Black Person Stress Disorder:
Institutionalized Racism Damages Black-Americans’ Mental and Physical Health
Mahfuj Hussain
Wesleyan University
Black Person Stress Disorder:
Institutionalized Racism Damages Black-Americans’ Mental and Physical Health
Research has shown that self-reported scores for physical and mental health for Black Americans are consistently lower than scores of White Americans, discrepancies between which are reduced when controlling for education and income (Williams, Yu, Jackson, & Anderson, 1997). Institutionalized racism is categorized as racism by individuals or groups governed by social and behavioral norms and it permeates the experiences of Black Americans, covertly hindering advancement. For example, only 40% of Black students graduate college within six years vs. 62% for White students (National Center for Educational Statistics), part of why can be attributed to poorer K-12 education outcomes (Payne & Biddle, 1999) as well as institutionalized racism as a major factor affecting Black student achievement in higher education (Spears, 1978). This paper investigates how the cyclic nature of low Black achievement, low socio-economic status, perceived discrimination, and institutionalized racism hinders achievement which leads to poorer health outcomes for Black Americans.
Literature review
In Williams et al.’s (1997) article, it was found that there are racial differences in perceived discrimination, self-reported measures of physical and mental health, and stress levels which are reduced when socio-economic status and education levels were controlled (Williams et al., 1997). The article reviews literature that shows race as an antecedent and determinant of SES and that SES differences between Black and White people reflects the impact of economic discrimination produced by societal structures (Cooper & David, 1986; Massey & Denton, 1993). The article also reviews literature which discusses how the most profound impact of racism is institutional, chiefly shaping the socio-economic opportunities of Black people. Additionally, there are stressful life experiences linked to race such as racial bias which can adversely change health (Cose, 1993). Williams et al. analyses sample data from the 1995 Detroit Area Study (DAS) to investigate the extent to which stress and race-related stress vary by race, the extent to which socio-economic status varies by race, and how race-related stressors account for racial differences in health.
The DAS includes data from 1139 adult (18 years and older) respondents from Wayne, Oakland, and Macomb counties of Michigan including Detroit. Race was measured by self-report. The study used four measures of health as dependent variables, which were self-rated ill health, psychological distress, bed-days (number of days unable to complete normal activities because of physical health problems and emotional health), and psychological well-being over the past month quantitatively. Age, education credentials, and household income were also recorded quantitatively. Respondents were classified into social classes (worker, supervisor, manager) based on responses to questions about their work, and experiences of discrimination and everyday discrimination were recorded with questions about perceived unfair treatment. Finally, chronic stress, financial stress, and live events were recorded with counts of problems, measure of difficulty meeting monthly payments, and description of life events.
Analysis revealed that Black people had lower rates of higher education, lower household incomes, lower social class rankings, yet higher rates of discrimination, financial stress, and life events than White people. Everyday discrimination was positively related to ill health and psychological distress. Income was negatively correlated with psychological distress, to say that higher SES individuals report less psychological distress. Adjusting for race related stress reduces the relationship between SES and psychological distress.
In Brondolo, Brady, Thompson, Tobin, Cassells, Sweeney, McFarlane, & Contrada (2008), perceived racism was shown to be positively associated with daily anger, nervousness, and sadness (Brondolo et al. 2008). The study discussed and extended the Reserve Capacity Model (RCM) which suggests that low socioeconomic status influences health by causing negative emotions. (Gallo & Matthews, 2003). The extension applied RCM to investigate effects of lifetime perceived racism to negative affects. American-born Black and Latinx adults (n=362) completed the Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CV). The sample population comprised of 127 Black women, 91 Black men, 79 Latina women, and 65 Latino men with an age range of 24 to 65 (M = 40.22, SD = 9.64). 50% of the population were employed in a variety of fields. 75% (n = 269) of respondents had completed at least high school, and the median gross household income was $18,000.
PEDO-CV utilizes the Positive and Negative Affect Schedule (PANAS) and ecological momentary assessments to measure trait negative affect and state negative affect, respectively. Trait negative affect includes quantitative data recording prevalence of mood states (e.g. distressed, upset, scared, irritable) on a scale of 1 to 5. State negative utilizes icons representing facial expressions next to names of the emotions to quantifies degrees of experiencing emotions (e.g. happy, relaxed, nervous, sad, and angry) on a scale of 1 to 100. Participants were a subset of volunteers for a study on racism, coping, and blood pressure. This larger study was conducted over three visits, the first measuring demographic variables and perceived racism. The PANAS was administered at the second meeting along with hostility questionnaires. Afterwards, participants were trained in diary completion and blood pressure was recorded before the end of a 20-minute journal session. Participants were compensated for their time. Brondolo et al. controlled for trait hostility and individual level socioeconomic status.
The study found that Black people reported more lifetime perceived racism and social exclusion than did Latinx and men reported more lifetime perceived racism than women did. Latinx people reported more trait negative affect than Black people did. No significant relationships concerning age were found. The study also found that perceived racism was significantly positively correlated with trait negative affect and daily anger, nervousness, and sadness after controlling for age and gender. Education level was also significantly correlated with daily diary measures of anger and nervousness and predicted poverty group status and employment status. Education was also shown to have moderating effects; individuals with a college degree or higher had no significant relationship between PEDQ-CV scores and trait negative affect. The study summarized that individuals with lower levels of SES tend to have higher levels of daily negative affect.
In Prelow, Mosher, and Bowman’s (2006) article, the authors determined that racial discrimination was positively correlated with depressive symptoms and negatively associated with life satisfaction. Researchers also found that scores on the Experiences of Discrimination Scale (EDS; Murry, Brown, Brody, Cutrona, & Simons, 2001) was positively correlated with life stress, negative financial events, and depression (Prelow, Mosher, & Bowman, 2006). Data was from 135 Black students attending a predominantly white institution in the northeast. Responses to questions measuring income ranged from less than $10,000 to more than $100,000. Participants first completed a 40-minute self-report survey alone or in groups that utilized the EDS, a subset of the Social Provisions Scale (SPS; Cutrona & Russell, 1987), a 12-item version of the Center for Epidemiological Studies Depression Scale (CES-D; Radloff, 1977; CES-D 12; Roberts & Sobhan, 1992), and the Satisfaction with Life Scale (SWLS; Diener, Emmons, Larsen, & Griffin, 1985) to measure racial discrimination, social support, depression, and life satisfaction respectively.
The EDS measures racial discrimination using questions about racial discrimination prevalence on a 1 (never) to 4 (several times) scale. A sample question is “How often has someone yelled a racial slur or racial insult at you?” (Murray et al., 2001). Social support was measured using the SPS which poses statements like “There are people I can depend on to help me if I really need it” with response options ranging from 1 (strongly disagree) to 4 (strongly agree) (Cutrona & Russell, 1987). The modified CES-D was used to assess depressive symptoms with statements (e.g. “I felt that everything I did was an effort”) on a 0 (rarely or none of the time) to 3 (most of the time) scale (CES-D; Radloff, 1977; CES-D 12; Roberts & Sobhan, 1992). Finally, life satisfaction was measured using the 5-item scaled from 1 (strongly disagree) to 7 (strongly agree) SWLS that poses statements like “In most ways my life is close to my ideal” (Diener et al., 1985).
Results showed that 98.5% of participants reported having experienced discrimination in the past year while more than 64% report experiencing more than six discriminatory events. 21.5% of respondents met or exceeded the clinical cut-off regarding depressive symptoms. The research utilized a buffering model recommended by Aiken and West (1991) which would have predicted social support would interact with discrimination to predict depressive symptoms and life satisfaction, however no significant correlations between discrimination and social support were found. This model was not supported. A mediator model was also used, checking four conditions to establish mediation (Baron & Kenny, 1986). This model found that less social support was associated with greater depressive symptoms and lower life satisfaction. The importance of discrimination as a stressor for Black Americans is highlighted by the research associating racial discrimination with depressive symptoms and less life satisfaction, and further demonstrating that Black Americans face higher levels of racial discrimination.
Conger, Wallace, Sun, McLoyd et al. (2002) found that low socio-economic status causes economic pressure in Black adults which leads to emotional distress in caregivers. Emotional distress in caregivers negatively affects parenting practices, and children are ultimately affected (Conger et al. 2002). Research has suggested that negative impacts of economic disadvantage on children derive from economic influences on parental behavior (Conger et al., 2000; McLoyd, 1998). Conger et al.’s study uses the family stress model of economic hardship to postulate mediated relationships of hardship, economic pressure, emotional state of caregivers, conflicts between caregivers, parental practices, and child adjustment. The model emerged from studies done on families of European descent in the rural Midwest. The model uses economic stress as a metric to predict child behavioral outcomes. Research was done under the Family and Community Health Survey (FACHS).
The FACHS recruited almost 900 Black families with a target child who was between the ages of 10 and 11 years old at the time of recruitment. FACHS conducted interviews with the child, the primary caregivers, and any older siblings. Participants were compensated based on the amount of time spent being interviewed. Before data collection, focus groups of Black women from similar neighborhoods were interviewed to find any modification of items that were culturally insensitive, unclear, or intrusive. Family members also were videotaped performing a 20-minute task used to evaluate parenting behavior. The task included discussion questions relevant to issues in daily life, such as enjoyable activities and handling of conflict. Raters of these videos were given training and had to pass written and viewing tests to become part of the staff. Measures of low family per capita income, negative financial events, economic pressure, caregiver depression, caregiver relationship conflict and withdrawal, parenting aspects, and child adjustment were recorded through examination of interactions and scaled tests.
The study determined that with full-information studies, the theoretical model of family stress would predict low income and negative financial events result in economic pressure that affect the moods of caregivers causing conflict and non-involved parenting, resulting in children externalizing negative behaviors. Findings consistently showed that economic pressure influences family relationships and child adjustment by increased emotional distress of caregivers, and that depressed moods would be linked to parenting behavior.
Discussion
Research has shown that Black Americans face economic stressors and race-related stressors which have detriment to health and socio-economic mobility. Findings show socio-economic status and education level moderating health since discrepancies are diminished when controlling for SES (Williams et al., 1997). This is not to say that wealthier Black Americans do not experience discrimination, but those with lower SES tend to be worse off due to prevalence of both economic and racial stressors. Black people have the highest poverty rate in America (U. S. Census Bureau), which affects the achievement of Black children in education due to economic stressors on parents (Conger et al., 2002). Low achievement creates a cyclic situation where Black people are poor because of their education levels and because they are poor, they are less likely to achieve higher education levels. Along with the economic aspects, Black Americans have higher levels of perceived discrimination which may further interfere with achievement because of increased depressive symptomology, sadness, anger, and nervousness (Prelow et al., 2006; Brondolo et al., 2008). Economic and psychosocial factors (chiefly institutionalized racism promoting discrimination) work together to impede Black achievement, life satisfaction, and upward mobility.
Limitations of These Studies
The studies reviewed each have their own limitations that prevent generalizability to a theory. These limitations concern demographic factors, data absence, and time since publication.
Demographic limitations. Conger et al.’s (2002) study recorded the effects of economic stress on children who were 10 to 11 years old. Erik Erikson’s model of psychosocial development (Erikson, 1998) categorizes the age group of 10 to 11 in the stage of industry vs. inferiority. This stage is vital to a child’s self-esteem and not meeting societal demands and feeling discouraged could affect psychosocial development. A longitudinal study could be used to examine how children adjust over the course of different ages with economic stressors in their parents’ lives. Furthermore, Prelow et al.’s (2006) study interviewed Black college men at a predominantly white institution. This specificity cannot make the results completely attributable to the mental health and symptomology of all Black people in the face of perceived discrimination.
Data limitations. Conger et al.’s (2002) study did not gather full-information studies to apply their models. They postulated that full-information studies would make their model predict low income and economic stressors would affect child adjustment.
Literature time limitations. Much of the literature on stress in Black Americans was conducted many years ago, some studies being as old as 20 years. Their relevancy cannot directly be applied to the Black experience today due to the cultural differences between then and now.
Conclusions and Future Study
To more thoroughly investigate the connections between socioeconomic status, perceived discrimination, achievement outcomes, and health outcomes, more studies would have to be done to maintain cultural relevancy. The literature reviewed come together in identifying economic stressors and perceived discrimination as two major aspects affecting the Black American experience. In today’s social climate, it is not hopeful that the systems in place that allow for institutional racism and a cycle of poverty among Black people will be dismantled. Further research will make these connections clearer, bridging gaps with interventions and education.
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