This research identifies which factors may be especially salient to the patient's perception of distress and help guide clinicians in developing targeted screening strategies and specific interventions based on patient response to the DT. It also points to the need for future research to more clearly characterize distress from the patient perspective and determine when interventions may be indicated.

Objectives The purpose of this paper was to systematically review the literature investigating the relationship between perceived racism/discrimination and health among black American women. Methods Searches for empirical studies published from January 2003 to December 2013 were conducted using PubMed and PsycInfo. Articles were assessed for possible inclusion using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 framework. In addition, the Agency for Healthcare Research and Quality (AHRQ) system for rating the strength of scientific evidence was used to assess the quality of studies included in the review. Results Nineteen studies met criteria for review. There was mixed evidence for general relationships between perceived racism/discrimination and health. Consistent evidence was found for the relationship between adverse birth outcomes, illness incidence, and cancer or tumor risk and perceived racism/discrimination. Inconsistent findings were found for the relationship between perceived racism/discrimination and heart disease risk factors. There was no evidence to support the relationship between perceived racism/discrimination and high blood pressure. Conclusions There is mixed evidence to support the association between perceived racism/discrimination and overall objective health outcomes among black American women. The strongest relationship was seen between perceived racism/discrimination and adverse birth outcomes. Better understanding the relationship between health and racism/discrimination can aid in identifying race-based risk factors developing primary prevention strategies. Future studies should aim to investigate the role of perceived racism/discrimination as a specific chronic stressor within discrete pathogenesis models.

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