Only Black Women Have Feelings?

Only Black Women Have Feelings?

This essay raises serious credibility questions. (Madeline Drexler, "How
racism hurts -- literally," Boston Sunday Globe, July 15, 2007) Are black women
different from white men when it comes to reacting to stress? Are black women
different from white men in reacting to discrimination? Are black women's
reaction to racism different from white men's reaction to discrimination based
upon sexual preference? Or disability? Were any studies done on the effects of
discrimination against white men who are accused of psychiatric illness? I don't
think so.
Why does the Globe continue to prioritize one form of discrimination
over others when many kinds of bias are equally unlawful and offensive? The
Globe discriminates in its focus on discrimination. See, e.g., how differently
the Globe reported on outrageous unlawful discrimination in access to health
care for persons with disabilities in Liz Kowalczyk, "Psychiatric patients feel
strain,"
Boston Globe, July 15, 2007.
This essay cherry picks ignoring the income and class of black people. Do
multi millionaire athletes and celebrities get worse medical care than poor
white men? I don't think so.
Most importantly psychiatrists say that you cannot control what another
person thinks or says about you. But you can control how you react to what they
say or do. These anecdotes suggest that black people are incapable of ignoring
what others say and do. Do black people have no control over their emotions and
thoughts?

Roy Bercaw, Editor ENOUGH ROOM

How racism hurts -- literally
Boston Sunday Globe
By Madeline Drexler
July 15, 2007

FOUR YEARS AGO, researchers identified a surprising price for being a black
woman in America. The study of 334 midlife women, published in the journal
Health Psychology, examined links between different kinds of stress and risk
factors for heart disease and stroke. Black women who pointed to racism as a
source of stress in their lives, the researchers found, developed more plaque in
their carotid arteries -- an early sign of heart disease -- than black women who
didn't. The difference was small but important -- making the report the first to
link hardening of the arteries to racial discrimination.

The study was just one in a fast-growing field of research documenting how
racism literally hurts the body. More than 100 studies -- most published since
2000 -- now document the effects of racial discrimination on physical health.
Some link blood pressure to recollected encounters with bigotry. Others record
the cardiovascular reactions of volunteers subjected to racist imagery in a lab.
Forthcoming research will even peek into the workings of the brain during
exposure to racist provocations.

Scientists caution that the research is preliminary, and some of it is quite
controversial, but they say the findings could profoundly change the way we look
at both racism and health. It could unmask racism as a bona fide public health
problem -- just as reframing child abuse and marital violence as public health
concerns transformed the way we thought about these ubiquitous but often secret
sources of suffering. Viewing racial discrimination as a health risk could open
the door to understanding how other climates of chronic mistreatment or fear
seep into the body -- why, for instance, pregnant women in California with
Arabic names were suddenly more likely than any other group to deliver low
birth-weight babies in the six months after 9/11.

Most striking, researchers note, is how consistent the findings have been across
a wide range of studies. The task now, they say, is to discover why.

"We don't know all the internal processes," said James Jackson, director of the
Institute for Social Research at the University of Michigan. "But we can observe
an effect, and we need to find out what's going on."

The burgeoning research comes at a time when lawmakers and government officials
are increasingly focused on the problem of racial disparities in health.
African-Americans today, despite a half century of economic and social progress
since the civil rights movement, face a higher risk than any other racial group
of dying from heart disease, diabetes, stroke, and hypertension. In the United
States, affluent blacks suffer, on average, more health problems than the
poorest whites. Spurred by statistics like these, dozens of states and cities
have been passing legislation intended to eliminate racial and ethnic
disparities in health.

Boston's Disparities Project, launched in 2005 by Mayor Menino's office and the
Boston Public Health Commission, is one of the most progressive blueprints for
change. It includes partnerships with medical institutions, detailed public
reports tracking progress, and community grants to tackle such entrenched
problems as street violence and lack of access to fresh produce. In May,
lawmakers on Beacon Hill held a hearing on proposed legislation that would
reverse the root causes of health inequities. The bill would establish a state
office of health equity, among other measures.

Critics of the new research tying racism directly to disease have charged that
it is flawed because one cannot objectively measure "racial discrimination." But
the science has grown more sophisticated, allowing investigators to measure
people's experiences with prejudice more precisely. And its proponents argue
that the sheer breadth of the work suggests the conclusions are important. Most
of the investigations have been done in the United States, but a growing body of
literature originates elsewhere -- from Finland and Ireland to South Africa and
New Zealand. These studies have found connections between racism and physical
health in populations ranging from Brazil's African-descended citizens to black
women in the Netherlands who had immigrated from the former Dutch colony of
Suriname.

"Across multiple societies, you're finding similar kinds of relationships," said
David Williams, a sociologist at the Harvard School of Public Health. "There is
a phenomenon here that is quite robust."

For decades, experts have agreed that racial disparities in health spring from
pervasive social and institutional forces. The scientific literature has linked
higher rates of death and disease in American blacks to such "social
determinants" as residential segregation, environmental waste, joblessness,
unsafe housing, targeted marketing of alcohol and cigarettes, and other
inequities.

But the new work draws on a different vein of research. In the early 1980s, Duke
University social psychologist Sherman James, introduced his now-classic "John
Henryism" hypothesis. The name comes from the legendary 19th-century
"steel-driving" railroad worker who competed against a mechanical steam drill
and won -- only to drop dead from what today would probably be diagnosed as a
massive stroke or heart attack. In James's work, people who churn out prodigious
physical and mental effort to cope with chronic life stresses are said to score
high on John Henryism. James showed that blacks with high John Henryism but low
socioeconomic position pay a physical price, with higher rates of blood pressure
and hypertension.

Racism, other research suggests, acts as a classic chronic stressor, setting off
the same physiological train wreck as job strain or marital conflict: higher
blood pressure, elevated heart rate, increases in the stress hormone cortisol,
suppressed immunity. Chronic stress is also known to encourage unhealthy
behaviors, such as smoking and eating too much, that themselves raise the risk
of disease.

In the 1990s, Harvard School of Public Health social epidemiologist Nancy
Krieger pushed the hypothesis further. She confirmed that experiences of
race-based discrimination were associated with higher blood pressure, and that
an internalized response -- not talking to others about the experience or not
taking action against the inequity -- raised blood pressure even more. A
controversial finding at the time, it has since been replicated by other
investigators: The suppressed inner turmoil after a racist encounter can set off
a cascade of ill effects.

Jules Harrell, a Howard University professor of psychology, said he was moved
this spring by a photo of the Rutgers University women's college basketball
team, sitting together with dignified expressions, after radio talk show host
Don Imus had labeled them with a racist epithet.

"The expressions on their faces," said Harrell. "All I could think was, 'Good
God, I'd hate to see their cortisol levels.' "

Collectively, these studies of the racism-health link have tied experiences of
discrimination to poorer self-reported health, smoking, low-birth-weight
deliveries, depressive symptoms, and especially to cardiovascular effects. In
the mid-1980s scientists began to take advantage of the controlled conditions of
the laboratory. When African-American volunteers are hooked up to blood-pressure
monitors, for example, and then exposed to a racially provocative vignette on
tape or TV -- such as a white store clerk calling a black customer a racist
epithet -- the volunteers' blood pressures rise, their heart rates jump, and
they take longer than normal to recover from both reactions. Perhaps, scientists
reasoned, the effort of a lifetime of bracing for such threats prolongs the
effect.

More recently, the lab has moved out into the real world. Several investigations
have linked blood pressure to real-time experiences of stress and discrimination
as recorded in electronic diaries. In one yet-to-be-published study, Elizabeth
Brondolo, a psychologist at St. John's University, found that daytime
experiences of racism led to elevated nighttime blood pressure, suggesting that
the body couldn't turn off its stress response.

Despite these suggestive findings, the field remains beset by unknowns. One of
the biggest problems is that researchers don't share a concrete, agreed-upon
definition of racial discrimination -- partly because such prejudice takes
myriad forms. They also don't know if more exposure to racism produces more
disease or if, instead, disease sets in only after a threshold has been passed.
They don't know if exposures during certain periods of life are more risky than
others. And they don't know why some victims cope better than others.

Skeptics distrust people's own accounts of racial discrimination, because the
experiences can't be objectively documented and because the victim can't always
know the motives of the perpetrator.

"You have to read these studies very carefully and see how they define
'discrimination.' What exactly are they measuring?" said Dr. Sally Satel, a
resident scholar at the American Enterprise Institute, a conservative
think-tank. "Typically, it comes down to an individual's perception of how he
was regarded by another person or by a system -- which is not the same thing as
being unfavorably dealt with on the basis of race."

The field's proponents counter that perception is precisely the issue. Studies
of depression, anger, and post-traumatic stress disorder also rely on the
patient's perceptions of events in their lives, they say -- not on objectively
verified facts. Why should research on discrimination be held to a different
standard?

Researchers have also refined the questionnaires and interview methods they use,
allowing them to tease out the effects of depression or hostility -- mood states
that can encourage a person to see discrimination where it's not. The questions
posed have also grown more subtle and indirect, enabling study participants to
talk openly about experiences they might otherwise deny or minimize.

Methods gauging changes in the body have likewise become more accurate. Stress
researchers have gone beyond such straightforward approaches as taking
blood-pressure readings or asking individuals to rate their own health. Now,
with noninvasive diagnostic equipment, they can look directly at coronary
blockages, levels of stress hormone, and the functioning of the immune system.
These measurements help scientists zero in on the mechanisms by which racial
discrimination may ultimately cause damage.

At the University of California, Los Angeles, psychologist Vickie Mays, director
of the Center on Minority Health Disparities, is taking a futuristic angle on
racism's bodily toll: peering into the brain itself. In a forthcoming study,
Mays will record what happens in the brain's circuits and structures during
laboratory conditions of discrimination and whether people vary in their brain
responses based on their lifelong exposure to racial prejudice.

"We know about [racism's] outcome -- but in many ways we don't know what makes
up the experience of racism," she said. "Is it processing in the part of the
brain responsible for emotions? Or in the part of the brain responsible for
fear?"

Racism remains challenging to explore scientifically, researchers say, partly
because it is difficult to get funding and partly because of institutional
reluctance to take on a potentially polarizing issue. In 2006, Harvard's David
Williams and a colleague submitted a grant proposal to the National Institutes
of Health to study whether perceived ethnic discrimination, coupled with
inequities in medical care, delayed stroke recovery in Latinos. As one reviewer
wrote back, "It is not a good investment of NIH dollars to study racism, because
even if we fund something, there is nothing we can do about it."

It's the kind of remark many scientists in the field have heard. These comments
are frustrating, they say, because they see the research as a crucial first step
toward a more clinical, less charged, discussion of the place of racism in
American society.

"The first step is validating that these effects could be real," said Tené
Lewis, a health psychologist at the Yale School of Public Health. "Once we have
a body of literature, we can say: 'OK, can we please talk about this?' "

Boston-based journalist and author Madeline Drexler, a former Globe Magazine
medical columnist, holds a visiting appointment at the Harvard School of Public
Health.