How racism affects health

This article, a year old, was just brought to my attention. Very interesting. This level of validation could possible lead to social change in how health services are provided, which would be wonderful.

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African-Americans today, despite a half century of economic and social progress since the civil rights movement, face a higher risk than any other racial group of dying from heart disease, diabetes, stroke, and hypertension. In the United States, affluent blacks suffer, on average, more health problems than the poorest whites.

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In the early 1980s, Duke University social psychologist Sherman James, introduced his now-classic "John Henryism" hypothesis. The name comes from the legendary 19th-century "steel-driving" railroad worker who competed against a mechanical steam drill and won -- only to drop dead from what today would probably be diagnosed as a massive stroke or heart attack. In James's work, people who churn out prodigious physical and mental effort to cope with chronic life stresses are said to score high on John Henryism. James showed that blacks with high John Henryism but low socioeconomic position pay a physical price, with higher rates of blood pressure and hypertension.

Racism, other research suggests, acts as a classic chronic stressor, setting off the same physiological train wreck as job strain or marital conflict: higher blood pressure, elevated heart rate, increases in the stress hormone cortisol, suppressed immunity.

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In the mid-1980s scientists began to take advantage of the controlled conditions of the laboratory. When African-American volunteers are hooked up to blood-pressure monitors, for example, and then exposed to a racially provocative vignette on tape or TV -- such as a white store clerk calling a black customer a racist epithet -- the volunteers' blood pressures rise, their heart rates jump, and they take longer than normal to recover from both reactions. Perhaps, scientists reasoned, the effort of a lifetime of bracing for such threats prolongs the effect.

More recently, the lab has moved out into the real world. Several investigations have linked blood pressure to real-time experiences of stress and discrimination as recorded in electronic diaries. In one yet-to-be-published study, Elizabeth Brondolo, a psychologist at St. John's University, found that daytime experiences of racism led to elevated nighttime blood pressure, suggesting that the body couldn't turn off its stress response.

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Despite these suggestive findings, the field remains beset by unknowns. One of the biggest problems is that researchers don't share a concrete, agreed-upon definition of racial discrimination -- partly because such prejudice takes myriad forms. They also don't know if more exposure to racism produces more disease or if, instead, disease sets in only after a threshold has been passed. They don't know if exposures during certain periods of life are more risky than others. And they don't know why some victims cope better than others.

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[url=http://www.boston.com/news/globe/ideas/articles/2007/07/15/how_racism_hu..."How Racism Hurts -- Literally" Boston Globe July 2007[/url]