The Impacts of Racism on Health

Camara Phyllis Jones, MD, MPH, PhD

Abstract of presentation at UNC-Chapel Hill on June 13, 2000

This presentation starts by examining the use of the variable "race" by health researchers, including the dangers of routinely documenting "race"-associated differences without vigorously investigating the basis of those differences. The variable "race" is critiqued as a rough proxy for socioeconomic status, culture, and genes but a precise measure of the social classification of people in a "race"-conscious society. This implies that racism may account for the marked "race"-associated differences in health outcomes observed in the United States.

Three levels of racism (institutionalized, personally-mediated, and internalized) are described, each of which has impacts on health. An allegory "Levels of Racism: A Gardener's Tale" is used to illustrate these three levels of racism and the relationships between them. Approaches to measuring each of these three levels of racism are briefly outlined. The question "How often do you think about your race?" is proposed as a summary measure of the psychological impact of chronic racial stigmatization. Data are presented on the distributions of this "race"-consciousness measure in two large surveys. In addition, plots of health status by socioeconomic status, stratified by "race", are proposed as another way to isolate various impacts of racism.

Comparison of systolic blood pressure distributions by "race" suggest accelerated aging of the "black" population compared to the "white" population. These data are the basis of the author's Accelerated Aging Hypothesis, that a) "black"-"white" differences in health outcomes in the United States are due to accelerated aging of the "black" population compared to the "white" population, and b) accelerated aging of the "black" population in the United States is due to racism.