between discrimination against African Americans and any potential influence it may have on the frequency of hypertension for Black people. In recent years, researchers have employed ambulatory blood pressure (ABP) monitoring in these studies since it provides a more comprehensive assessment of an individual’s body than other methods, and can better predict health outcomes (Brondolo et al, 2011).
The scientific research and empirical reviews point to one common finding: interpersonal discrimination is associated with higher ABP even after adjusting for varied demographic, health, and sex-related factors (Forde et al., 2020). Since increased discrimination is associated with higher ABP and APB is an indicator and contributor of hypertension, the data suggest that discrimination generates vulnerability to organ damage and heart disease in African Americans. This finding fits well into the reality of African American adults who experience disproportionately more hypertension than those from other racial groups (Lee et al., 2017). As interpersonal and institutional racism persist, African Americans are forced to contend with physical consequences to racially discriminatory conditions.
Brondolo, E., Love, E. E., Pencille, M., Schoenthaler, A., & Ogedegbe, G. (2011). Racism and hypertension: A review of the empirical evidence and implications for clinical practice. American Journal of Hypertension, 24(5), 518–529. https://doi.org/10.1038/ajh.2011.9
Forde, A. T., Sims, M., Muntner, P., Lewis, T., Onwuka, A., Moore, K., & Diez Roux, A. V. (2020). Discrimination and hypertension risk among African Americans in the Jackson Heart Study. Hypertension, 76(3), 715–723. https://doi.org/10.1161/hypertensionaha.119.14492
Lee, D. B., Kim, E. S., & Neblett, E. W. (2017). The link between discrimination and telomere length in African American adults. Health Psychology, 36(5), 458–467. https://doi.org/10.1037/hea0000450
This study explores how persistent racial discrimination leads to increased inflammation
and, consequently, more chronic diseases for African American women. The research uses the
weathering hypothesis, which proposes that African Americans experience premature aging and
related health issues due to the cumulative impact of the stress of enduring racial discrimination,
including its social, economic, and political exclusion. In other words, the weathering hypothesis
asserts that higher rates of disease, disability, and mortality seen in African Americans are
physiological responses to structural and interpersonal racism rather than lifestyle contributions
and lower economic status that are attributed to racial health disparities. Data were collected
from 391 African American women, with a mean age of 49, who participated in the Family and
Community Health Study.
The researchers collected blood assays provided by the women and assessed inflammation
using “seven cytokines central to the inflammatory response” (p.7). Women also reported their
discrimination experiences and doctor-diagnosed chronic diseases. While socioeconomic status
(SES), in part, contributed to the women’s chronic diseases, the findings support the weathering
hypothesis, showing that over and above the effect of SES, persistent racial discrimination
predicts higher inflammation levels, which in turn relates to chronic diseases, such as heart
disease, diabetes, and liver disease. According to the researchers, “in large measure, heightened
inflammation (physiological weathering) accounted for (mediated) much of the association
between racial discrimination and number of chronic diseases reported.” (p. 12)
Simons, R. L., Lei, M.-K., Klopack, E., Zhang, Y., Gibbons, F. X., & Beach, S. R. (2020). Racial discrimination, inflammation, and chronic illness among African American Women at Midlife: Support for the weathering perspective. Journal of Racial and Ethnic Health Disparities, 8(2), 339–349. doi:10.1007/s40615-020-00786-8