Connecting the dots between racism and poor mental health
This year, a team from the University of Manchester published a paper in the American Journal of Public Health on the cumulative effect of racial discrimination on the mental health of ethnic minorities. 1000women spoke with
This year, a team from the University of Manchester published a paper in the American Journal of Public Health on the cumulative effect of racial discrimination on the mental health of ethnic minorities. 1000women spoke with two of the authors, Dr Laia Becares and Professor James Nazaroo to find out more.
1000women: Laia, can you tell us what this study is about and how you did it?
Laia: We wanted to understand whether ethnic minority people who repeatedly experience racial discrimination over time, and across different settings, have worse mental health when compared to ethnic minority people who do not report experiencing racial discrimination, or who report fewer experience. We also wanted to examine accumulation across domains of racial discrimination (including being shouted at, being physically attacked, avoiding a place, or feeling unsafe because of one’s ethnicity). We were interested in exploring whether the association between racial discrimination and mental health is stronger if people experience racial discrimination in one domain only (for example, being physically harassed), or in several domains (for example, being physically harassed and avoiding places for fear of being racially discriminated against).
We investigated this through analysing data from the UK Household Longitudinal Study, also known as Understanding Society. Understanding Society follows people over time and asks them a wide range of questions, including about their lifestyle, health, job and income situation, their ethnic group, and whether they have experienced any racial discrimination.
1000women: And what did you find?
Laia: Our study shows that the higher the number of experiences of racial discrimination reported by ethnic minority people over time and across domains, the worse their mental health.
1000women: So unlike previous studies that look at the impact of racism at one point in time, you were able to investigate the cumulative impact of racial discrimination on the lives of ethnic minorities. How should the findings of this study be used to inform policy and practice?
There is clear evidence that racism is bad for mental health – and for physical health and health behaviours. Our findings add to this large pool of studies urging policy makers and society in general, to tackle racial discrimination. This should be applied across all aspects of policy and social welfare.
1000women: James, you’ve been researching ethnic differences in health for some time. How has the way we view them changed over this period?
James: When I began work in this area, in the mid-1990s, ethnic differences in health were widely considered to be a consequence of genetic differences or differences in culturally informed behaviours related to health – like diet, exercise or smoking. Socioeconomic explanations, including those relating to experiences of racism and discrimination, were not really considered. This has changed quite dramatically. Since the late 1990s the evidence on socioeconomic explanations, particularly those related to economic inequalities, has increased dramatically and most academics, public health practitioners, and those responsible for policy are now taking this evidence seriously. There is also a growing body of evidence on the negative impact of racism and discrimination on the health of ethnic minority people. So the ways in which we view the causes of ethnic inequalities in health have shifted over the past twenty years and, by implication, so has our understanding of how they might be addressed.
1000women: And has this shift translated into policy or practice?
James: No it hasn’t. This is in part because of the unwillingness on the part of those in power to tackle inequalities. It is also a consequence of those in power not taking the drivers of ethnic inequalities – prejudice, discrimination and racism – seriously enough, despite the statements of our ex-Prime Minister, David Cameron, on ethnicity. An important issue here, at least as far as I am concerned, is how we can develop a climate that is not promoting prejudice and racism, where our political leaders repeatedly undermine and attack the identities of those who are not white British. I would like to see strong political leadership combating racism and valuing the identities of ethnic and religious minorities, and the development of policies to explicitly address socioeconomic inequalities.
1000women: How do we get ethnic health inequalities to gain a more prominent position on the policy agenda?
James: Research evidence and NGOs and other groups that have campaigned in this area have done a good job of putting ethnic inequalities in health on the policy agenda. The problem isn’t that this is not on the agenda, it’s that the policy arena does not have access to the tools to deal effectively with the underlying economic and social inequalities. This is in the hands of our political elite.
1000women: As you mentioned, and as your study has shown, racial discrimination has an extremely negative impact on the health of ethnic minorities. However, racism is endemic to the UK’s social and political structures. How do we go about tackling it?
James: Institutionalised racism is incredibly difficult to tackle. This is in part because it is so deeply and historically embedded in our institutions. Take the campaign around ‘Why is my curriculum White?’, which so clearly illustrates how higher education curricula ignore non-Western histories and academics. Or the ‘Rhodes must fall’ campaign, which illustrates how the governance and funding of our institutions have racist, colonial, roots. Or consider the acute mental health sector, which has completely failed to even begin to grapple with an understanding of its role in relation to racism in broader society. To begin to deal with these issues, we need a much more critical perspective on the functions and operations of key institutions, but one that is done in partnership with, perhaps led by, those who are in positions of authority in those institutions, and with those who are served by those institutions.
James Nazroo is Professor of Sociology and Director of the ESRC Centre on Dynamics of Ethnicity at the University of Manchester. Laia Becares is a Hallsworth Research Fellow at the University of Manchester. To find out more about their research, click here.