How Discrimination Shapes the Health of American Racial and Ethnic Minorities
By Lauren Howe
Racial and ethnic minority Americans have worse overall health than White Americans. What causes this difference, and what can we do to close this gap?
When we think of things that make up our health, we might have all sorts of ideas: eating healthy, exercising, getting enough sleep, and preventing illness. But what we might not think of is how discrimination impacts health. New research presented at the SPSP Annual Convention symposium “Stigma and Ethnic-Racial Health Disparities: New Directions in Understanding Social-Cognitive Mechanisms,” shows that discrimination may damage the health of racial and ethnic minorities and contribute to racial and ethnic differences in health in the U.S.
New research by Elizabeth Brondolo explores how discrimination may explain why minority racial groups struggle with depression more than Whites. Brondolo measured people’s exposure to racism: how much people said they had been excluded, looked down upon, or harassed because of their race or ethnicity. The more people had experienced racism, the more they worried that people (especially those from other racial and ethnic backgrounds) would not understand their concerns or experiences. This belief that people would not be supportive was in turn related to depression. Could changing these beliefs break the link between race and depression.
Considering discrimination might also help us understand why African-Americans are more likely to be infected with HIV. Michelle Stock and her colleagues led their 18-25 year old African-American participants (95% of whom said they had experienced discrimination before) to believe that they had been excluded by either same-race or White peers using the online task Cyberball. When excluded by White peers, these young adults felt that they had been treated unfairly. These feelings of discrimination lead to anger and lower feelings of control, which in turn increased reports that these participants would be willing to use drugs or engage in risky sex – both risk behaviors associated with HIV infection.
The knowledge created by these researchers can help us find solutions for healthcare inequalities. One promising example aims to reduce doctors’ implicit biases, or the automatic associations healthcare providers have about patients from different racial groups. For instance, past research shows that doctors and nurses associate Hispanic or Latino patients with noncompliance, and White patients with compliance. New research from Jeff Stone and his colleagues finds that teaching medical students about implicit bias can help reduce it. In their program, students analyzed tapes of physicians showing implicit bias toward patients. They also worked in groups to identify and practice strategies for combating implicit bias, such as looking for a common, shared identity with patients. At the end of this program, students had reduced implicit biases, especially majority group medical students.
Thinking about how discrimination influences health can help address important health inequalities. In addition, this research expands our ideas about health by showing how our social environments can shape our health.
Lauren Howe is a 5th year PhD candidate in social psychology at Stanford University and the Shaper Family Stanford Interdisciplinary Graduate Fellow. Her research interests include rejection, patient-physician interactions, and trust in experts.
The symposium, Stigma and Ethnic-racial Health Disparities: New Directions in Understanding Social Cognitive Mechanisms was Chaired by Luis Rivera (risclab.rutgers.edu), Rutgers University and Co-Chair, Irene Blair, University of Colorado Boulder (psych.colorado.edu/~blair/).