Lord Darzi’s recent review of the health service reported that while the median age of death was 62 for white people, it was 40 for Black people, 33 for Asian people and just 30 for those from a mixed race background. The report, which focused mainly on NHS reform, was followed by calls for the new UK Government not to lose sight of wider determinants of health – but evidence of links between racism and health has been growing for a decade and now new research has underlined the extent of the issue as research co-author Yvonne Kelly from the ESRC International Centre for Lifecourse Studies explains.
It is 10 years since I blogged here about research showing anti-racism policies should be a key part of policymakers’ strategies to ensure lifelong good health for the UK’s children. I was reporting on two pieces of ESRC-funded research from the International Centre for Lifecourse Studies which found links between racism and behavioural problems, poor school performance and obesity.
The first study found depression and anxiety were commonly linked to the experience of racism by children and their parents; the second looked at how mothers’ experience of racism affected the physical and mental health of five year-old children, finding links to obesity as well as to social and emotional problems.
A decade ago, the evidence on links between racism and chronic physical ailments among children and young people was less clear. Our new research helps fill this gap.
Stress markers
We reviewed literature which used quantitative methods to look at health and wellbeing effects of racism on young people up to the age of 24 years, and we found 42 studies which focused on physical health links to racism. Although the effect sizes are moderate, they show clear cause for concern that racism is linked to an increased risk of chronic disease developing later in life.
These studies looked at levels of inflammation in the body, which can be the result of experiencing stressful and distressing situations and can lead to poor health both in the short term and later in life.
Although the effect sizes were moderate, we found racism was associated with a wide range of physical health conditions.
We found small to moderate links between racism and an inflammatory marker linked to higher body mass index, systolic blood pressure, asthma and anxiety about symptoms such as pain, weakness or shortness of breath.
Most of the relevant studies were carried out in the USA, particularly in urban areas, and just one in seven included indigenous populations, underlining a need for greater attention to the health impacts of racism on indigenous young people as opposed to other racialised groups.
Systematic racism
Previous evidence has shown systemic racism harms the health of children and young people through multiple direct and indirect routes. As well as creating health impacts, racism also creates the conditions that cause them, impacting families and communities and leading to the physical, economic and social conditions that lead to poor health.
It limits access to opportunities such as education, employment, financial security, housing and neighbourhood safety. In turn, this influences health behaviours such as physical activity, diet, smoking, alcohol and drug use, and thus causes exposure to the physical and biochemical causes of disease.
The picture we have built up through our research over the past decade also includes experiences of direct racism where children and youth themselves are targets, as well as vicarious experiences where they witness racism directed at others. Even when children do not directly witness the racism experienced by their caregivers, it can harm them because those adults suffer mental and physical effects from it. And people can also internalise this racism, leading to a sense of inferior status and treatment.
Complex picture
To sum up, our research has helped to build a complex picture of the ways in which racism contributes to a range of negative physical health conditions which have their roots in childhood and adolescence.
While more work is needed to understand these pathways and mechanisms, this must not be at the expense of action which can be taken immediately. In response to Lord Darzi’s review the Health Foundation called for a focus on incomes, housing and employment as drivers of poor health.
Our research shows policymakers need to go further and to consider a much broader range of changes in education, advocacy and partnerships to eliminate racism. Only then can we hope to create the healthy and equitable future which is so urgently required for all children and young people.
- Racism and health and wellbeing among children and youth– An updated systematic review and meta-analysis, is research by Naomi Priest, Kate Doery, Chiao Kee Lim, Jourdyn A. Lawrence, Georgia Zoumboulis, Gabriella King, Dewan Lamisa, Fan He, Rushani Wijesuriya, Camila M. Mateo, Shiau Chong, Mandy Truong, Ryan Perry, Paula Toko King, Natalie Paki Paki, Corey Joseph, Dot Pagram, Roshini Balasooriya Lekamge, Gosia Mikolajczak, Emily Darnett and Shuaijun Guo. It is published in Social Science and Medicine.