A Life Course Perspective on How Racism May Be Related to Health Inequities

Abstract

Recent studies show that racism may influence health inequities. As individuals grow from infancy into old age, they encounter social institutions that may create new exposures to racial bias. Yet, few studies have considered this idea fully. We suggest a framework that shows how racism and health inequities may be viewed from a life course perspective. It applies the ideas of agepatterned exposures, sensitive periods, linked lives, latency period, stress proliferation, historic period, and cohorts. It suggests an overarching idea that racism can structure one's time in asset-building contexts (e.g., education) or disadvantaged contexts (e.g., prison). This variation in time and exposure can contribute to racial inequities in life expectancy and other health outcomes across the life course and over generations. (Am J Public Health. 2012;102: 967-974.

Differential Effects of Personal-Level vs Group-Level Racial Discrimination on Health among Black Americans

“…19,20,23,45,46 However, prior research has generally focused on the effects of personal-level discrimination on mental health, and relatively little is known about the effects of witnessing/hearing about fellow in-group members' experience with discrimination on mental and physical health. Our study contributes to the growing literature of the discrimination-health disparities literature by drawing upon social psychology research of PGDD and investigating the independent effects of personal-and group-level discrimination on mental and physical health among Black Americans.…”

“…[17][18][19][20] It is now widely hypothesized that the experience of personal-level discrimination is one major factor contributing to the pervasive and prevalent health disparities that many racial/ethnic minorities face in the United States. [21][22][23][24][25] However, racial/ethnic minorities not only experience discrimination personally, but also witness or hear about fellow in-group members experiencing discrimination (ie, grouplevel discrimination). This is particularly true in the current society, where more and more people are exposed to information about other people's experiences with discrimination (eg, unarmed Black Americans being unfairly treated by the police, homosexual couples being refused service at restaurants), possibly because sharing information is easier than ever with the help of advanced technology (eg, smart phone) and social networking websites (eg, Facebook).…”

Race, Ethnicity, and Socioeconomic Status in Research on Child Health

“…16,[35][36][37][38] Racism also contributes to health inequities through multiple mechanisms. 39,40 Evidence is growing that racial discrimination (both individual and institutional) as a social stress on groups of children and families can influence psychology, physiology, and health behaviors. In response to this growing body of evidence, Geronimus 41 proposed the "weathering" hypothesis, which postulates that health deterioration among African American people is a consequence of cumulative economic or social adversity and political marginalization.…”

“…3 Low parental education is also prevalent among today's children. In 2012, less than one-third (31.4%) of children ages 6 to 18 years old lives with a parent who has a college education, and there are significant racial and ethnic disparities in parent education, with 40.4% of non-Hispanic white children living in a home with a college-educated parent, compared with 20.3% of non-Hispanic black and 13.1% of Hispanic children. 4 Disparities in health and health care related to both race or ethnicity and socioeconomic status (SES) are well documented 5 and have become an important focus for many healthrelated organizations, including the American Academy of Pediatrics (AAP), which included health equity in its strategic plan in 2008 and in 2010 published a policy statement on health equity and children's rights.…”

Introduction to the Handbook of Life Course Health Development

“…In response to this burgeoning knowledge, there is growing momentum among practitioners and policymakers to "connect the dots" between what we know and what we do, that is, between the rapidly expanding evidence base from the emerging field of life course health development (LCHD) and the practices and policies that are implemented within the fields of medicine, public health, nursing, mental health, education, urban planning, community development, social welfare, and others (Halfon et al 2014;Kuh et al 2013;Braveman 2014;Gee et al 2012;Lappé and Landecker 2015). At the same time, there is a strong impetus among researchers to continue to fill the substantial gaps in our knowledge and to ensure that research findings are appropriately synthesized and translated before being applied in clinical, public health, or public policy contexts.…”