Stress and Public Health: Reflections a Week after Charlottesville.

charlottesville

Some folks’s morning routine encompasses some variant of wash, rinse, and repeat. My morning routine is a bit different:

  1. Get up.
  2. Do devotion and pray my younger brothers don’t get racially profiled by the police between the time I saw them last and the time I see them again.
  3. Look in the mirror and remind yourself you have to be twice as good.
  4. Shower and brush my teeth.

It’s different because I’m black. And being black in America is stressful.

The Charlottesville catastrophe is one of the lovely, contributing factors to my stress. We can thank them for adding to the African-American narrative (for more information – check out this post on narrative ethics) later. The whole incident makes me sick. Mind you, I’m not sick because I’m surprised. I’m sick because I’m reminded once again that my skin color is enough to provoke hatred, even though those protestors know nothing about me. And though I’m not surprised, I thought it would be appropriate to talk about how racialized stress effects blacks in this country.

Health disparities and stress amongst African-Americans are not new. They are usually attributed to poverty, access, and the proverbial “hood”/”the streets.” However, in examining these valid factors, one must examine the effects of racism on health. To quote Dr. Amani Nuru-Jeter, Associate Professor of Epidemiology and Community Health Sciences at Berkeley School of Public Health,

“In our own work, we find that the “wear” associated with chronic racial discrimination, referenced in the quotes above, is linked with poor health, especially among those who are vigilant about, or expecting, mistreatment because of their race. The constant awareness of one’s race and feeling the need to “brace yourself” for the possibility of being treated differently because of race, as we have found in our work, is a consequence of repeated exposure to racial discrimination. Eric Garner’s cry for help – I can’t breathe – exemplifies this “wear,” both literally and figuratively.”

In the journal article Diagnosing Discrimination: Stress from Perceived Racism and the Mental and Physical Health Effects, Dr. Kathryn Freeman found that the effects of race on stress is significant.  This study found that blacks were .06% more likely to experience emotional health symptoms due to perceived racism. That shift in emotional stress also feeds into the physical stress of an individual – naturally with devastating effects. Dr. Freeman’s data also shows that the emotional stress perceived racism creates leads to more “poor mental health days”. These dynamics have also been documented and discussed to a greater degree in the article, Racism and Psychological and Emotional Injury: Recognizing and Assessing Race-Based Traumatic Stress.

Racialized stress also has tangible physical effects on an individual’s health. Both NPR and the Washington Post have have addressed a recent study done by researchers at the University of Wisconsin-Madison. This study found that African-Americans were 60% more likely to have stressful life events than Whites and that these stressful events added aged African-American’s brains four years. It only aged White Americans brain’s about 1.5 years. These results were also consistent regardless of the subjects’ living in areas with high infant mortality rates (which usually is an indicator of poverty and lack of access to medical care) or areas with lower rates. Based on these results, other researchers have looked further into the social effects on African-American’s brain aging. Kaiser Permanente and the University of California at San Francisco joined together to work on a study that examined clinical exam data for Kaiser Permanente members born between 1919 and 1932. Cross-referencing the selected members with states with the highest infant mortality rates in 1928, it was found that these members had a 40% higher risk of dementia – even while accounting for education and health disparities. Racialized stress is also correlated to pregnancy. Over 16% of African-American babies born in 2013 were preterm – 6% higher than white babies. African-American women also tend to have babies with lower birth weights than white women. Even while accounting for socioeconomic factors and health disparities, the birth weight gap still persists.

The evidence is out there. Racialized stress is a public health issue. Follow the bouncing ball – consistently stressed people will have poorer quality emotional and physical health. Poor quality emotional and physical health leads to less healthy families and community members. And even if you don’t believe that racialized stress exists, you are missing the point. Consistently perceived danger is almost as detrimental as actualized danger because it all leads down the same roads. We don’t really have an excuse anymore though. Charlottesville happened. The increase in cases of anxiety and depression in minorities between November 2016 and January 2017 aren’t myths. And I’m sure I’m not the only one that’s black and stressed.

*Taking deep breaths*,

The Neighborhood Bioethicist

 

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SOURCES

Anderson, Kathryn Freeman. “Diagnosing Discrimination: Stress from Perceived Racism and the Mental and Physical Health Effects*.” Sociological Inquiry 83, no. 1 (February 1, 2013): 55–81. doi:10.1111/j.1475-682X.2012.00433.x.
Brodish, Amanda B., Courtney D. Cogburn, Thomas E. Fuller-rowell, Stephen Peck, Oksana Malanchuk, and Jacquelynne S. Eccles. “Perceived Racial Discrimination as a Predictor of Health Behaviors: The Moderating Role of Gender.” Race and Social Problems; New York 3, no. 3 (October 2011): 160–69. doi:http://dx.doi.org.ezproxy.bu.edu/10.1007/s12552-011-9050-6.
“EARLY LIFE STRESS AND COPING IN AFRICAN AMERICANS: EFFECTS OF RACIAL DISCRIMINATION AND AWARENESS ON ADULT HEALTH.” The Gerontologist 55, no. Suppl_2 (November 1, 2015): 339–339. doi:10.1093/geront/gnv636.05.
“Fact Sheet: Health Disparities and Stress.” Http://Www.apa.org. Accessed August 16, 2017. http://www.apa.org/topics/health-disparities/fact-sheet-stress.aspx.
“‘I Can’t Breathe’: Racial Injustice as a Determinant of Health Disparities.” RWJF, January 15, 2015. http://www.rwjf.org/en/culture-of-health/2015/01/_i_can_t_breather.html.
Matthews, Derrick D., Wizdom Powell Hammond, Amani Nuru-Jeter, Yasmin Cole-Lewis, and Travis Melvin. “Racial Discrimination and Depressive Symptoms among African-American Men: The Mediating and Moderating Roles of Masculine Self-Reliance and John Henryism.” Psychology of Men & Masculinity, Recent Research on the Health and Well-Being of African American Men, 14, no. 1 (January 2013): 35–46. doi:10.1037/a0028436.
Ofri, Danielle, Stefan Kertesz, and Sally Satel. “Should Doctors Treat Trump Anxiety?” Slate, January 19, 2017. http://www.slate.com/articles/health_and_science/medical_examiner/2017/01/americans_are_experiencing_election_induced_medical_symptoms.html.
“‘Post-Election Stress Disorder’ Sweeps the Nation.” PBS NewsHour. Accessed August 20, 2017. http://www.pbs.org/newshour/rundown/post-election-stress-disorder-sweeps-nation/.
Shandanette Molnar. “Racial Disparities in Birth Outcomes and Racial Discrimination as an Independent Risk Factor Affecting Maternal, Infant, and Child Health.” Accessed August 20, 2017. https://mana.org/pdfs/ExecutiveSummary-Race-2015.pdf.
Silverstein, Jason. “How Racism Is Bad for Our Bodies.” The Atlantic, March 12, 2013. https://www.theatlantic.com/health/archive/2013/03/how-racism-is-bad-for-our-bodies/273911/.
“Stress of Poverty, Racism Raise Risk of Alzheimer’s for African Americans, New Research Suggests.” Washington Post. Accessed August 16, 2017. https://www.washingtonpost.com/local/social-issues/stress-of-poverty-and-racism-raise-risk-of-alzheimers-for-african-americans-new-research-suggests/2017/07/15/4a16e918-68c9-11e7-a1d7-9a32c91c6f40_story.html.
Thayer, Zaneta. “Racism Hurts Your Health—and Your Children’s, Too.” The New Republic, January 27, 2015. https://newrepublic.com/article/120858/racism-has-intergenerational-effects-health.
“Why Racism Is A Public Health Issue.” Accessed August 18, 2017. https://thinkprogress.org/why-racism-is-a-public-health-issue-b01056c63e44/.

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