Not just sticks and stones: Indirect ethnic discrimination leads to greater physiological reactivity

The social patterning of vicarious discrimination: Implications for health equity

BACKGROUND

Most research on discrimination and health operationalizes discrimination as direct individual experiences. Here, we examine the social patterning of vicarious discrimination, an important but largely overlooked dimension of discrimination.

METHODS

Drawing on community-based participatory research with a multi-stage probability sample (n = 178) of African Americans in Tallahassee, Florida, we measured vicarious discrimination, or exposure to discrimination through one's family and friends. We used chi-square tests to examine gender differences in the social domains and relational sources of vicarious discrimination. Negative binomial regression models were fit to identify predictors of exposure to vicarious discrimination.

RESULTS

Vicarious discrimination is more prevalent than direct experiences of discrimination (73 versus 61%) and more than 20% of participants report vicarious discrimination in the absence of direct discrimination. For women, vicarious discrimination most often involved the workplace; for men, police. However, gender differences are smaller for vicarious versus direct discrimination. Close friends and children were top relational sources of vicarious discrimination for men and women, respectively. Middle-aged participants reported the most vicarious discrimination.

CONCLUSIONS

Overall, our data show that vicarious discrimination is more common than widely understood and associated with individual-level sociodemographic characteristics that index one's position in broader social systems. The prevalence of vicarious discrimination in the absence of direct discrimination suggests that standard approaches, which measure individual exposures in isolation, are subject to misclassification bias. Our results imply that existing research on discrimination and health, which already demonstrates substantial harm, underestimates African Americans' true exposures to salient aspects of discrimination.

Distress among undergraduates: Marginality, stressors and resilience resources

Objective: This study addresses mental health concerns among university students, examining cumulative stress exposure as well as resilience resources. Participants: Participants were 253 first- and second-year undergraduate students (age = 18.76; 49.80% male, 69% students of color) enrolled at a large western US university. Methods: Data were obtained from a cross-sectional online survey examining marginalized statuses and multiple stressors alongside coping responses, adaptive self-concept, and social support as predictors of stress, anxiety, and depression. Results: Multivariate regressions demonstrated significant associations between stress exposures and lower levels of resilience resources with each mental health indicator (with substantial R2 of.49-.60). Although stressor exposures accounted for significant increases in mental health concerns, their exploratory power was attenuated by resilience resources (e.g., beta decreases from.25 to.16). Conclusions: Better understanding cumulative adversity/resilience resource profiles, particularly among marginalized students, can help universities in prioritizing institutional support responses toward prevention and mitigating psychological distress.

'Where are you really from?': a qualitative study of racial microaggressions and the impact on medical students in the UK

OBJECTIVE

To explore graduate-entry medical students' experiences of racial microaggressions, the impact of these on learning, performance and attainment, and their views on how these can be reduced.

DESIGN

Qualitative study using semistructured focus groups and group interviews.

SETTING

UK.

PARTICIPANTS

20 graduate-entry medical students were recruited using volunteer and snowball sampling; all students self-identified as being from racially minoritised (RM) backgrounds.

RESULTS

Participants reported experiencing numerous types of racial microaggressions during their time at medical school. Students' accounts highlighted how these impacted directly and indirectly on their learning, performance and well-being. Students frequently reported feeling uncomfortable and out of place in teaching sessions and clinical placements. Students also reported feeling invisible and ignored in placements and not being offered the same learning opportunities as their white counterparts. This led to lack of access to learning experiences or disengagement from learning. Many participants described how being from an RM background was associated with feelings of apprehension and having their 'guards up', particularly at the start of new clinical placements. This was perceived to be an additional burden that was not experienced by their white counterparts. Students suggested that future interventions should focus on institutional changes to diversify student and staff populations; shifting the culture to build and maintain inclusive environments; encouraging open, transparent conversations around racism and promptly managing any student-reported racial experiences.

CONCLUSION

RM students in this study reported that their medical school experiences were regularly affected by racial microaggressions. Students believed these microaggressions impeded their learning, performance and well-being. It is imperative that institutions increase their awareness of the difficulties faced by RM students and provide appropriate support in challenging times. Fostering inclusion as well as embedding antiracist pedagogy into medical curricula is likely to be beneficial.

Embedded racism: Inequitable niche construction as a neglected evolutionary process affecting health

Racial health disparities are a pervasive feature of modern experience and structural racism is increasingly recognized as a public health crisis. Yet evolutionary medicine has not adequately addressed the racialization of health and disease, particularly the systematic embedding of social biases in biological processes leading to disparate health outcomes delineated by socially defined race. In contrast to the sheer dominance of medical publications which still assume genetic 'race' and omit mention of its social construction, we present an alternative biological framework of racialized health. We explore the unifying evolutionary-ecological principle of niche construction as it offers critical insights on internal and external biological and behavioral feedback processes environments at every level of the organization. We Integrate insights of niche construction theory in the context of human evolutionary and social history and phenotype-genotype modification, exposing the extent to which racism is an evolutionary mismatch underlying inequitable disparities in disease. We then apply ecological models of niche exclusion and exploitation to institutional and interpersonal racial constructions of population and individual health and demonstrate how discriminatory processes of health and harm apply to evolutionarily relevant disease classes and life-history processes in which socially defined race is poorly understood and evaluated. Ultimately, we call for evolutionary and biomedical scholars to recognize the salience of racism as a pathogenic process biasing health outcomes studied across disciplines and to redress the neglect of focus on research and application related to this crucial issue.

The Association Between Perceived Discriminatory Climate in School and Student Performance in Math and Reading: A Cross-National Analysis Using PISA 2018

The negative consequences of perceived ethnic discrimination on adolescent adjustment are well documented. Less is known, however, about the consequences of discriminatory climates in school, beyond the individual experiences of discrimination. This study investigated whether a perceived discriminatory climate in school is associated with lower academic performance across adolescents from ethnic minority and majority groups, and which psychological mechanisms may account for this link. Using the 2018 Programme for International Student Assessment (PISA) data, the participants were 445,534 adolescents (aged 15-16, 50% girls) in 16,002 schools across 60 countries. In almost all countries, a discriminatory climate-i.e., student perceptions of teachers' discriminatory beliefs and behaviors in school-was associated with lower math and reading scores across all pupils, although minorities perceived a more discriminatory climate. Lower school belonging and lower values attributed to learning partially mediated these associations. The findings demonstrate that schools' ethnic and racial climates predict standardized academic performance across schools and countries among pupils from both ethnic majority and minority groups.

Identity affirmation is associated with adaptive cardiovascular flexibility in response to stress among sexual and gender minority people of color

BACKGROUND

Research with sexual and gender minority (e.g., lesbian, gay, bisexual, queer, asexual, trans, non-binary) people of Color (SGM-PoC) has largely focused on risk and negative health outcomes. The existing strengths-based mental health research suggests that identity affirmation may be associated with psychological resilience and good mental health among SGM-PoC, but little is known about predictors of physiological resilience and biomarkers of physical health in this population. Adaptive cardiovascular flexibility is an indicator of physiological resilience and physical health in that it enables the body to mobilize resources to adapt to challenges. This study explored the association between identity affirmation and physiological resilience, observed through cardiovascular flexibility in response to stress among SGM-PoC.

METHODS

Participants were 95 SGM-PoC of varying ethnoracial backgrounds, sexual orientations, and gender identities, residing in Canada. Participants completed questionnaires on sociodemographic and psychosocial variables, including a measure of identity affirmation, the Queer People of Color Identity Affirmation Scale (QPIAS). In a laboratory setting, we induced stress using the Trier Social Stress Test and measured heart rate variability (HRV) over time using wearable electrocardiogram devices.

RESULTS

Results from multilevel modeling analyses revealed that high QPIAS scores were associated with adaptive cardiovascular flexibility, as evidenced by reduced HRV during stress exposure, followed by HRV increase during recovery. As QPIAS scores increased, the shape of HRV trajectory increasingly reflected our predicted pattern of adaptive cardiovascular flexibility. Meanwhile, low QPIAS scores were not associated with this pattern and appeared to predict a more flatlined HRV activity during the experiment.

CONCLUSIONS

Findings indicate that Queer People of Color identity affirmation may be related to physiological resilience, observed through a more adaptive cardiovascular profile when responding to stress. Identity affirmation may thus be a protective factor for SGM-PoC, pointing to the critical importance of affirming resources and strengths-based health research.

An Examination of Discrimination on Stress, Depression, and Oppression-Based Trauma During the COVID-19 Pandemic and the Racial Awakening of 2020

Background

Discrimination is a pervasive societal issue that monumentally impacts people of color (POC). Many Black, Asian, and Hispanic/Latinx individuals report experiencing race-based discrimination in their lifetime. Discrimination has previously been linked to adverse health outcomes among POC, including stress, depressive, and posttraumatic stress disorder symptoms. These health disparities are posited to have become exacerbated by COVID-19 and the racial awakening of 2020. The current study examined the short- and long-term effects of discrimination on stress, depression, and oppression-based trauma among POC.

Methods

Participants were (n = 398) who identified as Black, Indigenous, Hispanic/Latinx, and Asian completed an online self-report survey assessing discrimination, depression, stress, and oppression-based trauma collected at 3 time points: (T1) beginning of the COVID-19 pandemic (May 2020), (T2) 6 weeks later during the racial awakening of 2020 (June 2020), (T3) one year later (June 2021).

Results

Significant positive paths were revealed from T1 discrimination to T2 depression, T2 stress, and T3 oppression-based trauma. The association between T1 discrimination and T3 oppression-based trauma was partially mediated by T2 depression, but not by stress; total and total indirect effects remained significant. The final model accounted for a significant proportion of the variance in T3 oppression-based trauma, T2 depression, and T2 stress.

Conclusion

Findings are consistent with prior research linking discriminatory experiences with mental health symptomatology and provide evidence that race-based discrimination poses harmful short-and long-term mental health consequences. Further research is necessary to better understand oppression-based trauma to improve the accuracy of clinical diagnosis and treatment of POC.

Is stress colorblind? Exploring endocrine stress responses in intergroup contexts using a virtual reality-based Trier Social Stress Test (TSST-VR)

Are social stress reactions dependent on the group identities of interaction partners? This study explored the role of ethnic context in modulating endocrine stress responses using a virtual reality (VR)-based adaptation of a standardized stress induction protocol, the Trier Social Stress Test (TSST-VR). Previous research found no clear link between endocrine stress response and ethnic context in the TSST, but conclusions remain limited due to the quasi-experimental nature of manipulating ethnic context in real-life face-to-face interactions. The VR adaptation of the TSST circumvents quasi-experimental limitations and thus provides a first, randomized-controlled investigation of the effects of ethnic context on endocrine stress responses. Forty-three men participated in the study, facing either an ingroup ("White") or an outgroup ("Arab") panel of interviewers. As expected, the TSST-VR produced physiological and subjective stress reactions. However, endocrine stress reactions occurred independent of interviewer ethnicity and could not be predicted based on implicit bias, explicit prejudice, or prejudice-related appearance concerns. Other physiological and subjective stress reactivity parameters also remained comparable across intergroup conditions. Implications for stress research are discussed.

Online Racism and Mental Health Among Black American Adolescents in 2020

OBJECTIVE

To determine whether rates of online racial discrimination changed over the course of 2020 and their longitudinal effects on Black youths' mental health.

METHOD

This longitudinal study collected 18,454 daily assessments from a nationally representative sample of 602 Black and White adolescents in the United States (58% Black, 42% White; mean age = 15.09 years, SD = 1.56 years) across 58 days during the heightened racial tensions between March and November 2020.

RESULTS

Black youths experienced increases in online racial discrimination, and these increases were not fully explained by time spent online or by general cybervictimization experiences. Online racial discrimination predicted poorer same-day and next-day mental health among Black youths but not among White youths. Black youths' mental health did not predict their online racial discrimination experiences.

CONCLUSION

Online racial discrimination has implications for shaping mental health disparities that disadvantage Black youths relative to their White peers. Programs can be implemented to decrease online hate crimes, and health providers (eg, pediatricians, psychiatrists) should develop procedures that mitigate the negative mental health effects following online racial discrimination experiences.

Brain-body pathways linking racism and health

Racial disparities in health are a major public health problem in the United States, especially when comparing chronic disease morbidity and mortality for Black versus White Americans. These health disparities are primarily due to insidious anti-Black racism that permeates American history, current culture and institutions, and interpersonal interactions. But how does racism get under the skull and the skin to influence brain and bodily processes that impact the health of Black Americans? In the present article, we present a model describing the possible neural and inflammatory mechanisms linking racism and health. We hypothesize that racism influences neural activity and connectivity in the salience and default mode networks of the brain and disrupts interactions between these networks and the executive control network. This pattern of neural functioning in turn leads to greater sympathetic nervous system signaling, hypothalamic-pituitary-adrenal axis activation, and increased expression of genes involved in inflammation, ultimately leading to higher levels of proinflammatory cytokines in the body and brain. Over time, these neural and physiological responses can lead to chronic physical and mental health conditions, disrupt well-being, and cause premature mortality. Given that research in this area is underdeveloped to date, we emphasize opportunities for future research that are needed to build a comprehensive mechanistic understanding of the brain-body pathways linking anti-Black racism and health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Immediate and delayed effects of everyday racial discrimination on mental health among Black college students: A mixed-methods approach

Experiences of racial discrimination significantly contribute to both mental and physical health outcomes. In this mixed-methods study, we examine both the immediate and delayed effect of discrimination experienced in daily life. Black students at a predominantly White university reported instances of racial discrimination, affect, anxiety, and depression several times per day over 4 weeks ( N = 114); this was followed by qualitative focus groups ( N = 25). Reporting an instance of discrimination corresponded with an acute decline in psychological wellbeing (higher negative affect, anxiety, and depression), consistent with previous work. However, this effect did not carry forward to later assessments during the same day or the following day as expected. Instead, positive affect temporarily increased in the hours following experiences of discrimination. Qualitative focus groups revealed social support, emotional reflection and processing, and feelings of taking action as important factors contributing to this bump in positive affect.

Racial Microaggressions and Anti-Racism: A Review of the Literature with Implications for School-Based Interventions and School Psychologists

Many racial-ethnic minoritized individuals are repeatedly exposed to subtle actions reflecting racial slights, termed racial microaggressions (RMAs), which are associated with adjustment problems in early adult and adult populations. Early adolescence represents a unique developmental period when minoritized youth begin their racial-ethnic identity exploration and are subjected to stereotypes and prejudice, thereby making them vulnerable to RMAs. Based upon the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist, a systematic literature search, screening and review of RMA literature focusing on high schoolers and younger youth was conducted and yielded 54 publications. This paper reviewed the publications and identified gaps in the field such as the need for systematic research on early adolescents including the frequency and severity of RMAs and the important contributions of peers, parents and teachers for RMA victims, and the need for more evidence-based programming for middle schoolers. Findings suggest that developing school-based microaggression anti-racism programs is clearly needed for minoritized and White youth.

Beyond Children's Mental Health: Cultural Considerations to Foster Latino Child and Family Mental Health

Clinicians trained to assess and treat child psychopathology are facing an increasing need to expand their clinical expertise outside of traditional frameworks, which have historically focused largely on the child or the child-mother dyad. Clinicians treating children also need to be prepared to assess and address the systems of care that affect a child's mental health, starting with their family. There is a scarcity of Latino mental health providers and limited clinical opportunities or settings that serve this population by incorporating a developmental, cultural, and sociopolitical framework into high quality care of the whole family.

Perceived control and reactivity to acute stressors: Variations by age, race and facets of control

Greater perceived control is associated with better health and well-being outcomes, possibly through more adaptive stress processes. Yet little research has examined whether facets of perceived control (personal mastery and perceived constraints) predict psychological and physiological stress reactivity. The present study evaluated the associations of personal mastery and perceived constraints with changes in subjective stress and cortisol in response to acute laboratory stressors, with age and race as potential moderators. In the Midlife in the United States Refresher Study (N = 633 adults aged 25-75), participants completed a baseline perceived control measure and were subsequently recruited to participate in the laboratory stress protocol. The protocol consisted of completing two mental stress tasks (mental arithmetic and Stroop) as well as providing saliva samples and subjective stress ratings. Race moderated the association between perceived constraints and subjective stress reactivity, such that higher constraints predicted greater subjective stress responses in White participants, but no association was observed in Black participants. Higher personal mastery and perceived constraints each predicted greater increases in cortisol in response to the stress tasks (AUC_i ) among younger but not older adults. These findings suggest that older adults were buffered against the association between facets of control and cortisol stress reactivity. Discussion on potential racial differences in the link between constraints and stress reactivity are elaborated further, as well as considerations for future work to distinguish between facets of control and examine age and racial differences.

Discrimination and depressive symptoms in sexual minority Latinx youth: Moderation by religious importance and attendance

Relative to heterosexual peers, sexual minority youth experience significant mental health disparities. This is partly due to prejudicial encounters (e.g., discrimination, victimization) because of their sexual minority status, and potential intersecting and compounding prejudicial experiences related to their ethnic minority status. However, even though religiosity has been identified as a protective factor in the general literature and may be especially relevant for youth in Latinx families, few studies have examined whether religiosity serves as a buffer of the relations between discrimination-related stress and mental health in sexual minority Latinx youth. Thus, the aims were to examine (a) whether ethnic and sexuality discrimination have additive or multiplicative effects on depressive symptoms, and (b) whether own or family religiosity (defined by religious importance and attendance) moderates the relations between discrimination and depressive symptoms. Sample included 377 youth (M_age = 20.29, SD = 2.61, age range 14-24). Results did not support an interaction between ethnic and sexuality discrimination, nor between own religiosity and ethnic discrimination, in predicting depressive symptoms. There were significant interactions between family religiosity and discrimination (ethnic and sexuality), in which family religiosity was negatively associated with depressive symptoms only at average and low levels of discrimination. There was a significant interaction between own religiosity and sexuality discrimination, in which own religiosity was negatively associated with depressive symptoms only at the low level of sexuality discrimination. Findings highlight the importance of examining the intersection of religion, sexuality, and Latinx minority status in relation to mental health outcome. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Associations between multiple indicators of discrimination and allostatic load among middle-aged adults

The objective of this paper is to examine associations between multiple measures of discrimination (i.e., everyday, lifetime, and appraised burden) and components of allostatic load (AL). We drew on pooled cross-sectional data from the Biomarker Project of the Midlife in the United States study (n = 2118). Ages ranged from 25 to 84 years and included mostly Black (n = 389) and white (n = 1598) adults. Quasi-Poisson models were fit to estimate prevalence ratios for each discrimination measure and high-risk quartiles across seven physiological systems (i.e., sympathetic and parasympathetic nervous system; HPA axis; inflammation; cardiovascular; metabolic glucose; and metabolic lipids) and overall AL scores. In fully adjusted models, everyday discrimination was associated with elevated lipids (aPR: 1.07; 95% CI 1.01, 1.13). Lifetime experiences of discrimination were associated with lower sympathetic nervous system (aPR: 0.82; 95% CI: 0.69, 0.98) and greater cardiovascular risk scores (aPR: 1.17; 95% CI: 1.02, 1.34) among those reporting three or more experiences, as well as increased inflammation (aPR: 1.13; 95% CI: 1.02, 1.25; aPR: 1.28; 95% CI: 1.14, 1.43), metabolic glucose (aPR: 1.35; 95% CI: 1.19, 1.54; aPR: 1.45; 95% CI: 1.24, 1.68), and metabolic lipids (aPR: 1.13; 95% CI: 1.03, 1.24; aPR: 1.28; 95% CI: 1.15, 1.43) scores for those reporting one to two and three or more experiences. Appraised burden yielded nuanced associations with metabolic glucose and parasympathetic nervous system scores. Everyday and lifetime measures were also associated with higher overall AL, though burden of discrimination was only associated with AL among those reporting "a little" burden. While AL summary scores provide insight into the cumulative impacts of discrimination on health, there appear to be distinct physiologic pathways through which varying forms of discrimination contribute to AL and, ultimately, to poorer health. These unique pathways may be useful in identifying potential points of intervention to mitigate the impacts of discrimination on health inequities.

A Population Health Perspective on Racism and Racial Microaggressions

Racism, one of the social determinants of health, often goes unnoticed by those less affected by its pernicious effects. The lived social experience of race has been linked to significant physical and mental health disparities. Individually or together, we know that racism and discrimination are associated with poorer health of persons from racial minority groups as evidenced in higher rates of mortality, earlier onset of disease, greater severity and progression of disease and higher levels of comorbidity and impairment. These disparities are persistent over time and, although may lessen in degree, are evident at every level of income and education. This article provides a glimpse of the impact of racism on individuals and groups, with a focus on microaggressions as a subtle but pervasive form of racism, and how it is an underlying causative factor for health disparities.

Racial Stress and Trauma and the Development of Adolescent Depression: A Review of the Role of Vigilance Evoked by Racism-Related Threat

There are known disparities in the burden of illness and access/quality of care for African, Latino/a, Asian, and Native American (ALANA) patients diagnosed with depressive disorders, which may occur because of health inequities. Racial stress and trauma (RST), or the significant fear and distress that can be imparted from exposure to racism, is one such inequity linked to the development of depression. The current review summarizes past research examining the association between racism, RST, and depression, as well as avenues in which RST becomes biologically embedded in ALANA individuals. We describe multimodal research that supports vigilance as a potential mediator of the association between RST and depression and consider the nuanced role that vigilance plays during experiences with racism. Finally, we describe methodological advances in the assessment of vigilance evoked by RST and the clinical implications that may be generated by future improvements. In each of these areas, we present examples of how ongoing and future research can be leveraged to provide support for psychosocial programs that facilitate autonomous community healing and resilience, increase calls for public policy changes, and support clinical interventions that lessen the burden of racism on ALANA communities.

Staying "One Step Ahead of a Racist": Expanding Understandings of the Experiences of the Covid-19 Pandemic Among People From Minoritized Ethnic Groups Living in Britain

Covid-19 has had a disproportionate impact on those in minoritized ethnic groups. Considerable attention has been given to evidence of ethnic inequalities in rates of infection, hospitalisation, and death. But other ways in which the pandemic experience has been affected by ethnicity have received less consideration. This paper explores the lived experiences of people in different minoritized ethnic groups living in South West England, during the United Kingdom's first pandemic lockdown, using qualitative data collected from interviews and comments provided on a survey. Perceived positive opportunities for growth were offset by anxiety and stress, which were themselves compounded by an awareness of the additional risks they experienced as members of racialised groups, and a sense that this was being ignored-or intentionally exacerbated-by the British authorities. Frustration with an incompetent and corrupt national Government was intensified by concerns regarding their racist motives. Racism in wider society undermined confidence in key public institutions, such as the NHS and the police, while also producing barriers to informal local-community pandemic responses. Only through recognition of the particular ways in which the pandemic affected those in minoritized ethnic groups, including the multiple and compounding effects of current and historical racism, will it be possible to identify avenues for transformative systemic policy change and opportunities to rebuild trust and a better post-pandemic society for all.

Vicarious Racism and Vigilance During the COVID-19 Pandemic: Mental Health Implications Among Asian and Black Americans

OBJECTIVES

Experiences of vicarious racism-hearing about racism directed toward one's racial group or racist acts committed against other racial group members-and vigilance about racial discrimination have been salient during the COVID-19 pandemic. This study examined vicarious racism and vigilance in relation to symptoms of depression and anxiety among Asian and Black Americans.

METHODS

We used data from a cross-sectional study of 604 Asian American and 844 Black American adults aged ≥18 in the United States recruited from 5 US cities from May 21 through July 15, 2020. Multivariable linear regression models examined levels of depression and anxiety by self-reported vicarious racism and vigilance.

RESULTS

Controlling for sociodemographic characteristics, among both Asian and Black Americans, greater self-reported vicarious racism was associated with more symptoms of depression (Asian: β = 1.92 [95% CI, 0.97-2.87]; Black: β = 1.72 [95% CI, 0.95-2.49]) and anxiety (Asian: β = 2.40 [95% CI, 1.48-3.32]; Black: β = 1.98 [95% CI, 1.17-2.78]). Vigilance was also positively related to symptoms of depression (Asian: β = 1.54 [95% CI, 0.58-2.50]; Black: β = 0.90 [95% CI, 0.12-1.67]) and anxiety (Asian: β = 1.98 [95% CI, 1.05-2.91]; Black: β = 1.64 [95% CI, 0.82-2.45]).

CONCLUSIONS

Mental health problems are a pressing concern during the COVID-19 pandemic. Results from our study suggest that heightened racist sentiment, harassment, and violence against Asian and Black Americans contribute to increased risk of depression and anxiety via vicarious racism and vigilance. Public health efforts during this period should address endemic racism as well as COVID-19.

Ethnic-Racial discrimination experiences predict Latinx adolescents' physiological stress processes across college transition

Consistent with conceptual frameworks of ethnic-race-based stress responses, and empirical evidence for the detrimental effects of ethnic-racial discrimination, the current study hypothesized that experiencing more frequent ethnic-racial discrimination during adolescence would predict differences in physiological responses to psychosocial stress across the college transition. U.S. Latinx adolescents (N = 84; M_age = 18.56; SD = 0.35; 63.1% female; 85.7% Mexican descent) completed survey measures of ethnic-racial discrimination during their final year of high school and first college semester (~5 months later), as well as a standard psychosocial stressor task during their first college semester. Repeated blood pressure and salivary cortisol measures were recorded to assess cardiovascular and neuroendocrine activity at baseline and stress reactivity and recovery. Data were analyzed using multilevel growth models. Experiencing more frequent ethnic-racial discrimination in high school, specifically from adults, predicted higher baseline physiological stress levels and lower reactivity to psychosocial stress during the first college semester, evidenced by both blood pressure and cortisol measures. Experiencing ethnic-racial discrimination from peers in high school also predicted higher baseline blood pressure in college, but not stress reactivity indices. Results were consistent when controlling for concurrent reports of ethnic-racial discrimination, gender, parents' education level, body mass index, oral contraceptive use, time between longitudinal assessments, depressive symptoms, and general perceived stress. Experiencing frequent ethnic-racial discrimination during adolescence may lead to overburdening stress response systems, indexed by lower cardiovascular and neuroendocrine stress reactivity. Multiple physiological stress systems are sensitive to the consequences of ethnic-racial discrimination among Latinx adolescents transitioning to college.

Examining the role of ethnic microaggressions and ethnicity on cortisol responses to an acute stressor among young adults

Objective: This study examined whether the frequency of experiences of ethnic microaggressions and the sensitivity to such experiences were associated with cortisol responses to an acute social stressor (Trier Social Stress Test; TSST) among an ethnically diverse sample of young adults (N = 109, Mage = 18.82 years, SD = 1.40 years, 74% female, 44% Latinx). Method: Self-reported experiences of and sensitivity to microaggressions were assessed using the Everyday Microaggressions Scale. Participants' salivary cortisol was collected before, immediately after, and at three 15-min intervals after the TSST (for a total of 5 salivary samples) to assess their cortisol responses to an acute social stressor. Results: Mixed model analyses revealed that experiencing a higher frequency of microaggressions (p = .005) and being more sensitive to those experiences (p = .001) were associated with a more blunted cortisol response (i.e., lower cortisol reactivity and recovery) to the TSST, relative to experiencing a lower frequency of microaggressions and being less sensitive to them. Furthermore, this blunted cortisol response to the TSST was more prominent among young adults of Latinx and other ethnic backgrounds (i.e., biracial, African American, and Native American) compared to their Asian American and non-Hispanic White peers (p = .034). Conclusion: Findings provide insight into the different ways in which experiences of ethnic microaggressions can be associated with biological markers of stress. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Race and ethnic variation in college students' allostatic regulation of racism-related stress

Racism-related stress is thought to contribute to widespread race/ethnic health inequities via negative emotion and allostatic stress process up-regulation. Although prior studies document race-related stress and health correlations, due to methodological and technical limitations, they have been unable to directly test the stress-reactivity hypothesis in situ. Guided by theories of constructed emotion and allostasis, we developed a protocol using wearable sensors and daily surveys that allowed us to operationalize and time-couple self-reported racism-related experiences, negative emotions, and an independent biosignal of emotional arousal. We used data from 100 diverse young adults at a predominantly White college campus to assess racism-related stress reactivity using electrodermal activity (EDA), a biosignal of sympathetic nervous system activity. We find that racism-related experiences predict both increased negative emotion risk and heightened EDA, consistent with the proposed allostatic model of health and disease. Specific patterns varied across race/ethnic groups. For example, discrimination and rumination were associated with negative emotion for African American students, but only interpersonal discrimination predicted increased arousal via EDA. The pattern of results was more general for Latinx students, for whom interpersonal discrimination, vicarious racism exposure, and rumination significantly modulated arousal. As with Latinx students, African students were particularly responsive to vicarious racism while 1.5 generation Black students were generally not responsive to racism-related experiences. Overall, these findings provide support for allostasis-based theories of mental and physical health via a naturalistic assessment of the emotional and sympathetic nervous system responding to real-life social experiences.

Racial exclusion causes acute cortisol release among emerging-adult African Americans: The role of reduced perceived control

Racial discrimination contributes to stress-related health disparities among African Americans, but less is known about the acute effects of racial exclusion on the hypo-pituitary-adrenocortical response and psychological mediators. Participants were 276 Black/African American emerging-adults (54% female; M _age = 21.74, SD = 2.21) who were randomly assigned to be excluded or included by White peers via the game Cyberball. Racial exclusion (vs. inclusion) predicted: greater negative affect (F(1, 276) = 104.885, p < .0001), lower perceived control (F(1, 276) = 205.523, p < .0001), and greater cortisol release (F(1, 274) = 4.575, p = .033). Racial exclusion's impact on cortisol release was mediated by lower perceived control (95% CI: .027, .112), but not negative affect (-.041, .013). These findings suggest that racial exclusion contributes to acute cortisol release, and that reduced perceived control is a consequence of racial discrimination that has important implications for the health of those who experience discrimination.

Reactions to Witnessing Ethnic Microaggressions: An Experimental Study

Introduction: Minimal research has examined how witnesses identify and respond to ethnic microaggressions including the role of colorblind racial attitudes.

Method: University student participants (N = 401) were randomly assigned to one of three experimental conditions in which they witnessed a research decoy experiencing an ethnic microaggression, an overt discriminatory interaction, or a neutral interaction (control).

Results: The study findings showed that 46% of participants who witnessed an ethnic microaggression identified it as unfair or differential treatment compared to 84% of those who observed an overt form of discrimination. Multilevel model analyses revealed a 3-way interaction (time × experimental condition × colorblind racial attitudes) such that participants with low colorblind racial attitudes had significant increases in negative affect and systolic blood pressure after witnessing overt discrimination.

Discussion: Key differences exist in the identification and responses associated with witnessing an ethnic microaggression compared to overt discrimination. Findings suggest that shifting colorblind racial attitudes may be a promising area of intervention to improve detection of ethnic microaggressions.

Discrimination, Stress and Reactivity to Alcohol Cues

Introduction: Our study investigated whether discrimination affects psychologi-cal/physiological stress and alcohol craving.

Method: Participants (N = 92) were asked to recall and write about (a) a neutral, (b) a negative, or (c) a discriminatory experience in the past and then completed a cue-reactivity procedure assessing their alcohol craving. In addition, we assessed levels of perceived stress before and after the discrimination manipulation, chronic substance use and craving, prior perceived discrimination, and strength of racial/ethnic identity.

Results: Results revealed a small effect in which the discrimination condition increased alcohol cue-elicited craving relative to the other conditions. Chronic craving moderated effects of discrimination on cortisol levels. Self-reported stress levels were increased in the discrimination and negative memory conditions relative to baseline. Strength of racial identity served as a protective factor for substance abuse in those who reported chronic high levels of discrimination.

Discussion: We discussed the direct link established between acute exposure to discrimination and craving, and experimental evidence for the relationship between discrimination and self-reported stress, but also addressed potential limitations of this work. It is further discussed how some individual differences factors (e.g., chronic craving) predict physiological stress in discriminatory settings. This work underscored the role of racial identity as a protective factor against alcohol abuse in individuals reporting high levels of discrimination.

Measures of Racism, Sexism, Heterosexism, and Gender Binarism for Health Equity Research: From Structural Injustice to Embodied Harm-An Ecosocial Analysis

Racism. Sexism. Heterosexism. Gender binarism. Together, they comprise intimately harmful, distinct, and entangled societal systems of self-serving domination and privilege that structure the embodiment of health inequities. Guided by the ecosocial theory of disease distribution, I synthesize key features of the specified "isms" and provide a measurement schema, informed by research from both the Global North and the Global South. Metrics discussed include (a) structural, including explicit rules and laws, nonexplicit rules and laws, and area-based or institutional nonrule measures; and (b) individual-level (exposures and internalized) measures, including explicit self-report, implicit, and experimental. Recommendations include (a) expanding the use of structural measures to extend beyond the current primary emphasis on psychosocial individual-level measures; (b) analyzing exposure in relation to both life course and historical generation; (c) developing measures of anti-isms; and (d) developing terrestrially grounded measures that can reveal links between the structural drivers of unjust isms and their toll on environmental degradation, climate change, and health inequities.

Vicarious Racism Stress and Disease Activity: the Black Women's Experiences Living with Lupus (BeWELL) Study

BACKGROUND

Indirect or vicarious exposure to racism (e.g., hearing about or observing acts of racism or discrimination) is a salient source of stress for African Americans. Emerging research suggests that these "secondhand" experiences of racism may contribute to racial health inequities through stress-mediated pathways. Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disease that disproportionately impacts African American women and is characterized by racial disparities in severity. Health outcomes in this population may be susceptible to vicarious racism given that SLE is shown to be sensitive to psychosocial stress.

METHODS

Data are from 431 African American women with SLE living in Atlanta, Georgia in the Black Women's Experiences Living with Lupus (BeWELL) Study (2015-2017). Vicarious racism stress was measured with four items assessing distress from (1) hearing about racism in the news; (2) experiences of racism among friends or family; (3) witnessing racism in public; and (4) racism depicted in movies and television shows. Multivariable linear regression was used to examine associations with disease activity measured using the Systemic Lupus Activity Questionnaire.

RESULTS

Adjusting for sociodemographic and health-related covariates, vicarious racism stress was associated with greater disease activity (b = 2.15; 95% CI = 1.04-3.27). This association persisted even after adjustment for personal experiences of racial discrimination (b = 1.80; 95% CI = 0.67-2.92).

CONCLUSIONS

Vicarious racism may result in heightened disease activity and contribute to racial disparities in SLE. Our findings suggest that acts of racism committed against members of one's racial group may have distinct health consequences beyond the immediate victim or target.

When Discrimination Hurts: The Longitudinal Impact of Increases in Peer Discrimination on Anxiety and Depressive Symptoms in Mexican-origin Youth

Life course models of the impact of discrimination on health and mental health outcomes posit that the pernicious effects of discrimination may not be immediate, but instead may become apparent at later stages in development. This study tests whether peer discrimination changes at particular transition points (i.e., transition to middle and high school) predict subsequent internalizing symptoms in Mexican-origin youth. In a sample of 674 Mexican-origin youth (50% female), this study used a latent change score framework to model changes in peer discrimination across time and to test whether changes in peer discrimination at 7th and 9th grades predicted greater depressive and anxiety symptoms in 12th grade controlling for 5th grade symptoms. Irrespective of longitudinal changes, greater peer discrimination in 5th grade predicted greater depressive and anxiety symptoms in 12th grade. Further, significant increases in peer discrimination from 7th to 8th grade and in 9th to 10th grade uniquely predicted greater anxiety symptoms in 12th grade. These findings suggest that longitudinal research on peer discrimination needs to take into account unique periods of risk. Future research implications are discussed.

Racial discrimination, educational attainment, and biological dysregulation among midlife African American women

OBJECTIVE

To examine the association between self-reported racial discrimination and allostatic load, and whether the association differs by socioeconomic position.

METHODS

We recruited a purposive cross-section of midlife (ages 30-50) African American women residing in four San Francisco Bay area counties (n = 208). Racial discrimination was measured using the Experience of Discrimination scale. Allostatic load was measured as a composite of 15 biomarkers assessing cardiometabolic, neuroendocrine, and inflammatory activity. We calculated four composite measures of allostatic load and three system-specific measures of biological dysregulation. Multivariable regression was used to examine associations, while adjusting for relevant confounders.

RESULTS

In the high education group, reporting low (b = -1.09, P = .02, 95% CI = -1.99, -0.18) and very high (b = -1.88, P = .003, 95% CI = -3.11, -0.65) discrimination was associated with lower allostatic load (reference=moderate). Among those with lower education, reporting low (b = 2.05, P = .008, 95% CI = 0.55,3.56) discrimination was associated with higher allostatic load. Similar but less consistent associations were found for poverty status. Associations were similar for cardiometabolic functioning, but not for neuroendocrine or inflammatory activity.

CONCLUSIONS

Racial discrimination may be an important predictor of cumulative physiologic dysregulation. Factors associated with educational attainment may mitigate this association for African American women and other groups experiencing chronic social stress.

The role of bicultural adaptation, familism, and family conflict in Mexican American adolescents' cortisol reactivity

Scarce research has examined stress responsivity among Latino youths, and no studies have focused on the role of acculturation in shaping cortisol stress response in this population. This study assessed Mexican American adolescents' Mexican and Anglo cultural orientations and examined prospective associations between their patterns of bicultural orientation and hypothalamic-pituitary-adrenal cortisol reactivity to an adapted Trier Social Stress Test. The sample included 264 youths from a longitudinal birth cohort study who completed the Trier Social Stress Test and provided saliva samples at age 14. The youths completed assessments of cultural orientation at age 12, and family conflict and familism at age 14. Analyses testing the interactive effects of Anglo and Mexican orientation showed significant associations with cortisol responsivity, including the reactivity slope, peak levels, and recovery, but these associations were not mediated by family conflict nor familism values. Findings revealed that bicultural youth (high on both Anglo and Mexican orientations) showed an expected pattern of high cortisol responsivity, which may be adaptive in the context of a strong acute stressor, whereas individuals endorsing only high levels of Anglo orientation had a blunted cortisol response. Findings are discussed in relation to research on biculturalism and the trade-offs and potential recalibration of a contextually responsive hypothalamic-pituitary-adrenal axis for acculturating adolescents.

A Preliminary Study of the Relationship between Perceived Racism and Cardiovascular Reactivity and Recovery in Native Hawaiians

Native Hawaiians, compared to other ethnic groups in Hawai‘i, have significantly higher mortality rates and die at a younger average age from cardiovascular disease (CVD). This may be partially explained by elevated cardiovascular responses to racial stressors. Our study examined the degree to which blood pressure (BP) and heart rate (HR) reactivity and recovery, and ratings of subjective distress to racial stressors, differ as a function of Native Hawaiian college students’ levels of perceived racism. This study had three phases. Phase 1 involved the development of a blatant and subtle racial stressor. Phase 2 involved assigning 132 students into high- or low-perceived racism groups based on scores on two perceived interpersonal racism measures. Phase 3 involved a psychophysiology laboratory experiment conducted with 35 of the 132 students. BP, HR, and subjective distress were measured during exposure to the blatant and subtle racial stressors. Systolic blood pressure (SBP) recovery following exposure to both stressors was significant for both groups. Although not significant, three trends were observed among the high-perceived racism group, which included: (1) greater reactivity to exposure to the subtle stressor than to the blatant stressor, (2) incomplete HR recovery following exposure to both stressors, and (3) incomplete SBP and diastolic blood pressure recovery following exposure to the subtle stressor. Participants also reported significantly greater subjective distress following exposure to the blatant than to the subtle stressor. Specific interventions, such as increased self-awareness of physiological responses to racial stressors, targeted at at-risk individuals are necessary to reduce a person’s risk for CVD.

Racial discrimination and cortisol output: A meta-analysis

RATIONALE

Although the relation between stress and physiology is well documented, attempts at understanding the link between racial discrimination and cortisol output, specifically, have produced mixed results, likely due to study characteristics such as racial/ethnic composition of the samples (e.g., African American, Latino), measures of discrimination, and research design (e.g., cross-sectional, experimental).

OBJECTIVES

To estimate the overall association between racial discrimination and cortisol output among racial/ethnic minority individuals and to determine if the association between racial discrimination and cortisol output is moderated by age, race/ethnicity, type of discrimination measure, sex, and research design.

RESULTS

Using a random effects model, the overall effect size based on k = 16 studies (19% unpublished) and N = 1506 participants was r¯ = 0.040, 95% CI = -0.038 to 0.117. Studies were conducted predominantly in the U.S. (81%). Notably, experimental studies (r¯ = 0.267) exhibited larger effect sizes compared to non-experimental studies (r¯ = -0.007). Age, race/ethnicity, type of discrimination measure, and sex did not moderate the effect sizes.

CONCLUSION

This meta-analysis provides evidence that the measurement of the association between racial discrimination and cortisol is complex, and it offers valuable insight regarding methods and designs that can inform future research on this topic. Limitations and future directions are discussed.