Volume 16, Number 6
There are many ways in which racism affects health. One that doesn’t command media attention is what is happening at the cellular level for African Americans in the United States, a process that hastens aging. This biological contributor to disparities in morbidity and mortality is an important component of the evidence that racism is a public health pandemic.
Telomeres are the repetitive DNA sequences at the end of chromosomes that serve to support the stability of chromosomes. As we age, telomeres shorten, so that telomere length can be used as a proxy for biological age. But age isn’t the only factor that affects telomere length. Numerous studies have shown that psychosocial stress contributes to the shortening of telomeres. Leukocyte telomere length (LTL) is used as an indicator of aging of the immune system. And because immune system function is critical to the health and well-being of the entire organism, researchers can use LTL as a reflection of the aging of an organism.
During the past decade, the topic of discrimination and LTL has been the focus of a number of investigations, and results have contributed to the understanding of racial health disparities. The experience of discrimination has been found to be associated with shorter LTL in black adults. This is an indicator of accelerated aging, reflected in part by the increased incidence of chronic illness and premature death.
One such study was just published in March of this year in Health Psychology. The study sample consisted of nearly 400 African Americans in the Coronary Artery Risk Development in Young Adults (CARDIA) Telomere Ancillary Study. Participants were asked whether they had “experienced discrimination, been prevented from doing something, or been hassled or made to feel inferior” due to their “race or color” in several contexts, including manifestations of institutionalized racism. The contexts were: school, getting a job, getting housing, work, getting medical care, or on the street or in a public setting. Experiencing discrimination in more of these domains was associated with more extensive LTL shortening.
Racism can be overt or subtle, and either form affects those experiencing discrimination. In-group favoritism may not be seen as overtly discriminatory but nonetheless makes a profound contribution to disparities. Even persons who maintain that they don’t have racist attitudes or behave in a discriminatory manner realize, with self-examination, that institutionalized forms of racism do affect attitudes and behavior. At a minimum, implicit biases are present. Personal responsibility is an essential component of any attempt to address the societal challenge of racism.
Clearly there is a need for law enforcement reform along with other initiatives to combat racism, but personal and broader societal changes are necessary to mitigate the cellular impacts of the experience of discrimination. Each of us has opportunities to have a positive impact at multiple levels, with our contributions to policy, with how we conduct ourselves in the workplace and the marketplace, and with our interpersonal relationships. Taking the perspective of a person of a different race and seeking more contact and interaction with persons of minority groups are two examples of strategies known to help reduce discrimination. Each step we take toward minimizing and eliminating covert as well as overt forms of racism represents a contribution to the health and wellbeing of our companion human beings.
Paul J. Hershberger, Ph.D.
… is a clinical health psychologist. He is Professor, Director of Research, and Director of the Division of Behavioral Health, Department of Family Medicine, Wright State University Boonshoft School of Medicine.
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