The effects of online and institutional racism on the mental health of African Americans.

OBJECTIVES: Although a wealth of literature has documented the adverse physical and mental health effects associated with exposure to racism, little scholarly attention has focused on the specific impact of online racism. Online experiences of racism have increased significantly over the years, and the intersection of online and "offline" racism makes it difficult for African Americans to find respite from overall experiences of racial discrimination in their daily lives. To address this gap in the literature, the present study was designed to examine the possible compounded effect of online and institutional racism by investigating whether offline institutional racism would serve as a moderator of the effects of online racism on psychological outcomes in a sample of African Americans. METHOD: One hundred and eighty-two African Americans answered survey data on their experiences of institutional and online racism, as well as their overall mental health. Moderated regressions and simple slope analyses were performed to examine the effects of online, institutional, and the interaction of online and institutional racism on psychological symptoms (i.e., psychological distress and well-being). RESULTS: Online racism was the strongest and most consistent predictor of all outcome variables. The interaction of online and institutional racism was significantly associated with psychological distress but not well-being. CONCLUSIONS: Findings suggest that participants who endorsed institutional racism experience increased severity in psychological symptoms in relation to increased exposure to online racism. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The role of age in understanding the psychological effects of racism for African Americans.

OBJECTIVES: The purpose of the current study was to test age as a moderator of the effects of types of racism on psychological symptoms for a sample of 184 African American women. METHOD: We hypothesized that increased age would be associated with greater severity in psychological symptoms in relation to exposure to types of racism. Moderated hierarchical regression analyses were performed to test our hypothesis. RESULTS: Findings revealed significant interactions between institutional racism and age in predicting anxiety. Younger women experienced more severe anxiety in relation to greater exposure to institutional racism compared to older African American women. CONCLUSIONS: Findings suggest that older age may function as a buffer to psychological outcomes related to racism exposure. Additional studies are needed to understand the ways in which older African American adults cope with racism-related experiences. (PsycINFO Database Record

Age Influences the Effects of Provider Racial Biases on Treatment Adherence and Blood Pressure Control for African American Hypertensive Patients.

OBJECTIVE: The purpose of the current study was to investigate age as a moderator of the effects of perceived provider racial biases on treatment adherence and blood pressure control for African American hypertensive patients. METHODS: One hundred-eighty patients were recruited from an outpatient medical clinic in the Southeastern region of the U.S. Moderated regression analyses and multinomial logistic analyses were used to test the study hypotheses. RESULTS: Findings revealed that age significantly moderated the effects of perceived provider biases on treatment adherence, such that older patients exhibited lower scores for treatment adherence in relation to exposure to provider biases. Logistic analyses revealed that older patients exhibited significantly greater probabilities for higher systolic blood pressure in relation to perceived provider biases. CONCLUSIONS: The findings suggest that subjective appraisal of exposure to provider racial biases is associated with adverse treatment adherence and blood pressure control for older African American hypertensive patients.

Systemic racism moderates effects of provider racial biases on adherence to hypertension treatment for African Americans.

OBJECTIVE: The purpose of the current study was to examine perceived exposure to systemic racism as a moderator of the effects of perceived exposure to provider racial biases on treatment adherence and mistrust of health care for a sample of African American hypertensive patients. We hypothesized that patients who endorsed high levels of systemic racism would exhibit poor adherence to hypertension treatment and increased mistrust in health care in relation to perceptions of exposure to provider racial biases. METHOD: The sample consisted of 100 African American patients who ranged in age from 24 to 82 years. All were diagnosed with hypertension and were recruited from an outpatient clinic located in the Southeastern region of the United States. Moderated regression analyses were performed to test the study hypotheses. RESULTS: Findings revealed a positive, significant main effect for perceived provider racial biases in predicting mistrust of care. This finding suggested that an increase in mistrust of health care was associated with increased perceptions of provider biases. In predicting treatment adherence, a significant interaction revealed that patients who endorsed low and moderate degrees of exposure to systemic racism displayed poor adherence to treatment in relation to greater perceptions of provider racial biases. CONCLUSIONS: The overall findings suggest that patients who perceive themselves as infrequently exposed to systemic racism possess the greatest risk for nonadherence to hypertension treatment in relation to increased perceptions of provider racial biases. Implications of the findings are discussed.

Neural correlates of race-related social evaluations for African Americans and white Americans.

OBJECTIVE: To examine differences in patterns of brain activation associated with a race-related social evaluative task for a sample of African American and White American adults. METHOD: Participants were exposed to images of White American and African American targets embedded in various contexts across three emotional valences: angry/hostile, happy/joyful, and neutral/ambiguous. Functional magnetic resonance imaging was used to measure brain activity. RESULTS: Between-group comparisons revealed that African Americans, as compared to White Americans, exhibited activation in the inferior frontal gyrus and parahippocampal gyrus to images of happy (vs. neutral) same-race targets. White Americans, compared, to African Americans displayed activation in the inferior frontal gyrus and anterior cingulate cortex to images of happy (vs. neutral) same-race targets. Activation in limbic areas was observed for African Americans to neutral (vs. happy) images of White American targets, while no significant pattern of activation was found for White Americans to images of neutral/ambiguous African American targets. A significant correlation was found between scores for previous exposure to race-related incidents and amygdala activation for African Americans to White American targets. CONCLUSION: White Americans generally exhibited more activation in regions associated with conflict resolution and cognitive control, while African Americans exhibited activation mostly in areas associated with emotion and memory. Our findings further imply that previous exposure to race-related incidents for African Americans may alter neural responses to White American targets in imaging studies. Implications of the findings are discussed.

Perceived racial discrimination in clinical encounters among African American hypertensive patients.

OBJECTIVES: To examine African American patient perceptions of racial discrimination in clinical encounters. General barriers to hypertension management were also investigated. METHODS: Six focus groups with 37 African American hypertensive patients were conducted and the transcribed sessions were analyzed for content. RESULTS: Patients valued providers who shared information regarding self-care behaviors to manage hypertension and those who provided information regarding treatment options. Provider assumptions about patient inability to afford services, and provider apathy in reaching diagnoses were perceived as racially discriminatory. Patients discussed providers' avoidance of touch during physical exams as overtly discriminatory. Patients reacted to discriminatory experiences by not keeping appointments with providers perceived as racially discriminatory. Barriers to hypertension management were associated with family responsibilities and lifestyle factors, but were not attributed to provider racial biases. CONCLUSION: Perceiving racial discrimination in clinical encounters may be an important barrier to appointment attendance for African American hypertensive patients.