Self-stereotyping in the context of multiple social identities

Social identity and health-related behavior: A systematic review and meta-analysis

This paper examined the relationship between social identity and health-related behavior, exploring whether social identities are associated with multiple health-related behaviors or only specific ones, and whether this association varies on the type of social identity, the type of social identity measures or the expected relationship between identity and behavior. In a systematic review and meta-analysis we assessed whether the pattern of findings can be explained by the social identity approach. An extensive literature search was conducted in several databases including EBSCO-host and PubMed, using elaborate search terms related to social identity and health-related behavior. This resulted in 10728 potential articles, with 115 articles (with 248 effect sizes from 133 independent samples, N = 112.112) included in the meta-analysis. We found a small but positive overall association between social identification and health-related behavior, which was present for actual behavior, as well as for intention and attitudes. This association was stronger for health-related social identities, positive health-related behaviors, when the expected relationship was positive and when indirect social identity measures were used. However, not all findings could be explained by the social identity approach, indicating a need for further research to better understand the relationship between social identity and health-related behavior, in order to more effectively incorporate social identity into health interventions.

Mediators of Social Acceptance Among Emerging Adult Survivors of Childhood Cancer

Purpose: Examine associations of social developmental factors (e.g., peer/parent social attachment, romantic relationships) and perceptions of social acceptance among emerging adult survivors of childhood cancer. Methods: A cross-sectional, within-group design was used. Questionnaires included the Multidimensional Body-Self Relations Questionnaire, Inventory of Parent and Peer Attachment, Adolescent Social Self-Efficacy Scale, Personal Evaluation Inventory, Self-Perception Profile for Adolescents, and demographics. Correlations were utilized to determine associations between general demographic, cancer-specific, and the psychosocial outcome variables. Peer and romantic relationship self-efficacy were assessed as potential mediators of social acceptance in three mediation models. Relationships between perceived physical attractiveness, peer attachment, parental attachment, and social acceptance were assessed. Results: Data were collected from N = 52 adult participants (Mage = 21.38 years, standard deviation = 3.11 years) diagnosed with cancer as a child. The first mediation model demonstrated a significant direct effect of perceived physical attraction on perceived social acceptance and retained significance after adjusting for indirect effects of the mediators. The second model demonstrated a significant direct effect of peer attachment on perceived social acceptance; however, significance was not retained after adjusting for peer self-efficacy, suggesting the relationship is partially mediated by peer relationship self-efficacy. The third model demonstrated a significant direct effect of parent attachment on perceived social acceptance; however, significance was not retained after adjusting for peer self-efficacy, suggesting the relationship is partially mediated by peer self-efficacy. Conclusion: Relationships between social developmental factors (e.g., parental and peer attachment) and perceived social acceptance are likely mediated by peer relationship self-efficacy in emerging adult survivors of childhood cancer.

My general manager is warmer than department manager: Stereotypes about senior and junior high-power individuals and their influences on spontaneous trait inference

Introduction

Previous research suggests that high-power (HP) individuals are stereotyped as positive competence but negative warmth.

Object

By subdividing HP individuals into junior and senior HP individuals, the current research conducted five studies to examine the warmth perception differences toward senior and junior HP individuals in Confucian culture and the downstream effects on spontaneous trait inference (STI).

Method and results

By using different paradigms, Study 1 and 2 found that participants tended to perceive junior HP individuals as negative on the warmth dimension and perceive senior HP individuals as positive on the warmth dimension. The following Study 3 and 4 further found that the warmth perception difference toward senior and junior HP individuals had an influence on STI. Specifically, participants were inclined to make STI from behaviors implying negative warmth traits when behavioral actors were junior HP individuals while they were inclined to make STI from behaviors implying positive warmth traits when behavioral actors were senior HP individuals. Additionally, Study 4 found that perceived social responsibility about HP individuals accounted for the power stereotype effects in STI, the more social responsibility participants perceived about senior HP individuals, the stronger power stereotype effects they showed in STI. The final Study 5 revealed that the different power stereotype effects in STI induced by senior and junior HP actors were observed only in Confucian culture, but not in non-Confucian culture.

Conclusion

The present research firstly demonstrated that the warmth perceptions about senior and junior produced different influences on STI in Confucian culture, and also enriched the understanding about the culture-specificity of the stereotype content model.

Overcoming constraints of the model minority stereotype to advance Asian American health

Asian Americans are the fastest growing U.S. immigrant group, projected to become the largest immigrant group by 2065, but the quantity of research on Asian Americans' health has not mirrored changing demographics. Asian Americans have been understudied for more than 25 years, with only 0.17% of National Institutes of Health (NIH) expenditures allocated to projects including Asian American, Native Hawaiian, and Pacific Islander populations (Ðoàn et al., 2019). This disproportionality may result in part from the model minority stereotype (MMS) being extended to health, perpetuating the ideas that Asian Americans are well-positioned with regard to health status and that associated research is not essential. Accordingly, the aims for this article are threefold: (a) bring attention to the inadequate representation of the Asian American population in health-related science, (b) question the MMS in health, and (c) outline potential pathways through which the MMS limits what is knowable on Asian American health issues and needs. We discuss the limited meaningfulness of nonrepresentative aggregated statistics purporting the model minority image and provide counterexamples. We also present a stereotype-constraints model with the MMS contributing to a bottleneck for Asian American health-related knowledge, accompanied by present-day circumstances (e.g., sparse data, few psychologists/behavioral medicine scientists focused on Asian American health). We conclude with initial recommendations for addressing MMS-associated constraints in psychology and more broadly. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

How Refugees' Stereotypes Toward Host Society Members Predict Acculturation Orientations: The Role of Perceived Discrimination

Refugee migration leads to increased diversity in host societies and refugees have to face many stereotyped attitudes in the host society. However, there has been little research on minority group stereotypes toward host society members and how these stereotypes relate to the acculturation-relevant attitudes of refugees in their first phase of acculturation. This study surveyed 783 refugees in Germany who had migrated mostly in the so-called "refugee crisis" between 2015 and 2016. At the time of the survey in 2018, they had been in Germany for an average of 27 months (SD = 15 months). These refugees reported their positive and negative sociability stereotypes toward German host society members, acculturation-related orientations, shared reality values, and perceived discrimination. Results showed that positive sociability stereotypes toward host society members were associated with increased cultural adoption and shared reality. In contrast, negative sociability stereotypes negatively affected cultural adoption and shared reality. However, stereotypes showed no association at all with cultural maintenance. Interactions between sociability stereotypes and discrimination experiences highlighted a disillusion effect, in the sense that discrimination reduced the motivation to adopt the host culture more strongly among refugees who held strongly positive sociability stereotypes. The study extends knowledge on the significance of minority group stereotypes in the context of refugee migration and reveals the maladaptive consequences of discriminatory behavior against refugees by host society members.

How Personal and Social Selves Influence the Development of Children and Adolescents at School

Abstract. How do different aspects of students' self-relate to their development at school? In educational psychology, this question has been examined essentially only in terms of the influence of the ability self-concept, a central part of the personal self. Starting with a literature review on why and how the ability self-concept impacts motivation and student outcomes, we argue that social selves – learners' knowledge about their group memberships and associated evaluations – have an impact, too. Students are more intrinsically motivated and more successful if they experience fit between learning environment and important self-aspects. Accordingly, we suggest a model according to which students try to increase fit by exerting primary control, i. e., by proactively changing the environment, with the self as agent. To that end (i) they mentally project the self as different from the actual self, with the mental self-projection serving as a self-evaluative standard and motiving behaviors aiming at its attainment, (ii) they choose behavioral options that allow for the enactment of important self-aspects, (iii) they choose interaction partners who share important self-aspects or are supportive of their behavioral enactment, and (iv) they switch between or prioritize different values, to best match affordances and constraints of the learning environment. If a student repeatedly fails to achieve fit through primary control, secondary control strategies are deployed, i. e., internal processes aimed at minimizing losses and saving resources for the pursuit of more attainable goals. To that end, students either disidentify with the learning environment or redefine their selves in a reactive manner, with, in many cases, detrimental effects on their academic outcomes. We hope to inspire educational psychologists to more systematically investigate the different self-aspects' impact on social and academic development of learners at school.

Can Identity Conflicts Impede the Success of Ethnic Minority Students? Consequences of Discrepancies Between Ethnic and Ideal Selves

Because of stigma and underrepresentation, many ethnic minority students may find it difficult to align their ethnicities with their ideal selves. However, these difficulties and their potential consequences have been empirically neglected. To inform this gap in the literature, we propose that the novel concept of ethnic/ideal self-discrepancies (i.e., perceived mismatches between who a person aspires to be and this person's conception of their ethnic self) is associated with the academic outcomes of ethnic minority students. As hypothesized, large ethnic/ideal self-discrepancies predict high academic disengagement, according to cross-sectional data from Study 1 ( n = 147) and Study 2 ( n = 105), as well as high academic disengagement 2 months later according to half-longitudinal data from Study 2 ( n = 78). In Study 3 ( n = 99), ethnic minority students experimentally induced to perceive high ethnic/ideal self-discrepancies reported significantly higher academic disengagement than ethnic minority students in a low discrepancy condition.

Shared reality in interpersonal relationships

Close relationships afford us opportunities to create and maintain meaning systems as shared perceptions of ourselves and the world. Establishing a sense of mutual understanding allows for creating and maintaining lasting social bonds, and as such, is important in human relations. In a related vein, it has long been known that knowledge of significant others in one's life is stored in memory and evoked with new persons-in the social-cognitive process of 'transference'-imbuing new encounters with significance and leading to predictable cognitive, evaluative, motivational, and behavioral consequences, as well as shifts in the self and self-regulation, depending on the particular significant other evoked. In these pages, we briefly review the literature on meaning as interpersonally defined and then selectively review research on transference in interpersonal perception. Based on this, we then highlight a recent series of studies focused on shared meaning systems in transference. The highlighted studies show that values and beliefs that develop in close relationships (as shared reality) are linked in memory to significant-other knowledge, and thus, are indirectly activated (made accessible) when cues in a new person implicitly activate that significant-other knowledge (in transference), with these shared beliefs then actively pursued with the new person and even protected against threat. This also confers a sense of mutual understanding, and all told, serves both relational and epistemic functions. In concluding, we consider as well the relevance of co-construction of shared reality n such processes.

Similarly Torn, Differentially Shorn? The Experience and Management of Conflict between Multiple Roles, Relationships, and Social Categories

In three studies we examined the experience and management of conflict between different types of multiple identities. Participants described a conflict between pairs of role, relational, or social identities before rating the experience (i.e., magnitude, stress, and growth) and management of conflict on a newly developed scale assessing four strategies: reconciliation, where identities are integrated, realignment, where one identity is chosen over another, retreat, where both identities are avoided, and reflection, where fit (with others, situation) determines identity selection. In general, the types of identities mattered for conflict management but not its experience: Magnitude and growth did not differ, however, stress was greater for role identity conflicts (Study 3 only) and participants endorsed the use of more realignment for role conflicts (Study 2) and more retreat for relational conflicts (Study 3) relative to other types of identity conflicts. Furthermore, findings suggested that the perceived flexibility of identities, not their importance or valence, were associated with realignment and retreat for roles and with retreat for relationships. Experiencing conflicts between multiple identities leaves people similarly torn, but multiple roles and relationships may be differentially shorn to manage conflict.

The Dark Side of Malleability: Incremental Theory Promotes Immoral Behaviors

Implicit theories drastically affect an individual's processing of social information, decision making, and action. The present research focuses on whether individuals who hold the implicit belief that people's moral character is fixed (entity theorists) and individuals who hold the implicit belief that people's moral character is malleable (incremental theorists) make different choices when facing a moral decision. Incremental theorists are less likely to make the fundamental attribution error (FAE), rarely make moral judgment based on traits and show more tolerance to immorality, relative to entity theorists, which might decrease the possibility of undermining the self-image when they engage in immoral behaviors, and thus we posit that incremental beliefs facilitate immorality. Four studies were conducted to explore the effect of these two types of implicit theories on immoral intention or practice. The association between implicit theories and immoral behavior was preliminarily examined from the observer perspective in Study 1, and the results showed that people tended to associate immoral behaviors (including everyday immoral intention and environmental destruction) with an incremental theorist rather than an entity theorist. Then, the relationship was further replicated from the actor perspective in Studies 2-4. In Study 2, implicit theories, which were measured, positively predicted the degree of discrimination against carriers of the hepatitis B virus. In Study 3, implicit theories were primed through reading articles, and the participants in the incremental condition showed more cheating than those in the entity condition. In Study 4, implicit theories were primed through a new manipulation, and the participants in the unstable condition (primed incremental theory) showed more discrimination than those in the other three conditions. Taken together, the results of our four studies were consistent with our hypotheses.

Binding Moral Foundations and the Narrowing of Ideological Conflict to the Traditional Morality Domain

Moral foundations theory (MFT) posits that binding moral foundations (purity, authority, and ingroup loyalty) are rooted in the need for groups to promote order and cohesion, and that they therefore underlie political conservatism. We present evidence that binding foundations (and the related construct of disgust sensitivity) are associated with lower levels of ideological polarization on political issues outside the domain of moral traditionalism. Consistent support for this hypothesis was obtained from three large American Internet-based samples and one large national sample of New Zealanders (combined N = 7,874). We suggest that when political issues do not have inherent relevance to moral traditionalism, binding foundations promote a small centrist shift away from ideologically prescribed positions, and that they do so out of desire for national uniformity and cohesion.

Understanding the Influence of Race/Ethnicity, Gender, and Class on Inequalities in Academic and Non-Academic Outcomes among Eighth-Grade Students: Findings from an Intersectionality Approach

Socioeconomic, racial/ethnic, and gender inequalities in academic achievement have been widely reported in the US, but how these three axes of inequality intersect to determine academic and non-academic outcomes among school-aged children is not well understood. Using data from the US Early Childhood Longitudinal Study—Kindergarten (ECLS-K; N = 10,115), we apply an intersectionality approach to examine inequalities across eighth-grade outcomes at the intersection of six racial/ethnic and gender groups (Latino girls and boys, Black girls and boys, and White girls and boys) and four classes of socioeconomic advantage/disadvantage. Results of mixture models show large inequalities in socioemotional outcomes (internalizing behavior, locus of control, and self-concept) across classes of advantage/disadvantage. Within classes of advantage/disadvantage, racial/ethnic and gender inequalities are predominantly found in the most advantaged class, where Black boys and girls, and Latina girls, underperform White boys in academic assessments, but not in socioemotional outcomes. In these latter outcomes, Black boys and girls perform better than White boys. Latino boys show small differences as compared to White boys, mainly in science assessments. The contrasting outcomes between racial/ethnic and gender minorities in self-assessment and socioemotional outcomes, as compared to standardized assessments, highlight the detrimental effect that intersecting racial/ethnic and gender discrimination have in patterning academic outcomes that predict success in adult life. Interventions to eliminate achievement gaps cannot fully succeed as long as social stratification caused by gender and racial discrimination is not addressed.

The "Reading the Mind in the Eyes" Test: Complete Absence of Typical Sex Difference in ~400 Men and Women with Autism

The “Reading the Mind in the Eyes” test (Eyes test) is an advanced test of theory of mind. Typical sex difference has been reported (i.e., female advantage). Individuals with autism show more difficulty than do typically developing individuals, yet it remains unclear how this is modulated by sex, as females with autism have been under-represented. Here in a large, non-male-biased sample we test for the effects of sex, diagnosis, and their interaction. The Eyes test (revised version) was administered online to 395 adults with autism (178 males, 217 females) and 320 control adults (152 males, 168 females). Two-way ANOVA showed a significant sex-by-diagnosis interaction in total correct score (F(1,711) = 5.090, p = 0.024, η_p² = 0.007) arising from a significant sex difference between control males and females (p < 0.001, Cohen’s d = 0.47), and an absence of a sex difference between males and females with autism (p = 0.907, d = 0.01); significant case-control differences were observed across sexes, with effect sizes of d = 0.35 in males and d = 0.69 in females. Group-difference patterns fit with the extreme-male-brain (EMB) theory predictions. Eyes test-Empathy Quotient and Eyes test-Autism Spectrum Quotient correlations were significant only in females with autism (r = 0.35, r = -0.32, respectively), but not in the other 3 groups. Support vector machine (SVM) classification based on response pattern across all 36 items classified autism diagnosis with a relatively higher accuracy for females (72.2%) than males (65.8%). Nevertheless, an SVM model trained within one sex generalized equally well when applied to the other sex. Performance on the Eyes test is a sex-independent phenotypic characteristic of adults with autism, reflecting sex-common social difficulties, and provides support for the EMB theory predictions for both males and females. Performance of females with autism differed from same-sex controls more than did that of males with autism. Females with autism also showed stronger coherence between self-reported dispositional traits and Eyes test performance than all other groups.

Stereotypes Can "Get Under the Skin": Testing a Self-Stereotyping and Psychological Resource Model of Overweight and Obesity

The authors draw upon social, personality, and health psychology to propose and test a self-stereotyping and psychological resource model of overweight and obesity. The model contends that self-stereotyping depletes psychological resources, namely self-esteem, that help to prevent overweight and obesity. In support of the model, mediation analysis demonstrates that adult Hispanics who highly self-stereotype had lower levels of self-esteem than those who self-stereotype less, which in turn predicted higher levels of body mass index (overweight and obesity levels). Furthermore, the model did not hold for the referent sample, White participants, and an alternative mediation model was not supported. These data are the first to theoretically and empirically link self-stereotyping and self-esteem (a psychological resource) with a strong physiological risk factor for morbidity and short life expectancy in stigmatized individuals. Thus, this research contributes to understanding ethnic-racial health disparities in the United States and beyond.

Math and Science Attitudes and Achievement at the Intersection of Gender and Ethnicity

Despite gender similarities in math and science achievement, women continue to be underrepresented in science, technology, engineering, and mathematics (STEM) education and careers. Increasingly, researchers are looking to gender differences in STEM attitudes as the root of this disparity. Theoretical support for the importance of STEM attitudes comes from several theories within educational, social, and vocational psychology, including Eccles’ expectancy-value theory, which maintains that education-related choices are shaped by attitudes—namely, expectations of success and task value as well as self-concept. Yet, the studies testing this model generally have not taken into account the intersection of gender and ethnicity. The current study addresses this gap in the literature by describing gender differences in math and science attitudes and achievement among 367 White, African American, Latino/Latina, and Asian American 10th grade students in neighborhood public high schools from a large northeastern city. Male and female adolescents earned similar end-of-year grades in math and science, whereas Asian American students outperformed students from the other ethnic groups in math and science. Self-report data from paper-and-pencil surveys indicate significant gender differences in that male adolescents reported greater math self-concept and expectations of success and female adolescents reported more science value; gender differences did not vary across ethnic groups. Attitudes were strong predictors of achievement, consistent with hypotheses. To our knowledge, ours is the first study to examine math and science attitudes and achievement at the intersection of gender and ethnicity across four major ethnic groups. We discuss implications for efforts aimed at improving the representation of women in STEM.

Why Can’t I Just Be Myself?

We examined the hypothesis that stereotype threat disrupts reflexive cuing of the default self-concept and instead evokes a more reflective process of self-definition. Across two studies, a reaction time measure of math schematicity assessed prior to a math test was predicted by baseline math schematicity among men (Study 1) and women in a nonthreatening condition (Study 2). However, among women under stereotype threat, math schematicity measured prior to a diagnostic math test was unrelated to baseline math schematicity and was instead associated with explicit endorsement of math. These effects occurred for math and not language self-schemas, suggesting that under threat, the working self-concept might be derived from conscious reflection rather than automatic activation.

Perceived discrimination as a risk factor for depressive symptoms and substance use among Hispanic adolescents in Los Angeles

OBJECTIVES

Discrimination has been associated with adverse psychological and physical health outcomes, but few studies have examined the effects of discrimination on Hispanic adolescents. This study assessed the relation of perceived discrimination with depressive symptoms and drug use. Covariates included immigrant generation status (GS). A second objective was to examine the potentially moderating effect of neighborhoods' ethnic composition as suggested by Mair et al.

DESIGN

Secondary data analyses of a longitudinal survey examined self-reports of Hispanic adolescents in 9th grade (the first year of high school) and 11th grade at seven high schools in Los Angeles.

RESULTS

(1) Perceiving discrimination in 9th grade significantly predicted depressive symptoms (β=0.23, p<0.01) and drug use (β=0.12, p<0.01) in 11th grade, even after controlling for socioeconomic status, gender, acculturation, and GS in the USA. The third GS group reported significantly higher perceptions of discrimination compared to newer immigrants. (2) Neighborhoods' ethnic composition was included as a moderator of the association between perceived discrimination and the outcomes, but did not moderate the relation.

CONCLUSION

Teaching Hispanic adolescents effective strategies for coping with discrimination, such as increasing their sense of belongingness in the American mainstream, may prove useful in preventing drug use and depressive symptoms.

Newcomer Conformity

The present research is the first to examine the impact of self-construal on newcomers’ motivation to conform with the goals of a novel group. We argue that when social identity (i.e., individuals’ concern for a specific group) has not yet been developed, newcomers rely on self-construal (i.e., individuals’ chronic concern for ingroups and connectedness with others in general) to derive norms for group-serving vs. self-serving behavior. Results of an experiment (N = 157) supported this prediction: Self-construal moderated the relationship between group goals and individual goals (cognitive conformity) as well as the relationship between group goals and members’ effort (behavioral conformity). Specifically, low independent and high interdependent self-construal was associated with greater cognitive and behavioral alignment of the self with the group compared to high independent and low interdependent self-construal. Findings are discussed regarding the role of self-construal as a precedent of conformity.

Eroticizing inequality in the United States: the consequences and determinants of traditional gender role adherence in intimate relationships

This article reviews the research on traditional gender-role adherence and sexuality for heterosexual men and women. Specifically, the consequences and predictors of following traditional gender roles of female submissiveness and male dominance in sexual relationships is examined. Despite evidence that men and women's sexual roles are becoming more egalitarian over time, empirical evidence suggests that the traditional sexual roles continue to dominate heterosexual relations. This article explores whether the sexual context is one in which both men and women feel particularly compelled to engage in gender stereotypic behavior, and why. In addition, this article reports on research that finds that men and women have automatic associations between sexuality and power that reinforce their gender stereotypic behavior in sexual contexts. The negative effects of traditional gender-role adherence for women's sexual problems and satisfaction is demonstrated. This article concludes that traditional sexual scripts are harmful for both women's and men's ability to engage in authentic, rewarding sexual expression, although the female submissive role may be particularly debilitating. Future directions of research are suggested, including interventions to reduce women's adherence to the sexually submissive female script.

Intergroup consensus/disagreement in support of group-based hierarchy: an examination of socio-structural and psycho-cultural factors

A meta-analysis examined the extent to which socio-structural and psycho-cultural characteristics of societies correspond with how much gender and ethnic/racial groups differ on their support of group-based hierarchy. Robustly, women opposed group-based hierarchy more than men did, and members of lower power ethnic/racial groups opposed group-based hierarchy more than members of higher power ethnic/racial groups did. As predicted by social dominance theory, gender differences were larger, more stable, and less variable from sample to sample than differences between ethnic/racial groups. Subordinate gender and ethnic/racial group members disagreed more with dominants in their views of group-based hierarchy in societies that can be considered more liberal and modern (e.g., emphasizing individualism and change from traditions), as well as in societies that enjoyed greater gender equality. The relations between gender and ethnic/racial groups are discussed, and implications are developed for social dominance theory, social role theory, biosocial theory, social identity theory, system justification theory, realistic group conflict theory, and relative deprivation theory. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Not all prejudices are experienced equally: Comparing experiences of racism and sexism in female minorities

Research exploring the perspectives of stigmatized people has examined general processes related to experiencing prejudice. Past work, however, has invoked the assumption that prejudices against different group memberships are experienced in a similar manner. Across three studies we directly compare experiences of racism and sexism among female minorities and show, in contrast, that people respond to different forms of prejudice in distinct ways. In Study 1 we examined the attributions invoked by Asian women to explain prejudice and discovered that participants made stronger internal attributions to explain racism than sexism. In Study 2 we investigated emotional reactions to prejudice and found that Asian women report experiencing more depression following a race-based rejection than a gender-based rejection. In Study 3 we observed that Asian women reported perceiving more racism than sexism in their environments. Implications for advancing theories of prejudice experiences are discussed.

Racism and hypertension: a review of the empirical evidence and implications for clinical practice

BACKGROUND

Despite improved hypertension (HTN) awareness and treatment, racial disparities in HTN prevalence persist. An understanding of the biopsychosocial determinants of HTN is necessary to address racial disparities in the prevalence of HTN. This review examines the evidence directly and indirectly linking multiple levels of racism to HTN.

METHODS

Published empirical research in EBSCO databases investigating the relationships of three levels of racism (individual/interpersonal, internalized, and institutional racism) to HTN was reviewed.

RESULTS

Direct evidence linking individual/interpersonal racism to HTN diagnosis is weak. However, the relationship of individual/interpersonal racism to ambulatory blood pressure (ABP) is more consistent, with all published studies reporting a positive relationship of interpersonal racism to ABP. There is no direct evidence linking internalized racism to BP. Population-based studies provide some evidence linking institutional racism, in the forms of residential racial segregation (RRS) and incarceration, to HTN incidence. Racism shows associations to stress exposure and reactivity as well as associations to established HTN-related risk factors including obesity, low levels of physical activity and alcohol use. The effects vary by level of racism.

CONCLUSIONS

Overall the findings suggest that racism may increase risk for HTN; these effects emerge more clearly for institutional racism than for individual level racism. All levels of racism may influence the prevalence of HTN via stress exposure and reactivity and by fostering conditions that undermine health behaviors, raising the barriers to lifestyle change.