Discrimination and racial disparities in health: evidence and needed research
Open accessAbstract
This paper provides a review and critique of empirical research on perceived discrimination and health. The patterns of racial disparities in health suggest that there are multiple ways by which racism can affect health. Perceived discrimination is one such pathway and the paper reviews the published research on discrimination and health that appeared in PubMed between 2005 and 2007. This recent research continues to document an inverse association between discrimination and health. This pattern is now evident in a wider range of contexts and for a broader array of outcomes. Advancing our understanding of the relationship between perceived discrimination and health will require more attention to situating discrimination within the context of other health-relevant aspects of racism, measuring it comprehensively and accurately, assessing its stressful dimensions, and identifying the mechanisms that link discrimination to health.
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Previous findings indicate that the association between racism and health is stronger in studies that employ multiple item or multiple domain measures of racism.
“The latter resonates with previous findings that the association between racism and health is stronger in studies that employ multiple item or multiple domain measures of racism [10, 22, 419].”
From Racism as a Determinant of Health: A Systematic Review and Meta-Analysis (2015) · cites this paper as [22]
In “Measuring discrimination accurately” (page unavailable), the paper recommends measuring multiple domains and asking multiple questions within each domain, saying this improves assessment. In “Measuring perceived discrimination comprehensively” (page unavailable), it says incomplete stress assessment can underestimate effects on health. It does not report a comparison showing that studies using multiple-item or multiple-domain racism measures find stronger racism–health associations. (LLM, conf=0.83)
Experimental — accuracy not yet measuredSystematic environmental effects that contribute to an increase in non-genetic risk factors in African Americans-current and historical racism, for instance-could explain the marked health differences between African Americans and European Americans.
“Whereas natural selection cannot easily explain the observed population difference, systematic environmental effects that contribute to an increase in non-genetic risk factors in African Americans—current and historical racism, for instance [53–55]—could, on the other hand, explain such marked differences.”
From Interpreting polygenic scores, polygenic adaptation, and human phenotypic differences (2019) · cites this paper as [55]
Structural racism is a pervasive determinant of health that adversely affects behavioral, mental, and physical health across the lifespan.
“Structural racism is a pervasive determinant of health that adversely affects behavioral, mental, and physical health across the lifespan.”
For Black youth, structural racism effects manifest in elevated rates of depressive and anxiety disorders, PTSD, substance use, suicidality, and physical conditions such as early onset hypertension, obesity, and cardiovascular disease.
“For Black youth, these effects manifest in elevated rates of depressive and anxiety disorders, post-traumatic stress disorder (PTSD), substance use, suicidality, as well as physical health conditions such as early age onset of hypertension, obesity, and cardiovascular disease [ 7 ].”
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References 256 · Cited by 3,371
- Authors
- Williams, D. R., & Mohammed, S. A.
- Affiliations
- Harvard University (US)
- University of Washington Bothell (US)
- Corresponding author
- Williams, David R.
- Venue
- Journal of Behavioral Medicine
- Published
- 2008-11-22
- Volume
- 32
- Issue
- 1
- Pages
- 20-47
- ISSN
- 0160-7715 (ISSN-L)
- 1573-3521
- PMC
- PMC2821669
- OpenAlex
- W2157096064
- Cited by
- 3,371
- References
- 256
- Citations by year
- 2026: 179 · 2025: 249 · 2024: 207 · 2023: 219 · 2022: 233 · 2021: 242 · 2020: 222 · 2019: 255 · 2018: 193 · 2017: 258 · 2016: 214 · 2015: 208 · 2014: 170 · 2013: 158 · 2012: 149
- FWCI
- 39.66
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- University Libraries (University of Maryland) (submittedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Digital Repository at the University of Maryland (University of Maryland College Park)
- Funders
- National Institutes of Health (5u01hl087322-05)
- National Heart, Lung, and Blood Institute (U01-HL 087322, U-01 HL 87322-02, 3U01HL087322-02S1)
- National Institute of Mental Health (R01MH059575, R01 MH 59575)
- Topics
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Sociology and Political Science › Gender, Health, and Social Inequality
- Keywords
- perceived discrimination, racial disparities in health, racism, health outcomes, stress, discrimination measurement, social determinants of health
- MeSH terms
- Ethnicity, Female, Health Services Accessibility, Humans, Male, Perception, Prejudice, Residence Characteristics, Sex Factors, Stress, Psychological, Healthcare Disparities
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