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Give Examples of “Everyday” Racism (Being Treated Differently / Unfairly) and Describe How These Might Affect Health in Different Ways

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Everywhere we look, we see differences in wealth, power, and status. Some groups have higher status and greater privilege than others. This inequality in the system is what we call social stratification. In this unequal social system, there is often unfair treatment directed against certain individuals or social groups. This is referred to as discrimination. Discrimination can be based on many different characteristics—age, gender, weight, ethnicity, religion, or even politics. For example, prejudice and discrimination based on race is called racism. Oftentimes, gender prejudice or discrimination is referred to as sexism. Discrimination is often the outcome of prejudice—a pre-formed negative judgment or attitude. Prejudice leads people to view certain individuals or groups as inferior.

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The impact of discrimination occurs at both structural and individual levels. Structural discrimination refers to macro-level conditions (e.g., residential segregation) that limit “opportunities, resources, and well-being” of less privileged groups.6 Individual discrimination refers to negative interactions between individuals in their institutional roles (e.g., health care provider and patient) or as public or private individuals (e.g., salesperson and customer) based on individual characteristics (e.g., race, gender, etc.).7 Individual and structural discrimination can cause either intentional or unintentional harm, whether or not it is perceived by the individual.3, 8 Discrimination can be understood as a social stressor that has a physiological effect on individuals (e.g., irregular heartbeat, anxiety, heartburn) that can be compounded over time and can lead to long-term negative health outcomes. Discrimination is often measured by either everyday or major discriminatory events. Everyday discrimination taps into more ongoing and routine experiences of unfair treatment. Some examples of everyday discrimination include being treated with less courtesy or respect than other people, receiving poorer service than other people at restaurants or stores, or being threatened or harassed. Major discriminatory events capture important or more significant experiences of unfair treatment.9, 10 Some examples of major discrimination include being unfairly dismissed from a job, being unfairly prevented from moving into a neighborhood because a landlord or realtor refused to sell or rent, or being unfairly denied a bank loan. Major discriminatory events are often the result of structural discrimination that can negatively affect individuals and communities. Residential segregation, disparities in access to quality education, and disparities in incarceration rates are some specific forms of structural discrimination

Residential segregation is a form of structural discrimination in the housing market. Residential segregation is a major cause of differences in health status between African American and white people because it can determine the social and economic resources for not only individuals and families, but also for communities. Residential segregation also affects disparities in access to quality education. Most school districts generate their income locally through property taxes, so residential segregation by income translates into very different possibilities for funding across school districts. Children who enroll in low-quality schools with limited health resources, increased safety concerns, and low teacher support are more likely to have poorer physical and mental health.

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In 1985, with the release of the Heckler report, America was put on notice that the health status of African Americans was significantly worse than that of their White counterparts (Heckler 1985). Unfortunately, since then, racial disparities in health have worsened in many ways. In 1990, for example, McCord and Freeman shocked the world by reporting that a Black male in Harlem had less of a chance of reaching the age of 65 than did the average male resident of Bangladesh—one of the poorest countries in the world. At the time of McCord & Freeman’s study, African American men fell behind men from Bangladesh in survival rates starting at age 40 (McCord & Freeman 1990, Sen 1993). In the United States, life expectancy for African American males experienced an unprecedented drop every year from 1984 to 1989, while all other combinations of Black/White male/female comparisons either remained the same or increased. The continuing legacy of poor health in African Americans, despite the overall improved conditions of their lives, is one compelling reason to take a closer look at the role discrimination may play. The health disparities that affect African Americans in this country arise from many sources, including cultural differences in lifestyle patterns, inherited health risks, and social inequalities that are reflected in discrepancies in access to health care, variations in health providers’ behaviors, differences in socioeconomic position.In attempting to elucidate the negative health outcome mechanisms of race-based discrimination, the effects of both overt and anticipated or perceived experiences of race-based discrimination have been examined. Studies of overt or manifest discrimination typically measure events occurring at the individual level by asking respondents if they have been “treated badly or unfairly,” “differently,” or are somehow “disadvantaged” relative to others based on their racial or ethnic background (Krieger et al

2005).

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Overall, microaggressions seem to appear in three forms: microassault, microinsult, and microinvalidation. Interethnic racial microaggressions occur between people of color as well. In the area of counseling and therapy, for example, research may also prove beneficial in understanding cross-racial dyads in which the therapist is a person of color and the client is White or in which both therapist and client are persons of color. Investigating these combinations of cross-racial dyads would be useful, because it is clear that no racial/ethnic group is immune from inheriting the racial biases of the society.

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Heckler MM. Report of the Secretary’s Task Force on Black and Minority Health. Washington, DC: U.S. Dep. Health Human Serv; 1985. U.S. Task Force on Black and Minority Health.

Excess mortality in Harlem. McCord C, Freeman HP N Engl J Med. 1990 Jan 18; 322(3):173-7.

The economics of life and death. Sen A Sci Am. 1993 May; 268(5):40-7.

Experiences of discrimination: validity and reliability of a self-report measure for population health research on racism and health. Krieger N, Smith K, Naishadham D, Hartman C, Barbeau EM Soc Sci Med. 2005 Oct; 61(7):1576-96.

Sears DO, Henry JP. The origins of symbolic racism. J. Personal. Soc. Psychol. 2003;85:259–275.

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