Is racism bad for your health?

With the recent white nationalist rallies in Charlottesville, VA and the ongoing questions around the appropriateness of Confederate monuments, it seems the conversation about race in the US is more volatile than ever. But, how does this national discussion of race and racism affect our health? H. David Chae, an associate professor of of Human Sciences and the Director of the Center for Health Ecology and Equity Research at Auburn University is studying these connections. As a young person growing up, Dr. Chae saw how the location of a person’s home may have predetermined their access to certain resources. He explained, “…from an early age I understood, on an unconscious level, that there were different realities that different people faced, and that oftentimes these fell along racial lines.”

Dr. Chae’s research explores how dimensions of racism generate racial disparities in health. He has received grants from the National Institutes of Health to study links between racial minority stress and risk factors for accelerated biological aging. In a recent PLOS One article entitled, Association between an Internet-Based Measure of Area Racism and Black Mortality, Dr. Chae and colleagues explored the extent to which racism in a particular area might be associated with health patterns.

Since it’s hard to measure racism in particular geographic areas, Dr. Chae used a proxy developed by a colleague: the proportion of Google searches containing the “n-word.” This measure obviously has some problems—it can’t assume that all “n-word” searches are negative or that those who search the “n-word” are racist. But, when you aggregate millions of searches over a period of time, you still are able to get a good sense of the climate from which those searches originate.

Based on Chae and colleagues’ work, this is a map of a distribution of searches containing the “N-Word.” Areas in red and orange contain greater proportions of searches.

Each unit increase in the level of n-word searches meant an 8.2% increase in the Black mortality rate. This equates to about 30,000 additional Black deaths per year. This rate persists when controlling for other factors such as education or poverty rate. Not only is there a significant association with the Black mortality rate, but there is also a significant association in the gap between Black and White mortality rates.  In other words, controlling for other factors, the more the “n-word” was Googled in a particular area, the higher the mortality rate for African-Americans who live in that area.

Obviously, this leads Dr. Chae and the researchers to consider what might contribute to this gap. One potential explanation is that people of color in these areas may be subject to violent civil rights violations such as hate crimes or police brutality. However, Chae argues that racism is a “social toxin.” It is “ambient” or “in the water,” no matter how aware we are. It’s not just these violent crimes, rather it’s about access to resources connected to health, such as space to play or healthy food.

As Chae explains,

Health behaviors are informed by the social context that people are embedded in. So, people’s ability to engage in a healthy diet or exercise is informed by the neighborhoods in which people live.”

I think even policy makers tend lose sight [of this]. That simply education campaigns around what constitutes a healthy diet would be sufficient, but we know that if you don’t give people the resources to engage in these healthy behaviors, then it is very unlikely they will be initiated or maintained. So I think there is a need to intervene on multiple levels, not only on the individual level but also on the broader social-contextual level…improving neighborhoods and environments.

In an age of racially-charged environments, it is more important than ever for both policy makers and the general public to understand the role racism plays in the health of American communities.  Chae is very committed to distributing his work outside the university, and he believes this comes from his experience growing up and seeing social inequalities and health around him. His TED talk delivered at TEDx Grand Rapids illustrates his commitment to public understanding of science.

Understanding both physical and social toxins, in Chae’s opinion, will be an important part of public health research in the future. Chae believes that we tend to lose sight of the covert, everyday slights and insults that gradually wears away at people’s health. These small microaggressions are often not illegal, but are often a part of every day culture. And, for that reason, Chae argues that it is important for individuals of all backgrounds to become aware of their own unconscious biases and participate in the public policy conversation around race. He states, “…when you learn to think of people as individuals and not as a part of a racial group, your performance on the [Implicit Association Test] improve. It’s kind of a common sense thing…treat people like people.”

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