Ninety-five percent of older African-American clinic patients reported at least some exposure to racism during their lives in a study by researchers at the San Francisco VA Medical Center and the University of California, San Francisco.
The study authors say that the ways in which patients react to racism may affect their health outcomes.
The authors also suggest that medical professionals need to be more aware of their African-American patients' day-to-day experience of racism and the effect that experience might have on their level of trust in the health care system, which in turn might affect how closely they follow medical advice. The study was published online on October 7 in the "OnlineEarly" section of Journal of the American Geriatrics Society.
"Consistently, African-Americans have been found to have worse health outcomes than whites," notes lead author Sandra Moody-Ayers, MD, a staff physician specializing in geriatrics at SFVAMC. "Now we're starting to think about the mechanisms. What are the causes of that health disparity? Is trust an issue? Although this study does not ask these questions directly, it's leading in that direction."
The study analyzed perceptions of societal racism among 42 African-Americans aged 50 and older with type 2 diabetes who regularly attended the primary care and endocrine clinics at Yale-New Haven Hospital in New Haven, Conn. Study participants reported their experiences of perceived racism using a modified version of the McNeilly Perceived Racism Scale originally developed at Duke University.
The results show that women and people of lower socioeconomic status tended to respond to racism "passively," according to Moody-Ayers, with responses ranging from "praying" to "accepting" to "forgetting." Men and people of higher socioeconomic status tended to respond "actively," which the researchers characterized as either "speaking up" or "trying to change things."
"This is significant because other studies have shown that when racism is dealt with in a passive, internalized way, there seems to be some impact on health. So that will be something for researchers to look at in the future," says Moody-Ayers, who is also a professor of medicine at UCSF.