Skip to main content
Log in

Discrimination and racial disparities in health: evidence and needed research

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

This paper provides a review and critique of empirical research on perceived discrimination and health. The patterns of racial disparities in health suggest that there are multiple ways by which racism can affect health. Perceived discrimination is one such pathway and the paper reviews the published research on discrimination and health that appeared in PubMed between 2005 and 2007. This recent research continues to document an inverse association between discrimination and health. This pattern is now evident in a wider range of contexts and for a broader array of outcomes. Advancing our understanding of the relationship between perceived discrimination and health will require more attention to situating discrimination within the context of other health-relevant aspects of racism, measuring it comprehensively and accurately, assessing its stressful dimensions, and identifying the mechanisms that link discrimination to health.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Acevedo-Garcia, D., Lochner, K. A., Osypuk, T. L., & Subramanian, S. V. (2003). Future directions in residential segregation and health research: A multilevel approach. American Journal of Public Health, 93(2), 215–221.

    PubMed  Google Scholar 

  • Acevedo-Garcia, D., Osypuk, T. L., McArdle, N., & Williams, D. R. (2008). Toward a policy-relevant analysis of geographic and racial/ethnic disparities in child health. Health Affairs, 27(2), 321–333. doi:10.1377/hlthaff.27.2.321.

    PubMed  Google Scholar 

  • Ackerman, K. D., Heyman, R., Rabin, B. S., Anderson, B. P., Houck, P. R., Frank, E., et al. (2002). Stressful life events precede exacerbations of multiple sclerosis. Psychosomatic Medicine, 64, 916–920. doi:10.1097/01.PSY.0000038941.33335.40.

    PubMed  Google Scholar 

  • Adegbembo, A. O., Tomar, S. L., & Logan, H. L. (2006). Perception of racism explains the difference between Blacks’ and Whites’ level of healthcare trust. Ethnicity & Disease, 16(4), 792–798.

    Google Scholar 

  • Ahmed, A., Mohammed, S., & Williams, D. R. (2007). Racial discrimination & health: Pathways & evidence. The Indian Journal of Medical Research, 126, 21–30.

    Google Scholar 

  • Arce, C. H., Murguia, E., & Frisbie, W. P. (1987). Phenotype and life chances among Chicanos. Hispanic Journal of Behavioral Sciences, 9, 19–32.

    Google Scholar 

  • Banks, A. D., & Dracup, K. (2006). Factors associated with prolonged prehospital delay of African Americans with acute myocardial infarction. American Journal of Critical Care, 15(2), 149–157.

    PubMed  Google Scholar 

  • Banks, K. H., Kohn-Wood, L. P., & Spencer, M. (2006). An examination of the African American experience of everyday discrimination and symptoms of psychological distress. Community Mental Health, 42(6), 555–570. doi:10.1007/s10597-006-9052-9.

    Google Scholar 

  • Baum, A., Cohen, L., & Hall, M. (1993). Control and intrusive memories as possible determinants of chronic stress. Psychosomatic Medicine, 55, 274–286.

    PubMed  Google Scholar 

  • Bauman, K. (1998). Direct measures of poverty as indicators of economic need: Evidence from the survey of income and program participation. U.S. Census Bureau Population Division Technical Working Paper No. 30.

  • Bazargan, M., Norris, K., Bazaragan-Hejazi, S., Akhanjee, L., Calderon, J. L., Safvati, S. D., et al. (2005). Alternative healthcare use in the under-served population. Ethnicity & Disease, 15, 531–539.

    Google Scholar 

  • Beiser, M. N., & Hou, F. (2006). Ethnic identity, resettlement stress and depressive affect among Southeast Asian refugees in Canada. Social Science & Medicine, 63(1), 137–150. doi:10.1016/j.socscimed.2005.12.002.

    Google Scholar 

  • Belli, R. F. (1998). The structure of autobiographical memory and the event hisory calendar: Potential improvements in the quality of retrospective reports in surveys. Memory (Hove, England), 6(4), 383–406. doi:10.1080/741942610.

    Google Scholar 

  • Benkert, R., Peters, R. M., Clark, R., & Keves-Foster, K. (2006). Effects of perceived racism, cultural mistrust and trust in providers on satisfaction with care. Journal of the National Medical Association, 98(9), 1532–1540.

    PubMed  Google Scholar 

  • Bennett, G. G., Wolin, K. Y., Robinson, E. L., Fowler, S., & Edwards, C. L. (2005). Perceived racial/ethnic harassment and tobacco use among African American young adults. American Journal of Public Health, 95(2), 238–240. doi:10.2105/AJPH.2004.037812.

    PubMed  Google Scholar 

  • Bhattacharyya, M. R., & Steptoe, A. (2007). Emotional triggers of acute coronary syndromes: Strength of evidence, biological processes, and clinical implications. Progress in Cardiovascular Diseases, 49(5), 353–365. doi:10.1016/j.pcad.2006.11.002.

    PubMed  Google Scholar 

  • Bhui, K., Stansfeld, S., McKenzie, K., Karlsen, S., Nazroo, J., & Weich, S. (2005). Racial/ethnic discrimination and common mental disorders among workers: Findings from the EMPIRIC Study of Ethnic Minority Groups in the United Kingdom. American Journal of Public Health, 95(3), 496–501. doi:10.2105/AJPH.2003.033274.

    PubMed  Google Scholar 

  • Birman, D., Tricket, E., & Buchanan, B. M. (2005). A tale of two cities: Replication of a study on the acculturation and adaptation of immigrant adolescents from the former Soviet Union in a different community context. American Journal of Community Psychology, 35(1/2), 83–101. doi:10.1007/s10464-005-1891-y.

    PubMed  Google Scholar 

  • Blank, R. M., Dabady, M., & Citro, C. F. (2004). Measuring racial discrimination. Washington, DC: National Academies Press.

    Google Scholar 

  • Blascovitch, J., Spencer, S. J., Quinn, D., & Steele, C. (2001). African Americans and high blood pressure: The role of stereotype threat. Psychological Science, 12(3), 225–229. doi:10.1111/1467-9280.00340.

    Google Scholar 

  • Bonilla-Silva, E. (1996). Rethinking racism: Toward a structural interpretation. American Sociological Review, 62, 465–480. doi:10.2307/2657316.

    Google Scholar 

  • Borrell, L. N., Jacobs, D. R. J., Williams, D. R., Pletcher, M. J., & Houston, T. K. (2007). Self-reported racial discrimination and substance use in the Coronary Artery Risk Development in Adults Study. American Journal of Epidemiology, 166(9), 1068–1079. doi:10.1093/aje/kwm180.

    PubMed  Google Scholar 

  • Borrell, L. N., Kiefe, C. I., Williams, D. R., Diez-Roux, A. V., & Gordon-Larsen, P. (2006). Self-reported health, perceived racial discrimination, and skin color in African Americans in the CARDIA study. Social Science & Medicine, 63(6), 1415–1427. doi:10.1016/j.socscimed.2006.04.008.

    Google Scholar 

  • Brave Heart, M. (2003). The historical trauma response among natives and its relationship with substance abuse: A Lakota illustration. Journal of Psychoactive Drugs, 35(1), 7–13.

    PubMed  Google Scholar 

  • Brave Heart, M., & DeBruyn, L. (1998). The American Indian Holocaust: Healing historical unresolved grief. American Indian and Alaska Native Mental Health Research, 8(2), 56–78.

    PubMed  Google Scholar 

  • Brody, G. H., Chen, Y. F., Murry, V. M., Ge, X., Simons, R. L., Gibbons, F. X., Gerrard, M., & Cutrona, C. (2006). Perceived discrimination and the adjustment of African American youths: A five-year longitudinal analysis with contextual moderation effects. Child Development, 77(5). doi:10.1111/j.1467-8624.2006.00927.x.

  • Brondolo, E., Brady, N., Thompson, S., Tobin, J., Cassells, A., Sweeney, M., et al. (2008a). Perceived Racism and negative affect: Analyses of trait and state measures of affect in a community sample. Journal of Social and Clinical Psychology, 27(2), 150–173. doi:10.1521/jscp.2008.27.2.150.

    PubMed  Google Scholar 

  • Brondolo, E., Libby, D., Denton, D., Thompson, S., Beatty, D., Schwartz, J., et al. (2008b). Racism and ambulatory blood pressure in a community sample. Psychosomatic Medicine, 70(1), 49–56. doi:10.1097/PSY.0b013e31815ff3bd.

    PubMed  Google Scholar 

  • Brondolo, E., Rieppi, R., Kelly, K. P., & Gerin, W. (2003). Perceived racism and blood pressure: A review of the literature and conceptual and methodolgical critique. Annals of Behavioral Medicine, 25(1), 55–65. doi:10.1207/S15324796ABM2501_08.

    PubMed  Google Scholar 

  • Brondolo, E., Thompson, S., Brady, N., Appel, R., Cassells, A., Tobin, J., et al. (2005). The relationship of racism to appraisals and coping in a community sample. Ethnicity & Disease, 15(4), 14–19.

    Google Scholar 

  • Brook, D., Brook, J., Balka, E., & Rosenberg, G. (2006a). Predictors of rebellious behavior in childhood parental drug use, peers, school environment, and child personality. Journal of addictive disorders, 25(2), 77–87.

    Google Scholar 

  • Brook, J., Morojele, N., Brook, D., Zhang, C., & Whiteman, M. (2006b). Personal, interpersonal and cultural predictors of stages of cigarette smoking among adolescents in Johannesburg, South Africa. Tobacco Control, 15(1), 48–53. doi:10.1136/tc.2005.014878.

    Google Scholar 

  • Brosschot, J. F., Gerin, W., & Thayer, J. F. (2006). The perservative cognition hypothesis: A review of worry, prolonged stress-related physiological activation, and health. Journal of Psychosomatic Research, 60, 113–124. doi:10.1016/j.jpsychores.2005.06.074.

    PubMed  Google Scholar 

  • Brotman, D. J., Golden, S. H., & Wittstein, I. S. (2007). The cardiovascular toll of stress. Lancet, 370, 1089–1100. doi:10.1016/S0140-6736(07)61305-1.

    PubMed  Google Scholar 

  • Broudy, R., Brondolo, E., Coakley, V., Brady, N., Cassells, A., Tobin, J. N., et al. (2007). Perceived ethnic discrimination in relation to daily moods and negative social interactions. Journal of Behavioral Medicine, 30(1), 31–43. doi:10.1007/s10865-006-9081-4.

    PubMed  Google Scholar 

  • Brown, C., Matthews, K. A., Bromberger, J. T., & Chang, Y. (2006). The relation between perceived unfair treatment and blood pressure in a racially/ethnically diverse sample of women. American Journal of Epidemiology, 164(3), 257–262. doi:10.1093/aje/kwj196.

    PubMed  Google Scholar 

  • Brown, T. N., Williams, D. R., Jackson, J. S., Neighbors, H. W., Torres, M., Sellers, S. L., et al. (2000). Being black and feeling blue: The mental health consequences of racial discrimination. Race and Society, 2, 117–131. doi:10.1016/S1090-9524(00)00010-3.

    Google Scholar 

  • Bryant, R. A. (2003). Early predictors of posttraumatic stress disorder. Society of Biological Psychiatry, 53, 789–795. doi:10.1016/S0006-3223(02)01895-4.

    Google Scholar 

  • Butler, C., Tull, E. S., Chambers, E. C., & Taylor, J. (2002). Internalized racism, body fat distribution, and abnormal fasting glucose among African-Caribbean women in Dominica, West Indies. Journal of the National Medical Association, 94(3), 143–148.

    PubMed  Google Scholar 

  • Bynum, M. S., Burton, E. T., & Best, C. (2007). Racism experiences and psychological functioning in African American college freshmen: Is racial socialization a buffer? Cultural Diversity & Ethnic Minority Psychology, 13(1), 64–71. doi:10.1037/1099-9809.13.1.64.

    Google Scholar 

  • Carr, D., & Friedman, M. A. (2005). Is obesity stigmatizing? Body weight, perceived discrimination, and psychological well-being in the United States. Journal of Health and Social Behavior, 46, 244–259.

    PubMed  Google Scholar 

  • Carter, R. T. (2007). Racism and psychological and emotional injury: recognizing and assessing race-based traumatic stress. The Counseling Psychiatrist, 35(1), 13–105.

    Google Scholar 

  • Casagrande, S. S., Gary, T. L., LaVeist, T. A., Gaskin, D. J., & Cooper, L. A. (2007). Perceived discrimination and adherence to medical care in a racially integrated community. Journal of General Internal Medicine, 22(3), 389–395. doi:10.1007/s11606-006-0057-4.

    PubMed  Google Scholar 

  • Casswell, S., Huckle, T., & Pledger, M. (2002). Survey data need not underestimate alcohol consumption. Alcoholism, Clinical and Experimental Research, 26(10), 1561–1567.

    PubMed  Google Scholar 

  • Chambers, E. C., Tull, E. S., Fraser, H. S., Mutunhu, N. R., Sobers, N., & Niles, E. (2004). The relationship of internalized racism to body fat distribution and insulin resistance among African adolescent youth. Journal of the National Medical Association, 96(12), 1594–1598.

    PubMed  Google Scholar 

  • Chen, F. M., Fryer, G. E., Jr, Phillips, R. L., Jr, Wilson, E., & Pathman, D. E. (2005). Patients’ beliefs about racism, preferences for physician race, and satisfaction with care. Annals of Family Medicine, 3(2), 138–143. doi:10.1370/afm.282.

    PubMed  Google Scholar 

  • Choi, Y., Harachi, T. W., Gillmore, M. R., & Catalano, R. F. (2006). Are multiracial adolescents at greater risk? Comparisons of rates, patterns, and correlates of substance use and violence between monoracial and multiracial adolescents. The American Journal of Orthopsychiatry, 76(1), 86–97. doi:10.1037/0002-9432.76.1.86.

    PubMed  Google Scholar 

  • Clark, R. (2006a). Interactive but not direct effects of perceived racism and trait anger predict resting systolic and diastolic blood pressure in black adolescents. Health Psychology–Sep;(5).Related Articles. LinkOut, 25(5), 580–585.

    Google Scholar 

  • Clark, R. (2006b). Perceived racism and vascular reactivity in black college women: Moderating effects of seeking social support. Health Psychology, 25(1), 20–25. doi:10.1037/0278-6133.25.1.20.

    PubMed  Google Scholar 

  • Clark, R., Anderson, N. B., Clark, V. R., & Williams, D. R. (1999). Racism as a stressor for African Americans: A biopsychosocial model. The American Psychologist, 54(10), 805–816. doi:10.1037/0003-066X.54.10.805.

    PubMed  Google Scholar 

  • Clark, R., Benkert, R. A., & Flack, J. M. (2006a). Large arterial elasticity varies as a function of gender and racism-related vigilance in black youth. The Journal of Adolescent Health, 39(4). doi:10.1016/j.jadohealth.2006.02.012.

  • Clark, V. R., Cobb, R. E., Hopkins, R., & Smith, C. E. (2006b). Black racial identity as a mediator of cardiovascular reactivity to racism in African-American college students. Ethnicity & Disease, 16(1), 108–113.

    Google Scholar 

  • Clark, R., & Gochett, P. (2006). Interactive effects of perceived racism and coping responses predict a school-based assessment of blood pressure in black youth. Annals of Behavioral Medicine, 32(1), 1–9. doi:10.1207/s15324796abm3201_1.

    PubMed  Google Scholar 

  • Cohen, S., Janicki-Deverts, D., & Miller, G. E. (2007). Psychological stress and disease. Journal of the American Medical Association, 298(14), 1685–1687. doi:10.1001/jama.298.14.1685.

    PubMed  Google Scholar 

  • Cohen, S., Kessler, R. C., & Gordon, L. U. (1995). Strategies for measuring stress in studies of psychiatric and physical disorders. In S. Cohen, R. C. Kessler & U. G. Lynn (Eds.), Measuring stress: A guide for health and social scientists (pp. 3–26). New York: Oxford University Press.

    Google Scholar 

  • Cozier, Y., Palmer, J. R., Horton, N. J., Fredman, L., Wise, L. A., & Rosenberg, L. (2006). Racial discrimination and the incidence of hypertension in US black women. Annals of Epidemiology, 16(9), 681–687. doi:10.1016/j.annepidem.2005.11.008.

    PubMed  Google Scholar 

  • Crimmins, E. M., Kim, J. K., Alley, D. E., Karlamangla, A., & Seeman, T. (2007). Hispanic paradox in biological risk profiles. American Journal of Public Health, 97(7), 1305–1310. doi:10.2105/AJPH.2006.091892.

    PubMed  Google Scholar 

  • Crouter, A. C., Davis, K. D., Updegraff, K. A., Delgado, M., & Fortner, M. (2006). Mexican American Fathers’ occupational conditions: Links to family members’ psychological adjustment. Journal of Marriage and the Family, 68(4), 843–858. doi:10.1111/j.1741-3737.2006.00299.x.

    PubMed  Google Scholar 

  • Dailey, A. B., Kasl, S. V., Holford, T. R., & Jones, B. A. (2007). Perceived racial discrimination and nonadherence to screening mammography guidelines: results from the race differences in the screening mammography process study. American Journal of Epidemiology, 165(11), 1287–1295. doi:10.1093/aje/kwm004.

    PubMed  Google Scholar 

  • Davis, S. K., Liu, Y., Quarells, R. C., Din-Dzietharn, R., & M.A.H.D.S.Group. (2005). Stress-related racial discrimination and hypertension likelihood in a population-based sample of African Americans: The Metro Atlanta Heart Disease Study. Ethnicity & Disease, 15(4), 585–593.

    Google Scholar 

  • De Vogli, R., Brunner, E., & Marmot, M. G. (2007a). Unfairness and the social gradient of metabolic symdrome in the Whitehall II study. Journal of Psychosomatic Research, 63, 413–419. doi:10.1016/j.jpsychores.2007.04.006.

    PubMed  Google Scholar 

  • De Vogli, R., Ferrie, J., Chandola, T., Kivimaki, M., & Marmot, M. (2007b). Unfairness and health: Evidence from the Whitehall II Study. Journal of Epidemiology and Community Health, 61(6), 513–518. doi:10.1136/jech.2006.052563.

    PubMed  Google Scholar 

  • DiMaggio, C., Galea, S., & Richardson, L. D. (2007). Emergency department visits for behavioral and mental health care after a terrorist attack. Annals of Emergency Medicine, 50(3), 327–334. doi:10.1016/j.annemergmed.2006.10.021.

    PubMed  Google Scholar 

  • Din-Dzietharn, R., Nembhard, W. N., Collins, R., & Davis, S. D. (2004). Perceived stress following race-based discrimination at work is associated with hypertension in African-Americans. The metro Atlanta heart disease study 1999–2001. Social Science & Medicine, 58, 449–461. doi:10.1016/S0277-9536(03)00211-9.

    Google Scholar 

  • Dohrenwend, B. P. (2006). Inventorying stressful life events as risk factors for psychopathology: Toward resolution of the problem of intracategory variability. Psychological Bulletin, 132(3), 477–495. doi:10.1037/0033-2909.132.3.477.

    PubMed  Google Scholar 

  • Dougall, A. L., Craig, K. J., & Baum, A. (1999). Assessment of characteristics of intrusive thoughts and their impact on distress among victims of traumatic events. Psychosomatic Medicine, 61, 38–48.

    PubMed  Google Scholar 

  • Dyrbye, L. N., Thomas, M. R., Eacker, A., Harper, W., Massie, F. S. J., Power, D. V., et al. (2007). Race, ethnicity, and medical student well-being in the United States. Archives of Internal Medicine, 167(19), 2103–2109. doi:10.1001/archinte.167.19.2103.

    PubMed  Google Scholar 

  • Epel, E., Lin, J., Wilhelm, F., Wolkowitz, O., Cawthon, R., Adler, N., et al. (2006). Cell aging in relation to stress arousal and cardiovascular diseases risk factors. Psychoneuroendocrinology, 31(3), 277–287. doi:10.1016/j.psyneuen.2005.08.011.

    PubMed  Google Scholar 

  • Etowa, J., Weins, J., Bernard, W. T., & Clow, B. (2007). Determinants of black women’s health in rural and remote countries. Canadian Journal of Nursing Research, 39(3), 56–76.

    PubMed  Google Scholar 

  • Evans, G. W., Jacobs, S. V., Dooley, D., & Catalano, R. (1987). The interaction of stressful life events and chronic strains on community mental health. American Journal of Community Psychology, 15(1), 23–34. doi:10.1007/BF00919755.

    PubMed  Google Scholar 

  • Facione, N. C., & Facione, P. A. (2007). Perceived prejudice in healthcare and women’s health protective behavior. Nursing Research, 56(3), 175–184. doi:10.1097/01.NNR.0000270026.90359.4c.

    PubMed  Google Scholar 

  • Ferrie, M. J., Vahtera, J., Marmot, M. G., & Kivimaki, M. (2006). Injustice at work and incidence of psychiatric morbidity: The Whitehall II study. Occupational and Environmental Medicine, 63, 443–450. doi:10.1136/oem.2005.022269.

    PubMed  Google Scholar 

  • Fischer, C. S., Hout, M., Jankowski, M. S., Lucas, S. R., Swidler, A., & Voss, K. (1996). Inequality by design: Cracking the bell curve myth. Princeton, NJ: Princeton University Press.

    Google Scholar 

  • Fix, M., & Struyk, R. J. (1993). Clear and convincing evidence: Measurement of discrimination in America. Washington, D.C: Urban Institute Press.

    Google Scholar 

  • Forman, T. A. (2003). The social psychological costs of racial segmentation in the workplace: A study of African Americans’ well-being. Journal of Health and Social Behavior, 44(3), 332–352. doi:10.2307/1519783.

    PubMed  Google Scholar 

  • Fowler-Brown, A., Ashkin, E., Corbie-Smith, G., Thaker, S., & Pathman, D. E. (2006). Perception of racial barriers to health care in the rural South. Journal of Health Care for the Poor and Underserved, 17(1), 86–100. doi:10.1353/hpu.2006.0022.

    PubMed  Google Scholar 

  • Gee, G. C., Chen, J., Spencer, M., See, S., Kuester, O., Tran, D., et al. (2006a). Social support as a buffer for perceived unfair treatment among Filipino Americans: Differences between San Francisco and Hawaii. American Journal of Public Health, 96(4), 677–684. doi:10.2105/AJPH.2004.060442.

    PubMed  Google Scholar 

  • Gee, G. C., Delva, J., & Takeuchi, D. (2007a). Relationships between self-reported unfair treatment and prescription medication use, illicit drug use, and alcohol dependence among Filipino Americans. American Journal of Public Health, 97(5), 933–940. doi:10.2105/AJPH.2005.075739.

    PubMed  Google Scholar 

  • Gee, G. C., Ryan, A., Laflamme, D. J., & Holt, J. (2006b). Self-reported discrimination and mental health status among African descendents, Mexican Americans, and other Latinos in the New Hampshire REACH 2010 Initiative: The added dimension of immigration. American Journal of Public Health, 96(10), 1821–1828. doi:10.2105/AJPH.2005.080085.

    PubMed  Google Scholar 

  • Gee, G. C., Spencer, M. S., Chen, J., & Takeuchi, D. (2007c). A nationwide study of discrimination and chronic health conditions among Asian Americans. American Journal of Public Health, 97(7), 1275–1282. doi:10.2105/AJPH.2006.091827.

    PubMed  Google Scholar 

  • Gee, G. C., Spencer, M., Chen, J., Yip, T., & Takeuchi, D. (2007b). The association between self-reported racial discrimination and 12-month DSM-IV mental disorders among Asian Americans nationwide. Social Science & Medicine, 64(10), 1984–1996. doi:10.1016/j.socscimed.2007.02.013.

    Google Scholar 

  • Gibbons, F. X, Yeh, H. C., Gerrard, M., Cleveland, M. J., Cutrona, C., Simons, R. L., & Brody, G. H. (2007). Early experience with racial discrimination and conduct disorder as predictors of subsequent drug use: A critical period hypothesis. Drug and Alcohol Dependence, 88(Suppl 1), 27–37.

    Google Scholar 

  • Goldsmith, A. H., Hamilton, Darrick., & Darity, William, Jr. (2007). From dark to light: Skin color and wages among African-Americans. The Journal of Human Resources, 42(4), 701–738.

    Google Scholar 

  • Gomez, J. P., & Trierweiler, S. (2001). Does discrimination terminology create response bias in questionnaire studies of discrimination? Personality and Social Psychology Bulletin, 27(5), 630–638. doi:10.1177/0146167201275011.

    Google Scholar 

  • Green, A. R., Carney, D. R., Pallin, D. J., Ngo, L. H., Raymond, K. L., Iezzoni, L. I., et al. (2007). Implicit bias among physicians and its prediction of thrombolysis decisions for black and white patients. Journal of General Internal Medicine, 22(9), 1231–1238. doi:10.1007/s11606-007-0258-5.

    PubMed  Google Scholar 

  • Greene, M. L., Way, N., & Pahl, K. (2006). Trajectories of perceived adult and peer discrimination among Black, Latino, and Asian American adolescents: Patterns and psychological correlates. Developmental Psychology, 42(2), 218–236. doi:10.1037/0012-1649.42.2.218.

    PubMed  Google Scholar 

  • Guyll, M., Matthews, K. A., & Bromberger, J. T. (2001). Discrimination and unfair treatment: Relationship to cardiovascular reactivity among African American and European American women. Health Psychology, 20(5), 315–325. doi:10.1037/0278-6133.20.5.315.

    PubMed  Google Scholar 

  • Harrell, S. P. (1997). The Racism and Life Experience Scales (RaLES): Self-administration version. Los Angeles, CA: California School of Professional Psychology.

    Google Scholar 

  • Harris, R., Tobias, M., Jeffreys, M., Waldegrave, K., Karlsen, S., & Nazroo, J. (2006a). Effects of self-reported racial discrimination and deprivation on Māori health and inequalities in New Zealand: Cross-sectional study. Lancet, 367(9527), 2005–2009. doi:10.1016/S0140-6736(06)68890-9.

    PubMed  Google Scholar 

  • Harris, R., Tobias, M., Jeffreys, M., Waldegrave, K., Karlsen, S., & Nazroo, J. (2006b). Racism and health: The relationship between experience of racial discrimination and health in New Zealand. Social Science & Medicine, 63(6), 1428–1441. doi:10.1016/j.socscimed.2006.04.009.

    Google Scholar 

  • Harvey, A. G., & Bryant, R. A. (2000). Memory for acute stress disorder symptoms: a two-year prospective study. The Journal of Nervous and Mental Disease, 188(9), 602–607. doi:10.1097/00005053-200009000-00007.

    PubMed  Google Scholar 

  • Harvey, A. G., & Bryant, R. A. (2002). Acute stress disorder: A synthesis and critique. Psychological Bulletin, 128(6), 886–902. doi:10.1037/0033-2909.128.6.886.

    PubMed  Google Scholar 

  • Hoyo, C., Yarnall, S. H., Skinner, C. S., Moorman, P. G., Sellers, D., & Reid, L. (2005). Pain predicts non adherence to pap swear screening among middle-aged African American Women. Preventive Medicine, 41, 439–445. doi:10.1016/j.ypmed.2004.11.021.

    PubMed  Google Scholar 

  • Jackson, B., Kubzansky, L. D., & Wright, R. J. (2006). Linking perceived unfairness to physical health: The perceived unfairness model. Review of General Psychology, 10(1), 21–40. doi:10.1037/1089-2680.10.1.21.

    Google Scholar 

  • Jang, Y., Kim, G., & Chiriboga, D. A. (2005). Health, healthcare utilization, and satisfaction with service: Barriers and facilitators for older Korean Americans. Journal of the American Geriatrics Society, 53(9), 1613–1617. doi:10.1111/j.1532-5415.2005.53518.x.

    PubMed  Google Scholar 

  • Jones, J. M. (1997). Prejudice and racism. New York, NY: McGraw-Hill Inc.

    Google Scholar 

  • Jones, C. P. (2000). Levels of racism: A theoretical framework and a gardener’s tale. American Journal of Public Health, 90(8), 1212–1215.

    PubMed  Google Scholar 

  • Kalichman, S. C., Simbayi, L. C., Kagee, A., Toefy, Y., Jootse, S., Cain, D., et al. (2006). Associations of poverty, substance use and HIV transmission risk behaviors in three South African Communities. Social Science & Medicine, 62, 1641–1649. doi:10.1016/j.socscimed.2005.08.021.

    Google Scholar 

  • Karlsen, S., Nazroo, J. Y., McKenzie, K., Bhui, K., & Weich, S. (2005). Racism, psychosis and common mental disorder among ethnic minority groups in England. Psychological Medicine, 35(12), 1795–1803. doi:10.1017/S0033291705005830.

    PubMed  Google Scholar 

  • Kaufman, J. S., Cooper, R. S., & McGee, D. L. (1997). Socioeconomic status and health in blacks and whites: The problem of residual confounding and the resiliency of race. Epidemiology (Cambridge, Mass), 8, 621–628. doi:10.1097/00001648-199710000-00002.

    Google Scholar 

  • Keith, V. M., & Herring, C. (1991). Skin tone and stratification in the black community. American Journal of Sociology, 97(3), 760–778. doi:10.1086/229819.

    Google Scholar 

  • Kessler, R. C., Galea, S., Gruber, M. J., Sampson, N. A., Ursano, R. J., & Wessely, S. (2008). Trends in mental illness and suicidality after Hurricane Katrina. Journal of Molecular Psychiatry, 13, 374–384. doi:10.1038/sj.mp.4002119.

    Google Scholar 

  • Kessler, R. C., Mickelson, K. D., & Williams, D. R. (1999). The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. Journal of Health and Social Behavior, 40, 208–230. doi:10.2307/2676349.

    PubMed  Google Scholar 

  • Khaylis, A., Waelde, L. C., & Bruce, E. J. (2007). The role of ethnic identity in the relationship of race-related stress to PTSD symptoms among young adults. Journal of Trauma & Dissociation, 8(4), 91–105. doi:10.1300/J229v08n04_06.

    Google Scholar 

  • King, K. R. (2005). Why is discrimination stressful? The mediating role of cognitive appraisal. Cultural Diversity & Ethnic Minority Psychology, 11(3), 202–212. doi:10.1037/1099-9809.11.3.202.

    Google Scholar 

  • Kraus, V., & Koresh, Y. (1992). The course of residential segregation: Ethnicity, socioeconomic status, and suburbanization in Israel. The Sociological Quarterly, 33, 303–319. doi:10.1111/j.1533-8525.1992.tb00377.x.

    Google Scholar 

  • Kressin, N. R., Kristal, R. L., & Manze, M. (2008). Perceptions of race/ethnicity based discrimination: A review of measures and evaluation of their usefullness for the health care setting. Journal of Health Care for the Poor and Underserved, 19, 697–730. doi:10.1353/hpu.0.0041.

    PubMed  Google Scholar 

  • Krieger, N. (1990). Racial and gender discrimination: Risk Factors for high blood pressure? Social Science & Medicine, 30(12), 1273–1281. doi:10.1016/0277-9536(90)90307-E.

    Google Scholar 

  • Krieger, N. (1999). Embodying Inequality: A review of concepts, measures, and methods for studying health consequences of discrimination. International Journal of Health Services, 29(2), 295–352. doi:10.2190/M11W-VWXE-KQM9-G97Q.

    PubMed  Google Scholar 

  • Krieger, N., Smith, K., Naishadham, D., Hartman, C., & Barbeau, E. M. (2005). Experiences of discrimination: Validity and reliability of a self-report measure for population health research on racism and health. Social Science & Medicine, 61(7), 1576–1596. doi:10.1016/j.socscimed.2005.03.006.

    Google Scholar 

  • Krysan, M., & Couper, M. P. (2003). Race in the live and virtual interview: Racial deference, social desirability, and activation effects in attitude surveys. Social Psychology Quarterly, 66(4), 364–383. doi:10.2307/1519835.

    Google Scholar 

  • Kubany, E. S., Haynes, S. N., Leisen, M. B., Owens, J. A., Kaplan, A. S., Watson, S. B., et al. (2000). Development and preliminary validation of a brief broad-spectrum measure of trauma exposure: The Traumatic Life Events Questionnaire. Psychological Assessment, 12(2), 210–224. doi:10.1037/1040-3590.12.2.210.

    PubMed  Google Scholar 

  • Kung, H. C., Hoyert, D. L., Xu, J., & Murphy, S. L. (2008). Deaths: Final data for 2005. National Vital Statistics Reports, 56(10), 4–26.

    Google Scholar 

  • Lam, B. (2007). Impact of perceived racial discrimination and collective self-esteem on psychological distress among vietnamese-american college students: Sense of coherence as mediator. The American Journal of Orthopsychiatry, 77(3), 370–376. doi:10.1037/0002-9432.77.3.370.

    PubMed  Google Scholar 

  • Lam, A. M., Tsoi, K. W., & Chan, T. S. (2005). Adolescent Chinese immigrants in Hong Kong: A comparison with locally born students and factors associated with their psychological well-being. International Journal of Adolescent Medicine and Health, 17(2), 157–168.

    PubMed  Google Scholar 

  • Landrine, H., & Klonoff, E. A. (1996). The schedule of racist events: A measure of racial discrimination and a study of its negative physical and mental health consequences. The Journal of Black Psychology, 22(2), 144–168. doi:10.1177/00957984960222002.

    Google Scholar 

  • Landrine, H., Klonoff, E. A., Corral, I., Fernandez, S., & Roesch, S. (2006). Conceptualizing and measuring ethnic discrimination in health research. Journal of Behavioral Medicine, 29(1), 79–94. doi:10.1007/s10865-005-9029-0.

    PubMed  Google Scholar 

  • Larson, A., Gillies, M., Howard, P. J., & Coffin, J. (2007). It’s enough to make you sick: The impact of racism on the health of Aboriginal Australians. Australian and New Zealand Journal of Public Health, 31(4). doi: 10.1111/j.1753–6405.2007.00079.x.

  • Lauderdale, D. S. (2006). Birth outcomes for Arabic-named women in California before and after September 11. Demography, 43(1), 185–201. doi:10.1353/dem.2006.0008.

    PubMed  Google Scholar 

  • Lepore, S. J., Evans, G. W., & Palsane, M. N. (1991). Social hassles and psychological health in the context of chronic crowding. Journal of Health and Social Behavior, 32, 357–367. doi:10.2307/2137103.

    PubMed  Google Scholar 

  • Lepore, S. J., Revenson, T. A., Weinberger, S. L., Weston, P., Frisina, P. G., Robertson, R., et al. (2006). Effects of social stressors on cardiovascular reactivity in Black and White women. Annals of Behavioral Medicine, 31(2), 120–127. doi:10.1207/s15324796abm3102_3.

    PubMed  Google Scholar 

  • Levine, R. S., Foster, J. E., Fullilove, R. E., Briggs, N. C., Hull, P. C., Husaini, B. A., et al. (2001). Black-white inequalities in mortality and life expectancy, 1933–1999: Implications for Healthy People 2010. Public Health Reports, 116, 474–483.

    PubMed  Google Scholar 

  • Levy, B. R., Slade, M. D., Kasl, S., & Kunker, S. R. (2002). Longevity increased by positive self-perceptions of aging. Journal of Personality and Social Psychology, 83(2), 261–270. doi:10.1037/0022-3514.83.2.261.

    PubMed  Google Scholar 

  • Lewis, T., Everson-Rose, S., Powell, L. H., Matthews, K. A., Brown, C., Karavolos, K., et al. (2006). Chronic exposure to everyday discrimination and coronary artery calcification in African-American women: The SWAN Heart Study. Psychosomatic Medicine, 68, 362–368. doi:10.1097/01.psy.0000221360.94700.16.

    PubMed  Google Scholar 

  • Lincoln, K. D., Chatters, L. M., Taylor, R. J., & Jackson, J. S. (2007). Profiles of depressive symptoms among African Americans and Caribbean Blacks. Social Science & Medicine, 65, 200–213. doi:10.1016/j.socscimed.2007.02.038.

    Google Scholar 

  • Lindström, M. (2008). Social capital, anticipated ethnic discrimination and self-reported psychological health: A population-based study. Social Science & Medicine, 66(1), 1–13. doi:10.1016/j.socscimed.2007.07.023.

    Google Scholar 

  • Locher, J. R., Roth, C. S., Sawyer-Baker, P., Bodner, E., & Allman, R. M. (2005). Soclai isolation, support, and capital and nutirtional risk in an older sample: Ethnic and gender differences. Social Science & Medicine, 60, 747–761. doi:10.1016/j.socscimed.2004.06.023.

    Google Scholar 

  • Major, B., Kaiser, C. R., O’Brien, L. T., & McCoy, S. K. (2007). Perceived discrimination as worldview threat or worldview confirmation: Implications for self-esteem. Journal of Personality and Social Psychology, 92(6), 1068–1086. doi:10.1037/0022-3514.92.6.1068.

    PubMed  Google Scholar 

  • Malat, J., & Hamilton, M. A. (2006). Preference for same-race health care providers and perceptions of interpersonal discrimination in health care. Journal of Health and Social Behavior, 47(2), 173–187.

    PubMed  Google Scholar 

  • Malat, J., & van Ryn, M. (2005). African-American preference for same-race healthcare providers: The role of healthcare discrimination. Ethnicity & Disease, 15(4), 740–747.

    Google Scholar 

  • Matthews, K. A., Salomon, K., Kenyon, K., & Zhou, F. (2005). Unfair treatment, discrimination, and ambulatory blood pressure in black and white adolescents. Health Psychology, 24(3), 258–265. doi:10.1037/0278-6133.24.3.258.

    PubMed  Google Scholar 

  • Mays, V. M., Cochran, S. D., & Barnes, N. W. (2007). Race, race-based discrimination, and health outcomes among African Americans. Annual Review of Psychology, 58, 201–225. doi:10.1146/annurev.psych.57.102904.190212.

    PubMed  Google Scholar 

  • McNeilly, M. D., Anderson, N. B., Armstead, C. A., Clark, R., Corbett, M., Robinson, E. L., et al. (1996). The percieved racism scale: A multidimensional assessment of the experience of white racism among African Americans. Ethnicity and Disease, 6(1,2), 154–166.

    PubMed  Google Scholar 

  • Merritt, M. M., Bennett, G. G., Jr, Williams, R. B., Edwards, C. L., & Sollers, J., 3rd. (2006). Perceived racism and cardiovascular reactivity and recovery to personally relevant stress. Health Psychology, 25(3), 364–369. doi:10.1037/0278-6133.25.3.364.

    PubMed  Google Scholar 

  • Miller, G. V., & Travers, C. J. (2005). Ethnicity and the experience of work: Job stress and satisfaction of minority ethnic teachers in the UK. International Review of Psychiatry (Abingdon England), 17(5), 317–327. doi:10.1080/09540260500238470.

    Google Scholar 

  • Monroe, S. M. (2008). Modern approaches to conceptualizing and measuring human life stress. Annual Review of Clinical Psychology, 4, 33–52. doi:10.1146/annurev.clinpsy.4.022007.141207.

    PubMed  Google Scholar 

  • Montgomery, E., & Foldspang, A. (2007). Discrimination, mental problems and social adaptation in young refugees. European Journal of Public Health, 18(2), 156–161.

    PubMed  Google Scholar 

  • Moody-Ayers, S. Y., Stewart, A. L., Covinsky, K. E., & Inouye, S. K. (2005). Prevalence and correlates of perceived societal racism in older African-American adults with type 2 diabetes mellitus. Journal of the American Geriatrics Society, 53(12), 2202–2208. doi:10.1111/j.1532-5415.2005.00501.x.

    PubMed  Google Scholar 

  • Nápoles-Springer, A. M., Santoyo, J., Houston, K., Pérez-Stable, E. J., & Stewart, A. L. (2005). Patients’ perceptions of cultural factors affecting the quality of their medical encounters. Health Expectations, 8(1), 4–17. doi:10.1111/j.1369-7625.2004.00298.x.

    PubMed  Google Scholar 

  • National Center for Health Statistics. (2007). Health United States, 2007 with Chartbook Trends in the Health of Americans. Hyattsville, MD.

  • Noh, S., Kaspar, V., & Wickrama, K. A. (2007). Overt and subtle racial discrimination and mental health: Preliminary findings for Korean immigrants. American Journal of Public Health, 97(7), 1269–1274. doi:10.2105/AJPH.2005.085316.

    PubMed  Google Scholar 

  • Oppedal, B., Røysamb, E., & Heyerdahl, S. (2005). Ethnic group, acculturation, and psychiatric problems in young immigrants. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 46(6), 646–660. doi:10.1111/j.1469-7610.2004.00381.x.

    PubMed  Google Scholar 

  • Pamuk, E., Makuk, D., Heck, K., & Reuben, C. (1998). Socioeconomic status and health chartbook. Hyattsville, MD: National Center for Health Statistics.

    Google Scholar 

  • Pantzer, K., Rajmi, L., Tebe, C., Codina, F., Serra-Sutton, V., Ferrer, M., et al. (2006). Health related quality of life in immigrants and native school aged adolescents in Spain. Journal of Epidemiology and Community Health, 60(8), 694–698. doi:10.1136/jech.2005.044073.

    PubMed  Google Scholar 

  • Paradies, Y. (2005). Anti-racism and indigenous Australians. Analysis of Social Issues aand Public Policy, 5(1), 1–28.

    Google Scholar 

  • Paradies, Y. (2006). A systematic review of empirical research on self-reported racism and health. International Journal of Epidemiology, 35(4), 888–901. doi:10.1093/ije/dyl056.

    PubMed  Google Scholar 

  • Pearlin, L. I., Schieman, S., Fazio, E. M., & Meersman, S. C. (2005). Stress, health, and the life course: Some conceptual perspectives. Journal of Health and Social Behavior, 46(June), 205–219.

    PubMed  Google Scholar 

  • Peters, R. M. (2006). The relationship of racism, chronic stress emotions, and blood pressure. Journal of Nursing Scholarship, 38(3), 234–240. doi:10.1111/j.1547-5069.2006.00108.x.

    PubMed  Google Scholar 

  • Peters, R. M., Benkert, R., Dinardo, E., & Templin, T. (2007). Assessing quality of care for African Americans with hypertension. Journal for Healthcare Quality, 29(3), 10–20.

    PubMed  Google Scholar 

  • Pettigrew, T. F. (1964). Profile of the Negro American. Princeton, NJ: Van Nostrand.

    Google Scholar 

  • Pieterse, A. L., & Carter, R. T. (2007). An examination of the relationship between general life stress, racism-related stress, and psychological health among black men. Journal of Counseling Psychology, 54(1), 101–109. doi:10.1037/0022-0167.54.1.101.

    Google Scholar 

  • Piette, J. D., Bibbins-Domingo, K., & Schillinger, D. (2006). Health care discrimination, processes of care, and diabetes patients’ health status. Patient Education and Counseling, 60(1), 41–48. doi:10.1016/j.pec.2004.12.001.

    PubMed  Google Scholar 

  • Pole, N., Best, S., Metsler, T., & Marmar, C. (2005). Why are Hispanics at greater risk for PTSD. Cultural Diversity & Ethnic Minority Psychology, 11(2), 144–161. doi:10.1037/1099-9809.11.2.144.

    Google Scholar 

  • Poyrazli, S., & Lopez, M. D. (2007). An exploratory study of perceived discrimination and homesickness: A comparison of international students and American students. The Journal of Psychology, 141(3), 263–280. doi:10.3200/JRLP.141.3.263-280.

    PubMed  Google Scholar 

  • Richman, L. S., Bennett, G. G., Pek, J., Siegler, I., & Williams, R. B. J. (2007). Discrimination, dispositions, and cardiovascular responses to stress. Health Psychology, 26(6), 675–683. doi:10.1037/0278-6133.26.6.675.

    PubMed  Google Scholar 

  • Roberts, C. B., Vines, A. I., Kaufman, J. S., & James, S. A. (2007). Cross-sectional association between perceived discrimination and hypertension in African-American men and women: The Pitt County Study. American Journal of Epidemiology, 167(5), 624–632. EPub.

    PubMed  Google Scholar 

  • Romero, A. J., Martinez, D., & Carvajal, S. C. (2007). Bicultural stress and adolescent risk behaviors in a community sample of Latinos and non-Latino European Americans. Ethnicity & Health, 12(5), 443–463. doi:10.1080/13557850701616854.

    Google Scholar 

  • Ryan, A. M., Gee, G. C., & Laflamme, D. F. (2006). The Association between self-reported discrimination, physical health and blood pressure: Findings from African Americans, Black immigrants, and Latino immigrants in New Hampshire. Journal of Health Care for the Poor and Underserved, 17(2), 116–132. doi:10.1353/hpu.2006.0079.

    PubMed  Google Scholar 

  • Salvatore, J., & Shelton, J. N. (2007). Cognitive costs of exposure to racial prejudice. Psychological Science, 18(9), 810–815. doi:10.1111/j.1467-9280.2007.01984.x.

    PubMed  Google Scholar 

  • Schaeffer, N. C., & Presser, S. (2003). The science of asking questions. Annual Review of Sociology, 29, 65–88. doi:10.1146/annurev.soc.29.110702.110112.

    Google Scholar 

  • Schulz, R., & Beach, S. R. (1999). Caregiving as a risk factor for mortality: The caregiver heal effects study. Journal of the American Medical Association, 282(3), 2215–2219. doi:10.1001/jama.282.23.2215.

    PubMed  Google Scholar 

  • Schulz, A. J., Gravlee, C. C., Williams, D. R., Israel, B. A., Mentz, G., & Rowe, Z. (2006a). Discrimination, symptoms of depression, and self-rated health among african american women in detroit: Results from a longitudinal analysis. American Journal of Public Health, 96(7), 1265–1270. doi:10.2105/AJPH.2005.064543.

    PubMed  Google Scholar 

  • Schulz, A. J., Israel, B. A., Zenk, S. N., Parker, E. A., Lichtenstein, R., Shellman-Weir, S., et al. (2006b). Psychosocial stress and social support as mediators of relationships between income, length of residence and depressive symptoms among African American women on Detroit’s eastside. Social Science & Medicine, 62(2), 510–522. doi:10.1016/j.socscimed.2005.06.028.

    Google Scholar 

  • Schulz, A. J., Williams, D. R., Israel, B. A., & Lempert, L. B. (2002). Racial and spatial relations as fundamental determinants of health in Detroit. The Milbank Quarterly, 80(4), 677–707. doi:10.1111/1468-0009.00028.

    PubMed  Google Scholar 

  • Schuman, H., Charlotte, S., Larwrence, B., & Maria, K. (1997). Racial attitudes in America: Trends and interpretations (Revised ed.). Cambridge, MA: Harvard University Press.

  • Schwarz, N. (2007). Cognitive aspects of survey methodology. Applied Cognitive Psychology, 21, 277–287. doi:10.1002/acp.1340.

    Google Scholar 

  • Seeman, T. E., Crimmins, E., Huang, M. H., Singer, B., Bucur, A., Gruenewald, T., et al. (2004). Cumulative biological risk and socio-economic differences in mortality: MacArthur studies of successful aging. Social Science & Medicine, 58, 1985–1997. doi:10.1016/S0277-9536(03)00402-7.

    Google Scholar 

  • Sellers, S. L., Bonham, V., Neighbors, H.·W., & Amell, J. W. (2006). Effects of racial discrimination and health behaviors on mental and physical health of middle-class african American Men. Health Education & Behavior, 27.

  • Sheridan, L. (2006). Islamophobia pre and post September 11th 2001. Journal of Interpersonal Violence, 21(3), 317–336. doi:10.1177/0886260505282885.

    PubMed  Google Scholar 

  • Siefert, K., Finlayson, T. L., Williams, D. R., Delva, J., & Ismail, A. I. (2007). Modifiable risk and protective factors for depressive symptoms in low-income African American mothers. The American Journal of Orthopsychiatry, 77(1), 113–123. doi:10.1037/0002-9432.77.1.113.

    PubMed  Google Scholar 

  • Simons, R. L., Simons, L. G., Burt, C. H., Drummund, H., Stewart, E., Brody, G. H., et al. (2006). Supportive parenting moderates the effect of discrimination upon anger, hostile view of relationships, and violence among African American boys. Journal of Health and Social Behavior, 47(4), 373–389.

    Article  PubMed  Google Scholar 

  • Smedley, B. D., Stith, A. Y., & Nelson, A. R. (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: National Academies Press.

    Google Scholar 

  • Smokowski, P. R., & Bacallao, M. (2007). Acculturation, internalizing mental health symptoms, and self-esteem: Cultural experiences of Latino adolescents in North Carolina. Child Psychiatry and Human Development, 37(3), 273–292. doi:10.1007/s10578-006-0035-4.

    PubMed  Google Scholar 

  • Sohler, N., Li, X., & C, C. (2007). Perceived discrimination among severly disadvantaged people with HIV infection. Public Health Reports, 122(3), 347–355.

    PubMed  Google Scholar 

  • Stam, R. (2007). PTSD and stress sensitization: A tale of brain and body. Part 1: Human studies. Neuroscience, 31, 530–557.

    Google Scholar 

  • Steele, C. M. (1997). A threat in the air: How stereotypes shape intellectual identity and performance. The American Psychologist, 52(6), 613–629. doi:10.1037/0003-066X.52.6.613.

    PubMed  Google Scholar 

  • Steffen, P. R., & Bowden, M. (2006). Sleep disturbance mediates the relationship between perceived racism and depressive symptoms. Ethnicity & Disease, 16(1), 16–21.

    Google Scholar 

  • Stetler, C., Chen, E., & Miller, G. E. (2006). Written disclosure of experiences with racial discrimination and antibody response to an influenza vaccine. International Journal of Behavioral Medicine, 13(1), 60–68. doi:10.1207/s15327558ijbm1301_8.

    PubMed  Google Scholar 

  • Stevens, G. W., Vollebergh, W. A., Pels, T. V., & Crinjnen, A. A. (2005a). Predicting externalizing problems in Moroccan immigrant adolescents in the Netherlands. Social Psychiatry and Psychiatric Epidemiology, 40(7), 571–579. doi:10.1007/s00127-005-0926-x.

    PubMed  Google Scholar 

  • Stevens, G. W., Vollebergh, W. A., Pels, T. V., & Crinjnen, A. A. (2005b). Predicting internalizing problems in Moroccan immigrant adolescents in the Netherlands. Social Psychiatry and Psychiatric Epidemiology, 40, 1003–10011. doi:10.1007/s00127-005-0988-9.

    PubMed  Google Scholar 

  • Sujoldzic, A., Peternel, L., Kulenovic, T., & Terzic, R. (2006). Social determinants of health—a comparative study of Bosnian adolescents in different cultural contexts. Collegium Antropologicum, 30(4), 703–711.

    PubMed  Google Scholar 

  • Tabibnia, G., Satpute, A. B., & Lieberman, M. D. (2008). The sunny side of fairness: Preference for fairness activates reward circuitry (and disregarding unfairness activates self-control circuitry). Psychological Science, 19, 339–347. doi:10.1111/j.1467-9280.2008.02091.x.

    PubMed  Google Scholar 

  • Taylor, J., Henderson, D., & Jackson, B. B. (1991). A holistic model for understanding and predicting depression in African American women. Journal of Community Psychology, 19, 306–320. doi :10.1002/1520-6629(199110)19:4<306::AID-JCOP2290190403>3.0.CO;2-Z.

    Google Scholar 

  • Taylor, J., & Jackson, B. (1990). Factors affecting alcohol consumption in black women, Part II. The International Journal of the Addictions, 25(12), 1415–1427.

    PubMed  Google Scholar 

  • Taylor, J., & Jackson, B. B. (1991). Evaluation of a holistic model of mental health symptoms in African American women. The Journal of Black Psychology, 18, 19–45. doi:10.1177/00957984910181003.

    Google Scholar 

  • Taylor, T. R., Williams, C. D., Makambi, K. H., Mouton, C., Harrell, J. P., Cozier, Y., et al. (2007). Racial discrimination and breast cancer incidence in US Black women: The Black Women’s Health Study. American Journal of Epidemiology, 166(1), 46–54. doi:10.1093/aje/kwm056.

    PubMed  Google Scholar 

  • Terrell, F., Miller, A. R., Foster, K., & Watkins, C. E., Jr. (2006). Racial discrimination-induced anger and alcohol use among black adolescents. Adolescence, 41(163), 485–492.

    PubMed  Google Scholar 

  • Thomas, K. S., Bardwell, W. A., Ancoli-Israel, S., & Dimsdale, J. E. (2006). The toll of ethnic discrimination on sleep architecture and fatigue. Health Psychology, 25(5), 635–642. doi:10.1037/0278-6133.25.5.635.

    PubMed  Google Scholar 

  • Tourangeau, R., & Yan, T. (2007). Sensitive questions in surveys. Psychological Bulletin, 133(5), 859–883. doi:10.1037/0033-2909.133.5.859.

    PubMed  Google Scholar 

  • Trivedi, A. N., & Ayanian, J. Z. (2006). Perceived discrimination and use of preventive health services. Journal of General Internal Medicine, 21(6), 553–558. doi:10.1111/j.1525-1497.2006.00413.x.

    PubMed  Google Scholar 

  • Tull, E. S., Cort, M. A., Gwebu, E. T., & Gwebu, K. (2007). Internalized racism is associated with elevated fasting glucose in a sample of adult women but not men in Zimbabwe. Ethnicity & Disease, 17(4), 731–735.

    Google Scholar 

  • Tull, E. S., Wickramasuriya, T., Taylor, J., Smith-Burns, V., Brown, M., Champaigne, G., et al. (1999). Relationship of internalized racism to abdominal obesity and blood pressure in Afro-Caribbean women. Journal of the National Medical Association, 91, 447–452.

    PubMed  Google Scholar 

  • Turner, R. J., Wheaton, B., & Lloyd, D. A. (1995). The epidemiology of social stress. American Sociological Review, 60(1), 104–125. doi:10.2307/2096348.

    Google Scholar 

  • Umaña-Taylor, A. J., & Updegraff, K. A. (2007). Latino adolescents’ mental health: Exploring the interrelations among discrimination, ethnic identity, cultural orientation, self-esteem, and depressive symptoms. Journal of Adolescence, 30(4), 549–567. doi:10.1016/j.adolescence.2006.08.002.

    PubMed  Google Scholar 

  • Utsey, S. O., & Hook, J. N. (2007). Heart rate variability as a physiological moderator of the relationship between race-related stress and psychological distress in African Americans. Cultural Diversity & Ethnic Minority Psychology, 13(3), 250–253. doi:10.1037/1099-9809.13.3.250.

    Google Scholar 

  • Utsey, S. O., Lanier, Y., Williams, O., Bolden, M., & Lee, A. (2006). Moderator effects of cognitive ability and social support on the relation between race-related stress and quality of life in a community sample of black Americans. Cultural Diversity & Ethnic Minority Psychology, 12(2), 334–346. doi:10.1037/1099-9809.12.2.334.

    Google Scholar 

  • Utsey, S. O., & Ponterotto, J. G. (1996). Development and validation of the index of race-related stress (IRRS). Journal of Counseling Psychology, 43, 490–501. doi:10.1037/0022-0167.43.4.490.

    Google Scholar 

  • Van Houtven, C. H., Voils, C. I., Oddone, E. Z., Weinfurt, K. P., Friedman, J. Y., Schulman, K. A., et al. (2005). Perceived discrimination and reported delay of pharmacy prescriptions and medical tests. Journal of General Internal Medicine, 20(7), 578–583. doi:10.1007/s11606-005-0104-6.

    PubMed  Google Scholar 

  • van Ryn, M. (2002). Research on the provider contribution to race/ethnicity disparities in medical care. Medical Care, 40(1), I140–I151. doi:10.1097/00005650-200201001-00015.

    PubMed  Google Scholar 

  • Veling, W., Selten, J. P., Susser, E., Laan, W., Mackenbach, J. P., & Hoek, H. W. (2007). Discrimination and the incidence of psychotic disorders among ethnic minorities in The Netherlands. International Journal of Epidemiology, 36(4), 761–768. doi:10.1093/ije/dym085.

    PubMed  Google Scholar 

  • Vines, A. I., Baird, D. D., McNeilly, M., Hertz-Piccioto, I., Light, K. C., & Stevens, J. (2006). Social correlates of the chronic stress of perceived racism among black women. Ethnicity & Disease, 16(1), 101–107.

    Google Scholar 

  • Vines, A. I., Baird, D. D., Stevens, J., Hertz-Picciotto, I., Light, K. C., & McNeilly, M. (2007). Associations of abdominal fat with perceived racism and passive emotional responses to racism in African American women. American Journal of Public Health, 97(3), 526–530. doi:10.2105/AJPH.2005.080663.

    PubMed  Google Scholar 

  • Vos, M. S., & de Haes, J. C. J. M. (2007). Denial in cancer patients, an explorative review. Psycho-Oncology, 16, 12–25. doi:10.1002/pon.1051.

    PubMed  Google Scholar 

  • Wadsworth, E., Dillon, K., Shaw, C., Bhui, K., Stansfeld, S., & Smith, A. (2007). Racial discrimination ethnicity and work stress. Occupational Medicine (Oxford, England), 57(1), 18–24. doi:10.1093/occmed/kql088.

    Google Scholar 

  • Wagner, J., & Abbott, G. (2007). Depression and depression care in diabetes: Relationship to perceived discrimination in African Americans. Diabetes Care, 30(2), 364–366. doi:10.2337/dc06-1756.

    PubMed  Google Scholar 

  • Waltermaurer, E., Watson, C. A., & McNutt, L. A. (2006). Black women’s health: The effect of perceived racism and intimate partner violence. Violence Against Women, 12(12), 1214–1222. doi:10.1177/1077801206293545.

    PubMed  Google Scholar 

  • Wamala, S., Boström, G., & Nyqvist, K. (2007b). Perceived discrimination and psychological distress in Sweden. British Journal of Psychiatry, 190, 75–76.

    Google Scholar 

  • Wamala, S., Merlo, J., Boström, G., & Hogstedt, C. (2007a). Perceived discrimination, socioeconomic disadvantage and refraining from seeking medical treatment in Sweden. Journal of Epidemiology and Community Health, 61(5), 409–415. doi:10.1136/jech.2006.049999.

    PubMed  Google Scholar 

  • Whitbeck, L. B., Adams, G. W., Hoyt, D. R., & Chen, X. (2004). Conceptualizing and measuring historical trauma among American Indian people. Journal of Community Psychology, 33(3/4), 119–130. doi:10.1023/B:AJCP.0000027000.77357.31.

    Google Scholar 

  • Williams, D. R. (1997). Race and health: Basic questions, emerging directions. Annals of Epidemiology, 7(5), 322–333. doi:10.1016/S1047-2797(97)00051-3.

    PubMed  Google Scholar 

  • Williams, D. R. (2004). Racism and Health. In K. E. Whitfield (Ed.), Closing the Gap: Improving the Health of Minority Elders in the New Millenium (pp. 69–80). Washington, D.C: Gerontological Society of America.

    Google Scholar 

  • Williams, D. R. (2005). The health of U.S. racial and ethnic populations. Journals of Gerontology: Series B 60B (Special Issue II):53–62.

  • Williams, D. R., & Collins, C. (1995). U.S. socioeconomic and racial differences in health: Patterns and explanations. Annual Review of Sociology, 21, 349–386. doi:10.1146/annurev.so.21.080195.002025.

    Google Scholar 

  • Williams, D. R., & Collins, C. A. (2001). Racial residential segregation: A fundamental cause of racial disparities in health. Public Health Reports, 116, 404–415.

    PubMed  Google Scholar 

  • Williams D, Gonzalez H, Williams S, Mohammed S, Moomal H, Stein D. (2008) Perceived discrimination, race, and health in South Africa. Social Science & Medicine, 67, 441–452.

    Google Scholar 

  • Williams, D. R., & Jackson, P. B. (2005). Social sources of racial disparities in health. Health Affairs, 24(2), 325–334. doi:10.1377/hlthaff.24.2.325.

    PubMed  Google Scholar 

  • Williams, D. R., & Neighbors, H. W. (2001). Racism, discrimination and hypertension: Evidence and needed research. Ethnicity & Disease, 11, 800–816.

    Google Scholar 

  • Williams, D. R., Neighbors, H. W., & Jackson, J. S. (2003). Racial/ethnic discrimination and health: Findings from community studies. American Journal of Public Health, 93(2), 200–208.

    Article  PubMed  Google Scholar 

  • Williams, D. R., Spencer, M., & Jackson, J. S. (1999). Race, stress, and physical health: The role of group identity. In R. J. Contrada & R. D. Ashmore (Eds.), Self, Social Identity, and Physical Health: Interdisciplinary Explorations (pp. 71–100). New York: Oxford University Press.

    Google Scholar 

  • Williams, D. R., Yu, Y., Jackson, J., & Anderson, N. (1997). Racial differences in physical and mental health: Socioeconomic status, stress, and discrimination. Journal of Health Psychology, 2(3), 335–351. doi:10.1177/135910539700200305.

    Google Scholar 

  • Wise, L. A., Palmer, J. R., Cozier, Y. C., Hunt, M. O., Stewart, E. A., & Rosenberg, L. (2007). Perceived racial discrimination and risk of uterine leiomyomata. Epidemiology (Cambridge, Mass), 18(6), 747–757.

    Google Scholar 

  • Wyatt, S. B., Williams, D. R., Calvin, R., Henderson, F., Walker, E., & Winters, K. (2003). Racism and cardiovascular disease in African Americans: Evidence and implications for the Jackson Heart Study. The American Journal of the Medical Sciences, 325(6), 315–331. doi:10.1097/00000441-200306000-00003.

    PubMed  Google Scholar 

  • Yehuda, R., Bryant, R., Marmar, C., & Zohar, J. (2005). Pathological Responses to Terrorism. Neuropsychopharmacology, 30, 1793–1805. doi:10.1038/sj.npp.1300816.

    PubMed  Google Scholar 

  • Yoder, K. A., Whitbeck, L. B., Hoyt, D. R., & LaFromboise, T. (2006). Suicidal ideation among American Indian youths. Archives of Suicide Research, 10(2), 177–190. doi:10.1080/13811110600558240.

    PubMed  Google Scholar 

  • Young, M., Stuber, J., Ahern, J., & Galea, S. (2005). Interpersonal discrimination and the health of illicit drug users. The American Journal of Drug and Alcohol Abuse, 31(3), 371–391. doi:10.1081/ADA-200056772.

    PubMed  Google Scholar 

  • Zamboni, B. D., & Crawford, I. (2007). Minority stress and sexual problems among African-American gay and bisexual men. Archives of Sexual Behavior, 36(4), 569–578. doi:10.1007/s10508-006-9081-z.

    PubMed  Google Scholar 

Download references

Acknowledgement

Preparation of this paper was supported in part by Grant R01 MH 59575 from the National Institute of Mental Health (D.R.W), Grant 3 U-01 HL 087322-02S1, a Research Supplement to U-01 HL 87322-02 from the National Heart Lung and Blood Institute (S.A.M.) and by the John D. and Catherine T. McArthur Foundation Research Network on Socioeconomic Status and Health (D.R.W). We wish to thank Steven Beeber and Gabriel Sirota for assistance with preparing the manuscript and Manuela Costa for assistance with the research.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David R. Williams.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Williams, D.R., Mohammed, S.A. Discrimination and racial disparities in health: evidence and needed research. J Behav Med 32, 20–47 (2009). https://doi.org/10.1007/s10865-008-9185-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-008-9185-0

Keywords

Navigation