Racism, Stress & Health

That there are Black-White inequalities in healthy aging is well-known. Compared to Whites, Blacks experience morbidity and mortality at earlier ages and show steeper age-related declines in health. Indeed, there are racial inequalities in health at nearly every stage in the life course and these inequalities have persisted as long as we have been documenting social group differences in health. However, despite our continual documentation of these inequalities, they persist and have even increased in some cases.

While there are many hypotheses regarding the causes of the persistent racial inequalities in health, structural racism is considered to be the fundamental cause, driving all other causes. With an emphasis on structural racism, we focus on the most powerful form of racism that maintains unequal access to social, economic, and political power based on racial group membership. Structural racism operates through societal institutions (i.e., institutional racism; e.g., employment, education, political, housing, health care) and does not require explicit intent on the part of institutional and societal actors to discriminate or treat people of different racial groups differently. Structural racism stands in contrast to much of the research on racism and health that focuses on interpersonal racism (composed of prejudice and discrimination) which contains notions of personal dislike or intention. Furthermore, structural racism operates through and is maintained by cultural racism, which centralizes the White racial frame, placing White (middle class) social mores and values as normative, and those of non-Whites as alternative. In the US, this White racial frame is characterized by the pervasive American creed and meritocratic hegemony and is juxtaposed against the insidious reality of political, social, and economic resources and barriers that are meted out by race. When members of non-White racial groups do not attain the American dream of upward mobility and material comfort, the race is stigmatized with negative stereotypes and the individuals that share the disadvantaged racial group status are burdened with this stigma, which has psychological implications even in the absence of personal discrimination. In sum, racism not only constrains Blacks through social, economic, and political mechanisms, but burdens Blacks with the stigmatizing stereotype of non-White, un-American normative values.

We examine the social and biological mechanisms that link the social, economic, and psychological consequences of structural racism to racial health inequalities over the life course. Examples of our work in the literature and in progress include clarifying critical periods in adulthood when economic strain result in poor health and examining the role of racism-related vigilance - and anticipatory stress burden of racism - in the health of Black Americans.

People

Research Assistant Professor, Survey Research Center, Institute for Social Research, University of Michigan

I am currently a Research Assistant Professor at the Survey Research Center of the Institute for Social Research at the University of Michigan, with an additional appointment in the Division of Nephrology in the Department of Internal Medicine. Both my pre- and post-doctoral training has emphasized interdisciplinary and transdisciplinary approaches to the study of health inequities, first at the Population Studies Center and then as a Robert Wood Johnson Foundation Health & Society Scholar, both at the University of Michigan.

Broadly speaking, I examine the ways in which social forces link racial group membership to the risk of poor health, particularly those conditions related to cardiovascular and renal diseases. In the US, despite tremendous resources devoted to the elimination of health inequalities, evidence suggests that they are growing. I would argue that our inability to eliminate (or even reduce) these inequalities is due to a lack of truly interdisciplinary approaches. Throughout my research program, I ground my approach to the study of race in the social sciences while integrating the biological sciences to ensure that the mechanisms I examine are both socially- and biologically-plausible.

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Projects

Transdisciplinary Approaches to the Study of Racism & Health Inequities (RacismLab)

The toxicity of racism has long been understood by communities of color - and with the growth of camera phones and social media, there has been a rapid growth in the public documentation and discussion of racism in the US. Within the Academy, there is a growing interest and scientific literature in multiple disciplines systematically documenting the linkages between racism and social, economic, political, and health-related resources and constraints. Nevertheless, there continues to be a lack of clarity about the ways in which racism affects the lives - and particularly the health - of people of color, making response and intervention challenging. This lack of clarity stems from little integration of scientific knowledge and collaboration across disciplines to foster deep theory development and hypothesis testing. Therefore, we are developing a transdisciplinary working group to bring together student and faculty scholars to develop innovative theoretical frameworks and empirical approaches to better understand the impact of racism on health.

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Chicago Community Adult Heath Study

CCAHS is the only study of a large U.S. city to offer comprehensive assessments of all neighborhoods in a city, which allows researchers to implement spatial analytic models. CCAHS began as a collaborative project with investigators from the Project on Human Development in Chicago Neighborhoods (PHDCN), and it contained modified versions of a community survey that was first administered in the same neighborhoods by PHDCN in 1995 and systematic social observations (SSOs) of blocks within neighborhoods similar to ones that PHDCN conducted in 1995 on a larger number of blocks but in a sub-sample of only 80 neighborhoods. Thus, at the neighborhood-level CCAHS is already a panel data set, containing unique and extensive neighborhood measures that are available in few other studies.

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Americans' Changing Lives

The Americans' Changing Lives (ACL) study is the oldest ongoing nationally representative longitudinal study of the role of a broad range of social, psychological, and behavioral factors (along with aspects of medical care and environmental exposure) in health and the way health changes with age over the adult life course.

The study began in 1986 with a national face-to-face survey of 3617 adults ages 25 and up in the continental U.S., with African Americans and people aged 60 and over over-sampled at twice the rate of the others, and face-to-face re-interviews in 1989 of 83% (n=2867) of those still alive. Survivors have been re-interviewed by telephone, and where necessary face-to-face, in 1994 and 2001/02, and again in 2011/12.

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Research Themes

Overview

Neighborhood

Racism, Stress, & Health

Resilience in Aging

Social Networks & Health

Disability Dynamics

Gene-Environment Interaction