Researchers studying the effects of racism on public health have their work cut out for them. Racism is famously difficult for social scientists to quantify because, for the most part, you can't just walk up to a person on the street, ask them if they're racist, and expect an honest answer. Over the past 50 years, the racist attitudes and opinions of most Americans have quietly gone to hide in the underground bunkers of our subconscious, and are usually expressed in small ways, unintentionally. Explicit racism that's out in the open as part of civic or business policy, for instance, is becoming less common in most parts of the US, but it's still out there.
It's been well documented that living in a racially hostile environment isn't great for the health of anybody who happens to be black. But a study published in the journal Psychological Science finds that both black residents and, to a lesser degree, white residents living in overtly racist communities around the country are dying of heart disease and other circulatory diseases at a higher rate than the national average. And whites with explicitly racist feelings die of circulatory diseases more than whites who don't recognize their own implicit racism.
"While most previous research has examined relationships between blacks' perceived racism and their own health, we examined relationships between whites' actual racial bias and the health of both blacks and whites in their community," says study lead author Jordan Leitner, a postdoctoral fellow in psychology at UC Berkeley.
The researchers also found this relationship between racism and poor health across a larger set of communities than has ever been studies before. Using a decade's worth of Centers for Disease Control data collected between 2003 and 2013, the research team examined death rates from circulatory diseases like heart attacks, angina, and coronary heart disease in counties all over the United States. They compared these data to racial bias data compiled from the responses of more than 1.4 million white people living in more than 1,000 communities.
This data was collected by Project Implicit, a website that offers a free test that measure both a person's conscious and subconscious thoughts and feelings in regards to gender, religion and race. Project Implicit measures overt racism with a pretty straightforward test asking the participant to measure how warm their feelings are toward black and white people on a scale of 0-10. Overt racism is defined as a stronger warmth toward white people than towards black people.
As implicit racial bias is tough to pull out of most folks, Project Implicit does this in a roundabout way. Their participants are given the task of sorting a set of words like "pain" or "peace" into either a "good" or "bad" category. They are also asked to categorize faces as either "African American" or "European American." On some trials, participants use the same button to categorize African American faces and words they deemed "bad," and in others they use the same button to categorize African-American faces and "good" words. Participants are said to have more implicit racial bias when they are faster at making categorization responses when the "bad" and "African American" categories share a button than when the "good" and "African American" categories share a button. (Project Implicit' data focused exclusively on black and white Americans, and did not analyze biases against other specific groups of people.)
Comparing these large data sets, the researchers found a link between poor circulatory health and living in a bigoted community — and this effect went beyond the fact that black people had less access to healthcare in these communities.
"This approach demonstrates that we can use large datasets to gain insight into how psychological phenomena relate to health on a massive scale," says Leitner. "One interesting finding from this study is that whites' explicit racial bias predicted greater circulatory death rate for both blacks and whites, even after accounting for a large set of sociodemographic factors, including income, education, population, and whether the community was rural or urban. This suggests that greater racial hostility is related to poorer health for both the group targeted by the hostility, as well as the group that harbors this hostility."
According to Leitner, these health problems can probably be chalked up to living under chronic stress, which previous research suggests leads to chronic inflammation and other physical impacts. Chronic inflammation, in turn, contributes to poor cardiovascular health. He and his colleagues are currently designing a study that will examine whether people in racially hostile communities show signs of heightened inflammation.
Leitner says he hopes this research will lead to a better understanding of the source of racial health disparities:
"Though this research does not establish causality, it does raise the possibility that racial hostility in one's environment contributes to important health outcomes," he says. "I think that as we learn more about why racial bias was related to racial disparities in health care and death rates, we will be better able to design interventions that improve the health of individuals and communities."