07/15/2016

The Health Costs of Racism

17:11 minutes

The videos of recent tragic shootings are disturbing and hard for anyone to watch. But it can be even harder if the person in the video looks like you.

In fact, researchers say that experiencing, witnessing, or even just hearing about discrimination could result in anxiety, depression, psychosis, or PTSD.

And early evidence suggests that racism can boost heart rate and blood pressure, and ultimately influence life expectancy in people of color.

“We used to think about problems like PTSD as being caused by a single traumatic event and what we’re now starting to understand is that often it’s an accumulation of experiences that results in traumatization,” says associate professor of psychology and brain sciences at the University of Louisville, Monnica Williams. “Something like racism, even if it’s at a very low level, if you’re experiencing it all the time, it can accumulate and cause symptoms very similar to PTSD such as depression, anxiety, nightmares, avoidance and so forth.”

Those who experience microaggressions and other racist interactions can be affected, but Courtney Cogburn, an assistant professor at Columbia University’s School of Social Work, says even just watching other people experience racism can cause health problems.

“Vicarious exposures to racism, which makes exposure to the media particularly important given the degree to which your average adult accesses media on a given day, if they’re being exposed to these types of stressors, it is having an impact on processes that can have implications for health,” Cogburn says. “That vicarious exposure to media becomes an important source of stress for us to understand.”

Willams says the effects of exposure to racism can manifest itself in a variety of symptoms including anxiety, anger, sadness, hopelessness, and impaired work performance.

“When you see people like yourself, people who remind you of your kids, or loved ones being victimized at the hands of people, often who are supposed to be protecting us — that’s very frightening,” Williams says. “When it happens over and over to people that you know and love, that’s going to have an effect.”

There are, however, things people can do to combat the negative effects of experiencing racism. Williams has been studying these coping mechanisms in her lab.

“One thing we found is that some people tend to take a more challenge approach to it like, ‘OK, this other person is believing stereotypes about me — what can I do to help change the way they think of me and my whole group?’” Williams says. “Versus negative coping strategies, which could be things like denial, or substance abuse, or just internalizing those things and feeling bad about yourself.”

Cogburn and others have also been working on projects to help combat racism and the ignorance that feeds it.

“We’re really interested in whether we can sort of capture more complex and subtle manifestations of racism in virtual reality to get people who don’t normally encounter these types of experiences the opportunity to walk in someone else’s shoes,” Cogburn says. “The premise here is their experiences with racism are so far removed from some people’s reality that they don’t understand that, they don’t get it. And so we’re wondering if we can leverage this technology to help people understand it in a way that they may not be able to really understand in their day-to-day lives.”

—Elizabeth Shockman (originally published on PRI.org)

Segment Guests

Monnica Williams

Monnica Williams is an associate professor in psychology and brain sciences and the director of the Center for Mental Health Disparities a the University of Louisville in Louisville, Kentucky.

Courtney Cogburn

Courtney Cogburn is an assistant professor at the Columbia School of Social Work at Columbia University in New York, New York.

Segment Transcript

IRA FLATOW: This is Science Friday. I’m Ira Flatow. The deadly French truck attack is the latest and the horrific videos in the news and social media showing violence and killings. This month in particular, before last night’s attacks, it’s been videos of racial violence that have been filling up our news feeds.

It’s deeply unsettling to watch this stuff. And when the victims of violence look like you, like your family, your friends, your kids, well, it’s even harder to bear. Early research suggests that witnessing this violence, even hearing about it, can take a toll on the body and the mind, especially for people of color. And the research shows clear links between roots of the violence, racism and discrimination, and anxiety, depression, psychosis, or PTSD.

Some scientists believe racism could even be tied to lower life expectancies for people of color. So what to make of all of this? How big an influence could racism, violence, discrimination play in mental and physical health?

And what are doctors supposed to do about it? That’s what we’ll be talking about with my next guests. Dr. Monnica Williams is an Associate Professor of Psychology and Brain Sciences and Director of the Center for Mental Health Disparities at the University of Louisville. Welcome to Science Friday, Dr. Williams.

MONNICA WILLIAMS: Thank you. It’s great to be here.

IRA FLATOW: Dr. Courtney Cogburn is an Assistant Professor at the Columbia School of Social Work at Columbia University. Welcome to Sci Fri, Dr. Cogburn

COURTNEY COGBURN: you.

IRA FLATOW: Let me ask you first. You’ve actually tried to measure people’s response to racism? How do you do that? Is it hard to measure?

COURTNEY COGBURN: definitely hard to measure. I mean, racism manifests in various ways from interpersonal context, someone calling you a name or following you in a store, to things that you might observe in the medias, or suggesting some of these racially violent videos that we’ve been seeing.

In one of our studies, we had people consumed some of this media. And we monitor their physiological, psychological, and behavioral stress responses as they consume that media.

IRA FLATOW: And Dr. Williams, you’ve done work on trauma and the ways lots of subtle incidents can build up to create symptoms of PTSD or other mental illness. How does that work?

MONNICA WILLIAMS: Well, we used to think about problems like PTSD as being caused by a single traumatic event. And what we’re now starting to understand is that often it’s an accumulation of experiences that resultant in dramatization. And so something like racism, even if it’s at a very low level, if you’re experiencing it all the time, it can accumulate and cause symptoms very similar to PTSD, such as depression, anxiety, nightmares, avoidance, and so forth.

IRA FLATOW: Now that I have two experts like you here on the program and considering what we saw last night in France and what other attacks the French people have gone through, for the citizens of France, how will this truck attack affect the way they’ll react to let’s say seeing trucks in traffic, especially kids like that? Is it going to have lasting effects, especially coming after the other attacks that have occurred in France?

MONNICA WILLIAMS: Well, it’s very normal for people to have PTSD-like reaction shortly after a traumatic stressor. Now, for most people, these effects go away over time. But sometimes they don’t. And when they don’t, that’s when someone would get a diagnosis of PTSD.

And so I think it’ll be very normal for people who saw the horrors of what happened in France to be very jumpy around trucks and other things that remind them of the horrors. But given that many people also saw people being killed and mangled, the effect of this may not go away. And I’m sure many, many people are going to have Post Traumatic Stress Disorder.

IRA FLATOW: Dr. Cogburn, what about racism or discrimination that doesn’t happen to you directly, but that you see or hear happening to other people? Can that cause, you know, these health effects, like we’ve been seeing on the news?

COURTNEY COGBURN: Absolutely. So we refer to that as the vicarious experience with stress, in particular [INAUDIBLE] exposures to racism, which makes exposures through media particularly important given the degree to which your average adult accesses media on a given day. If they’re being exposed to these types of stressors and it is having an impact on processes that can have application for health, than that vicarious exposure through media becomes an important source of stress for us to understand.

IRA FLATOW: Dr. Williams, do you agree? I mean, there are videos of discrimination, violence. They’re all over the place, on social media, in the news. Does that make it worse?

MONNICA WILLIAMS: Absolutely. When you see people like yourself, people who remind you of your kids or loved ones being victimized at the hands of people often who are supposed to be protecting us, that’s very frightening. And when it happens over and over to people that you know and love, that’s going to have an effect.

IRA FLATOW: How do you know when you are suffering from one of the effects of this exposure?

MONNICA WILLIAMS: Right. Well, one of the things I often see is anxiety in the clients that I treat for this. They are often very frustrated, very angry, very sad, very hopeless. Their performance at work is often impaired due to these experiences. And they’re not enjoying life.

IRA FLATOW: And how much recognition is there among doctors and clinicians and psychologists of the effects of racism on mental health? Because is it in the medical journals, like the DSM, that doctors use to diagnose illnesses?

MONNICA WILLIAMS: Well, we’ve had a lot of research done in the last 15 years which shows a clear connection between racial discrimination and negative physical and mental health outcomes. However, most clinicians, it’s still not on their radar yet. And we really don’t see it represented in the DSM-5.

IRA FLATOW: Not every racist event is something obvious, a name calling, or a violent act, or something like that. What about the more subtle slights that people of color might experience just in the daily life. Dr. Cogburn, can you describe what one of those situations might be like?

COURTNEY COGBURN: Well, I think, you know, in day to day life what an individual might encounter what have been called microaggressions could be someone surprised that you were so articulate after giving a talk or a presentation at work or shock that you didn’t come from a single parent home if you’re a black person given stereotypes about black families. But more subtle types can also emerge in media. So as opposed to someone, say, in blackface or using the n-word, you also may have a political pundit such as Pat Buchanan referring to the President as a drug dealer of welfare.

He’s not explicitly referencing race or black people. But he’s certainly using racially coded language or dog whistles to elicit negative racial sentiment, which can also, based on some of the work that we’re doing, elicit stress response. It could be problematic for health.

IRA FLATOW: Let’s go to the phones. Our number, if you’d like to join us, is 844-724-8255. Mountain View, California’s up first. Paul, welcome to Science Friday.

PAUL: Hello. I’d like to bring up an analogous situation over in India, where you have the so-called untouchables or Dalits, who they’ve been treated badly over the centuries, I guess. They are the victims of violence, of discrimination. They’re often born into lives where they have to do really menial jobs like cleaning toilets.

It seems we almost have a caste system here in the States as well. But I live in Mountain View. We have lots of Indian people here. I doubt many of them are untouchables. They tend to be people who, they don’t have white privilege, but they have caste privilege.

IRA FLATOW: Do you see a sort of racism with new immigrants also? I mean, from India, Pakistan, things like that?

PAUL: Yeah. I don’t know that they discriminate against Americans so much. I have seen some discrimination against Blacks. I don’t know if Indians, per se, are they perpetrators.

IRA FLATOW: Let me ask our guests. Monnica, what do you think?

MONNICA WILLIAMS: Well, one thing we do know is that racial or any kind of discrimination is harmful all over the world. Wherever you see stigmatized communities, you see these negative physical and mental health outcomes. And I think it makes sense that most of the Indians who come here from India they are not going to be of these very lower castes. They are going to be people who have more advantages. And so when they come here, they’re going to bring their thoughts about advantage and disadvantage as well.

IRA FLATOW: Do you see them as entering the same kind of discriminatory– or being victims of the same kind of discriminatory practices?

MONNICA WILLIAMS: Well, they are certainly going to have their share of discrimination. I mean, the research shows that every minority group gets some degree of racial discrimination. But it is different for different groups.

For example, among Asian Americans there’s this model minority identity. But even those kinds of stereotypes can have negative consequences as well. And people don’t always realize that.

IRA FLATOW: Are there strategies that people can use to positively cope when presented with racism and discrimination?

MONNICA WILLIAMS: Yes. And that’s actually been one of the areas of focus in our research lab is how people do you cope with racism and discrimination. And one thing we found is that some people tend to take a more challenge approach to it, like, OK, this other person is believing stereotypes about me. What can I do to help change the way they think of me and my whole group? Versus negative coping strategies, which could be things like denial or substance abuse or just internalizing those things and feeling bad about yourself.

IRA FLATOW: Courtney, do you have any suggestions?

COURTNEY COGBURN: I think part of what we’re considering is whether awareness and consciousness of racism is actually beneficial. I think this is something that more research should consider as a form of coping. There’s this sort of social consciousness as well as social engagement around these issues provide some degree of protection when having these sort of negative experiences.

IRA FLATOW: I understand that you have a project in the works to use virtual reality to allow people to experience racism and discrimination. Tell us about that.

COURTNEY COGBURN: Right. We’re really interested in whether we can sort of capture more complex and subtle manifestations of racism in virtual reality to give people who don’t normally encounter these types of experiences the opportunity to walk in someone else’s shoes and walk through a space, a community, an environment, where they could be exposed to some of these experiences. The premise here is that experiences with racism are so far removed from some people’s reality that they don’t understand it, they don’t get it. And so we’re wondering if we can leverage this technology to help people understand it in a way that they may not be able to to really understand in their day to day lives.

IRA FLATOW: See if I can get one more call in, a call or two before we go. Al in Minneapolis, hi. Welcome to Science Friday.

AL: Good afternoon, great show. Quick one for you. I know the angle has been more on the racism part of this with PTSD. But I have a general question about the PTSD affecting the entire country. We’ve been under the terrorism umbrella for the last 15 years.

And we get the occasional events that are very, very sad and unfortunate and effect relatively few people in the scheme of things. But you’ve got the Homeland Security Department. You have all these things that are just thumping the terrorism drum constantly.

And every time there’s an upsurge and a flareup like we had in France, which is just horrible, it’s all over the news. People are probably all on high alert. Does that have an entire country’s psyche? Is the entire country kind of just PTSDing up each level every time something happens? Or what’s your thoughts on that?

IRA FLATOW: Before you answer that, let me just remind everybody this is Science Friday from PRI, Public Radio International. Who would like to tackle that one? Yeah, go ahead.

MONNICA WILLIAMS: Yeah. This is a Dr. Williams. So I would say that I think it definitely affects all of our psyches. I don’t know that I wouldn’t necessarily say that that’s going to rise to the level of PTSD in everyone. But I think certainly there are social forces.

And we have our own social psychopathologies, racism, for example, being one of them. And I think we’re all affected by these events. And some people are going to be affected more than others certainly based on their history and experiences. But it does affect how we as a whole culture approach issues like this.

IRA FLATOW: But as a physician, should physicians, psychiatrists, expect or not be surprised or look to recognize this PTSD kind of that we’re talking about when someone comes in and says I’m just nervous, I’m upset, or expresses anxiety?

MONNICA WILLIAMS: Yeah. People are coming in with these problems all the time. The problem is that our mental health care providers, are not always looking for these problems and don’t know to ask about them. And also people of color are sometimes afraid to bring up issues of race and racism. Because they’re so used to being invalidated by other people who don’t experience these things.

IRA FLATOW: Let’s go to Carolyn in St. Petersburg, Florida. Hi, Carolyn.

CAROLYN: Hi, how are you? Thank you so much for taking my call.

IRA FLATOW: You’re welcome.

CAROLYN: I’ll keep it brief. I’m an African American woman. And I just purchased a home in a fairly upscale area in Saint Pete. And I think I’m the only– the first, well, maybe the only person of color in my community.

And while I haven’t experienced much overt racism, I have experienced what I would consider instances of microracism, where I feel like I’m almost educating the community. For an example, I was out walking my dogs. And a couple walked passed across the street and pointed and said something that I couldn’t hear what they were saying.

I said, excuse me, what did you say? And they pointed to me and said, Wanda Sykes. I wear my hair natural. And I thought, hm, interesting. And my comment back to them was, no. Sorry, but I’m not gay.

So I’ve tried to use some humor. But it was just a little offensive that because I’m a black woman who wears my hair natural, they pointed to me and called some celebrity who happens to look– have the same hairstyle and say, oh, you’re Wanda Sykes. So it’s a circumstance where I feel like I need to do some education for the community there. Because all black women who wear they’re hair natural believe it or not, are not Wanda Sykes.

IRA FLATOW: All right. Thank you for that call. Quick reaction from any of my guests?

COURTNEY COGBURN: I think– I think that, you know, some people may think of that example and I think, oh, well, it’s just a harmless comment about your hair. But what’s really problematic about microaggressions and other forms [INAUDIBLE] more overt manifestations of racism, is that they accumulate over time. They add up.

And essentially, they start to send a message that you are not as valuable, you’re not as visible as other groups, that you are othered in ways that become problematic. And that becomes problematic at psychological levels as well as physical levels that really are problematic. So just because it’s a comment about your hair doesn’t mean that it doesn’t have any significance in terms of it’s effects on someone.

IRA FLATOW: Thank you, Doctors, for taking time to be with us today. Dr. Monnica Williams is Associate Professor of Psychology and Brain Sciences and a Director of the Center for Mental Health Disparities University of Louisville. Dr. Courtney Cogburn, Assistant Professor at Columbia University School of Social Work. Thank you both, have a good weekend, for taking time to be with us today.

Charles Bergquist is our director. Our senior producer, Christopher Intagliata. Producers are Alexa Lim, Annie Minoff, Christie Taylor. Luke Groskin, our video producer. Also help, special help today from intern [? Nicole ?] [? Wetzman. ?] Thanks, [? Nicole. ?] Rich Kim is our technical director. Sarah Fishman and Jack Horowitz are our engineers at the controls here at the studios of our production partners at the City University of New York.

And if you ever wonder what color sounds like, self-professed cyborg Neil Harbisson has an antenna implanted in his head that lets him do just to that. And you can read about his unique color perspective at sciencefriday.com/cyborg. And I just remind you, we have our video up there if you want to know what goes on inside a recycling plant, with Luke Groskin going to one in Brooklyn. It is quite fascinating. It’s up there also on our website today. I’m Ira Flatow in New York.

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Meet the Producers

About Nicole Wetsman

Nicole Wetsman was Science Friday’s summer 2016 web intern. She has a degree in neuroscience from Bowdoin College in Maine, and she’s now a graduate student in the Science, Health, and Environmental Reporting Program at New York University.

About Christopher Intagliata

Christopher Intagliata is Science Friday’s senior producer. He once served as a prop in an optical illusion and speaks passable Ira Flatowese.

  • Pat Smith

    As a teacher and trainer, I saw first hand the mental health costs of racism. What does it do to a kid told “my Mom says I can’t have any black people over…” What does it do to a coworker who is the only one not asked to the shower luncheon? A friend described how when he, a young black man, got on an elevator, some of the other passengers would invariably shrink back toward the wall. Such rejection can only have a bad outcome.

  • Connie

    I go to the movies a lot and noticed that African American movie goers rarely seem to ‘jump in their seats’ when something scary or instantly tragic happens in a movie. It’s almost as if tragedy is normal and there is no surprise

  • Jaspers_companion

    I don’t know whether to laugh, cry or scream about this “new” awareness of the impact of racism. As a 69-year old white woman, I am stunned and appalled that it has not occurred to the majority that this has effected generations and, further, we are only now becoming aware because we are being targeted by terrorists. How sad.

    • Carolyn

      Thank you for this comment. I agree. I hope this revelation stays in the forefront of race and mental health discussions.

    • crazygemini12

      While I’m happy we’re studying this (as I’ve been affected by it), I also wonder when we’re going to start examining long-term effects of environmental racism, especially in light of everything going on in Flint and Standing Rock.

  • Manan

    Most people have inherent biases developed over time that might show up as racism in one form or the other. As a general human tendency, we are attracted to information that reinforces and justifies these biases. I think the difficult part and the key to get rid of these is to reach out and talk to people that you feel biased towards. It’s hard but beneficial for both parties involved.
    As an example, one of the callers on the show brought up the point that India has age old caste system which is comparable to racism and the fact that most of the recent Indian immigrants are of higher caste demonstrates this fact. While caste system is a horrible truth which is still around in parts of India, in last 50 or so years there has been a reverse discrimination due to the fact that up to 50 to 60% of the government jobs, public and private higher education and even job promotions have reservations for various casts/communities traditionally regarded as lower caste. This leaves lot of the “general” category students to risk taking large loans to seek higher education and jobs in countries like USA where they don’t have to face this kind of reverse discrimination.
    Again there is no reason for any of this to become a excuse to show discrimination towards either party. A light chat with masala chai or cold beer might clear up things and make life a little better.

  • Carolyn

    I can relate to how micro aggressions can wear you down. I am a 56 year old African American female who moved to a small predominantly white small town. I have had the little old white lady who greeted me by telling me she voted for Obama. Several people tell me they could remember when there were no black people in town (Is this the only conversation you could think of?), I have been mistaken for a store worker even when everyone else was in uniform. I have been dismissed by a kid who was hooking up our security system. Oh, and when I wear my hair natural I apparently look like Whooping Goldberg. I look nothing like Whoopi Goldberg. For years studies have indicated that African Americans have higher blood pressure levels than most groups. I am glad that some people are finally figuring out why. Then of course I am sure lots of Afican Americans could have indicated this.

  • Rustle

    This was not a program for SciFri.

    • Marie

      Why not? It is science.

  • trurl9

    Aged 56, I recently realized that I’m carrying a mental/emotional weight of being black. Wearing down due to being pursued by the constant shadow of racism. Can’t outrun racism any more by placing other distractions between me and it.

    Racial incidents aren’t often direct, they’re increasingly subtle. From being pulled over by twitchy police who were surprised that I didn’t have “much of a record”, to being racially abused, the last five years have shown me that I’m living in a less tolerant, diverse and accepting place.

    My local media (Portland, Oregon) would have me believe that we live in the land of milk and honey. Not quite. The milk sours and the honey crystallizes. I’ve heard the phrase that Oregon is heaven for white people several times recently.

    Still ruminating an incident that occurred several years ago. While trying to enjoy a rare day at the ocean, a muddy monster truck drove by with a bunch of noisy teen males doing what they do best. Mounted to the bed of their truck was a giant flag of the confederacy waving through the suddenly pensive and foggy air. What the hell is this? Really?

    Had to deal with the fact that I hate that flag: that disgusting symbol of racial oppression. I see that flag and experience a visceral physical reaction to it. Much the same feeling I experience when I see a Nazi swastika. These symbols represent racial evil in my perception of reality.

    Had to wrestle with my belief that those kids had the right to be stupid, but I was left to chase away my fear that they might stop and harass me. I receded into the trees and watched their truck pass and considered that “stupid” is near impossible to fix.

    Has Obama cause a backlash against blacks by whites? What is the psychological toll on all people given the U.S.A.’s history of slavery and racism? Is there undiagnosed “white guilt” that has transcended generations like some mutated recessive gene? We are learning how deeply blacks are scared but we never hear analysis how racism affects whites. We’re all wrapped in this together and ignoring racism as if it didn’t exist isn’t working.

    Most of my white associates won’t talk to me about race or other thorny issues. If they do they’ll say something like, “Dude, I’m not racist. I had nothing to do with slavery. Not my problem.” There are others who are inured in their privilege such that they’ve never considered walking in someone else’s shoes.

    I have to always consider where I am and who I’m dealing with. I’m not free to go about my business without some taking notice and objecting to my presence. Being bi-racial I’m never considered partially white, I’m considered wholly black.

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