Why Discrimination is a Health Issue

Original article written by David R. Williams for the Robert Wood Johnson Foundation’s Culture of Health Blog.


Black people in the U.S. experience more illness throughout their lives and die sooner compared to white people. Heart disease is the number one cause of death in the United States and middle-aged Black people have death rates that are about twice as high as their white counterparts. Elevated death rates are also evident for cancer, stroke, diabetes, kidney disease, maternal death and more.

Even when adjusting for higher levels of education—which can lead to higher incomes and the ability to live in healthier neighborhoods and to access high-quality health care—Black Americans still suffer from health disparities leading to higher mortality rates.


A large and growing body of research shows that day-to-day experiences of Black Americans create physiological responses that lead to premature aging (meaning that people are biologically older than their chronological age). Or, as described in the American Behavioral Scientist, “experiences of racial discrimination are an important type of psychosocial stressor that can lead to adverse changes in health status and altered behavioral patterns that increase health risks.”


Stress is a normal part of life, but when stress is a persistent, daily experience, it exceeds our ability to cope and the physiological systems designed to handle it fails. This resulting physical response leads to increased incidence of hypertension, diabetes, or other health issues.


The first data from an unprecedented survey of 3,453 African-Americans, Latinos, Asian Americans, Native Americans, whites, and LGBTQ adults from the Harvard T. H. Chan School of Public Health, NPR, and RWJF explores experiences with discrimination. Every demographic group surveyed felt that discrimination against their own race or ethnic group exists in America today. This included 78% of Latinos, 75% of Native Americans, 61% of Asian Americans, and 55% of Non-Hispanic Whites. However 92% of African-Americans surveyed were most likely to agree with this statement.


The word discrimination often brings to mind historical examples of denial of voting rights, hate crimes or discriminatory practices in housing and criminal justice. But not all discrimination is conscious, intentional or personal. It’s often built into institutional policies and practices such as mortgage lending, zoning or school funding practices—which, in turn, impacts where you live, the quality of education you receive or access to public transportation or good jobs—all of which are linked to health.


So what do we do about it? Although there are examples of programs and policies aimed at increasing health equity, there’s really no simple answer. But the first thing we have to do is acknowledge that the everyday racial discrimination embedded in our culture is sickening and killing Black Americans, and make a new commitment to work together to make America a healthier place for all.


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