Question

Through what pathways might racism and social exclusion affect the health of a population?

Answer 1

Racism can be defined as organized systems within societies that cause avoidable and unfair inequalities in power, resources, capacities and opportunities across racial or ethnic groups. Racism can manifest through beliefs, stereotypes, prejudices or discrimination. This encompasses everything from open threats and insults to phenomena deeply embedded in social systems and structures. Racism can occur at multiple levels, including: internalized (the incorporation of racist attitudes, beliefs or ideologies into one’s worldview), interpersonal (interactions between individuals) and systemic (for example, the racist control of and access to labor, material and symbolic resources within a society). Racism persists as a cause of exclusion, conflict and disadvantage on a global scale, and existing data suggests racism is increasing in many national contexts.

Racism and discrimination have adverse consequences to health. Racism is an organized system undergirded by an ideology of inferiority that categorizes population groups into ‘races’, assigns hierarchical status to these ‘racial’ groups, and uses this ranking to preferentially allocate societal goods and resources to those that are regarded as inherently superior. This often leads to the development of negative attitudes and beliefs toward racial out groups (prejudice), and differential treatment of members of these groups by both individuals and social institutions (discrimination). Individuals’ racial prejudice and discrimination are often used as indicators of racism in a society. However, racism often persists in institutional structures and policies even when there have been marked declines in racial prejudice at the level of individuals. Moreover, negative racial stereotypes are an additional source of discriminatory behaviour even among persons who are not prejudiced. Stereotypes are categorical beliefs about social groups that lead individuals to see members of a group as very similar to each other and as possessing common characteristics.This review will focus on evidence that racism and discrimination harm health among minorities in the United States (U.S.). Similar findings have been reported from studies conducted in other parts of the world.

Racism can impact health via several recognized pathways: (1) reduced access to employment, housing and education and/or increased exposure to risk factors (e.g., avoidable contact with police); (2) adverse cognitive/emotional processes and associated psychopathology; (3) allostatic load and concomitant patho-physiological processes; (4) diminished participation in healthy behaviors (e.g., sleep and exercise) and/or increased engagement in unhealthy behaviors (e.g., alcohol consumption) either directly as stress coping, or indirectly, via reduced self-regulation; and (5) physical injury as a result of racially-motivated violence.