Perceived discrimination and health: A meta-analytic review.

Pascoe, Elizabeth A.; Smart Richman, Laura

doi:10.1037/a0016059

Cited by 4,427Racial and Ethnic Identity ResearchHealth disparities and outcomesSocial and Intergroup Psychology

Perceived discrimination and health: A meta-analytic review.

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Pascoe, Elizabeth A., Smart Richman, Laura·2009·Psychological Bulletin

DOI 10.1037/a0016059PMC PMC2747726

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Abstract

Perceived discrimination has been studied with regard to its impact on several types of health effects. This meta-analysis provides a comprehensive account of the relationships between multiple forms of perceived discrimination and both mental and physical health outcomes. In addition, this meta-analysis examines potential mechanisms by which perceiving discrimination may affect health, including through psychological and physiological stress responses and health behaviors. Analysis of 134 samples suggests that when weighting each study's contribution by sample size, perceived discrimination has a significant negative effect on both mental and physical health. Perceived discrimination also produces significantly heightened stress responses and is related to participation in unhealthy and nonparticipation in healthy behaviors. These findings suggest potential pathways linking perceived discrimination to negative health outcomes.

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When differential or unfair treatment is perceived as racially motivated, it triggers physiological, cognitive-affective, and behavioral responses.
“When differential or unfair treatment is perceived as racially motivated, it triggers physiological (eg, cardiovascular reactivity, dysregulated hypothalamic-pituitary-adrenal axis activity), cognitive-affective (eg, rumination, emotion suppression), and behavioral (eg, avoidance, aggression) responses that prepare the individual to confront the situation [6-8].”
From App-Based Mindfulness Meditation for People of Color Who Experience Race-Related Stress: Protocol for a Randomized Controlled Trial (2022) · cites this paper as [7]
The Results section (‘The Perceived Discrimination–Stress Response Link’; page unavailable) reports cardiovascular and psychological stress responses to perceived discrimination, including racially charged experimental scenarios. The paper also discusses avoidant and active coping, but the passages do not establish rumination, emotion suppression, or aggression as responses, or say that all these responses prepare a person to confront the situation. (LLM, conf=0.85)
Experimental — accuracy not yet measured
Moderation by age, sex, education level and birthplace has been inconclusive in previous systematic reviews and meta-analyses.
“Moderation by age, sex, education level and birthplace of study participants has been found in previous individual studies (e.g., [42, 414]) but has been inconclusive in previous systematic reviews and meta-analyses [e.g., [13]).”
From Racism as a Determinant of Health: A Systematic Review and Meta-Analysis (2015) · cites this paper as [13]
The Results (page unavailable) report no significant gender moderation for mental or physical health, but significant gender moderation for health behaviors in a small set of studies. The Discussion > Limitations says age and education could not be adequately accounted for in the meta-analysis. Our copy does not establish an inconclusive moderation finding for birthplace, so the four-variable claim is only partly supported. (LLM, conf=0.84)
Experimental — accuracy not yet measured
This contrasts with the findings reported by Pascoe and Richman [13], where the association between perceived discrimination and physical health compared to mental health did not differ significantly.
“This contrasts with the findings reported by Pascoe and Richman [13], where the association between perceived discrimination and physical health compared to mental health did not differ significantly.”
From Racism as a Determinant of Health: A Systematic Review and Meta-Analysis (2015) · cites this paper as Pascoe and Richman [13]
Extensive evidence shows negative mental health effects of race-related stress in POC.
“Despite extensive evidence showing the negative mental health effects of race-related stress in POC [6-11,14-17] and the promise of mindfulness meditation to help these individuals cope [20-24,26,30-32,79], this evidence-based treatment continues to be understudied among this high-risk population in both traditional [30,35,36] and digital formats [46-48].”
From App-Based Mindfulness Meditation for People of Color Who Experience Race-Related Stress: Protocol for a Randomized Controlled Trial (2022) · cites this paper as [7]

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Campbell RER The effect of sexist discrimination on women’s health (Doctoral dissertation, Loma Linda University, 2000) Dissertation Abstracts International 2000 61 4B 2192
Huebner DM Mental and physical health consequences of perceived discrimination (Doctoral dissertation, Arizona State University, 2002) Dissertation Abstracts International 2002 63 2B 1030
Rodriguez MS Effects of perceived discrimination on mental health: Exploring intervening relationships (Doctoral dissertation, Kent State University, 2004) Dissertation Abstracts International 2004 65 9A 3589
Williams DR Spencer MS Jackson JS Contrada RJ Ashmore RD Race, stress, and physical health: The role of group identity Self, social identity, and physical health: Interdisciplinary explorations 1999 New York Oxford University Press 71 100

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Racism as a Determinant of Health: A Systematic Review and Meta-Analysis
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“More recently, two large-scale meta-analyses focused on the relationship between discrimination more generally, and mental health [13, 23] and physical health [13].”
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Racism and health: evidence and needed research
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The consequences of perceived discrimination for psychological well-being: A meta-analytic review.
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Impact of weight bias and stigma on quality of care and outcomes for patients with obesity
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Racism and Health I: Pathways and Scientific Evidence
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The social determinants of mental health and disorder: evidence, prevention and recommendations
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Stress and the mental health of populations of color: advancing our understanding of race-related stressors.
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Self-Reported Experiences of Discrimination and Health: Scientific Advances, Ongoing Controversies, and Emerging Issues
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The UCL–Lancet Commission on Migration and Health: the health of a world on the move
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Discrimination and Health Inequities
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Reactions to discrimination, stigmatization, ostracism, and other forms of interpersonal rejection: A multimotive model
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A systematic review of studies examining the relationship between reported racism and health and wellbeing for children and young people
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Methods for the Scientific Study of Discrimination and Health: An Ecosocial Approach
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Minority stress and physical health among sexual minorities
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Discrete emotions predict changes in cognition, judgment, experience, behavior, and physiology: A meta-analysis of experimental emotion elicitations.
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The EASL–Lancet Liver Commission: protecting the next generation of Europeans against liver disease complications and premature mortality
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More than skin deep: Stress neurobiology and mental health consequences of racial discrimination
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Physical and Mental Health of Transgender Older Adults: An At-Risk and Underserved Population
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Health Behavior Change: Moving from Observation to Intervention
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The effects of social isolation stress and discrimination on mental health
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Discrimination and sleep: a systematic review
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“Indeed, a vast amount of research shows that perceived discrimination may undermine health among stigmatized groups (for a review see Pascoe & Richman, 2009).”
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‘I never realised everybody felt as happy as I do when I am around autistic people’: a thematic analysis of autistic adults’ relationships with autistic and neurotypical friends and family
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Transmitting Trauma: A systematic review of vicarious racism and child health
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A Systematic Review and Meta-analysis of the Effects of Meditation on Empathy, Compassion, and Prosocial Behaviors
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Multiple Disadvantaged Statuses and Health
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The Risks of Ageism Model: How Ageism and Negative Attitudes toward Age Can Be a Barrier to Active Aging
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Stigma-based bullying interventions: A systematic review
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Authors: Pascoe, E. A., & Smart Richman, L.
Affiliations: Duke University (US)
ORCID: Pascoe, Elizabeth A.
Venue: Psychological Bulletin
Publisher: American Psychological Association (APA)
Published: 2009
Volume: 135
Issue: 4
Pages: 531-554
ISSN: 0033-2909 (ISSN-L)
1939-1455
DOI: 10.1037/a0016059
PMC: PMC2747726
OpenAlex: W2120100418
Semantic Scholar: 886863c7ce89acfe9551d8fca9699381297cef52
Cited by: 4,427
References: 275
Citations by year: 2026: 244 · 2025: 327 · 2024: 352 · 2023: 347 · 2022: 373 · 2021: 398 · 2020: 347 · 2019: 326 · 2018: 303 · 2017: 291 · 2016: 279 · 2015: 239 · 2014: 183 · 2013: 165 · 2012: 129
FWCI: 268.43
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Psychological Bulletin (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
SSRN Electronic Journal (submittedVersion)
DukeSpace (Duke University) (submittedVersion, cc-by-nc-nd)
Funders: National Institute of Mental Health (K01MH074942, 1 K01-MH074942-02)
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 › Social and Intergroup Psychology
Keywords: perceived discrimination, health outcomes, mental health, physical health, stress response, physiological stress, psychological stress, health behavior, harmful habits
MeSH terms: Adaptation, Psychological, Anxiety, Arousal, Depression, Humans, Models, Psychological, Prejudice, Psychophysiologic Disorders, Risk Factors, Social Perception, Health Behavior

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Perceived discrimination and health: A meta-analytic review.

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