RACISM | PUBLIC HEALTH

How Hate Hurts

From microaggressions to physical attacks, racial discrimination takes a significant toll on the health of Black Americans

My 21-year-old daughter is a multiracial college student in Denver who recently spoke before the Denver City Council on the impact of police brutality and discrimination on the health of Black people. She opened by quoting a Denver City Council proclamation that classifies racism as a public health crisis and states, in part, that “police brutality and murders contribute to an environment” that upholds “systemic inequities and psychological burdens that worsen the public health crisis.”

While such a proclamation is a good place for a city council to start, racism and the discriminatory acts it leads to must be recognized for their physiological as well as psychological effects. It’s easy for most who are not Black to acknowledge the fact that many Black people suffer emotionally from racism. But it’s also easy for those who are not Black to ignore the fact that Black people — even those who have never experienced physical harm at the hands of a racist — suffer physically from racism and discrimination.

The U.S. News and World Report article “For Black Americans, Discrimination May Increase Risk of High Blood Pressure” cites a study that provides evidence of the “connection between discrimination and poor health outcomes.” Published in July 2020 in the American Heart Association medical journal Hypertension, the study, “Discrimination and Hypertension Risk Among African Americans in the Jackson Heart Study,” is “one of the first large, community-based studies to report an association between lifetime discrimination and an elevated risk of high blood pressure within the Black population.”

When the more than 1,800 participants signed up for the study, none had been diagnosed with hypertension. Upon enrollment, they “reported on their experiences with unfair treatment, reflected on sliding scales for ‘everyday’ discrimination and ‘lifetime’ discrimination.” Over a total of seven years of follow-up visits, more than half of the study participants developed high blood pressure, with those who had reported experiencing “medium levels of lifetime discrimination” having nearly a 50% higher risk of high blood pressure than those who had reported low levels of lifetime discrimination. Those who had reported high levels were found to have a 34% higher risk.

The truth about telomeres

As my daughter told the Denver City Council, “the current system of policing in Denver and the culture of fear surrounding that system is exacerbating the health disparities faced by all members of minority communities, not just those directly affected by instances of brutality.” One of the studies she cited was “Perceived Unfair Treatment by Police, Race, and Telomere Length — A Nashville Community-based Sample of Black and White Men,” which was published in 2018 in the Journal of Health and Social Behavior. This and another source she referenced discuss “telomere length.” As 20-year-old post-graduate neurobiology student Shin Jie Yong explains in “How Racism Provides Cellular Ageing, Stress, and Inflammation,” a telomere is a DNA sequence located at each end of a chromosome. Every time a cell replicates, its telomeres become shorter, with “critically short” telomeres leading to cell aging, cell deterioration, and/or cell death. Since “telomere length correlates with chronological age,” Shin Jie Yong writes, “it also reflects the cumulative wear-and-tear — or ageing — at the cellular or immunological level.” The more quickly a person’s telomeres shorten, the more quickly that person can become susceptible to diseases normally caused by aging.

Shin Jie Yong cites multiple studies, including “Racial Discrimination and Telomere Shortening Among African Americans,” which was published in Health Psychology, the journal of the American Psychological Association, in March 2020. The abbreviated conclusion of this study of nearly 400 Black Americans states bluntly that the study’s findings add to current “evidence that racial discrimination contributes to accelerated physiologic weathering and health declines among African Americans through its impact on biological systems, including via its effects on telomere attrition.”

In addition to the impacts of telomere shortening on the health and lifespans of Black Americans, Shin Jie Yong also discusses how racism negatively affects Black Americans in other proven physiological ways, such as by increasing “pro-inflammatory and stress-responsive signalling pathways” and lowering immunity, which leads to “weaker antiviral and antibody defences.” The studies he cites provide ample evidence of the physiological as well as psychological impacts of racism on Black people.

Gene switches

In her article, “Study: Racism shortens lives and hurts health of Blacks by promoting genes that lead to inflammation and illness,” clinical psychologist and University of California associate professor April Thames refers to a 2019 study she co-authored, “Experiences of discrimination and racial differences in leukocyte gene expression.” Thames points out that while research has shown chronic stress affects brain function and can lead to age-related diseases such as Alzheimer’s, such research is now being expanded through “social genomics,” a relatively new field that “demonstrates how the function of genes…is influenced by social conditions.” As Thames explains, while healthy genes “turn off and on in a certain manner,” when a person is part of a group that is “marginalized,” their genes that are responsible for “innate immunity” — fighting off and responding to “foreign pathogens” — are altered in a way that affects their ability to function properly.

“When environmental stresses like socioeconomic disadvantage or racism trigger the sympathetic nervous system,” Thames writes, “…the behavior of our genes is altered.” When a person’s pathogen-fighting genes are made less effective while their genes responsible for controlling inflammation are triggered, the combination can lead to a host of health issues.

The study Thames co-authored not only found differences in gene expressions between people who were Black and those who were not, it found that “experiences with racism and discrimination accounted for more than 50%” of the difference in the pro-inflammation gene activity exhibited by the Black people studied. Thames concludes her article by stating racism and discrimination are toxic to human health because they damage “the natural defenses our bodies use to fight off infection and disease” and should be considered health risk factors alongside smoking.

The public health response

Luckily, it seems more local governments are starting to take steps toward addressing the public health impacts of racism and discrimination. According to the June 2020 article “Racism Is a Public Health Crisis, Say Cities and Counties” on the online publication Stateline, an initiative of The Pew Charitable Trusts, “more than 20 cities and counties and at least three states, Michigan, Ohio and Wisconsin,” have declared racism a public health crisis. On the national level, Senator Sherrod Brown of Ohio has introduced a similar resolution in Congress and is promoting “greater investment in public health and a better understanding of racial health disparities.”

While such proclamations and resolutions have their critics, public health officials find them encouraging. At least it’s more commonly understood now, as executive director of the American Public Health Association Dr. Georges Benjamin puts it in the Stateline article, that “health inequities” affecting Black Americans “at their very core are due to racism.”

I write fiction, poetry, and nonfiction when I’m not working as a copy editor. Author of the novel One Sister’s Song.

Bylines in Publishers Weekly, the Writing Cooperative, others. One Sister’s Song (novel). Not Nearly Everything You Need to Know About Writing (ebook).

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