Racism Is Literally Bad For Your Health

Oct 28, 2017
Originally published on October 29, 2017 12:11 am

Most people can acknowledge that discrimination has an insidious effect on the lives of minorities, even when it's unintentional. Those effects can include being passed over for jobs for which they are qualified or shut out of housing they can afford. And most people are painfully aware of the tensions between African-Americans and police.

But discrimination can also lead to a less obvious result: tangible, measurable negative effects on health. A new survey conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health asked members of different ethnic and racial groups about their experiences with discrimination. Ninety-two percent of African-American respondents said they felt discrimination against African-Americans exists in the United States today, and at least half said they have experienced it themselves at work or when interacting with police.

All of this discrimination can literally be deadly, according to Harvard professor David Williams, who has spent years studying the health effects of discrimination.

He tells NPR's Michel Martin: "Basically what we have found is that discrimination is a type of stressful life experience that has negative effects on health similar to other kinds of stressful experiences."

Interview Highlights


On the health problems caused by day-to-day discrimination

The research indicates it is not just the big experiences of discrimination, like being passed over for a job or not getting a promotion that someone felt they might have been entitled to. But the day-to-day little indignities affect health: being treated with less courtesy than others, being treated with less respect than others, receiving poorer service at restaurants or stores. Research finds that persons who score high on those kinds of experiences, if you follow them over time, you see more rapid development of coronary heart disease. Research finds that pregnant women who report high levels of discrimination give birth to babies who are lower in birth weight.

On discrimination at the doctor's office

Across virtually every medical intervention, from the most simple medical treatments to the most complicated treatments, blacks and other minorities receive poorer-quality care than whites. African-Americans who are college-educated do more poorly in terms of health than whites who are college-educated. And these racial differences in the quality and intensity of care persist for African-Americans irrespective of the quality of insurance that they have, irrespective of their education level, irrespective of their job status, irrespective of the severity of disease.

On how to start combating discrimination

Much of this discrimination that occurs in the health care context, and in other contexts of society, may not even be intentional. There is intentional discrimination, but we think the majority of the discrimination that occurs in the health care context is driven by what we call "implicit bias" or "unconscious unthinking discrimination."

If I am a normal human being, I am most likely to be prejudiced. Why? Because every society, every culture, every community has in groups and out groups. And if there are some groups that you have been taught — just subtly, as you were raised — to think of negatively, you will treat that person differently when you encounter someone from that group, without any negative intention on your part, even if you possess egalitarian beliefs. That's why you have to acknowledge that I and everyone else is a part of the human family, and these are normal human processes that occur, and the first step to addressing it is to acknowledge: "It could be me."

NPR's digital news intern Jose Olivares produced this story for digital.

Copyright 2017 NPR. To see more, visit http://www.npr.org/.

MICHEL MARTIN, HOST:

Let's turn now to a related topic. Most people can acknowledge that discrimination has an insidious effect on the lives of minorities from being passed over for jobs to being shut out of desirable housing. Most people are painfully aware of the tensions between African-Americans and police. But discrimination can also lead to a less obvious result - tangible, measurable, negative effects on health.

A new survey conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health asked members of different ethnic and racial groups about their experiences with discrimination. Among African-Americans, 92 percent said they believed discrimination against African-Americans exists today. More than half reported being discriminated against themselves. And all of this can be deadly according to Harvard University Public Health professor David Williams, who spent years studying the health effects of discrimination and talked to us about his findings.

DAVID WILLIAMS: Well, basically, what we have found is that discrimination is a type of stressful life experience that has negative effects on health similar to other kinds of stressful experiences.

MARTIN: Can you just give us one scenario where it would lead to a tangible, measurable effect on health?

WILLIAMS: The research indicates it's not just the big things of experiences of discrimination like being passed over for a job or not getting a promotion that someone felt they might have been entitled to, but even the day-to-day little indignities - being treated with less courtesy than others, being treated with less respect than others, receiving poorer service at restaurants or stores.

Research finds that persons who score high on those kinds of experiences - and if you follow them over time, you see more rapid development of coronary heart disease - the number one killer in the United States - by looking at what is actually happening to the arteries and the narrowing of the arteries. That occurs more rapidly among persons who record these day-to-day indignities of discrimination than persons who score low on those measures. That's just one example. Another example would be research finds that pregnant women who report high levels of discrimination give birth to babies who are lower in birth weight.

MARTIN: You know, our poll also found that almost a third of African-Americans said that they've experienced racial discrimination when going to the doctor. Could you talk a little bit about that?

WILLIAMS: Sure. That data is quite consistent with something that we in the medical and research community have known for some time - that across virtually every medical intervention, from the most simple medical treatments to the most complicated treatments, blacks and other minorities receive poorer quality care than whites.

MARTIN: Now, I can imagine that some people hearing our conversation might argue that this is really about class not race, that this is a function of socio-economics. But you specifically studied this question. What have you found?

WILLIAMS: There are, in the United States, striking differences in health and in access to health care by income and education and occupational status. But what the research finds is there still is a negative effect of race at every level of socio-economic status so that African-Americans who are college educated, for example, do more poorly in terms of health than whites who are college educated.

And these racial differences in the quality and intensity of care persist for African-Americans irrespective of the quality of insurance that they have, irrespective of their education level, irrespective of their job status, irrespective of the severity of the disease.

MARTIN: Professor Williams, you've been studying this for quite some time. Does your research indicate a solution? I think one might assume that most medical professionals don't think that they're discriminating against black people.

WILLIAMS: Yes. That is a really important point. We think the majority of the discrimination that occurs in the health care context is driven by what we call implicit bias or unconscious, unthinking discrimination. If I am a normal human being, I am most likely to be prejudiced - why? - because every society, every culture, every community has in groups and out groups. And if there are some groups that you have been taught, just subtly as you were raised, to think of negatively, you will treat that person differently when you encounter someone from that group without any negative intention on your part, even if you possess egalitarian beliefs. And the first step to addressing it is to acknowledge it could be me.

MARTIN: That's David Williams. He's a professor at the Harvard T.H. Chan School of Public Health. Professor Williams, thank you so much for speaking with us.

WILLIAMS: It's been great to talk to you. Thank you.

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