Around 46 per cent of Black Canadians 15 years old and older reported experiencing discrimination in the past five years, according to the 2019 General Social Survey (GSS) on Canadians’ Safety. Roughly 41 per cent of all Black Canadians experienced discrimination due to their race or skin colour. The likelihood of Black Canadians to be passed over for jobs for which they are qualified is as high as 40 per cent. One in five Black American adults, including three in ten Black American men, reported being a victim of police violence. Although the definition of discrimination varies among scholars, it is generally understood as “the direct interpersonal experience of unfair treatment because of membership in a particular social group,” according to Dr. David H. Chae of Auburn University.
It is less well known, however, that racism is just as pressing a public health issue. According to a recent study led by Dr. Chae, the racism that the Black people face may age them prematurely, leading to the early onset of serious health problems.
This aging occurs at a cellular level and pertains to the shortening of telomeres, the DNA-protein structures that sit at both ends of each chromosome in the cell and prevent chromosomes from fraying. As a natural cellular process, a small segment of telomere is lost in each cell division. When telomere length reaches a critical limit, the cell no longer divides and will die, which can lead to tissue and organ dysfunction and various chronic diseases, such as heart disease, stroke, diabetes, and dementia. Telomere length controls the lifespan of a cell and thus an individual. The shortening of telomeres can be accelerated by many factors, including smoking, obesity, exposure to pollution or other harmful agents, an unhealthy diet, a lack of physical activity, and stress.
A unique form of stress experienced by the Black population is racial discrimination, which has contributed to well-documented disparities in health. Numerous studies have shed light on the associations between racial discrimination and biological precursors of clinical disease outcomes, such as glucocorticoids (corticosteroid hormones that have inhibitory effects on immune responses and manage the acute onset of inflammatory and autoimmune disorders), proinflammatory cytokines (protein-based signalling molecules that mediate immune responses, such as proliferation and differentiation of lymphocytes, inflammation, allergies, and fever), and other markers of inflammation. One study specifically investigated one mechanism through which racism-related stress impacts the telomere maintenance system. Data was collected from around 400 African Americans who participated in the Coronary Artery Risk Development in Young Adults (CARDIA), Telomere Ancillary Study in 2000, and the follow-up took place ten years later. At the beginning and the end of the study, the participants with an average age of 40 were inquired about the discrimination they experienced in various contexts, including employment, housing, and medical care. This study concluded that increased experiences of racial discrimination in midlife were associated with accelerated telomere shortening and health declines. The results are concordant with a growing body of research on the role of racism in reducing life expectancy for Black people.
Although this study advances research on racial discrimination and health outcomes, there are some notable caveats to consider. One issue pertains to the generalization of the findings. The sample of the study was taken from metropolitan areas in the United States and thus may not represent populations from other geographic regions. Another limitation is the uneven gender distribution, as Black women and men may differ in their perceptions of racial discrimination and in their physiologic responses to racism-related stress. Moreover, the participants in the study were in midlife, so the results are likely specific to this age group. The authors themselves pointed to the need for more research to study biological consequences of racial discrimination in other stages of life, such as childhood, adolescence, and young adulthood, to obtain a more comprehensive understanding of the impact of racial discrimination on health outcomes.
In fact, another recent study led by Sierra Carter, a psychology professor at Georgia State University, shed light on the impact of racism-induced stress on aging earlier in life. Data, including self-reported questionnaires, from 368 participants in the Family and Community Health Study (FACHS) was included in Carter’s analyses. The findings of this study supported the conclusion that stress of racism accelerated physiological weathering. This weathering resulted in premature health deterioration and aging of bodily systems, putting Black people at a higher risk of diseases such as diabetes and cardio-vascular disease. Additionally, the findings suggested that encounters of racial discrimination were associated with augmented depressive symptoms between the ages of 10 and 15 and 20 and 29 even when confounding variables, including smoking and alcohol consumption, were controlled. Based on these findings, the authors inferred that depressive symptoms could be the driving factor of accelerated aging. Carter plans to examine more deeply the accelerated aging processes and possible early life interventions. She also emphasizes the importance of acknowledging racism-related stress when treating mental health conditions, such as depression.
Despite an increased understanding of the impact of structural racism on health, further research is needed to quantify and characterize structural racism and its effects on public health. Only then can the effectiveness of anti-racism interventions in health service delivery and policy making be further ameliorated to dismantle structural racism and advance health equity.