A new study from the University of North Carolina at Chapel Hill has found that African Americans and Caribbean blacks who experience frequent or recurrent multiple forms of discrimination are at greater risk for developing major depressive disorders, including generalized anxiety disorder, and for abusing drugs and alcohol.
Most significant, researchers found that discrimination involving disrespect and condescension alone did not appear to substantially increase risk for mental health and substance use problems. However, when adults faced this same prejudicial treatment as well as character-based and hostile treatment, they were at a much greater risk for the disorders.
The study, published in the August 2014 issue of Addictive Behaviors, confirms previous research findings suggesting that perceived discrimination can have detrimental effects on physical and mental health, said lead author Trenette Clark, an assistant professor at UNC’s School of Social Work. However, the study is believed to be the first to examine different classes of everyday discrimination and also advances the idea that the lifetime risk for psychological problems increases based on the type and frequency of discrimination that individuals experience, she added.
“We tend to think about sources of stress as a divorce, losing a parent, or losing a job, but discrimination is a stressor that can have lasting impact on one’s mental and physical health,” Clark said. “Everyday discrimination is just that—it happens everyday. It happens in the normal course of a day at places we must visit to live our lives, such as at the supermarket, and at work. Sometimes it is overt, but often it is subtle. It is reinforced on a regular basis and impacts children, families, and one’s ability to climb the ladder. It is a powerful source of stress that some people just don’t think about.”
Clark co-authored the study with Christopher Salas-Wright from the University of Texas at Austin; Michael G. Vaughn from Saint Louis University in St. Louis, Mo., and Keith Whitfield from Duke University. Clark received a grant from the UNC Institute of African American Research to support the study.
She and her colleagues relied on data from the National Survey of American Life, a study that compares the presence and severity of mental disorders in African-American, Caribbean black, and non-Hispanic white populations in the United States. The study focused on the experiences of everyday discrimination among more than 4,400 respondents, ages 18 to 65.
The co-authored study examined discrimination as a whole, but Clark said they were specifically interested in learning more about the different categories of discrimination. They identified four classes or groups. Individuals in the first class rarely experience discrimination or less than once a year. Those in a second group experience disrespectful and condescending types of discrimination a few times a year, while those in a third general group–the largest group–experience recurrent discrimination, including hostile insults and name-calling. The fourth group is composed of people who experience chronic discrimination of all forms, including disrespectful, condescending, character-based and hostile treatment.
Study findings were based, in part, on responses from participants to a variety of questions such as “How often do you receive poorer service than others at restaurants or stores?
How often do people act as if they think you are not smart? How often are you threatened or harassed? How often do people act as if they are afraid of you?”
Overall, more than 4 out of 5 African American and Caribbean blacks, or 83 percent, reported experiencing some kind of recurrent discrimination over the past year. Nearly 1 in 6, or 15 percent, reported experiencing chronic discrimination.
Compared to adults who rarely experience discrimination, those who encountered recurrent and multiple types of prejudicial treatment were two to two-and-a-half times more likely to develop alcohol-use and illicit drug-use disorders, while those who faced prejudicial treatment on a weekly or monthly basis were about four times more likely to develop those disorders.
Generally, African American and Caribbean black men reported the most experiences with chronic discrimination, researchers noted. More study is needed around the long-term cumulative effects of such experiences, but the impact, Clark added, is reflected in the recent protests across the country over the police involved shooting death of Michael Brown, an 18-year-old black teen from Ferguson, Mo. Brown, who was reportedly unarmed, was the fifth African American man to be killed by a police officer in the United States during the month of August.
“It’s not surprising that black males composed the majority of the chronic discrimination group because they are more likely–and Ferguson is a good example–to feel that they are being racially profiled,” she said. “They are more likely to perceive everyday or routine discrimination,” she said.
Although the study’s findings are illuminating, Clark noted that research has suggested that most African American and Caribbean blacks who experience discrimination do not develop mood or substance use disorders–findings that speak to the importance of individual resiliency, she said.
More study is needed around the different coping mechanisms that people use that are helpful, “such as spirituality and religiosity,” Clark said. Such insight could assist in the development of prevention programs.
“Prevention programs, in a nutshell, should focus on healthy ways of coping,” Clark said. “If we can implement prevention programs that teach adolescents and young adults how to cope with discrimination and other stressors in healthy ways, I think we will potentially see a lower prevalence of mood and substance-use disorders.”