Disparities Key reports from the List provided by Professor David R. Williams.

Velandy Manohar, MD., DLFAPA

1.The Intergenerational Transmission of Discrimination: Children’s Experiences of Unfair Treatment and Their Mothers’ Health at Midlife

Abstract A growing body of research suggests that maternal exposure to discrimination helps to explain racial disparities in children’s health. However, no study has considered if the intergenerational health effects of unfair treatment operate in the opposite direction—from child to mother. To this end, we use data from mother–child pairs in the National Longitudinal Survey of Youth 1979 to determine whether adolescent and young adult children’s experiences of discrimination influence their mother’s health across midlife. We find that children who report more frequent instances of discrimination have mothers whose self-rated health declines more rapidly between ages 40 and 50 years. Furthermore, racial disparities in exposure to discrimination among children explains almost 10% of the black–white gap but little of the Hispanic– white gap in self-rated health among these mothers. We conclude that the negative health impacts of discrimination are likely to operate in a bidirectional fashion across key family relationships.

2. Civil rights as determinants of public health and racial and ethnic health equity: health care, education, employment, and housing in the United States

Abstract

This essay examines how civil rights and their implementation have affected and continue to affect the health of racial and ethnic minority populations in the United States. Civil rights are characterized as social determinants of health. A brief review of US history indicates that, particularly for Blacks, Hispanics, and American Indians, the longstanding lack of civil rights is linked with persistent health inequities. Civil rights history since 1950 is explored in four domains-

Health care, Education, Employment, and Housing.

The first three domains show substantial benefits when civil rights are enforced. Discrimination and segregation in housing persist because anti-discrimination civil rights laws have not been well enforced. Enforcement is an essential component for the success of civil rights law. Civil rights and their enforcement may be considered a powerful arena for public health theorizing, research, policy, and action.

3.Stress and the Mental Health of Populations of Color: Advancing Our Understanding of Race-Related Stressors.

Abstract

This article provides an overview of research on race-related stressors that can affect the mental health of socially disadvantaged racial and ethnic populations. It begins by reviewing the research on self-reported discrimination and mental health. Although discrimination is the most studied aspect of racism, racism can also affect mental health through structural/institutional mechanisms and racism that is deeply embedded in the larger culture. Key priorities for research include more systematic attention to stress proliferation processes due to institutional racism, the assessment of stressful experiences linked to natural or manmade environmental crises, documenting and understanding the health effects of hostility against immigrants and people of color, cataloguing and quantifying protective resources, and enhancing our understanding of the complex association between physical and mental health.

4.Understanding How Discrimination Can Affect Health

Racial and ethnic differences in health, in which socially disadvantaged racial populations have worse health than whites, are large, pervasive across a broad range of outcomes, and persistent over time.1 They exist for the onset of disease, as well as the severity and course of illness. Socioeconomic status (SES)—whether measured by income, education, occupational status, or wealth—is a strong predictor of variations in health and has often been viewed as the driver of racial inequities in health. Research finds that although SES predicts variations in health status within each racial group, racial disparities persist at every level of SES.2 There is a large and growing body of empirical evidence indicating self‐reports of discrimination are race‐related aspects of social experience that can have negative effects on health. This paper provides an overview of research on self‐reported discrimination and health, as well as health care utilization. It begins by situating research on racial discrimination and health within the larger context of research on racism and health. Importantly, self‐reported experiences of discrimination are one mechanism by which racism affects health, and these exposures can be best understood and effectively addressed within the context of the role of racism in health. The paper then highlights key findings in this burgeoning literature.

Miles to Go before We Sleep: Racial Inequities in Health

Williams, David R.

Journal of Health and Social Behavior, v53 n3 p279-295 Sep 2012

Large, pervasive, and persistent racial inequalities exist in the onset, courses, and outcomes of illness. A comprehensive understanding of the patterning of racial disparities indicates that racism in both its institutional and individual forms remains an important determinant. There is an urgent need to build the science base that would identify how to trigger the conditions that would facilitate needed societal change and to identify the optimal interventions that would confront and dismantle the societal conditions that create and sustain health inequalities. (Contains 2 tables.)

6 Racism as a Stressor for African Americans: A Biopsychosocial Model

Racism as a stressor for African Americans. A biopsychosocial model - PubMed (nih.gov)

Abstract

Various authors have noted that interethnic group and intr-aethnic group racism are significant stressors for many African Americans. As such, intergroup and intragroup racism may play a role in the high rates of morbidity and mortality in this population. Yet, although scientific examinations of the effects of stress have proliferated, few researchers have explored the psychological, social, and physiological effects of perceived racism among African Americans. The purpose of this article was to outline a biopsychosocial model for perceived racism as a guide for future research. The first section of this article provides a brief overview of how racism has been conceptualized in the scientific literature. The second section reviews research exploring the existence of intergroup and intragroup racism. A contextual model for systematic studies of the biopsychosocial effects of perceived racism is then presented, along with recommendations for future research.

Multiple Citations: 5 Similar Articles and 5 reports cited by 509 articles

7.Social Sources of Racial Disparities in Health 
Social Sources Of Racial Disparities In Health | Health Affairs

Abstract

Racial disparities in mortality over time reflect divergent pathways to the current large racial disparities in health. The residential concentration of African Americans is high and distinctive, and the related inequities in neighborhood environments, socioeconomic circumstances, and medical care are important factors in initiating and maintaining racial disparities in health. Efforts are needed to identify and maximize health-enhancing resources that may reduce some of the negative effects of psychosocial factors on health. Health and health disparities are embedded in larger historical, geographic, sociocultural, economic, and political contexts. Changes in a broad range of public policies are likely to be central to effectively addressing racial disparities.

In my Testimony supporting the passage and enactment of HB 6662- An act declaring Racism as a Public health Crisis… that I submitted on March 26,2021 to the House Appropriations Committee. https://www.cga.ct.gov/asp/menu/CommDocTmyBillAllComm.asp?bill=HB-06662&doc_year=2021

I have provided specific information on the “Place Matters concept” in section 3 a-h. Prof. Raj Chetty https://www.brookings.edu/blog/social-mobility-memos/2018/01/11/raj-chetty-in-14-charts-bigfindings-on-opportunity-and-mobility-we-should-know/ This is an important foundational link.

Velandy Manohar, MD., DLFAPA