How Does Discrimination Affect People’s Health?

How Does Discrimination Affect People’s Health?


In clockwise order: Amani Nuru-Jeter, Zuelma Esquivel, Samantha Ang, and Nadia Safaeinili at UC Berkeley.

A UC Berkeley professor is studying the dynamics of how African-American women are affected by racism—and why socioeconomic status matters to health.

HuNia Bradley was riding BART recently when a police officer boarded the train. Immediately, the Richmond resident got tense.

“I was like, ‘Oh, shoot.’ Because as he was getting on, there were some gentlemen—two young African Americans—who were getting ready to do … a little dance,” she said.

Bradley, who is also African American, said she noticed the officer kept looking over at the two young men and was “tensing up” and “getting irritated.”

As the men began to perform for their fellow BART passengers, Bradley became scared. “I was looking [at the officer] and trying to send a message like, ‘Don’t you go over there; don’t you go over there.’ I remember thinking that I might have to do something. I was preparing how I was going to intervene, because it was not going to happen on my watch. I just remember feeling like, ‘Oh, my god, I’m going to start crying. Because if it goes down, I will be the one.’ ”

Although the officer didn’t do anything to the young men, Bradley said the experience “messed with [her] for a week.”

This heightened emotional response is something that Amani Nuru-Jeter, an associate professor at UC Berkeley’s School of Public Health, calls “anticipatory racism threat.” She describes it as a chronic experience of racism: “When you experience something so much that at a certain point, you just expect for it to happen.”

Scientists and researchers know plenty about how stress affects the body. They also know that, in general, African Americans have higher levels of biological dysregulation—meaning dysfunction of multiple regulatory systems in the body, including neuroendocrine, inflammatory, cardiovascular, and metabolic systems—than whites, and the problem is even worse among black women. There’s also an established link between chronic inflammation and racial discrimination among African-American women. But less is known about how biological dysregulation and racial discrimination are connected.

In 2012, Nuru-Jeter embarked on a study to find out just that. Her goal was to explore the association between chronic social stress, including racial discrimination, and mental and physical health among African-American women. In particular, she wanted to understand how the way African-American women assess the racism they experience and the way they cope with it affects the degree to which it impacts their health.

The African American Women’s Heart & Health Study recruited 200 self-identified African-American women between the ages of 30 to 50 residing in the Bay Area, mostly the East Bay. Bradley was one of them. Nuru-Jeter and her fellow researchers looked at the ways in which women cope with or manage chronic social stress, and then took a blood test to measure things such as metabolic function, inflammation, neuroendocrine responses, and cardiovascular health.

Although the study was finished in 2013, Nuru-Jeter is only now beginning to analyze the results. So far, her findings have confirmed an association between racial discrimination and increased inflammation, elevated blood pressure, and overall system dysregulation among the women she surveyed. One study participant, Charlene Rogers, said in an interview that a recent experience of being treated unequally at a bakery in El Sobrante raised her blood pressure. (Another recent UC Berkeley study found that black people who live in overtly racist communities are more prone to dying from heart disease and other circulatory diseases.)

How women cope with their stress also plays a role in their health, Nuru-Jeter said. “One example of that is a measure we had called ‘superwoman schema,’ which is this concept of the strong black woman, which is very predominant in black communities, dating back to Sojourner Truth and all of that,” she explained. “Women say it’s a protective thing; it’s their armor. One of the things we’re studying is the degree to which adopting this armor impacts their health. In some ways it’s protective, and in other ways it’s damaging.”

Nuru-Jeter also found that the association between racial discrimination and biological functioning differs depending on socioeconomic status. For example, for the group that had a higher level of education (considered above a high school diploma), increased levels of racial discrimination were associated with lower physiological dysfunction, whereas the opposite was true for those with lower levels of education.

Why the difference? Nuru-Jeter believes that it could be attributed to differences in coping styles or “one’s ability or willingness to recognize racism in its many forms. Because we know that when we recognize, acknowledge, or name racism, that in and of itself can buffer or minimize the negative health consequences of racial discrimination,” she said. Access to resources, such as financial or emotional support, could be another factor.

Nuru-Jeter hopes to expand on her work, and in the meantime is submitting her findings to journals. Her goal is to increase awareness of discrimination’s role in health so that it might inform the work of not just public health officials but also nonprofits and city planners. She cited endeavors such Healthy Black Families, a new nonprofit organization—of which she is a founding board member—that looks at ways to reduce the negative impact of racism on health among black families in Berkeley.

Ultimately, it comes down to ending systemic racism, Nuru-Jeter said. “I actually think that, if we really wanted to, if we really had the will, that we could make great strides in institutional and structural racism around the policies that we promote,” she said. “It’s a matter of people really being on board with it, like outside of this little study. Really, it is not like people don’t know.”

Published online on Sept. 26, 2016 at 11:00 a.m.