Physicist and social justice crusader Albert Einstein once referred to American racism as a "disease of white people." He was speaking metaphorically, but a host of research in recent years has shown that racism, like a disease, can harm the physical health of both its victims and its perpetrators. Now, the results of a national survey find that children who experience racism appear to be at higher risk of anxiety and depression, and tend to have poorer health in general.
There is no way to pinpoint any one cause behind the results of the survey, which is still awaiting peer review. But one explanation supported by previous research is that racism is stressful: These negative experiences increase stress hormones that tax the body’s immune system, and over time can erode physical health. "These associations were very strong in our data,” says Ashaunta Anderson, a University of California at Riverside pediatrician and author of the new analysis.
Anderson has spent almost a decade looking at how well children are prepared for school and how that affects their health, using surveys and focus groups. But in the last few years, she decided to focus specifically on how racism affects childhood health after finding that minority children tended to enter class far less prepared. "I realized what I was really more interested in were the race-based gaps," Anderson says. "Why aren't we looking at race itself?"
When she began surveying parents of young children preparing to enter kindergarten in California, she found that many had deep concerns about whether their children would face racism and how it would affect them. "I thought a good next step was just to describe the scope of the problem,” Anderson says. "What exactly does racial discrimination have to do with child health? And what might parents be able to do to counter any ill effects?"
Next, Anderson turned to the U.S. Census Bureau's National Survey of Children's Health, which randomly looks at the physical and mental health of one child from more than 95,000 American households. One question on the survey asks parents whether their child “was ever treated or judged unfairly because of his/her race or ethnic group.” Anderson tracked answers to this question, and compared them to the prevalence of various health issues that children were reported as having, including obesity and ADHD.
She found that a child's odds of having ADHD increased by 3.2 percent with exposure to racism, regardless of their socioeconomic background. She also found that children who had been exposed to racism were also more likely to suffer from anxiety and depression. Outside of mental health, those who experienced incidences of racism were more than 5 percent less likely to be rated as having "excellent" general physical health by their parents.
Why does this happen? "The more conservative answer is we can't be sure," Anderson says, because they were relying on only one question in the survey related to racial discrimination. However, the same children who tended to suffer anxiety and depression also tended to be reported as having worse general health by parents, Anderson says, meaning that the stress of racism could be playing a role in harming these kids physically. Anderson will present the preliminary results of her analysis, “The Detrimental Influence of Racial Discrimination in the United States,” this Sunday at the 2017 Pediatric Academic Sciences Meeting.
In her own work, Dartmouth University biological anthropologist Zaneta Thayer has found a similar relationship between racism and increased levels of the stress hormone cortisol, which can negatively impact the body’s immune system. In pregnant women, changes in the levels of this hormone and others can result in lower birth weights or changes in the cortisol levels of the fetus. "These findings suggest that discrimination experience can have biological impacts in pregnancy and across generations," she writes.
In a 2015 article in The New Republic, Thayer cites other studies concluding that African-Americans who experience racism often have what are considered unhealthy levels of cortisol, while young Hispanic people who perceived that they were being discriminated against had higher cortisol levels. African-American men who were the victims of racism even seem show genetic signs of early aging, University of Maryland researchers reported in 2014.
"This research complements a growing literature documenting the wide range of effects that racial discrimination has on health across the life course," says Thayer of Anderson's work. "These findings suggest that some individuals may be predisposed to poorer health in adulthood based on discrimination experiences in early life."
She cautions, however, that extrapolating causes from surveys that captures merely a snapshot of a child's health and experiences during one moment in time is difficult, and that relying on self-reported data from parents can lead to inaccurate figures.
"Nevertheless they are important and very interesting findings," Thayer says. "I hope that they will convince policymakers that an effective way to improve population health is to reduce the disproportionate burden of stress exposures, such as racial discrimination, on socially disadvantaged members of our society."
As to how that could be done? “I suppose that’s the million dollar question,” Thayer says. She sees the creation and enforcement of stronger anti-discrimination laws as a first step. Furthermore, Thayer says, “reducing poverty among minority children, while not necessarily directly reducing discrimination exposure, would likely give children more material and social resources to help buffer the negative impacts of discrimination on their development and health.”
It should be noted that Anderson didn’t control for access to healthcare in her survey. However, using the Census data, she was able to separate out children based on their families’ socioeconomic status—a factor that she notes “often predicts whether people can access healthcare well or not.” A study published last year by University of California at Berkeley researchers found that decreased access to healthcare among minorities could exacerbate the negative health effects of racism that they experience.
And the victims of racism aren’t the only ones facing its negative effects, according to the same Berkeley research. White people living in areas with intense racism toward African-Americans have been shown to be nearly 15 percent more likely suffer from heart disease, the authors found. A 2015 study from the University of Pennsylvania suggested that this could be because “community-level racial prejudice” makes it harder for people of all races to form social bonds, which has been shown to lead to higher risks of death.
The idea of looking at racism as a health problem that can be addressed chemically or psychologically is not a new one. In past years, some psychiatrists have proposed classifying "extreme racism" itself as a mental health condition in the Diagnostic and Statistical Manual of Mental Disorders. Others have investigated the possibility of a “racism pill” that could reduce implicit bias. These ideas have received pushback: Others argue that classifying racism as a disease absolves the racist person of their actions.
While systematic racism can seem daunting to confront as an individual, "there are things that families and parents and people can do," Anderson says. Studies have shown that minority children have reduced levels of anxiety when their parents reaffirm pride in their cultural background, she says.
"I usually tell parents to try to do activities that reinforce those things for their children," Anderson says, while avoiding strategies such as "promotion of mistrust," in which parents can consciously or unconsciously condition their children to avoid people of other races. Still, little research exists into ways to improve the health of children who are actively experiencing racism. In the future Anderson hopes to do just that, by following these childrens' health over time.