Approximately 13.4% of the population in the United States identifies as African American. Among this population, more than 16% reported having a mental illness in 2020. Although mental health conditions occur in the African American population at about the same or less frequency than in White Americans, the historical experiences of American Americans within the U.S. has and continues to be characterized by trauma and violence more often than for their White counterparts and impacts emotional and mental health of both youth and adults.
A systematic review conducted in 2015 revealed that discrimination based on race or ethnicity is a significant contributing factor to chronic disease. The study found that experiencing racism is associated with disparities in physical and mental health.
The systematic review mentioned above found that people who experienced racism were more likely to exhibit signs of poor mental health. To some extent, this discrimination also impacted their physical wellbeing. The research suggests that stress associated with racism can have long-lasting physical effects.
It can lead to an increased risk of high blood pressure and a weakened immune system. According to the Centers for Disease Control and Prevention, African Americans are at a higher risk of hypertension than other ethnic and racial groups.
Unfair treatment of people of color also has a consequential impact on physiological functioning and sleep. Study findings suggest that racism contributes to risky lifestyle behaviors like smoking, alcohol use and abuse, and unhealthy eating habits. Racism experiences also contribute to increased risk of kidney and heart disease.
Humans depend on their ability to respond to stresses, infections, and injuries to survive. These threats activate the immune system to react and fend off pathogens and repair damaged tissues. Inflammation signifies a select group of genes at work to repair the damage or counter the threat.
While inflammation serves to protect cells from a health threat, prolonged inflammation compromises health. The activated genes can promote heart attacks, metastatic cancer, and neurodegenerative disease.
Racism is toxic, and a study showed that inflammatory responses are more common among socially marginalized and isolated groups. Racism accounted for approximately 50% of prolonged inflammation among African Americans participants, especially those with suppressed immunity.
Inflammation within the spine and other joints is a hallmark of symptoms for spondyloarthritis, the family of related rheumatic diseases. Markers of inflammation, co-morbidities, and iritis / uveitis are significantly higher in African Americans with spondyloarthritis. African Americans have greater disease activity measured both subjectively (BASDAI) and objectively (ESR & CRP), and African American women have more severe Quality of Life measures.
One study suggests that racism is twice as likely to affect a person’s mental health than their physical health. Black, Indigenous, and People of Color (BIPOC) who reported cases of racial discrimination also experienced:
The fear of racism can also pose harm to an individual’s mental health. It can undermine healthy mental characteristics like hope, motivation, and resilience. Verbal and physical assault can further contribute to post-traumatic stress disorder.
The healthcare system in the United States is plagued with inequalities that significantly impact people of color and marginalized groups. The disparities are evident in health insurance coverage, poorer health outcomes, and uneven access to services. The African American population continues to bear the brunt of these imbalances, often with dire consequences. Although they now live longer, African Americans still grapple with illness and infirmity at excessively high rates and have a life expectancy rate that is lower in comparison to other ethnic groups.
A study in 2015 found that children from African American communities suffering from severe pain are less likely to receive pain medication. This indicates that racial bias has caused healthcare professionals to use different thresholds of pain based on race. While this may be inadvertently or purposefully, it influences how they administer care to different patients.
Health Insurance Coverage
Under the Affordable Care Act (ACA) more than 20 million Americans gained health insurance coverage, and among them, 2.8 million were African Americans. Despite this development, the uninsured rate of African Americans remains higher than that of White Americans. The high costs of medical insurance and access to affordable health care continue to disproportionately affect African Americans.
The problem is further compounded by other social determinants of health like wealth inequality, food insecurity, and lack of safe and affordable housing. All these factors increase the health risks of African Americans and their ability to obtain insurance.
African Americans and other marginalized communities should not bear the burden of coping with racism alone. There is an overarching need to address structural disadvantages, institutionalized racism, and socioeconomic deprivation to reduce discrimination.
On an individual level, there are also other steps such as talking about experiences and seeking assistance to help cope with the adverse physical and mental effects of racism.
Bottling up racial discrimination experiences can worsen the feelings of stress, frustration, and anger. Engaging with racial discrimination instead of ignoring it is more beneficial.
Individuals and communities should also foster a strong sense of racial identity. Studies show that doing so helps blunt or buffer the effects of racism. Communities are less likely to be distressed or mentally affected by discrimination when they feel strongly about their racial identity.
It is crucial to have a network of friends, family, and professionals to talk to for support, comfort, and advice. This will help people cope with the effects of racial discrimination and also foster a sense of security and identity. Having a robust support system may also help combat depression. A mental health professional can also provide a safe space to discuss and sort through feelings and hopefully improve overall mental health.
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