Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-30T20:02:48.508Z Has data issue: false hasContentIssue false
  • English
  • Français

MULTIPLE PATHWAYS LINKING RACISM TO HEALTH OUTCOMES

Published online by Cambridge University Press:  15 April 2011

Camara Jules P. Harrell ,
Tanisha I. Burford ,
Brandi N. Cage ,
Travette McNair Nelson ,
Sheronda Shearon ,
Adrian Thompson  and
Steven Green
Camara Jules P. Harrell*
Affiliation:
Department of Psychology, Howard University
Tanisha I. Burford
Affiliation:
Department of Psychiatry, University of Pittsburgh
Brandi N. Cage
Affiliation:
Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin
Travette McNair Nelson
Affiliation:
Department of Psychology, Howard University
Sheronda Shearon
Affiliation:
Department of Psychology, Howard University
Adrian Thompson
Affiliation:
Department of Psychology, Howard University
Steven Green
Affiliation:
Department of Psychology, Howard University
*
Camara Jules P. Harrell, Department of Psychology, Howard University, Washington, DC 20059. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

This commentary discusses advances in the conceptual understanding of racism and selected research findings in the social neurosciences. The traditional stress and coping model holds that racism constitutes a source of aversive experiences that, when perceived by the individual, eventually lead to poor health outcomes. Current evidence points to additional psychophysiological pathways linking facets of racist environments with physiological reactions that contribute to disease. The alternative pathways emphasize prenatal experiences, subcortical emotional neural circuits, conscious and preconscious emotion regulation, perseverative cognitions, and negative affective states stemming from racist cognitive schemata. Recognition of these pathways challenges change agents to use an array of cognitive and self-controlling interventions in mitigating racism's impact. Additionally, it charges policy makers to develop strategies that eliminate deep-seated structural aspects of racism in society.

Keywords

RacismHealth DisparitiesBehavioral InterventionsPsychosocial Stress
Type
Unpacking Racism and its Health Consequences
Information
Du Bois Review: Social Science Research on Race , Volume 8 , Issue 1: Special Issue: Racial Inequality and Health , Spring 2011 , pp. 143 - 157
Copyright
Copyright © W.E.B. Du Bois Institute for African and African American Research 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Baker, Houston A. (2008). Betrayal: How Black Intellectuals Have Abandoned the Ideals of the Civil Rights Era. New York: Columbia University Press.CrossRefGoogle Scholar
Barker, David J. P. (1998). Mothers, Babies, and Health in Later Life, 3 ed.Edinburgh, UK: Churchill Livingstone.Google Scholar
Barker, David J. P. (2002). Fetal Programming in Coronary Heart Disease. Trends in Endocrinology and Metabolism, 13(9): 364–368.CrossRefGoogle ScholarPubMed
Barksdale, Debra J., Farrug, Eugene R., and Harkness, Kimberly (2009). Racial Discrimination and Blood Pressure: Perceptions, Emotions, and Behaviors of Black American Adults. Issues in Mental Health Nursing, 30(2): 104–111.CrossRefGoogle ScholarPubMed
Beatty, Danielle L. and Matthews, Karen A. (2009). Unfair Treatment and Trait Anger in Relation to Nighttime Ambulatory Blood Pressure in African American and White Adolescents. Psychosomatic Medicine, 71(8): 813–820.CrossRefGoogle ScholarPubMed
Bell, Derrick (2004). Silent Covenants: Brown v. Board of Education and the Unfulfilled Hopes for Racial Reform. Oxford, UK: Oxford University Press.CrossRefGoogle Scholar
Berntson, Gary G. and Cacioppo, John T. (2000). From Homeostasis to Allodynamic Regulation. In Cacioppo, John T., Tassinary, Louis G., and Berntson, Gary G. (Eds.), Handbook of Psychophysiology, 2 ed., pp. 459–481. New York: Cambridge University Press.Google Scholar
Blascovich, Jim, Spencer, Steven J., Quinn, Dianne, and Steele, Claude M. (2001). African Amerians and High Blood Pressure: The Role of Stereotype Threat. Psychological Sciences, 12(2): 225–229.CrossRefGoogle ScholarPubMed
Bonilla-Silva, Eduardo (1997). Rethinking Racism: Toward a Structural Interpretation. American Sociological Review, 62(3): 465–480.CrossRefGoogle Scholar
Bonilla-Silva, Eduardo (2001). White Supremacy and Racism in the Post–Civil Rights Era. Boulder, CO: Lynne Rienner Publishers.CrossRefGoogle Scholar
Bonilla-Silva, Eduardo (2006). Racism without Racists: Color-Blind Racism and the Persistence of Racial Inequality in the United States. Lanham, MD: Rowman and Littlefield Publishers, Inc.Google Scholar
Brondolo, Elizabeth, Libby, Daniel J., Denton, Ellen-ge, Thompson, Shola, Beatty, Danielle L., Schwartz, Joseph, Sweeney, Monica, Tobin, Jonathan N., Cassells, Andrea, Pickering, Thomas G., and Gerin, William (2008). Racism and Ambulatory Blood Pressure in a Community Sample. Psychosomatic Medicine, 70(1): 49–56.CrossRefGoogle Scholar
Brondolo, Elizabeth, Rieppi, Ricardo, Kelly, Kimberly, and Gerin, William (2003). Perceived Racism and Blood Pressure: A Review of the Literature and Conceptual and Methodological Critique. Annals of Behavioral Medicine, 25(1): 55–65.CrossRefGoogle ScholarPubMed
Brosschot, Jos F., Gerin, William, and Thayer, Julian F. (2006). The Perseverative Cognition Hypothesis: A Review of Worry, Prolonged Stress-Related Physiological Activation, and Health. Journal of Psychosomatic. Research, 60(2): 113–124.CrossRefGoogle ScholarPubMed
Brosschot, Jos F., Verkuil, Bart, and Thayer, Julian F. (2010). Conscious and Unconscious Perseverative Cognition: Is a Large Part of Prolonged Physiological Activity Due to Unconscious Stress? Journal of Psychosomatic Research, 69(4): 407–416.CrossRefGoogle ScholarPubMed
Cacioppo, John T., Berntson, Gary G., Adolphs, Ralph, Carter, C. Sue, Davidson, Richard J., McClintock, Martha K., McEwen, Bruce S., Meaney, Michael J., Schacter, Daniel L., Sternberg, Esther M., Soumi, Steve S., and Taylor, Shelley E. (Eds.) (2002). Foundations in Social Neuroscience. Cambridge, MA: MIT Press.CrossRefGoogle Scholar
Cannon, Walter. B. (1929). Bodily Changes in Pain, Hunger, Fear, and Rage. New York: Appleton.CrossRefGoogle Scholar
Centers for Disease Control and Prevention (2008). ⟨http://www.cdc.gov/omhd/populations/BAA/BAA.htm⟩ (accessed February 11, 2011)Google Scholar
Chae, David H., Lincoln, Karen D., Adler, Nancy E., and Dyme, S. Leonard (2010). Do Experiences of Racial Discrimination Predict Cardiovascular Disease Among African American Men? The Moderating Role of Internalized Negative Racial Group Attitudes. Social Science and Medicine, 71(6): 1182–1188.CrossRefGoogle ScholarPubMed
Clark, Rodney, Anderson, Norman B., Clark, Vernessa R., and Williams, David R. (1999). Racism as a Stressor for African Americans: A Biopsychosocial Model. American Psychologist, 54(10): 805–816.CrossRefGoogle ScholarPubMed
Collins, James W., David, Richard J., Handler, Adren, and Andes, Stephen (2004). Very Low Birth Weight in African American Infants: The Role of Maternal Exposure to Interpersonal Racial Discrimination. American Journal of Public Health, 94(12): 2132–2138.CrossRefGoogle ScholarPubMed
Collins, James W., David, Richard J., Symons, Rebecca, Handler, Adren, Wall, Stephen N., and Dwyer, Lisa (2000). Low-Income African-American Mothers' Perception of Exposure to Racial Discrimination and Infant Birth Weight. Epidemiology, 11(3): 337–339.CrossRefGoogle ScholarPubMed
Conrad, Ansgar and Roth, Walton T. (2007). Muscle Relaxation Therapy for Anxiety Disorders: It Works but How? Journal of Anxiety Disorders, 21(3): 243–264.CrossRefGoogle Scholar
Cutler, David M. (2004). Behavioral Health Interventions: What Works and Why? In Anderson, Norman B., Bulatao, Rodolfo A., and Cohen, Barney (Eds.), Critical Perspectives on Racial and Ethnic Differences in Health in Late Life, pp. 643–674. Washington, DC: The National Academies Press.Google Scholar
Daniels, Ina, Harrell, Camara J. P., Floyd, Leah, and Bell, Sonia (2001). Hostility, Cultural Orientation, and Casual Blood Pressure Readings in African Americans. Ethnicity and Disease, 11(4): 779–787.Google ScholarPubMed
Daum, Irene, Channon, Shelley, Polkey, Charles E., and Gray, Jeffrey A. (1991). Classical Conditioning After Temporal Lobe Lesions in Man: Impairment in Conditional Discriminations. Behavioral Neuroscience, 105(3): 396–408.CrossRefGoogle Scholar
Davidson, Richard J. (2000). Affective Style, Psychopathology, and Resilience: Brain Mechanism and Plasticity. American Psychologist, 55(11): 1196–1214.CrossRefGoogle ScholarPubMed
Davidson, Richard J., Kabat-Zinn, Jon, Schumacher, Jessica, Rosenkranz, Melissa, Muller, Daniel, Santorelli, Saki F., Urbanowski, Ferris, Harrington, Ann, Bonus, Katherine, and Sheridan, John F. (2003). Alterations in Brain and Immune Function Produced by Mindful Meditation. Psychosomatic Medicine, 65(4): 564–570.CrossRefGoogle Scholar
Davidson, Richard J., Putnam, Katherine M., and Larson, Christine L. (2000). Dysfunction in the Neural Circuitry of Emotion Regulation: Perspectives from Affective Neuroscience. Science, 218(7): 591–594.CrossRefGoogle Scholar
Dressler, William W. and Bindon, James (2000). The Health Consequence of Cultural Consonance: Cultural Dimensions of Lifestyle, Social Support, and Arterial Blood Pressure in an African American Community. American Anthropologist, 102(2): 244–260.CrossRefGoogle Scholar
Du Bois, William E. B. (1906). The Health and Physique of the American Negro: A Sociological Study Made Under the Direction of Atlanta University by the Eleventh Atlanta Conference. Atlanta, GA: Atlanta University Press.Google Scholar
Eckersly, Richard (2005). Is Modern Western Culture a Health Hazard? International Journal of Epidemiology, 35(2): 252–258.CrossRefGoogle Scholar
Eisenberger, Naomi, Lieberman, Matthew D., and Williams, Kipling D. (2003). Does Rejection Hurt? An fMRI Study of Social Exclusion. Science, 302(10): 290–292.CrossRefGoogle ScholarPubMed
Estacio, Emee V. (2009). Editorial: Media Exploitation, Racism, and Health. Journal of Health Psychology, 14(2): 155–157.CrossRefGoogle Scholar
Fanon, Frantz (1967). Black Skin, White Masks. New York: Grove Press.Google Scholar
Fanon, Frantz (1968). The Wretched of the Earth. New York: Grove Press.Google Scholar
Fredrickson, Barbara L. (1998). What Good are Positive Emotions? Review of General Psychology, 2(3): 300–319.CrossRefGoogle ScholarPubMed
Fredrickson, Barbara L. (2001). The Role of Positive Emotions in Positive Psychology: The Broaden-and-Build Theory of Positive Emotions. American Psychologist, 56(3): 218–226.CrossRefGoogle ScholarPubMed
Geronimus, Arline T. (1992). The Weathering Hypothesis and the Health of African American Women and Infants: Evidence and Speculations. Ethnicity and Disease, 2(3): 207–221.Google ScholarPubMed
Geronimus, Arline T. (2000). To Mitigate, Resist or Undo: Addressing Structural Influences on the Health of Urban Populations. American Journal of Public Health, 90(6): 867–872.Google ScholarPubMed
Giscombe, Cheryl L. and Lobel, Marci (2005). Explaining Disproportionately High Rates of Adverse Birth Outcomes Among African Americans: The Impact of Stress, Racism, and Related Factors in Pregnancy. Psychological Bulletin, 131(5): 662–683.CrossRefGoogle ScholarPubMed
Golden, Philippe R., McRae, Kateri, Rand, Wiveka, and Gross, James J. (2008). The Neural Bases of Emotion Regulation: Reappraisal and Suppression of Negative Emotions, Biological Psychiatry, 63(6): 577–586.CrossRefGoogle Scholar
Greene, Natasha A. and Morris, Vernon R. (2006). Assessment of Public Health Risks Associated with Atmospheric Exposure to PM2.5 in Washington, DC, USA. International Journal of Environmental Research in Public Health, 3(1): 86–97.CrossRefGoogle ScholarPubMed
Gross, James J. and John, Oliver P. (2003). Individual Difference in Two Emotion Regulation Processes. Implication for Affective Relationships and Well-being. Journal of Personality and Social Psychology, 85(2): 348–362.CrossRefGoogle Scholar
Hall, Diane M., Cassidy, Elaine. F., and Stevenson, Howard C. (2008). Acting Tough in a Tough World: An Examination of Fear among Urban African American Adolescents. Journal of Black Psychology, 34(3): 381–398.CrossRefGoogle Scholar
Harrell, Camara J. P. (1999). Manichean Psychology: Racism and the Minds of People of African Descent. Washington, DC: Howard University Press.Google Scholar
Harrell, Camara J. P., Hall, Sadiki, and Taliaferro, James (2003). Physiological Responses to Racism and Discrimination: An Assessment of the Evidence. American Journal of Public Health, 93(2): 243–248.CrossRefGoogle ScholarPubMed
Harrell, Camara J. P., Neblett, Enrique, and Onyewuenyi, Ikechukwu (2010). Physiological Activity During Adolescence. In Swanson, Dena S., Spencer, Margaret B., and Edwards, Malik. C. (Eds.), Adolescent Development in a Global Era, pp. 31–62. San Diego, CA: Elsevier.Google Scholar
Harrell, Jules P., Merritt, Marcellus. M., and Kalu, Jamilee (1998). Racism, Stress, and Disease. In Jones, Reginald (Ed.), African American Mental Health: Theory, Research, and Intervention, pp. 247–280. Hampton, VA: Cobb and Henry Publishers.Google Scholar
Harrell, Shelly (2000). A Multidimensional Conceptualization of Racism-Related Stress: Implications for the Well-Being of People of Color. American Journal of Orthopsychiatry, 70(1): 42–57.CrossRefGoogle ScholarPubMed
Hobel, Calvin and Culhane, Jennifer (2003). Role of Psychosocial and Nutritional Stress on Poor Pregnancy Outcomes. Journal of Nutrition, 133(5): 1709S–1717S.CrossRefGoogle Scholar
Jackson, Daren C., Malmstedt, Jessica R., Larson, Christine L., and Davidson, Richardson J. (2000). Suppression and Enhancement of Emotional Response to Unpleasant Pictures. Psychophysiology, 37(4): 515–522.CrossRefGoogle ScholarPubMed
Jackson, James and Knight, Katherine M. (2006). Race and Self-Regulatory Behaviors: The Role of the Stress Response and HPA Axis in Physical and Mental Health. In Carstensen, Laura L. and Schaie, K. Warner (Eds.), Social Structure, Aging and Self-Regulation in the Elderly, pp. 189–207. New York: Springer.Google Scholar
Jaenisch, Rudolf and Bird, Adrian (2003). Epigenetic Regulation of Gene Expression: How the Genome Integrates Intrinsic and Environmental Signals. Nature Genetic Supplement, 33(3): 245–254.CrossRefGoogle ScholarPubMed
Jones, Camara P. (2000). Levels of Racism: A Theoretical Framework and a Gardener's Tale. American Journal of Public Health, 90(8): 1212–1215.Google Scholar
Jones, James M. (1972). Prejudice and Racism. New York: McGraw-Hill.Google Scholar
Kemeny, Margaret E. (2009). Psychobiological Responses to Social Threat: Evolution of a Psychological Model of Psychoneuroimmunology. Brain Behavior Immunology, 23(1): 1–9.CrossRefGoogle ScholarPubMed
Krieger, Nancy (1990). Racial and Gender Discrimination: Risk Factors for High Blood Pressure. Social Science and Medicine, 30(12): 1273–1281.CrossRefGoogle ScholarPubMed
Krieger, Nancy (1994). Epidemiology and the Web of Causation: Has Anyone seen the Spider? Social Science and Medicine, 39(7): 887–903.CrossRefGoogle ScholarPubMed
Krieger, Nancy (1999). Embodying Inequality: A Review of Concepts, Measures, and Methods for Studying Health Consequences of Discrimination. International Journal of Health Services, 29(2): 295–352.CrossRefGoogle ScholarPubMed
Krieger, Nancy (2005). Embodiment: A Conceptual Glossary for Epidemiology. Journal of Epidemiology and Community Health, 59(5): 350–355.CrossRefGoogle ScholarPubMed
Krieger, Nancy and Sidney, Stephen (1996). Racial Discrimination and Blood Pressure: The CARDIA Study of Young Black and White Adults. American Journal of Public Health, 86(10): 1370–1378.CrossRefGoogle ScholarPubMed
Kuzawa, Christopher W. and Sweet, Elizabeth (2009). Epigenetics and the Embodiment of Race: Developmental Origins of U.S. Racial Disparities in Cardiovascular Health. American Journal of Human Biology, 21(1): 2–15.CrossRefGoogle ScholarPubMed
Lauderdale, Diane S. (2006). Birth Outcomes for Arabic-Named Women Before and After September 11. Demography, 43(1): 185–201.CrossRefGoogle ScholarPubMed
LeDoux, Joseph (1996). The Emotional Brain. New York: Simon and Schuster.Google Scholar
LeDoux, Joseph (2002). Synaptic Self: How Our Brains Become Who We Are. New York: Penguin Books.Google Scholar
Levine, Robert S., Foster, James E., Fullilove, Robert E., Fullilove, M. T., Briggs, Nathanial C., Hull, Pamela C., Husaini, Baqar A., and Hennekens, Charles H. (2001). Black-White Inequalities in Mortality and Life Expectancy, 1933–1999: Implications for Healthy People 2010. Public Health Reports, 116(5): 474–483.CrossRefGoogle ScholarPubMed
Lewis, Tene T., Barnes, Lisa L., Bienias, Julia L., Lackland, Daniel T., Evans, Dennis A., and De Leon, Carlos F. Mendes (2009). Perceived Discrimination and Blood Pressure in Older African American and White Adults. Journal of Gerontology and Biomedical Science Medicine, 64(9): 1002–1008.CrossRefGoogle ScholarPubMed
Lieberman, Matthew D., Hariri, Ahmad, Jarcho, Johanna M., Eisenberger, Naomi I., Bookheimer, Susan Y. (2005). An fMRI Investigation of Race-Related Amygdala Activity in African-American and Caucasian-American Individuals. Nature Neuroscience, 8(4): 720–722.CrossRefGoogle ScholarPubMed
McEwen, Bruce S. (1998). Protective and Damaging Effects of Stress Mediators. New England Journal of Medicine, 338(3): 171–179.CrossRefGoogle ScholarPubMed
McEwen, Bruce. S. and Gianaros, Peter J. (2010). Central Role of the Brain in Stress and Adaptation: Links to Socioeconomic Status, Health, and Disease. Annals of the New York Academy of Science, 1186: 190–222.CrossRefGoogle ScholarPubMed
Miller, Kelly (1897). A Review of Hoffman's Race Traits and Tendencies of the American Negro. Washington, DC: The American Negro Academy.Google Scholar
Moore, David S. (2001). The Dependent Gene: The Fallacy of “Nature vs. Nurture.” New York: Henry Holt and Company.Google Scholar
Mustillo, Susan, Krieger, Nancy, Gunderson, Erica P., Sidney, Steven, McCreath, Heather, and Kiefe, Catarina I. (2004). Self-Reported Experiences of Racial Discrimination and Black-White Differences in Preterm and Low-Birthweight Deliveries. American Journal of Public Health. 94(12): 2125–2131.CrossRefGoogle ScholarPubMed
Obrist, Paul (1981). Cardiovascular Psychophysiology: A Perspective. New York: Plenum.CrossRefGoogle Scholar
Ochsner, Kevin and Gross, James J. (2005). The Cognitive Control of Emotion. Trends in Cognitive Neuroscience, 9(5): 242–249.CrossRefGoogle ScholarPubMed
Paradies, Yin (2006a). A Systematic Review of Empirical Research on Self-Reported Racism and Health. International Journal of Epidemiology, 35(4): 888–901.CrossRefGoogle ScholarPubMed
Paradies, Yin (2006b). Defining, Conceptualizing and Characterizing Racism in Health Research. Critical Public Health, 16(2): 143–157.CrossRefGoogle Scholar
Paradies, Yin, Chandrakumar, Loga, Klocker, Natascha, Frere, Marion, Webster, Kim, Burrell, Michelle, and McLean, Philippa (2009). Building on our Strengths: A Framework to Reduce Race-Based Discrimination and Support Diversity in Victoria. Melbourne, Australia: Victorian Health Promotion Foundation.Google Scholar
Pascoe, Elizabeth A. and Richman, Laura. S. (2009). Perceived Discrimination and Health: A Meta-Analytic Review. Psychological Bulletin, 135(4): 531–554.CrossRefGoogle Scholar
Pawlow, Laura and Jones, Gary (2002). The Impact of Abbreviated Progressive Muscle Relaxation on Salivary Cortisol. Biological Psychology, 60(1): 1–16.CrossRefGoogle ScholarPubMed
Phillips, Kristin M., Antoni, Michael H., Lechner, Suzanne C., Blomberg, Bonnie B., Llabre, Maria M., Avisar, Eli, Glück, Stefan, DerHagopian, Robert, and Carver, Charles S. (2008). Stress Management Intervention Reduces Serum Cortisol and Increases Relaxation During Treatment for Nonmetastatic Breast Cancer. Psychosomatic Medicine, 70(9): 1044–1049.CrossRefGoogle ScholarPubMed
Porges, Stephen W. (1995). Orienting in a Defensive World: Mammalian Modifications of our Evolutionary Heritage: A Polyvagal Theory. Psychophysiology, 32(4): 301–318.CrossRefGoogle Scholar
Porges, Stephen W. (2001). Polyvagal Theory: Phylogenetic Substrates of a Social Nervous System. International Journal of Psychophysiology, 42(2): 123–146.CrossRefGoogle ScholarPubMed
Schmader, Toni, Johns, Michael, and Forbes, Chad (2008). An Integrated Process Model of Stereotype Threat Effects on Performance. Psychological Review, 115(2): 336–356.CrossRefGoogle ScholarPubMed
Seeman, Teresa, Epel, Elissa, Gruenewald, Tara, Karlamangla, Arun, and McEwen, Bruce S. (2010). Socioeconomic Differentials in Peripheral Biology: Cumulative Allostatic Load. Annals of the New York Academy of Sciences, 1186(1): 223–239.CrossRefGoogle ScholarPubMed
Soares, Joaquim J. and Ohman, Arne (1993). Backward Masking and Skin Conductance Responses After Conditioning to Nonfeared but Fear-Relevant Stimuli in Fearful Subjects. Psychophysiology, 30(5): 460–466.CrossRefGoogle ScholarPubMed
Taylor, Jerome, Obiechina, Chioma O., and Harrison, Sherlyn (1998). Toward a Psychology of Liberation and Restoration: Answering the Challenge of Cultural Alienation. In Jones, Reginald (Ed.), African American Mental Health: Theory, Research, and Intervention, pp. 283–301. Hampton, VA: Cobb and Henry Press.Google Scholar
Thayer, Julian F. and Friedman, Bruce H. (2004). A Neurovisceral Integration Model of Health Disparities in Aging. In Anderson, N. B., Bulatao, R. A., and Cohen, B. (Eds.), Critical Perspectives on Racial and Ethnic Differences in Health in Late Life, pp. 567–603. Washington, DC: The National Academies Press.Google Scholar
Thayer, Julian F. and Lane, Richard D. (2007). The Role of Vagal Function in the Risk of Cardiovascular Disease and Mortality. Biological Psychology, 74(2): 224–242.CrossRefGoogle ScholarPubMed
Walters, Ronald W. (2003). White Nationalism, Black Interests: Conservative Public Policy and the Black Community. African American Life Series. Detroit, MI: Wayne State University Press.Google Scholar
Williams, David R. (1997). Race and Health: Basic Questions, Emerging Directions. Annals of Epidemiology, 7(5): 322–333.CrossRefGoogle ScholarPubMed
Williams, David R. and Mohammed, Selina A. (2009). Discrimination and Racial Disparities in Health: Evidence and Needed Research. Journal of Behavioral Medicine, 32(1): 20–47.CrossRefGoogle ScholarPubMed