How prejudice can harm your health

Long before the Rev. Dr. Martin Luther King declared health inequity the most shocking and inhumane form of injustice, W.E.B. Du Bois wrote that “the Negro death rate and sickness are largely matters of condition and not due to racial traits and tendencies.” Before Du Bois made his case, James McCune Smith — the nation’s first black doctor — carefully detailed the health consequences of freedom and oppression.

These men grasped an insight that modern researchers and policy makers often fail to make explicit: Discrimination, especially when chronic, harms the body and the mind. How we treat one another, and how our institutions treat us, affects how long and how well we live.

These men grasped an insight that modern researchers and policy makers often fail to make explicit: Discrimination, especially when chronic, harms the body and the mind. How we treat one another, and how our institutions treat us, affects how long and how well we live.

Research suggests that discrimination is internalized over a lifetime, and linked to a variety of poor health markers and outcomes: more inflammation and worse sleep; smaller babies and higher infant death rates; a greater risk of cancer, depression and substance use. The cumulative burden of discrimination is linked to higher rates of hypertension and more severe narrowing of important arteries in the heart and neck. Even the telomeres at the end of our chromosomes, which act as a sort of timer for aging cells, can shorten.

Discrimination, of course, is only part of the health equation. Individuals are not doomed to disease because of their circumstances. Health and illness are the result of a complex interplay between genetics, behavior and environmental conditions. But experiencing persistent bias can tip the scale.

In one study, researchers asked black women to complete questionnaires on how often they experienced minor “everyday” discrimination, as well as major instances of unfair treatment in housing, employment or with the police. They then followed the women for six years, and found that those who had reported more frequent discrimination were more likely to develop breast cancer. The more pervasive the reported discrimination, the higher their risk.

This remained true even after adjusting for more than a dozen other factors like family history, education level, physical activity and use of hormonal supplements or oral contraceptives. Similar work has found that discrimination is a strong predictor of lower back pain in black patients — but not in white patients, who were less likely to report discrimination and for whom discrimination was unrelated to pain.

To test this theory, researchers used surveys to assess the extent of lifetime discrimination that black and white patients had experienced. They then injected patients with phenylephrine (a chemical similar to adrenaline) and found that black patients had a larger temporary increase in blood pressure than white patients.

©2017 The New York Times News Service